MEDICAL .SCHOOL LUISP VETERINARY MATERIA MEDICA and THERAPEUTICS BY KENELM WINSLOW B.A.S., M.D.V., M.D. (Harv.), Major M. C, U. S. A. 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 PREVEN- TION AND TREATMENT OF THE DISEASES OF THE DOMESTIC ANIMALS," ETC. INCLUDING A CHAPTER ON BIOLOGICAL THERAPEUTICS BY DR. A. EICHHORN FORMERLY CHIEF OF THE PATHOLOGICAL DIVISION, BUREAU OF ANIMAL INDUSTRY, AND NOW DIRECTOR OF THE VETERINARY DEPARTMENT, LEDERLE ANTITOXIN LABORATORIES, PEARL RIVER, N. Y. EIGHTH EDITION REVISED Chicago AMERICAN VETERINARY PUBLISHING CO. No. 9 South Clinton Street Copyright, 1{J\1J By American Veterinary Publishing Co. 7 PREFACE TO EIGHTH EDITION The eighth edition has been wholly reprinted, revised and rewritten. It is in accord with the ninth edition of the United States Pharmacopoeia. Among remedies introduced for the first time are; chenopodium, arsphe- namine, Dakin's solution, chlorazene, dichloramine-T, scarlet red, methyl blue, pituitary gland, lobelia, lobelin and diuretin. Articles on the thyroid and adrenal glands have been greatly modified and enlarged. A large number of prescriptions of ascertained value have been intro- duced throughout the book to facilitate the practical application of drug treatment. In the sections on food and feeding, blood transfusion, and serum and vaccine therapy much new matter will be found. The author wishes to express his grateful acknowledgment for the kindness of Dr. Maurice C. Hall, of the Bureau of Animal Industry, in revising the matter on anthelmintics, and also his appreciation of the work of Dr. A. Eichhorn in writing the section on biological therapy. Too much appreciation cannot be accorded the publisher who, through- out the very considerable task of remaking and reprinting the work, has aided in every way with his notable energy and professional ability to produce as perfect a volume as possible in scientific value, technical accuracy, practical usefulness, and the book-making art. Kenelm Winslow. Seattle, Wash., December. 1919. 4J0H2 Digitized by the Internet Archive in 2012 http://archive.org/details/veterinarymaterie8wins CONTENTS Page PRELIMINARY CONSIDERATIONS 7 Definitions 7 Mode of Action of Drugs 7 Absorption of Drugs 9 Elimination of Drugs 9 CIRCUMSTANCES MODIFYING THE ACTION OF DRUGS.... 11 Mode of Administration 11 Dosage 14 Anatomy and Physiology 15 Time of Administration 16 Habit 16 Idiosyncrasy 16 GENERAL ACTIONS OF DRUGS 17 Drugs Acting on the Digestive Organs 17 Drugs Acting on the Circulation 29 Drugs Acting on the Nervous System 34 Drugs Acting on the .Respiratory Organs 39 Drugs Acting on the Urinary Organs 44 Drugs Acting on the Sexual Organs 48 Drugs Influencing Metabolism 50 Drugs Influencing Bodily Heat 50 Drugs Acting on !.he Skin 52 Drugs Which Destroy Microorganisms and Parasites 56 PHARMACY 59 INCOMPATIBILITY 68 PRESCRIPTION WRITING 70 CLASSIFICATION 97 INORGANIC AGENTS 99 VEGETABLE DRUGS 264 DOSES OF DRUGS . 464 POISONS AND ANTIDOTES .. 475 GENERAL THERAPEUTIC MEASURES 479 Food and Feeding 479 Counterirritants 491 Cold and Heat 497 Disinfectants, Antiseptics and Deodorants 505 Venesection 514 Transfusion 517 Saline Infusion 517 Hypodermoclysis 519 Enteroclysis 519 Kunsel's Treatment for Milk Fever in Cows 521 Lavage 522 Biological Therapeutics 525 Immunity 525 Infectious Diseases 527 Diagnostic Products 552 EPITOME OF MODERN TREATMENT OF DISEASES OF DOMESTIC ANIMALS 564 GENERAL INDEX 621 ILLUSTRATIONS Metric Diagram 76 Bleeding Hyperimmunized Horse to Produce Serum 530 Sterilizing Serum by Filtration 531 Testing Serum 532 Filling Sterile Containers with Scrum 532 Bacillus Anthracis 533 Intravenous Injection of Anthrax Bacilli 535 Negri Bodies 547 Well Defined Reaction to Tuberculin Test 554 Positive Reaction to Tuberculin Indicated by Diffused Swelling 555 Positive Reaction to Tuberculin Indicated by Circumscribed Swelling.. 555 Positive Reaction to Ophthalmic Test by Tuberculosis 557 Method of Applying Ophthalmic Test for Glanders with Brush 558 Method of Applying Ophthalmic Test for Glanders with Tube 559 Positive Reaction to Ophthalmic Test for Glanders 559 Ophthalmic Reaction to Mallein Test for Glanders 560 Strong Ophthalmic Reaction 561 PRELIMINARY CONSIDERATIONS. Definitions. Pharmacology is derived from the Greek, pharmakos, a drug, and is the sum of all exact knowledge pertaining to drugs, and therefore em- braces materia medica, therapeutics, pharmacy, and pharmacology in its more recent and limited interpretation. 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 prop- erties of drugs is pharmacognosy, while pharmacodynamics, or pharma- cology (in a limited sense), 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 appli- cation 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 Therapeutics; the use of drugs as based on clinical evidence ; and General Therapeutics, the use of remedial agents other than drugs, e. g., heat, cold, electricity, food, etc. Pharmacy is the art of preparing, compounding, dispensing and pre- serving drugs. Metrology, the science of weights and measures. 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, signifies literally to care for, from the Latin euro, and did not in its original sense mean to restore to health, although that is its present interpretation. A drug, derived from the Dutch, droog, meaning dry, is now used synonymously with medicine, although originally referring to an herb or dried medicinal plant. 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 ab- sorption. 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 be- cause 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. e., the power that most drugs 8 PRELIMINARY CONSIDERATIONS possess to influence one organ or apparatus rather than the whole system. Oftentimes this local action, in the case of secreting glands, is accom- plished 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 absorption. Furthermore, remedies are said to exert a pri- mary (or immediate) and secondary (or remote) action. The secondary effect is the result of the primary action; e. g., a saline cathartic primarily removes serous fluid from the bowels and sec- ondarily or remotely leads to absorption of serous exudations; a counter- irritant primarily produces irritation of the skin and sensory nerve-end- ings, 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, how- ever, may directly influence muscular tissue, as is seen in the 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 latter instance, it is usually impossible to determine whether medi- cines 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 forming 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 intra- venous injection of methylene blue. It is, in fact, the basis of all bac- teriological stains, of Ehrlich's theory 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 posi- tive or negative electricity. 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 KC1 is dissociated into a positive K ion and a negative CI ion. The action of the ion is a physical or electrical action. Sometimes one ion is inert, as the CI ion in KC1. 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 sul- phate. In case the ions of inorganic salts are inactive their medicinal effect may be due wholly to what is technically termed "salt action." ABSORPTION OF DRUGS 9 Salt action is dependent on osmosis. Concentrated salt solutions (hyper- tonic) draw water from the tissues and red blood cells; weak salt solu- tions (hypotonic) lose water to the red corpuscles and tissues; salt solutions of the same osmotic tension as the blood (isotonic) and tissues maintain an equilibrium as regards the water content of these. The principle of salt action depends upon the fact that if two solutions are brought in contact through a membrane (or cell wall) they tend to equal- ize in concentration. If cells are placed in dilute salt solution they swell because the solution passes into them until it is of like concentration to the dilute solution outside the cell. If cells are put into a concentrated salt solution they shrink because water passes out until the solutions within and without the cell are of equal strength. The same so-called salt action occurs with most solutions of soluble substances — alkalies, acids and sugar. Catharsis from salts and diuresis are due to salt action. Salt solutions in the bowels absorb water from the tissues and flush them out; salt solutions absorbed into the blood withdraw water from the tis- sues and hydremia of the blood leads to diuresis. Any non-toxic salt (crystalloid) in the blood increases its concentration and leads to a flow of water into it from the surrounding tissues, increases its mass, and pressure, and thus acts as a diuretic. No hypothesis can be formulated which will satisfactorily account 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 alcohol) and when the circulation is active. Absorption from the digestive 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 comparatively impervious skin- like mucous membrane and lack of vascularity 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. If 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 — as far as any action it may have on the body (unless an irritant) — as if it were on the skin. When absorbed, a medicine passes into the blood vessels or lymphatics and thence into the general circulation. That por- tion which enters the portal circulation reaches the liver and may be destroyed in part (some alkaloids) by this organ. After entering the 10 PRELIMINARY CONSIDERATIONS blood the drug may form unknown combinations with the tissues for which it has an affinity — thereby exerting its remedial effect — and is oxidized or decomposed, or rarely accumulates in the body, but usually is eliminated either unchanged or as decomposition-products in the breath, or by the excretions or secretions of the kidneys, bowels, liver, sudorip- arous, salivary and mammary glands, and mucous membranes. The urine is the most frequent channel of elimination for soluble drugs. The bowels constitute the next more common pathway of elimination. Volatile drugs (chloroform, 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 eliminated be given at frequent intervals it may be absorbed faster than it is ex- creted 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 elimination followed by rapid absorption; or (2) to slow — or sudden arrest of — elimination. The salts of the heavy metals, as lead, mercury, etc., and arsenical preparations are eliminated slowly. Digi- talis and strychnine are said to be especially prone to produce a cumu- lative action. Strychnine may, however, be given subcutaneously 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-elimi- nation. The drugs likely to cause a cumulative action must be adminis- tered infrequent^, once, twice, or thrice daily; whereas medicines which are rapidly decomposed and eliminated (alcohol, nitrites, etc.) 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 in- soluble drug passing unabsorbed through the alimentary 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 ab- sorption is less and finally least rapid: 1. Intravenous, by injection into the veins. 2. By inhalation (volatile drugs). 3. Subcutaneous, or intramuscular, by injection into subcutaneous tissue, or deep into a muscle. I. Intratracheal, by injection into the trachea. 5. Oral, by the mouth. 6. Rectal, by the rectum. 7. Inunction, by the skin. 8. Intramammary injection. 1. Injection into the veins (usually into the jugular) is not so com- monly 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 frequently thrown from 05 (150 mils) to 6!/^§ (200 mils) of fluidextract of cannabis indica into the jugular, and even chloral hydrate, a most irritating and caustic drug, in the dose of 15 (30 mils) dissolved in 85 (210 mils) of water, without producing any untoward symptoms. No method of administration can secure more rapid absorption, since intravenous injection is 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 immediate catharsis in colic and intestinal obstruction of horses. In such cases barium chloride and eserine sulphate are employed intravenously. The jugular is occluded with the hand and the injection is made with the same care described below in reference to the sub- cutaneous method. The intravenous use of warm normal salt solution is frequently valuable in hemorrhage, shock and poisoning (see p. 517). 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. Subcutaneous or hypodermatic injection is suitable for soluble, non-irritating drugs of small bulk, when a sure and rapid action is de- 12 CIRCUMSTANCES MODIFYING THE ACTION OF DRUGS sired. The medicinal solution should be free from solid particles and microorganisms. 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 alcohol (70 per cent.) and wiping the needle with the same, previous to their employment. Solutions may be preserved for hypodermatic use with boric acid (1 per cent.), but soluble tablets .'ire 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 alcohol; 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 js slowly emptied and the needle withdrawn, keeping slight pressure over the point of injection with the thumb for a few seconds. The use of irri- tating drugs — permissible in emergencies — as ether and ammonia, is less apt to be followed by abscess if injected deeply into the muscular sub- stance, and absorption is more rapid and painless, than when given subcutaneously. 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 producing any untoward symptoms. The proper quantity of a solution for subcutaneous use is 5-30 minims for dogs; 1-2 drams for horses, although large amount* of salt solution may be injected into the subcutaneous tissue or muscles (hypodermoclysis) with great benefit in hemorrhage, etc. (See p. 519.) The minimum doses of drugs should be employed by the subcuta- neous method. The indications for subcutaneous injection are: (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 impossible, 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 injec- tions 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., §i-ii (30-60 mils)] and more irritat- ing drugs are given in this way than by the subcutaneous method, and ab- sorption is about as rapid; the dose is the same. There is undoubtedly SUBCUTANEOUS INJECTION 13 danger, however, in giving irritant 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 a method of benumbing or killing the parasites (S. filaria and micrurus) infesting the trachea and bronchi, and has been employed to influence the mucous mem- brane of the larynx and trachea in certain inflammatory conditions. 5. Drugs are usually given by the mouth and are absorbed from the stomach and intestines. Many non-irritating and not unpleasant drugs are taken voluntarily in the food, gruel, milk or drinking water by animals. Cats and dogs will often swallow medicine enclosed in a piece of meat. Absorption is more tardy than by the subcutaneous method, more rapid when given in solution into an empty stomach than 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 a half hour to an 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 prac- tised when the use of drugs by the mouth is inadvisable or impossible, as in unconsciousness, dysphagia, convulsions; also to destroy parasites (pinworms) in the rectum, to influence an inflamed or ulcerated rectal mucous membrane, and to remove intestinal 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 non-irritating, soluble, and not too bulky, since a small amount is nec- essary (oi-.r>i dogs; §ii-§viii horses); to avoid tenesmus and expulsion. Warm starch solution (made by boiling) or linseed tea with a little laudanum is a good vehicle for medicinal enemata, and retention of ene- mata is facilitated by pressure on the anus with a towel for some minutes after the injection is given. Solids are sometimes employed by rectum in suppositories. For general use of enemata (see p. 27). 7. Drugs are absorbed very slightly by the shin, 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 applied externally for their local action only and not to influence the general system through the blood. Intramammary injections. — These are useful in acute parenchyma- tous 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. II CIRCUMSTANCES MODIFYING THE ACTION OF DRUGS Saturated boric acid solution is most often used, or ^ to Vii per cent, solution of sodium fluoride. Dosage. The ftudy of dosage is known as Posology. The action of drugs is altered both in degree and in kind by the dose. Thus, increasing 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 doses. Drugs, as digitalis, stimulating the heart in medicinal doses, usually de- press and paralyze the organ in poisonous doses. Many drugs promoting urinary secretion, in ordinary doses, cause inflammation 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 applies only 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 (being more susceptible), 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, i.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 an- atomy 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 rumi- nants. 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 digestion, 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 15 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. 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 sensi- tive is it to the influence of drugs. Since the cerebrum of man is rela- tively 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 com' pared 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 causes 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 diaphragm, together with the horseshoe-like band of fibres at its cardiac extremity, prevent the regurgitation of food. The intestines of the horse, on the other hand, are as voluminous as the stomach is greatly distended with gas which causes dilatation of the (as purgatives), 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 kid- neys are said to eliminate about 15 per cent, of the fluid ingesta in horses, as against 50 per cent, in man and dogs. 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 impervious, poorly vascular and skin-like gastric mucous membrane renders absorp- tion feeble and imperfect and enforces a comparatively larger dosage than is proper for horses of greater weight. Ruminants are also gener- ally insusceptible to emetics. The skin and kidneys of ruminants are still less active than is the case in horses. 16 CIRCUMSTANCES MODIFYING THE ACTION OF DRUGS 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 calomel, 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 suit- able canine dose in veterinary text books. Contrariwise, the dog is comparatively insensitive to many drugs powerfully influencing man, — notably morphine, aloes, colocynth 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 presence of other substances, as iodine and hydriodic acid, should be given on an empty stomach; and likewise all drugs, when a speedy action is desired. Irritants should be administered on a full stomach. Habit. — This circumstance does not have the same importance in veterinary medicine which it possesses in human practice, since we con- trol 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 anti- dote 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 hinder the absorption 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-irritants will not pro- duce their characteristic actions on the skin when the circulatory func- tions are at a low ebb. Idiosyncrasy. — Individual susceptibility to drugs is infrequent, but unfortunately cannot be anticipated. The writer has seen simple zinc oxide (free from adulteration or impurities) cause a frenzy of irritation DRUGS ACTING ON THE DIGESTIVE ORGANS 17 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 commonly more responsive to drugs than others. GENERAL ACTION OF DRUGS. DRUGS ACTING ON THE DIGESTIVE ORGANS. Sialagogues are agents increasing the secretion of saliva. Antisiala- yogues 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 indirectly to greater secretion; while, through excitation 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 peripheral 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 inhibi- tion of secretion. Sialagogues are often classed under three heads. 1st, Specific Siala- gogues, acting directly on the mechanism concerned with secretion, i.e., the gland cells, or nervous apparatus. Pilocarpine is the best example of the specific class. It stimulates the gland cell or peripheral nerve end- ings. 2nd, Reflex sialagogues; exciting sensory nerve terminations and indirectly or reflexly stimulating the nervous mechanism controlling secre- tion. As examples of this class may be mentioned alkalies, acids, emetics, and other agents stimulating the mucous membrane of the mouth and stomach. 3rd, Mixed sialagogues, acting both specifically and reflexly. Physostigmine, nicotine or tobacco and mercury preparations may be in- cluded in this category. Antisialagogues. — These drugs may act in various ways to lessen 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 called refrig- erants; as, for example, potassium nitrate, diluted phosphoric and other acids. The sialagogues are sometimes employed to stimulate the mucous 18 GENERAL ACTION OF DRUGS 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, i. e., atropine. Stomachics are drugs which, in therapeutic doses, mildly stimulate the mucous membrane of the mouth and stomach, thereby increasing the secretions and vascularity of these parts, the appetite, and gastric per- istalsis. These agents also reflexly influence the intestines, but this effect will be considered under carminatives. Stomachics may be divided into bitters, aromaties (drugs containing a volatile oil and often very pungent), and aromatic bitters (drugs con- taining a volatile oil and a bitter principle). While both the bitters and aromaties enhance the appetite, the action of the latter is more powerful and fleeting. Bitters act by directly stimulating the taste buds of the tongue. They act only locally (not in pills), and reflexly start digestion as the sight and smell of food do (p. 19). Very large doses of stomachics are distinctly irritating, and cause anorexia, nausea, and vomiting in animals capable of the act. Stomachics. Gentian Calumba Cascarilla Coriander Capsicum Pepper Ginger Cardamon Fennel BITTERS Quassia Hydrastis AROMATIC BITTERS Chamomile AROMATICS Fenugreek Anise Calamus Mustard Spearmint Taraxacum Serpentaria Peppermint Alcohol Ether Chloroform Alkalies (see Antacids) Uses. — Stomachics — particularly bitters — are serviceable in improv- ing the appetite and gastric digestion in atonic indigestion, and in en- feebled states of the digestive organs occurring in the course of chronic diseases or during convalescence from acute disorders. The aromaties are more frequently employed for their action on the intestines, when they are called carminatives. Bitters are contra-indicated in irritable or inflamed conditions of the alimentary tract. Antacids are drugs which are used to counteract acidity in the stom- ach and bowels resulting from indigestion and fermentation, or from excessive secretion of gastric juice. Some (not ammonia compounds) are also occasionally employed to alkalize the blood and urine. Pawlow's experiments, substantiated by many others, show that alka- DRUGS ACTING ON THE DIGESTIVE ORGANS 19 lies inhibit not only the secretion of acid gastric juice, but also all the other digestive secretions, i.e., the secretions of the intestines 'liver (bile), and pancreas (pancreatic juice). Antacids (as sodium bicarbonate and magnesia) are, however, indicated in gastric hypersecretion and hyper- chlorhydria. If administered several hours after eating, antacids counteract acid- ity due to fermentation and relieve pain caused by this condition. Since fermentation is frequently the cause of tympanites, the antacids are con- joined to advantage with carminatives (sodium bicarbonate and ginger). The alkaline carbonates allay pain by means of the carbonic dioxide set free, which is locally sedative and also stimulates peristalsis, and the antacids are also beneficial in dissolving mucus in catarrhal conditions of the alimentary 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 fre- quent use in digestive disorders, but ammonium carbonate is particularly appropriate in flatulence, because it possesses more power in stimulating peristaltic action and expelling flatus. ANTACIDS. Sodium carbonate Ammonium carbonate Sodium bicarbonate Magnesia Potassium carbonate Magnesium carbonate Potassium bicarbonate Calcium carbonate (chalk) Solution of potash Solution, of lime (lime water) Ammonia Acids. — Contrary to accepted ideas, Pawlow's and Starling's experi- ments show that mineral acids directly stimulate the secretion 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 stimula- tion through reflex action produced by the desire, sight, and smell of food, and is further increased by the taking 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 formation 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 intestines, acid chyme likewise leads to the formation of another hormone, secretin, which likewise is absorbed and stimulates the secretion of the intestines, liver and pancreas. Carminatives include the same drugs which were mentioned as stom- achics, and valerian, asafetida and the volatile oils ; but the term as gen- 20 GENERAL ACTION OF DRUGS erally employed refers to their effect in exciting peristaltic action, and so expelling gas from the stomach and bowels. The aromatics are consider- ably more valuable for this purpose than the bitters. Carminatives also prevent griping caused by many cathartics, aid digestion, and disguise the taste of disagreeable drugs. Capsicum and ginger are most fre- quently prescribed 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 tem- porary expedient. A wiser course consists in removing the cause of indi- gestion by proper feeding or by enforcing abstinence from food, and in the use of remedies calculated to strengthen the natural digestive func- tions. Pancreatin may be given during, or immediately after, eating, and will assist gastric digestion for some time before sufficient acid is se- creted to destroy it. In fact, some authors (Hare) insist that this sub- stance 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 vegetable origin. Its value is not yet definitely determined. Antiseptics. — These agents are sometimes used to prevent or arrest fermentation of food in the stomach and bowels. Since fermentation 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 digestive processes and may endan- ger the life of the patient, so that it is impossible to attain perfect anti- sepsis 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 and Naphtalin hyposulphite - Bismuth subnitrate Hydrogen dioxide Emetics are drugs which cause vomiting. The act of vomiting pro- ceeds 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 vomition. Vomiting is occasioned by simultaneous contraction DRUGS ACTING ON THE DIGESTIVE ORGANS 21 of the abdominal walls and the diaphragm. In this process the stomach is squeezed between the abdominal 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 pecu- liarities may be noted in reference to vomition in the domestic animals. Dogs, pigs and cats 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 animals b\^: 1. The small size of the stomach, which is not readily compressed between the abdomi- nal 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 vomition. 3. A horseshoe-like band of fibres at the cardiac orifice, which hinders dilatation of this opening. Rumi- nants are likewise comparatively insusceptible to emetics because of the large size of their digestive apparatus, which is not easily compressed between the parietes and diaphragm. Therefore the vomiting centre remains probably in a state of non-development in the horse and rumi- nant, by reason of non-use. Cattle and horses do, however, occasionally vomit. Cattle at sea fre- quently suffer from mal de mer, and the writer has observed actual vomi- tion 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 vomiting centre through the blood. 2. Local, by stimulation of the sensory 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 state- ments may be made: If an emetic is injected into the carotid and vom- iting instantly occurs, the drug has probably acted upon the vomiting centre ; if some time elapses before the occurrence of vomition, it is prob- able that the drug has acted upon the stomach during its elimination by that organ. Contrariwise, if, after the ingestion of an emetic, a consider- able period intervenes before vomiting comes on, it is probable that the agent has acted on the vomiting 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 suppose that the agent acts on the stomach directly or during its elimination. 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 diaphragm, with this reservation, that the drug may have been eliminated by the esophagus and intestines and have reflexly stimulated the vomiting centre through the medium of these parts. These remarks demonstrate the complexity of the subject. 22 . GENERAL ACTION OF DRUGS Emetics. Specific Mixed Local Apomorphine Tartar Emetic Tepid water Lobeline Ipecac Mustard Morphine Copper Sulphate Salt Senega Zinc Sulphate Alum Squills Ammonium Carbonate Apomorphine is the only emetic given hypodermically. It also acts well by the mouthy but causes more nausea and allied effects than drugs acting locally. Morphine and lobeline given for other purposes fre- quently induce emesis also, particularly if the dose be large. Mustard and salt, 1 teaspoonful each, in a cup of lukewarm water, form a convenient emetic for dogs. Ipecac is useful in respiratory dis- eases as an expectorant as well as emetic, and- zinc sulphate is a prompt emetic in poisoning. The other emetics are practically unimportant. Emetics cause, beside vomition, several other phenomena which are sometimes utilized therapeutically. Among these may be mentioned nausea, salivation, violent respiratory efforts, compression of the abdomi- nal 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 accompanies 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 phenomena are more apparent after, the use of specific emetics. Uses. — These apply particularly to dogs. 1. To empty the stomach in, case of poisoning, over-loading of the organ, and indigestion with convulsions in young animals : — Mustard, salt or zinc sulphate. 2. To expel foreign bodies from the fauces and gullet (apomorphine 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 cure depraved appetite, pica or licking habit, where animals lick foreign bodies; as wool eating in sheep, feather plucking in fowl, etc. Here apomorphine is indicated. 4. To lower blood pressure and increase secretion in the first stage of bronchitis : — Ipecac. 5. To stop vomiting: — Ipecac in minute doses. Contra-indications. — Pregnancy; hernia; inflammation of the stom- ach, brain or abdominal viscera; bleeding from the stomach, bowels or lungs; aneurism and asthenia. DRUGS ACTING ON THE DIGESTIVE ORGANS 23 Gastric sedatives and anti-emetics are agents used to relieve pain in the stomach anl vomiting. These include: Ice Cocaine Hot water Cerium oxalate Bismuth subcarbonate Lime water Bismuth subnitrate Minute doses of arsenic Carbon dioxide Minute doses of ipecac Hydrocyanic acid Minute doses of alcohol Morphine Minute doses of iodine Menthol Minute doses of silver nitrate Carbolic acid Chloroform Creosote Chloral Aconite Bromides Belladonna Nitrites Hyoscyamus Brandy and champagne 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 accom* plished 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 bismutli subnitrate (gr.x-xx), with tincture of aconite (Tl\i-ii), form suitable remedies. When vomiting arises from indigestion and fer- mentation, carbolic acid with bismuth often acts favorably. The vomit- ing following anesthesia is probably of central origin. Here enemata of laudanum (Tl\x-xxx) and sodium bromide (gr.xx-xxx) are beneficial Ipecac, iodine, silver nitrate and the like are useful in vomiting dependent upon an atonic or depressed state of the stomach. When vomiting is continuous, small quantities of milk and lime water, equal parts, or pep- tonized milk (oii-iv) or a dram of cracked ice with a few drops of brandy, should be given at half-hour intervals. It may be rarely neces- sary 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 secre- tions (succus entericus) of the intestinal glands and, perhaps, transuda- tion of fluid from the blood vessels in the walls of the intestines. (3) By hindering absorption 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: °live oil a , linseed f \ small dose. Cottonseed oil Castor oil ) Magnesia Liquid petrolatum and other Sulphur mineral oils (mechanical Nux vomica lubricant, not absorbed) 24 GENERAL ACTION OF DRUGS These drugs slightly increase intestinal action, chiefly by stimulation of peristalsis. 2. Simple Purgatives. — These stimulate secretion and peristaltic action. Among them may be mentioned: Aloes Senna Calomel Cascara sagrada Linseed oil Phenol phthalein Castor oil Frangula Rhubarb Bryonia 3. Drastic Purgatives. — Drastics are essentially gastro-intestinal irritants, and in large doses cause mucous and bloody diarrhea, conges- tion of the mucous membrane of the alimentary canal and severe colic. They may produce death in poisonous doses with collapse 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 {i.e., to dilate the blood vessels in the alimentary canal and to cause an outpouring of serum from the blood, thus relieving con- gestion 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 occurs. 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 Colocynth Jalap Gamboge Elaterium 4. Hydragogue Purgatives. — Hydragogues are agents which chiefly increase the fluidity of the intestinal contents. They include: (a) SALINE PURGATIVES Magnesium sulphate Sodium phosphate Sodium sulphate Potassium bitartrate (b) DRASTICS Jalap Elaterium Scammony Purgation by salines depends upon the absorbability of their ions. The least absorbable are the most cathartic. Among the basic ions (ca- tions), magnesium is least absorbable, and among the acid ions (anions), the sulphates, phosphates, citrates and tartrates are absorbed with most difficulty. 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 their slow diffusi- bility. Purgation follows, owing to the mechanical effect of the increased fluidity of the bowels, and since the augmented bulk of the intestinal contents excites peristaltic action. When it is desirable to remove fluid DRUGS ACTING ON THE DIGESTIVE ORGANS 25 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 considerable dilution. Concentrated or hypertonic saline solutions cause copious transudation and secretion in the stomach so that they become almost isotonic with the body fluids before leaving the viscus. They irritate the stomach and retard its motor functions. Saline purga- tives do not expel feces as well as others because they do not stimulate peristalsis as much and leave much of the solids behind while mostly liquid escapes. If absorbed they pass out by the kidneys and are diuretic. The drastics included in this class of purgatives have the power of markedly increasing intestinal secretion as well as peristaltic action. 5. Cholayogue Purgatives. — Cholagogues are agents which assist in removing bile from the body. Some cholagogues are not generally con- sidered 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-hydrochloric 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 evi- dence most active. The bile occurring at any time within the bowels is in part absorbed and then re-secreted. This process may be repeated indefinitely, but is prevented by purgatives, especially those increasing peristalsis in the duodenum and upper part of the jejunum (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 re- moving bile from the body; not by stimulating its secretion, but by hastening its excretion from the bowels. The results of former experi- menters have been swept aside by the more recent and thorough re- searches of Stadelmann, on animals, and of PfafF, on men, with biliary fistulae. 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 secretin do, however, have a feeble cholagogue action. Moreover, there is no morbid condition in which increasing the flow of bile would prove remedial. Clinically so-called cholagogues are, nevertheless, of value because they act as purgatives (calomel), or as intestinal antiseptics (calomel, 26 GENERAL ACTION OF DRUGS 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. General Uses of Purgatives. 1. To empty the bowels. — In this way are removed fecal accumula- tions and poisonous matters resulting from bacterial infection, and from fermentative and putrefactive changes in the intestinal contents in indi- gestion. Foreign bodies, bile, pathological discharges and intestinal para- sites are also expelled. Peristaltic action is quickened in chronic constipation, while spas- modic 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 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 congested areas, as in meningitis. The drastics are appropriate for this service. Pain and nervous phenomena in other regions are sometimes benefited by the counter-irritant action of drastic cathartics. 4. To deplete. — Cathartics, particularly concentrated saline solu- tions, deplete the body both locally and generally by withdrawal of serum from the blood vessels. Purgatives tend to combat inflammation (anti- phlogistic 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, in hemorrhoids (sulphur, liquid petrolatum), 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 puerperal eclampsia, uremia, lymphangitis and hemoglobinemia be excreted. Contra- indications. — 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, intestinal hemorrhage, collapse, anemia, hernia, prolapse of rectum, metritis, nephritis, pregnancy, general debility, and in wounds of and operations upon the pelvic or abdominal viscera. GENERAL USES OF PURGATIVES %V In well-defined enteritis and peritonitis cathartics are to be avoided. In mechanical obstruction of the intestines surgical interference is indi- cated 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 catarrh of the respiratory organs and influenza, metastasis, or change in the site of the 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 ordi- nary purposes, while Epsom and Glauber salts are suitable for ruminants and pigs, and calomel and castor oil for dogs. Water assists the action of purgatives, and its ingestion should be encouraged by supplying a lib- eral 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 rectum 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 accumula- tions, debilitated conditions, obstinate vomiting, unconsciousness, and in inability to swallow (sore throat and tetanus). 2. To relieve pain, spasm (of intestines and bladder), and shock, when deep, hot enemata (105°-115c F.) are used. 3. To save life. After severe hemorrhage, deep injections of hot normal salt solutions, 110° F. (Enteroclysis, see p. 519.) 4. To accelerate the action of purgatives, and as a preparation for abdominal and pelvic operations. 5. To supply food. (See Artificial Feeding, p. 1-90.) 6. For their local effect upon inflammation of the mucous membrane of the rectum and colon. Opium and boiled starcli solution ; silver nitrate and tannic acid — in diarrhea, dysentery, colitis and proctitis. 7. To kill intestinal parasites (pin worms), — solutions of quassia and common salt. 8. To administer medicines in dysphagia due to pharyngitis, teta- nus, unconsciousness (apoplexy, coma and convulsions) ; to obstinate vomiting and other causes. 9. To reduce temperature, — cold enemata in fever. 10. To produce diuresis, — deep injections (110° F.) for retention 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 sev- 28 GENERAL ACTION OF DRUGS eral gallons) to flow into the rectum from a height of (3 feet until vomit- ing 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 foreign 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 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 accom- plished 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 vaseline, 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., Oi; D., §ii) an hour before the use of larger enemata assists in softening the intestinal contents, or 1 to 2 ounces of glycerin are used, to the quart of warm water or normal saline, to soften the fecal masses. 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 simply to unload the bowels, to cause retention and absorption 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 obtained. To increase the purgative effect of enemata a cup each of soft soap, salt and molasses is 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 cathar- sis (H., Ci; D., Oi). Linseed oil or cottonseed oil is also mixed with water. Epsom salt is still more efficacious (H., flni to gallon of water; D., §ii-iv to pint) ; while oil of turpentine or tine, of asafetida (H., §ii-iv; D., 3i-iv) is very active and especially useful in colic and flatu- lence, mixed with the enema. When clysters are given to be absorbed they should always be injected very slowly by raising the water supply only 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. 519). In chronic constipation and torpidity of the bowels plain cold water (55° -60° F.) injections are indicated. DRUGS ACTING ON THE CIRCULATION 29 Medicated irrigations are most serviceable in catarrhal disorders of the bowels (dysentery, etc.), i.e., the fluid is allowed to flow in and out again till the solution returns clear. DRUGS ACTING ON THE CIRCULATION. I. — Acting Upon the Blood. (a) Blood plasma. — The alkalinity of the blood plasma can be in- creased by the use of the salts of the alkaline and earth metals; i.e., potassium, sodium, lithium, ammonium, magnesium and calcium com- pounds. This effect is of value therapeutically in rheumatism, hemo- globinemia and uric-acidemia. In the former two disorders, increasing the alkalinity of the blood plasma appears to assist in the elimination of toxic material, while in the latter condition 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 secre- tion. Drugs which remove considerable fluid from the body, as purga- tives, diaphoretics and diuretics, necessarily alter the composition of the blood plasma. By removing fluid from the plasma, these agents are use- ful in aiding 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, hemoglobinemia and lymphangitis. Venesection, saline infusions, hypodermoclysis and enteroclysis alter the character of the plasma and often have a life-saving value. (See p. 514.) (b) The red corpuscles. — The so-called blood tonics, or hematinics, influence the red corpuscles, increasing their number and content of hemo- globin when there is a deficiency of either. The effect upon the augmenta- tion 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 hemoglobin; arsenic increases the number of red corpuscles. Certain agents possess toxicolog- ical significance by destroying the composition of hemoglobin. Large doses of the coal tar products, as acetanilid, antipyrin and phenacetin, nitrites and potassium chlorate, convert hemoglobin into methemoglobin, a mixture, probably, of hematin and soluble albumin; while carbonic oxide, phosphorus, sulphur, arsenic, iodine, hydrogen sulphide and tur- pentine, in large doses, reduce oxyhemoglobin and prevent its combination 30 GENERAL ACTION OF DRUGS with oxygen. Acetanilid, potassium chlorate and amyl-nitrite destroy the red blood cells, if absorbed in considerable amount. (c) White corpuscles. — It is possible experimentally to arrest puru- lent exudations caused by irritation and inflammation when quinine is introduced into the blood or applied locally to blood vessels. This hap- pens because quinine and all cinchona salts, berberine sulphate and acetanilid — like other poisons to amebae — prevent the ameboid movement or migration (diapedesis) of leukocytes through the vessel walls. Unfor- tunately it is impossible to give large enough doses in practice to realize such favorable results in inflammatory disorders. An enormous increase of leukocytes (leukocytosis) occurs in acute diseases accompanied by a local exudation process, and also in leukemia, etc. Nucleic acid may induce leukocytosis and may be valuable in bacterial infections. Its thera- peutic value is still doubtful after many years of trial. Arsenic, and in some cases quinine, appear to reduce leukocytosis, and in leukemia seem thus to aid recovery. Drugs altering the consistency of the blood arc: calcium chloride and (to a less extent) other calcium salts, gelatin and potassium iodide, which increase the rate and degree of coagulation; cod-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. II. — Drugs 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 a stimu- lus, 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 coordination with 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 sym- pathetic nerves with centres (presumably) in the medulla, and in the inferior cornua of the anterior part of the spinal cord, with fibres con- necting 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 pro- duce an adequate flow in the capillaries. This depends upon the heart's output, the arterial resistance, and the amount and viscosity of the blood. DRUGS ACTING ON THE CIRCULATION 31 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 ven- tricles 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 (first part) and diastole and prolonging diastole may or may not increase the amount of blood entering them. In general, moder- ate 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 heartbeats, or both. The vagus centre is stimulated by agencies increasing blood-pressure, or causing asphyxia. On the other hand, agencies reducing 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 sen- sory 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 mechan- ism controlling the heart, and since it is difficult to determine the exact physiological details in such complex actions, we shall content ourselves with tabulating the actions of drugs ordinarily employed for their influ- ence 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. Slow th Digitalis Adrenalin Barium salts (b) Drugs incre Belladonna Atropine Hvoscvamus 32 GENERAL ACTION OF DRUGS (c) 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 Prussic acid Veratrum viride Ergot Antimony salts The drugs most frequently given to animals for their action on the heart are alcohol, ether, digitalis, strophanthus, ammonia, ammonium car- bonate, camphor, caffeine, strychnine, atropine, aconite and veratrum viride. The reader is referred to special articles on these drugs for therapeutical indications and other details. III. — Drugs Acting on the Blood Vessels. The following table includes the mechanism regulating vascular tension: Smooth muscular fibres 1. In the walls of the vessels Terminations of vasodilators and vasoconstrictors 2. Nerve supply of vessels Vasodilators Vasoconstrictors Vasoconstrictor or vasomotor centres in the medulla and subsidiary cen- 3. Centres tres in the spinal cord and sympa- thetic system, controlling the constricting nerves Each peripheral vessel contains regulating, constrictor fibres, except, possibly, those of the heart, lungs and brain. The vascular lumen is nar- rowed by stimulation, and widened by inhibition, of the vasoconstrictor apparatus. Some vessels possess dilating fibres which do not appear to be con- trolled by a distinct center. 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. Vascular 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 vascular 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. DRUGS ACTING ON THE CIRCULATION 33 (a) Drugs acting systemic ally to contract vessels. Pituitary extract Digitalis Strychnine Adrenalin Strophanthus Hamamelis Cocaine Squill Hydrastis Ergot Sparteine Physostigmine Atropine (b) Drugs acting systemically to dilate vessels. Amyl nitrite Thyroid secretion Nitroglycerin Chloral Spirit of nitrous ether Aconite Alcohol Opium Salicylates Belladonna (secondary action) Ether Hyoscyamus (secondary action) Chloroform Stramonium (secondary action) (c) Agents acting locally to contract vessels. Secretion of the suprarenal and Cold pituitary glands Astringents (d) Agents acting locally to dilate vessels. Heat Thyroid secretion Counter-irritants Uses. — Drugs or agencies causing general dilatation of vessels are useful in overcoming internal congestions and colds by equalizing the circulation ; that is, by causing the blood to be distributed more uniformly about the body. Some are also of benefit in morbid conditions attended with a high, vascular tension; and are serviceable in dilating peripheral vessels and in causing perspiration and loss of heat in fevers (spirit of nitrous ether and salicylates). 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 internal hemorrhage and inflammations (ergot) ; and to aid the absorption of dropsies and edemas. The uses of drugs locally contracting vessels will be described under astringents (p. 53) and of agents locally dilating vessels under counter-irritants (p. 52). 34 GENERAL ACTION OF DRUGS DRUGS ACTING ON THE NERVOUS SYSTEM. I. — Drugs Influencing the Brain. It is impossible to classify drugs according to their, action on the various centres of the brain, because our knowledge is insufficient. In a general way, drugs affecting the nervous system fall into two groups, — the excitant and depressant. But another difficulty 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 which excite in small doses cause depres- sion and paralysis after poisonous quantities. Apart from a transient stimulation, alcohol, ether and chloroform are essentially cerebral depressants, contrary to accepted ideas. Bella- donna 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 condi- tion 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 the brain and 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 excitability (sometimes seen in man) follow- ing the administration of morphine is much prolonged and not infre- quently completely obliterates the somnifacient action of the drug in this animal. We shall be content to classify drugs acting on the nervous system according to their most pronounced action in moderate doses. (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 employed to gen- erally excite the nervous system in depressed condition. 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 progressive- ly paralyzing the functions of the brain follow the so-called law of disso- lution— 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 suc- cumb to the action of cerebral depressants. The cerebral depressants are used mostly to relieve pain, when they are called anodynes or anal- DRUGS ACTING ON THE NERVOUS SYSTEM 35 gesics. Pain is due to irritation of any sensory nerve, or the sensory tract in the spinal cord, or of the sensory 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 (hyp- notics or soporifics) and stupor (some anodynes and anesthetics), and finally paralyze the respiratory and circulatory functions. The follow- ing 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 [ndica Urethrane Trional Chloral (Of little importance in veterinary practice) Uses. — Hypnotics are not of much value in veterinary medicine by simply promoting sleep. Their general sedative and anodyne actions are utilized in relieving motor excitement (spasms) or sensory excitement (pain). (b) General A aesthetics. Ether Nitrous oxide Methylene bichloride Chloroform Ethylene dichloride (Of slight value in veterinary medicine) Anesthetics are agents which abolish sensation generally or locally. It is thought that the general anesthetics act directly on the nerve cells. Anesthetics — like narcotics generally — first stimulate 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 cerebrum and spinal cord, and so abolish pain, sensation and reflex action. The law of dissolution is exemplified in their action. Anesthesia 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 irri- tation 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 circula- tion and respiration are renexly stimulated. Stimulation now ceases, and depression of the cerebrum, together with the motor, sensory and reflex spinal centres, appears, and ushers in the (2) anesthetic stage, characterized by muscular relaxation and complete abolition of conscious- 36 GENERAL ACTION OF DRUGS ness, sensation and motion. Between these two stages — the stimulant and the anesthetic — there sometimes occurs a transient state in which sensation is lost before consciousness. This has been styled the anodyne stage. Finally, the (3) paralytic stage ensues, accompanied by depression and then paralysis of the three great vital medullary centres controlling the circulation and respiration, together with that of the lowest reflex centres, so that involuntary micturition and defecation occurs. The ani- mal dies of a combination of vasomotor, heart and respiratory failure. If recovery should follow the paralytic stage, the bodily functions return in the reverse order of that in which they were lost; i.e., the lower vital functions first appear, followed finally by the higher cerebral functions. Uses. — Anesthetics are employed in surgical operations to relax muscles and prevent pain and struggling; in obstetrical operations and in the reduction of fractures, dislocations and hernia, to obtain 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. 225). (c) Drugs acting on the cortical motor centres of the brain. (1) DRUGS STIMULATING THE MOTOR CENTRES. Strychnine Physostigmine Atropine (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 excite- ment, particularly in epileptiform convulsions of dogs. II. — Drugs Acting on the Spinal Cord. The functions of the cord consist in the conduction of sensory im- pulses forward to the brain and of motor impulses backward to the muscles ; in the origination of nervous force in centres controlling 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 columns 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 experi- mentally, slight peripheral irritation will reflexly cause convulsions, and, if the cord is severed from the brain, the same phenomena appear. DRUGS ACTING ON THE NERVOUS SYSTEM 37 Primary action (A) Drugs stimulating the motor cells of the inferior cornua. Strychnine Ammonia Opium -» Brucine Anesthetics Ergot I Thebaine J 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 Bromides Ergot Nitrites Gelsemium Emetine Turpentine Salts \ Magnesium Sodium Alcohol Ether Chloroform Camphor Carbolic Acid Nicotine Veratrine Mercury Arsenic Potassium Lithium Salts -j Antimony Zinc Silver Saponin Chloral Morphine Apomorphine Uses. — Drugs depressing the motor cells of the cord are serviceable 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. III. — Drugs Acting on the Nerves. The nerve terminations, rather than their trunks, are influenced by drugs. (A) Drugs influencing peripheral sensory nerve-endings. (1) Stimulating sensory nerve-terminations. — Counter-irritants. (See p. 52.) 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 Yeratrine Menthol Chloral Heat Carbolic acid Prussic acid Cold Atropine Sodium bicarbonate LOCAL ANESTHETICS. Cocaine Stovaine Holocaine j Ether Eucaine Novocaine Cold \ Methyl-chloride Uses. — The local anodynes are employed to relieve pain of an inflam- matory, rheumatic or neuralgic character, and itching. The local anes- thetics are employel to prevent pain in surgical operations. (B) Drugs influencing peripheral motor nerve-endings. (1) STIMULATING MOTOR NERVE-TERMINATIONS. Strychnine . Aconite Pyridine Pilocarpine Nicotine 38 GENERAL ACTION OF DRUGS (2) DEPRESSING MOTOR NERVE-TERMINATIONS. Curare Cocaine Lobeline. Conium Camphor Nicotine Amyl-nitrite Prussic acid and many others Atropine Uses. — Drugs influencing the peripheral motor nerve-endings are not of any practical therapeutical value for this purpose (except lobeline). IV. — Drugs Acting on the Nerves of Special Sense. (A) Drugs acting on the eye. (1) Drugs influencing the pupil. — The mechanism controlling the pupil consists of the centres for the contraction of the pupil (in the cor- pora quadrigemina), the centres for the dilatation of the pupil (mid- brain and lower ciliospinal), the third nerve, the cervical sympathetic and the circular and radiating (latter sometimes absent) muscular fibres of the iris. Drugs may act either centrally or locally on these structures. The pupil is dilated by drugs (1) depressing the contracting centre (ocu- lomotor), (2) the terminations of the third nerve or (3) the circular fibres of the iris; and contrariwise, by (4) stimulating the dilating centre, (5) the terminations of the sympathetic or (6) the radial fibres of the iris; and, finally, by a combination of these actions. Again, the pupil is contracted by drugs stimulating (1) the oculo- motor centre, (2) the terminations of the third nerve or (3) circular fibres of the iris; and by depressing (4) the dilating centre, (5) the ter- minations of the sympathetic or (6) the radial fibres of the iris; and also by a combination of these actions. Drugs may act locally on the pupil through the medium of the circulation as well as when dropped into the eye. Furthermore, absorption and central action may occur when drugs are dropped into the eye as well as when entering the blood through the more ordinary channels. The drugs used in the treatment of the diseases of the eye are 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 (mydriatics). (1) Mydriatics. (a) ACTING LOCALLY. Atropine Homatropine Hyoscyamine Hyoscine Scopolamine Gelsemine Cocaine stimulates sympathetic endings (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 irrita- tion of sensory nerves, the sexual organs and digestive apparatus. Paralvze third nerve terminations DRUGS ACTING ON THE RESPIRATORY ORGANS 39 Uses. — Mydriatics are useful in dilating the pupil for examination of the eye, and to prevent adhesions of the iris in central corneal ulcers; in keratitis, to overcome photophobia and blepharospasm; and in iritis, to secure rest of the iris and ciliary muscles. (2) Myotics (a) ACTING LOCALLY. (b) ACTING CENTRALLY. Physostigmine Stimulate third Anesthetics Pilocarpine nerve endings Opium Uses. — 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 painful disorders of the eye; to lessen intra-ocular tension in glaucoma*; and, in alternation with 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 accom- modation. Intra-ocular tension in glaucoma is usually increased by atro- pine and other mydriatics, but is diminished by eserine and pilocarpine. (13) Drugs Acting on the Ear. Strychnine makes the hearing (and sight) more acute; while sali- cylic acid, salicylates and quinine cause, in man, subjective symptoms, including fullness, roaring and buzzing noises in the ears. DRUGS ACTING ON THE RESPIRATORY ORGANS. It is impossible to describe under this head all the drugs influencing the respiratory tract. Thus, agents affecting the circulation exert a powerful action on the blood supply and functions of the respiratory organs. The application of counter-irritants and heat and cold exter- nally, reflexly produce notable alterations of pulmonary conditions. Emetics are indirectly serviceable in assisting the expulsion of exuda- tions from the upper air passages in dogs. Furthermore, medicines hav- ing a depressing action on the nervous system are of importance in res- piratory disorders in relieving cough and spasm. We shall consider here those agents acting on the respiratory apparatus itself. Drugs Acting on the Respiratory Mucous Membrane. Errhines, or sternuatories, are drugs which are introduced into the nostrils to cause irritation, coughing and sneezing and expulsion of secre- tions, 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 opening up the filtration angle at the periphery of the anterior chamber and allowing drainage of lymph through the lymph spaces there into the canal of Schlemm, or to contraction of the intra-ocular vessels, so lessening secretion (Gronholm). 40 GENERAL ACTION OF DRUGS (A) Drugs Acting Locally. Administered by inhalation (in pint of water near the boiling point; unless otherwise stated). 1. Stimulating the mucous membranes and causing vascular dilata- tion, increased secretion and muscular contraction of the walls. 2. Producing a sedative action. 3. Exerting an antiseptic influence. 4. Relaxing spasm. 5. Causing a local astringent action. 6. Thinning exudations. (1) DRUGS EXERTING STIMULANT ACTION. Carbolic acid gr.xx Creosote Tllxx Oil of cubebs ^ss Tincture of benzoin 5SS Tincture of ipecac ,*ss Oil of turpentine 3ss-3iiss Oil of pine 3ss-3iiss (2) DRUGS EXERTING A SEDATIVE INFLUENCE. Diluted hydrocyanic acid (TTLx-xv in 5i cold water) (3) DRUGS PRODUCING AN ANTISEPTIC ACTION. Thymol gr. vii-xii Carbolic acid 3i Creosote §ss Compound tincture of benzoin §ss Sulphurous anhydride gas Formaldehyde vapor Oil of eucalyptus n\x-xx (in *ii of alcohol) Oil of cubebs §ss Oil of juniper Jss Benzoic acid 3ix (in §viii of alcohol) Tar water, undiluted Potassium permanganate gr.xv-3i Quinine hydrochlorate 3ss. (4) DRUGS RELAXING SPASM. Amyl nitrite H., oss-i; D., T^ii-iv, undiluted. Extract of belladonna gr. vii-xv Extract of hyoscyamus gr. ii-iv Extract of conium gr. viii (Burning stramonium leaves). (5) DRUGS CAUSING A LOCAL ASTRINGENT ACTION. Alum 3ss Zinc sulphate 3ss Solution of ferric chloride 3i Silver nitrate 3ss DRUGS ACTING ON THE RESPIRATORY ORGANS 41 (6) DRUGS THINNING SECRETION. Sodium bicarbonate 3ss. Solution of lime, undiluted. Ammonium chloride 3ss. Vinegar 5^* Lactic acid %i. Uses. — Inhalations are often beneficial in the treatment of coryza, pharyngitis, laryngitis, tracheitis and bronchitis. In the first stage of catarrhal inflammation of the upper air passages, antiseptics may cut short the attack. Simple steaming with vinegar or sodium bicarbonate moistens and soothes the dry, irritable mucous membrane and relieves congestion by promoting secretion. In the exudative stage, agents stimu- lating the respiratory mucous membrane and making the secretions less viscid are in order. If the mucous or purulent discharges are excessive, astringent sprays or inhalations are useful; and if they are foul-smelling, drugs combining stimulant and antiseptic actions may be employed. In- halations may be given by means of a bronchitis kettle, or by atomization to small animals. Care must be exercised that too large a quantity of the solution be not used lest absorption and poisoning ensue. Dogs may be placed over the perforated seat of a cane-bottomed chair with the steaming apparatus underneath. A hot brick is sometimes employed to give inhalations to horses by dropping it into a pail containing the proper solution. The head should not usually be covered during inhalation if the breathing is embarrassed or the respiratory tract obstructed, since fresh air is imperative. Simple steaming may be conducted for an hour. Inhalations containing special drugs may be given for fifteen minutes. (B) Drugs Acting Systemically. Expectorants are agents which influence the bronchial mucous mem- brane and its secretion. They aid or hinder expectoration in man, but are much less efficient in this respect in veterinary medicine, because the act of expectoration is performed with difficulty by the lower animals. Nevertheless, expectorants are useful in altering the character of the secretion and lessening the irritation caused by dry, tenacious discharges, and in stimulating the mucous membranes and improving their circulation and nutrition. Moreover, some drugs (volatile oils) exert an antiseptic action on the bronchial mucous membrane during their elimination. Many expectorants act reflexly from an irritant action on the stomach. Thus Henderson and Taylor have shown this to be the case with ipecac, ammo- nium compounds, antimony and senega. Expectorants. (1) INCREASING SECRETION. Apomorphine Ammonium chloride Turpentine Potassium iodide Squill Terpin hydrate Ipecac Camphor Terebene Pilocarpine Balsams Volatile oils Antimony and potas- Sulphur sium tartrate Tar 42 GENERAL ACTION OF DRUGS (2) DIMINISHING SECRETION. Belladonna Stramonium Opium Hyoscyamus , Acids Volatile oils, and drugs containing them, first increase and then decrease bronchial secretion as a secondary effect. (3) ALTERING THE NUTRITION OF BRONCHIAL MUCOUS MEMBRANE. Potassium iodide Cod-liver oil Sulphur Ammonium chloride (4) EXERTING AN ANTISEPTIC ACTION. Turpentine Tar Balsam of Tolu Terebene Ammoniacum Cubebs Terpine hydrate Balsam of Peru Copaiba (5) LOCALLY STIMULATING AND ANTISEPTIC TO MUCOUS MEMBRANES. Creosote Eucalyptol Guiacol Uses. — Expectorants are chiefly prescribed in bronchitis. In the early or dry stage drugs increasing secretion and at the same time de- pressing the circulation are often employed in sthenic cases. These drugs possess less value in the treatment of the horse, on account of comparative insusceptibility to them, than in the case of dogs. If exudation is excessive, then drugs lessening secretion are indi- cated. When the disorder is persistent, agents altering and improving the nutrition of the bronchial mucous membrane are beneficial. Bron- chitis accompanied by a copious foul secretion is treated with volatile oils, which exert an antiseptic action on the air passages. Expectorants are usually administered with other agents influencing the respiratory tract; e.g., drugs relieving cough and spasm and those stimulating the respiratory movements or circulation. Drugs Stimulating the Respiratory Centres.* C02 is a natural stimulant. Strychnine Cocaine Stramonium Atropine Belladonna Ammonium carbonate Caffeine Hyoscyamus Strong ammonia External counter-irritation and heat. Drugs Depressing the Respiratory Centres. Morphine, codeine and heroine, chloral and bromides are sedative to the respiratory centre and thus useful in cough, asthma and dyspnea. Uses. — Drugs stimulating the respiratory centre and movements are of great value in diseases of the chest — especially pneumonia and bron- chitis— attended with obstruction in the air passages and cyanosis. They promote coughing and efforts at expulsion of secretion and facilitate the entrance of oxygen into the blood. Some, possibly ammonia, stimulate the movements of the ciliae lining the tracheal mucous membrane. *The plural is sometimes used because, like the vaso-motor, the centres are bilateral in the medulla. DRUGS ACTING ON THE RESPIRATORY ORGANS 43 Strychnine and atropine are respiratory stimulants; atropine is indi- cated where exudation is abundant, while ammonium carbonate is pre- scribed to increase secretion. Certain drugs sometimes cause in large doses Cheyne-Stokes breathing in animals, e.g., opium, chloral, bromides, digitalis, ammonium carbonate and strychnine, owing to disturbance of the respiratory centre. Drugs depressing the respiratory centre are not used for this purpose but because they also relieve cough. Drugs Relaxing Spasm of the Bronchial Muscular Tunic and Relieving Cough. LOCALLY. White of egg Linseed tea Mucilage Syrups External counter-irritation and heat. SYSTEMICALLY. Opium Nitrites Codeine Chloral Heroin Bromides Hyoscyamus Chloroform Stramonium Phcnacetin Cannabis Indica Adrenalin Uses of Drugs Allaying Spasm and Cough. Coughing is a reflex act following irritation of sensory nerve endings in any part of the respiratory tract (usually of afferent vagal branches), in the pharynx, pleura, ears, teeth, stomach and liver. Sensory impulses conveyed to the reflex centre for coughing, — near the respiratory centre in the medulla, — are there transformed into motor impulses and result in coughing. Drugs may stop coughing by acting locally to relieve conges- tion and irritation (demulcents) or they may exert a topical sedative action on the nerve endings. They also act systemically by quieting the reflex centre for coughing, or the sensory or motor nerve endings ; also by abating congestion in promoting secretion (expectorants), or in influ- encing the circulation. Cough may be beneficial when it assists the expulsion of exudation, but is not so when it is constant and ineffective, as in congestion of the trachea, bronchial mucous membranes, lungs or pleura; in pulmonary consolidation; and in coughs originating outside of the respiratory tract. We should try to arrest coughing by agents removing the cause (conges- tion or irritation), such as counter-irritants, expectorants, local applica- tions (sprays, inhalations) and heart stimulants, but if these are inefficient and coughing is immoderate, we may resort to the use of sedative agents. Some preparation of opium is most frequently employed to stop coughing, but should be avoided if cyanosis exists, since inspiratory and expulsive efforts are weakened by the drug. Belladonna, on the other hand, stimu- lates the respiratory centres and arrests cough by depressing both the afferent and efferent vagal terminations in the lungs, while — like opium — lessening secretion. These drugs are often combined. When spasm of the bronchioles exists, as in asthma, adrenalin is particularly valuable. 44 GENERAL ACTION OF DRUGS DRUGS ACTING ON THE URINARY ORGANS. Diuretics are drugs increasing the secretion of urine. Four factors are concerned with urinary flow. (1) The composition and viscosity of the blood. (2) The state of local (renal) and general blood pressure. (3) The activity of the renal cells. (4) Reabsorption or rapidity of flow of urine in the constricted tubes. The renal mechanism influenced by drugs comprises: (1) The malpighian glomerules, which excrete alkaline fluid, urea and salts (chlorides, sulphates and phosphates), and other substances from the blood by osmosis. Their activity depends upon their blood supply, which is increased by agents causing dilatation of their afferent arterioles, thus accelerating the velocity and flow of blood to the glo- merules; and by drugs increasing general blood tension without corre- sponding constriction of the renal vessels. Drugs augmenting the mass of blood and tension in the malpighian bodies enlarge the surface of cubical epithelium covering the capillary loops and promote osmosis or filtration of fluid into the cavity of the malpighian capsule. There is also some true secretion by the cells lining the glomeruli. Sugar, peptone and egg albumin injected into the blood are excreted by the glomeruli. (2) The nucleated polyhedral cells lining the convoluted tubes. — These secrete the solid products resulting from the retrograde metamor- phosis of nitrogenous bodies circulating in the blood, as urea, uric acid, creatin, and other organic substances, pigment, phosphates and water. Also in animals having an acid urine, the change in reaction from alka- line secretion of the malpighian bodies to acid occurs in convoluted tubes, unless the urine is hurried along too rapidly by diuretics. (3) The constricted tubes. — These regulate the urinary secretion by either impeding its passage by constriction of their walls, thus aiding absorption, or by their active peristalsis facilitating the flow of urine. The chief function of the constricted tubes is to cause concentration of the urine. (4) Nervous mechanism. — This governs the calibre of the vessels of the malpighian bodies, and possibly controls the unstriped muscle of the constricted tubes. No secretory nerves, such as those controlling the secretory cells of the salivary glands, have been discovered in the kid- neys. Variations in the blood-supply are apparently sufficient to account for the secretion of urine. The flow of urine is therefore chiefly regulated by the vasomotor system, with centres in the medulla and thoracic and lumbar cord. The constrictor and dilator fibres run in the splanchnics, through the renal plexus, enter the kidney at the hilum, and accompany the arteries to their final endings. We may classify diuretics broadly in two groups: (1) Those acting chiefly upon the glomerules. (2) Those affecting mainly the renal cells of the tubules. (1) Diuretics increasing the glomerular fluid. (a) By increasing the flow through the renal arteries. (b) By lessening osmotic pressure of the blood. Water is the chief diuretic. Without an abundance of water diuresis DRUGS ACTING ON THE URINARY ORGANS 45 is impossible. This fact is often lost sight of. Water is absorbed from the bowels (hardly at all from the stomach), where it becomes salt solu- tion by taking up sodium chloride from mucus or food, or from super- ficial cells of the tract, or from that formed by the neutralization of HC1 from the stomach. Water then enters the blood as an isotonic or hypotonic salt solution, increasing its mass (hydremic plethora) and its pressure, thus dilating the renal arterioles and augmenting the flow of urine. Experimentally, Raphael doubled his urinary output by doubling his intake of water. But the most powerful drug (diuretin) only enhanced his urinary flow 50 per cent. The salts act chiefly upon the glomerules. When hypertonic salt solutions enter the blood they increase its osmotic pressure and water passes into the blood from the tissues. The osmotic pressure is then lowered, but the mass of blood is increased, together with vascular tension, and thus dilatation of the renal vessels, and diuresis. The most diuretic salts include potassium acetate, citrate, bitartrate, and solution of ammonium acetate. Sodium chloride and sulphate; potassium nitrate, bicarbonate and iodide; and magnesium salts; may act as diuretics, but not so certainly. Digitalis, squill and strophanthus are powerful diuretics when the circulation is poor, with venous engorgement and low pressure, by overcoming this condition and increasing the flow of blood through the arterioles of the glomerules. They may, like many diuretics, have a local action to dilate arteries in the kidneys and to stimulate renal cells, but this is doubtful. In fact it is probable that powerful diuretics usually act locally to dilate the renal arteries. This has been noted in the case of caffeine (Pearce) but has not been specifically proved in the case of most diuretics. The nitrites are diuretic if they dilate the renal arterioles more than the arte- rioles generally. (2) Diuretics stimulating the renal cells, or lessening absorption from the tubules, or both. The matter of absorption from the tubules is disputed. Some author- ities deny that resorption of water or other substances plays any im- portant part in urinary secretion. Caffeine and theobromine act chiefly through powerful stimulation of the renal cells of the tubules, besides dilating renal vessels through excitation of the heart and augmenting blood pressure. The irritant diuretics contain volatile oils, resins or aro- matics, as buchu, juniper (gin), turpentine and cantharides. They stimulate the renal cells, or hinder resorption, or both. Urea is the natural stimulant of the renal cells. The irritant glucosides, scoparin and asparagin, act as renal stimulants. Calomel either stimulates the renal cells, or causes diuresis indirectly, in relieving venous engorgement (which obstructs flow in the renal arterioles) by its cathartic action. Diuretics may lessen resorption in the tubules either by hindering the absorbing power of the tubules, or by hastening the flow of urine through them. The solids in the urine are chiefly increased during the first few days after the use of diuretics, and the filtered substancs from the mal* pighian bodies (urea and salts) are eliminated more proportionately by diuretics than the secreted matters (pigment, creatin, uric acid). Diuretics, according to Fischer's recent and much discussed theory, 46 GENERAL ACTION OF DRUGS act through influencing the colloid chemistry of the renal cells. Produc- tion of acid in the renal cells leads to their swelling, edema and lack of function. All salts, glucose and alkalies antagonize this condition, reduce edema of the renal cells, allow water to pass through them, and are all diuretic. Acidosis and edema of the renal cells are brought about by lack of oxygen — hence caffeine, digitalis and agents improving renal blood supply are diuretics in supplying oxygen. Salts and sugar dehydrate tissue; therefore, common salt, sucrose, glucose and lactose are diuretics in abstracting water from the tissue and renal cells. Uses. — Diuretics are useful in removing toxins and waste solid mat- ters in the blood resulting from disease or the imperfect oxidation of albu- minoid substances. Their action depends on an extra ingestion of water. In fevers the potassium salts are employed with spirit of nitrous ether, alcohol and digitalis. They are antipyretics by eliminating pyrogenic material. Tissue waste is increased by diuretics, and they are serviceable in plethora, rheumatism and obesity. In acute disease of the kidneys, salines and digitalis are indicated; in chronic renal disorders salines and diuretin (expensive) are often used. Diuretics remove water from the system. They are, therefore, employed in edema and dropsy of renal or cardiac origin (digitalis), and in chronic effusions, as in pleuritis and pericarditis. In cases with edema water must, however, be restricted and a salt-free diet given. Diuretics lessen irritation of the kidneys by diluting the urine when the secretion is concentrated or contains toxins or other irritants (uric acid, calcium oxalate, etc.). Finally, stimulating diuretics (buchu, turpentine, etc.), are indicated in chronic inflammatory diseases of the kidneys and bladder, and in relaxed and paretic disorders of the bladder (incontinence of urine) to excite the reflex and motor functions of the sphincter and detrusor muscles. Drugs Influencing the Reaction of Urine. In man and animals secreting an acid urine, the basic phosphates of sodium and potassium in the blood are decomposed by the renal cells, and acid phosphates of sodium or potassium — being more diffusible — are eliminated, giving the urine its characteristic reaction, while the bases remain behind. In the case of the herbivora the urine is alkaline, because there are larger quantities of magnesium and calcium salts in the food, which precipitate phosphoric acid in the stomach, and because there is an excess of alkaline sodium and potassium salts in the blood. The urine may best be made acid by! benzoic acid, which is converted into hippuric acid during its passage through the kidneys. Salicylic acid, urotropin, the mineral acids (as acid salts), and large quantities of the vegetable acids and boric acid tend to acidify the urine in a less degree. An acid urine may be made alkaline by alkalies, as salts of potassium, lithium, sodium and calcium, together with the vegetable salts, tartrates, citrates and acetates, which circulate as carbonates in the blood. Drugs promoting diuresis make the urine less acid because the basic sodium phosphate in the blood is not so readily broken up in the kidney when it diffuses through the cells in great dilution. Ammonia fails to make the urine alkaline because it is transformed into urea. DRUGS ACTING ON THE URINARY ORGANS 47 Uses. — Benzoic acid is sometimes of benefit in acidifying and disin- fecting an alkaline decomposing urine of pyelitis or cystitis. Recently urotropin has been used more successfully for these purposes. The alka- lies are thought to be useful in alkalizing the blood in certain disorders (rheumatism, hemoglobinemia, etc.), and the urine of carnivora, to prevent the precipitation of uric acid in the urine or to aid its solution when already precipitated. Drugs Influencing the Composition of Urine. Speaking generally, drugs act on the glomerules to eliminate water and salts. Drugs influence the tubules to secrete organic substances and water. Whether the glomerular fluid is chiefly an osmotic filtration or a true secretion is a moot point. The composition of the urine is also altered by most drugs eliminated in it, leading to changes in color, odor, reaction and the appearance of blood pigment, etc. Thus blood appears in the urine after toxic doses of turpentine, cantharides and salicylic acid; and blood pigment, in poisoning by potas- sium chlorate, acetanilid, nitrites, glycerin and mushrooms (muscarin) ; and occasionally by overdoses of mineral acids, naphtol, naphtalin and arsenic. Rhubarb and senna impart their coloring matter (chrysarobin) to urine, which makes acid urine brown, but alkaline urine a deep blood or purplish red. Carbolic acid, creosote, naphtalin and other tar-prod- ucts, together with gaultheria and uva ursi (due to contained arbutin), stain the urine a greenish-brown or blackish hue. Santonin dyes an alka- line urine cherry or purple-red, while an acid urine is turned yellow or greenish. Logwood gives its color to acid urine, while an alkaline urine is rendered red or violet. Poisonous doses of sulphonal and trional give rise to a claret-colored urine, owing to hematoporphyrin. Gamboge and carrots bestow their colors on the urine. Turpentine is said to give urine the odor of violets, but large doses impart the peculiar odor of the oil itself. Cubebs, copaiba, eucalyptus, valerian, musk, asafetida, sandal wood oil, asparagus and turpentine (large doses) communicate their special odor to the urine. Urinary Antiseptics. Certain drugs are sometimes given with the purpose of killing bac- teria in the urine in purulent pyelitis and cystitis. Among these are: Urotropin Salol Benzoic acid Buchu Boric acid Copaiba Methylene blue Cubebs Salicylic acid Volatile oils Urinary Sedatives. The foregoing list, in preventing decomposition, and: Hvoscyamus Opium Belladonna Alkalies (with an acid urine) 48 GENERAL ACTION OF DRUGS DRUGS ACTING ON THE SEXUAL ORGANS. (A) Influencing Chiefly the Male Generative Organs. The mechanism concerned with the sexual functions is presided over by cerebral and spinal lumbar centres. Agents may immediately excite the spinal centres or cause local irritation of sensory nerves in various parts of the body — more particularly in the neighborhood of the genital organs — and thus reflexly stimulate the lumbar centres. The cerebral centres are mainly affected by visual, nasal or oral im- pressions, and also reflexly by irritation of sensory nerve-endings, more especially those situated in the sexual organs. (1) Aphrodisiacs are drugs exciting sexual desire (and increasing sexual power in the male). They include: DIRECT APHRODISIACS. Strychnine, Phosphorus, Alcohol (act on centres). Cantharides (local irritant). Yohimbine (causes congestion of the sexual organs). INDIRECT APHRODISIACS. In debility: Iron, Strychnine, Arsenic (full diet). (2) Anaphrodisiacs are drugs lessening sexual desire. They are: Opium, Bromides, Purgatives, Nauseants, (bleeding), (spare diet). Uses. — Aphrodisiacs may sometimes be useful in impotence and loss of sexual desire. Irritants, as cantharides, may cause inflammation of the urinary tract. Loss of sexual desire and power should usually be treated by improving the general nutrition with tonics and good feeding and by regulating the use of the sexual organs, unless the trouble is due to organic disease. Drugs diminishing sexual appetite may be useful in quieting the centres and rendering them less sensitive to sources of local irritation. It is, however, more sensible to remove the cause of irritation, as smegma preputii, acid urine, urinary calculi, intestinal parasites, scybala, fissure of the rectum, hemorrhoids, etc. Anaphrodisiacs may be employed to subdue excessive sexual excitement and nervousness (hysteria) sometimes accompanying "heat" in the female. (B) Influencing the Female Sexual Organs. (1) Emmenagoyues are drugs which favor the occurrence of "heat" (ovulation) in the female when it is irregular or abnormally absent. We are at present ignorant of their exact mode of action. Some act directly, perhaps, by stimulating the centres or sexual organs. DIRECT EMMENAGOGUES. Savin, Rue, Cantharides (irritants). Ergot. INDIRECT EMMENAGOGUES. Purgatives (Aloes). In debility: Iron, Arsenic, Strychnine, Full diet. Uses. — The irritant emmenagogues are usually ineffectual in medic- inal doses, while they may cause inflammation of the urinary tract and DRUGS ACTING ON THE SEXUAL ORGANS 49 abortion (in pregnant animals) in large doses. The use of the indirect emmenagogues is more rational and effective. Aloes is thought to stimu- late the uterus reflexly by irritation of the large intestines, and may also act locally on the uterus after absorption. Absence of estrum, ordinarily a symptom resulting from a general or local condition, should be treated if possible by removing the cause (anemia, debility, plethora, obesity, deformity of genital tract). (2) Ecbolics, or oxytocics, are drugs stimulating uterine contrac- tion during or directly after parturition. The exact physiological details concerned in their action are unknown except in the case of ergot and pituitrin. They are: Ergot Quinine Pituitrin Hydrastis Cotton root bark Savin Corn smut (3) Drugs restraining uterine contractions. Anesthetics Chloral Cannabis Indica Bromides Uses. — Ecbolics (preeminently ergot) are used to contract the uterus and arrest hemorrhage after parturition; or to stimulate the womb during parturition in inertia. In poisonous doses they may lead to abor- tion during pregnane}'. Drugs restraining uterine contraction (especially opium) are sometimes given to prevent threatened abortion. (4) Drugs influencing milk-secretion. (a) Galactagogues are drugs increasing the flow of milk. They include : Extracts of the pituitary and Alcohol mammary glands. Full diet Pilocarpine Leaves of castor oil plant (internally or locally on udder as poultice). Drug treatment is practically valueless in increasing the secretion of milk; rich feeding is the chief desideratum. Many drugs are elimi- nated in milk and may produce their characteristic effects in animals or man drinking it. Among these are: Opium Arsenic Copper All volatile oils Mercury Carbolic acid Purgative I salts Lead Colchicum Rhubarb Zinc Euphorbium Senna Iron Ergot Castor oil Bismuth Salicylic acid Scammony Neutral salts Veratrine Jalap Ammonia Strychnine Iodine Acids Croton oil Potassium iodide Sulphur Aloes Antimony Atropine Turpentine 50 GENERAL ACTION OF DRUGS (b) Antigalactagogues. — Belladonna is the only efficient drug less- ening the secretion of milk, applied locally or given internally. It paralyzes the peripheral secretory nerve-endings and is useful in mam- mitis by diminishing the circulatory activity in the mammary gland. DRUGS INFLUENCING METABOLISM. (1) Alteratives. — The term "alterative" is a vague, indefinable word used to describe the action of certain drugs modifying tissue change and improving nutrition in some disorders. The word is simply a cloak for ignorance and should be dropped. The value of alteratives has been discovered by clinical experience. The following are often classed as alteratives : Arsenic and its preparations Phosphoric acid Mercury and its salts Colchicum Iodine and its salts Sarsaparilla Cod liver oil Sulphur Uses. — Alteratives are employed in those diseases in which experi- ence has proved them to be beneficial. Tonics. — The word "tonic" is another term even more vague and all-embracing than "alterative/' and, therefore, impossible to define pre- cisely. Tonics improve the general nutrition and health, and, as ordi- narily understood, refer to drugs promoting appetite and digestion (bitter tonics, as gentian) ; the state of the blood (hematinics, as iron and arsenic); or the condition of certain organs (heart tonics, as digitalis; nervines, as strychnine). Strychnine is the best example of a tonic. "Tone" is largely due to reflex activity (response to stimulation) which is preeminently stimulated by strychnine. Tonics are indicated in the treatment of debility (general or special) and anemia. DRUGS INFLUENCING BODILY HEAT. Antipyretics are drugs lowering the temperature of the body in fever. The mechanism concerned with temperature changes is as follows : 1. Heat Production. There are centres for heat-production at the base of the brain (tuber cinereum and corpus striatum), and less im- portant heat-producing centres in the upper part of the spinal cord. 2. Heat Loss. There are centres for heat loss in the cerebrum (cruciate and sylvian), and also at the base, in the tuber cinereum, in- creasing the frequency of respiration. Then the vasomotor and respira- tory centres in the medulla and the sweat centres (probably also situated in the medulla) all contribute to heat loss. This follows from the loss of heat through evaporation of sweat, by the dilatation of the superficial vessels in the absence of sweating, and through the more rapid exchange of air caused by increased frequency of respiratory movements. Heat is also lost in the passage of urine and feces. DRUGS INFLUENCING BODILY HEAT 51 3. Heat Regulation. There are centres in the tuber cinereum, and less important centres in the corpus striatum, which coordinate or adjust the relations between the heat-producing centres and the centres for heat-loss. The result is the uniform, normal temperature existing in health whereby the production of heat, caused chiefly by muscular activ- ity and favored by constriction of the superficial vessels, is balanced by loss of heat — through flushing of the surface vessels, or sweating, and by lessened muscular action and more rapid respiration. In the body the fall of a few degrees of temperature causes shivering or violent muscular action, together with marked constriction of the cutaneous vessels, which leads both to greatly increased heat production and diminished heat loss. The heat-regulating centres may be compared to the thermostat set to keep the temperature of rooms at a fixed point. This instrument acts through the expansion and contraction of metal whereby the heat is turned on or off. As in the thermostat, which preserves a uniform tem- perature by regulating the heat-production and heat-loss, so in the body the heat-regulating centres are set to keep the temperature at the normal point for the species. As one may set the temperature in the thermostat at any given point, within reasonable limits, so in the body the heat- regulating centres may be set at a higher or lower level. In fevers toxins set the heat-regulating centres at a higher point, while certain drugs set these centres at a lower level. The highest temperatures fol- low violent muscular action in the rigors of certain fevers. When the heat-regulating centres regain control, and stimulate the centres for heat- loss, sweating occurs and the fever rapidly falls (malaria). Fever is due chiefly to increased heat-production, combined with a certain diminution in heat-loss. Very recently it has been discovered that adrenalin secretion plays an important role in the production of fever. Adrenalin seems to be essential as an activator of the brain, enabling it to convert latent energy into heat and motion. The brain, liver and adrenals form a kinetic system for this end. To use a mechanical simile, the brain is the battery, adrenalin is the oxidizer, the liver is the gasoline tank (glycogen), and the muscles are the furnace in which combustion occurs. To go a step further it appears that the thyroid gland is the pacemaker, since it regu- lates the rate of discharge of energy. Is fever beneficial? Artificial heating of animals to a temperature of 104° F., after injection with fatal doses of bacteria, caused half to survive while all the controls died. Again, the factitious production of a chill in animals subjected to experimental infections, caused a subsequent fever and cure of the infection. Fever is probably the result of toxins. Whether these do or do not directly act on the heat-regulating centres is unknown. Action. — Now as to the precise action of antipyretics. Some act by diminishing metabolism, as quinine. Some dilate the superficial vessels and may also cause sweating, as salicylic acid, alcohol, ammonium acetate, nitrous ether, opium and ipecac. Some act by depressing the circulation, as aconite, veratrum, digitalis, antimony and venesection. These lessen metabolism. The modern, coal-tar antipyretics, as acetanilid, antipyrin 52 GENERAL ACTION OF DRUGS and phenacetin, act directly on the heat-regulating centres, either to increase their resistance to the action of the toxins of infections, or to lower the point at which the temperature of these centres is set — to use the thermostat analogy. Such agents also strengthen the control of the heat-regulating centres over the centres for heat-loss, and may or may not cause sweating. In excessive doses their depressing effect on the cir- culation is so marked that collapse may occur. That they act centrally is shown by the fact that they fail to act when the spinal cord is cut. They do not act in health because of the absence of disturbance of the heat-regulating centres by toxins. They do not act by diminishing heat- production — as lias been hitherto taught — since metabolism is not notably lowered by them. Acetanilid increases metabolism. They do not depend upon sweating, as they act under the influence of atropine which prevents diaphoresis. Uses. — Antipyretics are used to diminish fever. It is wiser to employ the coal-tar products for this purpose because they are not only more effective but also promote comfort by their sedative influence on the nerv- ous system. They are, however, generally contra-indicated unless fever is high or long-continued, since it has been pointed out that high tempera- ture is a natural protective agency in destroying toxins and bacteria. Cold is the best antipyretic measure, when it can be employed, in not only lowering fever and increasing the elimination of toxins in the urine, but in powerfully stimulating the vital nerve centres. (See p. 497.) DRUGS ACTING ON THE SKIN. (A) Drugs Influencing the Blood Vessels of the Skin (1) Locally dilating superficial vessels. IRRITANTS OR COUNTER-IRRITANTS. Cantharides Corrosive mercuric chloride Iodine Arsenous acid Mustard Silver nitrate Capsicum Zinc chloride Croton oil Carbolic acid Oil of turpentine and other Mineral acids volatile oils Caustic alkalies Ammonia water Anesthetics and alcohol (when evap- Camphor oration is prevented) Red mercuric iodide Heat Drugs are classified as follows, according to the degree of irritation they produce: Rubefacients are drugs which cause vascular dilatation and redness of the skin when locally applied, such as mustard and iodine (and heat). Vesicants are drugs producing inflammation of the skin and exuda- tion of serum under the epidermis (vesicles), when locally applied, such as cantharides. DRUGS ACTING ON THE SKIN 53 Pustulants are drugs inducing a still higher grade of inflammation when locally applied, accompanied by migration of leukocytes from the vessels into the vesicles, forming pustules. Caustics, or escharotics, are agents which, when locally applied, lead to so great a degree of irritation that the vitality of tissues is destroyed, e.g., nitric acid, caustic potash and the white-hot iron. Uses. — Irritants are often called counter-irritants when they are used against (counter) existing irritation or inflammation by reflexly causing contraction of vessels in congested or inflamed underlying parts. Thus a blister on the chest leads to contraction of the vessels in the inflamed pleura and relieves pleuritis. Counter-irritants are, therefore, employed locally to overcome internal congestion and inflammation. Rubefacients are often applied over the whole surface of the body (mus- tard and turpentine) to dilate superficial vessels and equalize the circula- tion in colds, chills and internal congestions. Vesicants are used to alter the circulation and nutrition of adjacent parts and to secure resolution and absorption of inflammatory products in joint and periosteal disorders. (For details see Counter-irritants, p. 491.) (2) Locally contracting superficial vessels. Astringents are drugs which, when locally applied, make the tissues drier and denser and lessen secretions. Their action is probably depen- dent on various factors: partial coagulation of the albuminous fluids of the tissues; coagulation of morbid secretions; removal of water; and contraction of the muscular coat of the blood vessels. They are local irri- tants with the exception of lead acetate and bismuth salts. The astrin- gents are: Lead Adrenalin Aluminum Tannic acid, and drugs containing it Zinc Hydrastis Salts «< Silver Cocaine Copper Antipyrin Ferric Methylene chloride / On evapora- Bismuth Ether \ tion Hamamelis Cold Ergot Styptics, or hemostatics, are drugs which arrest hemorrhage, when locally applied, both by coagulation of albumin of the blood and by direct contraction of the vessels and tissues surrounding them. Adrenalin and solutions of ferric alum, ferric chloride and subsulphate are the most powerful styptics, although all astringents possess an hemostatic action. Uses. — Astringents are employed in local loss of tone and relaxation of tissues accompanied by serous, mucous or purulent exudation from mucous membranes or raw surfaces. The irritating astringents are usually contra-indicated in acute inflammatory conditions, but are thought to prevent the out-wandering of leukocytes through the blood vessels, which results in purulent exudation. Styptics are employed in the treatment of hemorrhage from mucous 54 GENERAL ACTION OF DRUGS membranes, or in bleeding from other parts which cannot be stopped by surgical means, heat or cold. The coagulated blood is prone to sepsis, speedy decomposition and infection. (B) Drugs Locally Softening, Soothing and Protecting the Skin, Emollients. They include: Olive oil Lard Cottonseed oil Petrolatum Lanolin Cacao butter (Fomentations — Poultices) Demulcents are drugs exerting a soothing, protecting and softening influence on the mucous membrane of the alimentary canal, when given internally. They are mostly gums, syrups and albuminous fluids, as : Acacia Glycerin Linseed infusion or tea White of egg Liquorice Milk Syrup Starch • Molasses Sweet oil Honey Uses. — Emollients are serviceable in softening the skin when it has a tendency to be dry and fissured; also in chafing and superficial inflam- mation when emollients protect the skin from the natural irritation of the air. Demulcents are of value in inflammation of the mucous membrane of the digestive tract (olive oil, not starch or gums, which may decompose and irritate), and again in catarrh of the mucous membrane of the upper respiratory tract, because they exert a direct sedative influence on the throat, and either reflexly or in some measure directly, act on the bron- chial tubes. Demulcents are often employed to relieve irritation in the urinary tract, but after their decomposition in the alimentary canal and absorption into the blood they can not act as such. They act chiefly by supplying water. (C) Drugs Influencing the Secretions of Sweat. The mechanism controlling the sudoriferous glands and secretion of sweat, comprises sweat centres in the medulla and spinal cord; secretory nerves proceeding from them with terminations in the glands; the gland cells, and blood vessels of the skin. Any portion of this mechanism may be affected by drugs to increase or diminish sweat secretion. (1) Druys increasing the secretion of sweat, or diaphoretics. They may: (1) Stimulate the sweat centres. (2) Excite the secretory nerve-endings in the glands. (3) Increase the activity of the gland cells. (4) Stimulate the vasodilators and increase the vascularity of the skin. Stimulation of the secretory and of the vasodilator nerves usually go hand in hand, since they accompany each other in their course to the sweat glands. DRUGS ACTING ON THE SKIN 55 DIAPHORETICS. Pilocarpine Alcohol Spirit of nitrous ether Nitrites Volatile oils (reflexly stimulate the circulation, as camphor) Heart stimulants Ipecac and nauseants (relax vessels) External heat Preventing loss of heat (blankets) Warm drinks Antimony salts Solution of ammonium acetate Opium Camphor Ipecac Potassium acetate Potassium citrate Aconite The latter stimulates the gland cells, or secretory nerve-endings. . The others act indirectly by pro- moting the vascularity of the skin, and thus the activity of the sweat glands. Stimulate sweat centres 1 Action unknown (2) Drugs diminishing the secretion of sweat, or anhidrotics. They may depress the various parts of the mechanism which are stimulated by diaphoretics. They are: Atropine Belladonna Hyoscyamus Stramonium Cold externally Paralyze secretory nerve- endings Acids Zinc salts Xux vomica I Action undeter- Quinine mined Salicylic acid (locally) Uses. — There are two indications for the use of diaphoretics. First, to bring blood to the surface and to cause sweating, thus equalizing the circulation in "colds," chills and congestions and reducing temperature in fever by evaporation and radiation of heat from the skin. Ammonium acetate, alcohol and spirit of nitrous ether are commonly used in the treatment of the disorders first noted, but acetanilid and phenacetin are more powerful antipyretics. Second, to eliminate morbid material from the blood in failure of the kidneys, as urinary suppression, or uremia. These conditions are comparatively rare in veterinary practice. The skin of the lower animals generally is much less responsive to diaphoretics than that of man, while horses and cattle are more susceptible to these agents than dogs, cats or pigs. A warm covering and atmosphere assist the dilation of the peripheral vessels and activity of the gland cells and should always be obtained to aid diaphoresis. Anhidrotics are of little service in veterinary medicine. Excessive sweating is usually a sign of debility and is remedied by rest, tonics and good feeding. 56 GENERAL ACTION OF DRUGS DRUGS WHICH DESTROY MICROORGANISMS AND PARASITES. (1) Disinfectants or germicides are agents which destroy the micro- organisms causing infectious and contagious diseases, fermentation and putrefaction. Examples : Corrosive mercuric chloride Sulphurous acid Carbolic acid Chlorine Lime Heat Chlorinated lime (2) Antiseptics are agents which prevent the growth and develop- ment of the microorganisms occasioning fermentation, putrefaction and disease; more especially the micrococci producing suppuration. Those used externally for surgical purposes art:: Iodine and its tincture Lysol Salicylic acid Chlorazene Hydrogen dioxide Aristol Dichloramine-T Potassium permanganate Iodol Alcohol Zinc chloride Boric acid Carbolic acid Zinc sulphate Benzoin Corrosive sublimate Formalin Thymol Creolin Iodoform Balsam of Peru Cresol Antiseptics which are given internally : Naphtol Bismuth salicylate Salol Bismuth subnitrate Creolin Quinine Carbolic acid Volatile oils and others Deodorants, or deodorisers, are agents which destroy or counteract a foul odor. Those possessing any real value are also disinfectants and antiseptics, and remove the source of the odor, (For further details see special article on disinfectants, antiseptics and deodorants, p. 505.) Anthelmintics, vermifuges or vermicides are drugs which kill or expel worms, such as the various species of tapeworm, roundworm, pinworm, whipworm, etc. The term is also used to cover drugs removing such parasites as bots, which are not worms. These drugs are supposed to be relatively insoluble, but investigation has shown that they are usually absorbed in large part. Anthelmintics removing tapeworms : Aspidium (horse and dog) Calomel Aid in Oil of turpentine Aloes expulsion Kousso Linseed, cottonseed of dead Areca nut (sheep) or castor oil parasites Pumpkin seed Anthelmintics removing ascarids: Horses. Creolin Copper sulphate Oil of turpentine Carbon bisulphide Arsenic DRUGS WHICH DESTROY MICROORGANISMS AND PARASITES 57 Dogs. Santonin Spigelia Oil of chenopodium Anthelmintics removing pinworms : By mouth, cathartics, oil of chenopodium, thymol. Rectal injections containing salt, solution of lime, quassia, iron salts, phenol (1/4 of 1% solution), tannic acid (oss-Oi), and oil of turpentine (*ss-Oii) are used to destroy these parasites infesting the lower bowel. Anthelmintics removing strongyles: Thymol Copper sulphate Oil of chenopodium Chloroform Turpentine Anthelmintics removing bots (Gastrophilus spp.) Carbon disulphide Anthelmintics against lungworms : Carbolic acid (Intratracheal injections) Turpentine (Intratracheal injections) Chloroform (Injections in nostrils) Vermifuges are purgatives (as aloes and oil) used to expel dead parasites from the bowels after the administration of anthelmintics. Parasiticides, or antiparasitics, are drugs which destroy parasites, more especially those inhabiting the skin. We may classify them as those used: (1) Against fungi of ringworm and favus (Trichophyton spp.) Mercurial ointments Chrysarobin oint- Salicylic acid Tincture of iodine ment Boric acid Glycerite of phenol Cantharides Thymol Creolin Croton Oil Sulphurous acid Creosote Formalin (2) Against ray fungi of lumpy jaw, etc. (Discomyces or Acti- nomyces spp.) Tincture of iodine Iodoform Potassium iodide Copper sulphate Glycerite of carbolic acid Corrosive sublimate (3) Against fungi of thrush or aphtha, sporadic aphthous stomat- itis (Oidium albicans). Boric acid Alum Potassium chlorate Salicylic acid Potassium permanganate Hydrochloric acid (4) Against mites of scab, itch or mange. Sulphur Styrax Lime-sulphur dips Phenol Sulphur dioxide Corrosive sublimate Tar Salicylic acid Crude petroleum Cantharides Peruvian balsam 58 GENERAL ACTION OF DRUGS (5) Against lice. Staphisagria Creolin Oil of tar Tobacco Peruvian balsam Pyrethrum Styrax Arsenical dips Oil of anise Coal-tar preparations Phenol Creosote preparations (6) Against fleas. Pyrethrum Creolin Carbolic soap . Coal-tar preparations Oil of anise Creosote preparations (For details concerning the use of parasiticides, see special articles on the drugs enumerated above and p. 598.) PHARMACY. The More Important Medicinal Bodies and Principles Contained in Drugs. Alkaloideum, pi. alkaloide a, — alkaloids. Characteristics: 1. Alkaloids are nitrogenous bodies, being the active principles of many vegetable drugs. 2. They resemble mineral bases in that they have an alkaline reac- tion and unite with acids to form soluble crystalline salts. Hence their name, alkaloids. 3. Chemically they are ammonia compounds. One or more atoms of hydrogen (in NH3) are replaced by various radicals. 4. They are mostly insoluble in water, but very soluble in alcohol. Solutions possess a bitter taste. 5. They are similar to animal alkaloids (ptomaines) and probably have a like origin, i.e., from the decomposition of albuminoid material. Thus the symptoms of some kinds of ptomaine poisoning (sausage) re- semble those of plant alkaloid poisoning (atropine). Animal alkaloids (leukomains) may also be formed by body cells, as products of metabol- ism; viz., adrenalin. 6. Alkaloids are precipitated in solutions by tannin, forming insoluble tannates. They are usually solids and their salts are soluble and convenient for hypodermic use. 8. Their Latin ending is ina; English, ine; viz.: Morphina, mor- phine. Examples: An alkaloid of cinchona is quinine; of belladonna, atro- pine. Glucosideum, pi. glucosidea. — Glucosides are neutral, non-nitrogenous organic bodies, representing the active principles of many vegetable drugs. They yield glucose and other substances on decomposition. Hence their name. Their Latin ending is inum-j English, in; viz., salcinum, salicin. Examples: A glucoside of digitalis is digitalin; of santoninum is santonin. Oleum, pi. olea. — Fixed oils are combinations of glycerin with fatty acids ; usually oleic, stearic, margaric or palmitic acids. They are liquid at ordinary temperatures and soluble in benzin, chloroform and ether. Exposed to the air they undergo acid fermentation, resulting in "rancid- ity." Fixed oils are expressed from fruits and seeds of plants and animal tissue. They are "fixed" because they cannot be distilled. They leave a greasy mark on paper. Examples: Cod liver oil, castor oil, olive oil, linseed oil and croton oil. Oleum, pi. olea. — Fats are solid, fixed oils. Examples: Lard, cacao butter. 60 PHARMACY Oleum destillatum, pi. olea destillata. — Distilled oils are obtained by the distillation of flowers, fruits, leaves or seeds of plants; by macera- tion, infusion, expression ; or by extraction with solvents. They are either liquid or solid and possess an aromatic odor and taste. They are lighter than water, and soluble in alcohol, ether, and very slightly soluble in water. Distilled oils are miscible with fatty substances and mineral oils. They do not leave a greasy mark on paper. Synonyms: Essential oils, volatile oils and ethereal oils. Alcoholic solutions of these oils are known as essences. Examples: Oil of peppermint, oil of cloves, oil of wintergreen. Oleo-resina, pi. oleo-resinae. — Oleo-resins are semi-solid mixtures of resins and volatile oils. Many are natural products, exuding from trees, as crude turpentine, which contains the volatile oil of turpentine and a resin, or what is commonly termed "rosin." They are soluble in ether. Examples: Oleo-resin of capsicum, oleo-resin of aspidium. Resina, pi. resinae. — Resins are brittle, amorphous solids, soluble in alcohol and alkalies. They are obtained from oleo-resins by simple dis- tillation, as in the case of turpentine; or may be extracted from plants by means of heat or alcohol. Examples: The resins of Burgundy pitch and podophyllum. Balsamum, pi. balsama. — Balsams are oleo-resins with the addition of either cinnamic or benzoic acids, or both. They are solids or liquids. Examples: Balsam of Peru, balsam of Tolu. Gummus, pi. gummi* — Gums are solid exudations from plants. They are generally soluble in water, and their solutions are precipitated by alcohol. Example: Gum acacia. Gum resina, pi. gum-resinae, are solid exudations from plants con- sisting of a mixture of a gum and a resin. Pharmaceutical Processes. Many of the technical methods are those employed in chemistry, but of those more especially used in pharmacy are the following: Processes of Mechanical Division. Slicing. — This prepares the drug for further reduction, and is the first of all pharmaceutical processes. Bruising or Contusion. — Consists in breaking the drug by force, and is usually performed with an iron mortar and pestle. Rasping or Filing. — For those drugs not easily reduced by the for- mer process, as guaiac wood. Trituration. — Performed with mortar and pestle. The effect pro- duced where there is a circular motion, accompanied by pressure. Grinding and Sifting. — In order to exhaust drugs some must be ground and sifted to a finer powder than others. To accomplish this, *Gummi (indeclinable noun), often used for gum or gums. PHARMACEUTICAL PROCESSES 61 after grinding, we use sieves of different degrees of fineness, designated by numbers 20, 40, 60, 80, 100. These have reference to the number of meshes contained to the square inch. Therefore, when a 60 powder is directed to be used, it is that which will pass through a sieve containing 60 meshes to the square inch. Levigation. — Somewhat similar to trituration, but performed with a slab and muller. These should be made of glass, or some non-absorbent material, Elutriation. — This consists in mixing the powder, obtained by some of the former comminuting processes, with water; agitating it; allowing the coarser particles to settle, and pouring off the supernatant liquid which holds the finer particles in suspension. The powder settles from the latter and is dried. Mechanical Processes. Processes by which, liquids are separated from solids, and by which active principles and soluble constituents are separated from the inert portion of the drug. * Decantation. — The process by which solids are allowed to subside in a mixture and the supernatant liquid is slowly poured off or decanted. Liquids which will not mix, or that are of different specific gravity, may be decanted one from the other. Filtration. — This is the process of separating a solid insoluble sub- stance from a liquid by passing the liquid containing it through a porous substance called a filter. The filter commonly used consists of unsized or bibulous paper, although cotton, muslin, felt, earthenware, and other sub- stances are employed. Percolation consists in the following process : A pulverized vegetable drug (containing both soluble and insoluble constituents) is placed in a conical vessel, or percolator, and subjected to the action of a liquid called a menstruum, when the soluble portion, or percolate, flows from the lower opening. The menstruum as it descends becomes more and more saturated with the soluble constituents of the drug. The first that escapes is the strongest, and each successive portion of the percolate becomes weaker until the drug is exhausted. The percolate should not drop faster than 10 drops per minute. Percolation is employed in making tinctures, fluid and solid extracts, syrups and some other fluid pharmaceutical prepara- tions. Clarification. — Is the process whereby cloudy substances are made clear by the addition of some coagulable substances, as albumin or ichthy- ocolla. It is the adding to any fluid, containing a sediment, a substance which will carry down all undissolved particles, then filtering or decant- ing the liquid. Chemical Processes Used in Pharmacy. Solution. — The process by which soluble substances assume the fluid state through the action of a liquid. Lixiviatian. — Employed to separate a soluble constituent from an in- soluble porous body. The substance to be lixivated is mixed with water 62 PHARMACY and placed in a conical vessel, the bottom of which is covered with straw or coarse sand, and, after maceration has continued sufficiently, the satu- rated portion, called the lye, is drawn off from an opening in the lower part of the vessel. Crystallization. — Is the concentration of a liquid containing a soluble solid by means of heat, when on allowing it to stand until cool, crystals form. Stirring during cooling will produce granulation. Solution, filtra- tion and crystallization are the three best ways of obtaining pure salts. Processes Requiring the Application of Heat. Liquefaction. — Is the melting of substances which at ordinary tem- perature are hard, and when cool return to the same condition as before heating, as resin, wax, lard, tallow. Evaporation. — Is the conversion of a liquid into steam or vapor. Liquids which evaporate at ordinary temperature arc called volatile, as alcohol. To keep the heat below the boiling point of water, we use the water bath, which cannot reach a higher temperature than 100° C. To gradually increase the heat, use the sand bath. Distillation. — Is the vaporization of a liquid in a retort or a still, by heat, and conduction of the vapor through a cooled tube, where it is condensed and passes into a receiver and is called the distillate. Distilla- tion is used to purify liquids or recover a volatile liquid from a solid, solution or mixture. Where two liquids are mixed that have different points of vaporization and are separated in this way, the process is called rectification. Sublimation. — Distillation of a volatile solid. When the product is in a solid form, it is called a sublimate, as iodine, camphor, etc.; when in flakes, it is called flowers, as sulphur. Maceration. — A term used to denote the action of liquids upon drugs at ordinary temperature. Digestion. — Same process, with heat raised to 40° C. Menstruum. — Any fluid substance used to dissolve a solid body or extract its medicinal principles. Excipient. — Any substance used to give a pill mass proper con- sistency. Exsiccate. — The process of removing all moisture, even the water of crystallization, from a crystal, by the use of heat. Desiccate. — To remove all excess moisture. Heat not usualty employed in this process. Incineration. — The combustion of a substance for its ashes. Reduction is employed to recover a metal in its purity, when in a combined state. OFFICIAL PREPARATIONS 63 Pharmaceutical Preparations. The "United States Pharmacopeia" is an authoritative book, includ- ing the drugs in most common use, with a description of their properties, tests for their purity, and methods for making their preparations. It is revised each decade by a convention of representative delegates from medical schools and societies, schools of pharmacy and pharmaceutical associations, with the collaboration of medical officers of the army, navy and public health service. The last edition dates from September 1, 1916. All matter occurring in the "Pharmacopeia" is said to be accord- ing to the U. S. P., or official. That occurring in the "British Pharma- copeia" is marked B. P. The dispensatories in the United States are three: The United States, National and Kings, which contain all matter in the Pharmacopeia and much besides pertaining to materia medica and therapeutics. The National Formulary is published by the American Pharmaceutical Society and contains important formulae not included in the U. S. Pharmacopeia. Official Preparations. I. — Preparations Whose Solvent Is Water. Decoctum, pi. decocta. — Decoctions are solutions of crude drugs in water, obtained by boiling. Unless specified otherwise, their strength is 6 per cent., and the boiling is conducted fifteen minutes. Decoctions tend to undergo rapid decomposition, and are suitable only in case of those drugs whose active principle is soluble in water. They are unsuit- able when the active principle of a drug is volatile, decomposed by heat, or when it contains much starch, which would form an easily decompos- able, thick mass. Drugs containing hard, woody substances, especially albumin, which coagulates in boiling and remains in the crude drug, are those especially adapted for this method. Infusum, pi. infusa. — Infusions are aqueous solutions of drugs made by maceration in cold or boiling water, without the aid of ebullition. Maceration is done for half an hour, and the strength is 5 per cent., unless otherwise ordered. The same disadvantages apply in the case of infusions as with decoctions, in addition to the longer time required for their preparation. Some drugs, as digitalis or ergot, which yield their active principles to water and are more powerful when freshly made, are suitable for this process. Liquor, pi. liquores. — Solutions are preparations holding active non- volatile principles in solution in water. They have no uniform strength. Aqua, pi. aquae. — Waters are aqueous solutions of volatile principles. They have no uniform strength and are mostly solutions of volatile oils or gases. Mistura, pi. misturae. — Mixtures are compounds consisting of a com- bination of fluid preparations or compounds in which solid substances are dissolved or held in suspension by an appropriate vehicle. The term is thus very comprehensive, including most prescriptions for fluids used 64 PHARMACY in practice, but more narrowly it applies in pharmacy to insoluble mate- rials suspended by suitable vehicles in water, the whole to be shaken before using. They have no uniform strength. Emulsum, pi. emulsa. — Emulsions are similar to mixtures in that an oily substance in a state of fine division is held in suspension in a gummy or albuminous vehicle. They have no uniform strength. Syrupus, pi. syrupl. — Syrups are saccharine solutions. The vehicle is usually water, although vinegar and alcohol may be used, and they are all medicated except the simple syrup. They are not of uniform strength. II. — Preparations Whose Solvent Is Alcohol. Tinctura, pi. tincturae. — Tinctures are alcoholic solutions of non- volatile principles, made usually by maceration and percolation of the crude drug. They vary in strength; the more powerful drugs in 10 per cent., the weaker drugs in 20 per cent, solution. The alcohol in tinctures is often an important factor in the action of the preparation. Strong or diluted alcohol is used according to the solubility of the active principle. Spiritus, pi. spiritus. — Spirits are alcoholic solutions of volatile sub- stances, either gases or liquids or solids. They have no uniform strength. Elixir, pi. elixirs. — Elixirs arc alcoholic solutions of drugs containing sugar and aromatic substances. III. — Preparations Having Wine as a Solvent. Vinum, pi. vina. — Wines are weak tinctures containing a small amount of alcohol, the remainder of the solvent being white wine. They are no longer official. IV. — Preparations Having as a Solvent Diluted Acetic Acid. Acetum, pi. aceta. — Vinegars are solutions of the active principles of drugs in acetic acid prepared by maceration and percolation. They are not of uniform strength. V. — Preparations Made by Solution and Evaporation. Extraction, pi. extracta. — Extracts are concentrated preparations of the crude drug. Ordinarily alcoholic solutions of the crude drug are obtained by maceration and percolation, and then evaporated to a pasty mass. They are usually stronger, weight for weight, than the crude drug, but are not of uniform strength. Fluid extr actum, pi. fluidextracta. — Fluidextracts are permanent, con- centrated medicinal solutions of uniform strength. 1 mil of the fluid- extract is equivalent to 1 Gm. of the crude drug. This result is obtained by percolation (usually with alcohol) and partial evaporation.* VI. — Preparations Made by Distillation or Occurring Naturally, as Exudations from Trees. Oleo-resina, pi. oleo-resinae. — Oleo-resins are officially extracts ob- tained by percolation of the crude drug with ether, and evaporation of the solvent. They have no uniform strength. *The last (ninth) edition of the U. S. Pharmacopeia directs that many of the fluidextracts be assayed so that they will contain a definite prescribed amount of the active principle. OFFICIAL PREPARATIONS 65 VII. — Preparations Made By Mechanical Processes. Pulvis, pi. pulveres. — Powders are preparations of finely pulverized drugs. Sugar of milk is frequently added, on account of its hardness, to aid in pulverization and as a diluent. Comparatively tasteless, non-irri- tating and often insoluble drugs are given in this form. Drugs that are volatile, deliquescent or irritating are otherwise administered. Powders are used to advantage in veterinary practice, since they are often taken voluntarily on food. Trituratio, pi. triturationes. — Triturates are combinations of drugs and sugar of milk, prepared by trituration. They occur in powder or are pressed into tablets. Oleum, pi. olea. — Fixed oils are usually obtained by mechanical ex- pression from the product of plants or the tissue of animals. Pilula, pi. pilulae. — Pills are preparations of drugs made into globu- lar form by the addition of a suitable excipient, and should be of a con- venient size for swallowing. Massa, pi. massae. — Masses are pasty mixtures suitable for making pills. Suppositorium, pi. suppositoria. — Suppositories are medicinal sub- stances incorporated with cacao butter and moulded into solid, usually conical, bodies intended for introduction into the rectum or vagina, where they melt at the temperature of the body. Confectio, pi. confectiones. — Confections are pasty masses, consist- ing of powder incorporated with syrup. VIII. — Preparations Intended for External Use. Linimentum, pi. linimenta. — Liniments are liquid preparations with an oily, alcoholic or soapy basis. Oleatum, pi. oleata. — Oleates are medicinal solutions in oleic acid. Vnguentum, pi. unguenta. — Ointments are preparations having a fatty basis (80 per cent, of lard). Ceratum, pi. cerata. — Cerates are similar to ointments but harder, owing to the addition of 10 per cent, more wax. Glyceritum, pi. glycerita. — Glycerites are preparations whose solvent is glycerin. Emplastrum, pi. emplastra. — Plasters are solid, sticky, supple prep- arations intended for application to the skin, where they become adhesive at the temperature of the body. In veterinary parlance they are often known as "charges." Charta, pi. chartae. — Papers are fragments of medicated paper. Collodium, pi. collodia. — Collodions are solutions of gun cotton in ether and alcohol, leaving a thin, dry, adhesive coating when applied externally. IX. — Preparations Having Honey as an Excipient. Mel, pi. melita. — Honeys. IX. — Non-Official Preparations Peculiar to Veterinary Practice. Bolus, pi. boli. — Balls are substitutes for pills. They are of elongated, cylindrical shape, about two and one-half inches long, and should weigh about two ounces when intended for horses. Various excip- 66 PHARMACY ients are used to make a mass of the proper consistency. For immediate use, molasses and licorice root may be employed, and brown tissue paper is used as a covering for the balls. Gelatine capsules may take the place of the balls, and should be covered with paper to prevent slipping through the fingers when wet with saliva. Linseed meal is a good excipient on account of its gum. Soap is often used, and glycerin makes a good preservative and keeps the mass moist. Heat is often necessary in preparing a ball mass when the materials are resinous (as aloes) or waxy. A ball is given to a horse by holding it in the right hand, the tips of the fingers and thumb surrounding it in the form of a cone. The tongue of the animal being drawn to the operator's left with his left hand, the right is then quickly passed along the roof of the patient's mouth (avoiding the edges of the back teeth) until the back of the tongue is reached, when the ball is dropped, the right hand rapidly removed and the tongue released. If the mouth is narrow or the animal unmanageable, a balling iron or speculum is used to keep the mouth open. The horse may be backed into a narrow stall and the head steadied by an attendant with the assist- ance of a "twitch" on the nose. Substances of an irritating nature may be given in this form, and balls are also used when the disposition of the patient does not admit the giving of a drench. Haustus, pi. haustiis. — A drench is an extemporaneous fluid mixture, intended for immediate use as a single dose. Soluble substances are best given in solution to obtain the most rapid results, unless irritating. Even then they may be preferable when suffi- ciently diluted with water and demulcents. Insoluble drugs may at times be given to advantage in a mixture rather than in the form of a ball or powder. Most official fluid preparations require dilution before admin- istration, but for convenience small doses of tinctures and fluidextracts are dropped upon the tongue of horses unless the preparations at 2 excep- tionally acrid. Drenches are particularly applicable for cattle and sheep, as solids are not quickly absorbed in their capacious digestive apparatus, and drenches are given them with ease. The amount of liquid conveniently administered to horses is from one to two pints ; to dogs, from two to four ounces ; to sheep, six to eight ounces. Cattle take readily unlimited quantities. Care should be ob- served that drenches are so diluted as to be harmless to the mucous mem- brane, and, if containing insoluble drugs, that these be held in suspension by a suitable vehicle or thoroughly shaken before using. Drenches are best given to horses by making a loop on the end of a rope, passing the upper jaw through this, the other end of the rope being passed through a pulley in the ceiling and held by the operator or assistant. The horse should be first backed into a narrow stall. The neck of the bottle (which should properly be made of horn or tin) containing the drench, being introduced and held in the right hand of the operator between the out- side of the back teeth and the inside of the cheek of the patient, the left hand is used to steady the nose of the animal, but the nostrils should not be obstructed. OFFICIAL PREPARATIONS 67 In giving drenches to cattle the operator stands on their left and passes his right arm between the horns over the poll and down in -front of the face, grasping the nasal septum between the thumb and forefinger. The neck of the' bottle is then thrust with the left hand into the animal's mouth. Dogs are given drenches with the aid of an assistant, who holds the mouth closed with one hand, while he makes a cup by pulling the cor- ner of the lip away from the teeth with the other hand, into which the medicine may be slowly poured, the animal easily swallowing it. Small dogs may be placed sitting upon a table. A large dog may be put upon his hind quarters in a corner, and his head held between the knees of the operator. Cats are given drenches by rolling them in a heavy blanket with only the head out and the jaws held apart by means of two loops of tape about either jaw behind the incisor teeth. The jaws are then pulled apart by drawing on either loop from above and below the animals head. Sheep may be drenched by backing them into a corner and by holding the head of the animal between the knees of the operator. Drenches should never be poured into animals if in an unconscious condition, for then they are unable to swallow, and the fluid may gravitate into the trachea. If coughing ensues during the administration of a drench, the procedure should be immediately stopped. A pint syringe may be used to drench the larger animals. The jaws are held closed by a strap or rope about the head and the lips held to- gether by an attendant. The nozzle of the syringe^ or a rubber tube connected witli it. is introduced at one corner of the mouth and the fluid injected toward the back of the tongue. Electuar'uim, pi. electuaria. — Electuaries are medicinal pastes in- tended to be smeared on the teeth of animals, where they melt at the temperature of the body and become absorbed. Molasses, honey, glycerin, syrup or mucilage are used as excipients. Electuaries are used for their local action on the mouth and throat, and for convenience in administra- tion, if so crude a method may be thus described. A certain specified quantity of the electuary may be weighed by the dispenser and served as a sample, or a domestic utensil may be employed to measure the dose, which is smeared witli a thin, flat stick on the back teeth or tongue of the patient. INCOMPATIBILITY. Before entering the study of prescription writing, it is essential to consider the results of improper combination of drugs, i.e., incompati- bility. While a knowledge of chemistry, pharmacy and the physiological actions of drugs is necessary to avoid incompatibility, it is yet possible to formulate certain rules which will assist us in escaping unfortunate combinations. Incompatibility is conveniently divided into three classes: I. Chem- ical. II. Physical. III. Physiological. I. Chemical incompatibility occurs when drugs are so mixed that an unsuitable alteration in their chemical composition takes place. Certain substances should usually be prescribed alone because of the frequency with which chemical changes arise when they are combined with other medicines. These are: Lead, silver and zinc salts Mineral acids Iodine and iodides Solution of potassa and lime Tannic and gallic acids Quinine sulphate Liquid iron preparations Hydrocyanic acid Corrosive sublimate The possibilities of the following combinations must be kept in mind to avoid incompatibility: 1. Solutions of alkaloids are incompatible with tannic acid, alkalies, alkaline salts, and iodides and bromides, because precipitation occurs. 2. Glucosides are decomposed by acids and are, therefore, incom- patible with them. 3. Acids may not be added to alkalies, alkaline salts or vegetable acid salts, because decomposition and chemical change will ensue. 4. A mixture of salts in solution will decompose if either an insolu- ble compound or double salt can be formed; otherwise no change will take place. N 5. Chloral is incompatible with alkaline solutions, because chloro- form is generated. 6. Chloroform and potassium cyanide form prussic acid. 7. Potassium chlcrate, nitrate, or permanganate, liberates oxygen and should not be mixed with readily oxidizable substances, such as char- coal, sugar, sulphur, glycerin, carbolic acid, iodine, turpentine and organic materials, lest explosive compounds be formed. 8. Lime water precipitates mercury salts. 9. Both calomel and antipyrine are incompatible with sweet spirit of nitre. 10. Calomel may not be combined with nitrohydrochloric acid lest corrosive sublimate result. 11. Calomel and prussic acid form the poisonous mercuric cyanide. 12. Liquid iron compounds are incompatible with fluid preparations INCOMPATIBILITY 69 of the vegetable bitters (except those of calumba and quassia), because the tannic acid in them throws down a precipitate. 13. Considerable quantities of acid are incompatible with tinctures, since ethers are produced. 14. Water precipitates resinous tinctures. 15. Gum arabic is incompatible with lead and iron salts, and min- eral acids. 16. Strychnine is precipitated in solution by potassium bromide. 17. Pepsin and pancreatin are mutually destructive in fluid com- bination. 18. Solutions of potassium chlorate and iodide unite to form a poisonous compound. It is beyond our scope to attempt the enumeration of all possible drug-incompatibilities. The special incompatibilities of each drug may be found under the proper heading in the detailed description of them. Fur- thermore, we may avoid incompatibility by (above all) simplicity in prescription writing, i.e., the use of a few drugs in combination. Water or alcohol are generally the best solvents. II. Physical incompatibility consists in the production of unsightly- looking mixtures, but without necessarily causing any chemical alteration of their ingredients ; for example, the addition of water to insoluble pow- ders, oils and chloroform. While such combinations are pharmaceutically improper, they may sometimes be used to advantage in practice. III. Physiological incompatibility consists in the union of drugs possessing antagonistic physiological actions. For instance, the com- bination of purgatives and astringents; of morphine and atropine; of digitalis and nitroglycerin. Such prescriptions may be valuable therapeu- tically when the antagonism is not complete. This follows because, while deleterious action of one drug may be offset by another, its beneficial effect may at the same time exist or be accentuated. Thus the anodyne influence of morphine is increased by combination with atropine, but both the depressing action of morphine on the respiration and its constipating tendencies nre lessened by atropine. PRESCRIPTION WRITING. Words and Phrases Commonly Used in Prescription Writing, with Their Abbreviations. LATIN WORD. Acidum Ad Ad libitum Adde Ana Aqua fontana Aqua destillata Bene Bis in dies Cape, Capiat Capsula Ceratum Charta (karta) Chartula (kartula) Cochleare magnum Cochleare parvum Cola, Colatus Collyrium Compositus Congius Confectio Cortex Cum Decoctum Dilute, Dilutus Divide Dividendus Dividatur in parts sequales Dosis Emplastrum Enema Extractum Fac, fiat, fiant Filtrum, filtra Fluidus Glyceritum Gutta, Guttse Guttatim ABBREVIATION. Acid. Ad. lib. Add. A. aa. Aq. font. Aq. dest. Bis. ind. Cap. Caps. Cerat. Chart. Chart. Coch. mag. Coch. parv. Col. Collyr. Co. Comp. C. Conf. Cort. Decoc. Dil. D. Div. Dividend. D. in p. aeq. Dos. Emp. Enem. Ext. F. Fil. Fl. f. Give. Gtt. Gutt- ;. TRANSLATION. An acid I To, up to At pleasure Add (thou) Of each Water, spring Water, distilled Well Twice daily Take. Let him take A capsule A cerate A paper (medicated) A little paper for a powder A tablespoon A teaspoon Strain, strained An eye wash Compound A gallon A confection Bark With A decoction Dilute (thou), diluted Divide (thou) To be divided Let it be divided into ,equal parts A dose A plaster An enema An extract Make, let be made, let them be made A filter. Filter fthou) Fluid A ~lyeerin A drop, drops Drop by drop PRESCRIPTION WRITING 71 LATIN WORD. ABBREVIATION. TRANSLATION. Haustus Haust. A draught Hora H. Hor. An hour In dies Ind. Daily Infusum Inf. An infusion Injectio Inj. An injection Lac Milk Libra lb. A pound, a Troy pound Liquor, or Liq'uor liq. A solution Lotio (losheo) A lotion Magnus Mag. Large Mass a Mass. A pill-mass Misce m. Mix Mistura Mist. A mixture Mucilago Mueil. A mucilage Nox, Nocte Maneque Night, at night and in the morning Numerus, Numero No. A number, in number Octarius o. A pint Pars A part (governs genitive) Partes aequales P. ee. Equal parts Parvus Parv. Small Pilula Pil. A pill Pro re nata P. r. n. According to circum- stances; oceasioiiiM" Pulvis Pulv. A powder Quantum Sufficiat Q. S. (followed by genitive) As much as is necessary Quaqua hora Q.h. Every hour Saturatus Sat. Saturated Semissis ss. A half Semidrachma Semidr. A half drachm Sesuneia Sesnnc. An ounce and a half Signa S. Sig. Sign Solve, Solutns Solv. Dissolve, dissolved Solutio Sol. A solution Spiritus Spr. A spirit Suppositoria Suppos. A suppository Syrups Svr. A syrup Talis Tal. Such, or, like Tinctura Tr. A tincture Ter in die t. i. d. Three times a day Unguentum Urigt. An ointment Vinum Vin. A wine Vehiculum Vehic. A menstruum 72 PRESCRIPTION WRITING A prescription, derived from the Latin prae, before, and scriptum, written, comes to us from the early custom of physicians in writing down their advice beforehand for their patients' guidance. As now used it is the written formula of the practitioner describing to the pharmacist the manner of compounding and dispensing medicines, and to the attendant the mode of administering them. Formula? are official when simply taken from the "United States Pharmacopeia," and extemporaneous when concocted offhand by the prac- titioner. Extemporaneous formulae are simple when composed of one ingredient; a compound prescription is composed of several parts, which may be considered as follows: I. Heading. II. Names and quantities of drugs. III. Direction to compounder. IV. Direction to attendant. V. Signature of writer. The heading, "Recipe," is derived from the Latin, the imperative of the verb meaning to take, and is ordinarily represented by the sign I£, a corruption of U , the sign of the zodiac for Jupiter. After the Christian era the sign of the cross was used, or N. D., for Nomine Deo, in God's name; J. D. for Juvane Deo, meaning God helping, etc. We have now reverted to the old sign, which is all that remains of an appeal to Jupiter. This symbol seems to put the practitioner, even if involuntarily, into a position of reverence in thus offering a prayer in embryo (the old physi- cians also wrote one) whenever one writes a prescription. The custom also suggests that we are not yet sufficiently sure of our materia medica after all these centuries, to sacrifice the efficacy of prayer. In regard to the names and quantities of drugs, we find in the text- books that one should always strive after a classical arrangement, where- by four ingredients are essential to accomplish any result. These include: I. The basis, or active medicinal substance. II. The adjuvant, or assistant. III. The corrigent, or corrective. IV. The excipient, vehicle, or menstruum. But we shall find that while such a classical arrangement may exist in the text-books, we are usually content in practice with the basis, to- gether with a vehicle. The classical arrangement is essential in order that the old Latin motto be fulfilled: "Curare cito, tuto et jucunde/' Curare — to cure (the basis) ; cito — quickly (the adjuvant) ; tuto — safely (the corrigent); jucunde — pleasantly (the excipient). In a physic ball for horses we may employ aloes as a basis ; calomel as an adjuvant; ginger as a corrective; molasses as an excipient. More commonly in fluid preparations we prescribe several bases, or ingredients for curative purposes, neglecting any adjuvant or corrigent and simply using water as a vehicle. It is often of distinct advantage to write for a combination of several drugs whose action looks towards a common end. PRESCRIPTION WRITING 73 Yet one should always lean to simplicity rather than complexity in the number of ingredients. While it is difficult to avoid chemical antagonism, how much harder is it to prevent untoward physiological combinations in the body, which we can in no wise foretell. In olden times ignorance led practitioners to try the effect of an enormous number of drugs, with the hope that out of the charge one at least of the pellets in these shot- gun prescriptions might strike the desired spot, if the others failed to do so. But we now believe that the damage done by all the shot which miss far surpasses the good accomplished by the successful missile. Four hundred different remedies are included in one of these old formulae, whereas now it is rare to find four in a prescription. In relation to the third part of the prescription (the directions to the compounder), we find that a few regulation Latin phrases or words express these directions. If one is unfamiliar with Latin, one can easily memorize these words and phrases understandingly. The directions to the attendant are heralded by the Latin srgna, or signetur, meaning label, or let it be labelled; abbreviated, "Sig." or merely "S.," and being for the use of the attendant of the patient, are in English. The directions should be very precise. One should not write: "Use as directed," or "Give in water," but indicate exactly the quantity of medicine to be administered, the precise amount of water with which it is to be diluted, and the time at which it is to be given. For instance: "Give one table- spoonful in half a pint of water three times daily after feeding." Poisons should be marked as such. It is well sometimes to indicate that the prescription is "for a horse," in order to avoid mistakes and to quell the qualms of the conscientious druggist. Preparations which are not to be used internally should be labelled "external use." Under "signature" the name of the writer and date is included. If desirable, one may inscribe "non repetatur," do not repeat. Quantities used in prescription writing are indicated by the signs of the apothecaries or troy system of weights for solids. For liquids, signs representing units of the wine measure are employed. The troy grain and ounce are used by apothecaries as units of weights in dispensing prescriptions. In ordering large quantities (as pounds) the avoirdupois pound of 16 ounces is employed, and in buying ounces of drugs without a prescription the avoirdupois ounce is also utilized. The avoirdupois ounce contains 437 grains; the troy ounce contains 480 grains. The grain is of similar value in both systems. Troy or Apothecaries' Weight. Weight Sign Latin Name Pound lb Libra Ounce % Uncia Dram 5 Drachma Scruple 9 Scrupulum Grain gr. Granum 74 PRESCRIPTION WRITING Wine Measure. Measure Sign Latin Name Gallon C or Cong Congius Pint O Octarius Fluidounce if, Fluida Uncia Fluiddram f3 Fluida Drachma Minim TT\ Minimum A drop is often used synonymously with minim, which is correct if the substance spoken of is water, or a liquid of nearly similar density. If the liquid is not of similar density, then a minim, or the sixtieth part of a dram, is far from being a drop as measured by dropping a liquid from any ordinary utensil. Any amount from 45 drops to 276 drops, meas- ured in this way. may !><' obtained from a dram of fluid, according to its density, mode of dropping, and kind of vessel from which it is dropped. A gutta (gtt.), then, is of no fixed value, but means a drop as dropped from a vessel : while a minim is always the sixtieth part of a dram. RELATIVE VALUE OF UNITS IN THE WINE MEASURE. c o 0 5 ni 1C = 8 = 128 = 1024 = 61,440 Oi = 16 = 128 = 7,680 5 = 8 3i 480 60 RELATIVE VALUE OF UNITS IN TROY SYSTEM. ft) 5 5 9 Gr. 1 = = 12 ^= 96 = 288 = 5,760 $ = 8 === 24 = 480 5i = 3 3i , 60 20 The abbreviation, fl., is usually omitted in prescription writing, as referring to fluids, the character of the preparation being sufficiently apparent. The Roman numerals are used to express the quantities em- ployed when the apothecaries' system is used; when the metric system is employed Arabic numerals are used. 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 %, which is often indicated by a double s (ss), standing for semis, the Latin for one-half. When the apothecaries' (or troy) system is used the symbol precedes the Roman numerals; when the metric system is used the Arabic numerals precede the abbreviation of the unit. PRESCRIPTION WRITING 75 Approximate Equivalents of Wine Units in Domestic Measures. Teaspoon = oi-ii. = 5 mils (or cc.) Dessertspoon e= oii. = 10 mils (or cc.) Tablespoon = .^ss. <= 15 mils (or cc.) Cup = §iv. = 120 mils (or cc.) Tumbler = ^viii. ==: ^40 mils (or cc.) 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 com- monly in use in human and canine practice are the 2 and 4 dram; the 1, 2, 3, 4, 5, 6, 8, 12, and 16 ounce. The 2-dram bottles are useful for measuring the dose of fluid extracts for horses ; the 3-ounce bottle is convenient in writing prescriptions in the metric system for dogs, as it holds approximately 100 mils. The 4-ounce bottle is the common size, employed in canine practice, containing 24 doses of one teaspoonful each. The 1 1' pint and pint bottles are more appropriate for larger animals. The Metric System. The metric system will be described, because it is the universal sys- tem employed in scientific writings, and is now official (employed in the U. S. Pharmacopeia). It is based on the fact that a uniform, unchange- able standard is employed 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 (2.2016 lbs. avoirdupois), and is the unit of the measure of weight of ordinary commerce. Metric Diagram The weight of water that the small cube will contain is one gram. This is the unit of weight of the metric system. Since the large cube will contain one liter the small cube will contain one one-thousandth of a liter or one milliliter (abbreviated 1 mil). But for prescriptions and other small weighings lesser units than the kilo and liter are required and therefore the cube of one-hundredth of a meter is taken and the weight of water which this' cube holds is recognized as the unit of weight and called a gram (15,432 grains). The quantity of water contained in the cube of one-hundredth of a meter is used as a unit in measuring capacity in chemical and pharmaceutical practice and termed a cubic centimeter. The multiples of these measures, proceeding in decimal progression, are distinguished by Greek numerals as prefixes, i.e., Deca-10, Hecto-100, Kilo- 1000. The subdivisions of the unit are represented by the Latin prefixes, as deci-0.1, centi-0.01, milli-0.001. Hence, using the gram as the unit, we can arrange a table as follows: Kilogram Kg. = 1,000 grams == 1,000.0 Hectogram Hg. = 100 grams = 100.0 Decagram Dg. = 10 grams = 10.0 PRESCRIPTION WRITING 1 DECIMETER ORXoMETER icmorXmm CUBE •1CM. EACH DIMENSION kl Gram Gm. == 1 gram = 1.0 Decigram dg. 1= 1/10 gram = 0.1 Centigram eg. = 1/100 gram = 0.01 Milligram mg. = 1/1000 gram = 0.001 The metric system has the advantage of being arranged decimally, which makes the computation of percentages easy, and the transference of a quantity of one denomination to that of another, by merely shifting a decimal point. There are other advantages which make it of value to practitioners. Our present system is not uniform with that of any other country. The English, while using the same nomenclature for weights and measures, put a different value upon them. The system has another value, at least theoretically, in having one unit for weights and measures. The unit of the fluid measure is 1 cubic centimeter of water, which at 4° C. weighs one gram. As a matter of fact, fluids are dispensed in the metric system by measuring them in cubic centimeters (abbreviation cc), and if liquids were all of the same density as water, they would be equiv- PRESCRIPTION WRITING 77 alent to grams of water when measured in cc's. Unfortunately, this is not the case. Theoretically, medicine should be dispensed by weight in the metric system, but as medicines, when given to patients, are usually measured by bulk, they cannot be dispensed by weight without producing a complication. For example, suppose that we order chloroform in a prescription in the metric system, — ty Chloroformi 30 | S. Two teaspoonfuls in water. John Smith. thinking we are dispensing 10 grams,* for a teaspoonful holds 5 grams of water. But as chloroform weighs % more than water, we really have ordered 1% X 10=15 Gm. of chloroform. Therefore, in writing a pre- scription for chloroform with other ingredients, weighed in Gm., we would have to add ^ of the number of Gm. of chloroform in the prescription to the number previously estimated in order to make the chloroform of the same bulk as other liquids of the density of water. In order to avoid reducing substances of density differing from that of water, to terms of equivalency with that of water, it is the custom, and now official, to weigh solids in Gm. and measure liquids in cc. (mil). This is an exact method if the doses of drugs are learned in the same way: i.e., if the doses of solids are learned in Gm. and prescribed in Gm., and the doses of liquids are learned in cc. and prescribed in cc. (now mil). In writing prescriptions in the metric system a line is drawn perpen- dicularly across the right-hand side of the blank to indicate the decimal point; multiples of the unit being placed to the left of the line, while fractions are written to the right of the decimal line. In using this sys- tem we are spared the annoyance of special signs and different tables for weights and measures. As matters now stand we must be cognizant of both systems, and be able to convert the old into the new, or vice versa. One dram is equivalent to four grams, 5i. = 4 Gm. Therefore, 1 Gm.^3y4 or gr. 15. Then gr. i. = 1/15 of 1 Gm. ; or .066 Gm. The equivalent of gr. i is .06 Gm. In order to determine the equivalent of fractions of a grain in grams, we divide .06 by the denominator and multi- ply the result by the numerator of the fraction of a grain. For example: gr.%=% of .06 Gm. as .06 Gm.=gr.i. 3).06(.02X2=.04. Therefore, gr.%=04 Gm. 6 0 Again: to find the equivalent of gr. !/g in Gm. 8).066(.008 X 1 =.008 64 2 Therefore, gr. % = .008 Gm. Tor each dose. PRESCRIPTION WRITING Table for Converting Apothecaries' Weights and Measures Into Grams and Mita (Cubic Centimeters). SOLIDS. FLUIDS. Troy Weight. Metric. Apothecaries' Grains. Grams. Measure. Metric. Minims. Mil or cc, 1/64 .001 1 .06 1/40 .0015 2 .12 1/30 .002 8 .18 1/20 .003 4 .24 1/16 .004 5 .30 1/12 .005 6 .36 1/10 .006 7 .50 1/8 .008 8 .42 1/6 .010 9 .55 1/4 .016 10 .60 1/3 .02 15 .72 1/2 .03 16 1.00 1 .065 20 1.25 2 .13 25 1.55 3 .20 30 1.90 4 .26 35 2.20 5 .32 40 2.50 6 .39 48 3.00 8 .52 50 3.12 10 .65 60 (foi.) 3.75 15 1.00 72 4.50 20 (9i.) 1.30 80 5.00 24 1.50 90 5.60 26 1.62 96 6.00 30 1.95 100 6.25 40 2.60 120 (foii.) 7.50 50 3.20 160 10.00 60 (oi.) 3.90 180 (foiii.) 11.25 120 (§ii.) 7.80 240 (fgss.) 15.00 180 11.65 f3v. 18.75 240 15.50 f3vi. 22.50 300 19.40 f3vii. 26.25 360 23.30 f5i. 30.00 420 27.20 f$i. 60.00 480 31.10 fSiii. 90.00 oii. 62.20 f.^iv. 120.00 •3iv' 124.40 f^v. 150.00 *vi. 186.60 f.Vi. 180.00 5viii. 248.80 f|viii. 240.00 PRESCRIPTION WRITING 79 METRIC WEIGHTS. .001 .002 .003 .001 .005 .006 .007 .008 .009 .01 .02 .03 .04 .05 .06 .07 .08 .09 .10 .20 .30 .40 .50 .60 .70 .80 .90 1.00 2.00 3.00 4.00 5.00 6.00 7.00 8.00 9.00 10.00 :XACT EQUIVALENT IN APPROXIMATE EQUIVALENTS GRAINS. IN GRAINS. .0154 1/65 .0308 1/32 .0463 1/22 .0617 1/16 .0771 1/13 .0926 1/11 .1080 1/9 .1234 1/8 .1389 1/7 .15 43 1/6 .3086 1/3 .4630 6/13 .6173 7/11 .7717 3/4 .9260 9/10 1.0803 1 1.2347 1% 1.3890 1% 1.543 1% 3.086 3 4.630 4% 6.173 6 7.717 7l/2 9.260 9 10.803 11 12.347 12% 13.890 14 15.432 15 30.864 30, 3ss. 46.296 40, ®ii. 61.728 60, 5i. 77.160 so, ^ iv. 92.592 90, 3iss. 108.021 110, ftvflM 123.456 1 20, 3ii. 138.888 140. ftvii 154.320 150, Siiss. 80 PRESCRIPTION WRITING We stated that 3i. = 4 Gm. It follows that §i. would equal 32 Gm. As a fact, 3i. apothecaries' weight, is equivalent to a trifle less than 4 Gm. ; and an ounce, apothecaries' weight, is usually considered equal to 30 Gm. (exactly 31.10 Gm.) for the sake of convenience. A fluid ounce in wine measure is precisely equivalent to 29.57 cc. We have here another rea- son why both solid and fluid ounces should be valued at 30 Gm. or cc. Although it is the custom to regard the minim of liquid as the equivalent of one grain, it is inexact. An apothecaries' ounce weighs 480 gr. ; a fluid ounce of wine measure weighs 457 gr. Multiples of grams or cubic centimeters may be designated as such, instead of using the technical terms. It is perfectly proper to speak of 100 Gm. as one hundred grams, although technically equal to a hectogram. .1 Gm. may be called one- tenth gram, although technically a decigram. Similar remarks apply to cc, yet 1,000 cc. (approximately 1 quart) equal one liter, and this term is in common use. In the ninth (1916) edition of the U. S. Pharmacopeia the British term "mil" (abbreviation of milliliter — mille, Latin for one thousand and in the combining form usually meaning one one-thousandth) or the thousandth part of a liter is used instead of the more cumbersome cubic centimeter. Thus the word "mil" is rapidly coming into use in scientific literature to replace the abbreviation "cc." In time it may wholly replace it in medical literature but for the present it is necessary for the veterinary student to be familiar with both terms. Note that the abbreviation for gram, Gm., is capitalized and the abbreviation for grain, gr., is not. Rules for Forming the Genitive Case in Prescription Writing. The Latin names of drugs, as we learn them, when consisting of a single word, are in the nominative case. For example: oleum, an oil. The genitive case of a Latin word means of (the word), and is equivalent to the English possessive. Thus the Latin name oleum lint, consists of two words. The first, oleum, is the Latin nominative for oil, and the sec- ond word, lint, is the Latin genitive of the word meaning linseed. The name signifies, then, oleum (oil) and lint (of linseed). In writing pre- scriptions it is usually essential to put the Latin name of the drug in the genitive case, following the use of the heading IJ, standing for the Latin imperative Recipe, meaning in English, Take. For example : Potassi nitratis Si- Literally translated this means : Take Of potassium nitrate, ounce 1. There is- only one other case which is used in writing prescriptions (the accusative), but this, can be avoided by using abbreviations in the few instances in which it should be employed. The following rules can be memorized (with their exceptions) in order to form the genitive case (singular) : PRESCRIPTION WRITING 81 (1) Latin names of drugs ending in a form their genitive in ae. The only exceptions are three: physostigma takes the genitive in Us, physostigmatis; folia (leaves), pi. genitive, foliorum; theobroma, genitive theobromatis. In most instances the genitive of Latin nouns ending in a, can be made in practice by dropping the nominative ending (a) and add- ing ae in its place, viz.: Tinctur-a (a tincture), genitive tinctur-ae (of a tincture). (2) All pharmacopeial nouns ending in us, um (os and on), form their genitive in i. This genitive case can be formed in practice by drop- ping the nominative ending (us or um) and adding i in its place, viz.: bol-us, a ball; genitive bol-i, of a ball. Extract-um, an extract; genitive extract-i, of an extract. The nouns ending in os and on are very few. Exceptions: rhus, genitive rhois; fios, genitive floris. Fructus, quercus and spiritus do not change in the genitive, as it is the same as the nominative case. (3) All other Latin names of drugs, of whatever termination (except those ending as described under rules 1 and 2) have their geni- tive in s and is. The genitive case can be formed in practice, in some instances, by adding is to the nominative, as, for example ; chloral, genitive chloral-is ; ether, genitive, ether-is. To many nouns ending in the nominative in as or is, we not only add is to the nominative, but also change the latter letter of the nominative case. For instance, to sulphas (sulphate) not only do we add it, sulphas-is, but we change the latter letter, s, of sul- phas into a t so that the proper genitive of sulphas is sulphat-is. The same remark applies to all the other Latin names of salts, as sulphis, genitive sulphit-is; nitras, genitive nitrat-is; hydrochloras, geni- tive hydrochlorat-is ; citras, genitive citrat-is ; phosphas, genitive phosphat-is ; acetas, genitive acetat-is. Cortex is not cortex-is in the geni- tive, but corticis. Mas, genitive not mas-is, but maris. Adeps, genitive not adeps-is, but adipis. Mucilago, pepo and pulvis lengthen and change in the genitive to mucilagin-is, pepon-is and pulver-is. Aloe, genitive not aloeis, but aloes, adding s and not is. (4) Some Latin names of drugs do not change their ending in the genitive because indeclinable and not Latinized, or else they belong to the fourth declension, where the genitive case is the same as the nominative. Examples: spiritus, quercus and fructus, already mentioned as excep- tions to rule 2; Cannabis, digitalis, sinapis and hydrastis. The genitive of these nouns is the same as the nominative. The following are indeclinable: amyl, buchu, catechu, coca, curare, jaboraridi, kino, cusso, gummi, etc. If the Latin names for quantities and amounts thereof are written out in full (instead of using signs for quantities, and numbers for the amounts), the quantities and amounts in Latin must be put into the ac- cusative case, as they are the objects of the verb, recipe. 82 PRESCRIPTION WRITING For example: Sodii sulphatis, uncias duas, Translated : Take Of sodium sulphate, ounces two. The Latin noun uncia (ounce) is in the accusative case, and the ad- jective duas is also in the accusative, agreeing with uncias. But to write out prescriptions in full, as above, is not customary and would be consid- ered pedantic. Again, the Latin names of the ingredients should be written in the accusative case when no noun for weight or measure is employed. For example: I* Pilulas catharticas composite duas. Translated literally: Take Pills cathartic compound, two. Or, take two compound cathartic pills. Pilulas (pills) is in the accusative object of the verb recipe. Cathar- ticas, compositas, and duas are adjectives, agreeing with pilulas. We can only write this prescription correctly, without using the accusative case, by abbreviating it as follows: Pil. Cath. Co. ii. LIST OF LATIN NOUNS 83 List of Latin Nouns Found in the Pharmacopeia with Their Genitive Ending.* [The figure in parenthesis after each word indicates the declension to which it belongs.] Acacia, Acetanilidum, Acetas, Aceticum, Acetonum, Acetphenetidinum, Aceturn, Acidum, Aconitina, Aconitum, Adeps, Adhesivum, Adjuvans, .Ether, Alcohol, Aloe, Aloinum, Althaea, Alumen, Aluminum, Ammonia, Ammonium, Amygdala, Amyl, Amylum, Animal, Anisum, Anthemis, Antidiphtheriticum, Antimonium, Antipyrina, Antisepticus, Apocynum, Apomorphina, Aqua, Argentum, Arnica, Arsenas, Arsenosum, Arsenum, Asafetida, Aspidium, Atropina, Aurantium, Aurum, Balsamum, Belladonna, Benzaldehydum, Benzinum, Benzoas, Benzoicum, Benzoinum, Acacias (1). Acetanilidi (2). Acetatis (3). Acetici (2). Acetoni (2). Acetphenetidini (2) Aceti (2). Acidi (2). Aconitinae (1). Aconitii (2). Adipis (3). Adhesivi (2). Adjuvantis (3). Athens (3). Alcoholis (3). Aloes (3). Aloini (2). Althaeas (1). Aluminis (3). Alumini (2). Ammonias (1). Ammonii (2). Amygdalae (1). Amvlis (3). Amyli (2). Animalis (3). Anisi (2). Anthemidis (3). Antidiphthcritici (2). Antimonii (2). Antipyrinae (1). Antiseptici (2). Apocyni (2). Apomorphinae (1). Aquae (1). Argenti (2). Arnicas (1). Arsenatis (8). Arsenosi (2). Arseni (2). Asafetidae (1). Aspidii (2). Atropinae (1). Aurantii (2). Auri (2). Balsami (2). Belladonnae (1). Benzaldehydi (2). Benzini (2). Benzoatis (3). Benzoici (2). Benzoini (2). Benzosulphinidum, Berberis, Betanaphthol, Bicarbonas, Bismuthum, Bisulphis, Bitartras, Boras, Bos, Bromidum, Bromoformum, Boricum, Bromum, Buchu (indeclin- able). Caffeina, Calamus, Calcium, Calendula, Calumba, Calx, Cambogia, C amphora, Camphoras, Camphoricum, Canadensis, Cannabis, Cantharis, Capsicum, Carbo, Carbonas Benzosulphinidi (2), Berberidis (3). Betanaphtholis (3). Bicarbonatis (3). Bismuthi (2). Bisulphitis (3). Bitartratis (3). Boratis (3). Bovis (3). Bromidi (2). Bromoformi (2). Borici (2). Bromi (2). Caffeinae (1). Calami (2). Calcii (2). Calendulas (1). Calumbas (1). Calcis (3). Cambogiae (1). Camphoras (1). Camphoratis (3). Camphorici (2). Canadensis (3). Cannabis (3). Cantharidis (3). Capsici (2). Carbonis (3). Carbonatis (3). Carbonei (neuter genitive used as stantive) sub- Cardamomum Carum, Caryophyllus, Cassia, Cataplasma, Cera, Ceratum, Cerium, Cetaceum, Charta, Chimaphila, Chirata, Cardamomi (2). Cari (2). Caryophylli (2). Cassias (1). Cataplasmatis (3) Ceras (1). Cerati (2). Cerii (2). Cetacei (2). Chartae (1). Chimaphilae (1). Chiratas (1) Chloralformamidum, Chloralformamidi (2). Chloralum, Chloras, Chloridum, Chlorinata, Chloriformum, Chondrus, Chlorali (2). Chloratis (3). Chloridi (2). Chlorinatae (1). Chloroformi (2) Chondri (2). *Swan's Prescription Writing. 84 PRESCRIPTION WRITING Chromium, Chrysarobinum Cimicifuga, Cinchona, Cinchonidina, Cinchonina, Cinnaldehydum Cinnamomum, Citras, Citricum, Coca, Cocaina, Coccus, Codeina, Colchicina, Colchicum, Collodium, Colocynthis, Confectio, Conium, Convallaria, Copaiba, Coriandrum, Cormus, Cortex, Creosotum, Cresol, Creta, Cubeba, Cuprum, Cusso (indeclin able). Cyanidum, Cypripedium, Decocta, Dichromas, Digitalis, Disulphidum, Elastica, Elaterinum, Elixir (indeclin able). Emplastrum, Emulsum, Ergota, Eriodictvon, Chromii (2). Chrysarobini (2). Cimicifugae (1 ). Cinchonas (1). Cinchonidinae (1 ). Cinchoninae (1 ). Cinnaldehydi (2). Cinnamomi (2). Citratis (3). Citrici (2). Cocae (1). Cocainae (1). Cocci (2). Codeinae (1). Colehicinae ( 1 ) . Colchici (2). Collodii (2). Colocynthidis (3). Confectionis (3). Conii (2). Convallaria? (1). Copaiba? (1). Coriandri (2). Cormi (2). Corticis (3). Creosoti (2). Cresolis (3). Cretae (1). Cubebae (1). Cupri (2). Cyanidi (2). Cypripedii (2). Decoctae (1). Dichromatis (3) Digitalis (3). Disulphidi (2). Elasticae (1). Elaterini (2). Emplastri (2), Emulsi (2). Ergotae (1). Eriodictvontis Eriodictyi (Pharmacopeia) Eucalyptol, Eucalyptolis (3) (3). Eucalyptus, Eugenol, Euonymus, Eupatorium, Extractum, Fel, Ferrocyanidum, Ferrum, Ficus, Fistula, Fluidextractum, Feniculum, Folium, Eucalypti (2) Eugenolis (3). Euonymi (2). Eupatorii (2). Extracti (2). Fellis (3). Ferrocvanidi (2). Ferri (2). Fici (2), also ficus. Fistulas (1). Fluidextracti (2). Feniculi (2). Folii (2). Formaldehydum, Frangula, Galla, Gallas, Gallicum, Gambir (indeclin- able). Gelatinuni, Gelsemium, Gentiana, Geranium, Glandula, Glandulae (plu.), Glj cerinum, Glyceritum, Glycyrrhiza, Glyeyrrliizinum, Gossypium, Granatum, Grindelia, Guaiacol, ( ruaiacum, Guarana, Haematoxylon, Hammamelis, Hedeoma, I [examethylen- amina, Homatropina, Humulus, Hydrargyrum, Hydrastina, Hydrastis, Hydriodicum, Hydrobromicum, Hydrobromidum, Hydrochloricum, Hydrochloridum, Hydrocyanicum, Hydroxidum, Hyoscina, Hyoscyamina, Hyoscyamus, Hypophosphas, Hypophosphis, Hypophosphorosum Indica, Infusum, Iodidum, Iodoformum, Iodolum, Iodum, Ipecacuanha, Jalapa, Kaolinum, Kino (indeclinable). Krameria, Lac. Lactas, Lacticum, FormaldehydJ (2). Frangula' (1). Gallas (1). Gallatis (3). Gallici (2). Gelatin] (2). Gelsemii (2). Gentiana' (1). Geranii (2). Glandulae (1). Glandularum (1). Glycerini (2). Glyeeriti (2). Glycyrrhizae (1). Glyeyrrhiz-ini (2). Gossypii (2). Granati (2). Grindeliae (1). Guaiacolis (3). Guaiaci (2). Guaranae (1). Haematoxyli (2). Hammamelidis (3). Hedeomae (1). Hexamethylena- minae (1). Homatropinae (1). Humuli (2). Hydrargyri (2). Hydrastinae (1). Hydrastis (3). Hydriodici (2). Hydrobromici (2). Hydrobromidi (2). Jiydrochlorici (2). Hydrochloridi (2). Hvdrocyanici (2). Hydroxidi (2). Hyoscinae (1). Hyoscyaminae (1). Hyoscyami (2). Hypophosphatis (3). Hypophosphitis (3). Hvpophosphorosi '(2)- Indicae (1). Tnfusi (2). Iodidi (2). Iodoformi (2). Iodoli (2). Iodi (2). Ipecacuanha?. (1). Jalapae (1). Kaolini (2). Krameriae (1). Lactis (3). Lactatis (3). Lactici (2). LIST OF LATIN NOUNS 85 Lactucarium, Lappa, Laptandra, Lignum, Limo, Linimentum, Linum, Liquor, Lithium, Lobelia, Lupulinum, Lycopodium, Magnesium, Maltum, Manganum, Manna, Marrubium, Massa, Mastiche, Matico (indeclin- able). Matricaria, Medulla, Mel, Mentha, Menthol, Methyl, Methylthionina, Mezereum, Mistura, Morphina, Morrhua, Moschus, Mucilago, Myristica, Myrrha, Naphthalenum, Nitras, Nitricum, Nitris, Nitrohydrochlori- cum, Nux vomica. Oleas, Oleatum, Oleicum, Oleoresina, Oleum, Opium, Opulus, Oxalas, Pancreatinum, Paraffinum, Paraldehydum, Pareira, Pelletierina, Pepo, Pepsinum, Permanganas, Petrolatum, Lactucarii (2). Lappa? (1). Laptandrae (1). Ligni (2). Limonis (3). Linimenti (2). Lini (2). Liquoris (3). Lithii (2). Lobeliae (1). Lupulini (2). Lycopodii (2). Magnesii (2). Malti (2). Mangani (2). Mannae (1). Marrubii (2). Massae (1). Mastiches (1) Greek noun. Matricaria? (1). Mcdullae (1). Mellis (3). Mentha? (1). Mentholis (3). Methylis (3). Methylthionina ( 1 ) Mezerii (2). Mistura? (1). Morphina? (1). Morrhua? (1). Moschi (2). Mucilaginis (3). Myristica? ( 1 ) . Mvrrha? (1). Nkphthaleni (2). Nitratis (3). Nitrici (2). Xitritis (3). Xitrohvdrochlorici (2)-" Nucis Vomica? (3 and 1). Oleatis (3). Oleati (2). Oleici (2). Oleoresina? (1). Olei (2). Opii (2). Opuli (3). Oxalatis (3). Pancreatini (2). Paraffini (2). Paraldehydi (2). Pareira? (1). Pelletierina? (1). Peponis (3). Pepsini (2). Permanganatis (3). Petrolati (2). Phenol, Phenol sulphonas, Phenyl, Phosphas, Phosphis, Phosphoricum, Phosphorus, Physostigma, Phytolacca, Pilocarpina, Pilocarpus, Pilula, Pilula? (plural), Pimenta, Piper, Piperina, Pix, Plumbum, Podophyllum, Potassium, Prunifolium, Prunum, Prunus, Pulvis, Purshiana, Pyrethrum, Pyrogallol, Pyrophosphas, Pj roxylium, Quassia, Quercus, Quillaja, Quinina, Radix, Resina, Resorcinol, Rhamnus, Rheum, Rheus, Rosa, Rubus, Sabal, Sabina, Saccharum, Safrolum, Salicinum, Salicylas, Salieylicum, Salvia, Sanguinaria, Santalum, Santonica, Santoninum, Sapo, Sarsaparilla, Sassafras (inde- clinable). Scammonium, Scilla, Phenolis (3). Phenol sulphonatis (3). Phenylis (3). Phosphatis (3). Phosphitis (3). Phosjhorici (2). Phosphori (2). Physostigmatis (8). Phytolacca? (1). Pilocarpina? (1). Pilocarpi (2). Pilula? (1). Pilularum (1). Pimenta? (1). Piperis (3). Piperina? (1). PVis (3). Plumbi (2). Podophvlli (2). Potassii' (2). Prunifolii (2). Pruni (2). Pruni (2). Pulveris (3). Purshiana? (1). Pyrethri (2). Pyrogallolis (3). Pyrophosphatis (3) Pyroxilini (2). Quassia? (1). Quercus (4). Quillaja? (1). Quinina? (1). Radicis (3). Resina? (1). Resorcinolis (3). Rhamni (2). Rhei (2). Rhois (3) Greek noun. Rosa? (1). Rubi (2). Sabalis (3). Sabina? (1). Sacchari (2). Safroli (2). Salicini (2). Salicylatis (3). Salicylic! (2). Salvia? (1). Sanguinaria? (1). Santali (2). Santonica? (1). Santonini (2). Saponis (3). Sarsaparilla? (1). Scammonii (2). Scilla? (1). 86 PRESCRIPTION WRITING Scoparius, Spopola, Scopolamina, Scutellaria, Semen, Senega, Senna, Serpentaria, Serum, Sevum, Sinapis, Sodium, Sparteina, Spigelia, Spiritus, Staphisagria, Stearas, Stearicum, Stillingia, Stramonium, Strontium, Strophanthinum, Strophanthus, Strychnina, Styrax, Subacetas, Subcarbonas, Subgallas, Subnitras, Subsalicylas, Subsulphas, Succus, Sulphas, Sulphis, Sulphonethylme- fhanum, Sulphonmethanum, Sulphur, Sulphuricum, Sulphurosum, Sumbul (indeclin- able). Scoparii (2). Scopolae (1). Scopolamine (1). Scutellariae (1). Seminis (3). Senegae (1). Sennae (1). Serpentariae (1). Seri (2). Sevi (2). Sinapis (3). Sodii (2). Sparteinae (1). Spigelian (1). Spiritus (4). Staphisagriae (1). Stearatis (3). Stearici (2). Stillingiae (1). Stramonii (2). Strontii (2). Strophanthini (2). Strophanti (2). Strychninae (1). Styracis (3). Subacetatis (3). Subcarbonatis (3) Subgallatis (3). Subnitratis (3). Subsalicvlatis (3), Sulsulphatis (3). Succi (2). Sulphatis (3). Sulphitis (3). Sulphonethylme- thani (2). Sulphonmethani (2). Sulphuris (3). Sulphurici (2). Sulphurosi (2). Suppositoria, Suprarenales, plural. Syrupus, Talcum, Tamarindus, Tannas, Tannicum, Taraxacum, Tartaricum, Tartras, Terebenum, Terebithina, Terpinum, Tersulphas, Theobroma, Thiosulphas, Thymol, Thyroideae, plural. Tinctura, Tragacantha, rrichloraceticum, Trioxidum, Triticum, Trituratio, Trochiscus, ['lmus, I njiuentum, Uva ursi, Valeriana, Vanilla, Vanillinum, Veratrina, Veratrum, Viburnum, Vinum, Virginiana, Xanthoxylum, Zea, Zincum, Zingiber, Suppositoriae (1). Suprarenalium (8) Syrupi (2). Talci (2). Tamarindi (2). Tannatis (3). Tannici (2). Taraxaci (2). Tartarici (2). Tartratis (3). Terebeni (2). Terebinthinae (1). Terpini (2). Tersulphatis (8). Theobromatis (8). Thiosulphatis (3). Thymol is (3). Thyroidearum (1). Tincturae (1). Tragacanthae (1). Trichloracetici (2), Trioxidi (2). Tritici (2). Triturationis (3). Trochisci (2). Ulmi (2). Unguenti (2). Uvae ursi (1). Valerianae (1). Vanillae (1). Vanillini (2). Veratrinae (1). Veratri (2). Viburni (2). Vini (2). Virginianae (1). Xanthoxyli (2). Zeae (1). Zinci (2). Zingiberis (3). LIST OF LATIN ADJECTIVES 87 List of Latin Adjectives Found in the Pharmacopeia^ with Their Genitive Endings. Masculine. Feminine, Neuter. Norn. Albus, Alba, Album. Gen. Albi, Albae, Albi. Nom. Amarus, Amara, Amarum. Gen. Amari, Amarae, Amari. Nom. Ammoniatus, Ammoniata, Ammoniatum. Gen. Ammoniati, Ammoniatae, Ammoniati. Nom. Aromaticus, Aromatica, Aromaticum. Gen. Aromatici, Aromaticae, Aromatici. Nom. Cantharidatus, Cantharidata, Cantharidatum, Gen. Cantharidati, Cantharidatae, Cantharidati. Nom. Compositus, Composita, Compositum. Gen. Compositi, Compositae, Compositi. Nom. Corrosivus, Corrosiva, Corrosivum. Gen. Corrosivi, Corrosivae, Corrosivi. Nom. Depuratus, Depurata, Depuratum. Gen. Depurati, Depuratae, Depurati. Nom. Dilutus, Diluta, Dilutum. Gen. Diluti, Dilutae, Diluti. Masculine j and Feminine. Nom. Effervescens, Effervescens. Gen. Effervescentis, Effervescentis. Masculine. Feminine. Neuter. Nom. Exsiccatus, Exsiccata, Exsiccatum. Gen. Exsiccati, Exsiccatae, Exsiccati. Nom. Flavus, Flava, Flavum. Gen. Flavi, Flavae, Flavi. Masculine and Feminine. Nom. Flexilis, Flexile. Gen. Flexilis, Flexilis. Nom. Glacialis Glaciale. Gen. Glacialis » Glacialis. Masculine. Feminine. Neuter. Nom. Glycerinatus, Glycerinata, Glycerinatum. Gen. Gly^cerinati, Glycerinatae, Glycerinati. Nom. Granulatus, Granulata, Granulatum. Gen. Granulati, Granulatae, Granulati. Nom. Hydratus, Hydrata, Hydratum. Gen. Hydrati, Hydratae, Hydrati. Nom. Liquefactus, I>iquefacta, Liquefactum. Gen. Liquefacti, Liquefactae, Liquefacti. Nom. Liquidus, Liquida, Liquidum. Gen. Liquidi, Liquidae, Liquidi. Nom. Lotus, Lota, Lotum. Gen. Loti, Lota?, Loti. Masculine and Feminine. Nom. Mitis, Mite. Gen. Mitis, Mitis. Nom. Mollis, Molle. Gen. Mollis, Mollis. PRESCRIPTION WRITING Nom. Gen. Noifi. Gen. Nom. Gen. Nom. Gen. Nom. Gen. Nom. Gen. Nom. Gen. Nom. Gen. Nom. Gen. Nom. Gen. Nom. Gen. Nom. Gen. Nom. Gen, Nom. Gen. Masculine. Feminine. Niger, Nigri, Piperatus, Piperati, Ponderosus, Nigra, Nigrae, Piperata, Piperatae, Ponderosa, Ponderosi, Ponderosae Praecipitatus, Praecipitati, Praeparatus, Praeparati, Purificatus, Praecipitata, Praecipitatae, Praeparata, Praeparatae, Purificata, Purifieati, Purificatae, Reductus, Reducta, Reducti, Reductae, Ruber, Rubra, Rubri, Rubrae, Saccharatus, Saccharata, Saccharati, Saccharatae, Siccus, Sicca, Sicci, Siccae, Sicci, Siccae, Siccorum, Siccarum, Masculine i and Feminine. Solubilis. Solubilis. Masculine. Feminine. Stypticus, Styptici, Sublimatus, Styptica, Stypticae, Sublimata, Sublimati, Sublimatae, Neuter. Nigrum. Nigri. Piperatum. Piperati. Ponderosum. Ponderosi. Praecipitatum. Praecipitati. Praeparatum. Praeparati. I'wrificatum. Purifieati. Reductum. Reducti. Rubrum. Rubri. Saccharatum. Saccharati. Siccum. Sicci. Siccorum. / , , 0. . J- plural. Sicci. Solubile. Solubilis. Neuter. Stypticum. Styptici. Sublimatum. Sublimati. EXAMPLES OF PRESCRIPTIONS 89 Examples of Prescriptions for Different Preparations. TO WRITE A PRESCRIPTION FOR A PILL. 1. We calculate the number of pills we wish to prescribe and then multiply the dose of each ingredient in the pill by that number. We will suppose that we desire to prescribe 30 pills for a dog, containing reduced iron, socotrine aloes and sulphate of strychnine. The dose of reduced iron is gr.ii. ; of socotrine aloes gr.ss. ; of strychnine sulphate gr. 1/120. Multiply each dose by 30. Reduced iron gr.ii. X 30 — gr.60 Aloes gr.i£ X 30 = gr.l5 Strychnine gr.1/120 X 30 = gr.^4 The Latin of aloes socotrine is aloe, genitive aloes, of aloes ; soco- trina, genitive socotrince, of socotrine. The Latin of strychnine sulphate is strycknina, genitive strychnin-a?, of strychnine ; sulphas, genitive sulphat-is, of sulphate. The Latin of reduced iron is ferrum, genitive ferr-i, of iron: reduc- tum, genitive reduct-i, of reduced. Hence: Ferri reducti 5i. Aloes socotrinae gr.xv. Strychninae sulphatis gr.^ Misce et divide in pilulas xxx. (Abbreviated) M. et div. in pil. xxx. Signa. Give one pill three times daily. John Smith, D. V. M. The Latin names of the drugs being put in the genitive, and the signs and numbers for the proper quantities and amounts added, we come to the Latin directions to the pharmacist. (Misce) mix (et) and (divide) divide (in pilulas, accusative plural) in pills xxx. This is a regulation phrase and can be employed whenever we write a prescription for pills, so that it should be memorized. It can be abbreviated correctly as follows : M. et div. in pil. xxx. Instead of writing the prescription as just described, we can calcu- late the dose needed of each ingredient in the pill, and then write a pre- scription for one pill and direct the pharmacist to make 30 pills like it. Ferri reducti gr.ii. Aloes socotrinae gr.ss. Strychninae sulphatis gr.1/120 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.l = .06 Gm. Fractions of a grain are converted into grams, therefore, by 90 PRESCRIPTION WRITING dividing .06 by the denominator of the fraction and multiplying the result by the numerator. The dose of aloes (gr. I/2) is transformed into grams, then, as follows: 2). 06 (.03 X 1 = .08 06 00 Gr. 1/120 is converted into grams thus: 120). 0600 (.0005 X 1 = .0005 Gm. 600 Solids in Gm. Liquids in mils. Ferri reducti |12 Aloes socotrinae |03 Strychninae sulphatis [0005 M. et f. pil. 1 ; dispense pil. tales No. xxx. Sig. (as before). This prescription may be abbreviated in this manner:* Fer. reduc J 12 Aloes soc |03 Strvch. sulph |0005 M., etc. Prescriptions for balls are calculated and written in every respect 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 prescription for a physic qiass, 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 consis- tency. The dose of aloes is one ounce, and we know by experience that it will take an equal amount of molasses and one dram 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 already described. Molasses is syrupus fuscus in Latin, or brown syrup. Syrupus, genitive syrup-i, of syrup. Fuscus, genitive fusc-i, of brown. The Latin for powdered ginger is pulvis, powder, genitive pulver-is, of powder. Zingiber, ginger, genitive zingiber-is, of ginger. We will proceed to write the prescription thus : Aloes socotrinae, Syrupi fusci aa Sviii. Pulveris zingiberis %i. Misce et flat massa, in bolos viii., dividenda. (Abbreviated) M. et f. mass., in bolos viii., dividend. Sig. Give one ball at once. Johst Smith, D. V. M. *Abbreviations are those official in U. S. Pharmacopeia. EXAMPLES OF PRESCRIPTIONS 91 The Latin directions to the pharmacist are translated: (Misce) mix (et) and (fiat) let there be made (massa) a mass (in bolos, accusa- tive pi.), 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: Aloes soc. Syr. fusci aa 3vii>- Pulv. zingib &. M. et f. mass., in bolos viii., dividend, (as above). Or: Misce et divide in bolos viii. (Abbrev.) M. et div. in bolos viii. Translated: Mix and divide into balls 8. Or: M. et fac bolos viii. (abbrev.) M. et f. bolos viii. Translated: Mix and make balls 8. Mixtures are compounds in which fluids are mixed or solids dissolved or held in suspension by a suitable vehicle. We must first decide upon the number of doses which we wish to prescribe, and then the quantity of the mixture to be given at each dose. Suppose we wish to give sweet spirit of nitre and quinine to a horse. We propose to give the mixture three times daily for several days. The dose of the nitrous ether will be an ounce; the quinine will be dissolved in it. Bottles are in use containing 12 to 16 ounces, or 1 pint. We will decide upon the pint bottle. This, then, will hold 16 ounces, or 16 doses of sweet spirit of nitre. In each dose of the nitre we want dissolved gr.xx of quinine sulphate. 16Xgrxx = gr.cccxx = 3v. 9 i. Now, 5 drams of quinine sulphate will not dissolve in 16 ounces of sweet spirit of nitre, so that we will add enough diluted sulphuric acid to dissolve the quinine. We do not know how much sulphuric acid will be required, so we write after acid sulphuric, q. s., for quantum sufficiat, i.e., as much as suffices (to dissolve, understood). Again, we do not know exactly how much bulk* the quinine will take up when dissolved in the nitre; nor what amount of acid will be required. Yet, on the other hand, we want to fill our bottle. To get over these difficulties we will write after sweet spirit of nitre ad, under- lined (to) ; in other words, we order the druggist to take of sweet spirit of nitre enough to (make, understood) a pint. The Latin for quinine is quinina, genitive quinin-cc, of quinine. The Latin for sulphate is sulphas, genitive sulphat-is of sulphate. The Latin for spirit of nitrous ether is spiritus, genitive spiritus, of spirit ; nitrosus, genitive, nitros-i, of nitrous ; (Ether, genitive cother-is, of ether. The Latin for sulphuric acid diluted is acidum, genitive acid-i, of acid; sulphuricus, genitive sulphuric-i, of sulphuric; dilutus, genitive dilut-i of diluted. We may now write our prescription as follows: *The increase in volume of the drench through the addition of this amount of quinine would be negligible, but in cases where large quantities of solids are dissolved in liquids the increase in volume is marked. 92 PRESCRIPTION WRITING Quininae sulphatis ov. 9 i Acidi sulphurici diluti q. s. Spiritus aetheris nitrosi ad Oi. Misce. (Furnish 3*- bottle for measure.). Signa. Small bottleful three times daily in half a pint of water. John Smith, D. V. M. Abbreviated: Quin. sulph 3v. 9i. Acid, sulph. dil. q. s. Spts. aeth. nitros. ad Oi. M. S. (as above). We will write a prescription for a mixture containing 12 doses of chloral and potassium bromide for a dog. The quantity of the mixture given to each dose will be a teaspoonful. Now, there are six teaspoonfuls in one ounce. We will order a 2-ounce bottle, which will, therefore, hold 12 doses of a teaspoonful each. The dose of chloral is gr.v 5X12 = gr.lx, or 5i. The dose of potassium bromide is gr.x. 10X12 = gr.cxx, or 3ii. Then we will order enough water to fill the bottle. The Latin for chloral is chloral, genitive chloral-is, of chloral; Latin for potassium bro- mide is potassium, genitive potassi-i, of potassium; bromidum, genitive bromid-i, of bromide ; Latin for water is aqua, genitive aqu-ce, of water. Chloralis 5i. Potassii bromidi 3ii. Aquae ad 3ii. M. Signa. One teaspoonful in a tablespoonful of water every 3 hours. John Smith, D. V. M. A drench is a mixture which is given the horse in one dose. We will write a prescription for a horse, containing ether, chloroform and laudanum, to be administered as a drench.^JThe Latin for ether is (Ether, genitive cether-is, of ether ; dose, §i. The Latin for chloroform is chloro- formum, genitive chloroform-i, of chloroform; dose, 5ii. The Latin for laudanum is tinctura opii; tinctura, genitive tinctur-(£, of tincture ; opium, genitive opi-i, of opium ; dose, ^ii. The prescription reads : yEtheris l\. Chloroformi 3ii Tincturae opii 5»- Misce et fiat haustus. Translated: (Misce) mix, (et) and (fiat) let there be made (haus- tus) a drench. (Abbreviated) M. et. f. haust. Sig. Give at once in one dose in pint of water. John Smith, D. V. M. EXAMPLES OF PRESCRIPTIONS 93 In writing a prescription for powders, we may either write for one powder1 and direct the druggist to dispense several more like it, or write for the whole amount of the ingredients and order them divided into the required number of doses or papers. In the first case we will write for a powder containing one dose of each of the drugs. For example, we write a prescription for calomel and santonin, with sugar of milk as an excipient, since the dose of the drug is inconveniently small. This powder is suitable for a medium-sized dog. The Latin for calomel, or the lower chloride of mercury, is hydrargy- rum, genitive hydrargyr-i, of mercury; chloridum, genitive chlorid-i, of chloride; mite, genitive mit-is, of lower; dose; gr.i. The Latin for san- tonin is santoninum, genitive santonin-i, of santonin ; dose, gr.i. The Latin for sugar of milk is saccharum, genitive sacchar-i, of sugar; lac, genitive lac-tis, of milk; amount gr.x. The prescription will read: Hydrargyri chloridi mitis. Santonin i aa gr.i. Sacchari lactis gr.x. Misce et fiat pulvis 1 ; dispense pulveres tales vi. Translated: Mix, and let there be made powder 1; dispense pow- ders such vi. (Abbreviated) M. et f. pulv. 1; dispense pulv. tales vi. Sig. One powder every half hour until 4 doses are given. John Smith, D. V. M. In the second case, if we write a prescription for six powders, we multiply the dose of the ingredients in each powder by 6, and then order the prescription to be dispensed in six papers. Hydrarg. chlor. mit. Santonin aa gr.vi. Sacch. lact 5i. Misce et divide in chartulas numero vi. Translated: Mix and divide into papers in number vi. Sig. (as before). To write the above in the metric system. The dose of calomel or of santonin is gr.i— .06 Gm. .06X6*= .36 Gm.. or gr.vi. The amount of sugar of milk used as an excipient in each powder is gr.x. .06X10=. 6 Gm., the amount prescribed in each powder. The amount necessary for six powders is 6X6=3.6 Gm., approximately 1 Gm. Solids in Gm. Liquids in mils. Hydrarg. chlor. mit. Santonin aa |36 Sach. lact 4| M. et div. ch't. in No. vi. Sig. (as before). We will write a prescription for a horse, in the form of a powder, containing dried iron sulphate, nux vomica and sodium bicarbonate. The 94 PRESCRIPTION WRITING Latin for iron sulphate (dried) is ferrum, genitive ferr-i, of iron; sulphas, genitive sulphat-is, of sulphate; exsiccatus, genitive exsiccat-i, of dried; dose, 5i. The Latin for nux vomica is nux, genitive nuc-is, of nux; vom- ica, genitive vomic-ce, of vomica; dose, 5i. The Latin of sodium bicarbo- nate is sodium, genitive, sodi-i, of sodium; bicarbonas, genitive bicarbo- nat-is, of bicarbonate. We will order a sufficient quantity of the ingredi- ents to make thirty powders. The dose of iron and nux vomica is 3i.X30=3iii.j 5vi. The dose of sodium bicarbonate is5ii.X30c=3viiss. Ferri sulphatis exsiccati. Pulveris nucis vomicae aa 3m-> 5*1 Sodii bicarbonatis 3viiss- Misce et divide in chartulas xxx. Translated: Mix and divide into papers xxx. (Abbreviated) M. et div. in chart, xxx. Sig. Give one powder three times daily on the food. John Smith, I). V. M. In order to avoid the expense of having powders divided into papers, we may frequently direct one dose to be weighed by the druggist, and a measure to be furnished holding the quantity. I* Ferr. sulph. exsicc. Pulv. nuc. vom aa .=>iii.. 5vi. Sodii bicarb ...225j Misce et fiat pulvis. Translated: Mix and let there be made a powder. (Abbreviated) M. et f. pulv. (Furnish measure holding 3«s.) Sig. Give measureful on food three times daily. John Smith, 1). V. M. To transform this prescription into terms of the metric system: 5i.=30 Gm.; 3i.=4 Gm. Hence §iii. , 5vi.<=l 11 Gm. ;*viiss/=225 Gm. Solids in Gm. Liquids in mils Ferr. sulph. exsic. Pulv. nuc. vom. aa 114 Sod. bicarb 225 ' M. et. f. pulv., etc. S. (as before). Electuaries are not suitable preparations in which to prescribe powerful drugs, as we cannot secure any degree of accuracy in the dos- age. This happens because we do not usually know the exact amount of excipient which will be required to make the paste of the proper consis- tency. We will write for an electuary containing potassium chlorate, licorice and molasses. The Latin for potassium chlorate is potassium, genitive, potassi-i, of potassium; chloras, genitive chlorat-is, of chlorate; dose, oii. The Latin for powder of licorice root is (powder has been given before) glycyrrhiza, genitive glycyrrhiz-ce, of licorice; radix, geni- tive radic-is, of root. The Latin for molasses is syrupus, genitive syrup-i, of syrup; fuscus, genitive fusc-i, of brown; dose of licorice root and molasses immaterial. They are used as excipients. EXAMPLES OF PRESCRIPTIONS 95 Potassi chloratis. Pulveris glycyrrhizae radicis aa 3vi. Syrupi fusci q. s. Misce et fiat electuarium. Translated: Mix and let there be made an electuary. (Abbreviated) M. et f. electuarium. (Weigh 5vi. as sample). S. Give amount equal to sample every 2 hours smeared on teeth. Johx Smith, D. V. M. We cannot tell precisely what quantity of potassium chlorate will be administered in the ovi. ordered in this prescription, but we can be as- sured that it will not be larger than 3 drams, which is a small dose for the horse. Suppositories are occasionally prescribed to dogs. The excipient is cacao butter, of which about 15 grains is required. We will write a pre- scription containing iodoform and extract of belladonna root, to be dis- pensed in suppositories for a medium-sized dog. The Latin for iodoform is iodoformum, genitive iodoform-i, of iodoform; dose, gr.1/^ The Latin for extract of belladonna root is belladonna, genitive belladonn-ce , of bel- ladonna ; extractum, genitive extract-i, of extract ; radix, genitive radic-is, of root; dose, gr.1/^. The Latin for cacao butter is oleum theobroma; oleum, genitive ole-i, of oil ; theobroma, genitive theobromatis, of theo- broma. The quantity of cacao butter may be safely left to the discretion of the pharmacist. We will multiply the dose by ten, to make ten sup- positories. Iodoformi gr.v. Extracti belladonna: radicis gr.iiss. Olei theobromatis q. s. Misce et fiant suppositoria x. Translated: Mix and let there be made suppositories x. (Abbreviated) M. et f. suppos. x. Sig. Introduce one into the bowel every 4 hours. Johx Smith, D. V. M. In writing prescriptions for ointments the degree of dilution of the medicinal substance, or substances, must be determined. In case the dilu- tion is done in percentage, the metric system is particularly useful. A 5-per-cent. ointment of the yellow oxide of mercury is of value in some cases of conjunctivitis. We will write for 5 Gm. The Latin for yellow oxide of mercury is hydrargyrum oxidum flavum; hydrargyrum, genitive hydrargyr-i, of mercury; oxidum, genitive oxid-i, of oxide ; flavum, genitive flavi, of yellow. The excipient will be simple ointment. Latin for simple ointment is unguentum, genitive unguent-i, of ointment. If we order 5 Gm. of simple ointment we can determine the amount of mercury necessary to form a 5-per-cent. preparation with it by simply moving the decimal line forward two places, .05, which will give a 1-per-cent. ointment of mercury; and then, by multiplying by 5, .05X5=.25, we secure a 5-per-cent. ointment. 96 PRESCRIPTION WRITING Solids in Gm. Liquids in mils. Hydrargyri oxidi flavi |25 Unguenti 5) Misce et fiat unguentum. Translated: Mix and let there be made an ointment. (Abbreviated) M. et f. ung. Sig. Use externally. John Smith, D. V. M. There "is nothing of special note to consider in regard to writing prescriptions for liniments. We will write a prescription for carron oil as an example. Carron oil is composed of equal volumes of solution of lime and cottonseed oil. The Latin for oil of cottonseed is oleum gossipii seminis, oleum, genitive ole-i, of oil; yossypium, genitive gossypi-i, of cotton; semen, genitive semin-is, of seed. The Latin for solution of lime is liquor calcis; liquor, genitive liquor-is, of liquor; calx, genitive, calc-is, of lime. Liquoris calcis. Olei gossypii seminis iia o'rii. Misce et fiat linimentum. Translated: Mix and let there be made a liniment. (Abbreviated) M. et f. liniment. Sig. Apply externally. Johx Smith, D. V. M. CLASSIFICATION. PART I. Inorganic Agents. Section I. — Water, and solution of hydrogen dioxide. Section II. — Alkaline metals; potassium, sodium, ammonium and lithium. Section III. — Alkaline earth metals; calcium, barium, magnesium, heavy metals; including Sections IV-VI. Section IV. — Aluminum, cerium, plumbum, argentum, zincum, cuprum and bi$- muthum. Section V. — Ferrum, manganum. Section VI. — Hydrargyrum. Section VII. — Arsenic, atoxyl, sodium cocodylate, antimony. Section VIII. — Phosphorus. Section IX. — Chlorine, iodine, thyroid extract, bromine, orthoform. Section X.— Sulphur. Section XI. — Acids. Section XII. — Carbon Compounds. Class 1. Carbon. Class 2. Alcohol, ether, chloroform. Class 3. Nitrites. Class 4. Chloral, chloretone. Class 5. Antipyretics, analgesics. Class 6. Antiseptics. Class 7. Miscellaneous carbon compounds. | PART II. Vegetable Drugs. Section I. — Drugs acting on the brain. Class 1. Depressing the brain: opium. Class 2. Stimulating the brain: belladonna. Section II. — Drugs acting on the spinal cord. Class 1. Stimulating the inferior cornua: mix vomica, strychnine. Class 2. Depressing the inferior cornua: physostigma, gelsemium. Section III. — Drugs acting chiefly on the motor nerves. Class 1. Depressing the motor nerves: tobacco, conium and lobelia. Section IV. — Drugs acting on the sensory nerves. Class 1. Depressing the sensory nerves: cocaine, eucaine, stovaine, holocaine, yohimbine, novocaine. Section V. — Drugs acting on the secretory nerves. Class 1. Stimulating the secretory nerves: pilocarpus. Section VI. — Drugs acting on the heart. Class 1. Increasing the force and decreasing the frequency of the heart: digitalis, strophanthus, convallaria and squill. Class 2. Decreasing the force and frequency of the heart: aconite, vera- trum viride and album, veratrine. Section VII. — Drugs acting on the respiration: ipecac. Section VIII. — Vegetable antipyretics and antiseptics. Class 1. Cinchona and its alkaloids. Class 2. Salicylic acid, salacin, salol, oil of gaultheria and methyl salicylate, aspirin. •Section IX. — Volatile oils or drugs containing them. Class 1. Used mainly for their action on the skin: turpentine, oil of tur- 98 CLASSIFICATION pentine, terebene, terpin hydrate, Burgundy pitch, Canada turpentine, resin, tar, pitch, oil of cade, balsam of Peru, balsam of Tolu, benzoin, benzoic acid, black and white mustard, fibrolysin, thiosinamine, eucalyptus, arnica, myrrh. Class 2. Used mainly for their stomachic and carminative action upon the digestive tract: capsicum, ginger, peppermint, menthol, spear- mint, anise, cardamon, coriander, fennel, fenugreek. Class 3. Used mainly for their antispasmodic action in stimulating the nerv- ous system: valerian, ammonium, ferric and zinc valerianates, asafetida and ammoniacum. Class 4. Used mainly for their stimulant and diuretic action on the genito- urinary tract: buchu and oil of juniper. Section X. — Vegetable bitters: gentian, quassia, cascarilla, calumba, taraxacum, hydrastis. Section XI. — Vegetable cathartics. Class 1. Simple purgatives: aloes, linseed oil, castor oil, rhamnus purshiana, phenolphthalein, frangula, rhamnus catharticus, rhubarb (chrysa- robin), senna. Class 2. Drastic purgatives: croton oil, scammony root, jalap, gamboge, elaterin, colocynth, podophyllum, podophylin. Section XII. — Tannic acid and drugs containing it: nutgall, tannic acid, gallic acid, pyrogallol,- white oak, catechu, kino, hamamelis. Section XIII, — Vegetable demulcents: olive oiJ, cottonseed oil, soap, soft soap, glycerin, linseed, acacia, tragacanth, althaea, sugar. Section XIV. — Vegetable drugs killing parasites. Class 1. Used to destroy tape worms: aspidium, areca nut, kamala, kouso, granatum, pepo. Class 2. Used to destroy round worms: santonica, chenopodium, spingelia. Class 3. Used to destroy oxyurides: quassia. Class 4. Used to destroy lice: stavesacre. Class 5. Used to destroy fleas: pyrethrum. Section XV. — Vegetable drugs stimulating unstriated muscle, particularly of the uterus: ergot, cotton root bark. Section XVI. — Vegetable drugs acting mechanically: starch, oil of theobroma, purified cotton, pyroxylin, collodion, euphorbium. Section XVII. — Medicinal agents of animal origin: adrenalin, pituitrin, thyroid glands (see p. 192), cantharides, lard, suet, hydrous wool fat, yellow and white wax, spermaceti, honey, milk, sugar, pepsin, pancreatin, ox gall, papain, cod liver oil, ichthyol, thiol. NOTE. ABBREVIATIONS USED IN REFERENCE TO THE SYNONYMS IN THE DESCRIPTIONS OF DRUGS. B. P., British Pharmacopeia. E., English. P. G., German Pharmacopeia. Fr., French. G., German. DOSAGE. Three doses of each medicine are usually given; one for horses and cattle; one for sheep and swine, and one for cats and dogs, unless otherwise specified. The quantities are expressed in units of the apothecaries' weight or wine measure and also in the metric system. The solids in the latter to be dispensed in grams, the liquids in mils. Only those official drugs and preparations of the United States and British Pharmacopeias will be mentioned, which are considered to be of value to practitioners of veterinary medicine. In connection with doses the following abbreviations are used: H., Horse. C, Cattle. Sh. & Sw., Sheep and Swine. D. Dogs. The same dose may be given to dogs and cats of equal weight. PART I. INORGANIC AGENTS. SECTION I. Water. Aqua, Water. Aqua Destillata, Distilled Water. H20. (The latter used in filling many prescriptions.) Action external. — The reader is referred to special articles on "Cold and Heat" (p. 497), "Food and Feeding" (p. 479), and "Counter Irri- tants" (p. 491), for details concerning the action and uses of water, respectively, as a medium of heat and cold, as an article of diet in health and disease, and as a counter irritant. Cold water, externally, at first stimulates reflexly heat production, with slight rise of temperature, in- creased carbonic acid elimination and contraction of the vessels and muscles of the skin. If the cold water application is continued, the bodily heat falls, owing to physical abstraction of heat. "Reaction" follows the removal of cold, if properly applied, with dilation of the superficial vessels (and sensation of warmth and exhilaration in man). Moderate warm water (105° F.) applications stimulate cutaneous vascularity, favor diaphoresis, and diminish urinary secretion. Hot water (110°-120° F.) applications act as counter irritants in dilating the peripheral vessels, con- tracting those in more remote parts, and relieving pain, spasm, congestion and inflammation. Action internal. — Water is quickly absorbed from the intestines (to very slight extent from the stomach), and thus swells the secretion of urine, and, to a less extent, that of bile, saliva and pancreatic juice. Intes- tinal peristalsis is favored by a considerable amount of water. Water also increases tissue change, and elimination of carbonic dioxide and urea; promotes the appetite and washes out the tissues and urinary tract, thus removing waste matters from the body. The elimination of uric acid is lessened by water. Large quantities of water, if not taken at meal time — when they dilute the digestive juices and disorder digestion — favor the formation of fat. Uses external. — See "Heat and Cold," p. 497. Uses Internal. — Healthy animals may be given as much water as they desire, with certain restrictions in relation to work and feeding. It is unwise to allow horses much water, either immediately before or after severe work, or after feeding. If water is given before severe work it increases the bulk of intestinal contents, is apt to cause digestive disturb- ance, and interferes with the movements of the diaphragm. For these same reasons water should only be permitted in small amount (at a time) in "heaves" of horses. Horses must be given water sparingly for the first three hours after unloading following shipment on the railroad, when they are much wearied or are very thirsty. 100 INORGANIC AGENTS If a quantity of cold water is allowed horses after hard work, colic is very likely to occur. Working horses should, therefore, be watered, in reasonable amount, while at work; and, if this is impracticable, may be allowed but a few mouthfuls of water, or a gallon of oatmeal gruel after severe work, with whole hay hut no grain until after an hour's rest. When horses at rest drink much water after eating, the contents of the stomach (which is unusually small in this animal) are washed into the intestines and are not so thoroughly digested. This accomplishes two bad results: it deprives the animal of some nourishment and engenders digestive trouble and diarrhea. The best plan is to give resting horses water before eating, or to keep it at their command at all times. Cold water is desirable, frequently and in unlimited quantities, in fever, although there is a popular fear of it. Water is more valuable than any other known agent in fever to eliminate toxins. Drinking should be encouraged by putting salt on the food and by keeping water always at the animal's disposal. Also by giving large enemata of normal salt solution (p. 519). Hot water assists the action of diaphoretics ; cold water that of diuretics. Lukewarm water is an emetic, but hot water, in small and repeated doses, allays nausea and vomiting. Water is restricted in ordinary diarrheas, obesity, and to assist the absorption of exudations. The drinking of water should be encouraged by a liberal allowance of salt (which in itself aids digestion), in animals in a poor condition, to increase their appetite and flesh. Water is valuable in diluting a concentrated urine from which calculi are liable to be deposited. High rectal injections of water are absorbed, and con- sequently flush out the kidneys. Solution of Hydrogen Dioxide. Liquor Hydrogexii Dioxidi. Solution of Hydrogen Dioxide. (U. S. P.) Synonym. — Aqua Hydrogenii Dioxid, Liquor Hydrogenii Peroxidi (B. P.), Hydrogen Peroxide. An aqueous solution containing not less than 3 per cent., by weight of H£02, corresponding to not less than 10 volumes of available oxygen. Derivation. — Add barium dioxide, 300, to cold, distilled water, 500; agitate and keep at a temperature of 10° C. (50° F.). To this mixture (of barium hydrate) add a solution of phosphoric acid, 96, in cold distilled water, 320, and shake them together thoroughly. Filter, and wash the precipitate (barium phos- phate) with distilled water until the nitrate measures 1000. Add diluted sulphuric acid to the filtrate (until cloudiness disappears in a small filtered por- tion of it; absence of barium), and starch 10. Agitate frequently. Filter and refilter till the solution becomes clear. Properties. — A colorless liquid, odorless or having odor suggesting ozone, slightly acid to the taste, and producing a peculiar sensation and froth in the mouth; liable to deteriorate by age, exposure to heat, or protracted agitation. Reaction slightly acid. When exposed to the air at the ordinary temperature, or when heated in a water bath at a temperature not exceeding 60° C. (140° F.) the solution loses chiefly water. When rapidly heated it is liable to decompose suddenly. (The value of a given sample of hydrogen dioxide may be roughly ascertained by adding a few drams to a few crystals of potassium perman- ganate in a test tube. The greater the amount of effervescence the better the hydrogen dioxide. — Wallian.) Dose.— H. & C, 5i-ii, (30-60) ; D., 3i-ii, (4-8). SOLUTION OF HYDROGEN DIOXIDE 101 Action and Uses. — Hydrogen dioxide is probably the most powerful, non-toxic, surgical antiseptic and disinfectant. It is not poisonous to higher animals, and liberates oxygen immediately in the presence of all forms of living matter, excised organs, and drawn blood, thus destroying all bacteria and organized ferments. It is, moreover, a most efficient cleansing agent in wounds, the gaseous froth mechanically removing detritus better than irrigation. It thus acts like soap-suds in ordinary washing processes. Injected intravenously hydrogen dioxide causes death through the formation of gas (oxjrgen) emboli — in its catalysis in the blood — by plugging the heart and blood-vessels of the brain and lungs. The microbicidal action is transient and not persistent; only water remains. Therefore hydrogen dioxide is useless for the production of con- tinuous antiseptic action. The drug is an antiseptic in the digestive tract, and some oxygen may be absorbed by the blood, but this is extremely doubtful. The official solution contains 10 volumes of oxygen; that is, it yields up 10 times its bulk of oxygen gas. Most proprietary preparations are stronger, and contain 12 volumes of oxygen, and are more powerfully disinfectant. Hydrogen peroxide is particularly valuable as an antiseptic on sup- purating and septic wounds, necrosed tissue, abscess cavities, in anaerobic infections (tetanus), sinuses, ulcers, morbid growths and suppurating mucous membranes. It is well to add a little sodium bicarbonate to hydrogen peroxide, to neutralize its acidity, before using on mucous mem- branes or raw surfaces. Gauze saturated with it is used as packing to stop bleeding, as in epistaxis. In fistulae of the withers and poll, hydro- gen dioxide acts as an efficient cleansing and antiseptic agent, and it should be injected prior to the use of other antiseptics, stimulants and caustics, as carbolic acid In glycerine (see p. 2k8). Hydrogen dioxide is probably the best remedy we possess in the treatment of acute and mem- branous inflammation of the pharynx and tonsils in dogs and cats when applied directly to the throat, diluted with two parts of lime water, with an atomizer or brush, or on absorbent cotton on an applicator. To retain its germicidal action it should not be diluted with more than 1 or 2 parts of water. Typhoid bacilli were killed in two and one-half minutes by a 50-per-cent. solution (U. S. Hygienic Laboratory). It is commonly employed on wounds in full strength and only in glass, porcelain, or hard rubber vessels or instruments. The drug should not be used in cavities where an outlet for the free escape of gas is wanting. Peroxide of hydro- gen decomposes pus with effervescence, and thus is a guide to its presence or absence; it also destroys the pus cocci. Hydrogen dioxide is a safe and efficient agent in disinfecting drink- ing water, and is of some value in gastric fermentative indigestion of dogs where the vomitus and feces show evidence of gas formation or frothiness, and is absolutely safe. Recently good results have been re- ported from the use of hydrogen dioxide, diluted with three parts of lime water, in dysentery when given as high enemata twice daily. As substitutes for hydrogen peroxide we have the more stable, non- irritating and alkaline powders, as sodium. perborate and zinc peroxide- 102 INORGANIC AGENTS Sodium perborate is a white, granular, odorless salt containing not less than 9 per cent, of available oxygen. It is soluble and when it goes into solution it sets free hydrogen peroxide and sodium metaborate producing an alkaline product. It is very useful on wounds, ulcers and raw sur- faces on account of its being alkaline and permanent. It is used in 2 per cent, solution or as a dusting powder and, like H202, tends to stop hemorrhage and is both antiseptic and deodorant. Zinc peroxide is a yellowish-white, light, tasteless, odorless, insoluble powder, but liberates oxygen in contact with living tissue. It is used as a dusting powder on raw surfaces and gives up its oxygen slowly and possesses a slight alka- line reaction when moist. SECTION II. Alkaline Metals — Potassium, Sodium, Ammonium, Lithium. Potassium. Potassium is not used in medicine in the metallic state. Its com- pounds may be considered in three groups; 1, Potassa; 2, the Carbonates (acetate and citrate) ; 3, the Mineral Salts. Potassium compounds were formerly obtained from wood ashes by lixiviation; from sea water by evaporation, and from argol, a substance deposited in wine casks. Now they are obtained from potassium muriate, mined in Stassfurt, Saxony, which is thought to result from the boiling away of sea water in past ages. General Action of Potassium Salts. The action of salts on the body is determined not by the action of the chemical compound or its molecule but by the action of the ions which are dissociated when the salt goes into solution. Thus the action of potas- sium on the body may be studied by observing the action of KC1 since the influence of the CI ion (anion) may be ignored as it induces no physio- logical effect upon the organism. In lethal doses the action of all the potassium compounds is very similar. Stomach and Intestines. — The potassium salts, with the exception of the vegetable compounds, are irritants to the gastro-intestinal tract, if ingested in concentrated form. Heart. — When injected into a vein, potassium has a direct, paralyz- ing action on the heart muscle, and in lethal doses there is cardiac arrest in diastole. Much the same action is, moreover, observed on all higher forms of tissue. The functional activity of the nerves and muscles is depressed and abolished, more especially that of the brain and cord, so that paralysis of central origin occurs. Potassium has, however, no depressing influence upon the heart when given by the mouth, as enormously greater amounts than are ever given medicinally are daily consumed in the food. Bunge estimates from 50 to 100 grams may be thus daily ingested in food by man. This fact ex- plodes the fallacy that sodium salts are less depressant to the heart than POTASSIUM 103 the corresponding salts of potassium and are preferable as medicinal agents to the latter. Blood. — When given for any considerable period, the potassium, like the sodium salts, impoverish the system and produce a more fluid state of the blood. Large doses of the potassium salts are likely to occasion purging, while small doses are apt to cause diuresis. The carbonates and vegetable salts resemble each other in action, but that of the mineral salts is peculiar to the individual compound. Potassii Hydroxidum. Potassium Hydroxide. KOH. (U. S. P.) Synonyms. — Potassa caustica, B. P.; potash, potassium hydrate, caustic pot- sash, lapis causticus chirurgorum, E.; potasse caustique, Fr.; aetz kali, G.; kali causticum fusum, P. G. Derivation. — A solution of potassium hydrate is evaporated; the residue is fused and run into moulds. Properties. — Dry, white, or nearly white, fused masses, or sticks, hard and brittle, showing a crystalline fracture; odorless, and of a very acid and caustic taste. Exposed to the air, it very rapidly absorbs carbon dioxide and moisture, and deliquesces. 1 Gm. dissolves in 0.9 mils of water, about 3 mils of alcohol, in 2.5 mils of glycerin at 25°* C. (77° F.), also in 0.6 mil of boiling water; very soluble in boiling alcohol. Liquor Potassii Hydroxidi. Solution of Potassium Hydroxide. (U. S. P.) An aqueous solution of potassium hydroxide (KOH), containing not less than 4.5 per cent, of KOH. Potassium hydroxide, 60 Gm., distilled water, 940. Synonym. — Liquor potassae, B. P.; solution of potassium hydrate, solution of potash, E.; potasse caustique liquide, lessive caustique, Fr.; aetzkalilauge, G. ; liquor kali caustici, P. G. Derivation. — Boiling a solution of potassium carbonate with calcium hydrate leaves potassium hvdrate in solution, while calcium carbonate is precipitated. K,C03 + Ca (OH)2 = 2 KOH+Ca C03. Properties. — A clear, colorless, odorless liquid, having, even when diluted, a very acrid, caustic taste and a strongly alkaline reaction. It has a soapy feel and taste. Dose.— H. & C, Sss-i, (15-30); Sh. & Sw., 5ss-i, (2-4); D., TTlv-xx, (.3-1.3). Potassa Cum Calce. Potassa with Lime. (Non-official.) (Equal parts of potassa and lime.) Synonym. — Vienna paste. Properties. — A grayish-white powder, deliquescent, having a strongly alkaline reaction; should be soluble in diluted hydrochloric acid without leaving more than a small residue. Action and Uses. — Potassium hydroxide, its solution, and potassa cum calce are mainly of value as escharotics. Liquor potassae is unfit for internal use unless greatly diluted with water. It resembles potassium carbonate in its effects. Caustic potash is very destructive of tissue by dissolving proteids and forming alkali-proteids. It is most diffusible and, therefore, difficult to limit its action. This we may do, however, by applying a plaster to a part, with a hole in it, through which the caustic stick is applied. Before using the caustic, the outside of the plaster should be covered with oil or grease, but not the part under the aperture in it. After removing the plaster the operation of the caustic may be arrested by vinegar. Cauterization by this means is very painful under *When solubility is mentioned hereafter, reference will be had to solubility at the above temperature. 1W4 INORGANIC AGENTS ordinary circumstances, but may be made comparatively painless by incor- porating one part of morphine muriate with three parts of potassa cum calce, and adding enough chloroform to make a paste. Caustic potash is indicated where extensive destruction of tissue is desirable, as in the treatment of the bites of rabid dogs and of snakes. It is less commonly used for the removal of warts, and small growths, and as a caustic on indolent or exuberant granulations. Potash has been employed to form an issue, or artificial ulcer for the production of counter irritation. Potash may be prescribed in bronchitis, for its action, common to the alkalies, in thinning and increasing the bron- chial secretions. An excellent mild stimulating liniment consists of: R 01. terebinthinae 50.00 01. succini .. 20.00 Saponin pulv. 10.00 Potacsae 2.00 Aquae ad.... .1,000.00 M. et fiat linimentum. The potash saponifies the oils and exerts a stimulating action on the skin. Potassium bicarbonate is less irritating and more suitable for the latter indication. Potash is sometimes recommended as an antacid and sedative in gastric disorders, but is inferior to sodium bicarbonate for this purpose. Potassh Carbokas. Potassium Carbonate. K2C02. (U. S. & B. P.) Synonym. — Salts of tartar. Carbonate de potasse, Fr. Kaliuin carbonicum, P. G. Derivation. — Tbe solution resulting from the lixiviation of wood ashes is boiled to dryness, and the resultant mass is the "potash" of commerce. This is purified to some extent by burning in ovens, forming "pearlash," a mixture of the hydrate and carbonate. Water dissolves mainly the carbonate which is obtained by evaporation of the aqueous solution. Properties. — A white, granular powder, odorless, and having a strongly alka- line taste; very deliquescent. Soluble in 0.9 part of water; insoluble in alcohol. Dose.—tt.&i C, 5ss-i, (15-30); Sh. & Sw., 3ss-i, (2-4); D., gr.v-xx, (.3-1.3). Potassii Bicarboxas. Potassium Bicarbonate. KHC03. ' (U. S. & B. P.) Synonym. — Doppeltkohlensaures kali, G. Bicarbonate de potasse, Fr. Derivation. — Obtained by passing a stream of C02 through a solution of the carbonate. K2COs -f CO, + H20 = 2 KHC03. Properties.— Colorless, transparent, monoclinic prisms, or as a white, granular powder, odorless and having a saline and slightly alkaline taste. Permanent in the air. Soluble in 2.8 parts of water. Almost insoluble in alcohol. Becomes converted into the carbonate bv boiling. Dose.— H. & C, 5ss-i, (15-30); Sh. & Sw., oss-i, (2-4); D., gr.v-xx, (3-1.3). Preferable to carbonate for internal use, as it is less irritating. Potassii Acetas. Potassium Acetate. KC2H302. (U. S. & B. P.) Synonym. — Acetate de potasse, Fr. Essigsaures kali, G. Derivation. — Add acetic acid in excess to potassium carbonate. Evaporate to dryness and fuse residue. K2C03 + 2 HC2H,02 = 2 KC2H302 + H20 + C02. Properties. — A white powder, or crystalline masses of a satin-like luster; odorless, or with a faint acetous odor, and having a warming, saline taste. Very POTASSIUM CITRATE 105 deliquescent on exposure to the air. Soluble in 0.5 part of water and in 2.9 parts of alcohol. Dose. — Same as bicarbonate. Potassii Citras. Potassium Citrate. K3C0H5O7-^H.O. (U. S. & B. P.) Synonym. — Citrate de potasse, Fr.; Citronsaures kali, G. Derivation. — Neutralize potassium carbonate with a solution of citric acid, and evaporate to dryness. 3 K2COa -f 2 H3C6H507 = 2 K8CeHB07 + 3 H20 + 3 C02. Properties. — Transparent, prismatic crystals, or a white, granular powder; odorless and having a cooling, saline taste. Deliquescent when exposed to moist air. Soluble in 0.6 part of water; almost insoluble in alcohol, freely soluble in glycerin. Dose. — Same as bicarbonate. Action of the Carbonates and Vegetables Salts. The carbonate is too irritating for internal use, while the bicarbo- nate is more so than the similar sodium salt. Therefore the latter is in more common use as an antacid. Antacids neutralize abnormal gastric acidity if given in large doses some time after eating. The vegetable salts (the acetate and citrate) are converted into the carbonate in the blood and are non-irritating. The bicarbonate is also absorbed into the blood as the carbonate. These salts, together with the hydrate, alkalize the blood and urine. It is thought by many authorities that they increase oxidation within the body, as it is known that they do so outside the body in contact with organic matter. As a result of all ex- periments with the hydrates and carbonates, neither oxidation nor meta- bolism appear to be materially influenced. Uric acid elimination is not affected, but urea may be increased, replacing ammonia in the urine. The action of these salts is due wholly to the hydroxy! (OH) ion. The action of the carbonates is only less in degree and rapidity than the hydrates, since OH is freed in the body when carbonates combine with water. The carbonates are mainly useful as antacids ; the citrate and acetate as diuretics. Uses. — Potassium carbonate forms a useful addition to mixtures for application to the skin, as, through its strong alkalinity, it removes grease and sebaceous matter, permitting medicinal agents to penetrate the skin. A mixture of potassium carbonate, 15.0 (qSS.) ; sublimed sulphur, 50.0 (3i. 5v.) ; and water, 12 litres (3 gallons), makes a serviceable applica- tion for the milder forms of mange and eczema. The animal should be well washed with the mixture in a tub every second day, and Peruvian balsam, oil of cade or tar should be applied daily. Potassium bicarbonate in aqueous solution is serviceable in relieving itching (gr.v.-§i.). While probably not so generally efficient as the corresponding sodium salt, it is of benefit when given an hour after feeding to horses subject to colic at that time. It is more useful than sodium bicarbonate in alkalizing an over-acid urine (dogs), and in dissolving and eliminating uric acid from the blood. Potassium citrate and acetate are indicated in irritation or inflammation of the kidneys and bladder and cause absorption of exuda- tions (pleural effusions, for example), through their diuretic power. 106 INORGANIC AGENTS They are sometimes prescribed in fever on account of slight diaphoretic and powerful diuretic properties. Potassium acetate and citrate stimulate bronchial secretion and make it thinner, and are recommended accordingly in bronchitis. They are less efficient than potassium iodide for these purposes in this affection. Diuretic, diaphoretic and expectorant mixture for fever with bronchitis in horses. fy Tincturae aconiti 1 3iU Potassii citratis ,liv Spiritus aetheris nitrosi 3viii Aquae ad Oi M. Sig. 4 tablespoonfuls in drinking water 3 times daily. Potassii Nitras. Potassium Nitrate. KN03 (U. S. & B. P.). Synonym. — Nitre, saltpetre, E.; nitre prismatique, azotate (nitrate) de potasse, Fr.; saltpetersaures kali, kalisalpeter, G. Derivation. — Saltpetre is formed in the soil in certain regions and climates and is made artificially, by the putrefaction of animal or vegetable material, in the presence of heat, moisture, oxygen, and alkaline or earthy bases capable of fixing the nitric acid set free in this process, known as nitrification. The natural conditions for nitrification are present in some parts of India, and saltpetre is largely imported from Calcutta. Artificially, nitre beds are made of animal and vegetable matter, wood ashes, and calcareous earth or old plaster from houses. Sodium nitrate is imported extensively from Chili, where it occurs as a mineral product, and is used widely in this country in artificial fertilizers. Chili saltpetre may be converted into nitre by treatment with potash. Properties. — Colorless, transparent, six-sided, rhombic prisms, or a white, crystalline powder; odorless, and having a saline taste and producing a cooling sensation in the mouth. Slightly hygroscopic in moist air. Soluble in 2.8 parts of water; in 620 parts of alcohol. Dose.— H. & C, §ss-i, (15-30) ; Sh. & Sw., 5ss-i, (2-4) ; D., gr.v-xx, (.3-1.3). Action External. — Refrigerant. Action Internal. — Stomach and Intestines. — Nitre causes, in lethal doses, violent gastro-enteritis, often nephritis, muscular weakness, coma, collapse and depression of the circulation. The pulse becomes both slow and weak. There is muscular weakness and paralysis. Potassium nitrate is one of the most irritating salts of this group, but its toxic effect de- pends upon the influence of the nitrate ion, and — when concentrated — upon its "salt action" (see p. 115) in withdrawing water from the tissues. Blood. — Toxic doses of nitre have a slight destructive action (hemo- lysis) on the red blood cells. Heart. — Nitre is said to be more depressing to the heart than the other potassium compounds. There is no basis for this belief. Lungs. — The respiration is slowed by considerable doses of potas- sium nitrate, and it exerts an antispasmodic action by depression of the unsfriped fibres of the bronchi. It has an expectorant action similar to that of the acetate and citrate of potash. Kidneys. — Diuresis is the predominant medicinal action of nitre. It may induce diuresis through its "salt action" (see p. 115) but in that case should escape unchanged in the urine. Apparently little or none is thus eliminated, except after large doses. In moderate doses the salt is changed in the body. It is conjectured that it is first converted into POTASSIUM CHLORATE 107 nitrates, then into ammonia, and finally escapes from the lungs as free nitrogen. The diuretic action is chiefly due to direct stimulation of the renal cells. Potassium nitrate is more frequently prescribed than any other potassium salt in veterinary practice, and is commonly considered one of the best febrifuges. Its only service in fevers is as a diuretic. Administration. — Nitre is dissolved in a pail of drinking water and kept constantly at the larger animal's disposal. The salt is rendered harmless by dilution; vascular tension and diuresis are increased by the water, and the solution is cooling and grateful to the taste in fever. Smaller doses (oss.) may be given on the food to horses, but this method is not so desirable. Uses. — Nitre, ammonium chloride, and common salt, each one part, are dissolved in three parts water, and sometimes used for their refrig- erant effect on local inflammatory conditions. Ice poultices are more efficient. The value of nitre is over-estimated in veterinary practice. It is recommended in purpura and rheumatism as an alterative. Here again it is less serviceable than normal serum in the former, or salicylic acid and alkalies in the latter disease. Nitre is, however, in common use in such febrile affections as pneumonia and influenza, and in edema of the limbs and lymphangitis in horses for its expectorant and diuretic action. It is more irritating to the kidneys, than the citrate and acetate, and is not used in human medicine on that account. But it is cheaper and is given in drinking water to horses so largely diluted that its irritating action is avoided. Powdered potassium nitrate — mixed with an equal amount of stramo- nium leaves — is sometimes employed in asthma and bronchitis of dogs as an inhalation by burning the mixture. Potassii Chloras. Potassium Chlorate. KC103. (U. S. & B. P.) Synonym. — Kalium chloricum, P. G. ; chlorate de potasse, Fr.; chlorsaures kali, G. Derivation. — Pass chlorine into a mixture of potassium carbonate and cal- cium hydrate; dissolve the result in boiling water and recover the chlorate by crystallization. K2C03 + 6 Ca (OH)2 + 12 Cl = 2 KC103 + Ca C03 -f- 5 Ca Cl2 + 6 H20. Properties. — Colorless, lustrous, monoclinic prisms or plates, or a white pow- der, odorless, and having a saline taste. Permanent in the air. Soluble in 11.5 parts of water. Almost insoluble in alcohol, but soluble in glycerin. Explodes readily when rubbed with sugar, sulphur, charcoal, glycerin and many other sub- stances. Dose.— H. & C, 5ii-vi, (8-24) ; Sh. & Sw., oss-i, (2-4) ; D., gr.v-xx, (.3-1.3). Action Internal. — Stomach and Bowels. — In concentrated form potassium chlorate is an irritant to mucous membranes — causing vomiting and purging in the alimentary tract — owing to its withdrawal of water from the tissues. Its "salt action" is also seen in its increasing tension in the renal glomeruli and thus causing diuresis (see p. 115, sodium chlo- ride). Lethal doses occasion gastro-enteritis, diarrhea, cyanosis, depres- 108 INORGANIC AGENTS sion of the hearty coma and death from asphyxia. Jaundice and dark-colored urine occur in sub-acute poisoning. The Blood. — The blood is unaffected by medicinal doses, but in poi- soning the red corpuscles are broken down and crenated. The hemoglobin is converted into methemoglobin, which is probably a mixture of hematin and soluble albumin. Hemoglobin, mcthcmoglobiii and hematin and dis- integrated corpuscles appear in the urine. The blood is chocolate-colored after death. The liver, spleen, kidneys and intestines are softened and filled with disorganized blood. It was formerly thought that potassium chlorate parted with its oxygen in the blood, and it was prescribed in many disorders as an oxidizing agent. Potassium chlorate gives up very little oxygen to the body since almost all of the salt absorbed escapes unchanged from the organism. On the contrary, the important symp- toms of poisoning are due to lack of oxygen (asphyxia), methemoglobin not liberating its oxygen readily to the tissues. Death from fat embolism is not uncommon during convalescence from poisoning. Elimination. — Potassium chlorate is eliminated unchanged by all channels; mainly by the urine (90 to 9(3 per cent.), but also by the sweat, saliva, etc. Acting locally as a stimulant in the mouth, and then affecting the throat a second time by its elimination in the saliva, potassium chlo- rate is frequently prescribed in diseases of the mouth and pharynx as a topical stimulant. It is given in electuary, solution, or ball internally. Summary. — Sialogogue and diuretic. Uses. — Stomatitis is treated by chlorate of potassium in saturated solution applied on a swab. The salt is valuable in the treatment of pharyngitis in electuary. A favorite combination consists of the fol- lowing: Pharyngitis of horses. R Fluidextracti belladonnae 3i Potassii chloratis 5ii Pulveris glycyrrhizae 3v Syrupi fusci q. s. M. et fiat electuarium. (Weigh one ounce for sample dose.) f S. Smear amount equal to sample on teeth with stick 3 times daily. In membranous croup (roup) of fowl (gr.x.), and in that of foals, calves and pigs (gr.xxx.), it is useful when given in solution with an equal dose of the tincture of chloride of iron. A half ounce of a satu- rated solution of potassium chlorate, with a few drops of laudanum, forms a useful injection for hemorrhoids in dogs. Potassii Bitartras. Potassium Bitartrate. KHC^H^O*. (U. S. P.) Synonym. — Potassii tartras acidus, B. P.; cream of tartar, cremor tartari, acid tartrate of potash, E.; tartarus depuratus, P. G.; pierre de vin, Fr., wein- stein, G. Derivation. — Obtained from crude tartar (argol) deposited on the sides of wine casks during fermentation of grape juice, by purification. Properties. — Colorless or slightly opaque, rhombic crystals, or as a white, somewhat gritty powder; odorless and having a pleasant, acidulous taste. Per SODIUM 109 manent in the air. Soluble in about 155 parts of water, and in 8820 parts of alcohol. Reaction acid. Dose.— H. & C, 3ss-i, (15-30); Sh. & Sw., gss, (15); D., 3ss-i, (2-4). Action internal. — Intestines. — Potassium bitartrate is a non-irritating purgative in large doses. It is a hydragogue cathartic and has a strong affinity for water; abstracting it from the blood vessels in the bowels, holding the same in solution, and thus flushing out the intestines. Blood. — Potassium bitartrate is in part decomposed, converted into the carbonate, and absorbed as such into the blood. The greater part is apparently excreted by the bowels unchanged. A portion of the latter, however, may have been absorbed and eliminated by the intestines. Kidneys. — Potassium bitartrate is an active diuretic and renders the urine^more alkaline, but for some reason it is not ordinarily employed in veterinary practice. Nevertheless, it is the best and safest diuretic which can be used by the veterinarian in the treatment of the horse and smaller animals. Summary. — Diuretic in small doses. Hydragogue cathartic in large doses. It should be given in solution and is useful in dropsies, more par- ticularly of renal origin; also in catarrhal jaundice, and as a laxative for foals and calves. In cases where the urine of the horse is thick, stringy and high-colored, potassium bitartrate will cause it to regain its normal state. It may easily be administered in either food or drinking water, and its diuretic effect is enhanced when the salt is given with a large amount of water. Sodium. (The metal is not employed in medicine.) Sodii Hydroxidum. Sodium Hydroxide. NaOH. (U. S. P.) Synonym. — Soda caustica, B. P.; soda, sodium hydrate, caustic soda, natrum causticum, S. hydricum, E.; soude caustique, Fr.; natron, aetznatron, G. Derivation. — It is made from liquor sodas by evaporation, and run in moulds. Properties. — Dry, white, or nearly white, fused masses or sticks, hard and brittle, showing a crystalline fracture; odorless, and having an acrid and caustic taste. Exposed to the air it deliquesces, absorbs carbon dioxide, and becomes covered with a coating of carbonate. Soluble in 0.9 part of water; very soluble in alcohol. Liquor Sodii Hydroxidi. Solution of Sodium Hydroxide. (U. S. & B. P.) An aqueous solution of sodium hydroxide, containing not less than 4.5 per cent, of NaOH. Synonym. — Solution of sodium hydrate, E.; natrum hydricum solutum, soude caustique liquide, Fr.; liquor natri caustici, P. G. ; aetznatron lauge, G. Derivation. — An aqueous solution of sodium carbonate is boiled with calcium hydrate, and the supernatant liquid is siphoned off. Na.CO, + Ca (OH)2 = 2 NaOH + CaC03. Properties. — A clear, colorless, or yellowish, syrupy liquid, odorless, having a very acrid and caustic taste, and a strongly alkaline reaction. Dose.— H. & C, 5ss-i. (15.-30.) ; Sh. & Sw., 5ss-i (2.-4.) ; D., TTlvi-xx. (.3-1.3). Action and Uses. — Sodium hydroxide and its solution resemble compounds of potassium, but are used chiefly for chemical and pharmaceutical purposes. Liquor sodii hydroxidi should be given largely diluted with water. In poi- soning by the caustic alkalies or soap lye, give vinegar, diluted acetic acid, lemon juice and demulcents. Inject subcutaneously camphorated oil (H. & C, Bss-i; D., TTtxv-xx). 110 INORGANIC AGENTS Sodii Carbonas. Sodium Carbonate. Na2 C03 10 H20. (Non-official) Synonym. — Washing soda, sal soda, carbonas sodicus, E.; natrum carbonicum crudum, P. G.; carbonate de soude, Fr.; kohlensaures natron, soda, G. Derivation. — Made by Leblanc's process. Three steps: 1st. Salt and sulphuric acid heated together. 2 Na CI. + H„ S04 = Na, S04 + 2 HC1. 2nd. Sodium sulphate is heated with carbon. Na2SO, + 4 C = Na2 S + 4 CO. 3rd. Sodium sulphide heated with chalk. Na2 S + Ca C03 = Na^ COa + Ca S. Properties. — Colorless, monoclinic crystals, odorless and having a strongly alkaline taste. In dry air the salt effloresces, loses about half its water of crystallization and becomes a white powder. Soluble In 1.6 parts of water and in 1.02 part of glycerin. Reaction alkaline. Sodii Carbonas Monoiiydratus. Monohydrated Sodium Carbonate. Na.COs+H.O. (U. S. & B. P.) Synonym. — Natrum carbonicum siccum, P G.; carbonate de soude, Fr.; getrocknete soda, G. Properties. — A white, crystalline, granular powder; odorless, and having a strongly alkaline taste. When exposed to the air, under ordinary conditions, it absorbs only a slight percentage of moisture. Soluble in 3 parts of water; in- soluble in alcohol and ether; soluble in 7 parts of glycerin. Reaction alkaline. Action of sodium carbonate similar to the hydroxide, but infrequently employed in medicine. Dose.— H. & C, 3ii-vi, (8-24); Sh. & Sw., gr.xx-xl, (1.3-2.6); D., gr.v-xx, (.3-1.3). Given in large amount of water. Sodii Bicarbonas. Sodium Bicarbonate. Na HCOs. (U. S. & B. P.) Synonym. — Soda, baking soda, sodium hydrocarbonate, bicarbonate of soda, E.; natrum bicarbonicum, P. G. ; bicarbonate de soude, sel digestive de vichy, Fr.; doppeltkohlensaures natron, G. Derivation. — Pass CO. through a solution of sodium carbonate, Na2 C03 + C02 -f H20 = 2 Na HC03. Properties. — A white, opaque powder, odorless, and having a cooling, mildly alkaline taste. Permanent in dry, but slowly decomposed in moist air. Soluble in 10 parts of water, insoluble in alcohol and ether. Slight alkaline reaction. Incompatible s. — Decomposed by acid and acid salts, as bismuth subnitrate. Dose.— H., 5ss-ii, (15-60); Sh. & Sw., 5ss-i, (2-4); D., gr.v-xxx, (.3-2). General Action of Sodium Salts. Sodium and its salts are said to be less poisonous than the cor- responding salts of potassium because they are less depressing to the circulatory (see p. 102), muscular and nervous systems, but death has occurred after enormous doses. The salts possess a local paralyzing action on nerve and muscular tissue. They are absorbed and eliminated more slowly than the corresponding potassium compounds. Sodium salts alkalize the blood and urine, but are only slightly diuretic. Sodium car- bonate, phosphate, and sulphate dimmish the solids in the bile and, there- fore, increase its fluidity. Sodium Bicarbonate. Action External. — Sodium bicarbonate lessens irritability of the skin in itching and burns. Action Internal. — When sodium bicarbonate is given internally it counteracts gastric acidity, whether it be normal, abnormal (organic acids from fermentation), or excessive (hyperchlorhydria). It thus relieves SODIUM BICARBONATE 111 pyloric spasm. Its constant administration is said to weaken the diges- tive powers and create anemia, general cachexia, and scorbutic symptoms, but there appears to be no sufficient basis for this belief. Sodium bicar- bonate liberates carbonic dioxide in the stomach, which is a sedative and peristaltic stimulant, thus expelling gas and relieving pain in the viscus. The distention of the stomach with C02 gas is also a mechanical cause of its increased motility. Soda dissolves mucus and thins the biliary secretion. It is, therefore, useful in catarrh of the gastro-intestinal tract. Blood. — The blood is made more alkaline. Kidneys. — The urine is alkalized, but the salt is only feebly diuretic ("salt action," p. 115). Uses External. — In aqueous solution (1-50) sodium bicarbonate re- lieves itching in urticaria, prurigo and chronic eczema. It dissolves mucus in leucorrhea and is often used in this strength as a vaginal injec- tion. It also allays the pain of slight burns and of acute rheumatism. For this purpose cloths should be soaked in saturated solutions and placed upon the affected parts. Added to water (5i.-Oi.) in which instruments are to be boiled, it prevents rusting. Uses Internal. — Sodium bicarbonate is one of the most useful rem- edies in gastric or intestinal indigestion associated with abnormal acidity, or flatulence and distress. It does not always remove the cause of indi- gestion, however, and, therefore, should be combined with agents which do: e.g., cathartics, antiseptics, carminatives and stomachics. For this reason sodium bicarbonate is often prescribed to dogs with bismuth sub- carbonate, salol or beta naphtol; to horses with gentian or nux vomica and ginger. For horses with indigestion. I£ — Sodii bicarbonatis. Pulveris gentianae radicis. Pulveris zingiberis aa %1V M. S. Give 3 tablespoonfuls on feed t. i. d. Sodium bicarbonate with bismuth may be given thrice daily in indi- gestion and diarrhea of calves, especially when the trouble has arisen from feeding sour milk. For calves with diarrhea. 1$ — Sodii bicarbonatis 3" Bismuthi subcarbonatis 3ss M. S. 2 teaspoonfuls in milk t. i. d. Sodium bicarbonate is of value in alkalizing the blood in acute rheu- matism. In threatened coma in diabetes mellitus and in nephritis and in other conditions of acidosis, as after anesthesia, in shock, large doses of the salt given in solution by the mouth or intravenously, neutralize acid in the tissues and may avert a fatal ending. Sodium bicarbonate is of much worth in alkalizing the urine and in preventing the formation of calculi so often occurring in stall-fed cattle, rams and wethers, and may be placed on the feed or in the drinking water. The salt is supposed to assist the action of calomel, with which 1.12 INORGANIC AGENTS it is often conjoined to stimulate the flow of bile and aid the alkaline intestinal juices in transforming the inactive chloride into the active oxide (see p. 168). One may lessen the toxicity of acetanilid by prescrib- ing it in combination with sodium bicarbonate. Sodium bicarbonate is occasionally given in acute bronchitis, but it is distinctly inferior to the corresponding potassium salt in thinning and increasing bronchial secre- tions. This salt is highly recommended in the treatment of hemoglobinemia (azoturia) in horses when given in quantities of 10-30 ounces daily. Theoretically, sodium bicarbonate is of benefit in this disease,, by neutral- izing acid products of metabolism which lead to solution of the hemo- globin. Acidosis results from excessive oxidation in the body in over- exertion, fevers, infections, injuries, surgical operations, in poisoning — as by chloroform, foreign proteids (intestinal stasis), etc. The acid by- products are normally eliminated by the lungs (C02) or neutralized by the liver, adrenals and kidneys. When these organs are over-worked — - as in the above conditions (also in nephritis and diabetes) — sodium bicarbonate in very large doses may prevent the evil effects of acidosis (coma, edema, nephritis, etc.). Sodium bicarbonate relieves thirst in polyuria of horses, when placed in their drinking water. Administration. — Sodium bicarbonate may be given in solution, or on the tongue or food in the pure state. Sodii Sulphas. Sodium Sulphate. Na? SO< 10H2O. (U. S. & B. P.) Synonym. — Glaubers salt, sulphate of soda, E.; sulfat de soude, sel de Glau- ber, Fr.; Glaubersalz, natriumsulfat, G. ; natrium sulphuricum, P. G. Derivation. — Neutralize the residue left in the manufacture of HC1 from salt, with sodium carbonate. 2 Na HSO, -f Na2 CO, = 2 Na2S04 -f CO, -f- H2O. Properties. — Large, colorless, transparent, monoclinic prisms, or granular crystals, odorless, and having a bitter, saline taste. The salt effloresces rapidly in the air. Soluble in a little over its own weight of water; insoluble in alcohol; soluble in glycerin. Dose.— C, luiss, (500-750) ; H. (laxative), gii-iv, (60-120) ; Sh., Bii-iv, (60-120). Action Internal. — Digestive Tract. — The action of the saline cathar- tics depends upon the slow absorption of certain acid ions or anions (sulphates, phosphates, tartrates, and citrates) as compared with others (chlorides, bromides, and iodides). The latter, being readily absorbed into the blood, cause diuresis. The former salts fail of absorption — to any considerable extent — in the bowel, and so their solutions increase the fluidity of the ingesta and aid in the expulsion of feces. Peristaltic action is chiefly excited through increase of the mass of intestinal contents. Concentrated (hypertonic) solutions of the saline purgatives with- draw water from the blood-vessels of the bowels because the solution in the intestines has a greater osmotic pressure than the blood. When the solution in the bowel becomes sufficiently diluted to be isotonic with the blood some absorption and diuresis occur ("salt action," see p. 115). The blood and urine first become concentrated, and thirst is induced by the action of the saline purgatives both in withdrawing water from the blood and in preventing absorption of water from the digestive tract. SODIUM SULPHATE 113 Later diuresis may take place, especially when absorption of the saline occurs through failure of purgation. The basic ion, or kation, of some salts is less absorbable than that of others (as Mg), and when such a basic ion is combined with an acid ion of slow absorption (as in MgS04) the purgative effect is naturally at its maximum. Any cholagogue action, formerly attributed to the saline purgatives, has been proved to be wanting. The saline cathartics are sometimes called hydragogues. Uses Internal. — Sodium sulphate is not used much in human practice on account of its nauseating taste and it is said to produce more griping. For the larger animals it is sometimes preferred to the magnesium salt in veterinary medicine, as in catarrhal jaundice of horses. Sodium sulphate is the principal ingredient of Carlsbad salt, which has recently come into vogue with veterinarians, although long valued in human medicine. The formula for the artificial Carlsbad salt (Sal carolinum factitium), which is the preparation commonly used, is as follows: \i Sodii sulphatis exsiccati 40.0 Sodii bicarbonatis 35.0 Sodii chloridi 15.0 Potassii sulphatis 2.0 M. et fiat pulvis. Sig. One to two heaping tablespoonfuls on the food two or three times daily for horses. Sodium sulphate is thus given as Carlsbad salt or alone in small doses as a laxative, but in constipation associated with indigestion and malnutrition, gentian, powdered rhubarb, iron and other stomachics and tonics are often combined; while, in fever, small doses of Glauber's salt is useful in promoting the activity of the skin and kidneys, and for this purpose may be given as follows to improve appetite and digestion: For horses in fevers. Ijfc Spiritus aetheris nitrosi. Tincturae gentianae composite aa\ ov'u Acidi sulphurici diluti 3vii M. Sig. 4 tablespoonfuls in a pint of water twice daily to which same amount of Glauber's salt is added. Glauber's salt is useful in aiding the action of peristaltic agents, as aloes. Small doses are given to horses in their drinking water while the aloes is acting. Sodium sulphate is of benefit in the treatment of diarrhea, dysentery and overloaded and impacted colon of horses when given in frequent and repeated doses in connection with linseed oil. An enema, consisting of one pound of Glauber's salt in a quart of water, to which two ounces of oil of turpentine and four ounces of glycerin may with advantage be added, should be injected high into the bowel to secure rapid purgation in horses suffering with colic. Glauber's and Epsom salts are the most common purgatives given to ruminants. It is therefore impossible to enumerate special indications 114 INORGANIC AGENTS for their employment in the case of these animals. To assist the action, ginger and molasses are given with Glauber's or Epsom salt, and often an equal weight of sodium chloride. Vy, Magnesii sulphatis EbJ Sodii chloridi Ibss Fluidextracti zingiberis fA Syrupi fusci ,~,iv Aquae Oii M. Sig. Give at one dose to cow. When a speedy action is desired, Glauber's salt should be adminis- tered with a large amount of water and thirst should be encouraged by the addition of common salt. When, on the other hand, it is essential to remove fluid and morbid effusions from the body, the purgative salt should be exhibited in concentration and the patient should be deprived of water to a considerable extent. Glauber's and Epsom salts are not used so commonly in canine practice as calomel and castor oil, but find more favor with German than with English-speaking veterinarians. Sometimes salts are serviceable in irritable states of the bowels in dogs (piles, duodenitis and intestinal catarrh) in teaspoonful doses; and when given every second day, as a laxative, in eczema. Vomiting, how- ever, not uncommonly follows the ingestion of salts by dogs. Carlsbad salt forms a good cathartic for cage birds. About 3 grains are added to an ounce of their drinking water in the case of small birds. Sodii Chloridum. Sodium Chloride. NaCl. (U. S. & B. P.) Synonym. — Common or table salt, muriate of soda, sal commune or culinare, chloruretum sodicum, E.; natrium chloratum purum, P. G. ; chlorure de sodium, sel commun, sel de cuisine, Fr. ; chlornatrium, kochsalz, G. Derivation. — Mined in a native state and obtained by evaporation of brine, spring or sea water. Properties. — Colorless, transparent, cubical crystals, or as a white, crystalline powder, odorless, and having a purely saline taste. It is usually slightly hygro- scopic. Soluble in 2.8 parts of water; slightly soluble in alcohol; insoluble in ether or chloroform. Reaction neutral. D ose.— Cathartic, C, Ibss-i, (250-500) ; Sh., Bi-ii, (30-60). Action External. — Salt is a stimulant to the skin when applied in concentrated solution. Action Internal. — Salt is an essential constituent of food necessary to the composition of HC1 in the gastric juice, and of blood plasma, from which it is constantly eliminated in the urine. Herbivorous animals require sodium chloride in addition to that contained in their food; for blood is rich in common salt, while vegetables abound more especially in potassium salts. The potassium salts, according to Bunge, on entering the blood bring about a chemical reaction, whereby sodium chloride circu- lating in the plasma is split; the chlorine in sodium chloride combines with potassium, while the acid, set free from the potassium salt unites with sodium, and both products are swept away with the urine, thus removing sodium chloride from the blood. This is only replaced by that taken as food. Some doubt is cast upon this hypothesis by Lapicque, SODIUM CHLORIDE 115 who relates that African tribes, living wholly upon vegetables, use wood ashes (chiefly potassium) in place of table salt. Animals deprived of salt suffer from anemia, general weakness and edema. Stomach and Intestines. — Salt has caused gastro-enteritis and death in enormous doses. Large doses occasion emesis in dogs. Irritation of the stomach is caused by withdrawal of water from the mucous mem- branes by strong (hypertonic) solutions (osmotic action). This is called "salt action" and is common to all salts of the alkalies. Salt in the food often improves digestion — probably by bettering the taste of the food and exciting the appetite and so, reflexly, stimulating the flow of gastric juice, on the same principle that the sight, taste, and smell of food are the chief factors in the first secretion of HC1. Salt acts in the bowels as a mild hydragogue purgative. It is unfit as a cathartic for horses pr dogs ; but is useful for cattle and sheep when combined with magnesium or sodium sulphate. Salt creates thirst and, therefore, promotes the in- gestion of water. A large supply of water flushes the system and removes deleterious and imperfectly oxidized matters. Neither salt nor any of the sodium salts are as diuretic as the potassium salts. Salines generally, on being absorbed into the blood, increase its concentration, which causes a flow of water into the blood and increases its volume. This leads to enhanced vascular tension and so to diuresis. In the case of sodium salts, however, elimination is so rapid from the blood that they do not have time to attract water and occasion diuresis as do potassium salts. When an electrolyte is introduced into the blood it may act either through its ions (p. 8) or, if these are inert, by "salt action." This is practically osmosis. If a salt is introduced into the blood, water will be drawn into the vessels from the surrounding tissues until the concentration of the salt in the blood is equal to that outside the vessels, or until the blood is isotonic with the surrounding fluid. Hence a normal salt solution (0.9 per cent.) for injection into the blood is also said to be isotonic or equal in concentration to that normally in the blood. Blood. — The red corpuscles are augmented by salt. Concentrated or hypertonic salt solution, containing more than 0.9 per cent., injures the red cells, which become crenate and lose water; hypotonic solutions cause the red cells to swell, absorb water and lose hemoglobin. Metabolism. — Salt solution in the blood withdraws fluid lymph from the tissues by osmotic action, and stimulates protoplasmic activity, and thus favors the general functioning of the tissues; hence its use in de- pressed states of the system. In this way it appears to stimulate tissue change, as there is an increased elimination of nitrogen in the urine. Summary. — Emetic, cathartic, digestive, slight diuretic, protoplasmic stimulant. Uses External. — A solution consisting of one ounce each of salt, nitre and sal ammoniac, in one quart of water, may be used on bruises and sprains as a stimulant and refrigerant lotion. Severe hemorrhage, collapse and surgical shock are treated most successfully by injections 116 INORGANIC AGENTS of hot normal salt solution into a vein, under the skin, or into the rectum. The solution maintains the proper salinity of the blood, replaces the mass of blood lost, and supplies heat. The solution is made by adding salt to boiled or distilled water at a temperature of 100° to 105° F, (See p. 517.) A number of human deaths— preceded by vomiting, diarrhea, fever, delirium and coma, have occurred through the accidental intravenous in- jection of concentrated salt solutions. Salt is an efficient antidote exter- nally and internally to silver nitrate. Uses Internal. — Salt is a serviceable emetic for dogs, when zinc sul- phate is not at hand, in emergencies and poisoning. One teaspoonful may be stirred into a cup of Lukewarm water with a tablespoonful of mustard. It is a useful addition to Epsom salt, since it increases thirst and the ingestion of water, and assists purgation in overloaded conditions of the first and third stomachs of ruminants. One-half pound of salt is administered to cattle with one-half to one pound of Epsom salt, one- quarter pound of ginger and a pint of molasses in two quarts of water. The habitual ingestion of salt is prejudicial to ascarides and diminishes the secretion of mucus in which they live. It is even more efficacious in destroying pinworms inhabiting the lower bowels. Enemata containing 1 to 2 tablespoonfuls of salt to the pint of water are employed for this purpose. Salt should be kept constantly accessible to horses and cattle. Animals convalescing from acute diseases, and those with feeble digestion, need salt particularly. Horses are commonly given a bran mash once a week, with plenty of salt to enhance its laxative and hygienic action. Dogs usually procure sufficient salt in their ordinary food, but it should be added to their diet in the treatment of obesity. Salt increases edemas and dropsies and should be excluded from the diet in chronic nephritis, in chronic heart disease with edema, in ascites, in pleuritic effusions and hydrothorax — notwithstanding that formerly it was taught that salt aided the absorption of pleural effusions. The danger of con- centrated salts solution through its effect on the blood has been noted. In China the drinking of a pint or more of saturated salt solution is a com- mon method of committing suicide. Deaths from giving enemata contain- ing concentrated salt solution have been reported. Sodii Phosphas. Sodium Phosphate. Na,HP04 -j- 12 H20. (U. S. & B. P.) Synonym. — Sodium orthophosphate, phosphate of soda, E. ; natrum phosphori- cum, P. G. ; phosphate de sonde, Fr. ; natrium phosphat, phosphorsaures natrum, G. Derivation. — Digest bone ash with sulphuric acid. Cag 2P04 -f 2 H* SO* = Ca H4 2 P04 (acid calcium phosphate) -\- 2 Ca S04. Filter and add sodium car- bonate to filtrate. Ca H4 2 P04 + Na2 C03 = Na2H P04 -f HX> -f CO + Ca HP04. Evaporate, and sodium phosphate crystallizes out. Properties. — Large, colorless, monoclinic prisms, or as a granular, crystalline salt; odorless, and having a cooling, saline taste. The crystals effloresce in the air. Soluble in 2.7 parts of water; insoluble in alcohol; slightly alkaline reaction. Dose. — Same as sodium sulphate; D., 5i-ii, (4-8) as laxative. The phosphate resembles the sulphate, but is a milder purgative and is wrongly thought to be an hepatic stimulant. It is indicated in jaundice SODIUM PHOSPHATE 117 due to duodenitis, and as a laxative for foals and calves. It is occasion- ally prescribed in rickets as a source of phosphorus, but the calcium phosphate is more appropriate. Sodii Sulphis Exsiccatus. Exsiccated Sodium Sulphite. Na.. S03. (U. S. & B. P.) Synonym. — Natrum sulfuriosum, sulfis sodicus (natricus), sulphite of soda, E.; sulfite de soude, Fr. ; schwefligsaures natron, G. Derivation. — Saturate a solution of sodium carbonate or hydrate with sul- phurous anhydride gas. Na2 C03 -f- S02 = Na2SOs -j- C02. Properties. — A white powder, odorless, and having a cooling, saline, sulphur- ous taste. In air it is slowly oxidized to sulphate. Soluble in 3.2 parts of water; sparingly soluble in alcohol; neutral or feebly alkaline. Dose.— H. & C, 3i, (30); Sh. & Sw., 5ss-i, (2-4); D., gr.v-xxx, (.3-2). Sodii Bisulpiiis. Sodium Bisulphite. NaHS03. (Non-official.) ' Derivation. — Obtained from sodium carbonate or bicarbonate and sulphurous anhydride gas. Properties. — Opaque, prismatic crystals, or a granular powder, exhaling an odor of sulphur dioxide and having a disagreeable, sulphurous taste. Exposed to the air the salt loses sulphur dioxide and is gradually oxidized to sulphate. Soluble in 4 parts of water and in 72 parts of alcohol; reaction acid. Dose. — Same as sodium sulphite. Sodii Thiosuxphas Sodium Thiosulphate. Na,S203 5 H20. (U. S. P.) Synonym. — Sodium hyposulphite, hyposulphate of soda, E.; natrum subsul- furosum (hyposulfurosum), P. G.j hyposulphis sodi, hyposulfite de soude, sulfite solfure de sonde, Fr.; natriumthiosulfat, G. Derivation. — Dissolve sulphur in a boiling aqueous solution of sodium sulphite. Properties. — Colorless, transparent, monoclinic prisms, odorless, and having a cooling, afterwards bitter, taste. Permanent in air below 33° C. (91.4° F.), but efflorescent in dry air above that temperature. Slightly deliquescent in moist air. Soluble in 0.5 part of water; insoluble in alcohol; slightly soluble in oil of tur- pentine; reaction neutral or faintly alkaline. Dose. — Same as sodium sulphite. Administration. — The sulphites are given in solution, or may be added in powder to the food of horses. Action of the Sulphites, Bisulphites and Hyposulphites. Action External. — These salts are antiseptics, deodorizers and para- siticides externally and in the digestive tract. The antiseptic action is due to the destructive effect of the sulphites in withdrawing oxygen from organic matter to oxidize themselves into sulphates. Given internally, 96 per cent, of sodium sulphite escapes in the urine as a sulphate, while but 3 per cent, is eliminated unchanged. It has been taught that the sul- phites are converted into sulphur dioxide (S02) by the acids in the stomach, but this is very doubtful. Uses. — A 15 per cent, solution or ointment of the sulphites is used against pruritus and parasitic skin diseases. The salts are recommended in indigestion w^ith fermentation, flatulence and foul-smelling feces and in general septic conditions, but have proved as useless as most other drugs in the latter states. Sternberg found that neither the sulphites nor hyposulphites exerted any germicidal action on bacteria in culture media. 118 INORGANIC AGENTS The other sodium salts are of no particular value in veterinary prac- tice except sodium bromide. (See Bromine, p. 184.) Ammonium.* Ammonium is not employed in medicine. Ammonia (NH3) exists in the free state as a gas, and is used in medicine in solution in water or alcohol. Aqua Ammoniae. Ammonia Water. (U. S. P.) Synonym. — Liquor ammoniae, B. P.; spirits of hartshorn, E.; liquor ammonii caustici, P. G. ; spiritus salis ammoniaci causticus, ammonia aqua soluta, ammo- niaque liquide, eau (solution, liqueur) d'ammoniaque, Fr. ; salmaikgeist, aetzam- moniak, ammoniakfliissigkeit, G. An aqueous solution of ammonia (NH3), con- taining not less than 9.5 per cent, nor more than 10.5 per cent, by weight, of NH3. Properties. — A colorless, transparent liquid, having a very pungent odor, alkaline taste, and a strongly alkaline reaction. Spec. gr. 0.958. Derivation. — Evolve ammonia gas by heating ammonium chloride with cal- cium hydrate, and pass it into water. 2 NH4 Cl+Ca(OH)a=2NH3+2 H20 + Ca Cl2. Dose.— H. & C, §ss-i, (15-30); Sh. & Sw., 3i-ii, (4-8); D., TT^x-xx, (.6-1.3). PREPARATION'. Linimentum Ammoniae. Ammonia Liniment. (U. S. & B. P.). Ammonia water, 250; sesame oil, 750. (U. S. P.). Aqua Ammonite Fortior. Stronger Ammonia Water. (U. S. P.) Synonym. — Liquor ammonias fortis, stronger solution of ammonia, B. P.; eau d'ammoniaque forte, Fr.; starker salmiakgeist, G. An aqueous solution of ammonia (NH3), containing not less than 27 per cent, nor more than 29 per cent., by weight, of NH3. Derivation. — Same as aqua ammoniae. Properties. — A colorless, transparent liquid, having an excessively pungent odor, a very acrid and alkaline taste, and a strongly alkaline reaction. Spec, gr. 0.897. Dose.— H. & C, 5ii-vi, (8-24) ; Sh. & Sw., 5i, (4) ; D., TTlv-x, (.3-.6). PREPARATION. Spiritus Ammonia Spirit of Ammonia. Synonym. — Spiritus ammoniaci caustici dondii, ammoniated alcohol, E-; liquor ammoniae caustici spirituosus, P. G.; alcoole d'ammoniaque, liqueur d'am- moniaque vineuse, Fr. ; weingeistige ammoniakflussigkeit, G. An alcoholic solution of ammonia (NH3), containing 10 per cent., by weight, of the gas. Properties. — A colorless liquid, having a strong odor of ammonia, and a spec, gr. of about 0.808. This preparation combines the stimulating properties of ammonia and alcohol. Dose.— H. & C, §ss-i, (15-30); Sh. & Sw., 3i-ii, (4-8); D., TTlx-xx, (6-1.3). Ammonia Preparations. Action External. — Ammonia is a powerful irritant in stronger solu- tion, or gas. If it is applied for a sufficient time, hyperemia, vesication and sloughing ensue. Action Internal. — Stomach. — If swallowed in concentrated solution *The radical ammonium (NH4) of the ammonium compounds is not a metal, although it resembles so closely — in physical, chemical and physiological prop- erties— the other alkaline metals, that it is usually classed with them. AMMONIA PREPARATIONS 119 death may take place instantaneously from edema and spasm of the glot- tis. Otherwise, more or less extensive inflammation of the alimentary canal will follow, according to the amount ingested. Diluted vinegar and lemon juice, together with the white of egg, or sweet oil, should be given as antidotes. Tracheotomy may be indicated, if there is glottic obstruction. Ammonia, in passing through the mouth, throat, gullet and stomach, reflexly stimulates the heart and respiration before absorption can occur. Ammonia is an antacid in the stomach, but should not be employed in gastric irritability. Respiratory Tract. — Inhalation of stronger ammonia through the nostrils causes reflex stimulation of the heart and respiration by irritation of the nasal branches of the fifth nerve. Care must be exercised to pre- vent inflammation of the air passages. Ammonia stimulates the respira- tory centre when it is injected into the blood. Given under the skin in lethal doses, ammonia causes death by paralysis of the respiratory centres. Circulation. — It is probable that ammonia only acts reflexly to stimu- late the heart through irritation of the stomach when it is ingested. If given intravenously or subcutaneously, ammonia stimulates directly the heart muscle, and probably the accelerator and vasomotor centres, mak- ing the cardiac pulsations stronger and quicker and increasing vascular tension. Rarely the vagus centre is stimulated and the heart's action slowed. Lethal doses paralyze the cardiac muscle. Ammonia differs from alcohol in being more evanescent as a stimulant, in not affecting the brain nor metabolism, and in not acting as a food. Blood. — The normal blood contains ammonia, which is supposed to aid in maintaining its fluidity. The action on the blood is unknown. Ammonia is thought to prevent coagulation of blood within the vessels in conditions favorable to thrombosis. Nervous System. — An intravenous injection of a lethal dose of ammo- nia occasions tetanic convulsions in animals, owing to stimulation of the reflex and motor functions of the cord. Medicinal doses excite the spinal reflex and motor centres. When ammonia is applied directly to nerve tissue it excites in dilute solution, but paralyzes functional activity in concentration. The brain is unaffected by the therapeutic administration of ammonia. Elimination. — Ammonia combines with acid in the stomach and is absorbed into the blood. Ammonia and its carbonate are acted upon by the liver and there transformed into urea, in which form ammonia com- pounds escape in the urine. Urea being the most active diuretic there is some augmented flow. The urine is, however, not alkalized as by the salts of the other alkaline metals. Summary. — Heart and respiratory stimulant and antacid. Exter- nally, rubefacient, vesicant, and escharotic. Uses. — The indications for ammonia are closely in accord with its physiological actions. Externally. — It is frequently used in stimulating liniments. One 120 • INORGANIC AGENTS part each of water of ammonia and oil of turpentine, may be combined to advantage with 4 to G parts of camphor liniment. Ammonia water is one of the best remedies to relieve pain and antagonize the action of insect bites, as stings of bees and wasps. It should be applied directly to the poisoned part. Internally. — Ammonia is indicated when rapid stimulation of the heart and respiration is desirable. In emergencies it may be given intra- venously (aq. ammon. fort. 1 ; water, 4 parts) ; or by inhalation. It is serviceable in the treatment of prussic acid and aconite poisoning, syn- cope, collapse and shock following surgical operations; also in snake bites. The spirit of ammonia may be prescribed in fevers as a stimulant. Ammonia is inferior to ammonium carbonate or the aromatic spirit in cases of colic and tympanites. Am.momi Cahhoxas. Ammonium Carbonate X1I,H( ()., NH4NH2C02. (U. S. & B. P.). It consists of a mixture of varying proportions of acid ammonium carbonate (NH4 HC03) and ammonium carbonate (XH4 NIL CO,) and yields not less than 30 per cent, nor more than 32 per eent. of Nil,. Synonym.— Volatile salt, sal volatile siccum, E.j ammonium carbonicum, P. G.; carbonate d'ammoniaque, alcali volatil concret, sel volatil d'Angleterre, Fr.j Hiichtiges laugensalz, reines hirchhornsalz, koblensiiures ammonium, G. Derivation. — A mixture of ammonium chloride or sulphate, and calcium car- bonate, is sublimed and resublimed. Ammonium carbonate, so-called, is a mix- ture of ammonium carbonate and bicarbonate. 4 NH4 Cl+2 Ca Co, = NH4 HC03 NH,NH,CO,-f 2 Ca C12+NH3+H20. Properties. — White, hard, translucent, striated masses, having a strong odor of ammonia, without empyreuma, and a sharp ammoniacal taste. On exposure to the air the salt loses both ammonia and carbonic dioxide, becoming opaque, and is finally converted into friable, porous lumps, or a white powder. Soluble in 4 parts of water. Alcohol only dissolves the carbonate, leaving the acid car- bonate. Dose.— H., oii, (8); C, 3iii-vi, (12-24); Sh. & Sw., gr.xv-xl, (1-2.6); D.f gr.iii-x, (.2-.6); D., emetic, gr.xv, (1). PREPARATION. Spirit us Ammonite Aromaticus. Aromatic Spirit of Ammonia. (U. S. & B. P.) Synonym. — Sal volatile, alcoolat ammoniacal aromatique, Fr. ; aromatischer ammoniakgeist, G. Ammonium carbonate 34 grams Ammonia water 90 mils Oil of lemon 10 mils Oil of lavender 1 mil Oil of myristica 1 mil Alcohol 700 mils Distilled water, a sufficient quantity to make 1000 mils Properties. — A nearly colorless liquid when freshly prepared, but gradually acquiring a yellow color. It has a pungent odor and taste of ammonia. Spec, gr. 0.900. Dose.—H. & C, gi-ii, (30-60); Sh. & Sw., 5ii-iv, (8-15); D., 5ss-i, (2-4), well diluted. The aromatic spirit of ammonia nearly resembles ammonium carbo- nate in action, but the alcohol and volatile oils add to the stimulant qualities of ammonia and ammonium carbonate. Action Internal. — Ammonium carbonate is decomposed by acid in AROMATIC SPIRITS OF AMMONIA 121 the stomach and escapes in the urine as urea. It stimulates gastric secretion, vascularity and motion, and also excites intestinal peristalsis. It is, therefore, a stomachic and carminative. It is also an antacid, and, in large doses, an emetic to dogs. The action of ammonium carbonate is almost identical with that of ammonia water in stimulating the heart and respiration, but it has more power in augmenting the bronchial secre- tions. Summary. — Cardiac and respiratory stimulant, expectorant, stom- achic and emetic. Administration. — Ammonium carbonate is given in ball, or in solution in cold water, to avoid irritating fumes ; also, with syrup or gruel. It is often prescribed with other stimulants and antispasmodics, as alcohol, capsicum, camphor and asafetida. Uses. — The indications for the administration of ammonium carbo- nate are much the same as those for ammonia preparations. It is a more useful expectorant, however, and it and the aromatic spirit arc more serv- iceable in the treatment of flatulence. For the latter condition in horses with colic, a ball containing ammonium carbonate, mix vomica, and capsi- cum, is often efficient. Horse, for flatulent colic. I£ Pulveris nucis vomicae. Ammonii carbonatis aa oil Pulveris capsici 5i M. et fiat bolus No. i. S. Give at once. We may use ammonium carbonate alone in the case of acute or chronic bronchitis, or it may be combined with other stimulants, or expec- torants, as ammonium chloride. In electric shock, so common an accident in the large cities from "live" wires, the administration of full doses of aromatic spirit diluted with half a pint of water will prove a most effec- tive heart stimulant when the animal can swallow. Ammokh Cni.oifinrM. Ammonium Chloride. NH4 CI. (U. S. & B. P.). Synonym. — Sal ammoniac, ammonia muriaticum or hydrochloratum depura- tum, ammonia? hydrochloras or murias, muriate of ammonia, E.; chlorure d'am- monium, sel ammoniac, chlorhydrate d'ammoniaque, Fr. ; salmiak, chlorammo- nium, G. Properties. — A white, crystalline or granular powder without odor, having a cooling, saline taste. Somewhat hygroscopic. Soluble in 2.6 parts of water; in 100 parts of alcohol. An aqueous solution of the salt (1 in 20) in ice cold water does not show an immediate acid reaction with litmus. Dose.— H., 5ii, (8); C, 5iii-vi, (12-24); Sh. & Sw., gr.xv-xl, (1-2.6); D., gr.iii-x, (.2-6). Action Internal. — When ingested, sal ammoniac is a feeble heart and respiratory stimulant, and is not comparable to the ammonia com- pounds or ammonium carbonate in this respect. It is eliminated in great part unchanged by the urine, but also by the other channels. In its excre- tion it stimulates the mucous membranes, increases their secretions gen- erally, and is thought to improve their nutrition. Hence it has been 122 INORGANIC AGENTS termed an alterative. Ammonium chloride both excites the secretion of the bronchial mucous membrane and renders it less viscid in inflammatory conditions. It is mildly diaphoretic and diuretic. Summary. — Externally, refrigerant; internally, expectorant, altera- tive, feebly diaphoretic and diuretic. Uses. — Four ounces each of nitre and sal ammoniac may be dissolved in two quarts of water as a refrigerant lotion. Sal ammoniac is indicated more especially in the second stage of acute bronchitis, in chronic bron- chitis, and in chronic intestinal catarrh with diarrhea. Ammonium chlo- ride may be given to dogs as a cough mixture. If cough is excessive, codeine or morphine sulphate can be added to this prescription with advantage as follows: Cough mixture for dogs with bronchitis. fy Ammonii chloridi 3i.9i Glycerini 5ss Codeinae sulphatis gr.vi Aquae chloroformi ad 5iv M. Sig. Teaspoonful in water every 3 hours. Liquor Ammonii Acetatis. Solution of Ammonium Acetate. (U. S. & B. P.). Synonym. — Spirit of Mindererus, spiritus Mindereri, E.; liquor ammonii ace- tici, P. G.; acetate d'ammoniaque liquide, esprit de Mindererus, Fr.; ammonium- acetatlosung, G. An aqueous solution containing about 7 per cent, of NH4C2H30^ with small amounts of acetic acid and carbon dioxide. Derivation. — Ammonium carbonate, 5 Gm., is gradually added to 100 mils of cold, diluted acetic acid. Properties. — A clear, colorless liquid, free from empyreumatic odor and hav- ing a mildly saline, acidulous taste, and an acid reaction. Incompatibles. — Acids and alkalies. Dose.— H. & C, gii-iv, (60-120); D., 3ii-viii, (8-30). Action. — Spirit of Mindererus stimulates the secretory cells of the kidneys and sudoriparous glands. In the stomach it exerts a mild, antacid action. Summary. — Externally, refrigerant; internally, diuretic, diaphoretic and antacid. Uses. — Liquor ammonii acetatis is an exceedingly feeble medicine ("it is useful for the harm it has not done") and is often employed as a vehicle with more powerful agents of its class, e.g., spiritus etheris nitrosi. It is useful as a febrifuge. T£ Tine, aconiti oil. Sodii bromidi 3iv. Sp. aetheris nitrosi 3ss. M. Liquor, ammonii acetatis ad Siv. S. Teas, every hour. The foregoing prescription is a good palliative combination for dogs suffering with fever and restlessness. The solution of ammonium acetate is frequently conjoined with sweet spirit of nitre and ammonium chloride or potassium iodide, in the treatment of acute respiratory diseases of LITHIUM 123 horses, e.g., influenza, bronchitis and pneumonia. It may be added to the drinking water without rendering it unpalatable. Lithium. (The Metal Is Not Used in Medicine.) Lithii Carboxas. Lithium Carbonate. LI, Coa. (U. S. & B. P.). Synonym. — Carbonate of lithia, E.; Lithium carbonicum, P. G.; carbonate de lithine, carbonate lithique, Fr.; kohlensaures lithion, G. Derivation. — Made by action of lithium chloride in acid ammonium carbonate. 2 Li Cl+NH* HC03 = Li2C03+NH4Cl-j-HCl. Purified by washing with alco- hol and drying. Properties. — A light, white powder, odorless, and having an alkaline taste. Permanent in the air. Soluble in 78 parts of water; almost insoluble in alcohol. Reaction alkaline. Dose.— D., gr.iii-x, (.2-.6). Lithii Citras. Lithium Citrate. Li3C6Hs07-|-4 HO. (U. S. & B. P.) Synonym. — Lithium citricum, citrate of lithia, E.; citrate de lithine, Fr.; citronsaures lithion, G. Derivation. — Made by action of citric acid on lithium carbonate. 2 H3C0H5O7-f3 Li2C03 = 2 Li3C0H0O7 + 3 H20+3 Co.. Recovered by evapora- tion and crystallization. Properties. — A white powder, or in granular form, odorless, and having a cooling, faintly alkaline taste; deliquescent on exposure to moist air; soluble in 2 parts of water; almost insoluble in alcohol or ether. Reaction faintly alkaline to litmus. Dose.— D., gr.v-xx, (.3-1.3). ACTION OF LITHIUM SALTS. Lithium salts are said to form soluble compounds with uric acid in the blood, and so assist its elimination in the urine. As lithium combines more readily with acid sodium phosphate in the blood than with uric acid, it is doubtful whether it is a very efficient uric acid* solvent in the body. The lithium salts alkalize the urine and notably increase its secretion. Summary. — Lithium salts are diuretics, and uric acid solvents in some degree. The carbonate may be given in powder or pill; the citrate in solution. Uses. — Lithium compounds are of little value in veterinary medicine. They are serviceable, however, in the treatment of dogs with a very acid urine of high specific gravity. The salts will not dissolve calculi in the body, but may prevent their formation. Water is extremely useful in such conditions. Lithium citrate may be placed in the drinking water. Thirst should be encouraged by the administration of salt on the food, and high rectal injections may be given to create absorption of water by this channel. Lithium salicylate is thought to be the better salt for rheumatism. It is probable that treatment with salicylic acid and lithium would be more satisfactory. *Uric acid can not exist as such in blood, which is an alkaline fluid. 124 INORGANIC AGENTS SECTION III. Alkaline Earth Metals: Calcium, Barium and Magnesium. Calcium. (The Metal Calcium Is Not Employed in Medicine.) Cketa I'u i Paha i\. Prepared Chalk. Ca Co3. (U. S. & B. P.). Synonym.— Drop chalk, E.; craie prSparee, Fr.; priiparirte kreide, G. Derivation. — Made from chalk by levigation, elutriation and desiccation. Properties. — A white to grayish-white, very fine amorphous powder, often formed into conical drops; odorless and tasteless; permanent in the air. Almost insoluble in water; insoluble in alcohol. Incompatibles. — Sulphates and acids. Dose.— H., gi-ii, (30-60); C, gii-iv, (60-120); Sh. & Sw., oii-iv, (8-15); D., gr.x-5i, (.6-4). 1'UKI'AHATIONS. Pulvis <'nii, (.6-4). Mistura Crettt. Chalk Mixture. (U. S. P. & B. P.) Compound chalk powder, 20; cinnamon water, 40; water to make 100. Dose.—D., gi-ii, (30-60). Pulvis Cretce Aromaticus. (B. P.) Dose.— D., gr.x-5i, (.6-4). Pulvis CretCB A romaticus Cum OpU). (B. P.) (Contains 2% per cent, opium.) Dose.— D., gr.x-xl, (6-2.6). Calcii Carboxas PrjEcipetatus. Precipitated Calcium Carbonate. CaCOa. (U. S. & B. P.) Synonym. — Calcis carbonas praecipitata, B. P.; precipitated carbonate of lime, creta praecipitata, E.; calcium carbonicum praecipitatum, P. G. ; carbonate de chaux precipite, craie precipitee, Fr. ; praecipitirten kohlensauren kalk, G. Derivation. — Obtained by, precipitation of calcium chloride with sodium car- bonate. CaCl2J-Na,C03- CaC03+2 NaCl. Dry the precipitate. Properties. — A fine white micro-crystalline powder, without odor or taste, and permanent in the air. Nearly insoluble in water; insoluble in alcohol. The solu- bility is increased by presence of ammonium salts and especially by carbon dioxide. Dose.— H., §i-ii, (30-60) ; C, gii-iv, (60-120) ; Sh. & Sw., oii-iv, (8-15) ; D., gr.x-5i, (.6-4). CALCIUM CARBONATE. Action External. — Desiccant and slightly astringent powder; also protective. Action Internal. — Alimentary Canal. — Calcium carbonate is the slow- est acting antacid, because of its comparative insolubility, and is of value when it can exert its long-continued influence throughout the digestive tract. It resembles bismuth in mechanically coating or protecting an inflamed or irritable surface. It is not so astringent nor antiseptic as the bismuth salts, and these are generally preferable to chalk for the smaller animals. It is excreted unchanged in the feces. CALCIUM CARBONATE 125 Administration. — Calcium carbonate may be given to dogs in troches, pills or powder; to other animals in powder, balls or electuary. Chalk is commonly prescribed suspended in flour gruel, milk or mucilage to the larger animals. The official preparations are suitable for dogs. Uses. — Chalk forms a dusting powder for moist eczema, slight burns and intertrigo, zinc oxide and starch (1 to 4) is, however, a better prep- aration. Chalk is the most useful antacid for diarrhea accompanied by fermentation of the intestinal contents, while its local astringent and pro- tecting influence assist in overcoming the trouble. It is especially good for foals and calves given in flour gruel, and often combined with catechu, ginger and opium. II Cretaj prep. Tincture catechu eo. aa 5ii Fluidextracti zingiberis. Tincture opii aa 3SS M. (Shake.) Sig. Two tablespoonfuls in half pint of flour gruel 3 times daily The following prescription is appropriate for dogs with diarrhea: Ji Tincturae kino. Tincturae catechu e<». Tincturae opii camph. ...aa 5ss Misture cretae. ..ad ,->i\ M. Sig. Teaspoon ful every 3 hour-. A serviceable ball for horses with diarrhea is as follows: R Creolini. Cretae prep. Pulv. singiberis aa oss Pulv. opii "i M. et fiat bolus Xo. 1. Sig. Give at once. A laxative should always be given before using astringents in diar- rhea ; preferably linseed oil or salts, for large animals ; castor oil, for smaller patients. Calx. Quicklime, Lime. Calcium Oxide. CaO. (U. S. & B. P.) Synonym. — Burned lime, quicklime, calcaria, calx viva, calx usta, ealeii ox- idum, E.; calcaria usta, P. G. ; chaux, chaux vive, Fr.; kalk, gebrannter kalk, G. Derivation. — Prepared by burning white marble, oyster shells, or the purest varieties of natural calcium carbonate, to expel carbon dioxide. Properties. — Hard, white, or grayish-white masses or granules, or as a white powder; odorless and having a caustic taste. Reaction intensely alkaline. Soluble in about 840 parts of water; soluble in glycerin and syrup; insoluble in alcohol. PREPARATIONS. Liquor Calcis. Solution of Lime. (U. S. & B. P.) A saturated, aqueous solution of calcium hydrate. Synonym. — Lime water, solution of calcium hydrate, aqua calcarise ustne, aqua calcis, calcaria soluta, E.; aqua ealcariae, P. G. ; eau (liqueur) de chaux, Fr.; kalkwasser, G. Derivation. — Dissolve lime (50 Gm.) in water q. s. The percentage of cal- cium hydrate [Ca (OH),] varies with the temperature, being somewhat over 0.17 per cent, at 15° C. (59° F.), and diminishing as the temperature rises. Properties. — A clear, colorless liquid without odor, and having a saline and 126 INORGANIC AGENTS feebly caustic taste. It absorbs carbon |dioxide from the air, so that a pellicle of calcium carbonate forms on the surface of the liquid. Reaction strongly alkaline. Dose.— H. & C, 5iv-vi, (120-180); Calves, gii, (60); D., 3i-viii, (4-30). Syrupus Calcis. Syrup of Lime. (Non-Official.) Lime, 65; sugar, 350; water to make 1000. Dose. — Calves and dogs, 5ss-i, (2-4). Well diluted with water or milk. Linimentum Calcis. Lime Liniment. (U. S. & B. P.) Synonym. — Carron oil. Solution of lime and linseed oil, of each 500 mils. Dose. — Foals and calves, oii-iv, (60-120). Calcii Hydras. Slaked Lime. (B. P.) Used as disinfectant in stables. Action of Lime and Solution of Lime. External. — Lime is caustic, but less so than potassium or sodium hydrate. It is an irritant. The dust of quicklime will cause conjunc- tivitis. If inhaled, it will cause inflammation of the air passages; if swallowed, irritation of the digestive tract. The hydrate is a caustic also, but is not so active as lime. Solution of lime is a sedative and astringent. Internal. — Neither lime nor slaked lime (calcium hydrate) are used internally, except in the official preparations. The action of lime and its solution is due, not to calcium, but to the hydroxyl ion — that is, to the alkalinity. As compared with the alkalies the action is much slower and less in degree, on account of the comparative insolubility of calcium com- pounds. Solution of lime acts as a sedative, antacid and astringent in the stomach. It dissolves mucous secretions. Lime water is also a mild astringent in the bowels. Uses. — Lime is employed outside of the body to destroy putrefying organic matter by combining with water and forming slaked lime, wrhich absorbs many of the products of decomposition. Whitewash, a mixture of slaked lime and water, is not a disinfectant, although it covers sources of infection. It may be made so by combination with sufficient phenol to make a 2 per cent, solution. Linimentum calcis is one of the most satisfactory applications for superficial burns and acute eczema. Old clean cotton or linen cloths are soaked in it and spread over the burned surface of the body. This preparation has been facetiously called "car- rion" instead of carron oil, because it is not germicidal. Antiseptic appli- cations are of course desirable in burns, giving rise to a raw surface, and the addition of two per cent, of carbolic acid will not only render the preparation antiseptic, but more or less anesthetic as well. When the burn is extensive, boric acid with vaseline (1 to 8) will be safer. Ortho- form (see p. 196) is the most comfortable application which can be made on burns, but is expensive. A mixture of slaked lime and charcoal, equal parts, makes a useful stimulant, absorbent, dessicant, and antiseptic dressing powder for wounds and ulcers in horses. Lime water is service- able in relieving itching in skin diseases, and dries up moist surfaces through its astringent properties. With carbolic acid (1 to 50) lime water is most efficient in allaying pruritus. Lime water is inimical to aphthous ulcerations and may be employed to swab out the mouth in this PRECIPITATED CALCIUM PHOSPHATE 127 disease. Enemata of lime water destroy pin worms. Solution of lime is one of the best remedies in the treatment of vomiting in dogs. It is a direct sedative to the stomach, and, mixed with milk, equal volumes, pre- vents the rapid coagulation of the casein, lessens the formation of large, tough curds in the stomach, and assists the retention and digestion of milk. Syrup of lime is twenty-four times stronger in calcium hydrate than lime water, and is more astringent. It may be given to foals and calves suf- fering from indigestion and diarrhea. It should be administered in a considerable quantity of milk. Lime water may be given as an antidote in poisoning by acids. Car- ron oil is a good, mild laxative and antacid for horses with "heaves." It is given on the food. Furthermore, it is an excellent purgative for foals and calves in the treatment of diarrhea and indigestion. Calcii Phosphas Pr^cipitatus. Precipitated Calcium Phosphate Ca3(P04)2- (Non-Official.) Synonym. — Calcii phosphas, B. P.; precipitated phosphate of lime, E.; cal- cium phosphoricum. P. G.; phosphate de chaux hydrate, Fr. ; phosphaursaure kalkerde, G. Derivation. — Obtained from bone ash (impure calcium phosphate) by solution in hydrochloric acid and purified by precipitation with ammonia water and by washing with water. Properties. — A light, white, amorphous powder; odorless and tasteless and permanent In the ail Almost insoluble in cold water; insoluble in alcohol; easily soluble in hydrochloric or nitric acicN. Dose.— *H., 5ii-iv, (8-15); C, Jss-i, (15-30); Sh. & Sw., Si-ii, (4-8); D., gr.v-xx, (.3-1.3). Syrupus Calcii Lactopiiosphatis. Svrup of Calcium Lactophosphate. (U. S. & B. P.) Precipitated calcium carbonate, 25; lactic acid, 60; phosphoric acid, 36* stronger orange flower water, 50; sugar, 650; glycerin, 50; water, a sufficient quantity to make 1,000. Dose. — Foals and calves, 5ss-i, (15-30); D., 5i-iv, (4-15). Calcium Phosphate. Action and Uses. — Calcium salts are most important constituents of the body, being essential for the contractility of muscles, the activity of nerves, the coagulability of blood and, as calcium phosphate, forming 50 per cent, of bones. Calcium is not only necessary for the growth of bone, but also of soft tissues, about 15 grains being required daily by the human adult. Green vegetables, water, eggs and milk are the chief sources of supply. Milk contains more lime than does lime water (0.17%), and much more than meats. The reserve of calcium in the body is in the bones which keep the blood supplied. Much larger quantities of lime are lost in sickness, debility and starvation than in health by the feces and urine — four times as much in the former. Calcium salts mostly pass unchanged through the bowels. A small amount is absorbed and elimi- nated by the large bowel and by the kidneys. The food ordinarily con- tains an amount of lime in excess of the needs of the body. By with- holding lime from the food animals may develop conditions similar to rickets. Rickets, however, is not usually due to lack of lime salts, but to an 128 INORGANIC AGENTS 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 weakness 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 prevents 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 glycerophosphates of lime, potassium, magnesium, iron, sodium and quinine. They are used in anemia and malnutrition and convalescence. Dose, of the glycerophosphate of calcium and iron — H., 3i-ii. ; D., gr.v.-x. Cai.cii Chloridum. Calcium Chloride. Cad. (U. S. & B. P.) Synonym.- Calcium chloratum, chlorure de calcium, Fr.; chlorcalcium, cal- eium chlorid, G. Derivation. — Neutralize hydrochloric acid with calcium carbonate and evapo- rate: 2HCl+CaC03z=CaCl24-C02-(-H,0. Fusion at the lowest possible tem- perature reyders the salt anhydrous. Properties. — White, slightly translucent, hard fragments, granules or sticks; odorless; having a sharp, saline taste, and very deliquescent. Soluble in 1.2 part of water, in about 10 parts of alcohol. Dose.— H. & C, 5ss-i, (15-30); D., gr.5-20, (.3-1.3). Gelatinum. Purified Gelatin. (U. S. P.) Derivation. — The purified air-dried product of the hydrolysis of certain ani- mal tissues, as skin, ligaments, and bones, by treatment with boiling water. Properties. — An amorphous, more or less transparent solid, usually shredded or in thin sheets; colorless or with a slight yellowish tint, inodorous, and having a slight, characteristic, almost insipid taste. Insoluble in cold water, but swells and softens when immersed 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 chloride has been used of late exten- sively both to prevent and arrest hemorrhage. Outside of the body, cal- cium chloride causes blood to coagulate more quickly and firmly than usual, and the same kind of action appears to obtain — i.e., rendering blood more coagulable — when the salt is given internally. Calcium chloride is used as a 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 hemorrhage in cases likely to be attended by much bleeding. But, if given too long, calcium chloride lessens the coagulability of the blood and thus not more than 6 or 8 doses should be given, 3 times daily. Calcium lactate has the same action and is less irritating so that it is more suitable for dogs in the same doses as the r BARIUM 129 chloride. It may also be given subcutaneously, diluted with as much as 20 parts of water, and in purpura hemorrhagica is more efficient because sometimes not absorbed from the digestive tract in this disorder. It has been found that removal of the parathyroids in dogs causes lime starva- tion of the body and tetany. Also that lack of lime in the body favors muscular twitching, transudation, itch and edema. Therefore calcium chloride or lactate is given internally to relieve epilepsy, pleural effu- sions, urticaria, itching, bronchial asthma (spasm and edema), angio- neurotic edema, and rashes caused by injection of foreign serums. Cal- cium chloride solution added to poultices hastens the ripening of boils. It is necessary for the clotting of milk by rennin, and is often used to thicken cream when it is beaten. 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 sterilized fractionally for half an hour on three to five successive days, tetanus may ensue when it is injected under the skin, and numerous cases have been reported following such use in human surgery. Merck sells a perfectly sterilized gelatin. The simplest man- ner of employing gelatin to arrest hemorrhage internally is by injection per rectum; l^ ounces for small animals and 10 ounces to a pint for larger animals of the following aqueous solution, given at body tempera- ture 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 laudanum may be added to prevent expulsion. It should be repeated 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. Calx Chlorixata. {See Chlorine, p. 182.) Calcii Sulphas Exsiccatus. Dried Calcium Sulphate, or Plaster of Paris, used for bandages. Barium. (Barium is not used in the metallic state.) Barii Chloridum. Barium Chloride. BaCL. (Non-official.) Derivation. — Native barium sulphate is fused with charcoal. The resulting sulphide is treated with hydrochloric acid. BaS04-f2C = BaS + 2 CO.. BaS-j-2 HCl=BaCl2 + HjS. Properties. — Occurs 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., 5i-ii 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 re- sembles physostigmine in its action on the intestines. Heart and Blood Vessels. — Barium chloride makes the ventricular 130 INORGANIC AGENTS contractions of the heart stronger and slower. The salt stimulates direct- ly the heart muscle. Lethal doses are followed by slower and slower ventricular contractions, succeeded by peristalsis of the cardiac muscle, and, finally, by stoppage of the heart in systole. Barium chloride also directly excites the muscular walls of the capil- laries, and thus contracts the pulmonary, cerebral, and coronary arteries which lack constrictor fibres. Muscles. — Barium chloride stimulates muscular contraction when it is applied locally. It stimulates contraction of the uterus, bladder and other organs. Toxic doses, given intravenously^ cause convulsions owing to stimulation of the spina] cord and medulla. Thus there is initial stimulation of the medullary vagus, vaso-motor and respiratory centres, with rapid respiration. This is succeeded by paralysis of the central nervous system. Summary. — Circulatory stimulant, and purgative in large medicinal doses. Uses. — Many practitioners are afraid to use barium chloride, but repeated use of the drug has convinced Muir that it is safe when given in the dose of 1 gram or 15 grains, intravenously, or 4 to 8 grams (1 to 2 drams) by the mouth in solution for the horse.* Barium chloride is of value in colic and obstinate constipation 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 solu- tion 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 until 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 extract of cannabis may be given to lessen colic while barium is acting, when it is given by the mouth. Extensive experiments of Muirf 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 drams of sterile water; that 2 Gm. is a safe dose by the intra jugular method for a horse of ordinary weight and fair condition ; that the drug acts 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 follow- ing 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. *Lockhart reports two deaths in horses from 2% and 3 drams 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.) fJour of Comp. Med. and Vet. Archives, Jan. and Feb., 1899. MAGNESIUM 131 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. doses intrajugularly at about 2% hours apart, when death occurred from heart failure in nine minutes after the second dose. Barium chloride is useful in relieving tympanites of cattle. Four to five drams are given to cattle and one and one-quarter drams to calves in drench. Since writing the above many fatalities have oc- curred from the intravenous injection of barium, so that it has largely gone out of use save by the mouth. Used intravenously it cannot be said to be other than dangerous. In human practice it is not employed on account of its toxicity and irritating effect upon the digestive tract. Magnesium, (The metal is not used in medicine. ) Magxesii Sulphas. Magnesium Sulphate. MgS04 + 7 H^O. (U. S. & B. P.) Synonym. — Epsom salt, sal amarum, sal Epsomense, sal anklicum, sulfas magnesicus, etc., E. ; magnesium sulf ulicum, P. G. ; sulfate de magnesie, sel d'Epsom, sel de seidlitz, sel amer, Fr. ; bittersalz, schwefelsaure magnesia, G. Derivation. — It is obtained from native dolomite, a double carbonate of mag- nesium and calcium, or magnesite (MgC03). MgCO,-f H-.S04 = MgS04-fH20 + co2. Properties. — Small, colorless, prismatic needles or rhombic prisms, without odor, and having a cooling, saline and bitter taste; slowly efflorescent in the air; soluble in one part of water; almost insoluble in alcohol; reaction neutral. Incompatible*. — Lime water, alkaline carbonates, phosphoric acid, phosphates, silver nitrate and lead acetate. Dose.— H., laxative, 5ii-iv, (60-120) ; C, purgative, Ibi-ii, (500-1,000) ; laxa- tive 5"i-iv, (90-120); Calves, 5ii-iii, (60-90); Sh., giv-vi, (120-180); D., 3i-iv, (4-15). Action Internal. — Epsom and Glauber's salts are the best purgatives for general purposes in the treatment of cattle and sheep. The mode of action of Epsom salt is similar to that described under sodium sulphate. Briefly, magnesium sulphate causes purgation by increasing intestinal secretion, retarding absorption of fluid from the bowels, and by slightly 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 kid- neys and sweat glands, increasing the secretions of these organs, espe- cially when the dose is small. Summary. — Hydragogue cathartic. Feeble diuretic and diaphoretic. Uses. — For uses the reader is referred to sodium sulphate (p. 113). as the uses of the two salts 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 twice daily. Solutions of mag- nesium sulphate produce local anesthesia when injected under the skin or intraspinally. *Jour. of Comp. Med. and Vet. Archives, Jan. and Feb., 1899. 132 INORGANIC AGENTS 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 material. Its beneficial action is due to its dehydrating the tissues (as in the bowels), and may partly be ascribed to its local anesthetic influence. In the Great War a saturated solution of magnesium sulphate containing 10 per cent, of glycerin has been found of great value as a wet dressing for wounds infected with streptococci. It causes an outpouring of lymph and inhibits the growth of bacteria. The intravenous injection of magnesium sulphate causes general an- esthesia and death by paralysis of the respiratory centre. It acts locally and intradurally much like cocaine as a local anesthetic. One mil of a 25 per cent, solution for each 25 lbs. body weight is injected intradurally to cause spinal anesthesia and relieve the spasms of tetanus. 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 solutions of Epsom salt, which are often used to withdraw water from the blood in dropsies. The subcutaneous injection of 20 mils 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 Eichorn 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 neutral- ize the toxins. Ten drams of a 25 per cent, solution have been injected intraspinally with good effect in equine tetanus, but such treatment is not without danger. In urgent cases of tetanus a 6 per cent, solution may be given intravenously at the rate of 2 or 3' mils a minute until the spasms are relieved. Magnesii Carbonas. Magnesium Carbonate. (MgCo3)4 Mg(OH)..-f-5H,0. (U. S. P.) Synonym. — Magnesii carbonas ponderosa, or magnesii carbonas levis, B. P.; magnesia alba, carbonate of magnesia, E.; magnesium carbonicum, P. G.; car- bonate de magnesie, magnesie blanche, Fr. ; weisse magnesia, G. Derivation. — Mix concentrated, boiling, aqueous solutions of magnesium sul- phate and sodium carbonate, and evaporate. 5MgS04+5Na2C08+H20= (MgC03)4Mg4(OH)2+5 NA2S04+C02. Purified by digestion with water, filtration and drying. Properties. — Light, white, friable masses, or as a bulky, white powder, with- out odor, and having a slightly earthy taste; permanent in the air, practically insoluble in water, to which, however, it imparts a slightly alkaline reaction; insoluble in alcohol; dissolved by dilute acids with effervescence. Dose. — Foals and calves, 5i-ii, (4-8); D., gr.v-5i, (.3-4). Magnesii Oxidum. Magnesium Oxide. MgO. (U. S. P.) Synonym. — Magnesia, calcined magnesia, light magnesia, magnesia levis, B. HEAVY MAGNESIUM OXIDE 133 P.; calcined magnesia, magnesia calcinata, E.; magnesia usta, P. G.; magnesie calcinee, Fr. ; gebrannte magnesia, G. Derivation. — Heat magnesium carbonate. 4 (MgC03) Mg (OH)2 + 5 H20= 5 MgO-j-6 H20 + 4C02. 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 slowly absorbs mois- ture and carbon dioxide; almost insoluble in water; insoluble in alcohol. Dose. — Foals and calves, 5i-ii, (4-8); D., gr.v-3i, (.3-4). Magnesii Oxidum Ponderosum. Heavy Magnesium Oxide, or Heavy Magnesia. MgO. (U. S. P.) Synonym. — Magnesia ponderosa, B. P.; magnesie calcinee pesante, Fr.; schwere gebrannte magnesia, G. Derivation. — Made from light magnesia by trituration with alcohol, drying and pulverizing. Properties. — A white, dense, very fine powder, which conforms to the same reactions and tests as magnesii oxidum. Dose. — Foals and calves, 3i-ii, (4-8); D., gr.v-3i, (.3-4). Action of Magnesium Carbonates and Oxides. Internal. — Alimentary Canal. — These salts are antacid and counter- act abnormal acidity when exhibited after a meal. The carbonate 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 chlo- rides, 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 because feebly absorbed. Uses. — Phillip's milk of magnesia is a good laxative and antacid preparation for puppies. One or more teaspoonfuls may be added to milk, which will be taken voluntarily. Magnesia is a useful remedy for foals and calves affected with intestinal indigestion, tympanites and acid diarrhea, as follows: Magnesii oxidi ponderosi Pulveris rhei aa. 3iss. Pulveris zingiberis 3vi. M. et divide in chartulas No. vi. S. Give one powder in milk or flour gruel 3 times daily. Magnesia may give rise to intestinal concretions if its use is per- sisted in for a considerable period. Magnesium 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 anti- dote is kept on hand at drug stores and is made by adding solution of ferric sulphate to an aqueous mixture of magnesia (see ferri oxidum hydratum cum magnesia, p. 154). 134 INORGANIC AGENTS Heavy Metals: Including Aluminum, Cerium, Plumbum, Argentum, Zincum, Cuprum, Bismuthum, Ferrum, Manganum and Hydrargyrum. Aluminum. (The metal is not used as medicine.) Alumen. Alum. A1K (S04)2 + 12 H20 (U. S. P.) Synonym. — Alumen purificatum, B. P., potassium alum, aluminum and potas- sium sulphate, sulphate of aluminum and potassium, E.; alun, sulphate d'aluminc et de potasse, Fr. ; alaun, kalialaun, G. Derivation. — From alum slate, elay, shale, or schist, a native mixture of alu- minum 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 sulphates. 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 sul- phate of potassium and aluminum (alum) is formed, which crystallizes out on cooling, while potassium sulphate and ferric chloride remain as by-products. Alum is purified by recrystallization. Properties. — Large, colorless crystals, crystalline fragments, or as a white powder; alum is odorless and has a sweetish and strongly astringent taste. Solu- ble in 7.2 parts of water. It is freely soluble in glycerin; insoluble in alcohol; reaction acid. Tncompatibles. — Iron, lead and mercury salts, alkalies, lime, tartrates and tannic acid. Dose.— H. & C, 3ii-iv, (8-15) ; Sh. & Sw., gr.xx-3i, (1.3-4) ; D., gr.v-x, (.3-.6) ; emetic, D., 5i, (4). Alumen Exsiccatum. Dried Alum. A1K(S04)2. (U. S. & B. P.) Synonym. — Alumen ustum, P. G. ; burnt alum, E.; alun calcin6 (dess6ch§, brule), Fr. ; gebrannter alaun, G. Derivation. — Heat 100 Gm. of alum moderately until aqueous vapor ceases to be disengaged, and the product is reduced to 55 Gm. Properties. — A white, granular powder, without odor, possessing a sweetish, astringent taste, and attracting moisture on exposure to air. Soluble very slowly and incompletely in 20 parts of water; insoluble in alcohol. Reaction acid. Alumen and alumen exsiccatum may be either potassium or ammonium alum, A1NH4(S04)2 + 12H20, which closely resembles potassium alum in physical prop- erties and appearance. Alumini Hydroxidum. Aluminum Hydroxide. Al (OH)3. (U. S. P.) Synonym. — Aluminum hydrate, hydrated alumina, E.; hydrate d'alumine Fr.; thonerdehydrat, reine thonerde, G. Derivation. — Alum, 100 Gm. ; monohydrated sodium carbonate, 45 Gm.; water, a sufficient quantity. Mix hot, boiling solutions of alum and sodium carbonate. Precipitate strained, washed and dried. Properties. — A white, bulky, amorphous powder; odorless and tasteless; per- manent in dry air; insoluble in water or alcohol. Dose. — Same as alum. Aluminum Salts. Action External. — Dried alum is a superficial caustic, in contact with raw surfaces, on account of its affinity for water. It is only used exter- nally. Alum has no action on unbroken skin, but applied to mucous membranes or denuded parts it is antiseptic and astringent; coagulates albumin of discharges ; precipitates or coagulates albumin of the tissues ; squeezes blood out of the vessels; reduces inflammation and makes the part whiter, tougher and denser. Alum is a hemostatic, stopping bleed- ALUMINUM SALTS 135 ing by compression of the structures surrounding the vessels, and by causing blood to clot. Alum coagulates casein and gelatin in the pres- ence of an alkali. Action Internal. — Stomach and Intestines. — Enormous doses of alum produce gastro-enteritis, while large doses cause vomiting in carnivora. All the secretions are diminished in the alimentary canal, and constipa- tion ensues, unless the dose is excessive. Traces of alum are said to appear in the urine, but little is absorbed from the digestive 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 de- generation of the brain and cord, and inflammation of the bowel and kidneys in its elimination by these parts — like the other heavy metals. Alum does not occasion any astringent action in the body outside of the digestive tract, and is excreted by the bowels. Uses External. — Alum is employed mainly for local surgical pur- poses. 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 by insufflation of burnt alum. Alum is sometimes used on granulating surfaces of indolent ulcers, or wounds, as a slight caustic, stimulant and antiseptic. It can be employed alone, or as follows : Aluminis 5i. Carbonis ligni 5iv. Acidi salicvlici 3ii. M. S. Apply as dusting powder on wounds, galls or ulcers. The non-official liquor alumini acetatis is a useful astringent applica- tion, as a wet dressing diluted with 7 parts of water, in septic infections and boils and carbuncles. Alumen exsiccatum will often prevent the escape of synovia from small punctured wounds when applied to their apertures. Solutions (gr.iii.-v. to §i.) are occasionally instilled into the eye in conjunctivitis, but alum is not generally so satisfactory as boric acid, zinc sulphate, or silver nitrate, in this disease. Alum crystals may be applied with profit to granular lids. Alum is used more frequently in the treatment of stomatitis, or aphthous sore mouth. It is also benefi- cial 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 bronchitis in dogs. A 2 per cent, solution is appropriate as an injection for otorrhea, or canker of the ear, attacking dogs. A similar solution will relieve leucor- rhea, pruritus vulvae, 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. 136 INORGANIC AGENTS I* Aluminis exsiccati 25.0 Acidi arsenosi 15.0 Acidi carbolici 10.0 Cerati 25.0 M. et fiat unguentum. The following solution (Burow's) is applied as a wet dressing on contused, septic wounds for its astringent and antiseptic action: I* Aluminis 12.6 Plumbi acctatis 15. Aquae 100. M. (filter off ppt. of lead sulphate). S. Apply externally. 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 solu- tion 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 (ant- acid) 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 suljDhate, are, however, usually more valuable in diarrheal disorders. Alum is recommended for the cure of acute laminitis given inter- nally (5ii-vi. in ball every 2 hours), but there is no basis for the produc- tion of remote contraction of vessels in the foot in the physiological action of the drug. Its use in this manner is purely empirical. Cerium. (Cerium is not employed medicinally.) Cerii Oxalas. Cerium Oxalate. Ce2 (C204)3+9 H20. (U. S. & B. P.) Synonym. — Cerous oxalate, E.; oxalate de cerium, cerium oxalicum, Fr. ; oxal- saures ceroxydul, ceroxalat, G. Derivation. — Precipitate a solution of ammonium oxalate with a soluble salt of cerium. Properties. — A fine white, or slightly pink powder, without odor or taste, and permanent in the air; insoluble in water, alcohol or ether. Dose. — D., 5ss-ii, (2-4). Action and Uses. — The physiological details concerning the action of cerium are unknown. It is useful in relieving vomiting by mechanically protecting the gastric mucous membrane, and is often combined with bismuth salts. Cerium is absorbed with difficulty from the digestive tract and, as 1% ounces by the mouth do not poison dogs, the dose should be V2 to 1 dram (Baehr & Wessler, 1909). Given intravenously, it produces poisoning resembling that of bismuth. LEAD OXIDE 137 SECTION IV. Plumbum, Argentum, Zincum, Cuprum and Bismuthum. Plumbum. (Lead is not used in the metallic state in veterinary medicine , except as a last resort.) Plumbi Oxidum. Lead Oxide. PbO. (U. S. & B. P.) Synonym. — Litharge, E.; lithargyrum, P. G. ; protoxide de plomb, Fi\; blei- gliittc, G. Derivation. — Made by roasting lead in the air. Properties. — A heavy, yellowish or reddish-yellow powder, or in minute scales, without odor or taste. On exposure to the air it slowly absorbs moisture and carbon dioxide. Almost insoluble in water; insoluble in alcohol. Reaction faintly alkaline. Lead oxide is valuable only for its preparations. PREPARATION. Emplaslrum Plumbi. Lead Plaster. (U. S. & B. P.) (Diachylon Plaster.) Lead oxide, olive oil and lard, each 1000, boiling water, a sufficient quantity. Basis of other preparations. Plumbi Acetas. Lead acetate. Pb(C2HA)2+3 H20. (U. S. & B. P.) Synonym. — Sugar of lead, E.; acetate de plomb, sel (sucre) de saturne, Fr. ; assigsaures bleioxyd, bleizucker, G. ; plumbum aceticum, P. G. Derivation. — Heat lead oxide in acetic acid and water. PbO + 2 HC,H3CX + 2 H20=Pb(C2H302)2h3 H20. Lead acetate crystallizes on cooling. Properties. — Colorless, shining, transparent, monoclinic prisms or plates, or heavy, white crystalline masses, or granular crystals, having a faintly acetous odor and a sweetish, astringent, afterwards metallic taste. Efflorescent and ab- sorbing carbon dioxide on exposure to the air. Soluble in 1.4 parts of water and in 38 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, Si, (4) ; Sh. & Sw., gr.xv-xx, (1-1.8) ; D., gr.i-ii, (.06-.12). PREPARATIONS. Made from lead acetate in which lead exists as the subacetate, Pb20 (CH3COO)2. Liquor Plumbi Subacetatis. Solution of Lead Subacetate. (U. S. P.) Liquor Plumbi Subacetatis Fortis. (B. P.) Synonym. — Goulard's extract, acetum plumbi; plumbum hydrico-aceticum solutum, E.; liquor plumbici subacetici, P. G. ; sous-acetate de plomb liquide, extract de Goulard, vinaigre de plomb, Fr. ; bleiessig, G. Composition. — An aqueous solution of lead subacetate (approximately), Pb20 (CH3COO)2, containing not less than 18 per cent, of Pb. Liquor Plumbi Subacetatis Dilulus. Diluted Solution of Lead Subacetate. (U. S. & B. P.) Synonym. — Lead Water. Solution of lead subacetate, 40; water to make 1000. Ceratum Plumbi Subacetatis. (Unguentum, B. P.) Cerate of Lead Subacetate. Solution of lead subacetate, 20; camphor, 2; wool fat, 20; paraffin, 20; white petrolatum, 38. (U. S. P. 1906.) Plumbi Carboxas. Lead Carbonate. (PbC03)2 Pb(OH)2. B. P. (Non-official U. S. P.) Synonym. — White lead, E. ; blanc de plomb ceruse, Fr. ; bleiweiss, G.; cerus- sa, P. G. 4 Pb+2 HC2H302+2 02-f 2 C02=(PbCo3)2 Pb (OH)2+Pb(C2H802)2. Properties. — A heavy, white, opaque powder, or a pulverulent mass, without 138 INORGANIC AGENTS odor or taste. Permanent in air. Insoluble in water or alcohol. Used only exter- nally. Plumbi Nitras. Lead Nitrate. Pb (N03)2. (Non-official.) Synonym. — Plumbum nitricum, azotate (nitrate) de plomb, Fr. ; salpeter- saures bleioxyd, bleisalpeter, G. Derivation. — 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 alcohol. Only used externally in 1 per cent, solution as an astringent and deodorant in gangrenous surfaces, etc. Plumbi Iodidum. Lead Iodide. Pb I2. (Non-official.) Synonym. — Plumbum iodatum, iodure de plomb, Fr.; jodblei, G. Derivation. — Treat solution of lead nitrate with that of potassium iodide. Pb (N03)2+2 KI — PbL + 2 KNOs. Dry the precipitate. Properties. — A heavy, bright, yellow powder, without odor or taste; perma- nent in the air; soluble in about 1,300 parts of water; very slightly soluble in alcohol; used only externally. PREPARATION. Unguentum Plumbi lodidi. Ointment of Lead Iodide (B. P.) Employed externally to absorb glandular swellings. Action of Lead Salts. External. — 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 albu- min by forming a lead albuminate, so producing a protective pellicle over raw surfaces; wrhile the acid constituent has little effect (lack of irrita- tion). 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, probably a soluble albuminate. Lead is deposited in the tissues, especially 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 astrin- gent action. Toxicology. — Poisoning not infrequently occurs in animals at pas- ture, from eating paint, sheet lead, or products of lead or smelting 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 poisoning. 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 LEAD SALTS 139 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: DIGESTIVE SYMPTOMS. Lead line on gums. Anorexia. Colic. Thirst. Constipation. Abdomen retracted, or "tucked up." 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 respiratory muscles, or in convulsions. The lead line (gray or black dotted appear- ance) on the margin of the gums, at their junction with the teeth on the lower jaw, is due to sulphureted hydrogen in the mouth acting upon the lead deposited in the gums, and forming lead sulphide. Chronic poisoning may be very protracted, lasting as long as a year. Suscepti- bility of animals varies; cattle, sheep and swine being less resistant than horses. The fatal dose of lead acetate is said to be about an ounce and a half for cattle, and 5 ounces for horses. 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 tube 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 salt. Administration. — Lead acetate is given to the larger animals in solu- tion 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 dis- eases, as weeping eczema and erythema, and in excoriations, blistered sur- faces, bruises, strains, and burns. An efficient lotion having an astringent and sedative action in such conditions, contains as follows : Liquoris plumbi subacetatis §iv. Tincturae opii Si. Glycerini 3ii- Aquae ad Oi. M. (Shake.) S. External use. 140 INORGANIC AGENTS The "white lotion" of veterinary medicine is made by adding 3 drams each of lead acetate and zinc 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 externally in balanitis of dogs. The stronger solution of lead sub- acetate should not be employed extensively on raw surfaces or mucous membranes undiluted. The diluted solution of lead subacetate may be used as an injection for leukorrhea. 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 the cornea, because a permanent film may be deposited and obscure the sight. Lead iodide, in 10 to 20 per cent, ointment with petrolatum, has proved 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 diar- hea, dysentery, and hemorrhage from the stomach and bowels. It is fre- quently prescribed in these diseases witli opium, but should not be used over a long period. Argentum. Argenti Nitras. Silver Nitrate. AgNo3. (U. S. & B. P.) Synonym. — Nitrate (azotate) d'argent, nitre lunaire, Fr.; silbernitrat, sal- petersaures silberoxyd, G. ; argentum nitricum crystallisatum, P. G. Derivation. — Dissolve silver in nitric acid with heat. 3 Ag2 -J- 6 HN03 = 6 AgN03 + 3 H2. Evaporate and crystallize. 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 0.4 part of water and 30 parts of alcohol. IncompatibJes. — Alkalies and their carbonates, acids (except nitric and acetic), chlorides, potassium iodide, astringent infusions and solutions of arsenic. Dose.— H. & C, gr.v-x, (.3-.6); Sh. & Sw., gr.i-ii, (.06-.12) ; D., gr. Vs-Y2) (.008-.03). Argexti Nitras Fusus. Moulded Silver Nitrate. (U. S. P.) Synonym. — Lunar caustic, argenti nitras induratus, E.; argentum nitricum fusum, P. G. ; azotate d'argent fondu, F.; geharteter hollenstein, G. Derivation. — Melt silver nitrate, 100, with hydrochloric acid, 4, at as low a temperature as possible. Mix and pour into suitable moulds. Properties. — A white, hard solid, generally in the form of pencils or cones; becoming gray or grayish-black on exposure to light in presence of organic mat- ter; odorless, having a caustic, metallic taste, and neutral reaction. 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 zinc chloride). When applied exter- nally 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 super- ficial and localized in its effect. Silver nitrate is the caustic in most com- SILVER NITRATE 141 mon use, since it produces a more healthy condition in a granulating wound after its application and separation of the eschar. Silver com- pounds are powerfully antiseptic because silver itself is actively anti- septic and because the nitrate destroys germs in coagulating their proteid protoplasm. In dilution, silver nitrate is stimulant, astringent, antiseptic and caustic, according to its strength. Internal. — Silver nitrate is probably precipitated to a considerable 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 staining 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, 2% drams; iodine, 15 grains; and water, 3 ounces; or on fabrics use a solution of 15 grains of corrosive sublimate in 7 ounces of boiled water; add a small teaspoonful of table salt just before using. Soak material in solution for 5 minutes and wash in pure water. Large doses of silver nitrate cause gastro-enteritis with nervous symptoms — paralysis and convulsions — and death from depression of the respiratory centres. Common salt is the antidote, both externally and internally, forming the insoluble chloride. In addition to salt, opium and demulcents should be exhibited in acute poisoning. Silver nitrate in medicinal doses has probably a local stimu- lating, 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, asso- ciated with anorexia, weakness, anemia and emaciation. Uses External. — An aqueous solution (gr.iii. to 5i.) is most valuable in treatment of catarrhal conjunctivitis, while a stronger preparation (gr.x. to §i.) is employed for purulent conjunctivitis, as a stimulant, as- tringent 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 % per cent, solution it is stimulant and astringent to mucous membranes. Boils may be aborted by painting them with a saturated solution of silver nitrate. Pruritus ani, or vulvae, is relieved by painting the parts several times daily with a 4 per cent, solution. A solution (gr.iii. to §i.) may be used in the form of spray in the treatment of pharyngitis and laryngitis in the dog. In catarrh of the external ear, so common in dogs, the canal should be swabbed with a 5 per cent, watery solution of silver 142 INORGANIC AGENTS 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. — To insure purity, only the crystals should be em- ployed internally. Silver nitrate is not of much value for internal 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 salt and water should be used afterwards. Protargol. (Non-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 substance with silver; odorless, and possessing a strong metallic taste. Protargol has recently superseded silver nitrate (which contains 64 per cent, of silver) to some extent in medicine because, containing less silver (8.3 per cent.), protargol is decidedly less irritating, is not pre- cipitated 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 lacrimation which follows 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 application 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 irri- tation 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 zinc sulphate (Cheney). Protargol is indicated in acute catarrhal and purulent conjunctivitis in from 1 to 400, or 1 to 200 aqueous solutions; usually in one-half per cent, solution in the catarrhal form, two or three times daily, applied with a camel's hair brush or by instillation; 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 irriga- tions. Kingston reports favorable results in purpura hemorrhagica in horses from the intravenous injection of one ounce of a 5-per-cent. solu- tion of protargol twice daily. Argyrol. (Non-official.) Argyrol represents one of the numerous organic silver compounds, this preparation containing as much as 30 per cent, of the metal combined ARGYROL 143 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 a 1 : 500 solution of corrosive sublimate. Like protargol, it is not precipi- tated by the salts of the tissues, nor does it coagulate albumin, so that its action is not neutralized by the tissues — as is the case with silver nitrate ; and thus, unlike the latter, it possesses a penetrating power 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 actually sedative in 10 per cent, solution. In inflammatory diseases of the mucous membranes of the nose, throat, eye, urethra and bladder it has no equal. On account of its markedly irritating properties, silver nitrate has been largely replaced by argyrol and protargol. But neither are antiseptics in any degree, when compared to silver nitrate, and it is impossible to wholly explain their beneficial effects. The percentage of silver in the organic silver com- pounds does not indicate their antiseptic value (Marshall & Neave). Soluble Silver. (Non-official.) Soluble silver, known also as Colloidal Silver, or more commonly 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 Crede'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 sugar of milk. Collargol has been given in the past intravenously in all kinds of infections for its supposed antiseptic action but it has not proved successful and has dropped into disuse. The dose intravenously is 5ss-i (2-4) for horses; dogs, gr.i-ii (.06-0.12), given in 2 to 5 per cent, aqueous solution. Collargol has been given also by the rectum (H., oi-ii, in Oi water; D., gr.ii-iv in §ii-iii water). Crede'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 suppura- tion of glands, lymphangitis, phlebitis, cellulitis and mastitis. The dose by inunction is % to 1 ounce for horses, % to 1 dram for dogs. Collargol appears to be non-toxic when given intravenously or by inunction, if used with reasonable care. Zincum. (Zinc is not used in Medicine in the metallic state.) Zixci Chloridum. Zinc Chloride. ZnCl2. (U. S. & B. P.) Synonym. — Chlorure de zinc, Fr. ; zinkchlorid, chlorzink, G. ; zincum chlo- ratum, P. G. Derivation. — Dissolve zinc in hydrochloric acid by boiling. The solution con- tains the zinc chloride with chlorides of iron and lead as impurities. These are 144 INORGANIC AGENTS Uses. — Zinc chloride is employed in a paste made into small pieces with flour; or on lint soaked in a saturated solution, dried, and introduced precipitated by adding first nitric acid, then zinc carbonate. Filter and finally evaporate. Zn2 -j- 4 HC1 = 2 Zn CI, -f 2H2. Properties. — A white or nearly white granular powder, or porcelain-like masses, or moulded into pencils ; odorless ; it is so intensely caustic 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 0.25 parts of water; soluble in 1.3 parts of alcohol. Liquor Zinci Ciiloridi. Solution of Zinc Chloride. (U. S. & B. P.) Derivation. — Made as above with the addition of water and containing not less than 48.5 per cent, nor more than 52 per cent, of Zn Cl2. Properties. — A clear, colorless, odorless liquid, having a very astringent, metallic taste and an acid reaction. Spec. gr. about 1,548 at 25° "C. (77° F.). Used as disinfectant in 50 per cent, strength. Toxicology. — Zinc chloride is a powerful irritant if swallowed in any degree of concentration, and will, therefore, produce gastro-enteritis. Emetics or the stomach tube should be used, followed by demulcents and sodium bicarbonate, under the skin about the base of tumors to cause their destruction by sloughing. Small skin tumors may be removed by the following paste which mummifies the tissues and prevents hemorrhage: Zinci chloridi 5i. Pulveris •amyli 3ili- Cocainae hydrochloridi 5ss. Aquae 3ii. M. S. Apply externally. Stronger pastes spread on gauze or packed in cavities and left 2 or 3 days are used to remove cancer, as follows : Zinci chloridi Pulveris amyli aa oiii. Pulveris acaciae Aquae aa 3i. M. S. Apply externally. It is employed in the form of pencils on unhealthy, granulating sur- faces, as in "foot rot," and injected in strong solution into fistulous tracts to destroy their walls. It is not used internally. Zinci Sulphas. Zinc Sulphate. ZnSo4 + 7 H20. (U. S. & B. P.) Synonym. — White vitriol, E.; sulphate de zinc, vitriol blanc, couperose blanc, F.; zinksulfat, schwefelsaures zinkoxyd, weisser vitriol, G. ; zincum sulfuricum, P. G. Derivation. — Prepared by dissolving zinc in sulphuric acid. Zn2 -j- 2 H2S04 = 2 ZnS04 + 2 H2. Iron and tin exist as impurities, and are removed by chlorine solution and zinc carbonate. Properties. — Colorless, transparent, rhombic crystals, or as a granular, crys- talline powder, without odor, and having an astringent, metallic taste. Efflo- rescent in dry air; reaction acid; soluble in 0.9 parts of water, in 2.5 parts of glycerin; insoluble in alcohol. Incompatible s. — Lead acetate, silver nitrate, lime water, alkalies and carbo- nates, vegetable decoctions or infusions, and milk. PRECIPITATED ZINC CARBONATE 145 Dose.— H. & C., 5i-ii, (4-8) ; Sh. & Sw., gr.x-xx, (.6-1.3) ; D., gr.ii-iii, (.12-.2) ; Emetic — D., gr.x-xv, (.6-1). Zinci Carbonas PRiEciriTATus. Precipitated Zinc Carbonate. (U. S. P.) Synonym. — Zinci carbonas, B. P.; precipitated zinc carbonate, E.; carbonate (sous-) de zinc hydrate, hydrocarbonate de zinc, Fr. ; kohlensaures zinkoxyd, G. Derivation. — Solutions of nearly equal weight of sodium carbonate and zinc sulphate are boiled together; dry precipitate. 2 ZnC03, 3 Zn(OH),? (hydrated basic zinc carbonate) results. This, salt is in reality a mixture of zinc carbonate and oxide, containing not less than 60% of ZnO, with water of crystallization. Properties. — An impalpable white powder, without odor or taste; insoluble in water or alcohol. It is permanent in the air. Zinci Oxidum. Zinc Oxide. Zn O. (U. S. & B. P.) Synonym. — Flores zinci, oxyde de zinc, Fr. ; zinkoxyd, G.; zincum oxydatum, P. G. Derivation. — Heat the carbonate to redness. Properties. — A very fine amorphous, white or yellowish-white powder, free from gritty particles, without odor or taste. It gradually absorbs carbon dioxide from the air. Insoluble in water or alcohol. " Dose.— H. & C, 5i-ii, (4-8) ; D., gr.v-x, (.3-.6). PREPARATION. Unguentum Zinci Oxidi. Ointment of Zinc Oxide. (U. S. & B. P.) Zinc oxide, 200; benzoinated lard, 800. (U. S. P.) Zixci Acetas. Zinc Acetate. Zn (G,H302)2 + 2 H20. (U. S. & B. P.) Derivation. — Dissolve zinc oxide in diluted acetic acid and boil. ZnO -f 2 HGH30., = Zn(C2HaO,)2 + HX>. Evaporate and crystallize. Properties. — Soft, white, six-sided monoclinic plates, of a pearly lustre, hav- ing a faintly acetous odor, and, in dilute solutions, an astringent metallic taste. Exposed to the air the salt gradually effloresces and loses some of its acid; reac- tion acid; soluble in 2.3 parts of water and in 30 parts of alcohol. Incompatible 8. — Same as sulphate. Dose. — Same as sulphate. ACTION OF THE ZINC SALTS. External. — The salts of zinc (except the chloride) have an astringent action on raw surfaces and mucous membranes in precipitating solutions of proteids, as zinc albuminate, notably the sulphate and acetate. Ab- sorption is not followed by poisoning, as most of the zinc 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 sulphate or acetate may induce gastro-enteritis, which is to be treated with demul- cents and alkaline carbonates in order to form insoluble compounds. Vomiting will relieve carnivora; otherwise the stomach tube must be re- sorted to. Zinc salts apparently produce no remote effect upon the body when ingested. Given intravenously (double salts) to mammals, zinc 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 zinc salts are astringent, diminishing secretion in the digestive tract. USES OF ZINC SALTS. External. — Zinc sulphate is in common use as an astringent collyrium for subacute conjunctivitis (gr.ss.-ii. to §i.)« It is also employed in the 14G INORGANIC AGENTS treatment of canker of the ear in dogs (gr.x to §i.), or as "white lotion" (see plumbi acetas), in this affection. In diseases of the feet, as in canker of the horse, equal parts of zinc, 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.ii.-v. to 5i«) *n moist eczema, ulcers, atonic inflammations of mucous membranes, balanitis and urethritis in dogs, and leucorrhea. Zinc carbonate is a much milder astringent than zinc 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) 3»i Aluminis Siss. Calcii carb. praecip ox- Creosoti Cerae flavi aa 3Jss. Adipis 3xv. M. S. External use. The lard and wax are first melted together and then the other ingre- dients 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 follow- ing 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 poisoning by absorption or from the acid being licked off by the patient. Acidi carbolici 1.0 gr.xv. Zinci oxidi 15.0 5ss. Calaminae 5.3 gr.80 Glycerini 30.0 §i. Liquoris calcis ad 240.0 §viii. M. et fiat lotio (shake). Sig. External use. Zinc 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 *i.) or creolin (5 per cent.) to great advantage, when itching is a prominent symptom. Still better than zinc ointment is the addition of calamine 1 part to 7 parts of ointment; or a paste containing zinc oxide, starch and vaseline. Zinci oxidi 5iv. Pulveris amyli. Petrolati aa 3vi. M. S. External use. Zinc acetate can be used in all cases as a substitute for zinc sulphate. Lassar's paste is used in subacute eczema where stimulation (salicylic acid) is advisable. The formula is as follows: COPPER 147 Acidi salicylici 5ss. Zinci oxidi Amyli aa 3vi. Petrolati : gi. 3v. M. S. External use. Internal. — Zinc 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. Zinc oxide may be given in powder, pill, or dissolved in alkaline solutions. Zinc Valerate. See p. 388. Zinc Phosphide. See p. 182. Cuprum. (Copper is not used in the metallic state in medicine. ) Cupri Sulphas. Copper Sulphate. Cu So, -f-5 H20. (U. S. & B. P.) Synonym. — Cupric sulphate, blue vitriol, blue stone, E.; cuprum sulfuricum piirum, P. G. ; vitriol bleu, sulfate de cuivre, Fr. ; kupfervitriol, blauer-vitriol, schwefelsaures kupfer (kupferoxyd), G. Derivation. — Boil metallic copper and sulphuric acid together. 2 Cu -f- 2 H2 S04 = 2 CuS04-{-2 H2. Dissolve product in hot water and crystallize. Properties. — Deep blue, triclinic crystals, or as a blue, granular powder; odor- less, of a nauseous, metallic taste; slowly efflorescent in dry air; soluble in 25 parts of water; in 500 parts of alcohol; reaction acid. Incompatibles. — Mineral salts (except sulphates), alkalies and their car- bonates, 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-ii, (.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, paralysis and delirium), and finally death from collapse. When injected intra- venously copper salts lead to destruction of the blood, and fatty degen- eration 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 poi- soning. Smaller doses are astringent in the digestive tract. The copper absorbed from the alimentary tract lodges in the liver, kidneys, and thy- roid 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 cor- puscles as cuprohemol. 148 INORGANIC AGENTS Uses External. — Copper sulphate is employed in the solid, crystal- line form in granular conjunctivitis, by rubbing the stick over the affected surfaces of the lids. A solution (gr.-ii. to ^i.) is dropped into the eye for simple conjunc- tivitis. 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 in the following mixture, which is of value in thrush and canker of the feet in horses, and as an application for not too extensive chronic sores and unhealthy indolent granulating surfaces: Cupri sulpha t is Zinci sulphatis aa ,>ss. Liquoris plumbi acetatis 5i- M. S. Apply externally. 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 rot 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 zinc 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 corpuscles, firmness of flesh and amount of fat. Copper sulphate is often used as a vermicide in the treat- ment of lumbricoid worms and ozena, combined with iron. For horses with roundworms: Pulveris cupri sulphatis. Pulveris ferri sulphatis aa 3"- Pulveris foeniculi Carbonis ligni aa 5ni. M. et divide in chartulas No. xvi. S. One powder on feed night and morning. Follow last dose with a dose of aloes and linseed oil. For sheep 14 lb. (avoirdupois) is dissolved in 10 quarts of water as a vermifuge. The dose for lambs of 3 to 6 months is 5vi to ^iss ; for sheep of 1 to 2 years, §iiss-§iiiss. A dose of about an ounce and a half (50 mils) of a one per cent, solution of copper sulphate has proved the best remedy against stomach worms of sheep (Hemonchus contortus). It is recom- mended 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 permanganate BISMUTH 149 are safer and more effective antidotes in phosphorus poisoning, as too large doses of copper sulphate are required for this purpose. Cupri Acetas. Copper Acetate. (Non-official.) Synonyms. — Verdigris, cupric subacetate, E.; acetate de cuivre, vert-de-gris, F.; griinspau, G. Derivation. — Exposure of copper plates to pomace or residue resulting from expression of juice from grapes in wine making, or to immersion in pyroligneous acid. Properties. — 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, (.3-.6). Action External. — It is astringent, stimulant and escharotic accord- ing 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 expul- sion of ascarides from the horse. It should be given in doses of gr.15-30 (1-2 Gm.) twice daily with powdered gentian and charcoal, 1 dram 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.) Bismuthi Subcahboxas. Bismuth Subcarboi.ate. (BiO)2C03-|-H20? (U. S. P.) Synonym. — Bismuthi carbonas, B. P.; carbonate of bismuth, bismuthyl carbo- nate, E.; sous-carbonate de bismuth, Fr.; wismutsubcarbonat, basisches kohlen- saures wismutoxyd, G. Derivation. — Made by dissolving pure metallic bismuth in diluted nitric acid, precipitating with ammonia water, and redissolving in nitric acid. This solution is treated with ammonium carbonate, or a solution of sodium carbonate. 2Bi (N03)3-f3 Na2C03-4-H20— (BiO)2 CO.+H.O-^ C02+6 NaN03. The precipitated bismuth subcarbonate is filtered and washed. Properties. — A white, or pale yellowish-white powder, of somewhat varying chemical composition; odorless and tasteless, and permanent in the air. Insoluble in water or alcohol, but completely soluble in nitric or hydrochloric acid, with copious efflorescence. Dose.— H., 5ii-iv, (8-15); D., gr.x-xxx, (.6-2). Bismuthi Subxitras. Bismuth Subnitrate. BiO N03+H20? (U. S..& B. P.) Synonym. — Bismutum subnitricum, P. G.; bismuthum hydriconitricum, magis- terium bismuthi, E.; subazotas (s. subnitras) bismuthicus, sous-azotate de bismuth, Fr.; basisches salpetersaures bismutoxyd, G. Derivation. — Dissolve pure metallic bismuth in diluted nitric acid. First re- daction— BL+6 HN03 = 2 Bi (N03)3+3 H2. Final reaction— Bi (N03)3+H20 = BiONT03-j-2 HN03. Evaporate; add water; wash and dry precipitated bismuth subnitrate. Properties. — A heavy, white powder of varying chemical composition; odor- less and almost tasteless, and slightly hygroscopic in the air. Almost insoluble in water, insoluble in alcohol, and readily dissolved by nitric or hydrochloric acid. Dose. — Same as subcarbonate. Bismuthi Subsalicylas. Bismuth Subsalicylate. (U. S. P.) Dose.— D., gr.iv, (.24). Bismuthi wSubgallas. Bismuth Subgallate. (U. S. P.) Synonym. — Dermatol, E.; sous-gallate de bismuth, Fr. ; wismutsubgallat, G. 150 INORGANIC AGENTS Properties. — An amorphous, bright, odorless, tasteless, and yellow powder; permanent in the air; insoluble in water, ether, alcohol or chloroform; soluble, with decomposition, in warm acids; used externally as a substitute for iodoform; it is antiseptic and astringent; occasionally given internally. Dose.— D., gr.v-x, (.3-.6). ACTION OF BISMUTH SUBNITRATE AND SUBCARBONATE. External. — 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 absorp- tion and poisoning. Bismuth has no action on the unbroken 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, blackness of the mucous membranes of the digestive tract, and death. Probably, as ordi- narily used, all the bismuth absorbed from the alimentary canal is stored in the liver. In poisoning, however, it irritates the parts which eliminate it — i.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 tellurium 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 oxy- chloride 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 contamination with arsenic. The tongue and feces are stained black by bismuth salts, which are transformed into the sulphide. Bismuth, locally and mechan- ically, 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. External. — Bismuth subnitrate is a very good dusting powder on sores, and for moist skin diseases and ulcerated surfaces. It may be combined with zinc 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 attended with much secre- tion: USES OF BISMUTH SUBNITRATE AND SUBCARBONATE 151 Bismuthi subnitratis 50.0 §i. 5v. Acidi tannici 25.0 3vi. Iodoformi 15.0 3iv. Carbonis ligni 100.0 o"i- 5ii. M. et fiat pulvis. Sig. Dust on surface. It may be employed to advantage in coryza and ozena, by insufflation 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 fistula? and chronic suppurating 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 for a month. The paste, while warm, is drawn up into a metal or glass syringe. In small fistulae, 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 bis- muth, poisoning may occur. This is stopped by injecting warm oil into the cavity and aspirating the contents some 12 hours later. This method of Beck completely revolutionized the treatment of sinuses, especially those connected with bone. Various other suppurating cavities are cured by bismuth injections. 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 sequestrum of bone. Or the paste has not been soft enough to enter all pockets. When large amounts of the paste are required substitute chalk for bismuth. Dermatol (bismuth subgallate) is even more efficient than the subnitrate alone as an antiseptic and astringent 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. Sodii bicarbonatis oh. Bismuthi subcarbonatis 3ii. Cerii oxalatis 3i. M. et divide in chartulas No. vi. S. Give one powder on tongue every hour. 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 152 INORGANIC AGENTS 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 subcarbonate of bismuth with bicarbo- nate of sodium, while the sedative effect upon the bowels is enhanced by combining morphine with bismuth subnitrate. For diarrhea in dogs or cats: I* Tincturae opii camphoratae. Bismuthi subcarbonatis aa 5ss. Misturae crctae ad 3ii. M. (Shake.) Sig. y2 to 2 teaspoonfuls every 3 hours according to age and size. It is generally immaterial whether the subnitrate or subcarbonate 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. SECTION V. Ferrum. Metallic iron is official in the form of fine, bright and non-elastic wire, from which are made iron preparations and reduced iron. Ferrum Reductum. Reduced Iron. (U. S. P.) Synonym. — Ferrum redactum, B. P.; iron by hydrogen, Quevenne's iron, fer- rum hydrogenio reductum, ferrum ope hydrogenii paratum, E.; ferrum redactum, P. G.; fer reduit par l'hydrogene, Fr. ; reducirtes eisen, G. Derivation. — Hydrogen gas is passed over freshly made and carefully washed ferric oxide in a hot and closed tube. Feo03-j-3 H2 = Fe2-j-3 H20. Properties. — A very fine grayish black, lusterless powder, without odor or taste; permanent in dry air; insoluble in water or alcohol. Dose.— H., 5i-ii, (4-8); C, 3ii-iv, (8-15); Sh. & Sw., gr.xx-xxx, (1.3-2); D., gr.i-v, (.0G-.3). Ferri Sulphas. Ferrous Sulphate. Fe So4-j-7 HX>. (U. S. & B. P.) 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. Derivation. — Iron wire is dissolved by boiling in diluted sulphuric acid. Fe.,-)-2 H2S04 = 2 Fe S04+2 H2. Properties. — Pale, bluish-green, monoclinic prisms, without odor, and having a saline styptic taste; efflorescent in dry air. On exposure to moist air the crys- tals rapidly oxidize and become coated with brownish-yellow, basic ferric sulphate. When it has thus deteriorated the salt must not be used for any official purpose. Soluble in 1.4 parts of water; insoluble in alcohol. Dose.— H., oi-ii, (4-8); C, 3ii-iv, (8-15); Sh. & Sw., gr.xx-xxx, (1.3-2); D., gr.i-v, (.06-.3). Ferri Sulphas Exsiccatus. Exsiccated or Dried Ferrous Sulphate. Fe2So4+3 H20. (U. S. & B. P.) Synonym. — Ferrum sulfuricum siccum, P. G. ; sulfate de fer desseche, Fr.; entwjisserte 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. FERROUS SULPHATE 153 Properties. — A grayish-white powder, slowly soluble in water. Dose. — Same as sulphate. Ferri Sulphas Granulatus. Granulated Ferrous Sulphate. Fe2S04-f7 H20. (U. S. & B. P.) Synonym. — Sulfate ferreux precipitin, Fr.; praecipitirtes ferrosulfat, G. Derivation. — 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. Ferri Carbonas Sacciiaratxs. Saccharated Ferrous Carbonate (U. S. & B. P.) Synonym. — Ferrum carbonicum saccharatum, P. G.; saccharure de proto-car- bonate de fer, Fr. ; ziickerhaltiges kohlensaures eisen (ferrocarbonat), G. Derivation. — Ferrous sulphate, 50; sodium bicarbonate, 35; sugar, 70; sugar of milk, 10; sulphuric acid and water, q. s. Properties. — Greenish-brown powder, without odor; sweetish and ferruginous. Made by solution, precipitation and washing and drying. Contains not less than 15 per cent, of FeCo3. Dose. — Twice that of iron sulphate. Massa Ferri Carboxatis. Mass of Ferrous Carbonate. (U. S. P.) Dose.— D., gr.i-v, (.0G-.3) in pill. Pii.ul.e Ferri Carboxatis. (Blaud's Pills.) (Ferrous Carbonate, gr.i.) Dose.— D., 1 to 2 pills. Syrupus Ferri Iodidi. Syrup of Ferrous Iodide. (U. S. & B. P.) Properties. — Transparent, pale green liquid; having a sweet, strongly ferru- ginous taste, and a slightly acid reaction. Containing not less than 4.75 per cent, nor more than 5.25 per cent, of FeL. Dose.— H., Bss-i, (15-30); D., Tn_v-xxx, (.3-2). Ferri Ciiloridum. Ferric Chloride. FeCl3+H,0. (U. S. P.) Synonym. — Ferrum sesquichloratum, P. G. ; ferrum muriatum oxydatum, ferri perchloridum, sesquichloride (perchloride) of iron, E.; perchlorure de fer, chlo- rure 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-stop- pered bottles in dark. Properties. — Orange yellow, crystalline pieces, odorless, or with a faint odor of hydrochloric acid, and having a very strong styptic taste; deliquescent; soluble in 0.2 part of water and freely soluble in alcohol; having acid reaction; not used internally. Liquor Ferri Chloridi. Solution of Ferric Chloride. (U. S. P.) Synonym. — Liq. ferri perchloridi, B. P. An aqueous solution containing fer- ric chloride (Fe Cl3) corresponding to not less than 10 per cent, nor more than 11 per cent. Fe. Derivation. — Dissolve iron wire, 125, in hydrochloric acid, 680, nitric acid and water to make 1,000. (U. S. P.) First reaction.— Fe.-f 4 HC1 =2 Fe CL+2H,. Second reaction.— 6 FeCl2+6 HC1+2 HN03 = 3 Fe2 CL-f-2 NO + 4 H20. Properties. — A reddish-brown liquid, having a faint odor of hydrochloric acid; an acid, strongly styptic taste and an acid reaction. Dose.— H. & C, 5ii-iv, (8-15) ; Sh. & Sw., TTlx-xx, (.6-1.3); D., TT1 ii-x, (.12-.6). PREPARATIOXS. Tixctura Ferri Chloridi. Tincture of Ferric Chloride. (U. S. P.) Solution of ferric chloride, 350; alcohol to make 1,000. Dose.— H. & C, Bi-ii, (30-60); Sh. & Sw., TT\xx-xxx, (1.3-2); D., TT|,v-5i, (.3-4). Contains 13 per cent, of ferric chloride, or not less than 4.48 per cent, of metallic iron. 154 INORGANIC AGENTS Tinctura Fekri Perchloridi. Tincture of Iron Perchloride. (B. P.) Dose.— Same as Tinctura Ferri Chloridi (U. S. P.) Liquor Fehri Subsulphatis. Solution of Ferric Subsulphate. (U. S. P.) Synonym. — Solution of basic ferric sulphate FeO (S04)5, Monsel's solution, solution of persulphate of iron, E.; liquor hemostatique de Monsel, Fr. ; basisch- schewefelsaures eisenoxydlosung, Monselsche eisenlosung, G. Contains about 13.6 per cent, of metallic iron. Derivation. — Ferrous sulphate, 675; sulphuric acid, 65; nitric acid and dis- tilled 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.— H. & C, Sss, (15) ; Sh. & Sw., TTJx-xx, (.6-1.3) ; D., Tuji-x, (.12-.6). It has no value for internal use. Fekri Hydroxidum Cum Magnesii Oxido. Ferric Hydroxide with Magnesium Oxide. (U. S. P.) (Arsenic Antidote.) Solution of ferric sulphate, 40 mils.; water, 125 mils; 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 stomach lavage. Dose. — Large quantities should be repeated frequently ad libitum. Ferri et Potassii Tartras. Iron and Potassium Tartrate. (Non-official.) (Potassio-Ferric Tartrate.) Synonym. — Ferrum tartaratum, B. P.; tartarus ferratus, P. G. ; ferri potassio- tartras, ferrum tartarizatum, tartras ferico-kalicus, etc., E.; tartrate de fer et de potasse, tartre martial, Fr. ; weinsaures eisenoxyd-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, (.3-.6). Ferri et Ammokii Citras. Iron and Ammonium Citrate. (U. S. & B. P.) Synonym. — Ferrum citricum ammoniatum, P. G. ; ferri ammonio-citras, ferro- ammonium citricum, ammonio citrate of iron, E.; citrate de fer et d'ammoniaque (de fer ammoniacal), Fr. ; citronensaures eisenoxyd-ammonium (ammoniak), G. Properties. — Thin, transparent, garnet-red scales, odorless, and having a saline, mildly ferruginous taste; deliquescent in moist air; soluble in water; in- soluble in alcohol. Iron and ammonium citrate contains 16 per cent, of metallic iron. Dose.— D., gr.v-x, (.3-.6). Ferri et Quinine Citras. Iron and Quinine Citrate. (U. S. & B. P.) Synonym. — Ferri et quinine citras solubilis, chinum ferro-citricum, P. G.; citras ferrico-quinicus, citrate de fer et de quinine, Fr.; citronensaures eisen chinin, G. Properties. — Thin, transparent scales, of a greenish or golden-yellow color, odorless, and having a bitter, mildly ferruginous taste. Rapidly and completely soluble in cold water, partly soluble in alcohol. Quinine and iron citrate con- tains 11.5 per cent, of anhydrous quinine and not less than 13 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 tissues 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 ACTION OF IRON AND ITS SALTS 155 upon their acid constituent, are strongly astringent and more or less irri- tant— as the chloride, perchloride, sulphate, persulphate, and nitrate. They contract tissue by coagulating albumin, when applied to raw sur- faces 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 medi- cine. 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 sufficient quantity in the food to support healthy animals. If iron is ingested by a normal animal in ordinary doses, it has little effect unless 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 externally. 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 astrin- gency is due to the preparation also. Thus ferric chloride is especially astringent because of the ease of dissociation and corrosive action of the HC1 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 HC1 of the gastric juice, and then prob- ably into albuminates or carbonates in the duodenum. Iron is naturally absorbed from the organic compounds of the metal 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 or carbonate. But in any event the greater portion escapes from the bowel unabsorbed. The route which iron follows, after absorption, has been quite accurately ascertained by many experiments. It is taken up from the duodenum by the epithe- lial cells and leukocytes 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 in- 156 INORGANIC AGENTS travenously. 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, there is gastrointestinal and renal irritation succeeded by stimula- tion and final depression of the central nervous system. The numerous compounds of iron now manufactured by pharma- ceutical 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 cases and are worthless in others. Some — as ferratin (D., gr.iii-x) 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 building material for blood. It may also stimulate the blood-making organs and in this way perhaps increase the number of red corpuscles. The leuko- cytes 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, stimu- lating tissue change and vital activity. Elimination. — Iron is chiefly excreted by the intestinal mucous mem- brane (nine-tenths), however administered, yet it is also found in minute amounts in the urine (one-tenth), bile, saliva, sweat and tears. Summary. — Iron is essentially a blood tonic and restorative, increas- ing the number of red blood corpuscles, the amount of hemoglobin, and aiding nutrition. Externally it is an astringent, styptic and stimulant. Uses External. — Liquor ferri chloridi and liquor ferri subsulphatis are sometimes used to stop bleeding from wounds or natural cavities of the body. They may be injected, applied by swab, or on absorbent mate- rial, which is packed into the wound or cavity. As a local 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 drams 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. It is commonly administered in pill, and often with other tonics, as strych- nine, quinine, and arsenic. Reduced iron is non-irritating, non-astrigent and non-constipating. It may be placed on the tongue in the form of powder. Ferrous sulphate is one of the two most valuable forms of iron which can be prescribed to the larger animals. The other form is the tincture of ferric chloride. The sulphate is more astringent and irritat- ing than some of the other iron salts, but does not usually cause constipa- tion in the horse. Indeed, when constipation is due to loss of tone in the lower bowel, small doses, by their local stimulant action, may actually ACTION OF IRON AND ITS SALTS 157 assist peristalsis. The dried ferrous sulphate is prescribed to horses in anemia, and is the most common constituent of tonic powders. It is fre- quently combined with powdered gentian, nux vomica, arsenic, and bicar- bonate 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. Pulv. nucis vomicae aa oii. Ferri sulphatis exsicc 5i. M. et 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 indigestion, intestinal parasites, leukorrhea, 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 convalesc- ence, iron may well be preceded by alcohol and bitters. Large doses of iron sulphate are indicated in hemorrhage from the bowels, if unasso- ciated with acute inflammation, 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 scrofulous 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 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 contained 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, is somewhat stomachic. The tine- 158 INORGANIC AGENTS ture is, accordingly, particularly valuable in anemia, dependent upon chronic indigestion in horses and cattle, and in that occurring in con- valescence 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 pharyn- gitis, combined with chlorate of potash, glycerin and water. Horses with pharyngitis: I* Tincturae ferri chloridi. Potassii chloratis aa ass. Glycerini 3ii. Aquae ad %viu. M. S. Two tablespoonfuls every 2 hours on tongue. Also in membranous croup of fowl (roup) in 10 m. doses; and of foals, calves and pigs (oss.), with an equal amount of potassium chlorate. Iron is prescribed in intestinal hemorrhage (dried ferric subsulphate or M onset's salt given in 1 to 2 dram 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 fluid- extract of quassia or calumba is often combined with the tincture of ferric chloride without incompatibility. The following is a good tonic preparation for horses or cattle: Tincturae ferri chloridi %iv. Quininae sulphatis oiii. Liquoris acidi arsenosi 5vni- Aquae ad Oi. M. S. Two tablespoonfuls in water t. i. d. 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., 5ss.; D., gr.i. in aqueous solution. The following elegant solution of iron and ammonium acetate (Bash- am's mixture) may be given to dogs, but Blaud's pills are more con- venient : Tincturae ferri chloridi 3i. Acidi acetici diluti 3iss. Liquoris ammonii acetatis 3i- 3v. Elixir aromatici. Glycerini aa 3iii. Aquae 3ss. M. S. Teaspoonful in water t. i. d. Iron and quinine citrate is a useful combination for dogs, dispensed in pill. It is often employed in canine distemper and chorea. No drug MANGANESE 159 is given more indiscriminately than iron. Pallor is a poor indication. Blood examination is the only certain guide. Manganum. (Manganese is not used in medicine in the metallic state.) Potassii Permaxganas. Potassium Permanganate. KMn04. (U. S. & B. P.) Synonym. — Kalium permanganicum, P. G. ; permanganate of potash, E.; per- manganate de potasse, Fr.; kaliumpermanganat, uebermangansanres kali, G. Derivation. — Caustic potash, chlorate of potassium and black oxide of man- ganese are fused together, (j KHO+KC103-f Mn02 = 3 K2Mn04+KCl+3 H.O. The manganate of potassium is boiled with water till the color changes to purple and the permanganate is formed. 3 K2Mn04+2 H20 = 2 KMn04-|-4KHO-)-MnO;;. The liquid is neutralized with carbonic dioxide gas and evaporated. Properties. — Slender, monoclinic prisms, of a dark purple color, almost opaque by transmitted light, and of a blue metallic luster by reflected light; odorless, and having in solution a taste at first sweet, but afterwards disagreeable and astringent; permanent in air; soluble in 13.5 parts of water; it is decomposed by alcohol; reaction neutral. Incompatible^. — It is very readily deoxidized in the presence of organic matter. Dose. — H., gr.xv-xx, (1-1.3) in one pint of water; D., gr.i-ii, (.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 effects correspondingly so on the tissues. For this reason, and because bacteria are so combined with organic mat- ter in the tissues, its action is largely exerted on the latter, and potassium permanganate is, therefore, a better antiseptic than disinfectant. The antiseptic action of potassium permanganate is, moreover, quite super- ficial, since it parts with its oxygen as soon as it comes in contact with the albumin 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 decomposition; and in solution is stimulant to the tissues. A solution of permanganate 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 potassium 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 amenorrhea 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 15 160 INORGANIC AGENTS grains may be given to dogs in 8 ounces of water immediately after poisoning. Horses may be given 2 drams 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 morphine or opium have been absorbed into the blood, it is said that potassium permanganate is also antidotal when injected subcutane- ously. It is difficult to see, theoretically, how this could be the case, and practically has been proved not to be so. Uses External. — Potassium permanganate is a valuable antiseptic 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, otorrhea, and leukorrhea. In the stronger solution it is stimulant as well as antiseptic. It is a useful agent in stomatitis and sore throat, when applied locally by means of a swab. The powder is employed as a caustic upon ulcers. The hypodermic injec- tion of a two per cent, solution of potassium permanganate in the area about snake bite is the best antidote through local destruction of the venom by oxidation. Potassium permanganate is one of the best agents with which to sterilize the hands before operating. A saturated 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 putrescent rain water. 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 distilled with lime, and condensed. Properties. — A shining, silver-white metal, without odor or taste; liquid at ordinary temperatures, and easily divisible into spherical globules; insoluble in the ordinary solvents; boils at 3580° C, and is volatilized, yielding not more than 0.02 per cent, of residue; spec, gr., 13.5. When cooled to about 40° C, it forms a ductile, malleable mass. PREPARATIONS COXTATXIXG 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 sweet taste. Contains mercury in fine division by shaking the ingredients together. Dose. — Foals and calves, gr.x-xv, (.6-1); D., gr.i-x, (.0G-.6). RED MERCURIC OXIDE 161 Il.—Massa Hydrargyri. Mass of Mercury. (U. S. P.) Synonym. — Pilula hydrargyri, B. P.; blue mass, blue pill, pilulae coeruleae, E.; pilule de mercure, Fr. ; mercurial pillen, G. Mercury, 33 Gra.; oleate of mercury, 1 Gm. ; glycyrrhiza, 10 Gm.; althaea, 15 Gm.; glycerin, 9 Gm.; honey of roses, 32 Gm. Contains not less than 32, nor more than 34 per cent, of mercury in a state of fine division. (U. S. P.) Dose.— D., gr.i-x, (.06-.6). III. — Unguentum Hydrargyri. Mercurial Ointment. (U. S. & B. P.) (Blue Ointment.) Synonym. — Pommade mercurielle A parties egales, pommade Napolitaine, Fr. ; quecksilbersalbe, G. Mercury, 500 Gm. ; lard, 250 Gm. ; suet, 230 Gm.; oleate of mercury, 20 Gm. Contains 50 per cent, of mercury. (U. S. P.) Hydrakgyri Oxidum Rubrum. Red Mercuric Oxide. HgO. (U. S. & B. P.) Synonym. — Hydrargyrum oxydatum, P. G. ; peroxide of mercury, red precipi- tate, mercuric oxide, E.; deuto-oxyde (peroxyde) de mercure, oxyde mercurique, preeipite rouge, poudre de Jean de Vigo, Fr. ; rothes quecksilberoxyde, rother pracipitat (queeksilber-pracipitat), G. Derivation. — Dissolve mercury in diluted nitric acid. 3 Hg2+16 HNOa = 6 Hg (NO,)2. (Mercuric nitrate) -4-4 NO+8 H20. Rub mercuric nitrate with metallic mercury and heat. 2 Hg (NQ,)a+Hg2 = 4 HgO+2 X,04. Properties. — Heavy, orange-red, crystalline scales, or a crystalline powder acquiring a yellow color when finely divided; odorless, and having a somewhat metallic taste; permanent in the air; almost insoluble in water; insoluble in alcohol. PREPARATION. Unguentum Hydrargyri O.ridi Rubri. Ointment of Red Mercuric Oxide. (B. P.) (Non-official.) Synonym. — Red precipitate ointment. Red murcnric oxide, 10; water, 10; hydrous wool-fat, 40; petrolatum, 40. (U. S. P. 1905.) Hydrargyri Oxidum Flavum. Yellow Mercuric Oxide. HgO (U. S. & B. P.) Synonym. — Hydrargyrum oxydatum via humida paratum, P. G. ; hydrargyrum oxydatum praecipitatum (vel flavuni) precipitated oxide of mercury, E.; oxyde de mercure jaune (precipite), Fr. ; priicipitirtes (gelbes) quecksilberoxyde, G. Derivation. — Precipitate an aqueous solution of mercuric chloride, 100, with caustic soda, 40: HgCl2+2 NaOH = HgO-}-2 NaCl-fH20. Properties. — A light orange yellow, amorphous, heavy, impalpable powder; odorless, and having a somewhat metallic taste; permanent in the air, but turn- ing darker on exposure to the light; almost insoluble in water; insoluble in alcohol. preparations. Unguentum Hydrargyri Oxidi Flavi. Ointment of Yellow Mercuric Oxide. (U. S. P.) B. P. 2 per cent. Yellow mercuric oxide, 10; water, 10; hydrous wool-fat, 40; petrolatum, 40. Oleatum Hydrargyri. Oleate of Mercury. (U. S. P.) Hydrargyri Oleas. (B. P.) Yellow mercuric oxide, 25; alcohol, 20; oleic acid to make 100. (U. S. P.) Hydrargyri Chloridum Corrosivum. Corrosive Mercuric Chloride. Hg. Cl2. (U. S. P.) (Corrosive Chloride of Mercury, Corrosive Sublimate.) Synonym. — Hydrargyri perchloridum, B. P.; hydrargyrum bichloratum cor- rosivum, P. G. ; perchloride of mercury, bichloride of mercury, E.; Deutochlorure de mercure, sublime corrosif, chlorure mercurique, Fr.; quecksilberchlorid, aetzen- der quecksilbersublimat, G. Derivation. — Heat a mixture of mercuric sulphate, 20; sodium chloride, 10* ; manganese dioxide, 1. Hg S04-f2 NaCl-f Mn02= HgCl2-f Na2S04+Mn02. The bichloride sublimes and is condensed. Properties.— -Heavy, colorless, rhombic crystals, or crystalline masses, or as a white powder; odorless, and having characteristic and persistent metallic taste; permanent in the air; soluble in 13.5 parts of water and in 3.8 parts of alcohol. 162 INORGANIC AGENTS Incompatibles. — It is incompatible with most substances. Dose.— H. & C, gr.v-vii, (.3-.5) ; Sh. & Sw., gr.ii, (.12); D., gr.1/30-1/8, (.002-.008). Hydrargyri Ciiloridum Mite. Mild Mercurous Chloride. HgCl. (U. S. P.) (Calomel, Mild Chloride of Mercury.) Synonym. — Hydrargyri subchloridum, B. P.; hydrargyrum chloratum, P. G.; mild or mercurous chloride, subchloride or protochloride of mercury, E.; proto- chlorure (sous-muriate) de mercure, calomftle, Fr.; quecksilberchloriir, calomel, G. Derivation. — Heat mercurous sulphate and sodium chloride. Calomel sublimes. Hg2 SO4+2 Na CI = 2 HgCl-fNa,S04. Properties. — A white, impalpable powder, becoming yellowish-white on being triturated with strong pressure, and showing only small isolated crystals when viewed with a lens having a magnifying power of 100 diameters. Odorless and tasteless; permanent in the air; insoluble in water or alcohol. When strongly heated it is wholly volatilized without melting. Dose.— H., 3ss-i, (2-4); C, ov-vi, (20-24); D., gr.ss, (.03), in divided doses; D., gr.iii-v, (.2-.3) in single doses. PREPARATION. PiUtlce CatharticW Composites. Compound Cathartic Pills. (U. S. P.) Compound extract of colocynth, HO; calomel, 60; resin of jalap, 20; gamboge, 15; diluted alcohol, q. s. to make 1,000 pills. Dose.—D., pill 1 to 3. Hydrargyri Iodidum Rubrum. Red Mercuric Iodide. Hgl2. (U. S. & B. P.) (Birviodide of Mercury, Red Iodide of Mercury.) Synonym. — Hydrargyri biiodatum, P. G.; deutoiodide of mercury, mercuric iodide, E.; deut-iodure (bi-iodure) de mercure, iodure mercurique, Fr.; rothes jodquecksilber, quecksilberjodid, G. Derivation. — Mix aqueous solutions of corrosive mercuric chloride, 40 Gm., and potassium iodide, 50 Gm. The red iodide is precipitated. Filter, wash and dry. HgCl2+2 KI = HgI2-j-2 K CI. Properties. — A scarlet-red, amorphous powder; odorless, nearly tasteless, and permanent in the air; almost insoluble in water; soluble in 115 parts of alcohol. Unguextum Hydrargyri Nitratis. Ointment of Mercuric Nitrate (Citrine Oint- ment). (U. S. & B. P.) Mercury, 71 Gm.; nitric acid, 17.5 Gm.; lard, 76.0 Gm. (U. S. P.) Properties. — A lemon-yellow ointment. Hydrargyrum Ammoxiatum. Ammoniated Mercury. HgNH2Cl. (U. S. & B. P.) (White Precipitate, Mercuric Ammonium Chloride.) Synonym. — Mercurius praecipitatus albus, E.; oxychlorure ammoniacal de mercure, mercure precipite blanc, Fr. ; weisse quecksilber-pracipat, quecksilber- chloridamidid, 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; insoluble in water or in alcohol. PREPARATION. Unquenlum Hydrargyri Ammoniali. Ointment of Ammoniated Mercury. J ^ (U. S. & B. P.) Synonym.— White precipitate ointment. Ammoniated mercury, 10; white petrolatum, 50; hydrous wool-fat, 40. (U. S. P.) General Action of Mercury and Its Salts. External.— The salts of mercury are antiseptic, germicidal, irritant and— in the case of the soluble r alts— caustic, when applied to raw sur- ACTION OF MERCURY AND ITS SALTS 163 faces or mucous membranes. Corrosive sublimate is one of the slowest acting, most powerful and frequently used antiseptics. The germicidal action of mercury salts is due to their habit of combining with albumin wherever it exists and forming the albuminate 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 con- tact, but, unlike 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 corro- sive sublimate is lessened by this action since the salt is decomposed in contact with albumin and the coagulated proteid prevents 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 treat- ment of parasitic skin diseases. As a rule, antiseptics 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, particu- larly 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 inflam- matory 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 (nephritis), collapse and death. A subacute form of poisoning also occurs with colic, diarrhea or dysentery and anuria and death may occur after days from gastro-enteritis or nephritis. The immediate treat- ment consists in giving whites of eggs and milk to form non-corrosive albuminates, and these should be removed by washing the stomach with milk. Afterwards give milk and linseed tea as demulcents. The kidneys are stimulated to elimination by a milk diet and, every 2 hours, by a diuretic mixture of potassium bitartrate (H., §i. ; D., 5ss.), and milk sugar (H., §iv. ; D.. oii.), dissolved in boiling water and given with as much water as possible. Mercury stomatitis is treated by swabbing the mouth several times daily with .hydrogen dioxide, diluted with 3 parts of water and containing a little sodium bicarbonate, and by application of tincture of iodine to the gums once or twice daily. Vincent's angina organisms appear to be responsible for the inflammation in tissues of the Ifi4 INORGANIC AGENTS mouth lowered in resistance by elimination of mercury. Potassium iodide is given to hasten the elimination of mercury from the body. 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 eas- ily; 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, prostration 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 mercury 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 re- peated doses may lead to mercurialism if purgation does not occur. Stomach and Intestines. — Calomel and preparations of metallic mer- cury are most commonly used for their action on the digestive tract. It has been shown by Schaefer (1910) that calomel is transformed in the duodenum by the alkaline juices into a gray salt consisting of the car- bonate and oxide. The cathartic action of calomel depends upon the gray salt which is both locally irritating and antiseptic. The same change occurs outside the body when calomel is added to a solution of sodium carbonate. While calomel acts chiefly on the duodenum, sweeping out the bile, it continues its action on the whole of the small intestine. If the dose is insufficient to sweep out the whole intestinal tract it may empty the contents of the small bowel into the colon, causing putrefaction there of the undigested food. This is one of the reasons for following calomel with a saline to flush out the large bowel. 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 supposition being that they stimulated the liver and flow of bile. But experiments on man and animals show that they exert no apparent effect on the liver or biliary secretion. Their indubitable efficacy is due to their cathartic and intestinal antiseptic action, as such conditions (biliousness, etc.) are not owing to liver disorder but to indigestion. The purgative action of calomel and mercury is assisted by salines (as above), 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 cattle. Blood and Metabolism. — It is stated that calomel may be absorbed unchanged from the intestines by leukocytes to some extent. It is prob- USES OF MERCURY AND ITS SALTS 165 able, however, that mercury preparations are chiefly absorbed as albu- minates 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 antiseptic action of the salts of mercury in the in- testines 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, by stimulating the secreting cells of the kidneys, or relieving splanchnic engorgement by catharsis. Elimination. — When mercury is given continuously it accumulates in all the organs and 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 emunc- tories. Summary of Actions of Mercury and Its Salts. External. — Antiseptic, germicide, irritant, caustic, parasiticide, anti- pruritic and sorbefacient. Internal. — Antiseptic, purgative, antiphlogistic, alterative and diu- retic (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) witli intestinal indigestion and diarrhea, particularly if accompanied with jaundice. The oleatum or unguentum hydrargyri are rubbed into the skin to cause resolution of chronic inflammatory swellings, and also to kill animal and vegetable parasites. As the former action is due to ab- sorption, 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 connec- tion 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 prepara- tions are employed to kill the fungus of favus and ringworm, and to 166 INORGANIC AGENTS destroy lice and the acari of mange, when inhabiting circumscribed areas. Itching in skin diseases, as chronic eczema and psoriasis, is relieved either by blue ointment or the oleate of mercury. Hydrargyri Oxidum Rubrum et Flavum. The official ointments of the red and yellow mercuric oxides are pre- scribed, as stimulant and antiseptic preparations, in chronic conjunc- tivitis, corneal ulcers, granular lids and scaly skin diseases. They are also employed on indolent ulcers, swollen glands and old granulating surfaces. When used on mucous membranes, or raw surfaces, the official ointments should be diluted with equal parts of lard. For chronic Conjunctivitis, keratitis and ulcer of the cornea: I* J [ydrargyri oxidi flavi gr.iv. Petrolati Jss. If. S. Apply to eyeball once daily with soft earners hair brush. For eczema of lids, blepharitis and granular lids, use twice strength and rub on edge of lids twice daily. Hydrargyri Chloridum Corrosivum. External. — Corrosive sublimate is of value mainly as an antiseptic on the unbroken skin. It is germicide in solutions containing 1 part to 500, or 1000, of water. 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. Experiments by Harrington and Walker go to show that corrosive sublimate is much less active than commonly believed. A 1-1000 solution requires more than ten minutes' contact to kill common forms of pus cocci, so that dipping the hands for a few seconds in such solution does more harm than good in inducing a false security which does not exist. They conclude by say- ing that, as the result of their experiments, "corrosive sublimate in any of the strengths common^ 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 tincture of iodine, alcohol (over 50 per cent.), tincture of green soap, and 5 per cent, phenol kill all bacteria in less than one minute. A 1.5 per cent, solution of lysol kills most germs within one minute, while 1-500 corrosive requires more than 10 minutes to kill almost any pathogenic microorganisms. 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 lysol or chlorazene solution. Corrosive sublimate is, however, still regarded as the antiseptic sheet anchor by many surgeons CORROSIVE SUBLIMATE 167 for the irrigation of infected wounds and cavities, and for skin disin- fection. For hand and skin disinfection Harrington's solution of corrosive sublimate is perhaps the most effective of any in existence. Hydrargyri chloridi corrosivi gr.xii. Acidi hydrochlorici oii. Alcoholis 5**i. M. S. Immerse hands or apply to skin for 2 minutes. Wash off hands wijth* 70% alcohol to remove irritation of above. Mercuric bichloride, even in the weaker solution, is too damaging to the serous membrane of the peritoneal cavity, and there is too much dan- ger of absorption to warrant us in using it in intra-abdominal operations. As a caustic, saturated solutions are injected into fistulous tracts, e.g., fistula? of the withers, "quittor" and "poll evil," to destroy their so-called pyogenic membranes, and hasten repair, as follows. There is not much danger of absorption when used in this way. Hydrargyri chloridi corrosivi 3ii. Acidi hydrochlorici oi- Aquae ad Oi. M. S. For injection into fistulae. Corrosive sublimate is very useful in solution as a parasiticide, in destroying lice, ringworm, the spores of pityriasis, and the fungus of favus on the unbroken skin, and also relieves itching in pruritus, prurigo and urticaria, as follows: 9 Hydrargyri chloridi corrosivi gr.x. Glycerini 5i. Alcoholis (70% ) 5vm- M. S. Apply externally. Apart from the body, corrosive sublimate in solution 1-500 or 1-1000 is one of the cheapest and most effective disinfectants for premises in- fected 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, can be disin- fected by washing or soaking in solutions of bichloride. Before opera- tions, the operative field should be sterilized by scrubbing with green soap and then with Harrington's solution, after the hair has been shaved from the part. During an operation, irrigation with corrosive (1-3000) solu- tion or boiled normal salt solution is commonly practised. In epizootic abortion, in addition to quarantining 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 solution of corrosive sublimate. Yellow wash, made by the addition of mercuric bichloride to lime water, is sometimes employed as a stimulant 168 [NORGANIC ACCENTS application in chronic eczema, and to relieve itching. Jt contains the yellow oxide of mercury. I* Hydrargyri chloridi corrosivi gr.x. Liquoris calcis 3xx. M. et ft. lotio flava. S. Use externally. In purulent conjunctivitis, frequent irrigation with a 1-1000 solution of corrosive sublimate is of the greatest service. Internal. — Corrosive sublimate is of value in minute doses as a blood tonic, and is recommended as an antiphlogistic agent in inflammatory dis- eases 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 inflammatory diseases. Corrosive sublimate is sometimes employed with success as a counter- irritant and absorbent on exostoses, as follows: I* Hydrarg. chlorid. corros gr.xvi. Iodi. Glycerini aa 3iv. Alcoholis ad giv. M. S. Apply with brush every other day on splint or spavin. Mercuric bichloride is employed as an intestinal antiseptic in the treatment of dysentery and diarrhea with mucous or vile smelling dis- charges. 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. Administration. — 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 dram of calomel in one pint of lime water, forming the black oxide of mercury, and is a very efficient preparation to relieve itching and pro- mote recovery in chronic eczema, b}~ 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 must not be so used when potassium iodide is being administered internally as mercuric iodide may be formed, resulting in sloughing and destruction of the eyeball. It is the best 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, diuretic 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 purga- CALOMEL 169 tion 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. As calomel is transformed by the alkaline intestinal secretions into the gray mercurous oxide it has been the custom to com- bine sodium bicarbonate with it in order to facilitate this transformation. The administration of calomel should be followed 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 constipa- tion, 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 treatment of dysentery unless there is great weakness. It should be continued in repeated small doses till the character of the discharge changes. Foals and calves, with indi- gestion and diarrhea, may be given calomel to advantage to remove the source of irritation in the digestive tract. Calomel must be combined with a small dose of aloes, or with linseed oil, to form an effective cathar- tic 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, *4 to V2 grain each of santonin and calomel, with 5 grains of sugar of milk, are adminis- tered to dogs four times, at half hour intervals, and followed by castor oil. Lumbricoid worms in the horse may be treated by conjoining 2 drams of santonin with 1 dram of calomel, given to the fasting animal, and followed by a pint of linseed oil. A useful anthelmintic prescription for the horse for round or tape worm consists of the following: Aloes. Hydrargyri chloridi mitis. , Oleoresinae filicis maris aa 3i. Pulveris zingiberis 3ss. M. et ft. bolus No. i. Sig. Give to horse after fasting for 24 hours. Calomel was formerly very frequently used, and is occasionally pre- scribed to this day in the treatment of enteritis, pleuritis, meningitis, peritonitis, pericarditis, and iritis, for its antiphlogistic and alterative action in supposedly diminishing inflammatory exudations. At the present time these actions are very much questioned, and any beneficial effects accruing from the use of calomel in inflammatory dis- eases are now ascribed to its action as a purgative and intestinal antiseptic in destroying and eliminating bacteria and 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 (gr.i) sometimes acts as a useful diuretic, when combined with digitalis and squill (gr.i each) in pill form given t. i. d. Administration. — Calomel is given to cattle on the tongue or in gruel; to horses in ball, on the food, or on the tongue; to dogs in pill, tablet or on the tongue; to fowl on the food (gr.i.). The compound cathartic pill 170 INORGANIC AGENTS 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 and mercury. It is employed with 8 to 10 or 12 parts of lard or vaseline, and is of value in the treatment of periostitis with osseous deposits, especially for splints. Spavin and ringbone are treated with red iodide of mercury alone, but are generally cured more effectively by rest, firing, and blister- ing. The red iodide of mercury ointment is also of use for enlarged glands, chronic swelling about tendons, joints or bursae; 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. I* Hydrargyri iodidi rubri 5i. Adipis §i. to 5iss. M. Sig. Apply externally. Stronger ointment for spavin, ringbone, splints; weaker for tendons, joints, bursae, glands, throat. Unguentum hydrargyri nitratis, or citrine ointment, is similar to un- guentum hydrargyri ammoniati (white precipitate ointment), but more powerful, and should be diluted with equal parts of lard. These oint- ments 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. Arseni Trioxidum. Arsenic Trioxide. As203. (U. S. P.) Synonym. — Acidum arseniosum, B. P.; acidum arsenicosum, P. G. ; arsenous acid, white arsenic, arsenicum album, arsenic, arsenious anhyrid, E.; acid arse- nieux, arsenic blanc. Fr. ; arsenicsiiure, weisser arsenic, G. Derivation. — Arsenical ores are roasted and purified by sublimation. Properties. — Occurs either as an opaque, white powder, or in irregular masses of two varieties; one amorphous, transparent and colorless, like glass; the other crystalline, opaque, and white, resembling porcelain. Both are odorless and tasteless. Arsenic trioxide is soluble in water, the amorphous somewhat more so than the crystalline variety. Arsenic trioxide is slightly soluble in alcohol, but freely soluble in glycerin, and is dissolved by hydrochloric acid and alkaline solutions. Frequently the same piece has an opaque, white, outer crust enclosing the glassy variety. Contact with moist air gradually changes the glassy into the white, opaque variety. Faintly acid reaction in solution. When covered ARSENIC 171 with charcoal in an ignition tube and strongly heated, arsenic trioxide is reduced, and metallic arsenic is deposited on the cooler portion of the tube as a mirror, having a metallic luster, and this mirror is readily dissolved by solutions of cal- cium or sodium hypochlorite. Incompatibles. — Lime water, salts of iron and magnesia. Dose.— H., gr.i-v, (.06-.3) ; Sh. & Sw., gr.i-ii, (.06-.12) ; D., gr.1/30-1/10, (.002-.006). Usual dose for H., gr.ii-iii, (.12-.2). Liquor Potassii Arsexitis. Solution of Potassium Arsenite. (U. S. P.) (Fowler's Solution.) Synonym. — Liquor arsenicalis, B. P.; liquor kali arsenicosi, P. G.; arsenical solution, E.; liqueur arsenicale de Fowler, Fr. ; Fowlers' che tropfen, G. Arsenic trioxide, 10 Gm.; potassium bicarbonate, 20 Gm. ; compound tincture of lavender, 30 Gm. ; distilled water to make 1000 Gm. Strength about 1 per cent, of potas- sium arsenite. Dose— H. & C, 3ii-3i, (8-30) ; Sh. & Sw., 3i-ii, (4-8) ; D., Vtfi-x, (.12-.6). Usual dose for H., 5ss, (15). Liquor Acidi Arsexosi. Solution of Arsenous Acid. (U. S. P.) Synonym. — Liquor arsenici hydrochloricus, B. P.; hydrochloric solution of arsenic, E.; liqueur arsenicale hydrochlorique, Fr.; chlorarsenik-losung, G. Arsenic trioxide, 10 Gm.; diluted hydrochloric acid, 50 Gm. ; distilled water, a sufficient quantity to make 1000 Gm. Strength, about 1 per cent, of arsenous acid. Dose. — Same as Fowler's solution. Absphexamixe (Dioxy-diamido-arsenobenzol dihydrochloride) . Synonym. — "606," Salvarsan. Occurs as a fine yellow powder soluble in water, soluble in methyl, less solu- ble in ethyl, alcohol. It is kept in a vacuum in ampoules because it is oxidized and becomes poisonous on exposure to air. It may be given intramuscularly but as it may sometimes cause pain, inflammation and sloughing, it is usually given intravenously. It is dissolved in sterile distilled water (300 mils) and neu- tralized by adding 23 drops of 15% sodium hydroxide solution to 0.6 Gm. (gr. x) salvarsan. It is chiefly used as a specific in human syphilis, but is efficacious in dourine, surra, nagana and pernicious anemia, and is recommended in pleuro- pneumonia of cattle and petechial fever of horses. If given in the first days of pleuro-pneumonia one dose is said to have reduced the mortality to a fraction of one per cent. Dose.— H. & C, gr.45-75 (3.-5.); D., gr.v-x. (0.3-0.6), intravenously or intra- muscularly. Atoxyl. Sodium Arsanilate (Co H5 NH As 02). A combination of anilin and arsenic, a white, soluble, crystalline powder con- taining 35.6 per cent, of metal arsenic. Hare states that atoxyl is 1/40 as toxic as Fowler's solution. Atoxyl is given subcutaneously in ten per cent, freshly prepared solution in trypanosomiases (dourine, surra, nagana), sclerostomiasis, piroplasmes, anemias and leukemia. Dose. — H., gr.iv, gradually increased to gr.xv, once daily, or single doses (Gm. 1-3) once in 10 days. 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. Sodii Cacodylas. Sodium Cacodylate. (Na(CH3)2 As02.) Sodium cacodylate occurs as white prisms or soluble powder identical in action with arsenic. Dose.— H., 5ss-i, (2-4); D., gr.i-iii, (.06-.2), hypodermatically. It has been used successfully in the treatment of anemias, leukemia, dourine, and other trypanosomiases, chronic pneumonia, strangles, influenza, chronic skin diseases, mountain and swamp fever, and hemorrhagic septicemia in horses, given subcutaneously (gr. 45) every third day, or oftener. 172 INORGANIC ACE NTS Action of Arsenical Compounds. External. — Arsenous acid is a slowly acting caustic on raw surfaces and mucous membranes. It produces considerable pain, and may cause fatty degeneration of the epithelium of the skin, with inflammation of the tissues beneath, and lead to poisoning. In frogs poisoned by arsenic the epidermis peels off very rapidly, owing to degeneration of its lower layers. It is antiseptic and the chief preservative agent in embalming fluids, and is used to kill the protozoan spirochaeta of syphilis and of Vincent's angina and stomatitis. In small doses arsenic increases subcutaneous fat and causes the coat of hair in animals to become thicker and more glossy. Internal. — Digestive Tract. — In large amounts, arsenic is an' irritant, causing loss of appetite, nausea, diarrhea and digestive disturbance. Similar digestive disorders occur after large hypodermatic doses of ar- senic and are due to increased permeability of the capillaries in the walls of the gut, with edema of the bowel, and degeneration and exfoliation of its mucous membrane. 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. Experimentally arsenic increases the formation of leuko- cytes in bone marrow, and the white cells in the blood, and does not increase the red cells or hemoglobin. It lessens the number of white cells in leukemia. 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 paralyzed, and this action takes place when the heart is removed from the body. Arsenic enhances capillary permeability, hence the edema of the skin (puffiness of eyelids), and digestive tract in poisoning. Respiration. — In small doses arsenic quickens the breathing and stimulates the respiratory centre; whereas in lethal amounts the respira- tion fails through lowered blood pressure and exhaustion. Nervous System. — The nervous apparatus is powerfully influenced by arsenic. Toxic doses cause paralysis of the spinal tracts, in frogs, with loss of sensation, motion, and reflex action, and the brain and nerves are also depressed. The nerve trunks are chiefly affected in the higher animals. There is peripheral neuritis and trophic changes occur. Medici- nal doses of arsenic are stimulant to the nervous system generally. Bone. — Experimentally arsenic has been found to increase the den- sity of bone in growing animals of poor nutrition, the cancellous tissue being transformed to a certain extent into hard bone — possibly by in- crease of vascularity in the bone marrow. Metabolism. — Therapeutic doses probably diminish tissue change and the elimination of urea. Continued dosage diminishes liver activity and glycogen formation, thus more nitrogen is eliminated as uric acid and ACTION OF ARSENICAL COMPOUNDS 173 less as urea. Poisoning causes degeneration of the bone marrow and anemia, also widespread fatty degeneration of the tissues. Large doses, on the other hand, increase metabolic processes and the escape of nitroge- nous 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 the drugs whose physio- logical action — so far as we know it does not throw any light, in many instances, upon its therapeutic effects. Clinically arsenic improves the general condition and increases the number of red blood cells or prevents their destruction (by destroying a causative organism of anemia in the blood) in pernicious anemia, and lessens the number of leukocytes in the blood in leukemia, thus producing results directly opposite to experimental findings. 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, arc propor- tionately not nearly so susceptible to the poisonous effects of arsenic as the human subject; l1/^ grains is the smallest fatal dose reported in man. An amount as large as one dram 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 number 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 toxic single dose for the horse and cow, and from one to two drams for sheep with consider- able variations. Dogs have been killed by 2 grains; hogs by 15 grains. Mild toxic action is seen following therapeutic doses of arsenic when the physiological limit is reached. This condition is characterized by loss of appetite (nausea and vomiting in dogs), watery discharge from the nose and eyes, puffiness of the eyelids, indigestion with mild colic, and diar- rhea. The pulse may be accelerated and harder than normal. The appearance 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 albuminous; the pulse is feeble, small and frequent; the respiration is rapid and difficult from abdominal pain; the extremities are cold, and there is great weakness of the limbs. Collapse, with convul- sions and coma, often close the scene in from five to twenty hours to three days. A sub-aeute 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 is seen in the human subject living in apartments 174 INORGANIC AGENTS furnished with arsenical wall paper or fabrics, or in those working in arsenic, and is observed in animals living in the immediate vicinity of smelters and chemical works, and in connection with drainage of sheep dips on forage, or in pastures contaminated with arsenic from spraying of trees. In this condition there are symptoms similar to those noted above as occurring in the milder form of arsenic poisoning, together with gradual loss of strength and flesh, suppression of milk, nasal ulcers, local paralysis or paraplegia, and anesthesia. A slightly raised, dark red or purplish band % to -/*,; in. wide is often seen on the gums at the base of the upper and lower incisor teeth of horses, the hair grows unusually long, the breath lias a garlicy odor and there are salivation, drooling and cough, loss of appetite, and constipation with mucus coated feces, fol- lowed by diarrhea (Salmon), Fatty degeneration of the liver, kidneys, heart, stomach and muscles, in cases of chronic arsenical poisoning, is found after death. The post-mortem changes observed after acute poisoning are as fol- lows: The gastric mucous membrane, especially the villous portion in horses, is swollen, softened and covered with patches of a deep crimson, or dark brown color. There is rarely ulceration. The upper portion of the small intestines, and in horses sometimes the whole of the intestinal tract, is similarly affected with that of the stomach. There is generally a wide-spread fatty degeneration of the stomach, bowels, internal organs and muscles. Congestion of the trachea and lungs and hemorrhages into the latter are often present. The treatment of acute poisoning depends mainly upon the use of lavage of the stomach and the official freshly prepared arsenic antidote (ferri oxidum hydratum cum magnesia) in large quantities. If this can not be obtained, an antidote can be prepared by precipitating Monsel's solution, or the tincture of the chloride of iron, with sodium bicarbonate or ammonia. Dialyzed iron may be precipitated with an alkali. In either case the precipitate should be washed in a filter of muslin and given in large amounts. Magnesium oxide alone is an efficient antidote. H. & C, qSS.; D., gr.xv., every 15 minutes. If vomiting has not occurred, zinc sulphate should be given dogs and cats, or the stomach tube resorted to, and the stomach well washed out. The after treatment is carried out with castor oil, demulcents, opium and external heat. Sweet spirit of nitre is to be prescribed, with considerable water, to flush out the kidneys. The treatment of chronic poisoning consists in removal of the patient from poisoned forage and perhaps the use of potassium iodide — which is very expensive and of doubtful utility. Uses External. — A paste containing 1 part each of arsenous acid and gum arabic, with 5 parts of water, is used to destroy warts and morbid growths. Arsenous acid, diluted with 5 parts of lard, may be employed to slough out fistulous tracts. In any case, there is danger of poisoning through absorption, if a sufficient amount of arsenic is used; but, on the other hand, the danger is slight if a large enough quantity is applied to cause rapid sloughing. USES OF ARSENICAL COMPOUNDS 175 For the removal of malignant growths or warts: Arseni trioxidi. Pulveris acaciae aa. gr.lxxv. Cocainae hydrochloride gr.xxx. Glycerini aa fllxxx. M. et ft. paste. S. Apply externally one-quarter inch thick, cover with patent lint and continue application 24 to 48 hours, then remove and apply poultice to remove slough in 5 to 10 days. Arsenic has been the principal constituent of so-called "sheep-dips" employed to kill ticks and other parasites in the wool. Finlay Dun rec- ommends 2% lbs. of arsenous acid with an equal amount of pearl ash, soft soap, and sulphur, dissolved in 10 gallons of boiling water and added to 90 gallons of cold water. This quantity will suffice for dipping 100 sheep. The sheep are submerged, except their heads for a few seconds, and placed on a grating to drain into a tub, from which the water flows back into the first receptacle. The excess of water in their fleeces is squeezed out with the hands and a scraper. Sheep and other animals have been poisoned after dipping, by eating grass and fodder on which they have drained; therefore the sheep should always be kept on clean floors or yards in the open air and sunlight until they have become thoroughly dry. The lime and sulphur dip recommended by the U. S. Agric. Dep't, or the tobacco and sulphur dip, to be found under Scab (p. 606), is as effective and safer. Arsenic and tar solution is most effi- cient for destroying ticks and preventing Texas fever in cattle (see p. 584). Uses Internal. — Arsenic is of the greatest service in the treatment of indigestion in horses associated with malnutrition and staring coat, as follows: Arseni trioxidi 3i. Pulveris nucis vomicae %iv. Sodii bicarbonatis 3v"i. M. et divide in chartulas No. xxx. Sig. One powder on the feed 3 times daily. Arsenic is also of value in atonic diarrhea, and is used in both the serous and dysenteric varieties. In diminishing tissue change, and in acting as a blood tonic, arsenic is believed to improve the condition, en- durance, and wind in horses, and is popularly prescribed by dealers and others. The classical case of the arsenic-eating peasants of Styria seems to corroborate this view. These people appear to be very robust and healthy. Five grains of arsenic was given experimentally to one of them without producing any untoward effect. Arsenic seems to influence favor- ably diseased mucous membranes of the respiratory tract, to improve their nutrition, and hasten absorption and repair in diseases of the air passages. Coryza, ozena, chronic cough, asthma, emphysema and "broken wind" are greatly benefited by a course of arsenic, and in chronic condi- tions the treatment should be sustained for months in small doses. 176 INORGANIC AGENTS "Thick wind" and convalescence from acute bronchitis, pneumonia or influenza are favorably influenced by arsenic. Arsenic is one of the best agents we can prescribe in general debility and simple anemia and may be conjoined with bitters or iron. Debility and anemia of horses: I* Arseni trioxidi .">i. Ferri sulphatis. Pulveris nucis vomicae aa 3iv- Pulveris gentianae radicis 3vi"- M. S. Level tablespoonful on feed 3 times daily. Anemia, mal-nutrition, dog: I* Arseni trioxidi gr.ss. Ferri reducti gr.xv. Extract] nucis vomicae gr.iii. M. Fiant pilulae No. xx. S. One t. i. d. Arsenic is indeed the next best remedy to iron in anemia, and, in pernicious anemia and leukemia, it is the remedy offering the greatest chances of improvement, when given in gradually increasing doses until horses are taking as much as one ounce of Fowler's solution twice daily; and dogs one-half a dram. Arsenic is an efficient remedy for horses with round worms as follows : Arseni trioxidi gr.80 Pulveris nucis arecae %i. Ferri sulphatis exsiccati %i. M. et divide in chartulas No. viii. Sig. One powder on feed each morning, and follow with pint of linseed oil containing §ii. of oil of turpentine on eighth day. In dry, scaly skin diseases, arsenic is the most successful internal remedy, but should not be prescribed in moist conditions associated with a proliferation of new cells, or exudate of serum or other liquid. It is particularly useful in chronic squamous, or papular eczema, acne and chronic urticaria, when given for a considerable length of time in small doses. Arsenic is used in rachitis, osteomalacia and rheumatic conditions of joints, its curative effects being to a certain extent accounted for by its physiological action. In the human subject, arsenic is almost a specific in chorea, but does not seem to yield such good results in that disease in dogs, usually asso- ciated with distemper. Fowler's solution should be given to dogs with chorea, in doses of two or three drops three times daily, and gradually increased till the physiological limit is reached. The same treatment should be tried in diabetes mellitus in dogs. Large single doses of arse- nous acid (5ss.) are sometimes given with calomel (oi.) and aloes (3iv.), in a ball to horses to kill round worms. Administration. — Arsenic is given to horses as Fowler's solution, or arsenous acid, on the food. If continued for a long time, arsenic must TARTAR EMETIC 177 be prescribed in small doses once daily, or in larger doses once in two or three days. Arsenic is exhibited to dogs in tablet or pill, and as Fowler's solution. The administration of Fowler's solution secures more rapid and accurate results than that of white arsenic. Antimonium. ( The metal antimony is not used in medicine.) Antimonii et Potassii Tartras. Antimony and Potassium Tartrate. K (SbO) C4H4O0+% H20. (U. S. P.) Synonym. — Antimonium tartaratum, B. P.; tartar emetic, tartarated anti- mony, E.; tartarus stibiatus, P. G. ; tartrate de potasse et d'antimoine, emetique, tartre stibie, Fr. ; brechweinstein, G. Derivation. — Make a paste with cream of tartar, antimony trioxide and water. Set aside 24 hours, boil in water 15 minutes and crystallize. 2 K HC4H4O0-f- Sb203 = 2 K (SbO) C4H4OtS-f H.O. Properties. — Colorless, transparent crystals of the rhombic system ; or a white, granular powder, without odor, and having a sweet, afterwards disagreeable, metallic taste. The crystals effloresce on exposure to air. Soluble in 12 parts of water; insoluble in alcohol. Dose. — H. & C, 5ii-iv, (8-15) ; emetic, pigs, gr.iv-x, (.24-.G) ; D., u,-1/^, (.006-.03); emetic D., gr.i-ii, (.06-.12). PREPARATION. Syrupus Scilhf Compositus. Compound Syrup of Squill. (U. S. P.) Synonym. — Hive syrup. Fluidextract of squill, 80 mils; fluidextract of sene- ga, 80 mils; antimony and potassium tartrate, 2 Gm.; distilled water, 10 mils; syrup to make 1000 mils. Dose for Dog. — TT^v-xxx, (.3-2). Action of Antimonii et Potassi Tartras. Tartar emetic is the only antimony compound suitable for internal use. The sulphide and oxide of antimony are insoluble, save in the hydro- chloric acid of the gastric juice, and are not so certain or reliable in their action as tartar emetic. Kermes mineral and golden sulphur, containing variable amounts of antimony trisulphide and trioxide, are even more uncertain and unreliable than antimony sulphide or oxide. External. — Tartar emetic is irritant, and when rubbed into the skin produces a pustular eruption and often sloughing and destruction of tissue. Internal. — Stomach and Bowels. — Tartar emetic is a gastro-intestinal irritant, causing salivation and nausea in small doses, vomiting and diar- rhea in large quantities ; while toxic amounts are followed by vomiting (in carnivora), serous or bloody purging, great depression of the circula- tion and respiration, muscular weakness, collapse and death. Uneasiness, nausea, colic and death have been reported in horses only after enormous doses of tartar emetic by the mouth. The horse and ruminants are comparatively insusceptible to the action of tartar emetic. The writer has observed a cow, however, in which nausea and actual vomition occurred, following a therapeutic dose of kermes mineral in elec- tuary. Tartar emetic is a powerful but slowly acting emetic (attended with a good deal of nausea) in dogs. Tartar emetic has been recovered in the 178 INORGANIC AGENTS first vomitus following its intravenous injection. It also expels the con- tents of a bladder artificially replacing the normal stomach. These results go to show that tartar emetic acts both as a specific emetic upon the vomiting centre, and locally as a specific irritant and an emetic upon the mucous membrane of the stomach. Tartar emetic is eliminated in great part by the mucous membrane of the alimentary canal. Circulation. — The principal action of antimony is exerted upon the heart and vessels. The heart muscle is weakened and vascular tension markedly lowered by large doses of tartar emetic. This action depends upon the influence of antimony on the cardiac muscle itself, and possibly upon the vagus nerve-endings in the heart. Vascular tension is lowered through depression of the heart and of the peripheral vasomotor nerves or muscle of the vessel walls. Whether the vasomotor centre is also de- pressed is uncertain. The pulse is reduced in force and frequency by large doses of tartar emetic. Following lethal amounts, the heart becomes flabby and relaxed, and death occurs in diastolic arrest. The preceding remarks apply only to the action of tartar emetic upon carnivora. Antimony was formerly a very popular drug when general depressant and depletant treatment was in vogue, because of its powerfully depress- ing action upon the circulation. Respiratory Organs. — Small doses of antimony increase secretion of bronchial mucus. Toxic amounts weaken the respiratory movement by lowering the functional activity of the respiratory and vagus centres, and cause a copious outpouring of serous and mucous secretion into the bronchial tubes, which has the effect of drowning an animal in its own secretions. This action is only seen in horses after intravenous injection of toxic quantities of tartar emetic. The respiration is slow and labored in poisoning. Nervous System. — Large doses of antimony depress the functional activity of the brain and sensory tract of the spinal cord. Larger doses produce loss of reflex action and anesthesia, owing to the influence of antimony upon the sensory side of the cord; while in toxic amounts, anti- mony is a general paralyzant to all the spinal centres and to the motor nerves. Muscles. — In carnivora and man, antimony lessens muscular strength and relaxes spasm through its depressing action upon the motor nerves and muscular tissue. Elimination. — Antimony is mainly eliminated by the mucous mem- brane of the stomach and bowels, but also by the kidneys, bronchial mucous membrane, and other channels. Toxicology. — The symptoms are those described under "Action on the Stomach and Bowels." The fecal discharges in man are copious and of the rice water appearance characteristic of Asiatic cholera. If vomit- ing is not free, zinc sulphate should be given, or the stomach washed out. Tannic acid should be administered as a chemical antidote, together with the use of external heat, alcohol, digitalone, strychnine and morphine subcutaneously, and demulcents by the mouth. Uses External. — Tartar emetic is used in ointment, in the strength of 1-4, over chronically enlarged and rheumatic joints of cattle. It is PHOSPHORUS 179 also employed over the sides of the chest in cattle, to produce counter- irritation and pustulation in the strength of 1 part to 12 of lard. Internal. — The therapeutic value of tartar emetic is limited mainly to canine, practice. Antimony is still prescribed largely by the Germans as a general and circulatory depressant and expectorant for horses. Gen- eral depressant treatment has gone out of vogue and is not usually indi- cated in inflammatory affections, and even if it were, antimony does not exert such an action in any considerable degree upon horses or ruminants. Aconite is a much more valuable and efficient circulatory depressant than antimony for the horse. There are three indications for antimony in canine practice: 1st, as an emetic; 2nd, as a general depressant in inflammatory diseases and in strong patients; 3rd, as an expectorant in acute bronchitis. The first indication is generally attained more promptly and safely by zinc sulphate. The second and third indications may be combined by prescribing antimony in the first, or dry stage of acute bronchitis in dogs, in the form of hive syrup. For example: I* Syr. Scillae Co. Sp't's. ^Ether. Nitrosi aa oSS. M. Liq. Ammon. Acetatis ad qIv. S. Teaspoonful every 2 hours. Antimony may be employed as an emetic in bronchitis to clear the stomach and upper part of the respiratory tract of secretions. Ipecac is, however, a better and safer agent in dogs for this purpose, and antimony is generally counter-indicated in the second, or exudative stage -of bron- chitis. Bronchitis in horses: Antimonii et potassii tartratis. Ammonii chloridi aa oSS. M. et divide in chartulas No. viii. S. One powder on the feed t. i. d. Tartar emetic is useful in cattle to overcome paresis and impaction of the rumen. The Germans prescribe tartar emetic very commonly to horses as a parasiticide against round worms and tape worms. Four or five drams are given in a pail of water to the fasting animal, and followed by the administration of a dose of oil. Tartar emetic has recently been given intravenously in trypanosomiasis, its action resembling arsenic prepara- tions. SECTION VIII. Phosphorus. Phosphorus. Phosphorus. P. (U. S. & B. P.) Synonym. — Phosphore, Fr. ; phosphor, G. Derivation. — Digest bones in sulphuric acid, or treat bone ash with sulphuric acid; filter and evaporate. Ca3 (P04)2 (bone ash)-f2 H2S04 = Ca H4 (P04)2 (acid calcium phosphate) -f-2 Ca So4. Heat acid calcium phosphate, charcoal, and sand together, and distil over phosphorus into water. 180 INORGANIC AGENTS Heat breaks up Ca H4 (P04)2 into Ca (Po,), (calcium metaphosphate)-j-2 H20. Then: 2 Ca (PO«)2+2 SiO2-fl0 C=P4+2 Ca Si O3+10 C O. Properties. — A translucent, nearly colorless solid, of a waxy lustre, having at ordinary temperature about the consistency of beeswax. By long keeping, the surface becomes red and occasionally black. It has a distinctive but disagreeable odor and taste, but should not be tasted except in a state of great dilution. When exposed to the air it emits white fumes which are luminous in the dark, and have an odor somewhat resembling garlic. On long exposure to the air, it takes fire spontaneously. Sp. gr. about 1.830 at 10° C. It melts at about 44° C. Almost insoluble in water, to which it imparts its characteristic disagreeable odor and taste. Sparingly soluble in fixed oils, soluble in 400 mils of dehydrated alcohol, 17 mils of chloroform, 102 mils of absolute ether, 31.5 mils of benzene, and in 0.9 mil of carbon disulphide. Besides the official form there are several other allo- tropic forms of phosphorus, including the red, or amorphous, the black, and the crystallized metallic phosphorus. Red phosphorus is non-poisonous, owing to its insolubility preventing its absorption in the digestive tract. Dose.—H., gr.i-ii, (.06-.12) ; C, gr.ii-iii, (.12-.18); Sh. & Sw., gr.1/100-1/20, (.0006-.003); D., gr.1/100-1/20, (.0006-.003). PREPARATIONS. Oleum Phosphoratum. Phosphorated Oil. (B. P.) Phosphorus, 1 Gm.; expressed oil of almond and ether, of each a sufficient quantity to make 100 Gm. (U. S. P. 1890.) Properties. — A clear, yellowish liquid, having the odor of phosphorus and ether. The ether in this preparation evaporates in time and the strength is pro- portionately, and perhaps dangerously, increased. Dose.— H., 3ii-iii, (8-12); D., TTti-v, (.06-.3). Pilulae Phosphori. (U. S. P.) Each pill contains gr. 1/100 of phosphorus. Pilulae Phosphori. (B. P.) 2 per cent, phosphorus. Dose. — D., pills, i-ii. Action of Phosphorus Internal. — The sole physiological action of phosphorus which would suggest, and in some manner explain, its therapeutic use is that on bones. Phosphorus, when given in small doses to growing animals, apparently stimulates the bone-making cells (osteoblasts) and the growth of denser bone, both from cartilage and periosteum. In older animals the lamellae of spongy tissue are made thicker and, in fowl, the narrow cavity may be wholly obliterated by the deposition of hard bone through the ingestion of phosphorus. If calcium salts be withheld from the food the activity of the osteoblasts continues but the new bone is soft and of the nature of bones in rickets. The precise mode of action of phosphorus on normal and diseased bones (rickets and osteomalacia) has yet to be determined. There appears to be clinical evidence that phosphorus is a nerve stimulant and, in man, it is said that large doses cause mental exhilara- tion, and increased capacity for work, and excite sexual desire. Experi- ments with phosphorus on animals show no special action of the drug on the nervous system. Phosphorus is absorbed largely in an unchanged condition in solution in fatty matter in the bowels and as vapor. Some of the phosphorus is probably converted in the bowels and blood into phosphuretted hydrogen (PH3) and further oxidized into phosphoric ACTION OF PHOSPHORUS 181 acid in the body. Its fate is unknown, but some phosphorus is eliminated as vapor from the lungs and some in organic compounds in the urine. The toxic action of phosphorus differs decidedly from its therapeutic effect and so does the action of pure phosphorus from its compounds. The action of phosphates, phosphoric acid and hypophosphites is not at all that of phosphorus. Most of the hypophosphites are eliminated unchanged in the urine and do not act as phosphates, as formerly believed. They appear to have little more influence than sodium chloride, except the iron salt, where the metallic ion acts as other iron compounds. Phosphoric acid stimulates digestion and secretin formation, like other mineral acids, but is inferior in this respect to hydrochloric acid. It has been given internally for its supposed action as a phosphate, but the organic phosphate compounds of the body cannot be built from the inorganic salts. Lecithin owes its value to its phosphorus content (4%). On the market it is a yellowish white mass derived from yolk of eggs. It is essential in building the nuclein content of cells and has been given in anemia. Ordinary food is rich in lecithin, especially grains, eggs and milk, so that lecithin is com- monly not indicated in disease when the diet is ample. Calcium hypophosphate, lactophosphate and glycerophosphate act similarly to calcium phosphate (page 127). Toxicology. — The symptoms of poisoning do not ordinarily appear until some hours after ingestion of toxic doses (15 to 20 grains of phos- phorus poison horses; 1^> to 4 grains are toxic for dogs). Then abdomi- nal pain, nausea and vomiting (in those animals in which it is possible) and purging occur. The breath, vomitus and fecal discharges may be luminous, and have the odor of phosphorus. There is fever, anorexia and thirst. This condition is followed by an intermission in which the patient appears to be recovering, only to be succeeded by jaundice, hemorrhages (due to fatty degeneration of vessels and blood poor in fibrinogen), nervous symptoms, as delirium, coma and convulsions, and death. The urine rarely becomes albuminous in animals, but contains leucin and tyrosin. The heart muscle is directly paralyzed by lethal doses. Grave, destructive metabolic changes (autolysis) occur in the tissues — especially the liver. There is general fatty degeneration of the viscera and muscles. The blood is disorganized, and there are widespread ecchymoses. Jaundice follows closure of the common, or hepatic duct, or smaller biliary tubules (owing to proliferation of interstitial tissue, seen also in the stomach and kidney), and disorganization of the blood. There is rapid atrophy of the liver, and phosphorus poisoning in man is often indistinguishable during life from acute yellow atrophy of the liver. Nitrogenous elimination is increased. Imperfectly decomposed products of metabolism, as leucin and tyrosin, occur in the urine; also an excess of urea and ammonia and often blood, bile and fat and sarcolactic acid. It is a matter of dispute whether the fat deposited in the cells of the tissue is formed there (fatty degeneration), or is conveyed thence from that already existing in the subcutaneous tissue. Chronic poisoning, at- tended with necrosis of the jaw and other symptoms, and occurring among 182 INORGANIC AGENTS workers in phosphorus, is unlikely to occur in the lower animals. Acute poisoning is treated by emptying the stomach with a stomacli tube or by giving copper sulphate; the latter forming an insoluble phosphide of copper. Cathartics should also be administered. Permanganate of pot- ash (H., 3ii. in 2 qts. of water; D., gr.xv. in Oss. water) or hydrogen dioxide should be employed as antidotes, for their oxidizing action. Old turpentine is usually recommended as the antidote, but only the French variety is of any value, and that is generally unobtainable. Demulcents and opium are in order after evacuant and antidotal treatment has been carried out, but oil should never be given in phosphorus poisoning, as it assists the solution and absorption of the poison. Uses. — Phosphorus is indicated as a stimulant to the growth of bone in rachitis, after fractures, and in osteomalacia; as a nerve stimulant and tonic in conditions of nervous exhaustion and impaired vitality, due to excessive activity of the sexual organs or otherwise. It is used empiri- cally in treatment of boils, acne, and scaly eczema, epilepsy, chorea and paralysis, and has been prescribed with alleged advantage as a general stimulant in pneumonia. Administration. — Phosphorus may be given in pill or ball, with cacao butter, or in the official preparation to dogs, and in a saturated alcoholic solution to horses. Phosphide of zinc represents the action of phosphorus, and yields phosphuretted hydrogen in its decomposition in the body. It may be given to dogs (gr.1-10) in the form of pills. SECTION IX. Chlorine. Chlorum. Chlorine. CI. (The gas is not official.) Calx Chlorinata. Chlorinated Lime. Ca Cl2 02, Ca Cl2. (U. S. & B. P.) Synonym. — Calx chlorata; calcaria chlorata, P. G.; chloride of lime, hypo- chloride of calcium, calcium hypochlorite, bleaching powder or bleach. E.; chlo- rure de chaux, poudre de Tennant, ou de Knox, Fr.; chlorkalk, bleichkalk, G. A preparation often improperly called "chloride of lime." It should contain not less than 30 per cent, of available chlorine. Preserve in air-tight containers, in a cool, dry place. Derivation. — Pass chlorine gas over calcium hydrate, when chlorinated lime, a mixture of calcium chloride and hypochlorite results: 2 Ca(OH)2+2 Cl2 = Ca Cl2 O .., Ca CL-j-2 H20. It mav also be regarded as a mixture of lime and chlorine : 2 Ca(OH)2 + 2 Cl2z=2 Ca O, 2 CL+2 H20. Properties. — A white, or grayish-white granular powder, having the odor of chlorine and a repulsive, saline taste. It becomes moist and gradually decomposes on exposure to air, and, when in such condition, must not be used or dispensed. In water or in alcohol it is only partially soluble. It evolves chlorine on exposure to the air or on addition of an acid. Chlorinated lime possesses an alkaline reac- tion and bleaching properties. Dose. — Only of value externally. PREPARATION. Liquor Calcis Chlorinated. Solution of Chlorinated Lime. (B. P.) This solution should yield about 3 per cent, of chlorine. Liquor Sod^e Chlorinate. Solution of Chlorinated Soda. (U. S. & B. P.) Synonym. — Liquor sodae chloratae, Labarraque's solution, E.; chlorure de soude liquide, liqueur de Labarraque, Fr. ; chlornatron losung, bleichfliissigkeit, G. CHLORINE 183 An aqueous solution of chlorine compounds of sodium, containing not less than 2.5 per cent, of available chlorine. Derivation. — Monohydrated sodium carbonate, 70; chlorinated lime, 100; water to make 1,000. Properties. — A clear, pale, greenish liquid, having a faint odor of chlorine and a disagreeably alkaline taste. Dose. — Only of value externally. Action and Uses of Chlorine. Chlorine gas, in the presence of organic matter and moisture, unites with the hydrogen of water and sets free nascent oxygen. When chlorine comes in contact with sulphuretted hydrogen, it removes and destroys the compound. Chlorine is thus a powerful oxidizing disinfectant agent and deodorizer. One-quarter of 1 per cent, of chlorine in solution is an effec- tive germicide. When chlorine gas is inhaled undiluted, it is an irritant to the respiratory tract, producing sometimes spasm of the glottis, or severe bronchitis, and at other times a condition of narcotism, with death from paralysis of the respiratory center. In contact with living tissues, chlorine replaces the hydrogen of proteid compounds and forms hydro- chloric acid with the hydrogen thus set free. The symptoms of poisoning are explained by the local irritation of the hydrochloric acid "thus formed. In dilute form it is stimulant, antiseptic, and deodorant in relation to the body. Chlorine gas may be generated from salt and black oxide of man- ganese, 1 part each; with commercial sulphuric acid and water, 2 parts each. The spores of most bacteria are killed after three hours' exposure to a moist atmosphere containing 0.3 per cent, of chlorine gas. Chlorine may be used to advantage in this manner as a substitute for sulphur fumi- gation. Chlorinated lime varies much in strength. To be of any value it should be so irritating to the eyes that it cannot be held near the face. It owes its medicinal value to the hypochlorite of lime which it contains. If the compound is very moist, it is because calcium chloride preponder- ates. Chlorinated lime is often employed as a deodorizer, standing about premises in vessels, but is of no practical value unless it comes directly in contact with bacteria or sulphuretted compounds which it is desirable to destroy. It is the best and cheapest germ destroyer we possess for disinfecting premises and other appurtenances, apart from the body, as walls and floors of buildings, fecal and other discharges, sewers, privies and cesspools. A 10 per cent, solution is to be employed on the floors, walls and other parts of buildings. The pure compound may be mixed with manure and discharges. Chlorinated lime has the disadvantages of destroying the fertilizing value of manure, however, and of keeping floors constantly wet through its deliquescent properties. Even a 1 per cent, solution is germicidal, and may be employed to wash blankets, harness and other paraphernalia. It is said not to harm woolen or cotton fabrics, in the latter solution. Chlorinated lime is a useful disinfectant in privy vaults when the contents are kept continually covered with chlorinated lime. The water supply of over 600 American cities is sterilized by "bleach" (by making a 1 to one or two million solution). The best method consists in dissolving a quarter pound tin of high quality chlori- 184 INORGANIC AGENTS nated lime in a gallon of water. This will sterilize 8000 gallons of any ordinary clear river or well water in 15 minutes. Then, to combine with any free chlorine left in the water, and so remove it and its taste, a gallon of sodium thiosulphate solution (containing ]/> lb. of the salt) is added to the 8000 gallons of drinking water. A 1 to 1,000 solution of bleach is most effective in sterilizing all dairy utensils in place of steam (Winslow, Amer. Vet. Review, Aug. 1915). Upon the body, a 2 or 3 per cent, solution of chlorinated lime is employed as a stimulant, deodorant, and antiseptic for decubitus, foul-smelling and gangrenous sores, severe burns and indolent ulcers. It it used in 10 per cent, solution as a parasiticide in ringworm and scabies. A 1 per cent, solution forms a valuable wash in ulcerative stomatitis. Chlorinated lime may be prescribed, with an equal amount of lard, upon ulcers when a stimulating action is desired. Chlo- rinated lime (gr.xv. in Jii. of water) is one of the most effective antidotes for snake bite, when injected in several places in the region of the lesion. Its internal administration is undesirable. The solution of chlorinated soda is a slight caustic, deodorizer and antiseptic preparation on indolent, sloughing, foul-smelling surfaces. It may be prescribed in sore throat, or ozena, as a spray, or injected into the uterus, vagina or rectum. It is commonly diluted with 8 to 10 parts of water. Chlorinated lime has been found the most powerful antiseptic in surgery of the Great War. It is used in powder (known as eupad), made by grinding it up in a mortar and mixing it with an equal weight of boric acid. Or, is used in solution, made by shaking 25 Gm. of eupad with a liter of water, allowing it to stand for a few hours and filtering. This is known as eusol, and is em- ployed for wet dressings or for irrigation of wounds, while eupad is used as a dusting powder. Also see Dakin's solution, chlorazene, and dichlora- mine-T, p. 510. Bromine. Bromum. Bromine. Br Derivation. — From seaweed and mineral springs. Properties. — Heavy, dark, brownish-red liquid, volatilizing with the produc- tion of an irritating vapor. Soluble in 30 parts of water, and readily soluble in alcohol and ether. Of no value in veterinary medicine. Potassii Bromidum. Potassium Bromide. K Br. (U. S. & B. P.) Synonym. — Kalium bromatum, P. G. ; bromure de potassium, Fr.; brom- kalium, G. Derivation. — Obtained from liquor potassae, bromine, and charcoal by the same process described in making potassium iodide (p. 190). Properties. — Colorless, or white, cubical crystals, or as a granular powder; odorless, and having a strongly saline taste. Permanent in the air. Soluble in about 1.5 parts of water and in 250 parts of alcohol. Dose.— H. & C, gi-ii, (30-60); Sh. & Sw., 3ii-iv, (8-15); D., gr.v-oi, (.3-4). *Sodii Bromidum. Sodium Bromide. Na Br. (U. S. & B. P.) Synonym. — Natrium bromatum, P. G; bromure de sodium, Fr. ; bromna- trium, G. Derivation. — Similar to potassium bromide. Liquor sodae is used instead of liquor potassae. Properties. — Colorless, or white, cubical crystals, or a white, granular powder; *Ammonii bromidum, lithii bromidum, calcii bromidum and strontii bromidum are also official. These salts are given in the same doses as sodium bromide. BROMINE 186 odorless, and having a saline taste. From air the salt attracts moisture without deliquescing. Soluble in 1.1 parts of water, and in 16 parts of alcohol. Dose. — Same as potassium bromide. Action of the Bromides. External. — None. Internal. — Digestive Tract. — The bromides, when ingested in con- centrated form, may induce nausea and vomiting through irritation of the stomach produced by withdrawal of water from the gastric mucosa. This "salt action" is common to other salines. In a large, single dose, the bromides cause in horses muscular weakness, dulness and staggering gait, and slow respiration. The urine is increased in quantity and sexual desire diminished. Eromism may be produced in man, or the lower ani- mals, by the continuous administration of the bromides. This condition is characterized by general weakness and unsteady gait, mental dulness, indigestion, fetid breath, cutaneous anesthesia, loss of sexual power, and occasionally an acneform eruption. Death has never been caused in man by the bromides. Nervous System. — The bromides are essentially depressant to nerve tissue. Therapeutically, this depressing action is seen particularly in relation to the motor centres of the middle region of the cerebral cortex; to the intellectual areas in the anterior cerebral region (in man) ; and to lessening reflex action. The whole nervous system is depressed (except the medulla), but the motor tract in the brain and the sensory nerves are the first to succumb to the influence of the bromides. Intellection is clouded, and dulness and mental apathy are observed in man after large amounts. Reflex action is diminished owing to interference with the passage of impulses from the sensory to motor cells of the cord, and, later, to depression of the sensory nerves. Finally, with the continuous administration of large doses the motor area of the spinal cord, the motor nerves and muscles fall under the depressing action of these agents. Circulation. — Potassium bromide is a powerful depressant to the heart in toxic doses. Medicinal doses injected into a vein induce weak- ness of the heart, but therapeutic amounts, given by the mouth, exert no appreciable effect upon the circulation. The depressing action of potas- sium bromide upon the heart is due wholly to the potassium ion ; the bromine ion is not a heart depressant. There is practically no difference in the action of therapeutic doses of potassium, sodium, strontium, or am- monium bromides. Ischemia of the pia is seen under the influence of bromides. This is the result of depression of the cerebrum and sleep, and not the cause of sleep. The old idea that the beneficial action of the bromides, in relieving nervous excitability and in causing sleep, was due to the production of vasomotor spasm and cerebral anemia, is now ex- ploded. Temperature. — The temperature falls, following the action of toxic amounts of the bromides, owing to lessened muscular movements. Sexual Organs. — The bromides diminish sexual desire and power. In so doing they either depress the spinal centres or lessen peripheral sensi- bility of the genito-urinary tract. 186 INORGANIC AGENTS Elimination. — The bromides are eliminated unchanged by all chan- nels and are found in the sweat, urine, milk, saliva, intestinal secretions, etc. Elimination begins immediately but may not keep pace with continu- ous administration, and bromism may occur. Uses Internal. — The bromides, being particularly useful in the treat- ment of functional nervous diseases, do not possess nearly the value in veterinary medicine that they have in human practice. Moreover, their use is limited mainly to canine disorders, as bromides have little influ- ence upon diseases of horses. Bromides are especially indicated in irritation of the motor area of the cerebral cortex (convulsions), in general nervous excitability, in meningitis, and in conditions due to exalted reflex action in dogs. The bromides are indeed the best agents we can use to prevent con- vulsions in dogs. They should be combined with chloral and given, if necessary, per rectum. Dogs with convulsions: I* Chloralis 5ii. Sodii bromidi 3iv. Aquae 3"- M. S. Teaspoonful in water and repeat in an hour. The bromides are useful in canine chorea, in connection with Fowler's solution. With chloral the bromides are antidotes to strychnine poisoning. Sexual excitement in all animals may be allayed by the bromides. The bromides are occasionally of value in reflex cough, palpitation of the heart, and asthma, but are inferior to other agents in these disorders. Potassium bromide is recommended in the treatment of tetanus of the horse, but lobelia, belladonna and cannabis indica are generally more effectual. If the bromides are used they should be given with chloral. Ammonium and sodium bromide are commonly said to be less depressant in large doses to the heart than the potassium salt, and strontium bromide less disturbing to the stomach in dogs. There does not appear to be sufficient scientific basis for either of these statements (see above). Iodine .. Iodum. Iodine. (U. S. P.) Synonym. — Iodinum, U. S. P. 1870; iodum, P. G. ; iode, Fr.; jod., G. Derivation. — Iodine is a non-metallic element (halogen) existing in combina- tion in the animal, vegetable and mineral kingdoms. It occurs in seaweed, from which it is obtained by distillation. It is also mined in the form of iodates and iodides. Properties. — Heavy, bluish-black, brittle rhombic plates, having a metallic luster, a distinctive odor, and a sharp acrid taste. It is soluble in 2,950 parts of water, and in 12.5 parts of alcohol; freely soluble in chloroform, ether, and in aqueous solutions of iodides. Iodine volatilizes on heating with the formation of a purple vapor. With starch, a solution of iodine forms an insoluble blue com- pound. Dose.— H. & C, 3ss-i, (2-4); Sh. & Sw.} gr.x-xx, (.6-1.3). Not often used in solid state. IODINE 187 PREPARATIONS. Liquor Iodi Compositus. Compound Solution of Iodine. (Lugol's Solution.) (U. S. P.) Iodine, 5; potassium iodide, 10; water to make 100. (1-20.) Dose.— H. & C, 3ii-iv, (8-15); D., TTjii-x, (.12-.6). Should be given in one quart of water to the larger animals. Tinctura Iodi. (U. S. P.) Iodine, 70; potassium iodide, 50; water, 50; alcohol to make 1,000. Dose.— H. & C, 3ii-iv, (8-15); D., Tu>v, (.06-.3). Tinctura Iodi. (B. P.) Dose. — Same as U. S. P. tincture. Unguentum Iodi. (4 per cent.) (U. S. & B. P.) Too weak for most veterinary purposes. Action External. — Iodine is one of the most effective and valuable of antiseptics for surgical purposes. The tincture will kill all pathogenic bacteria in vitro within one minute, whereas a 1 to 1000 solution of mer- curic bichloride requires more than half an hour to destroy the same microorganisms. Moreover, the tincture has unusual penetrating power on the dry skin, finding its way into the hair follicles and cutaneous glands. The tincture of iodine is perhaps the most efficient and popular dis- infectant for use in sterilizing the skin for operations. But the skin must be dry or the sterilizing effect of the iodine is inhibited. Iodine must not be applied to the wetted skin because the wretting causes the epithelial cells to swell and thus prevents the iodine from penetrating into the sebaceous and sudoriparous glands, the very action upon which the special germicidal action depends. The tincture is also of much worth as an antiseptic on wounds and denudation of the skin caused by harness, bruises, etc. (see p. 513). Iodine acts as a slow, moderate and prolonged irritant upon the skin and mucous membranes. The yellow stain produced by iodine may be removed by ammonia water, alkalies and sodium hypo- sulphite. A small amount of iodine is absorbed through the unbroken skin, and it is thought to have a special resolvent and alterative action over and above that of other counter irritants. Whether this be true or not, its easy mode of application makes it a very convenient counter-irri- tant for local uses. Action Internal. — Iodine produces gastro-intestinal irritation and in- flammation in large doses; and in toxic quantities induces colic, vomiting in animals capable of the act, and purging and salivation. The pulse becomes rapid and weak; there is often suppression of urine, and occa- sionally nephritis. Widespread fatty degeneration has been found after fatal poisoning in the lower animals. If there is much starchy material in the bowels, the fecal discharges may be of a bluish color. Aphrodisiac action has been noted in man, following small doses of iodine. The treatment of acute poisoning is embraced in the use of starch by the mouth, or raw eggs, external heat; strychnine, digitalone, alcohol, and atropine subcutaneously. Chronic poisoning by iodine and iodides (iod- ism), in man, commonly causes symptoms analogous to a severe cold in the head, with pain over the frontal sinus, sore throat, running at the eyes and nose, gastric indigestion, together with an acneform, and occa- sionally purpuric or furuncular eruption. 188 INORGANIC AGENTS These more frequent symptoms of iodism occur more often after the administration of potassium iodide than after that of iodine. The physiological action of the iodides is similar to that of iodine, which is transformed into iodides in the body. But the iodides are usually pre- ferred for internal use since they are locally so much less irritating. Both iodine and potassium iodide are readily absorbed from mucous membranes, and are found in all the tissues and fluids of the body. Iodine is absorbed as iodides and, perhaps, in loose combination with albumin (iodoalbumi- nates) — and eliminated as iodides by all the usual channels, as well as by the mucous membranes. The kidneys eliminate the greater amount, but iodine is found in the saliva and gastric juice after it has ceased to be present in the urine. The activating effect of iodine on the thyroid gland probably accounts for much of its influence on the body. Iodine is essential for normal thyroid activity. Glandular hyperplasia (colloid goitre) is a physiological reaction to a deficiency of iodine. The iodine content of the gland varies inversely with the degree of enlargement, (iiving iodine in simple goitre in puppies causes reduction of the glandu- lar hyperplasia. An excess of iodine ingested in goitre will produce the same symptoms (hyperthyroidism) as occur in morbid conditions where an excess of thyroid secretion is formed (exophthalmic goitre in man), i.e., rapid heart, tremors, wasting, excitement, etc. Uses External. — Iodine is of most value applied externally, or local- ly. In sterilizing the skin for an emergency operation the hair should be clipped and shaved dry and the tincture of iodine applied without wash- ing of the skin. For other operations the skin may be scrubbed with soap and shaved and dried before applying the tincture. The tincture should always dry on the skin before the operation is begun. The routine method in human surgery for sterilizing the skin, accepted by leading surgeons, consists in first cleansing the skin with gasoline to remove the grease and then applying the tincture of iodine in full or half strength. Half strength should be used on mucous membranes, as the vagina. Potassium iodide is administered internally because it is not irritating to the digestive organs. Although potassium iodide does not exactly represent the action of iodine, yet it is usually preferable for the reason just stated. Potas- sium iodide renders iodine soluble, and prevents its precipitation in fluids within and without the body; it is therefore combined with iodine, when concentrated solutions are desirable. Six parts of potassium iodide and twelve parts of iodine are added to one hundred parts of water, or oint- ment, to make a suitable counter-irritant preparation for the horse. I* Potassii iodidi 6 Iodi : 12 Cerati 100 M. Sig. External use. A useful tincture for veterinary purposes contains 15 parts of iodine and 18 parts of potassium iodide in 100 parts of alcohol. IODINE 189 For resolvent purposes: Iodi 15 Potassii iodidi 18 Alcoholis 100 M. S. Apply externally. Iodine is employed in aqueous and alcoholic solution, or in ointment, as above, either painted upon or rubbed into the skin over enlarged glands, rheumatic swellings about the joints or upon the cbest in chronic pleur- itis. It is also of value in strains, bruises, periosteal inflammation and muscular rheumatism. In the horse, severe sprains and inflammation of joints, bones, and periosteum, are treated more satisfactorily by blistering agents. Iodine is a valuable disinfectant and parasiticide in alopecia areata, and particularly in ringworm and favus in dogs, when the tinc- ture is applied locally. Iodine is applied externally, in the form of the tincture, on patches of chronic mange and eczema. Iodine is often recommended for erysipelas, but is inferior to phenol for this purpose. In obstetric work the tincture of iodine should be applied to the cord after it has been ligated and trimmed, and reapplied every few days, to prevent septic infection with metastases in the joints. Lugol's solution, diluted with water to make 0.25% strength, is useful as a uterine douche in metritis of cows. Improvement in periodic ophthal- mia in horses has followed injections of one to three mils each of Lugol's solution and glycerine into the fat over the eyeball at 10-day intervals. Iodine is injected into joints, synovial sacs, abscesses, and cavities of the body to promote healing through its antiseptic and irritant action; to cause adhesive inflammation, and in this manner to close cavities and to prevent the accumulation of fluids in them. The official tincture (5i-ii.) is commonly used for injections. The tincture of iodine may be injected undiluted directly into the substance of enlarged glands, in amounts varying from 15 to 30 drops, to assist their absorption. If the tincture is injected into the subcutaneous tissue, abscess may ensue. In goitre in dogs, calves and lambs, injections of tincture of iodine (TT\x.) may be made every other day for 10 to 20 times — if painting on the tincture externally and potassium iodide or dessicated thyroid glands (gr.i in capsules thrice daily) internally are unsuccessful. Ozena may be treated to advantage by irrigation with a solution containing one dram of the tincture of iodine to the pint of nor- mal salt solution. In inflammation of the upper air passages, iodine is sometimes beneficial as a stimulant and antiseptic inhalation, which is produced by adding one-half a dram of iodine to the pint of boiling water. Uses Internal. — Iodine is thought to act more satisfactorily than potassium iodide in the treatment of diabetes insipidus or polyuria of the horse, in which it often appears to be a specific. One ounce twice daily, intratracheally, of Dieckerhoff's solution (iodine, 1; potassium iodide, 5; water, 100) has given good results in purpura of horses. Administration. — Iodine may be combined with gentian and iron in the form of a ball, as recommended by Finlay Dun, or better, given as Lugol's solution, which is less irritating and more active. 190 INORGANIC AGENTS Potassii Iodidum. Potassium Iodide. K I. (U. S. & B. P.) Synonym. — Jodkalium, G. ; kalium iodatum, P. G.; iodure de potassium, Fr. Derivation. — Iodine is dissolved in hot liquor potassac. G l-\-6 K O H =5 K I + K I 03-f-3 H20. The evaporated residue is heated with charcoal to remove O from K I 03 (Potassium Iodate). KI03+3 C=:KI+3 C O. The result is purified by crystallization. Properties. — Cubical crystals, either transparent and colorless or more or less opaque and white, or as a white, granular powder, having a pungent, saline, after- wards bitter taste. Permanent in dry air, but slightly deliquescent in moist air. It is soluble in 0.7 part of water; in 22 parts of alcohol, and 2 parts of glycerin. Dose.— H., 3ii-iv, (8-15); C, ovi, (24); Sh. & Sw., gr.xv-xxx, (1-2); D., gr.ii-x, (.12-.6). Sodii Iodidum. Sodium Iodide. Na I. (U. S. & £. P.) Synonym. — Iodure de sodium, Fr.; jodnatrum, G.; natrium iodatum, P. G. Derivation. — Made from sodium hydrate in the same manner as potassium iodide. Properties. — Colorless, cubical crystals, or as a white, crystalline powder, odorless and having a saline taste. In moist air sodium iodide deliquesces, or at first cakes and then deliquesces, and frequently undergoes decomposition, assum- ing a brown tint. Soluble in 0.55 parts of water and in 2 parts of alcohol. Dose. — Same as potassium iodide. Syrupus Acidi Hydriodici. Syrup of Hydriodic Acid. (U. S. P.) Contains 1.3 to 1.45 per cent, of H I. Derivation. — Diluted hydriodic acid, 125; water, 300; syrup, 575. Properties. — A transparent, colorless, or not more than pale, straw-colored, syrupy liquid; odorless, and having a sweet and acidulous taste. Dose.— D., TM.xv-3i, (1-4). Action External. — Potassium iodide is not absorbed unless rubbed into the skin with fat, and is not a local irritant, and therefore possesses very little value as an external application. Action Internal. — Potassium iodide and iodine are both described by that unsatisfactory term, alterative. In certain diseases, as in rheu- matism, iodine and the iodides alter nutrition and cause absorption of exudates in some unknown manner ; hence the term alterative. Potassium iodide forms in the tissues soluble double salts with the metals and there- fore is the antidote in chronic lead, arsenic, mercury and zinc poisoning in aiding their elimination. It is often taught that potassium iodide liberates iodine in the tissues, and that the latter forms soluble com- pounds with albumin, which are then readily eliminated; thus explaining the effect of potassium iodide in aiding resolution of morbid exudation and inflammatory thickenings. Free iodine is certainly formed in the body as it escapes into the stomach after administration of iodides. Iodides produce untoward symptoms (iodism) in medicinal doses more often than most other drugs. Those most characteristic resemble influ- enza in there being pain over the frontal sinus, running of the eyes and nose, sore throat, tenderness of the teeth and gums, and sometimes glandular swelling about the throat and parotids. An acneform, or more rarely, furuncular or purpuric eruption may occur. Often these unfor- tunate symptoms appearing with small doses may disappear with large ones. Arsenic and alkalies given with iodides lessen the likelihood of iodism. The sodium iodide is less irritating than the other salts. Occa- sionally there is fever. Iodides stimulate thyroid activity and are to a certain extent taken USES OF POTASSIUM IODIDE 191 up by the gland. Indeed it is probable that much of the therapeutic effect of iodides on the circulation is attributable indirectly to thyroid action. Thus in arteriosclerosis, and high blood pressure, where the drug is commonly used, it is thought to increase the blood flow in the vasa vasorum (vascular dilatation from thyroid action), and also to lessen viscosity of the blood itself. Occasionally chronic iodism takes the form of hyperthyroidism with anemia, emaciation, nervousness and tachycardia. Iodides increase the fluidity of nasal, pharyngeal and bronchial secretion. Supposed elimination of free iodine from the mucous membranes and skin is said to account for irritation of these parts after prolonged and excessive doses (iodism). Like other salts of the alkalies (see sodium chloride) the iodides are diuretics and. in concentration, may cause nausea and vomiting. The iodides are rapidly absorbed and mostly elim- inate as such chiefly by the urine ; but also by mucous membranes, and in milk, sweat, tears, etc. Some 80 per cent is excreted in 24 hours. If the drug is used for a considerable period the dose must be cut down as some of the iodides accumulate in the body. Uses Internal. — Potassium iodide is useful in causing absorption of enlarged, lymphatic glands, and its action should be assisted by the appli- cation of iodine or red mercuric iodide externally. Potassium iodide in small doses, diminishes congestion and increases the fluidity and amount of secretion in acute laryngitis, acute and subacute bronchitis, and appears to possess an alterative action in improving the condition and nutrition of the bronchial mucous membranes. It resembles ammonium chloride in the latter respect. It is also of value in bronchial asthma, pulmonary emphysema, and chronic bronchitis, unassociated with copious secretion. Chronic pleuritis, pericarditis, and ascites" are treated with potassium iodide, which assists absorption, and occasionally exerts a diuretic effect. Tardy resolution of pneumonic consolidation is hastened by potassium iodide. Endocarditis with cardiac hypertrophy is said to be benefited by potassium iodide and digitalis. Champignon, or scirrhus cord of horses, is sometimes cured by the sorbefacient powers of potassium iodide in full doses. Potassium iodide is the best remedy in colloid goitre of dogs, calves and sheep when tincture of iodine is used externally (see p. 193). In regions where the young are born with goiter small doses of iodine or iodides given pregnant animals may prevent such an occurrence. "Roaring" and "thick wind" may be cured by the administration of potassium iodide. Potassium iodide is the drug commonly given for aneurism. Probably it is only of use when this is of syphilitic origin and not in animals. Potassium iodide is the best remedy known for actinomycosis. It should be given to the larger animals in doses of three drams daily, or in the same .dose as Lugol's solution, until iodism appears, when the dose may be reduced to one-half this amount and continued two to six weeks. Iodine or Lugol's solution may be used in preference to potassium iodide on ac- count of the great expense of the latter salt. Potassium iodide is one of the many remedies prescribed in chronic rheumatism. Potassium 192 INORGANIC AGENTS iodide lias given good results in the treatment of periodic ophthalmia in horses with the first attack. They are given one ounce daily for two or three days, and kept in the dark with cold compresses over the eyes. Potassium iodide has a clinical reputation for its power to aid absorption and resolution in inflammation or effusions of the brain or cord, in hemi- plegia, paraplegia and meningitis Summary. — Iodine and potassium iodide resemble one another in many respects. Iodine is a local irritant, potassium iodide is not. The known physiological action of potassium iodide and iodine does not explain their medicinal uses. In combating certain diseases, in an inexplicable manner, they are known as alteratives. In man, iodine is superior to potassium iodide in the treatment of scrofula. In the horse, iodine is considered of more value in the treatment of diabetes insipidus ; while in both man and the lower animals, potassium iodide is regarded as more valuable in chronic rheumatism. In subacute rheumatism, one prescribes equal parts of sodium salicylate and iodide. The action of iodine in ben- efiting local disorders, when applied externally, is due to its counter irritant effect, rather than to absorption. Administration. — Potassium iodide is given in solution. Sodium iodide and syrup of hydriodic acid arc simply substitutes for potassium iodide. ThyROIDEUM Siccum. Dried Thyroids. (LT. S. P.) Synonym. — Glandulae Thyroideae siccae. Dose. — Dogs, gr.^-ii, (.03-.12), twice daily, on food or in capsules. The thyroid glands of animals which are used for food by man, freed from connective tissue and fat, dried and powdered and containing not less than 0.17, nor more than 0.23 per cent of iodine. A yellowish, amorphous powder, having' a slight characteristic odor, and containing the active ingredient of thyroid tissue; partially soluble in water. One part of the dried glands represents approximately 5 parts of the fresh glands. As the therapeutic activity of the glands depends chiefly upon their iodine content a standard of not less than 0.2 per cent of iodine has been adopted for commercial preparations. Action. — A condition of cachexia in which the cutaneous tissues swell and other abnormalities occur (myxedema), after total removal of the thyroid gland, was found to be overcome by feeding thyroid tissue. Likewise the same condition occurring spontaneously in the human adult and cretinism in children, from absence of thyroid tissue, are cured b}^ administration of thyroid gland. This was the beginning of the thera- peutic use of the thyroids. It was later discovered that iodine is the main inorganic constituent of the thyroid gland and that its functional activity depends largely upon this element. Nevertheless it is true that individual persons and animals may possess thyroid glands wholly want- ing in iodine without any interference with health. When the thyroid is removed from such individuals the same severe symptoms occur as are observed after removal of thyroids with high iodine content. There is evidently some essential principle in the thyroid gland besides iodine since no other preparation of iodine, other than the gland itself, has DRIED THYROIDS 193 any value in the treatment of myxedema and cretinism. Iodine may be as effective as the thyroid gland in the treatment of simple or colloid goitre, however. Iodine given as medicine or in food is capable of being assimilated and stored in the thyroid gland. The dried glands of dogs contain from 0.03 to 0.27 per cent of iodine; in sheep, the percentage varies from 0.048 to 0.383 ; in man, from 0.03 to 0.9 per cent. Large doses of thyroid gland given continuously to animals over a considerable period produce a fairly uniform syndrome, as follows: ane- mia, emaciation, weakness (especially of the hind legs), sweating, ner- vousness, tremors of the muscles and tongue, a tendency to fever, rapid pulse, diuresis, exophthalmos, and dilated pupils. Many of these symp- toms indicate stimulation of the sympathetic system. In exophthalmic goitre of the human, where an excess of thyroid secretion enters the blood, the symptoms resemble an overdose of the gland (hyperthyroid- ism). Emaciation is due to destruction of fat and protein. Protein loss, and increased nitrogen elimination in the urine, are directly dependent upon the iodine content of the thyroid gland administered. In the ab- sence of iodine neither occurs. Destruction of fat follows enhanced oxy- gen consumption in the body owing to the action of the thyroid gland (see antipyretics, p. 51). Emaciation is also due to diuresis and aug- mented elimination of fluids from the system. Whether this is caused by direct action of the thyroid substance on the kidneys, or otherwise, is unknown. The normal function of the liver and muscles to store sugar is inhibited by thyroid overdosage, and glycosuria may result. Rapidity of the pulse, one of the most frequent toxic symptoms fol- lowing large doses of thyroid gland, may be attributed to stimulation of the heart muscle or accelerators. A large dose of thyroid gland injected intravenously may slow the heart from vagus stimulation. Thyroid feeding tends to promote the growth of normal bone (Bircher) and many surgeons have found that it hastens the union of fractures. Thyroid action may be summarized as stimulating oxidative changes and metabolism, and affecting particularly the nervous system. Thyroid secretion is the great metabolic stimulant in the body. Toxic doses have caused a loss of half an animal's weight in 24 hours. The tissues are consumed as by fire. Uses. — The most remarkable success which attends the use of thyroid medication in cretinism and myxedema in human practice has no anal- agous field in veterinary medicine. In goitre in young animals thyroid treatment may be of benefit but usually iodide of sodium or potassium given internally will be found more valuable. In mild cases the applica- tion of a 10 per cent ointment of iodine twice daily by friction on the gland, or even the painting of tincture of iodine frequently on the gland will suffice. Thyroid administration is also used in obesity of dogs. It is rather uncertain in effect, sometimes proving successful while at other times it is a failure. Thyroid gland is also indicated in rickets, osteomalacia and, in delayed union in fractures. 194 INORGANIC AGENTS Iodoformum. Iodoform. C H I8. (U. S. & B. P.) Synonym. — Iodoforrnium, P. G. ; iodure de formyle, Fr.; jodoform trijodme- than, G. Derivation. — Alcohol, potassium carbonate, iodine, and water are heated to- gether. CaHtlO+2 KHCOa-f-8 I =2 CHI3-f2 KI-|-2 CO.-J-3 H20. Iodoform contains over 90 per cent, of iodine. Properties. — Fine, lemon-yellow, powder or in lustreless crystals of the hexag- onal system; having a peculiar, very penetrating and persistent odor, and an unpleasant and slightly sweetish taste suggestive of iodine. Nearly insoluble in water; soluble in 60 parts of alcohol, and in 7.5 parts of ether. Very soluble in chloroform, benzine, fixed and volatile oils. PREPARATIONS. Unguentum Iodoformi. Ointment of Iodoform (1-10). (U. S. & B. P.) Suppositoria Iodoformi. (B. P.) (Each containing 3 grs. of iodoform.) Action External. — Iodoform is an antiseptic, local anesthetic, stim- ulant, protective, and dessicant agent. While iodoform does not inhibit the growth of germs outside the body — many of the bacteria growing in iodoform itself — it is nevertheless a valuable antiseptic. This result may probably be accounted for by the decomposition of iodoform on moist wounds, with the liberation of iod-albuminates and diioddoacety- lene; by its absorption of exudates on which germs live, and possibly by neutralizing toxins. Iodoform is particularly useful in septic and suppurating wounds. When applied over extensive surfaces, absorption and poisoning may occur. The symptoms of iodoform poisoning are most diverse. Symptoms of gastro-intestinal irritation are seen in poisoning in dogs, as vomiting, diarrhea and albuminuria, together with nervous symp- toms, as convulsions, stupor and sleep. The pulse may be very rapid or infrequent; the temperature high or normal. Iodoform is in part absorbed unchanged, but the greater part is transformed into free iodine and iodides in the body. Frohner states the poisonous dose for dogs is 15 grs. for each kilo of live weight. One dram will poison a dog weigh- ing ten pounds, l1/^ ounces have killed a cow. Ecchymoses are found after death on the heart and kidneys, and there is congestion of the meninges. The symptoms of poisoning are peculiarly diverse since the effects are due both to iodoform and to iodides and iodine set free in the body. The rapid pulse is due to stimulation of the thyroid gland by iodine. The mania and delirium characteristic of iodoform poisoning in man are not seen in animals. The application of iodoform to wounds is sometimes followed by an erythematous eruption and fever. Iodine is eliminated in the urine in iodoform poisonirg and can easily be discov- ered by the starch test. General fatty degeneration of the internal or- gans is found after death. The local dessicant effect of iodoform on raw surfaces assists the antiseptic action, and the local anesthetic prop- erties combine to make iodoform the best antiseptic powder we possess, barring the odor. Action Internal. — The internal action of iodoform possesses no therapeutic value. Care must be observed to prevent animals licking off iodoform from the surface of the body, IODOFORM 195 Elimination. — Iodoform is eliminated in the form of iodine and iodides by all the secretions, chiefly by the urine as iodides. Uses External. — Iodoform is of value applied over suppurating and septic surfaces, sores, and ulcers, where it hinders the growth of bac- teria, stimulates unhealthy granulations, relieves pain, possibly neutra- lizes toxins, and certainly produces a vile odor. For this reason one of its substitutes should be employed when an antiseptic powder is desira- ble for use upon dogs living in or about dwellings. Iodoform is com- monly employed in its purity. It may be mixed in any proportion with boric acid, or with tannic acid (1-8), for its astringent effect. It is valuable in foul of the foot in cattle, or in foot rot in horses, with equal parts of alum or tannic acid. Combined with collodion (1-15), it forms a useful dressing for sealing small wounds or abrasions upon the hands. The anesthetic action of iodoform is taken advantage of to relieve pain in fissure of the rectum, and hemorrhoids. Zuill recommends the follow- ing combination by insufflation in the early stages of inflammation of the frontal sinuses: Iodoform, magnesia, silver nitrate — equal parts. Three grains may be used in suppositories for the smaller animals. Iodoform may cause healing in abscess — injected into the cavity with glycerin or vaseline — (1-10), using 2-4 drams of the mixture for smaller animals, or 1 ounce for the larger animals. In retained placenta and metritis of cows, Williams advises placing a capsule containing an ounce of iodoform in the uterus. Iodoform is very efficacious in the treatment of local tuberculous lesions. Iodoform combined with lard or oil (1-10), is an excellent agent for burns which are not so extensive as to endan- ger the patient through absorption and iodoform poisoning. For closing small wounds: Iodoformi 5i. Collodii 3ii. M. S. Apply externally with camel's hair brush. Antiseptic, astringent dusting powder: Iodoformi oi. Acidi tannici 5i. M. S. Apply externally. Iodolum. (Non-official.) Iodol. CJ4NH. Synonym. — Tetraiodopyrrol. Derivation. — Action of iodine on pyrrol in solution in alcohol. Contains 88.9 per cent, of iodine. Properties. — Crystalline, shining, light, grayish-brown powder. Tasteless and odorless. Practically insoluble in water; soluble in 9 parts of alcohol, and in ether and fatty oils. The surgical use of iodol has led to poisoning through absorption, but the latter is so slow that the danger is exceedingly slight. Iodol is suitable for all purposes in which iodoform is indicated. It is too expensive for general use, but is preferable for application to dogs, on account of its lack of odor. Abistolum. (Non-official.) Aristol. CjoH^Oalj. Synonym. — Dithymol diiodide, E. ; diiododithymol, Fr. ; dithymoldi jodid, G. 196 INORGANIC AGENTS Aristol is now official as thymolis iodidum, thymol iodide. It is more correctly dithymol-diiodide, obtained by the condensation of two molecules of thymol and the introduction of two atoms of iodine into the phenolic groups of the thymol; it contains 45 per cent, of iodine. Properties. — A bright, chocolate-colored or reddish-yellow, bulky powder, with a very slight aromatic odor. Insoluble in water and glycerin; slightly soluble in alcohol; readily soluble in ether, chloroform, collodion, and in fixed and volatile oils. Aristol is inferior as an antiseptic to either iodoform or iodol. It is used with some benefit in dry, scaly skin diseases in powder or oint- ment. Aristol is useful on sores, wounds and ulcerations which have a tendency toward dryness as it seems to increase moisture. Other anti- septic dusting powders include acetanilid, bismuth subnitrate, salol and boric acid. Acetanilid has been shown to be a good antibacterial agent. It is cheap and may be applied pure, and it is an efficient substitute for iodoform. A few cases of poisoning have been reported following its extensive surgical use. Bismuth subnitrate and salol may induce poison- ing when used over large surfaces. They are dessicants and feeble anti- septics. Boric acid is harmless and mildly antiseptic. Orthoform. Orthoform. (Non-Official.) Orthoform is the methyl-erster of meta-amido-paraoxy-benzoic acid. It occurs as a white or dirty yellow, light powder, sparingly soluble in water and alcohol but more so in glycerin and solutions of the mineral acids. It may be combined with iodoform, aristol, boric acid, salicylic acid, carbolic acid, turpentine and iodine without incompatibility. Action. — Externally, orthoform exerts a powerful anesthetic effect on raw surfaces, but has little action on intact mucous membranes and none on the unbroken skin. It is also a mild antiseptic, of about the same value as boric acid. It is but feebly toxic and poisoning does not occur unless large quantities are applied over abraded surfaces. In the dog, 15 grains per 2 pounds of body weight have proved toxic when given by the mouth; and 7% grains per 2 pounds of live weight are required to induce fatal poisoning. It appears to be a cerebro-spinal paralysant in these large doses. The anesthetic action of medicinal doses is usually pro- longed, varying from a few hours to two or three days. Orthoform has been used extensively in human medicine for the past few years, and cases of poisoning have been of rare occurrence and none fatal, although as much as two or three ounces have been applied on ulcerated surfaces in a week's time. Occasionally the drug produces an erythema or derma- titis owing to peculiar susceptibility of the patient. On the other hand, orthoform has been used successfully in the treatment of dermatitis fol- lowing poisoning in the human. Uses. — Orthoform is valuable chiefly for its power in relieving pain when applied to raw surfaces. It is an excellent application for burns. In superficial burns, orthoform may be combined to advantage with ich- thyol, of each 10 per cent., in lanolin. In burns of the second and third degree, the use of orthoform and boric acid, equal parts, forms an excel- lent remedy. Orthoform is serviceable in relieving pain and irritation of ulcers, hemorrhoids and fissures of the rectum. In human practice it is SULPHUR 197 largely employed in connection with diseases of the nose, ear and throat to arrest pain after operations, and in ulceration and inflammation of these parts, as sore throat. Nasal gleet in horses should be benefited if not cured by the insufflation of the powder. Orthoform is commonly used in ointment containing 10 to 20 per cent, of the drug. It may be blown pure into cavities or applied as a saturated solution in collodion. It may be sprayed on a part with an atomizer in 5 per cent, solution with equal parts of alcohol and water. It has been injected into the bladder in cystitis mixed with water. In ulceration of the stomach, orthoform will give relief owing to its local anesthetic action. It may be administered mixed with water and syrup in the dose of 0.5-1.0 (7V2~15-gr.) f°r dogs. It is an expensive drug at present. SECTION X. Sulphur. i Official Varieties. Sulphur Sublimatum. Sublimed Sulphur. S. (U. S. & B. P.) Synonym. — Flowers of sulphur, flores sulphuris, E.; fleur (creme) de soufre, Fr. ; schwefelblumen, schwefbliithe, G. Derivation. — Obtained from native sulphur by sublimation. Properties. — A fine, yellow powder, having a slightly characteristic odor and a faintly acid taste. Insoluble in water; slightly soluble in absolute alcohol; soluble or partially soluble in carbon disulphide, olive oil, benzine, benzol, oil of turpentine and many other oils; also in ether, chloroform, and in boiling, aqueous solutions of alkaline hydrates. PREPARATIONS. Sulphur Lotum. Washed Sulphur. S. (U. S. P.) Synonym. — Sulphur depuratum, flores sulphuris loti, P. G. ; soufre lave, Fr. ; gereinigte schwefel, G. Derivation. — Obtained from sublimed sulphur, which is treated with diluted ammonia water to wash out sulphurous and sulphuric and other impurities. Properties. — A fine, yellow powder, without odor or taste. Solubility, same as sublimed sulphur. Pulvis Glycyrrhizw Compositus. Compound Powder of Glycyrrhiza. (U. S. P.) Senna, 180; glycyrrhiza, 236; washed sulphur, 80; oil of fennel, 4; sugar, 500. Dose. — Dogs (laxative), 5ss-i, (2-4). Unguentum Sulphuris. Sulphur Ointment. (U. S. & B. P.) Washed sulphur, 150; benzoinated lard, 850 (U. S. P.) Sulphur Prwcipitatum. Precipitated Sulphur. S. (U. S. & B. P.) Synonym. — Lac (magisterium) sulphuris, milk of sulphur, E.; soufre pre- cipite, lait de soufre, Fr.; schwefelmilch, G. Derivation. — Obtained from a solution of sublimed sulphur, 100; in boiling calcium hydrate, 50; by precipitation with hydrochloric acid. Calcium sulphide and hyposulphite are formed. 12 S+3 Ca 02H, = 2 Ca S5-j-Ca S., 03-|-3 H20. Then: 2 CaS5+Ca S, 03-f 6 H CI = 3 Ca CL+12 S+3 H20. Properties. — A fine amorphous powder, of a pale yellow color, without odor or taste. Solubility same as sublimed sulphur. Dose (of sublimed, washed or precipitated sulphur). — H. & C, 3ti_iv> (60- 120); Sh. & Sw., 3i-ii, (30-60); D., 3ss-iv, (2-15). Larger doses laxative; smaller for constitutional action. Precipitated sulphur is the best preparation for internal use, as it occurs in a finer state of division and is more readily acted upon by the digestive juices. It may contain traces of sulphides or sulphureted hydrogen, owing to the method of preparation. 198 INORGANIC AGENTS Action External. — Sulphur has no action upon the skin when applied in the pure state. The ointment is the most effective parasiticide in de- stroying mites which produce mange, grease, and scab. Sulphur does not kill mites as readily as a sulphide which is formed by the addition of an alkali. When sulphur ointment is rubbed into the skin it causes consider- able irritation and an artificial eczema. Sulphur is converted into sul- phureted hydrogen and sulphurous acid by living tissue, and this trans- formation may occur to some extent when sulphur is rubbed into the skin with fat. Action Internal. — Digestive Organs. — Sulphur is not acted upon by the stomach, but is somewhat dissolved by the alkaline intestinal juices, and converted in part into sulphides (10 to 20 per cent, of sulphur is absorbed as sulphides) and sulphureted hydrogen. The sulphides, to- gether with sulphureted hydrogen, are absorbed into the blood. Minute traces of sulphureted hydrogen are eliminated by the lungs and skin, while oxidation of sulphides occurs in the tissues and they are eliminated as sulphates and unknown organic sulphur compounds. The sulphides •and sulphureted hydrogen act as laxatives, and in all probability sulphur itself exerts a mild, mechanical irritation upon the bowels. Peristaltic motion and intestinal secretions are both slightly increased. The fecal discharges are soft and pasty, and offensive flatus containing sulphureted hydrogen escapes from the intestines after the administration of sulphur. Constitutional Action. — Sulphur acts remotely during its elimination in stimulating the functions of the skin and respiratory mucous mem- branes,— so-called alterative action. Sulphur causes disorganization of the blood, and depresses and paralyzes the central nervous system after the continuous administration of colossal doses. Ordinary therapeutic quantities of sulphur have no effect of this kind. Uses External. — Sulphur is mainly of service externally as a local stimulant and parasiticide in skin diseases. The female mite, which pro- duces mange (acariasis), bores under the epidermis and lays her eggs in the burrows, while the male insect remains upon the surface. It is essen- tial, therefore, to remove the epidermis in order to expose the ova and female to the action of sulphur. The hair should be first shaved and the parts soaked and scrubbed with green soap and water. All cloths or brushes used in this operation should be burned or disinfected by boiling. Sulphur acts most efficiently in ointment, as fat fills up the burrows and deprives the insects of air. The official ointment is used in mange and eczema, but a combination with an alkali is more serviceable, unless there is active irritation of the skin. The following ointment is recommended: Sulphuris loti 5ii. Potassii carbonatis 3i. Aquae 3ss. Adipis benzoinati 3i- M. S. Use externally. This prescription is also useful in scab of sheep, and, diluted with SULPHUR 199 16 parts of lard, is curative in chronic eczema and grease. Sulphur is, however, chiefly used in dips for scab of sheep with lime (see p. 606). In obstinate cases of ringworm, itching, or mange, the following preparation is of value: Sulphuris praecipitati. Olei cadini aa 5ss. Saponis mollis. Adipis aa ol M. S. External use. True follicular mange in the dog, if extensive and of long duration, is practically incurable by any drug. Sulphur ointment is of benefit in chronic eczema and acne, for its local stimulant and alterative action. For the treatment of foot rot in sheep the U. S. Agric. Dep't. advises the following, and also in other forms of necrobacillosis, after removing scabs and necrotic tissue by the curette: H Sulphuris loti 3X- Cresolis *v. Adipis oC M. S. Use externally. Uses Internal. — Sulphur is commonly used for its mild laxative action in convalescence, pregnancy and in the treatment of young animals and dogs suffering with constipation and hemorrhoids. It may be of service in chronic bronchitis with copious secretion. Sulphur is frequently prescribed internally for its action in chronic diseases of the skin, and is thought to exert a beneficial alterative action. Sulphur is also recom- mended in chronic rheumatism. Disinfectant Action. — When sulphur undergoes combustion, sulphur- ous anhydride (S02) is evolved, and the latter combining with water forms sulphurous acid (S03) and sulphuric acid gas (H2S04). Sulphurous and sulphuric acid gas are strongly germicidal but dry sulphur dioxide (S02) is practically without disinfectant action. Sul- phurous acid owes its germicidal action to two properties. Chiefly to its being a powerful reducing agent, by which it is oxidized into sulphuric acid, and also to the acidity of both compounds. In withdrawing oxygen from organic matter it is poisonous to protoplasm in general and to bac- teria in particular. Bacteriological experiments, however, show that dry, sulphur fumigation, as ordinarily employed for disinfection, is of little worth for destroying disease germs. To be effective for killing bacteria there should be moisture in the air to convert S02 into S03 and H2S04. Generally formaldehyde disinfection is more efficient, but for killing ani- mal life sulphur is much superior, as formaldehyde may not injure animals at all. Thus, for killing flies, fleas, mosquitoes, bedbugs, lice, mice and rats in barns, granaries, houses and ships, sulphur should be used. Sul- phur destroys household fabrics, ornaments and utensils, but metal may be protected from its corrosive influence by a thin coating of vaseline. 200 INORGANIC AGENTS Cracks are covered by pasting paper over them, which may afterwards be washed off. The premises should be kept sealed 12 hours. Five pounds of flowers of sulphur should be used for each 1,000 cubic feet of air space. Flowers of sulphur to the depth of two inches is put in pans 12 to 18 inches wide at the bottom, and with sides four or more inches high Alcohol is poured over the sulphur to insure its combustion, which is started by throwing a lighted match upon the alcohol. The pans should float in two inches of water in larger pans to avoid fire and to supply moisture by evaporation of the water. In employing sulphur as a disinfectant, animals must of course be removed from the premises. The burning of one pound of sulphur in 1,000 cubic feet of space will produce one per cent, of S02 gas in the atmosphere. For killing insects and animals moisture is not desirable so that the pans containing sulphur may be placed directly upon sand or bricks. Sulphurous anhydride has been employed for its local antiseptic and stimulant action, in inflammatory diseases of the upper air passages in horses. For this purpose it is burned in such quantities that the vapor is capable of being inspired because largely diluted with air. With such dilution the antiseptic action is lost, and there is danger of producing considerable irritation, and the procedure is of doubtful value. The same treatment has been pursued in verminous bronchitis of lambs and calves, caused by the Strongylus filaria and S. micrurus. Chloroform inhalation is more efficient. Potassa Sulphurata. Sulphurated Potassa. (U. S. & B. P.) Synonym. — Sulphuret of potassium, liver of sulphur, E.; foie de soufre, Fr.; schwef elleber, G. ; kalium sulphuratum, P. G. Derivation. — Powdered and dried potassium carbonate, 200, is mixed with sublimed sulphur, and heated in a crucible. Potassa sulphurata is a mixture of potassium thiosulphite and trisulphide. 3 K2C03 + 8 S = K2S2Oa+2 K2S3+3 C02. Properties. — Irregular pieces of a liver-brown, when freshly made, changing to greenish-yellow and finally to gray through absorption of moisture, oxygen, and carbon dioxide from the air (containing a mixture of potassium carbonate, hyposulphite and sulphate). It has a very strong odor of hydrogen sulphide, and a bitter acrid and alkaline taste. Soluble in water, usually leaving a slight resi- due. Alcohol dissolves only the sulphides. Dose.— H. & C, 3ii-iv, (8-15); D., gr.ii-x, (.12-.6). Action Internal. — Sulphurated potassa is composed chiefly of potas- sium trisulphide (K2S3) and of potassium thiosulphate (K2S203). Its action is that of the sulphides generally. These give off H2S in the bowel, which leads to purging and local irritation. When injected into a vein the sulphides induce two notable phenomena in toxic doses. First, they cause convulsions in mammals — owing to action on the cerebrum — and, in lethal doses, paralysis of the respiratory and vasomotor centres. Second, they produce alteration in the hemoglobin of the red corpuscles with formation of a body like methemoglobin and called sulpho-hemoglobin. In frogs this happens during life but in mammals apparently comes on immediately after death. Externally the sulphides in solution dissolve the horny epidermis and hair, and lead to irritation of the skin after pro- longed action. ACIDS 201 The sulphides undergo oxidation in the blood and escape in the urine as sulphates and organic sulphur compounds and in the breath and sweat as hydrogen sulphide. Sulphurated potassa has been administered inter- nally as a substitute for sulphur, but is only of value externally. Action and Uses External. — Sulphurated potassa is one of the most serviceable agents we possess in the treatment of chronic forms of skin dieases, as acne, mange, lichen, but particularly eczema of the horse and dog. It is locally stimulant, alterative (?), and parasiticide. There is only one drawback to its general use, which is its exceedingly disagreeable odor. Peruvian balsam is frequently substituted for this reason in the treatment of skin diseases in dogs. A solution, "yellow lotion," is used in different strengths (1-8 to 1-15), according to the amount of stimula- tion which the skin will endure. The "yellow lotion" is a good agent for killing lice upon the skin. The following prescription will be found of benefit in eczema in canine practice: Potassae sulphuratae 5iiss. Chloralis 5ss. 01. anisi TTlii. Aquae ad 3iv. M. S. External use. The chloral relieves itching and the anise disguises to some extent the odor of hydrogen sulphide. SECTION XI. Acids. Acidum Hydrochloricum. Hydrochloric Acid. HC1. (U. S. & B. P.) .... (Muriatic Acid.) Synonym. — Acidum muriaticum, s. hydrochloratum, s. chlorhydricum, E.; acide chlorhydrique, s. muriatique, Fr. ; salz satire, G. An aqueous solution containing not less than 31 per cent, nor more than 33 per cent, of HC1. (U. S. P.) Derivation. — Distil together sulphuric acid, sodium chloride and water. The resulting hydrochloric acid gas is passed into distilled water, while acid sodium sulphate remains in the retort and is further acted upon by sodium chloride. Na Cl-f H2S 04 = H Cl-f-Na HS04; then: Na HS04+ Na CI = H Cl-f Na2S04. Properties. — A colorless, fuming liquid, having a pungent odor and an intense- ly acid taste. Spec, gr., about 1.155 at 25° C. Miscible, in all proportions, with water and alcohol. Incompatibles. — Alkaline and other carbonates, and lead and silver salts. PREPARATIONS. Acidum Hydrochloricum Dilutum, Acidum Nitrohydrochloricum, Acidum Nitro- hydrochloricum Dilutum. Acidum Hydrichloricum Dilutum. Diluted Hydrochloric Acid. (U. S. & B. P.) (Diluted Muriatic Acid.) Derivation. — Hydrochloric acid, 100; distilled water, 220. Diluted hydro- chloric acid contains 9.5 to 10.5 per cent, of absolute hydrochloric acid. (U. S. P.) Properties. — It does not fume in the air and is without odor. Spec, gr., 1.049. Otherwise corresponds to hydrochloric acid. (U. S. P.) Dose.— H., 5i-ii, (4-8); C, 3ii-iv, (8-15); Sh., 3ss-i, (2-4); Sw. & D., TUx-xxx, (.6-2). 202 INORGANIC AGENTS Acidum Sulphuricum. Sulphuric Acid. H2S04. (U. S. & B. P.) Synonym. — Oil of vitriol, E.; acide sulphurique, huile de vitriol, Fr.; schwefel- s&ure, vitriolol, G. A liquid composed of not less than 92.5 per cent, by weight of absolute sul- phuric acid, and not more than 7.5 per cent, water. Derivation. — Sulphurous anhydride, generated by roasting iron pyrites, or sulphur, is passed into leaden chambers. Nitric acid is introduced with steam, and the sulphurous anhydride undergoes oxidation and hydration. 2 HNOa-f-2 S02+H20 = 2 H2S04+N203. The nitrous acid combines with oxygen and water in the air, and is re-trans- formed into the nitric acid, acting continually as a carrier of oxygen to sulphurous anhydride. Properties. — A colorless, odorless liquid, of oily consistence, very caustic and corrosive. Spec. gr. about 1.83. Miscible, in all proportions, with water and alcohol, with evolution of much heat; the acid must be added with great caution to the diluent. (U. S. P.) Incompatibles. — Alkalies and carbonates, calcium and lead salts. PREPARATIONS. Acidum Sulphuricum Dilutum, Acidum Sulphuricum Aromaticum. Acidum Sulphuricum Dilutum. Diluted Sulphuric Acid. (U. S. & B. P.) Derivation. — Sulphuric acid, 50; distilled water, 420. Properties. — Diluted sulphuric acid contains 9.5 to 10.5 per cent, of H,S04. Spec. gr. about 1.067. (U. S. P.) Dose.— H., oi-ii, (4-8); C, 3ii-iv, (8-15); Sh., 3ss-i, (2-4); Sw. & D., TTlx-xxx, (.6-2). Acidum Sulphuricum Aromaticum. Aromatic Sulphuric Acid. (U. S. & B. P.) Synonym. — Tinctura aromatica acida, P. G ; elixir vitrioli Mynsichti, elixir of vitriol, E.; Slixir vitriolique, teinture (alcoolS) aromatique sulphurique, Fr.; saure aromatische tinctur, G. Derivation. — Sulphuric acid, 109; tincture of ginger, 50; oil of cinnamon, 1; alcohol to make 1,000. (U. S. P.) Properties. — Aromatic sulphuric acid contains 19 to 21 per cent, of H2S04, partlv in form of ethyl sulphuric acid. Spec. gr. about 0.933. (U. S. P.) Dose.— H., 5ss-i, (2-4); C, 3i-ii, (4-8); Sh., Tn.xv-xxx (1-2); Sw. & D., TTlv-xv, (.3-1). Acidum Nitricum. Nitric Acid. HN03. (U. S. & B. P.) Synonym. — Acide azotique, Fr. ; salpetersiiure, G. An aqueous solution containing not less than 67 per cent, nor more than 69 per cent, of HN03. Derivation. — Seven parts of sodium or potassium nitrate are distilled with four parts of sulphuric acid and water. KN03+H2S04 — KHS04-f-HN03. Properties. — A fuming liquid, very caustic and corrosive; it has a peculiar, somewhat suffocating odor. Spec. gr. about 1.403. (U. S. P.) Incompatibles. — Alkalies and carbonates, iron sulphate, lead acetate and alcohol. PREPARATIONS. Acidum Nitricum Dilutum, Acidum Nitrohydrochloricum, Acidum Nitrohydrochloricum Dilutum. /. Acidum Nitricum Dilutum. Diluted Nitric Acid. (U. S. 1905 & B. P.) Derivation. — Nitric acid, 100; distilled water, 580. Diluted nitric acid con- tains 10 per cent., by weight, of absolute nitric acid. Spec. gr. about 1.054. (U. S. P.) Dose.— H., 3i-ii, (4-8); C, 3ii-iv, (8-15); Sh., 3ss-i, (2-4); Sw. & D., ITlv-xxx, (3-2). II. Acidum Nitrohydrochloricum. Nitrohydrochloric Acid. (U. S. P.) (Nitromuriatic Acid.) » Synonym. — Acidum chloro-nitrosum, P. G.; aqua regia s. regis, — acide chloro- azotique s. chloro-nitreux, eau Regales, Fr.; salpetersalzsaure, konigswasser, G. Derivation. — Nitric acid, 18.0; hydrochloric acid, 82.0. Chemical composition uncertain. ACIDS 203 Properties.- — A golden yellow, fuming and very corrosive liquid; it has a strong odor of chlorine. The strong acid should always be freshly prepared and should be used in preference to the diluted acid. It may be made off hand by mixing 4 parts of nitric acid with 16 parts of hydrochloric acid. The mixture should remain in an open bottle not more than half full, until the fumes pass off Dose.— H., TTLxx-xl, (1.3-2.6); D., TTtiii-v, (.2-.3). 777. Acidum Nilrohydrochioricum Dilutum. Diluted Nitrochloric Acid. (U. S. & B. P.) (Diluted Nitromuriatic Acid.) Derivation. — Nitric acid, 10; hydrochloric acid, 45.5; distilled water, 194.5. Properties. — A colorless, or pale yellow liquid; it has a faint odor of chlorine and a very acid taste. Completely volatilized by heat. (U. S. P.) Dose.— H., 3i-ii, (4-8); C, *5ii-iv, (8-15)'; Sh., 3ss-i, (2-4); Sw. & D., l^v-xxx, (.3-2). Acidum Phosphoricum. Phosphoric Acid. H3P 04. (U. S. & B. P.) A liquid composed of not less than 85 per cent, nor more than 88 per cent, of H3P 04. Synonym. — Acide phosphorique, Fr. ; phosphorsaure, G. Derivation. — Heat phosphorus with diluted nitric acid till nitrous fumes cease. P3+5 HN03+2 H20 = 3 H3 P04+5 NO. Properties. — A colorless, odorless liquid, of a syrupy consistence; it has a strongly acid taste. Spec. gr. not below 1.72. Miscible, in all proportions, with water or alcohol. (U. S. P.) PREPARATION. Acidum Phosphoricum Dilutum. Diluted Phosphoric Acid. (U. S. & B. P.) Derivation. — Phosphoric acid, 100; distilled water, 765. (U. S. P.) An aque- ous solution containing not less than 9.5 per cent, nor more than 10.5 per cent, of H3P04. Spec. gr. about 1057. Dose.— H., 5i-ii, (4-8); C, 3ii-iv, (8-15); Sh., oss-i, (2-4); Sw. & D., TTlv-xxx, (.3-2). Acidum Aceticum. Acetic Acid. C2H402. (U. S. & B. P.) Synonym. — Acetum purum, — acetum destillatum, P. G.; acide acetique, Fr. ; essigsaiire, G. An aqueous solution containing not less than 36 per cent, nor more than 37 per cent, of C2H402 or CH3COOH. Derivation. — Distillation of dry sodium acetate with sulphuric acid and crys- tallization of the distillate. 2 Na C2 H302 + H2S04 = 2 HC2H302+Na2 S04. Properties. — A clear, colorless liquid, having a strong characteristic vinegar- like odor, a sharply acid taste and a strongly acid reaction. Spec. gr. about 1.045. Miscible with water or alcohol in all proportions. PREPARATION. Acidum Aceticum Dilutum. Diluted Acetic Acid. (U. S. & B. P.) Synonym. — Acide acetique dilue, Fr.; verdiinnte essigsiiure, G. Derivation. — Acetic acid, 120; distilled water, 610. Diluted acetic acid con- tains 5.7-6.3 per cent, of Q,H402. Spec. gr. about 1.008. Not employed internally except in the form of official aceta. Vinegar is impure diluted acetic acid, made by destructive distillation of wood, or by acetous fermentation and oxidation of alcoholic solutions, as cider. C2H50 H+02 z=C2H402-f H20. A temperature of 80° F., and the presence of the ferment or mould (Mycoderma aceti), are necessary. Acidum Aceticum Glacial. Glacial Acetic Acid. C2H402. (U. S. & B. P.) Synonym. — Acidum aceticum, P. G. ; acide acetique crystallis§, esprit de vin- aigre, vinaigre glacial, Fr. ; eissesig, G. Derivation. — Same as acetic acid. Properties. — A clear, colorless liquid of a strong vinegar-like odor, and a very pungent, acid taste. Contains not less than 99 per cent, of C2H402. Not used internally. ( ( j Acidum Tartaricum. Tartaric Acid. C4H606. (U. S. & B. P.) Synonym. — Acide tartrique, acide de tartre, Fr.; weinsaure, weinsteinsaure, G. Derivation. — Boil acid potassium tartrate or argol (incrustation in wine 2C4 INORGANIC AGENTS casks) with chalk to form calcium tartrate. 2 K H C4H4O0-fCa C 03 = Ca C4H4O0-|-K2C4H4O6+H2O-f C02. Add calcium chloride, which precipitates more calcium tartrate, and decompose with sulphuric acid. H2S044-Ca C4H40„ = C4H0O0 + Ca C04. Evaporate solution. Calcium sulphate crystals separate and are removed, while tartaric acid crystallizes on further evaporation. Properties. — Colorless, translucent, monoclinic prisms, or as a white, granular or fine powder; odorless, having an acid taste, and permanent in the air. Soluble in 0.75 parts of water, and in 3.3 parts of alcohol. Not commonly used in veterinary medicine. Dose.— H., 3ii-iv, (8-15); D., gr.x-xxx, (.6-2). Acidum Citricum. Citric Acid. CuH807. (U. S. & B. P.) Synonym. — Acidum citri S. limonum, S. limonorum, acide citrique, acide du citron, Fr.; citronensiiure, G. Derivation. — Usually prepared from the lemon (Citrus lemonum), or lime (Citrus bergamia). Boiling lemon juice (containing 7 per cent, of citric acid) is treated with chalk to form calcium citrate. 2 H8CGH0O7-f-8 Ca C03 =Ca3 (CcH507)2+3 C02+3 H20. Calcium citrate is boiled with sulphuric acid and the resulting citric acid is obtained by nitration, evaporation and crystallization. Ca. (C6HB07)2+3 H2S04 = 2 CBH807-{-3 Ca S04. Properties. — Colorless, translucent, right-rhombic prisms, or as a white pow- der; odorless, having an acid taste; efflorescent in warm air. Soluble in 0.5 part of water and in 1.8 parts of alcohol. Dose.— H., 3ii-iv, (8-15); D., gr.x-xx, (.6-1.3). PREPARATION. Syrupus Acidi Citrici. Syrup of Citric Acid. (U. S. P.) Citric acid, 10; water, 10; spirit of lemon, 10; syrup to make 1000. Dose. — Ad lib. Acidum Lacticum. Lactic Acid. C3H603. (U. S. & B. P.) Synonym. — Acide lactique, Fr. ; milchsiiure, G. An organic acid, usually obtained by subjecting milk-sugar or grape-sugar to lactic fermentation. A liquid containing lactic acid and lactic anhydrides, equivalent to a total of not less than 85 per cent, nor more than 90 per cent, of C3H603. Properties. — A colorless, or slightly yellow, syrupy liquid, nearly odorless, having an acid taste, and absorbing moisture on exposure to the air. Spec. gr. about 1.206. Freely miscible with water, alcohol, or ether. Dose.— H., oii-iv, (8-15); D., TTlxxx-3i, (2-4). Other acids to be found in other sections. Action External. — The concentrated mineral acids are powerful escharotics, but in dilution are stimulant, astringent, rubefacient, or vesi- cant, according to their strength. Acids have a great affinity for the alkaline juices of the tissues and blood, and weak acid solutions are thus neutralized. Strong acids coagulate albumin, probably by combining with alkalies, wrhich hold albumin in solution, and precipitating especially the globulins of the tissues. When mineral acids are present in abundance the albumin first coagulated is afterwards dissolved (except nitric acid), and the corrosive action of the acids is extensive. Acids further destroy tissue by combining with water, for which they have also a great affinity, particularly sulphuric and phosphoric acids. The former withdraws water to such an extent that the tissues are carbonized and blackened. Sulphuric acid is more destructive of tissue and acts more extensively than the other mineral salts. Nitric acid is less caustic, and hydrochloric acid is the least corrosive. Nitric acid stains the parts yellow, and hydro- ACTION OF ACIDS 205 chloric, white. The vegetable acids, as citric and tartaric acids, are slightly caustic, but are irritant to the skin, and still more so to raw surfaces and mucous membranes. An ounce of tartaric acid has caused death in man through its local effect. The action of the caustic alkalies is more widespread than that of the mineral acids. Diluted sulphuric and nitric acids are astringents, because of their power of constricting tissues, and also hemostatics in causing compression of blood vessels by contracting the tissues about them. Nitric acid is commonly employed externally, because its effect is limited by its own eschar, which is not dissolved by an excess of acid. Hydrochloric acid has no astringent effect and is not used externally for its caustic properties. The acids are antiseptic, but are less appro- priate than other agents in most cases, on account of their irritant action. Free hydrochloric acid as it exists in the gastric juice (0.2-0.3 of 1 per cent.) is a powerful antiseptic and -even germicide. Action Internal. — Alimentary Canal. — The classical experiments of Pawlow have materially altered our conceptions of the action of acids. We have shown (p. 19) that indirectly, by stimulating the formation of secretin in the stomach and intestines, they excite the activity of all the glands giving rise to the secretions concerned with digestive activity. They all aid digestion. Hydrochloric acid is particularly serviceable in gastric anacidity, being the natural acid of the gastric juice. The mineral acids also possess a certain degree of antiseptic action on the contents of the digestive tract. Diluted acids are called refrigerants in imparting a sense of coolness to the skin and mucous membrane of the mouth, and, by augmenting the secretion of saliva, relieve thirst in fever. The acids exert a local stimulant and astringent action upon the intestinal canal. Nitric acid is particularly a stimulant, sulphuric acid an astringent. Constitutional Action. — Almost all living matter possesses an alka- line or neutral reaction. An animal dies from acid poisoning even before its blood becomes neutral. The constitutional action of acids is seen after absorption of dilute solutions. Acids are immediately converted into salts — as acid can not exist as such in the tissues or blood. In the case of herbivora the fixed alkalies of the tissues and blood thus neutralize acid as it is absorbed. When the alkalies of the blood and tissues are consumed the animal dies. Herbivora are very susceptible to acid poi- soning, as in them the lessened alkalinity of the blood renders it unable to carry carbonic acid from the tissues to the lungs. Carnivora are more resistant to acid poisoning because they possess a protective power whereby they are able to liberate free ammonia from their tissues and thus neutralize absorbed acid and save — to a consider- able extent — the fixed alkalies in their blood and tissues. The symptoms of acute acidosis include: dyspnea, twitching, con- vulsions, coma, depression of the heart and vaso-constrictor centres, collapse and death by asphyxia and respiratory failure before the blood becomes even neutral. There is diminished carbon dioxide content in the blood explaining the peculiar dyspnea, gasping for breath, and later 6hort, shallow, feeble breathing. The acid-neutralizing power of the 206 INORGANIC AGENTS blood depends not only upon alkalies but also on protein, urea, and other nitrogenous bodies. Acid is absorbed from the digestive tract as acid salts and in this form is eliminated by the kidneys, which may lead to renal irritation and the presence of albumin and blood in the urine. The urine of herbivora therefore becomes strongly acid and contains large quantities of the salts of the alkalies; that of carnivora holds an excess of ammonia and — to a less degree — an increase in potassium and sodium salts. The organic acids are also absorbed as salts of the alkalies but medic- inal quantities do not reduce the alkalinity of the blood or render the urine acid. Large amounts may cause acute acidosis as from inorganic acids. They are oxidized into carbonates in the blood and may alkalize the urine by their elimination as alkaline carbonates. The vegetable salts are infrequently used in veterinary medicine. The effect of the mineral acids on the body is due almost wholly to their hydrogen ion, to which they owe their activity. Acids in excess in the body are a cause of urticaria. Diluted phosphoric acid relieves thirst and forms an agreeable cool- ing drink in fevers. Phosphoric acid is used as a tonic and reconstituent, but experiments have shown that phosphorus compounds of the body can not be built from inorganic forms of phosphorus. Poisoning. — If acid be spilled on the skin, alkalies should be applied, and in case of sulphuric acid the excess of acid should first be rubbed off, and then large quantities of very dilute alkaline solutions or soap- suds should be employed to avoid evolution of heat when the acid com- bines with water. When acids are swallowed, there is excoriation and sloughing of mucous membranes, difficulty in swallowing, vomiting of dark brown material and mucus (in animals capable of the act), severe colic, pain on movement, constipation, or, rarely, bloody diarrhea. Occa- sionally some acid flows into the larynx during deglutition and edema and suffocation rapidly ensue. There is inflammation of the upper part of the digestive canal, thirst, and collapse, with weak pulse and cold extremities. Softening, sloughs, hemorrhage and perforation of the mucous membrane of the mouth, gullet and stomach and small intestines are found post mortem. Treatment. — Soapsuds, lime water, magnesia, or other alkalies. Carbonates may be dangerous from escape of too much C02 gas and rupture of stomach. Demulcents, as milk and white of egg. Opium and stimulants. Give an enema of hot sodium bicarbonate solution, or a 3.5% solution of sodium carbonate, intravenously, to prevent systemic acidosis. Uses External. — Strong mineral acids are used as caustics. One part of sulphuric acid is mixed with three parts of sulphur, or asbestos, to form a paste for the destruction of morbid growths. The application of sulphuric acid is somewhat dangerous, as it is difficult to limit the action, and it is not by any means the best escharotic, nor so good as nitric acid, which produces less extensive destruction of tissue, and is a useful agent for the removal of tumors, for the cauteriza- ACTION OF ACIDS 207 tion of bites inflicted by rabid animals, and for the treatment of foul, sloughing wounds or foot-rot. The action of nitric acid may be limited by surrounding the part to which the strong acid is applied with oil, or by washing the acid off with soapsuds. Glacial acetic acid is frequently employed to remove warts and small excrescences. It is not so powerful as sulphuric or nitric acid. The acids in weak solution (5i.-Oi.) are useful in relieving irritation of the skin, as in urticaria, for their astringent action upon piles, and to stop slight hemorrhages. Vinegar diluted with 3 parts of water may be used for the same purposes. Nitric acid (TTLv.-xxx. to §i- of water) is a good antiseptic and astringent application to indolent ulcers, wounds, or, in the mouth, for ulcerative or mercurial stomatitis. Uses Internal. — The acids are all of value in digestive disorders. Hydrochloric acid is useful in fever, to relieve thirst and aid digestion, when a few drops may be put in the drinking water. Hydrochloric acid is especially indicated for gastric indigestion with deficiency in the secre- tion of gastric juice, in convalescence, and for fermentation and tym- panites in chronic gastritis. This applies to chronic tympany with diar- rhea in cattle when one to two drams may be given in the drinking water twice daily with salt and powdered nux vomica on the feed. Hydrochloric acid should be given after feeding, and is often combined with bitters. It acts as an antiseptic in addition to aiding digestion. Hypersecretion of hydrochloric acid, or hyperchlorhydria, is said to be characterized by acid reaction of the secretion in the mouth, and a desire to lick alkaline earthy matters. It is best treated by alkalies after feeding. All the acids are serviceable in the treatment of diarrhea and intestinal indiges- tion. Aromatic sulphuric acid (with opium) is more particularly valuable as a remedy for watery purging. Nitric and nitrohydrochloric acids are of more use in diarrhea with indigestion, jaundice, and disordered hepatic functions. The latter acid is often combined with nux vomica in the treatment of intestinal indigestion, and is a valuable remedy in catarrhal jaundice of dogs. The mineral acids are of service in preventing the formation of phosphatic calculi in horses. Sulphuric acid is utilized in acute lead poisoning, as an antidote, to form insoluble sulphates in the bowels. The acids are given for their remote astringent action in arresting or preventing hemorrhage (purpura) from internal organs, and in diminishing excessive sweating and mucous discharges; but are inferior to other agents in the treatment of these conditions. Administration. — The acids should be all thoroughly diluted with water for internal use. Acidum Picricum. Picric Acid. C6H2(N02)3OH. (Non-Official.) Synonym. — Acidum carbazoticum, carbazotic or nitrophenisic acid, trinitro- phenol, E.; acide picrique, carbazotique, nitroxanthique, Jaune-amer, Fr. ; pikrin- siiure, trinitrocarbolsiiure, welter'sches bitter, G. Derivation. — Picric acid is made by mixing together equal parts of phenol and sulphuric acid and adding, to the resulting phenolsulphonic acid, nitric acid in a thin stream with constant stirring as long as nitrous fumes are given off. Properties. — Picric acid occurs in bright yellow, inodorous scales or needles and, on being rapidly heated, will explode. It is soluble in 86 parts of water at 208 INORGANIC AGENTS 59° F., in 25 parts of boiling water which results in forming a saturated solution on cooling which contains about 1.2 per cent, of picric ac»d. It is readily soluble in chloroform and ether. Action Internal. — When given internally picric acid stains the skin, mucous membranes and urine yellow and, in large doses, causes nausea, vomiting and purging, convulsions, hemolysis and death in collapse. It is eliminated as picramic acid. Its use in medicine is chiefly confined to its external action. Action External. — Picric acid is a powerful germicide. Ehrenfried found the saturated aqueous solution fifty times more powerful than a one per cent, solution of phenol. While slightly irritating in saturated solution it soon produces a marked analgesic action which is persistent. Solutions coagulate albumin and on raw surfaces a scab is quickly formed through coagulated serum. This effect is valuable on clean, fresh wounds and in granulating wounds and ulcers which are free from pus. On suppurating surfaces the Scab formed may only confine the pus. There is no agent in surgery which stimulates so effectually the process of epidermization or the formation of new skin. Picric acid possesses great osmotic power, solutions permeating rubber gloves. Uses External. — Picric acid is commonly employed by dissolving it in the proportion of 3 drams to the quart of boiling water and the result- ing sterile, saturated solution is then ready for use. It has been applied with success to sterilize the unbroken skin for operations. Its greatest field of usefulness lies in the treatment of burns of the first and second degree. After cleansing the burns with tincture of green soap and water and lysol solution, and pricking vesicles, strips of sterile gauze soaked in the saturated solution are applied and covered with sterile, absorbent cotton and bandage. On the third day the dressing is removed, after wetting with picric acid solution, and reapplied to remain a week. The same application is useful in fresh lacerated wounds and in ulcers and granulating surfaces, after suppuration has ceased. The saturated solution is sometimes used to allay pruritus and as a stimulant in chronic eczema. Uses Internal. — The potassium salt — potassium picrate — is occasion- ally administered as an anthelmintic for round and tape worms. Young pigs, gr.iv-viii, (.24-. 5) ; lambs, gr.vii-xx, (.5-1.3). Acidum Boricum. Boric Acid. H3B03. (U. S. & B. P.) Synonym. — Boracic acid, E. ; acide borique crystallise, Fr.; borsaure, G. Derivation. — Made by evaporation and crystallization of solutions obtained by passing steam issuing from rocks in volcanic regions of Italy, through water; or by the action of hydrochloric or sulphuric acids upon borax. Na^B^ (borax) -flO H20-f2 HC1 = 4 H3B03-j-2 NaCl-f5 H20. Recovered by filtration and recrys- tallization. Properties. — Transparent, colorless scales, of a somewhat pearly lustre, or, six-sided triclinic crystals, or a light, whrte, very fine powder, slightly unctuous to the touch; odorless, having a faintly bitterish taste, and permanent in the air. Soluble in 18 parts of water and in 15.3 parts of alcohol; also soluble in 4.6 parts of glycerin. It is feebly acid. ACTION OF BORIC ACID AND BORAX 209 Dose. — H., 3ii-iv, (8-15); foals and calves, gr.xx-xxx, (1.3-2); D., gr.v-xv, (.3-1). PREPARATION Glyceritum Boroglycerini. Glycerite of Boroglycerin. (U. S. P.) Synonym. — Glycerinum acidi borici, B. P.; glycerite of glyceryl borate, solu- tion of boroglvceride. Boric acid, 310; glycerin to make 1,000. Solution prepared by heat (302° F.). Vnguentum Acidi Borici. (10 per cent.) (U. S. & B. P.) Sodii Boras. Sodium Borate. Na2B4Or. (U. S. P.) Synonym. — Borax, B. P., P. G.; natrum biboricum, boras, boras sodicus, E.; borate de soudre, Fr.; natrium pyroborat, G. Derivation. — Natural deposits of the crude article occur as incrustations on the shores of lakes in Nevada and California, which are purified by calcination and crystallization. Borax is also made bv boiling boric acid with sodium carbo- nate. 4 H3B03-f Na2C03 = Na2B407+C02+6 H20. Properties. — Colorless, transparent, monoclinic prisms, or a white powder, in- odorous and having a sweetish, alkaline taste. Slightly efflorescent in warm, dry air. Soluble in 20.4 parts of water at 77° F., and in 0.5 part of boiling water; insoluble in alcohol. At 176° F. it is soluble in one part of glycerin. Borax is slightly alkaline. Action of Boric Acid and Borax Boric acid and borax are essentially mild, non-irritating antisep- tics but not germicides. These agents are practically harmless, as ordi- narily employed, yet death in man has been reported from absorption of a 4 per cent, solution of boric acid used for irrigation of the large cavities of the body, and fatalities have resulted from its external use and from the ingestion of quantities of boric acid. Three drams of boric acid may be given daily to dogs, without causing any untoward effect. In man, boric acid poisoning has been exhibited by feeble pulse, subnormal temperature, vomiting, erythema and swelling of superficial parts, muscular weakness, involuntary evacu- ations, coma, and disordered respiration. Boric acid is eliminated by the urine, sweat, saliva and feces. Borax tends to alkalize the urine, but neither borax nor boric acid are diuretics. Boric acid and borax, like other antiseptics, relieve itching and de- stroy parasites upon the skin. Boric acid exerts an antiseptic action upon the contents of the digestive tract and upon the urine. It is thought to possess some emmenagogue action. Outside the body it has been shown (Post & Nicoll, Bernstein, 1907-10) that a saturated solution of boric acid neither kills, nor materially checks, the growth of pathogenic bacteria after 24 hours. It does inhibit saprophytic bacteria and fungi to some extent. The suppositious germicidal action of boric acid on the body has not been demonstrated experimentally. The value of boric acid and borax is chiefly surgical. They are employed more commonly upon the mucous membranes of the eyelids, mouth, nose, vagina, urethra and bladder, for their non-irritating, anti- septic properties, and also to relieve itching and to destroy parasites upon the skin. Boric acid is in more frequent use than any other agent in simple catarrhal conjunctivitis, and may be combined to advantage with cocaine as follows: 210 INORGANIC AGENTS I* Cocaine Hydrochlor gr.v-x. Acid. Borici gr.x-xx. Aquae ad .'. %\. M. S. Eye lotion. Borax is perhaps more appropriate in the mouth, being alkaline. It is applied by swab, in saturated solution, for aphthous and other forms of stomatitis. A saturated solution (4 per cent.) of boric acid is use- ful as an injection for ozena, cystitis and vaginitis. Borax in saturated solution assuages pruritis ani and vulvae, and is employed as an appli- cation for ringworm. Boroglyceride is indicated for burns and wounds. One of the very best non-toxic wet dressings for wounds and ul- cers consists of saturated aqueous boric acid solution with equal parts of alcohol. The following combination forms a soothing, protective dusting powder of chafed surfaces, intertrigo, erythema and moist eczema in dogs : Acidi borici ..3i. Zinci oxidi 3ss. M. S. Apply externally as dusting powder. Boric acid is prescribed in 10 per cent, ointment for burns, eczema and psoriasis. It is perhaps the best remedy for canker of the ear in dogs (otitis externa). The ear should be syringed out with a 2 per cent, solution, dried with absorbent cotton, and powdered with pure boric acid. The internal uses of boric acid are unimportant. It has been recom- mended and given as an emmenagogue, and as an intestinal antiseptic in fermentative diarrhea of foals and calves. Boric acid is often admin- istered in human medicine to acidify the urine and disinfect the genito- urinary tract, although not so etfk!i. M. S. Teaspoonful in water every 2 hours. Chloral is only indicated in chorea when the movements are so severe that the animal cannot secure sleep or rest. In distemper in dogs, chloral is used for the same purpose, when there is excessive cough and restlessness. Chloral is of service in prolapse of the rectum, uterus and vagina to relieve straining and aid in reduction and retention of the organ. In such cases it should be given by the mouth. Chloral is given per rectum in tetanus, so as to keep the animal continually narcotized, and may be employed in conjunction with tetanus antitoxin. Spasm of the os uteri is relieved by chloral when given per rectum in frequently repeated doses, until the safe physiological limit is reached. Chloral is inferior to ether or chloroform as an anesthetic, because it is not so safe, nor is the anesthesia so complete, but it relieves pain effec- tually, and is more easily administered. It is combined, in order to pro- duce anesthesia, with small doses of morphine, which decidedly enhance the anodyne action of chloral. To prepare a horse for surgical operation, 3 grains of morphine sul- phate and 1 grain of atropine sulphate may be injected under the skin, followed in 10 minutes by an enema containing 1 ounce of chloral, with 1 ounce of acacia, in a pint of water; or chloral (§i-ii in 10 to 20 ounces of water) may be used alone without the morphine and atropine as follows : 240 INORGANIC AGENTS Chlorali hydrati 3ii. Acaciae Si- Aquae ad Ovi. M. S. Give per rectum to horse as an anesthetic. The same dose may be given to cattle as an anesthetic before opera- tion. Chloral narcosis lasts 1 or 2 hours and may be given before casting to facilitate the act or to aid in the shoeing of vicious horses. The nar- cosis is not deep but sufficient for most operations. Chloral (H., *ss-i ; D., 3ss-ii, in 10% solution) injected into the peritoneal cavity will produce surgical anesthesia and has been used in colic in horses with barium chloride by mouth. In flatulent colic, first puncture to allow escape of gas. This treatment does not commend itself to the author as a safe procedure. The writer has found the intraperitoneal method generally safe and efficient in laparotomies in dogs but occasionally inefficient, and deaths have occurred from over-dose and peritonitis. The morphine and drop- ether anesthesia is safer and more satisfactory in dogs. Class 5. — Antipyretics and Analgesics. Chloretone. CC13(CH3)2C0H. (Non-official.) Chloretone occurs in colorless crystals of camphoraceous odor and bitter taste. It is very slightly soluble in water, soluble in alcohol and in 10 parts of glycerin. It may be made from acetone, chloroform and an alkali. It is allied to chloral and represents it in action but does not depress the heart and respiration in any ordinary doses and is an actual sedative to the stomach. Externally it is an antiseptic and local anesthetic although there may be some temporary burning produced by it on raw surfaces. It may be used also as a local anesthetic injected in 1 per cent, solution (alcohol, 15 parts, water, 85 parts). Chloretone is employed with an equal amount of boric acid (Borochloretone) as an application to wounds and ulcers as an antiseptic and local anesthetic. Internally the drug is administered in human practice before operations to prevent the vomiting subsequent to general anesthesia and its use is advised for the same purpose in dogs and also to quiet the animals for local anesthesia. Unless there is some specific reason why vomiting should not occur the sub- cutaneous injection of morphine is more efficacious to aid the action of either local or general anesthetics. Chorea and convulsion in dogs may be treated to advantage with the drug. It may be administered to dcgs in pills or capsules. Dose. — D., gr.v-x, (.3-.6). Acetanilidum. Acetanilid. CsH»0 N. (U. S. & B. P.) Synonym. — Phenylacetamide, antifebrin. An acetyl derivative of aniline. Derivation. — Glacial acetic acid and aniline are distilled together, and the residue is purified by repeated crystallization. H C,H3O2 + C0H5N H2 = ChH90 N-fH,0. Properties. — Colorless, shining, micaceous crystalline laminae, or a crystalline powder, odorless, having a faintly burning taste; permanent in the air. Soluble in 190 parts of water, and in 3*4 parts of alcohol; also soluble in 17 parts of ether, and in 3.7 parts of chloroform. Dose.— H., 5ii-iv, (2-15); Sh. & Sw., 5ss-i, (2-4); D., gr.iii-vii, (.2-.5). ACETANILID, ANTIPYRINE AND PHENACETIN 241 Acetphenetidinum, Acetphenetidin. Phenacetin. C10H13O2 N. (U. S. P.) Synonym. — Phenacetinum, B. P.; para-acetphenetidin. Derivation. — Obtained by the action of glacial acetic acid upon paraphene- tidin, a phenol derivative. HC2H302-fC6H6OC2HB NH=C10H13NO2+H2O. Properties. — White, glistening, crystalline scales or as a fine, crystalline pow- der; odorless, having a slightly bitter taste and producing a faint numbing effect on the tongue; permanent in the air. Soluble in 1310 parts of water, 15 of alco- hol, 14 of chloroform, and 90 of ether. Dose.— H. & C, 3iv, (15) ; D., gr.v-x, (.3-.6). Antipyrina. Antipyrine. CnHi2 ON2. (U. S. P.) Synonym. — Phenazonum, B. P.; phenyl-dimethyl-pyrazolon. Derivation. — Phenyl-hydrazine is acted upon by aceto-acetic ether, when phenvl-monomethvl-pvrazolon, ethvl alcohol and water result. H2N N H C(iH5 + C H3C OCH,COO CH5 =z C6H5 (C H3) C3H,N2O+C,H0 O H + H20. Then C6H5 (C H3) C3H,N20 + C H3 I (methyl iodide) — CuH,2ON2-f HI. Properties. — A white, almost odorless, crystalline powder or in tabular crys- tals, with a slightly bitter taste. Soluble in about its own weight of water, alcohol and chloroform. Incompaiibles. — Spirit of nitrous ether, iron sulphate, chloride and iodide; salicylates, tannin, chloral, calomel, and a large number of drugs. Dose.— H. & C, ovi, (24) ; Sh. & Sw., 5i. (4) ; D., gr.v-xx, (.3-1.3). Action of Acetanilid, Antipyrine and Phenacetin. External. — Acetanilid and antipyrine are antiseptics. Solutions of the latter contract vessels and exert a local anesthetic and hemostatic action. Internal. — These substances exert no action upon the digestive tract, but acetanilid possesses a decided antiseptic influence upon bacteria within the alimentary canal. Blood. — These agents have no influence upon the blood, in moderate medicinal doses, but in large doses (except antipyrine) they diminish the ozonizing power of the blood, reduce the hemoglobin of the red cor- puscles, change it to methemoglobin, and alter the color of the blood to a brownish-red hue. In large toxic quantities, administered continuously, they cause disintegration of the red corpuscles and elimination of the blood-coloring matter in the urine. Heart and Blood Vessels. — In ordinary therapeutic doses the^e drugs do not alter the normal condition of the heart or blood vessels, but in large medicinal doses they first stimulate and then slow and de- press the force of the heart by action (probably) upon the heart muscle. Phenacetin is the least, and acetanilid the most depressant. Antipyrine is said to stimulate the heart and increase blood pressure in minute quantities. These three antipyretics decidedly diminish blood tension in large medicinal doses, owing to depression of the heart and of the vaso- motor apparatus. Nervous System. — Usual therapeutic doses of these substances exert a sedative action upon the sensory nerves and sensory tract of the spinal cord. They are therefore anelgesics, although not comparable in this respect to opium. Poisonous quantities of these drugs diminish muscu- lar power, lessen reflex action and cause paralysis. Experiments appar- 212 INORGANIC AGENTS Respiration. — The respiratory functions are unaffected by thera- peutic doses of these medicines. In lethal doses respiration is quickened, ently show that acetanilid paralyzes the motor nerves, antipyrin the motor nerve endings, while motor depression seems to be of spinal ori- gin in the case of phenacetin. The brain is undoubtedly influenced by these agents, as evidenced by coma and convulsions in poisoning, but exact knowledge is wanting in relation to the action upon the brain. The functions of the cerebral cortex are thought to be depressed by phenacetin especially, and the special senses to be first stimulated and then paralyzed by this drug. Temperature. — Acetanilid, antipyrine and phenacetin are essentially antipyretics. While they do not invariably lower temperature, even in large doses in normal animals, they do so very materially in animals suffering from fever. They apparently render the heat-regulating cen- tres at the base of the brain less susceptible (narcotic effect) to the ac- tion of toxins and increase their control over heat-loss. They do not ap- parently lessen heat-production since metabolism is not diminished — acet- anilid even increases it. They frequently induce diaphoresis, but it is generally accepted that heat dissipation is increased to a greater extent than would be accounted for by sweating, and that it occurs even when diaphoresis does not take place. owing to the greater work thrown upon the respiratory centre by the altered condition of the blood, and this vital centre is ultimately para- lyzed. Kidneys. — The drugs under consideration produce slight diuresis in moderate medicinal doses. In poisoning, the urine may become dark- colored by the hematin escaping from the disintegrated red blood cor- puscles. Antipyrine lessens the nitrogenous products of tissue waste in the urine, and also diminishes the amount of that secretion. Acetanilid, on the other hand, increases the excretion of urea. Elimination. — Antipyrin is rapidly eliminated unchanged in the urine in some animals; in others it is oxidized. Acetanilid escapes in part unchanged and in part as different oxidation products in different animals; while phenacetin is chiefly eliminated as such and as glycuro- nate of phenetidin. Poisoning. — Toxic doses of these drugs cause, in the lower animals, nervous excitement and convulsions, and sometimes coma, loss of con- sciousness, staggering gait, muscular failure, sweating, rapid, feeble res- piration, weak pulse, cyanosis, occasional vomiting in dogs, fall of tem- perature and general paralysis. Treatment. — External heat, alcoholic stimulants by the mouth, rec- tum, or under the skin; digitalone, strychnine, and atropine subcuta- neously. Administration. — Antipyrine is given in solution by the mouth, rec- tum, or under the skin. Acetanilid and phenacetin can be administered in powder, tablet, pill or ball; or in solution in alcoholic liquor. Acet- anilid is to be preferred for horses on account of its being less expen- sive. The average dose of acetanilid is two drams for a horse, and ACETANILID, ANTIPYRINE AND PHENACETIN 243 three to five grains for a dog; and the dose of phenacetin is twice, and of antipyrine three times greater than that of acetanilid. Uses External. — Acetanilid is employed as an antiseptic dusting powder undiluted. A ten per cent, solution of antipyrine may be applied as a hemostatic upon bleeding surfaces. Uses Internal. — There are three indications for the use of these agents: 1. To lower temperature in fever. 2. To relieve pain. 3. To lessen motor excitement and spasm. While these agents are used chiefly in human medicine to relieve pain, especially of a neuralgic character, this kind of suffering is un- common in veterinary practice and here acute rheumatism is the disease chiefly amenable to their influence. In rheumatism the salicylates should be employed with the antipyretics, as sodium salicylate in solution with antipyrine. Phenacetin is the most serviceable for dogs, as it is less toxic, more sedative, and more permanent in its antipyretic action than antipyrine or acetanilid. Dogs suffering from distemper are greatly relieved by small and repeated doses of phenacetin, which lessen fever, cough and rest- lessness. In acute diseases, as pneumonia, influenza and laminitis, either of the antipyretics may be employed in one or two doses when there is hyperpyrexia. Doses of half an ounce of acetanilid 3 times a day for horses have proved serviceable in acute laminitis. For horses in acute laminitis. Acetanilidi ovi. Pulveris nucis vomicae $fes. M. et divide in chartulas No. xii. S. One powder on the feed t. i. d. Although animals do not seem to be so susceptible to the depressing influence of the antipyretics yet it is well to combine them with strych- nine. In experiments on mice, Worth Hale found the addition of caf- feine to acetanilid increased its depressing action on the heart muscle, so this common combination is inadvisable. Sodium bicarbonate lessens the toxicity of acetanilid. Antipyretics are generally inadvisable in asthenic febrile diseases, since they are too depressant in their action upon the heart and have no effect in removing the cause of the disease. The hyper- pyrexia of insolation may be treated with these agents, in combination with cold, externally and per rectum. Motor disturbances, including con- vulsions, chorea and spasm, may be abated by the antipyretics, but they are usually inferior to chloral, opium, or other antispasmodics. Phenacetin, combined with codeine or heroin, in powder or tablet, is a useful remedy for cough in dogs. For dogs with fever and cough. Acetphenetidini 3iss. Codeinae sulphatis gr.vi. M. et divide in capsulas No. xii. S. One capsule every 3 hours. 244 INORGANIC AGENTS Class 6 — Antiseptics. Acidum Carbolicum Crudum. Crude Carbolic Acid. Synonym. — Acide ph6nique cru, Fr. ; rohe carbolsJiure, G. Derivation. — A liquid consisting of various constituents of coal tar, chiefly cresol and phenol, obtained by fractional distillation at a temperature between 302° F. and 392° F., and twice rectified at a temperature between 338° F. and 374° F. Properties. — A nearly colorless, or reddish-brown liquid of a strongly em- pyreumatic and creasote-like odor, having a benumbing, blanching and caustic effect upon the skin or mucous membrane, and gradually turning darker on exposure to the air and light. Soluble in 15 parts of water. The aqueous solution has a slight acid reaction. Phenol. Phenol. (U. S. P.) Acidum Carbolicum. Carbolic Acid. C0H5O H. (B. P., P. G.) Synonym. — Hydroxybenzene, phenic acid, phenyl alcohol, phenylicum crystal- lisatum, E.; phenol acide phenique, acide carbolique, Fr. ; carbolsiiure, phenyl- siiure, G. Derivation. — Obtained from crude carbolic acid by agitation with caustic soda, heating to 338° F., and adding hydrochloric acid. Then by agitation with sodium chloride, digestion with calcium chloride, and distillation at a temperature between 336° F., and 374° F., and finally by crystallization. Properties. — Colorless, interlaced, or separate, needle-shaped crystals, or a white crystalline mass, sometimes acquiring a red tint; having a characteristic, somewhat aromatic odor, and when copiously diluted with water, a sweetish taste with a slightly burning after-taste. Deliquescent on exposure to damp air. Solu- ble in about 1.5 parts of water, and very soluble in alcohol, ether, chloroform, glycerin, carbon disulphide, fixed and volatile oils. Neutral or faintly acid reaction in solution (1-15). Phenol crystals melt when heated, but solidify again on cooling. A 95 per cent, solution of carbolic acid crystals, in alcohol, remains fluid at the ordinary temperature. The crystals are also liquefied by the addition of about 8 per cent, of water. Dose.— H. & C, 3ss-ii, (2-8) ; Sh. & Sw., gr.x-xx, (0.6-1.3) ; D., gr.ss-i, (.03-.06). PREPARATIONS. Unguentum Phenolis. (U. S. P.) Unguentum Acidi Carbolici. Ointment of Carbolic Acid. (B. P.) Phenol, 2.25; ointment, 97.75 (U. S. P.); 4 per cent., B. P. Qlyceritum Phenolis. (U. S. P.) Olyceritum Acidi Carbolici. Glycerite of Carbolic Acid. (B. P.) Phenol, 20; glycerin, 80. Phenol Liquef actum. (U. S. P.) Acidum Carbolicum Liquef actum. Liquefied Carbolic Acid. (B. P.) Carbolic acid liquefied by addition of 10 per cent, of water. Dose. — Same as acidum carbolicum. Action External. — Phenol causes burning pain when applied to the skin or mucous membranes, and this action is followed by local anes- thesia and the production of a dry white spot. If used in sufficient quantity, it leads to sloughing, but the escharotic effect is superficial, since the acid coagulates albumin, which forms a protective coating over the underlying parts. Phenol is an antiseptic and disinfectant, and, in proper solution, acts as a sedative upon the peripheral sensory nerves, and is one of the most efficient agents in relieving itching. It checks the growth of both organized (bacteria) and unorganized (digestive) fer- ments. Strong solutions (1-2 per cent.) kill most bacteria, but a con- PHENOL 245 siderable time is required to destroy the organisms of certain diseases and those relating to putrefaction. Some hours are required to kill an- thrax spores, by even a 5 per cent, solution. Two per cent, solutions destroy the digestive ferments. Animal and vegetable parasites, grow- ing upon the skin, perish by the application of carbolic acid and it is useful in the treatment of ringworm, lice, lungworm, and, especially, mange in sheep, but is unsuitable for local use on dogs or cats, or on their habitations. Action Internal. — Alimentary Canal. — Phenol exerts a local, anes- thetic action upon the sensory nerve endings in the stomach, and may act to a certain extent in the digestive tract as an antiseptic, hindering abnormal fermentation. It is probably converted into a sulpho-carbolate in the stomach. In concentration, carbolic acid is a powerful gastro- intestinal irritant. Blood. — Carbolic acid is absorbed into the blood and probably cir- culates in part as an alkaline carbolate of sodium and potassium. Heart and Blood Vessels. — Phenol, in poisonous doses, paralyzes the vasomotor centres and later depresses the heart. The effect upon the vessels is the more important and prominent, but neither action is observed after medicinal doses. Respiration. — Therapeutic doses do not influence the respiratory functions, but toxic quantities make the respiratory movements rapid and shallow at first, owing to stimulation of the respiratory centre and peripheral vagi, while death occurs after lethal amounts from paralysis of the respiratory centre. Nervous System. — The brain is depressed by toxic doses of phenol and stupor and coma occur. The convulsions appearing in carbolic acid poisoning are due to primary stimulation of the spinal motor area, which is finally depressed and paralyzed. When locally applied, phenol de- presses and paralyzes the peripheral sensory nerves. Temperature. — Phenol, in medicinal doses, slightly lowers tempera- ture both in health and fever, but it is not sufficiently antipyretic to be suitable for such a purpose in practice. It depresses heat production and increases heat loss. Elimination. — Phenol is eliminated by all ordinary channels, but mainly by the kidneys. The urine becomes dark colored — a very char- acteristic sign — even after large medicinal doses. Phenol normally oc- curs in small quantities in the urine of man and animals. Three grains have been recovered from the urine passed in 24 hours by a horse, and phenol is thought to be a product of intestinal fermentation. In large, toxic doses most of the carbolic acid is eliminated in the urine un- changed. Part, however, is oxidized into two bodies — pyrocatechin and hydroquinone — and these, as well as phenol, unite with sulphuric and glycuronic acids in the tissues. Thus phenol is eliminated in the urine as double sulphates and glycuronates of phenol, pyrocatechin and hydro- quinone. The last two are unstable and further undergo oxidation into dark substances, coloring the urine, which grows darker on exposure to 24G INORGANIC AGENTS the air. The normal sulphates are absent in the urine following car- bolic acid poisoning. Toxicology. — Carbolic acid ranks as one of the most powerful poi- sons— together with prussic acid, aconite and nitrobenzol — in existence. Several cases of death in man have occurred after the ingestion of one- half ounce of carbolic acid; and the smallest fatal human dose on record appears to be about one dram. One or two drams are fatal to dogs, and a dose as small as 15 grains is said to have caused the death of a dog, while the lethal amount for the horse is about one ounce. Many cases of accidental poisoning have occurred from absorption of phenol when applied externally for surgical purposes in dressings or solutions upon raw surfaces. The symptoms are the same as when absorption occurs from the digestive tract. Extensive gangrene, after continuous treatment with moist carbolic applications, is occasionally seen. Dogs and cats are particularly susceptible to the action of phenol. The milder symp- toms of poisoning include dulness, loss of appetite, muscular weakness and trembling and dark-colored urine having the odor of carbolic acid. After lethal doses death may be instantaneous through respiratory ar- rest, the heart continuing to beat for a time. The more ordinary symp- toms of severe poisoning in all animals are: trembling, rarely vomiting and purging, restlessness, salivation, loss of muscular power (animal reels and falls) , diminution of sensibility, anesthesia, dyspnea; the breathing is rapid, shallow and stertorous; the pulse is weak, irregular, and usually frequent; the temperature is lowered, and there are the usual symptoms of collapse, with insensibility, coma, loss of reflex ac- tion, general paralysis, occasional convulsions and death. Sometimes hematuria, albuminuria and hemoglobinuria have been observed. The condition resembles apoplexy, but the mucous membrane of the mouth is stained white in patches after ingestion of pure acid, dark with crude acid, and the odor of the poison lingering about the animal, together with the dark, green-colored urine, is characteristic of phenol poison- ing. The urine may be clear when first voided, but becomes dark on standing. The absence of carbolic acid in the urine affords certain evidence that the case is not one of poisoning by this drug. Post-mortem exami- nation reveals hard, whitish or brownish or black patches and sloughs upon the mucous membrane of the mouth, gullet, stomach, and even the small intestines. The blood is dark from asphyxia, and imperfectly coagulated. There is occasionally fatty degeneration of the liver and kidneys. The odor of the acid remains not longer than twenty-four hours. Both horses and dogs are very susceptible to phenol poisoning, where the whole body is bathed in more than a one per cent, solution as is sometimes done for lice or mite infestation. Such should receive atropine hypodermically. Treatment. — Unfortunately there is no satisfactory antidote for phenol. Emetics are usually valueless on account of the anesthetic con- dition of the mucous membrane of the stomach. We use, therefore, the PHENOL 247 stomach tube. Washing the stomach with 10 per cent, solution of alco- hol has proven most efficient. This follows because alcohol is a good solvent for phenol. The alcoholic solution of phenol should, therefore, be at once removed from the stomach or its use will aid, absorption and poisoning. After washing the stomach with alcohol one should give a strong solution of magnesium or sodium sulphate by the mouth or, when lavage is impracticable, one of these should be given at once. Con- cerning their action and value there could scarcely be more disagreement. Thus it has hitherto been commonly accepted and taught that insoluble sulphocarbolates are formed in the stomach. This is denied by Sollman and most authorities. Thornton affirms, as a result of his experiments, that harmless but soluble phenosulphates result. This, again, is denied by Baumann and others. Cushny declares that the employment of these sulphates in phenol poisoning is useless, while Hare advises their use. As the action of Epsom or Glauber's salt is harmless and their effect may be beneficial, we recommend their administration. For collapse, heart and respiratory failure, — camphorated oil, digitalis, strychnine, atropine, ether, and brandy subcutaneously, are to be employed, together with heat externally. Mucilaginous drinks are also useful. The local caustic action of carbolic acid on the skin or mucous membranes can be prevented by the immediate washing of the parts with strong alcohol. Of late years alcohol has also been regarded and widely given as a phy- siological and chemical antidote in carbolic poisoning. In experiments, cited by Thornton, on dogs with mixtures of toxic doses of carbolic acid and alcohol, and with the administration of poisonous doses of the acid followed by alcohol, the results go to show that alcohol does not in any way lessen or alter the poisonus effect of carbolic acid except in pre- venting the corrosive action on the stomach. His conclusions are some- what M-eakened, however, by the fact that doses of alcohol were used which in themselves might be toxic (4 to 9 ounces). It is now known that alcohol acts only as a solvent; not as an antidote. Administration. — Carbolic acid is commonly given internally, diluted several hundred times with water. Uses External. — A solution of carbolic acid (1-20) is frequently used in surgery to disinfect the unbroken skin, while a weaker solution (1-50) is more suitable as an antiseptic upon raw surfaces and mucous membranes. While corrosive sublimate has enjoyed chief popularity as a surgical antiseptic for many years on account of its cheapness and supposed superior bactericidal properties, recent experiments have shown that the value of corrosive sublimate is much over-estimated. It has been shown that while a 1 to 2000 solution of corrosive sublimate requires over thirty minutes to kill micro-organisms the same bacteria are killed in less than one minute by a 5 per cent, solution of carbolic acid (Post and Nicoll). So, while the antiseptic reputation of phenol has been rehabili- tated, yet its closely related chemical substitutes, cresol, creolin and lysol, have largely replaced phenol on account of their being less toxic and more actively germicidal, strength for strength. Pure carbolic acid is occa- sionally used as a caustic to destroy small growths, as warts, and the 248 INORGANIC AGENTS lining membrane of fistulae of the poll, withers, or lateral cartilages; to swab out a septic uterus, and as a local anaesthetic upon the skin. To destroy fistulae the pure phenol is injected and, after two minutes, the fistula is washed out with alcohol. A drop of pure acid, or a line drawn with a brush along a proposed path of incision, may render a hypoder- mic puncture or superficial incision painless. Carbolic acid with glycer- in (1-16) is one of the most excellent preparations for applying to sluggish ulcers and old sinuses and fistulae. The glycerin appears to entirely offset the corrosive action of the acid, and the result is a stimu- lation of the pyogenic membrane and promotion of healing which often can not be obtained by any other remedy. It is equally effective in canker and foul in the foot of cattle, and in foot rot of sheep (1 part in 10 of glycerin). Injection of ten to thirty drops of a two per cent, aqueous solution into the substance of boils, acne, glandular swellings, poisoned wounds, joints affected with chronic synovitis, and inflamed bur- sae, will often assist recovery and may abort the lesion. In the two last, TT^x-xxx. of the pure acid. In acute inflammation, the injections are made twice daily; in chronic conditions, once every other day; and if there is a large extent of surface involved, several injections are done at one time. Erysipelatous patches are best treated by swabbing them with pure phenol followed at once by swabbing with pure alcohol. This is done not only to the patch itself but the surrounding normal area should be somewhat encroached upon. Wet dressings, made by saturating aseptic gauze in % to 1 per cent, solutions of phenol and applied with a rubber cloth or oil paper or silk covering, have been much used in surgery in the treatment of septic wounds. Many cases of local gangrene have been reported in human surgery following such application to the extremities. It is safer and just as effective to use a 1 per cent, lysol (liq. cresolis co.) solution for an antiseptic wet dressing. Bacelli's treatment of tetanus with carbolic acid is said to be suc- cessful. One dram of the pure acid in solution (3 per cent.) should be injected subcutaneously in the region of the neck and shoulders of the horse every two hours during the first 32 hours, and less frequently afterward. As much as 36 drams may be given to the horse in 24 hours, for there appears to be a special tolerance for carbolic acid acquired in tetanus. The writer has found the solution too bulky to be used in practice and its remedial effect is doubtful. Magnesium sulphate is much more efficient. The glycerite of carbolic acid is employed as a local application in stomatitis, upon the ulcerations of actinomycosis with iodine, and also upon the skin to destroy ringworm. It is inferior, however, to tincture of iodine for the latter purpose. Two per cent, solutions are recom- mended to kill lice and the acari of scab and mange. Carbolic acid is the most serviceable remedy we possess to relieve itching. Two per cent, solutions may be employed upon the unbroken skin, but the strength should not be greater than half this amount upon excoriated surfaces. PHENOL 249 Pruritus (except in dogs and cats). Phenolis gr-xl. Glycerini 3i. Olei gossypii sem 3ii. M. S. Apply externally. In sub-acute moist eczema of dogs, carbolic acid with zinc oint- ment (gr. v.-^i.), or the following prescription, will be found of value in relieving itching and promoting recovery: Calaminae 3ss. Zinci oxidi 3ii. Acid. Carbol gr.xx. Liq. Calcis ad 3iv. M. Sig. External use. (Shake.) Care should always be taken not to apply carbolic preparations over any considerable extent of raw surface, and to muzzle dogs in the event of an opportunity being afforded them to lick off any undue amount of the acid. A solution (1-50) in boiling water forms an effi- cient antiseptic and sedative inhalation for horses suffering from catarrh of the upper air passages. One of the most excellent remedies for burns consists of carbolic acid in carron oil. It relieves pain and lessens sup- puration, although carbolic acid in oil possesses little antiseptic prop- erty, because phenol is so much more soluble in oil than in the watery protoplasm of bacteria. For burns. Phenolis 3i. Carron oil %vi. M. S. External use. Good results have been reported with intratracheal injections in verminous bronchitis of foals and calves, consisting of the following: Acidi carbolici Tl\xx. 01. terebinthinae 5ii. Chloroformi 3ss. M. Sig. Give at one injection intratracheally. Phenol, with camphor, forms a liquid which is without the toxic and caustic properties of phenol alone. It makes a serviceable application, on absorbent cotton or gauze, for small burns, wounds and ulcers, as in broken knees and in necrosis of the coronary band in horses. Phenolis %i. Camphoris 3m. M. (Phenol melted by heat.) S. Apply externally. 250 INORGANIC AGENTS Phenol is useful as a spray in the form of Dobell's solution which is indicated in coryza, in influenza and distemper. I* Sodii bicarb. Sodii boratis aa ">i. Phenol 3ss. Glycerini ...3i. Aquae Oii. 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 disin- fection 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 disinfectant. 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 phenol after absorption is not of value in general bacterial diseases. The subcutaneous injection of 2 drams (8 mils) 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 em- ployed as a prophylactic measure. Experience discredits 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 destruction 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 in dogs, and in counteracting intestinal fermentation and diarrhea in all animals. , Vomiting and diarrhea in dogs. Phenolis gr.v. Bismuthi subnitratis 5iss. M. et divide in capsulas No. x. S. One capsule every 2 hours. Creosotum. Creosote. (U. S. & B. P.) Synonym. — Kreosotum, P. G.; creosote, Fr.; kreosot, G. Derivation. — A mixture of phenols and phenol derivatives, chiefly guaiacol and creosol, obtained during the distillation of wood tar. Properties. — An almost colorless or yellowish, highly refractive, oily liquid, having a penetrating, smoky odor, and a burning, caustic taste. It does not readily become brown on exposure to the light. Spec. gr. not below 1.073 at 25° CREOSOTE 251 C. Slightly soluble in water. It is miscible with alcohol, ether, fixed and vola- tile oils. Dose,— H., «1v-xv, (.3-1); D., n\ss-ii, (.03-.12). Action and Uses. — The action of creosote upon animals is practi- cally the same as that of carbolic 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 as follows: Creosoti 3ii. Potassii hydroxidi 5ss. Olei gossypii sem Shiss. M. S. Apply externally. Internally, creosote is administered, as is carbolic acid, to check vomiting and to act as an intestinal antiseptic in indigestion with fer- mentation and diarrhea. Creosote is of much service as an inhalation (Tl\xx. to Oi. of boiling water) in sub-acute bronchitis, in fetid nasal discharge and in gangrene of the lung in horses. It is also given inter- nally in chronic bronchitis and in distemper of dogs. It is eliminated to some extent by the lungs and may act as an antiseptic in the lungs and digestive tract and have a favorable stimulant, expectorant action. Distemper, dog. Creosoti (beechwood) TT\.xxi. Bismuthi subcarbonatis oiiss. M. et divide in capsulas No. xxi. S. One three times daily. It is occasionally given by intratracheal injection (creosote, u\x. in § ss. of 50 per cent, alcohol) in gangrenous pneumonia of horses and to sheep and calves in the same manner in parasitic bronchitis (TT\,v. in 5 i. 50 per cent, alcohol). It may also be given by the mouth in verminous bronchitis to kill the lung worms or by means of its elimination from the bronchial mucous membrane. Neumann advises creosote (oii.), ben- zine (3 x.), and water (2 qts.) ; of the mixture for sheep, 1 teaspoonful daily, by the mouth, for 8 days for verminous bronchitis. Chloroform in- halation to a point where the animal staggers, followed by a purge, is more satisfactory. Cresol. Trikresol. C-HsO. (U. S. P.) Synonym. — Cresolum, cresylic acid, E.; cresol, Fr.; kresol, trikresol, G. A mixture of isomeric cresols obtained from coal tar. Preserve it in amber- colored bottles from the light. Cresol occurs as a colorless or yellowish to brown- yellow, highly refractive liquid, becoming darker or assuming a reddish tint with age and on exposure to light, and having a phenol-like, sometimes empyreumatic odor. Soluble in about 50 parts of water, usually forming a cloudy solution; it 252 INORGANIC AGENTS is miscible with alcohol, ether, benzene, petroleum, benzin or glycerin; it is dis- solved by solutions of the fixed alkalies. Sp. gr. 1.030 to 1.038 at 25° C. The isomeric cresols are meta-, ortho- and para-cresol. They are constituents of tars and are related to carbolic acid chemically and therapeutically. To increase their solubility as antiseptics they are suspended with soap (lysol), used in emulsion (creolin), or dissolved by salts (solved). Cresol is much more germi- cidal than phenol but is used more commonly in the form of creolin and lysol. The dose and toxicity of cresol are the same as that of phenol. Creolinum. Creolin. (Proprietary preparation.) Synonym. — Creoline, Fr. ; kreolin, G. Derivation. — Obtained from soft coal by dry distillation. Composition very complex. It is said to contain cresol and higher homologues of phenol. Properties. — Dark-brown, syrupy, alkaline liquid, of a tnrry 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. & C, 5ss-i, (15-30), in single dose. For continuous use — H. & C, oi-ii, (4-8); D., TTli-v, (.0G-.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 con- tinuously applied. Creolin generally represents carbolic acid, but is much more efficient as a germicide, less irritating, and does not endan- ger animal life from absorption. Creolin has 3.25 times the germicidal value of phenol and is but 1/6 as toxic (U. S. Hygienic Laboratory). Aqueous solutions (emulsions), containing from % to 1 per cent., are employed for antiseptic purposes. Action Internal. — Creolin is eliminated by all channels, giving the secretions a tarry odor, and coloring the urine brown. One or two drams 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 anti- septic, and better than carbolic acid. Uses. — Creolin is employed mainly outside of the body, and is a useful general antiseptic for surgical purposes in 1 per cent, solution. Antiseptic poultices, so valuable upon septic sloughing parts, are best made by soaking clean gauze in a 1 per cent, aqueous solution of creolin, and applying the same, covered by a waterproof protective. Creolin solutions are not to be recommended for instruments during operations, as the fluid is so turbid that they cannot be seen by the operator. A 2 per cent, solution is useful for a vaginal or uterine injection; a 1 per cent, solution for irrigation of the bladder in cystitis, or eye in! keratitis and conjunctivitis; and a % Per cent, solution for intestinal irrigation in dysentery. As a parasiticide, 2 per cent, solutions, or 10 per cent, oint- ments or soaps, may be used to kill lice, fleas, and acari of scab and mange. Frohner advises equal parts of creolin and alcohol, writh 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 may be used internally, as an intestinal antiseptic and anthelmintic. One ounce LIQUOR CRESOLIS COMPOSITUS 253 given on an empty stomach, in a quart of water, is one of the most effec- tive vermifuges for the horse. Liquor Cresolis Compositus. (U. S. P.) Compound Solution of Cresol. Synonym, Lysol (Proprietary Name). Cresol, 500 Gm.; linseed oil, 300 Gm.; potassium hydroxide, 80 Gm.; alcohol, 30 Gm.; water, to make 1000 Gm. Synonym. — Liquor cresoli saponatus, P. G.; solute de cresol compost, Fr.; kresolseifenlosung, G. Derivation. — From that part of tar oil which boils between 190° and 200° C, by dissolving in fat and saponifying in alcohol. Properties. — A clear, brown, oily liquid, of a feeble, creosote-like odor. Solu- ble in water, forming a clear, frothy, soapy fluid, and in alcohol, chloroform, and glycerin. Uses. — Compound cresol solution is used as a substitute for creolin in % to 2 per cent, aqueous solution. The compound cresol solution is 3 times, and lysol but 2.12 times, more germicidal than phenol. (U. S. Hygienic Laboratory.) A 1 per cent, solution of liq. cresol. co. is more effectively antiseptic than 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 injections. Lysol should be bought under the official name (liq. cresol. co.), as it is cheaper and more effective than lysol. Solutions do not roughen the surgeon's hands, and instruments submerged in them are not injured or obscured. The liquor cresolis compositus is perhaps the most widely used and valuable surgical antiseptic and disinfectant at our disposal. Betaxaphthol. C1()H O H. (U. S. P.) Synonym. — Naphthol, E. ; naphthol, B. P.; naphtholum, P. G.; naphthol-B, Fr.; beta naphthol, G. 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 (C1(JH7 H SOa). The latter acid is dissolved in water with milk of lime, and the resulting calcium salt is recovered by crystallization. The crystals are then dissolved in water and treated with sodium carbonate, when sodium naphthalin-sulphonate (C10 H; S03 Na) results. The latter is mixed with fused sodium hydroxide, when sodium naphtol (CV,H7 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 laminae, or a white, or yellowish-white, crystalline powder; having a faint phenol-like odor, and a pungent taste. Permanent in the air. Soluble in about 1000 parts of water, and in 0.8 part of alcohol; also soluble in ether, chloroform, glycerin, olive oil, or solutions of caustic alkalies. Dose.—H., 5ii-iii, (8-12); D., gr.i-x, (.06-.6). Actions and Uses. — Naphthol is a powerful disinfectant, antiseptic and parasiticide. It is said to be several times more germicidal than phenol. B-naphthol somewhat resembles carbolic acid in its toxic effect. It irritates the mucous membranes, causing sneezing and coughing in the respiratory tract, nausea and diarrhea when swallowed, and acute ne- phritis, with inflammation of the urinary tract and strangury in its elim- ination. It is a useful application externally for mange and ringworm. 254 INORGANIC AGENTS I* Betanaphtholis gr.l. Adipis 3i. M. S. Apply externally. Internally it is employed to kill round and tapeworms, and as an antiseptic in intestinal fermentation. Against hookworm in dogs 10 gr. are given in capsules, repeated in 2 hours, preceded by fasting and a laxative, and followed by castor oil. Oil of chenopodium is more effec- tive. Naphthol should be given in keratin coated pill (to avoid irritating the stomach), or capsules, to dogs, and in ball to horses. Methyl Bute. Pyoktanin. (Non-official.) Occurs in small indigo-colored crystals, slightly soluble in water, freely solu- ble in alcohol. It is often contaminated with arsenic and should be perfectly pure when used in medicine. It is slightly antiseptic and astringent. Methyl blue is used in the treatment of catarrhal and purulent conjunctivitis, eczema of the lids and blepharitis as follows: Methyl blue gr.ss. Aquae destillatae gi. M. S. Drop in eye 3 times daily. Methyl blue is a favorite preparation for the cure of small wounds, galls, and chafes in veterinary practice as below. The purple staining of the skin may be removed by washing with soap and water and alcohol. Methyl blue gr.ss. Tincturae iodi TTtxx. Unguenti zinci oxidi. Petrolati aa 5ss. M. S. Apply externally. Resorcixol. C0H6O2. (U. S. P.) Synonym. — Resorcinum. Resorcin. Metadioxybenzol, E. ; resorcine, Fr. ; resorcin, G. Derivative. — A diatomic phenol formed by the action of fuming sulphuric acid upon benzine, whereby benzine metadisulphonic acid [CtiH4 (H S 03)2] 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 nitrate evaporated to dryness. The residue is heated with sodium hydrate, with the formation of sodium resorcin [C6H4 (O Na)2]. Sulphurous acid is driven off from sodium resorcin by boiling, and the result is extracted with ether; impure resorcin is recovered by distillation, and is purified by sublimation or by recrystallization from water. Properties. — Colorless, or nearly colorless, needle-shaped crystals, or as a powder; having a faint, peculiar odor, and a sweetish, followed by a bitter, taste. It acquires a pink tint on exposure to light and air. Soluble in 0.9 part of water, and in 0.9 part of alcohol; freely soluble in ether or glycerin, and slightly soluble in chloroform. Dose.—H., 3iv-vi, (15-24); foals and calves, 5ss-i, (2-4); D., gr.ii-v, (.12-.3). Action and Uses. — Resorcin was originally employed as an anti- pyretic, but is not now used for this action, being too depressing to the heart. It is an efficient antiseptic, externally and internally; possesses a slight local anesthetic effect, and a milder action, topically, than phenol. FORMALDEHYDE 255 Resorcinol is chiefly used in skin diseases to cure itching, scaling and induration in subacute and chronic eczema and psoriasis. It may be combined with zinc ointment (1 to 8). Resorcinolis. Zinci oxidi aa 3i. Unguenti aquae rosae ox. M. (and heat to melt resorcinol crystals). S. Apply to skin twice daily, or is used in solution with glycerin and lime water, as follows : To relieve itching in erythematous eczema. Resorcinolis gr.xxx. Glycerini 5ss. Liquoris calcis 3n M. S. Apply externally. Internally, resorcin is of worth in diarrhea and fermentation. Formaldehyde. C H2 O. (Non-official.) Synonym. — Formic aldehyde. Derivation. — Obtained by partial combustion of wood alcohol, without igni- tion, by evaporation of the spirit in contact with a hot, platinized, asbestos plate. 2 C H3 O H + 02 = 2 C H O H+2 H20. Properties. — Formaldehyde is a pungent gas, having a spec. gr. of 1.6; soluble in water, forming a clear, colorless, stable solution when kept in glass-stoppered bottles, but volatilizing on exposure to the air. Formalin was the commercial name for an aqueous solution containing 40 per cent, of formaldehyde gas, but is now official. PREPARATION. Liquor Formaldehydi. (U. S. P.) Synonym. — Formol, formalin, E.; formaldehydum solutum, P. G.; solute d'aldehyde formique, Fr.; formaldehydlosung, G. Solution of formaldehyde. Containing not less than 37 per cent, of formalde- hyde gas. Action and Uses. — Formaldehyde and formalin are slowly acting microbicides. A 1 per cent, solution of formalin will kill Staphylococ- cus 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. choleras in less than 15 minutes. Clothes soaked in cultures of B. typhosus, S. cholerae 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 found that formaldehyde gas has wonderful disinfectant and penetrating properties, destroying all patho- genic bacteria in ordinary rooms containing the microorganisms buried under mattresses, between blankets, in clothing and other articles, in the air, dust, and morbid secretions. Harrington proved, however, that the penetrating power of formaldehyde 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, formaldehyde is the best gaseous disinfectant now known for the sterilization of infected premises. It does not kill insect pests, animal parasites or rats, but 256 INORGANIC AGENTS 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 tem- perature is below 50 degrees F. The premises containing the gas should be sealed from 4 to 24 hours. Formaldehyde vapor is extremely pungent and irritating to the mucous membranes, causing running of the nose and eyes in those exposed to its influence; but some experimenters have subjected animals to formaldehyde vapor (of disinfectant strength) for hours without causing their death. In Harrington's experiments two rabbits were killed by formaldehyde in the disinfection of a room, and exhibited the following post-mortem appearances: Congestion and hem- orrhage of the buccal mucous membrane; intense bronchitis with hyper- emia, and consolidation of the lung with a purulent and slightly fibrinous exudate. There was also congestion of the abdominal organs, includ- ing 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. Ammonia neutralizes the local action of formaldehyde solution, and that of the gas. The injection of 2 per cent, formalin in glycerin into badly infected and suppurating joints has proved curative in human surgery. From 2 to 4 drams are used, after aspiration, and the injection may be re- peated 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 irritant. Nausea, vomiting, coma with slow pulse, and death have followed its ingestion. The red blood cells are altered in form, and destructive changes have been noted in the liver and kidneys. Formaldehyde es- capes unchanged in the urine. Uses. — Internally formalin (oss-) has proved curative in acute tym- panites of cattle given in a quart of water and followed in an hour by Epsom salt (Healy and Nutter). In septicemia and purpura formalin (oi.) in a quart of sterile water, has been given intravenously by Mc- Clelland with reported success, and is advised by Frost (5i. by the mouth) in capsule or milk, in the treatment of bovine streptococcic mastitis. Formic aldehyde vapor is not injurious to clothing, metals, or other like articles, as is sulphurous anhydride or chlorine gas, and is commonly used in preference to other agents for the gaseous disinfection of premises infected with pathogenic bacteria. Formaldehyde gas may be generated by evaporating formalin in a vessel over a lamp, or other form of heating apparatus, or pouring it upon crystals of potassium per- manganate. According to Harrington the evaporation of 110 mils of formalin is sufficient to kill all pathogenic micro-organisms within 2^2 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 diam- eter 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 oc- curs. This should be done only in deep tin vessels to avoid the effects HEXAMETHYLENAMINE 257 of great frothing. This quantity of formalin and potassium permanganate is suitable for the 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 disinfection one may spray formalin in five per cent, solution with a force pump all over the floors, walls, fixtures, etc. Rubber gloves should be used to protect the hands. Formalin, in ^4 to 2 per cent, solution, has been used for surgical purposes, but, when used in sucli strength upon raw surfaces and mucous membranes 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 surgi- cal 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 appli- cation to raw surfaces or mucous membranes, and even in this dilution applications sometimes produce considerable pain and irritation and, for this reason, are contraindicated for ordinary surgical use. Success is reported from the use of formalin on sloughing surfaces of malignant growths and foul ulcers. A 4 per cent, solution is in- creased to 10 per cent, and finally to pure formalin, the solutions being applied on cotton saturated with the drug and retained on the part for thirty minutes each day. In 1-500 formalin is useful in grease heel applied on absorbent cotton and covered with bandage. 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. C6 (CH2)6 N4. (U. S. P.) (Urotropin, Urotropin.) Hexamine, B. P Urotropin occurs in colorless, lustrous, odorless crystals, or as a white, crys- talline powder, soluble in 1.5 parts of water and in 12 parts of alcohol; of a sweet afterward bitter taste, and slight alkaline reaction. It is made by com- bining solutions of ammonia and formaldehyde, and was first introduced into medicine by Nicolaier in 1895. Urotropin appears to be decomposed somewhat in the kidneys, but chiefly in the bladder in the presence of an acid urine, with the liberation of formaldehyde, and thus disinfects the urinary tract. It is, in fact, considered the best urinary antiseptic in human medicine and has been used with the greatest success in the treatment of all infectious diseases of the urinary passages, especially acute and chronic pyelitis and cystitis. It tends to render normal a putrid urine containing pus. This action is 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 acid sodium phosphate (D. gr.x. t. i. d.) or benzoic acid, should also be given. The sodium phosphate is incompatible with urotropin and so they should not be given at the same time. Urotropin is not an antiseptic in the body unless it is decomposed and sets free formaldehyde in sufficient amount. Thus sometimes the urine (after ten grains t. i. d.) in man contains as much as 1 to 5000 formaldehyde, which is distinctly of antiseptic strength. 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 (Crowe). For this reason the drug has been employed to 258 INORGANIC AGENTS disinfect these parts. More recently Bumham (1912) has cast doubt on this treatment by failing to find formaldehyde in germicidal amount in any of the secretions (except urine) after ingestion of urotropin. It can now be bought more cheaply under its official name than by its trade name urotropin. It should be given in solution thrice daily. Dose.—H. & C., 5ii-iv, (8-15); D., gr.v-x, (.8-.6). Class 7. — Miscellaneous Carbon Compounds Acidum Hydrocyanicum Dilutum. Diluted Hydrocyanic Acid. H C N. (U. S. & B. P.) Synonym. — Prussic acid, acidum hydrocyanatum, s. borussicum, E.;* acide cyanhydrique, s. hydrocyanique, Fr.; cyanwasserstonsiiure, blausiiure, G. Derivation. — An aqueous solution containing not less than 1.9 per cent, nor more than 2.1 per cent, of HCN, and not more than 0.1 per cent, of HC1. Pre- serve in small, dark, amber-colored, well-stoppered bottles. Obtained by distil- lation of potassium ferrocyanide, 20; sulphuric acid, 8; and water, 65; into distilled water. The following reaction first occurs: K4 Fe C„ N„+2 H2S04 = 2 K2 S O4 + H4 Fe C6 N8; then on the application of heat, the hydroferrocyanic acid resulting in the first reaction reacts with the remaining potassium ferro- cyanide and sulphuric acid, as follows: H4 Fe C8 Nu-r-K4 Fe C8 Na+H- S 0,= 6 H C N+K2 S 04+K2 Fe Ca N„). Diluted hydrocyanic acid can also be made by mixing hydrochloric acid, 5; with distilled water, 55; silver cyanide, 6. Shake together in a glass-stoppered bottle. Ag C N + H CI = H C N+Ag CI. When the precipitate of silver chlo- ride falls, pour off the clear, supernatant fluid. Properties. — A colorless liquid, of a characteristic odor, resembling that of bitter almond. It is very unstable and is apt to be inert as obtained from ordi- nary drug stores. Incompatibles. — Salts of iron, copper and silver; sulphides and red mercuric oxide. Dose.— H. & C, nixx-xl, (1.3-2.6); Sh., TTlx-xv, (.6-1); Sw., ITUi-v, (.12-.3) ; D., TTU-iii, (.06-.2). Action External. — Prussic acid is absorbed to some extent through the unbroken skin; paralyzes the peripheral sensory nerves, and acts as a local anesthetic. If the finger 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 consti- tutional action. Action Internal. — Alimentary Canal. — Hydrocyanic acid exerts a sedative effect upon the mucous membrane of the stomach and upper por- tion of the digestive tract. It is absorbed into the blood, but we are ignorant of its fate or mode of elimination. Blood. — In poisoning, the blood becomes first of a bright arterial hue, and later assumes a dark, venous color. The first condition is due to the fact that the tissues do not absorb oxygen owing to changes which interfere with cell respiration, or, in other words, to inhibition of the oxidizing ferments, oxidases, of the cells which enables them to utilize the oxygen of the blood. The dark color of the blood is probably owing to asphyxia and accumulation of carbonic dioxide, following the paralytic action of prussic acid upon the respiratory centre. A substance called cyanohemoglobin is formed outside the body by hydrocyanic acid when shaken with blood. The acid appears to deoxydize the normal oxyhemo- *Scheele's prussic acid contains 4 to 5 per cent, of the pure hydrocyanic acid. PRUSSIC ACID 259 globin, and blood thus treated has no ozonizing property. Cyanohemo- globin was thought to account for the action of prussic acid, but it does not exist within the body in the blood of poisoned animals. The red blood corpuscles are altered in shape by the action of prussic acid upon blood withdrawn from the vessels. They generally become rounder, then granular, and finally disintegrate and liquefy. But these changes do not occur in the blood during life. The general action of prussic acid is altogether independent of any influence upon the blood, since the same toxic effect is produced upon the bloodless, or "salt frog" (vessels con- taining 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, respi- ratory and vasomotor centres — and then paralyzes the whole nervous system. The brain, cord and nerves become paralyzed by large doses. The toxicity of prussic acid on the nervous system has been shown by Loeb to be due to interference with the oxidation processes in proto- plasm. The convulsions occurring in poisoning are shown by experi- ments to be due probably to stimulation of the hind-brain. The spinal cord is paralyzed at a period after coma and convulsions have appeared. The peripheral nerves and muscles are paralyzed directly by toxic doses, and not through the mediation of the central nervous apparatus. This is proved by shutting off the blood supply containing the drug, from a frog's leg, and leaving the nervous connections intact, when no effect of prussic acid is observed upon the limb. Heart and Blood Vessels. — Death sometimes occurs instantaneously from large lethal doses of prussic acid, owing to diastolic arrest of the heart. This action is due probably to paralysis of the heart (interfer- ence with oxidation processes). Moderate non-toxic doses stimulate the vagus centre of the medulla, without diminishing the force of the heart. When the vagi are previously divided, this action does not occur, but after large doses slowing of the heart is observed whether the vagi are cut or not; thus showing that the heart muscle is directly influenced. Moderate doses of prussic acid first stimulate, and then depress the vasomotor centres. Arterial pressure is therefore primarily raised con- siderably, but this is followed by a fall to, or below, the normal. Toxic doses stimulate the vasomotor centres very briefly, and this action is succeeded by profound depression and paralysis of the centres, accompanied by a great diminution of blood tension. Respiration. — Inhalation of the pure acid will cause death in a con- fined atmosphere, and even inhalation of the medicinal solution will induce the physiological symptoms of the drug. Therapeutic doses stim- ulate the respiratory centre so that the breathing becomes quicker and deeper. Toxic doses depress and paralyze the respiratory centre, its ganglion cells being so altered by the poison as to be unable to utilize oxygen. The breathing then is slow and deep. In the latter stage of poisoning, the breathing is feeble and shallow, and only occurs at long intervals. If death does not supervene immediately from diastolic ar- rest of the heart, it comes on more slowly by asphyxia. The respiratory 260 INORGANIC AGENTS movements become less frequent and forcible, the animal giving an occa- sional 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 centres con- trolling the heart, respiration and vessels. It acts as a poison by inter- fering with oxidation processes in the body. Topically applied, hydro- cyanic acid also paralyzes nerves and muscles, and acts therapeutically as a local sedative and anesthetic. Toxicology. — 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 animal survives for a few minutes, and we observe the following symptoms in dogs: The animal falls, froths at the mouth, the respiration is of a gasping character and occurs at infrequent intervals. There is unconsciousness, the pupils become dilated, there are muscular tremblings and clonic 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. Second: the pupils dilate, vomiting may occur, and the animal utters loud cries. Spasmodic defecation, micturition and erections may be present, with convulsions and unconsciousness. Third: the last stage is characterized by collapse, spasms, general paralysis and 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-quar- ters of an hour. Occasionally dogs continue to be paralyzed for several days and get well. The minimum fatal dose recorded in man is x% of a grain of pure acid, or about 50 drops of the medicinal solution, and the same for dogs. Four to five drams of the diluted acid fre- quently, but not invariably, cause subacute poisoning and death, in hqrses, within an hour. One to two drams of the pharmacopeial prep- aration usually kill dogs within ten minutes. Prussic acid is commonly used to destroy the domestic animals, but the intrathoracic injection of strychnine is often preferable for the de- struction of the smaller animals. Two to four drams of the medicinal acid are to be given to dogs and cats of the ordinary size, and certain, painless, and rapid death will occur if a fresh preparation of the drug can be obtained. The unopened half-ounce vial, kept by druggists, is recommended. Big dogs, horses, and the other larger animals are not killed rapidly, nor sometimes at all, by great quantities of the diluted acid. Hence, shooting is a more humane and preferable mode of deatl for them. In the experience of the writer, one to two drams 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 POTASSIUM CYANIDE 261 staring; the pupils dilated; the teeth are clinched tight and covered with froth, while the blood is of a very dark color. The treatment embraces hydrogen peroxide by mouth; emptying the stomach by large doses of promptly acting emetics, or by the stomach tube, or pump; atropine, ether and brandy subcutaneously, and inhalations of ammonia, together with artificial respiration, and hot and cold douches upon the chest. Uses. — Prussic acid is indicated for three therapeutic purposes: 1. To relieve gastric pain and vomiting, by its 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 value, but is occasionally used in veter- inary 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 verminous bron- chitis the medicinal acid may be given by inhalation (5 ss. in § i. of water) to calves, or internally (TT\,xv.) to assuage coughing and to kill the lung worms. Chloroform inhalations are more efficient. Prussic acid is a dangerous remedy for use in relieving itching unless the dose is carefully regulated. Ten minims of the acid, with gr. *4 of corrosive sublimate to the ounce of water, is efficient in pruritus in the larger ani- mals in amounts not larger than this for single applications, and not larger than half this for the smaller patients. Potassii Cyaxidu3i. Potassium Cyanide. K C N. (B. P.) Synonym. — Cyanure de potassium, Fr. ; cyankalium, G. Derivation. — Made by heating together potassium ferrocyanide and carbonate. Properties. — White, opaque, amorphous pieces; or a white, granular powder, odorless when perfectly dry, but in moist air exhaling the odor of hydrocyanic acid. Taste sharp and alkaline, and in moist air the salt deliquesces. Reaction very strongly alkaline. Solutions stain and destroy clothing. Soluble in about 2 parts of water; sparingly soluble in alcohol. Dose.— H., gr.i-ii, (.06-.12) ; D., gr.TV, (.006). Action and Uses. — Potassium cyanide is transformed, in the stom- ach 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; by 1 to 2 drams in horses; while 9 ounces were required to kill an elephant. Prunus Virginiana. Wild Cherry. (U. S. P.) Synonym. — ficorce de cerisier de Virginie, Fr. ; wildkirschenrinde, G. The bark of the wild cherry, indigenous in the United States, contains a fer- ment (emulsin) which, in the presence of water, acts on a glucoside (amygdalin, Cuo Hjt N Ou) contained in the bark, with the formation of hydrocyanic acid, glucose and a volatile oil. A fluidextract, infusion and syrup of prunus vir- giniana 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 hydrocyanic acid is more reliable, but syrupus pruni virginianae (U. S. P.) may be used as a vehicle for more efficient remedies, as follows: 262 INORGANIC AGENTS Ammonii chloridi 3iss. Syrupi scillae co gi. Syrupi pruni virginianae ad §iv. M. Sig. One teaspoonful for dogs for cough and bron- chitis. Repeat every 2 or 3 hours. Petrolatum. (U. S. P.) (Three varieties.) 1. — Petrolatum. Petrolatum. (U. S. P.) * Synonym. — Vaseline, cosmoline. Derivation. — A purified mixture of semi-solid hydrocarbons, obtained from petroleum. Properties. — An unctuous mass, varying in color from yellowish to light am- ber, having not more than a slight fluorescence, even after being melted; trans- parent in thin layers, completely amorphous, free or nearly free from odor or taste. The melting point of petrolatum ranges between 38° C. and 54° C. Spec, gr. 0.820-0.865. In other respects soft petrolatum has the solubility of liquid petrolatum. 2. — Petrolatum Liquidum. Liquid Petrolatum. (U. S. P.) (2 varieties, heavy and light.) Synonym. — Liquid paraffine, paraffine oil, E.; paraffinum liquidum, B. P.; P. G.; paraffine liquide, huile de paraffine, Fr. Derivation. — A mixture of liquid hydrocarbons, obtained from petroleum. Properties. — A colorless, oily, transparent liquid, without odor or taste when cold; or giving off, when heated, a faint odor of petroleum. Spec. gr. 0.828 to 0.905. Insoluble in water; scarcely soluble in cold or hot alcohol, or cold dehyd- rated alcohol; but soluble in boiling absolute alcohol, and readily soluble in ether, chloroform, carbon disulphide, oil of turpentine, petroleum, benzin, benzene, and fixed and volatile oils. 3. — Petrolatum Album. White Petrolatum. Petrolatum wholly or nearly decolorized. White or faintly yellowish unctu- ous mass, transparent in thin layers even after cooling to 0° C. ; completely amorphous. Otherwise it resembles, in solubility, petrolatum. Action and Uses. — Petrolatum is a valuable emollient. It soothes, protects and softens parts to which it is applied, and is superior to ani- mal and vegetable fats and oils in not becoming rancid, and therefore irritant and malodorous. Petrolatum may be used alone, -or as an ex- cipient 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. Petro- latum exerts a demulcent action upon the mucous membrane of the ali- mentary tract, and may be prescribed in electuary or capsule in inflamma- tion thereof. Liquid petrolatum is useful given internally in constipa- tion and in piles (Dogs and cats, 5ii-iv b. i. d.) to soften the feces. It is also very serviceable with menthol and camphor (aa gr.xv. to §i.) dropped in the nostrils (with a medicine dropper) for dogs with coryza. Petrolatum is sold universally under the proprietary 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 surfaces and sores. It is one of the most useful ETHYL CHLORIDE 263 agents in lubricating instruments, protecting metal from rust, preserving leather, and is sometimes employed as a vehicle for electuaries. Aethylis Chloridum. (U. S. P.) C2 H5 CI. Synonym. — Ethyl chloride, E. ; chlorure d'ethyle, Fr.; aethylchlorid, G. Ethyl chloride is a colorless, mobile, very volatile liquid, having a charac- teristic, ethereal odor, and a burning taste; slightly soluble in water but readily soluble in alcohol. It is made by the action of HC1 gas upon absolute ethyl alco- hol. It is usually sold in glass tubes with a screw or lever-spring metal top enabling the fluid to be sprayed upon the surface of the body in any desired amount. On account of its great volatility and rapid evaporation it abstracts heat and freezes a part, and so acts as a local anesthetic. It is convenient for minor surgical operations, as opening abscess or boil, or for aspiration. The vapor is very inflammable. Ethyl chloride is also used to produce transient, general anes- thesia. 1 or 2 drams 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 frequently as a preliminary to ether in human practice and is more agreeable to inhale. Plenty of air should be allowed, except at the outset. PART II. VEGETABLE DRUGS. SECTION I.— DRUGS ACTING UPON THE BRAIN. Opium. Opium. (U. S. & B. P.) Synonym. — Opium in E., Fr. and G. Derivation. — The air-dried, milky exudation obtained by incising the unripe capsules of Papaver somniferum Linne and its variety album De Candolle (Fam. Papaveraceae), and yielding in its normal, moist condition, not less than 9.5 per cent, of anhydrous morphine. Opium is procured from Turkey, Asia Minor, Persia, India and Egypt. The Smyrna, or Turkey opium is the more common variety used in the United States. It occurs in irregular, globular masses, cov- ered with poppy leaves and capsules of a species of dock, weighing from x/z to 1 pound. Properties. — In more or less rounded, mostly somewhat flattened masses of variable size, but usually about 8 to 15 cm. in diameter; externally grayish- brown, covered with fragments of poppy leaves; more or less plastic when fresh, becoming hard and brittle on keeping; infernally dark brown, interspersed with lighter areas, somewhat lustrous; odor characteristic, narcotic; taste bitter, characteristic. It yields its medicinal properties to water, alcohol, and diluted acids, forming dark brown solutions. Ether extracts its principles in part. Constituents. — There are nineteen or more alkaloids; the three first are used in human medicine, but narceine is of no value in veterinary medicine. Morphine. Codeine. Narceine. 2.5—22.8 per cent. .2 — .7 per cent. .1 — .7 per cent. Thebaine. Narcotine. Papaverine. .15 — 1. per cent. 1.3 — 10. per cent. 1. per cent. In addition to these, the following exist in minute quantity, but some are merely "pharmaceutical curiosities": — Protopine. Organic Acids. Cryptopine. Meconic Acid. Oxynarcotine. Lactic Acid. Hydronarcotine. Pectin. Laudanosine. Gum. 50. per cent. Laudaine. Resin. Phaeadine. Glucose. Codamine. Fixed Oils. Meconodine. A Volatile Oil. Gnoscopine. Odorous Bodies. Lanthopine. Caoutchouc. Water. 15. — 25. per cent. Ammonium Salts. Neutral Bodies. Calcium Salts. Meconin. Magnesium Salts. Meconoisin. 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., 3i-ii, (4-8); C, 5ii-iv, (8-15); Sh., gr.x-xxx, (.6-2); Sw., gr.v-xx, (.3-1.3); D., gr.ss-iii, (.03-.2). Opii Pulvis. Powdered Opium. (U. S. P.) Opium dried at a temperature not exceeding 70° C, and reduced to a very opium 265 fine powder and yielding not less than 10 nor more than 10.5 per cent, of an- hydrous morphine. Only those preparations are mentioned here which are applicable to veterinary practice. Dose. — Same as for opium, but preferable to the crude drug. PREPARATIONS. Extractum Opii. Extract of Opium. (U. S. & B. P.) Powdered opium, 100; starch; distilled water, a sufficient quantity. Made by maceration, percolation, evaporation, and addition of starch. Assayed to con- tain 20 per cent, of morphine. (U. S. P.) Dose. — About one-half that of powdered opium. H., 3ss-i, (2-4) ; C, 3i-ii, (4-8); Sh., gr.v-xv, (.3-1); Sw., gr.iiss-x, (.15-.6); D., gr.%-iss, (.015-.09). Pulvis Ipecachuanhw et Opii. Powder of Ipecac and Opium. (U. S. P.) Synonym. — Dover's powder, E.; pulvis ipecacuanha? 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 diaphoretic compound of opium. Dose.— H., 3ssi, (15-30); D., gr.iii-xv, (.2-1). Tinctura Ipecacuanhas et Opii. Tincture of Ipecac and Opium. (U. S. P. 1905.) 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 Opii. Tincture of Opium. (U. S. & B. P.) Synonym. — Laudanum, tinctura meconii, tinctura thebaicae, E.; tinctura opii simplex, P. G. ; teinture d'opium, teinture thebaique, Fr.; einfache opiumtink- tur, G. Granulated opium, 100; alcohol, 400; water, 400; diluted alcohol to make 1000. Made by maceration and percolation. Assayed and standardized to con- tain 1 Gm. of anhydrous morphine in 100 mils. (U. S. P.) Dose.— H., 5i-ii, (30-60) ; C, 5ii-iii, (60-90) ; Sh. & Sw., 3ii-vi, (8-24) ; D., TTtiii-xx, (.2-1.3). Tinctura Opii CampJiorata. Camphorated Tincture of Opium. (U. S. P.) Synonym. — Tinctura camphorae composita, B. P.; paregoric, elixir pare- goricum, paregoric elixir, E.; tinctura opii benzoica, P. 6.; teinture d'opium camphree, Fr. ; benzoesaurehaltige 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., 5i-iv, (4-15). Opium Deodoratum. Deodorized Opium. (U. S. P.) Synonym. — Opium denarcotizatum. Powdered opium, 500; purified petroleum benzin, q. s. Made by repeated maceration, agitation and percolation with purified petroleum benzin. The petro- leum benzin removes narcotic and odorous principles, which cause nausea and disagreeable after-effects in opium. Contains 10-10.5 per cent, of morphine. Dose. — Same as powdered opium. The eighth edition of the U. S. P. introduced Opium Granulatum (granulated opium) ; made by drying opium at a temperature not exceeding 70° C. and reducing it to a coarse (No. 8 to 20) powder. It should not yield less than 10 not more than 10.5 per cent, of anhydrous morphine. Dose. — Same as deodorized opium. Tinctura Opii Deodorata. Tincture of Deodorized Opium. (U. S. P.) Granulated opium, 100; purified petroleum benzin, 75; alcohol, 200; water to make 1000. Made by maceration and percolation with water, agitation with puri- fied petroleum benzin, and evaporation. Assayed and standardized to contain 1 Gm. of anhydrous morphine in 100 mils. Dose. — Same as tincture of opium, but less nauseating. Extractum Opii Liquidum. (B. P.) (Contains three-fourth of one per cent, of morphine.) Dose. — Same as laudanum. 266 VEGETABLE DRUGS Vinum Opii. (U. S. P.) Dose. — Same as laudanum. Morphtna. Morphine. C17 H19 N 03 + H20. (U. S. & B. P.) Synonym. — Morphia, E.; morphine, Fr. ; morphium, morphin, G. Derivation. — An alkaloid obtained from opium. 1. Macerate opium in cold water, forming a solution of morphine meconate. 2. Add calcium chloride to precipitate calcium meconate and resins. 3. Evapo- rate solution remaining, which contains morphine hydrochlorate, till it crystallizes; press in flannel to remove narcotine and coloring matter; redissolve; filter; evapo- rate and crystallize repeatedly. 4. Decolorize by digestion with charcoal. 5. Precipitate with ammonia and wash, when pure morphine is separated from codeine. Properties. — Colorless or white, shining rhombic prisms, or fine needles, or crystalline powder; odorless and having a bitter taste; permanent in the air; soluble in 83 10 parts of water, in 210 parts of alcohol. Dose. — Same as salts of morphine, but the latter are preferable on account of their solubility. Morphin.e Hydrochloridum. Morphine Hvdrochloride. C17H1H03 N H Cl-f 3 H.,0. (U. S. & B. P.) Derivation. — Morphine is stirred with hot distilled water, to which hydro- chloric acid is gradually added. Morphine hydrochlorate crystallizes out on cooling. Properties. — White, silky, glistening needles or cubical masses, or a white, crystalline powder, odorless, and having a bitter taste; permanent in the air. Soluble in 17.5 parts of water, and in 52 parts of alcohol. Soluble in glycerin; insoluble in ether and in chloroform. Incompatibility. — Incompatible with all agents containing tannin, alkaline carbonates, lime water, salts of copper, mercury, zinc and lead; and with Fowler's solution of arsenic. Dose.— H. & C, gr.ii-x, (.2-.6) ; Sh., gr.ss-ii, (.03-.12) ; Sw., gr.^-^, (.006-.03); D., gr.%-%, (.008-.03). Subcutaneously.— H., gr.iii-iv, (.2-.25) ; D., gr.%-%, (.008-.03). 124 parts of morphine hydrochloride correspond to 100 parts of morphine. Morphix^e Sulphas. Morphine Sulphate. (C1tHihO;. N)2 H2S 0, + 5 H20. (U. S. & B. 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. Soluble in 15.5 parts of water, and in 565 parts of alcohol at 25° C; insoluble in ether and chloroform. Dose. — Same as hydrochloride. 125 parts of morphine sulphate correspond to 100 parts of the pure alkaloid. The official salts of morphine may be used 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 Morphine Hydrochloride (B. P.) (One per cent, morphine.) Dose.— H., 3vi-3ii, (25-60); D., 1u_x-3i, (.6-4). Liquor Morphine Acetatis. (B. P.) Same strength and dose as above. Injectio Morphinje Hypodermica. (B. P.) (One per cent, morphine.) Dose. — Same as liquor morphini hydrochloride SUPPOSITORIA MORPHIX.E. (B. P.) (Gr. V2 morphine.) Dose. — Dog, 1 per rectum. Codeika. Codeine. C13H2103N + H20. (U. S. & B. P.) Derivation. — An alkaloid obtained from opium by evaporation of the ammo- OPIUM AND MORPHINE 267 niacal 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 evaporation. Properties. — Colorless, transparent, rhombic prisms, or a crystalline powder; odorless, and having a faintly bitter taste; slightly efflorescent in warm air. Solu- ble in 120 parts of water, 2 parts of alcohol, 18 parts of ether, and 0.5 part of chloroform at 25° C. Codeine sulphate commonly used. Dose.— D., gr.^-ii, (.015-.12). Heroin. (Diacetylmorphine.) (Non-official.) This remedy, derived from morphine, was first introduced by Dreser, in 1898, and is used extensively in human medicine as a substitute for morphine and codeine. Heroin occurs as a white, odorless, crystalline powder, possessing a slightly bitter taste and alkaline reaction. Practically insoluble in water, but readily soluble in weak acidulous solutions. Heroin hydrochloride is a white, crystalline, odorless powder, soluble in 2 parts of water. Experiments by Heinz show heroin to be 30 times more de- pressing to the respiration than codeine, and 5 times more depressing than mor- phine (also 5" times as toxic as morphine in dogs), while it also has a depressing effect upon the circulation (Hale). Whether it is superior to codeine in relieving cough is a question. The drug acts as a general motor depressant, hypnotic and analgesic, but is not comparable to morphine in these respects. The after-effects of small medicinal doses (nausea, constipation, etc.) are slight. Heroin is em- ployed in the treatment of all varieties of cough affecting the human subject, and in canine practice. Codeine is preferable in the author's experience. 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.1/24-1/6 (.0025-.01); horse, gr.ss-ii, (.03-.12). 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. Absorption read- ily 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. Thus in dogs and cats under morphine the X-ray shows retention of food in the stomach for 8 to 24 hours owing to pyloric spasm. On the other hand, large doses of morphine subcutaneously cause immediate vom- iting in dogs and cats. Secretions all over the body are decreased, except that of sweat. The action upon the alimentary tract in lessening secre- tion, is partly a local one and partly constitutional, following the absorp- tion of the drug. The mouth is made dry, thirst is increased and appe- tite impaired. Opium is absorbed rather slowly from the stomach and bowels, and causes delay in the passage of ingesta, especially in the jeju- num, and therefore constipation. Constipation is such a marked effect of opium that it is called the "bowel splint". This action is partly due to retention, and more complete digestion in the stomach, but mainly to local depression of nerve centres (Auerbach's plexus) in the intestinal walls by opium, as the effect is same when the bowel is separated from the cen- tral nervous system. 268 VEGETABLE DRUGS In diminishing both secretion and motion, opium causes constipa- tion in health, but is most useful in relieving vomiting and diarrhea. In toxic doses, opium may induce diarrhea, and this almost invariably occurs after large doses of morphine subcutaneously (gr. i.) which the author uses in preparing dogs for operation under ether — when little of the latter is required. This action may be due to stimulation of the intestinal muscle. Blood and Elimination. — After morphine has been injected under the skin of a dog it may be foundin the mouth and stomach within a few minutes. Some 30% is eliminated by the stomach, and nearly 40% by the feces. It is probably reabsorbed and resecreted in the digestive tract. Traces are found in the milk, sweat and urine, while that re- maining in the body is oxidized into the innocuous oxydimorphine. Mor- phine wholly disappears from the body in two days. Nervous System. — The most important action of opium is exerted upon the nervous system. It is necessary to study the drug from the comparative standpoint in order to obtain a full understanding of its effects. The brain of man, being more highly developed and sensitive, in comparison with other parts of the nervous system, than the brain of the lower animals, it follows that this organ is more powerfully in- fluenced 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, andthe influence upon dogs approaches more nearly that seen in human beings, only that a relatively greater dose is required to produce the same result, as the brain is not so highly organized or sensitive to the action of 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 devel- oped a part is, the more easily is it influenced by therapeutic agents. Opium exerts first a stimulating, and then a depressing action upon the brain and spinal cord, and in studying the action comparatively it will be noted that the influence upon the cord in the frog, horse, rumi- nant, and to some extent in the dog, preponderates frequently over the effect of the drug upon the brain, for the reasons stated above. Action on the Frog. — In non-poisonous doses, sleep is produced and diminished spinal reflex activity, followed by a period of reflex excite- ment. Toxic doses of 1 or 2 grains of morphine, injected under the skin, cause at first a condition where convulsions occur, if the animal is artificially irritated; later they come on spontaneously. This state is followed by general paralysis, respiratory failure and death. The con- vulsions are shown to be due mainly to stimulation of the receptive and transmitting cells of the spinal cord, as in strychnine poisoning. OPIUM AND MORPHINE 269 Action on Horses. — Three grains of morphine, injected subcutane- ously, occasion sometimes drowsiness, and at other times produce no vis- ible 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 followed by increased excitement aggravated by noises, sweating, ptyalism, muscular rigidity, staggering gait, trembling and delirium; while still larger doses (four drams of the extract of opium) cause violent trembling, convulsions, insensibility to pain and external irritation, without coma; or (morphine, gr. 36 hypo- dermically), 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 21/? 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 cerebral and spinal motor centres; and in dilatation instead of contraction of the pupil. The rationale of the latter phenomenon has not been discovered. Action on Ruminants. — These animals are comparatively insuscep- tible to opium. Ounce doses of the drug cause, in cattle, restlessness, excitement, hoarse bellowing, dry mouth, nausea, indigestion and tympa- nites. Sheep are affected in much the same manner. One to two drams of morphine have led to fatality in cattle. Fifteen to thirty grains of the alkaloid kill sheep. Swine are variously influenced; sometimes ex- cited, sometimes dull and drowsy. Action on Birds. — Birds, as represented by chickens, ducks and pigeons, are exceedingly insusceptible to opium. This is chiefly due to the slow absorption from the crop. Pigeons cannot be given enough opium by the mouth to cause death, but 8 to 10 grs. of morphine by the mouth, or 2 or 3 grs. hypodermatically, will prove fatal. The toxic symp- toms in birds are exhibited by unsteadiness, difficult breathing and fail- ure of respiration, convulsions and death. The pupils are unaffected, and sleep does not ensue. Action on Dogs. — When 8 or 10 grains of morphine are given to a moderately sized dog, coma comes on, from which the animal may re- cover. One half a grain injected under the skin of a dog weighing 25 lbs., causes nausea, vomiting and often purging (not occurring in man), sleep deepening into coma, contracted pupils, and shallow breathing; the condition lasting for several hours and followed by recovery. Opium rare- ly exerts an hypnotic action upon cats, but rather motor excitement. Lethal doses (average, 1/6 grain of morphine sulphate subcutaneously 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, con- tracted 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 270 VEGETABLE DRUGS spirit, timidity, and nausea, lasting for several hours. The action of opium on dogs differs from that on man only in degree. The dose re- quired is proportionately larger. There are often more preliminary ex- citement and symptoms of reflex irritation, as muscular twitching. These animals do not sweat, and the pupils are not so continuously contracted 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 (% gr«) causes usually a sense of well-being, together with itching of the nose, and later, of the skin generally, dryness of the mouth (occasionally there may be nausea, vomiting and faintness), followed by sleep, or a pleas- ant, dreamy state. The senses are less keen, with poorer vision and inhibited perception of pain or touch. After-effects may be absent, or consist of nausea, dizziness, 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 mor- phine subcutaneously is the smallest fatal human dose recorded. (Ave- rage dose for man, gr. 1/4.) The action of opium upon man, as com- pared with that upon the horse and ruminants, is characterized by its predominant depressing effect upon the higher mental functions. The motor centres of the brain and cord are only slightly influenced. General Action of Opium Upon the Nervous System. — The action of opium on the nervous system may be summarized as follows: On the Cerebrum. — The predominant action of opium on man and the dog consists in depression of the higher brain centres with the pro- duction of nervous sedation and sleep. In the hind-brain depression of the perceptive centres gives relief from pain. In the fore-brain depres- sion 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, how- ever, 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, imagination being in- creased at the expense of reason and judgment. This stage is often wholly absent. In the lower animals — other than dogs — the sedative and hypnotic effect of opium is less certain and may be completely want- ing. In a general way small and moderate doses cause cerebral depres- OPIUM AND MORPHINE 271 sion, while large doses give rise to spinal reflex excitability in the lower animals — especially in the horse, ass, cattle and cats. Medulla. — Large medicinal doses stimulate the vagus and vasocon- strictor centres, and pupillary centre in man, and usually in dogs, while the respiratory and cough centres are depressed. On the Spinal Cord. — Small medicinal doses depress the motor cells, but large and toxic amounts stimulate the motor cells indirectly and cause convulsions — probably — as in strychnine poisoning — by in- creasing 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 or cats. The result of a fatal dose is paralysis of the central nervous system, including the respiratory and, to much less degree, the vagus centres. The unique and inestimable value of opium depends upon its ano- dyne action. Relief from suffering is often induced without the produc- tion of sleep. Muscular weakness is present in man and dogs, but even this evi- dence of depression may be absent in horses and ruminants, yet pain be effectually relieved. Initial stimulation of the vomiting centre may cause emesis; but, as depression of the centre rapidly ensues, the act becomes later im- probable. The excitability of the motor and sensory nerves is slightly increased, but otherwise the nerves are not affected except in poisoning, when the sensory, and later the motor nerves are paralyzed. The mus- cles remain uninfluenced. Respiration. — After large doses of opium respiration becomes slow and feeble. Death occurs from failure of the respiratory centres — partly due to their insensitiveness to C02 stimulation. Thus exagger- ated breathing, due to C02 accumulation, alternates with temporary arrest of respiration (Cheyne-Stokes breathing). Circulation. — Medicinal doses commonly produce little effect upon the heart. Large doses slow the heart's action, while toxic quantities depress the organ. The cardiac muscle may be slightly stimulated, with acceleration jpf the pulse, but depression soon follows more or less syn- chronously with stimulation of the vagus centre, so that the pulse be- comes infrequent. Toxic doses of morphine directly depress the rhythm, conductivity, and contractibility of the heart muscle, so that irregular- ity, and heart block occur in poisoning. Finally, before death, depres- sion of the inhibitory apparatus occurs, and this, coexisting with depres- sion of the heart itself, produces 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 unimportant. Immediately after the administration of large doses there is a primary stimulation, followed in the toxic stage by some depression of the vaso- motor centres in the spinal cord and medulla. 272 VEGETABLE DRUGS Pupil. — The pupil of the horse is widely dilated by large doses of opium. The pupil in the dog occasionally remains unchanged, and often dilated before undergoing contraction. Contraction of the pupil is a characteristic physiological effect of large doses of opium in man and the dog. In birds the pupil is unaffected. These various contradictory phenomena are at present inexplicable. Dilatation, preceding death, occurs from depression of the centre. Kidneys and Metabolism. — The excretion of urea appears to be dim- inished by opium in man, but varies greatly in animals. Temporary retention of urine may follow the administration of a considerable dose of opium, owing to spasm of the bladder sphincter. The amount of urine voided may be greater or less than normal; more commonly the latter. Opium lessens the secretion of bile. The elimination of carbonic dioxide is diminished by the hypnotic action of opium, but is increased if there is general excitement and muscular activity following the use of the drug. Depressed respiration and quiet will result in lessened oxidation and tissue waste. Secretions. — All the secretions except sweat are diminished by de- pression of the secretory center by opium. Sweating is often increased if opium is given in combination with heat externally. Skin. — Opium induces mild diaphoresis in man; occasionally sweat- ing occurs in horses, but not at all in dogs. Temperature. — The bodily temperature may be slightly increased by large medicinal doses of opium, but is diminished by toxic quantities. Toxicology. — The symptoms of poisoning have already been suffi- ciently described in previous sections. The treatment embraces irriga- tion of the stomach, or the use of emetics, as apomorphine hydrochloride 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, 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 drams 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 in- gestion of morphine salts. The antidote has been recommended to be given subcutaneously after absorption, or hypodermic injection of mor- phine, but this is not of the slightest use. Morphine Contrasted with Opium. — Opium is more constipating, more sudorific, and more apt to disturb the digestion than morphine. Morphine is more anodyne and soporific; more readily absorbed and more suitable for use hypodermically. Synergists. — Belladonna aids the action of opium and yet is antago- nistic to it. It assists opium in its anodyne action and lessens nausea, CODEINE 273 indigestion, and constipation and counteracts the depression of opium on the respiration. 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 sopo- rific 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 follow- ing its administration. Opium often acts profoundly when combined with chloral, and this combination is occasionally used to induce anes- thesia (p. 239). 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 diar- rheal disorders. Codeine. — Codeine in large doses causes motor excitement and con- vulsions in dogs and cats. Codeine is inferior to morphine as an ano- dyne and hypnotic, but is a useful sedative in relieving bronchial irrita- tion and cough, and in the doses commonly employed does not induce constipation. Codeine differs from morphine in not being nearly so de- pressant to the respiration, and in not lessening secretion in the intes- tines (absence of constipation) and bronchioles. The writer would par- ticularly recommend it for dogs suffering with bronchitis, combined with phenacetin in powder or tablet. The other alkaloids of opium are not of sufficient therapeutic value to warrant their consideration in this work. Administration. — Morphine sulphate is employed hypodermically where an immediate effect is required. The preparations more frequently used in veterinary practice include laudanum and the deodorized tincture, powdered 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 diaphoretic action of ipecac with the sedative, antiphlogistic and sudorific 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 results in diarrhea, when given in pill or ball. Enemata composed of thin, boiled starch solution and laudanum at the body temperature are to be recommended in diarrhea of the young, dysentery and pain arising from strangury or disease of the genito-urinary organs. Opium suppositories are .of value in canine practice for the same purposes, and will relieve irritation and pain caused by piles. Uses External. — Opium is applied externally in various ways. In the form of laudanum it is sprinkled on poultices and prescribed in lini- ment (laudanum and soap liniment, equal parts) for its anodyne action. On raw surfaces, sores and ulcers, laudanum is often combined with lead water (1-25). Opium relieves pain by depressing nerve centres. It does not appear to have any action upon peripheral nerves (Cushny, Bastedo). 274 VEGETABLE DRUGS Indications for the Internal Use of Opium 1. To relieve pain and spasm. 2. To lessen secretions and peristalsis. 3. To allay motor excitement, diminish muscular action, and cough, and prevent hemorrhage. 4. To abort inflammation. 5. To act as a stimulating and supporting agent. The sudorific action of the drug upon the lower animals is slight and comparatively unimportant. Among the preceding indications the first three naturally follow from the physiological action of opium, while the latter two are deduced solely from clinical experience. 1. Although the anodyne and sedative action of opium is not so marked in its influence upon veterinary patients as in human subjects, yet it is by far the most valuable agent we possess -for relieving pain of any description, particularly when combined with atropine. In spas- modic colic of horses, opium arrests pain by preventing irregular and violent peristaltic action. It may be given as morphine (with atropine), subcutaneously; or as laudanum, in a drench, simultaneously with an aloes ball. In this affection opium actually assists the action of the purgative by overcoming spasm. Anodyne in colic in horses. I* Tincturae opii 5n- Aetheris 3i- Chloi'ofornii 3i. M. S. Give at one dose in pint of cold water, and fol- low with physic ball. Pain directly antagonizes the effect of opium, and repetition of the dose is both justifiable and necessary until relief is obtained. Hypo- dermic 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 digest- ive canal. Opium is indicated in all forms of pain and in motor excitement in cerebritis and meningitis. The pains and spasmodic contractions re- sulting 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 mor- phine is injected subcutaneously. The injection of morphine under the skin may prove antidotal in strychnine 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 hypodermically 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 OPIUM AND MORPHINE 275 After the animal has once been etherized the author has frequently done gastrojejunostomy 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 inhibited by the action upon secretion and motion, and opium should not be adminis- tered immediately after the ingestion of food, unless the demand for it at that time is imperative. Laudanum or morphine is also valuable in preventing threatened abortion, and in the treatment of after-pains and post-partum hemorrhage in mares, cows and bitches. Excessive vomiting in dogs may be combated with opium and bis- muth, or with morphine hypodermically. Opium quiets peristalsis and secures rest of the canal in gastritis and gastro-enteritis. In superpur- gation 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 intes- tinal antiseptics in various combinations, suited to the particular case. The following formulae are useful in diarrhea of horses and cattle. I* Tincturae capsici. Spiritus menthae piperitae aa 3vi. Spiritus camphorae. Tincturae opii aa oyi- M. Sig. 4 tablespoonfuls 3 times daily in pint of water. Pulveris opii. Pulveris gambir aa 3vi. Cretae praeparatae. Pulveris zingiberis. Sodii bicarbonatis aa oyi- M. et divide in chartulas No. vi. S. Give one powder in boiled flour gruel night and morning; one-third of dose for calves. Opium in diarrhea of dogs. Tincturae opii camphoratae 3vi. Misturae creta ad §iii. M. Sig. One tablespoonful in water every 3 hours after dose of castor oil. Peritonitis, enteritis, and acute obstruction of the bowels are treated most successfully with opium, which quiets the bowels, relieves pain and facilitates the vis medatrix naturae, besides acting as an antiphlogistic in the first mentioned diseases. By preventing muscular activity and allay- ing general excitability, opium is the most effective hemostatic in all internal hemmorhages, and it quiets the heart most effectively in acute endocarditis. 276 VEGETABLE DRUGS 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 re- tained secretions, opium is distinctly contraindicated, since it depresses the respiratory centres and lessens the irritation produced by the secre- tions in the bronchial tubes, which would otherwise cause coughing and expulsion of the exudate. Morphine sulphate (gr. 1/10 to gr. l/6) may be given in chloroform water every 3 hours in troublesome cough in house dogs. Opium in cough. Horses. Ammonii carbonatis. Ammonii chloridi aa 3i. Morphinae sulphatis gr.iv. Glycerini 3ii. Aquae : ad 3ym- M. S. Tablespoonful in half pint of water t. i. d. Opium in cough in dogs. Codeinae sulphatis gr.x. Elixir terpini hydratis 3iii. M. S. Teaspoonful every 2 or 3 hours. Opium, especially when combined with belladonna, notably dimin- ishes secretions, so that this combination is peculiarly appropriate in the treatment of cough and exudation, and it is only when increasing moist rales (pulmonary edema) are found to exist during this medication that it should be stopped. Pleuritic cough causes intense pain and accom- plishes nothing, so that opium here affords great relief without inducing bad results. 4. Opium possesses antiphlogistic action in aborting and combat- ing inflammation. Reflex excitability is lessened by opium, and there- fore irritation of nerve centres, which would otherwise cause vascular dilatation, stasis, and inflammation, is prevented by the drug. This is at least the theory. Opium and quinine are the two remedies having the most popular clinical reputation for aborting colds and inflammation, and the latter agent also diminishes reflex excitability. Inflammation of serous membranes is thought to be that form most favorably influenced by opium, as peritonitis, enteritis and meningitis, for which purpose the drug is frequently combined with calomel. But opium is also an ex- tremely useful antiphlogistic remedy in coryza, bronchitis, pneumonia and pleurisy, and in inflammations of the mucous coat of the digestive canal, as gastritis and dysentery. A single full dose should be given at the earliest possible stage of these disorders, and the patient should be kept as quiet as possible to secure the best result. 5. Opium stimulates and supports the system in a manner not ex- plicable on physiological grounds. It often conserves life in a remark- APOMORPHINE HYDROCHLORIDE 277 able way in patients weakened by long continued disease and in those suffering from shock, loss of blood following surgical operation, parturi- tion, or other natural causes. . Contra-indications. — In respiratory diseases associated with cyano- sis 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. Apomorphinje Hydrochloridum. Apomorphine Hydrochloride. CjtH^O, N H CI. (U. S. & B. P.) Synonym. — Chlorhydrate d' apomorphine, Fr. ; apomorphinhydrochlorid, G. Derivation. — The hydrochloride of an alkaloid, obtained by heating morphine (or codeine) in hermetically closed tubes, with an excess of pure hydrochloric acid. The morphine thus loses one molecule of water ; C17H1903 N = C17H1702 N+H20. Properties. — Minute, white or grayish-white, glistening, monoclinic prisms, odorless, having a faintly bitter taste, and acquiring a greenish tint upon ex- posure to light and air. Soluble in 50 parts of water and 50 parts of alcohol; very slightly soluble in ether or chloroform. It should be kept in small, dark, amber-colored vials. (U. S. P.) Dose.— Subcutaneously. H., gr. % (0.045). Foals, gr. % (.03). Sh. & Calves, gr. % (.03). Cows, gr. 1% (.09). D., gr. 1/10-1/5 (.006-.012) as emetic. By the mouth, D., gr. 1/40-1/25 (.0015-.0024) as expectorant. PREPARATION. Injectio Apornorphince Hypodermica. (B. P.) Approximately one per cent. Dose.—n. & C, TTllxxv, (5); Sh. & Calves, TTlxl, (2.7); D., nix-xx, (.6-1.3). Action Internal. — Small doses (gr. 1/60-1/30) cause vomiting in dogs, while larger doses produce salivation and trembling in addition 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 en- sues from respiratory failure. Nervous System. — The drug primarily stimulates the brain and induces delirium and excitement, but secondarily causes cerebral par- alysis. The origin of the convulsions is not ascertained. Apomorphine is a direct local paralyzant to the muscles, acting upon their substance or upon the motor nerve endings. Circulation. — Medicinal doses do not alter the force, but may in- crease the rate and tension of the pulse by stimulation of the cardiac accelerator nerves and vasoconstrictor centre. Toxic doses paralyze the heart muscle and lower blood pressure. Respiration. — The respiratory movements are at first markedly in- creased by large doses of apomorphine, owing to stimulation of the respiratory centre. 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 expectorant. Vomitiny Centre. — This is stimulated by therapeutic doses of apo- 278 VEGETABLE DRUGS morphine, but paralyzed by toxic 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 administered along with zinc sulphate or other emetic in poisoning. In narcotic poison- ing, 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 violent expiratory efforts during vomition, and these tend to expel secretions, which is furthermore assisted by the action of the alkaloid in rendering the secretions less viscid. Chronic dry bronchitis of dogs is likewise benefited by apomorphine. In pica in cattle, 1^2 gr- may De given on three consecutive days or in recent cases, gr. iii. 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. iy2 in water by the mouth may cure the habit of plucking out the plumage. Injectionis apomorphinoe hypodermicae (B. P.), ^ii. Sig. Give once daily subcutaneously to cattle, 5iii; foals or sheep, 5i ; with licking disease. 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 often relieves choking by grain, etc., in animals by its relaxing spasm, producing retching and increasing secre- tion of the gullet. One grain may be injected under the skin in horses. It should be tried before using a probang, as, if successful, it will act within fifteen or twenty minutes. The alkaloid decomposes in crystal, and rapidly in solution, becom- ing toxic and of a green hue. Solutions should be freshly prepared. The addition of hydrochloric acid to solutions preserves them as in B. P. hypodermic solution. Class 2. — Stimulating the Brain Belladonnte Folia. Belladonna Leaves. (U. S. & B. P.) Synonym. — Deadly nightshade, E.; feuilles de belladone, Fr.; tollkraut, toll- kirschen blatter, wolfkirschen-bliltter, G. Derivation. — The dried leaves and tops of Atropa belladonna Linne (Farn- Solanaceae), and yielding not less than 0.3 per cent, of the total alkaloids of belladonna leaves. Usually much twisted and matted together; leaves much crumpled; when soaked in water and spread out, leaves 6 to 20 cm. long, 4 to 12 cm. broad. Odor distinct, especially on moistening; taste somewhat bitter and acrid. The powder is dark green. Constituents. — Two alkaloids; 1, atropine, the chief one, representing the action of belladonna; and, 2, hyoscy amine. Atropine is now considered to be an artificial product of hyoscyamine, and therefore the latter to be the natural alkaloid. Dose.— H. & C, §ss-i, (15-30); D., gr.i-v, (.06-.3). BELLADONNA 279 PREPARATIONS. Extractum Belladonna? Foliorum. Extract of Belladonna Leaves. (U. S. & B. P.) Made by maceration and percolation with diluted alcohol, and evaporation to pilular consistence. Used in preparing the unguentum belladonnse. Contains 1.25 per cent, of alkaloids of belladonna leaves. Dose.— H. & C, gr.x-xx, (.6-1.3) ; Sh. & Sw., gr.ii-iv, (.12-.24) ; D., gr.y8-y2 (.008-.03). Tinctura Belladonnas Foliorum. Tincture of Belladonna Leaves. (U. B. & B. P.) Belladonna leaves, 100, diluted alcohol to make 1,000. Made by maceration and percolation to contain 0.03 Gm. total alkaloids in 100 mils. (U. S. P.) Dose.— D., TT^v-xxx, (.3-2). Unguentum Belladonna?. Belladonna Ointment. (U. S. & B. P.) Pilular extract of belladonna leaves, 10; diluted alcohol, 5; hydrous wool fat, 30; benzoinated lard, 55. (U. S. P.) Belladonna Radix. Belladonna Root. Synonym. — The dried root of Atropa belladonna Linne (Fam. Solanaceae), yielding not less than 0.45 per cent, of the total alkaloids of belladonna root. Cylindrical or somewhat tapering, usually split into longitudinal pieces, from 0.5 to 2.5 cm. in thickness; nearly inodorous, taste sweetish, afterward bitterish and strongly acrid. PREPARATIONS. Fluidextractum Belladonna? Radicis. Fluidextract of Belladonna Root. (U. S. P.) Made by maceration, percolation with alcohol and water, and evaporation. One mil of the extract = one Gm. of belladonna root. Standardized so that 100 mils of the fluidextract contains 0.45 Gm. of mydriatic alkaloids. The most re- liable preparation. Dose.— H., 5i.-ii. (4.-8.); C, 5ii.-iii. (8.-12.); Sh. & Sw., Tllx.-xv. (.6-1.); D., TTti.-iii- (.06-.2). Linimentum Belladonna?. Belladonna Liniment. (U. S. & B. P.) Camphor, 50; fluidextract of belladonna to make 1,000. (U. S. P.) Atropina. Atropine. C17H,, OsN. (U. S. & B. P.) An alkaloid obtained from belladonna. As it occurs in commerce, it is always accompanied by a small proportion of hyoscyamine extracted along with it, from which it cannot readily be separated. Derivation. — Atropine is obtained from a strong tincture of the root. Slaked lime is added, which splits up atropine malate and precipitates lime malate. The excess of lime is precipitated by sulphuric acid, and coloring matters by potas- sium carbonate, which also sets free atropine. The atropine is dissolved in chloro- form, recovered on evaporation, and purified by digestion with warm alcohol and charcoal. Properties. — White, rhombic prisms; odorless, having a bitter, acrid taste, and gradually assuming a yellowish tint on exposure to the air. Great caution must be used in tasting it and then only in much dilution. Soluble in 455 parts of water, 2 of alcohol, 1 of chloroform, 25 of ether, and 27 of glycerin. It melts between 114° and 116° C. Alkaline to litmus and phenolphthalein. Incompatible s. — Decomposed by sodium or potassium hydrate. Dose.— H., gr.ss-iss, (.03-.09); average dose, gr.i, (.06); C, gr.i-ii, (.06-.12); Sh. & Sw., gr. 1/20-1/12 (.003-.005); D., gr. 1/120-1/60 (.0005-.001). Atropine Sulphas. Atropine Sulphate. (C17H2303N)2 H2S04-l-H20. (U. S. & B. P.) Derivation. — 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; odorless, having a very bitter, nauseating taste, and permanent in the air. It should be tasted with the utmost caution, and only in dilute solution. Soluble in 0.4 part of water, 5 parts of alcohol, 3000 parts of ether, and in 420 parts of chloroform at 25° C. At 188°-191° C. atropine sulphate melts; when free from hyoscyamine it melts at 181° -183° C. 280 VEGETABLE DRUGS Dose.— H., gr.i-iss, (.06-.09); C, gr.i-ii, (.06-.12) ; Sh. & Sw., gr. 1/15-1/12 (.004-.005); D., gr. 1/120-1/80 (.0005-.0008), average dose, gr. 1/100 (.0006). Action of Belladonna and Atrophine External. — Belladonna is ordinarily not absorbed from the unbroken skin, but when applied to raw surfaces and mucous membranes, or, to a less extent, when rubbed into the skin with camphor (linimentum bella- donnse), chloroform, alcohol, etc., it depresses the sensory nerve endings and produces a local anodyne action. Thus applied it also depresses the peripheral motor nerve fibres, and is sometimes injected into spasmodi- cally 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 di- minishes the gastric secretion and is largely used to lessen gastric hyper- acidity. In the intestines atropine prevents undue griping produced by drastic cathartics through checking violent action caused by overactivity of the motor nerve (vagus) endings in the small intestines. Also it overcomes the intestinal contraction which forms about any irri- tating body in the lumen of the gut — even gas. While tending to prevent catharsis through depressing the motor (vagus) nerve endings of the small gut, it does not hinder the action of drugs stimulating directly the intestinal wall (arecoline) — only that of agents acting on the motor nerves — as eserine. On the contrary, atropine aids catharsis in most cases by: 1. relieving spastic abnormal conditions. 2. by preventing spasm and griping through over-action of the vagus. Circulation. — Belladonna is readily absorbed into the blood, but has no particular action upon this fluid within the body. Dilute solutions of atropine paralyze and stop corpuscular movement in the blood withdrawn from the vessels. The characteristic action of belladonna upon the cir- culation consists in depression of the peripheral pneumogastric fibres in the heart, with greater frequency of the pulsations. There is apparently, in the mammal, no direct stimulation of the cardiac muscle. Belladonna is therefore a heart stimulant, by increasing the number of its beats with- out 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 over-activity of the heart and to stimulation of the spinal and medullary vasomotor centres, with constriction of blood vessels, more especially of the abdomen. Dilatation of the vessels of the skin occurs at the same time in poisoning, 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. 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 delirifa- cient by some authorities. It stimulates the brain incoordinately, and large doses produce restlessness, nervous excitement and delirium in man, ACTION OF BELLADONNA 281 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 (stimu- lant and depressant) upon the spinal cord. The medullary vasomotor and respiratory centres are stimulated. Large doses cause complete loss of motion and reflex action in the frog, lasting for several days, and followed by reflex excitability and convulsions. Poisoning in mammals is exhibited by less paralyzant action 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 in- hibitory centres, so that normal stimuli pass through the latter unre- strained and result in convulsions. Nerves. — The action of belladonna upon the nerve endings is ex- tremely important, and represents, to a considerable degree, the thera- peutic value of the drug. The peripheral motor nerve terminations, and, to a less extent, their trunks, are depressed and paralyzed. This is never so complete, however, but that there is some voluntary power left in an animal fatally poisoned. Depression and loss of function of the afferent nerves come on more slowly, and exist to a less degree. Bella- donna, then, when applied locally or given internally, is an anodyne, but is far inferior in this respect to opium; and, whereas opium acts cen- trally, belladonna acts peripherally. 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 physiological symptoms following the administration of belladonna. This is due to paralysis of the peripheral terminations of the secretory nerve (chorda tympani) of the submaxillary gland, and of the secretory nerve endings of the other salivary and mucous glands in connection with the mouth. Another characteristic effect of belladonna consists in the production of dryness of the skin, which follows the action of the drug in paralyzing the peripheral nervous filaments supplying the secretory cells of the sudoriparous glands. In the same manner the tracheal and bronchial secretions are diminished, and also the secretion of milk (anti-galacta- gogue action), by depression of the terminations of the secretory nerves. The drug diminishes somewhat the secretions of the intestinal tract, and the secretion of gastric juice is diminished or arrested; but that of the pancreatic juice and bile not at all. The HC1 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 bella- donna, but is considerably lessened, or suppressed, in poisoning by the drug. Experiments upon man show that the urinary solids are increased: urea and uric acid to a slight extent; sulphates and phosphates to a con- siderable degree. Muscles and their Nerves: — Atropine is antispasmodic in its effect upon involuntary muscle. It depresses their motor nerve endings. Vol- untary muscles are not affected by any doses of atropine, although the 282 VEGETABLE DRUGS motor nerves controlling them are depressed by toxic amounts of the alkaloid. Atropine has been used successfully to produce three diverse actions on the bowel: (1) to quiet intestinal movement in inflammation of the bowels; (2) to relieve spasm in colic and spastic conditions generally; (3) very commonly to aid catharsis by preventing griping. In practice, small doses usually suffice, while, on the other hand, enormous doses (gr. 1/12, instead of the usual dose of gr. 1/100) have proved successful in moving the bowels in obstinate constipation (in human patients) due to obstruction when all other means failed. It is probable in these cases that the obstruction was due to spasm, or fecal impaction with spasm, and not mechanical. Conversely, it is the common practice to give atropine with morphine to prevent peristalsis in peritonitis and with satisfactory results, owing to the depressing action on the motor nerve (vagus) end- ings in the small intestines overcoming peritoneal irritation. 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 mod- erate doses, while paralyzed by large quantities of belladonna. A like depressing influence is believed to be exerted upon the effer- ent nerve endings of the unstriped muscles of the bladder, urethra, bile ducts, uterus and vagina. Belladonna acts medicinally as an antispas- modic in relation to the muscles. Respiration. — Small doses of atropine do not affect the respiration. Large therapeutic doses make the respiratory movements quicker and deeper, by stimulation of the medullary respiratory centre. Fatal doses produce respiratory failure and asphyxia, owing to paralysis of the respi- ratory centre and the peripheral vagus filaments concerned with the res- piratory movements. Belladonna also paralyzes the peripheral fibres of the pneumogastric nerve in the bronchial tubes and acts therapeutically as follows: 1. As a respiratory stimulant. 2. As an antispasmodic, by de- pressing the efferent vagus endings in the bronchial tubes and relaxing spasm of the smooth muscle of their walls. 3. As a sedative, by depress- ing 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 tem- perature, while fatal doses lessen bodily heat. The first phenomenon is produced by stimulation of the thermogenic centres, 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 temperature is accom- panied by increased heat loss, caused by radiation from the dilated cutaneous vessels. Eye. — The action of belladonna upon the eye affords another illus- tration of the depressing action of the drug upon the nerve terminations. The myoneural junctions of the third (oculomotor) nerve in the circular muscle are paralyzed, which leaves the radiating fibres free to act and ACTION OF BELLADONNA 283 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 con- sists 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. Intra- ocular tension is increased by large and continuous dosage of belladonna, and an artificial glaucoma may be thus produced. Elminatwn. — 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 inhibitory (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 inhibi- tory and secretory nerves and the motor nerves of the unstriped muscles, as well as the muscles themselves, of the viscera (allaying spasm of bronchi, intestines, stomach, etc.), 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 paralysis of the peripheral vagus endings and stimulation of the heart; the blood tension is augmented be- cause 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 present from the exciting action of the drug upon the cerebral motor centres. The spinal cord is unaffected by therapeutic doses. Locally ap- plied belladonna is a direct paralyzant to nerves, muscles, vessels and cells. Physiological Relations of Belladonna to Other Drugs In stimulating nerve centres atropine resembles both caffeine and strychnine, with this difference, that caffeine excites chiefly the higher psychical centres of the brain, while strychnine sensitizes the connecting 284 VEGETABLE DRUGS neurones of the cord so that the motor centres respond more acutely to sensory stimuli. A medicinal dose of atropine stimulates, while morphine depresses, the brain, respiratory functions, and intestinal peristalsis. This antag- onism 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 sen- sory nerves through its peripheral 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 stimulates secretory nerve terminations in the sweat and salivary glands, the peri- pheral oculomotor filaments, and the nerve endings in the involuntary muscle of the heart, stomach, intestines and uterus. Atropine counteracts the influence of aconite upon the heart. Toxicology. — Toxic doses of belladonna cause in animals dryness of the mouth, increased frequency of the pulse and respiration, elevation of temperature, dilation of the pupil and partial blindness, restlessness, nervousness, delirium, twitching of the muscles (occasionally erythema), and frequent micturition. These symptoms are succeeded, in fatal poi- soning, by fall of temperature, retention of urine, muscular weakness, staggering gait, partial anesthesia, convulsions and paralysis (one pre- ponderating over the other), weak, slow, irregular respiration, feeble, rapid pulse, paralysis of the sphincters, stupor and death. Death occurs mainly from asphyxia, but is due in part to cardiac failure. The physio- logical test consists in placing a drop of the urine (secreted by the poisoned animal) into the eye of a healthy animal, when mydriasis should follow if the case be one of belladonna poisoning. Three-quarters of a grain of atropine under the skin has proved fatal to dogs. Two grains of atropine produce mild toxic symptoms in the horse. Small dogs are slightly poisoned by gr. 1/80 of atropine; medium sized dogs by gr. 1/60 given hypodermatically. Cattle are as susceptible as horses, but neither are so readily influenced by the drug 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 insusceptible to belladonna, in regard to its effect upon the pupil, circulation, etc. The treatment of poisoning includes the use of the stomach tube, emetics, bromides, alcohol or ether in the stage of excitement ; and cardiac stimulants, as caffeine, and artificial respiration in the later depression. Also external heat and general faradism. Posi-Mortem Appearances. — These are not generally characteristic, except of asphyxia. The blood is dark and poorly coagulable. There is USES OF BELLADONNA 285 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 External. — Local application of belladonna is more effective 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; paralyzes the secretory nerves and so diminishes the amount of milk, vascular tension, pain and glandular activity. In fissure of the rectum, and in hemorrhoids, belladonna (with opium) in ointment or suppository, allays spasm and pain. 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 Eye. — 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.l/20-5i.) of atropine sulphate. A drop will suffice, and no trace of its effect will remain after the second day. A strong solution (gr.iv.-§i.) is essential to completely paralyze the iris and ciliary muscle. In the normal animal, accommodation is para- lyzed and vision disturbed for 8 or 12 days after the use of this solution. Atropine is particularly useful in keratitis and iritis. In the former dis- ease, photophobia and blepharospasm are diminished by the paralyzing action of atropine upon the trigeminus, and pain, congestion and inflam- mation are diminished by contraction of the peripheral blood vessels. In central perforating ulcer of the cornea, with protrusion of the iris, atro- pine, by dilating the pupil, draws the iris away and prevents its perma- nent adhesion (anterior synechia) to the cornea, while the perforation 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 surfaces of the iris to the anterior capsule of the lens (posterior synechiae), which both limits the normal variation in the pupillary diameter and interferes with the nutrition of the lens, and so predisposes 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 colds, bronchitis, influenza, etc., are frequently treated at the outset with belladonna, with the intent of cutting short the inflammatory process by improving vascular tone. This applies more 286 VEGETABLE DRUGS 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 bene- ficial effects of the drug in relieving cough, spasm and obstructed breath- ing noted below. In the second stage of acute diseases, as pneumonia, atropine is a valuable agent in combination with strychnine, to stimulate respiration, prevent effusion and vasomotor and cardiac depression. In slow heart due to vagal disturbance (vagus bradycardia) atropine in full doses may prove curative. Belladonna is of service also as a respiratory, cardiac and vasomotor stimulant in poisoning by various drugs, including opium, chloroform, ether, aconite, prussic acid, physostigma and pilo- carpine. Experiments by Reichert and others show that atropine, while stimulating the respiratory centre exerts a powerful depressing action on the pulmonic motor fibres of the vagi, and that in opium poisoning atropine, instead of strengthening, actually lessens respiratory power. Strychnine and caffeine are undoubtedly much better antidotes in this condition. Belladonna is an antidote in poisoning by antimony. In sur- gical shock, with low temperature, owing to vasomotor paralysis and vascular dilatation, and in collapse from injury and disease atropine is a most potent remedy, combined witli camphor subcutaneously. In pneu- monia, especially, belladonna is of great value following the crisis. 2. Belladonna is employed therapeutically to diminish excessive sweating and salivation, mercurial or otherwise. Injected half an hour before beginning ether anesthesia atropine is most useful in preventing excessive secretion and reflex vagal irritation, and in stimulating respira- tion. It is recommended in serous, or watery diarrhea. Edema of the lungs is combated most successfully with atropine (combined with strych- nine) subcutaneously. In the second stage of acute respiratory diseases, as bronchitis, influenza, canine distemper, and pneumonia, belladonna diminishes secretion, irritability and cough, and stimulates the heart and respiration. It may be associated with opium to increase the sedative effect. In mastitis belladonna should be given internally, and rubbed on the inflamed gland 3 times daily in the form of the linimentum bella- donnae, to lessen glandular activity, secretion and pain. Atropine is the best remedy, apart from antacids, to counteract gastric hyperacidity. 3. Belladonna does not have much influence over spasm of the volun- tary muscles, unless injected (atropine) into their substance. Rheumatic lameness, neuralgia, and cramps and spasm due to injury of nerves, may be treated in this manner. Belladonna liniment 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 spasmodic colic of horses succumbs most readily when atropine is given with morphine under the skin. In peritonitis and enteritis, full and repeated doses of atropine, with mor- phine, prevent reflex spasm and pain, and thus aid peristalsis. Large doses of atropine have been used in human medicine, and with remarkably good results, in the treatment of intestinal obstruction from impacted feces, and even in invagination and twist. USES OF BELLADONNA 287 Cough, stridulous 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. Fluidextr. belladonnae rad 5i. Pulv. potassii chloratis 5ii. Pulv. glycyrrhizae ov- Syrupi fusci Q. S. M. et f. electuarium. Sig. Give ^ ounce every two hours. (Furnish Y2 \ ounce for sample dose.) 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. Belladonna is often used by dealers to hide the existence of heaves which it may abolish for a day but which become worse when the effects of the drug wear off. A dry mouth and dilated pupils suggest the use of the remedy. Tetanus is favorably influenced by extract of belladonna given in electuary. In this section may be included the effect of small doses of belladonna in acting indirectly as a laxative in constipation, and thus assisting the action of peristaltic stimulants, as aloes and strychnine. Atropine, with morphine under the skin, are the best remedies in anaphylaxis, or serum disease, where asthma and cyanosis follow the injection of foreign proteids at infrequent intervals. As the serums used in veterinary practice are usually from the same species of animal (homologous) anaphylaxis will not occur. Atropine is useful in paralysis of horses and dogs due to absorption of phenol or the cresols from washes. It has been recom- mended highly in hemorrhage following castration and in all hemorrhage in the splanchnic cavities. Aloini gr.ih. Extracti belladonnae fol .'. gr.iss. Extracti cascarae sagradae gr.vi. Misce et divide in pilulas No. xii. Sig. One pill in morning for dogs with chronic con- stipation. Tincturae belladonnae 5iii. Sodii bromidi. Sodii iodidi aa 3ii. Aquae ad %iv. M. Sig. Teaspoonful three times daily for a dog with asthma. May be taken voluntarily in milk. 288 VEGETABLE DRUGS Hyoscyamus. Hyoscyamus. (U. S. P.) Synonym. — Hyoscyami folia, B. P.; henbane, herba hyoscyami (P. G.), E.; feuilles de jusquiame noire, Fr. ; bilsenkrant, G. The dried leaves and flowering or fruiting tops of Hyoscyamus niger Linn§ (Fam. Solanacew), yielding not less than .065 per cent, of the alkaloids of hyo- scyamus. Habitat. — Indigenous to England, the Continent, and Asia, and naturalized in the northern part of the United States. Description. — Usually much wrinkled, with numerous stems and with the flowering or fruiting tops intermixed; leaves when entire attaining a length of 25 cm., a breadth of 10 cm.; odor heavy, distinctive; taste somewhat bitter and acrid. Constituents. — Two alkaloids: hyoscy amine C^H^N 03, and hyoscine. The first resembles atropine in composition and action. Impure, amorphous, commer- cial hyoscyamine is a dark-brown fluid and contains as its active principle mainly hyoscine. Incompatibility. — Incompatible with caustic alkalies and vegetable acids, lead acetate and silver nitrate. Hyoscyamus may be given in pill wjth the two latter mineral salts. Dose.— H. & C, 5ss-i, (15-30); D., gr.v-xv, (.3-1). PREPARATIONS. Extractum Hyoscyami. Extract of Hyoscyamus. (U. S. & B. P.) Hyoscyamus in No. 40 powder, 1000 Gm. Made by maceration and percola- tion with diluted alcohol, and evaporation to pilular consistence to contain 0.25 per cent, of alkaloids of hyoscyamus. Dose.— H. & C, gr.xx-3i, (1.3-4); D., gr.ss-ii, (.03-.12). Fluidextractum Hyoscyami. Fluidextract of Hyoscyamus. (U. S. P.) Made by maceration, percolation with alcohol and water, and evaporation, so that 1 mil = 1 Gm. of hyoscyamus. Each 100 mils of fluidextract contains 0.065 Gm. of alkaloids of hvoscyamus. Dose.— H. & C, gss-i, (15-30); D., mv-xv, (.3-1). Tinctura Hyoscyami. Tincture of Hyoscyamus. (U. S. & B. P.) Hyoscyamus, 100; diluted alcohol to make 1000. Made by maceration and percolation. Standardized to contain 0.0065 Gm. of alkaloids of hyoscyamus in each 100 mils of the tincture. (U. S. P.) Dose.— D., 3i-iv, (4-15). The dose of hyoscyamus preparations is generally two to four times that of similar belladonna preparations. Succus Hyoscyami. Juice of Hyoscyamus. (B. P.) Dose. — Same as tincture. Hyoscyamistye Hydrobromidum. • Hyoscyamine Hydrobromide. Ci7H2S03 N H Br. (U. S. P.) Synonym. — Hyoscy aminum hydrobromicum, Fr. ; hyoscyaminhydrobromid, G. The hydrobromide of hyoscyamine, an alkaloid obtained from hyoscyamus and other plants of the Solanacece. It should be kept in amber-colored, well- stoppered vials. Properties. — White, prismatic crystals, without odor; deliquescent on exposure to the air. Great caution must be used in tasting it, and then only in dilute solution. Taste acrid, nauseous and bitter. Very soluble in water; soluble in 2.5 parts of alcohol, 2260 parts of ether, and in 1.7 parts of chloroform at 25° C. Dose.—H., gr.i-ii, (.06-.12) ; D., gr. 1/60-1/30, (.001-.002). Scopolamine Hydrobromidum. (U. S. P.) Scopolamine Hydrobromide. C17H2104 N H Br. Synonym. — Hyoscinae hydrobromidum, hyoscine hydrobromide, E.; brom- hydrate d'hyoscine, Fr.; skopolaminhydrobromid, G. The hydrobromide of laevorotary scopolamine, also known as hyoscine, ob- tained from various plants of the Solanaceae. Preserve in well-closed containers, protected from light. Properties. — Colorless, transparent, rhombic crystals, sometimes of large size; HYOSCYAMUS 289 odorless and having an acrid, slightly bitter taste. Soluble in 1.5 parts of water, and in 20 parts of alcohol; slightly soluble in chloroform. Dose.— H., gr. %-% (.001-.015) ; D., gr. 1/100-1/30 (.0006-.002). Action Internal. — The action of hyoscyamus is a resultant of that of its two alkaloids, hyoscine and hyoscyaraine. The latter is practically atropine, except that its mydriatic action is shorter. Hyoscine, in poi- sonous doses, is a powerful depressant to the cerebrum, respiratory centre, spinal reflex centres, and motor tract. It differs from atropine in being a cerebral sedative, and in its greater paralyzant action upon the spinal cord. The tetanic stage succeeding spinal paralysis, observed in atropine poisoning, does not ensue with hyoscine. The latter alkaloid slightly depresses and slows the heart, and does not paralyze the vagus termina- tions, nor depress the motor and sensory nerves or muscles. The circula- tion is but slightly influenced, and vasomotor depression occurs only in the latter stage of lethal poisoning. Death occurs from paralysis of the respiratory centres. Poisoning in animals is exhibited by loss of muscular power, slowing and failure of respiration, dryness of the mouth, stupor and asphyxia. The pulse may be infrequent, the pupils are dilated and the skin is moist rather than dry. Delirium and convulsions sometimes occur in man. The effect of the combined action of hyoscyamine and hyoscine in hyoscyamus is shown when we compare the drug with bella- donna. Hyoscyamus is more of a cerebral sedative and hypnotic, and less of a heart and respiratory stimulant. It is said to possess more power in overcoming spasm, and griping of cathartics, and in aiding intestinal movement. Hyoscyamus is also thought to exert a more pronounced antispasmodic action than belladonna upon the smooth muscles of the bladder and urethra. Uses. — Hyoscyamus is generally applicable in the same disorders for which belladonna is indicated. In relieving some sorts of spasm, hyo- scyamus 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 ad- vantage with strychnine, subcutaneously, in impaction of the bowels in horses. The former drug relaxes intestinal spasms, and assists the stimu- lant action of strychnine upon the intestinal muscle. Repeated small doses of oil will facilitate peristalsis in this condition. Hyoscine hydro- bromide 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 hyoscamine is difficult, and a pure preparation is to be recommended. Hyoscine has not been em- ployed to any extent in veterinary practice. It is used in human medi- cine as a hypnotic and sedative in mania and delirium of the insane. It causes no unpleasant after-effects. Scopolamine is identical with hyo- scine and is so named because obtained from Scopola atropoides. Scopo- lamine, or hyoscine, with morphine under the skin 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.l/6) with morphine sul- 290 VEGETABLE DRUGS phate (gr.i.) may be injected subcutaneously, and the dose repeated in twenty minutes. Hyoscine (or scopolamine) is sometimes given to horses to aid the action of chloroform and prevent its excitement. One hour before operation gr. 1/6-1/3 may be injected under the skin for this pur- pose. To produce general anesthesia in dogs, morphine is given with hyoscine in 2 doses — one 2 hours, and the other 15 minutes, before opera- tion. Thus (for each dose) morphine, gr.ss., with hyoscine, gr.l/100, is injected subcutaneously and will generally suffice for the performance of ordinary operations — although a few whiffs of ether may be required in addition. Dogs are comparatively insusceptible to scopolamine. It has been estimated by Bernardini that morphine may be given to the extent of gr.l/6 to each 2.2 lbs. of live weight; and hyoscine from gr. 1/120 U gr.l/15 to each 2.2 lbs. live weight for do#s. Cannabis. Cannabis. (U. S. P.) Synonym. — Cannabis indica, Indian cannabis (B. P.) The dried flowering tops of the pistillate plants of Cannabis sativa Linne or of the variety indica, Lamarck (Fam. Moracew). Cannabis, made into a fluidextract in which 100 mils represent 100 Gms. of the drug, when assayed bio- logically, produces incoordination when administered to dogs in a dose of not more than 0.03 mil of fluidextract per kilogram of body weight (gr.ss. per 2.2 lb). Synonym. — Indian hemp, E.; chanvre indien, Fr. ; indischer hanf, G.; herba cannabis indicae, P. G. Hashish is a confection of the drug. Arabian addicts of this preparation are frequently impelled by its influence to deeds of violence. They are called "hashashins"; 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. — Cannabis indica is indigenous to Asia, but the hemp plant (Can- nabis sativa) grown in America and many other parts of the world is also active (Cannabis Americana and Africana). Description. — In dark green or greenish-brown and more or less agglutinated fragments consisting of the short stems with their leaf-like bracts and pistillate flowers, some of the latter being replaced with more or less developed fruits ; odor agreeably aromatic, taste characteristic. The powder is dark green, giving a strong effervescence with dilute HC1. Incompatibility. — Water precipitates the active resinous principles. Lemon juice and other vegetable acids are the most efficient antidotes. Constituents. — The active principle of cannabis indica is cannabinol (O H C20 H2SC O H), a red oil or resin boiling at a high temperature, which apparently exerts the characteristic action (Marshall) of cannabis indica on man and animals. But the therapeutic value of the principle has not been sufficiently studied to enable it to be used as a substitute for the crude drug or its preparations. The drug yields various other bodies such as: 2. Cannabene, ClsH2o, or oil of Indian hemp, which is very toxic. 3. Cannabin, a resinoid. 4. Cannabindon, CsH120, 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. Cannabitetanine, a convulsant alkaloid. PREPARATIONS. Extractum Cannabis. Extract of Cannabis. (U. S. & B. P.) Made by maceration and percolation with alcohol, and by evaporation to a pilular consistence. 0.004 Gm. per kilo of body weight in dogs produces inco- ordination. Dose.— H., 3i-ii, (4-8); D., gr.^-i, (.015-.06). CANNABIS 291 Fluidextractum Cannabis. Fluidextract of Cannabis. (U. S. P.) Made by maceration and percolation with diluted alcohol. 0.03 mil per kilo body weight produces incoordination in dogs. Dose.— H., 5iv-vi, (16-24-); D., TTlii-x, (.12-.6). Administration. — The extract is given in ball, pill, electuary or suppository; or the fluid preparations may be used. Tinctura Cannabis Indicw. Tincture of Indian Cannabis. (U. S. & B. P.) Indian cannabis, 100; alcohol to make 1,000 mils. Made by maceration and percolation. (U. S. P.) 0.3 mil per kilo body weight produces incoordination in dogs. Dose. — D., TTLxx-xxx, (1.3-2). Action External. — Cannabis indica exerts a considerable irritant action when applied to mucous membranes. This is followed by local anesthesia. Action Internal. — Indian hemp is a distinct depressant to the func- tions of the brain and cord in poisonous doses, although therapeutically stimulating these organs in small quantities, and producing in man a kind of intoxication and mild delirium. The reflex activity of the spinal cord is primarily increased, but this is succeeded by diminution of reflex move- ment, and, after large doses, by anesthesia 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, given by the writer y2 ounce of the solid extract, became drowsy. Sleep after a few hours deepened into stupor, and stupor into coma. The respiration became slow, the pulse slightly accelerated, and the animal so anesthetic that amputation of the penis was done on the following day without producing the 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 drams) 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 cc. (Y2 ounce) was injected into the jugular about an hour after the first and caused sweating and a sleepy condition, in which the animal jerked and twitched his head as if dreaming. The temperature dropped to 96° F., and the sleepy state, alternating with excitement when annoyed lasted three hours, when delirium supervened and continued for six hours, at which time all the symptoms disappeared. Pony 575 pounds; condition fair. Received 15 cc. (V2 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 L asleep a; *Jou *Jour. Comp. Med. and Vet. Archives, April and May, 1900. 292 VEGETABLE DRUGS hours and could not be aroused. Temperature fell to 92.5° F. Respiration regu- lar; pulse from 42 to 30 during experiment. Gelding, 1050 pounds; in good condition. Given 45 cc. of fluidextract intra- venously. In three minutes rearing, kicking, snorting and going on like one mad. He ran back and forth along one sidei 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 cc. 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 nor- mal; the pulse was accelerated and the respiration slightly so. Muir deduces from his experiments that as much as 50 cc. (§iss.) of the fluidextract may be given with safety intravenously. In the human being, cannabis induces very peculiar mental phe- nomena, including hallucinations, a sense of double consciousness, and great prolongation of time, so that minutes are drawn out into hours, and hours into days. Sometimes sexual excitement, exaltation, and hilarious- ness are exhibited; at other times a dreadful premonition of impending death seizes the human subject. The drug is not fatal, except in colos- sal doses, but the effects may appear alarming. Intrajugular injection into a small dog, of five drams of the fluidextract (10 minims of which proved active in man) onty caused death after several hours (Hare). Preparations of Indian hemp have varied greatly in strength, many being entirely inert, and this fact constitutes one of the principal objec- tions to its use. This drawback is now abated by the physiological tests required by the 1916 U. S. P. Uses. — Cannabis is indicated for the relief of: 1, pain; 2, spasm; 3, nervous irritability. It is not precisely comparable to morphine as an analgesic, on account of the slowness of its action, but is superior to opium in not causing constipation, anorexia and indigestion. In relieving pain and producing deep narcosis for operation it is, however, superior to opium in horses. It is used 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 condi- tions of long continued pain or spasm. In thirty-five cases of tetanus in the human being, treated with cannabis, twenty-one recovered and four- teen 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 magnesium sulphate 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 bladder irritation and cystitis in overcoming spasm. The intrajugular injection of 10 to 15 mils of a reliable fluidextract of cannabis indica in horses will produce a rapid and safe general anes- thesia for surgical operations. The animal will often lie down and is both relaxed and unconscious for a considerable period. Operations on horses under cannabis narcosis are now commonly done by many practitioners. Palmer affirms, however, that intravenous injections of cannabis some- CAFFEINE 293 times cause thrombus and lameness in horses months afterwards owing to its insolubility in the blood (Vet. Review, Dec., 1913). Caffeina. Caffeine. CsHl0O2N4+H2O. (U. S. & B. P.) Synonym. — Theine, guaranine, E.; coffei'n, G.; cafeine, Fr. A feebly basic substance, obtained from the leaves of Thea sinensis Linne (Fam. Ternstroemiaceae), or from the seeds of Coffea arabica Linne (Fam. Rubiaceae), and found also in other plants; or prepared synthetically. 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 acetate and filtered. Hydrogen sulphide decomposes the excess of lead acetate remaining in the fil- trate. The latter is then concentrated by evaporation and neutralized with ammonia water. Caffeine crystallizes on cooling. The alkaloid is purified by charcoal and recrystallization. Properties. — White, flexible, silky, glistening needles, usually matted together in fleecy masses; odorless and having a bitter taste: efflorescent in dry air. Solu- ble in 46 parts of water, 66 parts of alcohol, 530 parts of ether, and 5.5 parts of chloroform at 25° C. Its solubility in water is increased by the presence of certain salts, — e.H1„0,N4, NaC7H5Q,,. (U. S. P.) (Contains 46 to 50 per cent, of anhydrous caffeine.) A mixture of caffeine and sodium benzoate. White powder, odorless, and has a slightly bitter taste. Soluble in 11 parts of water, in 30 of alcohol, and partly soluble in chloroform. Dose.— Twice that of caffeine. H., 3i-ii, (4-8); D., gr.i-vi, (0.06-0.3), sub. cutaneously. Action Internal. — Caffeine has no particular action upon the diges- tive tract, except in large quantities, when it may cause gastro-intestinal irritation. The effect of caffeine and raw coffee is identical, 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 investigations appear to show that 294 VEGETABLE DRUGS the oil (caffeone), of which there is from one to one-half dram in a cup of the beverage, has no physiological action except to disturb digestion and cause biliousness. This result is not in accord with the general belief, and it is probable that caffeone possesses a transient action in stimulating intestinal peristalsis, the cerebral functions, and in lessening vascular tension. Circulation. — Caffeine stimulates the heart muscle and vaso-constric- tor centre. 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^ but the coronary, pulmonary and cere- bral arteries are dilated, because of absence of constrictor nerves and increase in general blood pressure. Nervous System. — Caffeine is a certain and direct stimulant to the higher nervous centres (cerebral cortex). In moderate doses it produces wakefulness and restlessness (action of tea and coffee at night on man), and increases the capacity for mental and physical work (see muscles). In the lower animals caffeine often causes the most intense cerebral ex- citement and mania in large doses. The alkaloid affects the spinal cord like strychnine, and toxic quantities produce restlessness, increased reflex excitability and convulsions in the lower animals. It is undetermined whether the 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 antoginizes alcohol in stimu- lating the highest or controlling functions of the brain, the reasoning faculties, perception of sensory impressions and associations 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 its capacity (10-30%), 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 chiefly to be attributed to its effect on the muscles themselves. Kidneys. — Caffeine often increases the blood supply and volume of the kidneys, as shown by Roy's oncometer. But diuresis occurs in the isolated kidney, and without rise in general blood pressure. Also when the kidney is enclosed in plaster-of-paris so that it can not expand. Therefore diuresis is not due to circulatory changes. The renal cells must be stimulated, and perhaps resorption in the tubules is lessened, since, under caffeine, the composition of the urine is more like that of the blood (increased chlorides). 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 (and muscles) are stimulated (along with the vagus and vasomotor) by caffeine in moderate doses, and depressed by toxic amounts. CAFFEINE 295 Metabolism. — Caffeine increases tissue change and therefore the elimination of urea and carbonic dioxide — contrary to the time honored teaching. Toxicology. — Caffeine is a spinal and muscle poison to the frog. Tetanic convulsions occur in the batrachian similar to those produced by strychnine, but there is also muscular rigidity. These phenomena follow the direct stimulation of the spinal motor tract and muscles, and are suc- ceeded 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 gen- erally, are restlessness, occasionally vomiting in dogs, rapid breathing, primary reduction followed by rise in temperature, clonic or tonic con- vulsions, muscular weakness, and general paresis. Death occurs from heart or respiratory failure. The minimum fatal dose is about 1 gr. to 1 lb. of live weight in the cat. Administration. — Caffeine and its ordinary salts are decomposed by water and therefore should not be given subcutaneously. The alkaloid is best administered in solution with sodium salicylate, or benzoate, as follows : Caffeinae. Sodii salicylates aa gr.xxx. Aquae destillatae 3ii. M. S. Give at one dose hypodermically to horse. Ten drops to dog. Caffeinae sodio-benzoatis 3i. Aquae destillatae oii. M. S. Give at one dose subcutaneously, 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 admin- istered 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 veteri- nary medicine. It acts thus as an antidote to opium poisoning. One and a half grains of caffeine will save cats poisoned by the minimum fatal dose (gr. 1%) 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 stimu- lant effect upon the heart. The therapeutic indications are not the same as for digitalis, as caffeine differs from digitalis in the following par- ticulars : Does not slow the heart. Is not cumulative. Does not regulate the heart. Is transient in its effect. 296 VEGETABLE DRUGS Caffeine, in combination with acetanilid and other modern coal tar products is used to prevent circulatory depression but the U. S. Public Health Service (Hale) has shown that the toxicity of acetanilid is en- hanced by caffeine. Caffeine, tea and coffee are serviceable in the treat- ment of acute asthenic diseases in the horse (influenza and pneumonia), dog (distemper), and in foals and calves, acting as nervous and cardiac stimulants and perhaps restraining tissue waste. A cup of tea contains 1 to 2 grains, and a cup of coffee 1% to 3 grains, of caffeine. Caffeine is chiefly valuable in emergencies demanding immediate stimulation of the heart, respiration and vaso-motor centres as in belladonna, ether, alcohol, chloral, opium and cocaine poisoning. 3. The diuretic property of caffeine 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. Diuretin, or sodio-salicylate of theobromine, a crystallizable, bitter, volatile alkaloid, is probably the most active diuretic agent at our command and particu- larly useful in dropsy of cardiac or renal origin, non-irritating to the kidneys, but should not be used in acute nephritis. Theobromine has a similar action to caffeine, chiefly stimulating the secreting epithelium. The dose is 1 dram in 24 hours for dogs. Two capsules, each containing 10 grs., are given 3 times daily. SECTION II.— DRUGS ACTING ON THE SPINAL CORD Class I. — Stimulating the Inferior Cornua. Nux Vomica. Nux Vomica. (U. S. & B. P.) Synonym. — Semen strychni, P. G.; poison nut, Quaker button, E.; noix vomique, Fr.; krahen-augen, brechnuss, G. The dried, ripe seed of Strychnos Nux-vomica Linne (Fam. Loganiaceae), yielding not less than 2.5 per cent, of the alkaloids of nux vomica. Description. — Orbicular, nearly flat, sometimes irregularly bent, 15 to 30 mm. in diameter, 4 to 5 mm. thick; very hard when dry; externally grayish or green- ish-gray; covered with appressed hairs, giving it a silky luster; inodorous; taste intensely and persistently bitter. Constituents. — Two alkaloids. 1. Strychnine, 0.2-0.6 per cent. 2. Brucine (C23H26N204), 0.5-1.0 per cent. Similar in action to strychnine, but weaker and slower. Both alkaloids exist in combination with igasuric acid. Brucine occurs in rectangular octohedral crystals; is soluble in alcohol, in 7 parts of chloroform, and possesses a bitter taste. With sulphuric and nitric acids a beautiful blood- red color is developed. Nux vomica contains also, igasuric acid with which strych- nine and brucine are combined, and loganin, CzsH^Oh, an inert glucoside occurring in colorless prisms. Dose.— H. & C, 3i-ii, (4-8); Sh., gr.xx-xl, (1.3-2.6); Sw., gr.x-xx, (.6-1.3); D., gr.i-ii, (.06-.12). PREPARATIONS. Extractum Nucis Vomicce. Extract of Nux Vomica. (U. S. & B. P.) Made by maceration and percolation with diluted alcohol. Concentrate by distilling off alcohol. Wash residue with benzin and water. Decant benzin and agitate with dilute H2S04; then alkalinize with ammonia water and shake with chloroform. Add chloroform solution to residue and evaporate to dryness. Add dried starch and magnesium oxide so that extract contains 16% of the alkaloids of nux vomica. STRYCHNINE 297 Dose.— H. & C, gr.vii-xv, (.5-1); Sh., gr.iiss-v, (.15-.3) ; Sw., gr.i-ii, (.06- .12) ;D., gr.%-%, (.008-.016). Fluidextractum Nucis Vomicae. Fluidextract of Nux Vomica. (U. S. P.) Made by maceration and percolation with alcohol and water. The alcohol is distilled off. Alcohol and water are added to residue, so that the fluidextract shall contain 2.5 per cent, of alkaloids of nux vomica. Dose.— H. & C, 3i-ii, (4-8); Sh., nixx-xxx, (1.3-2); Sw., TTLx-xx, (.6-1.3); D., Uli-ii, (.06-.13). Tinctura Nucis Vomicae. Tincture of Nux Vomica. (U. S. & B. P.) Made by maceration and percolation of nux vomica, in alcohol, and water, and menstruum added so as to contain 0.25 per cent, of the alkaloids of nux vomica. Dose.— D., TTlv-x, (.3-.6). Strychnina. Strychnine. C^ H22 02 N2. (U. S. & B. P.) An alkaloid obtained from nux vomica, and also obtainable from other plants of the Loganiaceae. Derivation. — Nux vomica seeds are powdered and strychnine is extracted with water acidulated with hydrochloric acid. The solution is concentrated and strych- nine precipitated with lime. It is then redissolved in boiling alcohol 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 solu- tions of 1 in 700,000. Strychnine should be tasted with extreme caution. Perma- nent in the air. Soluble in 6420 parts of water, 136 parts of alcohol, 5 parts of chloroform, 180 parts of benzin. A solution of about 0.1 Gm. of strychnine in 2 mils of H2S 04 is not more than pale yellow (readily carbonizable organic im- purities), but on adding a fragment of potassium dichromate, a deep blue color is momentarily produced, changing to deep violet, then to purplish-red, cherry- red, and finally to orange or yellow. Dose. — Same as strychnine sulphate or nitrate (minimum quantities), which are preferable on account of their greater solubility. Strychnine Sulphas. Strychnine Sulphate. (C21H,2 02N2)2 H2S04+5 H20. (U. S. & B. P.) Derivation. — Made by the action of sulphuric acid on strychnine. Properties. — Colorless, or white, prismatic crystals, or as a white crystalline powder; odorless, and having an intensely bitter taste, perceptible in highly dilute (1 in 700,000) solution. Great caution must be used in tasting it and then only in very dilute solutions. Efflorescent in dry air. Soluble in 32 parts of water and in 81 parts of alcohol, and in 220 parts of chloroform. In other re- spects strychnine sulphate responds to tests for strychnine. Dose.— H. & C, gr.%-i, (.015-.06); Sh., gr. ■&-%, (.004-.015) ; D., gr. 1/200-1/40, (.0003-.0015). The larger doses are to be used when strychnine is given orally. Strychnince Nitras. — Strychnine nitrate, occurring in colorless, odorless, glistening needles, or as a white, crystalline powder, is now official. Has ver> bitter taste; soluble in 42 parts of water. Dose. — Same as strychnine sulphate. Strychninw 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 deter- mined by the following data: Dose per kilo (2.2 lbs. avoirdupois) live weight: Horse, sheep and cattle 0001-.0002 (gr.1/600-1/300) Swine 0002-.0003 (gr.1/300-1/200) Dogs i 0001 (gr.1/600) 298 VEGETABLE DRUGS In accordance with the foregoing figures, the dose for the Horse weighing 1,000 lbs. is .045-.09 (gr.%-1%) Dog weighing 100 lbs. is .0045 (gr.1/13) Dog weighing 50 lbs. is .00225 (gr.1/26) Dog weighing 25 lbs. is .00112 (gr.1/52) Dog weighing 10 lbs. is .00045 (gr.1/133) The foregoing table refers to oral administration; the subcutaneous dose of strychnine is but one-half of the dose by the mouth. Moreover, these doses may be given every three hours without pro- ducing poison by their cumulative action. Notwithstanding the fore- going figures, caution should be exercised in prescribing strychnine to dogs, as these animals appear sometimes extremely susceptible to strych- nine, and it is therefore advisable to begin with a minimum dose (gr. 1/200) in small animals. The dose of one grain should not be ordinarily exceeded in the case of horses, as one and one-half grains proved fatal in an exceptional case. If animals are depressed by disease, poison, or shock, they will often bear much larger doses than could ordinarily be administered with safety. Action External. — Strychnine is a powerful antiseptic, but is of no practical value on account of its poisonous properties. Brucine is a local anesthetic. Action Internal. — Diyestive Tract. — Strychnine and nux vomica act as bitter stomachics in increasing 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 stimu- lates 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 vasomotor centres with slight increase of blood pressure. Clinically, however, strychnine appears to accelerate and strengthen the heart-beat and this is thought to result from excitation of the cardiac muscle. There is, how- ever, no experimental evidence to show that medicinal doses of strychnine influence directly the mammalian heart (Cushny). Experimentally it has been found that either the vagus or accelerator centres may be sensitized, so that either slowing or quickening of the mammalian heart may result. Also that strychnine actually depresses the perfused heart muscle of the frog. The heart is accelerated by muscular activity in convulsions. Very large doses slow and weaken the heart. In poisoning, blood tension is still further enhanced through asphyxia and muscular movements oc- casioned by convulsions forcing the blood out of the abdomen. Nervous System and Muscles. — The effect of strychnine, which stands preeminent before all others, consists in the production of greatly exaggerated reflex action. Under its influence slight sensory stimuli re- sult in the most marked and uncontrollable motor impulses (convulsions). It is proved also that afferent impulses must reach the cord through the sensory tract for convulsions to occur. Section of the spinal cord from STRYCHNINE 299 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 responses to sensory stimuli — is situated between the entrance of the sensory roots into the cord and the motor cells of the inferior cornua. The receptive neurons (connecting the motor and sensory spinal neurons) appear to be directly influenced by strychnine so that nerve impulses pass through unhindered. Increased reflex excitability produced by strychnine has been here- tofore 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 con- trolling 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 acted upon by strychnine at all. According to Cushny, strychnine removes the natural resistance to the passage of afferent impulses to the motor cells and therefore a greater force remains to be expended on the motor cells. To put it more briefly, strychnine increases the conductivity of the cord for sensory impulses, both across and up and down the cord. As muscle tone depends upon afferent stimuli strychnine is supreme as a tonic. Metabolism is stimu- lated through the greater glandular and muscular activity caused by the increased irritability of the central nervous system. In fatal strychnine poisoning general paralysis ensues through de- pression of the spinal sensory and motor centres. This may be im- mediate after enormous doses, with absence of convulsions; or appear at the end of fatal poisoning. The motor nerve endings are also paralyzed but this is secondary in mammals to the more important paralysis of the motor and sensory spinal centres. The voluntary muscles and afferent nerves are not directly affected by strychnine. Respiration. — Strychnine has hitherto been regarded as chief among respiratory stimulants but recently noted clinicians have found little effect from it on the respiration in large therapeutic doses. In pathologic conditions with exhaustion it is likely the action, as upon other spinal centres, is indirect, i. e., 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, in the urine. It appears within half an hour of ingestion and a part is delayed in the tissues and may be discovered in the urine from 3 to 8 days thereafter. The greater part of strychnine is probably oxidized in the body. The drug is not cumulative, in the sense of producing sudden and violent action following its continual use in increasing doses. A toler- ance for it can be acquired in man and with difficulty in dogs. Administration. — For tonic purposes, strychnine may be given to 300 VEGETABLE DRUGS 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 emergencies, the alkaloid should be given hypodermically. Toxicology. — One-twentieth of a grain of strychnine nitrate, in- jected subcutaneously by the writer into a dog weighing 25 lbs., caused uneasiness and excitement, with protrusion of the eye-balls, and in the space of ten minutes, tetanic convulsions. The breathing was shallow and almost imperceptible, the pulse rapid and 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 about three minutes, and was fol- lowed by a period of relaxation. But the slightest noise or irritation of the skin brought on convulsions. The convulsions became less frequent and violent, and ceased altogether within half an hour. The same animal was given gr. 1/40 of the alkaloid on the following day, but without pro- ducing any appreciable result. One-tenth of a grain, given on another day and in the same manner, caused immediate uneasiness and restless- ness, and in ten minutes induced a severe convulsion, lasting for three minutes, in which the animal was so rigid that he could be lifted bodily without bending. The ears were drawn back, the limbs were extended and stiff, the tail was straight and rigid, and there was twitching of the muscles of the jaw and limbs. The corners of the mouth were drawn back (risus sardonicus), the mouth was covered with foam, and there was some trismus. The breathing was nearly suppressed, owing to tetanic spasm of the respiratory muscles. Following this convulsion, the jaw dropped, the muscles 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 poisoning 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 respiratory centre — 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, shoul'd warn one of the danger of approaching poisoning. The lethal dose for dogs has been set at gr. l/6-gr. 1/3. 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. 1/20 by the mouth would kill toy terriers, and cases are reported where they have been destroyed by gr. 1/60 of the alkaloid. The therapeutic dose should therefore be proportioned as STRYCHNINE 301 advised, to the weight of the animal. Five to eight grains of mix vomica will kill dogs. The minimum fatal dose of strychnine for man is one-half a grain. Usually four to seven grains constitute a lethal quantity, but recovery has ensued following the ingestion of 22 grains, after a full meal. Horses. — The toxic symptoms in horses resemble those already de- scribed in the dog. They do not appear for some time (20 minutes to 6 hours), depending on the rapidity of absorption when the drug is swal- lowed, and include excitement, muscular spasm and convulsions, increased frequency of the pulse^ and difficult respiration. Death occurs in con- vulsions or in the interim between them. The minimum fatal dose of strychnine, when given under the skin, is about 1% to 3 grains, and when swallowed, 3 to 5 grains of the alkaloid, or 1 to 2 ounces of nux vomica. A 1000-pound mare having clonic spasms in early stages of azoturia died with typical symptoms of strychnine poisoning within three minutes of receiving one grain of strychnine subcutaneously. Cattle are similarly affected with horses and dogs. There are exhib- ited muscular spasms, frequent pulse, difficult respiration, sensitiveness to light, sounds and external stimuli, protrusion of the eyeballs and con- vulsions. The fatal dose, by the mouth, varies greatly owing to difficulty of absorption in the complicated and capacious digestive apparatus of these ruminants. This is true of all medicines. When given under the skin, the lethal dose is a little larger than that for horses. The fatal dose for swine is said to be from gr. l/6-gr. 8/4. Chickens are comparatively insusceptible; also guinea pigs and some monkeys. Strychnine poisoning differs from tetanus in the fact that muscular rigidity is continuous in the latter, but disappears to a considerable degree, if not completely, in the periods between the convulsions, in the case of strychnine poisoning. Moreover, in tetanus the body and limbs are less, and the jaw more affected; while in strychnine poisoning the condition is reversed. Treatment. — The treatment embraces the use of chemical antidotes, as iodine or its salts, or tannic acid; animal charcoal and emetics or the stomach tube, before absorption has occurred. Chloroform, chloral and amyl nitrite were formerly considered the best antidotes to strychnine but recent experiments prove these too depressant to the respiratory centres. Artificial respiration is of service in paralysis, but not in con- vulsions, unless air be forcibly driven into the trachea through a catheter. The best treatment consists in ether anesthesia, intratracheal insufflation and intravenous saline infusion (Githens & Meltzer, 1912). Post-Mortem Appearances. — These are simply those of asphyxia, with the usual congestive lesions and dark fluid blood, except spinal hyperemia is observed. Uses Internal. — The indications for the employment of strychnine may be directly deduced from its physiological actions. The indications are as follows: 1. To stimulate the respiratory and vasomotor centres and nervous system. 302 VEGETABLE DRUGS To stimulate the spinal cord; more particularly the motor cells of the inferior cornua. 3. To stimulate appetite, digestion, muscles, and intestinal peris- talsis in atonic conditions. 4. To destroy dogs and other small animals. 5. As an aphrodisiac. 1. Strychnine is a good remedy to stimulate the respiration, vasomotor centres and nervous system, and to promote appetite and digestion in acute diseases. It is commonly employed in the treatment of pneumonia and influenza and in all acute diseases when the necessity arises. In the acute stages, with prostration and failing respiration, to stimulate the spinal and respiratory centres; and in convalescence to sharpen the appetite, and increase general tone. In pneumonia, when collapse is threatening, it is well to give strychnine subcutaneously with atropine to stimulate the respiratory centres. It should be realized, how- ever, that strychnine is not in any way comparable to digitalis as a heart stimulant and in heart weakness in pneumonia, or other diseases, digitalis is infinitely preferable. Strychnine is useful in influenza by counter- acting nervous depression and improving the appetite and digestion. In collapse and shock, following surgical operations, or in ether, chloral, chloroform and opium poisoning, strychnine is usually prescribed as a cardiac and respiratory stimulant, given in large doses subcutaneously. In surgical shock Crile finds strychnine harmful and it is undoubtedly true that morphine is much more effective. Strychnine has been popu- larly 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 dis- orders, often associated with asthma and known as "broken wind" or "heaves," in horses. It is also useful in asthma and chronic bronchitis of dogs. The beneficial effect in these diseases is explained by the stimulating action of the drug on the respiratory centres, and the favorable influence exerted on digestion. Strychnine is also appropriate in convalescence from acute diseases for the same reason. 2. In mild cases of chorea in dogs, strychnine is prescribed to ad- vantage with Fowler's solution. In accordance with its physiological action, strychnine is indicated in various paralyses of spinal origin, bat should not be used where there is irritation or inflammation of the spinal motor tract. It is employed in hemiplegia and paraplegia, resulting from hemorrhage, after the lapse of several weeks, when irritation produced by the clot has passed away. After paralysis of the motor tracts of the brain or cord, strychnine is, however, contraindicated since the reflexes below the lesion are cut off from normal cerebral control and they are over- active and the muscles in a state of overtone. Strychnine is essentially indicated in asthenia but not in conditions associated with a spasmodic STRYCHNINE 303 condition of muscles. Strychnine is said to be efficacious in the after- treatment of cerebro-spinal meningitis of horses, and also in the para- plegia of cattle (from parturient fever, and in the paraplegia coming on before parturition in weak cows and not disappearing after labor) and that of dogs resulting from various and often undiscovered causes. Strychnine is serviceable in the paralysis of lead poisoning, and in that form caused by traumatism or toxemia following influenza, distemper in dogs, and rheumatism. When injected into the muscular tissue, the alka- loid 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 "roaring" in horses. Either retention or incontinence of urine, resulting from atony or paralysis of the bladder, may-* be relieved by strychnine; also prolapse 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, quinine, 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 peristalsis, and therefore hinders fermentation, prevents relaxation, and so over-secretion from loss of vascular tone. Tonic for horse. Arseni trioxidi 3i. Pulveris nucis vomicae. Ferri sulphatis exsiccati aa 5iv. M. Divide in chartulas No. xxx. S. One powder on feed t. i. d Tonic for dogs. Ferri reducti. Quininae sulphatis. Pulveris nucis vomicae aa 3ss. M. et fiant pilulae No. xxx. S. One pill t. i. d. 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 subcutaneously in these con- ditions, and frequently in combination with pilocarpine, eserine or are- coline. 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 useful- ness. The aloin, strychnine and belladonna pills, with cascara sagrada, are useful in habitual constipation in dogs, but the weaker formula, con- taining gr. 1/120 of strychnine, should be employed. The value and application of strychnine in anorexia and atonic digestive disorders has been sufficiently treated above. 304 VEGETABLE DRUGS 4. There is no more convenient or humane agent for destroying small dogs and cats and other small animals than strychnine injected into the gluteal muscles (gr.ss to gr.i). Death occurs usually without struggling, pain or convulsions, and in less than a minute in many cases. But in others convulsive movements may persist for a time. For large dogs, and for the larger animals gen- erally, a well directed bullet is the most rapid, effective and humane method of accomplishing euthanasia. 5. Strychnine is useful in sexual asthenia as a stimulant to the spinal centres and reflexes, and as a general nervous tonic. Class 2. — Depressing the Inferior Cornua. Physostigma. Physostigma. (U. S. P.) Synonym. — Physostigmatis semina, B. P.; Calabar or ordeal bean, faba physostigmatis, S. faba Calabarica, E. The dried ripe seed of Physostigma vene- nosum Balfour (Fam. Leguminosw)> yielding not less than 0.15 per cent, of the alkaloids of physostigma. Habitat. — Calabar and the region of the mouth of the Niger, in Western Africa. Description. — Oblong or ellipsoidal, somewhat compressed reniform, 15 to 30 mm. long, 10 to 15 mm. thick; externally reddish- or chocolate-brown, smooth, somewhat wrinkled near the brownish-black groove which extends almost the entire length of the convex edge; taste at first starchy, afterwards acrid. Constituents. — The principal constituent is the alkaloid physostigmine, or eserine. There are also the alkaloids calabarine (resembling strychnine), a prod- uct resulting from the decomposition of eserine, and eseridine, similar to action in eserine, but weaker; and a neutral principle, physoterin, resembling cho- lesterine. Calabar Bean Dose.—H., gr.xv-xxx, (1-2); D., gr.%-i, (.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. Physostigmine Salicylas. Physostigmine Salicylate. C15N2102N3CTH(A. (U. S. P.) Synonym. — Eserine salicylate; salicylate d'eserine, Fr.; physostigmin- salicylat, G. The salicylate of an alkaloid obtained from physostigma. Derivation. — Physostigmine is obtained from the alcoholic extract of Calabar bean by dissolving the extract in water, adding sodium bicarbonate, shaking the mixture with ether, and evaporating the ethereal liquid. The salicylate of the alkaloid — the most stable salt — is made by adding physostigmine to a solution of salicylic acid in boiling distilled water, when the salt crystallizes on cooling. Properties. — Colorless, or faintly-yellowish, shining, acicular, or short, colum- nar crystals; odorless, and having a bitter taste. Soluble in 75 parts of water, and in 16 parts of alcohol; in 6 parts of chloroform. It acquires a red tint when long exposed to the air and light. Great caution must be used in tasting it. (U. S. P.) Dose.— H. & C, gr.iss-iii, (.09-.18) ; D., gr. 1/100-1/30, (.0006-.002). Given usually subcutaneously, intravenously or intratracheally to horses. Physostigmixe Sulphas. Physostigmine Sulphate. (B. P.) Synonym. — Eserine sulphate, E.; sulfate d'eserine, Fr.; physostigminsulfat, G. 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.iss-iii, (.09-.18) ; D., gr. 1/60-1/10, (.001- PHYSOSTIGMINE 305 .006); H., subcut., gr.i-iss, (.06-.09) ; intratracheally, gr.ss, (.03); foals and calves, subcut., gr. 1/12-1/6, (.005-.01); D., subcut., gr. 1/100-1/30, (.0006-.002). Given usually subcutaneously, intravenously or intratracheally to horses. Eserine decomposes on exposure to the air and solutions do not keep more than a week. The pure salt should be bought in hermetically sealed tubes, as tablets decompose when exposed to air. The salicylate is more stable than the sulphate. Physostigmine. Action Internal. — Alimentary Tract. — The flow of saliva is at first stimulated, whether by direct excitation of the salivary cells or not, is undetermined. Salivation ceases when the gland is deprived of blood by general vascular contraction. The peristaltic action of the stomach and bowels is increased by the direct local action of the alkaloid on the motor nerve endings (vagus) of the smooth muscles. There are three stages, in reference to this action, observed in poisoning. First, there is stimula- tion of peristaltic action, then tetanic contraction and diminution of the intestinal calibre, and finally relaxation and dilatation of the bowels. The secretions in the digestive tract are augmented 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 expul- sion of gas commonly occur in the space of half an hour, occasionally in a few minutes, and is often considerable in amount (11-20 lbs. of feces). The essential action of the drug is to stimulate the secretory nerve end- ings of glands, and the motor nerve endings of smooth and striated muscle. Circulation. — Eserine is readily absorbed, but exerts no influence on the blood. Moderate doses render the cardiac pulsations slower and more forcible, and increase vascular tension. Large toxic doses cause the heart to beat more rapidly and less forcibly. The first effect is due probably to stimulation of the peripheral vagi and heart muscle, and possibly the involuntary muscular fibres in the vessel walls. The second phenomenon follows depression of the heart and peripheral vagi, and terminates in cardiac paralysis and diastolic arrest. The action on the circulation is entirely subordinate to the influence of the drug upon the nervous system, and is unimportant from a therapeutical standpoint. Nervous System and Muscles. — The essential central action of physostigmine consists in depressing the respiratory centre in the medulla and the cells of the inferior cornua. This has been abundantly and direct- ly proved by application 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 motor nerve endings or myoneural junctions. 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 physostigmine, and acts like strychnine on the spinal cord. In poisoning by such, calabarine may induce convulsions. The involuntary muscles throughout the body are stimulated, including those of the stomach, intestines, gall bladder, bronchial tubes, heart, blood 306 VEGETABLE DRUGS vessels, iris (?), spleen, uterus, and bladder. 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 respiratory move- ments, and death occurs from asphyxia, before cessation of the heart, owing to paralysis of the medullary respiratory centre. The acceleration of breathing is due to the stimulation of the respiratory centre and of the pulmonary vagal endings. Secretions. — Secretion is generally increased, through stimulation of the secretory nerve endings and glandular tissue, including that of the salivary, gastric, intestinal, sudoriparous and lachrymal glands. In this respect eserine is antagonistic to atropine. Eye. — Physostigmine is a myotic, applied locally or administered in- ternally. Intraocular tension is diminished and there is spasm of accommodation. In all probability contraction of the pupil is brought about by stimulation of the oculomotor nerve endings (because absent in degeneration of the third nerve). Eserine is thus directly antagonistic to atropine in its effect upon the eye, but they resemble each other in that they both exert a local action and do not affect the irides of birds. Enormous doses of physostigmine paralyze the oculomotor nerves and dilate the pupil. Elimination. — Eserine is rapidly absorbed and eliminated, mainly by the urine, but also in the other secretions. Toxicology. — Physostigma has been called "ordeal bean," because native Africans suspected of crime are given the crude drug. Vomiting it, they are proved innocent and survive the ordeal. Retaining 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 simulate convulsions. Soon there is loss of muscular power and the animal falls or lies down. The respiration becomes rapid, labored, and stertorous ; the pulse is increased in frequency by large toxic doses, and the temperature slightly elevated. There are salivation and sweating. The pupil is sometimes contracted and, when enormous lethal doses have been injected, dilated. Vomiting occurs in animals capable of 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 abolished, 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 irregular, and death occurs from res- piratory 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 PHYSOSTIGMINE 307 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 became rapid and labored. No other symptoms developing within twenty-five minutes after the first dose, three grains of the alkaloid were administered in the same manner as before. The pulse became more frequent (78), the respiration (48) was difficult, and the muscular tremors increased in violence till they resembled convulsions. Sweating was profuse, while saliva dropped freely from the mouth. The respira- tion 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 contamina- tion of the eserine with calabarine, as the former was not a fresh preparation. An aged express horse, suffering for a week from impaction of the colon, was given twelve minims of a commercial extract of calabar bean. He fell down almost immediately, perspired freely, exhibited muscular tremors, and expired within a few minutes. The writer is unable to state the minimum fatal dose for horses, but eserine should be used with caution in weak subjects. — Wistslow. A gelding, 800 lbs., poorly nourished, temperature normal, pulse 60, was given physostigmine sulphate gr. 1% (0.1) in ^ dram of water intrajugularly. Muscular tremors and colic came on in seven minutes; in eleven minutes defeca- tion 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 lbs., tem- perature and pulse normal, was given 3 grains (0.18) of eserine sulphate under the skin. After thirty-two minutes elapsed, defecation began and continued with the expulsion of considerable mucus and flatus until six passages had occurred within one hour and twenty minutes. During this time the pulse had increased in frequency and the animal was restless and pawing the ground. An hour and a half after the first dose, a second dose of 3 grains (0.18) was given in the same way. In twenty minutes muscular tremors and weakness became marked, for the first time, and great distress was evident, the patient appearing to be in much pain; the respiration short, jerky and labored, and nostrils distended and work- ing. 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 contained much mucus and during passage were attended with considerable straining. The weight of feces aggregated 17 lbs. Four hours after the last dose all symptoms disappeared. — Muir.* Summary. — Full medicinal doses of physostigmine (gr. l%-3), given subcutaneously or intravenously, produce slight to considerable colic, in- creased peristalsis and mucus secretion, muscular tremors and weakness, and frequent defecation — beginning in ten to twelve minutes after intra- venous use, about thirty minutes or more after injection under the skin — and being twice as copious when the former mode of administration is employed than after the latter. Moreover, the disagreeable accompani- ments 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 injected *Jour. of Comp. Med. and Vet. Archives, Jan. and Feb., 1899. 308 VEGETABLE DRUGS into the external jugular vein, and that it safely may be 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. The toxic line is too closely approached, however, when physostig- mine is used in this way, and we should be careful not to cross it by extending the dose. Arecoline hydrobromide acts as rapidly and with- out the unpleasant accompaniments of purgation caused by eserine, so that the former is generally preferable as a cathartic for use by the intravenous method. According to Quitman eserine given subcutaneously in divided doses (gr.1/^ every 20-30 minutes to effect) is far more effective in emptying the bowels than arecoline given in this manner. Seldom more than one and one-half grains are required and in doses of this size it is safe even for aged animals. The minimum fatal dose of physostigmine is stated to be from gr. 1/15-1/12 for dogs, and gr. 1/30-1/20 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 respiration should be practised and external heat applied. The essential action of atropine in antagonizing eserine, consists in stimulation of the respiratory centres, while it de- presses the peripheral cardiac vagi, and so, to a certain extent, counteracts the primary influence of eserine on the heart. Large doses of atropine may only exaggerate the secondary depression of eserine upon the peri- pheral vagi in the heart, and so hasten a fatal result. Strychnine is antagonistic to eserine in stimulating the respiratory centres and inferior cornua. Uses External. — Physostigmine has been injected empirically, but it is asserted with good results, into chronic dropsical effusions. of joints and bursae 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 physiologic actions of eserine are put to thera- peutic uses. 1 . The myotic 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 per- sistent as that of atropine on the eye, and is somewhat painful. It is employed in 1 per cent, solution. 2. Physostigmine is mainly of value for its action in rapidly stimu- PHYSOSTIGMINE 309 lating the unstriated muscles of the alimentary canal. In obstinate con- stipation of horses it is particularly useful; eserine sulphate being given subcutaneously or intravenously with pilocarpine sulphate; the latter to increase the intestinal secretions. Strychnine sulphate may be added to counter act the depressing action of eserine on the respiratory centres and inferior cornua. For a horse with obstinate constipation or impaction of the bowels. Physostigminae sulphatis gr.i. Pilocarpine hydrochloride gr.iii. Strychnine sulphatis gr.ss. Aque destillate 3i. M. Sig. Give at once subcutaneously. 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 calculi 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. In pregnant animals it may produce abortion. The drug, like other purgatives, may aggravate the damage produced by twist or intussuscep- tion. 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 indigestion due to chronic intestinal catarrh, small and repeated doses of eserine are sometimes of benefit. In cattle, eserine (gr.-i.) and pilocarpine (gr.-iii.) subcutaneously are of great value in tympanites and impaction of the rumen and omasum, in acute gastritis, and in parturient apoplexy, to quickly empty the digestive canal. Eserine is sometimes given subcutane- ously to foals (gr. 1/12-1/6) for retention of meconium. It is effective in obstinate constipation of dogs given by the mouth (gr. 1/60-1/12) in pill, twice daily. Eserine has been employed in chronic bronchitis, asthma and em- physema, 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 advantage in either instance. In some cases of paraplegia, resulting from myelitis, a favorable effect has been obtained in man. Eserine is an appropriate purgative (hypoder- matically) in acute meningitis. Eserine has been used in strychnine 310 VEGETABLE DRUGS poisoning, but is inferior to chloral bromides and anesthetics, and while it is antagonistic to a certain extent, and alters the character of strych- nine convulsions, yet animals die more quickly when poisoned by both strychnine and eserine, than by strychnine alone. Gelsemium. Gelsemium. (U. S. & B. P.) Synonym. — Radix gelsemii, yellow jessamine, E.; jasmin sauvage, Fr. ; gel- semie, G. The dried rhizome and roots of Gelsemium sempervirens (Linne) Aiton filius (Fam. Loganiacew). Habitat. — Southern United States. Description. — Rhizome cylindrical, usually in pieces from 2 to 20 cm. in length and from 3 to 30 mm. in diameter; externally light yellowish-brown, longi- tudinally wrinkled, with purplish-brown longitudinal lines and transverse fissures; odor slight, taste bitter. The powder is dark yellow. Constituents. — The most important is the first alkaloid. 1. Gelsemine, C54HG0N4O12. A colorless, crystallizable, bitter principle, soluble in alcohol and ether, and slightly in water. 2. Gelseminine, a brown, amorphous, bitter alkaloid. 3. Gelseminic acid. 4. A volatile oil. Dose.— H., 3i-ii, (4-8) ; D., gr.v-x, (.3-.6). PREPARATIONS. Fluidextractum Gelsemii. Fluidextract of Gelsemium. (U. S. P.) Made by maceration, percolation and evaporation, so that 1 mil = 1 Gm. of the crude drug. Dose.— H., 5i-ii, (4-8); D., TTlv-x, (.3-.6). Tinctura Gelsemii. Tincture of Gelsemium. (U. S. & B. P.) Gelsemium, 100; alcohol and water to make 1,000. Made by maceration and percolation. (U. S. P.) Dose.— H., 3ss-i, (15-30); D., Tn.xv-5i, (1-4). Gelsemina. Gelsemine. (Non-official and uncertain in strength.) Dose.— H., gr.14-%, (.015-.03); D., gr.1/60-1/30, (.001-.002). Action External. — None. Action Internal — Gelsemium exerts no action on the digestive appa- ratus, or on the blood, after its absorption; neither does it affect the circulation in medicinal doses, but in toxic quantities it directly depresses the heart. The influence of the drug on the vasomotor system is unknown. Nervous System and Muscles. — The prominent action of gelsemium is that on the nervous system, as evidenced by paralysis and convul- sions after large doses. Both the convulsant and paralyzant effects are of spinal origin. That the convulsions are not cerebral is shown by the fact that they occur below the point of section in mammals (under the influence of the drug), with divided spinal cord. That they are not peri- pheral is proved by their occurrence in the hind extremities when the posterior aorta is tied before the animal is poisoned. The paralyzant action of gelsemium is due to direct depression of the cells of the inferior cornua, and this is followed, in the later stages of poisoning, by depression of the motor nerve endings and spinal sensory tract, with general anes- thesia. The cause of the secondary convulsions is undetermined. A tetaniz- ing principle in gelsemium, antagonistic to gelsemine, such as we find in physostigma, has been thought to be the cause of the convulsions. The GELSEMIUM 311 muscles, motor (except those of the face) and sensory nerves are un- affected by gelsemium. Respiration. — Gelsemium, in toxic doses, progressively weakens and paralyzes the medullary and spinal respiratory centres, and death occurs from asphyxia. Eye. — In poisoning, in animals, there is dilatation of the pupil pro- duced in the latest stages of the toxic period. In man, there is in addition to this, paralysis and drooping of the eyelids (ptosis), and paralysis of the recti muscles with strabismus. These symptoms have been attrib- uted with apparent reason to paralysis of the motor cells in the floor of the fourth ventricle and aqueduct of Sylvius, since they are a prolonga- tion of the spinal motor tract. As the pupil is dilated, however, by the application of much smaller doses than are required by the mouth, it seems probable that mydriasis results from local paralysis of the oculo- motor nerve endings. Toxicology. — Poisoning in animals is exhibited by muscular weak- ness, especially in the fore legs, staggering gait and falling. These symptoms are followed by convulsive movements of the muscles of the head, fore legs, and sometimes of the hind legs. The respiration is slow and difficult, the pulse feeble; temperature is reduced, and there is sweating. Consciousness is preserved until the occurrence of asphyxia. Death takes place from respiratory failure, with almost simultaneous cardiac arrest. Morphine subcutaneously has proved a successful anti- dote. Respiratory and heart stimulants should be employed in poisoning by gelsemium, such as strychnine, atropine, alcohol, and digitalis, together with artificial respiration, after evacuation of the stomach. Uses. — Gelsemium possesses little value in veterinary medicine. There is no therapeutic indication for gelsemium which cannot be filled to better advantage by some other remedy. Thus, gelsemium has been employed as a cardiac depressant and antipyretic in acute diseases (pneu- monia and pleurisy), but its other actions are disadvantageous and it is inferior to aconite, veratrum viride, or the modern antipyretics. In spas- modic diseases, irritable cough, vesical irritation, tetanus, chorea, etc., it is less satisfactory as a motor depressant than opium, belladonna, chloral, and bromides. Zuill, however, reports very successful results in horses from gelsemine (.08 Gm.) in tetanus. The dose should be given under the skin every half hour till muscular relaxation occurs. Lobeline is, however, in favor for this purpose. The drug has been used consider- ably to relieve rheumatic and neuralgic pains, but these succumb more readily to opium, coal tar products, etc. As a mydriatic, gelsemine is not to be compared with atropine for general purposes, but its action is more transient. A solution (gr.8-J)i) is instilled (in man) in drop doses every fifteen minutes for one hour, and then every thirty minutes for two hours, to secure wide dilatation of the pupil; or discs, containing gr. 1/300 of gelsemine (with gelatine) are used for application to the eye. 312 VEGETABLE DRUGS SECTION III.— DRUGS ACTING CHIEFLY ON THE MOTOR NERVES. Class 1. — Depressing the Motor Nerves. Tabacum. Tobacco. (Non-official.) Synonym.— Tabaci folia, B. P., Fr.; Tabak, G. The commercial dried leaves of Nicotiana Tabacum Linne (nat. ord. solanaceae). Habitat. — Tropical America. Cultivated in various temperate and tropical parts of the earth. Description. — The leaves are up to 50 cm. long, oval, or ovatelanceolate, acute, entire, brown, friable glandular-hairy of a heavy, peculiar odor and a nauseous, bitter and acrid taste. Constituents. — Chiefly nicotine, C10 H14 N2 (0.7-5.-11. per cent.). A colorless, volatile, oily alkaloid, resembling tobacco in odor and taste. Freely soluble in alcohol and ether; less so in water. Nicotine is decomposed by heat and therefore tobacco smoke contains little of it, but in its stead, pyridine, C5H5N, and various allied alkaloids, viz., picoline, C«;H7N; lutidine, C7HUN; rubidine, CUH17N; cori- dine, C10H15N; parvoline, CUH13N; and collidine, C8HUN; together with small amounts of sulphur, creosote, acetic and hydrocyanic acids and carbon compounds. Pyridine resembles nicotine in depressing the central nervous system and motor nerves and in paralyzing respiration, and is said to be formed more in pipe smoke, while, in the smoke of cigars, the less harmful collodine is produced by dry distillation. Furfurol is another harmful constituent of tobacco smoke — one of the constituents of fusel alcohol in new whiskey and distilled liquors producing headache. There is as much furfurol in some cigarettes as in 2 ounces of whiskey. Nicotine and furfurol exist to very slight degree in Turkish tobacco. Dose.— Nicotine, H. & C, gr. 1/60-1/20, (.001-.003). Action of Tobacco and Nicotine. Action External. — Tobacco is a local anodyne, antiseptic and para- siticide. Action Internal. — Digestive Tract. — The physiological effect of tobacco is due to nicotine. Nicotine increases peristaltic action and, in large doses, causes tetanic spasm of the intestines, even when it is injected into the blood. This happens through paralysis of the inhibitory or splanchnic ganglia, and stimulation of the motor ganglia (Auerbach's) in the bowel walls. In toxic quantities nicotine is a powerful gastrointes- tinal irritant, and produces the usual symptoms of pain, vomiting (in ani- mals capable of the act), purging and collapse. Circulation. — The action of nicotine on the circulation is complicated. The chief effect is due to primary stimulation of the vagus centre and heart muscle with more forcible contractions and slowing of the heart, followed shortly by depression of the cardiac vagus ganglia and heart muscle, with feeble and rapid pulse — after large toxic doses. In the same manner there is a transient stimulation followed by depression of the vasoconstrictor centres and ganglia, with consequent primary rise and subsequent fall in blood tension. Nervous System and Muscles. — Nicotine acts first to stimulate the reflex excitability of the spinal cord, medulla and hind brain in large TOBACCO AND NICOTINE 313 doses — but this action is quickly followed by depression and paralysis of the whole central nervous system and motor nerves. The muscles and sensory nerves escape its influence. The most characteristic specific action of nicotine consists in a transient stimulation, followed by complete loss of function, of the peripheral sympathetic ganglia, as seen in the effect of the drug upon digestion, the heart, secretions, and pupil. Respiration. — The respiratory centres are primarily stimulated but later depressed and paralyzed by fatal doses of nicotine and death occurs through respiratory failure. Secretions. — The secretions of sweat, saliva and bronchial mucus are at first increased and then diminished by the action of nicotine in stimu- lating and then depressing the ganglia in the course of the secretory nerves. Eye. — Nicotine affects the pupil variously. It is transiently dilated in the dog and cat; constricted in the rabbit; and, in man, contraction is followed by dilation. These differences appear to depend upon whether the drug stimulates more the sympathetic (dilation) or the oculomotor (contraction) ganglia. Elimination. — Nicotine is in part destroyed by the liver and adrenal secretion. It is also eliminated chiefly by the kidneys but also is found in the saliva and sweat. Toxicology. — Nicotine is one of the most powerful and rapidly act- ing poisons. When swallowed, it causes, in animals, local irritation and pain in the throat and stomach; muscular tremors and weakness, on account of which the animal falls. These symptoms are followed, first, by severe tonic and clonic convulsions, and then by abolition of voluntary motion and quietude. There are vomiting (in the case of some animals), purging and micturition. The respiration is at first shallow and rapid, but becomes weaker and slower, and death occurs from respiratory failure and general collapse. The pulse is primarily slow and intermittent, but later becomes rapid. The treatment of poisoning consists in evacuation of the stomach; the use of tannic acid; respiratory and heart stimulants, as strychnine, atropine, caffeine, and alcohol; together with external heat and artificial respiration. The minimum lethal dose is about one dram of tobacco, or one minim of nicotine, for small dogs. For horses, five to ten drops of nicotine or one-half pound of tobacco. Uses. — Tobacco is not a particularly valuable medicinal agent. Its internal action is often violent, and causes great nausea. Absorption and poisoning may follow its external application in the smaller animals. The drug may be employed for four purposes, as follows: 1. As a local sedative. 2. As a parasiticide. 3. As a motor depressant. 4. As a cathartic. External. — 1. Tobacco is an efficient sedative in decoction (1-40), for relieving pruritus ani and vulva?. It must be remembered that absorp- 314 VEGETABLE DRUGS tion and poisoning may occur when larger amounts are used externally than can be administered with safety by the mouth. 2. The latter remark applies also to the use of tobacco decoctions in killing parasites on the skin, such as the acari of mange and scab, to- gether with lice and fleas. For sheep with full fleece tobacco is one of the best curative and preventive agents in mange or scab as follows: Manu- factured tobacco, 1 lb.; flowers of sulphur, 1 lb.; water, 5 gallons. The tobacco is soaked in cold or tepid water for 24 hours and, on the night before the dipping, the solution is brought to a boil for a minute and the tobacco allowed to remain in it over night. Mix the sulphur in a pail to the consistency of a gruel with water. Strain and press the liquid out of the tobacco and add it to the sulphur and enough water to make 5 gal- lons. After dipping, the sheep must be turned into a clean yard or barn to drain. | ... j Internal. — 3. Tobacco has been employed as a motor depressant in spasmodic disorders, such as asthma, tetanus (given by the rectum or under the skin), and strychnine poisoning, but it is inferior to, and more dangerous than, other drugs. 4. The Germans prescribe tobacco to stimulate peristalsis in rumi- nants, in doses of 2 ounces, with one-half pound of common salt and one pound of Glauber's salt for cattle; and for sheep, % ounce, with 2 ounces of salt and 3 ounces of Glauber's salt. Tobacco was given for- merly in colic and intestinal obstruction, but this use is obsolete. The decoction (1 to 2 per cent.) may be injected into the rectum of horses, in non-toxic quantities, to kill oxyurides and ascarides, and to excite peristalsis and relieve spasm in colic. Tobacco smoke is sometimes used in the same manner to destroy worms in the lower bowels. Conium. Conium. (Non-official.) Synonym. — Conii fructus, B. P.; hemlock fruit, E.; grande cigue, Fr.; schierling, G. The full-grown, but unripe fruit of Conium maculatum Linne (Fam. Umbel- liferce), carefully dried and preserved, and yielding not less than 0.5 per cent, of conine. After being kept for more than two years, conium is unfit for use. Habitat. — Indigenous to Europe and Asia, but naturalized in the United States. Description. — Broadly ovoid, greenish-gray; odor slight, but when triturated with a solution of potassium hydroxide, strong, disagreeable, and mouse-like; taste characteristic, disagreeable, afterwards somewhat acrid. Conium fruit resembles carraway and anise seed, but these have oil-tubes or vittse. Dose.— Coniinae hydrochloridum. H., gr. %-iy2, (0.45-0.1) ; D., gr. 1/60-1/30, (0.001-0.002). Constituents. — There are two essential principles in conium; conine, or coniine, and methyl-coniine. Action of Conium. Nervous System and Muscles. — The predominant action of conium consists in paralyzing the voluntary and involuntary muscles, with loss of motion but without loss of consciousness or sensation. This effect is due to paralysis of the motor nerves. CONIUM 315 Toxicology. — The minimum fatal dose of conium is uncertain, owing to the proneness of the alkaloid to decomposition, and to the volatility and the variable amount contained in the crude drug. A few drops of the alkaloid will kill small cats and dogs. Herbivora, as goats, sheep and horses, are less susceptible than carnivora. The domestic animals occasionally become accidentally poisoned by eating hemlock at pasture. The symptoms exhibited are dulness, loss of muscular power (at first in the hind legs), stumbling and falling, or lying down. We observe, also, nausea, salivation (sometimes amaurosis), dilatation of the pupil and ptosis, sweating, and often muscular tremors and clonic convulsions. The pulse becomes slow and feeble, the breathing faint, the surface cold and clammy, and the animal often lies as still as though dead, so complete is the paralysis. Death finally occurs from asphyxia, frequently associated with coma. The respiration ceases before the heart-beat. The urine of poisoned animals may be used as a physio- logical test in frogs, to decide doubtful cases. The treatment of poisoning consists in evacuation of the stomach and the use of tannic acid, artificial respiration, external heat, and respiratory and cardiac stimulants, as strychnine, atropine, caffeine and alcohol. The post-mortem appearances are those of asphyxia, with sometimes evidences of gastro-intestinal irri- tation. Uses Internal. — Conium is rarely used in veterinary medicine on account of the uncertainty of its preparations and natural therapeutic limitations. Lobelia. Lobelia. (U. S. P.) The dried leaves and flowering tops of Lobelia inflata Linne (Fam. Lobe- liaceae). Synonym. — Indian or wild tobacco, E.; lobelie enflee, Fr. ; lobelienkraut, G. Habitat. — Eastern and central North America. Description. — Stems cylindrical, coarsely and irregularly furrowed, yellowish- green, occasionally purplish and with numerous spreading hairs; leaves alternate, sessile or narrowing into a short petiole, usually more or less broken; when entire, laminae ovate or oblong, from 2 to 9 cm. in length; pale green and with scattered, bristly hairs; flowers blue in long, loose racemes with short pedicels; seeds brown- ish, oblong and coarsely reticulate; odor slight, taste strongly acrid. The powder is dark green, odor irritating. Constituents. — 1. An alkaloid, Lobeline (C18H2303?) in broad, colorless, odor- less, tasteless, crystals. ~2. Lobelie acid. 3. Lobelacrin. 4. Inflatin. 5. Lobeli- anin, a volatile oil. 6. A gum. 7. A resin. PREPARATIONS. Fluidextr -actum 'Lobelim. Fluidextract of Lobelia. (U. S. P.) Made by maceration and percolation 'with acetic acid and diluted alcohol, and evaporation so that 1 mil=l Gm. of the crude drug. Dose.— 3ii-viii, (8-30); D., TTti-v, (.06-.3). Tincturw Lobeliw. Tincture of Lobelia. (U. S. P.) Lobelia powder, 100; alcohol to make 1000. Made by maceration and perco- lation. Dose. — H., gi-ii, (30-60) ; D., Emetic, 3i-iv, (4-15) ; D., Expectorant and seda- tive, TTLx-xxx, (0.6-2). Dose. — Lobeline sulphate (subcutaneously). — H. & C, gr. Af-% ; D> gr« 1/100-1/10. 316 VEGETABLE DRUGS Action of Lobelia and Lobeline. Lobelia, or wild tobacco, resembles closely in action real tobacco. It is a motor nerve paralyzant like conium, curare and tobacco. Again, like tobacco, it exerts a stimulant action on the sympathetic ganglia and causes vasoconstriction. Its degree of poisonous action is debatable. In human medicine great depression and fatalities have occurred, especially when vomiting does not follow large doses. There also appears to be a difference in the strength of preparations. Toxic doses cause emesis, in animals capable of the act, purging, prostration, feeble pulse, cold sweating, fall of blood pressure, coma, collapse, and sometimes convulsions. Moderate doses injected into a vein (lobeline), lead to fall of blood pressure and slow pulse, owing to vagus stimulation (central and peripheral), and, later, accelerated pulse and rise in blood pressure from stimulation of the vasoconstrictor ganglia. Edmunds found that a heart arrested by muscarine will begin beating again after the use of lobeline which appears, therefore, to stimulate the heart muscle. Like tobacco it increases secretion by stimulation of the sympathetic ganglia. E^mesis is due to stimulation of the vomiting center and local irritant action on the stomach. Purging is probably due to stimulation of Auerbach's plexus and the drug is eliminated from the blood by the stomach and intestines. Lobelia relaxes spasm of the bron- chioles by depressing the bronchomotor nerves, and increases secretion in its action as a nauseating expectorant. While it first stimulates the respiratory center, in poisoning the cen- ter is paralyzed. Treatment in poisoning consists in the use of heart and respiratory stimulants, as caffeine, camphor, atropine and strychnine with heat externally. Uses, Internal. — Hypodermatic. — Lobelia is used infrequently in human medicine and then only in bronchial asthma where it must be pushed to its physiological limit to relax spasm. This results frequently in emesis and is unpleasant. In bronchial asthma of dogs 20 minims of the tincture given every 15 minutes, till vomiting occurs, may give relief. It has not proved of value in heaves of horses. The therapeutic use of lobeline depends directly upon its antispasmodic action in paralyzing motor nerves and in its causing emesis. Lobeline sulphate (gr. 1/10) combined in tablet (Abbott) with arecoline hydrobromide (gr.ss), and strychnine sulphate (gr.%) has been found most successful in colic of horses. Spasm and pain may be so quickly relieved that morphine will not be required and at the same time catharsis secured. Lobeline is especially favorable in colic in subjects of heaves as it relaxes the bron- chioles while arecoline alone will increase dyspnea in these patients. Lobeline acts most satisfactorily in overcoming motor excitement in azoturia or hemoglobinuria of horses, when given under the skin. In tetanus of horses lobeline may relieve muscular spasms so that the animal is enabled to eat and drink, while it favors the action of cathartics. Given in conjunction with antitoxin, the use of slings, and maintenance of quiet and darkness, the drug has proven of great value. Lobeline appears to be a most useful antidote in strychnine poison- COCAINE HYDROCHLORIDE 317 ing. If given experimentally to dogs after the drug has been ingested, the emesis and motor relaxation may prevent all toxic symptoms. It has even proven an antidote to strychnine when given 10 minutes after a lethal dose has been injected subcutaneously, and also when given prior to the injection of a toxic dose of strychnine. In strychnine poisoning in horses successful results have been reported by Quitman with lobeline, but emptying the stomach by tube would seem also indicated. One-half grain of lobeline has been given subcutaneously to dogs (10-lb. dog) with only emesis, purging and salivation resulting (Browne), so that the drug would not be regarded as very toxic in these animals. Spasmodic conditions of dogs successfully treated by lobeline include chorea, eclampsia of bitches, and strychnine poisoning. In poisoning by any agent lobeline has an advantage over apomorphine in causing purging as well as emesis, and a hypodermatic tablet of gr. 1/60 is made for this purpose. A case is reported of strangulated hernia treated with lobeline resulting in so great relaxation that taxis was successfully performed, which was impossible before. SECTION IV.— DRUGS ACTING ON THE SENSORY NERVES. Class 1 . — Depressing the Sensory Nerves. Cocaine Hydrochloridum. Cocaine Hydrochloride.* C17H21 N04 HC1. (U. S. & B. P.) Synonym. — Chlorhydrate de cocaine, Fr.; cocain-hydrochlorid, G. The hydrochloride of an alkaloid obtained from Erythoxylon coca and its varieties. Cultivated in Peru and Bolivia and introduced into medicine by Roller in 1884. Derivation. — Cocaine hydrochloride is recovered by agitating an acidulated alcoholic solution of coca leaves with ether. The ethereal liquid is made alkaline with sodium carbonate and evaporated. The residue is purified, decolorized, neu- tralized with hydrochloric acid, and finally crystallized. Description. — Colorless, transparent, monoclinic prisms, in flaky, lustrous leaf- lets or a white crystalline powder; odorless; permanent in the air; of a saline, slightly bitter taste, and producing on the tongue a tingling sensation followed by numbness of several minutes' duration. Soluble in 0.4 part of water, 3.2 parts of alcohol, and in 12.5 parts of chloroform at 25° C; soluble in glycerin, insoluble in ether. Its aqueous solution is neutral to litmus paper, and is levorotatory. Dose.— H., gr.v-x, (.3-.6) ; D., gr. %-%, (.008-.045). Action External. — Solutions of cocaine (4-10 per cent.), applied to mucous membranes, produce perfect local anesthesia by paralyzing the sensory nerve endings. The functions of the nerves of special sense are abolished before those of ordinary sensibility. Stronger solutions para- *These are also official: Oleatum Cocainw (5 per cent.). U. S. P. Unguentum Cocainw (4 per cent.). B. P. Injectio Cocainw Hypodermica (10 per cent.). B. P. 318 VEGETABLE DRUGS lyze the motor nerve terminations. The local application of cocaine causes pallor and shrinking of the mucous membrane. The local anes- thesia and vascular constriction last from 15 to 60 minutes. If solutions stronger than 5% are used there may be some destructive action on proto- plasm and cells, as some local necrosis if injected under the skin, or ulceration of the cornea, if dropped in the eye. Thus strong solutions used for surgery are more prone to be followed by inflammation but such are not required for production of local anesthesia. Action Internal. — Digestive Tract. — Cocaine exerts a local anesthetic action upon the gastric mucous membrane, and in this way lessens the appetite and sometimes stops vomiting. Intestinal peristalsis is increased by moderate doses, but is decreased and destroyed by the paralytic action of large doses of cocaine. Nervous System. — The general action of cocaine on the nervous sys- tem may be summed up in descending stimulation followed by depression, beginning with the cerebrum and affecting in order the cerebellum, medul- la and spinal cord. Thus mental exhilaration and stimulation of the vital medullary and heat-producing centres (in poisoning) occur. Full doses of cocaine stimulate the psychical functions of the brain and cause intoxi- cation, which is followed, in poisoning, by stupor and convulsions. The convulsions are mainly of cerebral origin, but may be due in part to irri- tation of the spinal reflex centres. These latter centres are first stimu- lated by toxic doses, but depression and paralysis of the spinal cord follows; the sensory before the motor tract. The sensory nerves are paralyzed and the motor nerves depressed by toxic doses. The voluntary muscles, and probably motor nerve endings, are stimulated by medicinal doses of cocaine, and the alkaloid relieves fatigue and, experimentally, more than doubles the response to stimuli in wornout muscles. Volun- tary muscles are paralyzed by the local application of large quantities of cocaine. Cocaine is essentially a protoplasmic poison when applied even in dilute solution, directly to animal or vegetable cells, including epithelial cells, leukocytes, spermatozoa, muscle and nerves, and all motion or action of these instantly ceases. Circulation. — The action of cocaine upon the heart and vessels is not very marked, except in poisoning. The alkaloid is, however, a slight cardiac stimulant in moderate doses, increasing the pulse rate and ten- sion. The action upon the heart is caused, probably, by stimulation of the accelerator center and cardiac muscle. There is a brief initial stimulation of the cardio-inhibitory centre which is overcome by the muscular and accelerator effect. Vascular tension is increased because of stimulation of the medullary vasomotor centres, smooth muscle of the vessel walls, and because of the increased action of the heart. On the other hand, both small and large doses may diminish the pulse rate. Toxic doses depress and paralyze the heart muscle and vaso-constrictor centres, and rarely therapeutic doses, used in local anesthesia, may cause sudden collapse through some inexplicable action. Respiration. — Cocaine is a respiratory stimulant in medicinal doses, but a paralyzant in toxic amounts. The respiratory centre is first stimu- COCAINE 319 lated and the breathing is made deeper and quicker. Depression and paralysis of the respiratory centre follows ; cyanosis supervenes, and the respiration is shallow and irregular. Death occurs from asphyxia. Temperature. — The body heat is elevated, sometimes to an excessive degree, by poisonous doses of cocaine. Medicinal doses do not affect the temperature. The rise of temperature is said to follow stimulation of the thermogenetic center in the caudate nucleus. Kidneys. — The greater part of the cocaine, absorbed is oxidized within the body. The smaller part is eliminated by the kidneys. Experi- mental evidence concerning the influence of the alkaloid upon the secre- tion and composition of the urine is conflicting and indefinite. The amount of secretion probably depends upon the state of vascular tension and calibre of the vessels. The Eye. — Cocaine is used very largely in the eye. It produces local anesthesia, constriction of the blood vessels and dilatation of the pupil with lowering of intraocular tension. The action on the pupil seems to follow stimulation of the terminations of the cervical sympathetic in the radial muscle of the iris. Toxicology. — Moderate doses produce in dogs mental exhilaration and joyousness, so that they bark and jump about with delight. Poison- ing with large doses (gr. 14 of cocaine to 2 lbs. of live weight) may be divided into three stages. In the first stage, there is restlessness, anxiety and terror, with rhythmical movements. Noises frighten the animal and he fails to recognize his master. The second stage is characterized by a joyous condition, in which dogs bark, dance about and lick people's hands. In the third stage, weakness and nervous phenomena appear, — as muscu- lar twitching, rhythmical movements a pendulum-like motion of the head, convulsions and stupor. There is dyspnea, feeble pulse and failing res- piration. In an experiment upon a Newfoundland dog, weighing about 100 lbs., conducted by the writer, there were no symptoms produced by 3 grains of cocaine under the skin, except dilation of the pupils and a con- stant lapping with the tongue. In man, an amount of cocaine exceeding gr. % should not be employed under the skin, or upon mucous membranes, and death has occurred in susceptible patients from even smaller doses. The most powerful action follows the use of cocaine in very vascular parts, as about the face. One-half a grain of cocaine given subcutane- ously to a girl of eleven years old, was followed by a fatal result in 40 seconds, and the writer has seen violent convulsions produced by the instillation of a few drops of a 2 per cent, solution into the eye of a man. On the other hand, spontaneous recovery has obtained in the human sub- ject after the ingestion of 22 grs. of the alkaloid. In the horse, a toxic dose of cocaine (3i) causes restlessness and excitement, muscular twitch- ing and trembling, rhythmical movements of head (as nodding and weaving), dilated pupils and salivation, culminating within an hour in a state of acute mania and intense excitement. These symptoms are fol- lowed by gradual recovery after the lapse of a few hours. Three grains of cocaine given under the skin, will sometimes induce nervous excitement in susceptible horses. The treatment of dangerous forms of cocaine poi- 320 VEGETABLE DRUGS soning, with respiratory and heart failure, consists in the use of opium and rapidly acting stimulants, as morphine sulphate under the skin, nitro- glycerin upon the tongue, and strychnine atropine and brandy subcutane- ously. A short inhalation of ether has been shown to be a remarkably successful antidote in cocaine poisoning. Uses External. — Cocaine and its synthetic chemical substitutes are the most valuable agents we possess to cause complete local anesthesia for surgical purposes. Cocaine in surgery can often be combined most advantageously with adrenalin. The operations most suitable for the hypodermatic application of cocaine are included in the following. Removal of tumors. Opening of abscess. Docking and pricking the tail. Injuries and operations upon the Tarsal tenotomy. eyeballs and eyelids. Firing. Operations about the feet in horses. Neurectomy. Operations upon mucous mem- Herniotomy. branes. Operations about the rectum, vagina Laparotomy in bitches. and uterus. Examinations and operations about the larynx. The alkaloid may also be employed to dilate the pupil for examina- tion of the eye, and to detect lameness. In a case of doubtful foot lameness in the horse, injection of cocaine into the plantar nerve trunk, on either side of the leg and a little above the point of selection for plantar neurectomy, will often completely abolish sensation in the foot. This fact may be determined by pricking the soft parts above the hoof. If there is complete anesthesia of the foot, and the seat of lameness be situated therein, the horse will go sound while the anesthesia lasts. This method may be taken advantage of in the diagnosis of localized lameness elsewhere. If cocaine is injected over an area (suspected to be the cause of lameness), and the animal goes sound while the cocaine anesthesia lasts, the site of lameness becomes certain. It has been discovered that injections of powerful cocaine solutions into a sensory nerve trunk will paralyze its sensibility throughout the peripheral distribution (regional anesthesia). When ligation of a limb, or part, can be secured between the operative field and the heart, the anesthetic action of cocaine is more profound and toxic symptoms are less liable to occur, since the drug is not drained away in the blood during the operation. Many operations can be performed under cocaine, as neurectomy, firing, tenotomy, etc., without casting the horse. In using cocaine for the removal of tumors or opening of abscess, the solution is injected at several points in a circle about the base of the tumor or abscess, and not in the inflamed tissue of the latter. Following the first injection, the succeeding applications may be made painless by inserting the needle within the area made anesthetic by the previous injection (circumferential anesthesia). The amount of cocaine solution to be injected is of importance. This depends upon the strength of the solution, the weight and species of the animal, and the seat of application. A solution stronger than 4 COCAINE 321 per cent, is irritating to the eye. A 4 or 2 per cent., or even a much weaker solution, will ordinarily produce anesthesia when introduced un- der the skin. In the horse, subcutaneous injection of a 5 or 10 per cent, solution may be made to the amount of 2 drams of the former, or 1 dram of the latter solution (cocaine, gr. 6), but hinders wound healing and may produce necrosis, since cocaine is a protoplasmic poison. Larger doses may induce restlessness, excitement, etc., which, although not in- dicative of danger may interfere with operative procedures. When larger quantities are desirable, 2^> drams of a 4 per cent, solution, or 5 drams of a 2 per cent, solution, may be employed (equivalent to 6 grs. of the alkaloid), or Schleich's solution may be utilized. It is unwise to inject more than 10 grains of cocaine into horses, or more than gr.ii into large dogs, or more than gr. % into small dogs, while a safe maximum for the cat is gr. 14. The fatal dose for dogs is said to be 5 to 8 gr., and for horses 2 to 3 drams (Wooldridge). Novocaine is usually preferred to cocaine in both human and veteri- nary practice (see p. 323). It is commonly used in y2 to 2 per cent, solutions and almost any amount may be given subcutaneously in 1 per cent, solution without any fear of toxic action. The writer would recommend generally the employment of a normal salt solution (4 grains sodium chloride to 1 dram of water), containing from y2 to 2 per cent, of novocaine or cocaine. These weaker solutions will usually cause complete and safe local anesthesia. The solutions should always be warm — at body temperature — and not over twenty-four hours old, as acid develops which interferes with the anesthetic action. They are most conveniently made by solution of cocaine tablets in salt solution at the time of operation. It is commonly advisable to add 5 to 10 drops of l/l.OOO adrenalin solution (see p. 449) to each ounce or two of novocaine or cocaine solution. Ritter has secured most satisfactory general anesthesia in dogs by injecting intravenously 10 mils of a 1 per cent, solution of cocaine for small animals ; and 5 mils of a 3 to 5 per cent, solution in normal salt solution for large dogs. The anesthesia came on in 2 to 5 minutes and lasted 15 to 30 or more minutes. Moreover there were no untoward results and operations on any part of the body could be painlessly done without any struggling on the part of the patient. Both novocaine and cocaine have been used with success for work on a limb by injection into a vein between the site of operation and body. A tourniquet is first applied about the limb proximally to the point of injection. Local applications to mucous membranes may be reapplied, once or twice, at intervals of five minutes, to secure perfect anesthesia. A larger quantity of cocaine than recommended above for hypodermatic use, should not be employed. Cocaine* as already stated, produces a primary astringent action and, when properly diluted and applied in the firs!; stage of inflammation, it may prove a valuable abortive and sedative agent. 322 VEGETABLE DRUGS Hemorrhage from mucous membranes can be arrested by its topical application; coryza aborted, and hemorrhoids relieved by this method. Pruritus, about the anus and vagina, is allayed by cocaine. In relation to the eye, 5 to 10 drops (horse) of cocaine solution (1 to 4 per cent.) are employed for various purposes, embracing examination, removal of foreign bodies, operations, and the relief of suffering in acute inflamma- tion resulting from natural causes or mechanical irritation. The follow- ing prescription is of value in superficial inflammatory and painful con- ditions of the eye: I* Cocainae hydrochlor gr.v. Acid, borici gr.x. Aq. dest. ad 5i. M. S. Instill a few drops into the eye hourly. Injection into the eyeball is preferable to instillation for enuclea- tion. Solutions of cocaine should be freshly made, and must not be sterilized by boiling, although they should be made with sterile water, or, better, normal salt solution. The tablets supplied by pharmaceutical chemists are convenient for hypodermatic use. Ten grains of boric acid will pre- serve an ounce of cocaine solution for a month. Spinal anesthesia has come into use in both human and veterinary practice. Leonard Corning was the pioneer having shown in 1885 that cocaine injected between the 11th and 12th dorsal spines caused analgesia of the lower limbs in man. The point of injection in animals is in the lum bo-sacral space. This is found by drawing a line connecting the spines of the lumbar and sacral vertebrae and another at right angles connecting the summits of the internal angles of the ilium. Directly at the point of intersection of these lines is the place for puncture in the dog and cat and about % of an inch forward of this point is the site for puncture in the horse. The hair must be clipped and shaved from the dry skin and the site well swabbed with tincture of iodine and as soon as dry the puncture may be made with a boiled needle or trochar and canula. The smaller animals should be on their side with back arched. The needle or trocar is thrust in perpendicularly till the resistance lessens and cerebro-spinal fluid drops from the needle. This proves entrance into the spinal canal. No more fluid should be lost than is to be replaced by the injection. Sepsis means death, so that the necessity of asepsis will be fully appreciated. Anesthesia affects chiefly the pos- terior portion of the body and hind limbs but the fore limbs are also partly anesthetic. This action begins in 2 to 10 minutes, is fully de- veloped in 20 to 30 minutes, and lasts from 1 to 5 hours. While never generally accepted as a substitute in human surgery for ether, and while perhaps its use is diminishing, yet there is more reason for its employ- ment in veterinary surgery on account of the expense of general anes- thesia. The mortality from it has been about 3 per thousand in human surgery. PROCAINE 323 In addition the following undesirable results have been occasionally seen: sepsis and meningitis, 4 to 14 per cent, of failures to secure good anesthesia, collapse, retention of urine, chills, fever, vomiting, sweating, persistent paraplegia, pain in back and legs for months, nausea, cramps in the limbs, incontinence of urine, etc. Cocaine or its substitutes must be sterile for spinal anesthesia. As cocaine can not be boiled it may be dissolved in ether and when the ether has evaporated sterile water is added. A 2 per cent, solution of cocaine is commonly employed. Of this the dose is as follows: H., Tl\xx to xlv; Dog and Cat, TH_v to xv. The puncture may be made with the syringe attached to the needle for a handle. Then detach the syringe. After the spinal fluid drips from the needle which has entered the dura the syringe, already filled with the cocaine solution should be again attached to the needle and the proper amount injected. On re- moving the needle the puncture should be closed by collodion and cotton. Rudolf Klapp (Deutsche Zeitschr. f. Chir. 1904, Vol. lxxi, p. 187) has experimented upon animals with spinal injections for the production of anesthesia, and finds by combining gelatin, adrenalin and cocaine, the toxic effect of the latter is wholly averted and that this combination is a safe and perfect anesthetic for dogs. Five mils of a sterilized 10 per cent, aqueous gelatin solution, containing H\x of adrenalin (1-1000 solu- tion) and 0.02 to 0.04 Gm. of cocaine, are then injected through the trocar and the puncture sealed with iodoform collodion. The following operations have been performed painlessly under spinal anesthesia in the lower aniinals: neurotomy, tenotomy, cauteriza- tion, oophorectomy, castration, operations on the uterus and rectum, urethrotomy, herniotomy, etc. Wherever local anesthesia is available spinal anesthesia should not be used on account of its much greater dan- gers but its field of usefulness is wider than in human surgery. Use Internal. — Cocaine may be administered in aqueous solutions for the relief of persistent vomiting in dogs. The alkaloid is occasionally used as a stimulating and supporting agent in asthenic fevers and ady- namic conditions of the human patient. The subcutaneous injection of cocaine (gr.iii) is of great value in heat prostration of horses. According to Quitman, no other agent equals cocaine for instilling courage and con- fidence in a horse that is down on the street and refuses, or is appar- ently unable, to rise. For this purpose it should be given in full medicinal but not toxic doses (gr.ss for each 100 pounds of live weight). Procaiste. (Novocaine.) Xovocaine is the German name but now that the drug is made in America it is called procaine. Procaine, NH, C0H4 COC2 H4N (C2H5)2, occurs in colorless crystals very soluble in water. It is the latest and apparently the best substitute for cocaine as it is equal to cocaine as a local anesthetic and is one-seventh as toxic and much less irritating to the tissues — less, indeed, than either eucaine or stovaine. One-half to two per cent, solutions are suitable for subcutaneous use. Dropped into the eye in 5 to 10 per cent, solutions it will anesthetize the eye so that operations may be done on the eyeball or lid. It does not constrict vessels and therefore should be combined with adrenalin — 25 minims to 100 mils of pro- caine solution, using normal saline as a solvent. This combination is the best 1324 VEGETABLE DRUGS local anesthetic we possess at present for safety and efficiency. Two or three drams of a 3 per cent, solution injected into the nerve on either side of the limb are sufficient in the diagnosis of lameness in the horse. Its action is increased by combination with adrenalin and with the added hemostatic action this combination is useful injected about the circumference of tumors to aid their painless removal. Solutions keep well and may be repeatedly boiled. EucAiN^E Hydhochlokas. Eucaine Hydrochlorate. doH* N04 HC1. (Non-official.) This is a laboratory product, formerly known as eucaine hydrochlorate "B." Eucaine is used in 2 per cent, aqueous solution in the eye, and in 10 per cent, on mucous membranes, and is said to be harmless in #ny ordinary amount. It is employed as a substitute tor cocaine in the same manner and for the same pur- poses, but with the following advantages: Safer, 0.414 as toxic; cheaper; does not decompose on keeping in solution; can be sterilized by boiling; less irritating; does not dilate the pupil; is a slight antiseptic. Ophthalmologists find that the drug does dilate the pupil after several in- stillations, and that it does irritate the already inflamed eye. It, moreover, does not contract vessels when locally applied, and does sometimes produce poisoning like cocaine, but much less frequently. Stovaine. (C14H21NO.(HCl). (Non-official.) Occurs in small, lustrous scales, very soluble in water, acetic ether and alco- hol. It is a synthetic product used as a substitute for cocaine but is only 0/10 as toxic; slower to induce anesthesia (15 to 30 minutes) ; and the anesthesia is of longer duration (2 hours). Solutions may be boiled without harm to the drug. It produces some vasomotor relaxation, but solutions may be combined with TTLx of adrenalin solution to avert this. 3 to 5 grs. in 6 drams of sterile water may be used safely and successfully in spaying bitches of setter size (gr.ii for fox terriers). Two and one-half drams are injected intraperitoneally in the region of the internal inguinal rings, on each, side, and 1 dram into the skin incision. After keeping the animal on its back for 20 or 30 minutes the operation is begun (Eggleston and Miller). Cocaine (gr. %-%) injected into the muscle of the abdominal wall in dogs, along the line of incision, will induce anesthesia of the abdominal organs to a considerable degree. Stovaine is used in 5 per cent, solution to produce anesthesia by intraspinal injection. The dose of this solution for this purpose is for horses, oi-iiss; D., TTLxx-xxx; Cats, TTLx-xx. For excision of the eyeball in the horse one dram of a 5 per cent, solution is injected under the conjunctiva at four or five points. In the dog one dram of a 2 per cent, solution is sufficient for this operation. For subcutaneous use 1 to 2 per cent, solutions are suitable. Alt/ pine is another substitute for cocaine and is closely related in composition with stovaine. It is not, however, superior to cocaine since it is both more toxic and irritant. Apothesixe. (Non-official.) Apothesine is a local anesthetic, the cinnamic erster of gamma-diethylamino- prophyl-alcohol hydrochloride. It occurs in white crystals readily soluble in water and alcohol, slightly so in ether and acetone. It is slightly less toxic than novo- caine and is used in 1 and 2 per cent, solution, with or without adrenalin. It can be sterilized by boiling, and does not come under the narcotic law. Apothe- sine is widely used and is equal to novocaine, except that its anesthesia is not so lasting. Yohimbine Hydrochloride. C22H28N2O3HCI. Yohimbine is obtained from the bark of the yohimbehoa tree (Corynanthe yohimbe), and occurs in silky, prismatic crystals, or as an amorphous, white powder, slightly soluble in water, soluble in alcohol, ether, chloroform and acids. Yohimbine alters and turns yellow on exposure to air and light, but its hydro- chloride is permanent and is therefore to be preferred. Dose.— H. & C, gr. %-lV2, (.045-0.1); Sh. & Sw., gr. y2, (.03); D., gr. 1/12-1/0, (.005-.01); small dogs, gr. 1/120, (.0005). YOHIMBINE 325 Tablets are sold under the name of vetol for use in veterinary practice. The stronger tablets contain Gm. .1, or gr. iy2 of yohimbine hydrochloride, are colored red and are suitable for the larger animals. The weaker tablets are gray and contain Gm. 0.01, or gr. 1/6 of yohimbine and are suitable' for sheep and swine, or divided, for dogs. Treatment should be begun with the smaller doses thrice daily and gradually increased to the larger if no effect is observed from the smaller doses. The drug is given with food or drinking water, or in tablet form. Action. — External. — Yohimbine, in 1 to 2 per cent, solution, has a decided local anesthetic action similar to that of cocaine on the nerve trunks and terminations. Unlike cocaine it does not contract vessels (dilates them) nor cause mydriasis in the eye. It also resembles cocaine in its toxic action on the central nervous system. Action. — Internal. — Circulation. — Yohimbine occupies rather a unique position in medicine. Its peculiar therapeutic action consists in stimulation of the sexual organs. Cantharides, used for this purpose, is a powerful irritant to the urinary tract which is not the case with yohim- bine. Strychnine, phosphorus, and alcohol stimulate the spinal sexual cen- tres but are uncertain aphrodisiacs. Yohimbine has a specific action in causing local dilatation of the vessels of the testicles, ovaries, penis and vulva so that swelling and congestion of these parts occur. The testicles of rabbits, under its influence, become many times their natural size and the external genitals of the larger female animals may be seen to become swollen. Moreover, the lumbar spinal centres con- cerned with erection and the sexual act are directly excited by the drug. The sexual reflexes are made more acute for this reason and because of the increased irritability of the external genitals. In the male frequent and prolonged erections appear and sexual excitement is marked in both males and females following its ingestion. The author has noted ovarian pain in women taking the drug whicli may be attributed to swelling of the ovaries. The vascular dilatation is due to direct action of yohimbine on the vessel walls. The cutaneous vessels also dilate, the ears become warmer and redder and the combs in fowl become more brilliant. Vascular dilatation of the internal organs is said to occur also, with marked lowering of blood pressure. The heart is not affected by ordinary doses. Nervous System. — Large doses stimulate the central nervous system so that mental excitement and exhilaration (in man), and restlessness ensue. Respiration. — Even medicinal doses stimulate the respiratory centre and the movements become deeper and more rapid. Mammary Gland. — The action on this gland is similar to that on other parts of the sexual apparatus and congestion and increased milk secretion are observed. Toxicology. — Large doses induce restlessness and excitement, rapid pulse and respiration, with fall in blood pressure. Toxic amounts cause convulsions and paresis, diarrhea, salivation, dyspnea and heart weakness. One-half a grain is said to have proved fatal to a dog. Uses. — Yohimbine is indicated in functional impotency in the male 326 VEGETABLE DRUGS due either to lack of sexual desire or to lack of sexual power. Impotency may be symptomatic as of sexual excess, irritability, chronic prostatitis or vesiculitis, malnutrition, anemia, overwork and obesity. But in appar- ently healthy animals where no removable cause can be discovered yohim- bine offers most hope of a cure. It stimulates sexual desire by exciting the centres and peripheral reflexes, and sexual power in the male by causing erections. In the female also lack of sexual desire and absence of estrum may be corrected by the drug. Yohimbine appears to be more successful in veterinary than in human practice where the failures in the treatment of impotency are more fre- quent than the successes. In impotent bulls, stallions, rams, boars, and dogs, and in barren and frigid mares, cows, ewes, sows and bitches the drug often acts favorably. Its use has been extended to other conditions. Thus it is reported to have been successful in the treatment of chronic metritis by occasion- ing active uterine hyperemia. As a nerve stimulant it has been employed with supposed favorable results in bovine parturient paraplegia and in paraplegias of dogs. The drug is rather expensive at present. SECTION V.— DRUGS ACTING ON THE SECRETORY NERVES. Class I. — Pilocarpus and Pilocarpine. Pilocarpus. Pilocarpus. (U. S. P.) Synonym. — Jaborandi, B. P.; the dried leaflets of Pilocarpus jaborandi Holmes, known in commerce as Pernambuco jaborandi, or of Pilocarpus micro- phyllus Stapf., known in commerce as Maranham jaborandi (Fam. Rutacecv), yielding not less than 0.6 per cent, of alkaloids of jaborandi. Habitat. — Brazil in the neighborhood of Pernambuco. Description. — Pernambuco jaborandi. Leaflets when entire, oval, oblong or elliptical, from 4 to 10.5 cm. in length and from 2 to 4 cm. in breadth; peculiarly aromatic when crushed; taste bitterish, becoming somewhat pungent and having a sialogogue effect. Maranham jaborandi. Leaflets rhomboidally oval to obo- vate, or elliptical, from 1.5 to 5 cm. in length and from 1 to 3 cm. in breadth, the lateral ones nearly sessile, the terminal ones on margined petioles. The powder is dark green or greenish-brown. Constituents. — 1. Pilocarpine, CnH1GN302 (.25-.5 per cent.) is the alkaloid to which jaborandi owes its principal effect. 2. Jaborine, C22H32N404, an alkaloid resembling atropine in its action on the heart, pupils, intestines and salivary glands. It occurs occasionally as an impurity in commercial pilocarpine, to which it is antagonistic. It is soluble in alcohol. (Recent investigators deny the action or even existence of such a substance in pilocarpus.) 3. Pilocarpidine (C10H14N\O2), an alkaloidal product of the decomposition of pilocarpine, which is inert. It is soluble in alcohol. 4. A peculiar acid. 5. A volatile oil, chiefly pilo- carpene, C10Hl6. Dose.— H. & C, 3ii-iv, (8-15); Sh. & Sw., 3ss-l, (2-4); D., gr.v-3i, (.3-4). PREPARATIONS. Fluidextractum Pilocarpi. Fluidextract of Pilocarpus. (LT. S. P.) Made by maceration and percolation with diluted alcohol, and evaporation, so that each 100 mils of the fluidextract contains 0.6 Gm. of the alkaloids of pilo- carpus. Dose.— H. & C, 3ii-iv, (8-15) ; Sh. & Sw., 3ss-i, (2-4) ; D., TT),v-3i, (.3-4). PILOCARPINE 327 Extraction Jaborandi Liquidum. (B. P.) Dose same as above for fiuidextract. Pilocarpine Hydrochloridum. Pilocarpine Hydrochloride. CnH10N2O2HCl. (U. S. P.) Synonym. — Chlorhydrate de pilocarpine, Fr.; pilokarpin-hydrochlorid, G. Derivation. — The hydrochloride of an alkaloid obtained from pilocarpus, with alcohol and hydrochloric acid, by distillation and evaporation. The residue is dis- solved in a slight excess of ammonia and chloroform, shaken with water, and neutralized with hydrochloric acid. Crystals of the hydrochloride form on evapo- ration. The salt is purified by recrystallization. Properties. — Colorless, translucent crystals, odorless and having a faintly bitter taste; hygroscopic on exposure to the air. Soluble in 0.3 part of water and in 3 parts of alcohol; in 366 parts of ether; insoluble in chloroform. Dose. — H., sialogogue, gr.i-ii, (.06-.12); cathartic, gr.ii-v, (.12-.3) ; C, cathartic, gr.v-x, (.3-.6); H., diaphoretic, gr.vi-xii, (.36-.72), dangerous; Sh., gr.i, (.06); D., gr. &-%, (.006-.02). Pilocarpi xe Nitras. Pilocarpine Nitrate. (U. S & B. P.) Synonym. — Azotate de pilocarpine, Fr. ; pilocarpinnitrat, G. Properties. — Shining crystals, faintly bitter-tasting; odorless; permanent in the air. Soluble in 4 parts of water and in 75 parts of alcohol. Dose. — Same as for hydrochloride. Action of Pilocarpus and Pilocarpine Internal. — Alimentary Canal. — Pilocarpine increases enormously salivary secretion, and, in a less degree, the gastric and intestinal secre- tions. It stimulates peristaltic action of the stomach and bowels as well, and acts as a purgative. Salivation is due to direct excitation of the secretory nerve (chorda tympani) endings in the gland cells. Salivation occurs when pilocarpine is injected into the gland and prevented from entering the general circulation; also when the secretory nerves are sev- ered. The action on the salivary glands is set aside by atropine. The parotid, submaxillary, and sublingual glands become somewhat tense and tender under the influence of pilocarpine, and the saliva is rich in salts and ptyaline, and contains a slight excess of urea. The unstriped muscle of the stomach and intestines is stimulated by pilocarpine through its action on the efferent nerve endings and muscular tissue. Circulation. — Pilocarpine increases leukocyte formation in the blood. In the lower animals the alkaloid stimulates the vagus endings in the heart. The action is succeeded by depression of the vagus terminations and, after large doses, by depression of the heart muscles and vagus centres. The pulse is then at first slow, next it becomes accelerated, and final- ly slow and weak with loss of tension. Sometimes in man, and occasionally in dogs, the pulse, at the begin- ning, is frequent from vagus centre depression. Slight initial stimulation of the vaso-constrictor center is followed by paralysis — after toxic doses. Respiration. — The respiration is not directly affected by the drug, in moderate doses, but the bronchial secretions are greatly increased, the bronchioles are much constricted (stimulation of ends of bronchomotor nerves), and in poisoning there are, in consequence, edema of the lungs and dyspnea. Weakness of the circulation and contraction of the bron- chial muscles (lack of oxygen) account for the edema and dyspnea. 328 VEGFTAHLK DRUGS There is also great excess of secretion which may result in a drowning process. A poisoned animal is drowned in its own secretion. The res piration becomes weak and slow and death occurs from asphyxia after lethal doses. Nervous System and Muscles. — Medicinal doses do not cause any functional disturbance of the nervous system, but very large doses excite the spinal motor tract and reflex centres and cause convulsions in frogs, succeeded by spinal depression and paralysis. The latter is due in part to an influence on the muscles themselves. Tremors occur occasionally in man and the domestic animals in poisoning. The sensory nerves escape unscathed. The involuntary muscles are stimulated throughout the body, owing to the direct action of the drug upon their motor nerve terminations. Skin. — Moderate doses of pilocarpine stimulate but slightly the secretion of sweat in the lower animals, but in man the secretion is enor- mous (1 qt. to 1 gal.). The salivary secretion appears to supplant that of the skin in the domestic animals, unless very large doses are employed (H., gr.vii-xii), which cause diarrhea, salivation and loss of body weight (40 to 60 lbs.), and may entail pulmonary edema and heart failure. In the horse, after a therapeutic dose of pilocarpine is given under the skin, salivation occurs within 10 minutes and may last 2 hours, but the skin is only slightly moist — if at all. The secretory nerve terminations are stimulated. The secretions of tears, nasal mucus and milk are slightly increased in the same manner, and the growth of hair is rendered more luxurious. Temperature. — The temperature is reduced by evaporation from the skin, if there is much sweating. Genito-Urinary Organs. — Pilocarpine exerts a slight and uncertain oxytocic action on the pregnant uterus and has sometimes precipitated parturition in pregnant animals at full term. The unstriped muscle of the spleen and bladder is stimulated, and micturition is frequent. Pilo- carpine, in repeated small doses, augments the flow of urine and prob- ably increases tissue waste and the excretion of urea by its general action on the secretions. It is eliminated unchanged by the urine. Eye. — Pilocarpine contracts the pupil when applied to the eye; it also reduces tension of the eyeball and induces contraction of the ciliary muscle. The myosis is due to stimulation of the peripheral oculomotor nerve endings. When the alkaloid is given internally it may contract the pupil, but jaborandi, or the fluid extract, is less likely to do so on account of the opposing alkaloid (jaborine), which tends to dilate the pupil. Summary. — Pilocarpine possesses two important actions. 1. To in- crease secretions (stomach, pancreas, intestines, salivary glands, sudo- riparous, lachrymal and mammary glands, kidneys, bronchial and nasal mucous membranes, and ear). 2. To stimulate the involuntary muscles (stomach, intestines, heart, bronchial tubes, uterus, bladder, spleen, ves- sels and iris). Both actions are peripheral and are exerted on the secre- tory and motor nerve terminations. Administration. — Pilocarpine is given usually when an immediate PILOCARPINE 329 effect is desired. Therefore the hydrochloride or nitrate is employed subcutaneously. If prescribed in combination with eserine, the sulphate of both alkaloids may be used, or eserine sulphate and pilocarpine hydro- chloride may be injected separately. Toxicology. — Symptoms appear in five or ten minutes after the sub- cutaneous injection of pilocarpine, and in fifteen to twenty minutes after the injection of jaborandi. Salivation alone occurs after small doses, but with toxic quantities there are present salivation, accompanied by more or less sweating, contracted pupils, intestinal colic, purging and perhaps vomiting, a slow, weak pulse, and dyspnea. Muscular tremors are ob- served sometimes in man, and convulsions in frogs, but spasmodic move- ments are uncommon in the domestic animals. Dogs have been killed by gr. % °f pilocarpine. The administration of an amount larger than 5 grs. of the alkaloid to horses, subcutaneously, is attended with danger. Cattle withstand as much as 18 grains of pilocarpine subcutaneously with- out a fatal result. Atropine is the physiological antagonist of pilocarpine in relation to the heart, secretions, pupils, and, in large doses, probably to the intestines. On the other hand nilocarpine is not nearly so efficient an antidote to atropine as atropine is to pilocarpine. Enormous amounts of pilocarpine are required to antagonize small doses of atropine. So that it has not proved very useful in atropine poisoning and as an antidote an amount should be given at least 1 times that of the atro- pine taken. Atropine should be given along with strychnine, caffeine and artifi- cial respiration, in jaborandi or pilocarpine poisoning. Uses External. — The fluidextract of pilocarpus. 1 part, is often used with tincture of cantharides, % part, and alcohol 2 parts, for the cure •of alopecia ; or as follows. Fluidextracti pilocarpi Tincturae cantharidis aa 3ss Glycerini Petrolati liquidi aa 3i- M. S. Apply externally. Pilocarpine stimulates the skin in its elimination, and is sometimes of service in chronic eczema, psoriasis, prurigo and chronic urticaria. Uses Internal. — The chief value of pilocarpine in veterinary medi- cine consists in its use as a purgative to stimulate peristaltic action, and, to a certain extent, secretion — in combination with physostigmine — in obstinate constipation of horses, and in impaction of the rumen and oma- sum, and in acute gastritis of cattle (pilocarpine, gr.iii, with eserine sul- phate gr.i, subcutaneously). It is also given in colic, and in obstructions from twist and intussusception, with physostigmine. Pilocarpine has been recommended in pneumonia and bronchitis as an expectorant but its ten- dency to pulmonary edema and heart weakness would contraindicate its use in these disorders. The alkaloid is a good substitute for eserine for application to the eye (in y2 to 1 per cent, solution), and is less painful. Jaborandi is employed to remove waste matters from the blood and sys- 330 VEGETABLE DRUGS tem (in nephritis and effusions), but is of little value in veterinary prac- tice, compared with its efficiency in human medicine, on account of its feeLle sudjriric acton. It has been recommended (gr. 1/12-1/6, subcut.) in dropsy of cardiac origin, not uncommon in dogs, but is dangerous, since it tends to produce pulmonary edema and heart weakness. For the same reason it is inadvisable in pleuritic effusions and renal dropsy, and in all three conditions it is inferior to purgatives and diuretics stimulating to the heart, as caffeine and theobromine, and paracentesis. Pilocarpine is highly recommended by the Germans in cerebral and spinal meningitis, to assist absorption of effusion. I,t is recommended in chronic rheumatism as an eliminative, and in acute inflammation of the brain, and it may be employed to stimulate the gland in chronic idiopathic parotitis. Small doses of pilocarpine have been employed successfully to stimulate a fail- ing milk secretion, and to prevent excessive sweating in general debility. Jaborandi relieves dry throat and excessive thirst. Obesity, in robust dogs, may be treated with pilocarpine under the skin, in one-half grain doses daily. Success sometimes attends this method. The drug is contra- indicated when there is impairment of the respiratory functions, a weak or fatty heart, and in unconsciousness, when excessive secretion may obstruct the air passages. Also it is inadvisable in pregnancy, on account of the danger of abortion ; and in conditions where swallowing is difficult (pharyngitis, tetanus) because of the profuse salivation. SECTION VI.— DRUGS ACTING ON THE HEART. Class 1 . — Increasing the Force and Decreasing the Frequency of the Heart. Digitalis. Digitalis. Synonym. — Digitalis folia, B. P.; foxglove, digitalis leaves, E.; digitale, feuilles de digitale pourpr£e (de grande digitale), Fr.; fingerhutkraut, G. The carefully dried leaves of Digitalis purpurea Linn6 (Fam. Scrophulari- acew). In the form of the official tincture the minimum lethal dose should not be greater than 0.006 mil of tincture for each Gm. of body weight of frog. Description. — Leaves, when entire, attaining a length of 30 cm. and a breadth of 15 cm., ovate to oval, abruptly contracted into winged petioles; thin, dull, pale green or gray and densely pubescent on the under surfaces; odor slight, characteristic; taste strongly bitter. Constituents. — The active principles of digitalis are four glucosides; the three first represent its stimulant action. They are: 1. Digitoxin, the most poisonous and active. Said to be cumulative. It occurs in crystals, soluble in alcohol, and chloroform, slightly in ether, and in- soluble in water. Dose.— Gr., %-% (.008-.015); D., gr. 1/250-1/50 (.00025-.00125). 2. Digitalein, an amorphous, bitter substance, soluble in water and alcohol and non-cumulative. Dose.— H., gr. %-% (.008-.015); D., gr. 1/100 (.0006). 3. D;gitalin, a bitter, crystalline body, soluble in alcohol, and sparingly solu- ble in water and ether. Dose.— H., gr. %-% (.008-.015) ; D., gr. 1/200-1/100 (.0003-.0006). 4. Digitonin* (C27H440;3), resembling, or identical with, saponin of senega. *There exists another glucoside in digitalis — digitophyllin — which has been Insufficiently studied. DIGITALIS 331 Soluble in water. It is a heart depressant, muscular paralyzant and powerful irritant, besides being antagonistic to digitalis. In addition to these principles, there are: 5. Digitin, an inert body. 6. Digi- talic and antirrhinic acids. 7. Tannin, coloring matters, starch, sugar, gum, a volatile oil, salts, etc., common to most vegetables. Five substances are found in commerce: 1. Nativelle's digitalin (C25H40O15), occurring in white crystalline tufts com- posed of needles. It is bitter, and soluble in alcohol and chloroform; insoluble in water or ether. It contains digitoxin, digitalin, digitalein and digitonin, but chiefly digitoxin, and is cumulative. Dose.— H. & C, gr. %-%, (.015-.03); D., gr. 1/60-1/30, (.001-.002). 2. Homolle's or Quevenne's digitalin, an amorphous, whitish powder, or small scales; very bitter, inodorous, and soluble in alcohol and in 2,000 parts of water. It is composed largely of digitalin, with a little digitoxin. Dose.— H. & C, gr. % (.015) — gr. 22% of digitalis leaves; D., gr. 1/60-1/30 (.001-.002) =gr. 1^-3 of digitalis leaves. 3. German digitalinum purum, consisting chiefly of digitalein with some digitalin and digitonin. Dose.—U., gr.ss-i, (.03-.06); D., gr. 1/60-1/30, (.001-.002). Neither Nativelle's nor Homolle's digitalin form a complete substitute for digitalis, and their use is not recommended. Schmiedeberg's digitalin, however, is said by eminent authority to be the best substitute. This preparation is the digitalin "German" of Merck, and may be given in the same doses as Homolle's digitalin. No one glucoside of digitalis represents the action of the whole drug, as obtained by use of the tincture or fluidextract. 4. Digitoxin (too irritating for hypodermatic use), see above for doses. 5. Digitalin, see above for doses. While there are at leacst 4 different "digitalins" on the market, none is the real glucoside but they consist of mixtures of the gluco- sides and do not represent the full therapeutic value of digitalis. Incompatibility. — Digitalis is incompatible with tannic acid, lead acetate, cin- chona and ferric salts. Digitalis Folia Dose.—U., gr.x-3i, (.6-.4); C, 3ss-iss, (2-6); Sh. & Sw., gr.v-xv, (.3-1); D., gr.ss-iii, (.03-.2). PREPARATIONS. Fluidextractum Digttalis. Fluidextract of Digitalis. (U. S. P.) Made by maceration and percolation with alcohol and water, and evaporation so that 1 mil = 1 Gm. of the crude drug. The minimum lethal dose should not be more than 0.0006 mil for each gram of bodv weight of frog. Dose.— H., TTlx-5i, (.6-4); C, 5ss-iss, (2-6); Sh. & Sw., TTlv-xv, (.3-1); D., TTlss-iii, (.03-.2). Tinctura Digitalis. Tincture of Digitalis. (U. S. & B. P.) Made by maceration and percolation of powdered digitalis (100), with suffi- cient alcohol and water to make 1,000. (U. S. P.) Dose.— H. & C, 3ii-vi, (8-24) ; Sh. & Sw., TTLxxx-3iss, (2-6) ; D., ITtv-xxx, (.3-2.). Lethal dose 0.006 mil for each gram of body weight of frog. Infusum Digitalis. Infusion of Digitalis. (U. S. & B. P.) Digitalis, 15; cinnamon water, 150; boiling water, 500; cold water to make 1,000. By maceration. (U. S. P.) The infusion is not so good a preparation as the tincture or fluidextract because the most powerful glucoside, digitoxin, is not soluble to anv extent in water. Dose.— H. &*C, 5ii-vi, (60-180); Sh. & Sw., 3ss-i, (15-30); D., 3i-iv, (4-15).* Digitalone is a watery, fluidextract corresponding in strength to the tincture (10 per cent, of crude drug) preserved by admixture with chloretone (0.6 per cent.) and representing all the active principles of digitalis. It is moreover standardized by physiological tests and is sterile. It is excellent, therefore, to use under the skin in emergencies as in heart *The infusion contains chiefly digitonin and digitalein, on account of their solubility in water, and therefore is lacking in the most stimulating principles. 832 VEGETABLE DRUGS failure from disease, after operations, and in shock and poisoning. Two other preparations are of value for injection into vein, muscle, or under the skin. (1) Digipuratum, of which 1 tablet or 1 mil = gr. l1/^ of digitalis, is an extract freed from digitonin and a mixture of digitoxin and true digitalin. (2) Digalen is a solution of digitoxin or digitalein in water, alcohol and glycerin, and is given intramuscularly or intravenously in the same dose as the tincture by mouth. It is not so reliable as digipuratum. The tincture or fluidextract should not be given under the skin because they are precipitated in the tissues. The action of digitalis being slow, such drugs as alcohol, ammonia and camphor should first be resorted to in heart failure. Action of Digitalis. External. — None. Internal. — Alimentary Canal. — Digitalis in large doses is a gastro- intestinal irritant, and in poisoning causes nausea, colic, purging, and vomiting in animals capable of the act. It has been shown that vomiting is due to irritation of the vomiting center by large doses and occurs when the drug is given under the skin. Circulation. — The dominant action of digitalis is expended upon the heart and blood vessels. After medicinal doses we find the pulse becomes: 1. Slower.. 2. Fuller and stronger. 3. More regular in rhythm, if pre- viously irregular. In poisoning, these phenomena are reversed and the pulse is: 1. Rapid. 2. Weak. 3. Irregular. The therapeutic effects following moderate doses are due to: 1. Stimulation of the heart muscle, and perhaps its contained ganglia (pulse stronger and somewhat less frequent). 2. Excitation of the vagus centre and the vagus cardiac ter- minations (pulse infrequent). 3. Stimulation of the muscular walls of the vessels and vasomotor centres (increased vascular tension). When given by the mouth in therapeutic doses digitalis often does not cause either general vascular constriction or rise in blood pressure. The labora- tory results are obtained by large doses given intravenously. Clinically, digitalis acts by favorably altering an abnormal flow and distribution of blood, owing to venous stasis, without necessarily increasing blood pres- sure. In consequence of the action on the heart the ventricular contrac- tions are complete and forcible (stimulation of the heart muscle) ; and the diastolic period is lengthened (increased dilatation of the ventricle owing to vagus stimulation) ; therefore, more blood enters the viscus and more is squeezed out with each contraction. In poisoning, the symptoms noted above follow: 1. Excessive irritability of the heart muscle (pulse rapid). 2. Insufficient filling of the vessels and paralysis of the vessel walls (pulse weak). 3. Irregularities of rhythm occur (pulse irregular). There may be several systoles with scarcely any diastolic periods; the heart may beat slowly and wTeakly at one time, and rapidly and strongly at another. All sorts of indescribable irregularities in rhythm may be seen. At one time the heart beats slowly and weakly; at another time the heart beats rapidly and strongly. The heart, during this irregular toxic period, is seen to be unequally affected, in that one portion (the apex) may be firmly contracted while the rest of the ventricle is dilated. Moreover, the auricles and ventricles do not act synchronously, owing to inhibition of impulses (heart-block) from auricle to ventricle. The DIGITALIS 333 irregularities and rapidity of rhythm increase more and more (delirium cordis), until both auricles and ventricles lapse into fibrillary contrac- tions, and death in mammals occurs in diastolic arrest with dilatation to the extreme limit. Recent work shows that in the last stage of poisoning by digitalis irritability of the heart muscle accounts for the acceleration of the heart, while the fact that one pair of chambers is acted upon more readily than the other pair explains the arrhythmia. The nutrition of the heart is improved by digitalis in various ways. The coronary arteries are filled from the aorta with the most highly oxygenized blood in the body, during ventricular systole, but their finer ramifications are supplied during diastole. Digitalis increases pressure in the aorta and prolongs diastole, both augmenting coronary flow. The more forcible systole aids in completely emptying the coronary veins. Experimentally digitalis solution flowing through the coronaries constricts them. But it is highly improbable that this happens with clinical doses, while digitonin (also adrenalin and caffeine) has been found to actually dilate coronary vessels. The normal pulsations of the heart and arteries create a kind of self- massage of these parts, causing a sucking in and expulsion of blood and lymph through the vessels of the heart and arteries — a process vital to their nutrition. Drugs stimulating the circulation (digitalis) thus greatly increase the self-massage and nutrition of the heart and vessels. It must be especially emphasized here. that the peculiar and benefi- cent action of the digitalis series is due mostly to its action in directly stimulating the heart muscle which results in this organ doing two and one-half times its usual work (Gottlieb and Magnus). In the frog the action of digitalis in exciting cardiac contractions is much more marked than in mammals. Here the ventricular contractions become longer and stronger and the rest periods shorter and weaker until in lethal poisoning the heart stops in one prolonged systole with complete obliteration of the ventricular chamber. The physiologic stand- ard consists in 0.007 Gm. digitalis per Gm. of frog causing systolic arrest of the heart. The slowing of the rhythm in the frog is due to prolonged systole. In mammals slowing in rhythm is due to both prolonged systole and diastole, mainly the latter. Slowing of the heart owing to increased diastolic rest would naturally diminish the total output of the heart but with medicinal doses of digitalis the stimulating effect on the heart muscle is much more marked than vagus stimulation. When diastole is much prolonged by an over-dose of the drug then the total output of the heart is actually lessened. In the normal mammalian heart dilatation of the ventricles is favored by digi- talis but, in the heart dilated by disease, the dilatation may be overcome by the drug's action in stimulating the heart muscle. The action of digitalis on the heart is more pronounced in dogs and sheep than in horses and cattle. The characteristic effect of digitalis is observed when it is applied locally to the isolated nerve-free apex, or when the vagi are previously cut or paralyzed by atropine, and when the spinal cord is destroyed. These facts show that the heart muscle is influ- enced. That the peripheral vagi are stimulated, is shown by the fact that an amount of galvanic stimulation of the vagi, ineffective before poisoning. 334 VEGETABLE DRUGS will, after exhibition of digitalis, cause diastolic arrest of the heart. In regard to the vessels, experiments conducted on the terrapin exhibit the fact that when the vessels are deprived of their nerve supply, the heart excised, and an artificial circulation substituted, even then vascular con- traction and retardation of flow will occur under the influence of digitalin added to the factitious blood. The resultant of the various actions of medicinal doses of digitalis is increased work of the heart, so that more blood is pumped throughout the body in any given unit of time. We may sum up the action of digitalis on the circulation as follows: 1. It increases the force of cardiac systole. 2. It causes more blood to be expelled during each systole. 3. It slows the heart, chiefly through prolonging diastole. 4. It acts in a certain degree to cause vaso-constriction and in- creased blood pressure, but this is often not in evidence with therapeutic doses by the mouth. 5. It alters the distribution and rate of flow of blood in various parts of the body through its stimulating effect upon the heart. Respiration. — The respiratory centres are only influenced by toxic doses, being first stimulated and then depressed by digitalis: the respira- tion is first rapid and deep, and later weak and imperfect. Nervous System and Muscles. — These are not influenced by thera- peutic doses of digitalis. Toxic quantities cause loss of reflex action, muscular weakness, vomiting, and convulsions in the frog. The first two phenomena are due to primary stimulation of the inhibitory reflex centres of Setschenow in the medulla, followed by general paralysis of the spinal cord, and direct depression of the motor nerves and muscles; while the convulsions are also caused by stimulation of the medulla. Temperature. — The temperature is unaffected by medicinal doses. Toxic doses reduce temperature. Fever is lowered by large doses of digitalis, but it is rarely safe to use the drug as an antipyretic. More- over, digitalis is sometimes inoperative as a heart stimulant in fever, because the functional activity of the vagus centres and peripheral termi- nations is depressed and insensitive to the action of the drug. Kidneys. — Metabolism and Elimination. — The influence of digitalis on the amount of urinary secretion is variable. It may exert a slight stimulating effect upon the renal secreting cells, (albumin and blood in urine in poisoning). The consensus of opinion a,\iong the best authori- ties is, however, that digitalis exerts little direct action upon the renal epithelium or blood vessels but that it acts as a diuretic chiefly in over- coming a poor circulation (low blood pressure and venous stasis, or obstructed venous flow from the kidneys) in heart weakness. The effect of digitalis on tissue waste is uncertain and the mode of its elimination is unknown. Experiments relative to the composition of the urine are conflicting. The smooth muscle of the uterus is said to be stimulated to contraction by digitalis. Cumulative Action. — Digitalis and strychnine are said to be cumula- tive in their action. Evidence is stronger in the case of the former drug than in that of the latter. By cumulative action is meant sudden transi- DIGITALIS 335 tion from a therapeutic to a toxic effect. This may be due to three causes. 1. Tardy absorption. 2. Increasing susceptibility. 3. Delayed elimination and accumulation of the drug in the system. The cumulative action of digitalis is chiefly due to the latter cause. It should never be administered in full medicinal doses uninterruptedly for any considerable length of time. Toxicology. — Poisoning may occur from large single doses within 3 to 10 hours of their ingestion, and last for 16 or more hours with a fatal result; or may appear suddenly after the administration for several days of large medicinal doses (cumulative action). A minimum fatal dose for the horse is about 3vi of digitalis, or gr.iss of Homolle's digitalin. For dogs, 5i of digitalis, or gr. ^4 of digitalin. Cattle take enormous doses of digitalis by the mouth without toxic effect. Large doses may, however, induce abortion and a dose of two and a half drams is said to have caused premature labor in a cow. The symptoms exhibited are chiefly concerned with the digestion and circulation. They consist in dullness, lassitude, loss of appetite, nausea, flatulence, diarrhea, infrequent, full pulse (reduced 6-10 beats in the horse), and contracted pupils. There is vomiting in dogs. In fatal cases these symptoms are followed by severe colic and tympanites; rapid, feeble, dicrotic, irregular or intermittent pulse (120-140 in horses), while the heart may be heard and felt beating wildly and strongly, and a systolic blowing murmur can frequently be detected. This is due to mitral or tricuspid regurgitation caused by irregular contraction of the columnse carnae. The pulse is imperceptible because of the failure of the heart to fill the vessels. The extremities are cold, the eye is pro- truding, and salivation occurs. Bloody diarrhea is very often present and the urine may be suppressed. The breathing finally becomes difficult and death ensues within a few hours, or as late as several days. Treatment. — Evacuation of the stomach and bowels. Tannic acid, as a chemical antidote, alcohol, opium, and aconite, which is the physio- logical antagonist in depressing the action of the heart and lowering blood tension. In addition, external heat should be applied and com- plete quiet and rest secured. Administration. — In view of its slow absorption and elimination full doses of digitalis should not be given by the mouth oftener than twice daily or once in twenty-four hours, after its effect has been secured. Very large doses may be given, however, repeatedly, in case of threatened heart failure, by the subcutaneous method. The appearance of indi- gestion, nausea or dullness, and a decided fall in the pulse rate, should be a warning to stop the administration at once. The best preparations are the tincture, infusion, and fluid-extract. Uses External. — Digitalis is occasionally employed as a poultice of the leaves, applied over the loins to promote diuresis, or in local inflam- mation, to contract vessels. Uses Internal. — Among all other drugs digitalis stands out pre- eminently as the heart stimulant. None may take its place. Yet it has even been classified as a heart depressant. It may, however, exert a 336 VEGETABLE DRUGS sedative effect upon a weak, rapid, irregular heart, by increasing the in- hibitory and muscular power. Digitalis is indicated: (1) In all condi- tions where the heart is weak, irregular or intermittent, and the circula- tion sluggish; (2) as a diuretic, chiefly in dropsy secondary to cardiac disease, but also in that of renal origin. 1. In syncope following disease, shock, injury or poisoning (aconite;, digitalone is invaluable when injected subcutaneously together with alco- holie stimulants. Its action is slow, however, and in emergencies it should be reinforced by the use of caffeine or adrenalin. In acute dis- eases, digitalis is one of the most generally serviceable stimulants. The drug is peculiarly applicable in the second stage of pneumonia, because it strengthens the right ventricle, forces the blood through the obstructed lung, and prevents systemic venous engorgement and arterial anemia. In other words, it equalizes the circulation. Moreover, in stimulating the peripheral vagi, digitalis improves the tone of the bronchioles and pre- vents collapse of the air vesicles, and. by the same action, steadies the rhythm of the breathing. The drug is likewise an efficient circulatory stimulant in influenza of horses and distemper of dogs. Digitalis is frequently preseribed in chronic bronchitis and emphysema, to strengthen the heart and obviate passive pulmonary congestion and cough. Valvular disease of the heart, in its various phases, is the most common field of usefulness for digitalis in human medicine, but in veterinary practice these disorders are rarer and the exact lesion difficult or impossible to diagnose. Also horses with valvular or organic disease of the heart are unsafe and useless for work. In cattle digitalis by the mouth appears to be without action, from probable destruction in the rumen, as the drug is active given intravenously. In mitral stenosis and regurgitation and aortic stenosis, with lack of compensatory hypertrophy of the heart and evidence of circulatory disturbances, digitalis is clearly indicated. In these conditions the drug enables the heart to pump more blood into the arteries and prevents engorgement of the right heart and veins and the occurrence of dropsy. Digitalis cures irregularity of the heart due to auricular fibrillation because it either inhibits the fibrillating auricles or the functions of the bundle of His in transmitting the pathological stimuli to the ventricles. Digitalis may be contra-indicated in aortic insuffi- ciency, because in prolonged diastole it allows more time for the blood to flow back from the aorta through the leaky valve into the ventricle. In the second stage of aortic disease when the mitral valve is beginning to break down digitalis is decidedly indicated. As a general proposition, digitalis is inferior to aconite in simple cardiac hypertrophy. But this does not apply when enlargement of the heart is insufficient to compen- sate for valvular lesions. Digitalis is extremely successful in palpitation of the heart (horses) following over-exertion, but is not appropriate in palpitation due to nervousness (dogs), or to indigestion. Digitalis may be exhibited to advantage in rheumatic fever and in endocarditis or pericarditis to quiet the heart and secure rest by prolonging diastole. 2. Digitalis is a valuable diuretic in dropsy of cardiac origin by STROPHANTHUS 337 stimulating the heart and overcoming venous stasis in the kidneys and elsewhere. Digitalis is frequently prescribed to dogs with squill and calo- mel (D., gr.i of each) in pills for this purpose. It is often desirable to combine iron preparations with digitalis. Turbidity results from the action of iron on the tannic acid contained in digitalis when in solution, but this can be removed by the addition of a little diluted phosphoric acid. Strophanthus. Strophanthus. (U. S. & B. P.) The dried, ripe seeds of Strophanthus Kombe Oliver, or of Strophanthus his- pidus De Candolle (nat. ord. Apocynaceae), deprived of the long awns. Synonym. — Strophanthi seniina, B. P.; strophanthussamen, G.; semence de strophanthus, Fr. Habitat. — Tropical Africa. There are eighteen species, and the seeds from two are found in commerce. This has led to some confusion, as the chemical and physiological properties of their different products vary to some extent. Description. — Lance-ovoid, flattened and obtusely edged; from 7 to 20 mm. in length, about 4 mm. in breadth, and about 2 mm. in thickness; externally of a light fawn color, with a distinct greenish tinge, silky lustrous from a dense coating of closely appressed hairs (S. kembe), or light to dark brown, nearly smooth and sparingly hairy (S. hispidus), bearing on one side a ridge running from the centre to the summit; fracture short and soft; fractured surface whitish and oily; odor heavy when the seeds are crushed and moistened; taste very bitter. The minimum lethal dose should not be greater than 0.00006 mil of tincture for each gram of body weight of frog. Constituents. — The chief; one is (1) Strophanthin, C31H48012 (8-10 per cent), a glucoside occurring in white or yellowish powder, and having a very bitter taste. Soluble in water and alcohol, and insoluble in chloroform or ether. De- composed by sulphuric acid into glucose and strophanthidin. Strophanthin is said to be contained only in S. Kombe. It varies in composition and strength and decomposes in solution. (2) Kombic acid. (3) An alkaloid, ineine. (4) Tanghin- in, occurring in rhombic prisms. PREPARATION. Tinctura Strophanthi. Tincture of Strophanthus. (U. S. & B. P.) Made by maceration and percolation of strophanthus (100) with alcohol and water to make 1000. (Standardized as above.) (U. S. P.) The tincture becomes inert in a few days when combined with water. Dose.— H. & C, 3i-iv, (4-15); D., THji-x, (.12-.6). The minimum doses should be used at first, since preparations vary in strength. Strophanthinum. Strophanthin. (U. S. P.) White or yellowish-white powder, very soluble in water and dilute alcohol. Dose.— H., gr. y5-% (.012-.03) ; D., gr. 1/200-1/60 (.0003-0.001). The gluco- side is not always pure and the dose is uncertain and must be given with caution in the smaller doses first. * Action External. — Strophanthus is a local anesthetic. Action Internal. — Strophanthus is a gastro-intestinal irritant in large doses, like digitalis, and produces violent purging and sometimes vomiting. It occasionally causes diarrhea in medicinal doses. On account of its bitter qualities it may act in small medicinal doses as a stomachic, im- proving appetite and stimulating gastric secretion and motion. Circulation. — The action of strophanthus on the circulation is very similar to that of digitalis, but it is a more powerful and uncertain heart stimulant and produces less vascular constriction. By its influence the heart beats are made more forcible, infrequent and regular. Diastole is 338 VEGETABLE DRUGS prolonged and systole is strengthened but unaltered in time. Arterial tension is raised and the pulse wave is increased in volume and force. The physiological details are not so well ascertained as are those of dig- italis, but it is known that strophanthus directly stimulates the heart muscle in moderate doses. The vessels are slightly contracted, but not as much so as by digitalis. Increased blood pressure results mainly from the augmented heart's action. In poisoning, the peripheral vagi are paralyzed and vascular tension falls, owing probably to tetanic con- traction of the ventricles. The heart is arrested in systole or diastole. Nervous System. — Muscles and Respiration. — Strophanthus is a pow- erful muscle poison. Therapeutic doses increase muscular activity and tone, while toxic quantities paralyze voluntary muscles. Medicinal doses not only stimulate the voluntary muscles, but also the unstriped muscle of the heart, and to some extent that of the vessel walls. The nerve centres and trunks are unaffected except by the local application of strophanthus, which paralyzes the sensory nerve endings and muscular tissue. The respiration is uninfluenced by therapeutic doses of strophanthus, but in poisoning death sometimes takes place from respiratory failure following paralysis of the respiratory muscles. Kidneys. — The kidneys are irritated by large doses of strophanthus and the urine is albuminous. Inflammation of the renal tubules with minute hemorrhages are found post mortem. The renal vessels are not dilated, and the oncometer shows that the size of the kidney is not in- creased. Strophanthus has not so much diuretic action as digitalis. The active principle is eliminated in the urine. A cumulative action in the lower animals and in man has been noted by several observers. Uses Internal. — In general, it may be stated that the indications for strophanthus are identical with those for digitalis, but the former is not so certain in its effects. It is of value as a substitute for digitalis when this medicine is not effective, as sometimes occurs when it hinders the transmission of impulses over the bundle of His. Strophanthin has been used with remarkable success as a heart stimulant given once daily intra- venously or intramuscularly, well diluted with water, as it is too irritating subcutaneously. Strophanthus is indicated in mitral disease, cardiac dropsy, pericardial effusions, pulmonary edema, and chronic nephritis; but in heart disease digitalis should be tried first. Scilla. Squill. (U. S. & B. P.) Synonym. — Squills, E.; meerzwiebel, G. ; scille, squille, Fi\; bulbus scillae, P. G." The fleshy, inner scales of the bulb of Urginea maritima (Linne) Baker (Fam. Liliaceae), cut into pieces and carefully dried. Habitat. — Southern Europe, on the shores of the Mediterranean. Description. — In irregular, more or less curved, somewhat flattened pieces; from 0.5 to 5 cm. in length, yellowish-white, somewhat translucent, nearly smooth and lustrous; odor slight; taste bitter and acrid. The minimum lethal dose (as tincture) not more than 0.006 mil for each gram body weight of frog. Constituents. — Various active principles have been recovered, but it is doubt- ful if any completely represent the action of the drug. All possess some poison- ous properties. Merck sells three substances derived from squill: (1) Scillitoxin, SQUILL 339 a glucoside. (2) Scillipicrin. (3) Scillin. In addition the drug contains mucilage. Squill Dose.—H., 5i-ii, (4-8) ; C, 3ii-iv, (8-15) ; Sh., gr.xv-xxx, (1-2) ; D., gr.i-v, (.06-.3). PREPARATIONS. Fluidextr actum Scillw. Fluidextract of Squill. (U. S. P.) Made by maceration and percolation with diluted alcohol, alcohol and water, and evaporation. Minimum lethal dose not more than 0.00006 mil for each Gm. of body weight of frog. Dose.— H., 3i-ii, (4-8); C, 5ii-iv, (8-15); Sh., u^xv-xxx, (1-2); D., TTli-v, (.06-.3). Tinctura Scillw. Tincture of Squill. (U. S. & B. P.) Made by maceration and percolation of squill, 100; with alcohol and water to make 1000. Standardized as above. (U. S. P.) Dose.— H., 5vi-5iss, (24-45) ; C, giss-iii, (45-90) ; Sh., 5iss-iii, (6-12) ; D., ulv-xxx, (.3-2). Syrupus Scillcc. Syrup of Squill. (U. S. & B. P.) Made with vinegar of squill, 450; adding sugar, 800; straining and adding water to make 1000. (U. S. P.) Dose.— H., 5ss, (15); D., 5ss-i, (2-4). Incompatible with ammonium carbonate. Syrupus Scillw Compositus. Compound Syrup of Squill. (U. S. P.) Synonym. — Coxe's Hive Syrup. Fluidextract of squill, 80; fluidextract of senega, 80; antimony and potassium tartrate, 2; distilled water, 10; syrup, q. s. to make 1000. Dose.— D., nlv-xxx, (.3-2). Pil. Ipecachuanhae cum Scilla. (B. P.) Contains 5 per cent, opium. Dogs, gr.ii-viii. The compound syrup (U. S. P.), or the pill of ipecac with squill (B. P.), is a good cough remedy for dogs. Action Internal. — G astro-intestinal Tract. — Therapeutic doses do not exert any effect, but toxic quantities cause vomiting and purging in dogs, with fall of temperature, stupor, intermittent paralysis, convulsions, sup- pression or scanty secretion of bloody urine, and death, within 12 or 15 hours. Lesions of gastro-enteritis and congestion of the kidneys are found after death. Circulation. — The action of squill on the heart and vessels is prac- tically identical with that of digitalis. Respiration. — Clinical experience, rather than physiological experi- ments, has shown that squill acts sus an expectorant during its elimination from the bronchial mucous membrane, thereby increasing secretion and vascularity. Kidneys. — Squill is eliminated mainly by the kidneys, and in its ex- cretion directly stimulates them and increases the amount of urine. In toxic doses it produces acute parenchymatous nephritis and urinary sup- pression. Squill is a more powerful diuretic than digitalis. Uses Internal. — Squill is useful in ascites of dogs, resulting from valvular lesions or otherwise, to stimulate the heart and cause diuresis. It may be given to advantage in pill with digitalis, calomel, and extract of hyoscyamus — one grain of each. Small doses of squill are often ex- hibited to dogs in the second stage of acute bronchitis, and occasionally to horses, as an expectorant; and in large doses as an emetic for dogs in the form of the simple or compound syrup. The drug is indicated in bronchitis, with scanty secretion, or when exudation is excessive to improve the tone of the bronchial mucous membrane. 340 VEGETABLE DRUGS Cough syrup for dogs. Syrupi ipecacuanha? 3iii. Syrupi scillae .....ad giv. M. S. ^easpoonful every 3 hours. Class 2 — Decreasing the Force and Frequency of the Heart. Aconitum. Aconite. Synonym. — Aconiti radix, B. P.; aconit napel, Fr.; tubera aconiti, P. G.; eisenhut, stormhut, G. The dried tuberous roots of Aconitum Napellus Linne (Fam. Ranunculaceae). Should yield not less than 0.5 per cent, of ether-soluble alkaloids of aconite. Minimum lethal dose not more than 0.00004 mil of fluid- extract per Gm. of body weight of guinea-pig. Habitat. — Northwestern North America, Europe and Asia in mountainous regions, and cultivated in the United States for its showy flowers. Description. — More or less conical or fusiform, from 4 to 19 cm. in length, and from 1 to 2 cm. in diameter at the crown; externally dark brown or grayish- brown, smooth or longitudinally wrinkled; odor very slight; taste sweetish, soon becoming acrid and developing a tingling sensation, followed by numbness. Constituents. — The alkaloid representing the action of the drug is aconitine (C3«H47NOu), which is precipitated by ammonia from an aqueous solution of an alcoholic extract of the root of various species. Pseudo-aconitine (C^H^NOn), aconine (C^H^NOn), and other alkaloids, as benzaconine and picraconitine, with aconitic acid (C„H606), are inert. Aconite Dose.—H. & C, gr.iii-xx, (.2-1.3); D., gr. 1/10-ii, (.006-.12). Aconitince Nitras. (Squibb.) Dose. — Suhcutaneouslv. H., gr. 1/30, (.002); D., 1/200-1/100, (.0003-.0006). Aconitina. Aconitine. (U. S. & B. P.) It is colorless, or occurs in white, rhombic tables or prisms, odorless and permanent in the air, almost insoluble in water, and soluble in 28 parts of alco- hol, in 65 parts of ether, and 1 part of chloroform. Its salts are soluble in water. Aconitine or its solutions, unless very dilute, are too poisonous to be tasted. Commercial preparations vary in purity and strength (as much as a hundred fold), owing to its ready decomposition by hydration, and since it is extremely poisonous (an Indian arrow poison) its internal administration is undesirable. Aconitine often contains a considerable proportion of aconine and benzaco- nine, and so varies in activity, which is a great objection to the use of one of the most powerful drugs known. PREPARATIONS. Tinctura Aconiti. Tincture of Aconite. (U. S. & B. P.) Synonym. — Teinture de racine d'aconit, Fr.; eisenhuttinktur, G. Made by maceration and percolation of aconite, 100; with alcohol and water to make 1000. Minimum lethal dose not more than 0.0004 mil per Gm. of body weight of guinea- pig. (U. S. P.) Dose.— H., Tllxx-3i, (1.3-4); C, 5ss-iss, (2-6); Sh. & Sw., Iltx-xx, (.6-1.3); D., TTlii-x, (.12-.6). Fhridextractum Aconiti. Fluidextract of Aconite. (U. S. P.) Made by maceration and percolation with alcohol and water, and evaporation. Assayed so that each 100 mils contains 0.45-0.55 Gm. of alkaloids of aconite. (Standardized as above.) Dose.— H. & C, Tlliii-xx, (.2-1.3); D., HU/10-ii, (.006-.12). Unguentum Aconitince. (B. P.) (2 per cent.) Linimentum Aconiti. (B. P.) Fleming's Tincture. (Non-official. ) (79 per cent.) Dose.— H., Tllvii-xv, (.5-1.; D., Tll^-ii, (.015-.12). ACONITE 341 Aconite and Aconitine. Action External. — Aconite or aconitine applied to mucous mem- branes, raw surfaces or the unbroken skin, irritates and then paralyzes the nerves of touch and temperature. This is evidenced in the human subject by a sensation of tingling and burning, followed by numbness and local anesthesia. Action Internal. — Digestive Tract. — Aconite in medicinal doses has no special effect on the digestive organs. Toxic doses produce nausea and retching, and, in animals capable of the act, vomiting. Circulation. — The chief therapeutic value of aconite depends upon its influence over the heart and vessels. It reduces the frequency of the cardiac pulsations, owing to stimulation of the vagus centre in the medulla, and lowers blood tension. This is the chief effect of aconite on the circulation in medicinal doses. The action on the heart is not to weaken it in therapeutic doses but simply to slow it — pure inhibition. It is improper, therefore, to classify aconite as decreasing the force of the heart, save in toxic doses. In medicinal doses it makes the systolic con- tractions more powerful and causes increased dilatation in diastole. It may, however, be regarded as a circulatory depressant in slowing the heart and lessening the output of blood, since it thus weakens blood pres- sure. In fatal poisoning by the drug the action of the heart becomes rapid and irregular. The time of contraction of the auricles does not correspond with ventricular contraction (heart block) and the lack of rhythm and irregularity increase until the heart is thrown into delirium and fibrillation, as with digitalis. Depending on this condition of the heart, the blood pressure is naturally subject to momentary variations. The rapidity and irregularity of the heart are due to paralysis of the inhibitory apparatus and great irritability of the cardiac muscle, with weakened contraction and conduc- tion, occurring simultaneously. The vasoconstrictor-centre is slightly stimulated by medicinal doses, but the blood pressure is lowered through the slowing of the heart beats, prolonged diastole, and lessened cardiac output. In poisoning there is paralysis of the vasomotor centres. The heart is arrested in diastole, but death immediately results from respiratory failure. Nervous System. — The most striking effect of aconite on the nervous system (in man) consists in tingling followed by loss of sensation and temperature sense after large medicinal doses. This phenomenon is due to stimulation succeeded by depression of the sensory nerve terminations. The drug is not comparable with opium, since doses large enough to pro- duce a general anodyne action are dangerous. Poisonous doses of aconite cause muscular twitching and loss of motor power, which result from excitation, and finally paralysis of the motor nerve endings. Convulsions occur in poisoning. These are thought to follow stimulation of the medulla as the higher cerebral centres are often unimpaired. Stimulation and then depression of the lower divisions 342 VEGETABLE DRUGS of the nervous system — especialty the medulla, spinal centres, and peri- pheral sensory and motor nerves — describe the general effect of aconite. Respiration. — Following primary stimulation, with increased depth and frequency of breathing, the breathing of animals under the influence of aconite resembles that observed after section of the vagi. The res- piration is slow and labored; the expiration is prolonged, and is suc- ceeded by a considerable interval before the next inspiration. This condition is brought about by depression of the medullary respiratory centres. Temperature. — The bodily heat is reduced by aconite in fever, after medicinal doses, and in poisoning by the drug. Heat loss is due to stimu- lation of the heat regulating centres which reduce a febrile temperature to normal; to diminished action of the heart; and to sweating, if it occurs. Skin. — Aconite sometimes produces slight diaphoresis, due to stimu- lation of the nerve endings in the sweat glands and to dilation of the peripheral blood vessels. Kidneys and Elimination* — Aconitine is chiefly eliminated in the urine. Toxicology. — The minimum fatal dose of aconite is about 3i for the horse ; gr.xx for medium sized dogs ; and gr.v-vi for cats. The smallest fatal dose recorded in man is a teaspoonful of tincture of aconite (U. S. P. 1890), equivalent to about gr.xxx of the crude drug. The minimum lethal quantity of aconitine is gr. -^ for man, and about the same for cats. Tor dogs it is from gr. l/± *° gr« %• The writer has found that cats will live from fifteen minutes to half an hour after re- ceiving the smaller deadly doses under the skin, but large doses produce death immediately by paralyzing the heart. Large therapeutic doses cause, in horses, restlessness, pawing the ground, shaking of the head, champing of the jaws, increased secretion of salivary mucus, and at- tempts at swTallowing probably owing to the peculiar sense of irritation produced by the drug in the throat. Nausea and retching are observed in all animals, wrhile vomiting occurs in dogs and cats. The pulse and respiration are weakened and generally retarded. After lethal doses these symptoms are intensified. We observe violent retching, frequent and difficult attacks of swallowing, ejection of frothy mucus from the mouth, copious sweating in horses; pulse first weak and infrequent, later rapid, running and almost imperceptible; respiration slow, interrupted, and shallow, and reduction of temperature. Death is preceded by mus- cular twitchings in the horse and loss of strength, so that the subject falls and is unable to rise ; or in the case of cats and rabbits, the animals jump vertically into the air, topple over backwards and go into convul- sions, lying helpless on their side. The labial muscles are retracted, anc! the lips drawn back, showing the teeth covered with foam. The face is *While a time-honored remedy in veterinary practice recent experiments by Mackensie, Price, and Rudolf and Cole, independently, have failed to find that aconite lowers pulse or fever in usual medicinal doses. ACONITE 343 anxious, the eyeballs are retracted or protruded, and the pupils more commonly dilated. Death takes place usually from asphyxia, occasion- ally from syncope. The post-mortem appearances are simply those re- sulting from asphyxia. Treatment. — Evacuate the stomach by siphon. Emetics are contra- indicated as disturbing the heart. Cardiac and respiratory stimulants are to be given subcutaneously, as alcohol, ammonia, ether, digitalone, atropine and strychnine, in addition to inhalation of amyl nitrite. The patient must be kept quiet, and artificial respiration done if practicable and necessary. Experimental evidence seems to prove atropine the most valuable single antidote to aconite in stimulating the respiratory and vasomotor centres. Uses External. — Aconite may be applied in liniment (fluid extract of aconite, 40; chloroform liniment, 60) to relieve pain of an inflammatory, neuralgic, or rheumatic character; or as aconitine in ointment (2-4 per cent.) for the same purposes. Aconitine is very expensive, however. Care must be exercised to prevent undue absorption and poisoning, and danger of animal licking it. Uses Internal. — Aconite is useful in fever because: 1. It diminishes the frequency of the heart and reduces blood pressure. 2. It lowers temperature and produces sweating and diuresis. 3. It relieves pain and restlessness to some extent. Aconite is particularly applicable, conjoined with sweet spirit of nitre, in the first stages of febrile diseases; in those attacking the young; and in those of self-limited and short duration, viz., coryza, laryngitis, pharyngitis, pleuritis, bronchitis and pneumonia uncomplicated with in- fluenza. It is also indicated in the initial period of acute muscular rheu- matism, enteritis and peritonitis (combined with opium), and in mammitis, lymphangitis, and laminitis. Fever in Horses. Fluidextracti aconiti 3iss. Spiritus aetheris nitrosi ad 3iv. M. S. Tablespoonful in cup of water hourly. Spasmodic and painful disorders, as colic, are relieved more suc- cessfully by powerful anodynes and antispasmodics (opium and bella- donna). In chronic or long continued fevers, the use of aconite should not be persisted in, but it should be given at the very outset of fevers and re- peated frequently in small doses. Ttlxv. for the horse, and TTLii. for the dog, every fifteen minutes for two hours, and afterwards TTLxxx. for the horse and TT(,iii. for the dog, hourly, being governed, however, bv the condition of the pulse and temperature and the physiological effects. Aconite is a useful sedative in some cardiac disturbances. It quiets ner- vous palpitation, and that form resulting from hypertrophy of the heart. 344 VEGETABLE DRUGS Palpitation of Heart in Horses. Fluidextracti aconiti 3ii. Fluidextracti digitalis. Fluidextracti belladonnae radicis aa o»- (Furnish 3ii bottle). M. S. Small bottleful on tongue t. i. d. It can be administered to advantage in the first stages of acute pericarditis and endocarditis. Veratrum Viride. Veratrurn Viride. (U. S. P.) Synonym. — Veratri viridis rhizoma, B. P.; American hellebore, green helle- bore root, Indian poke root, E.; griiner germer, G. The dried rhizome and roots of Veratrum viride Aiton (Fain. Liliaceae). Description. — Rhizome upright, obconical, usually cut longitudinally into 2 or 4 pieces, from 2 to 7 cm. in length and from 1.5 to 3 cm. in diameter, externally light brown to dark brown or brownish-black, frequently bearing at the summit numerous closely arranged, thin leaf-bases, otherwise rough and wrinkled. In- odorous but sternutatory; taste bitter and acrid. Powder grayish-brown to dark brown. Constituents*. — 1. Veratrine or cevadine (Cj^H^NOy), a pure alkaloid. 2. Jervine (C2t)H3TN03), a pure alkaloid. 3. Protoveratrine (CjkHbjNOu), a powerful alkaloid resembling aconitine. 4. Pseudojervine. 5. Rubijervine. 6. A resin, a gastro-intestinal irritant. Veratrum Dose.—H. & C, oss-i, (2-4); Sh. & Sw., gr.xx-xxx, (1.3-2); D., gr. 1/10-i, (.006-.06). PREPARATIONS. Fluidextr actum Veratri Viridis. Fluidextract of Veratrum Viride. (U. S. P.) Made by maceration and percolation with alcohol, and evaporation, so that 1 mil=l Gm. of the crude drug. Dose.— H. & C, 3ss-i, (2-4); Sh. & Sw., TT^xx-xxx, (1.3-2); D., 1TU/10-i, (.006-.06). Tinctura Veratri Viridis. Tincture of Veratrum Viride. (U. S. & B. P.) Made by maceration and percolation of veratrum viride, 100; and alcohol to make 1000. (U. S. P. Dose.—H. & C, gss-i, (15-30); Sh. & Sw., 3ii-iv, (8-15); D., H\v-xv, (.3-1). Veratrum Viride. Action Internal. — The action of the drug is a resultant of the action of veratrine, jervine and protoveratrine — chiefly to that of veratrine. Circulation. — The most noteworthy therapeutic value of veratrum viride depends upon its effect upon the circulation. It first lowers the force (jervine), and, if continued, the frequency (veratrine, protoveratrine and jervine) of the pulse, and also reduces vascular tension (jervine). Veratrum viride is considerably more depressant to the circulation than aconite, which does not directly lessen arterial pressure. . Veratrum is, however, inferior to aconite for general purposes, as it does not possess the anodyne, diaphoretic, or diuretic properties peculiar to the latter drug. *Great confusion exists concerning the alkaloids in veratrum because writers apply different names to the same alkaloids. VERATRUM 345 The temperature is reduced several degrees by large doses of veratrum. Toxicology. — The symptoms exhibited in veratrum poisoning are: salivation, vomiting, or attempts at vomiting, purging, abdominal pain, muscular weakness, difficulty in progression, loss of power and general paralysis muscular tremors and spasms, and occasionally convulsions. The pulse is unaltered in rate at first, but later becomes infrequent and compressible and finally rapid, thread-like and running. The respiration is shallow, the temperature reduced, the skin is cold and clammy; there are semi-consciousness, loss of sight and death from asphyxia. Treatment should be pursued with the stomach tube and cardiac and respiratory stimulants, as alcohol, strychnine and atropine; tannic acid as a chemical antidote ; opium to subdue pain ; and demulcents to relieve local irritation of the digestive tract. Warm water should be given the smaller animals to wash out the stomach and to assist vomition, and quietude should be enforced. In man, fatal poisoning is rare, since the drug is spontaneously vomited. The same would probably apply to dogs. Recovery has ensued in horses after ingestion of two ounces of veratrum root. Administration. — It is advisable to give small doses of the tincture or fluid extract hourly. In the case of the smaller patients, the dose should be preceded by the administration of a correspondingly small dose of laudanum (n\v-x) to prevent vomiting. Uses Internal. — The alkaloids of veratrum are difficult to obtain in their purity, and are not much used in practice. The drug is applicable as a circulatory sedative at the outset of sthenic diseases afflicting strong, plethoric animals. Veratrum viride bleeds an animal into its own vessels by causing vascular dilatation. The indications are similar to those applying to venesection, and are therefore limited. In some cases of acute diseases, included within the limits defined above, it may prove of service to cut short or even abort the attack. Aconite is usually a safer and better drug to use, however. In this list may be placed sthenic pneumonia, cerebritis, laminitis, puerperal fever, and, when veratrum is combined with opium to obviate stimulation of peristaltic action, enteritis, peritonitis, and abdominal wounds and injuries. Veratrone is a proprietary preparation very con- venient for hypodermatic use in these diseases (H., 3i; D., m\v-x). Veratrum is said to relieve pain, lower temperature and lessen the dura- tion of acute rheumatic fever. Veratrum Album. Synonym. — Veratri albi rhizoma, white hellebore root, E. Habitat. — Europe (used on the continent). Constituents. — 1. Protoveratrine (C^H^NOn), an alkaloid acting like vera- trine on the heart. 2. Jervine. 3. Rubijervine. 4. Pseudojervine and other alka- loids. The Germans recommend it to be given as an emetic to swine, in milk, gr.v-xx, (.3-1.3), and as an emetic to cattle, 3iv-vi, (16-24). Its use is, however, attended with some danger in these doses. 346 VEGETABLE DRUGS Veratrina. Veratrine. (U. S. & B. P.) A mixture of alkaloids obtained from the seed of Asagroea officinalis (Chamisso and Schlechtcndal) Lindley (Fam. Liliaceae). (U. S. P.) This sub- stance contains the pure alkaloid veratrine or cevadine (C32H40NO»), cevadilline, sabadine, sabadinine, and veratridine. The action described below is that of pure veratrine. Derivation. — Obtained from the seed by alcohol, which is recovered by dis- tillation, and the residue is treated with water to precipitate resins; filtered, and veratrine is precipitated from the filtrate by ammonia. It is further purified by solution in water, decolorization and reprecipitation. Properties. — White, or grayish-white, amorphous; odorless, but causing in- tense irritation and sneezing when even a minute quantity reaches the nasal mucous membrane; having an acrid taste, and leaving a sense of tingling and numbness on the tongue. Slightly hygroscopic. Very slightly soluble in cold or hot water; soluble in 2.2 parts of alcohol, and very soluble in boiling alcohol; also soluble in 3 parts of ether, and in 1 part of chloroform. Dose.— H., gr.ss-ii, (.03-.12) ; C, gr.ii-v, (.12-.3); Sw., gr.%-%, (.015-.03), subcutaneously in alcohol, D., gr. 1/50-1/10, (.0012-.00G). The smaller doses to be given subcutaneously. PREPARATION. Unguentum Veralrince. (B. P.) Action External. — Veratrine is a powerful irritant. If inhaled in minutest quantity it causes sneezing and a mucous, or bloody discharge. When injected under the skin, veratrine occasions suffering and restless- ness. Rubbed into the skin or applied to a mucous membrane or raw surface, it produces redness and pain followed by local anesthesia. Action Internal. — Here again veratrine is an intense irritant. After ingestion of large doses, there are salivation, violent vomiting, in animals capable of the act; often severe purging, pain, collapse, fall of tempera- ture and other symptoms common to gastro-enteritis. Nervous System and Muscles. — Veratrine is a poison to the medulla, spinal cord, motor and sensory nerves and muscles, first exalting and then depressing and paralyzing their functional activity. The cerebrum escapes its influence. Spasms and convulsions occur in veratrine poison- ing, in the stage of motor excitement, while paralysis follows depression of the nerves and muscles. The action of the substance begins and ends sooner in the nerves than the muscles. The effect of veratrine on volun- tary muscle is peculiar. A tracing of a muscle during contraction shows that the latent period, and that of ascent, is unaltered; but the amount of contraction is much augmented, as shown by the increased height of the curve; and the time of relaxation is greatly prolonged. Circulation. — Veratrine affects the heart muscle much as it does the striped muscle, and the vagus nerve similarly to the spinal nerves. The cardiac muscle, vagus and vasomotor centres are primarily stimulated, while later the heart muscle, vagus endings and vasomotor centres are depressed and paralyzed. Three conditions have been noted in relation to the pulse, corresponding to different stages in the action of veratrine. 1. A small dose may induce a temporary rise of pulse rate, force and ten- sion, by stimulation of the cardiac muscle and vasomotor centres. 2. Large doses are followed by slowing and weakening of the pulse. The vagus centre is stimulated and the heart muscle depressed. 3. Towards VERATRINE 347 the end of fatal poisoning the pulse becomes weak, thread-like, rapid and irregular from paralysis of the heart muscle, vagus endings and vaso- motor centres. It sometimes happens, however, that the pulse remains weak and slow in this stage because the paralyzing influence of the sub- stance on the heart muscle prevents quickening of the heart even after the removal of inhibitory control. The heart is dilated and irresponsive to galvanism, after death, as are also the voluntary muscles. Respiration. — Lethal doses paralyze the respiratory centres and death occurs from respiratory arrest. The breathing may be quickened by small doses of veratrine, owing to transient stimulation of the respira- tory centres and vagus nerve endings in the lungs. Toxicology. — The symptoms of poisoning are referable to the action of veratrine on the digestive, nervous and muscular apparatus, heart, and respiratory organs. They include nausea, salivation, clammy sweat- ing, excessive vomiting in dogs, cats and cattle, attempts at vomiting in the horse, abdominal pain, severe purging, muscular twitchings or con- vulsions (excited by external stimuli), loss of muscular power and paralysis. The pulse, at first weak and infrequent, becomes thready, rapid and irregular. The temperature is reduced and the respiration is weak and slow. Death occurs in convulsions or paralysis. One-sixteenth of a grain has caused alarming symptoms in man. The minimum fatal dose is about one grain for dogs. One grain subcutaneously, or five to six grains by the mouth, produce poisonous symptoms in horses. Treatment. — External heat; respiratory and cardiac stimulants should be employed subcutaneously. Potassium carbonate and demulcent drinks are to be given internally. Uses External. — Veratrine is of trivial value, since its therapeutic application is narrowly limited. It is occasionally useful in the official ointment, or in greater strength (gr.xl to 5i) for its local anesthetic action applied over rheumatic joints. It may be employed also as a simple rubefacient. An aqueous solution of veratrine sulphate, or an alcoholic dilution of the pure alkaloid, is recommended in shoulder lame- ness, myalgia, and chronic rheumatic affections of the horse, to be in- jected every alternate day, or oftener, into the muscular tissue over the seat of the trouble. The animal should be led about for fifteen or thirty minutes while the pain of the treatment lasts. The initial dose is gr. % (0.4 Gm.), to be increased to gr. iy2 (0.1 Gm.). Uses Internal. — Veratrine has been employed as a cardiac sedative and antipyretic in pneumonia, acute rheumatism, and in other sthenic disorders, but it is inferior for these purposes to aconite or veratrum viride, and its other effects are undesirable. The remedy is lauded by foreign authorities as an emetic and cathartic for cattle in impaction of the third stomach, and in conditions where it is desirable to quickly un- load their digestive apparatus. For this purpose P. Cagny advises vera- trine, gr. 2^/2-3 (.15-.20), subcutaneously, to be followed if necessary by daily doses of grs. 5-7^2 (0.3-D.5 Gm.) in mucJaginous drinks by the mouth. The same writer finds the drug useful in "broken wind." Vera- trine, given subcutaneously, is considered the best emetic for swine by 348 VEGETABLE DRUGS some practitioners. Veratrine stimulates intestinal secretion and peristal- sis in the horse, but is inferior to sserine and pilocarpine in that animal as a quickly acting cathartic. SECTION VII.— DRUGS ACTING ON THE RESPIRATORY ORGANS. Ipecacuanha. Ipecac. (U. S. & B. P.) Synonym. — Ipecacuanha, racine bresilienne, Fr.; brechwurzel, ruhrwurzel, G. The dried root of Cephaelis Ipecacuanha (Brotero) A. Richard, known in commerce as Rio ipecac, or of C. acuminata Karsten, known in commerce as Cartagena ipecac (Fam. Rubiaceae), and yielding not less than 1.75 per cent, of the ether soluble alkaloids of Ipecac. Habitat. — South America from Brazil to Bolivia, and New Granada. Culti- vated in India. Description. — Rio Ipecac. In cylindrical pieces, curved and sharply flex- ous, occasionally branched, from 3 to 15 em. in length and from 2.4 to 4 cm. in thickness, externally dark brown; odor very slight, the dust sternutatory; taste bitter and nauseous, somewhat acrid. Cartagena Ipecac. Cylindrical or slenderly fusiform, more or less tortuous, from 3 to 12 cm. in length, and a thickness of 2 mm., externally grayish-brown. The powder from both varieties is liffht brown. Constituents. — 1. The alkaloid emetine (C,4H1«(CH,)N08), existing to the extent of 2 per cent., and representing in the main the action of the crude drug. It is a white, odorless, uncrystallizable powder, with a bitter, burning taste, and soluble in alcohol and chloroform; less so in ether, and very slightly in water, turning yellow on keeping:. The impure commercial alkaloid occurs in brownish- red transparent and deliquescent scales, very soluble in water. (2) Cephaeline (C14H„,N02), resembling emetine in action. (3) Psychotrine. which is inert. 4. An amorphous, bitter glucoside. 5. An astringent, ipecacuanhic acid. 6. A vola- tile oil, starch, gum, tannin, coloring matter, etc. Hemidesmus exists as an impurity, it is cracked, not annulated: also bitter almond powder, which exhales the odor of prussic acid when wet. Emetine (Emetinae hydrochloridum, U. S.) a white, or very slightly yellowish crystalline powder, without odor, freely soluble in water and alcohol, is rarely used in veterinary practice. Dose of Powdered Root,—H., 3i-ii, (4-8) ; C, 3ii-iv, (8-15) j Sh., 3ss-i, (2-4) ; D., gr.ss-ii, (.03-.12). Emetic. — D. & Sw., gr.xv-xxx, (1-2). PREPARATIONS. Fluidextractum Ipecacuanha?. Fluidextract of Ipecac. (U. S. P.) Made by maceration and percolation with alcohol, diluted HC1 and water, and evaporation so that 1 mil = 1 Gm. of the crude drug. Assayed to contain 1.8-2.2 per cent, of ether soluble alkaloids of ipecac. Dose. — Same as powdered root. Extractum Ipecacuanha? Liquidum. (B. P.) Dose.— One-half that of the U. S. P. fluidextract. Syrupus Ipecacuanha?. Syrup of Ipecac. (U. S. P.) Fluid extract of ipecac, 70; acetic acid, 10; glycerin, 100; sugar, 700; water to make 1000. Dose. — D. (expectorant), TTtxv-3i, (1-4). Pulvis Ipecacuanha? et Opii. (U. S. & B. P.) (See opium.) Tinctura Ipecacuanha? et Opii. (See opium.) Action External. — Ipecac, and still more emetine, are decided irri- tants when applied to mucous membranes, raw surfaces, or even to the unbroken skin ; causing, variously, hyperemia, vesication, pustulation, and f IPECAC 349 ulceration, according to their strength and the mode of application. Emetine kills amebae in 1 to 100,000 solution and is a powerful antiseptic, being 5 times more powerful than phenol in 5% solution. Action Internal. — Digestive Tract. — Ipecac is naturally a local irri- tant in the alimentary canal as well as externally. It increases the flow of saliva and gastric juice, besides dilating the blood vessels of the stomach. Small doses are stomachic, improving the digestion and tone of the gastric mucous membrane, and, in some cases, minute quantities are anti-emetic in allaying vomiting. Large doses, on the other hand, cause a little nausea and free vomiting. It is probable that emetine is not, as frequently stated, a specific emetic; that is, does not act directly on the vomiting centre, although, when emetine is thrown into the blood, vomit- ing is produced, by means of its elimination through the stomach. This is substantiated by the following facts: (1) Emetine is recovered in the first vomitus after its subcutaneous injection. (2) Vomition does not occur so rapidly, and more emetine is required, when the alkaloid is in- jected in place of being ingested. (3) Furthermore, when the vagus is previously divided, vomiting does not follow hypodermic medication of emetine. The act does, however, follow the administration of apomor- phine and tartar emetic under similar conditions. Therefore it is probable that in whatsoever way ipecac is exhibited, vomiting proceeds from direct irritation of the stomach or the vagus endings situated therein. Ipecac and emetine do not act so promptly as zinc sulphate or apomor- phine (under the skin). The latter are accordingly preferable as evacu- ants in poisoning. Compared with tartar emetic, ipecac is less persistent and prostrating in its effect. It is probably the mildest emetic at our command. Ipecac and emetine increase secretion and cause hyperemia and purging, sometimes of a bloody character, in their passage through the bowels. Gastro-enteritis may follow the administration of large quan- tities to dogs. Experimental evidence has apparently shown that ipecac is an hepatic stimulant (cholagogue), increasing the secretion of bile. This action is doubtful. Circulation. — Emetine has been given subcutaneously to stop internal hemorrhages. Its mode of action is uncertain and its use for this purpose is now uncommon. The drug is specially toxic if given intravenously. There is a slowing and weakening of the heart and fall in blood pressure from toxic amounts. Lethal doses paralyze the heart muscle. Respiratory Organs. — The lungs are often found intensely hyperemic after death by ipecac poisoning. Not only this; portions are seen to be collapsed and consolidated. In therapeutic doses the pulmonary mucous membrane is stimulated during its elimination and is made more vascular; the secretion of bronchial mucus is increased and cough is reflexly excited. Ipecac is thus strictly a stimulating expectorant in so far as its action on the bronchial mucous membrane is concerned; but it is, perhaps unfortu- nately and misleadingly, classed by some (Brunton) as a depressing expectorant because of the side influence on the circulation. Skin. — Ipecac is mildly diaphoretic in addition to and independent of this action common to nauseants in general. 350 VEGETABLE DRUGS Toxicology. — The following toxic phenomena are exhibited by ani- mals: vomiting, loss of muscular power and paralysis, increased, fol- lowed by diminished reflex activity, failure of heart and respiration, and post mortem evidences of congestion and inflammation of the lungs and intestines. Three ounces of ipecac have killed a horse, and two grains of emetine have proved fatal to a dog, or 1/6 gr. daily for 3 days under the skin. Emetine has a cumulative effect. When given continuously by subcutaneous injection there are signs of gastro-intestinal irritation, nephritis and edema, hemoptysis, neuritis, paralysis, coma and heart failure after a certain amount is administered (27 grs., man). Uses. — The indications for the therapeutic employment of ipecac may be described under the following heads: 1. Emetic and anti-emetic. 2. Expectorant. 3. Diaphoretic. 4. In dysentery and chronic diarrhea. 1. Powdered ipecac is a good agent for dogs, cats and pigs, given in luke-warm water, in repeated doses if necessary, to empty an overloaded stomach. Also in acute bronchitis and laryngitis of dogs and cats, when the patient is endangered by accumulation of secretion, ipecac, by the forcible expulsion attending vomiting, removes secretion from the upper respiratory tract and clears out the stomach of any secretion which may have been swallowed. Ipecac is efficacious in stopping vomiting in cases of acute catarrh of the stomach in dogs, and is given as the wine with tincture of aconite, one drop each in a dram of ice water at half hour intervals. The drug is also of service in reflex vomiting, and that due to an atonic or depressed condition of the stomach. Therapeutically, ipecac should only be of value in the latter disorder, but it nevertheless is often efficient in the vomiting of irritable dyspepsia, as noted above. 2. Ipecac is prescribed in the first stage of acute bronchitis, when the secretion is scanty, and again in bronchitis of long standing, to stimu- late the bronchial mucous membrane. It may be given to dogs and cats in repeated expectorant doses of the wine or syrup, with other expecto- rants, diaphoretics and diuretics, as syrup of squill and spirit of nitrous ether, or as Dover's powder, to all animals. Acute bronchitis in dogs. Syrupi ipecacuanhas 3iii. Syrupi scillae Sii- Tincturae opii camphoratae ad §iv. M. Sig. Teaspoonful every 3 hours. 3. Ipecac is a feeble diaphoretic, and inferior to sweet spirit of nitre, aconite, alcohol or external heat, for general sudorific purposes. The combination of opium and ipecac, in Dover's powder, is an appro- priate mixture to relieve pain and cause diaphoresis in acute rheumatism, and may cut short attacks of acute inflammation of the respiratory tract. CINCHONA 351 4. Ipecac is probably the best single remedy for the treatment of amebic dysentery of man. It should be given in the form of powder, bolus, or pill every four hours, combined with opium to prevent nausea or vomiting. More recently emetine hydrochloride is given to man once daily under the skin. (gr. y2) for 10 day periods as more certain than ipecac. SECTION VIII.— ANTIPYRETIC AND ANTISEPTIC ORGANIC AGENTS. Class 1 . — Cinchona and Its Alkaloids. Cinchona. Cinchona. (U. S. P.) Synonym. — Cinchonae cortex, B. P.; cinchona flava, yellow cinchona bark, cali- saya bark, cortex chinae calisayae, E.; quinquina, Fr.; chinarinde, G. The dried bark of Cinchona Ledgeriana Moens, Cinchona calisaya Weddell, Cinchona officialis Linne, and of hybrids of these and of other species of cinchona (Fam. Rubiaceae), yielding not less than 5 per cent, of cinchona alkaloids. Habitat. — Indigenous in South America on the east slope of the Andes, and northwards into Colombia; southwards to the lower part of Bolivia, at altitudes varying from 5,000 to 10,000 ft. Cultivated in India, East Indies, Jamaica, and to some extent in South America. Description. — In quills or curved pieces of variable length, bark from 2 to 4 mm. thick, or in small broken fragments or in transversely curved pieces from 3 to 7 mm. thick; externally gray, grayish-brown or reddish-brown; odor slight, somewhat aromatic; taste very bitter and astringent; powder, light brown. Constituents. — (a) Four chief alkaloids and three artificial products. *Isomers (1) Quinine (CX1H,4N.,0.,+3 H,0). Solutions of its salts are fluorescent. Turns plane of polarization to left. Gives green color with ammonia and chlorine water. Precipitated from its salts as hydrate. (2) Quinidine (C20H24N,O.). Solutions of its salts fluorescent. Differs from quinine in turning plane of polarization to right, and in being insoluble in ammonia except in excess. (Quinicine is an artificial amorphous alkaloid, probably not occurring natural- ly, and obtained from quinine by heat and excess of a mineral acid. Quinoidine is a cheap brown amorphous substance obtained from the mother liquor after quinine sulphate has crystallized out, and contains a mixture of quinidine, cin- chonine and cinchonidine.) •Isomers (3) Cinchonine (CidH22N20). Is not fluorescent. Turns plane of polarization to right. Does not assume a green color with ammonia or chlorine water. (4) Cinchonidine (C1DH2:N20) is slightly fluorescent. Turns plane of polarization to left. Cinchonicine is an artificial alkaloid obtained from cinchonine by heat and an excess of a mineral acid. Some other alkaloids of no particular importance are: Quinamina (C^H^NaC^). Paricina (dGH18N20). Aricina, etc. •Isomers are bodies composed of the same elements, in the same proportions, but possessing different chemical or physical properties. <>52 W VEGETABLE DRUGS (b) Less Important Constituents. — (5) Kinic, or quinic acid (C7H12O0), occurs in colorless prisms. Related to benzoic acid and eliminated in the urine as hip- puric acid. Found in coffee beans and other vegetables. The alkaloids in cinchona are naturally united with kinic or kinovic acid, and salts of this combination are used in medicine; i.e., quinine kinate, which is soluble and may be employed subcutaneously. (6) Kinovic, or quinovic acid (C^H^O,,), a white, amorphous substance allied to kinovin. (7) Kinovin, or quinovin (C^HuO,), a glucoside readily decomposed into glucose and kinovic acid. (8) Cincho-tannic acid, or kino-tannic and kinovi-tannic acid (2-4 per cent.). The astringent principle of cinchona. Distinguished 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, metal- lic salts or gelatin. Dose.— H., 5ii-iv, (8-15) ; C, Ji-fi, (30-60) ; Sh. & Sw., 3i-iv, (4-15) ; D. & C, gr.x-3i, (.6-4). PREPARATIONS. Fluidextr actum Cinchonw. Fluidextract of Cinchona. (U. S. P.) Made by maceration and percolation with glycerin, HC1, alcohol and water, and evaporation so that it shall contain 4.5 per cent, of total alkaloids of cin- chona. (U. S. P.) Dose. — Same as cinchona. Extractum Cinchonw Liquidum. (B. P.) Contains 4-5 per cent, of alkaloids. Dose. — Same as cinchona. Infusum Cinchonw Acidum. (B. P.) Dose.—H., Oi, (500); D., 5ii-iv, (8-15). Tinctura Cinchonw. 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, 0.9 Gm. alkaloids in 100 mils of tincture. (U. S. P.) Dose.— H., 3i-ii, (30-60); D., 3ss-ii, (2-8). Cinchona Rubra. Red Cinchona. (U. S. P.) Cinchona? rubrae cortex, B. P. The dried bark of Cinchona succirubra Pavon (Fam. Rubiaceae), containing not less than 5 per cent, of the alkaloids of red cinchona. Habitat. — Ecuador, west of Chimborazo. Description. — In quills or curved pieces of variable length, bark from 2 to 4 aim. in thickness, or in small broken fragments or in transversely curved pieces from 3 to 7 mm. in thickness; externally gray, grayish-brown or reddish-brown; odor slight; taste very bitter and astringent. Powder is light brown. Constituents. — Same as cinchona. Dose. — Same as cinchona. PREPARATION. Tinctura Cinchonw 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. Con- tains 0.45 per cent, of alkaloids of cinchona. (U. S. P.) Dose.—H., gii-iv, (60-120); D., 3ss-iv, (2-15). QUININE 353 •Quixixje Sulphas. Quinine Sulphate. (C20H24O2N2)2 H2S04+T H20. (U. S. & B. P.) Synonym. — Chininum sulfuricum, P. G.; quiniae sulfas, or sulphate of quinia, E. ; sulfate de quinine, Fr. ; schwefelsaures chinin, G. Derivation. — Prepared by boiling cinchona bark with hydrochloric acid and adding lime to the filtered decoction to precipitate alkaloids and coloring matter. The precipitate is washed and digested in boiling alcohol to dissolve quinine and cinchonine. The alcohol is distilled off and the residue dissolved in diluted sul- phuric acid, boiled with animal charcoal, filtered, and quinine sulphate crystallizes, leaving cinchonine sulphate in solution. Properties. — White, silky, light, flexible, glistening crystals, making a very light and easily compressible mass; or as hard, prismatic monoclinic needles; odorless, and having a persistent and very bitter taste. It effloresces rapidly when exposed to dry air, and then becomes lusterless; when exposed to light it acquires a brownish tint. Soluble at 25° C. (77° F.), in 725 parts of water, and in 107 parts of alcohol; also in 30 parts of glycerin; slightly soluble in chloroform and ether; and freely in dilute acids. Incompatibles. — Alkalies and their carbonates, iodine, and tannic acid. Dose.— H. (tonic), gr.xv-5i, (1-4) ; C, oss-iss, (2-6) ; Sh. & Sw., gr.v-x, (.3-.G) ; D. & Cats, gr.i-ii, (.06-.12). Antipyretic Dose— H. & C, 5ii-iv, (8-15); Sh., gr.xxx-xl, 2-2.6); Sw., gr.xv-xxv, (1-1.6); D. & Cats, gr.v-x, (.3-.6). Quininje Bisulphas. Quinine Bisulphate. Co0H24O2N2 H2S04-r-7 H20. (U. S. & B. P.) Derivation. — Made by the action of sulphuric acid on quinine sulphate sus- pended in water; filtration and crystallization. Properties. — Colorless, transparent or whitish, orthorhombic crystals or small needles; odorless, and having a very bitter taste; efflorescing on exposure to the air, and turns yellow on exposure to light; soluble in 9 parts of water and in 23 parts of alcohol, and in 15 parts of glycerin. 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 solu- tions for medicinal use. The salt is serviceable for administration in pill; or for hypodermic injection, when it should be given in about one-third smaller dose than that of quinine sulphate by the mouth. Quinixje Hydrobromidum. Quinine Hydrobromide. C20H24N2O2 H Br-|-H20. (U. S. P.) Derivation. — Made by the action of barium bromide, in solution, on quinine sulphate suspended in water; filtration, evaporation, and crystallization. Properties. — White, light, silky needles; odorless, and having a very bitter taste. The salt effloresces on exposure to air. Soluble in 40 parts of cold water, and in 0.9 part of alcohol; also soluble in 23 parts of ether, in 0.6 part of chloro- form, and in 7 parts of glycerin. Dose. — Same as quinine sulphate. fQuixiXJB Hydrochloridum. Quinine Hvdrochloride. C20H24O2N2 H Cl-f-2 H20. (U. S. & B. P.) Derivation. — Made by the action of hydrochloric acid on quinine, and by crystallization. Properties. — White, silky, glistening needles; odorless, and having a very bitter taste. The salt effloresces when exposed to warm air. Soluble in 18 parts *Tinc. Quinince Ammoniata (B. P.), from the sulphate. Dose. — H., 3ss-l; D., 3ss-i. iTinctura Quinince (B. P.), from the hydrochloride. Dose. — H., ?>ss-i: **., ■ >■)] VEGETABLE DRUGS oi' Water, and in 0.8 part of alcohol, 0.7 part of chloroform, and in 7 parts of glycerin. Done. Same as quinine sulphate.*] Quinine Valeras. Quinine Valerate. C20H24N3O2CBH10Oa+H3O. (B. P.) ( Non-official.) Derivation. Made bj decomposition of quinine sulphate with ammonia, fol- lowed by the immediate action of valerianic acid, and crystallization from a cold solution. Properties. White, or nearly white, pearly, lustrous, triclinic crystals, 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. I)., gr.i-ii, (.06-.12). Three times daily as tonic-. QriMNi bt rin:.i: Hydeochloridum. Quinine and Urea Hydrochloride. (V. S. P.) r,„H_/),X,HCI, CO(NH3)2HCl h5 IPO. monym. Quininse Bimuriatis carbamas. Quinine and urea bimuriate. Prepared by dissolving quinine hydrochloride, MK), in dilute H CI, 800; mixing with 60 to (it parts of urea C()(NI1 ,),,; warming, filtering and allowing to erys- Lallize. Oceans in colorless, translucent prisms, or as a white, granular powder. odorless and having a very bitter taste. Permanent in the air. Soluble in 0.9 part of water and in U.i parts of alcohol. Chinoidinum ob QriNoiuiN cm. Chinoidine or Quinoidine. Brown, resinous mass, containing mixture of quinidine, cinchonine and.cin- chonidine. A cheap substitute for quinine sulphate. Dose.- Three or four times that of quinine sulphate. Qr.xmiN i Sulphas. Quinidine Sulphate. (C2.,H..4N,0,),, H8S04+2 PLO. (Non-Official.) The neutral sulphate of an alkaloid obtained from the hark of several species of cinchona (nat. ord. Rubiaceae). Synonym- Sulfate de quinidine, Fr.; schwefelsaures chinidin (cinchinin), G. Derivation- 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 hitler taste- permanent in the air. Soluble in 100 parts of cold water, and in H parts of alcohol; in 7 parts of boiling water, and very soluhle in boiling alcohol; also in 14 parts of chloroform and in acidulated water; almost insoluble in ether. Dose.— One-third larger than quinine sulphate. Cixcmoxix.i Suxphas. Cinchonine Sulphate. (C,.,H..,ON .)» H,S04+2 (U. S. P.) Derivation. — Obtained from the mother liquors after the crystallization "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. — White, lustrous, prismatic crystals, odorless and having a very hitter taste. Permanent in the air. Soluhle in 60 parts of water, and in 12.5 parts of alcohol. Also soluhle in 47 parts of chloroform, but almost insoluble in ether. Dose. — One-third larger than that of quinine sulphate. Cixcuoxiuix.i: Sulphas. Cinchonidine Sulphate.* (C19H2.,N20)2 H2S04+3 H.O. (U. S. P.) D?+$vation. — Procured from the mother liquors, after the crystallization of \QviniiKi' Salicylas, Quinine Salicylate ( P. S. P.). Soluble in 77 parts of water. Occurs in colorless needles. Dose as for sulphate. *Elixvr Ferri, Quimnw et Strychninw Phosphatwm (U. S. P.), and Syrupus Ferri Phosphatis cum Qwmina et Strychmna (B. P.), (dose— DM 3i), are good tonic preparations for dogs. ACTION OF QUININE 000 quinine sulphate, by further concentration. Purified by crystallization from alco- hol, and finally from hot water. Properties. — White, glistening needles or prisms; silky, acicular, odorless and having a very bitter taste; permanent in the air. Soluble in 65 part- of water, and in 90 parts of alcohol; also soluble in 620 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 undifferenti- ated protoplasm is to stimulate in small doses, or in much dilution, and to depress and paralyze in large doses, or in strong solutions. It lias the same action on unorganized living matter (ferments) in many easts but does not affect some. It is still more destructive to protozoa, especially to the organisms of malaria. Quinine is a powerful a i obi- eide. A solution (1 to 250) of the alkaloid or its salts is poisonous to the microbes of fermentation and putrefaction. A one per cent, solution quickly destroys bacteria and vibrios, but spores may live in it for some days. Quinine and its sails cause irritation oi the denuded skin, or mucous membranes, but exert no effect upon the unbroken si Action Internal.' — Digestive Tract. — Quinine, in therapeutic doses, acts as a simple bitter (stomachic), and therefore promotes appetite and gastric digestion. It stimulates the taste buds oi the tongue and thus appetite and. reflexly, the "appetite" gastric juice which Pawlow found necessary in starting digestion; together with the Hew of saliva and the vascularity and peristalsis of the stomach. Experimentally, qu slightly lessens the activity of the ferments of the gastric '>u(\ pancreatic juices (pepsin, trypsin) in dilution, while di : them in larger amounts. Large doses, particularly it the stomach b le, rnaj cause vomiting. Quinine becomes dissolved in the gastric juice and is con- verted into the chloride. A portion unabsorbed finds its way into the bowels and is there precipitated by the alkaline juices and bile, whose acids form insoluble salts with quinine, unless the bile is in 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 possesses sc\ I 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 mesentt irritated, the white corpuscles do not collect in the arterioles or migrate through their walls (diapedesis). Again, when inflammation has already begun in the mesentery, quinine stops the transmigration of leukocytes. and yet does not step these in the tissues from wandering away. More- over, large doses markedly lessen the number of white corpuscles in the blood. Thus quinine has a pronounced toxic action on amebae, and also on ameboid parasites, as of malaria, rabies, and intestinal forms. While medicinal doses of quinine given by the mouth unquestionably produce leukopenia, yet it is generally considered highly improbable that the 356 VEGETABLE DRUGS effect of quinine in inhibiting the movement of leukocytes observed in the frog, when large doses are introduced into the blood, occurs after the therapeutic use of the drug in mammals. But it has recently been shown that a solution of quinine in blood, equal to that when a small dose (gr. iii., man) is ingested, increases markedly phagocytosis in the case of all the common pathogenic organisms. Very large doses diminish phagocy- tosis. It is hard to explain this action when we consider leukocytosis 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 number of red corpuscles. The latter diminish in size in febrile conditions, but, under the action of quinine (and other antipyretic agencies), regain their normal condition. This follows the effect of quinine in lowering tempera- ture, and is not due to any specific power of quinine exerted on the cor- puscles themselves. Heart and Blood Vessels. — Quinine in ordinary 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 commonly continues to beat for some time after breathing ceases. The action on the heart is like that on all forms of living tissues — primary stimulation followed by depression and paralysis. Nervous System. — Here again the general action consists in primary stimulation followed by depression and paralysis of the the cerebrospinal system. The breathing is first accelerated and then weakened and death occurs from paralysis of the respiratory center. 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 einchonine 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 com- monly follow a large medicinal dose (cinchonism). Blindness also very rarely occurs in man after large doses. Vomiting, diarrhea, albuminuria and skin eruptions sometimes occur in poisoning by the drug due to local irritation. There are contraction of the retinal vessels and degenerative 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. Spinal Cord and Nerves. — Quinine, in experiments on the frog, first stimulates and then lessens reflex activity. This condition disappears on section of the medulla. Toxic doses, however, 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 USES OF QUININE 357 are not observed in mammals. Muscular contractility is stimulated by small and paralyzed by poisonous doses of quinine. After subcutaneous injection of quinine there is slow loss of sensation and local anesthesia lasting for hours or days. The hydrochloride of quinine and urea is com- monly used for this purpose. Uterus. — In experiments with the intravenous or subcutaneous injec- tion 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 con- tractions in inertia of parturition but there is considerable testimony affirming that it increases at the same time the tendency to flowing. Kidneys, Metabolism and Elimination. — Quinine lessens the elimina- tion of both urea and uric acid. It is therefore evident that there is some alteration or inhibition of metabolism whereby nitrogenous 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 C02 and absorption of oxygen by the lungs is unaltered by quinine. This accords with the known fact that the oxidizing ferment of the tissues is not influenced by the drug (Jacquet). About three-fourths of the quinine absorbed 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 temperature 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 plasmod.um malariae, which is destroyed by the alkaloid, and the malarial fever is therefore overcome. 2. By retarding nitrogenous decomposition or metabolism and thus lessening the production of heat in the tissues. Quinine does not lower temperature by action on heat-regulating centres as it occurs after divi- sion of the spinal cord. It is less effective as an antipyretic than coal tar derivatives. 3. By dilating the vessels of the skin and therefore inducing loss of heat. In poisoning there are deafness, blindness, slow weak heart and breathing, gastric disturbances, diarrhea, and perhaps albuminuria, hematuria or hemoglobinuria. 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, gelatine 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 follow; but this does not fre- quently happen in the horse. The bisulphate, hydrobromide and hydro- 358 VEGETABLE DRUGS chloride are most suitable for hypodermic use. The first sail is more soluble, but the latter two are less irritating. Al a temperature of 45° C. (118 F.) Quinine bisulphate is soluble in 8.8 parts of water. Quinine hydrobroniide is soluble in 45.02 parts of water. Quinine hydrochloride is soluble in 21.4 parts of we 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 precipi- tation 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; cinchonine, 40. The cin- chona compounds are indicated for tonic and stomachic purposes. Uses External. — Quinine and urea hydrochloride lias 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 lias three advan- tages 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 injection into tbe tissues, in 25 per cent, solution it is used to anesthetize mucous membrane, but is not so satisfactory as cocaine for this purpose. It has been used in a great variety of operations, including those within the belly. Tbe 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. Uses Internal. — It 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 con- venience, we may classify the uses of quinine under the following heads: 1. Tonic Action. — Quinine sharpens the appetite but retards ab- sorption, irritates the stomach and inhibits pepsin action in ordinary doses. It is chiefly a tonic 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 following acute diseases, that the drug is indicated. Here, combina- tion with iron is often of service, and the tincture of the chloride is a good preparation because it contains sufficient free muriatic acid to dis- solve any of the salts of quinine. The compound tincture of cinchona 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. 2. Antiseptic and Antipyretic Effect. — Quinine possesses much less antipyretic power than phenacetin. antipyrin and acetanilid. It is there- SALICYLIC ACID 3f)fl fore not used for this purpose nearly so much as formerly. It acts n... e favorably with a falling than a rising temperature, and should be given two or three hours before the probable time of maximum 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 inflam- matory diseases of the respiratory tract, quinine may prove abortifacient. Later in these diseases the drug may be given as an antipyretic (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 indi- cate that quinine had a restraining influence on the resulting septic state, and. in some cases, saved life, but its use as an internal antiseptic rests on little but tradition. 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 injected into the affected muscles in this disorder, in horses, with favorable results. 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 mil of a 1 per cent, solution of bi- muriate of quinine and urea to the pound, live weight, has been injected intra-abdominally in cattle as a treatment for tick fever. Quinine stands preeminent in the treatment 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 be made only by the discovery of Laveran's plasmodium in the red blood corpuscles. Malaria but rarely, if ever, 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 an expected 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 be pursued by the hypodermic method. 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. Acidum Salicylicum. Salicylic Acid. C7HB08. (U. S. & B. P.) Synonym. — Acid salicylique, Fr.; salicylsaiire, G. An organic acid, existing naturally in combination in various planes, hut chiefly prepared synthetically from carbolic acid. Derivation. — Made by passing carbonic dioxide through sodium carbolate at a 360 VEGETABLE DRUGS temperature of 428° F. (220° C). 2 NaC0H6O (sodium carbolate) +C02= NaaC7H403 (sodium salicylate) +C0H0O (phenol). Sodium salicylate is treated with hydrochloric acid, when salicylic acid is precipitated. Na^C7H403+2 HCl^z C7HG03+2 NaCl. Properties. — Fine, prismatic needles, or as a bulky, white, crystalline powder; odorless, having a sweetish, afterward acrid taste, and permanent in the air. Synthetic salicylic acid is white and odorless; when prepared from methyl salicylate the acid may have a slightly yellow or pink tint and a slight, gaul- theria-like odor. Soluble in about 460 parts of water, and in 2.7 parts of alcohol. Also soluble in 8 parts of ether and in 4.2 parts of chloroform. Incompatible. — Spirit of nitrous ether. Impurities. — In artificial salicylic acid, metacreosotic and orthocreosotic acids. Dose.— H. & C, 3ii-3i, (8-80); Sh., 3i-iv, (4-15); Sw., 3ss-i, (2-4); D., gr.v-xxx, (.3-2). PREPARATION. Unguentum Acidi Salicylici (2 per cent.), B. P. Salicinum. Salicin. C]3H1807. (U. S. & B. P.) A neutral principle (glucoside) obtained from several species of Salix and Populus (Fam. Salicaceae). Habitat. — Europe, but cultivated in North America. Derivation. — Obtained from a decoction of willow bark. Salicin crystallizes on evaporation, after removal of tannin by agitation with lead oxide. It is puri- fied by repeated solution and crystallization. Properties. — Colorless, silky, shining crystalline needles, or rhombic prisms, or a crystalline powder; odorless, and having a very bitter taste. Permanent in the air. Soluble in 23.5 parts of water, and in 88.5 parts of alcohol; insoluble in ether or chloroform. Dose.— H. & C, 3ii-5i, (8-30); Sh., 3i-iv, (4-15); Sw., 3ss-i, (2-4); D., gr.v-xxx, (.3-2). *Somi Salicylas. Sodium Salicylate. NaC7H503. (U. S. & B. P.) Synonym. — Silicylate de soude, Fr.; natriumsalicylat, G. Derivation. — Made by the action of salicylic acid on sodium carbonate. 2 HC7H503+Na2C03— 2 NaC7H503 + H20 + C02. The solution is filtered, and heated to expel carbon dioxide. Properties. — A white, microcrystalline powder or scales, or as an amorphous powder, colorless or having not more than a faint pink tinge; odorless, or having a faint characteristic odor, and a sweet, 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 alcohol; also soluble in glycerin. Dose. — Same as salicin. Phenylis Salicylas. Phenyl Salicylate, C13Hl0O3. (U. S. P.) Synonym. — Salol, B. P. ; salicylic ether of phenol. Derivation. — Made by heating salicylic and carbolic acids with phosphorous pentachloride. Properties. — A white, crystalline powder, having an aromatic odor, and a characteristic taste. Permanent in the air. Almost insoluble in water; soluble in 6 parts of alcohol. Very soluble in ether, chloroform, benzene, and in fixed or volatile oils. Dose.— H., 3iii-vi, (12-24); D., gr.v-x, (0.3-0.6). Salicylic Acid, Salicin, Sodium Salicylate and Phenyl Salicylate or Salol. Action External. — Salicylic acid, sodium salicylate, salicin and salol *Strontii salicylas is now official. Strontium salicylate is less irritating to the stomach. Dose same as for the sodium salt. ACTION OF SALICYLIC ACID 361 are powerful antiseptics resembling carbolic acid in action but less toxic and irritant. A solution of salicylic acid (1-60) is equivalent to a solu- tion of carbolic acid (1-22) in destroying some bacteria, but is not gen- erally 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 sali- cin, 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 in- creases 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 con- stitutional action is desired. Salicin splits up in the bowels into salicylic acid, salicylous acid (HC7H502), salicyluric acid (HC9H8N04), 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 characteristic smoky color produced in poisoning by phenol. Salol is an intestinal antiseptic. Salicylates retard enzyme action. Circulation. — Moderate doses of sodium salicylate, or salicylic acid slightly 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 artificial, and Eggle- ston, 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 vaso- motor 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 quickened by the stimulation of the peripheral vagi and respiratory centres produced by sodium salicylate and salicylic acid ; but after large doses the respira- tory centres are depressed and paralyzed and death takes place by asphyxia. Temperature. — Medicinal doses do not influence the normal tempera- ture of healthy animals, but do often lower bodily heat in fever, and fre- quently induce sweating. The largest therapeutic doses must be given to secure an antipyretic action. Antipyresis occurs from heat loss due to dilation of cutaneous blood vessels. Kidneys and Elimination. — Salicylic acid, salicin and sodium salicy- 1162 VEGETABLE DRUGS late circulate in the blood as sodium salicylate and arc eliminated in fche urine as salicyluric and salicylic acids. This happens in this wise: Some of the salicylic acid of sodium salicylate combines with glyeocoll in the body and forms salicyluric acid. HC7H503-f-C2H5N02 (glycocoll)= HC^H.NOj (salicyluric acid)-j-H20; while some of the sodium salt is decomposed by phosphoric 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 18 hours. Large doses given continuously accumulate in the body, and 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 through protein destruction in the body, and usually the amount of unne itself. It is made aseptic by Hie escaping salicylic acid, or in the case of salol, by both carbolic and salicylic acids. Sometimes salicylates irritate (he kidneys in large doses and blood and albumin appear in the urine. The urine of animals taking salicylic acid may be rendered green by indi- ean and pyrocatechin. formed through the action of pancreatic juice, and takes on a purple color with ferric chloride. Salicylic acid is also elim- inated in the milk, sweat and bile. Toxicology. — In man, continued large doses give rise to delirium, 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, accel- erated respiration, irregular pulse, loss of muscular 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 dram of sodium salicylate, subcutane- ously. Administration. — Sodium salicylate contains 4-8 grains of the acid to the dram. 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-oi) ; or with syrup (1-5), and aqua ammoniae in suffi- cient 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 dram of either for large dogs, should rarely be ex- ceeded. 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 bicarbonate, and ammonium acetate solution. Salicylic acid may be applied as a dusting powder with zinc oxide (1-8), or in ointment (1-20 or 30), 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 363 Acidi salicylici 3i. Zinci oxidi. Pulveris amyli. Petrolati aa oi'- M. S. Apply externally. Ringer recommends the following in pruritus ani and vulva1: Acidi salicylici r>ii. Olei theobromatis 3v. Cetaceae .~>iii. Olei myristicae -. ."iss. M. S. Apply externally. Salicylic 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 (5ii in §i) 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. Uses Internal. — The salicylic acid group are specifics in rheumatic fever. They lower temperature, lessen pain, and by shortening the attack lessen the danger of cardiac complications. Sodium salicylate should be given every three hours in doses of 3ii 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 probably worthless in chronic rheumatic arth- ritis where the local application 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 coal tar products as general antipyretics, and are useless in hyperpyrexia. Sodium salicylate is sometimes prescribed in gastric fermentation of horses when the salicylic acid, set free by the hydrochloric acid of the gastric juice, acts as an antiseptic. Also in colds and acute pharyngitis. and in chorea and pleurisy, all of which may be of true rheumatic (strep- tococcic) origin. Salol is a good intestinal antiseptic in diarrhea and intestinal indigestion, particularly when combined 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 to dogs, for painful rheumatism, as follows: Phenylis salicylatis. Acetphenetidini ... aa 3iss. Codeinae sulphatis... gr.vii. M. et divide in capsulas No. xxx. S. Two capsules t. i. d. It is probably inferior to sodium salicylate, but can be conveniently administered in powder as just noted. Salol is also a local anesthetic 364 VEGETABLE DRUGS and antiseptic in the urinary tract (carbolic acid from decomposition), and is useful in cystitis and urethritis, to alleviate pain, to prevent fre- quent micturition, and to render the urine aseptic. It may be combined 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. Acetylsalicylicum. Acetylsalicylic Acid. CpHgO*. (Acidum Acetylsalicylicum, B.^P.) Aspirin is made by heating fifty parts of salicylic acid with seventy-five parts of acetic anhydride at a temperature of 302° F., and hy purification and crystal- lization. It occurs in small colorless, crystalline needles, odorless and having an acidulous taste. It is soluble in 100 parts of water and freely soluble in alcohol end ether. With alkalies it is decomposed into salicylic acid and salicylates with the liheration of acetic acid. It passes through the stomach unchanged and is slowly dissolved in the alkaline juices of the intestines, 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 Is given salicylates, and profession and public use it largely, to the exclusion of the former favorites (quinine and phenacetin), for colds, sore throat, influenza, headaches, and neuralgic pain. It is often combined with other antipvretics and analffesics, as acetphenetidin, but is too expensive for large animals. It is incom- patible with alkalies, their carbonates or bicnrbonates. Dose.— H., oii-iv, (8-15); D., gr.v-xx, (0.3-1.3). Given in capsules or tablets to dogs; with syrup to horses. Oleum Gattltheri.e. Oil of Gaultheria. Synonym. — Oil of checkerberrv, oil of wintergreen, oil of boxberry, E.; essence de gaulth£rie, Fr. ; wintergriinol, G. A volatile oil. distilled from the leaves of Gaultheria procumbens Lmno (Fam. Ericaceae), consisting almost entirely of methyl salicylate (CH,C7H503), and identical with volatile oil of betula or sweet birch and oil of teaberry. 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 1.182 at 77° F. Solubility same as methyl salicylate. Very expensive. Dose.— H., oii-Si, (8-30); D., TTlv-xv, (.3-1). Methyl Salicylate. CH3C-H,03- (U. S. P.) Derivation. — Prepared by distillation of salicylic acid, or salicylates, with methyl alcohol and sulphuric acid (artificial or synthetic oil of wintergreen), or is obtained by distillation from Gaultheria procumbens (natural oil of winter- green), or from Betula lenta (oil of birch). Properties. — A colorless, yellowish or reddish liquid, having the characteristic odor and taste of gaultheria, with the essential composition of which it is iden- tical. It is wholly identical with oil of betula (birch). Spec. gr. 1.180-1.185; when from sweet birch or gaultheria, 1.172 to 1.182. Sparingly soluble in water. Soluble in all proportions in alcohol, glacial acetic acid, or carbon disulphide. Dose.— H., oii-Bi, (8-30); D., Tu_v-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 salicylate. Eleven parts of methyl salicylate (98 per cent. CH3C7H503) are equiva- lent to nearly ten parts of salicylic acid. The oil and methyl salicylate VOLATILE OILS 365 are free from the impurities of artificial salicylic acid, while methyl salicylate is of more certain composition than the oil. Both behave simi- larly to salicylic acid therapeutically, although the oil is more of a local irritant, and they are used for the same purposes as salicylic acid. Either may be given in emulsion, or to dogs in capsules, and in combina- tion with salicylic acid or salicylates. Methyl salicylate is serviceable in the following liniment for rheu- matism: I* Tine. opii. Methyl salicylatis. Chloroformi aa oi- Lin. saponis ad. oym- 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 administration of salicylates to a slight extent. It is usually best to combine this treat- ment witli 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 protective 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 (rubefacients), sometimes blistering (vesicants), and often local anesthesia, notably oil of cloves and peppermint. They are also parasiticide, antiseptic and disinfectant, penetrating into the protoplasm o* bacteria. Internally, these agents stimulate the flow of gastric, salivary and intestinal secre- tions and increase the vascularity and movements of the stomach and bowels, and are antiseptic, stomachic and carminative. They therefore temporarily improve digestion, overcome flatulence and colicky pain by expelling gas from the stomach and 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 irritants. They often cause polynuclear leukocytosis when ingested, but not when given intravenously. The action is not specific but may be produced by agents irritating the mucous membrane of the digestive tract. 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, 366 VF.CRTAP.I.I DRUGS secretion, and contractility of the unstriated muscle <>i' the bronchia) tubes arc increased, and volatile oils thus assisl expectoration and cough- ing. In irritating the kidneys and mucous membrane of the genito-uri nary tract, the volatile oils are stimulant and diuretic; while in poisonous doses they produce acute nephritis, strangury, hematuria and abortion. 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, rubefa- cient, vesicant, local anesthetic, sialagogue, stomachic, carminative, anti- spasmodic, stimulant, expectorant, emmenagogue, abortifacient, and diu- retic actions. Class 1 . — Used Mainly for Their Action on the Skin. Tesebixthixa. Turpentine. (H. P.) A concrete oleoresin obtained from I'inns palustris Miller, and from other species of I'inns (nat. ord. Coniferae). 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 terebintbinate odor and taste. Oleum Terebixthixjb. Oil of Turpentine. (U. S. & B. P.) A volatile oil distilled with water from the concrete oleoresin obtained from Pinus palustris Miller or from other species of Pinus (Fam. Pinaceae). Synonym. — Spirit of turpentine, E.; essence de terebinthine, Fr. ; terpen- tine, G. Properties. A colorless liquid, having a characteristic odor and taste, both of which become stronger and less pleasant by age or exposure to the air. Spec. gr. 0.860 to 0.870 at 25° ('. 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 rubber, sulphur, phosphorus, iodine, and many alkaloids. Old oil of turpentine and French oil of turpentine (Pinns maratima) are oxidizing agents. Constituents. — Turpentine contains 20 to 25 per cent, of oil of turpentine. Oil of turpentine is composed of several isomeric hydrocarbons, called terpenes, and having the formula C10H1B. The chief ones in the oil are pinene, phellan- drene, limonene, and dipentene. The oil of juniper, savin, cubeb, caraway, cloves, thyme, etc., contain various terpenes. They differ from each other in their boiling points and direction in which they rotate the plane of polarization. The terpenes are oxidized into camphors. Dose.— Carminative- H. & C, ^\-\\, (30-60); Sh. & Sw., 5i-iv, (4-15); D., TTLx-xxx, (.6-2). Anthelmintic— H. & C, Sii-iv, (60-120); D., 3ss-iv, (2-15). Diuretic— H. & C, oii-vi, (8-24). PREPARATIONS. Linimentum TerebinthinW. 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 Terebinthinw Rectificatum. Rectified Oil of Turpentine. (U. S. P.) Derivation. — Made by shaking oil of turpentine with an equal volume of solu- tion of sodium hydroxide, distillation, and shaking with anhydrous calcium chloride. Properties. — A thin, colorless, liquid, having the same properties as oil of turpentine. ACTTOX OF TURPENTINE 3fi7 Terebencm. Terebene. C10H16. (U. S. & B. P.) A Liquid consisting of dipentene and other hydrocarbons, obtained by the action of concentrated sulphuric acid on oil of turpentine. Properties. — A colorless, thin liquid, having- a rather agreeable, thyme-like odor, and an aromatic, somewhat terebinthinate taste. Spee. gr. 0.8G0 to 0.865 at 25° C. Only slightly soluble in water, hot soluble in 3 times its volume of alcohol, and in glacial acetic, or carbon disulphide. Dose.— H. & C, oii-vi, (8-24); TUv-xv, (.3-1). Terpixi Hydras. Terpin Hydrate. C1„Hls(OH)2+H.O. (V . S. P.) The hydrate of the dihydric alcohol, terpin. Derivation. — Rectified oil of turpentine, alcohol and nitric 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. Propertie 8.— Colorless, lustrous, rhombic prisms, nearly odorless and having a slightly aromatic and somewhat bitter taste. Efflorescent in dry air. Soluble in 200 parts of water and in 1.3 parts of alcohol. Dose.—H., .~)ss-ii, (2-8); 1)., gr.v-xx, (.3-1.3). Oil of Turpentine. Action External. — Oil of turpentine is an irritant to the skin, caus- ing itching-, pain and redness, or even vesication, followed by local anes- thesia. It produces intense irritability and restlessness when applied externally to some horses. The oil is antiseptic, disinfectant and parasiti- cide, 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 stomachic. In acting similarly in the bowels, particularly in stimulating 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 irrita- tion of the nerve endings in the digestive tract caused by turpentine, lends to reflex stimulation of the nervous system and heart. Circ uhition.— Turpentine is readily absorbed into the Blood, Experi- mental 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 v JSels are some- what contracted and the drug is employed to arrest hemorrhage in the digestive tract and in remote organs. It is inferior to ergot as an hemo- static. Large doses of turpentine lower the cardiac force and freque icy, and cause vascular dilatation and fall of blood pressure. Respiration. — Oil of turpentine enhances the strength and rapidity 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, seere- 368 VEGETABLE DRUGS tion. 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 re- flex activity, and, at times, convulsions. Kidneys and Genito-Urinary Tract. — The kidneys are very prone to irritation during its elimination. Small doses induce frequent micturi- tion. 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. Toxicology. — Turpentine poisoning is not an uncommon occurrence from the administration of large doses (undiluted) by empirics. Post- mortem appearances reveal gastro-enteritis, sometimes congestion and in- flammation 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. Terebene is admin- istered in a similar manner. Terpin hydrate may be exhibited in pill, ball or alcoholic solution. Uses of Oil of Turpentine, Terebene and Terpin Hydrate External. — Oil of turpentine is employed as a stimulant and counter- irritant with ammonia and soap liniment (white liniment), or as the offi- cial liniment in rheumatism, myalgia, sprains, shoulder lameness, swollen joints, gangrene, frost bites, burns and ulcers. White liniment. Olei terebinthinae ovi Aquae ammonias fortioris. Pulveris saponis aa oSS. Ammonii chloridi Si- Aquae Oii. M. Mix ammonia, soap and ammonium chloride in pint of water; shake; add turpentine and enough water to make 2 pints. Sig. Use externally. Oil of turpentine is a very efficient disinfectant with which to steril- ize the skin or accidental wounds when more appropriate agents are not USES OF TURPENTINE 369 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 tympan- itis, 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.- A blanket is thoroughly sprinkled with turpentine, folded, and rolled into a cylindrical form which will fit into an ordinary pail. Boiling water is then poured on the blanket until it is saturated. The blanket is quickly wrung out, placed over and around the horse's trunk, covered with rubber protective and dry blankets, and allowed to remain in place fifteen to thirty minutes. Uses Internal. — Digestive Tract. — Oil of turpentine is of greatest utility in colic and in expelling gas in tympany given internally and per rectum. Spiritus menthae piperitae. Spiritus ammoniae aromatici. Olei terebinthinae aa 5ii. Olei lini Oi. M. Sig. Give at once in one dose for horse or cow with flatulence. Enemata can also be employed for their stimulant action on the nervous system and circulation, in collapse. One or two ounces of oil of turpentine are dissolved in two or four ounces of cottonseed oil, when used as an enema for horses. Turpentine is an anthelmintic for rourd and tape worms. Round or tapeworm in horses. Olei terebinthinae 3u« Olei resinae aspidii oi- Olei lini Oi. M. Sig. Give in one dose to horses after starving 24 hours. Olei terebinthinae. Olei chenopodii aa 3i- Chloroformi 5ii. Olei ricini oxiv. M. Sig. 5ss to ii for adult dog (for round worms) in equal amount of castor oil (Hoare). Hall and Foster found turpentine ineffective against ascarids and hookworm in dogs, and against roundworms in hogs, causing nephritis in the latter. In 2 mil doses, with an equal amount of olive oil, it proved a 370 VEGETABLE DRUGS good remedy for roundworms in poultry (2 lbs. -9 Lbs. .live weight). Old oil of turpentine is often advised as an antidote for phosphorus because il contains ozone and tonus a harmless, camphor-like bodj turpentine phosphoric acid. lis use has. however, been found worthless. Turpen tine is occasionally given in indigestion, chronic diarrhea, and dysentery of horses and cattle, as a local stimulant and antiseptic. Respiratory Organs. — Oil of turpentine is an efficient stimulating and antiseptic expectorant in subacute and chronic bronchitis; and deodor- ant in gangrene of the lungs. it is administered internally, and by inhalation in the proportion of one tea spoonful to the quart of boiling water. Tercbcix is used as a substitute tor oil of turpentine, as a stimu- lating expectorant, and is likewise prescribed as an antiseptic and earmi native in flatulence, and as a genito-urinary stimulant. Terpin hydrate increases bronchial secretion and is employed in both acute and chronic bronchitis. Bronchitis in dons. Codeinae sulphatis gr.vi. Elixir, terpini hydratis, ad ,"iii. M. Sig. Teaspoonful every .'J hours lor cough. Oil of turpentine has been found beneficial in verminous bronchitis of calves and lambs (caused by Strongylus micrurus and filaria), in- jected into the trachea midway in the neck, according to the following proscription : B Ol. Terebinthinae ."ji-ii. Acid, Carbol. Glycerini Chlorofonui aa oSfs. M. S. Inject in one dose. Chloroform is more successful, however (see p. 225). "Gapes" in fowl, due to Syngamus trachealis, is cured by the same- mixture diluted with 5 parts of oil and applied to the throat internally with a feather. Verminous bronchitis in calves may also be cured by pouring- into each nostril, once daily, 2 drams of turpentine with the head upturned. Also give internally, and to lambs with this disease, 1 dram in milk or gruel once daily. Circulation. — Oil of turpentine is of some worth as a cardiac stimu- lant and hemostatic. It is said to have been exhibited in parturient fever and apoplexy of cattle with success. Bleeding from the nose, lungs, digestive tract, uterus, kidneys, and bladder, and hemorrhages occurring in purpura hemorrhagica, are sometimes stopped by the internal use of turpentine. Genito-Urinary Tract. — Oil of turpentine is indicated as a stimulant in amenorrhea, chronic pyelitis and cystitis. The drug is contra-indicated in acute inflammation of the kidnevs and alimentarv canal. TAR, PITCH AND OIL OF CADI-. 371 / Pix Burgundica. Burgundy Pitch. (B. P.) The prepared, resinous exudation of Abies excelsa Poiret (nat. ord. Coniferae). Synonym.— Poix blanche, poix de Bourgogne, Fr.; Burgunder harz (pech), G. Habitat. — Southern Europe, mountainous regions. Properties. — Hard, yet taking gradually the form of the vessel in which it is kept; brittle, with a shining, conchoidal fracture; opaque or translucent; reddish- brown or yellowish-brown; odor agreeably terebinthinate; taste aromatic, sweet- ish, not bitter. It is almost entirely soluble in glacial acetic acid, or in boiling alcohol, and partly soluble in cold alcohol. Constituents. — 1, resin; 2, a volatile oil (CinH10). Dose.— H. & C, gi-iii, (30-90); Sh. & Sw., 5i-ii, (4-8); D., gr.xx-xl, (1.8-2.6). PREPARATION. Em plant rum Picis. Pitch Plaster. (B. P.) Tekkbinthina Canadensis. Canada Turpentine. (B. P.) A liquid oleoresin obtained from Abies balsamea (Linne), Miller (nat. ord. Coniferae). Synonym.— Canada balsam, balsam of fir, balsamum Canadense, E.; baume de Canada, Fr. ; Canadischer terpentin, G. Habitat. — Canada and N. United States; west to Minnesota, south on moun- tains to Virginia. Properties. — A yellowish or faintly greenish, transparent, viscid liquid, of an agreeable terebinthinate odor, and a bitterish, slightly acrid taste. When exposed to the air it gradually dries, forming a transparent varnish. Tt is completely soluble in alcohol, chloroform or benzol. Constituents. — 1, volatile oil, 20-30 per cent.; 2, resins; 3, and chiefly a and b cannadinolic acid. Dose.- 11. & C, r.i-iii, (30-90); Sh. & Sw., .n-ii, (4-8); D., gr.xx-xl, (1.3-2.6). Action and Uses of Burgundy Pitch and Canada Turpentine. Burgundy pitch is slightly stimulating to the skin and is used as a mild counter-irritant (in plaster) in rheumatism, strains, swelling of joints, and upon the chest. Burgundy pitch, Canada turpentine, crude turpentine. Venice turpentine, Bordeaux turpentine and frankincense have much the same action and uses as oil of turpentine internally. They are administered in the same manner and in nearly identical doses, but are less commonly employed than the latter. Resina. Rosin. (U. S. & B. P.) The residue left after distilling the volatile oil from the concrete oleoresin obtained from Pinus palustris Miller and from other species of Pinus (Pinaceae). Sy n on ym.— Colophony, resin, E.; colophonium, P. G. ; colophone, Fr.; kolo- phonium, geigenharz, G. Properties.— Usually in sharp, angular, translucent, amber-colored fragments, frequently covered with a yellow dust, brittle at the ordinary temperature; frac- ture shiny and shallow-conchoidal; odor and taste slightly terebinthinate. Spec. gr. 1.07-1.09. Soluble in alcohol, ether, and fixed or volatile oils; also in solutions of the fixed alkali hydroxides. Constituents. — Chiefly abietic acid anhydride (C«H8607), 80-90 per cent. PREPARATIONS. Ceratum Resince. Resin Cerate. (U. S. P.) Synonym. — Basilicon ointment. Rosin, 350; yellow wax, 150; lard, 500. Emplastrum Elasticum. Rubber adhesive plaster. Rubber, 20; petrolatum, 20; lead plaster, 960. (U. S. P. 1905.) Emplastrum Resince. Resin Plaster. (U. S. & B. P.) Unguentum Resinw. (B. P.) 372 VEGETABLE DRUGS Action and Uses of Rosin. Rosin is a local stimulant and antiseptic externally. The cerate is an excellent preparation for burns, wounds, ulcers, and abraded surfaces. The fumes arising from burning rosin (on a hot shovel) are said to be of value when inhaled in chronic or subacute bronchitis. Pix Liquida. Tar. (U. S. & B. P.) A product obtained by the destructive distillation of the wood of Pinus palus- tris Miller, or of other species of Pinus (Fani. Coniferae). Synonym. — Resina empyreumatica liquida — goudron, goudron vegetal, Fr.; theer, G. Habitat.— United States. Properties. — Semi-fluid, viscid, blackish-brown; non-crystalline, translucent in thin layers, becoming granular and opaque with age; odor empyreumatic, tere- binthinate; taste sharp, empyreumatic. Tar is slightly soluble in water; miscible with alcohol, ether, fixed or vola- tile oils, and solutions of potassium or sodium hydrate. Constituents. — Mainly — 1, oil of turpentine; 2, methylic alcohol; 3, creosote; 4. guaiacol; 5, phenol; 6, pyrocatcchin; 7, toluene; 8, xylene (also cumene, methene, chrysene, retene) ; 9, acetic acid; 10, acetone; 11, resins. Dose.— H. & C, gss-i, (15-30); Sh. & Sw., 3i-ii, (4-8); D., TTlxv-3i, (1-4). PREPARATIONS. Unguentum Picis Liquid®. Tar Ointment. (U. S. & B. P.) Tar, 500; yellow wax, 150; lard, 350. Pix Carbonis Preparata. Prepared Coal Tar. (B. P.) Liquor Picis Carbonis. Solution of Coal Tar. (B. P.) Oleum Picis Liquids Rectificatum. Rectified Oil of Tar. (U. S. P.) A rectified, volatile oil distilled from tar. Properties. — A thick liquid having a dark reddish-brown color, and a strong empyreumatic odor and taste. Spec. gr. 0.960 to 0.990. Soluble in alcohol. Pix Nigra. Pitch. (Non-official.) A solid, shining, black, bituminous substance. Soluble in ether, oils, and aqueous alkaline solutions. It contains an altered resin, and a crystalline prin- ciple, retine (CjsHjs). Oleum Cadinum. Oil of Cade. (U. S. & B. P.) An empyreumatic oil obtained by the dry distillation of wood of Juniperus Oxycedrus Linne (Fam. Pinaceae). Synonym. — Oleum juniperi empyreumaticum, E.; huile de cade, Fr. ; kadeol, G. Habitat. — North Africa, Spain, France, and Portugal, on the borders of the Mediterranean, in waste places and stony hill-sides. Properties. — A dark brown, clear, thick liquid; having a tarry empyreumatic odor and a warm, faintly aromatic and bitter taste. Spec. gr. 0.980 to 1.055. It is almost insoluble in water, but imparts to it an acid reaction. Partially soluble in alcohol; completely soluble in ether, chloroform, oil of turpentine, or carbon disulphide. Constituents. — Phenols and cadinene (latter unimportant). Dose. — Same as that of tar. Action and Uses of Tar, Oil of Cade and Pitch. Externally, tar produces hyperemia, and, when rubbed continually into the skin, sometimes papules and pustules. It is a stimulant, rube- facient, antiseptic and parasiticide externally. Poisoning may follow the extensive application of large quantities of tar over a denuded sur- TAR 373 face, or if it be licked off the skin. Tar is mainly employed in veterinary medicine on the skin, and is a valuable remedy to relieve itching and as a local stimulant in chronic eczema ("grease"), and sometimes in moist eczema and erythema, psoriasis, pityriasis, pruritus, and lichen. It also destroys the parasites of mange and ringworm. It is applied with fat, vaseline, soap or alcohdl, in the proportion of 1-2 to 10. The official ointment (1-2) is generally appropriate in the above-mentioned skin diseases, but may require dilution. The following preparation is service- able on patches of scaly eczema : Picis liquidae. Saponis mollis. Alcoholis aa o«- M. S. External use. Pure tar painted over the surface with a brush, is often most effi- cient in obstinate cases of eruptive disorders. A lotion of oil of tar, sul- phurated potassa, or Peruvian balsam, is more cleanly and suitable for house dogs with eczema. (See diet foi eczema in dogs, section on foods and feeding, p. 479.) Tar is of the greatest utility in stimulating the growth of horn, and is the principal ingredient of hoof ointments for horses. It may be mixed with an equal part of lard for this purpose, or the following mixture is well spoken of: Picis liquidae. Cerae flavae. Mellis aa 3*v. Glycerini 3iii. Adipis Bxxiv. Melt and mix the lard and wax together; add the other ingredients and stir while cooling. S. External use. Oakum, soaked with tar, is frequently packed under leather, beneath the shoes on horses' feet, to soften and stimulate the horn and to cure thrush and canker. Tar is also a beneficial application for foot rot of sheep. Pine tar is useful in keeping the gadfly away from sheep in sum- mer. Two holes are bored in a log, the larger one surrounding the deeper one. In the larger place pine tar, in the smaller and deeper put salt. When getting salt the animal automatically smears his nose with tar. Tar is usually kept on hand for farming purposes, and is therefore, a popular antiseptic and protective in the treatment of wounds and broken horns in cattle. Oil of tar may be applied, dissolved in alcohol (1-8), as a lotion, and is an agreeable substitute for tar in chronic eczema or psoriasis of dogs. It is used in the pure state as a parasiticide for mange, scab, ring- worm or favus. Oil of cade represents oil of tar and tar in their actions and uses, but its odor is pleasanter. It is prescribed externally in chronic eczema and pruritis, in equal parts with wax, or as follows : d74 \ EGETABLE DRUGS Olei cadini -,i Alcoholis. Sapo. mollis aa Vy M. Sig. Apply externally with brush. Oil of cade can also be used in any proportion or manner in which tar is applicable. Pitch likewise possesses the same action as tar, and is sometimes employed for making hoof ointments and plasters. Internally. — Tar — on account of its constituents, phenol and creosote — in large quantities causes toxic effects, with symptoms resembling car- bolic acid poisoning: e.g., abdominal pain, vertigo, signs of gastrointes- tinal irritation, and the passage of dark-colored urine. 1 1 is not exceed- ingly poisonous, however, as recovery has been reported in man after the ingestion of an amount varying from one to two pints. Tar is elimi- nated by the kidneys, with the production of irritation and diuresis; also by the mucous membrane, and affects more especially that lining the bronchial tubes, where it acts as a local stimulant and antiseptic. For this reason the drug is an excellent expectorant in subacute or chronic bronchitis when given internally or by inhalation. The latter process may be conducted by pouring tar on a heated shovel, or, better, by dis- solving tar in boiling sodium carbonate solution and steaming the patient with the vapor. Tar is occasionally exhibited in chronic gastro-intestinal catarrh and obstinate diarrhea, with good results. Tar is of value internally in influencing those skin disorders which are benefited by its external application. Inhalations of tar are sometimes serviceable in pharyngitis and laryngitis, as well as in bronchitis. Balsamum Peruvianum. Balsam of Peru. ( U. S. & B. P.) A balsam obtained from Toluifera Pereirae (Royle) Baillon (Fam. Legumi- nosae). Synonym. — Balsamum peruvianum nigrum, balsam indicum, baume de P6ro, baume des Indes, Fr.; Peru balsam, G. Habitat. — Central America. Properties. — A viscid liquid of a dark brown color; free from stringiness or stickiness; transparent and reddish-brown in thin layers; of an agreeable vanilla- like odor and a bitter acrid taste, with a persistent after-taste. When swallowed it leaves a burning sensation in the throat. It does not harden on exposure to the air. Spec. gr. 1.130 to 1.160. Soluble in alcohol, chloroform, or glacial acetic acid. Completely soluble in 5 parts of alcohol. Constituents. — 1, a volatile oil, yielding cinnamein, C,,H7(C7H7)02, about 60 per cent.; 2, cinnamic acid, C9H802; 3, a resin (32 per cent.), yielding benzoic acid, HC7H302 on dry distillation; 4, styrol, CSHS; 5, stilbene, CMH12; 6, a volatile oil, benzylic benzoate, C7H5 (C7H7)0,; 7, benzvlic alcohol, C7HsO; 8, styracin, C,H7 (C9Hn)02. Dose.— H. & C, 5i-ii, (30-60) ; Sh. & Sw., 5i-ii, (4-8) ; D., ITLx-xxx, (.6-2). Balsamum Tolutanum. Balsam of Tolu. (U. S. & B. P.) A balsam obtained from Toluifera Balsamum Linne (Fam. Leguminosae). Synonym. — Baume de Tolu, baume de Cathagene, Fr. ; Tolubalsam, G. Habitat. — New Granada and Venezuela. Properties. — A yellowish-brown, or brown, plastic solid, becoming brittle when old, dried or exposed to the cold; transparent in thin layers; has a pleasant aromatic odor, resembling that of vanilla, and a mild aromatic taste. Soluble in alcohol, ether, chloroform and solutions of fixed alkalies; almost insoluble in water. BENZOIN OYO Constituents.—!, a volatile oil, tolene, doHlfl, 1 per cent.; 2, a volatile oil, benzylic benzoate, C:H5 (C7H7)0~; 3 benzoic acid, HC7H0O,; 4, cinnamic acid, CyHb02; 5, benzylic cinnamate, C,HT(C\H7)02; 6, resins. Dose. — Same as balsam of Peru. PREPARATION. Syrupus Tolutanus. Syrup of Tolu. (U. S. & B. P.) Tincture of tolu, 50; magnesium carbonate, 10; sugar, 820; water to make 1000. (U. S. P.) host.— D., 3i-iv, (4-15). Action and Uses of Balsams of Peru and Tolu. Externally, tin- balsams arc stimulant, antiseptic and parasiticide. Balsam of Peru is a useful remedy in alcoholic solution (1-8) for chronic eczema of dogs. It may also be serviceable in ointment (1-8) for sore hats in cows, or as an application to kill lice and the parasites of (sar- coptic) mange and ringworm. For mange or ringworm.' I* Balsami peruviani 3i. nti sulphuris ,ji- • M. S. Apply externally 3 times daily. It is, undiluted, a most excellent stimulant and antiseptic dressing upon wounds and ulcers. In fact there is no better agent for dressing ordinary wounds. Occasionally renal inflammation follows its very ex- tensive external use. Internally, the balsams are stomachic and carminative, and are elimi- nated by the skin, mucous membranes and urinary organs, stimulating these parts. They are therefore occasionally prescribed in chronic bron- chitis, pyelitis and cystitis. The syrup of tolu is an exceedingly mild preparation, but forms an agreeable vehicle for cough mixtures in canine practice. The balsams may be administered in emulsion rubbed up with either glycerin, mucilage, or white of egg and water. Bi > zo] n i - m . B< nzoin. ( U. S. & B. i' ) gum benjamin, K.: ben join, Fr.; ben- zoe, G. A balsamic resin obtained from S Benzoin Dryander, and some other species of Styrax (Fam. Styraceae) [ East Indies and known in commerce as Sumatra benzoin and Siam benzoin. Habitat. — Siam, Sumatra. Java and Borneo. Properties. — Sumatra Benzoin.— In blocks or lumps • size, made up of tears, compacted togeth* >rown, r y, or grayish- brown resinous mas externallj h or rusty brown, milky-white on fresh fracture; hard and brittle at ordinary tempei ut softened by boat and becoming gritty on chewing; odor aromatic, taste aromatic and slightly acrid. Soluble in alcohol to extent of 75 per cent. Siam Benzoin. — In pebble-like tears of variable size, yellowish-brown to rusty brown externally: odor agreeable, bal- samic vanilla-like; taste slightly acrid. ' Soluble in alcohol to extent of 90 per cent. Alcoholic solutions of benzoin become milky by the addition of water. Constituents. — 1, benzoic acid, 12 to 20 per cent.; 2, cinnamic acid, sometimes; 8, several resins; 4, a volatile oil. PREPARATIONS. Adeps Benzoinatus. Benzoinated Lard. (U. S. & B. P.) Made by melting lard, 1000, with Siam benzoin, 10; and straining. ( Lr. S. P.) 376 VEGETABLE DRUGS Tinctura Benzoini. Tincture of Benzoin. (U. S. P.) Made by maceration of benzoin, 200, in alcohol; filtration, and addition of alcohol to make 1000. Dose.—H. & C, 5i, (30); D., 3ss-i, (2-4). Tinctura Benzoini Composita. Compound Tincture of Benzoin. (U. S. & B. P.) Synonym. — Friar's balsam. Benzoin, 100; purified aloes, 20; storax, 80; balsam of tolu, 40; alcohol to make 1000. Made by maceration in alcohol and filtration. (U. S. P.) Acidum Benzoicum. Benzoic Acid. C7H(i02. (U. S. & B. P.) Synonym. — Acide benzoique, fleurs de benjoin, Fr.; benzoesiiure, benzoeblu- men, G. Derivation. — Obtained from benzoin by sublimation, or artificially prepared. Properties. — In lustrous scales or friable needles. The synthetic acid is white, odorless, or with a slight odor of benzaldehyde; the natural acid is white, or yellowish, acquires a darker color on exposure to light, and has a slight odor of benzoin. Benzoic acid has a pungent taste, is somewhat volatile at moderately warm temperatures and freely volatile with steam. Soluble in 275 parts of water, and in 2.3 parts of alcohol. Also soluble in 3 parts of ether. 4.5 parts of chloro- form, and readily soluble in carbon disulphide, benzene, fixed and volatile oils, but sparingly soluble in petroleum benzin. Incompatibles. — Alkalies, ammonium carbonate. Dose.— H. & C, 5ii-iv, (8-15); D., gr.v-xv, (.3-1). Ammoxii Benzoas. Ammonium Benzoate. NH4C7H&02- (U. S. & B. P.) Made by the action of benzoic acid and ammonia water. In white crystals or crystalline powder. Soluble in 10 parts of water; in 35.5 parts of alcohol. Dose. — Same as benzoic acid. Sodii Bexzoas. Sodium Benzoate. NaC7Hs02. (U. S. & B. P.) Made by the action of a hot solution of sodium carbonate on benzoic acid. Occurs in a white amorphous or crystalline powder. Soluble in 1.8 parts of water; in 61 parts of alcohol. Dose. — Same as benzoic acid. Action of Benzoin, Benzoic Acid and Benzoates. These substances may be represented by benzoic acid. Action External. — Benzoic acid is an irritant applied externally, also when its vapor is inhaled. It is an efficient antiseptic; a solution (1-1000) will inhibit the growth of many forms of bacteria. Action Internal. — Medicinal doses of benzoic acid exert only an anti- septic action in the alimentary canal. Large doses occasion increased bronchial and cutaneous secretion, with accelerated pulse. Enormous doses cause gastro-intestinal irritation, slowing of the pulse and respira- tion, convulsions, general paralysis and asphyxia. Benzoic acid is ab- sorbed into the blood, acts as an antipyretic in fever, and is converted (probably in the kidneys) into hippuric acid and eliminated in the urine as such. It thus renders an alkaline urine acid, and stimulates and exer- cises an antiseptic influence upon the urinary mucous membrane. The change into hippuric acid is due to combination with a nitrogenous body — glycocoll — but the source of glycocoll is uncertain. Benzoic acyl C7HGOo+glycoc°ll C9H5N0o=hippuric acid C9H9N03 +H20. Benzoic acid is somewhat diuretic, but does not alter the composition of the urine in any constant manner, although metabolism is said to be in- creased. It is eliminated by the bronchial mucous membrane, augmenting secretion, and acting as an antiseptic in the bronchial tubes. When the MUSTARD 377 vapor of any of the substances under consideration is inhaled in proper dilution, a similar expectorant action is attained. Benzoic acid is like- wise excreted by the skin and salivary glands, exciting their functional activity. Uses External. — The compound tincture of benzoin is a valuable stimulant and antiseptic application for wounds, sores and ulcers. It is often applied to the part on gauze or lint, followed by bandaging. There is no better agent for treating cuts and abrasions that do not require bandaging when painted on the part with a brush several times daily. Uses Internal. — Benzoic acid is sometimes given in powder, pill, or ball, as an intestinal antiseptic, and as a remedy for rheumatism. It is inferior to salicylic acid in the latter disorder. The benzoates are said to be equally efficient as antiseptics and have been highly recommended in diarrhea and dysentery. Benzoin, in the form of the tincture, and the benzoates, are service- able in laryngitis, tracheitis, and bronchitis, to promote secretion and antisepsis. An inhalation of the tincture (5ii-Oi hot water) is also verj7 serviceable in these diseases for the same purposes. The benzoates are of value in pyelitis and cystitis, particularly in carnivora with a normal acid urine, to acidify and disinfect the decom- posing urine and stimulate the tract. They should be given with hexa- methylenamine in these disorders as this drug acts most favorably in an acid urine. Sinapis Alba. White Mustard. (U. S. P.) Synonym. — Sinapis albae semina, B. P.; semen erucae, P. G.; yellow mustard seed, E.; moutarde blanche, Fr. ; weisser senf, G. The seed of Sinapis alba (Linne), (Fam. Cruciferae). Habitat. — Southern Europe and Asia; cultivated in temperate climates. Description. — Sub-globular, from 1.5 to 2 5 mm. in diameter; testa yellowish, nearly smooth; embryo yellowish, oily with 2 cotyledons; inodorous, taste mildly pungent, acrid. The powder is light yellowish or pale brownish-yellow, develop- ing a slight odor when moistened. Constituents. — 1, a glucoside, sinalbin (C3„H44N2S201G), and a ferment, myro- sin, 10-15 per cent. The latter converts the former, in the presence of water, into the active principle of the drug, acrinyl sulphocyanide (C7H7ONCS), a very acrid, volatile body, sinapine sulphate (C1<;H23N05H2S04), and glucose; 2, a bland, fixed oil, 25 per cent.; 3, gum, 20 per cent. Dose.— H., 3ss, (15); C, 3ss-i, (15-30); Sh. & Sw., 3i-ii, (4-8); D., gr.x-xv, (.6-1). Sinapis Nigra. Black Mustard. (U. S. P.) Synonym. — Sinapis nigras semina, B. P.; semen sinapis, P. G. ; moutarde noire (Grise), Fr. ; schwarzer senf, G. The seed of Brassica nigra (Linne) Koch (Fam. Cruciferae). Habitat. — Southern Europe and Asia; cultivated in temperate climates. Description. — Ellipsoidal or irregularly sphenoidal, from 1 to 1.6 mm. in diameter; testa deep reddish-brown, sometimes yellowish-brown with a grayish tinge, minutely pitted or reticulate; embryo greenish-yellow or dark yellow, oily with two large cotyledons; odor, when dry, slight, on moistening very irritating; taste strong, pungent and acrid. The powder is light brown or greenish-brown, on moistening very irritating; taste strongly pungent and acrid. Constituents. — 1, a glucoside, sinigrin (or potassium myronate), and a fer- ment, myrosin. In the presence of water the latter converts the former into the acrid, volatile, official oil of mustard (allyl sulphocyanide, C3H5CNS), acid potas- o*tB ,;:i.|. DRUGS .mill sulphate, and glucose; 2, a fixed, bland oil, similar to thai in white mustard; .'i, gull). Dose. — Same us white mustard. Commercial fi i mixture of black and white mustard, and constitut< ( B. P.). PREPARATION. Oleum Sinapih Voi \m Oil of Mustard. (U. S. & B. P.) 8yno I . . < leum sinapis aethereum, I I, G. a black mustard b} ma ctive liquid, having a verj | gent and ,ie in alcohol, etl ng neutral to litmus paper. Spec. gr. 1.013 to I ^Ratio.n. is (B r. ) : volatile oil of mustard, camphor and castor oil. Action External- Mustard quickly dilates the vessels of the skin and causes hyperemia. It its application is frequently repeated, thi so much vascular urs under the epidermis, and b oaed. Mustard indui sensation of burn ng in m urpentine to liorses. and th l is followed by partial anesthesia. It is one of the most 1 id by tin's action contracts vessels in the underlying p ,t and congestion. In rapidly - . . es the nervous system, respirator} i. Mustard , fore a rubefa- cient, vesicant, and counter-irr ernally. ■Action Internal. — Mustard stimulates gastric vascularity, secretion and motion, and promotes the appetite in small doses. .Large doses occa- sion vomiting in of the act. Intestinal peristalsis and secretion are probably likewis jmented by mustard. It is thus a stomachic, carminative .and emetic internally, but is rarely administered save as an emetic because of its pungency and the difficulty attending its exhibition. Mustard is absorbed to some extent, but we are ignorant concerning its ultimate fate or remote action. It is said to be a diuretic. Uses External. — Mustard is an extremely valuable counter-irritant for relieving pain or congestion in almost any internal part. It is more commonly employed in the acute respiratory disorders of the domestic animals, as in laryngitis, bronchitis, congestion of the lungs, pleurisy. pneumonia, to stop incessant cough, and after exposure to severe cold; and the flour of mustard, with an equal amount of wheat flour, is used in a very thin paste made with warm water and applied with friction to the skin. Boiling water should not be mixed with mustard, nor vinegar, nor alcohol, as they interfere with its action. The volatile oil of mustard is a cleanly and convenient substitute for the crude drug. A small quantity, diluted with olive oil. or cottonseed oil (1-15), may be rubbed into either side of the chest in bronchitis, pleurisy, and other chest disorders, as a counter-irritant. After the application of mustard, the part may be bandaged, or hot blankets may be placed over the body and the treatment reinforced by the use of mustard on the limbs and bandaging. Tf mustard is employed THIOSINAMINE 379 continuously to keep up constant counter-irritation, the drug should be washed off in 20 or 30 minutes, and the process repeated once in 2 hours. It is unwise to induce much vesication over an extensive surface with mustard, as the result is painful and resolution is slow. Mustard is also serviceable in painful abdominal diseases, as colic, tympanites, enteritis and peritonitis, but oil of turpentine appears here to be more efficient. A sinapism (mustard application) over the loins is useful in acute nephritis, and will not lead to irritation of the kidneys from absorption which may ensue after cantharidal blistering. Cantharides has, however, a more active, permanent and revulsant effect in most local inflammatory conditions, and is more potent in acute laryngitis. The action of mustard is rapid and fleeting, unless applied continually in considerable strength. For this reason it is indicated to impress the nervous system instantane- ously, in opium, alcohol and other narcotic poisoning; in respiratory fail- ure, in collapse and extreme depression in the course of acute diseases (pneumonia and parturient apoplexy), applied all over the body, or over the cardiac region in syncope. Mustard is of utility in muscular or articu- lar rheumatism, and is employed on swollen glands (strangles), inflamed joints and tendons; but is usually less efficacious than a good cantharidal blister in these three latter conditions. Uses Internal. — Mustard is an efficient emetic for dogs, in table- spoonful doses, given in a cup of tepid water. It is usually at hand, and not only empties the stomach in poisoning, but reflexly stimulates the heart and respiration. If administered for its carminative or stomachic effect, mustard must be given in pill or ball. Tkiosixamixa. Thiosinamine. CH.N^S. (Non-official.) Thiosinamine (ally] thiourea) is made by heating together volatile oil of mus- tard and an alcoholic solution of ammonia, collecting the crystalline product of condensation, and reervstalli/.ation from alcohol. It occurs in colorless crystals, having a slight, alliaceous odor, and is moderately soluble in water in which it is decomposed. Tt is also soluble in about 3 parts of alcohol and readily soluble in ether. Fibrolysin (non-official) (NH2, CS, NHCH2CH: CH2) + C„H4(OH) (COONa) has now largely superseded thiosinamine because it is freely soluble in water, produces less irritation and is more readily absorbed than thiosinamine. Fibro- lysin is a sterilized solution of a double salt of thiosinamine and sodium sulphate containing 15 per cent, of the double salt. It is a clear, colorless, aqueous solution of faint odor and acrid taste. It decomposes in the air but not in sealed, brown glass vials in which it is marketed. Each ampul contains 11.5 mils, or sufficient for one injection for a horse. Actions and Uses. — Thiosinamine and fibrolysin have a peculiar action on pathological exudates when given by the mouth, under the skin, or into the blood. They cause a local reaction, where old inflammatory exudation exists, with softening and absorption of inflammatory exudates beginning within a few hours after their subcutaneous use. There may be considerable pain and dark congestion about the site of injection and the amount of urine is sometimes greatly increased. While they are said not to interfere with the general health, in man they sometimes produce nausea and vomiting. Fibrolvsin is the better of the two for the reasons stated. It has 380 VEGETABLE DRUGS been employed to cause resolution in indurated and thickened tendons, in anchylosis of joints, and elephantiasis of horses and cattle; also in swollen and indurated glands, in large scars, lupus, and keloid growths, and corneal opacites. The value of the drug is still undetermined since re- ports have been more or less at variance. Fibrolysin solution is probably best given intramuscularly into the gluteals, but may also be injected intravenously or subcutaneously once daily, or once every second or third day. Scarlet Red is a synthetic, non-toxic dye very valuable in 4 per cent, ointment (with lard) in stimulating the growth of epithelium over slug- gish wounds and ulcers, as in burns, gangrene, decubitus, and granulating surfaces that formerly required skin grafting. It is not antiseptic. Eucalyptus. Eucalyptus. (U. S. P.) Synonym. — Feuilles d'eucalyptus, Fr. ; eukalyptus-blatter, G. The dried leaves of Eucalyptus globulus Labillardiere (Fam. Myrtaceae), collected from the older parts of the tree. Description. — Laminae, lanceolately scythe-shaped; from 8 to 30 cm. long; 2 to 5 cm. broad; rounded below, tapering above; entire, leathery, grayish-green, glandular, feather-veined between the midrib and marginal veins; odor slightly aromatic; taste aromatic, bitter and cooling. Constituents. — 1, a volatile oil (see below); 2, a crystallizable resin; 3, a crystallizable, fatty acid; 4, cerylic alcohol. Dose.— H. & C., 3ii-iii, (60-90); D., 5ss-ii, (2-8). PREPARATIONS. Fluidextr actum Eucalypti. Fluidextract of Eucalyptus. (U. S. P.) Made by maceration, percolation with diluted alcohol, and evaporation, so that 1 mil = 1 Gm. of the crude drug. Dose. — Same as for eucalyptus. Unguentum Eucalypti. (B. P.) Oleum Eucalypti. Oil of Eucalyptus. (U. S. & B. P.) A volatile oil distilled from the fresh leaves of the eucalyptus, rectified by steam distillation, and yielding when assayed, not less than 70 per cent, by vol- ume of eucalyptol (cineol). Properties. — A colorless or pale yellow liquid, having a characteristic, aro- matic, somewhat camphoraceous odor, and a pungent, spicy, and cooling taste. Spec. gr. 0.905 to 0.925. Soluble in all proportions in alcohol, carbon disulphide, or glacial acetic acid. Constituents. — 1, a volatile oil, eucalyptol or cineol (C10H18O) ; 2, eucalyptene (C10HW); 3, cymene (C10HU). Incompatibles. — Alkalies, mineral acids, and metallic salts. Dose.— H., 5i-ii, (4-8); D., TTlii-x, (.12-.6). Eucalyptol. Eucalyptol. C^H^O. (U. S. P.) An organic oxide (cineol) obtained from the volatile oil of Eucalyptus globu- lus Labillardiere (Fam. Myrtaceae) and from other sources. Derivation. — Crude eucalyptol distills over from eucalyptus leaves at a tem- perature varying from 338° to 352° F., and is purified by redistillation from potassium hydrate or calcium chloride. Properties. — A colorless liquid, having a characteristic, aromatic and distinct- ly camphoraceous odor, and a pungent, spicy and cooling taste. Spec. gr. 0.921 to 0.923. Soluble in all proportions, in alcohol. Dose. — Same as oil of eucalyptus. Action of Eucalyptus, Oil of Eucalyptus and Eucalyptol. External. — The oil is a powerful antiseptic and disinfectant, and is even said to be three times more efficient in this respect than carbolic EUCALYPTUS 381 acid. It is but slightly irritating to the skin, unless its vapors are con- fined by bandaging, when it may cause vesicles and pustules. Some local anesthesia follows primary skin irritation. Internal. — Digestive Tract. — Oil of eucalyptus excites gastric and salivary secretion, and acts, both locally and during elimination, as a stimulant to the mucous membrane of the alimentary canal. Large doses occasion diarrhea, and the fecal discharges are impregnated with the odor of the oil. It is a stomachic, carminative, antiseptic and anodyne in the digestive tract. Circulation. — Oil of eucalyptus arrests the ameboid movements of the white blood corpuscles, and diapedesis, in inflammatory areas ; inhibits the growth of the plasmodia malaria?; is an antipyretic and antiperiodic, and generally comports itself like quinine; but is nevertheless distinctly inferior to it. Small doses reflexly stimulate the heart and cause an in- crease in blood pressure; while toxic doses depress the heart's action and lower vascular tension. Respiration. — Small doses accelerate the respiratory movements. Large doses make the respiration slower and weaker, and death ensues through respiratory failure. Nervous System. — Poisonous quantities depress the brain, medulla and spinal cord. Reflex activity is lost. Animals stagger, suffer great loss of muscular power and sensation in their limbs, and fall ; the breath- ing is slow and irregular, the pulse weak, and there are occasional con- vulsions. The breathing stops before the cardiac pulsations. Elimination. — Oil of eucalyptus is excreted by the skin, kidneys, and mucous membrane of the bronchial tubes and bowels, and therefore stimulates and disinfects these parts during its elimination. Hence the drug is a diaphoretic, diuretic, and genito-urinary stimulant, stimulating expectorant, and carminative. Administration. — The oil, or eucalyptol, is administered in emulsion with gum; dissolved in alcohol; or in capsules. Uses of Eucalyptus, Oil of Eucalyptus and Eucalyptol. 'External. — Eucalyptol is probably more generally useful than either eucalptus or the oil. It is employed as an antiseptic with vaseline (1-8), on sores, wounds, and ulcers, and in lubricating instruments for use in the cavities of the body. It partially disguises the odor of iodoform, and is frequently combined with the latter in ointment. Eucalyptol is serviceable as a stimulating, antiseptic and deodorant inhalation in catarrhal diseases of the respiratory tract with putrid discharges, and in pulmonary gangrene. The ordinary doses (by the mouth) are placed in hot water for this purpose. Eucalyptol, with sweet oil (1-5), forms an efficient stimulating and anodyne liniment. Internal. — In chronic bronchitis, eucalyptol is often valuable in stim- ulating and disinfecting the bronchial mucous membrane during its elimination. It is also efficacious in chronic pyelitis and cystitis, for the same reason. The oil has been given with asserted success in various bacterial diseases, as septicemia, canine distemper, influenza, etc., for its 382 VEGETABLE DRUGS antiseptic action. In human medicine, eucalyptus and its derivatives arc mainly of worth as substitutes for quinine in malaria, when the latter drug is inadmissible. Eucalyptol may be given as a stomachic and car- minative in digestive disorders with foul-smelling fecal evacuations. Myrrh a. Myrrh. (T. S. cSc B. P.) Synonym. — Myrrhe, F., G. A gum-resin obtained from one or more species of Commiphora (Fam. Bur- se raceae). 'Habitat. — Eastern Africa and Southwesterh Arabia, along the borders of the Red Sea. Description. — In roundish or irregular tears or masses: brownish-yellow or reddish-brown, and covered wilb brownish yellow dust; fracture waxy, somewhat splintery; translucent on the edges, sometimes marked with nearly white lines; odor balsamic; taste aromatic, bitter and acrid. When triturated with water, myrrh yields a brownish-yellow emulsion; it is soluble in alcohol. Constituents. I, an active resinous principle, myrrhin ((\.l I:. (),„), 23 per cent.; 2, myrrhol (C ,11 .,()). a volatile oil 2-1 per cent.; :>, arabin, a gum, 50 to 60 per cent.; I, a hi nee. Dose.— H. & C., 3ii-iv, (8-15); Sb. & Sw.. 3ss-i, (2-4); I)., gr.v-xxx, (.8-2). PREP \K ei'iONS. Tinctura Myrrhw. Tincture of Myrrh. (U. S. & B. P.) Made by maceration of myrrh, 200, with alcohol, and nitration to make 1000. (U. S. P.) * Do.se.— H. & C, ;,i-ii. (30-60) ; Sb. & Sw., .">iii-vi, (12-24) ; 1) , 3es-i, (2-4). Tinctura Aloes et Myrrhas. 'tincture of Uoes and Myrrh. (U, S. P. 1905). Made by maceration and percolation of myrrh, 100; purified aloes, 100; glycyrrhiza, LOO; with alcohol and water to make tOOO. (U. S. P.) Done.— H. & C, 5)i-iv, (60-120); Sb. & Sw., Sss-i, (15-80); I)., 3i-ii, (4-8). PilulCB Aloes. {V. S. P.) Dose. — D., 2 pills (2 grains each.) Action and Uses. — Myrrh, externally, is a mild stimulant and anti- septic by virtue of its resin and volatile oil. ft is a stomachic and carmin- ative internally, exciting the appetite and increasing the secretion, motion and blood supply of the stomach and bowels. Myrrh is eliminated by the mucous membranes of the bronchial and genito-urinary tracts, and stimulates and disinfects these parts during its excretion. The drug- is occasionally prescribed as a stimulating expectorant in chronic bronchitis; as a. stimulant and antiseptic in chronic cystitis; also as a uterine stimu- lant and emmenagogue in ammenorrhea, and in chronic leukorrhea. Myrrh is thought to prove beneficial in anemia, when combined with iron. It assists the action of purgatives, and myrrh may be exhib- ited as a laxative in the form of the tincture of aloes and myrrh. The tincture forms a serviceable mouth-wash in aqueous emulsion (1-J6), and is sometimes employed as. a stimulant and antiseptic on wounds, sores and ulcers, diluted with 4 to 8 parts of water. Myrrh is administered in tincture, ball or pill. Class 2. — Used Mainly for Their Stomachic and Carminative Action Upon the Digestive Tract. Capsicum. Capsicum. (U. S. P.) Synonym.— Capsici fructus, B. P.; cayenne pepper, African or pod pepper, E.; capcique, piment des jardins, pigment rouge, poivre ele cayenne, Fi\; Span- isher pfeffer, G. Called commonly "red pepper," when dried and powdered. CAPSICUM 383 The dried, ripe fruit of Capsicum brutescens Linne (Fain. Solanacese), de- prived of its calyx and other foreign matter. Habitat. — Tropical America; cultivated also in other tropical countries. Description. — Oblong-conical, from 8 to 20 mm. in length and from 2 to 15 mm. in diameter; brownish-red or orange, shining, membranous and translucent. Containing 6 to I? reniform, yellowish seeds. Odor characteristic, sternutatory; taste intensely pungent. The powder is yellowish-hrown. Constituents. — t, capsaicin (C,H1(X02), a crystallizable, acrid body; 2, capsi- cin, a volatile alkaloid; 3, a fixed oil; •!•, fatty matter; 5, resin. Dose.— H„ gr.xx-5i, (1.3-4); C., 5i-ii, (4-8); I)., gr.i-viii, (.06-.5). PREPARATIONS. Fluidextraetum Capsici. Fluidextract of Capsicum. (U. S. P. L905.) Made by maceration and percolation with alcohol, and evaporation, so thai 1 mil=rl Gm. of the crude drug. Dose.— H., lllxx-oi, (1.3-4); C, .~>i-h, (4-8); I)., Illi-viii, (.()(i-..-)). Tinctura Capsici. Tincture of Capsicum. (lT. S. & B. P.) Made by maceration and percolation of capsicum, 100, witli alcohol and water to make 1000. (U. S. P.) Dos*, li., oii-iv, (8-15); C., r>ss-i, (15-80); I)., niv-oi, (.3-4). Oleoresina Capsici. Oleoresin of Capsicum. (U. ,S. P.) Made by percolation with, ether, distillation, and evaporation of the residue. Dose.— H., Tl^x-xxx. (.6-2); C, ."ss-i, (2-4); I)., Tll^-i, (.015-.06). Unguentwm Capsici. (P. P.) Administration. — Capsicum and the oleoresin are given in ball or pill. The fluidextract should be freely diluted with water. Action and Uses. — Capsicum generally resembles the volatile oils in its action. Externally, it is rubefacient and counter-irritant, producing about the same degree of irritation as mustard, but causing considerably more pain, while its fumes are unbearable. Capsicum is used mainly as a .stomachic and a carminative in augmenting the appetite, gastric vascu- larity, secretion, and motion, and intestinal peristalsis. Capsicum is employed on the sLin in local paralysis — as of the lip — in horses, with mustard in paste; or as tin; fluidextract painted on plaster splints to pre- vent dogs from gnawing them off. Internally, capsicum is of greater value than black or white pepper, and is indicated in atonic indigestion and flatulent colic in horses (see ammonium carbonate and hydrastis). It may be combined advantageously with bitters, as mix vomica. Capsicum is a favorite stimulant and tonic remedy — to the digestion — with bird fanciers. Jt is also said to incr the laying of eggs when given to liens. Zingiber. Ginger. (U. S. & P. P.) Synonym. — Ingwer, G. ; gingembre, Fr. The dried rhizome of Zingiber officinale Etoscoe (Fain. Zingiberaceae) . Habitat. — East and West Indies and India; cultivated in tropical climates. Description. — The rhizomes vary in appearance according to the variety. The Jamaica, African, Calcutta, Calicut, Cochin, and Japanese gingers are official. Odor agreeably aromatic; iaste aromatic and pungent. Powdered ginger is light yellow, or light brown to dark brown. Constituents. I, a volatile oil (% to 2 per cent.); 2, a resin; 3, gingerol, said to supply pungent taste, while the oil gives flavor. Dose.— H., oii-fji. (8-30); C, 0i-iv, (30-120); Sh. & Sw., oi-ii, (4-8); 1)., gr.v-xv, (.3-1). 384 VEGETABLE DRUGS PREPARATION. Fluidextr actum Zingiberis. Fluidextract of Ginger. (U. S. P.) Made by maceration and percolation with alcohol, and evaporation, so that 1 mil=l Gm. of the crude drug. Dose. — Same as that of ginger. Oleoresina Zingiberis. (U. S. P.) Dose.— H., gr.xxx-3iss, (2-6); D., gr.i-v, (.06-.3). Action and Uses. — Ginger is chiefly administered in powder as a stomachic and carminative in atonic indigestion of horses and ruminants. It is frequently combined with sodium bicarbonate and bitters. Ginger also aids the action of purgatives and prevents griping. The powder or fluidextract should be added to magnesium sulphate when it is given in full purgative doses to cattle or sheep. (See magnesium and sodium sul- phate.) Mentha Piperita. Peppermint. (U. S. P.) Synonym. — Folia (herba) menthae piperitae, P. G.; menthe poivree, Fr.; pfefferminze blatter, G. The dried leaves and flowering tops of Mentha piperita Linn6 (Fam. Labiatae). Habitat. — Indigenous in North America, Europe and Asia. Description. — Leaves more or less crumpled and frequently detached from the stems; ovate-oblong to oblong-lanceolate, light green to purplish-brown, 1 to 9 cm. in length. Odor aromatic, characteristic; taste aromatic, pungent, followed by a cooling sensation in the mouth. Constituents. — 1, a volatile oil (1 per cent.) ; 2, menthol. Oleum Mentha Piperita. Oil of Peppermint. (U. S. & B. P.) Synonym. — Essence de menthe poivree, Fr.; pfefferminzol, G. Properties. — A volatile oil distilled from the flowering plant of mentha piperita, rectified by steam distillation, and yielding not less than 5 per cent, of esters, calculated as menthyl acetate, and not less than 50 per cent, of total menthol (free and as ester). A colorless liquid, having a strong odor of pepper- mint, and a pungent taste, followed by a sensation of cold when air is drawn into the mouth. Spec. gr. 0.896 to 0.908. It forms a clear solution with an equal volume of alcohol*, but becomes tur- bid when somewhat further diluted. Constituents. — 1, menthol (50-65 per cent.) ; 2, menthene, C10H18, a liquid ter- pene obtained by distillation. Dose.— H. & C, TTlxv-xxx, (1-2); D., ITtf-v, (.06-.3). PREPARATIONS. Spiritus Mentha Piperitw. Spirit of Peppermint. (U. S. & B. P.) Synonym. — Essence de menthe poivree, Fr.; Englisch pfefferminzessenz, G.; spiritus menthae piperitae anglicus, P. G. Oil of peppermint, 100; peppermint, 10; alcohol to make 1000. Made by maceration and nitration. (U. S. P.) Dose.—ll. & C, 3ii-iv, (8-15); D., ITJxv-xxx, (1-2). Aqua Mentha? Piperitw. Peppermint Water. (U. S. & B. P.) Oil of peppermint, 2; purified talc, 15; water to make 1000. Made by tritu- ration and filtration. (U. S. P.) Dose. — Used as vehicle in canine practice. Menthol. Menthol. C10H,,OH. (U. S. & B. P.) Synonym. — Mint or peppermint-camphor. A secondary alcohol obtained from the oil of peppermint or other mint oils. Derivation. — Made from the oil of peppermint by fractional distillation; freez- ing of the higher boiling point product, and crystallization. Properties. — Colorless, acicular or prismatic crystals, having a strong odor and taste of peppermint; when tasted it produces a sensation of warmth, fol- lowed by a sensation of cold when air is drawn in the mouth. Slightly soluble PEPPERMINT AND MENTHOL 385 in water; freely soluble in alcohol, ether, chloroform, carbon disulphide or glacial acetic acid. When it is triturated with about an equal weight of camphor, thymol, or chloral hydrate, the mixture becomes liquid. Menthol may be dissolv ,*d by heat in oleic acid, fats or liquid vaseline or volatile oils. Dose.— H., gr.vii-xv, (.5-1); D., gr.ss-ii, (.03-.12). Action and Uses of Peppermint and Menthol Peppermint and oil of peppermint owe their medicinal virtues chiefly to the menthol they contain. They resemble the other volatile oils in most respects, but are more anesthetic and antiseptic than some. Men- thol is used mostly externally, and is extremely valuable in relieving itching and neuralgic pain. It may be employed with alcohol or chloro- form in solution (5ss to §i) in urticaria or pruritus. An ointment is also serviceable, or a solution by heat in oleic acid (1 to 24) . For burns, the following will be found beneficial: Sweet oil and lime water, each one ounce; menthol, one dram. The cooling sensation produced by menthol is due to a specific effect upon the nerves of temperature. The anesthetic and antiseptic action of menthol has been taken advantage of in the treatment of boils and superficial abscesses. A 10 to 50 per cent, solution in ether is said to abort these lesions when painted frequently on the inflamed parts. A menthol and camphor solution is one of the best preparations to use in a medicine dropper for acute or chronic nasal catarrh of dogs. Mentholis 5i. Chloroformi gii. M. Sig. For urticaria or pruritus. Apply externally. Mentholis. Camphorae aa gr.xxx. Petrolati liquidi o"- M. Sig. Instil x drops in each nostril 3 times daily with medicine dropper for nasal catarrh in dogs. Internally, the essence of peppermint or oil is of worth in cases- of mild colic and flatulence on account of its anesthetic, carminative and antiseptic action. Menthol may be given to dogs to relieve vomiting. Peppermint water assuages thirst in fever, and this preparation is also used as a pleasant vehicle in the administration of disagreeable drugs to dogs. The oil is prescribed in pill or ball to prevent the griping of cathartics. Administration. — The essence is the preparation in most common use and is given in water. The oil is dissolved in spirit, or exhibited to dogs on sugar. Menthol may be administered in alcohol and syrup, equal parts ; or in pill or capsule to dogs. Mentha viridis (spearmint) is official together with oleum menthae viridis (oil of spearmint), spiritus menthae viridis (spirit of spearmint), and aqua menthae viridis. The actions, uses and doses are the same as those of peppermint and its preparations, but the latter are more popular and pleasant. 386 VEGETABLE DRUGS Anisum. Anise. (U. S. P.) Synonym. — Anisi fructus, B. P.; anisvert, Fr.; anis, G. The dried, ripe fruit of Pimpinella Anisum Linne (Fain. Umbellifene). Habitat. — Southeastern Europe, Egypt, Western Asia; also cultivated. Description. — Cremocarp ovoid or pyriform, laterally compressed, from 3 to 0' mm. in length and from 2 to 3 mm. in breadth; externally grayish, greenish- gray, seldom grayish-brown. Odor and taste agreeable and aromatic. The powder is yellowish-brown. No mouse-like odor should be developed when solution of potassium hydrox- ide is poured upon anise (absence of Conium macula turn) . Constituents.— OH of anise. Dose.—H. & C, 5i-H, (80-60); Sh. & Sw., ."ii-iii, (8-12)} D., gr.x-xxx, (.6-2). Oleum Anisi. Oil of Anise. (U. S. & B. P.) A volatile oil distilled from anise or from the fruit of star anise (IUicium verum). Properties. — A colorless or pale yellow, strongly refractive liquid, having the characteristic odor and taste of anise. Spec. gr. about 0.978 to 0.988. Soluble in 3 volumes of 90 per cent, alcohol. Dose.— H., TTtxx-xxx, (1.3-2); D., n\i-v, (.06-.3). PREPARATIONS. Aqua Anisi Anise Water. (U. S. & B. P.) Oil of anise, 2; purified talc, 15; water to make 1000. (U. S. P.) Used as vehicle. Spirit us Anisi. Spirit of Anise. (U. S. & B. P.) Oil of anise, 100; alcohol, 900. (U. S. P.) Dose.— D., 5i-ii, (4-8). Actions and Uses of Anise. Oil of anise resembles in action the other volatile oils. It is em- ployed with olive oil or alcohol (1-10) to kill fleas or lice on dogs, rubbed over the skin; and one drop of the pure oil may be placed on the feathers of fowl to cause destruction of lice. The oil is sometimes prescribed to disguise the taste or odor of drugs (see potassa sulphurata), and is or- dered in cough mixtures for its expectorant properties. Anise fruit is given to horses and ruminants on their food — fre- quently with sodium bicarbonate and ginger — to relieve mild forms of indigestion and flatulence through its stomachic and carminative action. Cardamomi Semen. Cardamom Seed. (U. S. P.) Synonym. — Cardamomi semina, B. P.; fructus (vel semen) cardamomi (minoris), P. G.; cardamomes, Fr. ; cardamomen, kleine kardamomen, G. The dried seeds of Elettaria Cardamomum (White et Maton), (Fam. Zingi- beraceae). Habitat. — Malabar. Description. — Mostly agglutinated in groups of from 2 to 7, the individual seeds, oblong-ovoid, in outline, 3- or irregularly 4-sided, convex on the dorsal sur- face, strongly longitudinally grooved on one side, from 3 to 4 mm. in length; odor aromatic; taste aromatic, pungent. The powder is greenish-brown. The seeds are active; the pericarp has no medicinal virtue. Constituents. — 1, a volatile oil, which contains a terpene (C10H16) known as terpinene; 2, a fixed oil, 10-11 per cent. Dose. — Same as that of anise. A tinctura and tinctura cardamomi composita are official. They serve as coloring (red) and flavoring agents, and may be employed as vehicles in doses of one to two drams, in canine practice. The dose of the fluidextract is the same as that of the drug. CoRiANDRU3r. Coriander. (U. S. P.) Synonym. — Coriandri fructus, B. P.; coriander fruit, E.; coriandre, Fr.; kori- Bnder, G.; fructus coriandri, P. G. The dried, ripe fruit of Coriandum sativum Linne (Fam. Umbelliferae) . VALERIAN AND VALERATES 387 Habitat. — Southern Europe or Central A*ia. Description. — Mericarps usually coherent; cremocarp nearly globular, from 3 to 5 nun. in diameter; externally light brown or rose colored; the powder is light brown. Odor and taste agreeably aromatic. Constituents— 1, the volatile oil, oleum coriandri, a colorless, or pale yellow liquid, having the characteristic odor and taste of coriander. Dose of coriander and its oil, same as for anise and its oil. F(Exiculum. Fennel. (U. S. P.) Synonym. — Funiculi fructus, B. P.; semen foeniculi, fennel fruit or seeds, E ; fenon.il, Fr. ; fenchel, G. The dried, ripe fruit of cultivated varieties of Foeniculum Vulgare, Miller (Fam. Umbelliferoe). . Habitat. — Southern Europe and Levant. Description. — Mericarps usually separate, each being broadly elliptical, more or less "urved, from 4 to 10 mm. in length and from 1 to 3.5 mm. in breadth; dorsal surface convex, yellowish-green to grayish-brown. Odor and taste aromatic and characteristic. Constituents. — A volatile oil of almost similar action and composition to oil of anise, oleum foeniculi. A colorless, or pale yellowish liquid, having the charac- teristic aromatic odor of fennel, and a sweetish, mild and spicy taste. Soluble in alcohol. Dose of fennel and its oil, same as that for anise and its oil. X Fcenugbkek. (Non-official.) The seeds of Trigonella fcenum graecum, cultivated in France and Germany. They are oblong, cylindrical, somewhat compressed, obliquely truncated at each end; 1 to 2 lines long; of a brownish-yellow color, and have a strong, peculiar odor, and oily, bitterish taste. Fu-nugreek contains both a volatile and fixed oil. Dose. — Same as for anise. Actions and Uses of Cardamom, Coriander, Fennel and Fenugreek. These drugs resemble anise in actions, uses, and doses. They enter into the composition of many popular tonic or "condition" powders and drinks, and, by their stomachic and carminative properties,, aid digestion. Ginger is perhaps in more frequent demand than other agents of tin's class, by the profession. Class 3. — Used Mainly for Their Antispasmodic Action in Stimulating the Nervous System. Valeriana. Valerian. (U. S. P.) Synonym. — Valerianae rhizoma, B. P.: valerian e, Fr.; baldrian, G. The dried rhizome and roots of Valeriana officinalis Linne* (Fam. Valerian- aceae). Habitat. — Europe and Northern Vsia. Naturalized in New England. Description.— Rhizome upright, from 2 to 4 cm. in length and from 1 to 2 cm. in diameter, usually cut longitudinally into 2 to 4 pieces; externally yellowish- brown or dark brown. Odor pronounced of valeric acid, becoming stronger upon ageing; taste sweetish, camphoraceous and somewhat bitter. The powder is light brown to grayish-brown. Constituent*. — 1, a volatile oil (y2 to 2 per cent.), consisting of pinene, a terpene, and borneol, CV.H^O; 2, valeric acid (C,H„,02), a colorless, oily acid, with burning taste and odor of valerian. Soluble in alcohol and ether, and in 30 parts of water. Valeric acid, C-.H^O,, is also made artificially by a complicated process from the distillation of chromic acid and amylic alcohol; 3, tannic acid; 4, resin; 5, malic, formic and acetic acids. Dose.— H. & C, 3i-ii, (30-60); D., gr.x-3i, (0.6-4). PREPARATIONS. FMdextractum Valeriana;. Fluidextract of Valerian. (U. S. P. 1905.) 388 VEGETABLE DRUGS Made by maceration and percolation with water, and evaporation, so that I mik=l Gm. of the crude drug. Dose.— H. & C, Si-ii, (30-60) ; D., Tllx-oi, (.6-4). A tinctura Valerianae (1-5), and a tinctura Valerianae ammoniata (1-5) pre- pared with aromatic spirit of ammonia, are also official. The dose of either is Sss-ii, (2-8), for dogs. Tinctura Valerianic Ammoniata. (B. P.) Dose.— D., 5ss-i, (2-4). Ammonii Valeras. Ammonium Valerate. NH4C5Hu02. (U. S. P.) Synonym. — Ammonium valerianate. Made by the action of ammonia gas upon valerianic acid, and crystallization. Properties. — Colorless, or white, quadrangular plates, emitting the odor of valeric acid, of a sharp and sweetish taste, and deliquescent in moist air. Very soluble in water and in alcohol; also soluble in ether. Dose.— D., gr.ii-v, (.12-.3). Ferri Valeras. Ferric Valerate. (Non-official.) Made by precipitating a solution of ferric sulphate with a solution of sodium valerianate, and washing and drying the precipitate. 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). Zixci Valeras. Zinc Valerate. Zn(C5HD02)2+2 H20. (U. S. & B. P.) Synonym. — Zinc valerianate. Made by crystallization from a mixture of hot solutions of zinc sulphate and sodium valerate. Properties. — White, pearly scales, or as a white powder, having the odor of valeric acid, and a sweetish, astringent and metallic taste. On exposure to the air it slowly loses valeric acid and becomes partially insoluble in water. Soluble in 70 parts of water, and in 22 parts of alcohol. Incompatibility. — Incompatible with acids, metallic salts and soluble carbo- nates; also vegetable astringents. Dose.— D., gr.i-iii, (.06-.18). Administration. — Valerian should be given in the form of the fluidextract 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 zinc valerate is the most popular, and is administered in pills in canine practice. Action and Uses of Valerian and Valerates. The physiological action of valeric acid and the valerates is an un- known quantity, but clinical evidence supports their value. The volatile oil in valerian has much the same properties as other volatile oils in stim- ulating secretion, motion, vascularity and appetite, in relation to the digestive organs; and, in its elimination, the oil excites the mucous mem- branes 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, 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, ASAFETIDA 389 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. Zinc valerate is more commonly employed in canine practice for chorea. Ferric valerate is supposed to combine the tonic and antispas- modic 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 oss-i; and to dogs in quantities of 1Uii-v. Asafaetida. Asafetida. (U. S. P.) Synonym. — Asafetida, B. P.; ase fetide, asa fcetida, Fr. ; stinkasant, teufels- dreck, G. A gum-resin obtained by incising the rhizomes and roots of Asafoetida Linne and Ferula foetida Regel (Fam. Umbelliferae) and some other species of Ferula indigenous to Persia and adjacent countries. Habitat. — Persia, Afghanistan and Turkestan. Properties. — In a soft mass, sometimes almost semi-liquid, or in irregular, more or less pliable masses composed of agglutinated tears of variable size im- bedded in a yellowish-brown or dark brown matrix, or in loose ovoid tears, from 1 to 4 cm. in diameter. On moistening with water the tears become milky white; odor persistent, alliaceous; taste bitter, alliaceous and acrid. When triturated with 3 parts of water 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 asafetida its disagreeable odor; 2, gum, about 25 per cent.; 3, bassorin resin, 65 per cent., containing ferulaic acid (CoH.A). Dose.— H. & C, gss-i, (15-30) ; Sh. & Sw., oi-ii, (4-8) ; D., gr.iii-xii, (.18-.8). Administration. — Asafetida is given in ball to the larger animals 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. — Pilulae asafoetidae (prr.iii each) ; dose — D., 1-4. Tinctura asa- foetidae (1-5); dose— H., 5ii-iv, (60-120); D., oss-i, (2-4). Emulsum (mistura) asafoetidae, milk of asafetida (1-25); dose— D., gss-i, (15-30). 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 movements, headache, dizzi- ness, and sexual desire. Asafetida is chiefly used as a carminative, stimulating expectorant, and nerve stimulant or antispasmodic. Liquid preparations may cause nausea and vomiting in dogs owing to the nauseous taste. Being used as a condiment in the East it is described by old writers as "cibus deorum, stercus diaboli" (food of the gods, stink of the devil). The drug is of most service in flatulent colic of horses, when it is combined with am- monium carbonate in ball, or is given in this form simultaneously with linseed oil and oil of turpentine. Flatulent colic in horses. Pulveris asafoetidae 31. Pulveris capsici 31. Ammonii carbonatis oii. Pulveris nucis vomicae 31. M. et fiat bolus No. 1. S. Give at once. 390 VEGETABLE DRUGS 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 catarrh, but it is probably inferior to ammoniacum for this purpose. As an antispasmodic agent, asafetida is useful in functional spasmodic 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 added to alcoholic liquors in veteri- nary practice to prevent their "misappropriation" by stable attendants, and, applied externally, it may stop feather pulling in birds and bandage chewing in dogs. Class 4. — Used Mainly for Their Stimulant and Diuretic Actions on the Kidneys and Genito-Urinary Tract. Buchu. Buchu. (U.S. P.) Synonym. — Buchu folia, B. P.; feuilles de buceo, Fr.; buckubliitter, bucco- blatter, G. The dried leaves of Barosma betulina (Thunberg) Hurtling et Wendling, known in commerce as short buchu; or of Barosma serratifolia (Curtis) Willde- now, known in commerce as long buchu (Fani. Rutaeeae). Habitat. — South Africa. Description. — Short Buchu. Rhomboidally ova] or obovate; from 9 to 25 mm. in length and from 4 to 13 mm. in breadth; color varying from vivid green to yellowish-green; odor and taste characteristic, aromatic and mint-like. Long Buchu: Linear-lanceolate, from 2.5 to 4 cm. in length and from 4 to 6 mm. in breadth; color, odor, and taste like short buchu. Constituents. — 1, a volatile oil, having an odor somewhat like peppermint, l1/^ per cent.; 2, a stearopten (buchu camphor or diosphenol, Ci0H16Oa), possessing an odor like peppermint and in solution in a liquid hydrocarbon, but crystalliz- ing on exposure to the air; 3, barosmin, a glucoside, soluble in alcohol (sparing- ly), in ether, volatile oils, diluted acids and alkalies; 4, gum; 5, rutin, a bitter substance. Dose.— H. & C, gi-ii, (30-60); D., gr.xv-xxx, (1-2). PREPARATIONS. Fluidextractum Buchu. Fluidextract of Buchu. (U. S. P.) Made by maceration, percolation and evaporation, so that 1 mik= 1 Gin. of buchu. Dose.— H. & C, 5i-ii, (30-60); D., Tm>v-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 animals 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 organs 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 arrtl dis- infects the mucous membranes, slightly increases the secretion of urine, and imparts its peculiar odor to the latter. The drug is of some value in the treatment of chronic or subacute OIL OF JUNIPER 391 pyelitis, cystitis and urethritis. It is stimulating, but only slightly irri- tating. Buchu has been recommended in chronic nephritis, and is useful in irritation of the urinary bladder, with frequent 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. Oleum Juniperi. Oil of Juniper. (U. S. & B. P.) Synonym. — Oleum fructus (vel baccae) juniperi, oil of juniper berries, E.; essence de genievre, Fr. ; wachholderbeerol. G. A volatile oil distilled from the fruit of Juniperus communis Linne (Fam. Pinaceae). Habitat.— Canada and United States; Rocky Mountains, south to New Mexico. Properties. — A colorless, or faintly green or yellow liquid, having the charac- teristic odor and taste of juniper fruit. Spec. gr. 0.854 to 0.879. Soluble in 4 volumes of alcohol. Composition. — The chief constituents of oil of juniper are the terpenes — pinene and cadinene. Dose.—H. & C, 3i-ii, (4-8); D., Mlii-x, (.12-.6). PREPARATIONS. Spirit us Juniperi. Spirit of Juniper. (U. S. & B. P.) Oil of Juniper, 50; alcohol, 950. (U. S. P.) Dose.— H. & C, 51-ii, (30-60); D., 5ss-i, (2-4). Spiritus Juniperi Compositus. Compound Spirit of Juniper. (U. S. P.) Oil of juniper, 8; oil of caraway, 1; oil of fennel, 1; alcohol, 1400; water to make 2000. Dose.-U. & C, Tjii-iv, (60-120); D., oi-iv, (4-15). Action and Uses Oil of juniper resembles oil of turpentine physiologically as well as chemically. It is a 'stomachic and carminative, particularly when com- bined 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 elimination. 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 albuminuria. Oil of juniper is indicated in chronic pye- litis 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 period of acute bronchitis and influenza, stimulating the bronchial mucous membrane by virtue of the volatile oil, and acting as a circulatory 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 (Ji-ii), or are exhibited in infusion. 392 VEGETABLE DRUGS So-called Solid Volatile Oils or Stearoptens Camphora. Camphor. C10HH1O. (U. S. & B. P.) Synonym. — Gum camphor, laurel camphor, E.; camphre, Fr.; kanipf'er, G. A ketone obtained from Cinnamomum Camphora (Linne) Nees et Eber- maier (Fam. Lauraceae), and purified by sublimation. Habitat. — China, Japan, Cochin China andSunda Islands. Properties. — White, translucent masses or granules of a tough consistence and having a penetrating, characteristic odor, and a pungent aromatic taste. It is readily pulverizable in the presence of a little alcohol, ether or chloroform. Spec. gr. 0.990. Slightly soluble in water, but freely soluble in alcohol, ether, chloroform, carbon disulphide, benzin, and in fixed and volatile oils, and milk. When camphor is triturated, in about molecular proportions, 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 camphor is a solid crystalline Substance separated from any volatile oil on long standing or at low temperature. Camphor is chemically an oxidation product of a terpene (pinene or cymene), — the principal constituent of all volatile oils. A terpene is a hydrocarbon containing 10 atoms of carbon, and the terpene (C10H,0) from which camphor is derived is isomeric with that of oil of turpentine and many other volatile oils. Dose.— H., 3i-iii, (4-12); C, oii-iv, (8-15) ; Sh. & Sw., gr.xv-in, (1-4); D., gr.iii-xx, (.18-1.3). IMtKI'AKATIONS. Aqua Camphorw. Camphor Water. (U. S. & B. P.) Triturate camphor, 8, with alcohol, 8, and purified talc, 15; then with water to make 1000. Filter. (U. S. P.) Dose. — Ad lib. Spiritus Camphorw. Spirit of Camphor. (U. S. & B. P.) Dissolve camphor, 100, in alcohol, 800; fdter, and add alcohol to make 1000. (U. S.) Dose.— H. & C, 5i-ii, (30-60); D., 3ss-i, (2-4). Linimentum Camphorw. Camphor Liniment. (U. S. & B. P.) Synonym. — Camphorated oil. Camphor, 200; cottonseed oil, S00. (U. S. P.) Dose.— H. & C, 5ss-i, (15-30); D., TT]x-xv, (0.6-1). Tinctura Camphorw Composita. (B. P.) (Paregoric.) Contains 1 part of morphine in 2000=gr.^ opium in 5i paregoric. Dose. — D., 3ss-i. Camphora Monobromata. Monobromated Camphor. C10H15OBr. (U. S. P.) Derivation. — Made by heating camphor and bromine together at a tempera- ture of 172° F. (77.7° C.) and solution in benzin. C10H10O+2 Br— C10H15OBr+HBr. Recrystallized from hot alcohol. Properties. — Colorless, prismatic needles or scales, or as a powder, having a mild, camphoraceous odor and taste; permanent in the air. 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 chemically and physiologically. It is a slight antiseptic externally, and parasiticide. The vapor of camphor kills moths, fleas, bugs, etc. Camphor is a mild irritant, producing a rubefacient action followed by partial anesthesia. It is eliminated in part by the skin and occasions 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 normal conditions and in therapeutic doses. USES OF CAMPHOR 393 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 cor- responding effect on blood pressure. Poisonous quantities of camphor depress the heart and the pulse becomes feeble and rapid. Leukocytosis is favored by camphor. Respiration. — Camphor does not influence the respiration materially in therapeutic doses. Occasionally the respiration is made slower and deeper. Camphor, like volatile oils, stimulates the bronchial mucous membranes in its elimination by the lungs, and increases the blood supply and secretion of these parts. The characteristic 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 antispasmodic. It stimulates the nerve centres in the brain, medulla, and spinal cord, and thus overcomes spasm due to nervous weakness and incoordination. Poisonous doses depress and paralyze the higher nervous centres. Kidneys and Sexual Organs. — Camphor is oxidized in the body into camphorol (C10HlcO.,) and eliminated in the breath and sweat, but mainly in the urine, as camphoglycuronic acid. The drug influences the sexual organs, in some cases, but in most instances does not affect them. Full medicinal doses sometimes stimulate the sexual functions (aphrodisiac action). Very large doses are said to depress sexual desire (anaphro- disiac 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 or cattle induce delirium and convulsions (cerebral stimulation) with rapid pulse and breathing, but usually recovery ensues. Two to four drams 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 External. Camphor is applied in powder as a stimulant and antiseptic on indolent sores ; mixed with chalk or zinc oxide, as a dusting powder, in chafing or erythema, for its anesthetic properties. It is em- ployed in liniments (Lin. Saponis, Lin. Camphorae), 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. 394 VEGETABLE DRUGS 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. Camphorae 3i. Olei olivae 5iv. M. Sig. Inject as one dose subcutaneously (Horses). Inject n\xv for dogs. Repeat hourly. The effect of these injections is to produce some induration and not more than 1% drams should be injected at one point. Camphor is of benefit in exhausting acute diseases (influenza, pneu- monia and canine distemper), for the same reason, and because it pos- sesses diaphoretic and antipyretic properties. It may be combined with alcohol, spirit of nitrous ether, and ammonia compounds, in these affec- tions. % Respiratory disorders are improved by camphor, since it is an expec- torant, diaphoretic, stimulant and antiseptic. It is prescribed in spas- modic 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 pre- scribed alone in diarrhea, or with brandy and laudanum. Sun cholera mixture is a favorite in diarrhea. Spiritus camphorae. Tincturae opii. Tincturae rhei. Tincturae capsici. Spiritus menthae piperitae aa 3ss. M. Sig. Two tablespoonfuls for H. & C. n\xx to 3i for dogs, in plenty of water. Camphor is sometimes given as an antispasmodic in hysteria and "thumps" (spasm of diaphragm) of horses; and in nervous palpitation 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 proved of service in purpura hemorrhagica of horses given thrice daily in pills (gr. 75). Thymol. Thymol. C10HMO. (U. S. & B. P.) Synonym. — Thymic acid, E.; acide thymique, Fr. ; thymiansaure, G. A phenol occurring in the volatile oils of Thymus Vulgaris Linn<5 (Fam trabiatae) and in some 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 com- pound is decomposed with hydrochloric acid, and thymol is crystallized from an alcoholic solution. THYMOL 395 Properties. — Large, colorless, translucent, rhombic prisms, having an aromatic, thyme-like odor, and a pungent, aromatic taste, with a very slight caustic effect upon the lips. As a solid it is heavier1 than water, but when liquefied by fusion it is lighter than water. It melts at 48° to 51° C, remaining liquid at consider- ably lower temperatures. When triturated with about equal quantities of cam- phor, menthol, or chloral, it liquefies. Soluble in about 1010 parts of water, and in about 1 part of alcohol, 1.5 parts of ether or 0.7 part of chloroform; also readily soluble in carbon disulphide, glacial acetic acid, and in fixed or volatile oils. Dose.— H., 5ss-ii, (2-8) ; Sh. (single dose), 3ss-iiss, (2-10) ; D., gr.i-xv, (.06-1). Anthelmintic, gr.ii per 2.2 lb. live-weight (0.13 per Kg.). 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 digestive tract is slow; but after considerable doses by the mouth, or when injected into the blood, toxic symptoms occur. One dram given intravenously to a dog caused prostration, coma and respiratory failure. Recovery en- sued after the use of artificial respiration. Often no lesions are discov- erable after death. At other times there is hypermia of the lungs and kidneys caused by elimination of the drug. The urine is colored green- ish or yellowish-brown by transmitted light. Thymol is used externally for general antiseptic purposes, for ap- plication to ulcers, and as an injection in cystitis in aqueous saturated solution. It is employed in ointment with vaseline (1-15) to destroy ringworm and to relieve itching in pruritus, eczema, lichen, psoriasis, etc. It may be applied as follows for the same purposes: Thymol gr.xv. Alcohol Siiss. Glycerin 3v. Aq. ad Oi. M. An efficient antiseptic mouth wash consists of borax, gr. 40; thymol, gr. 20; water, * iv. It is indicated in stomatitis. Thymol internally is a powerful anthelmintic and parasiticide. It is employed as an intes- tinal 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. Thymol has been regarded as a specific for hookworm of dogs, as it is in fact for man. Starve the patient for 24 hours and give the drug in 2 doses, and follow in 2 hours with 3 compound cathartic pills, or calomel. For a dog with hookworm: R Thymolis. Sodii bicarbonatis aa oss. M. et divide in capsulas No. vi. Sig. Give 3 capsules, and 3 more in 2 hours, and follow in 2 hours bv cathartic. 396 VEGETABLE DRUGS Hall and Foster found thymol much less efficient than chloroform (TlXiii per 2.2 lb. live-weight) in castor oil (§i to ii) for ridding dogs of hookworm. Thymol in capsule (.13 per Kg.-gr.ii per 2.2 lb. weight) was more successful against whipworms and still more successful against ascarids. SECTION X.— VEGETABLE BITTERS. Gentiana. Gentian. (U. S. P.) Synonym. — Gentianae radix, B. P.; radix gentianae rubrae (vel lutae vel majoris), gentian root, E.; radix gentiana?, P. G. ; racine de gentiane (de gen- tiane jaune), Fr. ; enzianwurzel, bitterwurzel, rother (gelber) enzian, G. The dried rhizome and roots of Gentiana lutea Linne (Fain. Gentianeae). Habitat. — The yellow gentian is indigenous in the Alps and mountains of southern and central Europe. Description. — In nearly cylindrical pieces sometimes branching, of variable length and from 5 to 35 mm. thick; externally yellowish-brown, the rhizome annulate, the roots longitudinally wrinkled; the powder is light brown or yellow- ish-brown; odor strong, characteristic; taste slightly sweetish, then strongly and persistently bitter. Constituents. — The chief one is (1) gentiopicrin (may be split into genti- genin and glucose), a bitter crystalline glucoside, soluble in alcohol and water. There is also (2) gentisic acid (CMH10Os), combined with gentiopicrin and gum, and (3) a trace of volatile oil; (4) gentianose, a sugar. Contains no tannin. Incompatibles. — Iron in solution forms a black compound with the coloring matter in gentian. Silver nitrate and lead salts are incompatible with gentian. Dose.— H., 5ss-i, (15-30); C, 5*-", (30-60); Sh. & Sw., 3i-ii, (4-8); D., gr.v-xxx, (.3-2). PREPARATIONS. Extractum Gentianw. 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. Fluidextr actum Gentianw. Fluidextract of Gentian. (U. S. P.) Made by maceration and percolation with diluted alcohol, and evaporation, so that 1 mil— 1 Gm. of the crude drug. Dose. — Same as gentian. Tinctura Gentianw Composita. Compound Tincture of Gentian. (U. S. & 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, gi-iv, (30-120) ; D., 5i-iv, (4-15). Administration. — 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, are chiefly used to improve the appetite. They locally stimulate the taste buds of the tongue but not when given in pill or capsule. They are stomachics indirectly by exciting the first secretion of gastric juice, or "appetite juice" of Paw- low, who found that appetite, or the sight or smell of food, reflexly started the secretion of gastric juice in dogs. Bitters should be given just before (10 to 20 minutes) eating. They may lessen normal appetite or cause nausea in irritable stomach. Bitters reflexly cause dilation of the blood vessels in the stomach, and increase salivary as well as gastric secretions. Furthermore, the bitters excite gastric and intestinal peri- QUASSIA 397 stalsis to a slight extent. The bitters only act as tonics by their local effect in facilitating the digestion 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 espe- cially indicated in feeble gastric digestion caused by acute disease, over- work, insufficient and poor food, and in that form associated with general debility and anemia. In the latter state, characterized 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. Tonic powder for horses or cattle. Ferri sulphatis . exsiccati 5iv. Pulveris gentianae Ibi. M. S. Heaping tablespoonful on feed t. i. d. Again, loss of appetite, general weakness, and feeble digestion oc- curring in horses during convalescence from acute diseases, as influenza and pneumonia, are favorably met by a combination of compound tincture of gentian and whisky (1 ounce each), or by diluted hydrochloric acid and the compound tincture. Acidi hydrochlorici diluti *ii. Tincturae gentianae compositae Oi. M. S. Two tablespoonfuls in water t. i. d. before feeding. The drug is useful in atonic indigestion, or mild chronic gastric or intestinal catarrh of young animals, when conjoined with sodium bicar- bonate, which acts as a peristaltic stimulant (C02), 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. Quassia. Quassia. (U. S. P.) Synonym. — Quassiae 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, known in commerce as Jamaica quassia, or of Quassia amara Linne (Fam. Simarubacece), known in commerce as Surinam quassia. Jamaica Quassia. — Usually in chips, raspings or shavings, occasionally in small cubes or billets; yellowish-white or bright yellow, with a few light gray pieces coarsely grained; fracture tough, fibrous; odor slight; taste bitter. Surinam Quassia. — The crude drug closely resembles the Jamaica variety; calcium oxalate crystals in microscopic sections few or entirely absent, thus dis- tinguishing the variety from Jamaica quassia. Constituents. — Chiefly, quassiin (C1(JH1203), a bitter, neutral principle occur- 398 VEGETABLE DRUGS ring in crystalline rectangular plates. There is also a volatile oil, but no tannin. Z)o^.— Quassiin, D., gr.%-%, (.008-.02). PREPARATIONS. Eztractum Quassia'. 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). Tinctura Quassiw. 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 Quassiw 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 to 80, in cold water for half an hour, B. P.). The dose of the infusion is §iv for horses, 3ii-iv for dogs. Actions. — Quassia is the most active and bitter stomachic we possess. Large doses irritate the digestive tract. The drug is poisonous to the lower forms of animal life. One grain will kill a frog with the produc- tion of convulsions and respiratory and heart failure. A sweetened in- fusion is often employed to destroy flies. Considerable doses of quassia increase the secretion of urine, and stimulate peristaltic action and con- traction of the urinary bladder. It is an antiseptic and prevents fermen- tation 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, how- ever, 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 Oxyuris 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 (5ii to Oi) for half an hour. The rectum should be first thoroughly washed out with soap and water, and one-half pint of this infusion is given in enema to dogs; two quarts to horses. Calumba. Calumba. (U. S. P.) Synonym. — Calumbae radix, B. P.; columbo, E.; Colombo, Fr. ; kolombowur- zel, G. The dried root of Jateorhiza palmata (Lamarck) Miers (Fam. Menisper- maceae). Habitat. — Mozambique, East Africa. Cultivated in the East Indies. Description. — In circular or oval disks attaining a diameter of 9 cm. and sel- dom exceeding 2 mm. in thickness, or in longitudinal or oblique slices attaining a length of 30 cm., a breadth of 35 mm., and a thickness of 16 mm.; externally brown and roughly wrinkled. Powder is greenish-brown to grayish-yellow. Odor slight; taste slightly aromatic, very bitter." Constituents. — 1, calumbin (C^H^Ot), a neutral bitter, crystalline substance; 2, an alkaloid, berberine (C20H17NO4), found in berberis, hydrastis, etc.; 3, calum- bic acid (C21H2206) ; 4, starch, 33 per cent. Dose.— H. & C, 5ss-i, (30-60) ; Sh. & Sw., 5i-ii, (4-8) ; D., gr.v-xxx, (.3-2). C ALU MBA 399 PREPARATION. Tinctura Calumbw. 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, 3ii-iv, (60-120); D., 5i-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 bitter. Berberine, calumbin and calumbic acid are all bitter, but none of them possess any powerful physiological action. Calumba is indicated in the same cases as gentian, but, being free from tannin, may be combined with iron prepa- rations without producing an unsightly, inky mixture. It is less irri- tating than other bitters, and may be prescribed in more irritable condi- tions of the stomach. Calumba is frequently used during convalescence from the acute diseases and diarrhea. Tonic for dogs in convalescence from acute diseases. Tincturae ferri chloridi 5ss. Tincturae calumbae ad %iv. M. S. Teaspoonful t. i. d. in water. Taraxacum. Taraxacum. (U. S. P.) Synonym. — Taraxici radix, B. P.; dandelion, E.; pissenlit, dent dc lion, Fr. ; lt'iwenzahn, G. The dried rhizome and roots of Taraxacum officinale Weber (Fam. Com- posita?). Habitat. — Naturalized in the United States and growing commonly in waste places. Indigenous in Europe. Description. — Cylindrical or somewhat flattened, gradually tapering, usually in broken pieces, from 6 to 15 cm. in length' and from 5 to 15 mm. in thickness; externally brown or blackish-brown, longitudinally wrinkled; odor slight or in- odorous; taste bitter; powder light brown. Constituents. — 1, taraxacin, a bitter, soluble, crystalline substance; 2, inulin; 3, taraxacerin (CsH,60) ; 4, resin, causing the milky juice; 5, asparagin, of no medicinal value. Dose.— H., ,->i-ii, (30-60) • Sh. & Sw., oii-iv, (8-15) ; D., oi-ii, (4-8). PREPARATIOXS. Extractum Taraxaci. Extract of Taraxacum. (U. S. & 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 mil=l Gm. of taraxacum. Dose. — Same as taraxacum. Extractum Taraxici Liquidum. (B. P.) Dose. — Same as taraxacum. Administration. — The fresh juice squeezed from the root (succus, B. P.) may be given to horses; or the official preparations may be used. Action and Uses. — Taraxacum is a simple stomachic and bitter and 400 VEGETABLE DRUGS 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. Hydrastis. Hydrastis. (U. S. P.) Synonym. — Hydrastis rhizoma, B. P.; golden seal, yellow root, yellow puc- coon, orange root, Indian dye, Indian tumeric, E.; racine orange, Fr.; Canadische gelbwurzel, G. The dried rhizome and roots of Hydrastis canadensis Linne (Fam. Ranun- culaceae), yielding not less than 2.5 per cent, of the ether-soluble alkaloids of hydrastis. Habitat. — North America in woods, west to Missouri and Arkansas. Description. — Rhizome horizontal or oblique, subcylindrical and usually more or less fiexuous, from 1 to 5 cm. in length and from 2 to 7 mm. in diameter; occasionally with stem bases; externally yellowish or grayish-brown. The powder is yellowish brown; odor distinct; taste bitter. Constituents. — 1, berberine (C2„H1TNO,») 3 to 4 per cent., an alkaloid occur- ring in yellow crystals and found in many plants of the families Berberaceae, Ranunculaceae, and Menispermaceae; 2, hydrastine (C2,H21NO«), a colorless, crys- talline alkaloid, soluble in alcohol and ether; 3, canadine (C21H21N04), occurring in white, acicular crystals. Dose.— H. & C, 3ii-5i, (8-30); Sh. & Sw., oi-ii, (4-8); D., gr.v-3i, (.3-4). PREPARATIONS. Fluidextr actum 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 the ether-soluble alkaloids of hydrastis. Dose.— H. & C, 5ii-5i, (8-30) ; Sh. & Sw., 5i-ii, (4-8) ; D., Tu_v-5i, (.3-4). Extractum Hydrastis Liquidum. (B. P.) Dose.— H. & C, 5i-iii, (4-12); D., nTv-xv, (.3-1). Tinctura Hydrastis. Tincture of Hydrastis. (U. S. & B. P.) Made by maceration and percolation of hydrastis, 200; with diluted alcohol, to 1000. Dose.— H., Si-ii, (30-60); D., 5ss-ii, (2-8). Glyceritum Hydrastis. Glycerite of Hydrastis. (U. S. P.) Made by maceration, and percolation, of hydrastis, 1000, with alcohol, and evaporate. Add water to the residue, set aside 24 hours and filter; add enough water to the filtrate to make 100 mils contain 2.5 Gms. of ether-soluble alka- loids, then add glycerin, 500. Dose. — Same as fluid extract. Hydrastixa. Hydrastine. C21H2lO0. Occurs in white, glistening prisms of bitter taste and permanent in the air. Almost insoluble^ in water; sparingly soluble in alcohol and ether; soluble in chloroform. Dose.— H., gr.iii, (0.18); D., gr.1^, (0.015). Hydrastinine Hydrochloridum. Hydrastinine Hydrochloride. C^HnO.NHCl. (U. S. P.) The hydrochloride of hydrastinine, an alkaloid obtained from the oxidation of hydrastine. Properties.— Light, yellowish needles, or a yellowish-white crystalline powder; odorless, and having a bitter, saline taste; deliquescent on exposure to damp air. Very soluble in water and alcohol. Dose.— H., gr.v, (0.3); D., gr.y2, (0.03). Hydrastis. (N on -official.) • Ihe /°mmercial name for a mixture of variable composition, consisting chiefly of berberine, together with hvdrastine, 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). HYDRASTIS 401 Actions. — Hydrastis and its alkaloids, berberine and hydrastine, act as simple bitters and stomachics, in small doses, by improving the appe- tite 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 increases 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. Hydrastine acts on the nervous system as a mild form of strychnine, stimulating slightly the vagus, respiratory and vasoconstric- tor centres, and increasing reflex excitability. It has no appreciable effect on the heart and but slightly raises blood pressure. It excites all kinds of muscle and thus is a good tonic. Poisonous doses of hydrastine and berberine are followed by convulsions and paralysis; the former is more convulsant. In poisoning by either alkaloid there is great cardiac and vasomotor depression. Hydrastinine hydrochloride stimulates vaso- constrictor centres and also constricts vessels locally, but is chiefly used for its action in stimulating uterine muscle and stopping metrorrhagia at times other than parturition. A 10% solution is applied locally to stop bleeding from the nose, uterus and rectum. Uses. — Hydrastis, berberine, and hydrastine are employed in ano- rexia and atonic indigestion. The fluidextract of hydrastis and hydras- tine (both, however, are very expensive) are especially efficient for horses in combination with other bitters and iron, as follows: I* Fluidextr. capsici 5ii. Fluidextr. hydrastis. Fluidextr. nucis vomicae aa 5iii. M. (Furnish 5ii bottle.) Sig. Small bottleful t. i. d. on tongue, or: — Hydrastinae gr.xxx. Pulv. gentianae. Pulv. nucis vomicae. Ferri sulph. exsicc aa 5ii. M. et div. in ch't., no. xii. Sig. One powder on food t. i. d. Hydrastis is exhibited empirically (probably as a local stimulant and antiseptic) in atonic and inflammatory conditions of the digestive organs, with great benefit, as in chronic gastro-intestinal catarrh or catarrhal jaundice. Hydrastis is used most frequently in human medi- cine to stop uterine hemorrhage of all descriptions, and is often conjoined with the fluidextract of ergot for this purpose. Hydrastinine hydrochlo- ride has been employed with great success as a hemostatic in metrorrhagia. Hydrastine is given to horses and dogs as a bitter tonic. Externally, the fluidextracts of hydrastis (1-8 to 1-2), or hydrastine (gr.v-5i), in aqueous solution, are most serviceable as local stimulants in the treatment of the subacute stages in inflammatory diseases of mucous membranes, and in relaxed or atonic conditions of these tissues. The solutions are applied as injections, or lotions, in leukorrhea, endometritis, balanitis, otorrhea, stomatitis, etc., and upon indolent ulcers. 402 VEGETABLE DRUGS SECTION XI.— VEGETABLE CATHARTICS. Class 1 . — Simple Purgatives. Aloe. Aloes. (U. S. P.) (Aloe Barbadexsis, Aloe Socotrixa, Pharm. 1890.) Socotrine Aloes. Synonym. — Aloe succotrina, aloes sueotrin, s. soeotrin, Fr. ; soeotora, i. soeo- trinische aloe, G. Habitat. — Eastern Africa. The inspissated juice of the leaves of Aloe Perryi Baker, yielding Socotrine aloes; or Aloe vera Linne, yielding Curacoa aloes; or Aloe ferox Miller, yielding Cape aloes (Fam. Liliaceae). Properties. — In yellowish-brown to blackish-brown opaque, or smooth and glistening masses; fractured surface somewhat conchoidal; sometimes soft or semi-liquid; odor aromatic or saffron-like, never fetid or putrid; taste nauseous, bitter. Soluble to extent of 50 per cent, in water; solution yellowish. The powder is dark brown. Curacao Aloes. Aloe Barbadenais. Barbadoes Aloes. (B. P.) Synonym. — Curacoa aloes, E.; aloes dea Barbades, Fr.; Barbados-aloe, G. The inspissated juice of the leaves of Aloe vtra (Linne) Webb (nat. ord. Liliaceae). Habitat. — The island of Barbadoes. Properties. — In orange to blackish-brown, opaque masses; fractured surface uneven, waxy, somewhat resinous; odor characteristic but not aromatic as in Socotrine aloes. Not less than 60 per cent, of Curacao aloes is soluble in cold water, the solu- tion being of a purplish-red color. The powder is deep reddish-brown. Aloe Capexsis. Cape Aloes. Synonym. — Aloes der Cap, Fr. Habitat. — Africa. Properties. — Cape Aloes — In reddish-brown or olive-black masses, usually covered with a yellowish-powder, or in thin, transparent fragments of a reddish- brown color; fracture smooth and glassy; odor characteristic. Not less than 60 per cent, of Cape aloes is soluble in cold water, the solution being of a pale yellow color. The powder is greenish-yellow, changing to light brown on ageing. Dose of Aloes.— U., gss-i, (15-30); C, 3"i-ii, (30-60); Sh., 5$s-i, (15-30); Sw., 5ii-iv, (8-15); D., gr.xx-5i, (1.3-4); Foals, 1 to 3 months, oss-ii; Foals, 6 months, oiii; Foals, 1 year, oiv. Constituents. — 1, aloin; 2, a resin; 3, a volatile oil, giving the odor; 4, a trace of gallic acid. Aloixum. Aloin. (U. S. & B. P.) Synonym. — Aloine, Fr. A pentoside or mixture of pentosides obtained from aloes, varying in chem- ical composition, physical and chemical properties according to the source. Pre- serve it in well-closed containers, protected from light. Derivation. — Obtained by pulverizing and macerating Barbadoes 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, nitration, recrystallization, and finally by solution in hot alcohol and crystallization. Nataloin is derived from Cape aloes. Properties. — A micro-crystalline powder or in minute acicular crystals from lemon-yellow to dark-yellow in color, odorless, or possessing a slight odor of aloes and an intensely bitter taste. It becomes darker on exposure to light and air. Aloin varies in solubility with its composition. It is soluble in water, alcohol or acetone; slightly soluble in ether. Aloes from Curacoa aloes is soluble in about 65 parts of water and 10.75 ACTION OF ALOES 403 parts of alcohol. Barbaloin and socaloin are soluble in about 60 parts of cold water. Barbaloin is soluble in 20 parts of alcohol. Socaloin in 30 parts of abso- lute alcohol. Dose. — H. & C, 5ii-iii, (8-12); D., gr.ii-xx, (.12-1.3), in combination with other purgatives. PREPARATIONS OF ALOES. The official preparations are numerous, but most are not applicable to veteri- nary practice. tinctura Aloes et Myrrhw. Tincture of Aloes and Myrrh. (U. S. P. 1905.) Synonym. — "Elixis pro," elixir proprietas Paracelsi, E. Made by maceration and percolation of purified aloes, 100; myrrh, 100; and liquorice root, 100; with alcohol and water to make 1000. Pilulae Laxativae Composite, U. S. P. 1905. 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. It is absorbed from the denuded skin and thus may occasion purging. Action Internal. — Alimentary Canal. — Aloes is first of all a purga- tive. In addition to this it is a bitter, and therefore small doses excite salivary and gastric secretion, together with the movements and vascu- larity 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 (12-36 hours). This probably happens because the drug does not act till it reaches the large intestines, locally, or through elimination. Aloes is preeminently the best purgative for horses, but does not operate so well on the other domestic animals. Epsom salt, Glauber salt or linseed oil are preferable for cattle; linseed oil or carron oil for foals and calves; and castor oil or calomel for dogs. In chronic constipation in dogs eascara sagrada, phenolphthalein 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 (l°-2° F.) and pulse, with purging lasting from 2 or 3 to 24 hours. Aloes also possesses anthelmintic properties because of its bitter qual- ities and purgative action. Socotrine aloes may be used in the official preparations, but Barbadoes aloes finds most favor in veterinary medicine, and is probably the stronger of the two. Cape aloes is a little inferior 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 principles of aloes, and is usually as operative, but some manufactures are ineffective. Kidneys and Sexual Organs. — Aloes causes reflex, or sympathetic 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 404 VEGETABLE DRUGS 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 3 feedings before exhibition of the purge. An effective aloes ball is made by melting and mixing Barbadoes aloes (1 lb.) with glycerin and molasses (each §ii), and powdered ginger root (&) , on a water bath. When the mass is properly mixed it is removed from the fire and alcohol (3v) is added. The mass is poured on a layer of flaxseed meal to cool, and then is weighed into portions of SlO1/^ each. These are rolled into balls, covered with tissue paper, and preserved in tight tin or glass ves- sels. Horses should not be worked after receiving aloes balls, but should be given a little walking exercise 12 hours after the administration of the dose. Colic and superpurgation may follow if the dose is repeated within 48 hours, or if large quantities of cold water or green food are allowed during the action of the cathartic. If aloes does not operate satisfac- torily, it is safer to give linseed oil by the mouth and rectal injections, than to administer a second does of aloes. Uses External. — The tincture of aloes and myrrh is sometimes ap- plied 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 inflam- mation 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 contra-indicates the use of aloes, lest abortion ensue. The therapeutic scope of aloes being large, it is impos- sible to enumerate all the diseases in wrhich it is useful. Perhaps this cathartic is more commonly serviceable in indigestion and spasmodic or flatulent colic. In acute inflammatory diseases of the brain and cord aloes is often combined with calomel (5i) in ball to enhance the effect. The admin- istration of an aloes ball is followed by that of small doses of Epsom salt (§iv) in the drinking water in the treatment of hemoglobinemia 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 destruction of round-worms in horses. Laxative physic ball for horses, less powerful than above. I* Pulveris aloes 5iv. Pulveris zingiberis. Pulveris nucis vomicae aa 3ii. Glycerin q. s. M. et fiat bolus in No. 1. Sig. Give at once. It is often taught that aloes is contraindicated in hemorrhoids, but LINSEED OIL 405 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 pill is one of the best laxatives in chronic constipation of dogs and cats. Each pill contains 1/120 gr. of strychnine. Aloes may be useful in jaundice due to constipation, but in general it is inferior to salines, calomel and podo- phyllin in the treatment of this disorder. According to Brunton, the presence of bile in the intestines is essential 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, in combination with iron, are valuable in amenorrhea, or absence of estrum, about the time that "heat" should occur. Oleum Lini. Linseed Oil. (U. S. & B. P.) Synonym. — Oil of flaxseed, E.; huile de lin, Fr. ; leinol, leinsamenol, G. A fixed oil expressed from linseed without the use of heat. Properties. — A yellowish, oily liquid, having a peculiar odor and bland taste. When exposed to the air it gradually thickens, darkens in color, and acquires a strong odor and taste. Spec. gr. 0.925 to 0.935. Slightly soluble in alcohol, miscible with ether, chloro- form, benzin, 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., 5vi-xii, (180-360); D. & C, 5ss-ii, (15-60). Action and Uses. — Linseed oil exerts a laxative, or mild purgative effect by its mechanical action in lubricating the bowels and their con- tents. It is suitable for horses when a derivative or depleting 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, dysentery, and in pregnancy. Aloes, on the other hand, would be contraindicated in these conditions. Carron oil (linseed oil and lime water, equal parts), is particularly appropriate as a remedy for "heaves" in horses (oii~iv)> and is one of the best cathartics for foals, lambs and calves (^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. Carron Oil. Olei lini. Liquoris calcis aa. 5iv. M. S. Four tablespoonfuls 3 times daily on feed for horses with heaves; also in the same dose as a cathartic for foals or calves. Carron oil is frequently employed on cotton cloth or gauze in burns. It was first used for this purpose in the Carron iron works. It is not so good as boric acid ointment since it is not antiseptic. Linseed oil is frequently given to ruminants, although Epsom salt is generally the best purge for them. It is indicated for these animals 406 VEGETABLE DRUGS when a milder operation than that obtained by a full dose of sails is required, and for its demulcent action in irritable states of the digestive organs. Linseed 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 is 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 oil (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 dram of either to the smaller animals, as an expectorant in bronchitis. The mixture is often a most serviceable one and probably acts by improving the nutrition of the bronchial mucous membrane. Linseed oil and sweet oil resemble cod liver oil in this respect, and while both are probably inferior to the latter, as expectorants, they are more palatable and cheaper. Oleum Uicixi. Castor Oil. (U. S. & B. P.) Synonym. — Oleum e semini ricini, huile de ricin, Fr.; ricinusdl, (i. A fixed oil obtained from the seed of Ricinus communis Linne (Fain. Eu- phorbiaceae). Habitat. — India. Cultivated in many countries. Properties. — A pale, yellowish and almost colorless, transparent, viscid fluid, having a faint, mild odor and a bland, afterwards slightly acrid, and generally nauseating taste. Spec. gr. 0.915 to 0.9(55. 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, alcohol (absence of more than about 5 per cent, of most other fixed oils). Partly soluble in benzin. Constituents. — 1, ricinolein, or ricinoleic acid glyceride, CjHb(C18H840»)8; 2, an acrid principle; 3, palmitin, stearin and myristin; 4, possibly a non-purgative alkaloid, ricinine. Dose.— H. & C, Oi, (500); Sh. & Sw., f>ii-iv, (60-120); D. & Cats, gi-ii, (30-60); poultry, 5i, (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.x8 mm.), ovoid, flattened, and white inside. They contain 50 per cent, of oil, and an acrid, poisonous substance, a toxalbumin, ricin. Three seeds have caused death in man, and they are ten times more purga- tive 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 intes- tines the oil is decomposed into its component parts — fatty acids, glycerin and ricinoleic acid — by the bile and pancreatic juice, and the ricinoleic acid is further changed to ricinoleates (soaps, as sodium ricinoleate), 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 in dogs, 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 con- ditions of the digestive tract. It is useful in constipation only as an occasional remedy since it is followed by greater tendency to this condi- tion, but small doses (D., 3i) are sometimes given daily in chronic con- CASCARA SAGRADA 407 stipation. It is also indicated in overloaded bowels, indigestion, 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 notably useful in irritation and inflammation of the intestines in young animals, however, as in diarrhea, dysentery, and enteritis ; diarrhea from distemper in dogs ; retained meconium in foals and calves ; and can be combined with ano- dynes and antispasmodics 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 dram of the latter; or with glycerin (equal parts) and a few drops of oil of winter- green. It is administered to puppies (3i-ii) with an equal volume of sweet oil. The soft gelatine capsules, containing oss-i, are most con- venient and palatable in giving castor oil to small dogs. Castor oil may be exhibited to horses with oil of peppermint (H\xx); or in digestive irritation, in warm cooked flour gruel with laudanum (^ss) and fluid- extract belladonna (oi) ; to foals and calves with mucilage or gruel and 5 drops of oil of peppermint. In diarrhea in foals and calves. Olei ricini .5 i j i . Tincturae opii 5i. Olei menthae piperitae TTtv. M. Sig. Give at once in a pint of warm cooked flour gruel. Purge for large dog. Olei ricini. Glycerini aa 3iss. Olei cinnamomi TF\ii. M. Sig. Give at one dose. Cascara Sagrada. (U. S. & B. P.) Synonym. — Rhamnus purshiana, California buckthorn, sacred bark, chittem bark. The dried bark of the trunk and branches of Rhamnus Purshiana de Candolle (Fam. Rhamnaceae). Habitat. — United States from northern Idaho west to Pacific Ocean. Description. — Usually in flattened or transversely curved pieces, occasionally in quills; bark from 1 to 5 mm. in thickness; outer surface dark brown or brownish-red, longitudinally ridged, often nearly covered with grayish or whitish lichens; inner surface yellowish to light brownish, becoming dark brown with age; odor distinct; taste disagreeable, bitter and slightly acrid. Constituents. — 1, a glucoside, cascarin or frangulin (see below) ; 2, three resins; 3, a volatile oil; 4, malic and tannic acids. Dose.— D., gr.v-xxx, (.3-2). PREPARATIONS, Fluidextractum Cascarcc Sagrada\ Fluidextract of Cascara Sagrada. Made by maceration and percolation with diluted alcohol, and evaporation, so that 1 mil=l Gm. of the crude drug. (U. S. P.) Dose. — D., TTtv-xxx, (.3-2). 408 VEGETABLE DRUGS Fluidextr actum Cascarcc Sagradcc Aromaticum. (U. S. P.) Dose. — TTXv-xxx, (.3-2). Extractum Cascarcc Sagradcc Liquidum. (B. P.) Dose. — D., TTlv-xxx, (.3-2). Extractum Cascarcc Sagradcc. (U. S. & B. P.) Dose. — D., gr.ii-viii, (.12-.5). Syrupus Cascarcc Sagradcc Aromaticus. (B. P.) Dose.—D., 5ss-ii, (2-8). Frangula. Frangula. (U. S. P.) Synonym. — Rhamni frangulae cortex, B. P.; buckthorn, alder buckthorn, black alder, E.; ecorce de bourdaine (bourgene), Fr. ; faulbaumrinde, G. ; cortex fran- gulae, P. G. The dried bark of Rhamnus Frangula Linn6 (Fam. Rhamneae). Habitat. — Europe and northern Asia. Description. — In quills varying in length, frequently flattened or crushed; from 0.5 to 1 mm. in thickness; outer surface grayish-brown or purplish-black; odor distinctive; taste slightly bitter. Constituents. — 1, a glucoside, frangulin (C^H^O,,,), converted in time into (2) emodin (C^H^Os), a glucoside, to which the drug owes its purgative action. Frangulin also yields emodin, a constituent of rhubarb as well, and rhamnose (C0H12O5), by hydrolysis. Dose.— D., 3ss-i, (2-4). PREPARATIONS. Fluidextr actum Frangulcc. Fluid Extract of Frangula. (U. S. P.) Made by maceration and percolation with alcohol and water, and evaporation, so that 1 mil of the preparation=:l Gm. of the crude drug. Dose.—D., 3ss-i, (2-4). Actions and Uses. — The buckthorns are laxatives in the doses em- ployed in medicine. The fresli bark of R. frangula produces violent gas- troenteritis (frangulin), and the same effect is produced by the bark of cascara sagrada, so that both should be kept a year before using. Frangula is rarely employed, but cascara sagrada is one of the best purgatives for chronic constipation in dogs, acting in 10 or 12 hours. 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 Cascara? Sagradae Aromaticum (U. S. P.), Syrupus Cascarse Sagrada? Aromaticus (B. P.), are the best preparations. The aromatic syrup of cascara sagrada may be prescribed to advantage with an ounce or two of castor oil, as an occasional purgative for dogs. Pills of extract of cascara sagrada are kept in stock by druggists, one of the most convenient forms for dogs. A syrup of purging buckthorn (Rhamnus catharticus) D., gi-ii ; Cats, oss~^ *s a^so occasionally given dogs and cats with castor oil. Phenolphthaleinum. Phenolphthalein. C20H14O4. (U. S. P.) Is made from phenol, phthalic anhydride and sulphuric acid by the action of heat. It occurs in white, or faintly yellowish-white crystalline powder. It is tasteless and odorless, and soluble in 600 parts of water, in 13 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 peristaltic stimulant and is especially indicated in habitual constipation, producing watery movements. It does not cause griping, produces no bad effect on the system even when used over long periods of time, and is non-toxic in RHUBARB 409 enormous doses. It is sometimes prescribed with aloes. Phenolphthalein is elimi- nated chiefly by the intestines. It is the common constituent of candy cathartics. Dose. — H., 3i-3iss, (4-6) ; dogs, gr.ii-x, (0.12-0.6) ; puppies and cats, gr.ss-ii, (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, Mulford), or in pill with aloes, strychnine, belladonna and cascara (Phenalos, Mulford). Rheum. Rhubarb. (U. S. P.) Synonym. — Rhei radix, B. P.; rhubarbe, Fr.; rhubarber, G. The rhizome and roots of Rheum officinale Baillon, Rheum palmatum Linne, and the var. tanguticum Maximowicz (Fam. Polygonacefe), or probably other species of Rheum, grown in China and Thibet, deprived of most of the bark and carefully dried. Description. — In sub-cylindrical, barrel-shaped, or conical pieces known in commerce as "rounds," or in plano-convex pieces known in commerce as "flats," or in irregularly formed pieces, frequently with perforations. It is hard and moderately heavy; attaining a length of 17 cm. and a diameter of 10 cm., often cut in pieces of variable form and size; outer surfaces yellowish-brown, mottled, with alternating, longitudinal striae of grayish-white parenchyma and reddish or brownish medullary rays; odor aromatic, characteristic; taste characteristic, slightly bitter and astringent, gritty when chewed and tingeing the saliva yellow. The powder is bright orange-yellow to yellowish-brown; becoming red with alkalies; when examined under the microscope it exhibits calcium oxalate. Constituents. — 1, the purgative principle which gives the yellow color, a glucoside, chrysarobin (C^H^Ot), yields 2-3 per cent, of chrysophanic acid (C^H^O.,), also called rhein or chrysophan; 2, rheotannic acid (CocH^Ou), which gives astringency to rhubarb; 3, calcium oxalate (35 per cent.), causing gritti- ness; 4, resinous bodies: phaeoretin, emodin, aporetin and erythroretin. Chryso- phanic acid and the resins are somewhat purgative, but the exact purgative principles have yet to be discovered. Dose— Stomachic— H. & C, 5i-ii, (30-60) ; Sh., 5i, (4) ; D. & Cats, gr.v-x, (.3-.6). Mild Purgative. — Foals and Calves, 5i-ii, (4-8) ; D., 5i-ii, (4-8). Fowl, gr.v-vii in pill. PREPARATIONS. Fluidextr actum Rhei. Fluidextract of Rhubarb. (U. S. P.) Made by maceration and percolation witli alcohol and water, and evaporation, so that 1 mil=l Gm. of the crude drug. Dose. — Same as that of rhubarb. Pulvis Rhei Compoxitus. Compound Powder of Rhubarb. (U. S. & B. P.) Synonym. — Gregory's powder. Rhubarb, 25; magnesium oxide, 65; ginger, 10. Dose. — Foals and Calves, Bss-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 there- fore in small doses improves digestion in all animals by increasing the flow of salivary and gastric juices, and by stimulating the appetite, vas- cularity, and movements of the stomach. It is called a stomachic and bitter tonic. Larger doses cause mild purgation in the case of dogs and cats, 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 com- monly described as an agent which stimulates peristaltic action, but it is not certainly known how purging is brought about. Secondary constipa- tion is more apt to follow the use of rhubarb than other drugs, because of rheotannic acid. This substance may be absorbed and eliminated into 410 VEGETABLE DRUGS the bowels after the occurrence of purgation. Rhubarb, by virtue of ehrysophanic acid, stains the feces, urine, mijk and sweat yellow in its excretion. Uses. — Rhubarb is an efficient laxative remedy for the treatment 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 care of foals, calves and lambs with diarrhea. The fluidextract may be given to dogs, but rhubarb is not so generally useful a purgative for these animals as castor oil, calomel, cascara sagrada, phenolphthalein, or compound laxative pills. Rhubarb has been recommended when a laxative is desirable, in cases of hemor- rhoids, to improve local tone, and also as a purgative in diarrhea of young- animals due to worms. Diarrhea in Foals and Calves. I* Pulveris rhei compositi f>ii. Sig. 1 tablespoonful in milk 3 times daily. Diarrhea in dogs. Olei ricini. Syrupi rhei aromatic! aa .5>- M. Sig. Give at once in one dose. One or two drops of the tincture of rhubarb in the drinking water form a serviceable laxative for small birds. Chrysarobixum. Chrysarobin. C^H^O^ (U. S. & B. P.) Synonym. — Chrysarobine, Fr.; araroba depurata, G. A neutral principle, extracted from Goa powder, a substance found deposited in the wood of Vouacapoua Araroba (Aguiar) Druce (nat. ord. Leguminosae). 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 chloroform and solutions of alkalies. It is oxidized into ehrysophanic acid (C,6Hio04), and glucose. PREPARATION'. Unguentum Chrysarobini. Chrysarobin Ointment. (U. S. & B. P.) Chrysarobin, 6; benzoinated lard, 91. (U. S.) 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 ringworm, and as a stimulant to the skin in chronic cutaneous disorders, particularly psoriasis and 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. In SENNA 411 psoriasis the following ointment is useful after the scales have been washed off: Chrysarobini 3i. Aetheris. Alcoholis aa q. s. ft. sol. Collodii gii. M. 9ig. Apply with brush to skin. Senna. Senna. Synonym. — Senna Alexandrina, senna Indica, B. P.; senna leaves, E.j folia sennae, P. G.; feuilles de senc, Fr. ; sennesbliitter, G. The dried leaflets of Cassia acutifolia Delile, known in commerce as Alex- andria senna, or of Cassia angusti folia Vahl, known in commerce as India senna (Fam. Leyuminosa). Description. — Alexandria Senna — Usually unbroken, occasionally in fragments, leaflets inequilaterally lanceolate or lance-ovate, from 2 to 3.5 cm. in length and from 6 to 10 mm. in breadth, having- extremely short, stout petiolules; acutely cuspidate, entire, subcoriaceous, brittle, pale green or grayish-green, sparsely and obscurely hairy, especially beneath, the hairs appressed; odor characteristic, laste somewhat mucilaginous and bitter. Pods few, broadly elliptical, somewhat reniform, dark green, thin and mem- branous. India Senna — Leaflets usually unbroken, from 2 to 5 cm. in length and from 6 to 14 mm. in breadth, usually more abruptly pointed than those of Alexandria senna, yellowish-green and smooth above, paler beneath; in odor and taste closely resembling Alexandria senna. Pods few, elliptical, more or less reniform and from t to 5 cm. in length. Powdered Alexandria senna is light green. Habitat. — Alexandria Senna. — Upper Egypt, Nubia, and Central Africa. Indian Senna, or Tinnivtlly Senna. — Eastern Africa to India. Constituents. — 1, the purgative properties are chiefly due to magnesium and calcium cathartates; salts of cathartin (C^H^N^SO;,), a black, amorphous sul- phurated glucoside; 2, two glucosides, sennacrol and sennapicrin, insoluble in water; 3, chrysophanic acid; 4, cathartomannit (C2,HmO,!,), an unfermentahle sugar; 5, emodin. Dose.— H. & C, .liv-v, (120-150); Sh. & Sw., gi-ii, (30-60); D. & C, 3i-iv, (1-15) ; fowl, gr.xv-xx in pills. PREPARATIONS. Fluidext racfum Senna'. Fluidextract of Senna. (U. S. P.) Made by maceration and percolation with diluted alcohol, and evaporation, so that 1 mil=l Gm. of the crude drug. Dose. — Same as senna. Pulvis Glycyrrhizw Compositue. Compound Powder of Glvcvrrhiza. (U. S. & B. P.) Synonym. — Compound liquorice powder. Senna, 180; glycyrrhiza, 236; washed sulphur, 80; oil of fennel, 4; sugar, 500. Dose.— D., 5ss-ii,* (2-8). Si/rupus Sennw. (U. S. & T3. P.) Dose.— D., 3i-iv, (4-15). Action Internal. — Senna stimulates and increases the vascularity of the intestinal mucous membrane, and causes increased peristalsis of the large intestines, particularly of the colon. It produces copious pale- yellow and watery evacuations-. The drug has a nauseous taste and purg- ing is accompanied by some griping and flatulence. Senna acts more satisfactorily when combined with other purgative agents. It is absorbed 432 VEGETABLE DRUGS and will occasion catharsis in sucklings after administration to their mothers, and after intravenous injection. The urine may be colored red or yellow by its elimination. It is extremely 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, is added to solutions of magnesium sulphate. This combination is more suitable for cattle or sheep. The syrup or compound liquorice powder may be given to dogs as a simple purgative in occasional or habitual con- stipation. Class 2. — Drastic Purgatives Oleum Tiglii. Croton Oil. (U. S. P.) Synonym. — Oleum crotonis, B. P.; huile de croton tiglium, Fr.; krotonol, G. A fixed oil expressed from the seed of Croton Tiglium Linne (nat. ord. Euphorbiaceae). Habitat. — India, Indian Archipelago, and Philippine Islands. Also cultivated. Properties. — A pale yellow or brownish-yellow, somewhat viscid, and some- what fluorescent liquid, having a slight characteristic odor, and a mild, oily, after- wards burning and acrid taste (great caution is necessary in tasting). Spec. gr. 0.935 to 0.950. When fresh it is soluble in about 60 parts of alcohol, the solubility increasing by age. It is freely soluble in ether, chloroform, carbon disulphide, and in fixed and volatile oils. Constituents. — 1, crotonoleic acid (C5Hs02), the purgative principle. A slight amount is free in the oil but it is mostly formed in the bowels. It resembles ricinoleic acid in its chemistry; 2, crotonol (C^H^O.,), a non-purgative body causing irritation of the skin; 3, tiglinic acid (C5H802), and many volatile acids existing as glycerides and accounting for the odor of croton oil; 4, free and com- bined fatty acids. Dose.— H., TTlxv-xxx, (1-2); C, 5ss-i, (2-4); Sh. & Sw., TT^v-x, (.3-.6); D., TTLss-iii (.03-.18). 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 con- tain from 50 to 60 per cent, of croton oil and a toxalbumin, crotin, which is, however, less poisonous than the toxalbumin of castor oil seeds, ricin. Action External. — Croton oil is a most powerful irritant, causing 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, creating 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^il in the bile and alka- line 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 large doses creates gastro-enteritis. Medicinal doses CROTON OIL 413 notably augment the intestinal secretions — 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 purgation 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 mem- brane; in part to absorption and elimination of the purgative principle by the bowels. Toxicology. — Ten drops of croton oil will kill a dog unless vomiting occurs. Eight to thirty drops prove fatal to a horse, intravenusly. The treatment of poisoning includes the use of emetics or stomach tube, de- mulcents and opium. Administration. — Croton oil may be placed on the tongue of an un- conscious 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. It may be ex- hibited 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 (1T[x), when a powerful deriva- tive and purgative action is indicated, as in acute inflammation of the brain and cord, with calomel and aloes in ball. Uses External. — Croton oil is ordinarily superseded by milder coun- ter-irritants, as turpentine, mustard, or stimulating liniments; but it may be employed so as to secure any degree of irritation according 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 (20-30TTL), with 30 parts each of oil of turpentine and linseed oil ; in acute disorders of the chest (10-15TI\ on either side) and abdomen (40T1\), 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 rheu- matic joints. It is less likely to cause severe inflammation and blemish- ing 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, and in impaction of the omasum. Also in unconscious conditions where its small bulk will allow of its exhibition. Again, for its derivative and rapid effect in cerebral conges- tion, parturient apoplexy, etc. 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. For Cattle. Olei tiglii 3ss. Olei lini Oii. M. S. Give at one dose in drench. 414 VEGETABLE DRUCS For Horses. Hydraryri chloridi mitis 3i. Olei tiglii "T.xv. Pulveris aloes 3v. M. et fiat bolus No. i. S. Give at once. Blister for Cattle. J* Olei tiglii .v Olei terebinthina? 5ii. Pctrolati §iii. M. S. External use with friction. Scammonije Radix. Scammony Hoot. (U. S. P.) Synonym. — Scammonee, Fr. ; scammonium, G. The dried root of Convolvulus Scammonia Linn6 (Faua. Convolvulaceae) , yielding not less than 8 per cent, of total reins. Description. — Cylindrical, tapering, from 10 to 25 cm. in length, and from 1 to 4.5 cm. in thickness; externally grayish to reddish brown. The powder is light, grayish brown. Constituents. — 1, a resin (80-95 per cent.); 2, gum; .'J, starch. Dose.— D., 5i-ii, (4-8); Cats, 3ss-i, (2-4); S\v., 5ii-iv (8-15). PREPARATION. Reaina Scammonii. Resin <>f Scammony. (U. S. P.) Scammonice Resina. (B. P.) Derivation. — Made by maceration and percolation with alcohol, distillation to remove the excess of alcohol, and precipitation in water. Properties. — Yellowish to brown masses or fragments, breaking with a resin- ous glassy fracture; translucent at the edges; or a yellowish-gray to yellowish- brown powder, having a slight, peculiar odor, and a somewhat acrid taste. Solu- ble in alcohol, ether, and insoluble in fixed and volatile oils. Constituents. — Mainly scammonin (CssH^.O^), identical with jalapin. Dose. — One-half that of scammony. Jalapa. Jalap. (U. S. & B. P.) Synonym. — Tubera jalapse, P. G.; jalap tubcreux, Fr.; ialape, jalapenknol- len, G. The dried tuberous root of Exogonium Purga (Wenderoth) Bentham ( Fam. Convolvulaceae), yielding not less than 7 per cent, of total resins of jalap. Habitat. — Mexico. Description. — Fusiform, irregularly ovoid or pyriform, upper end more or less rounded, lower end slightly tapering, the large roots often incised or cut into pieces; from 4 to 15 cm. in length and from 12 to 60 mm. in diameter; externally dark brown, longitudinally wrinkled or furrowed and with numerous lenticels; odor slight but distinctive, smoky; taste somewhat sweet and acrid. The powder is light brown. Constituents. — 1, a hard resin (7-22%), chiefly the glucoside jalapurgin (CG2H100O32) ; 2, a soft resin. Dose.—B., 5i-ii, (4-8); Cats, 3ss-i, (2-4); Sw., 5ii-iv, (8-15). PREPARATIONS. Pulvis Jala pie Composite. (U. S. & B. P.) Jalap, 35; potassium bitartrate, 65. Dose. — D., gr.xv-lx. Resina JaJapw. Resin of Jalap. (U. S. & B. P.) Derivation. — Made by maceration and percolation with alcohol, partial distil- lation; precipitation with water; washing and drying. Properties. — Yellow to 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 SCAMMONY AND JALAP 415 in the air. Soluble in alcohol; insoluble in carbon disulphide, benzene, and fixed and volatile oils. Not more than 10 per cent, of it is soluble in ether. Constituents. — 1, jalapurgin or convolvulin (C^HjooO^), the most active prin- ciple; 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 dissolved by the bile in the duodenum, and a purgative substance is formed which chiefly stimulates the intestinal glands and causes a copius outpouring of secre- tion. Both drugs excite peristaltic action and increase the vascularity of the intestinal mucous membrane, particularly scammony, 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 alter exhibition of scammony 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 calomel. Dropsy in dogs. I* Resinae jalapae gr.xx. Hydrargyri chloridi mitis gr.iii. M. et divide in capsulas No. ii. S. Give 2 capsules at one dose. Jala]) 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 liquid petrolatum. Cambogia. Gamboge. (B. P.) Synonym. — Gutti, P. G. ; gutte, gomme-gutte, Fr.; gummigutt, gutti, G. A gum-resin obtained from Garcinia Hanburii Hooker filius (nat. ord. Gut- tiferae). Habitat. — Siam, Anain, and Camboja. Properties. — In cylindrical pieces, usually hollow in the centre, 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. 416 VEGETABLE DRUGS Constituents. — 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., 3ss-i, (15-30); C, 3i-iss, (30-45); Sh. & Sw., gr.xx-3i, (1.3-4); D., gr.v-x, (.3-.6). Action and Uses. — Gamboge is a drastic, hydragogue purgative, and slightly diuretic. Its action is uncertain and often violent, with produc- tion of griping pains. Large doses cause vomiting in carnivora 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, indigestion, impaction of the third stomach, and cerebral diseases of cattle, combined with salts, or rubbed up with water and an equal amount of aloes (aaji). The gum forms an emulsion when the drug is triturated with water. Purge for Cattle. Pulveris cambogiae 31- Sodii sulphatis. Sodii chloridi aa tt>ss. Aquae Oii. M. S. Give at one dose. Colocyxthis. Colocynth. (U. S. P.) Synonym. — Colocynthidis pulpa, B. P.; bitter apple, gourd, or cucumber, E.; coloquinte, Fr.; koloquinthen, G. The dried pulp of the fruit of Citrullus Colocynthis Schrader (Fam. Cucur- bitaceae). Habitat. — A vine growing in North and South Africa, South and West Asia, and Japan, etc. Description. — Fruits, before the removal of the seeds, nearly globular, from 4 to 7 cm. in diameter, usually more or less crushed and in broken pieces, with occasional patches of the nearly smooth epicarp; yellowish-white or brownish; light, spongy; odor slight; taste intensely bitter. The powder is yellowish-white or buff. Constituents. — 1, the chief purgative principle is colocynthin (C^H^O^)* 1-2 per cent. An amorphous or crystalline bitter glucoside. Soluble in water and alcohol. There is also (2) an insoluble, resinous body called colocynthitin, colo- cynthein or citrullin. Dose— Colocynthin.— H., 5ss-i, (2-4); D., gr.^-i, (.015-.06). Colocynth.— D., gr.ii-iii, (.12-.18). Elaterinum. Elaterin. C^H^Os- (U. S. & B. P.) Synonym.— Elaterine, Fr. ; elaterin, G. A neutral principle obtained from elaterium (wild or squirting cucumber), a substance deposited by the juice of the fruit of Ecballium Elaterium (Linne) A. Richard (nat. ord. Cucurbitaceae). Habitat. — Elaterium grows in North Africa, West Asia and Southern Europe. It is also cultivated. Derivation— Elaterium is exhausted with chloroform. Ether is added and elaterin is precipitated and is purified by redissolving in chloroform and crystal- lizing. PODOPHYLLUM 417 Properties. — Minute, white, hexagonal scales, or prismatic crystals, without odor, and having a slight, acrid, bitter taste. Insoluble in water; soluble in 325 parts of alcohol; also soluble in 450 parts of ether, or in 15.5 parts of chloro- form. Permanent in the air. Dose.— D., gr. 1/20-1/12 (.003-.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 griping, gastro- intestinal inflammation, excessive wratery purging, and collapse. Elaterin frequently fails to purge horses and dogs, although death may follow large doses. Colocynth acts more certainly in the lower animals and is recommended by P. Cagny in dropsy and cerebral disease. Neither drug, however, is of any importance in veterinary medicine. Colocynth is con- tained in the compound cathartic pill given to dogs in doses of from one to three pills. Podophyllum. Podophyllum. Synonym.- -Podophylli rhizoma, B. P.; May apple, mandrake root, E.; rhi- zome de podophyllum, Fr. ; fussblattwurzel, G. The dried rhizome and roots of Podophyllum pellatum Linn€ (Fam. Ber- berideae), yielding not less than 3 per cent, of resin. Habitat. — North America. Description.— Rhizome horizontal, nearly cylindrical, jointed, compressed on the upper and lower surface's, sometimes branched; in pieces from 3 to 20 cm. in length, the internodes from 2 to 9 nun. in diameter; externally dark brown, longi- tudinally wrinkled or nearly smooth with irregular, somewhat V-shaped scars of scale leaves; odor slight, more pronounced and characteristic in the powder; taste sweetish and disagreeably 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. S. & B. P.) Synonym. — Podophyllin. Derivation. — Made by maceration and percolation of podophyllum with alco- hol; partial evaporation, and precipitation of the resin with diluted hydrochloric acid; washing with water, drying. Properties. — An amorphous powder, varying in color from light brown to greenish-yellow, turning darker when subjected to a temperature exceeding 25° C, or when exposed to light. It has a slight, peculiar odor, and a faintly bitter taste. Permanent in the air. Soluble in alcohol and partly soluble in ether and chloroform. Constituents.— Chiefly podophyllotoxin (C23Ha4Oa-|-2 H20), stated to be a mix- ture of a purgative principle, picropodophyllin, and an inert body, podophyllinic acid, associated with a coloring matter, podophylloquercitin, and other resins. Dose.— H. & C, 3i-ii, (4-8); D., gr. ^-i, (.006-. 06). Dose.— D., 1 pill. Action. — Podophyllin is a powerful though slow acting cathartic. Podophyllotoxin when given in large doses under the skin or into a vein causes glomerular nephritis and hemorrhages into various organs. Large doses cause purging and vomiting in animals, and lethal quantities occasion gastro-enteritis, colic, super-purgation, with bloody fecal evacua- tions, convulsions and death. It acts in the same way whether it is ap- plied externally, injected into the blood, or given internally. Podo- 418 VEGETABLE DRUGS phyllin 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 bile, which seems to be a solvent for it. It is probable that the .intestinal secretions are somewhat augmented. The fecal move- ments, 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 un- equally, 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 is often regarded as essentially a cholagogue, but there is no sufficient evidence to warrant this assumption. Laxative pill for dogs. Resinae podophylli gr.i. Hydrargyri chloridi mitis grx. Aloini .: : gr.iii. M. et fiant pilulae No. x. S. One pill at night. 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 potassae and diluted with water. Uses. — Podophyllin, clinically, appears to be particularly useful in chronic constipation associated with jaundice and he'patic disorders. The result of its action is said to be more favorable when the fecal discharges are dark colored, whereas calomel is more successful if the evacuations are of a light hue. SECTION XII.— TANNIC ACID, AND DRUGS CONTAINING IT. Galla. Nutgall. (U. S. & B. P.) Synonym.— Galls, E.; gallae, P. G.; noix de galle, galle de chene, Fr.; galliip- fel, G. Excrescences on the young twigs of Quercus infectoria Olivier and other allied species of Quercus (Fam. Fagacew), induced by the punctures on the leaf- buds and by the deposited ova of Cynips tinctoria Hartig (Order Hymenopterw). Not more than 5 per cent, of galls float in water. Habitat. — Levant. Description.— Nearly globular, from 0.8 to 2.2 em. in diameter; externally blackish-olive-green or blackish-gray; heavy, sinking in water, excepting the smaller galls; internally grayish or dark brown, consisting of a central portion slightly radiating and resinous, occasionally hollow and traversed by a narrow radial canal extending to the exterior as shown by the perforation in the whole gall; odor slight; taste strongly astringent. Constituents.— 1, (gallo) tannic acid, 60 per cent.; 2, gallic acid, 2-3 per cent; 3, sugar; 4, resin. PREPARATIONS. Unguentum Gallw. Nutgall Ointment. (U. S. & B. P.) Nutgall, 20; Ointment, 80. (U. S. P.) | ACTION OF TANNIC ACID 419 Unguentum Gallce Cum Opio. (B. P.) Acidum Tannicum. Tannic Acid. HC14H90„. (U. S. & B. P.) Synonym. — Acidum gallo-tannicum, tanninum, tannin, digallic acid, E.; acid tannique, tannin, Fr.; gerbsiiure, tannin, G. A tannin usually obtained from nutgalls. Derivation. — Powdered nutgall is exposed to damp air for 48 hours. It is then treated with water and ether. The water dissolves 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-white to light brown amorphous powder, gradu- ally 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. Very soluble in water and alcohol; also in about 1 part of glycerin, with the application of a moderate heat; freely soluble in diluted alcohol, sparingly in dehydrated alcohol; almost insoluble in absolute ether, chloroform, benzene, or petroleum benzin. Incompatible s. — Alkaloids, alkalies, mineral acids, silver, ferric, lead and anti- mony salts, gelatin and emulsions. Dose.— H. & C, 5ss-5ss, (2-15) ; Sh. & Sw., 3ss-i, (2-4) ; D., gr.i-xv, (.06-1). PREPARATIONS. Collodium Stypticum. Styptic Collodion. (U. S. P. 1905.) Tannic acid, 20; alcohol, 5; ether, 25; collodion, to 100. Made by solution. Unguentum Acidi Tannic'}. 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.) Administration. — Tannic acid is given in solution in aromatic waters, alcohol, syrup, wine, glycerine, and water; also it is exhibited in powder. The drug is used externally in powder, ointment, glycerite 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 secretion, and so fills up the mouths of glands, making the tissues harder, denser, and drier. Tannic acid causes a species of "tanning" compatible 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 forma- tion 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 surrounding the blood vessels. Tannic acid causes arrest of leuko- cyte movements, and diapedesis of the same, at the point of its applica- tion. Tannic 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 physiological properties. The official tannic acid — gallotannic acid — is contained in nutgall and oak bark, while another variety — catechutannic acid — is found in kino, catechu, etc. Action Internal. — Tannic acid dries the mouth by closure of glan- 420 VEGETABLE DRUGS dular (mucous) ducts with coagulated secretion, and by constriction 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 digestion 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 in the bowels is converted first into sodium tannate, and then sodium gall ate, which is not astringent. For this reason tannic acid only acts a short time in the intestine and other drugs are more often used in diarrhea. Traces appeal in the blood and urine as sodium tannate or gallate. Of the tannic acid swallowed 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 influence of tannic or gallic acid on the tissues, after absorption in the form of sodium gallate or tannate, is nil. Catechu and kino are often chosen in place of tannic acid in the treatment of diarrhea, because they are less soluble (than tannic acid), and their colloid and extractive matters prevent the con- version of tannic acid into non-astringent salts, and the contained cate- chutannic acid comes in contact with the intestinal mucous membrane for a longer time. The salts of tannic acid (tannates) are not astringent. Uses External. — Tannic acid is a valuable astringent in a great variety of local inflammatory lesions. In the form of the glycerite, tannic acid may be applied advantageously to the skin in moist eczema, and as a remedy for frost bites. It is a useful application for sore and cracked teats. The mouth is painted with glycerite for the cure of ulcerative or aphthous stomatitis. The same preparation is injected into the ear in otorrhea of dogs, and into the vagina to arrest vaginitis and leukorrhea. 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 leukorrhea (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 some- times utilized as an inhalation in subacute laryngitis, tracheitis, and bronchitis. Powdered opium and nutgall ointment (1-14), or glycerite of tannin, are serviceable in hemorrhoids and rectal fissures, ulcers, or pro- lapse of the rectum. Uses Internal. — Tannic acid is exhibited in powder or solution to arrest bleeding in the stomach. It is an astringent in diarrhea 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 tannates. which should be removed if possible by evacuation of the stomach. 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 pan- creatic juice in the bowel. It is more suitable for young animals in diarrhea than is tannic acid. Dose.— H. & C, 5i-iv, (4-15); foals & calves, gr.xx-xl, (1.3-2:6); D. & C, GALLIC ACID 421 gr.x-xx, (.6-1.3). on food. Tannocol is a gelatine precipitate and is identical in uses and doses. Tannigex, Tanxyl Acetate, C1SHU0U. Made by heating tannin and acetic anhydride in the presence of glacial acetic- acid. Occurs as a light gray, odorless, tasteless powder. Insoluble in water but soluble in alcohol and alkalies. It passes unchanged 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 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. Tannoform, a combination of tannin and with formaldehyde, and tannopin, the union of tannin with hexamethylenamine; are yellow, odorless and tasteless powders used for the same purposes and in the same doses as tan- nigen and tannalbin. The latter are astringent and antiseptic dusting powders externally. Acidum Gallicum. Gallic Acid. C7H0O5+H,O. (U. S. & B. P.) Synonym. — Acide gallique, Fr.; gallussjiure, 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,4Hu01( + H20= 2 HC7H&0:, (gallic acid). The liquid is then expressed from the paste and the residue is boiled with distilled water and filtered, when hot, through animal charcoal. Gallic acid crystallizes out from the filtrate. Properties. — White, or pale fawn-colored, silky, interlaced needles or tri- clinic prisms; odorless; having an astringent or slightly acidulous taste; perma- nent in the air. Soluble in 87 parts of water, and in 4.6 parts of alcohol; in 100 parts of ether, and in 10 parts of glycerin. Incompatible)*. — Metallic salts and spirit of nitrous ether. Dose.— H. & C, oii-^ss, (8-15); Sh. & Sw., oss-i, (2-4); 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, albumin- uria, bronchorrhea, leukorrhea, and excessive sweating. Pyrogallol. Pyrogallol. C,H,(OH)3. (U. S. P.) Synonym. — Pyrogallic acid. Derivation. — Trihvdroxvbenzene obtained chieflv bv the dry distillation of gallic acid, C7Hc05=CcH3(6H)3+C02. Properties. — Light, white, or nearly white, laminae, or fine needles; odorless, and having a bitter taste; acquiring a grayish tint on exposure to air and light. Soluble in 1.7 parts of water, and in 1.3 parts of alcohol; also soluble in 1.6 parts of ether. Action and Uses. — Pyrogallol is an excellent agent for the treatment of chronic psoriasis and for ringworm. An ointment containing an amount of pyrogallol varying from gr.x-3i to the ounce of lard, is commonly employed. Toxic symptoms may follow its extensive applica- tion. 422 VEGETABLE DRUGS Quercus. White Oak. (U. S. P. 1905.) The dried bark of Quercus alba Linno (Farn. Cupuliferw), collected from trunks or branches ten to twenty-five years of age, and deprived of the periderm. Synonym. — Quercus cortex, B. P.; cortex quercus, P. G.; ecorce de chene, Fr.; eichenrinde, G. Habitat. — North America, in woods. Description. — In nearly flat pieces, 2 to 10 mm. thick; externally 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, 0 to 11 per cent.; 2, a bitter principle, quercin; 3, resin; 4, a sugar, quercite. Dose.— H., gss-i, (15-30); C, Ji-ii, (30-60); Sh. & Sw., 3i-ii, (4-8); D., gr.x-xxx, (.6-2). Preparation. — Fluidextractum Quercus. — II., Jss, (15); D., nT,15, (1). 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 i;>oultices, infusions, and decoctions, as an astringent. It is administered internally 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. Catechu. Catechu. (B. P., P. G.) Synonym. — Catechu nigrum, cutch, E.; cachou de pt'gu, Fr. ; katechu, pegu- catechu, G. Gambir. Gambir. (U. S. P.) [To replace Catechu, Pharm. 1890.] Synonym. — Catechu, B. P., P. G.; pale catechu, catechu pallidum, terra japo- nica, E.; gambir cubique, Fr. ; gambir, G. A dried extract prepared from decoctions of the leaves and twigs of Ourou- paria Gambir (Hunter) Baillon (Fam. Rubiacew). Description. — Usually in cubical or rectangular pieces from 20 to 30 mm. in diameter; externally pale grayish-brown to reddish-brown, more or less dull and porous; friable; internally of a light brown or dull earthy color; inodorous; taste bitterish and very astringent. Constituents. — 1, catechutannic acid (40 per cent.) is the active principle; it is converted into the isomeric inactive catechuic acid, or catechin (C21H20O9-r- 5 HzO), 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., gss-i, (15-30); C, 51-ii, (30-60); Sh. & Sw., 3i-ii, (4-8); D., gr.v-xxx, (.3-2). PREPARATIONS. Tinctura Catechu. (B. P.) Dose.— H. & C, gi-ii, (30-60); Foals, Calves and Sheep, §ss-i, (15-30); D., 3ss-ii, (2-8). Pulvis Catechu Compositus. Kino, Rhatany and Catechu. (B. P.) Dose. — Same as catechu. Tinctura Gambir Composita. Compound Tincture of Gambir. (U. S. P.) Gambir (a species of catechu), 50; saigon cinnamon, 25; alcohol to make 1000. 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 kino 423 gruel. The powder, or an infusion of any strength, may be applied ex- ternally. 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 solubility, and is a useful remedy in diarrhea, particularly in that of a watery or serous nature. It is frequently prescribed in this disorder with other synergistic agents, as opium, ginger and chalk. For diarrhea in horses, cattle, sheep or calves. Cretae praeparatae. Pulveris gambir. Pulveris zingiberis aa oili. Pulveris opii 5vi. (1) M. et divide in chartulas No. viii. Sig. Give one powder 3 times daily in boiled flour gruel to horses. (2) M. et divide in chartulas No. vi. Sig. Give one powder in flour gruel 3 times daily to cattle. (3) M. et divide in chartulas No. x. Sig. Give one powder 3 times daily in flour gruel to calves or sheep. The compound tincture of gambir with laudanum is an equally suit- able 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 membrane, 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. Kixo. Kino. (U. S. & B. P.) The spontaneously dried juice of Pterocarpus Marsupium Roxburgh (Fam. Leguminosae). Habitat. — East Indies. Kino, indigenous in the West Indies, is occasionally imported here. Properties. — In small, brittle angular fragments, usually considerably less than 15 mm. in diameter, varying in color from dark reddish-brown to reddish-black; inodorous; taste very astringent; when masticated it colors the saliva somewhat pink. The powder is of a dark brick-red color. Partly soluble in cold water, solu- ble in alcohol. Constituents. — The most important is (1) kinotannic acid (CsHjsOs, 75 per cent.), resembling catechu-tannic acid, but not identical with it. There are also: 2, kinoin, a crystalline, neutral substance; 3, pyrocatechin, CfiH4(OH)2; 4, gum; 5, pectin; 6, kinored, formed by oxidation from kinotannic acid. Incompatibles. — Mineral acids, metallic salts, strong solutions of alkaloids, alkalies, and gelatin. Dose.— H., gss-i, (15-30); C, 3i-ii, (30-60); Sh. & Sw., 3i-ii, (4-8); D., gr.v-xxx, (.3-2). PREPARATIONS. Tinctura Kino. Tincture of Kino. (U. S. & B. P.) Prepared by maceration of kino, 100; in boiling water with agitation and addition, after cooling, of boiled water and alcohol to make 100. (U. S. P.) 424 VEGETABLE DRUGS Dose.— H. & O, 3i-H, (30-60); Foals, Calves and Sheep, 3ss-i, (15-80); D., 3ss-ii, (2-8). Pulvis Kino Compositus. Compound Powder of Kino. (B. P.) (Pulv. cinnamon, 4 grs.; kino, 15 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 catchu. The gum and pectin contained in kino render 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. Hamamelidis Folia et Cortex. Hamamelis Leaves. (B. P.) Synonym. — Witch-hazel. The leaves of Hamamelis virginiana LinnS (Fam. Hamamelidaceae), col- lected in autumn. Description. — Short, petiolate, about 10 cm. long, obovate or oval, slightly heart-shaped and oblique at the base, sinuate-toothed, thickish nearly smooth; inodorous; taste astringent and bitter. Hamamelidis Cortex. Hamamelis Bark. The bark and twigs of Hamamelis virginiana Linne (Fam. Hamamelidacew) . Constituents. — The most important principle is (1) tannic acid, 8 per cent.; there are also: (2) a bitter substance, and (3) a resin. PREPARATIONS. Fluidextracium HamameUdis Foliorum. Fluidextract of Hamamelis Leaves. Made by maceration and percolation with alcohol, glycerin and water, and evaporation, so that 1 milr= 1 Gm. of the crude drug. Dose.— H. & C, J5i-ii, (30-60) ; D., 3ss-ii, (2-8). Extractum Hamamelidis Liquidum. (B. P.) Dose. — Same as fluidextract. Aqua Hamamelidis. 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. Unyuentum Hamamelidis. (B. P.) Action and Uses. — Hamamelis is apparently physiologically inert, as shown by experiments on healthy animals. It nevertheless possesses con- siderable 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 emplo}red. Internally hamamelis is useful in diarrhea and mucous discharges. It arrests hemorrhage from the uterus, kidneys, lungs and digestive tract; sometimes in a surprising manner. The fluidextract is a successful hemostatic in bleeding from the bladder or rectum (piles) wrhen injected (1-8) into these parts. It lessens sore- ness 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 takes their place — are often more efficient externally and internally (in the same doses) than the official fluidextract. SOAP LINIMENT 425 SECTION XIII.— VEGETABLE DEMULCENTS. Oleum Oliv.e. Olive Oil. (U. S. & B. P.) Synonym. — Sweet oil, E.; oleum olivarum, P. G.; huile d'olive, Fr.; oilvendl, G. A fixed oil obtained from the ripe fruit of Oleo europoea Linne (Fam. Olea- ceae). It should be kept in well stoppered bottles in a cool place. Habitat. — Southern Europe and Asia. Properties. — A pale yellow, or light greenish-yellow, oily liquid, having a slightly peculiar odor, and taste, with a faintly acrid after-taste. Spec. gr. 0.910 to 0.915. Slightly soluble in alcohol, but miscible with ether, chloroform, or car- bon disulphide. Very frequently adulterated with cotton seed, or other seed oils, which probably are of equal medicinal value, however. Constituents.— I, olein, CSH5 (C1SH3302)3, 72 per cent., a fluid oil, a combina- tion of oleic acid (HC1SH3302) and glyceryl; 2, palmitin, CaH^CwI^Oa),, about 28 per cent., a combination of palmitic acid (HC,uH3,02) and glyceryl; and (3) arachin, C20H,to02. Dose.— Laxative.— H. & C, Oi-ii, (500-1000); D., 3ii-iv, (60-120). Oleum Gossypii Semixis. Cotton Seed Oil. (U. S. P.) A fixed oil obtained from the seed of Gossypium herbaceum Linne and of other species of Gossypium (Fam. Malvaceae). Habitat. — S. United States and other semi-tropical countries; cultivated. Properties. — A pale yellow, oily liquid, odorless or nearly odorless, and having a bland taste. Spec. gr. 0.915 to 0.921. Slightly soluble in alcohol but miscible with ether, chloroform, or carbon 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 massage 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 % pint, or more, of olive oil is serviceable in softening hard fecal masses in dogs, and should be fol- lowed 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 membrane in sub- acute or chronic bronchitis, and is of considerable benefit in these dis- orders, but inferior to cod liver oil or linseed oil. Olive oil is an efficient demulcent in inflamed conditions of the ailmentary tract, and in poisoning by irritants. Large quantities form soap-like masses, — with the alkaline intestinal juices, — which have been mistaken for gall stones. Cotton seed oil is of equal therapeutic value wTith sweet oil. Sapo. Soap. Synonym. — Sapo duras, B. P.; hard soap, white castile soap, E.; savon medicinal, Fr.; medizinische seife, G. Derivation. — Soap is made by boiling olive oil with a solution of caustic soda, C3H3(C18H3302)3 (olein) +3 NaOH=3 NaC^HasOj (sodium oleate or soap) -f C3H5(OH)3 (glycerin). Properties. — A white, or whitish solid, in the form of bars, hard, yet easily cut when fresh; or as a fine, yellowish-white powder, 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. 426 VEGETABLE DRUGS Soap, 60; camphor, 45; oil of rosemary, 10; alcohol, 700; 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 evaporation. Sapo Mollis. Soft Soap. (U. S. & B. P.) Synonym.— Potassium oleate, sapo viridis, green soap, E.; savon mou, savon vert, Fr. ; kali seife, griine seife, G. A soap prepared from potassa and a fixed oil. Derivation. — Dissolve potassium hydroxide, 86; in water, 100; by heat, and add cottonseed oil, 430; stir and heat till it froths from boiling, and add alcohol, 50. Withdraw heat and stir till paste forms. Test for alkalinity and add water to make 1000. (U. S. P.) Properties. — A soft unctuous, yellowish-white to brownish-yellow mass, having a slight characteristic odor and an alkaline taste. Soluble in about 5 parts of hot water and in 2 parts of alcohol. 1'REPARATION. Linimentum Saponis Mollis. Liniment of Soft Soap. (U. S. P.) Synonym. — Tinctura saponis viridis. 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 color to rosin. Super-fatted soaps are of neutral reaction and unirritating. They are used as a basis for medicinal soaps containing tar, carbolic acid, etc. Action and Uses. — Most soaps are alkaline. Soap is a detergent or cleansing agent. The lather mechanically removes dirt, while the alka- linity assists in the removal of grease, dead epidermis, and sebaceous matter from the skin. The caustic alkali contained in soap relieves itch- ing 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. This liniment or, as it is commonly called, tincture of green soap, is as powerful a disin- fectant as tincture of iodine, 5% phenol, or 1 to 500 mercuric chloride, in killing common pathogenic bacteria within one minute. So it is an admirable hand disinfectant. 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 prelimi- nary 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 advisable to combine oil of turpentine or water of ammonia with it. If an anodyne effect is indicated, tincture of aconite or opium is added. Chafing of the skin produced by harness, should be treated by wash- GLYCERIN 427 ing the skin with soap and water, and then by dusting with zinc 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 employed 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 plasters, 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 decomposed by these salts, and insoluble soaps, i. e., calcium and magnesium stcarate, 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. A piece of soap, when shaped by the hands into a conical form, dipped an instant into water, and introduced into the rectum, is one of the best agents for moving the bowels in the case of puppies and all young animals. Enemata of soap suds are in every day use. A mixture of sapo mollis, molasses, and water, in varying proportions, is a more efficient preparation. Oil of turpentine may be added in flatulence. Glycerixum. Glycerin. C3H5(OH), (U. S. & B. P.) Synonym.— Glycerine, glycerole, E.; glycerine, Fr.; glycerin, oelsuss, G.; glycerinum, P. G. Derivation. — A liquid obtained by the hydrolysis of vegetable or animal fats or fixed oils, purified by distillation, and containing not less than 95 per cent, of trihydric alcohol. It occurs as a by-product in the manufacture of soap, but is made chiefly from palm oil by the action of superheated steam at a temperature of about 600° F. Properties. — A clear, colorless liquid, of a thick, syrupy consistence, having not more than a slight, characteristic odor which is neither harsh nor disagreeable, sweet to the taste and producing a sensation of warmth in the mouth. When exposed to the air it absorbs moisture. Spec. gr. not less than 1.249. Miscible with water or alcohol; insoluble in ether, chloroform, carbon disulphide, benzin, benzol, and fixed and volatile oils. Reaction neutral. Glycerin is a solvent for alkaloids, digestive ferments, fixed alkalies, bromine, iodine, tannin, extracts, salicin, borax, boric acid, phenol, etc. Dose.— H. & C, Si, (30); D., 3ss-i, (2-4). PREPARATIONS. Glyceritum Amyli. Glycerite of Starch. (U. S. & B. P.) Starch, 10; water, 10; glycerin, 80. Made by solution with heat. There are also official glycerites of phenol (1-5), of tannic acid (1-4), of boro- glycerin (31 per cent.) and of hydrastis. Suppositoria Glycerini. Suppositories of Glycerin. (U. S. P.) Glycerin, 30 Gm.; monohydrated sodium carbonate, 0.5 Gra.; stearic acid, 2.0 Gm.; water, 5 mils. Made *by solution with heat and moulded into ten sup- positories. Action External. — Glycerin is hygroscopic, emollient, sometimes 428 VEGETABLE DRUGS parasiticidal, and antiseptic. It does not evaporate or become rancid. The chief medicinal value of glycerin depends upon its affinity for water, so that (in solution) it keeps moist the surface to which it is ap- plied. Pure glycerin is, however, slightly irritant to the skin and may cause some inflammation of raw surfaces and mucous membranes on account of withdrawal of water from the tissues. It should therefore be diluted with water for most therapeutic purposes. Action Internal. — Glycerin is absorbed and oxidized in the body, and possesses some value as a carbohydrous food. It may give rise to a substance in the urine which reduces cupric oxide and renders the sugar test positive. It is somewhat antiseptic in the digestive tract, and appears to inhibit the formation of glycogen in the liver in some cases of glycosuria. Large doses are irritant and slightly purgative. Enormous quantities cause poisoning in animals, with the production of hemoglobi- nuria, glomerulonephritis, muscular weakness, dryness of the mucous membranes, restlessness, collapse, tremor, convulsions, coma and death. Uses External. — These are manifold. It is largely employed in lotions, ointments, and as a vehicle for the substances of which it is a solvent. Glycerite of starch is a successful remedy for rough, dry skin, and scaly eczema. Glycerite of phenol is an appropriate application for fetid sores and ulcers, and, diluted with an equal part of glycerin, will destroy the acari of mange and scab. It should be used with caution to prevent poisoning. Glycerite of boroglvcerin is an excellent preparation for the treatment of aphthous stomatitis and thrush. In dryness of the meatus, and in canker of the ear (otorrhea) in dogs, the following mix- ture is recommended: Tincturae iodi 5i. Glycerini 5ss. M. S. Drop in ear. (Furnish medicine dropper.) Scratches and cracked heels of horses, fissured and excoriated sur- faces, and erythema, are successfully treated with the following prescrip- tion: Tine, opii 5i- Liq. plumbi subacetat giv. Glycerini ^n. Aquae ad jfviii. M. S. Apply externally. Uses Internal. — Glycerin is employed as an excipient for balls and pills, and as a vehicle for nauseous and irritating drugs. It is not a valuable remedy for internal use, but is sometimes given with the food to prevent intestinal fermentation and relieve flatulence. It may prove curative in cases of glycosuria ; and in trichinosis when given by the mouth, and in high rectal injections after active purgation. Glycerin is a useful addition to cough mixtures in moistening and soothing the GLYCYRRHIZA 429 throat, and in not interfering with digestion. When injected into the rectum in quantities of 3*v-vi f°r horses, or §ss-i for dogs, it often causes prompt evacuation of the lower bowel. The suppositories may be employed in canine practice. Glycyrrhiza. Glycyrrhiza. Synonym. — Glycyrrhiza? radix, B. P.; radix liquiritiae, P. G.; liquorice or licorice root, E.; reglisse, hois de reglisse, boix doux, racine douce, Fr. ; siiss- holz, G. The dried rhizome and roots of Glycyrrhiza glabra typica Regel et Herder, known in commerce as Spanish licorice, or of Glycyrrhiza glabra ylandulifera Regel et Herder, known in commerce as Russian licorice (Fam. Lcguminos(C). Habitat. — S. Europe and W. Asia; cultivated. Description. — Spanish Licorice (also known as Italian, Levant, Persian, Turk- ish, or Arabian Licorice). — Nearly cylindrical, upper portion more or less knotty; usually in pieces from 14 to 20 cm. or more in length and from 5 to 20 mm. in thickness; externally yellowish-brown or dark brown, longitudinally wrinkled; internally lemon-yellow; odor distinctive; taste sweetish and slightly acrid. Russian Licorice. — Nearly cylindrical, somewhat tapering, sometimes split longitudinally, from 15 to 30 cm. in length and from 1 to 5 cm. in diameter; when deprived of the outer corky layer, it is externally pale-yellow; internally lemon- yellow; odor distinct; taste sweetish. Powdered glycyrrhiza is pale brownish-yellow (Spanish licorice) or pale yel- low (Russian licorice). Constituents. — 1, a yellow, sweet, amorphous glucoside, glycyrrhizin (C24H3COp), about 6 per cent., which with acids yields a bitter substance, glycyr- rhetin, and glucose; 2, glyeyramin; 3, asparagin, about 3 per cent.; 4, an acrid resin; 5, starch; 6, glucose. PREPARATIONS. Fluide.rtractum Glycyrrhiza^ Fluidextract of Glycyrrhiza. (U. S. P.) Made by maceration and percolation with chloroform water, and evaporation, with addition of alcohol and water, so that 1 mil = l Gm. of the crude drug. Dose of the root or fluidextract is unimportant. Extractum Glycyrrhiza) Liquidum. (B. P.) Dose unimportant. Pulvis Clyryrrhizir Compusitus. (U. S. P.) (See p. 411.) Action and Uses. — Licorice is demulcent and slightly laxative, The powdered root is employed as an excipient in making electuaries, since it is soothing to the throat. It is alsoi used as an excipient in the prepara- tion of balls, and more or less successfully conceals, in the form of the fluidextract, the taste of aloes, cascara sagrada, ammonium chloride, tur- pentine, hyoscyamus and quinine sulphate. Lixum. Linseed. (U. S. & B. P.) Synonym. — Flaxseed, E.; semence de lin, Fr. ; leinsamen, flachssamen, G. ; semen lini, P. G. The ripe seed of Linum usitatissimum Linne* (Fam. Linaceae). Habitat. — Most temperate climates. Description. — Ovate or oblong-lanceolate,, flattened, 3 or 5 mm. long, obliquely pointed at one end; externally chestnut-brown, very smooth and glossy, covered with transparent, mucilaginous outer wall which swells in water; odor slight; taste mucilaginous, oily. Ground linseed (linseed meal or flaxseed meal) should be recently prepared and free from unpleasant or rancid odor. It is a grayish-yellow powder con- taining brownish fragments. Constituents. — 1, linseed oil, 30 to 35 per cent, in the embryo; 2, gum, 15 per cent, in the epidermis; 3, proteids, 25 per cent.; 4, a trace of amygdalin. 430 VEGETABLE DRUGS Action and Uses. — Linseed is a food. Oil cake or linseed cake from iwhich the oil has been expressed is exceedingly rich in protein (25-30 per cent.), and is also richer in fat (10 per cent.) than most foods. Cottonseed meal, which contains considerably more protein and fat, is more frequently employed in the United States. Gruel made from crushed linseed meal cake, or linseed meal, is useful as a restorative in all animals recovering from acute and debilitating diseases. The cake (1 lb.), or a pint of cottonseed meal per diem, is a good addition to the ordinary fodder for horses suffering from malnutrition, with rough staring coats and dry skin, and for those affected with "broken wind." Gruel of linseed meal or cake is also serviceable for calves or lambs when reared on skimmed milk or other poor food. Linseed tea, made by steeping 1 part of whole linseed in 20 parts by weight, of boiling water, for 1-4 hours, followed by straining, is a valuable demulcent preparation in pharyngitis, bronchitis, gastro-enteritis, and is possibly useful in acute cystitis and nephritis. It may be given in any amount which an animal will take voluntarily. The mucilage contained in linseed tea cannot be carried through the blood and eliminated by the kidneys, so that it must act by virtue of the water contained in it and perhaps by some intrinsic diuretic property. The addition of a few drams of gum arabic to the quart of linseed tea will improve the demulcent action. Linseed, linseed meal or farina lini is the best substance to use in the preparation of poultices. It should be mixed with an equal quantity of bran, when the poultice is applied directly to the part. If the poultice is enclosed in a bag, the outside should be oiled to prevent its sticking to the skin. Linseed meal, mixed with an equal amount of molasses, forms a common excipient for ball masses. Linseed tea, made thicker than usual, is a good local applica- tion in irritation of the rectum, or vagina. Acacia. Acacia. Synonym. — Acaciae gummi, B. P.; gum arabic, E.; gomme arabique, Fr. ; arabisches gummi, G. A gummy exudation of Acacia Senegal Willdenow and of other African species of Acacia (Fam. Lemuminosae). Habitat.— -N., E., and W. Africa. Properties. — In ovoid, more or less spheroidal tears, or in broken, angular fragments from 2 to 30 mm. in diameter, varying from white or yellowish-white to light amber-colored; translucent; very brittle; fractured surface glass-like, sometimes iridescent; nearly inodorous; taste insipid, mucilaginous. Insoluble in alcohol; slowly and almost completely soluble in twice its weight of water, forming a mucilaginous liquid, which has a slight, characteristic odor and is acid to litmus. Constituents.— Arabin or arabic acid (Ci2H22On), in combination with about 3 per cent, of magnesium, potassium and calcium. Incompatibles— Alcohol, ferric salts, lead subacetate, borax, and sulphuric acid. Preparations.— Mucilago acacias, U. S. & B. P. (35 per cent., U. S. P.), and syrupus acaciae, U. S. P. (10 per cent.). Dose. — Ad lib. Action and Uses. — Gum arabic is but slightly nutritious. It is a use- ful demulcent in covering and protecting inflamed mucous membranes of TRAGACANTH 431 the upper respiratory and digestive tracts. It may be given freely in water, but large quantities may undergo fermentation and cause indi- gestion and diarrhea. A 10 per cent, aqueous solution is sometimes injected into the bladder, vagina or rectum in inflammation t>f these parts. Acacia is chiefly of value in medicine for the preparation of mixtures, emulsions, pills, balls and electuaries. About oiii of mucilago acacia are required to suspend § i. of oil or resinous tincture. Acacia is sometimes prescribed in genito-urinary irritation. Animals will voluntarily drink aqueous solutions. Tragacaxtha. Tragacanth. (U. S. & B. P.) Synonym. — Gomme adragante, Fr.; gomma adraganta, G. A spontaneously dried gummy exudation from the stems of Astragalus gum- mifer Labilliardiere, or from other Asiatic species of Astragalus (Fam. Legumi- nosae). Habitat. — Asia Minor. Properties. — In flattened, lamellated fragments varying from ribbon-shaped bands to long and linear pieces, which may be either straight or spirally twisted, and from 0.5 to 2.5 mm. in thickness; whitish to light brown in color, trans- lucent and horny; fracture short; rendered more easily pulverizable by heating to 50° C.j inodorous; taste insipid, mucilaginous. Add 1 Gm. of tragacanth to 50 mils of distilled water; it swells and forms a smooth, nearly uniform, stiff, opalescent mucilage free from cellular fragments. Constituents. — 1, arabin, 53.3 per cent., not identical with arabin of acacia, however; 2, bassorin (CoHioOo), 33 per cent., a gum, swells up with water but does not dissolve; 3, starch; 4, ash. PREPARATION. Mucilago Tragacanthce. Mucilage of Tragacanth. (U. S. & B. P.) Tragacanth, 6; glycerin, 18; water to make 100. (U. S.) Dose. — Ad. lib. Action and Uses. — Tragacanth is a demulcent, but is chiefly used in the preparation of mixtures and emulsions to suspend oils, resins and insoluble powTders. Althaea. Althaea. (U. S. P.) Synonym. — Marshmallow root, E.; racine de guimauve, Fr. ; altheewurzel, eibischwurzel, G.; radix althaeae, P. G. The root of Althaea officinalis Linne (Fam. Malvaceae), deprived of the brown, corky layer and small roots, and carefully dried. Habitat. — N. and W. Asia and Europe. Cultivated in Europe, and natural- ized in E. United States and Australia, growing in salt marshes. Constituents. — 1, bassorin, 35 per cent.; 2, pectin, 10 per cent.; 3, asparagin, 1 per cent.; 4, sugar, 8 per cent. Action and Uses. — Althaea is occasionally employed as a demulcent in irritable conditions of the digestive canal, and as a vehicle in the form of syrup. Saccharum. Sugar. C^H^On- (U. S. P.) Synonym. — Saccharum purificatum, B. P. ; sucrose, refined sugar, cane sugar, E.; sucre, sucre de canne, Fr.; zucker, rohrzucker, G. The refined sugar obtained from Saccharum officinarum Linne, and from Beta vulgaris Linne var. Ropa Dumort (Fam. Chenopodiaceae), and from other sources. Habitat. — Indigenous in S. Asia, but cultivated in many tropical and sub- tropical countries. 432 VEGETABLE DRUGS Properties. — White, hard, dry crystals, or as a white, crystalline powder, odorless, and having a sweet taste. Permanent in the air. Soluble in 0.5 part of water; in 0.2 part of boiling water, and in 170 parts of alcohol. Insoluble in ether or chloroform. PREPARATION. Syrupus. Syrup. (U. S. P.) Synonym. — Simple syrup, E.; sirop de sucre, Fr. ; weisser syrup, G. ; syrupus simplex, P. G. Made by solution of sugar, 850; with heat in distilled water, straining, and addition of distilled water to make 1000. (U. S. P.) Molasses. (Non-official.) Synonym. — Theriaca, B. P.; sacchari faex, syrupus fuscus, treacle, E.; m61asse, Fr. ; melasse, G. The brown, uncrystallizable syrup that drains away from the crystals of raw sugar in the refining process. Action and Uses. — Sugar, syrup and molasses are demulcents, and are sometimes employed in medicated syrup or electuary, for their sooth- ing action on the throat in catarrh of the upper air passages. They are liable to ferment in the alimentary canal if given continuously, with the production of acidity and indigestion, so that they are not suitable for general use as demulcents. Sugar, syrup and molasses are mainly useful as vehicles, corrigents, preservatives, and excipients in pharmacy. Sugar is utilized as a constituent of powders, and syrup and molasses are excip- ients in the preparation of balls and electuaries. Sugar increases the solubility of calcium salts (see Syrupus Calcis, p. 126) and protects fer- rous compounds from oxidation (see Ferri Carb. Sacch., p. 153). Sugar is an antiseptic, and, in syrup, prevents the fermentation of active medicinal substances. Brown sugar and molasses are laxative (withdraw water from the tissues), in large doses, and are prescribed in veterinary practice, with ginger, to aid the action of salts on cattle (Oss-i) and sheep (Jii-vi). (See Epsom salt, p. 131.) Molasses and milk, equal parts, form an excellent enema for stimulating peristalsis, 4 to 6 ounces of each for dogs, and 2 quarts of each for horses or cows. SECTION XIV.— VEGETABLE DRUGS KILLING PARASITES. Class 1 . — Used to Destroy Tape-Worms. Aspidium. Aspidium. (U. S. P.) Synonym. — Filix mas, B. P.; radix filicis maris, male fern, male shield fern, E.; fougere male, Fr.; wurmfarn, waldfarn, johanniswurzel, G. ; rhizoma filicis, P. G. The rhizome and stipes of Dryopteris Filix-mas (Linne) Schott, or of Dryop- teris marginalis (Linne) Asa Gray (Fam. Polypodiacece), collected in the autumn, freed from the roots and dead portions of rhizome and stipes and dried at a temperature not exceeding 70° C. Habitat. — D. filix-mas, Europe; D. marginalis, U. S. Description. — Usually with the blackish-brown outer layers removed; rhi- zome 1 to 3 cm. in thickness, cylindraceous and nearly straight, or curved and tapering toward one end, usually split longitudinally, roughly scarred with re- mains of the stipe-bases, or bearing several coarse longitudinal ridges and grooves; odor slight; taste sweetish, astringent, bitter, acrid. The chaff, together with the dead portions of the rhizome and stipes, should ASPIDIUM 433 be removed, and only such portions used as have retained their internal green color. Powdered aspidium should be freshly prepared and have a bright green color. Constituents. — Aspidium contains: (1) filicic acid (C35H42013), a white, amorphous or crystalline substance, and a series of bodies, as aspidin, aspidinin, flavaspadic acid, albaspidin, aspidol, filmaron and flavaspidinin. It is not known to which of the bodies the action of aspidium may be attributed. There are also: (2) a fixed oil, 6 per cent.; (3) resin, 4 per cent.; (4) filicin (C35H4o012), a crys- talline principle soluble in chloroform, benzol, fixed and volatile oils; (5) filix-red, a coloring matter; (6) a small quantity of a volatile oil. Dose.— H. & C, 5v-vi, (150-180); Sh., f,ii-iv, (60-120); Lambs, 3i-ii, (4-8); D. & C, 3ss-i, (15-30). PREPARATION. Oleoresina Aspidii. Oleoresin of Aspidium. (U. S. P.) Made by percolation with ether, distillation and evaporation of the ether. Dose (also of the extractum filicis liquidum, B. P.). — H. & C, oiii-vi, (12-24) ; Sh. & Sw., 5i-ii, (4-8); D. & C, nixv-5i, (1-4). Action and Uses. — Aspidium is chiefly of value in veterinary medi- cine as a taeniacide or agent destroying tape-worms, particularly those inhabiting dogs. Large quantities of the drug cause hemorrhagic, gastro- enteritis, tremors, weakness, stupor, coma, acute nephritis and cystitis. Six drams of the oleoresin have proved fatal in man and sheep; five drams in a medium-sized dog; and three ounces in the case of a cow. Aspidium must never be given with oil, which aids its absorption. Dogs should be fasted 24 hours or fed on a little milk; then the oleoresin should be administered, and the dose repeated in 3 hours. After the expiration of 12 hours from the administration of the first dose, a purga- tive quantity of castor oil is to be exhibited. An injection of salt and water assists the expulsion of segments of taenia from the rectum. If the head of the taenia is not expelled the treatment may be repeated in three days or a week. The oleoresin may be flavored with a few drops of oil of peppermint, and is often combined with a small dose of areca nut (gr.i to the lb. live weight) in emulsion with mucilage of tragacanth, or with fluid extract of kousso, 3i to 3ii. The oleoresin may also be ex- hibited in pills or capsules. For setter dog with tapeworm. Oleoresinae aspidii 3i. Fluidextracti arecae seminis 5iii. Mucilaginis acaciae *"• Olei menthae piperita? T^v. M. Sig. Give one-half in one dose. It is on the whole the best agent against the tapeworms of dogs, including Taenia serrata, T. marginata, T. ccenurus and T. echinococcus. Male fern is not efficient against round worms in dogs and is dangerous except for strong cats and then not more than a mil should be given. Oleo-resin of male fern has a decided action in destroying the flukes in the liver, gall bladder, and bile passages of sheep in distomiasis. Four doses of 5 grams each should be given 24 to 48 hours apart and, if liver cirrhosis has not set in, recovery may ensue. Two ounces each of 434 VEGETABLE DRUGS creolin, Peruvian balsam and oleoresin of male fern to the pint of alcohol are useful as a lotion in the treatment of canine follicular mange. Areca. (Non-official.) Synonym. — Areca-nut, betal-nut, E.; noix d'areque, Fr.; arecanuss, G. The seed of Areca Catechu (nat. ord. Palmaceae). Habitat. — India, Coromandel and Malabar coasts; also in warm parts of Asia. Description. — The seeds resemble nutmeg in size, shape and color. They yield a brown powder, partially soluble in water and alcohol. The taste is astringent. Constituents. — 1, the active principle is the liquid alkaloid, arccoline (C8H13N02). Arecoline hydrobromide (CsH13N02HBr) is the commercial salt, occurring in colorless, anhydrous needle-shaped prisms, soluble in alcohol and water. H. & C, gr.%-11/^, (0.04-0.09); average dose, gr.i, (0.06), subcutaneously. Repeat if necessary at half hour intervals for 2 or 3 doses. There are three other alkaloids, arecaine, aracaidine and guvachine, which are of no medicinal value. Red tannic acid. An oil. Dose— Areca Nut. — H., 5ss-i, (15-30); Lamb, 3i, (4); D., gr.ii for each lb. of live weight, or gr.xv-5ii, (1-8) ; Fowl (against A. gibbosa), gr.x-xl in pill. Action and Uses.- — Areca nut is an anthelmintic more commonly- classed as a taeniacide, but capable of killing round-worms satisfactorily. It acts more successfully as a vermicide in dogs than in the case of the larger animals. Areca nut is an astringent in small doses, but large amounts induce catharsis. When the drug is used as an anthelmintic the animal should be deprived of food for 24 hours previous to its admin- istration. The powder is given to dogs in milk, frequently with oleoresin of male fern in small quantity, or mixed with butter, or in pills or cap- sules, as it is rather irritating to the stomach and may cause vomiting. Areca nut should be freshly ground. It is not a wholly safe anthelmintic for weak animals, puppies or cats. If purgation does not follow the use of areca nut within a short time, a dose of castor oil is indicated. The fluidextract is a more convenient preparation. Fluidextracti seminis arecae 3ss. Oleoresinae aspidii 5i. Mucilaginis acacia? 3ii. Olei menthae piperitae Tit v. M. Sig. Give one-half to dog with tape or round worms. I* Seminis arecae Ziv. Sig. Teaspoonful (5i) in milk for lambs with worms. Seminis arecae Ibi. Sig. 2 tablespoonfuls (51) on feed 3 times daily for horses with tapeworm. 1 tablespoonful once daily on feed for colts with round worms. Arecoline has not been studied in scientific detail as to its physio- logical actions, but in general it resembles pilocarpine in stimulating the ends of the secretory nerves, the ends of the motor nerves of smooth muscle, and the ends of the third nerve in the eye. Thus arecoline is directly opposed by atropine which depresses these structures. It causes KAMALA 435 more salivation than pilocarpine, beginning in the horse in 5 minutes, after injection under the skin, and continuing for an hour with champing of the jaws, and flow from the mouth in some cases. It contracts the pupil. It stimulates the secretions of sweat, saliva, and succus entericus. It moreover stimulates peristaltic action, and is one of the quickly acting purgatives given under the skin. Like pilocarpine arecoline increases secretion and constriction of the bronchi, and leads to dyspnea, especially in animals with asthma or heaves. While sometimes causing considerable nausea and colic yet arecoline is not so powerful or poisonous as eserine and barium chloride and, as it can be given subcutaneously, is often pre- ferred by practitioners to the aforesaid drugs. In large doses it dimin- ishes the force and frequency of the pulse and in lethal doses paralyzes the heart. The pulse is slow and weak, the breathing is shallow and slow, there is cyanosis, dyspnea, sweating and salivation, and death from res- piratory failure. Large doses cause muscular spasms. Atropine should be given promptly under the skin in arecoline poisoning and may save animals after otherwise lethal doses (horses, 13 grs. subcutaneously) of arecoline. Arecoline is indicated in mild colics, indigestion, flatulent colic and impacted colon in horses. Also in acute laminitis and azoturia of horses. It should be given once daily in laminitis and is a particularly success- ful remedy. In severe impactions and great distention, obstruction and inflammation of the bowels, it is contraindicated. Also in the weak and pregnant, in spasmodic colic, and in respiratory disorders. In constipa- tion of cattle it is of value. Its cathartic action usually begins within 15 minutes. One per cent, solutions of arecoline hydrobromide are some- times used to contract the pupil and reduce intraocular tension, and to offset the action of atropine. It may be used in place of eserine or pilo- carpine as a myotic. Kamala. Kamala. (Non-official.) Synonym. — Rottlera, kameela, kamola, Fr., G. The glands and hairs from the capsules of Mallotus philippinensis (Lamarck) Mueller Arg. (nat. ord. Euphorbiaceae). Habitat. — India, China and the Philippine Islands. Properties. — A granular, mobile, brick-red or brownish-red powder, inodorous, and nearly tasteless; imparting a deep red color to alkaline liquids, alcohol, ether or chloroform, and a pale yellow tinge to boiling water. Constituents. — The chief principle is (1) rottlerin (C22H2oOc), occurring in yellow acicular crystals, soluble in hot alcohol, ether, benzol, and carbon disul- phide. There are also (2) resins, 80 per cent. Dose.— D., oss-ii, (2-8) ; H. & C, 5i, (30). Action and Uses. — Kamala is an anthelmintic. It is employed more frequently as a taeniacide, but will also kill ascarides and oxyurides. Large doses may give rise to nausea and vomiting in dogfs and cats. Kamala is also a purgative, so that it is rarely necessary to employ one after its administration. It should be given in syrup to the fasting ani- mal, and repeated in eight hours if the first dose is not operative by that time. Cusso. Kousso. (Non-official.) Synonym. — Brayera, kooso, kusso, E.; cousso, kousso, Fr.; koso, cusso, kusso, G. ; flores kosso, P. G. 436 VEGETABLE DRUGS The female inflorescence of Hagenia abyssinica (Bruce) Gmelin (nat. ord. Rodaceae). Habitat. — Abyssinia. Description. — In bundles, rolls, or compressed clusters consisting of pannicles about 25 cm. long; the two roundish bracts at the base of each flower, and the four or five obovate, outer sepals are of a reddish color, membranous and veiny; odor slight, fragrant and tea-like; taste bitter, acrid and nauseous. Constituents. — 1, the active principle is kosin or koussin (C31H38O10), a yellow- ish, bitter, crystalline glucoside, soluble in alcohol, chloroform, benzol and ether, but insoluble in water; dose — dogs, gr.x-xl, (.6-2.6) ; 2, a volatile oil; 3, gum; 4, tannic acid; 5, two resins. Dose. — Small dogs, 3ss-i, (2-4); large dogs, ,"*>ii-iv, (8-15). PREPARATION-. Fluidextr actum Cusso. Fluidextract of Kousso. (Non-official.) Synonym. — Extractum brayerae fluidum. Made by maceration and percolation of kousso witli alcohol, and evaporation, so that 1 mil=l Gm. of the crude drug. Dose. — Same as kousso. Action and Uses. — Kousso is an effective taeniacide in dogs and cats. Large doses cause nausea, colicky pains and some catharsis. Kousso i" administered in milk, or as an infusion flavored with peppermint; also in the form of the fluidextract, or glucoside in capsules, to the fasting animal. It should be repeated 3 times, at hour intervals, and followed by a small dose of castor oil if the bowels are not sufficiently relaxed. There is little danger of poisoning even by great quantities of the drug. Granatum. Pomegranate. (U. S. P.) Synonym. — Granati cortex, B. P.; ecorce de grenadier (or de balaustier), Fr.; granatrinde, G.; cortex granati, P. G. The dried bark of the stems and roots of Punica Granatum Linne (Fam. Pumicaceae). Habitat. — India and S. W. Asia. Also cultivated and naturalized in sub- tropical countries. Description. — The stem bark is mostly in somewhat flattened or transversely curved pieces, to some extent in quills, from 2 to 8 cm. in length; bark from 0.5 to 3.5 mm. in thickness; outer surface yellowish to grayish-brown; odor slight; taste astringent, somewhat bitter and nauseous. The root bark is in transversely curved pieces; externally brownish-yellow to dark brown with irregular patches of cork ; internally dark yellow. The powder is yellowish-brown to dark brown; calcium oxalate crystals in rosette aggregates. Constituents. — The active principle is (1) pelletierine (C8Hi3NO), V2 per cent., a colorless, oily, aromatic alkaloid, soluble in alcohol, chloroform and ether; four salts occur in commerce; the tannate, sulphate, hydrobromide and hydro- chloride; the first is more frequently used; dose — D., gr.ii-v, (.12-.3); 2, punico- tannic acid, 22 per cent.; 3, methyl, pseudo, and iso-pelletierine; the latter is a taeniacide. Dose. — Dogs, oss-iss, (2-6). PREPARATIONS. Flmdextractum Granati. (U. S. P.) Dose. — D., oss-i, (2-4). Pelletierince Tannas. (U. S. P.) Dose. — D., gr.iv, (.24). Action and Uses. — Pomegranate is inferior to the foregoing drugs as an anthelmintic, since it is disagreeable and prone to produce vomiting. Pomegranate is an astringent, but, in large doses, acts as an emetic and SANTONICA 437 purgative and has occasioned weakness, colic, dizziness and convulsions. In sufficient amount pelletierine is said to paralyze motor nerves like curare. Granatum is an anthelmintic, chiefly against tape-worm. The decoction (1-8, B. P.) may be employed (with 14 part syrup of ginger) in three doses, at hour intervals, for dogs. The patient should be pre- viously fasted for 24 hours, and castor oil is indicated if purging is not produced by pomegranate. Tannate of pelletierine is a yellowish, astrin- gent-tasting powder, soluble in 12.6 parts of alcohol and 235 parts of water. It is invariably used in human medicine in preference to the crude drug, and should be followed in 2 hours by a dose of castor oil. The use of pelletierine is undesirable in young animals. Pepo. The seed of the ordinary pumpkin is a very efficient and harmless vermicide not only for tapeworm but for round worms as well. Very recently Sollmann experimenting with anthelmintics finds pepo highly efficient, more so than many others generally esteemed, as spigelia. He states that its active principle is solu- ble in water but destroyed by boiling. It has the advantage of being practically harmless for the higher animals. Fresh seed should be used and the coverings removed and an infusion made by rubbing up the remaining part in cold water and the whole allowed to stand for 2 hours and water filtered off and given. Or the rubbed up pulp may be given in an electuary with sugar or syrup. The dose for dogs is 2 ounces of the seed. It should be given after starving for 24 hours and followed by a dose of castor oil in 2 hours. Class 2. — Used to Destroy Round-Worms. Saxtoxica. Santonica. (Non-official.) Synonym. — Levant worm seed, E.; barbotine, semencine, Fr. ; wurmsamen, zitwersamen, G.; flores cinae, P. G. The dried unexpanded flower heads of Artemisia pauciflora Weber (nat. ord. Compositae). Habitat. — Northern middle Europe and Asia. Description. — Heads 2 to 4 mm. long, oblong-ovoid, slightly flattened, obtuse, consisting of an involucre of about 12 to 18 closely imbricated, glandular scales with broad midribs, enclosing 4 or 5 rudimentary florets. Santonica has the appearance of a granular, yellowish-green or greenish-brown, somewhat glossy powder; odor strong, peculiar, somewhat camphoraceous ; taste aromatic and bitter. Constituents. — The active principle is (1) santonin. There is also (2) a vola- tile oil, 2 per cent., consisting chiefly of cineol, C10H18O. Saxtoxixum. Santonin. C15Hlb03. (U. S. & B. P.) Synonym. — Santonine, Fr.; santonin, G. The inner anhydride or lactone of santonic acid obtained from Artemisia pauciflora (Ledebour ) Weber (Fam. Compositae). Derivation. — Made from a mixture of lime and santonica by exhausting with alcohol, evaporation of the latter, and by the addition of acetic acid to the residue. Santonin is obtained by treating an alcoholic solution of the residue with animal charcoal and crystallization. Properties. — Colorless, shining, flattened, rhombic prisms, or as a crystalline powder; odorless and nearly tasteless at first, but afterwards developing a bitter taste; permanent in the air, but turning yellow on exposure to light. Nearly insoluble in cold water; soluble in 43 parts* of alcohol, in 110 parts of ether and 1.7 parts of chloroform. Dose.— D., gr.% to the pound live-weight. It should not be given to puppies under two months old, and a total dose above gr.iv should be avoided for dogs or hogs. H., 3*4 -iv, (1-15). 438 VEGETABLE DRUGS Action and Uses. — Santonin is preferable to santonica. Santonin is chiefly valuable as a parasiticide against round-worms; viz.: A. lum- bricoides of cattle and swine, A. mystax and marginata of cats and dogs, and A. megalocephala of horses. It is ineffective against tapeworm or hookworm but it has a fair degree of efficacy against whipworm (Hall and Foster). Large doses cause poisoning, with the occurrence, in dogs, of nausea and vomiting, weakness, giddiness, muscular trembling, salivation, twitch- ing of the head muscles, rolling of the eyes and grinding of the teeth. Then flexion and extension, and rotation of the head from side to side, are followed by epileptiform convulsions. Between the convulsions momentary contractions of the muscles all over the body may be seen (Cushny). The convulsions are due to stimulation of the cerebral cortex and the parts lying between the cerebral peduncles and medulla. There are — slow pulse, dilated pupils, and rapid respiration, and death ensues from asphyxia. While 5 to 6 grains induce symptoms of poisoning in dogs, Y2 to 1 dram has often failed to produce a fatal result. Santonin is eliminated by the kidneys, increasing their secretion, coloring an acid urine yellow, and an alkaline urine purplish-red, or a bloody hue. Xan- thopsy or yellow sight occurs in man, probably from a specific action on the retina. There is congestion of the heart, lungs and nervous centres observed after death, but no gastro-enteritis. Santonin is very slowly absorbed from the intestines and is oxidized in the tissues and eliminnted as oxysantonins. The best treatment of poisoning consists in emptying the stomach and bowels by emetics and purgatives, and in the use of artificial respiration, cold to the head, inhalations of anesthetics, and ene- mata of chloral, to relieve the convulsions. The administration of san- tonin should be preceded or accompanied by that of a cathartic, as santonin is repugnant, rather than fatal, to worms. The drug may be given to fasting puppies as follows: Hydrarg. chlorid. mitis. Santonini aa gr.iii. M. et div. in capsulas no. iii. Sig. One capsule in morning every third day (for round worms), or for dogs: — Santonini gr.vi. 01. ricini §iss. M. Sig. Give one-third every third day (for round worms). Hogs of 40 lbs. may be given 2 grains each of santonin and calomel on feed every third day as an effective mixture against round worms, but it is more costly and troublesome than oil of chenopodium. Santonin is not so commonly or successfully used in the treatment of round-worms in horses, as turpentine and aloes, creolin, etc. A ball containing oil of santonin and 5i of calomel, or a combination of 5iv santonin and 1 pint of castor oil, are suitable prescriptions for the horse. Santonin is too CHENOPODIUM 439 expensive for general use for horses. Santonin is often remedial in in- continence of urine in young animals, when belladonna fails, and is fre- quently beneficial in the treatment of amaurosis. Class 3. — Used to Expel Round and Hook Worms. Chenopodium:. American Wormseed. (Non-official.) The fruit of Chenopodium ambrosoides, a perennial plant growing in the United States and the West Indies. The seeds contain a volatile oil of an aro- matic and disagreeable odor, to which the action of chenopodium is due. Dose.—U., oii-iii, (8-12) ; D., nliii, (0.2), per 2.2 lb.; Cats, Tltf-iii, (.06-0.18). The drug has been used extensively in the treatment of hookworm in man. Cases of poisoning have occurred with nausea, vomiting, diar- rhea and dysentery, weakness, staggering, paralysis, stupor and coma. Ascaridole the active principle, depresses the muscular tone of the bowels, heart and vagus center. Treatment consists in the use of castor oil, caf- feine and strychnine. The oil is given to dogs on sugar or in capsule. Hall and Foster have found oil of chenopodium the most successful agent against ascarids in dogs, giving 0.2 mils per kilo live weight; and the best remedy in lambs for hookworm in the same dosage. Dogs are starved for 21 hours and given a dose of castor oil before the chenopodium is administered. For mixed infestation with intestinal parasites in dogs (ascarids, hookworm, whipworm) the same investigators discovered that a combina- tion of chloroform and oil of chenopodium in the dose of 0.2 mils per kilo (TT\iii per 2.2 lb.), of each, with castor oil, 30 mils, was the best remedy as follows for 22 lb. dog: Olei chenopodii. Chloroformi aa 3ss. Olei ricini %i. M. S. Give at one dose after starving 24 hours. Against hookworms in dogs, chloroform was found most efficient in the same dose (0.2 per kilo) ; more so than chenopodium. Chenopodium is very efficient against round worms in hogs, giving about 1 minim to every 2 lbs. live-weight on the feed. The hog should be previously fasted for 24 hours and fed individually. The oil of chenopodium is also very successful against hookworm and stomach worms of sheep, given to them in the same dosage (0.2 mils per kilo) as for dogs, in a glass of milk. Spigelia. Pinkroot. Spigelia or pinkroot is the root and rhizome of Spigelia marilandica (Caro- lina pink), growing in the Southern United States. Spigelia is used against round worms and should be followed by a purge. For this purpose it is often given with senna. Round worms, Dogs. Fluidextracti spigelian et sennae oi- Sig. Two teaspoon fuls as dose. It has some toxicity for higher animals and may cause poisoning resembling that of belladonna, as dilatation of the pupils, stupor, coma. It contains an alka- loid, spigeline, a bitter, volatile oil and tannin. 440 VEGETABLE DRUGS Dose.— Dogs (30 lbs.), Fluidextract, 3i, (4.0); unofficial flextr. spijjelioe et sennas, D., 3ii, (8); puppies, 3ss, (2). Class 3. — Used to Destroy Lice. Staphisaoria. Staphisagria. (U. S. P.) Synonym. — Staphisagriae semina, B. P.; stavesacre, E.; staphisaigrie, Fr.; stephauskorner, lausekorner, G. The ripe seeds of Delphinium Staphisagria Linnc (Fam. Ranunculaceae). Habitat. — Shores of Mediterranean; cultivated. Description. — Irregularly triangular, flattened, or somewhat tetrahedral, one side being convex, from 4 to 7 mm. in length and from 3 to 6 mm. in breadth; externally dark brown, becoming lighter with age; odor slight, disagreeable; taste intensely bitter and acrid. Constituents. — 1, the important principle is delphinine (C22H30NO„), a white, poisonous, crystalline alkaloid resembling aconite; soluble in alcohol, chloroform, and ether; 2, delphisine (C27H„oN204) ; s, delphinoidine ^zHogNNCL) ; 4, staphisa- grine (C22H33NO&) ; 5, a fixed oil. Action and Uses. — Powdered staphisagria is employed solely to kill lice (pediculi) in ointment (1-2) with benzoinated lard or vaseline. Creo- lin solutions (3-6 per cent.), tobacco infusions (5-10 per cent.), and oil of anise with sweet oil (1-10 per cent.), are also used for the same pur- pose. The latter mixture is an elegant preparation for pet dogs. The tincture of larkspur (Delphinium consolida), another species of the same genus, is also a very efficient parasiticide against pediculi. It contains 1 part of larkspur seeds to 16 of alcohol. Class 4. — Used to Destroy Fleas. Pyrethrum. Pyrethrum. (U. S. P.) Synonym. — Persian, Caucasian or Dalmatian insect powder. The dried root of Anacyclus Pyrethrum (Linne) De Candolle (Fam. Com- posite). Habitat. — Caucasian Mountains; cultivated in California, U. S. Description. — Somewhat fusiform, nearly simple, 5 to 10 cm. long, 2 to 20 mm. in diameter, externally dark brown or grayish brown, longitudinally wrinkled and somewhat furrowed; odor distinct, taste pungent, very acrid, producing a prompt sialagogue effect. The powder is light to dark brown. Pyrethrum powder is the best parasiticide for fleas (pulicidae). It is used more frequently to kill these parasites on cats and dogs. Pyrethrum is simply dusted over the whole body or is applied in the form of a tincture (1-4), diluted with 10 parts of water. The application of Dalmatian insect powder to kittens and puppies, Or to dogs and cats in enfeebled condition, may be attended with danger unless the powder is brushed off within 10 or 15 minutes after its use. Deaths have occurred in these animals following its free and careless employment. SECTION XV.— VEGETABLE DRUGS STIMULATING UNSTRI ATED MUSCLE, PARTICULARLY THAT OF THE UTERUS. Ergota. Ergot. (U. S. & B. P.) Synonym. — Ergot of rye, spurred rye, E.; ergot de seigle, bl6 cornu, Fr.; mutterkorn, kornmutter, zapfenkorn, G.; secale cornutum, P. G. The sderotium of Claviceps purpurea (Fries) Tulasne (Fam. Hypocreaceae), replacing the grain of rye, Secale cereale Linn6 (nat. ord. Gramineae). Habitat. — Ergot is obtained mainly from Spain and Russia. Description. — Subcylindrical, obscurely three-angled, tapering toward both ACTION OF ERGOT 441 ends but obtuse, somewhat curved, 1.5 to 3 cm. long and about 3 mm. thick; externally purplish-black, longitudinally furrowed on each side, more conspicu- ously on the concave side; fracture short, pinkish or reddish-white; odor pecu- liar,' heavy, increased by trituration with potassium hydroxide T. S. ; taste disagreeable. Constituents.— The active principles of ergot have hitherto been considered to be sphacelinic acid, sphacelotoxin, cornutine, and ergotinic acid but these were not pure and the recent researches of Barger and Dale have shown the true active principles to be the following alkaloids: (1) ergotinine, C35H3!)Or)N,, inert but easilv converted into its hydrate (2) ergotoxine, C35H41OoN5, which is most active; (8) tyramine, OH-C,,H4-CH2CH2NH.>, resembling adrenalin in chemistry and therapeutics; (4) histamine or ergamine which, intravenously, causes great fall of blood pressure from peripheral action, and also contracts the uterus; and (5) isoamylamine (CH3)2CHCH2CH2NH2; (6) an inert oil; (7) saponin bodies. The two latter cause suspension of the active principles in alcohol and water. Dose.— H. & C, gss-i, (15-30) ; Sh. & Sw., 3i-ii, (4-8) ; D., 3ss-i, (2-4). PREPARATION'S. Fluidextractum Ergotw. Fluidextract of Ergot. (U. S. P.) Made by maceration and percolation with diluted alcohol and acetic acid, and evaporation, so that 1 mil=l Gm. of ergot. Dose.— H. & C, 5ss-i, (15-30) ; Sh. & Sw., 3i-ii, (4-8) ; D., 3ss-i, (2-4). Extractum Ergota'. Extract of Ergot. (U. S. & B. P.) Synonym. — Ergotin. Made by evaporation of the fluidextract to a pilular consistence. Dose.— H. & C, gr.xx-oi, (1.3-4); D., gr.ii-x, (.12-.6). (By mouth or sub- cutaneously.) Extractum Ergotw Liquidvm. (B. P.) (3i ergot=5i of preparation.) Dose. — Same as fluidextract. Tinctura Ergotw Ammoniata. (B. P.) (109 gr. to 51.) Dose.— H. & C, 3ss-ii, (15-60) ; Sh. & Sw., 3i-iv, (4-15) ; D., 3ss-ii, (2-8). Injectio Ergotini Hypodermica. (B. P.) (33 per cent.) Dose.— H., 5%-l%, (3-6); D., TTliii-x, (.2-.6). Ergotoxine Phosphate. — D., gr.1/50. Tyramine.— D., gr.%, (0.03), given subcutaneously in shock for raising blood pressure. Ergot deteriorates with age. Both it and its preparations should be fresh. As the essential action of ergot on the circulation is to cause con- traction of the blood vessels until, in poisoning, it finally occludes them, the test for active ergot is the production of gangrene of a cock's comb. The standard is the development of a purple hue in the comb of a rooster from the injection of 0.75 mil of fluidextract per kilo; or 1.87 mg. of ergotoxine. Wood states that the fluidextract loses 10% in strength a month, but Haskell and Eckler found these preparations up to the standard until over two years old. Action Internal. — Digestive Organs. — Ergot (tyramine) stimulates the splanchic inhibitory fibres supplying the stomach and intestines so that the motion and tone of these are somewhat inhibited, while vomit- ing and purging follows toxic doses of ergot, due to paralysis of these same nerves. Circulation. — Ergot is absorbed into the blood, but does not influence that fluid. The essential action of ergot is caused by its two alkaloids, ergotoxine and tyramine. Its effect on the circulation resembles that of 442 VEGETABLE DRUGS adrenalin but, when injected into the blood, the action is less powerful and of much longer duration. Constriction of the blood vessels of the belly and limbs with stimula- tion of the heart, constitutes the chief action on the circulation. This is brought about by the stimulating effect of ergotoxine on the vaso-con- strictor nerve endings, especially of the sympathetic nerves from the thoracic and lumbar spinal cord. There is great rise in blood pressure, as always occurs when the vaso-constrictors of the splanchnic area are stimulated. Stimulation is followed by paralysis of the splanchnic ves- sels, after large doses. Tyramine given intravenously produces marked rise in blood pres- sure lasting 4 or 5 times longer than that from adrenalin. It constricts blood vessels, locally and generally, and its effects are so lasting that it may cause local gangrene. By the mouth, or subcutaneously, its action is much less noticeable. The rate and force of the heart are augmented by stimulation of the heart muscle or accelerator nerve endings (tyramine). This is fol- lowed by slowing of the heart caused by stimulation of the vagus centre by the increased blood pressure. After large doses there is depression of the accelerator nerve endings in the heart (ergotoxine). While such are the actions of the alkaloids yet, when the whole drug is given intraven- ously, there may be a rise or fall of blood pressure owing to other principles. And, when ergot is given by the mouth, the effect of medicinal doses in increasing blood pressure is so feeble as to be of no therapeutic value. Ergot produces practically no constriction of the blood vessels when local- ly applied to the mucous membranes, and for this reason it can be given by the mouth and subcutaneously, whereas the constriction induced by adrenalin is so great that its absorption is prevented and its systemic action is only fully shown when it is given intravenously. Nervous system. — The nervous system is not affected by medicinal doses of ergot, nor by large single doses of the drug. Certain changes occur in poisoning, but these are not understood. Respiration. — Toxic doses of ergotoxine, intravenously, depress the respiratory centre, and the breathing becomes slow and shallow, while asthma is caused by ergamine intravenously from stimulation and con- striction of the bronchial muscle. Uterus. — The most important action of ergot is that on the womb. It stimulates rythmical uterine contractions by the paramount effect of the drug in directly stimulating the uterine muscle. Which of its alkaloids is chiefly responsible for this effect is uncertain. Tyramine is said to stimulate the inhibitory fibres of the hypogastric nerve and while its action is commonly overcome by ergotoxine and histamine yet in the non- pregnant cat it may lead to relaxation of the womb, when given alone, because the inhibitory nerves predominate. Contractions ordinarily alter- nate with relaxation of the womb under the influence of ergot, but after large doses the contraction may last many minutes. Ergot acts most powerfully on the pregnant uterus and may cause abortion. On the non- pregnant uterus it has less effect but is clinically of value in improving USES OF ERGOT 443 the tone and arresting hemorrhage from the non-pregnant womb, as well as following parturition. Ergot and pituitrin are the oxytocics in most common use. Administration. — The fluidextract is generally given by the mouth. Some proprietary preparations are made for subcutaneous use. The prep- aration known as "Ergot Aseptic/' and sold in glass ampules containing one dose (for average-sized bitches), is most convenient for hypodermic use in small animals to stop post-partum hemorrhage. Bonjean's ergotin, or the official extract, are employed hypodermatically. Extr. Ergotae gr.xi. Alcohol. Glycerini. Aq. dest aa 5i. M. Sig. Give one-half subcutaneously to a horse; 10 to 15 M. to dogs. Injections should be made deeply into the muscular tissue to avoid abscess. Ergot should be repeated frequently to arrest hemorrhage. Toxicolvgy. — Enormous single doses are required to poison animals or man. When as mucli as two drams of ergot to the pound, live weight, are given to dogs, death is not constant. Three ounces, however, have proved fatal to small dogs. Acute poisoning is characterized by vomiting (in dogs), diarrhea, profuse salivation, dilation of the pupils, rapid breathing, and feeble, frequent pulse. The animal cries out, has con- vulsive twitchings, staggering gait, paraplegia, intense thirst, icterus, coma, and death takes place by respiratory failure. Abortion may occur in pregnant animals. Horses, cattle, and sheep are unaffected by any ordinary quantity of the drug. Chronic poisoning or ergotism rarely occurs in animals owing to con- tinuous ingestion of ergotized grains. It is characterized by gastro- intestinal indigestion, with nausea, vomiting, colic, diarrhea or constipa- tion, and abortion often ensues in pregnant animals. In addition to gastro-intestinal irritation the symptoms naturally assume two forms: 1, the gangrenous form; 2, the spasmodic form. In the first variety of ergotism there are coldness and anesthesia of the extremities, including the feet, ears, and tail of quadrupeds ; the comb, tongue and beak of birds — followed by the appearance of passive congestion, blebs, and dry gangrene in the vicinity of these parts. The hoofs and beaks often drop off. Death ensues from general exhaustion. In the spasmodic form (due to spasm of arteries of central nervous system), are seen tonic contrac- tion of the flexor tendons of the limbs and anesthesia of the extremities; muscular trembling and general tetanic spasm, with opisthotonos, con- vulsions and delirium. Death also occurs from asthenia. When a cock is given large doses it becomes drowsy, breathes with difficulty, sways in standing, loses appetite and often has vomiting and diarrhea with ano- rexia. The comb and wattles become of a dusky purple. With larger doses the comb becomes gangrenous, dries and falls, and there may be gangrene of the legs, tongue and wing, but recovery may ensue if the drug is withheld. 444 VEGETABLE DRUGS Uses. — Two therapeutic indications for the use of ergot can be di- rectly deduced from its physiological actions: 1, to cause uterine con- traction; 2, to produce vascular contraction. 1. Ergot is occasionally of service in simple uterine inertia in bitches and cats, when there is no malposition of the fetus, or mechanical obstruction (pelvic deformity, rigid os uteri) to its passage. Very small doses must be given for this purpose in order to intensify the force of the uterine contractions without inducing spasm of the uterus. Pituitrin has, however, superseded ergot for this purpose. The more common causes of dystocia are remedied most advantageously by manual interference. Ergot is of chiefest value in obstetric practice, after expulsion of the placenta, to prevent or arrest post-partum hemorrhage which sometimes occurs in cows and ewes. If administered before delivery of the pla- centa, ergot may give rise to tonic contraction of the womb and retention of the afterbirth. Ergot is of benefit in some disorders of the unimpregnated and non- parturient uterus. Thus to aid the expulsion of cysts, and to contract the uterus and its blood vessels in hypertrophy, subinvolution, chronic metritis and fibroid tumors. Ergot is given as a routine treatment in human medicine after delivery to hasten involution of the uterus, 3 times daily for a week or 10 days. In paralysis of the bladder, ergot is occasionally useful by creating contraction of the muscular coat of its walls. This condition is most satisfactorily treated by the injection of an ordinary dose of ergotin into the empty urinary bladder. 2. Ergot is commonly recommended for combating internal hemor- rhage, when surgical measures are impossible. Under this head may be included bleeding from the nose, mouth, stomach, intestines, lungs, uterus and kidneys. Ergot has been thought beneficial in causing constriction of the blood vessels in the early stages of some hyperemias and inflam- mations, notably pulmonary, cerebral and spinal congestion, parturient apoplexy, cerebritis, cerebro-spinal meningitis, spinal meningitis and myelitis. There are two physiological reasons for the uselessness of ergot in preventing internal hemorrhages and congestions in special organs: (a) The fact that general blood pressure is augmented would favor hemor- rhage from a ruptured vessel, (b) The fact that the blood vessels of the brain and lungs are not supplied by vaso-constrictors to be stimulated by ergot. The effect of the drug on these organs would therefore be to cause vascular dilatation from increase of general blood tension. It is only in uterine hemorrhage that ergot proves of much value owing to the contraction of that organ. Ergot is recommended in surgical shock but adrenalin, tyr^ ine, morphine, digitalone, camphor and strychnine are more valuable. In dysentery, watery diarrhea, diabetes insipidus and bleeding piles ergot is said to be of service but we believe it of doubtful utilitv. 445 SECTION XVI.— VEGETABLE DRUGS ACTING MECHANICALLY. Amylum. Starch. C0H10O3. (U. S. & B. P.) Synonym. — Corn starch, E.; fecule (amidon) de maize, Fr. ; kraftmehl, mais- stiirke, G. The starch grains obtained from the fruit of Zea Mays Linn6 (nat. ord. Gramineae). Habitat. — "Western hemisphere. 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 triangular 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'. Olyceritum Amyli. (U. S. P.) (See p. 427.) Glycerlnum Amyli. (B. P.) Action and Uses. — Starch is a mechanical protective externally, used as a dusting powder, alone or with zinc oxide (1-1), 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 paint- ing the mixture on in layers with a brush. Boiled starch gruel (2 table- spoons 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. Zinc oxide, one part; starch and vaseline, each 3 parts, form a very satisfactory preparation for acute eczema in dogs, which does not rub off so readily as zinc ointment. Oleum Theobhomatis. Oil of Theobroma. (U. S. & B. P.) Synonym. — Butter of cacao, E.; beurre de cacao, Fr. ; kacaobutter, G. ; oleum (butyrum) cacao, P. G. A fixed oil expressed from the roasted seed of Theobroma Cacao Linne (nat. ord. Sterculiaceae). 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, CTHNT402, 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 in- flammation of the throat and digestive tract. Gossypium Purificatum. Purified Cotton. (U. S. P.) Synonym. — Absorbent cotton, E.; cotton absorbant, Fr.; gereinigte. baum- wolle, G. The hairs of the seed of Gossypium herbaceum Linne, and of other culti- vated species of Gossypium (nat. ord. Malvaceae), freed from adhering impurities and deprived of fatty matter. Habitat. — Tropical Asia and Africa; cultivated in subtropical and tropical countries, mostlv in the Southern United States. 446 VEGETABLE DRUGS 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 ammonia solution of cupric oxide. Uses. — Absorbent cotton is used as a cheap, convenient and cleanly substitute for ordinary sponges; to make poultices by soaking it in anti- septic solutions (as lysol or creolin, 1-2 per cent.) and placing it between layers of gauze ; and for surgical dressings. Oakum, consisting of the fibres of old rope, is often employed as a cheap absorbent material, saturated with tar, in packing horses' feet. Tow, — The coarser unbleached fibres of flax ; and lint, — the scrap- ings of soft, loosely woven linen, — are also utilized as -absorbent sub- stances for surgical purposes. Pyroxylinum. Pyroxylin. (U. S. & B. P.) Synonym. — Gun cotton, soluble gun cotton, colloxylin. Derivation. — A product obtained by the action of nitric and sulphuric acids on cotton and consisting chiefly of cellulose tetranitrate C,2H10(ON02)4Oo. Pyroxylin is a yellowish-white, matted mass of filaments, resembling raw cotton in appearance, harsh to the touch; exceedingly inflammable, burning when un- confined, very rapidly and with a luminous flame; less explosive than cellulose hexanitrate. Slowly but completely soluble in 25 parts of a mixture of 3 volumes of ether and 1 volume of alcohol. PREPARATIONS. Collodium. Collodion. (U. S. & B. P.) Pyroxylin, 40; ether, 750; alcohol, 250. Made by solution, agitation, and de- cantation of clear portion. Collodium- Cantharidatam. Cantharidal Collodion. (U. S. P.) Synonym. — Blistering collodion. Made by maceration and percolation of cantharides, 60; with glacial acetic acid, 5; and acetone, 55; distillation of the acetone, and evaporation of the resi- due until it weighs 15 (Gm.), and solution in flexible collodion, 85. Collodium Flexile. Flexible Collodion. (U. S. & B. P.) Mix collodion, 950; camphor, 20; and castor oil, 30. (U. S. P.) 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 collodion is less apt to crack. Collodion contracts the superficial tissues and will often abort boils when applied directly over them. Collodion is employed as a vehicle for the application of many other agents, as salicylic acid (p. corrosive sublimate, carbolic acid, iodoform, etc. Euphorbium. Euphorbium. (Non-official.) Synonym. — Euphorbe, Fr. The dried juice of a cactus-like plant, Euphorbium resinifera, growing in Morocco and regions contiguous to the Atlas Mountains. Obtained by incising the stems and branches. Description. — In dull yellowish tears, of the size of peas; odorless; taste acrid; powder of a grayish color; insoluble in water, but soluble in alcohol, ether and oil of turpentine. Constituents. — 1, an amorphous, bitter, acrid resin (C10H1GO2), 40 per cent., the active principle; 2, euphorbon (C13H220), a crystalline resin, soluble in chloro- form and ether (20 per cent, of drug). SUPRARENAL GLANDS 447 Action and Uses. — Euphorbium is an intense irritant, both exter- nally and internally. It is sometimes emploj^ed 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: Pulveris euphorbii. Pulveris cantharidis - aa 3ii; Hvdrargyri chloridi corrosivi 5i. Petrolatf %\. Cerati o*ss. M. et fiat unguentum. S. Rub into skin as a blister. There is no danger of absorption and genito-urinarv inflammation from the use of euphorbium, as with cantharides. SECTION XVII.— MEDICINAL AGENTS OF ANIMAL ORIGIN. Thyroid Glands, Dried. (See p. 192.) Suprarexalum Siccum. Dried Suprarenals. Synonym. — Supraren. sice., U. S. P. VIII.; desiccated suprarenal glands. The suprarenal glands of animals which are used for food by man, cleaned, dried, freed from fat, and powdered, and containing not less than 0.4 per cent, nor more than 0.6 per cent, of epinephrine, the active principle of the suprarenal gland. One part of dried suprarenals represents approximately 6 parts of fresh glands, free from fat. If assayed biologically one gram of dried suprarenals contains the equivalent of ten milligrams of laevo-methylamino-ethanol-catechol. A light yellowish-brown, amorphous powder, having a slight, characteristic odor; partially soluble in water. Adrexalix or Epixephrix, C«H3(OH)2 CHOH CH2 NHCH3. Adrenalin (epinephrin) is the active principle of the suprarenal glands, first isolated by Abel (It is an animal alkaloid or leukomain), 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 HC1. 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 the active principle of the suprarenals. Adrenalin is from 825 to 1,000 times more powerful than the glands in its physiological effect. Solutions may be boiled for a moment without impairing their therapeutic activity. Solu- tions of adrenalin deteriorate on standing, with formation of a reddish color and precipitate, and should be discarded. Action. — Circulation. — The action of adrenalin on the circulation is only seen to advantage when the drug is given intravenously. There is a great rise of blood pressure and the heart beats first more rapidly and strongly, then more slowly, and again it is accelerated. The cause of the high blood pressure is stimulation of the vasoconstrictor nerve end- ings. The vessels in the abdonimal cavity are more particularly con- tracted while the blood vessels of the lungs, brain and heart are not supplied with vasoconstrictor fibres and are not constricted. While 448 DRUGS OF ANIMAL ORIGIN there is blanching of the vessels of the intestines the skeletal vessels arc dilated by adrenalin intravenously. 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 pressure. Acceler- ation again occurs when the blood pressure falls away, and the vagus ceases to be stimulated, and accelerator stimulation resumes its sway. Adrenalin also directly stimulates the heart muscle itself. The action on the circulation is very transient, lasting not more than five minutes, and being repeated with each new dose. But the predominant and most valuable effect of adrenalin consists in the complete blanching of mucous membranes and raw surfaces 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. When painted on a mucous membrane or raw surface the constriction of the blood vessels takes place at once and lasts for a quarter to two hours. Subcutaneous injection of a ] 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 lasting for three to six hours. Neither ecchymoses nor sloughing occurs after the proper injec- tion of the drug. Sometimes great vasodilation follows the use of adrenalin aggravating congestion, or hemorrhage from the part, but this is rare. The local constricting action is undoubtedly due to direct stimula- tion of the vasoconstrictor nerve endings as it does not occur when adrenalin is painted on the lung or brain since their vessels are not sup- plied with constrictor fibres. There appears to be little or no absorption of adrenalin when it is applied to mucous membranes or taken by mouth. This may be due to local destruction of the drug or to vasoconstriction. Subcutaneously the action is but slight on the blood vessels, more so in relaxing bronchi. Still more active is the intramuscular injection but the specific effect on the vessels is seen in highest degree when the drug is given into the veins. This must be done slowly in saline infusion to avoid heart failure (left ventricle) from the great peripheral resistance resulting. For these reasons the intramuscular, or better, intravenous injection is indi- cated for its systemic effect. Respiration. — Adrenalin given under the skin in small doses makes the breathing deeper but, when injected intravenously, the respiration be- comes more rapid and shallow. Adrenalin has a marked effect (Park) in relaxing the bronchi, owing presumably to stimulation of the sympathetic (broncho-dilator) fibres. Abdominal Organs. — Here stimulation of the sympathetic nerve end- ings give rise to different actions according to the special functions of the fibres stimulated. Thus movements of the bowels and stomach are ADRENALIN 449 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-colic sphincters, on the other hand, receive motor fibres from the sympathetic and are thus contracted by the stimulation of the sympathetic. Action on the uterus (contraction or relaxation from preponderance 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. Eye. — Dilatation of the pupil, owing to sympathetic nerve stimula- tion, occurs after the intravenous injection of adrenalin solution but not when it is instilled into the eye. Toxicology. — Poisoning may be produced in animals by the intra- venous and subcutaneous injection of adrenalin. In smaller poisonous doses there are glycosuria, diuresis and nephritis, while fatal amounts cause vomiting, restlessness, tremors, paraplegia, prostration, dyspnea from edema of the lungs, respiratory failure and death. Sugar appears in the urine after toxic doses owing to an abnormal increase in the split- ting of liver-glycogen and its discharge as sugar into the blood. There is increase in the secretion of saliva, tears, bile and esophageal and bron- chial mucus. The secretions are increased by sympathetic stimulation but not greatly, on account of the vascular constriction. Ill effects from therapeutic use of adrenalin include 1. Local relaxation of the vessels, following local use, with secondary hemorrhage. 2. Hemorrhage increased, if given in cerebral or pulmonary bleeding, from lack of con- striction of vessels in these organs and generally increased blood pressure. 3. Pulmonary edema and left ventricle failure from general vasocon- striction with weak heart. Summary. — Study of the evolutionary development of the suprarenals shows that the secreting portion of the glands is derived from and is controlled by 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 (sympa- thetic nerve stimulation), and contracts or relaxes the uterus according as to whether the motor or inhibitory fibres predominate in the hypo- gastric nerve. Powerful emotions, as fright or anger, lead to immediate increased secretion of the adrenals in the normal animal, and the phenomena of dilated pupils, erection of hair, inhibition of digestive movements and increase of blood pressure, are typical of sympathetic stimulation. Adrenalin given during administration of chloroform has a very unfortunate effect in leading to ventricular fibrillation and perhaps death. Uses. — External. — Adrenalin chloride is commonly sold in a 1 to 1000 aqueous solution in the shops. It has proved 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 450 DRUGS OF ANIMAL ORIGIN 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 irritating, and in some instances when stronger solutions were used so much ischemia was pro- duced that the blood vessels could not be found and ligatcd and secondary hemorrhage ensued. It is usually sufficient to add T!\x adrenalin solu- tion (1-1000) to each ounce of novocaine or cocaine solution. The combination of cocaine with adrenalin marks a distinct progress in local anesthesia. 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 counteracts. the vascular relaxation seen sometimes after the use of cocaine. Adrenalin has also proved of great service in arresting hemorrhages from wounds, mucous membranes and cavities of the body. A solution equivalent to a 1 to 5000 of adrenalin in sterile salt solution may be applied for this purpose directly to the bleeding surface, or gauze satu- rated with it may be packed into wounds and cavities, as the nose, uterus and vagina. Adrenalin chloride is useful also in many inflammatory dis- eases 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 solu- tion containing 2 per cent, of boric acid forms a useful preparation for general applications in inflammations of mucous membranes. Increased congestion may follow in some cases. Two to four mils of adrenalin solu- tion are injected on either side of the fetlock in acute laminitis to lessen the blood supply in the foot. Reports have been somewhat conflicting. Internal. — Adrenalin has been given empirically in azoturia with favorable results according to the reports of many reliable practitioners. Two drams of the 1-1000 solution in a little water are given subcu- taneously 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. Adrenalin given subcutaneously may at once relax bronchial spasm and relieve asthma. It is not of benefit for the arrest of internal hemorrhage other than in the digestive tract. This follows because it does not con- tract the vessels of the brain and lungs and because its effect in increas- ing general blood tension is inimical to its local effects in constricting vessels. Reichert, as the result of his experiments on morphinized dogs, believes that adrenalin is a valuable and rapidly acting stimulant to the heart, vasomotor system and respiration in poisoning by opium and anesthetics. Adrenalin solution undiluted may be applied on absorbent cotton in pruritus of anus or vulva. USES OF ADRENALIN 451 The latest experimental and clinical studies show adrenalin is of chief value for internal use in conditions of greatly reduced blood pres- sure, as in poisoning by ether, by chloral, and in surgical shock, but not in chloroform inhalation. Here it is now considered an efficient remedy, although its action is very transient. In these conditions adrenalin solu- tion should be injected directly into a vein. Horses, Tl\xx, dogs, H\ii. Ten times this dosage may be safely given into a vein slowly with a saline infusion. Bossi has artificially produced osteomalacia in sheep by re- moval 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 (11\v-xv t.i.d.). Administration. — Adrenalin is preferable to the so-called suprarenal extracts, the dried and powdered suprarenal capsules of sheep and oxen. When the drug is given by the mouth or rectum, its action on the system at large is slow and uncertain, owing to the tardiness of absorption, pre- sumably due to the vascular constriction it occasions and to its rapid decomposition. Intravenous injection is most effective in solutions of 1 to 10,000, or more dilute, in normal salt solution. Subcutaneous injec- tion is somewhat uncertain owing to slow absorption, through vascular constriction. But the 1-1,000 solution (H., 5 i; D., TT^x) 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 by mouth in 1 to 1,000 solution subcutaneously or intramuscularly are: Dogs, Tl\x-xv, (0.6-1); horses, oi-iv, (1-15). Adrenalin should be repeated once in two hours when given internally as an hemostatic. It is an ex- pensive drug. Hypophysis Sicca. Desiccated Hypophysis. (U. S. P.) The posterior lobe obtained from the pituitary gland of cattle, cleaned, dried, and powdered. A yellowish or grayish, amorphous powder, having a character- istic odor and but partially soluble in water. Dose. — About 1/30 of the solution of hypophysis. Liquor Hypophysis. Solution of Hypophysis. (U. S. P.) A colorless, or nearly so, transparent, watery extract of the principle of the fresh posterior lobe of the pituitary gland of cattle, sold under name of Pitui- trin. Derivation. — Extract finely minced gland with acidulated water, boil the solu- tion 10 minutes and filter and sterilize. One mil diluted 20,000 times has the same activity on the isolated uterus of the virgin guinea pig as a 1 to 20,000,000 solution of beta-iminazolyl-ethylamine-hydrochloride. Efforts to isolate an active principle from the posterior lobe have thus far been unsuccessful. The action of the extract is attributed to a hormone (Schae- fer). Administration of pituitrin will not offset the effects of removal or disease of the gland (acromegaly, gigantism, obesity, wasting or imperfect development of the sexual organs) since it is the functioning of the anterior lobe which chiefly controls growth and development of the body. Removal of the anterior lobe, or of the whole pituitary gland, in dogs, causes death in 2 to 5 days with coma, glycosuria, relaxed muscles, and slow feeble pulse and respiration (Cushing). Peritz finds disease of the pituitary gland may be classified as follows: Dwarfism is due to hypo- and gigantism and acromegaly to hyper-function of the anterior lobe. Decreased function of the posterior lobe causes adiposity, while hyper-function results in diabetes insipidus. These forms may be mixed as adi- 452 DRUGS OF ANIMAL ORIGIN posity with dwarfism or acromegaly. Disease of the pituitary with that of other glands, as the genitals, leads to enuchoidism, etc. Dose.— Mares and Cows, 3i-iii, (4-12); Sows and Ewes, 1T145, (3); Bitches, TTtxv, (1), as oxytocic. Actions. — Pituitrin somewhat resembles adrenalin in its effect upon the body. The mechanism by which this effect is produced is different in the case of the two agents. When injected intravenously pituitrin causes a rise of blood pressure, which is rather less than that obtained with adrenalin, but lasts longer (5 to 30 or even 60 minutes). The heart's action is also slowed but not increased in strength. Experiments show that pituitrin stimulates directly smooth muscle and this explains its action on vessel walls, and also accounts for its influence in stimulating intestinal peristalsis and uterine contractions of the pregnant organ. Another important distinction between these glandular products: While adrenalin fails to constrict the arteries of the lungs, brain and heart, because of the absence of sympathetic constrictor fibres in the vessels of these organs, pituitrin causes contraction of the pulmonary, cerebral and coronary arteries by stimulating the muscular coat of these vessels. The arterioles of the spleen and kidney are dilated, and diuresis follows the action of pituitrin from increased blood pressure. Pituitary extract apparently increases the flow of milk and fat but only empties out all the secretion by stimulation of smooth muscle. It lessens polyuria in diabetes insipidus. It has no action on the non-pregnant womb. Like adrenalin, the action of pituitrin is most marked after intravenous, subcutaneous and intramuscular injection, and is practically nil when the extract is given by the mouth. Pituitary extract inhibits to a certain extent the secretion of the thyroid, in hyperthyroidism, and also that of the pancreas. Pituitrin is not especially toxic, since neither 15 mils of the extract by the mouth, nor 3 mils hypodermically, caused any poisonous symptoms in 400 Gm. guinea pigs (Houghton). To summarize: Pituitrin (posterior lobe) stimulates smooth muscle and hence the heart, vessel walls, uterus and intestines; it increases cer- tain secretion, as the urine; and causes contraction of the arterioles of the lungs, brain and heart ; and increases carbohydrate metabolism. The anterior part of the gland increases oxidation, stimulates growth of skeletal and connective tissue, and aids development of the sexual organs. Uses. — The uses of pituitrin hang directly upon its known physio- logical action. Thus it is given intravenously to constrict blood vessels in shock. While its action is less powerful and sudden, its influence is more permanent, than that of adrenalin. It has been largely employed to stimulate rhythmic contractions of the parturient (human) uterus in inertia. Unless the os is fully dilated the contractions produced by pituitrin are occasionally so violent as to cause rupture of the uterus — which has occurred in several reported cases, but it is a valuable drug in uterine inertia in bitches, cats and sows. In tympanites — especially that due to atony of the intestines fol- lowing surgical operations — pituitrin is sometimes immediately successful. In flatulent colic of the horse pituitrin is worthy of trial. It appears to be the most certain agency for rapidly evacuating the bowels in human CANTHARIDES 453 medicine. It may be used as a quickly acting diuretic, or to stop pul- monary hemorrhage. In some cases of rapid heart (tachycardia) pitui- trin has proved serviceable. In shock it should be given intravenously; in other conditions subcutaneously or intramuscularly. The anterior lobe has been given with success in human medicine to stimulate growth and sexual functions in infantilism and dwarfism; and in a condition where there is great obesity, poor development of the sexual organs and general lassitude. The human dose of the powdered anterior lobe is 2 to 3 grains ; of the posterior lobe, gr.ss. Caxtharis. Cantharides. (U. S. & B. P.) Synonym. — Spanish flies, blister beetles, muscae hispanicae, E.; cantharides, Fr.; spanische fliegen, canthariden, G.; cantharides, P. G. Cantharis is the beetle, Canthoris vesicatoria De Geer (Fam. Meloideae, order Coleoptera), and yielding not less than 0.6 per cent, of cantharidin. Habitat. — Southern Europe, Germany and Russia; living chiefly on Oleaceae and Caprifoliaceae. Description. — From 15 to 25 mm. in length, 5 to 8 mm. in breadth, oblong, somewhat compressed above; of a brilliant green or bluish-green, metallic luster, changing in different parts, especially beneath, to a golden-green; head triangular, separated into two lateral lobes by a faint median line; mandibles stout and partly concealed; antennae filiform, of 11 conical joints, the upper ones being black; eyes comparatively small; prothorax angulate; legs with five tarsal joints; wings membranous and brownish; elytra or wing sheaths each with two parallel lines and finely wrinkled; odor strong, disagreeable; taste slight, afterwards acrid. Cantharides with an ammoniacal odor must not be used. Constituents. — 1, the active principle is cantharidin, C10H12O4 (0.6 to 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; 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 unpowdered in tightly stoppered bottles. Dose.— H. & C, gr.v-xx, (.3-1.3); Sh. & Sw., gr.iv-viii, (.25-.S) ; D-, gr.i-ii, (.06-.12). PREPARATIONS. Tinctura Cantharidis. Tincture of Cantharides. (U. S. & B. P.) Made by maceration with heat for 24 hours and percolation of cantharides, 100; with alcohol to make 1000. (U. S. P.) Dose.— H. & C, 3ii-iv, (8-15); D., TTln-xv, (.12-1). Ceratum Cantharidis. (U. S. P.) Cantharides powdered, 350; glacial acetic acid, 25; oil of turpentine, 150; yel- low wax, 175; rosin, 175; and benzoinated lard to make 1000. Unguentum* Cantharidis. (B. P.) Action External. — Cantharides, by virtue of cantharidin, is an in- tense irritant. When applied to the skin in ointment it produces no effect for several hours, but after that time causes dilatation of the cutaneous vessels, hyperemia, and blisters, which appear in from 3 to 12 hours. The blisters soon break, discharge their serous contents, and then dry and crust the surface. If the action of cantharides is maintained con- tinuously; 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, destruc- tion of hair follicles, and scars. The drug is therapeutically a rubefacient and vesicant, and counter-irritant, in occasioning dilatation of the super- ficial vessels, and reflexly, contraction of those in the remote underlying 454 DRUGS OF ANIMAL ORIGIN parts. Cantharides acts more powerfully on the skin of horses and dogs, than on that of cattle and swine. If applied over an extensive surface, absorption and poisoning may occur. Action Internal. — Cantharides affects mainly the digestive and genito-urinary tracts. It is a violent gastro-intestinal irritant. Toxic doses cause vomiting, in animals capable of the act, at first bilious (and containing greenish specks of the wings and wing cases), then mucous, and finally bloody. There is purging in all associated with great pain and straining, of a mucous, fibrinous, and often hemorrhagic character. There are salivation, swelling and pain in the salivary glands. The gastro-enteritis is accompanied by general prostration, and feeble, rapid pulse. A few hours after the occurrence* of the preceding symptoms there is enough absorption of cantharidin 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 hastened in the non-pregnant female. Stupor, coma, and collapse close the scene after lethal doses. Twenty grains of cantharides have killed a man; forty, a dog; one dram 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, camphor, digitalone, strychnine and atropine under the skin. Oils and fats dissolve can- tharidin and must not be given in poisoning as demulcents. 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 mucous membrane. Hyperemia of the brain and spinal cord have also been reported. Uses External. — Cantharides is employed more frequently than any other counter-irritant, to cause blistering, in veterinary practice. The reader is referred to the section on counter-irritants (p. 491) for an account of their actions. The action of cantharides is too tardy and irritating, and there is too much danger of absorption and poisoning to recommend it for the production of counter-irritation over an extensive area (chest and abdomen) in acute pulmonary congestion, pneumonia, bronchitis, colic, enteritis and peritonitis. Mustard, turpentine, and ex- ternal 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 paraplegia. A cantharidal application is often efficacious in muscular or joint CANTHARIDES 455 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 epi- gastrium. Cantharides is the remedy usually employed in the treatment of dis- eases of the bones, joints, bursae, 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. Can- tharidal ointment is often sufficient, together with complete rest, in the treatment of synovitis, and strains of tendons and ligaments. A can- tharides 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 applied around these lesions. The actual cautery, followed by a cantharides 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 em- ployed in ointment (1 to 4* to 8) made by melting and mixing the excipi- ents in a double boiler; i.e., over a water bath, and stirring in thor- oughly the powdered drug. The following is a good preparation: Pulv. cantharidis. Cerae flav aa 5ii- Adipis 3xiv. M. S. External use. More powerful are the following: n Pulveris cantharidis. Pulveris euphorbii aa 3il. Hydrarg. chloridi corros 3i. Petrolati ^i. Cerati ^iss. M. et fiat unguentum. Sig. Apply externally as directed. Pulveris cantharidis. Hydrargyri iodidi rubri aa 3ii. Adipis 3ii. M. et fiat unguentum. Sig. Apply externally as directed. The technique of blistering consists in cutting the hair and washing the part to be blistered, and rubbing the blister long and thoroughly into *The U. S. P. cerate may be used, as it is a powerful preparation. Its strength is 32 per cent, cantharides. 456 DRUGS OF ANIMAL ORIGIN 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 pre- vent 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, usually in dogs; 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 recommended to increase sexual desire in cows and mares, but it has usually to be given in toxic doses to produce an aphrodisiac action. The tincture should be employed when the drug is exhibited internally. Adeps. Lard. (U. S. & B. P.) Synonym. — Axungia, axungia porci s. porcina, prepared lard, hog's lard, E.; axonge, graisse de pore, Fr. ; schweineschmalz, G.; adeps suillus, P. G. The purified internal fat of the abdomen of the hog (Sus. Scrofa Var. do- mesticus Gray Fam. Suidae). Properties. — A soft, white, unctuous solid, having a faint odor free from rancidity, and a bland taste; insoluble in water; very slightly soluble in alcohol; readily soluble in ether, chloroform, carbon disulphide, or benzin. Melts between 36° and 42° C. to a clear liquid. PREPARATIONS. Ceratum. Cerate. (U. S. P.) Synonym. — Cerat simple, Fr.; einf aches cerat, wachssalbe, G. White wax, 300; benzoinated lard, 700. Unguentum. Ointment. (U. S. P.) Synonym. — Unguentum simplex, B. P.; simple ointment, E.; pommade simple, Fr.; wachssalbe, G. Benzoinated lard, 800; white wax, 200. (U. S. P.) Ceratum Resince. (See p. 371.) Adeps Btnzoinatus. (See p. 375.) Sevum Preparatum. Prepared Suet. (U. S. & B. P.) Synonym. — Mutton suet, E.; graisse de mouton, Fr.; hammeltalg, G.; sebum ovile, P. G. The internal fat of the abdomen of the sheep Ovis aries Linn§ (Fam. Bovidae), purified by melting and straining. Properties. — A white, solid fat, nearly inodorous, and having a bland taste when fresh, but becoming rancid on prolonged exposure to the air. Insoluble in water or cold alcohol; soluble in about 60 parts of ether, and slowly in 2 parts of purified petroleum benzin. Constituents. — 1, olein; 2, stearin; 3, palmitin; 4, hircin. Adeps Lan^e Hydrosus. Hydrous Wool Fat. (U. S. & B. P.) Synonym. — Lanolin, E. ; wasserhaltiges wollfett, G. The purified fat of the wool of sheep (Ovis aries, Linn6; Fam. Bovidae), combined with not less than 25 nor more than 30 per cent, of water. wax 457 Properties. — A yellowish-white, or nearly white ointment-like mass, having not more than a slight odor. Insoluble in water, but miscible with twice its weight of the latter, without losing its ointment-like character. Constituents. — 1, cholesterin, C26H43(OH) ; 2, ethers of oleic, stearic, palmitic and other acids. ADEPS LANiE. (U. S. & B. P.) (Wool fat without water. Anhydrous lanolin.) Action and Use of Lard, Suet, and Hydrous Wool Fat. Lard is used mainly as a basis of ointments and cerates: Benzoin is commonly added to it to prevent or retard 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. Lanolin 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. Cera Flava. Yellow Wax. (U. S. & B. P.) Synonym. — Beeswax, E. ; cire jaune, Fr. ; gelbes wachs, G. A product obtained by melting and purifying the honey comb of the bee, Apis mellifica Linne (Fam. Apidae). Properties. — A yellow to gray-brown solid, having an agreeable, honey-like odor, and faint, characteristic taste. Spec. gr. 0.950-0.960. It is brittle when cold; by the heat of the hand it becomes plastic; melts between 62° and 65° C. Insoluble in water; sparingly soluble in cold alcohol, but completely soluble in ether, chloroform, fixed and volatile oils. Constituents. — 1, myricin or myrical palmitate (CgoH61, doH^C^), a sperma- ceti-like substance; 2, cerin or cerotic acid (C27HM02) , an imperfectly saponifiable waxy body; 3, hydrocarbons (C27H56 and C34HM) 12 per cent.; 4, an alcohol (C^H^O); 5, ceryl alcohol (C^H^O). Cera Alba. White Wax. (U. S. & B. P.) Synonym. — Cire blanche, Fr. ; weisses wachs, G. Yellow wax, bleached. Properties. — A yellowish-white solid, somewhat translucent in thin layers, having a faint, characteristic odor. It is free from rancidity and nearly tasteless. Spec. gr. 0.950-0.960. Solubility, melting point, and composition the same as those of yellow wax. Uses. — Yellow 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. Cetaceum. Spermaceti. (U. S. & B. P.) Synonym.— Blanc de baleine, cetine, Fr. ; walrat, G. A concrete, fatty substance, obtained from (the head of the sperm whale) Physeter macrocephalus Linne (Fam. Physeteridae). Habitat. — Indian and Pacific Oceans. Properties. — White, somewhat translucent, slightly unctuous masses of a scaly, crystalline fracture, a pearly lustre; a very faint odor, and 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 disulphide, fixed and volatile oils. 4£8 DRUGS OF ANIMAL ORIGIN Constituents.— 1, chiefly a fat, cetin or cetyl palmitate (ClHH^!MH«Ot), com- posed of cetylic alcohol (C10H33OH) and palmitic acid (HC10H2lO,) ; 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. Mel. Honey. (U. S. & B. P.) Synonym. — Miel, Fr.; honig, G. A saccharine secretion deposited in the honeycomb by the bee, Apis mellifica Linne (Fam. Apidae). Properties. — A thick, syrupy liquid of a light yellowish or yellowish-brown color; translucent when fresh, but gradually becoming opaque and crystalline; having a characteristic odor, and a sweet, faintly acrid taste. Nearly soluble in water. Constituents. — 1, grape sugar (dextrose); 2, fruit sugar (glucose); 3, a vola- tile oil; 4, wax; 5, formic acid, a trace. Fresh honey contains sucrose or cane sugar, which is changed into grape and fruit sugars. PREPARATION. Mel Depuratum. Clarified Honey. (U. S. & B. P.) Synonym. — Mel depuratum, P. G. ; miel despume, mellite simple, Fr.; gereinig- ter honig, G. Derivation. — Melt honey with two per cent, of its weight of paper-pulp in water bath; skim, strain, and add five per cent, of its weight of glycerin. Dose. — Ad lib. Honey is employed as an excipient in electuaries and confections. It is a demulcent and mild laxative for young animals. Oxymel (clarified honey, 8 parts ; water and acetic acid, each 1 part) is a soothing prepara- tion for the throat. Saccharum Lactis. Sugar of Milk. (C12H22On + H20.) (U. S. & B. P.) Synonym. — Lactose, lactin, milk sugar, E.; sucre de lait, Fr.; milchzucker, G. Lactose obtained from the whey of cows' milk, by evaporation, and purified by recrystallization. Properties. — White, hard, crystalline masses, or as a white powder, producing a gritty feeling on the tongue; odorless, and having a faintly sweet taste. Per- manent in the air. Soluble in about 4.9 parts of water; insoluble in alcohol, ether, or chloroform. Dose. — Ad lib. Uses. — Sugar of milk is less soluble and therefore less sweet than cane sugar. It is harder, and thus assists in the subdivision of drugs, and serves as a vehicle in the making of powders and triturates. It also forms the basis of homeopathic preparations. Sugar of milk is a considerable diuretic and may be given to dogs in 2 to 4 dram doses daily, in solution in the drinking water, for dropsy of renal or cardiac origin. Pepsinum. Pepsin. (U. S. & 3. P.) Synonym.— Pepsine, Fr.; pepsin, G. A mixture containing a proteolytic ferment or enzyme, obtained from the glandular layer of the fresh stomach of the hog v^us scrofa, var. domesticus PEPSIN 459 Gray) (Fam. Suidse). It digests not less than 3000 times its own weight of freshly coagulated and disintegrated egg albumin. Derivation. — The chopped mucous membrane of a pig's stomach is macerated for several days in a weak, aqueous solution of hydrochloric acid, with frequent stirring. The pepsin is precipitated from this solution by the addition of sodium chloride and rises to the surface. The floating 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, transparent or trans- lucent scales or grains, or spongy masses, or a fine white or cream-colored amorphous powder, free from any offensive odor, and having a slightly acid or saline taste. It should be not more than slightly hygroscopic. Soluble in about 50 parts of water, the solution being more or less opalescent; more soluble in water acidulated with hydrochloric acid; nearly insoluble in al- cohol, ether or chloroform. Pepsin, when in solution, is incompatible with alkalies, alkaline earths, or alkali carbonates. Dose. — D., calves and foals, gr.x-5i, (.6-4). PREPARATION'S. Qlyccrinum Pepsini. (B. P.) (Contains hydrochloric acid, 5i=gr.v pepsin.) Dose. — D., oi-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 action on fat or carbohydrates of the food. The drug should usually be given along with hydrochloric acid, which converts any pep- sinogen, in the gastric tubules, into pepsin. Pepsin contains the unor- ganized 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 diges- tion caused by acute illness. Its use must not be long persisted in, as the normal functions of the stomach will fail from lack of use. Pepsin is administered in pill, or solution with hydrochloric acid. Pancreatixum. Pancreatin. (U. S. P.) Synonym. — Zymine, B. P.; pancreatina, Fr.; pankreatin, G. It contains enzymes, consisting principally of amylopsin, trypsin, and steap- sin, found in the pancreas of warm-blooded animals, and obtained from the fresh pancreas of the hog (Sus scrofa var. domesticus Gray) (Fam. Suidac), or of the ox (Bos taurus Linne) (Fam. Bovidae). It converts not less than 25 times its own weight of starch into soluble carbohydrates when assayed as directed U. S. P. Pancreatin of a higher digestive power may be brought to this standard by admixture with sugar of milk. Preserve it in well-closed containers. Derivation. — Chopped hog's pancreas is macerated in a dilute aqueous solu- tion of hydrochloric acid for 48 hours, and pancreatin, which is separated by add- ing 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 drams 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- Hke taste. Slowly and almost completely soluble in water; insoluble in alcohol. Dose. — D., gr.v-xv, (-3-1). 460 DRUGS OF ANIMAL ORIGIN Action and Uses. — Pancreatin fulfils a fourfold function by virtue of the four ferments contained in it. It digests proteids by means of the ferments, trypsin and myopsinj 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. It does not digest food in an acid medium, but may aid digestion in the stomach, before much gastric juice has been secreted, during the first half hour after the ingestion of food. Pancreatin acts more efficient- ly in intestinal indigestion because of the presence of an alkaline secre- tion. 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 (especially fat), 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. 490). For this purpose a good preparation can be made extemporaneous- 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 5i to the pint of warm milk, with a little sodium bicarbonate, to artificially digest it. Fel Bovis. Oxgall. (U. S. P.) Synonym. — Bile (fiel) de boeuf, Fr.; ochsengalle, G. The fresh bile of the ox, Bos taurus Linn6 (Fam. Bovidae). Properties. — A brownish-green or dark green, somewhat viscid liquid, having a characteristic odor, and a disagreeable, bitter taste. Spec. gr. 1.015 to 1.025. It is neutral, or faintly alkaline. PREPARATION. Extractum Fellis Bovis. Powdered Extract of Ox Gall. (U. S. P.) Synonym. — Fel bovinum purificatum, B. P.; fiel de boeuf purine. Fr. ; gerei- nigte ochsengalle (rindsgalle), G. Macerate ox gall, 800; with alcohol, 1000, and decant liquid portion. Wash remainder with alcohol, 500. Decant liquid portion and add to first, and filter mixture. Distill alcohol from filtrate; evaporate and dry residue. Add starch to make product weigh 100 Gm. Dose. — Same as for oxgall. Dose. — D., gr.v-xv, (.3-1). Actions and Uses. — Purified oxgall contains all the active elements of bile, — biliary acids, coloring matter and cholesterin. One part of ox- gall 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 COD LIVER OIL 461 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 ob- struction to the normal flow of bile — to aid intestinal 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 im- pacted feces (2 drams to 2 ounces of water). Internally it is given to dogs in pills 2 hours after meals. Papain. (Non-official.) (Not of animal origin, but therapeutically related to above.) 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 is 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 Intestinal indi- gestion in pill or powder. It has also been used to destroy pyogenic membrane of fistulae 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). Oleum Morrhu.e. Cod Liver Oil. (U. S. & B. P.) Synonym. — Oleum jecoris ascelli, P. G. ; 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 Linne and other species of Gadus (Fam. Gadidae). Habitat. — North Atlantic Ocean. Properties. — A pale-yellow, thin, oily liquid, having a peculiar, slightly fishy, but not rancid odor, and a fishy taste. Spec. gr. 0.918 to 0.922. Slightly soluble in alcohol, but soluble in ether, chloroform or carbon disulphide, or ethyl acetate. Brown oils are not desirable therapeutically. Constituents. — 1, glycerin oleate (or olein), 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, f ellinic and bilif ellinic acids ; 5, gaduin (C^H^Oe) ; 6, morrhuol, a crystalline substance containing iodine, phos- phorus and bromine; 7, traces of iron, lime, and magnesia; 8, decomposition prod- ucts or cadaveric alkaloids, in brown oils. Dose.— H. & C, gii-v, (60-120); Sh. & Sw., gss-i, (15-30); D. & C, 3i-iii, (4-12). Action Internal. — Cod liver oil resembles other oils in aiding nutri- tion, the accumulation of fat, and the maintenance of bodily heat, but surpasses them in three particulars: 1, cod liver oil is more easily ab- sorbed; this has been proved comparatively by injecting various oils into separate ligated portions of the living animal bowel; 2, cod liver oil is more readily oxidized after absorption; this is shown by the fact that it reduces and therefore changes the color of potassium permanga- nate solutions more quickly than other oils; 3, 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 462 DRUGS OF ANIMAL ORIGIN aid the diffusion of substances through a mucous membrane (osmosis) when the latter is moistened by bile; by others it is attributed to the presence of free acids in the oil which would tend to saponify and 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 thera- peutic 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 (Tu^x), small animals; Si to large animals ; or with whisky ; 3, shaken with white of an egg, or mucil- age 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 administration begun with the smaller doses as recommended above. Uses. — Cod liver oil is indicated generally in conditions of malnutri- tion 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 influ- enza, 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, weakness, and emaciation in all young animals. It often proves curative 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 conveniently and properly substituted for cod liver oil, in the case of the large patients; while morrhuol (gr.iii«=l teaspoonful cod liver oil?) given in pills, or lipanin (oleic acid, 6; olive oil, 100) may be exhibited in dram doses to dogs when cod liver oil does not agree. Ichthyolum. Ichthyol. (Non-official.) Synonym. — Ammonium ichthyol sulphonate, E. ; housenblase, G.'} colie de poison, Fr. Derivation. — A bituminous quartz occurring in the Tyrol Mountains, contain- ing the fossil remains of fish, is distilled' with strong sulphuric acid, and sulphur- ous acids are removed from the distillate by sodium chloride, while sulphonic acid separates out. The latter is usually saturated with ammonia, forming ichthyol; ICHTHYOL 463 but similar preparations are made by the combination of sulphonic acid with sodium, lithium and zinc. 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 in- separable 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, accom- panied with inflammation, pain, swelling, and induration; also in «jpi- dermal 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 enlargements. 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 applied to the unbroken skin in 25 to 50 per cent, ointment, with lanolin or lard. Solutions in water, glycerin, oils or al- cohol, are sometimes employed of various strengths. Ichthyol is rarely given internally for chronic rheumatism. 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 mixture 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 siccum in powder, dusted on inflamed parts, as in acute moist eczema. DOSES OF DRUGS. In the following table three doses are usually given for each drug. The first dose is for horses and cattle, in both the apothecaries' and metric systems of weights and measures. The second dose is for sheep and swine, in both the apothecaries' and metric systems of weights and measures. The third dose is for dogs (and also cats) in both the apothe- caries' and metric systems of weights and measures. Letters are used to signify the name of the animal for whicli the dose is intended. Thus: H., Horses; C, Cattle; Sh., Sheep; Sw., Swine; D., Dogs (which also includes cats in most cases). The following abbreviations are also employed: lb., pound; pt., pint; oz., ounce; dr., dram; m., minim; gr., grain; Gm., gram; mil, milli- liter (cc, cubic centimeter). These doses are suitable for animals of average weight. Dose Table. Acetanilid.— H. & C, dr. 2-4, (Gm. 8-15). Sh. & Sw., dr. %-lf (Gm. 2-4). D., gr. 3-7, (Gm. .2-.5). Acetum Opii.— H., oz. 1-2, (mils 30-60). C, oz. 2-3, (mils 60-90). Sh. & Sw., dr. 2-6, (mils 8-24). D., m. 3-20, (mils .2-1.3). Acid, 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. 1/30-1/10, (Gm. .002-.006). Aero, Benzoic— H., dr. 2-4, (Gm. 8-15). D., gr. 5-15, (Gm. .3-1). Acid, Boric— H., dr. 2-4, (Gm. 8-15). D., gr. 5-15, (Gm. .3-1). Acid, Carbolic— H. & C, gr. 15-30, (Gm. 1-2). Sh. & Sw., gr. 5-10, (Gm. .3-.6). D., gr. y2-l, (Gm. .03-.06). Acid, Citric— H., dr. 2-4, (Gm. 8-15). D., gr. 10-20, (Gm. .6-1.3). Acid, Gallic— H. & C, dr. 2-4, (Gm. 8-15). Sh. & Sw., dr. %-l, (Gm. 2-4). D., gr. 5-20, (Gm. .3-1.3). Acid, Hydriodic (syrup of). — D., dr. 1, (mils 4). Aero, Hydrochloric (dilute).— H., dr. 1-2, (mils 4-8). C, dr. 2-4, (mils 8-15). Sh. & Sw., m. 15-20, (mils 1-1.3). Sw. & D., m. 5-20, (mils .3-1.3). Acid, Hydrocyanic (dilute).— H. & C, m. 20-40, (mils 1.3-2.6). Sh., m. 10-15, (mils .6-1). Sw., m. 2-5, (mils .12-.3). D., m. 1-3, (mils .06-.2). Acid, Lactic— H. & C, dr. 2-4, (mils 8-15). D., dr. %-l, (mils 2-4). Acid, Nitric (dilute).— H., dr. 1-2, (mils 4-8). C. dr. 2-4, (mils 8-15). Sh., dr. y2-l, (mils 2-4). Sw. & D., m. 5-30, (mils .3-2). Acid, Nitrohydrochloric — H., m. 20-40, (mils 1.3-2.6). D., m. 3-5, (mils .2-.3). Acid, Nitrohydrochloric (dilute). — H., dr. 1-2, (mils 4-8). C, dr. 2-4, (mils 8-15). Sh., dr. y2-l, (mils 2-4). Sw. & D., m. 5-30, (mils 3-2). Acid, Phosphoric (dilute).— H., dr. 1-2, (mils 4-8). C, dr. 2-4, (mils 8-15). Sh. & Sw., dr. y2-l, (mils 2-4). D., m. 5-30, (mils 3-2). Aero, Salicylic— H. & C, dr. 2-8, (Gm. 8-30). Sh., dr. 1-4, (Gm. 4-15). Sw., dr. %-l, (Gm. 2-4). D., gr. 5-30, (Gm. .3-2). Acid, Sulphuric (dilute).— H., dr. 1-2, (mils 4-8). C, dr. 2-4, (mils 8-15). Sh., dr. V2-I, (mils 2-4). Sw. & D., m. 10-30, (mils .6-2). Acid, Sulphuric, Aromatic — H., dr. %-l, (mils 2-4). C, dr. 2-4, (mils 8-15). Sh., m. 15-30, (mils 1-2). Sw. & D., m. 5-15, (mils .3-1). Acid, Sulphurous.— H. & C, oz. 1-2, (mils 30-60). Sh. & Sw., dr. 1-2, (mils 4-8). D., dr. y>-2, (mils 2-8). Acid, Tannic— H. & C, dr. ^-4, (Gm. 2-15). Sh. & Sw., dr. &-1, (Gm. 2-4). D., gr. 1-15, (Gm. .06-1). Acid, 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. TV2, (Gm. .006-.12). DOSE TABLE 465 Aconite, Extract of Leaves.— H., gr. 3-6, (Gm. .2-.4). D., gr. %-l, (Gra. .03-.06). Aconite, Extract of.— H., gr. 1-3, (Gm. .06-.2). D., gr. rV-%, (Gm. .006-.015). Aconite, Fluidextract of.— H., m. 3-20, (mils .2-1.3). D., m. TV-2, (mils .006-.12). Aconite, Tincture of.— H., m. 20-60, (mils 1.3-4). C, dr. y2-iy2, (mils 2-6). Sh. & Sw., m. 10-20, (mils .6-1.3). D., m. 2-10, (mils .12-.6). Aconitine Nitrate (Squibb).— H., gr. 1/30, (Gm. .002). D., gr. 1/400-1/200, (Gm. .00015-.0003). Adrenalin Solution.— (By mouth), H., dr. 2-4, (mils 8-15). D., TTtlO-60, (mils 0.6-4). Aloes.— H., oz. %-l, (Gm. 15-30). C, oz. 1-2, (Gm. 30-60). Sh., oz. %-l, (Gm. 15-30). Sw., dr. 2-4, (Gm. 8-15). D., gr. 20-60, (Gm. 1.3-4). Aloin.— H. & C, dr. 2-3, (Gm. 8-12). D., gr. 2-20, (Gra. .12-1.3). Alum.— H. & C, dr. 2-4, (Gm. 8-15). Sh. & Sw., gr. 20-60, (Gm. 1.3-4). D., gr. 5-10, (Gm. .3-.6). Emetic, dr. 1, (Gm. 4). Ammonia, Aromatic Spirit of.— H. & C, oz. 1-2, (mils 30-60). Sh. & Sw., dr. 2-4, (mils 8-15). D., dr. V2-l, (mils 2-4). Ammonia, Spirit of.— H. & C, oz. V2-l, (mils 15-30). Sh. & Sw., dr. 1-2, (mils 4-8). D., m. 10-20, (mils .6-1.3). Ammonia, Water of.— H. & C, oz. fc-1, (mils 15-30). Sh. & Sw., dr. 1-2, (mils 4-8). D., m. 10-20, (mils .6-1.3). Ammonia, Stronger Water of.— H. & C, dr. 2-6, (mils 8-24). Sh. & Sw., dr. 1 (mils 4). D., m. 5-10, (mils .3-.6). Ammonium, Solution of Acetate.— H. & C, oz. 2-4, (mils 60-120). D., dr. 2-8 (mils 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. 15 (Gm. 1). Ammonium Chloride.— H., dr. 2, (Gm. 8). C, dr. 3-6, (Gm. 12-24). Sh. & Sw., gr. 15-40. (Gm. 1-2.6). D., gr. 3-10, (Gm. .2-.6). Ammonium Valerate. — D., gr. 2-5, (Gm. .12-.3). Amyl Nitrite. — H., dr. %-l, (mils 2-4). D., m. 2-5, (mils .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, (mils 1.3-2). D., m. 1-5, (mils .06-.3). Anise, Spirit of.— D., dr. 1-2, (mils 4-8). Antimony and Potassium Tartrate. — H., dr. 2-4, (Gm. 8-15). Sw., emetic, gr. 4-10, (Gm. .24-.6). D., gr. jfe-%, (Gm. .006-.03). Emetic, D., gr. 1-2 (Gra. .06-.12). Antimony, Wine of. — D., m. 5-60, (mils .3-4). Antipyrin.— H. & C, dr. 6, (Gm. 24). Sh. & Sw., dr. 1, (Gm. 4). D., gr. 5-20, (Gm. .3-1.3). Anti-Strangles Antitoxin. — H., 30 mils. Antistreptococcus Serum. — H., 20-50 mils. Antitoxin Anti-Straxgles. — H., 30 mils. Influenza — H., 30 to 90 mils. Tetanus — H., 10 mils as prophylactic. Apomorphine Hydrochloride. — Subcutaneously — H., gr. %, (mils 0.045). Foals, gr. y2, (mils 0.03). Calves & Sheep, gr. y2, (mils 0.03). Cows, gr. V/Zi (mils 0.09). D., gr. TV to %, (mils 0.006-0.012), as emetic. By the mouth, as expectorant— D., gr. 1/40 to 1/25, (mils 0.0015-0.0024). Areca Nut.— H., oz. V2-l, (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. Arecoline Hydrobromide. — H. & C, gr. %-lV2, (0.04-0.09); average dose sub- cutan., gr. i, (Gra. 0.06). Arsenic. — See Acid, Arsenous. Arsenic, Fowler's Solution of.— H. & C, dr. 2-8, (mils 8-30). Sh. & Sw., dr. 1-2, (mils 4-8). D., m. 2-10, (mils .12-.6). Arsphenemine.— H. & C, gr. 45-75, (Gm. 3-5). D., gr. 5-10, (Gm. 0.3-0.6). . Asafetida.— H. & C, oz. %-l, (Gm. 15-30). Sh. & Sw., dr. 1-2, (Gm. 4-8). D., gr. 3-10, (Gm, .2-.6). Asafetida, Emulsion of. — D., oz. y2-l, (mils 15-30). 466 DOSE TABLE ASEFETIDA, Pill. — D., (1-4). Asafetida, Tincture of.— H. & C, oz. 2-4, (mils 60-120). D., dr. V2-l, (mils 2-4). Aspidium, Fluidextract of (B. P.)— H. & C, dr. 3-6, (mils 12-24). Sh. & Sw., dr. 1-2, (mils 4-8). D., m. 15-60, (mils 1-4). Aspidium, Oleoresin of.— H. & C, dr. 3-6, (mils 12-24). Sh. & Sw., dr. 1-2, (mils 4-8). D., m. 15-60, (mils 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 Sulphate.— H., gr. 1-1%, (Gm. .06-.09). C, gr. 1-2, (Gm. .06-.12). Sh. & Sw., gr. 1/15-1/12, (Gm. .004-.005). D., gr. 1/120-1/80, (Gm. 0.0005- .0008). Average dose, D., gr. 1/100, (Gm. .0006). Balsam of Peru.— H. & C, oz. 1-2, (mils 30-60). Sh. & Sw., dr. 1-2, (mils 4-8). D., m. 10-30, (mils .6-2). Barium 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. %-%, (Gm. .008-.03). Belladonna, Tincture of Leaves. — D., m. 15-30, (mils 1-2). Belladonna Root, Fluidextract of. — H., dr. 1-2, (mils 4-8). C, dr. 2-3, (mils 8-12). Sh. & Sw., m. 10-15, (mils .6-1). D., m. 1-3, (mils .06-.2). Benzoin, Tincture of.— H., oz. 1, (mils 30). D., dr. y2-l, (mils 2-4). Betula, Oil of. — See Gaultheria. Bismuth Salicylate. — D., gr. 5-10, (Gm. .3-.6). Bismuth Subcarbonate.— H., dr. 2-4, (Gm. 8-15). D., gr. 10-30, (Gm. .6-2). Bismuth Subnitrate. — Dose same as subcarbonate. Brandy.— H. & C, oz. 2-4, (mils 60-120). Sh. & Sw., oz. 1-2, (mils 30-60). D., dr. 1-4, (mils 4-15). Buchu, Fluidextract of.— H., oz. 1-2, (mils 30-60). D., m. 5-30, (mils .3-2). Buckthorn (Rhamnus Catharticus), Syrup of. — D., oz. 1-2, (mils 30-60). Cats, oz. y2-l, (mils 15-30). Caffeine.— H., 5ss-ii, (Gm. 2-8). D., gr. V2-3, (Gm. .03-2). Caffeine, Citrated.— H., dr. 2-4, (Gm. 8-15). D., gr. 1-6, (Gm. .06-.36). Caffeine Sodium-Benzoate.— H., dr. i-2, (Gm. 4-8). D., gr. 1-5, (Gm. 0.06-0.3), subcutaneously. Calamus.— H. & C, oz. 1-2, (Gm. 30-60). Sh. & Sw., dr. 2-3, (Gm. 8-12). D., gr. 15-60, (Gm. 1-4). Calamus, Fluidextract of. — Dose same as Calamus. Calcium, Precipitated Carbonate of.— H., oz. 1-2, (Gm. 30-60). C, oz'. 2-4, (Gm. 60-120). Sh. & Sw., dr. 2-4, (Gm. 8-15). D., gr. 10-60, (Gm. .6-4). Calcium Chloride.— H. & C, oz. %-l, (Gm. 15-30). D., gr. 5-20, (Gm. .3-1.3). Calcium, Lactophosphate, Syrup of. — Foals and Calves, oz. V&-1> (mils 15-30). D., dr. 1-4, (mils 4-15). Calcium, Precipitated Phosphate of.— H., dr. 2-4, (Gm. 8-15). C, oz. V&-1, (Gm. 15-30). Sh. & Sw., dr. 1-2, (Gm. 4-8). D., gr. 5-20, (Gm. .3-1.3). Calomel. — See Mercury. Calumba.— H. & C, oz. %-l, (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, (mils 60-120). D., dr. 1-4, (mils 4-15). Camphor.— 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. y2-i, (mils 15-30), not more than dr. IY2 injected at one point. D., m. 15-30, (mils 1-2). Camphor, Spirit of.— H„ oz. 1-2, (mils 30-60). D., dr. %-l, (mils 2-4). Cannabis Indica, Extract of.— H., dr. 1-2, (Gm. 4-8). D., gr. &-1, (Gm. .015-.06). Cannabis Indica, Fluidextract of.— H., dr. 4-6, (mils 15-24). D., m. 3-10, (mils .2-.6). Cannabis Indica, Tincture of.— D., m. 15-30, (mils 1-2). Cantharides.— H. & C, gr. 5-20, (Gm. .3-1.3). Sh. & Sw., gr. 4-8, (Gm. •24-.S). D., gr. 1-2, (Gm. .06-.12). DOSE TABLE ' 467 Caxtharides, Tincture of.— H., dr. 2-4, (mils 8-15). D., m. 2-15, (mils .12-1). Capsicum.— H., gr. 20-60, (Gm. 1.3-4). C, dr. 1-2, (Gm. 4-8). D., gr. 1-8, (Gin. .06-.48). Capsicum, Fluidextract of. — Dose same as Capsicum. Capsicum, Oleoresin of.— H., m. 10-30, (mils .6-2). C, dr. y2-l, (mils 2-4). D., m. 14-I, (mils .015-.06). Capsicum, Tincture of.— H., dr. 2-4, (mils 8-15). C, oz. %-l, (mils 15-30). D., m. 5-60, (mils .3-4). Carbon Bisulphide. — H., dr. 2-4, (mils 8-15). Cardamox.— H. & C, oz. 1-2, (Gm. 30-60). Sh. & Sw., dr. 2-3, (Gm. 8-12). D., gr. 10-30, (Gm. .6-2). Cardamox, Fluidextract of. — Dose same. (Non-official.) Cardamox, Compound Tincture of. — D., dr. 1-2, (mils 4-8). Cardamox, Tincture of. — D., dr. 1-2, (mils 4-8). Cascara Sagrada.— D., gr. 5-30, (Gm. .3-2). Cascara Sagrada, Fluidextract of. — D., m. 5-30, (mils .3-2). Cascara Sagrada (Solid) Extract of.— D., gr. 2-8, (Gm. .12-.5). Cascarilla.— H. & C, oz. %-l, (Gm. 15-30). Sh. & Sw., dr. 1-2, (Gm. 4-8). D., gr. 10-30, (Gm. .6-2). Castor Oil.— H. & C, pt. 1, (mils 500). Sh. & Sw., oz. 2-4, (mils 60-120). D., dr. 1-2, (mils 4-8). Fowl, dr. 1, (mils 4). Catechu.— H., oz. %-l, (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, (mils 30-60). Foals, Calves and Sheep, oz. V2-I, (mils 15-30). D., dr. V2-2, (mils 2-8). Cerium Oxalate. — D., gr. 3V2-I, (Gm. 2-4). Chalk, Compound Powder of. — D., gr. 10-60, (Gm. .6-4). Chalk Mixture.— D., oz. 1-2, (mils 30-60). Chalk, Prepared.— H., oz. 1-2, (Gm. 30-60). C, oz. 2-4, (Gm. 60-120). Sh. & Sw., dr. 2-4, (Gm. 8-15). D., gr. 10-60, (Gm. .6-4). Charcoal (Wood, and animal, purified).— H. & C, oz. 1-2, (Gm. 30-60). Sh. & Sw., dr. 2-4, (Gm. 8-15). D, gr. 20-60, (Gm. 1.3-4). Chexofodium, Oil of.— H., dr. 2-3, (Gm. 8-12). D., m. 3, (Gm. 0.2), per kilo, (2.2 lb). Cats, m. 1-3, (Gm. .06-.18). 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). Chloretoxe.— D., gr. 5-10, (Gm. 0.3-0.6). Chloroform.— H. & C, dr. 1-2, (mils 4-8). Sh. & Sw., m. 20-30, (mils 1.3-2). D., m. 2-20, (mils .12-1.3). Chloroform, Spirit of.— H. & C, oz. 1-2, (30-60). Sh. & Sw., dr. 2-4, (mils 8-15). D., dr. V2-I, (mils 2-4). Cixchoxa 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). Cixchoxa, Compound Tincture of.— H., oz. 2-4, (mils 60-120). D., dr. %-4, (mils 2-15). Cixchoxa, Extract of.— H., dr. 1-2 (Gm. 4-8). D., gr. 5-30, (Gm. .3-2). Cixchoxa, Fluidextract of.— H., dr. 2-4, (mils 8-15). C, oz. 1-2, (mils 30-60). Sh. & Sw., dr. 1-4, (mils 4-15). D., gr. 10-60, (mils .6-4). Cixchoxixe Sulphate, Tonic Dose.— H., gr. 20-60, (Gm. 1.3-4). C, dr. %-l% (Gm. 3-6). Sh. & Sw., gr. 6-15, (Gm. .36-1). D., gr. l%-2%, (.1-.15). Cixchoxixe Sulphate, Antipyretic Dose. — H., dr. 2^-5, (Gm. 10-20). Sh. & Sw., gr. 40-50, (Gm. 2.6-3.3). D., gr. 7-15, (Gm. .5-1). Cixchoxidixe Sulphate. — Dose same as Cinchonine Sulphate. Cocaixe Hydrochloride. — H., gr. 5-10, (Gm. .3-.6). D., gr. %-%, (Gm. .008-. 045). Cod Liver Oil.— H., oz. 2-4, (mils 60-120). Sh. & Sw., oz. V2-l, (mils 15-30). D., dr. 1-3, (mils 4-12). Codeixe— D., gr. 1,4-2, (Gm. .015-.12). Colciiicixe.— H. & C, gr. i/0-V2, (Gm. .01-.03). D., gr. 1/120-1/50, (Gm. .0005- .0012) 468 DOSE TABLE Colchicum Corm.— H. & C, dr. %-2, (Gm. 2-8). Sh., gr. 10-20, (Gm. .6-1.3). Sw. & D., gr. 2-8, (Gm. .12-.5). Colchicum Corm, Fluidextract of. — Dose same as Colchicum. Colchicum Corm, Tincture of.— H. & C, dr. 3-8, (mils 12-30). D., m. 10-30, (mils .6-2). Colchicum Corm, Wine of.— H. & C, dr. 3-8, (mils 12-30). D., m. 10-30, (mils .6-2). Collargol (Colloidal Silver). — See p. 143. Colocynth.— D., gr. 3-8, (Gm. .2-.5). Colocynthik.— H., dr. y2-l, (Gm. 2-4). D., gr. %-l, (Gm. .015-.06). Coniine Hydrobromide.— H. & C, gr. %-l%, (Gm. .045-.1). Sh. & Sw., gr. %-%, (Gm. .012-.024). D., gr. 1/30-1/12, (Gm. .002-.005). Conium.— 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. Conium, Extract of.— H. & C, gr. 12-24, (Gm. .72-1.5). Sh. & Sw., gr. 2-4, (Gm. .12-.24). D., gr. 14-I, (Gm. .015-.06). Convallaria, Fluidextract of.— H. & C, dr. 1-2, (mils 4-8). D., m. 5-10, (mils .3-.6). Copper Sulphate.— H. & C, dr. 2-4, (Gm. 8-15). Sh. & Sw., gr. 20-40, (Gm. 1.3-2.6). D., gr. 1-2, (Gm. .06-.12). Emetic— D., gr. 6-20, (Gm. .36-1.3). Corrosive Sublimate. — (See Mercury.) Cotton Root Bark. — (See Gossypium.) Creosote.— H., m. 15-30, (mils 1-2). C, dr. %-l, (mils 2-4). Sh. & Sw., m. 5-15, (mils .3-1). D., m. %-2, (mils .03-. 12). Creolin.— H. & C, dr. 1-2, (mils 4-8). D., m, 1-5, (mils .06-.3). Single dose as anthelmintic. H., oz. V2-l, (mils 15-30). Croton Oil.— H., m. 15-30, (mils 1-2). C, dr. %-l, (mils 2-4). Sh. & Sw., m. 5-10, (mils .3-.6). D., m. V2-3, (mils .03-.2). Digitalein— H., gr. %-%, (Gm. .008-.015). D., gr. 1/100, (Gm. .0006). Digitalin.— H., gr. %-Vi, (.008-.015). D., gr. 1/200-1/100, (.0003-.0006). Digitalinum Purum, German.— H., gr. ss-i, (.03-.06). D., gr. 1/60-1/30 (.001- .002). Digitalis.— H., gr. 10-60, (Gm. .6-4). C, dr. %-l%, (Gm. 2-6). Sh. & Sw., gr. 5-15, (Gm. .3-1). D., gr. %-8, (Gm. .03-.2). Digitalis, Fluidextract of. — Dose same as Digitalis. Digitalis, Extract of.— H., gr. 5-10, (Gm. .3-.6). D., gr. Vs-%, (Gm. .008-.03). Digitalis, Infusion of.— H. & C, oz. 2-6, (mils 60-180). Sh. & Sw., oz. %-l, (mils 15-30). D., dr. 1-4, (mils 4-15). Digitalis, Tincture of.— H. & C, dr. 2-4, (mils 8-15). Sh. & Sw., dr. %-l%, (mils 2-6). D., m. 5-30, (mils .3-2). Digitalone, subcut.— H., dr. 2-4, (mils 8-15). D., m. 5-20, (mils 0.3-1.3). Digitoxin.— H., gr. %-%, (.008-.015). D., gr. 1/250-1/50, (.00025-.00125). Diuretin— D., gr. 20, (Gm. 1.3). Dover's Powder.— H., oz. %-l, (Gm. 15-30). D., gr. 5-10, (Gm. .3-.6). Dover's Powder, Liquid.— H., oz., V2-l, (mils 15-30). D., m. 5-10, (mils .3-.6). Elaterin— D., gr. 1/20-1/12, (Gm. .003-.005). Ergot.— H. & C, oz. %-l, (Gm. 15-30). Sh. & Sw., dr. 1-2, (Gm. 4-8). D., dr. V2-I, (Gm. 2-4). Ergot, Fluidextract of. — Dose same as Ergot. Ergot, Extract of (Ergotin).— H. & C, gr. 20-60, (Gm. 1.3-4). D., gr. 2-10, (Gm. .12-.6). Ergot, Tincture of.— H. & C, oz. %-2, (mils 15-60). Sh. & Sw., dr. 1-4, (mils 4-15). D., dr. %-2, (mils 2-8). Eserine. — (See Physostigmine.) Ether.— H. & C, oz. 1-2, (mils 30-60). Sh. & Sw., dr. 2-4, (mils 8-15). D., m. 10-60, (mils .6-4). Ether, Spirit of, and Compound Spirit of.— H. & C, oz. 1-2, (mils 30-60). Sh. & Sw., dr. 2-4, (mils 8-15). D., m. 10-60, (mils .6-4). Ether, Nitrous, Spirit of (Sweet Spirit of Nitre).— H. & C, oz. 1-4, (mils 30-120). Sh. & Sw., dr. 2-4, (mils 8-15). D., m. 10-60, (mils .6-4). Eucalyptus, Fluidextract of.— H., oz. 2-3, (mils 60-90). D., dr. V2-2, (mils 2-8). DOSE TABLE 469 Eucalyptus, Oil of.— H., dr. 2-4, (mils 8-15). D., m. 5-20, (mils .3-1.3). Eucalyptol. — Dose same as Oil of Eucalyptus. Fennel.— H. & C, oz. 1-2, (Gm. 30-60). Sh. & Sw., dr. 2-3, (Gm. 8-12). D., gr. 10-20, (Gm. .6-1.3). Fel Bovis.— (See Oxgall.) Fenugreek.— H. & C, oz. 1-2, (Gm. 30-60). Sh. & Sw., dr. 2-3, (Gm. 8-12). D., gr. 10-30, (Gm. .6-2). Fibrolysin. — H., 11.5. mils subcut. Frangula, Fluidextract of. — D., dr. V2-l, (mils 2-4). Gamboge.— H., oz. %-l, (Gm. 15-30). C, oz. 1-1%, (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-oz. 1, (mils 8-30). Sh. & Sw., dr. V2-2, (mils 2-8). D., m. 5-15, (mils, .3-1). Gelsemine.— H., gr. Vi-%, (Gm. .015-.03). D., gr. 1/60-1/20, (Gm. .001 -.003). Gelsemium.— H., dr. 1-2, (Gm. 4-8). D., gr. 5-10, (Gm. .3-.6). Gelsemium, Fluidextract of. — Dose' same as Gelsemium. Gelsemium, Tincture of.— H., oz. y2-2, (mils 15-60). D., m. 15-60, (mils 1-4). Gentian.— H., oz. %-l, (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, (mils 30-120). D., dr. 1-4, (mils 4-15). Ginger.— H., dr. 2-oz. 1, (Gm. 8-30). C.r 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. Glycerin.— H. & C, oz. 1, (mils 30). D., dr. %-l, (mils 2-4). Glycerophosphates, Lime and Iron. — H., dr. 3 (Gm. 12). D., gr. 5-15, (Gm. 0.3-1). Glycyrrhiza. — See licorice. Gossypium Root, Fluidextract of Bark of.— H. & C, oz. V2-l, (mils 15-30). Sh. & Sw., dr. 1-2, (mils 4-8). D., dr. %-l, (mils 2-4). Granatum (Pomegranate). — D., dr. V2-\V2 (Gm. 2-6). Granatum, Fluidextract of. — Dose same as granatum. Granati Radicis Cortex, Fluidextract of. — D., dr. V2-2, (mils 2-8). H^matoxylon, Extract of.— H. & C, dr. %-4, (Gm. 2-15). Sh. & Sw., dr. %-l, (Gm. 2-4). D., gr. 5-15, (Gm. .3-1). H.ematoxylon, Fluidextract of.— H. & C, oz. %-l%, (mils 15-45). Sh. & Sw., dr. 1^-3, (mils 6-12). D., m. 15-45, (mils 1-3). Hamamelis, Fluidextract of.— H. & C, oz. 1-2, (mils 30-60). D., dr. V2-2, (mils 2-8). Hamamelis, Water of. — Same doses as fluidextract. Hydrastin.— H., gr. 15-30, (Gm. 1-2). D., gr. 3-5, (Gm. .2-.3). Hydrastine Hydrochloride. — H., gr. 5, (Gm. 0.3). D., gr. V2, (Gm. 0.03). Hydrastis, Fluidextract of.— H. & C, dr. 2-oz. 1 (mils. 8-30). Sh. & Sw., dr. 1-2 (mils 4-8). D., m. 5-60, (mils .3-4). Hydrastis., Glycerite of. — Dose same as Fluid Extract. Hydrastis, Tincture of.— H., oz. 1-2, (mils 30-60). D., dr. V2-2, (mils 2-8). Hyoscine Hydrobromide.— H., gr. %-%, (Gm. .01-.015). D., gr. 1/150-1/100 (Gm. .0004-.0006). Hyoscyamine Hydrobromide and Sulphate. — H., gr. 1-2, (Gm. .06-.12). D, gr. 1/60-1/30, (Gm. .001-.002). Hyoscyamus.— H. & C, oz. %-l, (Gm. 15-30). D., gr. 5-15, (Gm. .3-1). Hyoscyamus, Fluidextract of. — Dose same as Hvoscyamus. Hyoscyamus, Extract of.— H. & C, gr. 20-60, '(Gm. 1.3-4). D., gr. V2-2. (Gm. .03-.12). Hyoscyamus, Tincture of. — D., dr. 1-2, (mils 4-8). Hyoscyamus, Succus of. — D., dr. 1-2 (mils 4-8). Hypophosphites, Compound Syrup of. — D., dr. 1 (mils 4). Influenza Antitoxin. — H., 30 to 90 mils. Iodine.— H. & C, dr. %-l, (Gm. 2-4). Sh. & Sw., gr. 10-20, (Gm. .6-1.3). D., gr. 2-5, (Gm. .12-.3). 470 DOSE TABLE Iodine, Compound Solution of.— H., dr. 2-4, (mils 8-15). D., m. 2-10, (mils .12-.6) Iodine, Tincture of.— H., dr. 2-4, (mils 8-15). D., m. 2-10, (mils .12-.6). Ipecac— H., dr. 1-2, (Gm. 4-8). C., dr. 2-4, (Gm. 8-15). Sh., dr. y2-l, (Gm. 2-4). D., gr. y2-2, (Gm. .03-.12). Emetic— D. & Sw., gr. 15-30, (Gm. 1-2). Cats, gr. 5-12, (Gm. .13-.72). Ipecac, Fluidextract of. — Dose same as Ipecac Ipecac, Syrup of. — D., Expectorant, m. 15-GO, (mils 1-4). Ipecac, Wine of. — D., Expectorant, m. 15-60, (mils 1-4). Iron and Ammonium Citrate. — D., gr. 5-10, (Gm. .3-.6). Ikon, 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, (mils 8-15). Sh. & Sw., m. 10-20, (mils .6-1.3). D., m. 2-10, (.12-.6). Iron, Chloride, Tincture of.— H. & C, oz. 1-2, (mils 30-60). Sh. & Sw., m. 20-30, (mils 1.3-2). D., m. 5-60, (mils .3-4). Iron, Iodide, Syrup of. — D., m. 5-10, (mils .3-6). Iron, (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., gr. 20-30, (Gm. 1.3-2). D., gr. 1-5, (Gm. .06-.3). Iron, (and) Strychnine Citrate— D., gr. 1-2, (Gm. .06-.12). 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. V2-l, (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. %-l, (Gm. 2-4). Jalap, Fluidextract of. — Dose same as Jalap. Jalap, Resin of.— Sw., dr. %-l, (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, (mils 60-120). D., dr. 1-4, (mils 4-15). Juniper, Oil of.— H. & C, dr. 1-2, (mils 4-8). D., m. 2-10, (mils .12-.6). Kamala.— H., oz.'l, (Gm. 30). D., dr. V2-2, (Gm. 2-8). Kino.— H., oz. %-l, (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, (mils 30-60). Foals, Calves and Sheep, oz. %-l, (mils 15-30). D., dr. y2-2, (mils 2-8). Koussin.— D., gr. 5-40, (Gm. .3-2.6). Kousso.— Small dogs, dr. %-l, (Gm. 2-4). Large dogs, dr. 2-4, (Gm. 8-15). Kousso, Fluidextract of. — Dose same as Kousso. Krameria.— H., oz. Vz-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, (mils 30-60). Foals, Calves and Sheep, oz. V2-l, (mils 15-30). D., dr. V2-2, (mils 2-8). Lead Acetate.— H. & C, dr. 1, (Gm. 4). Sh. & Sw., gr. 15-20, (Gm. 1-1.3). D., gr. 1-2, (Gm. .06-.12). Licorice. — 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, (mils 120-180). Calves and Foals, oz. 2, (mils 60). D., dr. 1-8, (mils 4-30). Linseed Oil.— H., pt. %-l, (mils 250-500). C, pt. 1-2, (mils 500-1000). Sh. & Sw., oz. 6-12, (mils 180-360). Dogs and Cats, oz. y2-2, (mils 15-60). Lithium Carbonate. — D., gr. 3-10, (Gm. .2-.6). Lithium Citrate.— D., gr. 5-20, (Gm. .3-1.3). Lobelia, Fluidextract of. — H., dr. 2-8, (mils 4-30). D., m. 1-5, (mils .06-.3). DOSE TABLE 471 Lobelia, Tincture of. — H., oz. 1-2, (mils 30-60). D., emetic, dr. 1-4, (mils 4-15). D., expectorant and sedative, m. 10-30, (mils .6-2). Lobeline Sulphate. — (Subcutaneously), H. & C, gr. TV%j (Gm. .006-.015). D., gr. 1/100-1/10, (Gm. .0006-.006). 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), lb. 1-2, (Gm. 500-1000); (laxative), oz. 3-4, (Gm. 90-120). Calves, dr. 2-3, (Gm. 8-12). Sh. oz. 4-6, (Gm. 120-180). D., dr. 1-4, (Gm. 4-15). Male Fern, Oleoresin and Fluid Extract of.— H. & C, dr. 3-6, (mils 12-24). Sh. & Sw., dr. 1-2, (mils 4-8). D., m. 15-60, (mils 1-4). Menthol.— D., gr. 2, (Gm. .12). Mercury with Chalk. — Foals and Calves, gr. 10-15, (Gm. .6-1). D., gr. 1-10, (Gm. .06-.6). Mercury, Corrosive Chloride of.— H. & C, gr. 5-8, (Gm. .3-.5). Sh. & Sw., gr. 2, (Gm. .12). D., gr. 1/30-%, (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. %-l, (Gm. 2-4). C, dr. 5-6, (Gm. 20-24). D., gr. 1/10-%, (Gm. .006-.03), in divided doses; gr. 3-5, (Gm. .2-.3), in single doses. Methyl Salicylate.— H., dr. 2-8, (mils 8-30). D., m. 5-15, (mils .3-1). Morphine and its Salts.— H. & C, gr. 3-10, (Gm. .2-.6). Sh., gr. i/,-2, (Gm. .03-.12). Sw., gr. tV%, (Gm. .006-.03). D, gr. %-%, (Gm. .008-.0~3). Sub- cutaneously— H., gr. 3-4, (Gm. .2-.24). D., gr. %-%, (Gm. .008-.03). Morrhuol— D., gr. 1-5, (Gm. .06-.3). Mustard.— H. & C, oz. y2-l, (Gm. 15-30). Sh. & Sw., dr. %-2, (Gm. 2-8). D., gr. 10-15, (Gm. .6-1). Emetic— D., oz. %, (Gm 15). Myrrh, Tincture of— H. & C, oz. 1-2. (30-60). Sh. & Sw., dr. 3-6. (12-24). D., dr. 1. (2-4). ' Naphthalin.— H., dr. 2-4, (Gm. 8-15). D., gr. 1-20, (Gm. .06-1.3). Naphtol.— H., dr. 2-3, (Gm. 8-12). D., gr. 1-10, (Gm. .06-.6). Nicotine— H. & C, gr. 1/60-1/20, (Gm. .001-.003). Nitroglycerin (1 per cent, solution). — H. & C, dr. y2-l, (mils 2-4). D., m. 1-2, (mils .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. 2%-5, (Gm. .15-.3). Sw., gr. 1-2, (Gm. .06-.12). D., gr. %-1,4, (Gm. .008-.015). Nux Vomica, Fluidextract of. — Dose same as Nux Vomica. Nux Vomica, Tincture of.— D., m. 5-10, (mils .3-.6). Olive Oil.— H. & C, pt. 1-2, (mils 500-1000). D., oz. 2-4, (mils 60-120). Opium, Camphorated Tincture of (paregoric). — D., dr. 1-4, (mils 4-15). Opium, Extract of.— H., dr. %-l, (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. %-%, (Gm. .01-.03) . Opium, Powder.— H., dr. 1-2, (Gm. 4-8). C, dr. 2-4, (Gm. 8-15). Sh., gr. 10-20, (Gm. .6-1.3). Sw., gn 5-20, (Gm. .3-1.3). D., gr. %-3, (Gm. .03-.2). Opium, Tincture of.— H., oz. 1-2, (mils 30-60). C, oz. 2-3, (mils 60-90). Sh. & Sw., dr. 2-6, (mils 8-24). D., m. 3-30, (mils .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). Papain.— Foals, Calves and Dogs, gr. 2-10, (Gm. .12-.6). Pelletierine Tan nate. — D., gr. 2-5, (Gm. .12-3). Pepo.— D., oz. 2, (Gm. 60). Peppermint, Oil of.— H. & C, m. 15-30, (mils 1-2). D., m. 1-5, (mils .06-.3). Peppermint, Spirit of.— H. & C, dr. 2-4, (mils 8-15). D., m. 15-30, (mils 1-2). Pepsin.— Dogs, Foals and Calves, gr. 10-60, (Gm. .6-4). Phenacetin.— H., dr. 4, (Gm. 16). D., gr. 5-10, (Gm. .3-.6). Phenolphthalein.— H., dr. 1-1%, (Gm. 4-6). D., gr. 2-10, (0.12-0.6). Cats & Puppies, gr. %-2, (Gm. 0.03-0.12). Phenol. — See Acid Carbolic. 472 DOSE TABLE Phosphorated Oil.— H., dr. 2-3, (mils 8-12). D., m. 1-5, (mils .06-.3). Phosphorus.— H., gr. 1-2, (Gm. .06-.12). C, gr. 2-3, (Gm. .12-.2). Sh., Sw. & D, gr. 1/100-1/20, (Gm. .0006-.003). Phosphorus, Spirit of.— D., m. 7-20, (mils .5-1.3). Physostigma.— H., gr. 15-30, (Gm. 1-2). D., gr. %-l, (Gm. .015-.06). Physostigma, Fluidextract of. — Dose same as Physostigma. Physostigmine Sulphate and Salicylate. — H. & C. By the mouth, gr. l%-3, (Gm. .09-.18). D., gr. 1/60-1/10, (Gm. .001-.006). H. Subcut, gr. 1-1%, (Gm. .06-.09). Intratracheally, gr. */,, (Gm. .03). Foals and Calves subcut., gr. 1/12-%, (Gm. .005-.01). D. subcut., gr. 1/100-1/30, (Gm. .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. 1/10-1/3, (Gm. .006-.02). Pilocarpus.— H. & C, dr. 2-4, (Gm. 8-15). Sh. & Sw., dr. V2-l, (Gm. 2-4). D., gr. 5-60, (Gm. .3-4). Pilocarpus, Fluidextract of. — Dose same as Pilocarpus. Pituitrin.— H., dr. 1-4, (Gm. 4-15). D.. m. 10-60, (Gm. 0.6-4). Podophyllin— H. & C, dr. 1-2, (Gm. 4-8). D., gr. ^-1, (Gm. .006-.12). Pomegranate. — See Granatum. Potassium Acetate.— H. & C, oz. %-l, (Gm. 15-30). Sh. & Sw., dr. %-l, (Gm. 2-4). D., gr. 5-20, (Gm. .3-1.3). Potassium Bicarbonate. — Dose same as Acetate. Potassium Bitartrate— H. & C, oz. V2-l, (Gm. 15-30). Sh. & Sw., oz. y2, (Gm. 15). D., dr. Vz-1, (Gm. 2-4). Potassium Bromide.— H. & C, oz. 1-2, (Gm. 30-60). Sh. & Sw., dr. 2-4, (Gm. 8-15). D., gr. 5-60, (Gm. .3-4). Potassium Carbonate.— H. & C, oz. V2-l, (Gm. 15-30). Sh. & Sw., dr. %-l, (Gm. 2-4). D., gr. 5-20, (Gm. .3-1.3). Potassium Chlorate. — Dose same as Carbonate. Potassium Citrate. — Dose same as Carbonate. Potassium Hydroxide, Solution of.— H. & C, oz. %-l, (mils 15-30). Sh. & Sw., dr. %-l, (mils 2-4). D., m. 5-20, (mils .3-1.3). Potassium Iodide.— H., dr. 2-4, (Gm. 8-15). C, dr. 6, (Gm. 24). Sh. & Sw., gr. 15-30, (Gm. 1-2). D., gr. 2-10, (Gm. .12-.6). Potassium Nitrate. — Dose same as Carbonate. Quassia, Extract of.— H., dr. 1-2, (Gm. 4-8). D., gr. V2-3, (Gm. .03-.2). Quassia, Fluidextract of.— H. & C, oz. 1-2, (mils 30-60). Sh. & Sw., dr. 2-4, (mils 8-15). D., m. 15-60, (mils 1-4). Quassia, Tincture of.— H. & C, oz. 2-4, (mils 60-120). D., dr. Y2-2, (mils 2-8). Quassiin.— D., gr. %-%, (Gm. .008-.02). Quercus Alba.— H., oz. %-l, (Gm. 15-30). C, oz. 1-2, (Gm. 30-60). Sh. and Sw., dr. 1-2, (Gm. 4-8). D., gr. 10-30, (Gm. .6-2). Quercus Alba, Fluidextract of. — Dose same as Quercus Alba. Quinidine.— Tonic dose— H., gr. 20-60, (Gm. 1.3-4). C, dr. sA~lV2, (Gm. 3-6), Sh. & Sw., gr. 6-15, (Gm. .36-1). D., gr. l%-2%, (Gm. .1-.15). Antipyretic dose— H., dr. 2%-5, (Gm. 10-20). Sh. & Sw., gr. 20-40, (Gm. 1.3-2.6). D., gr. 7-15, (Gm. .5-1). Quinine and Its Salts. — Tonic dose — H., gr. 15-60, (Gm. 1-4). C, dr. V2-lY2, (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. V2-I, (Gm. 2-4). D., gr. 2-5, (Gm. .12-.3). Rhamnus Catharticus, Syrup of.— D., oz. 1-2, (mils 30-60). Cats, oz. %-l, (mils 15-30). Rhamnus Catharticus, Fluidextract of. — D., dr. V2-l, (mils 2-4). Rhubarb.— Stomachic— H. & C, oz. 1-2, (Gm. 30-60). Sh. & Sw., dr. 1, (Gm. 4). D., gr. 5-10, (Gm. .3-.6). Purgative— Foals, Calves and Dogs, dr. 1-2, (Gm. 4-8). Fowl, gr. 5-7 in pill. Rhubarb, Fluidextract of. — Dose same as Rhubarb. Rhubarb, Compound Powder of. — Foals and Calves, oz. V2-l, (Gm. 15-30). DOSE TABLE 473 Sabina, Fluidextract of.— H., oz. 1-2 (mils 30-60). D., m. 5-15, (mils .3-1). Sabina, Oil of.— H. & C, dr. 2-4, (mils 8-15). D., m. 1-5, (mils .06-.3). Salicin.— H. & C, dr. 2-8, (Gm. 8-30). Sh., dr. 1-4, (Gm. 4-15). Sw., dr. V2-l, (Gm. 2-4). D., gr. 5-30, (Gm. .3-2). Salol.— H., dr. 3-6, (Gm. 12-24). D., gr. 5-10, (Gm. 0.3-0.6). Santonin.— H„ dr. Vi-4, (1-15). D., gr. 1-3, (.06-.18). Puppies, gr. %-%, (.015- .03). Savin. — See Sabina. Scammony.— D., dr. 1-2, (Gm. 4-8). Cats, dr. %-l, (Gm. 2-4). Scammony, Resin of.— D., dr. %-l, (Gm. 2-4). Cats, gr. 15-30, (Gm. 1-2). Senna.— H. & C, oz. 4-5, (Gm. 120-150). Sh. & Sw., oz. 1-2, (Gm. 30-60). D., dr. 1-4, (Gm. 4-15). Fowl, gr. 15-20 in pill. Senna, Fluidextract of. — Dose same as Senna. .tfect:>* Senna, Syrup of. — D., dr. 1-4, (mils 4-15). ochlrv*% Silver Nitrate.— H. & C, gr. 5-10, (Gm. .3-.6). Sh. & Sw., gr. 1-2, i/**$'6- .12). D., gr. y8-y2, (Gm. .008-.03). $ ?* Sodium Bicarbonate.— H. & C, oz. %-2, (Gm. 15-60). Sh. & Sw., dr. +&l\ (Gm. 2-4). D., gr. 5-30, (Gm. .3-2). Sodium Cacodylate.— H., gr. 8-30, (Gm. 0.5-2). D., gr. %-l%, (Gm. 0.05-0.1) subcut. Sodium 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). Sodium Chloride— Purgative— Cattle, lb. %-l, (Gm. 250-500). Sh., oz. 1-2, (Gm. 30-60). Sodium Bromide.— H. & C, oz. 1-2, (Gm. 30-60). Sh. & Sw., dr. 2-4, (Gm. 8-15). D., gr. 5-60, (.3-4). Sodium Hydroxide, Solution of.— H. & C, oz. Ms-1, (mils 15-30). Sh. & Sw., dr. %-l, (mils 2-4). D., m. 5-20, (mils .3-1.3). Sodium Phosphate.— C, lb. 1-1%, (Gm. 500-750). H. & Sh., oz. 2-4, (Gm. 60- 120). D., dr. 1-2, (Gm. 4-8). Sodium Salicylate.— H. & C, dr. 2-8, (Gm. 8-30). Sh., dr. 1-4, (4-15). Sw., dr. %-l, (Gm. 2-4). D., gr. 5-30, (Gm. .3-2). Sodium Sulphate.— C., lb. 1-1 %, (Gm. 500-750). H., oz. 2-4, (Gm. 60-120V Sh ., oz. 2-4, (Gm. 60-120). D., dr. 1-4, (Gm. 4-15). Sodium Sulphite, Bisulphite and Thiosulphate. — H. & C, oz. 1, (Gm. 30). Sh. & Sw., dr. V2-I, (Gm. 2-4). D., gr. 5-30, (Gm. .3-2). Spigelia, Fluidextract. — D., dr. 1, (mils 4). Spigelia and Senna, Fluidextract. — D., dr. 2, (mils 8). Puppies, dr. y3. 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, (mils 24-48). C, oz. 1^-3, (mils 45-90). Sh., dr. 1^-3, (mils 6-12). D., m. 5-30, (mils .3-2). Squill, Syrup of.— H., oz. %, (mils 15). D., dr. V2-l, (mils 2-4). Squill, Compound Syrup of. — D., m. 5-30, (mils .3-2). Strophanthus, Tincture of. — H. & C, dr. 1-4, (mils 4-15). D., m. 2-10, (mils .12-.6). Strophanthin.— H., gr. %-%, (Gm. .012-.03). D., gr. 1/200, (0.0003). Strychnine and Its Salts.— H., gr. V2-2, (Gm. .03-.12). C., gr. 2-3, (Gm. .12-.2). Subcutaneously— H. & C, gr. y2 to 1. Sh., gr. V4-1, (Gm. .015-.06). D., gr. 1/120-1/60, (Gm. .0005-.001). Sulphur.— H. & C, oz. 2-4, (Gm. 60-120). Sh. & Sw., oz. 1-2, (Gm. 30-60). D., dr. %-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. 8-15). D., dr. 1-2, (Gm. 4-8). Taraxacum, Fluidextract of. — Dose same as Taraxacum. Taraxacum, Extract of.— H. & C, dr. 1-4, (Gm. 4-15). D., gr. 5-30, (Gm. .3-2). Terebene.— H. & C, dr. 2-6, (mils 8-24). D., m. 5-15, (mils .3-1). Terpin Hydrate.— H., dr. %-2, (Gm. 2-8). D., gr. 5-20, (Gm. .3-1.3). 474 DOSE TABLE Tetanus Antitoxin. — H., 10 mils prophylactic dose. Thymol.— H., dr. y2-2, (Gm. 2-8). Sh. (single dose), dr. V2-2y2, (Gm. 2-10). D., gr. 1-15, (Gm. .06-1). Thyroid Gland, Desiccated. — D., gr. y2-2, (Gm. .03-.12), twice daily. Turpentine, Oil of.— Carminative— H. & C, oz. 1-2, (mils 30-60). Sh. & Sw., dr. 1-4, (mils 4-15). D., m. 10-30, (mils .6-2). Anthelmintic— H. & C, oz. 2-4, (mils 60-120). D., dr. %-4, (mils 2-15). Diuretic— H. & C, dr. 2-6, (mils 8-24). Valerate of Ammonium. — D., gr. 2-5, (Gm. .12-.3). Valerate of Iron. — 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). ^nrAIAN' Fluidextract of. — Dose same as Valerian. Vai^jN, Tincture of.— D., dr. %-2, (mils 2-8). Vale. ' D- m. xv. Mustard paste and heat externally. Phosphorus. Antidotes. — Potassium permanganate, H. 5ii 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. l1/^; D. gr. 1/60. "Digitalone," subcut., H. gss; D. m. xx to m. xl. Alcohol subcut. H. Siv; D. 3ii. Strychnine sulph. subcut., H. gr.i; D. gr. 1/100 to gr. 1/60. Artificial respiration. Pilocarpine. Jaborandi. Atropine sulph. subcut. H. gr. iy2; D. gr. 1/60. Potassium Carbonate, See Alkalies. Potassium Cyanide, See Prussic Acid. Potassium Hyduate, See Alkalies. Prussic Acid. Hydrocyanic Acid. Potassium Cyanide. Hydrogen peroxide by mouth. Artificial respiration. Lavage. Atropine sulph. subcut., H. gr.i; D. gr. 1/100, every half hour. Camphorated oil subcut., H. oh 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 salt, 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. subcut., 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. sub- cut., H. gr.i; D. gr. 1/100 to gr. 1/40. Sodium Carbonate, See Alkalies. Sodium Hydrate, See Alkalies. Strychnine. Nux Vomica. Lavage with tannic acid solution under influence of ether inhalation. If convulsions are already present give ether inhalation and normal salt solution intravenously, together with artificial respiration or intratracheal insufflation. Sulphate of Copper, See Copper. Sulphuric Acid, See Acids. Tartar Emetic, See Antimony. Turpentine, Oil of. Give emetic or lavage. Give demulcents: — egg white, gum arabic solution, linseed tea. Epsom salt, linseed oil. Intravenous saline infusion. Zinc Salts, Soluble. Lavage if emesis is not copious. Cathartics, as linseed or castor oil, or Epsom salt. Morphine sulph subcut., H. gr.v; D. gr.ss. Stimulants. Mustard paste and heat externally. GENERAL THERAPEUTIC MEASURES. Food and Feeding In order to comprehend the rationale of feeding in disease it is essen- tial to know something of the principles of feeding in health. A food has been denned as "that which, being innocuous in relation to the tissues, is a digestible, absorbable substance that can be oxidized in the body and decomposed in such a way as to give up to the body the forces it con- tains." A complete food is composed of organic and inorganic constituents. 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 arc divided into nitrogenous and non-nitrogenous classes. These are analo- gous to the constituent parts of the animal body into which they are transformed. The greater portion of animal tissue is made up of nitrog- enous elements, while the larger part of plants is composed of non- nitrogenous material. Among the nitrogenous elements the most im- portant 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 compound, as protein, is known as a nutrient in relation to feed- ing. The nutrients of importance are proteids, fat, and carbohydrates. The first two are common to animal and plant structure; the latter to plants alone. A complete food contains the three nutrients just men- tioned and inorganic substances. Carbohydrates include such bodies as sugar, starch, and cellulose, or woody matter of plants. Proteids con- sist of carbon, hydrogen, oxygen, nitrogen, and sulphur, united in differ- ent proportions. Carbohydrates are composed of carbon, hydrogen and oxygen. Fat is similar in composition to carbohydrates but in its com- bustion 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 carbohydrate material. Very recent experiments have revolutionized our ideas concerning the feeding of animals. These have shown (by feeding pure protein, carbohydrates, fat and salts) that a food containing proteids, carbo- hydrates, fat and salts is very far from being complete as has hitherto been accepted. To begin with there are two essentials in every complete food with- out which animals not only cease to grow and thrive but sicken and die. These until very lately were unknown quantities. 1. There is a soluble, organic substance essential for growth, health and life, which exists in fresh meat, milk, eggs, vegetables (especially in growing parts), in the kernel or germ of grains and in fruit. It is absent in pure starch, sugar and fats. It is destroyed by heating, drying 480 GENERAL THERAPEUTIC MEASURES and curing, and is wanting therefore in sterilized, boiled, dried, canned and processed food products and in boiled milk and many commercial cattle foods. The substance is known as a vitamine and has not yet been isolated as an entity but is rather appreciated by its absence. Thus when animals or man live on food in which vitamines are wanting mal- nutrition, scurvy, rickets and pellagra result. The seeds of plants or grains do not contain sufficient vitamine to form a complete food although it is contained in the germ of grains. But an admixture of grains with the leaves or growing tops of plants (roughage), containing vitamines, makes a complete food — as polished rice (germ removed) and alfalfa. Vitamines are obtained in animal feeding by making watery solutions of grains. In man orange or lime juice and raw vegetables or fruit are used for the vitamine content and prevent and cure scurvy, etc. 2. A special soluble fat is a second essential in a complete food. This is absent in some food containing fat but is especially active in the form of the soluble fat in egg and milk. The vitamines are more abundant in such roughage as clover and alfalfa hay, and corn fodder. The water- soluble vitamines are more abundant in seeds. Roughage without much leafy portion, as straw, is a poor food from lack of vitamines. A ration of wheat straw and wheat grain, or of wheat straw and corn grain, may lead to the production of weak or dead calves from mal-nutrition. Neither may oat straw be fed in too large amounts to breeding cows. Where wheat or oat straw is fed cows i% should be combined with corn silage or alfalfa or clover hay to supply vitamines. The corn plant may be used 'as a complete food for growth and reproduction. Proteids in various foods have very dissimilar values. Proteids are split into amino-acids in the intestines and are absorbed and used to build up the various tissues in this form. Proteids are valuable according to their yield of amino-acids (18 varieties). Some are necessary for the construction of some tissues, others for other tissues. Skim milk pro- teid has three times the value of cereal proteid. But by combining cere- als as corn and oil meal we may get such a favorable mixture of amino- acids that the combination has double the value for building animal tissue that either has singly. The addition of a small amount of animal prod- uct to cereal food greatly increases its value because meat scraps contain the essential soluble fat, valuable proteids and the most essential salts. This brings us to the fourth discovery that the proportion of neces- sary salts in food (sodium, potassium, lime and magnesium) is of greater importance than their mere presence, which has hitherto been thought all that was necessary. The absence of the proper proportion of salts in food is shown by unthrifty and stunted growth, and especially by abor- tion, or dead or dying fetus at birth. Such trouble, especially among swine, results from the lack of proper salts and the essential soluble fat in the food. These experiments mark the beginning of a tremendous advance in scientific feeding. Hitherto computation of the food requirements has been based simply on the pounds of digestible nutrients and the proportion of pro- teids to carbohydrates, this proportion being known as the nutritive ratio. Now scientific feeding is founded on the fuel value or energy value FOOD AND FEEDING 481 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 calory 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° C. 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 calculating daily rations. Thus, for maintenance of animals of 1,000 lbs. live weight per diem, it has been found that cattle 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 cattle are such that for each pound of digestible protein there should be 8 to 10 lbs. of carbohydrates and 20 to 30 lbs. of total dry matter. More important still, it has been found that there are necessary — in addition to the maintenance require- ments of cows — 0.05 lbs. 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 com- pute 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 necessarj". Multiplying the additional requirements 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 requirements for maintenance to those for milk yield we get the total daily requirements for cows weighing 850 lbs. and yielding 25 lbs. of milk as follows: Digestible protein. Energy value. Lbs. Therms. For maintenance 0.45 5.6 For 25 lbs. of milk 1.25 7.5 1.70 13.10 We shall now have to consult a table* showing the energy value, proteid content, and dry matter in all ordinary fodders, and combine 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 30 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, ♦Armsby, Bull. 346 and 459, U. S. Dep't. Agric, 482 GENERAL THERAPEUTIC MEASURES Therefore no more protein is required by a horse at light work than at rest, for repair of the machine. More fuel for working* the machine is, however, needed. The requirements for working horses are: For light work, digestible protein, 1.0 lb.; therms, 9.8. For moderate work, di- gestible 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, demand 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 transformed into tissue but is split up (katabolized) by the cells, or enzymes within the cells (chiefly of muscles), and thus produces heat or energy. The other part is directly built into living protoplasm. If the amount of circulatory protein is deficient, then the organized protein is called upon, the tissues are robbed of their substance, and the body emaciates. When a larger 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 reap- pear in the urine, but is utilized in tissue formation. This also applies to previously starving animals on being well fed. An excess of circu- lating protein, besides being wasteful economically, is harmful in caus- ing various disordered conditions, resulting in the formation of products of imperfect oxidation. The vegetable proteids are transformed into bodies of simpler chemi- cal composition in the stomach and are there converted in part 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 to transmute peptones and proteoses into amino-acids. All proteids are absorbed into the blood as amino-acids. It was formerly thought that they were ab- sorbed as proteoses and peptones but these are transformed in the in- testinal mucous membrane into amino-acids. The amino-acids in the blood serve to build up all the forms of proteid tissue peculiar to the various organs needed to supply waste or growth. The remaining unused portion of the amino-acids in the blood is decomposed or de-aminized in the liver into nitrogenous and non-nitrogenous constituents. The nitrogen escapes from the kidneys in the form of urea and the carbon molecule is split up (like that of carbohydrates) by the muscles cells to form heat and energy, with C02 as the end product. During starvation amino- acid is found in the blood and tissues and evidently it is the only avail- able form in which proteids can be utilized in the body, whether in the building up (anabolism) or breaking down of tissue (katabolism). It FOOD AND FEEDING 483 is the circulating medium or currency of proteids, as glucose is the cur- rency of carbohydrates. Proteids in excess are not stored as amino- acids but as body protein or tissue. The following role is played by protein as a nutritive: — 1. It is the building material for cell protoplasm of tissues of all kinds. 2. It forms energy directly by undergoing destruction without tissue-building. 3. It may be transformed (through its CHO) into sugar or gly- cogen but can not form fat in the body contrary to former belief. 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. The glycogen undergoes combustion in the liver and muscles with a production of heat equal to 4.18 calories for each gram of carbohy- drates. C02 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, glycerol 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 compara- tively inexpensive carbohydrates will compensate for an insufficient ra- tion 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 pro- teid, but is now employed to include nitrogenous bodies (gelatin) de- rived 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, conserve protein con- sumption, but are not tissue builders. 484 GENERAL THERAPEUTIC MEASURES Carbohydrates aid directly in the production of fat. Fat in the food may be directly assimilated as such if there is a sufficient carbohy- drate and proteid ration to protect it from decomposition. The role car- bohydrates 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 carbo- hydrates, and directly from fat contained in the food. 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, car- bonic 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 proteids 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, con- stituting the most concentrated food; and the seed coverings or chaff. Refuse and by-products of manufacture are extensively used, as bran, cottonseed meal, linseed meal, and brewers' grains. In addition, animal matter, as flesh meal, bone meal, and dried blood, are sometimes of value. Pasture grass may be taken as a standard of comparison for green fodders. In 100 lbs. of grass there are approximately digestible: Protein 1.04 lbs. Fat 0.5 lbs. Carbohydrates 10.34 lbs. 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 compared with green pas- ture 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 nutri- ent, 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 FOOD AND FEEDING 485 top, may be taken as a standard of comparison for dry fodder. In 100 lbs. of timothy hay there are approximately digestible: Protein 3.65 lbs. Fat 78 lbs. Carbohydrates 45.8 lbs. Clover hay has double the amount, and rowen or aftermath about one-third more protein than is contained in ordinary meadow hay. Alfalfa represents clover hay. The latter should be bright and free from dust to avoid heaves in horses, or it should be moistened. Alfalfa should not be fed to the extent of more than two-thirds of the roughage for horses ; it should be chopped and timothy hay makes the best combination with it. Corn with equal weight of alfalfa makes a good balanced ration for horses. Oats may be selected as a standard of comparison for grains. 100 lbs. of oats contain of digestible nutrients as follows: Protein 836 lbs. Fat 4.5 lbs. Carbohydrates 45.0 lbs. Corn yields slightly less protein and considerabl}7 more carbohydrates and fat, while cottonseed meal contains nearly three times as much pro- tein, and four times as much fat as are found in oats. If corn is fed horses it should be combined with chopped alfalfa or a small quantity of cotton seed oil meal, not more than a lb. daily to 1000 lbs. of live weight, to add protein. The change to corn from oats should be gradual to avoid colic. Bran (or shorts) has approximately the same chemical composition as oats. The straw of wheat, barley, rye, oats, and corn has a somewhat similar value. In 100 lbs. of wheat straw there are digestible: Protein 0.37 lbs. Fat 0.3 lbs. Carbohydrates 36.00 lbs. In order to compare the composition of food with that of the tissues into which it is converted, we submit the following: PERCENTAGE COMPOSITION OF LIVE ANIMAL. IX 100 LBS. OF WELL FED LIVE OX THERE ARE: Protein 15.8 lbs. Fat 7.1 lbs. Ash 4.8 lbs. Water 54.3 lbs. Contents of digestive tract 18.0 lbs. Certain of the fodders are especially adapted or otherwise for the various domestic animals. Green clover is prone to fermentation and the formation of flatulency if given in large quantities to any animal. A sudden change from dry to luxuriant green food is always undesirable for a similar reason. Green grass cut short by a lawn mower should not be given horses, as it is swallowed in an 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 been removed is responsible for colic in horses and 486 GENERAL THERAPEUTIC MEASURES 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 laxa- tive 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. Cotton- seed meal is supplied cattle to compensate for a deficiency of nitrogen in the food, while in horses it acts as a slight laxative and may improve the general condition. Straw and corn fodder are not readily digested by horses unless cut and steamed, but are suitable for ruminants and are often preferable to a poor quality of hay. The demands of the system for food vary in relation to tissue change, which is diminished by rest, increased by work, and either accelerated or decreased by disease. The requirements for nutriment are greater during the growing period and for the formation of the various natural products, as milk or wool. The state of the digestive organs and assimilative powers guide us in selecting the kind and 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 attainable. We may restrict the diet as a whole or in part. Starving diminishes circulatory protein, increases tissue waste, weakens an animal, and lessens the natural resist- ance against disease. Restricting the diet is useful in controlling un- manageable animals, in diminishing sexual excitement, and in the treat- ment of plethora when combined with proper exercise. In most acute inflammatory diseases, as in acute laminitis, a restricted laxative diet is desirable, as steamed oats with bran and salt, roots and green fodder. In acute indigestion, or in acute inflammation of the alimentary tract, and in acute nephritis, all food should be withheld for at least 24 hours. In acute peritonitis all food is contraindicated, by the mouth. In the milder forms of acute gastro-enteritis we must restrict the diet to small quantities of easily digested food, as cracked or steamed oats, chopped hay and gruels, with the addition of a little green fodder or roots for horses; while carnivora are given milk and lime water. In chronic digestive dis- orders the food must be readily digestible and assimilable, and of a nitrogenous character, since anemia and malnutrition follow the defective digestion and absorption. In chronic indigestion or gastro-enteritis of horses, Zuill recommends 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 FOOD AND FEEDING 48? and desirable. The dietary for constipation in horses should consist of bran mashes twice a week with plenty of salt; roots and green fodder at frequent intervals, combined with suitable exercise and appropriate drug treatment. Dogs suffering from 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 in- valuable 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, is 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 movements 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 because of the loss from the blood and tissues, and because intestinal digestion is disordered and starchy food would be undigested and cause fermentation, etc. Practically, a certain amount of starchy fojd seems to be service- able 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 Iran and straw and green fodder, are not allowable. Swine should be supplied with gruels of boiled milk and barley, flour or oatmeal (strained). Fowl with diarrhea may be fed on boiled rice and given a few drops of laudanum two or three times daily. Dogs and cats should have boiled milk, boiled rice or strained rice gruel, cooked lean meat and crackers. Eeef 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 avoidance 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 milk does not agree. In severe attacks of gastro- enteritis, or in gastric or intestinal ulceration with hemorrhage from the stomach or bowels (after preliminary starving), the food should be bland and fluid, as soaked bread, oatmeal, barley or flour gruels, linseed tea (made by boiling linseed in a muslin bag immersed in water), and small quantities of green fodder for the larger animals; while milk and lime water, white of egg and water, broths and beef juice are indicated for carnivora. In the latter animals we may have to resort to predigested food given by the mouth, or, if vomiting is persistent, by the rectum. The diet in cases of catarrhal jaundice should be easily digestible, bland, and such as will not require much bile for its digestion. The larger patients should be given gruels, 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 488 GENERAL THERAPEUTIC MEASURES cooked lean meat. Feeding in hemoglobinuria 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 operations, 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 restricted to advantage in obesity, cardiac disease with edema, or in the treatment of chronic exuda- tions, 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 diminished and the load put upon the heart is lessened, both of which may prove beneficial in cardiac diseases. A full, or restorative diet should be especially rich in protein. Gen- erous feeding is distinctly in order in the treatment of general debility, malnutrition, anemia, weakness of the digestive organs, convalescence from acute diseases and in animals particularly sensitive to c^ld, 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, diarrhea, albuminuria, ascites and edema. A restorative diet for herbivora includes grain, as corn, bran, oats and cottonseed meal; hay and grass with occasionally beef meal, milk and eggs. For omnivora, corn, potatoes, blood, beef meal, milk and soups. For carnivora, meat extracts, cream, milk, eggs, broths and meat juice. In most wasting diseases, fat, protein and water are the food elements especially needful. An abundance of water stimulates the appetite, secretions, excretions, tissue changes and vital processes gen- erally. Salt should be given freely as an aid to digestion in increasing the formation of hydrochloric acid, and indirectly that of pepsin. Alco- hol, being a nutritive and capable of easy absorption, assimilation and decomposition in the body, forms a most valuable adjunct to a restora- tive 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 hydro- chloric 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 stom- ach, but as soon as convalescence sets in the increased tissue waste pro- duces an excessive demand for food and the digestive organs may become overtaxed. The initial dietetic treatment of fevers consists in the use of FOOD AND FEEDING 489 oats, bran mashes, and gruels, with the addition of a small quantity of grass or roots tor horses. The change irom this diet should be very gradual to a dry, coarse fodder, in order to avoid digestive disorders. Ine bitters, alconol, hydrochloric acid, and salt, together with a copious supply of water, wdi lurthermore 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 tat is essential in the body in lubricating the tissues, in acting as a protection against cold, in serving £s an enveloping and shielding cushion to the underlying tissues, and Unally 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 kent for breeding purposes, are those most commonly afflicted with obesity. Fat in the body may be formed from fat, albuminoids, and carbohydrates of the food. Carbohydrates, if in excess of the needs of the economy, pro- tect 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; ar^l 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 fol- lowed too closely, digestive disorders, loss of strength and nervous dis- turbances 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 vene- section, 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 molecular activity diminished. Exercise, on the other hand, stimulates the circu- lation, 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 RATION FOR THE HORSE. Oatmeal 7 lbs. Straw 3.5 lbs. Hay 7 lbs. Linseed meal 1 lb. Salt 5 per cent, of above. 480 GENERAL THERAPEUTIC MEASURES DAILY RATION FOR DOG WEIGHING 115 LBS. Cooked oatmeal 3 lbs. Fat % lb. SAME LATER. Oatmeal 1 lb. Flesh meal % lb. Fat % lb. Salt 1 teaspoonful. DAILY RATION FOR FAT SETTER OF POINTER. Lean meat iVz lbs. Bread Wz lbs. Fat 3 oz. Animals suffering from fatty degenerative changes do not stand sucli a rigid d.et as the foregoing. These animals are affected with a weak heart due to fatty degeneration cf the myocardium, with atrophy of its muscular fibres. They have dyspnea on exertion. The cardiac insuffi- ciency leads, in its turn, to secondary troubles, as catarrh of the digestive and respiratory organs, and disorder of the liver and k dneys, following general passive congestion. The treatment should be directed in such cases to lessening the amount of bload 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 shou'd 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 pre- vented from feeding an exclusively nitrogenous diet in these cases, as the oxidizing power of the blood is not sufficient 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 irri- tating, tenesmus and ejection quickly occur. From two to four ounces of liquid nourishment may be given to small or medium-sized dogs; from four to eight ounces to large dogs. One quart may be employed for horses. The nutrient enema should be introduced into the bowel through a flexible rubber tube carried up into the colon. An hour before the enema is given the bowel is to be washed out thoroughly with cold water. The nutrient injection should not be given oftener than once in six hours, and if the bowel is irritable, not oftener than Once in twelve hours. The absorptive power of the rectum is slight, but that of the colon is consider- ably 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 ounces of finely FOOD AND FEEDING 491 chopped beef, and the mixture is ready for immediate use. The pepton- izing powders of Fairchild Brothers & Foster are most convenient in pre- paring digested food. Each powder consists of five grains of pancreatic extract and fifteen grains of sodium bicarbonate. A useful nutrient enema for a large dog may be made of two eggs and six ounces of milk. Four to six eggs may be 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. Milk pancreatinized for 24 hours, with the addition of glucose to the extent of 5%, is said to be most efficient as a nutritive enema (Short & Bywaters). In using the peptonizing powders, one is placed in a quart glass jar to- gether 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 con- taining 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 tot 100° F. If predigested food is to be given by the mouth, it is well not to keep the glass jar immersed in hot water more than five minutes, as otherwise the taste will be bitter and disagreeable. A small dose of laudanum is always useful to prevent the expulsion of enemata. Brandy may be added in the proportion of one ounce to the pint of milk after peptonizing. The addition of salt to egg-albumin greatly facilitates absorption. Panapeptone and brandy, each one ounce, in six ounces of normal salt solution form a good substitute for the pep- tonized milk enema. Gruels of all kinds, and broths, may be peptonized, as well as milk. The digestive powers of the large intestines are but slight. Sugar is absorbed unaltered; undigested proteids (with certain exceptions) and fat are not absorbed. Peptones, soluble proteids, as milk, meat juice, egg albumen, and emulsified fat are absorbed. Antiperistalsis, shown by X-ray, may carry bland enemata of milk and eggs up into the bowels as far as the cecum, or large enemata may even reach the small intestines — if given slowly — without being injected high up (Cannon). 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 hospital cases, this method may be preferable. 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 exist- ing. 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 492 GENERAL THERAPEUTIC MEASURES degrees of potency. There first appears redness of the skin, accompanied by some burning or pain (rubefacient action), and if the irritation pro- gresses there is a serous exudate poured out into the mucous layer of the skin. This leads to swelling and edema. Greater irritation causes more exudation of serum and an elevation of the epidermis in a circumscribed area or areas, and the formation of blebs or blisters (vesication). If the irritation ceases at this point, the blisters break open and their contents dry on the surface, covering the parts with a thick scab. Synchronous with vesication we observe a similar process attacking the hair follicles. The hairs are loosened and fall, but as the papillae are usually unaffected, the growth of hair is soon renewed. The recovery of hair is facilitated by the application of grease to parts. Certain agents cause circumscribed inflammation of the gland orifices of the skin, with the formation of pus- tules (pustulants), as croton oil, and these create necrosis of the hair papillae, and, therefore, permanent loss of hair. If the irritant is severe, suppuration follows vesication ; or, if an ordinary irritant is applied with violent friction, is covered with a bandage, or placed over an alread}' in- flamed 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 escharotic, or caustic, occasioning death of the tissues. The same agent, as has already been pointed out, may produce one or more of these actions according to circumstances. The inner aspect of limbs and the flexures of joints are peculiarly sensitive, owing to the thin- ness of the skin over these areas. If a counter-irritant is rubbed properly into the skin it may penetrate into the mucous layer. Reference has been made to the local influence of irritants. We will now direct attention to their remote effect. It is certainly known that irritation of the surface decidedly affects distant organs. Brown-Sequard 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 influence of counter-irritants may be partially summed up in reflex action; i.e., 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, secretion 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 become slower and deeper by reflex stimulation of the respiratory centre, and also by making the respiratory movements more painful, if the application be made to the chest wall. The circula- tion is likewise affected by stimulation of the vagus and vasomotor cen- tres, and both the force of the heart and blood pressure are increased, COUNTER-IRRITANTS 493 unless the irritation is very widespread and severe, when the reverse happens. Xne abdominal vesseis are tiiose constricted ; tiie vessels of the biiin and lnnbs are unadected. in accordance with the foregoing remarks, the use of considerable heat, together with mustard or turpen- tine, is ot great value in conditions of vital depression, surgical shock, collapse and coma. Moreover, the effect on locai biood supply is still greater and lull of importance, since it may explain the benencial action obtained in the ordinary use of counter-irritants. In experiments con- ducted upon ammais, it has been observed that when sinapisms are placed over the nead, the blood vessels in the pia mater are hrst dilated, but soon contract and remain in that condition lor some time. Likewise there was seen, following energetic counter-irritation 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 cause rehexly vascular contraction in more remote areas. In accordance with this dem- onstration, the importance of these agents in remote inflammation lies not so much in their bringing blood to the surface, as in forcing it out of distant parts. This fact is not generally appreciated. The use of the word "drawing" signifies the common idea of a counter-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 stimulation of the calori- facient 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 neuralgic. The phenomenon is not altogether explicable. The subduing 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 attributes the relief of pain afforded by counter-irritants to anemia and rapid compression brought to bear on the nerves in these underlying parts. The viscera supplied by the sympa- thetic nerves have no pain sense. Pain attributed to the viscera is really "referred pain" felt in the cerebro-spinal nerves through reflex action. Thus pain and tenderness are felt in the belly wall when the viscera are inflamed. In disease of internal organs Head has constantly found certain corresponding areas of skin tenderness. This because both the internal organ and the skin area are innervated from the same segment of the brain or cord. Theoretically and practically counter-irritation of a skin area affects the internal organ corresponding (by nervous connection) to this area more than other parts. These areas of skin tenderness for dis- 494 GENERAL THERAPEUTIC MEASURES eased 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 assuaging superficial pain it is found, that where the treatment can be made over the root of the painful nerve, better results are obtained. In pain in the chest wall a blister should be placed next the spine over the root of the spinal nerve involved; in pain in the head in man, counter-irritation is applied over the back of the neck. Counter-irritation should be done over the temple, in pain in the eye (iritis) ; behind the ear, for pain in that organ. In the treatment of enlarged glands and in acute 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: possible stimulation of trophic nerves and nutrition of a part; augmentation of tissue change, locally and generally, and dilatation of vessels (when applied after the subsidence of acute inflammation or in chronically in- flamed parts), with renewed activity of the circulation and consequent absorption of inflammatory exudations. The local action of skin irri- tants increases the leukocytes and opsinins in the inflammatory area (acted upon) and leads to bacterial destruction. The toxins are also more rapidly removed by their influence. Futhermore, counter-irritants re- flexly overcome spasm and pain occurring in colic, by stimulating and replacing normal peristaltic action in place of abnormal localized con- tractions. In like manner they excite uterine contractions by stimulation of the involuntary muscular fibres of the womb. To briefly summarize: — the therapeutic action of counter-irritants may be due to: 1. Alteration of the circulation. 2. To the nervous relation between the skin and viscera. 3. To the "counter"-ing effect of a superficial over a deep pain. INDICATIONS FOR COUNTER-IRRITANTS. 1. To overcome congestion and inflammation in remote parts. 2. To promote absorption of inflammatory products locally. 3. To relieve pain. 4. To stimulate the heart, respiration and nervous functions. Rubefacients. — In this class are included the volatile oils — turpen- tine, oil of wintergreen, etc. — 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 em- ploy comparatively mild agents in order that we may apply them over an extensive surface without causing serious or permanent results. Mus- tard is rubbed with warm water into a thin paste (a sinapism), and rubbed over the chest of horses in congestion of the lungs, in acute bron- chitis, or in the first stage of pleuritis, to obtund pain and lessen conges- tion. Sinapisms also relieve obstinate cough, revive failing respiration, COUNTER-IRRITANTS 495 and stimulate reflexly the vital functions in collapse, shock and narcotic coma. Applied over the cardiac region, they avert syncope. To assist the action of mustard, we often cover the application with hot, wet blankets, and then with dry ones. Stimulating liniments are sometimes preferred. One volume of oil of mustard may be combined with fifteen volumes of oil of turpentine, or ammonia water, thirty parts, and oil of turpentine, fifteen parts, are added to spirit of camphor and soap lini- ment, 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 conges- tion in enteritis, peritonitis, diarrhea and other difficulties. The beneficial result accruing from the use of external counter-irritants in bowel troubles is often facilitated by the injection of hot (115° F.) rectal enemata. Stimulating liniments are serviceable in aiding resolution of swelling, following the acute stage of cellulitis, lymphangitis, neuritis, mammitis, rheumatism, strains and bruises. They are often employed in laryngitis. In chronic skin diseases, as eczema, mild counter-irritants (tar, oil of cade, Peruvian balsam, etc.) substitute an active reparative process, tend to aid absorption of exudation and induration, and relieve pain and itch- ing. The tincture of iodine may abort incipient inflammatory lesions, as boils and abscess, by means of its counter-irritant and antiseptic prop- erties. VESICANTS AND THE ACTUAL CAUTERY. Cantharides, red iodide of mercury, and croton oil, are more com- monly used in veterinary medicine to cause blistering. Reference will be had, hereafter, to cantharidal blisters. Blisters and the cautery are especially indicated to cause resolution of inflammatory products and modification of inflammatory processes ; to secure fixation and rest of parts, and to relieve pain. It is impossible to enumerate all the condi- tions in which they are useful. In the treatment of severe sprains, as curb arid "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 conditions by the production of an acute inflammation, with increase of vascularity, tissue change and fatty degeneration. In "break- down," 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 are secured bv the enforced maintenance of rest and fixation of the joint, together with the production of new bone. In exudative diseases of serous membranes, as pleurtis. pericarditis, peritonitis, meningitis, arthritis, and synovitis, bl:sters facilitate absorp- tion and recovery after the acute staore is over. This favorable result is not due to loss of serum, but to modification of the inflammatory process. In the first three diseases named above, blisters — fly-blisters — mav be ap- plied in spots evrrv few davs in different places over the affected area. Blisters reflexlv stimulate the nerve centres in meningitis, in addition to their action on the inflammatory lesion. They should be applied over 496 GENERAL THERAPEUTIC MEASURES the poll or spine according to the location of the trouble. Absorption in chronically enlarged glands is assisted by blisters. They also hasten "ripening" of suppurating glands or abscess when this process is slow, and hasten their resolution after evacuation of pus. The blister should be rubbed on about the inflamed area in these lesions. Vesicants are also valuable in pharyngitis and laryngitis for severe cases, when stimulating liniments are ineffectual; and, in lessening pain, exudation and swelling of the throat, may avert the necessity of trache- otomy. A blister applied about the coronet in diseases of the feet is serviceable in stimulating the growth of the hoof and promotes repair in navicular disease, laminitis, and cartilaginous quittor, after the acute stage is passed. In arthritis and synovitis, the whole diseased area, with the exception of the flexure of the joint, is covered with a blister. Since it is often impossible to immobilize a part, in veterinary practice, by splints, blisters are sometimes employed for this end after reduction of disloca- tions. The hair should be clipped from an area to be blistered, the skin washed with soap and water, and the animal tied up or restrained in some way from biting the part. It is the custom to cover immediately the sur- rounding parts with grease, but protection from the acrid discharge can be secured more effectively by frequent sponging with soap suds and water; or painting the skin, under the blistered surface, with a solution of 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 Escharotics are agents which destroy tissue. They com- prise such substances as the caustic alkalies, mineral acids, silver nitrate ; iron, zinc and copper sulphates; ferric, zinc and mercuric chlorides; car- bolic acid, arsenic, together with the actual cautery. They are indicated in the treatment of exuberant granulations, morbid growths, septic, sloughing and necrotic parts, pyogenic membranes, fistulous tracts, and for the destruction of poisons, as in rabid dog and snake bite. Escharotics stimulate and modify nutrition in unhealthy wounds and ulcers. Many form chemical compounds with the tissue elements. Heat oxidizes animal tissues, and also coagulates 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 insoluble albuminate with the tissues to which it is applied, and protects the underlying structures from further action. It is most superficial in its action, but possesses specific properties in altering the condition of unhealthy wounds for the better. Extreme heat, exemplified by the white-hot iron, acts as a counter-irritant in stimulating reflexly the nervous system; in increasing the vascularity of surrounding parts, and in favoring revulsion of blood ; m aiding absorp- tion 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 ar- ticles on special agents for further details. Suppurants. — Any of the more active counter-irritants, as croton oil, COLD AND HEAT 497 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 con- nective 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 con- stant 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 irri- tant action, both setons and issues of rowel may be first saturated with cantharides ointment or oil of turpentine. They have been employed in acute disease of the eye, meningitis, "strangles," and in joint and shoulder lameness, near the seat of trouble. Setons and issues of rowel are bar- barous 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 affec- tions by lowering temperature and serving as a stimulus to the respira- tory, circulatory and nervous functions generally. Locally, cold causes contraction of the peripheral vessels and muscles of the skin, forcing out fluids from the part and reducing local temperature. This is more dis- tinctly 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 particularly if followed by heat, when an active hyperemia is substituted for the ische- mia. 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 forcing out, and then bringing back the fluids, of the tissues, we can maintain such an activity of the circulation that even solid exudations are absorbed. Cold, locally, lessens nervous irritability and pain directly, and, also, by contracting the afferent vessels, it diminishes the impact of the blood on sensitive parts. Moderate heat is said, 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 *The cold air treatment — of lobar 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. 498 GENERAL THERAPEUTIC MEASURES and sloughing 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 controlling the circulatory, respiratory, diges- tive 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 secretion 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. Cold is employed, locally, in congestions of superficial parts, and tends to abort inflamma- tion 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 poul- tices (cracked ice and sawdust in linen bags) or by thin rubber ice bags surrounding the throat. In the same way are treated sprained tendons, capped hocks, broken knees, recent curbs, and lymphangitis. In fact, most superficial inflammatory surgical affections are benefited by cold applications. Ice and ice water are useful in checking venous or capil- lary hemorrhage, although hot water is often more serviceable. Cold water enemata are valuable in atonic constipation, diarrhea, and to reduce temperature in fever. In the uterus, ice in small lumps will arrest metror- rhagia, 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 surface of the body. It is merely bathing. Water at the temperature of 50° to 60° F. is applied by a rough, coarse cloth. The water is thrown on in con- siderable quantities, beginning with the head and going rapidly over the neck, trunk and limbs successively, rubbing the skin briskly all the while with the cloth. Two attendants are required for the application of an ablution to the larger animals. The patient is finally dried and warmly blanketed. The process may be repeated each half hour in fever, or twice daily as a tonic measure in chronic diseases. The rationale consists in the stimulus afforded by the cold to the nervous system, accompanied by con- COLD AND HEAT 499 traction 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 to be replaced by more over-heated blood. The internal temperature is thus lowered, and instead of an internal congestion being brought about, as may happen when the skin is simply exposed to cold, we have a constant withdrawal of heated blood from the interior. In this perpetual interchange not only does cooling of the blood and body occur, but the circulation is equalized and congestions are overcome. The Sheet Bath. — Whole baths are impracticable for our larger patients, and the sheet bath may be substituted to advantage for anti- pyretic 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 insola- tion. 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 application is put on the head and the sheet applied and covered with dry woolen blankets. The duration of application is from one quarter to three hours, according to the object in view. If it is used as a strictly antipyretic measure, it should be changed frequently. The wet pack differs materially from other hydriatic procedures in that reaction occurs slowly, for there is no artificial stimulus in the shape of friction to accelerate it. The primary 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. Vascu- lar 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 nutri- 500 GENERAL THERAPEUTIC MEASURES ment 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 promotes rest and quiet. 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. Evaporation is thus pre- vented, but not vaporization. Such an application may be used with safety in febrile diseases, as pleuritis and pneumonia. If it is not re- newed frequently, hyperemia of the surface occurs, and this may be bene- ficial in aborting or relieving internal congestion. It then acts as an ordinary poultice, and is of value in various local inflammations resulting from strains, blows and bruises; also, in laryngitis. Besides relieving internal congestion, the Priessnitz poultice stimulates absorption, removes induration and hastens suppuration, locally. The wet pack and Priess- nitz poultice are more appropriate for practical use than the other methods in veterinary practice, since the evaporation from the hair of animals contraindicates methods suitable in human medicine. Cold Baths are only practicable for the smaller animals. Dogs may be immersed in water at 90° F., which is rapidly cooled down to 60°. The bath should last about fifteen minutes, the surface of the body being rubbed constantly. Ice water should be frequently poured over the head. After removal from the water, the patient must be thoroughly dried, wrapped in warm blankets, and a stimulant given if necessary. Such treatment may be used as an antipyretic measure if the temperature is over 103° F. in the rectum. Douches. — A douche is a forcible impact of water against the sur- face of the body. It is not used for its antipyretic effect, but acts as a stimulant to the nervous system at large, whereby the respiratory action is deepened and strengthened, and the circulation invigorated. The douche is given advantageously in the treatment of coma, of alcohol, chloroform, 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. Syncope 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 is worth mentioning here. After the shoes have been removed the extreme pain may be allevi- ated by standing the horse in quite hot water, sufficient to reach up to or above the fetlocks. Good results are obtained by changing to ice water after the first day and continuing this for several days, in this way caus- *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 supply- ing moist heat, and it does not aid phagocytosis. REFRIGERANTS 501 ing 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 con- tinuously 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 ex- pensive block tin tubes are easily bent and rendered useless by the move- ments of our patients. The treatment of lacerated wounds by means of a stream of water from a convenient hydrant, causes the part to granu- late quickly and greatly facilitates the healing process, but care should be taken not to allow the water to run over the wound more than three or four hours at a time each day, otherwise the part will become "water- logged" and tend to break down and slough rather than to fill in with healthy granulation tissue. Cold Drinks are both refreshing and antipyretic in action. Cool water should be placed where the patient can take it as he desires. In stomatitis, tetanus and angina, cool water is distinctly grateful and com- forting. 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 ap- plied for a short time by means of an atomizer, to induce local anesthesia of a part, through the powerful refrigeration produced in their evapora- tion, and is most satisfactorily employed in conjunction with cocaine injections. One turn of a cotton or linen bandage or a single thickness of similar stuff, put about a part and wet continuously with cold water, forms a good evaporating medium in allaying superficial inflammation and pain. A mixture of clay, and equal parts of water, vinegar and diluted solution of lead acetate, makes a cheap and efficient cooling application for external use in the treatment of bruises and sprains. The paste should be removed as quickly as it dries. Refrigerants. — Certain medicines either produce a 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 astringents, and diminish the circulation in the part. Externally, acetate of lead, chloride of am- monium, nitrate of potash, and vinegar, are used most frequently as refrigerants. The mineral acids and salts of potassium and sodium, especially potassium nitrate, are administered more commonly, internally, both for their cooling effect and to allay thirst. 502 GENERAL THERAPEUTIC MEASURES Heat. Water at a moderate degree of heat — what is termed lukewarm — i. e., 86° to 95° F., applied to the body, stimulates the action of the skin, relaxes peripheral vessels and diminishes nervous excitability, pain and spasm in neighboring parts. Water at a temperature of 112° to 120° F. contracts blood vessels of underlying parts, relieving 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, inflammation and destruction of tissue. The action of powerful heat on the whole body, or upon single organs is similar to that of counter-irritants. Mild, moist heat is beneficial in the treatment of wounds in poorly vascular parts where there is a tendency to indolent granulation, as about the feet in horses. Again, in low grades of inflam- mation with induration, as in strains of tendons, where moderate heat tends to stimulate the circulation and hasten absorption. In the treat- ment 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 sinuses. A modern view of poulticing is that it aids the migration of leuko- cytes, and therefore is productive of good in assisting their phagocytic action. Hot applications increase exudation, congestion, collection of leukocytes and opsinins, locally. All these results are inimical to bac- terial growth. The abscess can thus be more speedily formed and more quickly defined. Herein heat differs from cold. In irritable and spas- modic troubles of muscular origin in various 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 vessels 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 benefited thereby. The Priessnitz poultice continuously applied has a similar action. In vasomotor paralysis, seen in collapse, following loss of blood or poisoning, and in shock due to traumatism or surgical operation, heat is eminently a life-saving means. In such conditions the loss of vascular tone and dilatation of the vessels lead to dangerous, and even fatal, cooling of the body. Heated dry blankets, or those wrung out in hot water, should be applied to the larger animals, together with hot rectal injections; while POULTICES OR CATAPLASMS 503 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, caffeine, adrenalin, atropine, digitalis and strychnine, and saline in- fusions. MODES OF APPLYING HEAT. Poultices or Cataplasms * — Cataplasms are compositions for the local application of heat and moisture. They are made commonly of flaxseed meal, bran, oatmeal, bread, potatoes and carrots. One or other of these is stirred up in boiling water until a thick, pasty consistency is produced. 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 the entire foot. The bagging is then folded and tied about the pasterns, and over around the front and sole of the foot. The whole should occasionally be immersed in water to prevent drying of the poul- tice. 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 tissues, and aids suppuration and sloughing. Poultices are not em- ployed very much, except in the treatment of horses' feet, as they are clumsy, laborious contrivances, and difficult to keep in place. If long- continued, they cause tissues to become swollen, sodden and macerated, destroying their vitality. Antiseptic poultices are made by soaking sheet cotton, gauze or other absorbent material, in hot antiseptic solutions, as corrosive sublimate, 1-1000; creolin or lysol, 1-100. The material is very lightly wrung out, wrapped about with dry gauze, covered with oil paper, silk or rubber protective, and applied to the part with a bandage. Anti- septic poultices are useful in 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, i.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. *Cataplasma Kaolini consists of kaolin, or porcelain clay, and is applied ex- ternally as a poultice. It acts to retain the body heat and is very similar to "Antiphlogistine," a substitute for the ordinary poultice. 504 GENERAL THERAPEUTIC MEASURES .Counter-irritation, as has been pointed out, is produced by hot poul- ticing 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 oil of turpentine over the hot blank- ets, or by saturating flannel cloths in turpentine and wringing them out in very hot water. To get a very active counter-irritant effect, a mustard paste may be rubbed over the chest, and then hot blankets applied. Hot Water Bags, made of rubber, and enclosing water at a tempera- ture of 120° F., may be placed along the spine, and by stimulating the cord and sympathetic ganglia, cause stimulation of vasoconstrictors 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 fol- lowed by drying and bandaging. Fomentations reduce swelling and pain, and hasten repair in bruises, strains and local inflammatory lesions. Injections of hot water are employed to cleanse wounds, stop bleed- ing 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 congestion in the pelvis, by producing uterine contractions, and atonic constriction of ves- sels 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 col- lapse 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 -'- lTie 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 animals. Dry Heat may be applied by means of hot blankets, hot water bags, ACTION OF HEAT 505 hot salt or sand in cloth bags, a flatiron or hot, wet cloths between waterproof coverings. Dry heat is often preferable to moist heat for simply relieving pain and congestion, as animals are less 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 exuda- tions. Agents may be incorporated in the inhalation having a sedative, stimulating or antiseptic action. (Vid. "Agents Acting on the Respiratory Organs," p. 39.) The teclmic consists in placing a bucket containing a boiling mash under the horse's nose, or in pouring cool water over a heated brick or iron in the bottom of a pail. The practice of tying a bag over a horse's head, and 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° F. are impracticable for larger animals. They can be given to the smaller animals in collapse, shock, rheumatism, and to abort cold after exposure. Glowing 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 similar in effect, producing vasomotor paralysis, congestion, inflammation, de- struction of tissue and death. Even the sensations to which they give rise resemble each other so closely, that coolies on first handling ice said they could not hold it because it burned their fingers. Strong heat (115° to 120° F.) contracts blood vessels in underlying parts and overcomes pain and congestion. Heat of this degree approaches cold in similarity of action. A moderate degree of heat dilates vessels, while cold of like intensity contracts them. Moderate heat relieves pain by relaxing tissue, diminishes vascular tension by dilating efferent 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 increased by moderate heat, but decreased by cold applied locally, or generally in fever. Swelling of tissue is reduced by cold directly; only indirectly by heat, which may, indeed, increase it. Softening and sloughing of parts, suppuration and "ripening" of abscesses and "cleaning off" of wounds, are facilitated by moderate heat, but hindered by cold. Disinfectants, Antiseptics and Deodorants. Disinfectants, or germicides, are agents which destroy the micro- organisms, causing infectious and contagious diseases, fermentation and putrefaction. Antiseptics are agents which prevent or retard the growth 506 GENERAL THERAPEUTIC MEASURES and development of the micro-organisms occasioning fermentation, putre- faction and disease, more especially the micrococci producing suppuration. Deodorizers, or deodorants, are agents which destroy or counteract a foul odor. They are not necessarily antiseptics or disinfectants. Con- siderable confusion exists in relation to the terms disinfectant and anti- septic, 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 may, in dilution, act as antiseptics, anti- septics are not often disinfectants, and in the nature of things are not strong enough to kill germs, although they may hinder their growth. Antiseptics may then be regarded as a subdivision of disinfectants. The two terms are unnecessary and misleading, as either might embrace both interference with the growth and destruction of micro-organisms. Dis- infection may fall short of sterilization; i.e., death of all germs. Re- peated boiling of a fluid containing micro-organisms wholly kills them; but, while disinfectants may destroy the germs of disease, they often fall 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 introduced within the body, may be classed as antiseptics, since they can rarely be used in such strength as to kill all micro-organisms without injuring or killing their host. DISINFECTANTS AND DISINFECTION. Air, sunlight, heat and water are naturally the best disinfectants. Air scatters and dilutes micro-organisms, making them pathologically in- active. There is no more effective way to disinfect a stable, in which animals are living, than by free ventilation with pure air. It is well known that 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 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, accomplishes more harm than good, since a congested surface offers a more suitable field for bac- terial growth. Air, on the other hand, may be a medium of infection when contaminated with dust containing pathogenic bacteria (B. tuber- culosis). 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 MECHANICAL MEANS OF ASEPSIS 507 our command. Dry heat, to be efficacious, must be applied at a tempera- ture of 140° C. (284° F.) for three hours to kill all bacteria and spores; but this degree of heat scorches most fabrics and destroys many materials. Boiling water quickly kills all non-spore-bearing pathogenic bacteria, and these include most of the organisms causing the common contagious and infectious diseases (anthrax excepted). Two hours of continuous boiling will not destroy the most resistant micro-organisms — the spores of the hay bacillus — but moist or saturated steam, at 230° F., will infal- libly kill any spores whatsoever within a few minutes. Fire is the most complete disinfectant, because it not only destroys germs, but their food and products. Water, like air, dilutes germs and aids oxidation and destruction of organic matter; but, again like air, drinking water may be the source of infection when sufficiently contaminated. MECHANICAL MEANS OF PROCURING ASEPSIS. Hitherto the placing of sole reliance on chemical agents to secure surgical sterility of the skin and fresh infected wounds has been a mis- take. 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, alco- hol. The wound was then exposed, foreign matter and loose tissue removed by forceps and scissors, and the 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 appar- ently as good results by using iodine (See p. 513). CHEMICAL AGENTS. Mercuric bichloride, carbolic acid, quicklime, chlorinated lime, sul- phurous acid, and chlorine, are more frequently employed as disinfectants. Corrosive sublimate solutions are decomposed by keeping, and by contact with albumin and ammonia. Acids, or common salt, added to bichloride solutions prevent, in a measure, this decomposition; but, nevertheless, mercuric bichloride is rendered unfit for the disinfection of masses of decomposing albuminous matter, as manure. One of the best solutions, employed by the Paris Disinfection Service, is composed of corrosive sublimate 2 grams; tartaric acid, 4 grams; 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 articles made wholly, or in part, of leather, rubber and fur; for blankets, cotton and woolen fabrics, and for floors, walls, and wood work of stables. Surgical 508 GENERAL THERAPEUTIC MEASURES instruments, and other metallic implements and fixtures, are injured by corrosive sublimate solutions. Carbolic acid is more expensive than corro- sive sublimate, and less efficient in cases where the latter is applicable. Carbolic acid can, however, be used to disinfect albuminous material and metallic substances. It is employed on animal excreta in 5 per cent, aqueous solution (about 8 ounces to the gallon of hot water). This solu- tion 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 cresol is as efficient and cheaper than a five per cent, carbolic acid solu- tion; 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 probably the best and cheapest disinfectant we possess for use in privies, drains, sinks, cesspools, and sewers, and for the destruction of micro-organisms on floors, and in feces and urine. A few pounds of this preparation may be thrown into privies or cesspools once a week, and the pure compound, or a saturated solution, may be scattered over floors or mixed with manure. A 5 per cent, solu- tion 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 ^2 to 1 ounce to each 65 gallons of water. Chlorinated lime is a powerful deodorant as well as disinfectant, but is of no value in either capacity unless the compound contains so much chlorine gas that the face cannot be held near it with- out 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 infection during transportation. Disinfection by sulphurous acid and chlorine gas is done to destroy germs which cannot be reached by other methods. Five pounds of sulphur and two ounces of turpentine or alco- hol (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 suffi- ciently tight to insure proper disinfection, it is difficult to secure com- bustion 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 chlo- rinated lime, to which is added crude muriatic acid, one pound of the former to three of the 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 anthrax 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 ANTISEPTICS 509 means of gaseous disinfection. (See p. 255.) 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 parasitic in- vasion. 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, lice, and mosquitoes), and gain entrance by means of the air passages, digestive canal and blood ; but even in the two former cases, the micro-organisms are in a certain sense outside of the body, since it is not easy for them to penetrate the intact and healthy ciliated mucous membrane of the respiratory tract. But when the mucous mem- brane is damaged by inflammation, and the cilia? 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* acts as a natural antiseptic, while the liver is thought to destroy toxins resulting from bacterial life. When digestion is in a normal condition, putrefaction and fermenta- tion do not occur; but when its activity is diminished, and the secretion of the digestive juices is lessened, and the hepatic functions are de- pressed, then a chance is offered for bacterial growth, fermentation and absorption of toxins, or even actual transmigration of micro-organisms through the intestinal walls. To these natural agencies of defense, which may be likened to outlying pickets shielding the animal from bacterial invasion, we must add the intrinsic power of resistance vested in the tissues, blood serum (opsinins, bacteriolysins, agglutinins), and leukocytes in combating micro-organisms; and the production of antibodies in the system antagonizing the toxins formed by bacterial action. Micro-organ- isms 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 number 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 im- possible to administer antiseptics in sufficient amount to seriously inter- fere with bacterial growth in the tissues, without injuring or even killing the patient. There are certainly known but two instances (quinine in malaria and salvarsan 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 rheu- matism, act therapeutically as internal antiseptics. Antiseptics are of benefit in rendering the contents of the digestive tube more or less aseptic, •Experiments in human patients show that many forms of pathogenic bac- teria may live in bile. It is but moderately bactericidal. 510 GENERAL THERAPEUTIC MEASURES and (after absorption) they exert some antiseptic action on the mucous membrane of the respiratory tract (volatile oils), and also on the urinary tract (urotropin), during their elimination. The principal agents used as antiseptics for surgical purposes are: iodine, dichioramine-T, phenol, compound cresol solution, creolin, hydrogen dioxide, corrosive sublimate, potassium permanganate, zinc chloride, iodoform, salicylic acid, aristol, iodol, and boric acid. Those employed internally include naphthol, salol, creolin, 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 preceding pages. Probably the greatest advance in the treatment of wounds in the great war was the use of chlorine preparations. Dakin's solution was that most successfully employed, consisting of 0.45 to 0.5 per cent, of sodium hypochlorite (NaOCl). The solution must be very accurately made since it is antiseptically inefficient if too weak, and irritating and caustic if too strong. Moreover, it is of the greatest importance that its alkalinity be most precisely determined by titration with sodium thio- sulphate by a competent chemist. The solution is unstable and must be made every few days. The treatment is carried out by a most elaborate technic (Carrel-Dakin) in which intermittent or continuous irrigation through a number of small rubber tubes introduced into all the recesses of the wound is the chief feature. Closure of the wound is done when bacterial counts, taken from the wound secretion, show not more than one microbe in 5 or 6 microscopic fields on three successive days. Dakin's solution gives off all its chlorine and loses all its antiseptic action within an hour. The difficulty of making and using it are so great that it is indicated in surgery only in well appointed hospitals, and by especially trained surgeons. Dakin has therefore prepared a more stable and non-irritating chlo- rine compound in dichloramine-T. (toluene parasulfondichloramine). This is a crystalline, slightly yellowish solid, having a strong chlorine- like odor. It is sparingly soluble in water but is soluble in chlorinated eucalyptol and in chlorinated paraffine oil, or better, in chlorcosane, a chlorinated oil of paraffin and white wax. To prepare a solution of dichloramine-T, 4.6 grains of dichloramine-T are dissolved in chlorcosane (§i) (Squibb) by first gently heating the latter and stirring in the former. The solution will keep about 3 weeks. In the treatment of wounds from 5 to 7.5% solutions of dichloramine-T are used. In the nose and throat, from one to two per cent, solutions. It is said that dichloramine-T has 20 to 40 times the germicidal strength of other chlorine solutions and shortens wound healing about one-third over ordinary methods. It is applied to fresh accidental wounds, in place of iodine, by spray, swab, medicine dropper or syringe in sufficient quantity to cover the wound, and then gauze is applied and the dressing renewed in 24 hours. As chlorine has a solvent action on dead tissue chloramine-T is very beneficial in putrid or gangrenous wounds applied twice in 24 hours. In cavities it is also most appropriate as it gives out chlorine for 18 to 24 hours and its antiseptic action is thus similarly prolonged. In fistulous withers and poll very encouraging DEODORIZERS 511 reports have been given out. It bids fair to supplant all other antiseptics in the treatment of accidental and infected wounds, and of sinuses. CHLORAZENE. As a substitute for the unstable and difficult-of-preparation, Dakin's solution, Dakin has prepared chlorazene (para-toluene-sodium-sulpho- chloramide). This is a stable, non-caustic and non-toxic salt occurring in white, soluble prismatic crystals. It is used commonly in 1 per cent, aqueous solution which gives up its chlorine in contact with animal pro- teids. It is more powerful than most antiseptic solutions in common use. It may be applied by the Carrel method through small rubber tubes in- serted in the recesses of wounds, the whole being covered by sterile gauze, and intermittent irrigation being practiced every 2 hours to saturate the gauze. Or gauze compresses, kept wet with the solution, may be applied to superficial wounds. It is generally applicable as a substitute for the more common antiseptics in use in surgery. Fresh wounds are freed from dirt by swabbing with liquid neutral soap, without water, before applying chlorazene solution on compresses. A a/4 per cent, solution has been used successfully in infectious mastitis by injection into the udder after empty- ing the gland of milk. Fistulae of poll and withers, and quittor, are favorably influenced by injections of chlorazene. Also canker of the ear in dogs. Scratches in horses may be cured by compresses wet with chlo- razene. It is commonly marketed in tablets. Dichloramine-T is pre- ferred in many cases, not requiring irrigation and drainage, in supplying more prolonged antiseptic action as the chlorine is more slowly set free. 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 mal- odorous gases, resulting from foul decomposing matter and excreta, may be freer from bacteria than ordinary air, and are not usually the car- riers 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 neces- sary that they come into direct contact with putrefying material, and sh'uiM not be placed about the habitations of man or animals, with the ridiculous idea that they are achieving more than the production of a vile odor. PRACTICAL DISINFECTION. The premises occupied by animals suffering from contagious dis- eases, together with all articles contained therein, such as harness, blank- ets, 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 necessary. Floors that are too old to readily clean should be taken up and burned. Manure 5] 2 GENERAL THERAPEUTIC MEASURES and valueless infected objects should be burned or the manure mixed with live per cent, solution of chlorinated lime. Where the floors are of earth, the earth should be removed lor a depth of lour mclies and mixed with the chlorinated lime (5 per cent.) solution, and replaced by fresh earth or, better, concrete. .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. creolis comp. The best way to apply the disinfectant is by means of a hand force or spray pump to every part of the building. In some cases, where only a stall or small area requires disinfection, a brush will do. The best outht 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 1 per cent, solution of compound cresol solution, or 2 per cent, solution of cresol. Tins 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 disin- fectants may be used alone or, in the strengths mentioned, in whitewash. Thus one slakes 7% 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 recom- mended when the avoidance of odor is necessary as in the production of milk. This should be followed by a coat of whitewash. Feed boxes, after drying of the disinfectant, should be washed with hot water to avoid poisoning. Gaseous disinfection is now in order, where the stable can be made air-tight and the animals removed, but is not usually necessary. Formaldehyde (p. 255) or sulphur (p. 197) may be employed. Live steam is the most useful when a suitable apparatus for its application to wood-works, haymows, etc., is obtainable. After thorough ventilation healthy animals 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 conceded that asepsis can be attained more satisfactorily and safely without the general use of antiseptics. For antiseptics, as has been noted, inflict a certain amount of damage upon denuded surfaces, and, in so far, lessen the resistance of the body to the inroads of bacteria. Modern surgery attempts to secure a comparative asepsis by mechanical cleanliness, which is more efficient, simpler, and harmless to the body. Antiseptics are indicated to assist asepsis in the toilet of the unbroken skin, and when sepsis has already ♦Farmers' Bull, No. 480, U. S. Dept. Agric, 1912. SURGICAL ANTISEPSIS AND ASEPSIS 513 occurred, or is unavoidable. The gross neglect of aseptic precautions, often seen in the operations of veterinary surgery, would be considered criminal practice in human surgery. Asepsis is, nevertheless, very difficult to secure in the lower animals living among filthy surroundings and lying on fecal discharges. In addi- tion 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 move- ments 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 com- pretely sterilize normal skin and tissues, yet the surgical result may be perfect. Therefore, in surgical operations, we should endeavor to pro- cure as small an amount of infection, or dosage of micro-organisms, as possible, consistent with existing environment and conditions. The following aseptic technic is especially applicable in the case of any surgical operation undertaken upon a noninfected part. If it is possible to carry out all the details, and the result is successful, 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 scrubbed with a brush, green soap and water for ten minutes, and then with 70 per cent, alcohol. Since tincture 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 alcohol. After the skin is incised there is no further necessity for antiseptics unless the wound is already infected, or becomes so by exposure to impure air or contact with dirt. The hands of the operator, including the finger nails, should be brushed until clean with green soap and water, and then with 70 per cent, alcohol. In accidental wounds the tincture of iodine or dichloramine-T 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 carries 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 skin is cleansed by mop- ping with gasoline or ether and the dirt removed 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 absorb- ent 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 5.14 GENERAL THERAPEUTIC MEASURES iodine treatment (or dichloramine-T) 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 wet, or better, dry sterilized rubber surgical gloves after thorough hand-disinfec- tion— in pus cases, to prevent contamination of the hands ; in clean cases, to avoid infection of the wound from the hands. If gloves are not worn in operating upon clean cases, they are all the more useful in dressing or operating upon pus cases to avoid contamination of the hands which later might give rise to wound infection when the naked hands come in contact with a clean wound. Instruments are thoroughly scrubbed with soap and water, and boiled for ten minutes in an aqueous solution of sodium bicarbonate (1 teaspoonful to the quart), and then placed in a solution of carbolic acid (1-40), or removed to a sterile towel. New sponges only should be employed, which have been previously cleansed, and then soaked in carbolic acid (1-40) solution, or pieces of sterile gauze may be used. If irrigation is desirable, normal salt solution (1 heaping teaspoon- ful 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 surrounded 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 ordi- nary cooking stove, in closed tin cans, until it becomes scorched and slightly brown. The same gauze may be used for sponges. Unsterilized articles are not to be suffered to come in contact with the operator, or wound, during the operation. Wound infection from exposure to the air and other media, is pre- vented by immediate dressing and bandaging, or by collodion applications. Venesection. Venesection, or Iblood-letting, formerly abused, has, for that reason, fa11 en 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 con- gestion 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 ten- sion 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 VENESECTION 515 (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 accompanied 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" with- out 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 fol- lowing disorders are those most suitable for treatment by venesection when they exist in an alarming form in robust animals: Cerebral congestion. In isolation and Sthenic pneumonia. tympanites. Sthenic pleuritis. Apoplexy, particularly parturient apo- Urticaria. plexy of cows. Lymphangitis. Acute cerebral meningitis. Azoturia. Active pulmonary congestion and apo- Toxemia, bacterial. plexy. Toxemia, mineral. Passive pulmonary congestion in car- Toxemia, vegetable. diac disease. (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 respiration 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 apoplexy of cows, and, when the disease has once occurred, it may be employed as a prophylactic measure in plethoric animals immediately before parturition. Venesec- tion alleviates dangerous pulmonary congestion, removes the venous load on the right heart, and relieves dyspnea and cyanosis by making it pos- sible for the heart to force a smaller quantity of blood through the less obstructed lungs. A feeble and easily compressible pulse does not necessarily contra- indicate venesection in engorgement of the lungs, for this condition leads to stasis in the pulmonary circulation, prevents the proper flow of blood into the left ventricle, and thus causes arterial anemia. Therefore, so far from contraindicating blood-letting, this condition urgently demands it. Alarming dyspnea, great cyanosis, together with a general plethoric 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 obstruc- 516 GENERAL THERAPEUTIC MEASURES tion 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 blood 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 1/5 of the total quantity of blood should not be withdrawn. The total quantity of blood is equal to about 13.5 per cent, of the body weight in horses; to 2.2 per cent, of the body weight of fat swine; to 6.6 per cent, of the body weight in dogs, and to 7.7 per cent. of the body weight in man. Large horses or cattle may be bled to the extent of from 4 to 6 qts. ; smaller subjects, 2 to 1< qts. ; sheep, l/> 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 symptoms, for the relief of which venesection is employed. The bleeding is arrested by suturing the lips of the wound and by pressure with a bandage. Local Blood-letting, or Scarification, is often useful in relieving ten- sion 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. Scarification is practiced by making numerous small, parallel in- cisions 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 poulticing, 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 above-mentioned condi- tions whenever there is great swelling, pain and tension in the affected parts, and not otherwise. SALINE INFUSION 517 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. Transfusion has been dis- carded in the past because of the dangers of sepsis, embolism, destruction of the infused blood corpuscles and nephritis. Within the last few years direct transfusion has been widely done in human surgery and without danger. The simplest form of transfusion consists in bleeding the donor through a large sterile needle (introduced into a vein), into a sterile glass vessel, gradually adding 2 per cent, solution of sodium citrate, while con- tinually stirring the mixture with a glass rod to prevent clotting. At least 6 ounces of citrate solution should be used to the pint of blood. The mixture of citrate solution and blood should be used warm and injected slowly by the use of a sterile funnel connected with rubber tube to a needle, which is introduced into the vein of the recipient. The chief dangers of transfusion of blood are embolism and hemo- lysis. The citrate solution prevents the first (by preventing clotting), and hemolysis may be avoided by mixing 5 parts of the serum of the recipient with 1 part of undiluted blood of the donor (Hare) in the excavation of a drop culture slide, oil being placed around it to prevent drying. If the two bloods be incompatible the red cells of the donor will be clumped and another donor will have to be found. Clumping or agglu- tination of the red cells of the donor by the serum of the recipient, is often followed by hemolysis of the patient's blood — if transfusion of sucli incompatible blood is done. The writer has, however, performed direct transfusion on many dogs without ill effects where no tests for compati- bility of blood had been made. Another simple method is by direct transfusion from vein of donor to vein of recipient by paraffine coated glass tubes. Direct transfusion of blood is life saving in cases of profuse hemor- rhage. It is also used with success in shock or collapse from any cause, and in severe anemias and chronic infections. The injection of warm, normal salt solution (0.9 of 1 per cent.) has been found to fill many of the indications for transfusion of blood, and yet is free from the 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 chlo- ride— 0.9 of 1 per cent. — contained in this fluid. The solutions should be filtered and boiled previous to their use, when this is possible, and are made by adding a teaspoonful (69 gr.) of sodium chloride to the pint of sterile water, which is used at a temperature of usually 103° to 115° F., according to the mode of introduction and circumstances. The injec- tion 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 diure- sis in the effort of nature to restore the plasma to its proper composition. If the solution is too strong (hypertonic) it will draw water from the 518 GENERAL THERAPEUTIC MEASURES tissues and injure the blood cells so that they shrivel. If too dilute (hypotonic) the red cells are injured, the blood is laked (hemolysis), and salts abstracted from the tissues. Calcium salts offset the toxic action of common salt (increased con- traction of muscle), and alkalinity is desirable. Elimination from the bowels and kidneys is so rapid that the fluid from an infusion is removed in half an hour in healthy animals. Large infusions, without much loss of blood, tend to cause general and lung edema. It is safer to weigh salt at any rate and not use a rough estimate, as a teaspoonful to the pint. Hare recommends the following which may be bought in dry form steril- ized: calcium chloride, 0.25; potassium chloride, 0.1; sodium chloride, 0.9; water, 1000 mils. Locke's solution is considered the best by many authorities: sodium chloride, 0.9; potassium chloride, 0.042; calcium chloride, 0.0024; sodium bicarbonate, 0.03; dextrose, 0.1; and distilled water, to make 1000 mils. Saline infusions do not increase blood pressure in normal animals as they are so rapidly removed. But after hemorrhage they may maintain normal blood pressure by replacing blood. They favor coagulation of blood in hemorrhage, and so tend to stop bleeding, as well as replacing lost blood. Hogan's solution is almost as immediately successful as a blood transfusion after severe hemorrhage (not permanently so) and incomparably more convenient. It consists of sterile solution of gelatin, sodium chloride and carbonate prepared for immediate use by Squibb. The gelatin is free from tetanus bacilli and is remedial especially in coagulating blood. Simple distilled and ordinary water are noxious to the tissues. Mode of Introduction. — Saline infusions are introduced within the body (1) by intravenous injection; (2) by injection into muscular tissue (hvpodermoclysis); and (3) by rectal injection (enteroclysis). Intravenous injection is the most rapid and certain method, but not so simple and practicable as hvpodermoclysis. Any superficial vein which can be readily seen and isolated, may be utilized; preferably the jugular or internal saphena vein in animals; the median basilic, or cephalic, at the bend of the elbow in man. The apparatus consists of a glass funnel or rubber bag connected by four or more feet of rubber tubing, with a canula or curved piece of glass tubing 4 inches long and !/4 inch in diameter for horses ; % inch in diameter for dogs. The apparatus should be boiled immediately before using. The vein is made prominent by manual pressure exerted by 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 1^2 to 2^2 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 aneur- ism 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 SALINE INFUSION 519 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 exposing the vein as above. The appa- ratus is filled with salt solution — including the funnel, tubing, and canula — at a temperature of 103° 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 in- cision and the heart, should of course be removed before beginning the injection. 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 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 in- jected will vary from a few ounces to two pints in the case of dogs; from 2 to 6 quarts for horses. Considerable quantities of isotonic salt solution may be introduced into the blood without harm, not exceeding 30 mils per kilo live weight (Crile), providing the inflow is not too rapid; i.e., exceeding one fluid dram to the pound of live weight in fifteen min- utes. When this amount is exceeded the heart and kidneys cannot take care of the great quantity of fluid in the vessels and tissues. A return to the normal volume, force, and rate of the pulse, and of color to the mucous membranes, will lead us to stop the saline infusion. The use of 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 subcutaneous tissue of the neck, abdomen or thigh, 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: i.e., by filling the jar with salt solu- tion and forcing the air into the jar, thus displacing the fluid. The foun- tain syringe is the best apparatus. Hypodermoclysis may be employed in the same cases as intravenous infusion, and is simpler but not so ef- fective. We are guided as to the quantity of solution desirable by the same indications 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. Enteroclysis. Enteroclysis applies to slow, rectal injection of normal salt solution (105° to 120° F.) to secure absorption. This method may be applied 520 GENERAL THERAPEUTIC MEASURES in cases not so urgent as to demand intravenous saline infusion or hypo- dermoclysis, more especially moderate degrees of hemorrhage, shock, col- lapse and circulatory depression, when the intrinsic heat of the injection is valuable in restoring the normal bodily temperature. U ses. INDICATIONS FOR SALINE INFUSIONS. Grave hemorrhage. Purpura hemorrhagica. Shock, traumatic, operative, and eke- Aside from hemorrhage, in collapse or trie. shock from any cause. Give ;i sin, ill Suppression of urine. infusion of adrenalin. A large injec- Severe diarrhea. tion of saline in such eases may lead Eclampsia. (Venesection most sue- to edema of the lungs and body. cessful.) Hypodermoclysis, or the intravenous injection of saline infusions, finds its greatest usefulness as a life-saving measure in severe hemor- rhage. 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 ordi- nary causes. In fact, respiration is but slightly impaired in human sub- jects suffering from pernicious anemia, when there is an 80 per cent, reduction in the normal red corpuscles, and one-half of the blood may be (withdrawn from animals and replaced with normal salt solutions witiiout serious damage resulting. Notwithstanding the great value of salines in hemorrhage, the transfusion of blood is unquestionably more efficient. Levin found that dogs die from a loss of blood equal to 1.5-5.5% of their body weight. The heart would stop but would start up again shortly with saline infusion. But by replacing the blood lost with blood trans- fused the animal would be as well as ever within a few minutes. Saline infusions greatly dilute the blood — and, therefore, poisons in the blood — • in toxemia, while they increase the activity of the kidneys and elimination of toxins. The 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: septicemia, pneu- monia, uremia, diabetic coma, purpura hemorrhagica,* tetanus, ulcerative endocarditis, pyelitis ; acute alcohol, ether, chloroform, carbonic monoxide, arsenic and mushroom poisoning; and toxemias resulting from acute in- fectious disorders. The same treatment may be applied to hemoglobinuria and other toxemias peculiar to the domestic animals. Venesection for the purpose of removing the poisoned blood may be resorted to prior to prac- *G. W. Dunphy (Amer. Vet. Review, June, 1905) writes that he treated two cases of purpura hemorrhagica in the horse by injection 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 dem- onstrates the wonderful life-saving influence of intravenous saline infusion after the loss (by a horse) of 25 liters of blood. TREATMENT FOR MILK FEVER 521 tising saline injection in the toxemias, but recently Levin has found this treatment ineffective in experimentally produced toxemias. Excluding shock and hemorrhage, where heat is invaluable, saline infusions are gen- erally 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. 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 affected with milk fever should be stripped of milk and thoroughly washed with warm water and soap and the teats cleansed with 70 per cent, alcohol or some other effec- tive 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 re- maining teats. The ligatures on the teats may" be permitted to remain in place for an hour and a half, when they should be removed. The inflation of the udder may be repeated in six hours, if necessary, owing to the non- improvement of the patient. As synergistic measures, the subcutaneous injection of one-half grain of strychnine nitrate, the use of enemata to empty the bowels, and 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 con- nected with a milking tube may be employed with much success; the results being probably 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 by 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 cow's 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 satisfactory 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 par- tially 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 for more than half an hour to retain the injected air 522 GENERAL THERAPEUTIC MEASURES is unnecessary, and has led to serious consequences by shutting off the circulation in the end of the teat. The results of the Kunsel treatment are wonderful. Kunsel reported a series of twenty-two cases of milk fever, without a death, following the use of his method. Similar results have been secured in this country. The rationale of the treatment has yet to be elucidated. Various hypotheses have been advanced, such as the effect of the oxygen on a hypothetical anerobic bacillus in the udder; the action of the oxygen on the blood and general metabolism in destroying toxic products in the economy; the action of air-compression in the udder in overcoming con- gestion in this part, and thus preventing anemia of the central nervous system; and a possible stimulation of the secretory function of the mam- mary 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 extraordi- narily toxic when injected into other animals, whereas colostrum 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 absorption of this toxin. Lavage. Lavage is a term applied to washing out the stomach with the stom- ach tube. This process, while an every-day occurrence in human medi- cine, was too long neglected in veterinary practice. Fortunately, new interest was awakened in this useful procedure by Phillips, of St. Louis, who perfected a- tube and demonstrated the practicability of its use in 1903. The use of the stomach tube in the treatment of indigestion in horses was quickly popularized by Knisely of Topeka, Kansas. Stom- ach lavage is now a routine procedure with most veterinarians. The stomach tube is also largely used for the administration of oil and other drenches to horses. 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. Gastric indigestion and flatulence are shown by colic, distention in the region of the stomach, difficulty in tho- racic breathing and eructations of gas by the mouth, or attempts at retch- ing and vomiting. To pass the tube, the horse may be backed into a stall. The opera- LAVAGE 523 tor 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 nostril of the horse is also lubricated in the same way. The operator pushes the tube gently along the floor of the left nasal fossa with the left hand, while guiding its direction with the right hand. The first obstruction is likely to be met, when the tube has been entered about a foot, by its contact with the turbinates. The point of the tube should then be held downwards, by the pressure of the right fore- finger pushed as far as possible into the nostril, while the outer part of the tube is lifted upward to force the point down into the pharynx. When the tube enters the pharynx attempts at swallowing are likely to occur and these are just what are needed to close the epiglottis over the larynx and to force the tube into the gullet. If swallowing is not evident it may be brought on by pushing the end of the tube gently backward and forward into the pharynx, and, when an attempt at deglutition occurs, the tube should be thrust forward. If the tube goes into the trachea instead of the 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 may be passed via the mouth by using a speculum or by tying the mouth shut. For the double tube this route is perhaps best. 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 tl e 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 the water is injected with a syringe, care must be taken to avoid forcing air into the stomach. When passage of the tube becomes impossible through one nos- tril, the other one may be tried. Phillips reported failure to pass the tube in the horse in only 5 per cent, of trials. Many operators experi- ence practically no failures in passing the tube. The tube is best made of red Para rubber and long enough to reach from the stomach to 524 GENERAL THERAPEUTIC MEASURES the ground when in place. Occasionally in impacted stomachs it is im- possible 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 proved satisfactory and is easily carried about. The apparatus consisting of two tubes, a small inlet and a larger outlet tube joined together, while superior for some purposes 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 arc required. A large human catheter, or small human rectal tube is 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 siphon off. The tube must of course be filled with water when it is lowered in order to act as a siphon. Lavage of the stomach and indeed the whole alimentary canal may also be accomplished in dogs by inverting the animals or hanging 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 six feet above the patient. Water is allowed to flow until vomiting begins. It is well to introduce the rectal tube slowly for several feet 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 and some practitioners use it to free dogs of worms. Here a purge is first given and then the lower bowel is emptied by allowing soap solution (several gallons) to be intermittently rejected. Then the dog is inverted and normal salt solution allowed to flow into the tectum until it flows almost as fast from the mouth. If this does not occur, apomorphine hydrochloride (gr. l/lO to 1/20 under the skin) will aid the water to flow through. A second treatment given in three days completes the vermifuge treatment. The worms are not always wholly removed and occasionally rupture of the gut occurs. The method is in common use, however, by leading practitioners (Quitman). BIOLOGICAL THERAPEUTICS. By A. Eichhorn. INTRODUCTION. The fundamental principles underlying biological therapy are inti- mately connected with the study of immunity. In order to intelligently apply biologic therapeutics to the treatment and prevention of disease, it is essential to be familiar with the principles of immunity. It is true that our knowledge of this intricate subject has not yet been made suffi- ciently clear in all of its phases, nevertheless, the principles of the phe- nomena are clearly understood. No doubt the extensive investigations which are being carried out at present in this line will sooner or later disclose a most wonderful activity which is taking place in the body dur- ing the struggle between infection and resistance. The principal bio- logic tests which have played such an important part in immunology will be further advanced. Reference is made especially to the complement- fixation, agglutination, precipitation, and other tests, and particularly to the latest of them all — the Abderhalden test — which has conclusively shown that not only in disease, but also under certain physiological con- ditions, certain ferments, enzymes, or other products are developed by the body and may be detected by the application of this test. It is there- fore of the greatest importance that the subject of immunity should be well understood by all those who apply biologic products to the treatment and prevention of disease. Immunity. The study of immunity during the last few years has advanced to such an extent that, not only has our theoretical knowledge of the subject been furthered, but its practical usefulness has been established beyond a doubt. The progress in this line has not been confined to the applica- tion of the present knowledge of immunity to the science of human medi- cine, but many of the reactions are now utilized in veterinary medicine. Immunity represents the resistance or non-susceptibility to disease, or in other words the ability of the living organism (human or animal) to resist the action of the causes of disease. Immunity is either natural or acquired. The acquired immunity is again subdivided into active and passive immunity. In glancing over the list of diseases to which various species of ani- mals are susceptible it becomes evident that some animals are never spon- taneously infected with many of the microorganisms that cause extensive and fatal ravages in others. Such differences point to variations in the defensive mechanism since the invader in these cases is the same. This non-susceptibility which is congenital or the result of normal growth is called "natural immunity." Even in susceptible species infectious diseases frequently terminate in recovery and recovered individuals are to a greater or less extent re- sistant to future attacks of the same diseases. This condition is called "acquired immunity." Acquired immunity may be brought about (1) by inoculation with attenuated virus, as for instance in vaccination against 526 GENERAL THERAPEUTIC MEASURES smallpox; (2) by injecting killed bacteria such as hemorrhagic septice- mia; (3) by injecting the specific toxins of bacteria as in the production of tetanus antitoxin; (4) by the injection of antitoxins or immune blood serum of animals that have recovered from disease, or that have been hyperimmunized by the above mentioned methods as for instance in the prophylactic inoculation against tetanus with tetanus antitoxin. Animals acquire an active immunity to certain diseases when they have survived a natural or modified course of the disease produced either by infection with the particular germs or by inoculation with their specific vaccines, bacterins, or toxins. In this case the animal produces its own immunity either because it had the disease naturally or because it has been intentionally and artificially produced in a changed and less severe form. Artificial or intentional active immunization is ordinarily called "vacci- nation." Passive immunity is produced by the introduction of immunizing substances of an actively immune animal into another animal. This im- munity is usually conferred by the injection of blood-serum from immu- nized animals, such serum carrying with it certain substances by which protection is conferred. The immunizing substances of an actively im- munized or a hyperimmunized animal are known as immune bodies or "antibodies." They comprise two classes: those acting on bacteria are antibacterial, as for instance anti white scours serum, anti anthrax serum ; while those acting on toxins are called antitoxic, as for instance tetanus antitoxin. Active immunity develops only after one or two weeks, while passive immunity is established immediately after the inoculation, but passive immunity does not last and protect animals for a long period as it usually disappears within one to two months. This is due to the fact that just as soon as the injected immune bodies are eliminated from the animal organism, immunity will cease; however, in the active form, the stimula- tion of the infection upon the body cells causes the continuous develop- ment of antibodies (immune bodies), and, therefore, a lasting immunity is produced. From these brief remarks it can readily be seen that the production of active immunity, whenever its employment is practicable, has a great advantage over passive immunity, and the tendency is to employ this method whenever possible. On the other hand, it frequently becomes nec- essary to employ means by which the spread of the disease can be imme- diately checked, and in such instances passive immunity has the advan- tage over active immunity, inasmuch as it affords the animal immediate protection against infection (in many instances, it exerts also a curative action). Frequently, however, both methods are used as a combined in- oculation by which the animal is given immediate and also lasting protec- tion against an infectious disease. This form of immunization is known as the "simultaneous method." This method was first employed by Lorenz in swine erysipelas. Later it was employed by Kolle and Turner in rinderpest, by Soberheim in anthrax, and by Dorset in hog cholera. The object of the treatment is to stimulate with the material used for immuni- zation, the production of anti-substances which have not existed previ- ously in the body or are present only in very small quantities. These are BIOLOGICAL THERAPEUTICS 527 the anti-bodies, or immune bodies, and the substances which stimulate the body to the production of such immune bodies are known as anti-gens. Infectious Diseases. An infectious disease may be defined as any malady caused by the in- troduction into the body of minute pathogenic organisms of the vegetable or animal kingdom, having the power to multiply indefinitely and set free certain noxious substances, which are chiefly responsible for the morbid changes. Most of the contagious and infectious diseases of animals are due to the action of bacteria, examples, tuberculosis, anthrax, blackleg, tetanus, etc. Others, dourine, rabies, are due to minute forms of animal life — protozoa. Another class are caused by fungi of a higher order than bacteria — examples — actinomycosis and aspergillosis. Lastly, we find a group of infections due to unknown causes. Hog cholera, foot and mouth disease, smallpox, etc., belong to this class and we speak of the organisms that cause them as ultra-microscopic or ultra-visible because we have not been able to detect them by the aid of the most powerful micro- scope. They are also known as filtrable viruses, since they pass through porcelain filters through which the ordinary microorganisms will not pass. Bacteria may be defined as minute unicellular organisms of plant-like character. They multiply by cell division or by a process known as spore formation. The spore has analogies to the seeds of higher plants and its development usually occurs when the conditions of growth of the bacteria are unfavorable. It is a great deal more resistant to destructive agents than the bacterium that produces it. The protozoa, lowly forms of animal life, have a more complex struc- ture than the bacteria and their cultivation under artificial conditions is far more difficult than is the case with the bacteria. To this class belong the trypanosomes causing mat de caderas, dourine, tick fever and malarial or biliary fever of horses. Mention must also be made of the fungi producing mycotic lymphan- gitis and streptothricosis of horses. The infective agents that cause disease may gain access to the body in various ways. They may be swallowed with the food or water — exam- ple, anthrax; be inhaled, example, influenza (probably); may infect wounded surfaces, example, tetanus; may find their way through certain natural openings, as the milk ducts of the teats; the genital organs or the eye, examples, abortion disease, hog cholera. Lastly, certain of them may reach the body of the host through introduction by an intermediate bearer, example, the piroplasm of tick fever, which reaches the blood of its bovine host through the bite of the cattle tick. Some infective agents may enter the body by two or more of these channels. Whatever the cause from which they arise, all of these contagia have quite definite incubative pe- riods, varying with the different organisms. Animals suffering from in- fectious disease are more or less directly a menace to others; they are factories for the production and distribution of disease germs. The infec- tion may be direct — from animal to animal — or indirect, through infec- tions of the feed, pasture, stable, byre, or by intermediate carriers as flies, buzzards, rats, etc., or lastly, as seen above, through introduction into the bodv bv an intermediate host. It is therefore evident that in the 528 GENERAL THERAPEUTIC MEASURES control of infectious disease prevention is the most important procedure. The healthy must be segregated from the sick, and this is best accom- plished by removing the healthy animals from the infected ones rather than vice versa. In some cases destruction of the infected animals is im- perative. Examples — in tuberculosis of cattle, contagious pleuro-pneumo- nia of cattle, foot-and-mouth disease, and in countries where diseases ap- pear that have not hitherto gained a foothold, it may become necessary to destroy not alone the infected but also the exposed animals. This is the method heretofore adopted in this country in the control of foot-and- mouth disease, and the results have amply justified the means. Disinfection is important. It consists in the use of certain substances which destroy the bacteria or their spores, or both. Among these are found fresh slacked or unslacked lime, chlorinated lime (bleaching pow- der), carbolic acid, corrosive sublimate, formalin, formaldehyde gas, cre- olin, cresol, etc., etc. The prevention of some infectious diseases is most successfully ac- complished by vaccination and without doubt this method of prevention when properly applied reduces the losses to a minimum. Vaccination is effective against blackleg, anthrax, tetanus, influenza, rabies, hemorrhagic septicemia, white scours, hog cholera and rinderpest. It is always essen- tial that the products used for the vaccination should be pure and potent and they should be employed with proper care. The biological products prepared for the cure and prevention of infections are prepared under license of the United States Department of Agriculture. Parallel with our broader knowledge of the subject of immunity the development of biological therapy is progressing. Since the beginning of progress in the exploitation of products through which infectious diseases may be prevented and cured it has been found that one of the most desir- able means of preventing the extension of various infectious diseases is to furnish the susceptible and exposed animals with artificial immunity. This is the case in blackleg, anthrax, rabies, hog cholera, tick fever, and the like. Many animals prove to be naturally immune against some of these diseases, while others must be made immune by treatment with suitably prepared materials before they are able to successfully withstand attacks from a specific organism. Investigators the world over have expended the greatest amount of their study in attempts to discover and perfect effective and at the same time practical means of immunizing animals against the more destructive of the infectious diseases. Large sums have been appropriated for the use of able investigators for the advancement of these researches, both from governmental sources and from gifts of private wealth. The goal sought by these searchers is the discovery of some means by which immunity may be conveyed to a large number of animals at the least expense. Suc- cessful vaccination against some of these diseases consists in giving the animals that are to be protected a mild attack of the disease ; to provide the body tissues with such a degree of resistance that no disease germs taken into the system can remain to find lodgment, develop and cause in- jury. After such vaccination the animal is sufficiently protected and can go with perfect safety into fields that would have proved deadly before vaccination was performed. BIOLOGICAL THERAPEUTICS 529 Vaccination is especially indicated when we desire to confer an active and therefore lasting immunity to the animals. Of course, there are types of infectious diseases in which it is not the organisms which produce the disease, but their toxins. The ultimate result, however, is the same, since in such cases instead of the germicidal action of the protective sub- stances created in the body, antitoxic substances are produced which take their place. Taking all of these factors into consideration, it appears natural that the greatest and the surest achievement may be expected from immu- nization in those diseases in which the specific cause of the disease has been definitely established, and as a matter of fact, the attained suc- cesses have proved the most reliable where these conditions have been ful- filled. Preparations Used in the Production of Immunity and as Diagnostic Agents: In the production of immunity three principal methods are used. A vaccine is either a living, attenuated or weakened virus of the dis- ease. The reduction of the virulence is accomplished by subjecting the virus to a degree of heat or desiccation or other unfavorable influences, not sufficient to destroy it, but only to weaken it. Good examples of vaccines are anthrax vaccine and blackleg vaccine. In some instances the fully virulent organism is used for immunizing purposes, as, for instance, in abortion; or, again, an unattenuated virus may be used when passed through certain species of animals which increases the viru- lence for the particular species through which it is passed, but reduces its virulence for other species of animals, as, for instance, suspensions of a brain emulsion of fixed rabies virus, passed through rabbits is used for the immunization against rabies in other species of animals. Vaccines produce a mild attack of the disease, thereby rendering the animal resistant against subsequent exposure to natural infections. Bacterins (bacterial vaccines) are standardized suspensions in physio- logical salt solution (or in oil) of the killed pathogenic bacteria. Vac- cination with bacterins against certain diseases such as hemorrhagic septicemia, white scours and other infections is now a procedure of estab- lished success. Bacterins are standardized to a definite number of dead organisms per mil either by actual counting of stained organisms in a blood counting apjDaratus or by mixing a definite amount of blood and the suspension of the bacterin to be counted and then establishing the rela- tive proportion of organisms to the number of red blood cells in the preparation, from which by simple calculation it is possible to establish the number of organisms contained per mil. Bacterins contain the dead organisms and their products through which immunity is established by a stimulation of the body to the forma- tion of protective substances against the subsequent attacks of the viru- lent germ. Sera contain the protective substances and when injected into the body either exert a bactericidal action against the virulent virus or act as antitoxins possessing a neutralizing power over the poisonous products (toxins) of the disease producing organisms. For the preparation of immune sera usually horses are used, prin- 530 GENERAL THERAPEUTIC MEASURES cipally because their size enables the drawing of large volumes of blood. If the horse is to be treated for the production of antitoxin small amounts of the respective toxin are at first injected. If the animal is to be treated with antibacterial serum, suspensions of the bacteria of the specific dis- ease are injected. Periodical potency tests are made consisting in agglu- tination, complement fixation test and the ability of the serum to protect other animals. When a suitable potency test is obtained a quantity of blood is drawn from the jugular vein into sterile containers. After standing 24 hours the separate serum is siphoned off, properly preserved, if necessary Berkefeld filtered and filled into final containers. Immune sera contain either antibodies which have an immediate neutralizing action upon the toxins generated during the course of the disease; or antibodies which have the power of helping to destroy or render inert the living organisms themselves. Hence the term "anti- toxic sera" for those sera possessing antibodies which neutralize the toxin; and the term "antibacterial sera" for those which contain anti- bodies capable of helping to destroy or render inert the organisms causing the disease. Immune sera are assimilated most rapidly if ad- ministered intraven- ously. This applies especially where it is desired to administer for therapeutic ac- tion. For prophylac- tic purposes the in j ection is made either intramuscular- ly or subcutaneously. In addition to the foregoing there are other products such as sensitized vaccines, sensitized bacterins, germ free extracts, natural and artificial aggressins and bacterial filtrates, employed for the protection of animals against disease ; but with all these products the principle of their action is the same and consists of the production of protective substances against their respective infections. Taking up the uses to which biological products are put, they may be divided into four groups: 1 . Those that are used as prophylactic agents only, such as anthrax, rabies, and blackleg vaccine. 2. Those that are used principally as curative agents, such as vari- ous immune sera. 3. Those used for both prophylactic and curative purposes, such as various bacterial vaccines, anti-anthrax serum, tetanus antitoxin. 4. Those used as diagnostic agents, such as mallein and tuberculin. In the prevention of various infectious diseases in both man and Bleeding an Hyperimmunized Horse to Produce Serum BIOLOGICAL THERAPEUTICS 531 animals, biologies stand out pre-eminently and considering them as a unit it may be said that prophylaxis is their most valuable asset. As cura- tive agents some biological products are very efficacious, but there are others which while highly valuable in immunization against certain dis- eases are of little or no value in the treatment of such affections. In this respect I might mention Pasteur's rabies vaccine, blackleg vaccine and anthrax vaccine. Biological Products Should Not Be the Sole Reliance in the Control of Disease. There is a tendency in the prevention and treatment of infectious diseases to rely solely on the biological products employed. It is highly essential in attempting to treat or prevent a disease, to give due consid- eration to the various factors associated with the condition. Thus in treating a case of fistulous with- ers we should not merely inject a polyvalent vaccine and sit down and wait for the animal to get well, but the local or surgical treatment should also be given due consideration in addition to the vaccine. Furth- er, in attempting to control a disease by immunization it is not sufficient to limit our activ- ities to vaccination of the ex- posed and susceptible animals, but it is equally essential to in- augurate the necessary sanitary measures, and, if possible, the source of infection should be looked for and eliminated. Thorough disinfection, and ef- forts to minimize the danger of exposure to infection, also should be considered. It must be remembered that in serum or passive im- munization, the immunity con- ferred is only of short duration, lasting in most instances for only a short period, at times not over a month. Therefore in cases of immediate dan- ger when this method of immunization is employed, it is very important to guard against the risk of subsequent infections and losses when the tem- porary immunity has been lost. In such instances the passive immuniza- tion should be followed up if necessary with the active form, which renders the animal non-susceptible for a much greater length of time. Importance of the Technic of Administration. Another factor in biological therapy which must be given careful attention, if good results are to be obtained, is the technic of administra- Sterilizing the Serum by Filtration Through Berkefeld Filters 532 GENERAL THERAPEUTIC MEASURES Testing- a Lot of Serum to Discover the Possible Presence of Contaminations tion. In the first place, the animal to be treated should be properly pre- pared, the site of inoculation should be carefully cleansed and disinfected; all instruments and utensils coming in contact with the material to be administered should be thoroughly sterilized and care taken to prevent dhem from coming in contact with con- t a m inating agents after having been so sterilized. Bacterial suspensions should be shaken vigorous- ly to insure an even mixture and great care should be taken to see that the dose administered is ac- curate. When deal- ing with such prod- ucts as anthrax vac- cine and hog cholera virus it is important that the empty con- tainers and unused portions of such products be properly disposed of and not carelessly thrown aside with the possibility of their being a factor in future outbreaks of the disease. Another important feature to be considered in biological therapy is the method of the keeping of these products. All biological products are very sensitive to ex-" posure to light and to high tempera- tures. It is neces- sary to protect these products from light and to keep them at a somewhat cool temperature in order to avoid deteriora- tion. Practitioners have no means of recognizing changes that may have taken place in a product and may, at times, use it after it has become inert. This phase is particular- ly important in con- nection with immunization of highly infectious diseases where, with the aid of vaccines., as for instance with anthrax, we desire to check the Automatically Filling Sterile Containers Serum With Sterile BIOLOGICAL THERAPEUTICS 533 spread of the disease, or to prevent its extension in localities where the disease is very prevalent. When in such cases an inert vaccine is used, both the veterinarian and stock owner are often at a loss to explain the reason if the disease appears. Unfortunately such cases are quite numer- ous, and from my personal experience in testing out vaccines from vari- ous sources I can state that the failure to keep the vaccines under proper conditions is often responsible for bad results. While many different biologic products are being prepared for the prevention and treatment of disease, there are some which stand out prominently over others in their specific action. Many of these products now play an important part in the control of animal plagues, whether for their value as diagnostic agents of obscure or latent disease or as pre- ventive and curative remedies. In the following a brief outline is given of the conditions in which the application of biological products has been especially successful. ANTHRAX. (Charbon; Splenic Fever, etc.) Anthrax is an infectious disease caused by specific bacteria known as anthrax bacilli (B. anthracis), and is usually restricted by conditions of soil and moisture to certain geographic localities. All domestic animals are susceptible to this disease, al- though goats and hogs are ni u c h more r e s i s taut than other species. The anthrax ba- cillus is a rod- shaped organism, which in the body of the infected ani- mals multiplies by a simple dividing process, but out- side of the animal and under condi* tions not so favor- able for this form of multiplication it forms spores. The spores under fa- vorable conditions again change into the disease produc- ing germs. The spores are very resistant and are known to retain their infective qualities for twenty years. In putrid material the bacillus is readily de- stroyed, but the spores are resistant even against such influences. The in- fection as a rule, results from the ingestion of spores by susceptible ani- Bacillus Anthracis. Showing the Capsule Stained 534 GENERAL THERAPEUTIC MEASURES mals. The spores may be present in infected grounds or may be washed from other localities by inundations or drainage by streams. With the re- ceding of the water they are deposited upon the ground ; vegetation in such infected places may also contain them. Animals pasturing in such dis- tricts ingest the spores with the feed or water, and since the gastric juice does not destroy all of them, some pass into the intestines where infection takes place. The disease may also be introduced into the animals through the skin by the bite of infected flies, and through the lungs by inhaling the germs. The period of incubation varies from two to fourteen days. Differential Diagnosis. It frequently becomes necessary to differentiate anthrax from black- leg. In blackleg the swellings under the skin crackle under pressure of the fingers, owing to the presence of gas in the tissues, while the tumor of anthrax, being due to the presence of serum, is of somewhat doughy consistence. The blood of animals dead from blackleg is normal and the spleen does not appear swollen or darkened as is the case in animals affected with anthrax. The chief difference between anthrax and tick fever is that the course of the former is more acute and the blood of the animal is dark and of a tar-like consistency, while in tick fever it is in some cases even thinner than normal. Of the utmost importance is the disposition of the carcasses of ani- mals which have died of anthrax. These are in most instances responsible for the propagation of the disease. The simplest means is to bury the carcasses deep — at least six feet under the surface — where they cannot be exposed by dogs or wild animals. The premises and all the utensils that came in contact with the infected animals should be thoroughly dis- infected. Likewise chlorinated lime should be sprinkled at every place where any discharges from affected animals have accumulated. All carcasses should be disposed of without being opened, since the access of the air into the opened carcass causes the spore formations which may retain their infective power for years, whereas, if the carcass is not opened the germs do not produce spores and are readily destroyed through the process of decomposition. Preventive Inoculation Anthrax may be successfully controlled by periodical vaccination of all stock in infected localities. This method, even if practiced alone, will have splendid results in minimizing the losses from anthrax. However, such vaccination must be carried out regularly in infected localities and irrespective of whether the disease has already appeared on the premises or not. Fortunately, in anthrax we have at our command various methods of vaccination which have been proved highly efficient in the production of immunity. This was one of the first infectious diseases in which protec- tive vaccination was successfully demonstrated, and for this we are in- debted to Pasteur. Heretofore the Pasteur method was used, principally, for the pre- vention of anthrax in the United States. There are, however, disadvan- tages in this method of vaccination that have probably been responsible BIOLOGICAL THERAPEUTICS 535 for the numerous failures resulting therefrom. Special mention might be made of the unstable keeping qualities of the Pasteur vaccine, and further, that it requires two handlings of the animal before immunity is estab- lished, that its standardization is not carried out accurately and that in herds where the disease has already appeared it is apt to induce losses through the temporary reduction of the resistance of the animal during the development of immunity. These conditions are, no doubt, responsible for the extensive experi- mental work undertaken by the U. S. Bureau of Animal Industry during the past three years on immunization against anthrax. The results of the work have been published in the Bureau of Animal Industry Bulletin, No. 340, by the writer, in which the advantages of the simultaneous treat- ment with anti-anthrax serum and attenuated spore vaccine are pointed out and endorsed. Anti-anthrax serum is prepared from horses which have been im- munized against anthrax. Then they are injected with minute doses of virulent cultures which are gradually increased until the animals tolerate intravenous injections of suspensions of mass cultures of virulent anthrax bacilli. The serum is then subjected to potency tests on guinea pigs and rabbits and if found satisfactory the animals are bled and re-injectcd at regular intervals. The spore vaccines are produced from specially selected anthrax cul- tures which have been proven good spore producers. They are subjected to attenuation by cul- tivating them at a temperature of 42l/2° C. (108.5° F.). The No. 1 vaccine or the vaccine of greater attenuation, is attenuated from 18 to 21 days, and must be pathogenic only to mice. The second or stronger vaccine is at- tenuated from 11 to 13 days and should be pathogenic to guinea pigs and mice but not rabbits. The attenuated vaccines retain their weakened pathogenic prop- erties for an indefinite period. They are then cultivated for the vaccine production on agar me- dia for four to six days until the maximum spore formation has been attained. After washing off the growth it is heated to 60° C. (140° F.) for one hour in order to destroy the vegetative forms. The suspension is then standard- ized by plating to establish the number of spores contained per mil. The suspension of spores is then diluted to a desirable strength and properly preserved. The simultaneous method consists of the injection of a potent anti- intravenous Injection of Virulent Anthrax Bacilli in the Production of Anti- Anthrax Serum 536 GENERAL THERAPEUTIC MEASURES anthrax serum on one side of the animal, and the injection of an attenu- ated spore vaccine on the other side. The advantages of this method are apparent. It confers immediate protection, requires only a single han- dling and reduces the losses from vaccination to a minimum. These investigations have further established that should it be found desirable to employ the double vaccination, it is much safer to use attenu- ated spore vaccines than the Pasteur vaccines, on account of the better keeping qualities of the product and the possibility of more accurate dosage. These findings were obtained through extensive investigations made by the Bureau of Animal Industry, not only in the laboratories and experiment stations but also in numerous field tests. The remarkable curative properties of anti-anthrax serum in the treatment of animals in anthrax infected districts are well established. Since it has been made available for the treatment of this disease, numer- ous reports are at hand which indicate that even in the most severe cases of infection, an intravenous injection of 50 to 100 mils of anti-anthrax serum has often resulted in the recoveries of animals in 1 to 4 days. Veterinarians in anthrax districts should not hesitate to use these new methods of vaccination as they cannot be considered in the experimental stage. The results obtained in hundreds of thousands of animals have demonstrated, and the experiments made by the Department of Agricul- ture should prove sufficient factors for establishing their merits. BLACKLEG. (Symptomatic Anthrax.) This is a non-contagious, infectious disease of young cattle charac- terized by bloody swelling under the skin on the fleshy parts of the body. The disease is confined almost entirely to young cattle and other species of animals are rarely affected. It is seen most frequently in animals ranging in age from six months to 2% years, and well-bred, well condi- tioned animals seem more susceptible than scrub stock. Cause. Blackleg is caused by the Bacillus gangraenae emphysematosa^, com- monly known as the "blackleg bacillus." This organism produces spores, or, resistant forms that, once established in the soil, remain for long periods, sometimes several years, until they gain entrance to the animal body, whereupon they grow and reproduce the disease. When this fact is understood the persistence of the disease in a locality is readily compre- hended. Blackleg is a pasture disease, the infective agent being found in the soil, and the germs are taken in with the food and water or through slight wounds in the skin, such as briar pricks or barbed wire scratches. Treatment. Treatment is ineffectual after the disease is once fully developed as it results almost invariably in death. Some have advocated cutting into the swellings, roweling and dragging the animals about. Such measures cannot be too strongly condemned. The fluids which are liberated con- tain the germs of the disease and as a result more infection is distributed to the grief of the owner and loss of future generations of calves. More recently the administration of anti blackleg serum has resulted BIOLOGICAL THERAPEUTICS ■ 537 in recoveries of animals affected with blackleg, especially when the injec- tion is made before the disease has advanced too far. Too strong emphasis cannot be placed upon the proper disposal of the carcasses. They should not be left to be torn apart and distributed over the country by predacious animals and buzzards, but should be buried deeply where they die, without opening, using quick lime or other strong antiseptic to disinfect the carcass and the place where the body has lain. Prevention. There is no other biological product used as extensively for the pre- vention of disease as is blackleg vaccine, and no other which has become so well established. The good results that followed its introduction are recognized throughout the United States. In blackleg districts a consid- erable portion of calves are annually vaccinated with this product. The available statistical data prove the remarkable reduction of losses from this disease, as a result of sj'stematic vaccination. Notwithstanding the tremendous economic saving that has resulted from its use, it must be admitted that blackleg vaccine prepared in the usual pellet or powder form from blackleg infected meat is a compara- tively crude product. Blackleg vaccine as marketed at the present time cannot be accurately standardized; a single dose may contain 100,000 or 1,000,000 spores and at other times a much smaller number, or even none at all. Such a variation must naturally result in irregularities of the immunizing action of the vaccine, and it is no doubt due to this fact that direct losses from vaccination and deaths from the natural infection after vaccination cannot be entirely avoided. Nevertheless, blackleg vaccination even as heretofore practiced has given splendid results, though complaints against the reliability of the method are not infrequent, both from veterinarians and stockmen. Realizing the shortcomings of the vaccine, investigators have been at work to develop a more uniform product that would avoid losses from vaccination, and at the same time, confer on the animals effective pro- tection against blackleg. The investigations revealed that certain germ-free filtrates possess great immunizing properties and further that the injection of such fil- trates into cattle will afford them a protection against the natural infec- tion of blackleg. Professor Naoshi Nitta of the laboratory of pathology and bacteri- ology of the Tokyo Imperial University, Japan, has recognized the value of this method of immunization against blackleg, and has developed the procedure to such a state of perfection, that it is now uniformly employed in Japan and Korea. In the July, 1918, issue of the Journal of the American Veterinary Medical Association, Professor Nitta published the results of the vac- cinations with blackleg filtrate in Japan and Korea in an article entitled "Investigations on Blackleg Immunization", in which he includes ar. fol- lows : "The filtrate of a pure culture of the blackleg organism confers a high degree of immunity on animals treated and it has been already suc- cessfully used in thousands of cattle in infected districts. It is inexpen- sive, the material for preparation being aerobic cultures of the organisms 538 GENERAL THERAPEUTIC MEASURES in meat-piece broth, and its injection is not accompanied by the least danger, because the filtrate is quite germ-free." The successes attained in the Far East with blackleg filtrate have been duplicated in the United States. The statistical data available on over one million vaccinations prove conclusively the effectiveness of the product, and in consideration of the many advantages of a germ-free fil- trate its superiority for the control of the disease in cattle is apparent. The greatest advantage of the blackleg filtrate is that it does not contain the blackleg germ in any form and therefore, cannot induce the disease under any circumstances. At the same time, it possesses all of the immunity producing properties of the vaccine, so-called aggressins (extracts), and liquid culture vaccines. Blackleg filtrate should not be confused with blackleg serum, which confers only a passive immunity, lasting but a few weeks; whereas the blackleg filtrate affords protection to the animals for about one year. Blackleg filtrate is prepared by cultivating the blackleg bacillus in a special medium until the maximum growth is obtained and the liquid becomes thoroughly charged with the products of the germs. The prod- uct is then suitably preserved and filtered through porcelain which re- moves all the germs. It is then properly standardized and carefully tested on animals for potency and sterility. Germ free extract (natural aggressin) is obtained from animals ar- tificially infected with the disease and after death the fluids of the affected muscles are extracted by pressure. After filtering, testing and suitably preserving the filtrate it is ready for use. Blackleg vaccine, powder and pellet form, is prepared from the af- fected muscle of an animal artificially infected with blackleg. The muscles of the involved part are cut into strips, dried and pulverized in a drug mill. The powder is then mixed with distilled water into a paste, filled into shallow pans and placed in an attenuating oven where it is subjected to a temperature of 95° C. (203° F.) for a period of six hours. The attenuated material is then ground into a powder which is prepared into either pellet or powder form. The product known as liquid blackleg vaccine represents attenuated cultures of the blackleg organisms. Anti blackleg serum is obtained from horses or cattle which have been injected with cultures of blackleg, at first with small doses, which later are increased until as high as 500 mils are injected intravenously. The serum is then standardized on guinea pigs for its protective value against a definite amount of virus. In order to minimize the losses from this disease it is essential not to defer vaccination until its actual appearance among the animals. Sus- ceptible stock should be vaccinated periodically and systematically; its occurrence cannot be controlled otherwise. A further advantage to be gained by such practice lies in the preven- tion of reinfection of the soil through the discharges of sick animals and from improper disposition of carcasses, thereby "wearing out" the infec- tion from the soil. CANINE DISTEMPER. Canine distemper is a highly infectious disease of dogs accompanied by fever and an acute inflammation of the mucous membranes. The BIOLOGICAL THERAPEUTICS 539 etiology of this disease has occupied the attention of bacteriologists since the time of Pasteur. According to the investigations of Carre, which have since been con- firmed by Lignieres, canine distemper is caused by a filtrable virus, which in the beginning of the disease is contained in the nasal discharge. These findings, however, have not been uniformly confirmed. The investigations of Ferry, McGowan and Torrey, on the other hand, appear to indicate that the B. bronchisepticus which they independently isolated, plays an important part in the etiology of canine distemper. Its relation to the cause of the disease is not generally accepted; nevertheless the presence of this organism in the excretions, tissues, and at times in the blood of infected dogs, indicates its close association with the pathological process developing in the course of the disease. In view of these findings and the fact that besides the B. bronchi- septicus there are other organisms involved in the secondary infections associated with the affection, the use of a bacterin containing these or- ganisms is entirely logical. Treatment. The results obtained from the canine distemper vaccines and bac- terins are encouraging and justify their use both for preventive and cura- tive purposes. Dogs, affected with the distemper, should be placed under good hygienic conditions; a uniformly warm place protected from draughts, is essential. Likewise, the patient should be given concentrated nourish- ment, such as milk, meat broths, etc. Bacterin treatment has given variable results. Animals which are exposed to the infection should be given the specific vaccine as a prophy- lactic. The value of the vaccine lies particularly in its protective action against the more severe symptoms of the disease which are due to the secondary invading organisms and which have proved to be the cause of the severity and fatality of the disease. Anti-canine distemper serum is being prepared by injecting horses with cultures of B. bronchisepticus. The prophylactic and curative value of such serum has been reported to give favorable results; others again fail to obtain any advantages from such serum. ABORTION DISEASE. Epizootic Abortion; Enzootic Abortion; Slinking of Calves. Abortion disease is an infectious disease affecting chiefly cattle and to a lesser degree other domestic animals, and is characterized by an in- flammatory condition of the female reproductive organs, which results in the expulsion of the immature young. Cause. — The Bacillus abortus of Lang is now generally recognized as the causative agent of the disease in cattle. The possibility that other organisms may also be responsible for abor- tion in cattle is being now recognized. In recent investigations by Theo- bold Smith, a spirillum was isolated from cases of infectious abortion. It was formerly claimed that abortion is due to injury, such as blows, horn thrusts, falls, etc., or the eating of spoiled food and of certain plants having oxytocic properties. While abortion may occur from such causes 540 GENERAL THERAPEUTIC MEASURES in a limited number of cases, careful investigations have demonstrated these claims to be largely unfounded. It is now generally recognized that in herds where abortion occurs from time to time, it may be safely assumed that the disorder is of an infectious nature and should be treated as such. Natural Mode of Infection. The manner in which pathogenic organisms gain admittance to the tissues of the host in any disease is of greatest importance for a clear understanding of the methods of its prevention. Many investigators claim to have demonstrated that in abortion disease, the infection is transmitted through the digestive tract, by the ingestion of contaminated food and water. The germs are taken up from the intestines into the lymph vessels, thence reach the blood stream and are carried by it to the genital organs, where they find conditions best suited to their develop- ment. Some claim that calves are infected in this manner by suckling infected mothers, the organisms being present in the milk; or, on the teats, having been contaminated by coming in contact with infective dis- charges. It is claimed that infection contracted in this manner remains dormant in the body of the calf until pregnancy begins, and then the or- ganism finding conditions suitable for its development produces the disease. Still other investigators believe that the natural habitat of the B. abortus (Bang) is the udder of cows and that it will exist but a short time in the nonpregnant uterus or other tissues of cattle. From the udder it reaches the uterus by way of the blood stream; if pregnancy exists, it develops in the uterus causing abortion, retained afterbirth, pyometra and other sequelae of the disease. The udders of healthy cows are in- fected from contamination with the discharge from the uteri of aborting cows or from milk from infected udders ; the organisms entering by way of the teat openings. Diagnosis. The diagnosis of abortion disease is made upon the history and symp- toms of the disease and from the changes occurring in the fetal mem- branes and in the expelled fetus. This, however, is substantiated with certainty only by the isolation of the B. abortus Bang. The fact, how- ever, that repeated abortions are observed in a herd is sufficient evidence of the presence of this disease. The fact that animals may be affected with the disease and disseminate the germs, even though they carry the fetus to full time, renders the control of the disease very difficult. Prevention and Treatment. The enforcement of the strictest sanitary measures alone are fre- quently of no avail in the attempt to check contagious abortion in in- fected herds. Medicinal treatment has likewise proved ineffective. On the other hand, in view of the fact that self-immunization of infected animals is now almost uniformly recognized, it appears self-evident that this might be hastened by timely injection of proper biological products; and furthermore, that susceptible animals might be rendered immune or highly resistant against the infection. Unfortunately up to the present no absolute specific vaccine or bac- terin has been developed for the prevention of abortion disease. While BIOLOGICAL THERAPEUTICS 541 good results from the injection of abortion bacterin have been reported by many veterinarians, nevertheless experimental work along this line has not established definite good results from such treatment. It is essential that in conjunction with any specific treatment the sanitary measures also be given proper attention. Extensive investigations of the British Commission on abortion dis- ease have demonstrated that the disease may be reduced to a minimum by single injections of active live abortion organisms. They apparently have demonstrated that a single injection of live organisms when given to virgin heifers and non-pregnant cows at least two months before breed- ing confers to the treated animals an effective immunity. Similar good results from this treatment are reported by Hadley, who also claims that animals treated with living germs proved protected for two years and probably for a longer time, whereas the British Commission states that it is necessary to continue the inoculations for a time on the infected ani- mals after abortions cease to occur. From all indications immunization with live organisms is most encouraging and at the present time appears to be the best means for controlling the disease. Furthermore the method appears to be without danger as far as the spread of the disease is con- cerned when employed in infected herds. EQUINE INFLUENZA. This term applies to a group of contagious diseases of horses which are manifested by blood infection, with inflammation of the air passages and frequently associated with pneumonia and pleuropneumonia. Cause. — We have no positive knowledge on the true causative agent of any of these diseases ; however, it is now believed at least one of them is due to a filtrable virus with the Streptococcus pyogenes equi and the Bacillus equisepticus as secondary invaders. Prevention and Treatment. The infected animals should be isolated from the healthy ones and placed in well ventilated stables. In the treatment of influenza in horses (pink eye, shipping fever, contagious pleuro-pneumonia, stable pneumonia, stockyards disease, etc.), also in purpura hemorrhagica, strangles, septicemia and other infectious catarrhal affections, the value of anti-influenza serum has been thoroughly tested and proved. The serum is also useful as a prophylactic against these diseases. Numerous reports from its use by practicing veterinarians and also from the results on horses of the foreign armies, indicate that improvement is rapid when the minimum subcutaneous dose is 50 mils. The dosage employed and recommended is 50 to 200 mils daily. In all serious, acute cases, the serum should be administered intravenously, the dose being not less than 200 mils. The nature of this serum is such that ill effects will not follow, no matter how large a dose is given. The fre- quency of the dose depends upon the character of the case, the compli- cations, the extent of toxemia and the results obtained. While numerous reports are favorable in regard to this product, others fail to observe any beneficial action from its use. Influenza bac- terin contains streptococci isolated from influenza cases, and while the causative agent of this disease has not been definitely determined, it is 542 GENERAL THERAPEUTIC MEASURES generally accepted that the Streptococcus pyogenes equi plays a most im- portant part in its pathogenesis. This organism which, in its principal character is identical with the streptococcus of strangles, must be recognized as a significant factor in connection with the changes occurring in the course of the disease; and this may explain the beneficial results which are obtained from the bio- logical products. Dr. Gregg of the British remount organization recommended the use of serum from horses recovered from influenza for the treatment of this disease. His observations, which included thousands of cases, are very conclusive as to the beneficial action of such serum. These facts would justify the use of influenza serum produced from horses which recently recovered from influenza and which have been subjected to repeated in- jections with many strains of streptococci of equine origin. Hemorrhagic septicemia is the name applied to a highly fatal infec- tious disease existing in various species of domestic and wild animals, and is due to a micro-organism known as the Bacillus bipolaris septicus. The same germ causes disease among different species. In cattle and sheep it is called hemorrhagic septicemia; in swine it is known as swine plague and when affecting chickens it is known as fowl cholera. In horses this organism appears to be found only in secondary infections of influenza or shipping fever. Wild animals are also susceptible and may be respon- sible for the spread of the disease to domestic animals. The bipolar bacillus is widely spread, and is found even in the diges- tive tract of normal animals. In such instances, however, it is not patho- genic, and attains such qualities only under certain special conditions, when it becomes highly virulent, causing many fatalities among the vari- ous species. Once the bipolar organism enters the circulation it multiplies with great rapidity, causing a poisoning of the blood and fatal conse- quences. The best results are obtained from vaccination with the specific bac- terins for the disease in the respective species of animals, that is, for the control of hemorrhagic septicemia in cattle a bacterin prepared from the B. bovisepticus. For the control of the disease in sheep a bacterin made from the B. ovisepticus, and for hogs a bacterin prepared from the B. suisepticum should be used. Such practice would naturally tend to yield the best results from vaccination against hemorrhagic septicemia of the various species. HEMORRHAGIC SEPTICEMIA. Hemorrhagic septicemia of cattle is, usually, an acute infectious dis- ease which manifests itself either as an inflammation of the digestive tract, in the form of a swelling of the skin and underlying tissue, or as a ne- crotic pneumonia. The cause is the B. bovisepticum. The period of incubation is only from one to two days. This disease is sometimes mistaken for anthrax, and is differentiated from it by the absence of the swelling of the spleen, and by the character of the blood which in anthrax is very dark and does not become light red on exposure to air, nor does it coagulate, while in hemorrhagic septicemia the blood is normal in appearance and readily coagulates. Forage poi- BIOLOGICAL THERAPEUTICS * 543 soning (cerebro-spinal meningitis), known also as "corn stalk disease", may be at times mistaken for hemorrhagic septicemia. The fact is, how- ever, that this disease manifests hemorrhages in different parts of the body, whereas in forage poisoning the only lesions present are infection of the meninges of the central nervous system (often slight) and in the less occult cases an extra amount of fluid in the brain and spinal canal. TREATMENT. Medicinal treatment is absolutely useless in acute cases. More re- cently the administration of liberal doses of serum has been shown to favorably affect the protracted cases and a considerable proportion of such animals have been saved by administration of anti-hemorrhagic septi- cemia serum. The injections should be made intravenously, and not less than 50 to 100 mils of the serum should be given as the initial dose, to be repeated in from eighteen to twenty-four hours if the severity of the symptoms demands it. All affected animals should be immediately isolated. The carcasses should be burned, or buried, and the premises thoroughly disinfected. In fact, all precautionary measures recommended for anthrax should be fol- lowed. The disease being fatal in character, attention must be directed to preventing and checking all outbreaks. For this purpose vaccination has been employed with uniformly good results. Although one of the newer biologic products, hemorrhagic septicemia bacterin is one of the most dependable, satisfactory, inexpensive and important of all such products. The first time vaccination was resorted to in the United States was in an outbreak of hemorrhagic septicemia which occurred among the buf- falo in the Yellowstone National Park in 1911. The method of prepara- tion of the bacterin used in that instance has been described by Mohler and Eichhorn in an article on "Vaccination Against Hemorrhagic Septi- cemia" in 1911. Since that time this method has been employed on hundreds of thousands of animals throughout the United States and the results justify the use of the bacterin for preventive purposes. In severe outbreaks it is advisable to treat the animals with protec- tive doses of serum alone in order to prevent further losses. Since such treatment produces only a passive immunity it should be followed in two or three weeks with the injection of bacterin in order to develop an active immunity. In a recent publication, by the Bureau of Animal Industry, on hemor- rhagic septicemia it is stated that cattle, sheep, swine, rabbits and fowls if treated with heated cultures of hemorrhagic septicemia organisms ob- tained from animals of the same species will almost invariably be pro- tected against injections of living cultures of the same germ, even though applied in comparatively large quantities. Hemorrhagic Septicemia in Sheep. This disease in sheep is characterized by a septicemic condition asso- ciated with a discharge from the eyes, nose, and a pleuropneumonia. The cause is the B. ovisepticus. The infection occurs usually through the digestive tract from infected food or drinking water. Young sheep are far more susceptible than older animals. 544 GENERAL THERAPEUTIC MEASURES The older sheep usually develop a chronic form, unless they have been subjected to some unusual hardships as a long drive or shipment on a train, when they may develop an acute form of the disease and die with great rapidity, sometimes as many as ten per cent, of a band succumbing daily. The acute forms are easily mistaken for anthrax, from which they differ principally by the absence of gelatinous infiltrations and hemor- rhages under the skin and by the absence of enlargement of the spleen. PREVENTION AND TREATMENT. The disease does not yield to any medicinal treatment, therefore at- tention must be directed towards preventive measures. Affected animals should be isolated and those showing advanced symptoms should be de- stroyed. Vaccination in this disease has given very satisfactory results and all animals exposed to the disease should be given a prophylactic vaccination. Hemorrhagic Septicemia of Hogs. (Swine Plague.) Hemorrhagic septicemia i;: hogs manifests itself as a multiple necrotic pleuropneumonia. It is caused by the B. suisepticum. It frequently occurs as a mixed infection with the virus cholera, although it may appear as an independent disease. Differentiation of this disease from hog cholera due to the filtrable virus is often very difficult, especially since the diseases may appear simul- taneously in the same animal. The fact, however, that this disease is not as. highly contagious as hog cholera, and also that it almost invariably localizes in the lungs, is suggestive of hemorrhagic septicemia. PREVENTION AND TREATMENT. At the present time we have no satisfactory treatment for this dis- ease. It may, however, be effectively prevented, provided suitable meas- ures are enforced. Isolation of the affected animals, thorough cleaning and disinfection of the premises, are essential factors. Vaccination with a bacterin prepared from the specific organisms of this disease has given good results. Swine plague infection is so common in some localities that veterinarians have found it is advisable to use hemorrhagic septi- cemia vaccine in conjunction with the serum simultaneous treatment for the prevention of cholera. Otherwise the hogs continued to die with marked chronic symptoms and lesions of a lung infection — with hemor- rhagic septicemia. In such cases it is assumed that the serum-simul- taneous method will not prevent the development of the pathological process resulting from the secondary infection with the hemorrhagic septicemia organism. Thus can we account for the continuance of losses in such instances. HOG CHOLERA. Hog cholera is a blood infection of swine produced by a filtrable virus in association with which necrotic processes develop in the intestinal tract and in the lungs. Prevention and Treatment. Proper sanitary measures consisting of a thorough cleaning and dis- infecting of the premises are primarily essential in the control of this disease. The spread of the disease should be controlled by vaccination of the animals with anti-hog cholera serum. BIOLOGICAL THERAPEUTICS 545 Anti-hog cholera serum is prepared by hyperimmunizing immune Logs with intravenous injections of blood from hogs sick with hog cholera. Ten days following the injections the hyperimmunized hogs are bled and either the defibrinated blood or the recovered serum is used for prophy- laxis and treatment of the disease. The defibrinated blood aside from containing the inert corpuscular elements of the blood cannot be produced in a sterile form, whereas the clear serum being free from corpuscles can be readily sterilized by various methods, therefore possessing many ad- vantages over the bloody serum. Anti-hog cholera serum is probably the most important biological product produced in recent years. Its effectiveness in the prevention of hog cholera caused by the titrable virus is no longer questioned. How- ever, it is essential to have a potent serum and to adhere to the strictest precautions against contamination both in handling and administration of the serum. In spite of the fact that the protective value of hog cholera serum has been established beyond a doubt, numerous complaints are made of its failure to immunize against hog cholera. Various factors are re- sponsible for such failures. Among these, probably the most commonly recurrent one is a mistake in diagnosis. Practitioners are very prone to establish a diagnosis of hog cholera in case several animals die, without determining the character of the post-mortem lesions. An insufficient knowledge of other infectious diseases of swine may also be responsible to some extent for the failure in hog cholera vaccinations. A serum without the proper potency, used by the simultaneous method, with a potent virus, may bring about bad results. It should be understood that anti-hog cholera serum represents one of the crudest of biological prod- ucts. We have no means of properly standardizing it, or of establishing cvvith any degree of certainty the amount of protective substances con- tained in the blood serum. It must be acknowledged that the study of diseases of swine has been somewhat neglected. Veterinarians are apt to accept any outbreak of infection as hog cholera, frequently relying for their diagnosis on lesions which are far from pathognomonic. The lesions which are commonly ac- cepted as those of hog cholera may also be associated with other diseases. Thus, for instance, hemorrhages in the kidneys may appear in association with any septicemia condition, as is likewise the case with the cutaneous subpleural and subperitoneal hemorrhages. They may arise from exces- sive acid or oily substances in the food, from injuries or from overheating. It is therefore apparent that in order to establish an accurate diagnosis of the "virus disease" it is essential to take into consideration everything which is characteristic of the symptomatology and anatomical changes of the disease. The preventive treatment of hog cholera consists either in the admin- istration of serum alone or in the simultaneous treatment. The serum alone method of immunization is now used only in excep- tional cases, principally due to the fact that the immunity produced by this treatment is of only short duration, not over eight weeks. It is prin- cipals used on suckling pigs in infected territories. The immunity con- ferred upon such pigs is only temporary no matter what method is used and revaccination with the double treatment should invariably follow at the time of weaning. The serum alone method should also be used on 646 GENERAL THERAPEUTIC MEASURES hogs in infected herds which at the time of treatment show a temperature over 104° F. Such hogs and also those showing slight symptoms of cholera should be injected with at least double the quantity of the im- munizing dose. Animals showing distinct and severe symptoms of the disease should not be treated. The simultaneous treatment consists of an injection of serum and a corresponding dose of hog cholera virus in another part of the body. This method of treatment confers to the animal a life immunity. It is indicated in healthy herds where it is desired to prevent the development of hog cholera; also in herds where the infection has already occurred, in which instance the treatment should be applied only to hogs showing no signs of the disease. It is important that hog cholera virus should never be injected with- out the corresponding dose of anti-hog cholera serum. The two should never be mixed together before injection and it is also essential to make the injection of virus on the opposite side of the body, or at some distant point to the serum injection. The serum is injected subcutaneously and preferably into the arm pit (axillary region). With the clear, sterilized serum this location is especially desirable since on account of the loose connective tissues in this region an immediate absorption takes place. The serum may also be injected in smaller hogs into the subcutaneous tissues of the groin. RABIES. Rabies is a fatal disease which is contracted through a bite from an infected animal. At the present time the belief is growing that the cause of rabies is a parasitic protozoan discovered by Negri and generally known as the "Negri body." His discovery has been amply confirmed and most observers agree with his interpretation as to the nature of these bodies as well as on their significance. Dogs are in most instances responsible for the spread of the disease. This is due to the fact that the affected dogs travel a long distance and bite other dogs, as well as other animals and men. The period of incubation is from 16 to 40 days, although cases have been reported as occurring as early as 14 days after natural infection and as late as 60 days. Folk tales of the development of rabies many months and even years after infection owe their origin to mistaken diagnoses or to the disease due to an unobserved infection more recent than the sup- posed inoculation. Certain prodromal symptoms may be noted by changes in the dog's disposition, quiet friendly animals may become un- easy and vicious and occasionally, the savage dog grows more affectionate. In this prodromic period the owner may detect changes unnoticed by the veterinarian. It should be noted that the bite of the dog is infectious even at this stage and earlier before any symptoms whatever have devel- oped. In the prodromic stage the dog is no more inclined to bite its owner than when normal but is quite apt to snap at strangers. The veterinarian must keep this in mind at all times in making examinations of dogs. Death usually ensues in from three to seven days. The symptoms in other animals vary with the species and with their natural weapons of offense. BIOLOGICAL THERAPEUTICS 547 Prevention by Pasteur Method. In the Pasteur method, rabies vaccine is prepared by inoculating rabbits subdurally with fixed virus which in six to eight days produces paralysis. When completely paralyzed, the rabbits are killed and the spinal cords are removed under aseptic conditions. Fixed virus is rabies virus which, by continuous passage through rabbits, has reached a stage of maximum virulence for that animal. Rabbits of four or five pounds weight, inoculated subdurally with fixed virus, will die in eight days. By the passage of the virus through rabbits, the virulence is enhanced for the rabbit but attenuated for other animals and man. Besides being weakened by the passage through rabbits, the virus is further attenuated by drying the spinal cords for varying periods of time. The cords are suspended over a layer of potassium hydroxide and kept at a temperature of 22° C. from one to eight days. As a result of this drying process, the virus in the substance of the cords is gradually weakened or attenuated. If suspended in this manner long enough, the virus may be entirely de- stroyed: the virus being strongest when the cords are fresh. Each day during the process of drying, the strength decreases in direct proportion to the extent of the drying. In the preparation of each dose of rabies vaccine, a portion of a rabbit's cord, in which the virus has been prop- ly a 1 1 enuated by drying for periods of one to eight days, is e m u 1 sified by grinding under a s e ptic condi- tion « with d-Ivp- Negri Bodies in a Ganglion Cell; (a) Nucleus of Ganglion uuns wiiii gi^c Cell. (b) Covering of Negri Body; (c) Large erin, and filled and Small Internal Bodies into vials. Pas- teur's antirabic treatment consists of the injection of 25 doses of rabies vaccine, the injections being given daily for 21 successive days. The vaccination of human beings against rabies by the Pasteur method has been well established in every country of the world. Rabies vaccine has been used to only a limited extent in veterinary practice. The apparent neglect of utilizing this treatment for animals is due to the fact that vaccination by the Pasteur method, aside from the considerable expense of the vaccine, requires 25 injections in order to produce the desired immunity which, of course, necessitates a large number of visits by the veterinarian. Whereas, with the dilution method, immunity is established with six injections, which in itself gives decided advantage to this form of vaccination and it is therefore given preference for the protective treatment of animals. 548 GENERAL THERAPEUTIC MEASURES The Antirabic Treatment with the Hogyes Dilution Method. This consists of six injections of various dilutions of rabies vaccine prepared from the fresh brain of a rabbit affected with rabies. The fixed virus contained in the brain is not changed by drying or any other method of attenuation and is used in a fresh active state in the varying dilutions. Rabies vaccine is used for the preventive treatment of rabies during the incubation period. After the symptoms of the disease are developed, antirabic treatment is of absolutely no value. A cure for rabies is as yet undiscovered but the antirabic treatment is quite effective in preventing the development of the disease in domestic animals, bitten by rabid dogs or other animals. Rabies affects chiefly dogs; but horses, cattle, sheep, goats, pigs, cats, poultry and wild animals, particularly wolves, foxes and prairie dogs, are also susceptible and are sometimes affected. In the western states rabies has been prevalent among coyotes of recent years and many cases in domesticated animals have been due to inoculation by rabid coyotes. TETANUS. Tetanus is characterized by muscular spasms of the face, neck, body and limbs. The muscular contractions are very rigid and persistent. The disease is caused by the tetanus bacillus — Nicolaier's bacillus. It is very often found present in the soil, in dust, and especially in manure. The tetanus bacillus is a straight, slender rod possessing slight motility and propagates by fission and also by spore formation. The spore is usually situated at one pole of the rod, thus giving the spore-bearing bacil- lus a drum-stick-like appearance. In cultures it may form longer slightly curved threads. It produces a very powerful poison, and the action of this poison on the nervous system is responsible for the symptoms of tetanus. The tetanus organism remains at the point of inoculation, which usually occurs through a wound. The infection may enter the body through wounds of an operation, particularly castration. Nail pricks are the commonest mode of infection. The disease is more prevalent in cer- tain localities than others. In southern countries the infection is so widely spread that unless preventive measures are undertaken the disease almost invariably follows favorable injuries. Horses and mules are especially susceptible to the disease, although at times it may occur in cattle, sheep, hogs and dogs. Prevention and Treatment The affected animal should be placed in a quiet, dark box-stall and away from other animals and all noises. The attendant must be very careful and quiet in order to prevent unnecessary excitement and increasing spasm. Tetanus antitoxin in large doses is also indicated. For this purpose it is necessary to inject intravenously not less than 3000 units and also at the same time the same amount subcutaneously, and the subsequent dosage should depend on the progress of the case. It is advisable to repeat the injections at least every 24 hours. Tetanus antitoxin is prepared from horses. At first a very small amount of the toxin is injected which is gradually increased until the animal develops a tolerance for large amounts of toxin injections. Test bleedings are then made and the serum subjected to standardization in order to establish the number of units contained therein per mil. BIOLOGICAL THERAPEUTICS 549 A tetanus antitoxic unit is ten times the least amount of serum which saves the life of a 350-gram guinea pig for 96 hours against the official test dose of a standard toxin. If the serum is found of desired potency the animal is bled from the jugular vein. The blood is allowed to clot, the clear serum which separates is tested for sterility and after the addition of a preservative it is filled into containers ready for use. The preventive treatment with antitoxin has proved effective beyond any doubt and is always successful, provided it is undertaken early in the period of incubation. This treatment consists of the injection of tetanus antitoxin under the skin after an injury of any kind or after operations. It is advisable to inject animals with antitoxin in all cases when there is the slightest danger of tetanus developing. When the antitoxin is not administered for four days or more after inoculation, the result is uncertain. The prophylactic dose is 500 units during the first seventy-two hours after inoculation ; after that it should be increased 500 units for each twenty-four hours that have elapsed since probable inocu- lation. Unlike many other biologic products, in tetanus antitoxin it is pos- sible to establish accurately the number of units contained per mil of the antitoxin and thereby we can always safely establish a uniform dose for the protection of animals. The curative action of tetanus antitoxin is very problematic, even excessively large doses at times failing to relieve the affection in the slightest degree. This, however, can be readily ex- plained by the pathogenicity of the tetanus toxin which, when once the disease is establised and is progressing, becomes anchored in the nerve cells, producing there morbid changes that can not be remedied. White Scours in Calves. White scours is an acute infectious disease of new-born calves which in the majority of cases develops as a persistent diarrhea and loss of strength, finally resulting in death. In every country in which stock breeding has been highly developed the mortality in young animals from white scours is very large. Calves in the first few days of their lives are especially threatened, but even later fatal cases may occur. White scours is caused by specific pathogenic germs. The infection as a rule is taken up by the mouth. In some cases, however, the germs may enter the body through the navel. Investigations have conclusively established that the great majority of outbreaks are due to an infection with virulent strains of colon and para-colon bacilli ; also that the newly born calves are susceptible to infections through the digestive tract with other germs. The germs, which are persistent and difficult to eradicate from infected premises, are responsible for the losses of the calves. Fortunately, investigators in Denmark succeeded in producing a highly potent serum from horses which when injected into exposed calves will prevent the disease, or in case the infection is already established, it exerts a very favorable action upon the course of the disease. That is, the serum has proved to possess, aside from its preventive action, also great curative value. Anti-white scours serum is prepared by consecutive intravenous in- jections of horses with numerous strains of colon and other germs which 550 GENERAL THERAPEUTIC MEASURES have been isolated from cases of white scours in calves. The horses are first treated with suspensions of dead organisms containing various strains of B. coll, para-coli, meta-coli, abortus, aerogenes and enteritidis. After this preparatory treatment, live cultures are injected intravenously into the horses, beginning with small amounts until the highest tolerance is reached. Then they are bled and again given a cycle of injections with suspensions of the various live organisms. The standardization of anti-white scours serum is carried out by taking samples of blood from the horses during the course of treatment and the serum is subjected to the agglutination test against the various strains used in the treatment. It is required that a potent serum should agglutinate each respective strain in a dilution of at least 1 :1500. It has been found that serum possessing such an agglutinating titer against the different strains possesses prophylactic and curative value for white scours of calves. It is, of course, necessary that such serum should possess polyvalent properties, since it is well known that different strains of the colon and other germs are responsible for the disease, and if the serum has been prepared only against a particular strain it would exert only slight influ- ence against the other disease-producing strains. In the preparation of the horses producing anti-white scours serum a great number of strains of the colon and para-colon group are being used; also strains of abortion, aerogenes and meta-colon bacilli, since it has been found that at times some of these organisms are associated with white scours in calves. Repeated observations made by investi- gators abroad and also in this country have shown that the systematic treatment with potent serum results in the elimination of loss from this infection even in the most severe infections, where prior to this procedure the losses in calves amounted to from 75 to 100 per cent. Sanitary meas- ures should necessarily be carried out in order to eradicate the infection from the premises. In herds where the disease is prevalent it is essential to administer to each calf as soon as possible after birth a protective dose of the serum. The following statement is made by Williams on the use and effec- tiveness of anti-white scours serum: "In herds where abortion, premature birth, retained after-birth, and scours, are common it is better that the calf should have liberal doses of calf-scours serum before it has its first feed. Usually it is well to give twenty mils immediately after scours set in; the calf may take twenty to thirty mils of serum every four to six hours if required. The enemas of warm salt solution repeated ever four to six hours aid also." Other Indications for Specific Bacterin Therapy. Aside from the diseases described in which biological products have proved efficacious, there are numerous other conditions in which the em- ployment of bacterial vaccines have given encouraging results. Follow- ing the exploitation of the vaccine therapy by Wright, bacterins have been prepared for practically all conditions in which micro-organisms are asso- ciated with the pathological processes. Among these the pyogenic affec- tions have commanded special attention, as these conditions are especially promising to yield to such specific therapy. BIOLOGICAL THERAPEUTICS 551 While the results attained are not uniformly satisfactory, neverthe- less, from the statistical data available, there appears to be no doubt that the application of bacterin therapy in most of the infections induced by pyogenic organisms is justified, especially if dependence is not entirely placed upon their action, but sanitary, hygienic, therapeutic, surgical and other means are employed in association with the biologic treatment. The widely distributed staphylococcus is primarily or secondarily re- sponsible for suppurative processes. Most frequently, however, a bacteri- ological examination of such conditions reveals a mixed infection with streptococci and many times the colon bacillus is also present. In all such cases a bacterin containing these organisms when properly applied will yield good results, and this has been found to be the case especially in infected wounds such as open joints, nail puncture, wire cuts, abscesses, fistulous withers, poll evil, quittor etc. In recent investigations by Scho- field, navel ill in foals yielded most readily to the treatment with mixed bacterial vaccines, and similar good results were obtained by other investi- gators. Infectious mammitis is, in the majority of cases, induced by strep- tococci. The infection is usually very persistent, causing at times great losses in herds, not only in a reduction of the milk supply, but also from the entire or partial functional destruction of the udder of the affected animals. Specific bacterin therapy has been frequently employed for combat- ting this condition and favorable reports are available from such treat- ment. Since infectious mammitis is frequently associated with a mixed in- fection of streptococci, staphylococci, and possibly the bacillus coli, the injection of bacterins containing these organisms should be undertaken, especially since no other specific remedy is known for the control of this disease. It is natural that, aside from the administration of the bacterin, attention must be directed toward strict sanitary, hygienic and the usual therapeutic measures. Autogenous Bacterins. In all persistent and aggravating conditions in which a specific organ- ism has been found to be the responsible factor, it is advisable to utilize a bacterin prepared from the respective species of bacteria; thus, for in- stance, in a furunculosis a staphylococcus bacterin acts very promptly and prevents recurrence. There are numerous other conditions in which the use of mixed bacterial vaccines, staphylococcus bacterins, streptococcus bacterin and colon bacterin have given excellent results, but it is neces- sary to emphasize that in order to obtain the best results, every case should be individually studied and a product selected in accordance with the clinical, and if necessary, with the bacteriological findings. Further- more, it is again emphasized that in treating such conditions with bac- terins, the necessary medical and surgical measures must not be neglected. Where the circumstances permit a bacterin made from cultures obtained from the case they are intended to treat has the preference over a stock bacterin made from the same species of bacteria. Obviously such a bac- terin has limited application and always means a delay of several days in instituting treatment. 552 GENERAL THERAPEUTIC MEASURES DIAGNOSTIC PRODUCTS. There is a class of very important biologic products which for the present, though not of therapeutic value, are being used as diagnostic agents in the control of diseases. It is a known fact that the entrance of an infection into the animal organism always has a stimulating effect upon the production of anti-bodies ; the appearance of anti-bodies in the system is an indication of a struggle against the infection. As a result of the struggle the body shows either an increased or diminished re- sistance against the infection; an increased resistance being manifested as immunity, and a decreased resistance as hyper-susceptibility. This state of hypersensitiveness toward the infection or its products may, in some diseases, be utilized for diagnostic purposes. Thus, for instance, an animal affected with glanders or tuberculosis will develop a hyper- sensitiveness to the respective products of the germs, that is, to mallein or tuberculin, and the injection of such products into infected animals will result in a general or local reaction, manifesting itself by a rise of temperature, systemic disturbance, and local swelling at the point of inoculation. Investigations have also established that such reactions may be in- duced in various ways, thus according to the method of application they are known as subcutaneous, ophthalmic, intradermal, intrapalpebral, and cutaneous tests. The underlying principle in all these tests is the same in that it is aimed to utilize the hypersensitive state of an infected animal, to respond to the introduction of the respective antigen in visible or otherwise determinable manifestations. In the subcutaneous test we thereby obtain a typical rise in temperature associated with more or less systemic disturbance; in the ophthalmic test infected animals respond with a purulent conjunctivitis; in the intradermal test we obtain a pro- nounced infiltration. Diagnosis of Tuberculosis. The relative value of the various tests has been studied carefully, and for the present time in tuberculosis the subcutaneous test has to be given first place, although the intradermal method is also being recog- nized as quite accurate and dependable. The intradermal test is less expensive in time and labor, but its application and interpretation requires considerable skill and experience. Both the intradermal and ophthalmic test for the diagnosis of tuberculosis may be used as supplementary to the thermic test. Tuberculin is prepared by cultivating tubercle bacilli in a five per cent, glycerin bouillon for six to eight weeks at 37° C, whereupon the tubercle bacilli are killed by boiling and the bouillon is then freed from the killed bacilli by filtration. The concentration of the filtrate containing the tuberculin to 6.1 of its original volume represents what is known as Koch's "old tuberculin." The subcutaneous tuberculin as marketed at the present time is either rediluted Koch's old tuberculin or the original filtrate without concentration of which one mil represents a definite amount of Koch's old tuberculin. It is required by the Bureau of Animal Industry that a dose of subcutaneous tuberculin should contain not less than 0.5 grams of Koch's old tuberculin and manufacturers are instructed to designate BIOLOGICAL THERAPEUTICS 553 on their labels and literature the amount of Koch's old tuberculin con- tained per mil. Thermic tuberculin when injected subcutaneously, not containing any germs, is unable to produce the disease or any kind of injury to a healthy animal. On the other hand if the animal is affected with tuberculosis a rise in temperature will follow the administration of tuberculin. The following instructions on tuberculin testing are issued by the Bureau of Animal Industry: The Subcutaneous Test The following directions for tuberculin testing are taken from the B. A. I. publication on "Instructions concerning the work of the tuberculosis eradication division." The subcutaneous test is the official test of the United States Bureau of Animal Industry. Carefully and conscientiously applied, with good judgment exercised in both its administration and interpretation, it is regarded as highly effective. It is not a suitable test to apply generally when the animals have high temperatures and it may not be practicable in cases of cattle which cannot be controlled easily. Directions for the Application of the Subcutaneous Test. 1. So far as practicable, the cattle should be stabled under usual conditions and with usual surroundings. 2. The cattle should be fed and watered in the customary manner, except that it should be done only immediately after the measuring of temperature. Occasionally it is advisable to limit the quantity of con- centrated food given animals under test. This is especially true if large quantities of that kind of food are allowed. 3. A careful physical examination of each animal should be made before or during the application of the test. 4. During the period immediately before the injection of tuberculin each animal's temperature should be taken at least three times at not less than two-hour intervals. Care should be taken to let the thermom- eters remain inserted for a sufficient length of time to insure correct reading. Animals showing evidence of any acute disease or condition or showing extensive pus formations should not be injected with tuberculin. Any animal showing pronounced abnormal preliminary temperatures like- wise should not receive the tuberculin test. Inquiry concerning the his- tory of the herd should be made, and it should be ascertained, if pos- sible, whether any animal in the herd has ever given a positive reaction to tuberculin, the number of tuberculin tests applied to the herd pre- viously and, also whether any cattle in the herd have been treated at any time in any other manner with tuberculin. The information thus obtained should be used in determining the method to be employed in the tuberculin testing of the herd. 5. The hypodermic syringes and needles should be disinfected be- fore testing any herd with tuberculin. Before being used for the injection of each animal, needles should be washed in a disinfectant solution. A five-per-cent solution of carbolic acid is suitable for steriliz- ing the instruments. Open bottles of tuberculin should be protected from contamination. Thermometers should be sterilized before the temperature is taken, and should be dipped in a disinfectant solution before and after each reading. 554 GENERAL THERAPEUTIC MEASURES 6. For cattle which are apparently healthy, and which have not been injected with tuberculin within a period of at least 60 days, the dose of tuberculin prepared by the Bureau of Animal Industry is as follows : Two mils for calves ranging from six months to one year of age. Four mils for cattle more than 1 year old to maturity. Older animals or animals clinically suspicious may receive a larger dose. 7. The measurements of temperature following the injection of tuberculin should commence at the eighth hour and be continued every two hours until the twentieth hour after injection, when, if there is no tendency for the temperature to rise, the test may cease. Temperatures upon cattle which are showing a rising tendency following the injection of tuberculin should be measured more frequently. 8. Suspected cattle should be submitted to a retest after the expira- tion of not less than 60 days. This class of cattle and those which show possible physical evidences of tuberculosis, emaciation, old age, or which have been tested repeatedly should receive double the dose of tuberculin indicated above. 9. Experience has shown that animals, especially those of doubtful record, re- c e i v i n g large doses of tubercu- lin, may re- spond early to the test, and inspec- tors are ad- vised, w h e r ever practicable, to o b t ain temp era- t u r e s at from the fourth to sixth hour following the use of large doses of tuberculin. 10. A rise of 2° F., or more, above the maximum temperature ob- served prior to the injection of tuberculin, or a temperature above 103.8° F., should be regarded as an indication of tuberculosis, provided the tem- perature reaction shows the characteristic rainbow curve. 11. Animals which after injection show a rise of temperature of 2° F., with a maximum of between 103° and 103.8° F., as well as those which show a rise of less than 2° F., with a maximum temperature of 103.8° F., are regarded as suspicious. The presence of a general systemic reaction or a typical curve should be eonsidered in determining the classi- fication between suspects and reactors. The Intradermal Test. The intradermal test is not officially recognized by the U. S. Bureau of Animal Industry, except on strictly range cattle or animals whose An Unusually Well Defined Reaction to the Intradermal Tuberculin Test BIOLOGICAL THERAPEUTICS 555 movements are difficult to control. This test is being studied carefully by the bureau with a view to its more extensive employment in area work. Directions for the Application of the Intradermal Test. 1. Various sites may be selected for the intradermal injections. The sites most used are the subcaudal region and the skin of the lower eyelid. The injections should be made with a hypodermic syringe pro- vided with a needle about one-fourth inch in length and of small caliber. The syringe and needles used generally by the dental profession are sat- isfactory, but many operators prefer a moderately large syringe with adapters for the use of the dental needle. 2. The injection should be made into the dermal tissue, care being taken to prevent the tuberculin from being discharged into the sub- cutaneous tissue, or superficially into the epidermis. An injection into a A Positive Reaction to the Intradermal Test for Tuberculosis Indicated by A Diffused Swelling A Positive Reaction to the Intradermal Test for Tuberculosis Indicated by a Circumscribed Swelling . loose subcaudal fold is liable to result in the production of an infiltration so slight as to prove of no diagnostic value; hence, a more preferable site is the undersurface of the tail, where the soft skin lies close to the bone. The swelling or edema here is more pronounced. In case the eye is selected the injection is made in the lower lid one-fourtli inch below the border and about one-half inch from the corner of the eye. 3. Swellings that appear within the first hour and disappear early are not diagnostic. Swellings present at the forty-eighth hour are gen- erally diagnostic; hence, observations should be made at the forty-eighth and seven-second hours and, if possible, at a period between the nine- tieth and ninety-sixth hours, or longer. The later the appearance of the local reaction, the more positive the diagnosis. The local reaction is often confirmed by a thermal reaction, this being especially true in those cases in which tuberculin has not been administered recently by the subcutane- ous method. These two methods may be employed simultaneously, well- defined reactions to both tests being obtained from infected animals. The 556 GENERAL THERAPEUTIC MEASURES failure to obtain a reaction, of course, is not positive evidence of health; therefore a careful report is expected concerning the character of lesions shown and the extent of infection disclosed at post-mortem examination of animals which have failed to react to. the tests. 4. Detailed reports of each lot tested should be forwarded promptly to the Tuberculosis Eradication Division, and when possible the intra- dermal and subcutaneous methods should be checked against each other and post-mortem records be made complete. Special reference should be made to isolated, well-encapsulated lesions unaccompanied by evidence of the presence of more active areas of infection. The Ophthalmic Test. The ophthalmic test at present is not accepted by the bureau for testing cattle for interstate shipment. It is believed, however, that it is valuable as a check test. Directions for the Application of the Ophthalmic Test. 1. Place two tuberculin tablets in the conjunctival sac beneath the lower lid and by holding the hand gently over the eye for a short time (about 45 or 50 seconds) make sure that the disks are not "winked out." 2. As this is experimental work, observations should be taken at approximately the third hour following the introduction of the tablets and at frequent intervals up to at least 24 hours. If the left eye is always selected for treatment, it follows, of course, that the right eye may be regarded as the control eye. This obviates unnecessary memoranda and assists the inspector in making final disposition of the animal, since exudate appearing during the test should be limited to the treated eye. 3. It should be noted, however, that animals exhibiting well-encap- sulated lesions upon post-mortem examination have been very slow in responding to the test. The prior use of tuberculin by the subcutaneous method sometimes invites a very early response to ophthalmic tuberculin when but a brief period of time intervenes between the two tests. 4. In the case of an animal whose tested eye exhibits dark, albumin- ous exudate, equivalent in volume to 8 minims or more, the fact should be indicated in reports by the symbol "PX." If the exudate exhibits gran- ular casts or flakes of a yellowish tint, the report should read "PXX." When the exudate tends to smear over the ball and pupil of eye, note the- fact with the symbol "PXXX." The word "negative" may be abbreviated "N." It is preferable to use double columns noting such observations, the condition of both the treated and the control eyes, using the upper space for the treated eye thus : No. 2 p. m, 5 p. m. 8 p. m. 11 p. m. 2 a. m. Remarks 1 N N PX PXXX PX Reacted 1 N N N N N (Control) Negative 2 N N N N N Negative 2 N N N N N Negative 5. Each animal should be marked carefullv for identification so that, in case of slaughter, the identity of each animal may be traced through the post-mortem and the test properly judged. BIOLOGICAL THERAPEUTICS 557 6. The proper dosage is 0.2 milligram (gr. .003) of tuberculin, which is contained in two tablets. The tuberculin is non-irritating to the normal eye and it must be remembered that irritants of varied types may produce eye discharges. Hence only normal eyes should be selected for testing. 7. The so-called sympathetic reaction is not confirmative of tuber- culosis, and animals exhibiting discharges from both eyes should be classed as suspicious and be retested when normal conditions exist. 8. Hyperemia is not invariably present. When limited to the treated eye it may be regarded as confirmative of a reaction. It appears more uniformly in sensitized eyes, also in the treated eye of an animal that has reacted to subcu- taneous tuberculin within a short time. 9. The best results are obtained from this test when one sensitizing tablet is used two or three days prior to the application of the regular ophthalmic test. This method should be fol- lowed wherever practicable. The Combined Applica- tion of the Three Tests. Recent experiences of the bureau indicate that in badly diseased herds, or in herds which have been in- jected frequently with tu- berculin by the subcutane- ous method, it is advisable to apply the ophthalmic and possibly the intrader- mal tests. Whenever all these tests are employed, the intradermal injection should be made first, and at the same time one ophthalmic disk should be inserted as a sensitizing agent for the regu- lar ophthalmic test. Observations should be made following the use of the sensitizing tablet, as frequently typical reactions occur from the use of one tablet. Intradermal observations should be made on the forty-eighth, sev- enty-second, and ninety-sixth hours. Two ophthalmic disks should be used the second or third day, and at the same time the regular injection by the subcutaneous method can be made. It has been observed that the combined use of the three tests detects additional reactors which might have escaped one of the tests alone. Whenever this method is followed a detailed report covering the work should be submitted to the bureau. An Average Positive Reaction to the Ophthalmic Test for Tuberculosis, Showing- a Dis- tinct Purulent Discharge 558 GENERAL THERAPEUTIC MEASURES Diagnosis of Glanders. In glanders the ophthalmic or eye test appears to have established itself as the most satisfactory. Recently, however, the intrapalpebral or cutaneous test is given preference by some. The product used for the diagnosis of glanders is known as mallein which represents a toxic substance produced in cultures of the Bacillus mallei. Mallein is prepared by cultivating the Bacillus mallei in glycerin peptone bouillon for a period from six to eight weeks. The bacilli in the growth are then killed by boiling in a water bath. The dead organisms are then filtered out, and the fil- trate containing the mallein is concentrated to 0.8 of its origi- nal volume which represents the bubcutaneous mallein. Concen- trated mallein which is also known as ophthalmic mallein represents a concentration to one-tenth of the original volume. Refined mallein which is used for the production of the mallein discs is a dry powder obtained from mallein which has been precipitated with absolute alcohol. After filtering the pre- cipitate it is redissolved in nor- mal salt solution and washed repeatedly with absolute alcohol. The precipitate is finally dried (over calcium chloride or sul- U ~~s\ \ \ Vs* phuric acid. The dry precipi- I \ \ \ Jj tated mallein mixed with sugar of milk is then made up into the mallein discs. Dry tuberculin known also as refined tuberculin is prepared in a similar manner from Koch's old tuberculin. Method of Applying the Ophthalmic Test for Glanders with the Camel's Hair Brush Application of the Diagnostic Mallein Tests for Glanders. The subcutaneous test while the oldest of the mallein tests is now used only to a limited extent. In its reliability this test does not compare favorably with the results from the subcutaneous tuberculin test. The test is made by injecting the mallein solution into the suspected animals in which it produces a characteristic temperature rise and a local and general reaction. Rise in temperature begins in from four to eight hours and the maximum temperature is reached in from 10 to 20 hours with a gradual return to normal. At least two temperatures should be taken before the injection of the mallein, three hours apart, and at least five temperatures after the injection beginning not later than the 8th hour and continuing to the 18th hour at intervals of two hours. BIOLOGICAL THERAPEUTICS 559 A positive reaction consists in a rise of temperature of at least 2.5° F., with the temperature rising to 103° or above. In reacting horses at the point of injection a hot, painful, edematous swelling develops which may persist for several days, p Normal horses may show a slight local swelling which disappears rapidly. Ophthalmic Mallein Test. Before the application of the test the eye should be exam- ined and in the presence of in- flammatory conditions the tests should not be made. With a dropper or with the aid of a camels hair brush, 0.1 to 0.2 mil (3 to 4- drops) of concentrated mallein is placed on the lower eyelid. In case mallein discs are used one disc should be placed into the conjunctival sac. Care should be taken that it does not drop out before being dissolved which usually takes from 30 to 50 seconds. In case the animal is affected with glanders a reac- Method of Applying the Ophthalmic Test for Glanders With the Collapsible Tube An Average Positive Reaction to the Oph- thalmic Test for Glanders, Showing the distinct purpulent discharge tion develops in from six to thirty-six hours in the tested eye. The reaction is manifested by a purulent secretion or discharge with the reddening of the con- junctiva frequently associated with an edematous swelling of the eyelids. The reading should be made in from 18 to 36 hours following the application of the test. Intrapalpebral Mallein Test. The intrapalpebral or intra- dermal mallein test is made into the lower eyelid. The mallein used is a 50% dilution of the concentrated mallein with phe- nolized salt solution. A fold of the skin of the lower lid is grasped by the fore- finger and the thumb as near the margin as possible. The needle is inserted into the skin parallel 560 GENERAL THERAPEUTIC MEASURES Introducing the Mallein Negative Reaction Sero-Mucous Discharge Pus Drops In Conjunctival Sac Purulent Discharge Discharge With Pasting To- gether of Eyelids OPHTHALMIC REACTION TO MALLEIN TEST FOR GLANDERS BIOLOGICAL THERAPEUTICS 561 to the margin of the eyelid and midway between the inner and outer canthus. About 0.1 to 0.2 mil of mallein is injected. If the injection is properly made a swelling the size of a small split pea should appear immediately at the point of injection. The injection should be made between the layers of the skin. If, however, it should be made under the skin it only does with delays the reaction but not materially interfere the test. As a rule the characteristic manifestations of the reaction for glanders, following the intrapalpebral test commences in five to six hours and lasts 24 to 36 hours or longer. It con- sists of a pronounced swelling of the lower lid and may affect a considerable area around the eye. In association with the edema there is usually a puru- lent discharge from the con- junctival sac and is in most in- stances accompanied with an inflammatory condition of the conjunctiva. TJJie reaction may vary in extent and intensity. The swelling may vary from a slight degree to an extent of affecting the entire area around the orbit. Likewise the dis- charge may be slight while at other times the reaction may result in true pyorrhea to such an extent as to cause gluing of the eyelids. It is advisable to examine the animal between the 16th and 30th hour fol- lowing the test. Among these biologic diagnostic agents tuberculin and mallein are, without a doubt, of the greatest importance to the live stock industry. With the aid of these the presence of latent cases of tuberculosis and glanders can be determined accurately in most instances, and thereby the control and eradication of the disease is much facilitated. Attention is called to the successful work carried on in Austria where with the aid of ophthalmic mallein, glanders has been eradicated successfully in the past few years. Austria has been at all times badly infected with glanders, but through the enthusiastic and untiring efforts of Professor Schniirer the eradication of the disease from the country has been accomplished almost entirely. The aid of laboratory biologic tests has been employed in only a few doubtful cases. There are now numerous biologic products being prepared for diag- nostic purposes, but most of these are still in the" experimental stage and their value has not been sufficiently proved. The application of biologic Strong Ophthalmic Reaction 562 GENERAL THERAPEUTIC MEASURES reactions for diagnosis has also been developed to a remarkable degree in recent years, and without some of these the control of certain diseases would have been impossible. It is especially desired to mention dourine, in which it is impossible to diagnose the latent form without the aid of the complement-fixation and agglutination tests. This applies also to infec- tious abortion in which the affected animals manifest no clinical signs of the infection and a diagnosis can be made only by subjecting the blood of the animals in the suspected herd to either the agglutination or comple- ment-fixation tests. Therefore the importance of these is apparent in the control of these diseases. SUMMARY. The importance of biologic therapeutics cannot be overestimated. To utilize the forces behind evolution (natural selection, the struggle for ex- istence, the survival of the fittest) in our conflict with bacterial and pro- tozoan infections, through the employment of the dead or living patho- genic organism or its products in our warfare against it, is perhaps the culminating triumph of modern medicine. In employing these means, however, we must always keep in mind certain limitations of this newer therapy. Biologic remedies are not specifics in the sense that they will al- ways cure, although in a sense specific for a given disease. They do not always cure or immunize, and the diagnostic agents (examples, tuber- culin, mallein) do not always detect disease. To the trained mind these limitations are not unexpected or disappointing; they exist because the ever-varying individual equation exists. Happily, the best known and longest used are as nearly specific as any remedy can be, as specific as quinine in malarial fever or mercury in syphilis. Diphtheria antitoxin, tetanus antitoxin, rabies vaccine, anthrax vac- cine, blackleg filtrate and calf scours serum have given results absolutely unattainable by any other means. The accuracy of the diagnostic agents mallein and tuberculin, is so great that we destroy reacting animals that to the clinician appear healthy with absolute confidence that in the great majority of instances the post- mortem examination will justify our diagnosis made solely upon the find- ings of that biologic test. The principles of biologic therapeutics are correct; when we are con- fronted with partial or total failure, it is almost invariably due to the fact that our knowledge is neither complete nor final; each year extends the field of their usefulness, clears our vision and improves our verifiable results. In order to thus profit by this newer therapeutic method we must use biologic remedies early, rather than late, in full, not insufficient dosage ; and must assure ourselves that the remedies we use are potent. Antisepsis must be thorough and the use of the drugs tending to ameliorate symp- toms or conserve the vital powers cannot be neglected. In those so common cases where secondary infections complicate the primary we must combat them with all the means at our command; and in the use of the diagnostic agents only patient taking of temperatures, and rational checking of the symptoms of reaction will safeguard the rep- utation of the practitioner and the welfare of his community. BIOLOGICAL THERAPEUTICS 563 Having done all this, we can lean on biologic therapeutics as on a staff, can widen our sphere of influence, gain increased consideration for our profession, increase the health, wealth and happiness of our country, and so render this world a better place in which to live. AN EPITOME OF MODERN TREATMENT OF DISEASES 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. To prevent, give opium; rest, laxative diet. 2. Contagious in cows and ewes. Consider all abortions in cows con- tagious. One in five have latent or active infection. Infection probably enters through teat in adults and is situated in udder of non-pregnant, and in womb and vaginal discharge of pregnant cows, but B. abortus disappears from uterus soon after parturition. Or germs enter cow through food and attack fetus in utero through blood. Young may be infected by milk, or in utero, but infection does not last long. Bull conveys organisms mechanically not by semen. There are many healthy carriers never showing signs of disease. Symptoms: Abortions, retained afterbirth, sterility, nymphomania and mastitis in cows; while B. abortus causes in calves through milk white scours, infectious arthritis and pneumonia. To prevent: Injections of living B. abortus in cows 2 months before breeding cause immunity for 2 years (?) and without danger of spreading disease. All animals examined by agglutination test before putting them into the herd. Segregate reactors. Aborting animals isolated till vaginal discharge ceases. Test bull before service; also cut hair from sheath and penis and latter douched with fountain syringe and horse catheter with y), arecoline hydrobromide (gr.ss) and strychnine sulphate (gr.Vg) subcut. may cure spasmodic or flatulent colic without mor- phine. Spasmodic colic, ether and aromatic spirit of ammonia (each, 5ii) with spirit of chloroform, §i, may be given; or chloral, 5i in one pint of linseed oil. Enemata and hot turpentine stupes, useful in all kinds of colic. In flatulent colic, oil of turpentine, 3ss; carbolic acid, Tl\x; ether and spirit of chloroform (each 3i), may be prescribed together in a pint of linseed oil. A cathartic is indicated at the earliest moment — an aloes ball, or linseed oil, and hot enemata, in spasmodic colic; in flatulent colic, give arecoline, and enema; 572 EPITOME OF MODERN TREATMENT also puncture with trocar between last rib and angle of ilium on right, or left side (when most distension here), if tympanites is increasing. In colic from overloading the stomach, use the stomach tube; also arecoline or eserine. With impaction of small intestines or colon, alternate linseed oil and Glau- ber's salts and give strychnine with atropine on tongue thrice daily; empty rectum by hand and use enemata as above; try arecoline, and copious drenches flaxseed tea. Colic due to enteroliths and volvulus cured by sur- gery. In twist of colon eserine or arecoline often relieves. Colic from in- vagination may be treated by elevation of hind quarters, enemata in enor- mous quantity, or laparotomy. Physostigmine may relieve 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 chloride, croton oil, stimulants, if collapsed — ether or am- monia, or strychnine. In diabetic coma, sodium bicarbonate, see Diabetes Mellitus. Congestion of Lungs. See Pulmonary Congestion. Conjunctivitis. In mild form, drop in eye boric acid (2 per cent.) solution, or zinc sul- phate solution (gr.i to 5i) ; 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 purulent cases, silver nitrate solution (gr.x to §i) may be painted on everted lid (in- stead of argyrol) once daily, in addition to frequent boric acid irrigations. Other remedies include: cocaine, protargol, mercuric oxides, citrine ointment, creolin, lysol, corrosive sublimate, scarification. Apply hydrargyri oxidum flavum in vaseline (gr.i to 5i) at night to lids, to prevent them from adhering. Constipation. Diet, exercise. Dogs. — Two or three compound cathartic pills or castor oil. Injections of oii sweet oil followed by warm water, combined with massage of belly and removal of feces by finger or blunt curette or obstetric forceps 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, 5ss, once or more daily, or liquid petrolatum, pill laxative compound, or phenolphthalein; calomel occasionally. Horses: — Aloes, linseed oil, calomel, Epsom salt, arecoline, eserine, barium chloride, enemata. Cattle: — Epsom salt, 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), liquid petrolatum, phenolphthalein, or calomel (gr.i). Birds: — Fowl, calomel, gr.i on food; castor oil, 3i; cold enemata,. tincture 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.iiss to §i). 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, gen- tian, quinine, calumba, quassia, hydrastin, iron, cod liver oil. DISEASES OF DOMESTIC ANIMALS 573 Convulsions, Eclampsia, Epilepsy. 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 veteri- narian should give chloroform inhalation, and afterwards administer fluid- extract ipecac, Tl\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 sodium bro- mide thrice daily for considerable time; and tincture of belladonna or chloral, if bromides ineffectual. Or acetanilid with monobromated camphor may be prescribed in capsules thrice daily for dogs. In puerperal eclampsia of bitches, inject morphine (gr.ss-i) subcutaneously, or employ chloroform in- halation, 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 oi), or calomel. After a year, opacity becomes permanent; do iridectomy under clear area in cornea. Corneal Ulcer. 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 yel- low infiltrated area of ulcer with point of knitting needle heated cherry red, after using cocaine. Corns in Foot of 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 Horses. Fresh air, outdoors in suitable weather; moderate covering, legs bandaged and mustard paste rubbed on them in stable. Diet: — roots, bran mashes with few ounces of linseed oil. Fluidextract belladonna (3ss every 2 hours, first day or two). Inhalations, compound tincture benzoin. Other remedies are: — Spirit of nitrous ether, aconite, Dover's powder, opium, cocaine, adrenalin, menthol, quinine, arsenic, bismuth. Cough. Well-ventilated quarters, warm clothing; inhalations, turpentine stupes, mustard to throat and chest, Priessnitz poultice. From catarrh in upper air- passages, see Coryza, Pharyngitis, 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. Cough, Chronic, of Horses. See Bronchitis, Chronic and Broken Wind. Laryngitis. Cracks or Fissures. See Fissures. Cramps. Atropine, belladonna. Crib Biting. See Wind-Sucking. Croup, or Roup. Pseudo-Membranous Croup. "Diphtheria." True diphtheria is rarely seen in cats and dogs (Klebs-Loeffler bacillus). Croup common in fowl. Isolate sick and newly-bought fowl. Infected premises disinfected and whitewashed. Dead fowl burned, utensils dis- 574 EPITOME OF MODERN TREATMENT 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 tincture of ferric chloride, Tl\v, in a little glycerine and water. Diarrhea relieved by 10-15TTI of 2 per cent, tannin solution, for fowl. Open distended sinuses under eye. Wash eyes with boric solution (2 per cent.) Give bacterins. Croup in Calves, Lambs and Pigs. Isolate, disinfect premises. Tincture 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. Curb. Fomentations, cold irrigation, Priessnitz poultices, cantharidal blistering and actual cautery. Rest and high-heeled shoe. Cow Pox. See Variola. Cystitis, Acute and 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.Mj-%). Large animals, spirit of nitrous ether, laudanum (each 3i), may be given together every 4 hours, sodium bicarbonate, potassium citrate or acetate. When acute symptoms pass, pre- scribe one of the following: hexamethylenamine, sodium benzoate with boric acid. If urine is alkaline, use acid; when cystitis is persistent employ colon, or mixed bacterin 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. Debility. Nourishing diet — milk, eggs, linseed and cotton seed meal. Small animals — 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. Decubitus. Bed Sores. Prevention: Change position often or use slings; sufficient bedding and cleanliness. Alcohol with tannic acid (5 per cent.) to harden skin. Treatment: Nitrate of silver (gr.xx to 3i) painted on skin to abort, or on granulating surface of sores. Zinc oxide ointment, aristol, chlorinated lime. Delirium. 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 which interfere with eruption of permanent teeth. In dogs, when dentition delayed, give syrup of calcium lactophosphate. Depraved Appetite. Pica. Licking Habit. 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. DISEASES OF DOMESTIC ANIMALS 575 Foals — Keep in stable, give salt by mouth and apomorphine (gr.%-%) subcutaneously once or twice weekly. Diabetes Insipidus. 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. Diabetes Mellitus. In dogs, restrict diet to cooked meat and fat and broths; avoid liver. Sodium bicarbonate in enormous doses to prevent coma, codeine, opium. Diaphragm, Spasm of. Hiccough. Thumps. Horses, compound spirit of ether; chloral, spirit of chloroform. Give purge and use lavage; lobeline or morphine subcutaneously, with atropine; inhalation of amyl nitrite or chloroform. Fomentations over diaphragm, trac- tion on tongue. Enema, laudanum (oiv) with sodium bromide (3i), in pint of boiled starch solution. In hogs when due to ascarids give appropriate treat- ment for parasitism. 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, *ss; 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 acids. Antiseptics, especially with flatulence and foul discharges; carbolic acid, creolin, salol, naphthalene, boric acid. In Fowl: — Dry, warm housing. Boiled rice and boiled milk. Laudanum, Tlli-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 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 immunized to polyvalent colon bacilli, as preventive. White diarrhea of new-born chicks — 1. Due to B. pullorum in ovaries and eggs of infected hens. Resemble typhoid bacilli. Diagnosis made by injection of wattles with a vaccine. Reaction in 24- hours: Also by agglu- tination test. Disease communicated from hen to egg and from infected chicks during first four days of life. Use eggs from uninfected 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 uncon- taminated vessels. Feeding sour milk useful. Only strongest birds at 8 to 10 weeks selected for breeding. 2. White diarrhea of chicks due to Coc- cidium 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. Surface soil removed 3 inches down and burned, disinfect the houses, roosts, premises and utensils. See also Enteritis and Dysentery. Arsenic in chronic cases. Diphtheria. Due to Klebs-Loeffler bacillus in man, is occasionally seen in cats and dogs. They should be killed to prevent spread of the disease to man. See Croup, Pseudo-Membranous. 57G EPITOME OF ^MODERN TREATMENT Disinfection or Sterilization. Of skin. See wounds. Of eye, irrigate with 2 per cent, boric acid solution. Tears act as normal salt solution and prevent sepsis. Of horses' feet. Remove shoe, trim horn and paint with tincture of iodine. Of uterus, irrigate with 2 per cent, lysol solution. Of vagina, swab out with green soap and warm water and sterile gauze and 2 per cent, lysol solution, or swab with l/z strength tincture of iodine without washing. Dislocations. 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 Dogs and Cats. A bacterial vaccine prepared from B. bronchisepticus is the surest mode of prophylaxis if given a month before exposure. Three injections necessary. In animals already exposed use antitoxic serum combined with bacterin. Treatment of the disease is most successful with an antitoxic serum com- bined with a mixed bacterin of 13. bronchisepticus and pus cocci, sodium cacodylate, Keep the patient constantly clean with 2 per cent, lysol baths. The ken- nels must be frequently washed with same and feces constantly removed to avoid secondary staphylococcic infection which is generally the cause of death. Give gr.ii calomel night and morning at onset, till free catharsis produced. For conjunctivitis, boric acid gr.x; and zinc sulphate, gr.i; in ,-,i water. If severe, 10 per cent, argyro] solution. If opacity or ulcer of cornea, see Cor- neal Opacities and Ulcers for treatment. Cough: — Wet flannel bandage and oil silk about neck; also syrup ipecac (TTtv-xv), in syrup squill (5i), with codeine (gr.Vs-Vz), if necessary. Anorexia overcome by tincture nucis vomicae (TTtv-xx), with equal amount of dilute hydrochloric acid in water after eating. Vomiting and diarrhea treated with bismuth subnitrate (gr.x-xxx) with tannigen (gr.v-x) and laudanum (TTlv-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-ii) ; strychnine. In anemia, reduced iron in pills. In eruption, use zinc 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 must be cleaned and disinfected. Country air favors recovery. Dourine. See Maladie du Coit. Dropsy, Cardiac. Renal, Hepatic. Ascites. Increase function of heart, kidneys and liver by stimulants to these organs, and use purges and diaphoretics. Digitalis, and squill are often combined with spirit of nitrous ether and potassium citrate or acetate. Restrict fluids; give horse physic ball; cattle: magnesium sulphate in con- centrated solution; dogs: compound jalap powder (5ss) 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, strophantus, oil of juniper, pilocarpine, calomel, colocynth, elaterin, sugar of milk. Withhold salt from the food when there is nephritis. See also Hydrothorax. DISEASES OF DOMESTIC ANIMALS 577 Dysentery. Common in new-born, especially calves, when it is usually fatal. Prevent by antiseptic treatment of aborting and parturient cows; by isolation of patients and disinfection of their discharges; by segregation of cows about to calve. Add formalin to the milk (Tl\v-x to the gallon). Treatment of little value in calves. In other animals, 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: naphta- lin, turpentine. Arsenic. Dysentery, Chronic Bacterial, of Cattle. Johne's Disease. 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, tur- pentine, etc., have little but temporary effect, as the disease is fatal. Dyspepsia. See Indigestion. Dyspnea. See Laryngitis, Broken Wind, Croup, Asthma. Pulmonary and cardiac: Nitroglycerin, nitrites, chloroform inhalation or morphine in asthma or angina pectoris. In chest diseases, counter-irritation externally. Tracheotomy in mechanical obstruction. Treat causal disease. Eclampsia. See Convulsions. Ecthyma in Horses and 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 zinc ointment; or, when animal can not lick it off, hydrargyrum ammo- niatum (gr.v-Ji) in zinc ointment. Ulcerations are treated w'ith Peru balsam covered with zinc ointment. Disinfection of premises and utensils. Eczema. 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, zinc 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, gtycerite of tannin, ard use bacterins of pus cocci prepared for such cases. With much itching, zinc ointment with creolin (2 per cent.). In chronic eczema with scaly, thick- ened skin, tar ointment, oil of cade in olive oil (1-8), or with zinc 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, compound 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 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 zinc 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 iodo- 578 EPITOME OF MODERN TREATMENT form (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: — Icthyol, sul- phurated 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, hamame- lis, glycerite of starch, pilocarpine, phosphorus, cod liver oil. Elephantiasis of 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, nbrolysin, potassium iodide internally, exercise. Tonics, see Urease. Emphysema, 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 they favor sepsis. Emphysema, Pulmonary. Chief lesion in "Broken Wind." See Broken Wind. Empyema Thoracis. Incision into intercostal space, or better, excision of a portion of a rib for drainage, and great care in asepsis, under local anesthesia, to facilitate ex- pansion 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. Irrigation of the chest advisable if discharge fetid. Use chlorazene or dichloramine-T or iodine and potassium iodide, each gr.6, to pint of water for irrigation. In localized abscess, aspiration is sufficient sometimes. Encephalitis. Cerebritis. Meningo-Cerebritis. 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 salt with croton oil. With high fever and bounding pulse, venesection and aconite, or veratrum. In excitement and mania, morphine, chloral, bromides. Lumbar puncture behind 5th lumbar vertebra, to relieve pressure and for bacterial examination of cerebro-spinal fluid. In convalescence, overcome paralysis by ergot, given with potassium iodide. Endocarditis. Acute — In acute rheumatism give sodium bicarbonate and salicylates, and blistering over heart. If pulse strong, give aconite, and fasten ice-bag over heart in acute stage. Morphine to quiet dyspnea. Digitalis in irregular pulse, with nux vomica. Aconite only at onset; later, digitalis, and strych- nine. 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: external heat, alcohol and strychnine, in case of threat- ened collapse. 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 salt 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 DISEASES OF DOMESTIC ANIMALS 579 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 (5i). Sucklings fed every three hours, so as not to gorge. Cows giving milk containing over 4>y2 per cent, fat may be unfit mothers. After castor oil, give bismuth subnitrate (gr.xxx) three times daily. Brandy for debility, and paregoric (5ii) if much pain and diarrhea. Entropium. If only inturned eyelashes, they may be pulled out at intervals. The appli- cation 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 normal shape. Otherwise remove elliptical piece of skin from eye- lid and suture. At same time split margin of lid lengthwise, leaving all eyelashes on outer flap, and lengthen palpebral fissure at outer canthus by cutting with scissors. Epilepsy. See Convulsions. Epistaxis. Nose Bleed. Pack nostril with gauze soaked in hydrogen dioxide. Inject vinegar and water (1-2). Insufflation of powdered alum or tannic acid. Internally, ergot, haniamelis or turpentine. In purpura inject fresh horse serum; ergot, cal- cium 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, enzootic. In sheep, attacks head. Swine, as mal rouge or swine erysipelas. See hog cholera. Antistreptococcus serum in horse. Generous diet with alcohol, milk and eggs. Isolate patient and after recovery disinfect premises. Well-ventilated quarters. Antiseptic treatment of any wound present. Paint affected area with pure phenol followed 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, zinc oxide and starch, lead acetate, boric acid, camphor, vaseline, hamamelis, tar. When erythema results in a dermatitis, as in cracked heels of horses, stimu- late with stick silver nitrate, or Peruvian balsam, and use astringents, as pink ointment and white lotion. In general erythema, give purge and light diet. Esophagus. (Dilation and Obstruction. Inflammation and Paralysis.) In dilatation, feed frequently with small amounts of concentrated and soft food. Resect esophageal pouch. In obstruction — If foreign body, give soft food. In dogs, pass a bristle probang or coin catcher; in horses, inject apomorphine or use stomach tube and stilet and inject water. Or expose gullet and ligate (temporarily) gullet about stomach tube, above obstruction, and forcibly inject water. Esopha- gotomy. Apomorphine subcutaneously in dogs. Inflammation of esophagus due to irritants — Give linseed gruel with 1 per cent, boric acid, cold milk. Externally, Priessnitz poultice. Later, rub ex- ternally with equal parts oil of turpentine and sweet oil. In paralysis, apply fly blister, give strychnine internally, pass sound. Estrus Equi. See Bots. Estrus Larvae in Accessory Sinuses of Sheep. False Gid or Sturdy. Gadfly Vertigo. Treatment is unsatisfactory. Tar on salt boxes or on nose of sheep to pre- vent entrance of gadflies (see pix liquida). Impossible to insufflate or inject agents to expel larvae. Early slaughter often most satisfactory. Trephine 580 EPITOME OF MODERN TREATMENT either side of median line between eyes and remove with forceps and irriga- tion (2 per cent, lysol), or by injection of a little benzine and water (Moussu). Exostoses. In early stages treat as for Periostitis, which see. For later outgrowth of bone, iodine or cantharides. Red mercuric iodide, point firing; rest. Fainting. See Syncope. False Quarter. 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 witli 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 tine, of iodine and goose grease (1-8). F'ever. 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 septicemia, and in continued low fevers: quinine, alcohol, strychnine. In convalescence, see 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 saturated boric acid solution. Milk removed with boiled milking tube. Touch fissure with solid silver nitrate, and coat with compound tincture of benzoin frequently, and keep covered with boric acid in vaseline (10 per cent.). Also Peru balsam or tannin. Fistula. Surgery should receive first consideration. The following ointment has proved of 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. 1$. Bismuth subnitrate, 6 parts; white wax and soft paraffin, 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. In fisu- lous withers and poll a 7% solution of dichloramine-T in chlorcosane has proved curative. 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 sub- limate. If fistula refuses to heal, suspect foreign body or dead bone or ten- don in wound. In fistulous withers and poll evil the use of a mixed bacterin has been successful. Flatulence. See Tympanites, Colic, Indigestion. Fleas. In Dog and Cat — Frequent grooming and 2 per cent, creolin or lysol baths, followed by clean water and drying. Clean bedding of sawdust or shavings, frequently changed. Application of pyrethrum to dampened hair, but not in puppies and kittens. Carbolic soap. Oil of anise. DISEASES OF DOMESTIC ANIMALS 581 Fly-Blow in Sheep. Dress wounds with tar, and 2 per cent, solutions of lysol or creolin. FOOT-AND-MOUTH DlSEASE. EPIZOOTIC ECZEMA. In Cattle, Sheep, Swine and Goats. — The only rational treatment is prophy- lactic. Strict quarantine of infected premises and animals, and kill all exposed and diseased animals as soon as possible. After diseased animals removed, disinfect premises. Healthy animals not put in disinfected prem- ises for three months. 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 constantly at animal's command. Clean, dry bedding. Feet washed with 2 per cent, lysol or creolin. Com- presses wet with white lotion containing phenol, 1 per cent., constantly kept about coronets of cattle. Tar also 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. Durinsr enzootic, inoculation of saliva of patient into well ani- mal will cause a milder form of disease. Foot-Rot in Sheep. Two forms, 1. Infections, due to B. necrophorus. 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, applying1 oint- ment 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 originating in bruises of sole, and purely traumatic, treatment consists in putting sheep on soft, dry pastures, cutting away dead horn and applying tar. Founder. See Laminitis. Foreign Bodles in Alimentary Tract. 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 svmptoms of straining and lodge- ment there. Abdominal section, if foreign body is not passed. In ruminants the treatment is purely surgical. Foul in the Foot of Cattle. Canker. Often due to B. necrophorus. 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. Fowl Cholera. Treat with dilute hydrochloric acid (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. Prevent by isolation of well in new quar- ters, and administering hemorrhagic septicemia bacterin. 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 582 EPITOME OF MODERN TREATMENT chromic cat-gut; or use bone plugs or metal plates. Compound tract ii res treated antiseptically through window in plaster of Paris splint. Fracture of jaw, rectal feeding. Frontal and Maxillary Sinus, Diseases. See Catarrh Chronic, Estrus Larvae. Frost Bite. Rub part with snow or cold water to gradually restore warmth tempera- ture of premises low for first twenty-four hours. Id mild eases, rub on turpentine liniment. With vesiculation and destruction of tissue, treat as advised in burns of second and third degree. Iehthyol, glycerite of tannin. Fungus Hematodes. A sarcomatous growth protruding from the orbit in cattle and sheep, less often in horses. Enucleate the eyeball ami fatten for slaughter. Gall Stones. Also see Colic No medical treatment will remove gall stones when they are once formed in the gall bladder. Galls, Wind. See Tenosynovitis. Gangrene. Apply antiseptics to wound, as dichloramine-T, or compress wet with cor- rosive sublimate (1-3,000), Dakin's solution, etc., while waiting for line of demarcation to form. Remove dead tissue by knife or actual cautery. Or apply bromine with glass rod, or phenol and glycerine (1-H), to slough. In moist gangrene, apply following paste: phenol (3ss), powd. charcoal (.~,ii), glycerine (5iv). Tonics: tine, of ferric chloride and quinine. Gapes (In Poultry). See Parasites. Garget. See Mammitis or Mastitis. Gastritis and Gastro-Enteritis. See Indigestion, Acute. Gastroduodenitis. See Jaundice. Gid. See Coonurosis. 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 cc. of blood withdrawn from the jugular by aspirating syringe or trocar and canula. The serum which separates should be sent to a laboratory for complement fixation or agglutination 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. Apply a mixture of icthyol and mercury and belladonna ointments and lard, equal parts, in acute and subacute cases, to aid resolution. Tincture of iodine painted on gland. May prevent abscess by fly blister. When abscess inevitable, hot poultice. See also mercury and mercuric oxides. Red mercuric 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.ii to oi) in the eye thrice daily. After acute attack subsides, mild eserine solution (gr.1^ to §i). 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. DISEASES OF DOMESTIC ANIMALS 583 Glossitis, Idiopathic 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. Glycosuria. See Diabetes Mellitus. Goitre. See Bronchocele. Grapes. See Grease. Grease. Dermatitis seborrhceica 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 exu- berant 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. Grogoiness. See Navicular Disease. Haematemesis. See Hemorrhage. Heart Disease, Chronic. 1. Valvular lesions. 2. Enlargement (hypertrophy, dilatation). 3. Myo- carditis, 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 substitutes for digitalis: strophanthus and ca^eine. With high-tension pulse, combine nitro-glyeerin with digitalis. With urgent dyspnea, give morphine. In dropsy, give Horse and Cow aloes and salts; Dog, compound 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.. oi; 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, reduce fat. See Obesity. In chronic heart disease with infrequent pulse, digitalis is contraindicated; use camphor, ether, alcohol or aromatic spirit of ammonia. When there is anemia, iron is of great value. Heat Stroke. See Sun Stroke. Hematuria. Ice to loins. Aqua hamamelidis internally. Ergotin under the skin, or extract ergot internally. In hematuria of acute nephritis, after first week, give tincture cantharis (H., 5ss; D., m.i) with same amount of fluidextract of cannabis indica. In bleeding from bladder, irrigate with adrenalin with 1-5,000 solution; also inject water at 120 deg. F. Urethral hemorrhage stopped by retention of catheter in urethra. If adrenalin stops bleeding, when injected into bladder, the source of the trouble is proven. Hematuria 584 EPITOME OF MODERN TREATMENT in young cows: This is enzootic in low-lying pastures; change pastures, drain pastures and fertilize them with lime and phosphates. Hemoglobinuria. Azoturia in Horses. Support in slings in box stall. Quiet with lobeline. Empty bladder by pressure through the rectum or by catheter. Adrenalin solution intramuscu- larly, 3ii-iv, purge with arecoline hydrobromide 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, digitalis or strychnine. Diet — Bran mashes, hay, roots, green food, little hay. Prevent by light feeding, when not working, or by exercise every day. Hemoglobinuria in Cattle. 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 dip: Dipping cattle (15 to 30 seconds) in this mixture in concrete or wooden vats 5% ft. deep and 40 ft. long is most successful in eradicating ticks in large numbers of cattle. Boil white arsenic (10 lbs.) and sal soda (25 lbs.) in 25 gallons of water for 15 minutes, or till arsenic dissolves. Cool with cold water to 140° F. and add 1 gallon pine tar gradually, while stirring. Bring the mixture to 500 gallons by adding sufficient water. (U. S. Dept. Agr.). 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 jn 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. Immunizing.- — Young stock may be immunized by inoculation with 1-3 mil 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) or better, transfusion of blood, 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. Inter- nally, calcium chloride and gelatin. Hemoptysis. See Hemorrhage. Hemorrhage from Wounds. See Wounds. Hemorrhage, Internal. Quiet and rest of animal and bleeding part, with lowering of blood pres- sure in internal hemorrhage; opium. Infusion of salt solution after arrest of bleeding. Gelatin and calcium chloride to coagulate blood. Adrenalin chlo- ride best hemostatic when can reach bleeding spot. Subcutaneous injections of fresh horse serum (antidiphtheric serum is most convenient, but fresh serum is more effective) has given 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 gss for small animals; 32-4 for large patients. Trans- fusion of blood most successful. Gastric (hematemesis) and intestinal hemorrhage (enterorrhagia), 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 hamamelis or tannic acid by mouth. DISEASES OF DOMESTIC ANIMALS 585 In enterorrhagia, tannic acid with opium, or Monsel's salt, as above. Ham- amelis. Diet, oil of turpentine in slight enterorrhagia. In bleeding from rectum, enemata (H., Oi; D., 52-4). Enemata to contain either adrenalin (5*ss to Oi), Monsel's salt, or alum, or tannic acid (3*ss-Oi). In hemoptysis, morphine under the skin, or chloral and bromide by mouth. To prevent recurrence, give calcium chloride every 2 hours, and gelatin. Hemorrhage, Post-Partum. Remove fetal membranes. Intrauterine injections of hot sterile water (115-120 deg. F.). Pack uterus with aseptic gauze. Ergotin subcutaneously. Raise hind quarters. Secure quiet by morphine, or laudanum. Tight binder about abdomen to support uterus. In laceration of uterus, tight packing of sterile gauze or suture. In severe bleeding, Hogan's solution intravenously, or blood transfusion. Strychnine and alcohol, to avert collapse. Hemorrhagic Septicemia. Cattle, Sheep, Swine. Bacterins containing B. bovisepticum, B. ovisepticum, B. suisepticum (swine plague), B. avisepticum will afford immunity. Organisms from the same species are preferable to those from other species. A curative serum from hyperimmunized animals gives good results in treatment of existing cases in doses up to 100 mils intravenously. Forage disease or corn stalk poisoning (cerebro-spinal meningitis) due to B. botulinus may confuse diagnosis. Bodies of dead burned or buried deeply. Hernia. Umbilical Hernia in New-Born — Give purge, and, after 12 hours' fast, cast 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 introduced 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 pro- trusion. 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, Pemphigus, Bullae. 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 zinc oxide; bismuth nitrate as dusting powder; zinc ointment. Hog Cholera. Under this title three distinct diseases are sometimes confounded — 1. Hog cholera or swine fever, in U. S. and Great Britain. 2. Swine plague, hemor- rhagic septicemia or contagious swine pneumonia. 3. Swine erysipelas or mal rouge. Life immunity is secured by simultaneous injection of anti-hog cholera serum and hog cholera virus at distant points in' the body. Serum alone protects young pigs till weaning (when simultaneous treatment is given), or cures hogs with beginning hog cholera. Severe cases should not be treated. It is sometimes necessary to also inject bacterin of B. suisepti- cum as swine plague not infrequently complicates hog cholera. In erysipel- atous form immunity which lasts a year is secured by vaccination with an attenuated virus, but is attended with 1 to 2 per cent, mortality. Not com- mon 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. Hoose. Husk. Verminous Bronchitis. Due to presence in the bronchial tubes of S. filaris in lambs; S. micrurus in calves. 586 EPITOME OF MODERN TREATMENT By inhalation — Lambs. Give chloroform inhalation till animals stagger. After 3 hours follow with dose of Epsom salt to remove worms coughed lip and swallowed. 2 or .'* treatments 3 days apart will cure. Calves, 3iJ each of oil of turpentine and ether poured in each nostril of upturned head for one or more treatments (Head). Inhalation equal parts tar, sulphur and turpentine from kettle for 25 minutes for three treatments. Lambs — Internally, oil of turpentine (5i), or oil of turpentine and tine, camphor; of each 3i once daily in milk; or creosote; (.~)ii), benzine (3i), ami water (2 qts.) in teaspoonful doses for week (Moussu) once daily. Intratracheal Injections — Calves, oil of turpentine (oii), phenol (m.xx), with chloroform (3ss) for one injection. Generous feeding. Iron and bit- ters. Slaughter of severe cases. Hyatids in Cattle and Sheep. See Coenurosis. Hydrocele (Dropsy) of Scrotum. Distinguish from hernia by failure to reduce and translucency. Insert hypodermic needle, and then completely empty with aspirator or tine trocar. Screw on hypodermic syringe to needle and inject pure phenol (m. x to xxx small animals; 5ii or more in large animals). Jn failure to cure, open scro- tum, swab tunica vaginalis with pure phenol, and drain. Hydrocephalus (Dropsy of Lateral 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. Hydrophobia. See Rabies. Hydrothorax. Purge with concentrated solution of salts in large animals; in dogs, give compound 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 of Colon in Horse. See Colic from Impaction. Impaction of Omasum, Dry Murrain, Fardel Bound, Stomach 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 cases. Enemata — 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. Impaction of Rumen in Sheep and Cattle. To relieve tympany, puncture with trocar in most prominent point in left flank. Follow with daily doses of Glauber's salt and linseed oil, and fluid- extract 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 salines, nux vomica and mashes as above. In acute and chronic cases, rumenotomy is indicated when medical treatment is unsuccessful, except in febrile cases and old cows; not more than two- thirds of rumen contents should be removed (Moussu). Incontinence of Urine. See Urinary Retention and Incontinence. Impotence, Inability to Copulate. 1. Loss of sexual desire and .power (functional). — Regulate exercise and work, by deceasing or increasing, if either excessive. Avoid excessive or early copulation. Yohimbine hydrochloride. Give tincture cantharides and fluidextract nux vomica well diluted, thrice daily. 2. Organic impotence — Growths, disease and malformations or paralysis rarely yield to drugs. DISEASES OF DOMESTIC ANIMALS 587 3. Premature ejaculation in male — Prevent masturbation and excessive copulation. Cold enemata and improvement in hygiene by outdoor life. Indigestion, Acute, in the Horse. Includes acute gastro-intestinal catarrh. Use stomach tube with eructations, retching, pain and distension of stom- ach. With flatulence, aloes ball with calomel, (3ss). With violent pain, see Colic. Lysol (5iv) in ball of use in flatulence. Follow later with powdered sodium bicarbonate, ginger and nux vomica thrice* daily. After an acute attack give dilute hydrochloric acid and fluidextract of nux vomica to stimu- late gastric functions. When diarrhea is chief feature, give calomel (5ss) in a quart of linseed oil; then prescribe opium and tannic acid (each 5ii) 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. Indigestion, Acute, in Cattle. Acute Gastritis, Rumenitis, Reti- culitis, Omasitis, Abomasitis. Apply fly blister over affected stomach. In abomasitis, venesection (2 to 4 qts.) in severe cases. Eserine with pilocarpine under the skin. Daily doses of Glauber's salt. Nux vomica in convalescence. Diet — Gruels, milk, bran mashes and little hay. Indigestion. Chronic. Chronic Gastro-Enteritis (Horse). Diet. Attend to condition of teeth. Powder (sodium bicarb., ginger and nux vomica) thrice daily on feed. Dilute hydrochloric acid in some cases. Carlsbad salt (oi) on feed for constipation. Also daily, soapsuds enema. In diarrhea, with putrid feces, copper sulphate or lysol (5ss) daily. Indigestion, Chronic, in Cattle. Chronic Tympanites. Without diarrhea or constipation, give fluidextract nux vomica with Carls- bad salt (2 tablespoonfuls) on feed thrice daily. In constipation with mucus, add to Carlsbad salt sodium bicarbonate. With diarrhea, give dilute hydro- chloric acid (oi-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. Indigestion in Calves. Milk Indigestion. Abomasal Indigestion. 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 creameries must be scalded. In hand-fed, give scalded milk and pure water (half and half), warm, till digestion good. At onset, castor oil (5ii). 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. Indigestion. Acute, in Swine.. Acute Gastritis. 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 (5ss) on food thrice daily. Avoid improper food, sour swill, hotel washings, etc. Give boiled milk and gruels. Clean utensils, trough and pen. Indigestion, Acute. Acute Gastroenteritis in Dogs. Restrict water and starve patient. Encourage vomiting by fluidextract ipecac (5i). 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 powdered 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 con- valescence, tine, nux vomica thrice daily. Induration. Apply Priessnitz poultice. Rub into parts frequently, equal parts, ich- 588 EPITOME OF MODERN TREATMENT thyol, unguentum hydrargyri and unguentum belladonna, or employ a fly blister. Fibrolysin. Inflammation. Acute— General treatment with aconite, veratrum, or, in robust patients and with very urgent symptoms, venesection. Cool, airy, box stall, moderate body covering and bandage for limbs, in case of horses. Internally, laxa- tives. Calomel is an intestinal disinfectant as well. Externally, counter- 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- alcohol, hydrochloric acid. In chronic inflammation, supportive treatment. Internally, iodides to aid resolution. Externally, in local troubles, counter-irritants. Influenza in Horses. Shipping Fever. Distemper. Pink 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 milk laxatives. Diet — Bran mashes, boiled oats, milk, beef tea, eggs, green food. Strychnine solu- tion dropped on tongue thrice daily and turpentine liniment rubbed daily onto limbs and belly to prevent edema. Steaming with compound tincture 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. Anti- pyretics rarely desirable, except in hyperpyrexia, then a few doses of acetanilid at 3-hour intervals. 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. In shipping fever a variety of bacteria have been found. Prominent among these are streptococci (In 80% of cases); also staphylococci, pneumococci, B. equisepticus, B. coli, etc. These are probably secondary infections in most cases. Shipping fever includes influenza (due to unknown filtrable virus), strangles, due to S. equi, and contagious pneumonia. In these three diseases bacterins of the above organisms have a distinct preventive and curative effect by averting secondary infections. The antitoxic serum taken from horses recovered from influenza (preferably in the same outbreak) has most curative and temporary preventive action. The same remarks apply to the great 1918 human influenza outbreak, due to unknown organism, where bacterins afforded some transient immunity against sec- ondary and chiefly streptococcic infections. Suspects showing rise of tem- perature and all cases of influenza should be isolated. Communication of influenza by utensils and attendants should be avoided. Disinfect premises when cases no longer exist. For special complications, as pneumonia, pur- pura, enteritis, meningitis, paraplegia, synovitis, laminitis, etc., see titles of these disorders. Interfering. Improve the general condition and shoeing. Set shoes a little away from inner margin of foot 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. Intertrigo. See Erythema. Intestinal Hemorrhage. See Hemorrhage, Enterorrhagia. Intestinal Indigestion and Catarrh. See Indigestion and Enteritis. Intussusception or Invagination. See Colic. DISEASES OF DOMESTIC ANIMALS 589 Iritis. - I*PW 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. Jaundice. Gastro-Duodenitis. Cholangitis. In Dogs and Horses. 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 salt on feed thrice daily. Diet — green fodder, pulped roots, boiled potatoes, steamed and cracked oats. An abun- dance of water. Johne's Disease. See Dysentery. Keratitis. Abscess and Ulcer of Cornea. Brisk Purges. Quinine in good doses. Extr. opii (gr.x), boric acid (gr.lv) in water (oiv)» 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 lacrimation) with application to lids of yellow oxide of mercury oint- ment (gr.iv-5ss). Or holocain hydrochlorate (gr.ii-Ji) 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 (3ii-Oi). Fine galvano- cautery may be used instead. In abscess of cornea and pus in anterior chamber, rarely advisable to incise. Keratoma and Keraphyllocele. Horny tumor from sole or horny laminae of horse's foot. Excision and antiseptic dressings. Recurrence is frequent. Laminitis, Horses and Cattle. 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 acetanilid (5iv), or bleed from jugular or toe in severe cases. Inject adrenalin locally. Give arecoline subcutane- ously, employ enemata and linseed oil, and encourage animal to lie down, or cast or sling in very acute cases. Give two ounces of alum in capsules every two hours until eight ounces are given. After subsidence of acute inflam- mation, 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. Laryngitis, Acute. Chiefly in Horses and Dogs. Locally, cold wet compress applied to throat and covered with oiled silk; or ice bag; or turpentine and sweet oil (equal parts); or, in severe cases, mustard paste, tincture of iodine, or fly blister. Steam inhalations with com- pound tincture of benzoin (5i-Oi). Internally, brisk cathartic and tine, aconite with spirit of nitrous ether every few hours for fever. Laryngeal cough and spasm relieved by morphine or Dover's powder and ammonium chloride on feed (horse), and by codeine and ammon. chloride mixture (dogs). Laryngitis, Chronic. Chiefly in Horses and Dogs. Locally to throat, wet compresses, tincture of iodine or stimulating tur- pentine liniment, as above. Dogs — Application to larynx of 2 per cent, silver nitrate solution on human 590 EPITOME OF MODERN TREATMENT 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-t radical ligament, with a hollow needle (1 to 2 per cent, solutions of alum or lead acetate) are most effective. Also give ammonium chloride and Carlsbad salt on the feed thrice daily. Laryngitis, Membranous. Chiefly in Cattle, occasionally in calves, lambs, pigs, dogs and eals, see Croup. Bleed from jugular (1 to 6 qts.), or give tartar emetic (3ii to iii) in strong 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. Leukorriiea. Sec Vaginitis, Septic Metritis, Metritis, Puerperal Fever. Symptomatic treatment with injections of 1 per cent, liquor cresolis com- pound, 1 per cent, solution of alum, or zinc sulphate. Iron and gentian in young and under-nourished. Generally secondary to endometritis, metritis, contagious abortion, tuberculosis, granular and li. necrophorous vaginitis, etc. Leukemia. Rare in' horses, cattle, swine, dogs and cats. Generally fatal. Fowler's solution of arsenic pushed to fullest extent — II. and C, trom ;yss to 3ii; D., from m.v to m.xxx, twice daily. Otherwise the treatment is as for Anemia, Pernicious. Lice, Pediculosis, Phthiriasis. Horse: Hccmatopinus macrocephalus, Trichodeetfi pilosus, and T. pube- scens. Cattle: II. eurysternus, large ox-louse; II. vituli, calf-louse; and T. scala- ris, small ox-louse. Sheep: T. sphwrocephalus. The pupiparous dipteran, Melophagus ovinus, commonly called the "sheeptick," ked or fag, also infests the skin of the sheep. Dog: H. piliferus, and T. latus. Cat: T. subrostratus. Pig: H. suis. Goat: H. stenopsis and T. climax. Fowls: Goniodes diss-imilis, Goniococtes 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 tincture staphisagria, or oil of anise in sweet oil (1 to 10) ; also creolin in 5 per cent, solution; and corrosive sublimate in 1 per cent, solution, applied in spots and carefully 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: Apply sodium fluoride in small pinches to the skin under the feathers of the neck, breast and back, and under the wings and tail. Apply kerosene to roosts and nests. Wash floors and sprinkle with sulphur. Whitewash walls. Keep hens out of stable to prevent hen mites from infesting horses. Isolate infested animal till cured and disinfect its former quarters. Employ general cleanliness and generous feeding. Lichen. See Eczema. Licking Habit. See Depraved Appetite. Lip-and-Leg Ulceration in Sheep. Enzootic, 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 slough. May be similar lesions about coronets and pastern joints and DISEASES OF DOMESTIC ANIMALS 591 fold 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 aI>ove. 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°/o 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. Lithiasis. See Calculi. Liver Rot in Sheep. (Occasionally in cattle.) Due to Distomum hepaticum and other species of Distomata or fluke worms; Order, Trematoda. Aspidium and kamala have both been found to effect cures. 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 lbs. to the acre) on pastures from May to August. Drain pastures to destroy snails, the intermediary host of the dis- tomata. Diseased animals should be slaughtered and their livers burned. Keep sound sheep away from infested pastures. Disinfect manure of infested animals with quick lime. Louping III in 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 flock as for scab. Wet pastures avoided or drained. Long grass and rushes must be avoided. Luxations. See Dislocations. Lymphangitis. Cellulitis. Inflammatory Edema. Idiopathic in horse in hind legs. Apply from the beginning hot compresses of 2 per cent, lysol or creolin solution, covered with waterproof protective and bandage, to whole limb; change frequently. Give aloes, 5iv, calomel, 5i, in ball, and light diet — mashes, green food and hay. Enforce absolute rest. Tincture 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 bandaging, 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 reso- lution, together with laxatives to remove water from the system, as artificial Carlsbad salt on the food. Lymphangitis, Mycotic or Epizootic, 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 objects and premises contaminated by affected animals. Lymphatics, Inflamed. See Glandular Enlargements. Maggots From Flyblow. Apply kerosene, or turpentine and oil. Other antiseptics. 592 EPITOME OF MODERN TREATMENT Maladie du Coit. Dourine in Stallions and Mares Caused by Trypanosoma Equiperdum. 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, pruri- tus and discharge from nose and eyes. Does not occur in geldings. Treatment. Kill diseased mares, castrate infected stallions, castrate or iso- late exposed stallions and frequent inspection of exposed mares. Castration 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 irrigations of penis and vagina. Stallion, 2 per cent, lysol or creolin, or 1-2,000 solution of corro- sive. In mares, injections of 2 per cent, lysol. Also apply local application of 5 per cent. argyrt>l solution after cleansing as above. 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 zinc sulphate solution, and use black wash exter- nally. 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 sodium cacodylate (gr.xl), hypodermically every four hours. 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 dis- appears spontaneously. Malignant Catarrhal Fever in Cattle. Prophylaxis: clean, dry, well ventilated stables and removal of infected soil from barns. Isolate sick and disinfect discharges. Gi\«e 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. Mallenders and Sallenders in the Horse. Squamous Eczema. See Eczema. 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 to 10). Carlsbad salt on the food. Regular exercise. Arsenic and iron. Malnutrition. See Debility. Malta Fever. In goats and sheep, occasionally solipeds, ruminants, dogs, cats, rabbits, rats, fowl and duck. Has occurred in this country in Texas and Mississippi valley region. Infection through milk and urine and by copulation with in- fected 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 m Causes severe and prolonged febrile illness in man. Diagnosis by agglutination test of serum of infected animal. Prophylaxis only of importance. A vaccine is still in the experimental DISEASES OF DOMESTIC ANIMALS 593 stage. Animals showing symptoms should be killed and premises thoroughly disinfected. All suspected animals must be tested by the agglutination 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 pasteurized 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. Mastitis. Garget. At onset, milk every hour and give frequent massage of udder with full dose of Glauber's salt and common salt. 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 bandage and wide band about body. The surgeon should cleanse udder thoroughly and irrigate each quarter of the udder with warm 3 per cent, borax solution through sterile milking tube, in parenchymatous form. After gentle manipulation, draw off fluid in 15 minutes. If suppuration threatens, apply mercury binodide ointment (10 per cent.). With interstitial form and surrounding edema, puncture swelling in points by actual cautery, avoiding the veins. Then apply boric acid oint- ment (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. Segregate cows and 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, Contagious Streptococcus. 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. necrophorus and staphylococci. Mange. Acariasis. Scabies. Itch. Scab. 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 oil with 5 per cent, creolin over night. Remove scabs with green soap and water next morning. No better remedy than lime and sulphur dip as for scab in sheep. 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 1 pint crude petroleum oil, 1 pint oil of tar, 3 quarts white rose oil, mix; or liquid tar and sulphur, each 5i; with soft soap and alcohol, each Sii; or creolin and soft soap each 5i; alcohol Sviii. Also balsam of Peru and sulphur ointment, (1 to 7), 3 per cent, lysol or creolin solutions. Ointments in localized mange. In dermodectic and symbiotic mange, milder remedies — Peruvian balsam, car- bolic soap, or creolin and glycerin (1 to 10). In Dogs — Follicular mange, caused by Dermodex foliculorum, var. canis, attacks head, neck and limbs, invading hair follicles and sebaceous glands; 594 EPITOME OF MODERN TREATMENT difficult of cure. Sarcoptic mange, caused by Sarcoptes squami ferns, 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 oint- ment (oi-.v), 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 (V2 of 1 per cent.) for 15 minutes; follow by friction with pnr« 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 bacterin for suppuration. Masturbation. Onanism. Dogs and Rams; Bulls and Stallions. Regular exercise or work, and light diet. Punishment; moderate amount of copulation. Castration, if habit incurable. Megrims. See Vertigo, Blind Staggers . Melanosis. Melanotic Sarcom \. Seen chiefly in grey horses. Remove by knife; recurrence rather the rule. Meningitis. See Encephalitis and Cerebrospinal Meningitis, Metritis, Acute and Chronic. 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 tincture of 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 iodoform gauze for a few days. Afterwards daily lysol irrigations. Muscular Rheumatism. Warm covering. Give a purge: H., physic ball, C, Glauber's salt, D., two compound cathartic pills. Rest of affected parts. Give sodium salicylate and potassium iodide in combination, in capsules, to dogs, to 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 chloro- form liniment. Heat is also very efficacious; hot wet blankets covered with rubber sheet and dry blanket, or apply dry blanket and iron over it with hot flat iron. Puncture of affected muscles with sterile needles, or injection of sterile water, sometimes effective. Shoulder lameness — Inject veratrine into muscle (H., gr. % to l1^ in alcohol, m.xxx), followed by walking exercise. Chronic cases — Tonic treatment; cod liver oil; massage with liniment, moder- ate exercise and attention to hygiene. Myalgia, Myositis. See Muscular Rheumatism. Myocarditis. See Heart Disease. Nagana or Tsetse — Fly Disease. Horses, Cattle and Dogs. Caused by Trypanosoma Brucei conveyed by Glossina morsitans or tsetse fly. Arsenical preparations as atoxyl, sodium cacodylate most useful. Nasal Catarrh or Rhinitis, Chronic. Gleet (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, oiiss to Oi), with 5i tincture of iodine. Dobell's solution. Astringents, cupric sulphate or alum (y2 per cent.); tannic acid or zinc sulphate (y2 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 com- DISEASES OF DOMESTIC ANIMALS 595 plement fixation or agglutination test. Discharge from one nostril is not usually simple gleet. Navel Disease. See Umbilical Infection. Navicular Disease (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 sub- side, 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. Necrobacillosis. See Lip-and-Leg Ulceration in Sheep. Nephritis, Acute. (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 salt to cattle; compound jalap powder to dogs (3i) at onset. Hot blankets over whole body and mustard paste over loins. Pilocarpine, with strychnine, hypodermically. With marked hematuria, fluidextract ergot thrice daily. In later stages, as a diuretic, tine, digitalis with potassium citrate. In convalescence, tine, ferric chloride. Uremia is combated by cathartics and venesection; and convulsions by chloral hydrate, chloroform inhalation and morphine under the skin. Nephritis, Chronic. (All Animals.) Tincture of 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. Sodium bicarbonate for acidosis and edema. In Uremia, treat as recommended for Acute Nephritis. Nephritis, Suppurative. Pyelo-Nephritis. Pyelitis. 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 of water by placing an abundance of salt upon food. In early stage, spirit of nitrous ether and potassium acetate thrice daily. Hexa- methylenamine, 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 tincture of ferric chloride on the tongue. Isolation of patients is desir- able to prevent infection of parturient animals. Nervous Palpitation of the Heart. Seen in horses and dogs from over-exertion, indigestion, "nervousness." In severe cases, morphine. Also spirit of chloroform in less urgent cases. Or chloral and potassium bromide may be given. In asthenia and over-exer- tion, especially with irregular pulse, prescribe tincture of digitalis with tincture of aconite thrice daily. In anemia, give ferrous sulphate and nux vomica to horses. Indigestion, as a cause, demands a physic and restriction of food. Nettlerash. Surfeit. Hives. See Urticaria. Neuralgia. Neuritis. 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 rheumatic cases. To simply relieve pain, morphine injected locally under the skin, antipyrine, internally. Aconitine locally, gelsemium internally. In wound or injury, apply antiseptic poultice. In asthenia, see Debility. 596 EPITOME OF MODERN TREATMENT Nymphomania. See Sexual Excitement. Obesity. Diet the chief remedy. In dogs, tablets of desiccated thyroid gland, (gr.i-iii each) thrice daily. Restlessness and palpitation show overdosage; otherwise increase above dose. Potassium iodide, after meals thrice daily. Daily laxative and exercise. Omphalophlebitis. See Umbilical Infection. Opacity of Cornea. 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 min- utes, using corrosive sublimate (1 to 2,000), or lysol (2 per cent.), or other antiseptic solution, or simply inject ether. Often best to simply cover punc- ture 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 to 10), sterile gauze and bandage, if latter possible. If suturing impossible, apply fly blis- ters 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. Open Joint, Infected. Open so as to irrigate and drain thoroughly, then flush with ether. Band- age and dress with sterile gauze daily, after thorough irrigation with anti- septic fluid, as above. Fixation by splint, if possible. (Bier's hyperemia.) Repeated blisters in large animals may aid. Recovery occurs only with stiffness, or ankylosis, 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. Ophthalmia. (Periodic in Horses.) 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 (oii), thrice daily, and sloppy or green food. Iron and gentian during convalescence. Ophthalmia, Simple. See Conjunctivitis. Orchitis or Epididymo-Orchitis. 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 flaxseed 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. As- piration of fluid in tunica vaginalis advisable if done aseptically. In hema- toma resulting in abscess, incise tunica vaginalis and stitch it to edge of skin incision; wipe out with pure phenol and drain sac. Tuberculous form asso- ciated with tuberculosis of kidneys, bladder and prostate (examine per rectum) ; if only testicle affected, castrate. Osteomalacia. In enzootic cases treatment is unavailing. Treatment must be undertaken 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 phosphate, give C. 3i; Sh. and Sw., 3i-ii. To this add equal parts ferrous sulphate and mix DISEASES OF DOMESTIC ANIMALS 597 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 restricted diet. In subacute and chronic stages, firing, blistering and rest. Otorrhea (In Dogs). Canker of the Ear. Otitis Externa. In the acute stage, with much pain, give frequent and long-continued in- jections of hot solution of saturated boric acid, or 3 per cent, carbolic, or 1 to 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 compound 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, zinc or copper sulphate, or silver nitrate. To avoid pain of injection one may blow in a little powdered cocaine first. Diachylon oint- ment is also useful in chronic form, and boric acid in alcohol (1 to 20). The occurrence of granulations in the canal calls for use of stick nitrate after cocainization. Over-Reach, Wound of 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. Oxyurides. See Parasites. Palpitation. 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, etc. Attend to bladder and rectum, 'change position of patient and supply good bedding. Later use electricity, and administer potassium iodide. Treatment generally inadvisable, as recovery is protracted and partial. 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 circulation 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 evacua- tion 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 to 3 compound cathartic pills or calomel, cerium and bis- muth by the mouth, and use enemata and manual removal of feces. In the horse, paraplegia occurs sometimes transiently during colic, and in mares ix heat There is also an infectious enzootic form. Apparent para- plegia in the horse if often really hemoglobinuria. Treat causative disease. In cattle, paraplegia is seen in impaction of the rumen and parturient apo- plexy. (See Indigestion and Apoplexy, Parturient.) In general, evacuate 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 infrequent, and recovery commonly occurs. Treatment — Remove sources of pressure or irritation, as halter in facial paralysis. Use preferably galvanic current from 598 EPITOME OF MODERN TREATMENT the onset of paralysis over the nerve root and paralysed area, or faradic current, if it causes contraction of muscles and is not toqnainful. Also apply sinapisms or eapsicum, or light applications of thermocautery over the course of the affected nerve. In chronic stage, employ massage with a lini- ment, hot and cold douches, alternately; electricity, as above, and strychnine hypoderrnically in large doses. Parasites, Intestinal. Order, Cestoda, Tapeworms. Of the dog — Taenia marginata, T. serrata, T. coenurus, T. echino coccus, T. serialis, and l>i/n/lidium caninum. 4 Sheep — Moniezia expansa, M. planissima, and M. trigonophora, and, in western U. S., Thysanosoma actinioides. Cattle — Moniezia expansa and M. planissima. Horses — Anoplocephala perfoliata, A. magna, and A. mamillana. Poultry — About 20 species of tapeworms. Treatment — Withhold all food for 24 hours, give anthelmintic, purge imme- diately following it, and repeal dose 2 weeks later if ineffective. Isolate the infected animal, burn feces and tapeworms, and prevent animals from eating raw meat or entrails of other animals. Special treatment. — Dogs — Olcoresin of male fern or arcca nut in capsules, followed by compound cathartic pills or castor oil. If the head of the worm is not removed, repeat the treatment in 2 weeks. Also pelletierine, pomegra- nate, and kousso are used as taeniacides. , Sheep — Give areca nut (3i to ii) to lambs and repeat in 2 weeks if not effective. Cattle — Arsenous acid (gr.xv), once daily for two or three days, followed by 1 lb. of Glauber's salts, has been used. Also tartar emetic, 3iss to iiss, or male fern. Horses — Treat with male fern or kamala. Poultry — Areca nut (gr.xxx) in pills with butter; repeat in three days. Phylum — Nemathelminthes, roundworms. Order — Nematoda. In the Horse and Ass — Ascaris equorum. Carbon bisulphid in capsule, 3 doses of 5iii each at 1-hour intervals. Other treatments that have been used are: Tartar emetic (3ii-iv) in a physic ball of aloes. Oil of turpentine (5*v) with oleoresin of aspidium (3i) in pint of linseed oil; or, santonin (5iv) in oil, or calomel (5i) with santonin in ball. Follow this treatment with course of iron and nux vomica on feed thrice daily for weeks. Dog — Belascaris marginata and Toxascaris limbata. Cat — Belascaris mys- tax. For roundworms in dog, oil of chenopodium, m.iss per 2.2 lb. live weight, immediately preceded or followed by castor oil Si- For cat use smaller dosage. Santonin daily for several days in castor oil or in pill with equal amounts of calomel; or areca nut in capsules. Poultry — Fowl: Ascaridia perspicillum. Oil of chenopodium, m.ii-iii per pound of live weight, with castor oil 3i-ii, to birds fasted 24 hours. Or oil of turpentine and olive oil, each 30 m. For 100 fowls, soak 1 lb. chopped tobacco stems in enough water to cover for 2 hours. Mix stems and water and feed with half of the usual ration after fasting for 24 hours. Two hours later ^ usual ration fed to fowl with Epsom salt, 10 ounces. Efficient for A. perspicillum and to some extent for Heterakis papillosa and tapeworm. Pigeons: Areca nut (gr.xv) in pills with butter every third day. Other remedies which have been used include: Arsenic, creolin, naphthol, ether, copper sulphate, tannic acid, and kamala. Horse — Oxyuris equi, pinworm. Enemata of strong solutions of common salt, of quassia, or of lime water, after flushing bowel with soap and water. Or fast 36 hours and give oil of chenopodium 3iv-v with a quart of linseed oil, or give turpentine §ii-iv with a quart of linseed oil. Dog — Trichuris depressius cuius, whipworm: Santonin, gr.ss-i daily, with calomel aa, for a week. Then suspend treatment for 1 week and repeat for 1 week. Horse — Strongylus equinus, 8. edentatus, and 8. vulgaris, and Cylicosto- DISEASES OF DOMESTIC ANTMALS 599 mum spp. (including Cy. tetracanthum and numerous other species). Oil of chenopodium or turpentine, as given above for pinworms in the horse. Thymol (H. 5iii, foals oi), in ball coated with keratin, for five mornings, followed at end of treatment by aloes ball, has also been used. Dog — Ancylostoma caninum. Hookworm disease. For hookworms in dog, 3 doses of 5 to 10 minims of oil of chenopodium, according to size of dog, each with half ounce of castor oil, at hour intervals, followed an hour later by chloroform 5ss-i in castor oil 5ss. Use diminished doses for weak animals. Swine — Ascaris suum. For roundworms in swine, oil of chenopodium mi to 2 lbs. live weight in castor oil oii-iv. Fast animal 24 hours and withhold feed or water for 2 to 3 hours afterward. Strongylidae in cattle, sheep, lambs, and goats. Internally, oil of turpen- tine (5iv), to cattle. To sheep, oil of chenopodium, miii per 2.2 lb. live weight, emulsified in milk or given in oil. Numerous species occur in aboma- sum, and, with tapeworm, in intestines. Prophylaxis: Isolate sick, rotate pastures, disinfect pastures with copperas (80 lbs. to acre in 10 per cent solution) ; generous diet with plenty of salt. Stomach worms (Haemonchus contortus) of sheep and cattle: Give 50 mils of 1 per cent solution of cop- per sulphate to lambs, 50 to 100 mils to adult sheep, and 200 mils to cattle. Areca nut (gr. 100), on bran with arsenous acid (gr.ii), once daily for five or six doses, is also used. Dictyocaulus micrurus and D. filaria. See Verminous bronchitis, Hoose or Husk. Gapes in poultry and birds, due to Syngamus trachealis: Oil of turpentine on feather in trachea; or tracheotomy; or removal by wire or horsehair loop. Inject a few drops of turpentine or ether into trachea. Inject a 5 per cent, solution of sodium salicylate intratracheally. Medicinal treatment not satis- factory. Clean thoroughly and disinfect premises and utensils, and isolate sick animals. Parotitis. Secondary to various infections as strangles, pharyngitis; idiopathic; trau- matic and actinomycotic. Also due to salivary calculus. In acute inflamma- tions, treat as recommended under glandular enlargements. In chronic, idiopathic, massage with turpentine liniment and give pilocarpine internally. Parturient Apoplexy, Paralysis, or Mammary Toxemia. See Apoplexy. Parturient Fever. See Puerperal Fever. Patella, Dislocation of. (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 recur- rence, 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. Pericarditis, Acute. In horses and dogs, from acute infections and trauma. In cattle and goats, from swallowing sharp bodies which penetrate the pericardium. The treat- ment of the latter form is unsuccessful. At the onset, bind an ice bag over the heart and give morphine and atropine 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 dis- ease, administer strychnine with whiskey and aromatic spirits of ammonia and digitalis. With large effusion, weak pulse, and much dyspnea and cyano- sis, puncture pericardial sac. Incision over anterior border of 5th or 6th rib, four inches above lowest point on the breast in large animals, 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. 600 EPITOME OF MODERN TREATMENT Peritonitis, Acute and Chronic. Acute form — In all animals; generally secondary to some local inflamma- tion, injury, as operation for hernia and castration, or lesion in the belly, as perforation of stomach or intestines, or pelvis. Parturient sepsis is a fre- quent 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 peristalsis 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 turpentine 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 tincture of 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. Pharyngitis, Acute. Occurs in horses, dogs, pigs; less often in cattle and cats; rare in sheep and birds, except pseudo-membranous form. In enzootic type, isolate patient. Good ventilation and housing; liquid or soft diet. Gruels, cooked roots, mashes, milk and greert food for larger animals. Milk, gruels and soups for smaller patients. Drenches are dangerous in leading to foreign body pneu- monia. Tincture of aconite hourly is useful till fever is reduced. 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. A wet compress covered with oil silk and bandage; or equal parts of camphor liniment and oil of turpentine rubbed in and applied on cloth, wet with same, are useful in less urgent cases. Antiphlogistine spread on hot and thick, after shaving skin, and renewed each 12 hours, is also beneficial. When abscess of glands threatens, frequent hot poulticing or application of a fly blister are in order. Relieve constipation by carron oil or artificial Carlsbad salt in doses of a few ounces on the food, and by enemata. Inhalations of 2 per cent, carbolic acid are efficacious, with cleansing and greasing of nostrils with vaseline. Abscess about the pharynx calls for incision of skin and exploration with director or fingers. Severe dyspnea demands immediate tracheotomy. In dogs, silver nitrate solution (10 per cent.) may be painted on throat, or m.v of tincture of ferric chloride may be given in one-half dram of glycerine every 2 hours for effect on throat. In swine, apply a good fly blister from ear to ear and give veratrum or ipecac (of either, gr.xxx) on food to cause emesis and avert suffocation. Phlebitis. Due to infection following injury and operation. If diffuse it is incurable. ■ Excise thrombotic portion of infected vein. Open abscess. Give a purge. Apply warm covering, secure rest of part. Apply Crede's ointment. Phrenitis. See Encephalitis. Phthiriasis. See Lice. Pica. See Depraved Appetite. Piles. Hemorrhoids (In Dogs). Keep bowels loose with liquid petrolatum, or equal parts of sulphur and compound licorice powder (3ss-i in capsules), or with two parts of sulphur and one of potassium bitartrate (3ss in capsules). Apply externally fluid- extract of hamamelis, and inject some into the rectum. With much itching and pain: acidi gallici, gr.x; orthoformi, gr.x; extract opii, gr.iv; extract belladonnae, gr.iv; unguentum ad. 3iv; apply externally. If aggravated and DISEASES OF DOMESTIC ANIMALS 601 persistent, give an anesthetic; stretch sphincter ani until it is paralyzed; clamp base of piles and burn off pile down to clamp with dull red thermo- cautery. Lock bowels for three days with opium. Then give injection of sweet oil and castor oil, or two or three compound cathartic pills. Piroplasmosis. See Texas Fever. Pleuro-Pneumonia of Cattle. Destroy patients and those exposed. Slightly diseased are fit for beef. Premises cleaned and disinfected. Pleuritis and Empyema. Pleurisy. Venesection with much pain and dyspnea. Fever and pain are relieved by acetanilid. Also by the application of mustard paste and hot blankets with rubber covering to the chest. Instead of acetanilid, we may give — to relieve pain and dyspnea — laudanum, Sii, in a pint of linseed oil to the horse; or morphine subcutaneously. With effusion, administer calomel, and also a combination of fluidextract of digitalis (5i), oil of juniper (3i), and potas- sium acetate (5i) in water thrice daily to horses; to dogs, powdered squills and digitalis (aa gr.i), in pill with calomel (gr.ss), three times daily. Use wet compress about chest continuously, and applications of mustard occa- sionally. Give dry diet with water reduced to minimum. With large or persistent effusion, puncture the chest. In the horse, in the 8th and 9th intercostal spaces at the anterior margin of the rib and near the lower border of the lung, shave hair and use strict asepsis. After puncture, or in the later stages, employ potassium iodide, and give tincture of ferric chloride with gentian or nux vomica on the feed. Also give to larger animals nourishing diet with milk, eggs, and whiskey; to dogs — milk, bovinine and meat juice. In empyema or purulent pleurisy, the chest wall must be incised and often a portion of two or more ribs resected; all adhesions to pleurae broken under partial anesthesia; and wound closed, save for drainage. Irrigation of the chest is not desirable except in case of fetid discharge. Pneumonia, Croupous, and Broncho-Pneumonia. At the onset in rare cases with great dyspnea and full, bounding pulse, venesection. Tincture of aconite in repeated doses every two hours, is more often useful in the beginning, to reduce the frequency of the pulse, except in influenza and asthenic conditions. An abundance of fresh cold air to stimulate the respiratory centers is of great import. In the horse, bandage the legs after rubbing mustard paste on them. For large animals, the diet should include hay, grain, roots, mashes, and, if animals do not eat well, eggs and milk; for dogs — milk, bovinine, broths, meat juice and a little meat. In the stage of hepatization, high fever (104.5 deg. F.), acetanilid (3iv) may be given to horses in a single dose. Usually, however, cold enemata, cold air, and cold compresses on the chest, changed frequently, will be safer and more efficient. Weakness of the pulse calls for digitalis, strychnine, camphor, ammonium carbonate, singly, in alternation or combination, and repeated every few hours. The action of the kidneys is favored by spirit of nitrous ether. Keep the bowels active by enemata or with oil by the mouth. With the approach of crisis, stimulants are especially indicated, but should not be used until weakening of the pulse demands them. With overloading of the right heart and jugular pulse, employ venesection. During resolution admin- ister expectorants, as ammonium chloride and carbonate in combination, par- ticularly in broncho-pneumonia, and in this disease nutritious feeding is urgently demanded. In delayed resolution, give potassium iodide twice daily. In convalescence, appetite and digestion are stimulated by whiskey with tincture of gentian and nux vomica. Poisoning. See Table of Antidotes. Use of stomach tube most effective. Emetics in dogs, cats and swine — mustard, zinc sulphate, apomorphine. Stimulants, as strychnine, camphor. Poll Evil. See Abscess and Fistula. Polyuria. See Diabetes Insipidus. 602 EPITOME OF MODERN TREATMENT Post-Partum Hemorrhage. See Hemorrhage. Post-Partum Paralysis. See Apoplexy, Parturient. Prolapse of Rectum (In Cattle and Swine). If slight, of mucous membrane alone, apply ice cold water, and astringents — as fluidextract of hamamelis — and replace bowel, after washing and greasing it, and raising the hind quarters, qr, if impossible to reduce, apply actual cautery to prolapse in lines radiating from its center to the circumference, and burn through the sphincter in two places to aid its contraction after return of bowel. Introduce morphine suppository, or give drug subcutaneously to prevent straining. If all coats of bowel are prolapsed, as happens in larjre prolapses, return bowel if possible, and then apply cautery in lines parallel to long axis of the bowel — just within the anus to cause contraction there and prevent prolapse. Then apply pad over anus, and give opium. In severe (old or gangrenous) prolapse of great size, one must empty lower bowel by enema, push back any loop of small intestine in the prolapsed portion and amputate the prolapsed portion, performing an end to end anastomosis be- tween the two ends of the bowels. To prevent escape of the upper segment of bowel back into the belly, the two layers of bowel should be fixed by two or three silk sutures placed just outside the anus, before amputating. Prolapse of Uterus or Vagina. After cleansing and replacing parts, prevent recurrence of prolapse by the use of opium, as above; elevation of hind quarters; and by truss; West's vulval clamp; or closure of the vulva by wire sutures of the quilled type. Prostatitis (Occasional in All Entire Males). Occurs from extension from urethritis and cystitis, and from frequent copulation or masturbation. Rarely diagnosed. The Symptoms suggest cystitis with frequent, intermittent and painful micturition; and also rectal trouble with rubbing of the anus against objects. Examination shows en- larged and painful swelling about the neck of the bladder. Treatment — Frequent hot rectal injections through double tube to allow of return flow; smart cathartic and diet of gruels, mashes or milk; entire rest. Internally, give a mixture of spirit of nitrous ether, potassium acetate and tincture of belladonna in full dose thrice daily. If there be much pain and straining, administer morphine in suppository, or subcutaneously. If swelling of pros- tate blocks urethra, pass a catheter. Abscess opened, not through rectum, but via perineum by careful dissection with catheter in bladder and finger in rectum as guides. Pruritis. Itching. Attacks Horses and Dogs and other animals independent of any skin eruption. First endeavor to remove or treat the cause. Hepatic or diges- tive trouble, constipation, piles, fissure and worms cause pruritus ani; preg- nancy leads to pruritus vulvae, diabetes, exposure to cold and heat, nervous debility. In general itching — baths — sodium bicarb, (lb. 1-2 to 30 galls.), or sponging with vinegar. Local itching: Phenol, 5i; liq. potass., 5i; ol. lini, oi. M. Sig. Use externally. Where there is danger of poisoning from licking or absorption, use liquor picis alkalinus (1-32), or hydrogen dioxide pure. All antiseptics appear to be antipruritics. In pruritis of anus or vulva, apply hot fomentations, dry by sopping gently with soft cloth, and dust on powdered starch. Also, saturated boric acid solution or silver nitrate in spirit of nitrous ether (3 per cent.), are efficient in these troubles. In debility, give iron, arsenic, and nux vomica. Other agents relieving itching are: Carbolic acid, hamamelis, chloral, alcohol, prussic acid, corrosive sub- limate, tobacco, cocaine, salicylic acid, potassium bicarbonate, tar, oil of tar, oil of cade, menthol, lime water, alum, yellow wash, black wash, thymol. Psoas Muscle Strain in Horses and Dogs. Complete rest and the application of hot blankets about the loins and body with waterproof covering and dry blanket outside, frequently renewed. Give morphine suppository to dogs; laudanum, §iv in boiled starch solution; to horses, per rectum. Use slings in case of strain of both muscles in horses. DISEASES OF DOMESTIC ANIMALS 603 Psoriasis. See Eczema, Scaly or Sqamous Mallenders. True psoriasis is unknown in veterinary practice. Ptyalism. Salivation. To combat the symptoms, give belladonna or atropine, or alum. Puerperal Fever, Parturient Fever, Parturient Septicemia, Septic Metritis. Infection following labor is treated by removing local sources, as retained membranes and blood clots; by initial repair of lacerations; and by irrigating the vagina and uterus twice daily with Lugol's solution (5ii to Oii), after washing the external genitals with the same and lowering the hind quarters. Abrasions should be dusted with dry boric acid. Keep the bowels loose with salts in cows; castor oil in bitches; linseed oil or mineral oil in mares. Give ergot thrice daily to contract the womb. Administer large doses of alcohol (ovi large patients), with nourishing diet of grains, milk, eggs and (for small patients) beef juice and bovinine. Strychnine in full doses is also indicated. Knemata of normal saline solution (sodium chloride, 5i-Oi), in large amounts, so as to be retained, are of much value. Raise the receptacle holding the enema but a short distance above the patient so as to allow it to flow slowly. Try injection of antistreptococcus serum or bacterin. Prophylaxis: Isolation of animals about to calve or threatened with abortion. Treat as contagious disease. Avoidance of same utensils, sponges, attendants, food and water for sick and well. Disinfection of premises. Quarantine of patient till all dis- charge stops. Pulmonary Congestion and Edema. Large doses subcutaneously of atropine in edema of the lungs. With severe dyspnea, venesection is the most effective measure in congestion. Ex- ternally, apply turpentine stupes or mustard paste and hot blankets to chest, frequently renewed. Also give a powerful hydragogue cathartic. In passive congestion due to heart disease or weakness, give digitalis, strychnine and other heart stimulants. Pumiced Foot in Horses. Weakness and convexity of the sole as sequel to laminitis. Apply blister to coronet and wide bar shoe, leather and oakum packing with tar. Punctured Foot in Horses. Remove shoes and pare away horn till the bottom of the puncture is ex- posed. If this treatment has not been applied at time of puncture and inflam- mation and pus have formed, expose suppurating area and then employ bran and flaxseed poultice mixed with 3 per cent, lysol or creolin solution for few days. Later, dress with Peru balsam and aseptic gauze, pad of oakum and bandage. Purpura Hemorrhagica in the Horse. Employ remedies increasing the coagulability of the blood — give fresh horse serum (5H) subcutaneously, or blood transfusion, calcium chloride and gela- tine by the mouth or rectum. Also turpentine thrice daily, to avert hemor- rhages. If turpentine unsuccessful, try adrenalin chloride solution given intramuscularly. With streptococcus' infection, antistreptococcic serum, in- travenously, has given good results (10 to 50 mils), and the dose of this may be repeated in 12 hours if improvement is slow. Good hygiene and food are of chief importance. Supply an airy, light, dry, warm box stall; a ration of oats, bran, roots, green fodder; and 'milk and eggs, if there is anorexia. Only mild laxatives, as linseed oil, are indicated. During convalescence, a powder of arsenous acid (gr.iii), ferrous sulphate (3i), with nux vomica (3i), may be given thrice daily on the food. Swelling about the nostrils may be reduced by constant bathing in cold water. Sores and ulcers demand treatment (see Decubitus). Tracheotomy is demanded for severe dyspnea. No harness of any sort should be permitted. Skin swellings are best overcome by the remedies preventing hemorrhage and increasing the coagulability of the blood. Incisions and local applications are generally harmful or unavailing. Pyemia. See Septicemia. 604 EPITOME OF MODERN TREATMENT Quarter Evil. See Black Quarter. Quittor. (In the Horse.) Fistula of the coronet. Remove shoes. A bar shoe may be needed if the foot is broken down. If there is pus in the sole, make counter-opening here. Open up sinus to the bottom with knife or actual cautery. The latter is best in destroying pyogenic membrane of the fistula. Remove necrotic tissue. Give mixed vaccine. Irrigate wound with 1% lysol solution, and apply aseptic gauze and jute, wet with lysol solution, and bandage. Keep this wet antiseptic poultice on for several days, or a week, till acute inflam- mation subsides. Inject fistula occasionally with dichloramine-T or phenol in glycerine (1-16). Apply dry aseptic dressing after the wet antiseptic poul- ticing. Repair of the horn hastened by fly blister to coronet. Rabies in Animals. Hydrophobia in Man. (See Bites.) When persons or animals are bitten by a dog, supposedly rabid, a diag- nosis is imperative. An animal suspected of rabies should be kept caged for inspection. Death occurs invariably within 4 to 10 days in rabies. If sus- pected dog runs away, dies or is killed inside of 10 days Pasteur treatment advisable. If suspected rabid animal alive and in good health, after 10 days, rabies is improbable. If there is any doubt about the diagnosis, microscopicaF examination of the brain — for Negri's bodies in Amnion's horn (Hippocam- pus Major) and changes in the plexiform ganglion of the vagus — by a trained pathologist will determine the diagnosis. Specimen for pathologist should be head and neck above 3rd cervical vertebra on ice, or brain with upper part of cord in glycerin. Otherwise, grind small amount of fresh cerebellum with twice weight of normal salt solution. Drill hole through frontal bone of guinea pig asepti- cally, little to one side of middle line, to dura. Use cocaine. Inject 10 drops of brain emulsion through dura with hypodermic syringe. Average incubation, 14 days, but animal must be kept 100 days to prove test negative. All persons bitten by rabid dogs should at once be sent to a Pasteur institute for Pasteur treatment, or -virus may now be procured from Pasteur institutes, and makers of biological products for home treatment, if the his- tory of case, duration and location of bite are given. For immediate treat- ment of bites of rabid animals, See Bites. Pasteur treatment is successful in preventing hydrophobia in 99 per cent, of persons having recent rabid infection. If clinical history and autopsy are suggestive of rabies, it is un- wise for bitten persons to await results of inoculation experiments before undertaking Pasteur treatment. Prophylaxis: When a case of rabies de- velops all dogs within a radius of twenty miles should be muzzled for six months. Animals bitten by rabid dogs should be killed at once, or given prophylactic treatment. The newer Hogyes dilution from fresh brain of rabid rabbits requires but six injections of vaccine. Rheumatism, Acute Articular. (In Cattle, Dogs, Horses, Pigs and Goats.) See also Arthritis, Infectious. Give sodium salicylate with an equal amount of sodium bicarbonate in solu- tion. If the salicylates cause vomiting in dogs, administer aspirin in capsules thrice daily. To the affected joints, apply cloths wet in pure methyl salicy- late, or cloths soaked in a hot, saturated solution of Epsom salt, baking soda, and covered with waterproof and bandage. Inject joints with formalin and glycerin. In the later, or subacute stages, prescribe equal parts of sodium salicylate and iodide three times daily. Iodine ointment rubbed on the joints, or firing and blistering, are most effective in chronically enlarged and stiff joints. Rest, and liquid diet are indicated at the onset. In the later period, cod liver oil, quinine, iron, arsenic and strychnine with generous feeding, are required. For complications, as pleuritis, endocarditis, see these titles. Rheumatism, Muscular. See Muscular Rheumatism. Rickets. Rachitis. In the case of sucklings improve the mother's food in nitrogen, fat and DISEASES OF DOMESTIC ANIMALS 605 salts. Give the mother cottonseed or linseed meal, or beef-meal, with rich ration of grain. Or the suckling may be weaned and receive — if herbivorous — oatmeal gruel of milk and a tablespoonful of linseed meal daily; cod liver oil; raw eggs and beef meal. Carnivora may be given milk, strong broths, gruels with milk, juice squeezed from rare beef, bovinine, cod liver oil. With anemia, syrup of ferrous iodide (foals and calves, m.xv; puppies, m.ii-v). Phosphorus and phosphates are bone foods. Prescribe syr. of calcium lacto- phosphate, or glycerophosphates, or phosphorated oil (foals and calves, 3i; puppies, m.ss to m.i). General care and hygiene are of chief importance. These include grooming, cleanliness, warm, dry quarters, and fresh, country air. Pigs must be removed from dark, unhealthy styes. Ringbone in the Horse. Either a periarthritis or osteoarthritis of the pastern bones or os pedis, and in the first involving the external, and in the second case, the articular surfaces of the bone. When a fore limb, apply a thin-heeled bar-shoe; when in hind limb, a high-heeled shoe, to favor the natural shifting of weight at- tempted by the patient. When the animal is in the stable, place a wet swab about the pastern, only work on soft ground, if possible. In acute cases, with lameness and heat in the part, apply cold swabs and enforce rest; follow by firing and blistering to secure resorption or ankylosis, if lameness persists. If this is unsuccessful, perform neurectomy. Ringworm. (Tricophytosis. Tinea or Herpes Tonsurans.) Attacks cattle, dogs, horses, pigs, sheep, goats, cats and poultry. Horse. Trichophytic ringworm, caused by Trichophyton mentagrophytes , T. flavum, T. equinwm, T. verrucosum; and Microsporous ringworm, by Microsporum Audouini. Cattle. Ringworm always a Trichophytosis and due to T. mentagrophytes. Dog. Four varieties of ringworm occur: (1) Trichophytic (T. caninum) ; (2) Microsporous (M. Audouini var. caninum) ; (3) Eidamellian (Eidamella spinosa) ; and favus (Oospora canina). See Favus. The disease is transmitted from animal to man and from individual to indi- vidual of same species; rarely from one species to another species among animals. Isolate patients, and disinfect premises, harness, clothing, bedding, cleaning utensils and objects in contact with the patient. Burn hair and crusts from the skin. The disease may be spread over the body by grooming. First soak crusts in oil and remove them with green soap and water. Paint diseased area daily with tincture of iodine, or rub in ointment (1 to 8) of iodine crystals and goose grease once daily. Moussu recommends on cattle with localized spots, equal parts of chloral, phenol and tincture of iodine. When generalized, wash the body with green or tar soap and apply boric acid (3ii) in alcohol (3x) and ether (oiiss). Salicylic acid in alcohol (1 to 10) may also be used over large areas without fear of poisoning from absorption or licking of the drug. Many other drugs are curative, as 10 per cent, ointment of either creolin, lysol, or tar. In small areas, ung. hydrargyri ammoniati. It is best to clip the hair about diseased patches and pull out that on the patches, if feasible. Roaring. In horses; rarely in cattle and dogs. Due to left-sided paralysis of the larynx, from toxemia of acute infec- tions ; also to thickening of the mucous membrane, obstructions, stenoses, and new growths in the upper air passages. Paralysis of the larynx is relieved only by denudation of mucous membrane from left ventricle or rarely from both. Temporary or false roaring is common after influenza and laryngitis and is curable by the application of a fly blister over the larynx, or better, red mercuric iodide. Give internally potassium iodide, thrice daily for some time. The local injection of strychnine into the region of the larynx once daily is said to delay the onset of paralysis. Arsenic internally may aid the action of the iodide in promoting resolution of thickened mucous membrane. 606 EPITOME OF MODERN TREATMENT Rot in Sheep, Distomiasis. See Liver Rot. Roup. See Laryngitis, Diphtheria, Croup. Saddle Galls. Avoid friction and undue pressure of badly fitting harness, and heavy cloth or felt linings. Use only harness linings of light leather. Treat at first with wet dressing of two parts of saturated boric acid solution and one part alcohol on aseptic gauze, covered with oil silk blanket and surcingle. Treat inflamed sebaceous follicles as advised for acne (see Acne). Islands of necrotic tissue, or sitfasts, must be removed by the knife. To the re- maining wound apply balsam of Peru and aseptic dressings, or an astringent, stimulant and antiseptic powder. Sand Crack. Quarter-Crack. Prophylaxis: — Avoid weakening the foot by paring away sole and frog, and thus putting all the horse's weight on wall of foot. Occurs in inner quarter of fore foot; in toe of hind foot. Remove the shoes, and pare thin the edges of the fissure. Apply flaxseed and bran poultice mixed with 2 per cent, creolin, and rest, to relieve the inflammation. After the inflamma- tion has passed, treat the crack by either removing a V-shaped piece of horn; by paring away the upper portion of crack to sensitive laminae and coronary band above, and clamping the crack below ; or by grooving the wall above at right angles with the crack. All these measures lend to im- mobilize the edges of the crack and allow of formation of new horn. To stimulate growth of horn, also blister the coronet. Apply bar shoe, with thin heels and side clasps in fissure of toe; a three-quartered bar shoe in quarter- crack. Employ covering of wood tar on hoof continuously. Sarcoma. Use knife freely and try Coley's mixture of toxins of erysipelas and B. prodigiosus. At times successful in human practice. Satyriasis. See Sexual Excitement. Scab in Sheep. Due to Dermodectes communis, var. ovis. Lambs and yearlings most susceptible. Segregate and dip newly-bought sheep. Isolate sick and disinfect prem- ises and contaminated objects. Shear sick and remove crusts with soft soap solution (1 to 50), aided by brush. Treatment is done with baths or dips. They are given only four hours after feeding and at body heat. Repeat dip in ten days and keep animal in bath two minutes. Dip head under once, in sulphur dip; keep mouth, nose and eyes out in poisonous (tobacco, arsenical) dips. For shorn sheep, use U. S. Bureau of Animal Industry dip which is cheap, safe and efficient. Flowers of sulphur, 24 lbs.; unslaked lime, 8 lbs.; water, 100 galls. Mix lime in box with water to make paste; sift on sulphur; stir all well together. Boil with 25 galls, of water for two hours or longer, till solution of chocolate-liver color and sulphur mostly disappears from surface. Settle mixture in a barrel with bunghole four inches from bottom; allow four hours for settling. Draw off only clear liquid into dipping vat and add water to make 100 galls. For animals in full fleece, use manufactured tobacco, 1 lb.; flowers of sulphur, 1 lb.; water, 5 galls. Soak tobacco 24 hours or more, on night before dipping, boil tobacco solution for a minute and allow tobacco to remain in it over night, Mix sulphur to paste with water in a pail. Strain liquid from tobacco by pressure, and add liquid to sulphur paste and enough water to make 5 gal- lons. After dipping, turn sheep into clean yard. Dip apparently healthy sheep first; then scabby ones, when a flock is attacked. There are many excellent commercial dips on the market; follow specific directions with each. Other agents include: creolin, 2 gallons; arsenic, 1.5 lbs.; iron sulphate, 10 lbs.; water, 100 gallons, etc. Good pasturing and generous feeding aid re- sistance against scab. Scabies. See Mange. Scratches. See Erythema. DISEASES OF DOMESTIC ANIMALS 607 Seedy Toe in Horses. Sequel to laminitis. Remove all diseased horn and apply Peru balsam to the exposed tissues. If there is lameness, use bran and flaxseed poultice mixed with 2 per cent, lysol solution. Otherwise, blister the coronet. Apply a bar-shoe with sole pressure and keep the cavity dressed with the balsam. Frequent changing of the shoe and trimming of the foot is required to restore and keep it in normal shape. Septicemia. Pyemia. Sapremia. In blood poisoning, with germs or their products, the treatment is chiefly surgical: the use of antiseptic poultices or other antiseptic applications to wounds; the removal of septic and dead tissue by the knife; the drainage of purulent foci, etc. Nourishing diet — reinforced by milk and eggs, beef juice, bovinine, alcohol and quinine, etc. The fresh horse serum (D., 5ii-iv, H., 5ii-iv) given subcutaneously has germicidal effect. Blood transfusion in protracted sepsis. Oil of turpentine may be used as a stimulant and anti- septic (H., 5i) in emulsion with milk and eggs. Calomel is useful as an antiseptic cathartic. Saline infusions are often most valuable. Collargol intravenously. Antistreptococcic serum is remedial in streptococcus infec- tion. The tincture of ferric chloride is indicated during and succeeding an attack. Sexual Excitement. Nymphomania. Satyriasis. In female (nymphomania), sexual excitement depends upon various in- flammatory diseases, as vaginitis, metritis and other disorders of the vagina, womb, ovary. Retained testis is a common cause in males. Over feeding, lack of exercise, and constant companionship with females favor sexual ex- citement in the male. Treatment consists in removing the cause, as surgery in organic lesions yielding to the knife. Secure only proper amount of coition and avoid proximity of male to opposite sex. Give hard work, low diet, and full doses of potassium bromide. If trouble due to spinal or cere- bral lesions, little can be done. As a last resource, castration of either sex or slaughter. Shipping Fever. See Influenza. Shoe Ball. See Capped Elbow. Shoulder Ball (In the Horse). Sprain of the spinati and, to a less extent of the teres muscles, with swell- ing, followed by atrophy of these parts. In the acute stage, apply constant, hot fomentations to the shoulder muscles, and secure absolute rest. When local tenderness and swelling abate, apply cantharides blister to muscle, and later exercise at pasture may lead to recovery. Local intramuscular injections of veratrine may be of service in atrophy of the muscles. Occa- sional blistering is of most service. Avoid ploughing to prevent return of trouble. Sick, Destruction of. Strychnine, chloroform, prussic acid, venesection. Side Bone in the Horse. Ossification of the Lateral Cartilages. Rest and cold swab about foot with heat and lameness. In other cases, firing and blistering are indicated, and the application of a bar-shoe. The effects of concussion may be somewhat averted by making a groove below the cartilage in the wall of the foot with a knife or firing iron. Neurectomy in otherwise sound limbs. Sitfast. See Saddle Galls. Sleepy Staggers. See Encephalitis. Snake Bite. See Bites. Sore Throat. See Pharyngitis. Sores. See Wounds. Sore Shins. See Periostitis and Ostitis. 608 EPITOME OF MODERN TREATMENT Spasm of the Diaphragm (In the Horse). Thumps. Give spirit of chloroform or compound spirit of ether. If persistent try lobeline or morphine under the skin; also Inhalations of amy] nitrate. Apply hot applications over the diaphragm; pull out the tongue. If breathing becomes difficult, use venesection to avert pulmonary apoplexy. Spasms. See Convulsions, Eclampsia, Epilepsy, Chorea, Tetanus, Colic, Asthma, Thumps, Etc. Spavin, Bog. See Bog Spavin. Spavin, Bone (In the Horse). In acute cases, rest and the application of a compress kept constantly wet with cold water. This may be followed by firing and blistering — to secure ankylosis — in young animals. The use of a high-heeled shoe may benefit many cases. Other operations which may relieve the lameness are cunean tenotomy and anterior and posterior tibial neurectomy. Splint. Apply cold compresses, when the animal is in the stable, and later the ointment of red mercuric iodide, every other day till blistering occurs. When this is not curative, fire in points and blister with cantharides, fol- lowed by rest. In very acute cases, incise the periosteum at the onset. Speedy Cut (In the Horse). Apply antiseptic gauze, wet with 2 per cent, lysol and cover with rub- ber or oil silk, and bandage, to injury on cannon or knee. Otherwise treat as for Wounds. Employ a boot to save knee from being struck. To pre- vent, pare away inner wall of striking foot and use accurately fitting three- quarter shoes. Shoe once in three weeks. Avoid too rapid work. Spinal Inflammation. Spinal Pachy- and Lepto-Meningitis, Myelitis. Traumatism, tuberculosis, septicemia, pyemia, distemper, strangles and growths are etiological factors. Treatment depends on etiology to some extent. In acute spinal meningitis, treat as for cerebro-spinal meningitis, except cold should be applied to spine rather than to the head. In the later stages, blisters applied over the lumbar region — or over centers correspond- ing to the peripheral lesions — are indicated. Potassium iodide may be useful in aiding resolution. Tonics, as strychnine and iron, are valuable. When there is marked paraplegia, keep horses in slings and empty bowels and bladder regularly. Employ faradism and massage of paralyzed muscles. Recovery is uncertain and treatment is often economically inadvisable. Sprains or Strains of Muscles, Tendons or Ligaments. Usually involve actual rupture of the fibres of these structures. At the onset, secure rest and immobilization of the part as far as possible. Take off weight by slings; apply high-heeled shoe in strain of flexor tendons of feet in horses. Apply compresses wet with hot saturated solution of Epsom salt and covered with waterproof cloth, or cold irrigations and Priessnitz poultice at night, with rubber bandaging to prevent exudation and swelling of the part. After the acute symptoms abate, alternate hot and cold applications of water — to stimulate circulation — and begin soon with mas- sage and movement of the part and gradually increasing exercise. Keep the part bandaged if possible when not applying treatment. Various lini- ments may be used to aid massage, as chloroform or turpentine liniment. Firing and blistering, or simply blistering, and turning out animal to pas- ture, may secure recovery. Subsequent cicatrization with contraction of tendons and ligaments can not be prevented except in part by early move- ment of the injured limb. Tenotomy may be used for contraction. Fibro- lysin, may be injected ior induration. Neurectomy is occasionally advisable for lameness. Sterility (Sexual). See Barrenness and Impotence, Stomach Staggers. See Indigestion, DISEASES OF DOMESTIC ANIMALS 609 Stomatitis. In simple stomatitis, use mel boracis (B. P.) on a swab in the mouth. The food should be liquid or soft. Give potassium chlorate internally. With ulceration, swab out mouth with 1 per cent, lysol or creolin solution several times daily and touch the ulcers with 10 per cent, silver solution, or with tincture of iodine. To the large animals, give a few drams of Glauber's salt and saleratus on the food thrice daily. There is also an in- fectious pustular form of stomatitis affecting horses. The local treatment is the same as above but isolation of patients followed by disinfection is indi- cated. To sheep, sodium chloride and salicylate in their drinking water (in the proportion of 15 gr. each to the pint). Hydrogen dioxide is perhaps the most effective antiseptic mouth-wash, but more expensive than boric acid. Stomatitis is very prevalent in the young. Fresh air, cleanly prem- ises and exercise must be given. Nourishing food is a requisite to recovery. Isolate the sick and avoid common use of utensils for eating or drinking. Stomatitis is a complication of infected umbilicus in calves; gangrenous tissue must be cut away and the navel swabbed with tincture of iodine and packed with iodoform and boric acid. Strains. See Sprains. Strangles in Horses. Give antistrangle bacterin or serum as a preventive and polyvalent anti- streptococcic serum as a curative agent. A bacterin made of S. equi is a good prophylactic agent given to horses in doses of 1 to 2 mils. Isolate the sick in roomy, airy box-stall and disinfect the vacated prem- ises. Diet — Gruels, mashes, steamed oats, grass, roots; and milk, eggs and alcohol, if there is anorexia. Apply, and frequently renew, hot flaxseed poultices to the inflamed submaxillary gland, and open when "ripe." Syringe abscess cavity with hydrogen dioxide and dress with Peru balsam. Remove induration by a fly blister to the surrounding area. Treat compli- cations as they arise. Tracheotomy is required for obstruction about the larynx. Stringhalt in Horses. Several forms. 1. In some cases it is purely a functional nervous disease like chorea; treatment on this basis includes the use of bromides, improvement in gen- eral hygiene, and rest. 2. A form dependent on retraction of peroneo-phalangeus, which may be cured by peroneal tenotomy and aponeurotomy. 3. A form produced by tarsal deformative arthritis, or spavin. Treat as recommended for spavin. 4. Patellar form. Sometimes cured by section of the tibio-patellar liga- ment. Sturdy. See Coenurus Cerebralis. Sunstroke. Insolation. Heat Stroke. 1. Apoplectic form, with coma and very high rectal temperature. Turn hose of cold water on the head and body and make vigorous friction of the body with ice. With injected mucosa and labored breathing, venesection. With failing pulse, inject under the skin of the horse camphor (gr.xv), with ether (3ss), and sweet oil (5ii). Also cocaine, strychnine subcut. 2. In the form with weak pulse and prostration (without hyperpyrexia), give stimulants as above, and externally hot pack. Prophylaxis: Head coverings; give cold water frequently and apply it to head; moderate work; avoid work in heat of day. Surgical Shock. Give morphine hypodermically, and adrenalin intramuscularly, and apply heat externally with mustard. Inject normal salt solution into the rectum, intraperitoneal^, into a vein, or under the skin. Blood transfusion. Also camphor, atropine, pituitrin, strychnine and tincture of digitalis given hypodermatically. Surfeit. See Urticaria. 610 EPITOME OF MODERN TREATMENT Surra. Surra occurs in solipeds, dogs, rats, camels and elephants and is trans- mitted by inoculation by flies (Tabanidae) into cattle, sheep, goats, buffalo, guinea pigs and rabbits. Due to Trypanosoma evansi. Appeared in im- ported cattle in U. S. in 1906 but was immediately eradicated. Character- ized by irregular, intermittent fever, urticaria and edematous swellings on various parts of the body, catarrh of nose, eyes and vagina, with progres- sive emaciation, weakness and anemia. Diagnosis is made by inoculation of rabbits with blood from infected animals. The trypanosomes appear in rabbit's blood in 4 to 9 days accompanied by fever. Prevention. Isolate suspected animals in individual fly-proof stalls and inoculate rabbits with their blood. Kill those affected. In India, where disease is indigenous, increasing doses of arsenic, or of sodium cacodylate, atoxyl, or arsenophenylglycin. Usually fatal in horses, not in cattle which act as "carriers." Swine Fever. See Hog Cholera. Syncope. Heart Failure. Painting. See Cerebral Anemia. Keep the head low and inject under the skin pure ether. Give subcutane- ouslv caffeine with digit alone every few hours. Also the injection of camphor is useful. Synovitis. Rest and fixation of joint most important. Slings or the use of splints secure rest and fixation. The application of an ice and sawdust poultice, or ice bag bandaged on to the joint or constant cold irrigation, or some- times more useful, is hot saturated solution of Epsom salt on compresses covered by waterproof protective and bandage. Compression of the joint by rubber or flannel bandage is serviceable after the more acute symptoms abate. In subacute stage, firing and blistering are to be recommended. When effusion and most of the thickening about the joint disappear, allow gentle exercise, which may be gradually increased. See also Open Joint, and Arthritis. Tapeworms. See Parasites, Intestinal. Teats, Fissured, Cracked. Wash udder thoroughly with soap and water and saturated boric acid solution. Withdraw milk through sterile milking tube. Coat fissures with compound tincture benzoin, or with solid lunar caustic. Keep teats anointed with 10 per cent, boric acid vaseline. Teats, Obstructed. Concretions removed by manipulation of teat or by passing bougie, or teat siphon. Inflammatory thickening relieved by poulticing and fomentations. It may be necessary to cut the teat with teat bistoury to relieve a stricture. Growths within the teat and warts without are removed by scissors or ligature. Tendons, Rupture of. Splints, slings, and treatment as for fracture. If open wound, suture the tendon and sheath. Subcutaneous rupture unites more surely with aseptic suturing in human practice. But there is great danger of sepsis in veteri- nary practice. Tenosynovitis. General treatment as for synovitis. Bier's hyperemia. Rest, fixation, applications of heat and cold," counterirritants, and finally exercise. See Thorough-Pin. Tetanus. Common to all animals; especially to horses, cattle and sheep. Therapeutic treatment with antitoxin is often unsuccessful. In slowly developing and chronic cases tetanus antitoxin is successful as a therapeutic agent. Prophylaxis (within 4 days after inoculation) is usually very effec- DISEASES OF DOMESTIC ANIMALS 611 tive in preventing tetanus when antitoxin is injected. In wounds of the feet, in regions where tetanus is prevalent; also in the new-born, in cows just calved, and for all animals after surgical operations in regions infected by tetanus, the antitoxin preventive treatment should be employed. Immunity thus conferred lasts about a month and is without danger. Repeat these injections of antitoxin at the end of the first and third week, to prevent the intoxication caused by belated crops of tetanus bacilli. Locally, any wound likely to contain tetanus germs must be opened freely to the bottom and tincture of iodine used. In new-born lambs and calves sterilize the stump of cord after ligation with iodine. Magnesium sulphate is the most successful drug in the treatment of tetanus (see magnesium sulphate). To relieve spasm of jaw and elsewhere, give lobeline (gr.rV), subcutaneously, or chloral (3ii-iii) in boiled starch solution by rectum. Chloroform by in- halation may give temporary freedom from spasm. The use of slings, a quiet, darkened box-stall, and gentle management are desirable. The diet should be of a sloppy character — milk, gruels, and perhaps some green fodder, with water within reach at all times. Empty the bowels manually or by enema; the bladder by catheter or pressure within the rectum. Thorough disinfection of the premises after a case of tetanus is imperative. Texas Fever. See Hemoglobinuria in Cattle. Thick Wind in Horses. Treat as for Broken Wind. Thorough-Pin of the Hock and Knee. Tenosynovitis of the perforatus tendon just at the summit of the os calcis. Usually chronic, as hydrops of the tendon sheath. In acute cases, apply a high-heeled shoe and secure rest, and apply wet compresses and flannel bandage about the lower limb and hock. In chronic cases, apply spring truss, or operate by aseptic excision or curetting of wall of the sac and free drainage, to secure obliteration of the sac and adhesion of the tendon to the tendon sheath. There is considerable danger of sepsis, however, in the operation. Aseptic aspiration of the sac and injection of tincture of iodine or of phenol (m.x-xx) may produce the same result with less danger of infection. Unless the animal is valuable, operation is inadvisable. Firing and blisters have little curative value. Hydrops or hygroma of the common tendon sheath of the perforatus and perforans at the back of the carpus. This is treated exactly as recommended for hydrops or dropsy of the per- foratus tendon (thorough-pin) at the hock. Thrombosis. Of the Cerebral Arteries. See Apoplexy. Of the Anterior Mesenteric Artery. See Colic. Of Femoral and Axillary Arteries. Shown bv intermittent lameness and complete paresis, with loss of pulse, in affected' limb. Treatment by rest for many weeks and potassium iodide thrice daily. The clot in femoral artery may be felt per rectum, and massage over it has been recommended, but is liable to cause sudden death by embolus. Swelling of the limb may be combated, by bandaging. Thrush (In the Mouth). See Stomatitis. Thrush in Frog of Horse. Keep the feet out of manure and urine by constant cleanliness of stable or by movable leather sole and calks, to prevent moisture from reaching the foot. Remove from wet yard or pasture. Dust calomel and iodoform (equal parts) on the frog and work the powder into deft of the ^ by means of a probe, and pack with tow on top of it. Application of wood tar. and tow and leather soles may be placed over this If seen in fore feet without apparent cause, or if there is swelling of the limbs and evidence of poor circulation, give a purge, tonics and regular exercise. Ticks. Wood Ticks. Ixodes. „ Ticks are the means of transmitting tick or Texas ^ver to cattle (Boo- philus annulatus or Rhipicephalus annulatus), and the allied disorders- 612 I ITIOME OF MODERN TREATMENT Australian tick fever and ixodic anemia of cattle — by inoculating the or- ganisms of these diseases through their bites. In sheep, louping ill is like- wise communicated by ticks (Ixodes ricinus or reduvius), which inoculate a special organism by means of their bites. The Ixodes americanus — common in dogs, cattle and man — is the most frequent in the U. S. I. reduvius attacks dogs and cattle, as well as sheep. Ticks should not be torn away from the skin, as their bodies will be severed from their heads and the latter be left in the skin. Unless buried deep in the skin, the application of butter, kerosene, oil of turpentine or benzine will cause the ticks to loose their hold. The whole tick may be removed by cutting them out with scissors, skin and all. Ked or Keb refers to Melophagus ovinus, which is not a tick, but a wingless fly attacking sheep and usually confused with ixodidae. This insect may be removed by baths, as for scab in sheep, and their inroads prevented by application! of kerosene. Baths or dips are also prophylactic in louping ill. Tinea Tonsurans. See Ringworm. Toothache. In the Horse — Extraction by forceps, or by trephining and punching out the offending molar. In the Dog — Counter-irritation of gum by tincture of iodine; filling the tooth with dental amalgam after proper removal of carious matter; lancing the gum for alveolar abscess; or extraction. Tracheitis, or Tracheo-Bronchitis. See Bronchitis. Tread. Bruise of coronet by opposite foot or by foot of another horse. Apply wet compress (8 per cent, creolin) and treat as for Wounds. Trematoda, Fluke Worms. See Liver Rot. Trichinosis. The Trichina spiralis attacks all animals, but more often swine. Treat- ment is wholly preventive in destroying rats and mice, where pigs are kept, and in not feeding flesh to swine. Trichinous meat should be burned. Tuberculosis. In order of frequency affects Cattle, Birds, Swine, Cats, Goats, Horses, Sheep and Dogs. Most animals are infected by the bovine type of B. tuberculosis. Dogs and cats are somewhat susceptible to the human type of bacillus. Infec- tions occur through the digestive and respiratory tracts, and extend by the lymphatics — sometimes by the blood stream (leukocytes) or by continuity — and bacteria often penetrate a part without producing lesions at the point of entry. Tuberculosis is acquired by the bacilli in the nasal and uterine discharge and feces of patients, infecting the water, fodder and dust of a barn; also through the young feeding on milk from tuberculous animals. Crowding, poor ventilation and poor nutrition favor the disease. Tubercu- losis is not usually inherited; the young are most susceptible; some six months' habitation in infected surroundings may be required for the disease to be acquired by the previously healthy. Treatment — This is rarely advisable in animals, since it is so often un- successful and because the existence of the disease threatens the life of other animals, and man through diseased meat, milk, and — in the case of cats and dogs — through their sputum. An outdoor life, day and night, together with highly nutritious diet, may lead to recovery and is the most hopeful and successful form of treatment for animals, as for man. Prophy- laxis is secured by an outdoor life, or one in clean, well- ventilated and uninfected stables. Milk from tuberculous animals should be boiled before it is fed to hogs or other animals. The sick should be isolated and killed, or Bang's segregation method may be used. Cows showing physical signs of tuberculosis — particularly of the lungs, uterus and udder — should be killed. Animals reacting to tuberculin test should be isolated; their calves removed to separate farm, barn, or partitioned portion of same barn. DISEASES OF DOMESTIC ANIMALS 613 Calves fed from mother on day of birth, thereafter on boiled milk from same, or milk from healthy cows. Two sets of employees if possible. If not, then the healthy animals should be first tended, and the overalls and shoes should be changed before tending the tuberculous. Also there must be separate utensils for the healthy and tuberculous. The healthy and sick should be separated in pasture. The healthy animals must be tuberculin tested as usual. The infected barn should be washed and cleaned and sprayed with 3% formalin, or 1-500 corrosive sublimate solution, on the walls, floors, and feed boxes; the floors should be covered with quicklime; and the premises then disinfected with formalin or sulphur vapor. The tuberculin test must be applied to all newly-bought animals, before they are included in the herd, and the whole herd should be tuberculin-tested every 3 months until no animals react. Raw milk from tuberculous cows is unfit for food and is a means of transmitting the disease to man, espe- cially to infants. Von Behring's bovovaccine — of dry, living, tubercle bacilli of the human type — appears to confer immunity, for a more or less indefi- nite period, in cattle. It is indicated for injection into young animals, as a preventive agent, when tuberculosis is prevalent in a herd. Its value is still a matter for the future to determine. Tympanites, Acute (In Cattle and Sheep). Gaseous distension of the rumen is common in sudden changes of diet from dry fodder to clover or lush grass. Perform active massage of the left flank. Pass a stomach tube. To stimulate peristalsis, throw a stream of cold water against the left flank, and give half an ounce of formalin in one quart of water, and one hour later Epsom salt (cattle), internally. With increasing distension, plunge a knife, or, better, a trocar and canula, into the most prominent part of the left flank, midway between the angle of the hip and last rib. Compress the tissues about the canula, to prevent gas and food from entering the tissues. The canula may be left in place 21 to 48 hours and the animal should receive but little food — hay and bran mash. If the rumen is impacted, see Indigestion. Udder, Inflammation of. See Mastitis. Ulcers. Wounds with general tendency to break down (necrosis) and suppurate rather than to heal. These include ulcers at point of ear (dogs) and point of tail (cattle and dogs). Ulcers in hind legs of horses, associated with swelling and general de- bility. Gangrenous ulcers, carbuncle of coronet or foot rot in horses — from in- jury, special infection and frost bite about the coronary region. Indolent ulcer about the coronet of old horses. Corneal ulcers and stomatitis ulcers in dogs and other animals. Ulcers due to carcinoma of the skin (horses and dogs) ; to tuberculosis, actinomycosis and glanders in horses. Decubitus, or ulcers due to pressure in lying down. Ulcers due to treads on coronet and to pressure of collar and saddle on the neck and withers. Treatment— In general, the treatment consists in destroying and removing the unhealthy necrotic tissue and substituting in its place a healthy wound. For this purpose we use the actual cautery, curette, scissors, knife or caustics, as in the case of gangrenous ulcers. For less urgent cases we may apply the stick lunar caustic, tincture iodine, phenol, or strong solutions of mercuric bichloride, formalin (10 per cent.), or zinc chloride. If there is much surrounding inflammation and tissue to be gotten rid of by slough- ing, we should apply aseptic gauze soaked in Dichloramine-T dissolved in oil or 2 per cent, lysol and covered with waterproof and bandage till sloughing has proceeded and inflammation subdued. Then we may dress with ointment of scarlet-red, Peru balsam, or stimulating and antiseptic powder, as calomel and iodoform. For ulcers due to specific diseases see names of those diseases. Removal of cause of irritation is essential, as of 614 EPITOME OF MODERN TREATMENT foreign body or dead tissue. Rest of the part is also requisite, as bandag- ing or ear-cap in case of ulcer of the ear in dogs. Umbilical Infection. Foals, calves and lambs. Due to streptococci, staphylococci, colon bacilli, B. necrophorus, etc. Prevention. Segregate cows about to calve. Excise cord aseptically and ligate. Swab stump with tincture of iodine and cover with salicylic acid and starch (1 to 4). Clean surroundings and bedding. If navel necrotic do not ligate cord but cut away dead tissue and syringe navel sinus daily with 2 per cent, lysol solution, being careful not to force it through urachus into bladder. With persistent urachus inject saturated solution of alum and boric acid containing 2 per cent, phenol. Udder and perineum of mother kept clean so that suckling will not swallow necropho- rus or colon bacilli. A bacterin made from navel exudate will prevent if given to a new-born, and sometimes 10 mils of antistreptococcus serum given within 24 hours of birth will prevent when disease enzootic. Septic arthritis often follows. Disinfect premises used for parturition before a new animal is admitted. Urethritis in Dogs. Associated with balanitis very often. At first give cathartic and light diet of milk and bread, and enforce rest. Foment frequently with hot saturated boric acid solution and inject hot 2 per cent, solution of the same into the urethra. Internally, give tincture hyoscyamus (m.x to xx) and sweet spirit of nitre (m.xxx) with potassium citrate (gr.xv) in solution thrice daily. After subsidence of more acute symptoms, inject 1 per cent, solution of zinc sulphate and lead acetate in combination or use 5 per cent, argyrol solution; or silver nitrate solution (1-16,000 to 1-4,000). Use boiled, soft-rubber catheter, if there is urethral obstruction. Obstruction from swelling of urethra, or urethral stone, may require perineal section. Urinary Retention and Incontinence. If retention is due to spasm of the sphincter, as in colic, then the appli- cation of hot fomentations to the loins, morphine and atropine subcutane- ously, or warm baths in small animals, will relieve. Pressure on the bladder through the rectum, or the use of the catheter, are most rapidly effective in horses. If retention of urine is due to stone in the ischial region or S • curve of the urethra in oxen, then massage it out; do urethrotomy; or slaughter before the bladder ruptures and absorption of urine spoils the meat. In sheep with urethral stone, massage the urethra and excise the spiral filament at the end of the penis; or slaughter. In retention from phimosis, paraphimosis, and stone in the bladder, circumcision, incision of the sheath, and cystotomy are respectively indicated. Stone in the bladder in sheep and cattle may be prevented by giving sodium bicarbonate with the food and allowing water at the animal's constant disposal; and this generally is necessary in fattening. (See Calculus.) Retention of urine from paralysis of the detrusor muscles, in nervous disease, may be overcome by the use of strychnine and remedies combating the primary disorder. Urinary incontinence may be caused by paralysis of the sphincter muscle of the bladder from prolonged retention of urine; or from obstruction by stones and new growths in the bladder. In paretic conditions, the admin- istration of strychnine, alternate injections into the bladder of cold and hot water, and treatment indicated for general debility are in order. Urticaria, Nettlerash, Surfeit, Hives. In horses, cattle, pigs and dogs. Due to external irritation by nettles; bites of insects, fleas and lice; chemicals, and sudden cooling of the skin. Also to irritants within the body — as products of indigestion and toxins from infections, pregnancy rheumatism, and hemoglobinemia ; and to specific foods and medicines. Treatment— Give a purge— H., aloes; C, Epsom salt and calomel; swine, calomel; dogs, the same, or two to three compound cathartic pills. Exter- DISEASES OF DOMESTIC ANIMALS 615 nally, bathe with saleratus and water (gi-Oii), or vinegar, pure or diluted. Sanitas (1 to 2) and terebene (1 to 8) in water, are also beneficial. Uterine Subinvolution. Give fluidextract of ergot in full dose thrice daily for two weeks, and it may well be combined with a moderate dose of quinine sulphate. In sub- involution or hypertrophy of the womb following labor, the use of hot vaginal injections also aids the action of ergot in restoring a normal con- dition. Vaginitis and Vulvo- Vaginitis. Due to infection of injured parts after labor; to the action of strong injections or foreign bodies; and a third form to infection from the bull. Croupous vaginitis is sometimes seen as a variety of puerperal infection. In the acute stage, with swelling of the vulva and inflammation and dis- charge from the vagina, anoint the vulva with carbolized vaseline and inject sodium bicarbonate solution (3ss-Oi) through a sterile, perforated soft-rubber tube. If there are lacerations in the vagina, it should be irri- gated with 1 per cent, lysol solution and the vagina filled with dry boric acid and packed with sterile gauze. Renew the dressings frequently. After the subsidence of the acute stage, inject zinc or copper sulphate solution (of either, 5i-Oi) twice daily. An occasional swabbing of the vagina with freshly made 10 per cent, argyrol is also beneficial. Examine the vagina with a speculum, as a vaginal discharge may arise from the uterus. Vaginitis, Infectious Granular of Cattle. Cows, urinary frequency and straining, thin vaginal discharge; swelling congestion of vulva and vagina. Gray coat on vagina through which minute, red, and later translucent, follicles seen. In bulls some balanitis. Sterility abortion, nymphomania, loss of milk in cows; often sterility in bulls. May last for months. Prevention. 1. Segregate the sick and kill cows with uterine infection. 2. Examine cattle for disease before purchase. 3. Infected bulls not per- mitted to serve cows. Service not allowed before 10 weeks in cows, or 8 weeks in bulls, after onset of disease. Wash penis of bulls with 1 quart 1 per cent, lysol after service where disease prevails. 4. Daily cleanliness and use of chlorinated lime on floors, with destruction of infected utensils. 5. Wash hind quarters with soap and antiseptic solution daily. Give daily injection 2y2 per cent, solution of liquor cresolis compositus, followed by insertion of 10 per cent, lysol ointment (oiiss) by syringe or capsule in cows, and apply 6 per cent, ointment of same to penis in bulls. Use the ointment daily for 5 days, every other day for 10 days, then every third day for a month. Clip hair of sheath in bull and syringe daily with lysol solution before using ointment. Over-strong solutions aggravate condition. Vaginitis and anovulvitis in cows and heifers, with yellow, cheesy necrotic patches due to B. necrophorus and enzootic — Segregate sick, give 2 per cent, lysol vaginal injections, clean and disinfect premises with 5% phenol solution. Varicose Veins. Permanent dilatations of veins. Very rare in the domestic animals. Treatment — Support by bandage. Radical cure can only be obtained by excision of the vein or double ligation, at either end of dilatation. Variola. Pox of Sheep, Cattle, Swine, Dogs, Birds and Monkeys. Sheep pox is the most common and important disease — variola ovina. It is not readily communicable to man but occasionally to dogs, swine and goats. Variola in sheep is highly infectious and very fatal (90 per cent.). In sheep pox, slaughter of the sick and exposed animals and thorough disinfection of the infected premises are essential. Infection may last for six months in the infected premises, and for six weeks about sheep after their recovery from variola. The sheep — on recovery — should therefore be dipped in 2 per cent, creolin or lysol solution. Ovination, or inoculation of sheep with the virus of sheep pox, has been done with greatly varying 616 EPITOME OF MODERN TREATMENT mortality (from 2 to 20 per cent). Inoculation from an already inocu- lated sheep, by means of the virus taken from a pustule at the tenth day, and introduced into the tail of a healthy sheep, will produce immunity without eruption. No inoculations must he made until variola breaks out in a flock, or the disease may be spread by the process. Medical treatment includes cleanliness of surroundings and bedding; warm shelter; fresh air; soft and nourishing food. The nostrils and eyes should be cleaned with saturated boric acid solution; and chalk may be put in the drinking water, if diarrhea is present. Cow pox and horse pox appear to arise from contact of healthy animals with variolous or vaccinated persons. Cow pox therefore usually occurs in cows; occasionally in bulls, oxen and young stock. Cow pox is rare and valuable in providing a source of vaccine lymph. The use of a milking tube; frequent hot fomentations; and measures advised for mastitis are indicated, when the udder is inflamed. In horse pox, clip the hair and cleanse and bathe the parts with 2 per cent, lysol solution, and apply wet compresses of the same. In later stages, the use of carbolized vaseline is to be recommended. Verminous Bronchitis. See Bronchitis. Vertigo. Megrims. Blind Staggers in the Horse. Occasionally seen in dogs, pigs, cattle and sheep. Cover the eyes with a blanket; remove harness about the neck; and walk the animal about. Also throw cold water forcibly over the head. Cerebral congestion from pressure on the neck, or from short over-draw check, from overheating, and from chronic lung or heart disease, may cause it. Cerebral anemia or general anemia may induce the disorder. A strong glare of light affecting the eyes, foreign bodies in the ears, and perhaps indigestion, may induce megrims. Often it is an inexplicable neurosis. If cause can be discovered, it should be remedied, if possible. Animals may often be ridden without danger of an attack (which would appear if they were driven). Certain blinders favor the disorder. Regular and hard exercise is often beneficial. Following a seizure, give an aloes ball. Vesicular Exanthema. See Maladie du Coit. VlLLITIS. CORONITIS (In HORSES). Inflammation of the coronet with heat, bulging and tenderness of the coronet; and brittle, striated appearance of hoof. If severe, separation of the hoof may occur. Remove shoes and enforce rest, with bran and flaxseed poultice to the forefeet. With the subsidence of acute symptoms, apply fly blister to the coronet. May work with bar shoes, or the animal may be sent to pasture if recovery is not rapid, but wet pastures or standing in water and snow are often responsible for the disease. Volvulus or Twist of the Bowel. See Colic. Twist of the pelvic flexure of the colon in the horse is often mistaken for enteritis. Death from colic is more often death from twist. Pelvic flexure absent from proper position in left flank by rectal examination. Eserine subcutaneously is the most successful treatment. May be reduced by rectal manipulation. If this is unsuccessful, one may do a laparotomy. Warbles. Hypodermosis (In Cattle, Rarely in Horses, at Pasture). Caused by Hypoderma bovis and lineata. Prophylaxis — Prevent gadflies from lighting on cattle by the use of covers, by the application of Stockholm tar, and by spraying 3 per cent, creolin solution on the skin; also by thorough brushing to remove the eggs laid on the skin. Injection of kerosene into the openings of the swellings on the skin, by means of a machinist's oil can (when done at the earliest moment) leads to killing the larvae and subsidence of the swellings. Otherwise there is nothing to do but gently express the larvae by pressure with mouth of bottle when they are ready to escape. Incision of the swellings is un- desirable. DISEASES OF DOMESTIC ANIMALS 617 Warts. Verrucae. Papillomata. In young animals on the belly, prepuce, mammae, lips, eyelids, ears, mouth and vagina (bitches) ; and about the fetlocks (grapes) in horses. They should be removed by excision with scissors, or the knife. Torsion and ligature are also employed. Strong acetic or nitric acid may be ap- plied to small growths, but are not so certain as scissors and should never be used about the mouth or eyes. Warty growths of the lids are apt to become malignant and should be removed with a free elliptical incision; also warts on the penis should be freely removed with scissors and their base cauterized with strong nitric acid. The actual cautery may be em- ployed, as in grapes. Weed. See Lymphangitis. Whistling. See Roaring. Wind Galls. This condition is a tenosynovitis and hygroma of the sheath of the per- foratus behind the metacarpus. See Tenosynovitis. Wind-Sucking. Crib-Biting in Horses. Cover stable fixtures with metal and give so much work that vicious habits will not be acquired. The use of a muzzle or spiked strap about the larynx may sometimes prevent wind-sucking. Avoid any articles which can be bitten; feed off the ground, or remove manger after feeding. Cut hay and grain with an ounce of carron oil are indicated in tympany. Iso- lation of wind suckers is advisable, to avoid acquisition of the trick by other animals. Withers, Fistulous. See Fistula. Worms. See Parasites, Intestinal. Wounds. Simple Operative Wounds — The hair should be shaven from the surround- ing area. The simplest, and as effective as any method of skin sterilization is the application of tincture of iodine to the dry skin, or the following may be used. The skin should be washed with green soap and water, with 70 per cent, alcohol and finally with pure ether or, better, Harrington's solu- tion. The operator's hands should be cleansed likewise and covered with rubber gloves. The wound should be handled as little as may be. All hemorrhage must be arrested. If the wound is deep, it should be closed by layers of buried catgut sutures, the skin by silk-worm gut sutures (interrupted). Drainage should be avoided unless the conditions are very unfavorable. Cover the wound with dry aseptic gauze and bandage. Secure rest by splints if possible. Leave dressings in place for a week or two, unless they become soiled and displaced. Accidental Wounds — If the wound is fresh, arrest hemorrhage by suture; hot (or even boiling) water; ice water; actual cautery, in very vascular or deep seated parts, using a dull-red heat; rubber tourniquet; acupressure; pressure by fingers or hemostatic forceps; torsion; or chemicals — as adren- alin solution. If hemorrhage not severe or after bleeding arrested, cover wound with sterile gauze and shave or clip hair from surrounding area without the use of water. Cleanse skin with gasoline or ether. Then remove dirt from wound with sterile gauze or scissors and forceps, and also loose tissue. Then apply tincture of iodine to wound and surrounding skin and cover with dry sterile gauze. Or curette, scrub with gauze, and wash wound with sterile salt solution for 15 minutes if soiled, and apply dry sterile gauze. Recently a solution of dichloramine-T (5-7%) in chlorcosane has come into favor as a primary and subsequent dressing in accidental wounds in prefer- ence to iodine. Divided structures, as tendons, nerves and muscles, should be sutured with sterile, iodized catgut. If the surroundings are favorable and the wound can be bandaged, it should be closed as an operative wound without drainage. If the wound is deep and the conditions unfavorable, drainage by a sterile rubber tube placed into the deeper parts of the wound, and the rest of the wound sutured— should be the rule. It is always easy G18 EPITOME OF MODERN TREATMENT to reopen a wound and remove sutures, if infection occurs, but to secure a first intention is impossible wben the wound has become generally in- fected. The first dressing should always be retained as long as possible to avert infection. If the wound becomes infected employ bacterins. Bier's Hyperemia Treatment. — Passive hyperemia is secured by suction, as cupping and the use of other suction apparatus, and also by placing an elastic ligature about a part sufficiently tight to prevent the return of venous blood, but not so tight as to obstruct the arterial inflow. Passive hyperemia is useful in infections and inflammations— particularly of limbs and joints— because of the following actions: 1. Bactericidal effect. 2. Relief of pain. .'}. Resolution Of inflammatory deposits and relief of stiffness in joints. 4. Arrest of absorption of toxins into circulation. 5. Shortening or aborting infections. Methods of application- A rubber Esmarch bandage, about 3 inches wide and 5 feet long, is wound about the limb of a horse tighl enough to produce a warm edema below the bandage. The bandage is kept in place 20 hours out of the 24, in severe cases; or 10 hours in the 24, in milder infections. Just how tight to apply the bandage is not possible to describe. In the horse the chief point is to avoid producing a cold limb because of too great constriction. Some animals will bite or paw and so displace the bandage. The rubber bandage should have tapes sewn on each end, and is wrapped about the limb and kept sufficiently tight by tying the two tapes together. The bandage is placed in the forelimb on the forearm above the chestnut one day, and the next below the knee (on the metacarpus), and so shifted from day to day. In the hind limb the bandage fa placed one day about the middle of the tibia, and the next day below the hock. It should always be placed as far above the lesion as possible, but in the horse it can not be affixed at groin and axilla, as in man. The position of the bandage is shifted from day to day to avoid necrosis of the skin. It is well to protect the rubber by a cloth bandage over it. If the infection is of the knee or hock, the constriction must be above these points. The bandage should be applied at the earliest stage of infection to secure the best results. Then edema may be expected from the bandage, but, in later stages, edema may not occur, and if this is the case the treatment is of little service. If the treatment is successful either pus will not form and resolution occur, or else it will be necessary to make but small in- cisions to liberate pus, and the course of the condition should be much shortened. The treatment is only applicable to cases which can be under frequent observation in order that the obstruction produced by the bandage may be regulated. Placing the finger under the bandage after its applica- tion will give one an idea of the amount of pressure, and observation of the limb will show one if the result is obtained — edema, but warmth in the distal parts, with apparent relief of pain. The turns of the elastic bandage should spread over some area of skin and not be applied one over the other. The appropriate conditions in veterinary practice for Bier's hyperemia include the following: Infections of the sheaths of tendons and about the feet from injuries, punctures, etc.; joint infections and stiff joints, in- cluding rheumatic joints. These embrace purulent tenosynovitis and ar- thritis, and phlegmons about the hoof in horses. A wet antiseptic dressing may be applied loosely over the point of infection. It is yet to be proved of how much value this method is in veterinary practice, although many favorable reports have been made. Infected and contused wounds should be treated by the application of aseptic gauze soaked in 2 per cent, compound cresol solution, covered with oil silk and bandage and renewed each day, until the septic condition has been somewhat overcome. The use of a mixed bacterin, at the outset may greatly shorten the period of healing. Unhealthy granulations are treated by applications of lunar caustic and stimulant, antiseptic remedies, as Peruvian balsam or carbolic acid in glycerin (1-10— 16). A bandage should always be employed when possible. Otherwise, healing may be had under a scab DISEASES OF DOMESTIC ANIMALS 619 by the application of tannin, silver nitrate stick, or 10 per cent, formalin; or the wound may be kept covered with an ointment of 10 per cent, boric acid in vaseline. Sometimes, if one trims off all septic tissue and disinfects the wound with tincture of iodine, or pure carbolic acid, followed by alcohol and free irrigation with 2 per cent, lysol solution, it may be possible to secure first intention by suture of an old wound. In veterinary practice, asepsis is difficult to obtain, as the application and retention of bandages, the attainment of rest of a part by position and splint, and a pure atmos- phere and premises, are often unattainable. But when possible, particularly in canine practice, the methods of human surgery should be closely fol- lowed. If a fresh wound is much soiled, it may be treated with pure tincture of iodine, as above. Perforating Wounds of the Abdomen— The surrounding region should be prepared by shaving and disinfection of the skin, as described for operative wounds. If there is protrusion of the viscera, it should be protected mean- while by a covering of sterile gauze wrung out in hot water. If omentum prolapse, it should be ligated and excised. If there is a protrusion of bowel, it must be cleansed by the most painstaking and prolonged irrigation with warm (110 deg. F.) sterile normal salt solution (1 teaspoonful of sodium chloride to the pint of boiled water), and then returned into the belly. The abdominal wall should be closed in layers with buried sterile, chromic or tannated catgut; the skin may be approximated by interrupted silkworm gut sutures, while sutures of silkworm gut should be placed through all layers — except the peritoneum — at several points, to reinforce the catgut and prevent hernia. The wound may be sealed with iodoform and collodion (1 to 8) and covered with dry aseptic gauze held in place by adhesive plaster and bandage. Punctured Wounds — Hemorrhage may be arrested by pressure of an aseptic tampon of gauze, after the external wound has been shaved and thor- oughly disinfected with tincture of iodine. If signs of local inflammation and infection occur, then one must incise the wound down to its lowest point and drain. Gunshot Wounds — The chief indication is to disinfect thoroughly the wound of entrance with tincture of iodine and cover with a dry, sterile, gauze dressing and bandage, and enforce rest so far as possible. Do not probe or try to remove the bullet unless it is subcutaneous. If local and general infection ensue, then incision becomes necessary to afford drainage, but not for the purpose of discovering the missile. Joint Wounds — Here application of tincture of iodine to the wound and surrounding skin with immediate sealing of the wound with iodoform and collodion (1 to 8), actual cautery, or suture, and the application of splints, antiseptic dressing, and bandaging, are indicated. See also Ulcers, Open Joints, Bites and Babies. The following agents are used in the treatment of wounds, and their indi- cations may be found by consulting the index for their names: Dichlora- mine-T, chlorazene, hydrogen dioxide, lime and charcoal, alum, silver nitrate, potassium permanganate, mercuric oxides, corrosive sublimate, resin, naphtha- lin, chloral, chlorinated soda, chlorinated lime, iodoform, iodol, aristol, acetan- ilid, bismuth, salol, boric acid, sulphurous acid, nitric acid, charcoal, carbolic acid, creosote, creolin, lysol, formalin, glutol, vaseline, salicylic acid, tar, balsam of Peru, benzoin, myrrh, eucalyptol, zinc sulphate, conium, laudanum, oil of turpentine, camphor, thymol, hydrastis, tincture of aloes and myrrh, collodion, glycerite of tannin, cantharides, antiseptic poultices. GENERAL INDEX Ablution, 498 Abortion disease, 539 Absorption of drugs, 9 Acacia, 430 Aceta, 64 Acetanilid, 240 Acetanilidum, 240 Acetic acid, 203 Acetphenetidin, 241 Acetphenetidinum, 241 Acetylsalicylic acid, 364 Acetylsalicylicum, 364 Acid, acetic, 203 diluted, 203 glacial, 203 acetylsalicylic, 364 arsenous, 170 benzoic, 376 boric, 208 carbolic, 244 crude, 244 citric, 204 syrup of, 204 cresylic, 251 digallic, 419 gallic, 421 hydrochloric, 201 diluted, 201 hydrocyanic, diluted, 258 lactic, 204 muriatic, 201 diluted, 201 picric, 207 sulphuric, 202 aromatic, 202 diluted, 202 nitric, 202 diluted, 202 nitrohydrochloric, 202 diluted, 203 nitromuriatic, 202 diluted, 203 phosphoric, 203 diluted, 203 prussic, 258 pyrogallic, 421 tannic, 419 tartaric, 203 thymic, 394 Acids, 201 Acidum aceticum, 203 dilutum, 203 glacial, 203 benzoicum, 376 boricum, 208 carbolicum, 244 crudum, 244 liquefactum, 244 citricum, 204 gallicum, 421 hydrochloricum, 201 dilutum, 201 hydrocyanicum dilutum, 258 lacticum, 204 nitricum, 202 dilutum, 202 nitrohydrochloricum, 201 dilutum, 202 phosphoricum, 203 dilutum, 203 picricum, 207 salicylicum, 359 sulphuricum, 202 aromaticum, 202 dilutum, 202 tannicum, 419 tartaricum, 203 Aconite, 340 fluidextract of, 340 tincture of, 340 Aconitina, 340 Aconitinae nitras, 340 Aconitine, 340 Aconitum, 340 Action of drugs on animals, 15 on dogs and pigs, 16 on horses, 15 on ruminants, 15 Adeps, 456 benzoinatus, 375, 456 lanae, 457 hydrosus, 456 Administration of drugs, 11 time of, 16 Adrenalin, 447 ^Ether, 220 purificatus, 220 /Ethylis chloridum, 263 Aggressin, blackleg, 538 Alcohol, 212 absolutum, 212 ammoniated, 118 dehydrated, 212 dehydratum, 212 deodoratum, 212 deodorized, 212 diluted, 212 dilutum, 212 Alder buckthorn, 408 Alkaline earth metals, 124 metals, 102 Alkaloids, 59 Alkaloidea, 59 Allyl-iso-thiocynate, 378 Allyl thiourea, 379 622 GENERAL INDEX Aloe Barbadensis, 402 Capensis, 402 Socotrina, 402 Aloes, 402 and myrrh, tincture of, 403 Aloes, Barbadoes, 402 Cape, 402 Curacao, 402 Socotrine, 402 Aloin, 402 Aloinum, 402 Alteratives, 50 Althaea, 431 Alum, 134 burnt, 134 dried, 134 Alumen, 134 exsiccatum, 134 Aluminum, 134 and potassium sulphate, 134 hydrate, 134 hydroxide, 134 Alumini hydroxidum, 134 Alypine, 324 Ammonia, aromatic spirits of, 120 liniment, 118 water, 118 stronger, 118 Ammoniated alcohol, 118 mercury, 162 ointment of, 162 Ammonii benzoas, 376 bromidum, 184 carbonas, 120 chloridum, 121 valeras, 388 Ammonium, 118 acetate, solution of, 122 benzoate, 376 carbonate, 120 chloride, 121 ichthyol sulphonate, 462 valerate, 388 Amyl nitrite, 232 Amylis nitris, 232 Amylum, 445 Analgesics, 240 Anatomy and physiology, 15 Anesthesia, 225 Anesthetics, general, 35 local, 37 Anhidrotics, 55 Animals, action of drugs on, 15 Anise, 386 oil of, 386 spirit of, 386 water, 386 Anisum, 386 Anodynes, 35 local, 37 Antacids, 18 Anthelmintics, 56 against lungworms, 57 removing ascarids, 56 bots, 57 pinworms, 57 strongyles, 57 tapeworms, 56 Anthrax, 533 differential diagnosis of, 534 preventive inoculation for, 534 spore vaccine, 535 symptomatic, 536 Anti-anthrax serum, 535 blackleg serum, 536 canine distemper serum, 539 hog cholera serum, 545 influenza serum, 541 white scours serum, 549 Antiemetics, 23 Antifebrin, 240 Antigalactagogues, 50 Antimonii et potassii tartras, 177 Antimonium, 177 Antimony and potassium tartrate, 177 Antiparasitics, 57 Antipyretic organic agents, 351 Antipyretics, 240 Antipyrina, 241 Antipyrine, 241 Antisepsis, surgical, 512 Antiseptic organic agents, 351 Antiseptics, 20, 56, 244, 505, 509 urinary, 47 Antisialagogues, 17 Antitoxin, tetanus, 548 Aphrodisiacs, 48 Aphtha, parasiticides against fungi of, 57 _ Apomorphine hydrochloride, 277 Apomorphinae hydrochloridum, 277 Apothesine, 324 Apothecaries' weight, 73 Aqua, 99 Aquae, 63 Aqua ammoniae, 118 fortior, 118 anisi, 386 camphorae, 392 chloroformi, 223 destillata, 99 menthae piperitae, 384 regia, 202 Areca, 434 Argenti nitras, 140 fusus, 140 Argentum, 140 Argyrol, 142 Aricina, 351 Aristol, 195 Aristolum, 195 Aromatics, 18 Arseni trioxidum, 170 GENERAL INDEX 623 Arsenic, 170 trioxide, 170 Arsenous acid, 170 solution of, 171 Arsenum, 170 Arsphenamine, 171 Asafetida, 389 milk of, 389 Ascarids, anthelmintics removing, 56 Asepsis, mechanical means of, 507 surgical, 512" Aspidium, 432 oleoresin of, 433 Aspirin, 364 Astringents, 53 Atoxyl, 171 Atropine sulphas, 279 Atropina, 279 Atropine, 279 sulphate, 279 B Bacterin, canine distemper, 539 hemorrhagic septicemia, 542 influenza, 541 therapy, specific, 550 Bacterins, autogenous, 551 definition of, 529 mixed. 551 Baking soda, 110 Balls, 65 Balsam of fir, 371 of Peru, 374 of Tolu, 374 Balsama, 60 Balsams, 60 Balsamum Peruvianum, 374 Tolutanum, 374 Barii chloridum, 129 Barium, 129 chloride, 129 Baths, cold, 500 hot, 505 local, 500 sheet, 499 Beeswax, 457 Belladonna leaves, 278 extract of, 279 tincture of, 279 liniment, 279 ointment, 279 root. 279 fluidextract of, 279 Belladonna? folia, 278 radix, 279 Benzoic acid, 376 Benzoin, 375 compound tincture of, 376 tincture of, 376 Benzoinated lard, 375 Benzoinum, 375 Berberine, 400 Betal nut, 434 Betanapthol, 253 Betula, oil of, 364 Bicarbonate of soda, 110 Bichloride of mercury, 161 Biological products, technic of ad- ministering, 531 therapeutics, 525 Birch, oil of, 364 Bismuth subcarbonate, 149 subgallate, 149 subnitrate, 149 subsalicylate, 149 Bismuthi subcarbonas, 149 subgallas, 149 subnitras, 149 subsalicylas, 149 Bismuthum, 149 Bisulphide of carbon, 211 Bitter apple, 416 ash, 397 wood, 397 Bitters, 18 vegetable, 396 Black alder, 408 Blackleg, 536 aggressin, 538 filtrate, 537 vaccine, 537 Black mustard, 377 Blaud's pills, 153 Bleaching powder, 182 Blister beetles, 453 Blood, drugs acting on the, 29 vessels, drugs acting on the, 32 Blue mass, 161 ointment, 161 pill, 161 stone, 147 vitriol, 147 Boli, 65 Boracic acid, 208 Borax, 209 Boric acid, 208 Bots, anthelmintics removing, 57 Boxberry, oil of, 364 Brain, drugs influencing the, 34, 264 Brandy, 213 Brayera, 435 Bromine, 184 Bromum, 184 Buchu, 390 fluidextract of, 390 tincture of, 390 Buckthorn, 408 California, 407 Burgundy pitch, 371 624 GENERAL INDEX Cacao, butter of, 445 Cade, oil of, 372 Caffeina, 293 citrata, 293 Caffeine sodio-benzoas, 293 Caffeine, 293 citrated, 293 sodio-benzoate, 293 Calabar bean, 304 Calcii bromidum, 184 carbonas praecipitatus, 124 chloridum, 128 hydras, 126 phosphas praecipitatus, 127 sulphas exsiccatus, 129 Calcined magnesia, 132 Calcium, 124 carbonate, 124 chloride, 128 hydrate, solution of, 125 lactophosphate, syrup of, 127 oxide, 125 phosphate, 127 precipitated, 127 sulphate, 129 dried, 129 Calisaya bark, 351 Calomel, 162 Calumba, 398 tincture of, 399 Calx, 125 chlorinata, 129, 182 Cambogia, 415 Camphor, 392 liniment, 392 monobromated, 392 spirit of, 392 water, 392 Camphora, 392 monobromata, 392 Camphorated tincture of opium, 265 Canada balsam, 371 turpentine, 371 Cane sugar, 431 Canine distemper bacterin, 539 vaccine, 539 practice, gastric sedatives and anti- emetics in, 23 Cannabis, 290 extract of, 290 fluidextract of, 291 Indian, tincture of, 291 indica, 290 Cantharidal collodion, 446 Cantharides, 453 tincture of, 453 Cantharis, 453 Capsicum, 382 fluidextract of, 383 oleoresin of, 383 tincture of, 383 Carbo ligni, 210 Carbolic acid, 244 crude, 244 glycerite of, 244 liquefied, 244 ointment of, 244 Carbon, 210 disulphide, 211 Carbonei disulphidum, 211 Carbonate of bismuth, 149 of lithia, 123 of magnesia, 132 Cardamom seed, 386 Cardamomi semen, 386 Carlsbad salt, 113 Carminatives, 19 Carron oil, 126 Cascara sagrada, 407 fluidextract of, 407 Castile soap, white, 425 Castor oil, 406 seeds, 406 Cataplasms, 503 Catechu, 422 kino and rhatany, 422 pale, 422 Cathartics. 23 vegetable, 402 Caustic soda, 109 Caustics, 53, 496 Cautery, actual, 495 Cayenne pepper, 382 Cera alba, 457 flava, 457 Cerata, 65 Cerate, 456 of lead subacetate, 137 Cerates, 65 Ceratum, 456 cantharidis, 453 plumbi subacetatis, 137 resime, 371, 456 Cerebral depressants, 34 excitants, 34 Cerii oxalas, 136 Cerium, 136 oxalate, 136 Cetaceum, 457 Chalk mixture, 124 powder, compound, 124 prepared, 124 Charbon, 533 Charcoal, 210 Chartae, 65 Checkerberry, oil of, 364 Chenopodium, 439 Cherry, wild, 261 Chinoidine, 354 Chinoidinum, 354 Chloral. 236 hydrate, 236 GENERAL INDEX 625 Chloralum hydratum, 236 Chlorazene, 511 Chloretone, 240 Chloride of lime, 182 mercury, mild, 162 Chlorinated lime, 182 solution of, 182 soda, solution of, 182 Chlorine, 182 Chloroform, 222 Chloroformum, 222 Chlorum, 182 Cholagogue purgatives, 25 Chrysarobin, 410 ointment, 410 Chrysarobinum, 410 Cinchona, 351 compound tincture of, 352 fluidextract of, 352 red, 352 rubra, 352 tincture of, 352 Cinchonicine, 351 Cinchonidin?e sulphas, 354 Cinchonidine, 351 sulphate, 254 Cinchonina? sulphas, 354 Cinchonine, 351 sulphate, 354 Circulation, drugs acting on the, 29 Citrate of lithia, 123 Citric acid. 204 syrup of, 204 Citrine ointment, 162 Clarification, 61 Classification of drugs, 97 Clysters, 27 Cocaina? hydrochloridum, 317 Cocaine hydrochloride, 317 Cod liver oil, 461 Codeina, 266 Codeine, 266 Cold and heat, 497 water, modes of employing, 498 Collargol, 143 Collodia, 65 Colloidal silver, 143 Collodion, 446 blistering, 446 flexible, 446 styptic, 419 Collodions, 65 Collodium, 446 cantharidatum, 446 flexile, 446 stvpticum, 419 Colloxylin, 446 Colocynth. 416 Colocynthin, 416 Colocynthis, 416 Colophony, 371 Columbo, 398 Compound cathartic pills, 162 Confectiones, 65 Confections, 65 Conium, 314 Copper acetate, 149 sulphate, 147 Copperas, 152 Coriander, 386 Coriandrum, 386 Corn starch, 445 Cornua, inferior, drugs depressing the, 304 stimulating the, 296 Corrosive chloride of mercury, 161 mercuric chloride, 161 sublimate, 161 Cosmoline, 262 Cotton, absorbent, 445 gun, 446 purified, 445 seed oil, 425 Cough, drugs relieving, 43 Counterirritants, 52, 491 indications for, 494 Coxe's hive syrup, 339 Cream of tartar, 108 Crede's ointment, 143 Creolin, 252 Creolinum, 252 Creosote, 250 Creosotum, 250 Cresol, 251 compound solution of, 253 Cresylic acid, 251 Creta praeparata, 124 Croton oil, 412 Crystallization, 62 Cupri acetas, 149 sulphas, 147 Cuprum, 147 Cusso, 435 Cutch, 422 D Dakin's solution, 510 Dandelion, 399 Decantation, 61 Decocta, 63 Decoctions, 63 Definition of drug, 7 of materia medica, 7 of medicine, 7 of metrology, 7 of pharmacy, 7 of pharmacology, 7 of prescription, 72 of therapeutics, 7 of toxicology, 7 Demulcents, 54 vegetable, 425 Deodorants, 56, 506, 511 Deo 'oiizers, 6, 506 626 GENERAL INDEX Depressants, cerebral, 34 Desiccate, 62 Deutoiodide of mercury, 162 Diacetylmorphine, 267 Diachylon plaster, 137 Diagnostic agents, preparations used as, 529 products, 532 Diaphoretics, 54 Dichloramine-T, 511 Digalen, 332 Digallic acid, 419 Digestion, 62 Digestive organs, drugs acting on, 17 Digestives, 20 Digipuratum, 332 Digitalein, 330 Digitalin, 330 Homolle's 331 Nativelle's, 331 Quevenne's, 331 Schmiedeberg's, 331 Digitalis, 330 fluidextract of, 331 folia, 331 infusion of, 331 tincture of, 331 Digitalone, 331 Digitonin, 330 Digitophyllin, 330 Digitoxin, 330 Dioxy-diamido-arsenobenzol dihy- drochloride, 171 Disease influencing action of drugs, 16 Diseases infectious, 527 Disinfectants, 56, 505 chemical, 507 Distemper, canine, 538 Distillation, 62 Dithymol diiodide, 195 Diuretics, 44 Dogs, action of drugs on, 16 Dosage, 14, 98 Doses of drugs, 464 Douches, 500 Dover's powder, 265 liquid, 265 Drastic purgatives, 24 Drench, 66 prescription for, 92 Drinks, cold, 501 Drop chalk, 124 Drugs, absorption of, 9 acting mechanically, 445 acting on blood, 29 on blood vessels, 32 on brain, 264 on circulation, 29 on digestive organs, 17 on ear, 39 on eye, 38 on heart, 30, 330 on kidneys and genito-urinary tract. 390 on motor nerves, 312 on nerves, 37 on nerves of special sense, 38 on nervous system, 34 on respiratory mucous mem- brane, 39 on respiratory organs, 39, 348 on secretory nerves, 326 on sensory nerves, 317 on sexual organs, 48 on skin, 52 on spinal cord, 36, 296 on urinary organs, 44 circumstances modifying action of, 11 classification of, 97 containing tannic acid, 418 decreasing force and frequency of the heart, 340 definition of, 7 depressing the interior cornua, 304 motor nerves, 312 respiratory centers, 42 sensory nerves, 317 destroying microorganisms and parasites, 56 disease influencing action of, 16 doses of, 464 eliminated in milk, 49 elimination of, 9 habit influencing action of, 16 idosyncrasy influencing action of, 16 increasing force and decreasing frequency of the heart, 330 influencing blood vessels of the skin, 52 bodily heat, 50 brain, 34 composition of urine, 47 female sexual organs, 48 male generative organs, 48 metabolism, 50 milk secretion, 49 reaction of urine, 46 secretions of sweat, 54 killing parasites, 432 medicinal bodies and principles in, 59 mode of action of, 7 mode of administration of, 11 of animal origin, 447 relaxing spasm of bronchial mus- cular tunic and relieving cough, 43 softening, soothing and protecting skin, 54 stimulating the inferior cornua, 296 GENERAL INDEX 627 nervous system, 387 respiratory centers, 42 unstriated muscle, 440 to expel round and hookworms, 439 to destroy fleas, 440 lice, 440 roundworms, 437 tapeworms, 432 used for action on skin, 366 vegetable, 264 E Ear, drugs acting on the, 39 Ecbolics, 49 Elaterin, 416 Elaterinum, 416 Electuaria, 67 Electuaries, 67 Electuary, prescription for, 94 Elimination of drugs, 9 Elixir ferri, 354 of vitriol, 202 Elixirs, 64 Elixis pro, 403 Elutriation, 61 Emetics, 20 Emmenagogues, 48 Emollients, 54 Emplastra, 65 Emplastrum elasticum, 371 picis, 371 plumbi, 137 resinae, 371 saponis, 426 Emulsa, 64 Emulsions, 64 Emulsum asafoetidae, 389 Enemata, 27 cold, 501 Enteroclysis, 519 Epinephrin, 447 Epsom salt, 131 Ergot, 440 Ergota, 440 Ergot, extract of, 441 fluidextract of, 441 Ergotin, 441 Ergotoxine phosphate, 441 Escharotics, 53, 496 Eserine, 304 salicylate, 304 sulphate, 304 Ether, 220 amylo-nitrous, 232 spirit of, 220 Ethyl chloride, 263 Eucainae hydrochloras, 324 Eucaine hydrochlorate, 324 Eucalyptol, 380 Eucalyptus, 380 fluidextract of, 380 oil of, 380 Euphorbium, 446 Evaporating solutions, 501 Evaporation, 62 Excipient, 62 Excitants, cerebral, 34 Expectorants, 41 Exsiccate, 62 Extracta, 64 Extracts, 64 Extractum belladonnas foliorum, 279 cannabis, 290 cascarae sagradae, 408 liquidum, 408 cinchonae liquidum, 352 ergotae, 441 liquidum, 441 fellis bovis, 460 gentianae, 396 glycyrrhizae liquidum, 429 hamamelidis liquidum, 424 hydrastis liquidum, 400 hyoscyami, 288 ipecacuanhas liquidum, 348 jaborandi liquidum, 327 nucis vomicae, 296 opii, 265 liquidum, 265 quassiae, 398 rhei, 409 taraxaci, 399 liquidum, 399 Eye, drugs acting on the, 38 Fats, 59 Favus, parasiticides against fungi of, 57 Feeding, artificial, 490 Fel bovis, 460 Female sexual organs, drugs influ- encing, 48 Fennel, 387 Fenugreek, 387 Fern, male, 432 Ferri carbonas saccharatus, 153 chloridum,153 et ammonii citras, 154 potassii tartras, 154 quininae citras, 154 hydroxidum cum magnesu oxido, 154 sulphas, 152 exsiccatus, 152 granulatus, 153 valeras, 388 Ferric chloride, 153 solution of, 153 tincture of, 153 hydroxide with magnesium oxide, 154 628 GENERAL INDEX subsulphate, solution of, 154 valerate, 388 Ferrous carbonate, mass of, 153 carbonate, saccharated, 153 iodide, syrup of, 153 sulphate, 152 dried, 152 granulated, 153 Ferrum, 152 reductum, 152 Fibrolysin, 379 Filix mas, 432 Filtrate, blackleg, 537 Filtration, 61 Flaxseed, 429 oil of, 405 Fleas, drugs to destroy, 440 parasiticides against, 58 Fleming's tincture, 340 Flowers of sulphur, 197 Fluidextracta, 64 Fluidextracts, 64 Fluidextractum aconiti, 340 belladonnae radicis, 279 buchu, 390 cannabis, 291 capsici, 383 cascarae sagradae, 407 sagradae aromaticum, 408 cinchona?, 352 cusso, 436 digitalis, 331 ergotae, 441 eucalypti, 380 frangulae, 408 gelsemii, 310 gentianse, 396 glycyrrhizae, 429 granati, 436- hamamelidis foliorum, 424 hydrastis, 400 hyoscyami, 288 ipecacuanha?, 348 lobelia?, 315 nucis vomicae, 297 pilocarpi, 326 rhei, 409 scillae, 339 sennae, 411 taraxaci, 399 Valerianae, 387 veratri viridis, 344 zingiberis, 384 Fceniculum, 387 Fomentations, 504 Food and feeding, 479 Formaldehyde, 255 Formalin, 255 Formic aldehyde, 255 Formol, 255 Formula for acute bronchitis in dogs, 179, 350 for alopecia, 329 for anemia in dog. 176 for anesthetic for horse, 240 for anodyne iit colic in horses, 274 for anthelmintic for horses, 169 for antiseptic dusting powder, 195 for application to dead tissue, 136 for asthma in dogs, 287 for Basham's mixture, 158 for blister, 447, 455 for blister for cattle, 414 for brain stimulant, 295 for bronchitis in dogs, 370 for bronchitis in horses, 106, 179 for burns, 249 for burns, wounds and ulcers, 249 for calves with diarrhea, 111 for camphor oil for use in alcohol and opium poisoning, 394 for Carlsbad salt, 113 for carron oil, 405 for catarrhal conjunctivitis, 210 for caustic to destroy pyogenic membranes, 167 for chronic conjunctivitis, keratitis and ulcer of the cornea, 166 for chronic constipation in dogs, 287 for chronic eczema and pruritis, 374 for closing small wounds, 195 for colic in the horse, 222 for colic remedy, 239 for conjunctivitis, 254 for cough and bronchitis in dogs, 262 for cough in dogs, 276 for cough in horses, 276 for cough mixture for dogs with bronchitis, 122 for cough syrup for dogs, 340 for counterirritant, 188 for counterirritant and absorbent on exostoses, 168 for debility and anemia of horses, 176 for dermatitis, erythema and moist eczema, 146 for diarrhea in dogs, 151, 275, 410 for diarrhea in dogs and cats, 152 for diarrhea in foals and calves, 407, 410 for diarrhea in horses and cattle, 275 for diarrhea in horses, cattle cal- ves and sheep, 423 for distemper in dogs, 251 for diuretic, 295 for Dobell's solution, 250 GENERAL INDEX 629 for dogs with convulsions, 186 for dogs with diarrhea, 125 for dogs with fever and restless- ness, 122 for drastic cathartic for cattle, 413 for drastic cathartic for horses, 414 for dropsy in dogs, 415 for dusting powder, 135, 210, 211 in eczema, erythema and scratches, 146 for eczema, 363, 373 of dogs, 249 for ergot preparation, 443 for erythematous eczema, 255 for eye lotion, 322 for febrile conditions in dogs, 235 for fevers in horses, 113, 343 for fits in puppies, 239 for flatulence in horse or cow, 369 colic in horses, 389 for foals and calves with diarrhea, 125 with intestinal indigestion, tympanites and acid diarrhea, 133 for follicular mange, 251 for foot rot in sheep, 199 for Harrington's solution of corro- sive sublimate, 167 for heart stimulant, 295 for hoof ointment, 373 for hookworm in dogs, 395 for horses with acute laminitis, 243 for horses with diarrhea, 125 with indigestion, 111 with pharyngitis, 158 with roundworms., 148 for impaction of the bowels, 309 for indigestion in horses, 175, 401 for itching in pruritus, prurigo and urticaria, 167 for Lassar's paste, 146 for laxative physic ball, 404 pill for dogs, 418 for licking disease in cattle, 278 for liquid tonic, 397 for lotion for skin diseases, 139 for mange and ringworm, 254, 375 for nasal catarrh of dogs, 385 for ointment used in psoriasis, 411 for otorrhea in dogs, 428 for palpitation of heart in horses, 344 for pharyngitis in horses, 108 for pink ointment for scratches in horses, 146 for pruritus, 249 ani and vulva, 363 for purgative for cow, 114 for purge for cattle, 416 for large dog, 407 for removal of malignant growths or warts, 175 for removing cancer, 144 small skin tumors, 144 for resolvent, 189 for rheumatism, 365 in dogs, 363 for ringworm, 395 itching or mange, 199 round or tapeworm in horses, 369 worms in dogs, 369, 438, 439 in horses, 176 in puppies, 438 for scratches and cracked heels of horses, 428 for skin diseases, 255 for sulphur ointment, 198 for sun cholera mixture, 394 for tapeworm in dog, 433 in horses, 434 for tape or round worms in dog, 434 for thrush and canker of the feet in horses, 148 for tonic for dog, 303 for dogs in convalescence, 399 for horses, 157, 303 for horses and cattle, 158 powder, 397 for urticaria or pruritus, 385 for verminous bronchitis of calves and lambs, 370 of foals and calves, 249 for vomiting and diarrhea in dogs, 250 for white liniment, 368 for worms in dog, 439 in lambs, 434 for wound dressing, 136 dusting powder, 151 for wounds, galls and chafes, 254 for yellow lotion to kill lice on the skin, 201 for vellow wash in chronic eczema, 168 Fowler's solution, 171 Foxglove, 330 Frangrula, 408 fluidextract of, 408 Friar's balsam. 376 Fungi of thrush or aphtha, parasiti- cides against, 57 Galactagogues, 49 Galla, 418 Gallic acid, 421 Galls, 418 Gambir, 422 compound tincture of, 422 Gamboge, 415 630 GENERAL INDEX Gastric sedatives, 23 Gaultheria, oil of, 364 Gelatin, purified, 128 Gelatinum, 128 Gelsemina, 310 Gelsemine, 310 Gelsemium, 310 fluidextract of, 310 tincture of, 310 Genito-urinary tract, drugs acting on, 390 Gentian, 396 compound tincture of, 396 extract of, 396 fluidextract of, 396 Gentiana, 396 Germicides, 56, 505 Ginger, 383 fluidextract of, 384 Glacial acetic acid, 203 Glanders, diagnosis of, 558 intrapalpebral mallein test for, 559 ophthalmic mallein test for, 559 subcutaneous mallein test for, 558 Glands, pituitary, 451 suprarenal, 447 thyroid, 447 Glauber's salt, 112 Glucosidea, 59 Glucosides, 59 Glycerin, 427 suppositories of, 427 Glycerinum, 427 amyli, 445 pepsini, 459 Glycerita, 65 Glycerite of boroglycerin, 209 of carbolic acid, 244 of starch, 427 Glycerites, 65 Glyceritum acidi carbolici, 244 tannici, 419 amyli, 427, 445 boroglycerini, 209 hydrastis, 400 phenolis, 244 Glycerole, 427 Glycyrrhiza, 429 compound power of, 197, 441 fluidextract of, 429 Golden seal, 400 Gossypium purificatum, 445 Goulard's extract, 137 Granatum, 436 Gray powder, 160 Green vitriol, 152 Guaranine, 293 Gum arabic, 430 Gum-resinae, 60 Gummi, 60 Gums, 60 Gun cotton, 446 H Habit influencing action of drugs, 16 Hamamelidis cortex, 424 folia et cortex, 424 Hamamelis bark, 424 leaves, 424 fluidextract of, 424 Haustus, 66 Heart, drugs acting on the 30, 330 decreasing force and frequency of, 340 increasing force and decreas- ing frequency of, 330 Heat, 502 and cold, 497 bodily, drugs influencing, 50 contrasted with cold, 505 dry, 504 modes of applying, 503 Heavy metals, 134 Hellebore, American, 344 Hcmatinics, 29 Hemlock fruit, 314 Hemorrhagic septicemia, 542 bacterin, 542 of cattle, 542 of hogs, 544 of sheep, 543 Hemostatics, 53 Henbane, 288 Heroin, 267 Hexamethylenamina, 257 Hexamethylenamine, 257 Hexamine, 257 Hive syrup, 177 Hoffman's anodyne, 220 Hogan's solution, 518 Hog cholera. 544 Homolle's digitalin, 331 Honey, 458 clarified, 458 Honeys, 65 Hookworms, druers to expel, 439 Horses, action of drugs on, 15 Hot water bags, 504 Hvdraqrogue purgatives, 24 Hydrargvri chloridum corrosivum. 161, 166 mite, 162, 168 iodidum rubrum, 162, 170 oxidum flavum, 161 rubrum, 161 et flavum, 166 Hydrartrvrum, 160 ammoniatum, 162 cum creta. 160 Hvdra stm, 400 Hvdrastina, 400 Hvdrastine, 400 Hydrastininae hydrochloridum, 400 Hydrastinine hydrochloride, 400 GENERAL INDEX 631 Hydrastis, 400 fluidextr.act of, 400 glycerite of, 400 tincture of, 400 Hydrate of chloral, 236 Hydriodic acid, syrup of, 190 Hydrochloric acid, 201 solution of arsenic, 171 Hydrocyanic acid, diluted, 258 Hydrogen dioxide, solution of, 100 Hydroxybenzene, 244 Hyoscine hydrobromide, 288 Hyoscyaminae hydrobromidum, 288 Hyoscyamine hydrobromide, 288 Hyoscyamus, 288 extract of, 288 fluidextract of, 288 juice of, 288 tincture of, 288 Hypnotics, 35 Hypochloride of calcium, 182 Hypodermoclysis, 519 Hypophysis, desiccated, 451 sicca, 451 solution of, 451 Hyposulphate of soda, 117 Ichthyol, 462 Ichthyolum, 462 Idiosyncrasy influencing action of drugs, 16 Immunity, definition of, 525 preparations used in production of 529 Incineration, 62 Incompatibility, chemical, 68 physical, 69 physiological, 69 Indian poke root, 344 tobacco, 315 tumeric, 400 Infusa, 63 Infusion, saline, 517 Infusions, 63 Influenza bacterin, 541 equine, 541 Infusum cinchona? acidum, 352 digitalis, 331 Inhalation, 11 Inhalations. 505 Injectio apomorphinae hypodermica, 277 cocainae hypodermica, 317 ergotini hypodermica, 441 morphinae hypodermica, 266 Injection, intramammary, 13 intratracheal, 12 intravenous, 11 rectal, 13 subcutaneous, 11 of hot water, 504 Inorganic agents, 99 Insect powder, Persian, Caucasian or Dalmatian, 440 Intradermal test for tubercu- losis, 554 Intramammary injection, 13 Intratracheal injection, 12 Intravenous injection, 11 Inunction, 13 Iodine, 186 compound solution of, 187 ointment, 187 tincture of, 187 Iodinum, 186 Iodoform, 194 ointment of, 194 suppositories, 194 Iodoformum, 194 Iodol, 195 Iodolum, 195 Iodum, 186 Ipecac, 348 and opium, powder of, 265 tincture of, 265 fluidextract of, 348 syrup of, 348 Ipecacuanha, 348 Iron and ammonium citrate, 154 potassium tartrate, 154 quinine citrate, 154 by hydrogen, 152 perchloride, tincture of, 154 Irrigation, cold water, 501 Irritants, 52 Itch, parasiticides against mites of, 57 J Jaborandi, 326 Jalap, 414 resin of, 414 Jalapa, 414 Jessamine, yellow, 310 Juniper, compound spirit of, 213 oil of, 390 spirit of, 391 K Kamala, 435 Kidneys, drugs acting on, 390 Kino, 423 compound powder pf, 424 rhatany and catechu, 422 tincture of, 423 Kousso, 435 fluidextract of, 436 Kunsel's treatment for milk fever, 521 632 GENERAL INDEX Labarraque's solution, 182 Lactic acid, 204 Lactin, 458 Lactose, 458 Lanolin, 456 anhydrous, 457 Lard, 456 Lassar's paste, 146 Latin adjectives, list of, 87 genitive, rules for, 80 nouns, list of, 83 Laudanum, 265 Lavage, 522 Laxatives, 23 Lead acetate, 137 carbonate, 137 iodide, 138 ointment of, 138 nitrate, 138 oxide, 137 plaster, 137 subacetate, diluted solution of, 137 solution of, 137 water, 137 Levigation, 61 Lice, drugs to destroy, 440 parasiticides against, 58 Licorice powder, compound, 411 root, 429 Lime, 125 liniment, 126 slaked, 126 solution of, 125 syrup of, 126 water, 125 Linimenta, 65 Liniments, 65 prescription for, 96 Linimentum aconiti, 340 ammoniae, 118 belladonnas, 279 calcis, 126 camphorae, 392 chloroformi, 223 saponis, 425 mollis, 426 sinapis, 378 terebinthinae, 366 Linseed, 429 oil, 405 Linum, 429 Liquefaction, 62 Liquid paraffine, 262 petrolatum, 262 Liquor acidi arsenosi, 171 ammonii acetatis, 122 calcis, 125 chlorinatae, 182 cresolis compositus, 253 ferri chloridi, 153 subsulphatis, 154 formaldehydi, 255 hydrogenii dioxidi, 100 hypophysis, 451 iodi compositus, 187 morphinae acetatis, 266 hydrochloride, 266 picis carbonis, 372 plumbi subacetatis, 137 dilutus, 137 fortis, 137 potassii arsenitis, 17_1 hydroxidi, 103 quassias concentratus, 398 sodc'e chlorinatne, 182 sodii hydroxidi, 109 zinci chloridi, 144 Liquores, 63 Litharge, 137 Lithii bromidum, 184 carbonas, 123 citras, 123 Lithium, 123 carbonate, 123 citrate, 123 Liver of sulphur, 200 Lixiviation, 61 Lobelia, 315 fluidextract of, 315 tincture of, 315 Lobeline, 315 Locke's solution, 518 sulphate, 315 Lugol's solution, 187 Lumpy jaw, parasiticides against ray fungi of, 57 Lunar caustic, 140 Lungworms, anthelmintics against, 57 Lysol, 253 M Maceration, 62 Magnesia, heavy, 133 Magnesii carbonas, 132 oxidum, 132 ponderosum, 133 sulphas, 131 Magnesium, 131 carbonate, 132 oxide, 132 heavy, 133 sulphate, 131 Male generative organs, drugs in- fluencing, 48 Mallein, 558 test for glanders, 558 Mandrake root, 417 Manganum, 159 GENERAL INDEX 633 Mange, parasiticides against mites of, 57 Marshmallow root, 431 Massa ferri carbonatis, 153 hydrargyri, 161 Massae, 65 Masses, 65 Materia medica, definition of, 7 May apple, 417 Medicine, definition of, 7 Mel, 458 depuratum, 458 Melita, 65 Menstruum, 62 Mentha piperita, 384 Menthol, 384 Mercurial ointment, 161 Mercuric ammonium chloride, 162 bichloride, 161 chloride, corrosive, 161 iodide, 162 nitrate, ointment of, 162 oxide, 161 red, 161 ointment of, 161 yellow, 161 ointment of, 161 Mercurous chloride, 162 Mercury, 160 ammoniated, ointment of, 162 mass of, 161 oleate of, 161 with chalk, 160 Metabolism, drug influencing, 50 Methyl blue, 254 salicylate, 364 Metric system, 75 Metrology, definition of, 7 Microorganisms, drugs destroy- ing, 56 Milk, drugs eliminated in, 49 fever, Kunsel's treatment for, 521 of sulphur, 197 secretion, drugs influencing, 49 sugar, 458 Mint, 384 Mistura cretae, 124 Misturae, 63 Mites of scab, itch or mange, par- asiticides against, 57 Mixture, prescription for, 91 Mixtures, 63 Molasses, 432 Monohydrated sodium carbonate, 110 Monsel's solution, 154 Morphia, 266 Morphina, 266 Morphinae hydrochloridum, 266 sulphas, 266 Morphine, 266 hydrochloride, 266 sulphate, 266 Mouth, drugs given by, 13 Mucilago acaciae, 430 tragacanthae, 431 Muriate of ammonia, 121 soda, 114 Muriatic acid, 201 Muscle, unstriated, drugs stimulat- ing, 440 Mustard, black, 377 volatile oil of, 378 white, 377 Mydriatics, 38 Myotics, 39 Myrrh, 382 and aloes, tincture of, 382 tincture of, 382 Myrrha, 382 N Naphthol, 253 Narcotics, 35 Nativelle's digitalin, 331 Nerves, drugs acting on the, 37 motor, drugs acting on the, 312 drugs depressing, 312 secretory, drugs acting on, 326 sensory, drugs acting on, 317 drugs depressing, 317 Nervous system, drugs acting on the 34 drugs stimulating, 387 Nicotine, 312 Nightshade, deadly, 278 Nitre, 106 Nitric acid, 202 Nitrites, 232 Nitrite, amyl, 232 Nitroglycerin, solution of, 232 Nitrohydrochloric acid, 202 Nitromuriatic acid, 202 Nitrous ether, spirit of, 232 Novocaine, 323 Nutgall, 418 ointment, 418 Nux vomica, 296 , , extract of, 296 fluidextract of, 297 tincture of, 297 Oak, white, 422 Oakum, 446 Oil of vitriol, 202 Oils, 60, 65 distilled, 60 solid volatile, 392 volatile, 365 Ointment, 456 634 GENERAL INDEX prescription for, 95 Ointments, 65 Olea, 59, 65 destillata, 60 Oleata, 65 Oleate of mercury, 161 Oleates, 65 Oleatum cocainse, 317 hydrargyri, 161 Oleoresina aspidii, 433 capici, 383 zingiberis, 384 Oleo-resinae, 60, 64 Oleo-resins, 60, 64 Oleum anisi, 386 cadinum, 372 eucalypti, 380 gaultheriae, 364 gossypii seminis, 425 juniperi, 391 lini, 405 menthse piperita?, 384 morrhuse, 461 olivae, 425 phosphoratum, 180 picis liquidae rectificatum, 372 ricini, 406 sinapis volatile, 378 terebinthinae, 366 rectificatum, 366 theobromatis, 445 tiglii, 412 Olive oil, 425 Ophthalmic test for tuberculosis, 556 Opii pulvis, 264 Opium, 264 and ipecac, powder of, 265 tincture of, 265 camphorated tincture of, 265 denarcotizatum, 265 deodoratum, 265 deodorized, 265 tincture of, 265 extract of, 265 granulated, 265 granulatum, 265 powdered, 264 tincture of, 265 Orange root, 400 Ordeal bean, 304 Orthoform, 196 Oxgall, 460 powdered extract of, 460 Oxytocics, 49 Pack, wet, 499 Pancreatin, 459 Pancreatinum, 459 Papain, 461 Papayotine, 461 Papers, 65 Para-acetphenetidin, 241 Paraffine oil, 262 Parasites, drugs destroying, 56 vegetable drug killing, 432 Parasiticides, 57 against fleas, 58 fungi of ringworm and favus, 57 thrush or aphtha, aphthous stomatitis, 57 lice, 58 mites of scab, itch or mange, 57 ray fungi of lumpy jaw, 57 Para-toluene-sodium - sulpho-chlora- mide, 511 Paregoric, 265 Paricina, 351 Pasteur method of rabies preven- tion, 547 Pelletierinae tannas, 436 Pelletierine, 436 Pepo, 437 Pepper, red, 383 Peppermint, 384 -camphor, 384 oil of, 384 water, 384 Pepsin, 458 Pepsinum, 458 Perchloride of iron, 153 mercury, 161 Percolation, 61 Permanganate of potash, 159 Persian insect powder, 440 Persulphate of iron, solution of, 154 Petrolatum, 262 album, 262 liquidum, 262 Pharmaceutical preparations, 63 processes, 60 Pharmacology, definition of, 7 Pharmacopeia, United States, 63 Pharmacopeial preparations, 63 Pharmacy, 59 definition of, 7 Phenacetin, 241 Phenic acid, 244 Phenol, 244 liquefactum, 244 salicylic ether of, 360 Phenolphthalein, 408 Phenolphthaleinum, 408 Phenylacetamide, 240 Phenyl-dimethyl-pyrazolon, 241 Phenyl salicylate, 360 Phenylis salicylas, 360 GENERAL INDEX 635 Phosphate of lime, precipitated, 127 soda, 116 Phosphorated oil, 180 Phosphoric acid, 203 Phosphorus, 179 Physiology and anatomy, 15 Physostigma, 304 Physostigminae salicylas, 304 sulphas, 304 salicylate, 304 sulphate. 304 Picric acid, 207 Pigs, action of drugs on, 16 Pil. ipecachuanhae cum scilla, 339 Pill, prescription for, 89 Pills, 65 Pilocarpine hydrochloridum, 327 nitras, 327 Pilocarpine, 326 hydrochloride, 327 nitrate, 327 Pilocarpus, 326 fluidextract of, 326 Pilule, 65 aloes, 382 asafcetidae, 389 catharticae compositae, 162 ferri carbonatis, 153 laxativae compositae, 403 phosphori, 180 Pinkroot, 439 Pinworms, anthelmintics removing, 57 Pitch, 372 Burgundy, 371 plaster, 371 Pituitrin, 451 Pix Burgundica, 371 carbonis preparata, 372 liquida, 372 nigra, 372 Plaster of Paris, 129 Plasters, 65 Plumbi acetas, 137 carbonas, 137 iodidum, 138 nitras. 138 oxidum, 137 Plumbum, 137 Podophyllin, 417 Podophyllotoxin, 417 Podophyllum, 417 j-esin of, 417 Poison nut, 296 and antidotes, 475 Poke root, Indian, 344 Pomegranate, 436 Posology, 14 Potassa cum calce, 103 sulphurata, 200 with lime, 103 Potassii acetas, 104 bicarbonas, 104 bitartras, 108 bromidum, 184 carbonas, 104 chloras, 107 citras, 105 cyanidum, 261 hydroxidum, 103 iodidum, 190 nitras, 106 permanganas, 159 Potassio-ferric tartrate, 154 Potassium, 102 acetate, 104 Potassium alum, 134 arsenite, solution of, 171 bicarbonate, 104 bitartrate, 108 bromide, 184 carbonate, 104 chlorate, 107 citrate; 105 cyanide, 261 hydroxide, 103 solution of, 103 iodide, 190 nitrate, 106 oleate, 426 permanganate, 159 Poultice, Priessnitz, 500 Poultices, 503 Powders, 65 prescription for, 93 Preparations, non-official, 65 official, 63 Prescription, definition, of, 72 for drench, 92 electuary, 94 liniments, 96 mixture, 91 oinment, 95 pill, 89 powders, 93 suppositories, 95 writing, 70 Latin words and phrases used in, 70 examples of, 89 Priessnitz poultice, 500 Procaine, 323 Protargol, 142 Protochloride of mercury, 162 Prunus Virginiana, 261 Prussic acid, 258 Pulveres, 65 Pulvis catechu compositus, 422 G36 GENERAL INDEX cretae aromaticus, 124 cum opio, 124 compositus, 124 glycyrrhizae compositus, 197, 411, 429 ipecachuanhae et opii, 265, 348 jalapae compositus, 414 kino compositus, 424 rhei compositus, 409 Pumpkin seed, 437 Purgatives, 23 Purgatives, cholagogue, 25 drastic, 24 general uses of, 26 hydragogue, 24 saline, 24 simple, 24 Pustulants, 53 Pyoktanin, 254 Pyrethrum, 440 Pyrogallic acid, 421 Pyrogallol, 421 Pyroxylin, 446 Pyroxylinum, 446 Quaker button, 296 Quassia, 397 extract of, 398 tincture of, 398 Quassiin, 398 Quercus, 422 Quevenne's digitalin, 331 iron, 152 Quicklime, 125 Quicksilver, 160 Quinamina, 351 Quinicine, 351 Quinidinae sulphas, 354 Quinidine, 351 sulphate, 354 Quininae bisulphas, 353 et strychininae phosphatum, 354 ureae hydrochloridum, 354 hydrobromidum, 353 hydrochloridum, 353 salicylas, 354 sulphas, 353 valeras, 354 Quinine, 351 and urea hydrochloride, 354 bisulphate, 353 hydrobromide, 353 hydrochloride, 353 salicylate, 354 sulphate, 353 valerate, 354 Quinoidine, 354 Quinoidinum, 354 Rabies, 546 prevention by Pasteur method, 547 treatment with Hogyes method, 548 vaccine, 547 Ray fungi of lumpy jaw, parasiti- cides against, 57 Rectal injection, 13 Rectified spirit, 212 Red mercuric iodide, 162 oxide, 161 ointment of, 161 precipitate, 161 ointment, 161 Reduced iron, 152 Reduction, 62 Refrigerants, 501 Resin, 371 cerate, 371 plaster, 371 Resina, 371 Resinae, 60 Resina jalapae, 414 podophylli, 417 scammonii, 414 Resins, 60 Resorcin, 254 Resorcinol, 254 Respiratory centers, drugs depress- ing, 42 drugs stimulating, 42 mucous membrane, drugs acting on the, 39 organs, drugs acting on, 39, 348 Rhamuns purshiana, 407 Rhatany, kino and catechu, 422 Rheum, 409 Rhubarb, 409 compound powder of, 409 extract of, 409 fluidextract of, 409 Ringworm, parasiticides against fungi of, 57 Rosin, 371 Roundworms, drugs used to de- stroy, 437 Rubber, adhesive plaster, 371 Rubefacients, 52, 494 Rules for Latin genitive, 80 Rum, 213 Ruminants, action of drugs on, 15 Rye, ergot of, 440 Saccharum, 431 lactis, 458 Sacred bark, 407 Sal ammoniac, 121 GENERAL INDEX 637 carolinum factitium, 113 soda, 110 Salicin, 360 Salicinum, 360 Salicylic acid, 359 Saline infusion, 517 purgatives, 24 Salol, 360 Salt, Carlsbad, 113 common, 114 Epsom, 131 Glauber's, 112 volatile, 120 Saltpetre, 106 Salvarsan, 171 Santonica, 437 Santonin, 437 Santoninum, 437 Sapo, 425 mollis, 426 Scab, parasiticides against mites of, 57 Scammoniae radix, 414 Scammony, resin of, 414 root, 414 Scarification, 516 Scarlet red, 380 Schmiedeberg's digitalin, 331 Scilla, 338 Scillin, 339 Scillipicrin, 339 Scillitoxin, 338 Scopolamine hydrobromidum, 288 Scopolamine hydrobromide, 288 Sedatives, gastric, 23 urinary, 47 Senna, 411 fluidextract of, 411 syrup of, 411 Sera, definition of, 529 Serum, anti-anthrax, 535 blackleg, 536 canine distemper, 539 hog cholera, 545 influenza, 541 white scours, 549 Sexual organs, drugs acting on the, 48 Sialagogues, 17 Silver, colloidal, 143 nitrate, 140 moulded, 140 Simple purgatives, 24 Sinapis alba, 377 Sinapis nigra, 377 "606," 171 Skin, drugs acting on the, 52 influencing blood vessels of the, 52 softening, soothing and pro- tecting, 54 used for action on, 366 Soap, 425 green, 426 hard, 425 liniment, 425 plaster, 426 soft, 426 liniment of, 426 Soda, 109, 110 washing, 110 Sodii benzoas, 376 bicarbonas, 110 bisulphis, 117 boras, 209 bromidum, 184 cacodylas, 171 carbonas, 110 monohydratus, 110 chloridum, 114 hydroxidum, 109 iodidum, 190 phosphas, 116 salicylas, 360 sulphas, 112 sulphis exsiccatus, 117 thiosulphas, 117 Sodium, 109 arsanilate, 171 benzoate, 376 bicarbonate, 110 bisulphite, 117 borate, 209 cacodylate, 171 carbonate, 110 chloride, 114 hydrate, solution of, 109 hydrocarbonate, 110 hydroxide, 109 solution of, 109 hyposulphite, 117 iodide, 190 perborate, 102 phosphate, 116 salicylate, 360 sulphate, 112 sulphite, exsiccated, 117 thiosulphate, 117 Soluble silver, 143 Solution, 61 Solutions, 63 Soporifics, 35 Spanish flies, 453 Spasm of bronchial muscular tunic. drugs relieving, 43 Special sense, drugs acting on, 38 Spermaceti, 457 Spigelia, 439 638 GENERAL INDEX Spinal cord, drugs acting on the, 36, 296 Spirits, 64 Spiritus, 64 aetheris, 220 nitrosi, 232 ammoniae, 118 aromaticus, 120 anisi, 386 camphorae, 392 chloroformi, 223 frumenti, 212 glycerylis nitratis, 232 juniperi, 391 compositus, 213 vini gallici, 213 Splenic fever, 533 Squill, 338 compound syrup of, 177, 339 fluidextract of, 339 syrup of, 339 tincture of, 339 Staphisagria, 440 Starch, 445 Stavesacre, 440 Stearoptens, 392 Stomachics, 18 Stovaine, 324 Strongyles, anthelmintics removing, 57 Strontii bromidum, 184 salicylas, 360 Strontium salicylate, 360 Strophanthin, 337 Strophanthinum, 337 Strophanthus, 337 tincture of, 337 Strychnina, 297 Strychininae hydrochloridum, 297 nitras, 297 sulphas, 297 Strychnine, 297 nitrate, 297 sulphate, 297 Stupes, 504 Styptics, 53 Subchloride of mercury, 162 Subcutaneous injection, 11 test for tuberculosis, 553 Sublimation, 62 Succus hyoscyami, 288 Sucrose, 431 Suet, mutton, 456 Sugar, 431 of lead, 137 milk, 458 Sulphate of quinia, 353 soda, 112 Sulphite of soda, 117 Sulphur, 197 lotum, 197 ointment, 197 praecipitatum, 197 sublimatum, 197 sublimed, 197 washed, 197 Sulphurated potassa, 200 Sulphuric acid, 202 Suppositoria, 65 glycerini, 427 iodoformi, 194 morphinae, 266 Suppositories, 65 prescription for, 95 Suppurants, 496 Suprarenals, dried, 447 Suprarenalum siccum. 447 Sweat, drugs influencing secretions of, 54 Sweet oil, 425 spirit of nitre, 232 Swine plague, 544 Syrup, 432 of Tolu, 375 Syrupi, 64 Syrups, 64 Syrupus, 432 acaciae, 430 acidi citrici, 204 hydriodici, 190 calcii lactophosphatis, 127 calcis, 126 cascarae sagradae aromaticus, 408 ferri iodidi, 153 phosphatis cum quinia et stry- chnina, 354 fuscus, 432 ipecacuanhas, 348 scillae, 339 compositus, 177, 339 sennae, 411 Tolutanus, 375 Tabacum, 312 Tables of weights and measures, 78, 79 Tannic acid, 419 glycerite of, 419 ointment of, 419 Tannigen, 421 Tannin, 419 Tannyl acetate, 421 Tapeworms, anthelmintics remov- ing, 56 drugs used to destroy, 432 Tar, 372 coal, prepared, 372 solution of, 372 ointment, 372 GENERAL INDEX 639 rectified oil of, 372 Taraxacum, 399 extract of, 399 fluidextract of, 399 Tartar emetic, 177 Tartarated antimony, 177 Tartaric acid, 203 Terebene, 367 Terebenum, 367 Terebinthina, 366 Canadensis, 371 Terpin hydrate, 367 Terpini hydras, 367 Tetanus, 548 antitoxin, 548 Tetraiodopyrrol, 195 Theine, 293 Theobroma, oil of, 445 Therapeutics, biological, 525 definition of, 7 Thiol, 463 Thiosinamina, 379 Thiosinamine, 379 Thrush, parasiticides against fungi of, 57 Thymic acid, 394 Thymol, 394 iodide, 196 Thymolis iodidum, 196 Thyroid glands, 192 dried, 447 Thyroideum siccum, 192 Tinctura asafcetidae, 389 aconiti, 340 aloes et myrrhae, 382, 403 belladonnas foliorum, 279 benzoini, 376 composita, 376 buchu, 390 calumbas, 399 camphoras composita, 392 cannabis indicae, 291 cantharidis, 453 capsici, 383 catechu, 422 cinchonas, 352 compositus, 352 digitalis, 331 ergotas ammoniata, 441 ferri chloridi, 153 perchloridi, 154 gambir composita, 422 gelsemii, 310 gentianae composita, 396 hydrastis, 400 hyoscyami, 288 iodi, 187 ipecacuanhas et opii, 265, 348 kino, 423 lobelias, 315 myrrhae, 382 nucis vomicae, 297 opii, 265 camphorata, 265 deodorata, 265 quassias, 398 quininas, 353 ammoniata, 353 scillas, 339 strophanthi, 337 Valerianae ammoniata, 388 veratri viridis, 344 Tincturas, 64 Tinctures, 64 Tobacco, 312 Indian or wild, 315 Tonics, 50 Tow, 446 Toxicology, definition of, 7 Tragacanth, 431 mucilage of, 431 Tragacantha, 431 Transtusion, 517 Treacle, 432 Treatment, epitome of, 564 Trikresol, 251 Triturates, 65 Trituration, 60 Triturationes, 65 Troy system, relative value of units in, 74 weight, 73 Tuberculin, 552 Tuberculosis, diagnosis of, 552 intradermal test for, 554 ophthalmic test for, 556 subcutaneous test for, 553 Turpentine, 366 Canada, 371 liniment, 366 oil of, 366 rectified oil of, 366 spirit of, 366 Tyramine, 441 U Unguenta, 65 Unguentum, 456 acidi borici, 209 carbolici, 244 salicylici, 360 tannici, 419 aconitinas, 340 belladonnas, 279 cantharidis, 453 capsici, 383 cetacei, 458 chrysarobini, 410 cocainas, 317 640 GENERAL INDEX eucalypti, 380 gallae, 418 cum opio, 419 hamamelidis, 424 hydrargyri, 161 hydrargyri ammoniati, 162 oxidi flavi, 161 nitratis, 162 oxidi rubri, 161 iodi, 187 m iodoformi, 194 phenolis, 244 picis liquidae, 372 plumbi iodidi, 138 resinae, 371 sulphuris, 197 veratrinae, 346 zinci oxidi, 145 United States Pharmacopeia, 63 Urinary antiseptics, 47 sedatives, 47 organs, drugs acting on the, 44 Urine, drugs influencing composition of, 47 reaction of 46, Urotropin, 257 Vaccine, anthrax spore, 535 blackleg, 537 canine distemper, 539 rabies, 547 Vaccines, definition of, 529 Valerian, 387 fluid extract of, 387 Valeriana, 387 Vaseline, 262 Vegetable bitters, 396 cathartics, 402 demulcents, 425 drugs, 264 Venesection, 514 Veratrina, 346 Veratrine, 346 Veratrum album, 345 viride, 344 fluidextract of, 344 ' tincture of, 344 Verdigris, 149 Vermicides, 56 Vermifuges, 56, 57 Vesicants, 52 and the actual cautery, 495 Vetol, 325 Vina, 64 Vinegars, 64 Vinum opii, 266 Volatile oils, 365 salt, 120 W Water, 99 distilled, 99 Waters, 63 Wax, white, 457 yellow, 457 Weight, troy or apothecaries', 73 Weights and measures, tables of, 78, 79 Wet pack, 499 Whisky, 212 White arsenic, 170 lead, 137 lotion, 140 mustard, 377 oak, 422 petrolatum, 262 precipitate, 162 ointment, 162 scours in calves, 549 vitriol, 144 Wild cherry, 261 Wine measure, 74 relative value of units in, 74 units, equivalents of, in domestic measures, 75 Wines, 64 Wintergreen, oil of, 364 Witch-hazel, 424 Wool fat, anhydrous, 457 hydrous, 456 Wormseed, American, 439 levant, 437 Yellow jessamine, 310 mercuric oxide, 161 ointment of, 161 Yohimbine hydrochloride, 324 Zinc acetate, 145 carbonate, precipitated, 145 chloride, 143 solution of, 144 oxide, 145 ointment of, 145 peroxide, 102 sulphate, 144 valerate, 388 Zinci acetas, 145 carbonas Praecipitatus, 145 chloridum, 143 oxidum, 145 sulphas, 144 valeras, 388 Zingiber, 383 ,. v." 4.1062