Class Book-.: GopyrightN ^ COPYRIGHT DEPOSIT. ENLARGED AND REVISED TO 1854. THE MEDICAL FORMULARY: A COLLECTION OF PRESCRIPTIONS, DEBITED FEOM THE WETTINGS AND PRACTICE OF MANY OF THE MOST EMINENT PHYSICIANS IN AMERICA AND EUROPE. TOGETHER WITH THE USUAL DIETETIC PREPARATIONS AND ANTIDOTES FOR POISONS. OV^VR/c TO WHICH IS ADDED AN APPENDIX, / ON THE $ 3 ENDERMC USE OF MEDICINES, AND ON THE USE OF ETHER AND CHLOROFORM. THE WHOLE ACCOMPANIED WITH A FEW BRIEF PHARMACEUTICAL AN T D MEDICAL OBSERVATIONS. BY BENJAMIN ELLIS, M.D., LATE PROFESSOR OF MATERIA MEDICA AND PHARMACY IN T THE PHILADELPHIA COLLEGE OF PHARMACY. TENTH EDITION, REYISED AND MUCH EXTENDED. BY ROBERT P. THOMAS, M.D., PROFESSOR OF MATERIA MEDICA IN THE PHILADELPHIA COLLEGE OF PHARMACY. : Alorbos autem, non eloguentia sed remediis curari." — Cels. De Med. lib. i. PHILADELPHIA: BLANCHAKD AND LEA 1854. Entered according to the Act of Congress, in the year 1853, by BLANCHARD AND LEA, in the Office of the Clerk of the District Court of the United States in and for the Eastern District of Pennsylvania. run, \di:i,i'hia : T. K. AND P. <;. OOLLINS, PBINTER8. TO N. CHAPMAN, M.D., PROFESSOR OF THE INSTITUTES AND PRACTICE OF MEDICINE AND CLINICAL PRACTICE IN THE ETC. ETC. WHOSE TALENTS AND URBANITY HAVE RAISED HIM TO THE FIRST RANK IN THE PROFESSION, AND HAVE ACQUIRED FOR HIM THE CONFIDENCE AND ESTEEM OF A LARGE AND ENLIGHTENED COMMUNITY, THIS WOEK IS VERT RESPECTFULLY DEDICATED BY HIS OBLIGED FRIEND, THE AUTHOR. EDITOR'S PREFACE The lamented decease of Dr. Samuel George Morton, since the appearance of the last edition,, has rendered it necessary to place this work in other hands. During the lifetime of its author, Dr. Morton afforded a friendly revision of the first two editions, and after his death assumed the editorial charge of the seven succeeding editions. Being intimately acquainted with the author's views, he faithfully carried them out, by adding, from time to time, standard formulae from the best writers. Influenced by similar feelings, the present Editor has made a careful selection of a large number of prescrip- tions from the leading American and foreign authorities ; in most instances, giving a preference to those which serve to introduce the new remedies announced in the last few years. Some of the old formulae have been omitted, and others less complicated have been substi- tuted. To all of the additions, the word " Editor" or the names of their authors have been scrupulously placed. The arrangement of the original work, founded on that adopted by Dr. Chapman in his Therapeutics, has been retained for internal remedies, which constitute the subject-matter of Book I. But for convenience of refer- vi editor's preface. ence, it lias been thought advisable to bring together under a common head those intended for external use. Accordingly, Book II. has been devoted to external applications. This course appeared the more indis- pensable from the fact that the true therapeutic value of a large number of the articles used in the skin dis- eases has not yet been tested by time and experience. The table of the doses of medicines has been entirely rewritten, and the present Editor is alone responsible for any errors therein contained. The various changes in nomenclature that have oc- curred during twenty years, have caused much discre- pancy in prescribing, and much difficulty in compound- ing. To obviate these, all the formulae embracing officinal articles have been brought to the standard of our National Pharmacopoeia, for the double purpose of extending a practical knowledge of its terminology among prescribers, and of facilitating as well as simpli- fying the duties of the apothecary. ROBERT P. THOMAS. Philadelphia, October, 1853. CONTENTS Preface of the Editor . Preface of the Author Introduction Table of Drops Table of Abbreviations Table of Doses for Children Table of the Doses of Medicines Tabular View of the Doses of the Principal Articles of the Materia Medica ..... xxiii PAGE v xi xv xvii xix xx xxi BOOK I. OF INTERNAL REMEDIES. Class I. Emetics . 35 Powders . 36 Wines and Tinctures 38 Solutions and Mixtures . 39 Various Emetic Preparations' 42 II. Cathartics 43 Powders . 44 Pills 47 Confections and Electuaries 52 Emulsions 53 Mixtures . 55 Infusions and Decoctions 58 Wines and Tinctures 60 Enemata 61 Suppositories 63 III. Diuretics 65 Powders . 65 Pills 66 Infusions and Decoctions 68 Solutions and Mixtures , 70 Vlll Ll CONTENTS. Class page IV. Antilithics and Lithdntriptics . . . .76 Powders . 76 Pills 77 Solutions and Mixtures . 77 V. Diaphoretics . 79 1. Ordinary Diaphoretics ' 80 Powders 80 Mixtures 82 Infusions 86 2. Alterative Diaphoretics 87 Pills 87 Decoctions . 88 Mixtures 90 VI. Expectorants 92 Powders, Pills, and Lozenges 92 Sirups 96 Mixtures . 98 Inhalation 107 VII. Emmenagogues 110 Powders and Pills . 110 Decoctions and Infusions 113 Tinctures . 114 VIII. Anthelmintics . 117 Powders and Pills . 117 Infusions and Decoctions 120 Electuaries and Mixtures 121 Clysters . 123 IX. Stimulants . . 124 Powders and Pills 124 Mixtures and Infusions . . 126 X. Narcotics 133 Pills 133 Mixtures and Tinctures . . 137 Clysters and Suppositories 142 External Use of Narcotics 143 XI. Antispasmodics 147 XII. Sialagogues . 151 XIII. Tonics 155 1. Anti-intermittents 155 Powders and Pills . 155 Decoctions and Infusions 159 Solutions and Mixtures 161 2. Ordinary tonics 164 Powders and Pills . 164 Decoctions and Infusions . 170 Mixtures and Tinctures 172 CONTENTS. IX Class page XIV. Alteratives ... . 177 Powders and Pills " 177 Tinctures and Mixtures 181 XV. Astringents . 190 Powders and Pills 190 Mixtures and Infusions 194 XVI. Absorbents or Antacids 198 Powders and Pills . 198 Mixtures and Solutions . 199 BOOI L II. OF EXTERNAL APPLICATIONS. XVII. Caustics or Escharotics . - 205 Issues and Setons 209 XVIII. Epispastics .... 211 XIX. Rubefacients 215 XX. Anomalous External Applications . 222 A. Collyria 222 Powders 222 Solutions and Mixtures 223 B. Injections 228 a. For the Ear 228 b. For the Urethra . 230 C. Gargles and Mouth "Washes 233 D. Liniments, Lotions, &c. 237 E. Ointments 245 Powders ... 252 F. Cataplasms . 253 G. Baths . 255 H. Fomentations 257 I. Fumigations . 258 BOOK III. OE DIETETIC PREPARATIONS AND POISONS. Dietetic Preparations . . . . . . . 261 Poisons ..... . 269 Appendix I. Endermic Use of Medicines , 278 II. Use of Ether and Chloroform . . 280 Index ...... 285 PREFACE. The elegant and judicious formation of prescriptions is one of the difficulties which the young practitioner in medicine is obliged to encounter. While a student, he is compelled, from the circumstances under which he is placed, to confine his attention to the leading principles of the science. Consequently, the minor points (and the art of directing medicines is considered one of them) are postponed to that period when he shall have undertaken the practical duties of his pro- fession. To obviate, in some measure, the inconvenience which the graduate at first experiences, the volume now offered the public was undertaken and executed. It contains, in a condensed form, and we think advantageously ar- ranged, many of the most important prescriptions em- ployed in modern practice, and which, though most of them may be already recorded, are scattered through various medical works. The arrangement framed by Professor Chapman for his Therapeutics, appearing to combine greater advan- tages than any other, we have taken the liberty of adopting it as the basis of this Formulary. Xll PREFACE. Each Class has been subdivided into Powders, Pills, and Liquids ; without any attempt to preserve the dif- ferent preparations of the same article together, but only with a view to convenience. A few concise rules will be found prefixed to each Class, and observations have been attached to those prescriptions which possess peculiarities either in their composition or effects. The application of the remedies to diseases has been generally left to the judgment of the practitioner, and therapeutical detail as much as possible avoided, as it would have been inconsistent with the nature and design of the work. The object is to furnish models for extemporaneous formulae, the proportions of which may be either in- creased or diminished, according to the age, sex, consti- tution or idiosyncrasy of the patient, all of which are to be taken into consideration when a prescription is di- rected, as well as the climate and peculiar epidemic which may be prevailing. The prescriptions have been couched in the Latin language, and the names of the several articles will be found regularly terminated. The design was to furnish something like a Medical Grammar, to those unacquaint- ed with the dead language ; and even those versed in the classics, may occasionally find words used in pre- scriptions which are new to them. A series of Dietetic preparations and the principal poisons have been placed in Book III. The former are written in the English language, and it is hoped that they may be found useful in furnishing directions neces- sary to be given to the nurse. PREFACE. Xlll The latter are those Poisons which are usually taken by accident or design, with their appropriate antidotes and some practical observations. Appendix No. I. contains some concise remarks on the mode of using remedies on the " Endervnic plan" as well as the quantities employed, and the effects produced by several of the most potent remedial agents. 1 The materials for the work have been collected from various sources, the writings of different authors, pe- riodical journals, manuscripts, and the contributions of our friends. It is hoped, therefore, that the difficulties which have attended its progress will form some apology for the errors which it may possibly be found to contain. As a reason for not more frequently attaching the names of authors to the prescriptions, it may be observed that they are a kind of common medical property, which every physician feels himself privileged not only to em- ploy, but modify as may best correspond with his own views. It is, therefore, difficult to say to whom many of them belong; they have been touched, and retouched, till they have lost their identity. In conclusion, we beg leave to present our acknow- ledgments to some of our friends for the encouragement they have given to the undertaking. To Dr. Chapman we are particularly indebted for the kindness and inte- rest he has manifested in its publication, and offer to him (the only return we can make), our warmest thanks. 1 Appendix No. II. is a concise and able article on the use of Ether and Chloroform, drawn up by the late Dr. Morton, to which the attention of the reader is directed. XIV PKEFACE. It is with particular pleasure we embrace this opportu- nity of expressing our obligations to our friend Dr. S. G. Morton, whose intimate acquaintance with the sub- ject, and classical knowledge, are only equalled by the kindness and industry he has displayed in facilitating the work. There are others whose names it would gratify us to mention, but who, we know, will be more pleased by our silence. The countenance they gave us on the present occasion has only increased the debt previously incurred. B. E. INTRODUCTION Befoee entering upon the main object of this work, it is necessary to notice a few circumstances which per- tain more especially to Pharmaceutic Chemist^ yet appear to be called for in this place ; and though they are familiar to every educated physician, may be useful to the student who has not yet turned his attention to prescriptions. In the first place, it is requisite to be well acquainted with the signs of quantity, or those symbolic characters which are used in writing prescriptions. In the ancient practice of medicine, there were very many of these symbols, not only for the purpose of denoting the quan- tity of the ingredient, but the ingredient itself. Most of these, however, have become obsolete ; and a few only are retained as indispensable to the convenience of the practitioner. These will be found in the following Table, which is adopted in the Pharmacopoeias for the regulation of weights. English. Name. Latin Name. Symbol. Contains. A pound, An ounce, A dram, A scruple, Libra, Uncia, Drachma, Scrupulus, ft, 3, d, 12 ounces. 8 drams. 3 scruples. 20 grains. XVI INTRODUCTION. In the manipulation of liquid substances, measures have in most countries superseded the use of weights. The Table of Measures recommended by the London College, gives particular names and symbols to the parts forming a gallon,, in order to prevent their being con- founded with those denoting weights ; as in the follow- ing Table : — English Name. Latin Name. Symbol. Contains. A gallon, A pint, A fluidounce, A fluidram, Congius, Octarius, Fluiduncia, Fluidrachma, none, o, n, f3, 8 pints. 16 fluidounces. 8 fluidrams. 60 minims. The minims used in the Table, have been adopted in the United States Pharmacopoeia in place of drops; and although we have not employed this measure in our prescriptions, yet we can readily perceive it to possess some important advantages over the ancient practice. The symbol (k) is sometimes used by medical writers, though very improperly, to denote both minims and drops. 1 The size of a drop varies according to the greater or less fluidity and gravity of the liquid, and the shape of the vessel from which it is dropped ; but, as a general rule, we cannot do better on these occasions than use a small phial with a thin edge. Dr. Dorsey observes that, whenever great precision is necessary, it is easy to dilute the active medicine, and give it in form of a mixture. If sixty grains be diffused in six ounces of water, for instance, each half ounce will contain five. 1 Tss. to j. Inula, 9j. to 3j. Iodinium, gr. i to j. Iodinii, Tinctura, gtt. v. to x. Iodinii Compositus, Liquor, gtt. v. to x. Composita, Tinctura, gtt. xv. to xxx. Ipecacuanha, gr. ij. to xx. Ipecacuanhas, Syrupus, f 3j • *° ij* , Vinum, f3j- to iv. Ipecacuanhas et Opii, Pulvis, gr. x. Jalapa, gr. x. to xx. Jalapa), Extractum, gr. x. to xv. ■ , Tinctura, f 3j- to ij. Juglandis, Extractum, gr. xx. to xxx. Juniperi, Baccae, 5j- to ij. , Oleum, gtt. v. to xv. Compositus, Spiritus, f3j. to iv. Kino, gr. x. to xx. , Tinctura, fjj. to ij. Kousso, Flores, 3ss. Krameria, gr. xx. to xxx. Krameria), Extractum, gr. x. to xx. , Syrupus, f 3j. to ij. Lactucarium, gr. iij. to x. Lappa, 5j. Lauro-Cerasi, Aqua, f3*s. to j. Lavandula), Oleum, gtt. ij. to v. Compositus, Spiritus, f 3ss. to j. Liriodendron, 3* H - to ij. Lobelia, gr. v. to x. Lobelia) Tinctura, gtt. xx. to f3j- Lugol's Solution, gtt. v. to x. Lupulina, gr. v. to x. Lupulinae, Tinctura, f3j. Magnesia, 3ss. to j. Magnesia) Carbonas, %sa. to j. Citratis Liquor, f^iv. to Sulphas, 3j. Magnolia, 3ss. to j. Manganesii Oxidum gr. iij. to x. Iodidi, Liquor, gtt. x. to xxx. Sulphas, 9j. to 3ij. Manna, ^j. Mannite, 3j. Matico, 3ss. to ij. Matricaria, 3ss. to j. MenthaePiperitae,01eum,gtt.j.toij. — , Tinctura, gtt. x. to xx. Aqua, f^ss. Menthae Viridis, Aqua, f^ss. Mezerei Decoctum, f 3ij. to iv. Mistura Creta), f ifss. to j. Monardse Oleum, gtt. ij. to iij. Morphia? Acetas, gr. £. Murias, gr. £. — Sulphas, gr. £. Sulphatis, Liquor, f3j. to ij. Moschus, gr. x. Mucunse Electuarium, f3j. to f^ss. Myrrha, gr. x. to xx. Myrrhse Tinctura, f3ss. to j. Naphthaline, gr. ij. to xv. Nucis Vomicae, Extractum, gr. ss. to j. Nux Vomica, gr. iij. to v. Oleum Amygdalao Amarae, gtt. £ to j. Anisi, gtt. v. to x. Oajuputi, gtt. ij. to v. — Limonis, gtt. ij. to iv. — Morrhua), f^ss. — Oliva), f3j- — Pimcntsc, gtt. ij. to v. — Kicini, f3j. — Kosmarini, gtt. ij. to iij. TABLE OF DOSES, ETC. XXV11 Oleum Rutae, gtt. ij. to iij. Sabinae, gtt. ij. to iij. Sassafras, gtt. iv. to vj. Succini Rectificatum, gtt. v. to xv. Terebinthinae, gtt. x. to f3ij. Tiglii, gtt. i to ij. Opium, gr. j. Opii, Acetum, gtt. x. , Confectio, gr. x. , Extractum, gr. ss. , Tinctura, gtt. xx. to xxv. Acetata, Tinctura, gtt. xx. Camphorata, Tinctura, fJJ. to ij. ,Vinum, gtt. xx. to xxv. ,McMunn's Elixir, gtt. xx. to xxv. Pareira, 3ss. to j. Petroleum f3ss. to 3j« Phloridzin, gr. x. to xij. Piperis Fluidum, Extractum, gtt. j. to iij. Pix Liquida, 3 SS - to j* Plumbi Acetas, gr. j. to iij. Iodidum, gr. ss. to iij. Nitras, gr. \ to $. Podophylli, Extractum, gr. v. to xv. Podophyllin, gr. ss. to ij. Potassae Liquor, gtt. x. to xx. Arsenitis, Liquor, gtt. x. Acetas, 9j. to 3ij. Bitartras, 3j • to ij . Carbonas Purus, gr. x. Bicarbonas, gr. x. to 3ss. Chloras, gr. x. to xxx. Citras, gr. xx. to xxv. Citratis, Liquor, f ^ss. Nitras, gr. x. to xv. Sulphas, Jss. to j. Tartras, 3j- to i§ss. Potassii Bromidum, gr. iij. to x. Cyanuretum, gr. -J to I. Ferrocyanuretum, gr. x. to xv. Iodidum, gr. iij . to x. Sulphuretum, gr. ij. to vj. Prunus Yirginiana, 3 SS - to j. Pruni Virginianae, Infusum, f ^ij. , Syrupus, fjss. Pulvis Aromaticus, gr. x. to xx. Doveri, gr. x. Quassias, Extractum, gr. ij. to v. ■, Tinctura, f3j- to ij. Quercus Alba, et Q. Tinctoria, gr. xx. to3j^ Quiniaa Sulphas, gr. j. to x. Valerianae, gr. ij. to vj. et Ferri Citras, gr. iij. to x. Rhamni Syrupus, f ^ss. Rheum, 9j. to 3ss. Rhei Fluidum, Extractum, f 5ss. Aromaticus, Syrupus, f 3j * t° iv. , Tinctura, f§ss. , Yinum, f 3ij. Rubia, 9j. to 3ss. Rubus Yillosus, et R. Trivialis, 9j « to 3ss. Sabbatia, 3 SS - to j. Sabina, gr. v. to x. Sabinae Oleum, gtt. ij. to iij. Salicin, gr. ij. to x. Sanguinariae Tinctura, f 3ss. to j. Santonine, gr. iij. to iv. Sarsaparillae, Extractum, gr. x. to Fluidum, Extractum, Compositus, Syrupus, fgss. Scammonium, gr. v. to xv. Scilla, gr. j. to ij. Scillae, Acetum, f3ss. to j. , Syrupus, f 3j. Compositus, Syrupus, f3ss. to j. Oxymel, f 3j. to ij. Senega, gr. x. to xx. Senegas Syrupus, f 3j • to ij* Senna, 3ss. to 3ij« Sennae Confectio, 3j« to ij. Fluidum, Extractum, f]fss. Serpentaria, gr. x. to xxx. Serpentarias Tinctura, f 3j. XXVU1 TABLE OF DOSES, ETC Simaruba, 9j. to 3j« Sinapis (as an emetic), 3ij» Sodae Acetas, 9j. to 3j» Boras, 9j. to ij. Carbonas, gr. v. to xx. Bicarbonas, gr. x. to xxx. Pbospbas, ^ss. to j. Sulpbas, iss. et Potassae Tartras, %\], to jfss. Sodii Cbloridum, gr. x. to 3y« Spigelia, gr. x. to 3j. Spigelise et Sennas Fluidum, Ex- tract, f 3j- to f^ss. Spiritus JEtberis Nitrici, f 3j. Spiritus j3Stheris Compositus, f 3j. Spiritus Pyroxilicus, gtt. x. to xl. Stanni Pulvis, ^ss. Stramonium, gr. j. to ij. Stramonii Foliorum, Extractum, Seminis, Extractum, gr. 1 to h Tinctura, gtt. xx. to xxx. Strycbnia, and its salts, gr. -j- 1 ^ to i. Styrax, gr. x. to xx. Sulphur, 9j. to 3ij. Sulpburis Iodidum, gr. j. Tabacum, gr. j. to v. Tabaci, Vinum, gtt. x. to xx. Taraxaci, Extractum, 9j. to 3j« Terebintbina, 9j. to ij. Testa praeparata, gr. x. to 1. Ulmi, Infusum, ad libitum. Uva Ursi, 3ss. to j. Valeriana, 3ss« to j. Valerianae Fluidum, Extractum, , Oleum, gtt. v. , Tinctura, f 3j to ij. Veratrum Album, gr. j. to iij. Veratri Albi Vinum, gtt. x. to xx. Veratrum Viride, gr. j. to iij. Veratria, and its salts, gr. jV to £. Zinci Acetas, gr. j. to ij. Chloridum, gr. \ to ij. Cyanuretum, gr. -^ to \. Oxidum, gr. ij. to v. Sulpbas, gr. j. to x. Valerianas, gr. j . to ij . Zingiber, gr. x. to xx. Zingiberis Tinctura, f 3j« BOOK I OF INTERNAL REMEDIES CLASS I. EMETICS. Emetics are medicines which excite vomiting, independently of any effect arising from the mere quantity of matter intro- duced into the stomach. In the administration of Emetics a few simple rales are worthy of attention. Whatever may be the apparent necessity for emptying the stomach, we must take into consideration all the circumstances of the case, and more particularly if there be much arterial excitement with determination to the head ; for where these symptoms are present, bloodletting should be some- times premised. When it is required, as in cases of poisoning, a full dose of the emetic substance is to be administered ; but in the generality of instances, it is better to give it in divided doses, frequently repeated, until the desired effect is produced. In cases of torpor or congestion, it is sometimes requisite to arouse the system by retching or vomiting, which may be done by administering the emetic with only a small quantity of fluid ; but when the object is to empty the stomach and duodenum merely, free draughts of tepid water or weak chamomile tea ought to be given as soon as nausea takes place. When poisons have been taken, our object is to evacuate the stomach as speedily as possible, and for this purpose we select an emetic which is prompt in its action. But where the excit- ability of the stomach is greatly diminished by a Narcotic, it is necessary to assist the emetic by the addition of some excitant. When such an effect is caused by opium, the system may be generally rendered susceptible by the use of vinegar, mustard, or ammonia. In these cases, however, the stomach-tube is our best resource. The evacuation of the stomach may be greatly facilitated by tickling the fauces with a feather, or introducing the point of the finger as far back as possible and titillating the parts. If 36 EMETICS. this fails, a resort to another article of the same class will often accomplish the object. There are a few cases in which emetics are obviously inad- missible, as in apoplexy, or where there is great determination of blood to the head, depending upon constitutional causes; pregnancy; hernia; prolapsus uteri ; active hemorrhage from the lungs and uterus ; acute gastritis, &c. If emetic medicines are ever allowable in these diseases it is for the most part in nauseat- ing doses only. By the frequent use of emetics the stomach acquires an in- creased susceptibility to their action ; hence persons of delicate habits should use them cautiously. When excessive vomiting occurs, it may be checked by resort- ing to some one or more of the following resources : — Ice, broken into small pieces and allowed to dissolve in the mouth. Lime-water and milk, a tablespoonful of each, mixed cold and given at intervals of fifteen or twenty minutes. A drop or even half a drop of creosote, mixed in a wine- glass of cold water, of which give a teaspoonful every 15 or 20 minutes. The infusion of camphor made with boiling water and given cold, a teaspoonful frequently repeated. Brandy and water, and clove and green tea, conduce to the same. end; and where other internal means fail in irritable con- stitutions, an anodyne injection will sometimes accomplish the object. Among external appliances, mustard to the epigastrium is one of the best; also, spice-plasters and hot fomentations of brandy and cloves. EMETIC POWDERS. Powder of Ipecacuanha. R. Pulveris Ipecacuanhas, 9ij. Divide it into two doses. Signa. — One to be taken in a little molasses or sugar and water, and followed by a draught of tepid water. If one powder does not produce the desired effect, the second to be taken in like manner. Powder of Ipecacuanha ivitli Tartarized Antimony. K. Pulveris Ipecacuanha), 3ss. Antiinonii ct Potassse Tartratis, gr. ij. Misce,e1 divide in pulveres ij. — To be taken in the same manner as the former, EMETICS. 37 Tartar emetic increases the efficacy of ipecacuanha, producing a more prompt and certain effect than the latter drug. This combination is an eligible one in most cases where emetics are indicated. When tartar emetic is given alone, it is generally in solution, a formula for which will be found below. Powder of Alum. R. Aluminis, 3J. Fiat pulvis. This is highly recommended by Dr. Meigs in croup. " It is best given in the state of fine powder, mixed with honey, sirup of any kind, or molasses." The dose is a teaspoonful, to be repeated every fifteen minutes until free emesis is produced. Meigs. Turpeth Mineral. R. Hydrargyri Sulphatis flavi, gr.xij. Divide in pulveres iv. Dose, one powder for a child three years old, to be repeated, in croup, every fifteen minutes, until emesis is produced. " If the first dose fails, the second usually acts as soon as it touches the stomach." Hubbakd. In cases of narcotic poisoning it is necessary to resort to the most prompt and certain means of evacuating the stomach. Ipecacuanha was formerly thought to be a specific for poisoning by opium, but experience has shown that mustard, salt, alum, turpeth mineral, and the sulphates of zinc and copper are more reliable. Powder of Mustard. R. Pulveris Sinapis, |j. Signa. — Take a teaspoonful in a cupful of tepid water every ten minutes. This is a very prompt and safe emetic. Emetic of Common Salt. R. Sodii Chloridi, I]. Signa. — Administer one-half in a cupful of warm water, and repeat the dose in ten minutes. Salt frequently proves a prompt and efficient emetic, invigor- ating rather than depressing the powers of the system. 38 EMETICS. Powder of Sulphate of Copper. R. Cupri Sulphatis, gr. ij. Signa. — To be given in a little sirup and water. This medicine is seldom employed as an emetic except in those cases of poisoning where other articles have failed, or are not at hand. It should be followed by a large draught of warm water. All vegetable astringent infusions are incompatible substances. Powder of Sulphate of Zinc. R. Zinci Sulphatis, gr. x. vel 3ss. Signa. — To be taken in molasses, and followed by a draught of warm water. This medicine is very prompt in its operation and very generally employed in cases of poisoning. It is also used as a nauseating remedy in phthisis; and both as an emetic and tonic in dyspepsia. The stomach is said to be invigorated, rather than exhausted by its operation. Powder of Ipecacuanha and Calomel. R. Pulveris Ipecacuanhas, gr. viij. Hydrargyri Chloridi Mitis, gr. v. Misce. This powder generally proves both emetic and purgative in a child five years old. < Powder of Ipecacuanha with Rhubarh. R. Pulveris Ipecacuanhas, Khei, aa 9j. Misce. Signa. — To be taken in sirup. More or less purging will generally follow the emetic opera- tion of this dose. EMETIC WINES AND TINCTURES. Wine of Ipecacuanha with Antimony. R. Yini [pecacuanhae, fSj. Ant iinonii et PotasS89 Tartratis, gr. j. Fiat solutio. Signa,— A teaspoonful to be taken every ten or fifteen minutes, until vomiting is induced, which may be assisted with tepid drinks. EMETICS. 39 Antimonial Wine. R. Villi Antimonii, f 3j. Signa. — A teaspoonful to be taken every ten or fifteen minutes, until free emesis is effected. If antimonial wine is given for the purpose of producing speedy vomiting, we may safely give half an ounce of it at once ; and in the croup of infants, twenty drops every fifteen minutes, until the medicine operates, is a safe dose. Tincture of American Hellebore. R. Eadicis Yeratri Viridis, 3viij. Alcoholis, Oj. Macera per dies decern, vel quatuordecim, et exprime. Signa. — Dose for an adult, six to eight drops every three hours, and to be increased one or two drops each dose, until nausea, vomiting, or a reduction of the frequency of the pulse takes place. Then reduce to one-half in all cases. Norwood. Dr. Norwood describes this article as a good diaphoretic, a prompt and efficient emetic, and an arterial sedative of the first rank. He recommends its use in hooping-cough, croup, inflam- mation of the lungs, and typhoid fever. — Southern Med. and Surg. Journal, Jan. 1853. Tincture of Lobelia. R. Tincturse Lobelise, f 3j. Signa. — Give a teaspoonful every two hours in asthma. This quantity will produce distressing nausea in other dis- eases, and sometimes will even cause vomiting. EMETIC SOLUTIONS AND MIXTUEES. Solution of Tartrate of Antimony. R. Antimonii et Potassse Tartratis, gr. iv. Sacchari, 5j- Aquae destillataa, f^iv. Misce, et fiat solutio. — A tablespoonful to be given every ten or fifteen minutes, until it operates freely. Solution of Suljohccte of Zinc and Alum. R. Zinci Sulphatis, Jiss. Aluminis, 3ss. Aquse ferventis, Oss. Misce. — Let the solution be filtered through blotting-paper. — A 40 EMETICS. tablespoonful for adults, and a teaspoonful for a child of six months old (and so on in proportion to the strength and age of the patient), every morning upon an empty stomach. This is the celebrated solutio vitriolica of Dr. Mosely, who principally employed it in dysentery and phthisis pulmonalis. Solution of Emetia. R. Emetine fuscas, gr. iv. Aquas destillatas, f Jij. Syrupi, f ^ss. Fiat solutio. Signa. — Give two teaspoonsful every half hour. Emetia is destitute of the peculiar odor and nauseous taste of ipecacuanha, and may therefore be preferable in some cases. It will be observed that we have introduced the impure or colored emetia, which is much less energetic than the perfectly white alkali. The best antidote for an overdose, is a strong infusion of nuto^alls. Mixture of Ipecacuanha, &c. R. Pulveris Ipecacuanhas, 3ss. Antimonii et Potassas Tartratis, gr. j. Tincturas Scillas, f^j. Aquas destillatas, f^vij. Fiat mistura. Signa. — Four tablespoon sful at first ; afterwards two tablespoonsful every ten minutes until vomiting is in- duced. This mixture is recommended in dropsies previously to giving digitalis. Infusion of Ipecacuanha. R. Pulveris Ipecacuanhas, 3ij. Aquas bullientis, f3vj. Macerate for one hour and filter. — Of this from one to two table- spoonsful may be given every half hour, until it excites vomiting. Infusion of Lobelia Injlata, or Indian Tohacco. R. Lobelias, §j. Aquas bullientis, Oj. Fiat infusio. Signa. —A small wineglassful may be taken every half hour, until vomiting succeeds. This remedy is too hazardous and distressing for ordinary but in asthma, and some spasmodic affections, much bene- EMETICS. 41 fit is often experienced. It should, however, be administered with extreme caution. Infusion of Tobacco. R. Tabaci, 3j. Aquas bullientis, Oj. Macera per horam unam in vase leviter clauso, et cola. This infusion is characterized by the nausea and depression following its administration. It is only used for strangulated hernia, to reduce dislocations, for obstinate colic, and in spasm of the urethra. One-half of the above may be employed at one time as an enema, to be followed by the remaining portion in thirty minutes, if sufficient relaxation is not produced. One or two tablespoonsful by the mouth generally prove emetic. Sirup of Seneha and Squills. R. Syrupi Scillas Compositi, f^j. Signa. — Give from ten drops to a teaspoonful, every quarter or half hour, or hour, according to the age of the patient and violence of the disease. This is the hive sirup of Dr. Coxe ; it has acquired much con- fidence from its efficacy in croup ; and should it not be suffi- ciently active in this violent disease, a grain of tartrate of antimony may be added to each ounce. Sirup of Ipecacuanha. R. Syrupi Ipecacuanhas, f^j. Signa. — Give a teaspoonful to a child two years old, every fifteen minutes until it proves emetic. As one fluidounce'only represents fifteen grains of the pow- dered root, this must be considered a weak preparation. The following formula employed in New York, I consider better : When made it affords three pints of sirup, which keeps well without crystallization. A fluidounce of this sirup is equiva- lent to one dram of powdered ipecacuanha. Sirup of Ipecacuanha. "R. Take of Ipecacuanha, bruised, six ounces (troy), Alcohol, one pint and a half Water, one pint. Mix, to form a tincture. Digest for ten days, filter and add one pint of water by way of displacement, evaporate in a water -12 • EMETICS. batli to two pints, add immediately, of refined sugar, three pounds and a quarter (troy) and bring to the boiling point." COGGESHALL. The dose as an emetic, and modes of using, are the same as above. Editoe. VARIOUS EMETIC PREPARATIONS. Tartar Emetic and Quinia. B. Antimonii et Potassoe Tartratis, gr. iij. Quinia) Sulphatis, gr. x. Misce, et divide in partes vj. equales. — This preparation is com- mended hy Dr. Grola as successful in intermittent fever, when quinia alone produced no favorable result. He directs a powder to be given every two hours during the apyrexia. It causes both emesis and alvine evacuations, and prevents the recurrence of the paroxysm. Emetic Lozenges of Emetia. B. Sacchari, j|ij. Emetiae Impurae, gr. xxxij. Misce, et fiant trochisci singuli gr. xviij. One of these lozenges, taken fasting, will generally produce vomiting in children. Three or four will speedily excite it in adults. Magendie. Tobacco Poultice. R. Tabaci, Ij. To be beat up with sufficient water to form a cataplasm, and ap- plied to the region of the stomach, when emetics cannot be administered by the mouth. A dram or two of snuff mixed with lard, or a single tobacco-leaf bruised and softened with hot water and applied over the sternum of a child in croup, usually provokes vomiting. The utmost care should be taken to guard against the violent effects of tobacco, even when thus externally applied. CLASS II CATHARTICS. As a general rule it may be observed of cathartics that they are capable of fulfilling three different indications: 1. Simply to evacuate the bowels; 2. To excite an increased discharge from the mucous coat of the intestines ; and 3. To stimulate the neighboring viscera, and cause them to secrete a greater quan- tity of their peculiar fluids. It seldom or perhaps never hap- pens that the same article will produce these three different effects ; and in order to accomplish them, we must combine different substances in one formula. There are some, as magnesia, that produce their effect by absorbing the acid generated in the alimentary canal, and thus become converted into a purgative salt. There are others, as aloes, that expend their principal force upon the rectum and great intestines, and for this reason are very advantageously employed in diseases of the lower bowels and of the uterus and its appendages. These remedies should always be given on an empty stomach ; if administered immediately after a full meal, they arrest the di- gestive process, are liable to produce nausea, if not vomiting, and do not open the bowels with the same certainty or effect. When simple costiveness is to be removed, the evening may be selected for the exhibition of a cathartic. If this should not prove sufficient, we can repeat the dose in the morning and at regular intervals through the day until the effect is produced. The principle, says Dr. Paris, which should govern our conduct in the administration of purgatives, may be briefly stated: The excitement is to he repeated till the requisite action is induced, yet no single excitement being such as may prove an irritant to the organ. But in the treatment of many diseases, it is preferable to purge through the day, in order that the sleep of the patient may not be disturbed at night. 44 CATHARTICS. The operation of these remedies may be very much accelerated by the free exhibition of diluent drinks, such as gruel, barley water, &c. &c. By combination we are enabled to modify and control the action of many remedies, and some of the most drastic purga- tives may be made to operate mildly and yet certainly by uniting several of them in the same dose. The addition of an emetic substance, such as tartar emetic, or ipecacuanha, in small quantities, gives activity to the com- bination, while it modifies the harshness of the drastic purga- tives. Finally, the operation of a cathartic may often be promoted by judicious venesection ; and if spasm of the intestines be present, opium may be advantageously joined with the purga- tive. PURGATIVE POWDERS. Powder with Calomel and Jala]). R. Hydrargyri Chloridi Mitis, gr. v. Pulveris Jalapas, gr. x. Misce. Signa. — To be given in molasses or sirup. Powder with Calomel and Rhubarb. R. Hydrargyri Chloridi Mitis, Pulveris Rhei, aa gr. v. Olei Cinnamomi, gtt. j. Misce. Signa. — To be given in molasses. Powder with Calomel and Soda. R. Hydrargyri Chloridi Mitis, gr. viij. SodaB Bicarbonatis, gr. xij. Misce. Signa. — To be given in molasses. Tli is combination forms a safe and mild purgative. Nausea seldom follows its administration. Powder with Calomel, Jalap, and Rhubarb. R. Hydrargyri Chloridi Mitis, gr. v. Pulveris Jalapa^ Rhei, aa gr. v. Olei ( linnamomi, gtt. j. Signa, — To be given as the former. CATHARTICS. 45 Powder with Rhubarb and Magnesia. R. Pulveris Khei, 3j. Magnesias, 9ss. Olei Cinnamomi, gtt. j. Misce. Signa. — To be given in sirup, or sugar and water. Calcined Magnesia. R. MagnesiaB, 3j- R. Magnesias (Henry), 3j. R. Magnesias (Husband), 3j. R. Magnesias (Ellis), 3j. Magnesia is an antacid, and laxative, much used in the diseases of women and children. The lightness and consequent great bulk of the officinal powder, constitute serious objections to its use. To obviate these, Henry of England, and Thos. J. Husband, and Chas. Ellis and Co. of this city, have severally prepared a heavy magnesia as a substitute. Henry's magnesia has long been favorably known; Husband's and Ellis's are entitled to equal consideration with the imported article, since the experiments of Prof. Procter have shown that, for forming liquid mixtures, and for rapidity of antacid action, they are equal if not preferable to it. Dose of either, from thirty grains to a dram, in milk or water. The operation of magnesia, when it meets with no acid in the bowels, is promoted by giving the patient lemonade. Powder of Jalap and Or earn of Tartar. R. Pulveris Jalapas, 3j. Potassas Bitartratis, 3vj. Misce, et divide in chartulas vj. Signa. — Give one powder every three hours in molasses. This powder is a hydragogue cathartic. "It constitutes one of the best medicines which I have ever tried, as well in drop- sical as in all other cases, where long-continued purging is demanded." Chapman. Compound Powder of Jalap and Gamboge. E. Pulveris Jalapas Compositi, 3iij. Gambogias, gr. vj. Misce, et divide in chartulas vj. Signa. — Give one powder every two hours in molasses or sirup. 46 CATHAETICS. The compound powder of jalap has long been celebrated in dropsical affections ; but it also forms a very convenient purge in many inflammatory cases. In order to increase its certainty and activity, we may conveniently add the Gamboge, as in the above formula. Powder of Sulphur and Cream of Tartar. R. Sulphur is loti, §ss. Potassas Bitartratis, Ij. Misce. Signa. — Mix in a sufficient quantity of molasses, and give a teaspoonful three or four times a day to children. In some diseases of the skin. It should be always recollected that sulphur promotes in- sensible perspiration in a very marked degree, and hence ren- ders the patient more liable to be affected by vicissitudes of climate. Powder with Milk of Sulphur and Calcined Magnesia. ~R. Sulphuris prascipitati, Magnesias, aa *ss. Misce. Signa. — A teaspoonful to be taken three or four times a day. This preparation is better adapted to delicate stomachs than the former. Either of them forms a good aperient during an alterative course of medicine. Chapman. Seidlitz Powders. R. Sodse et Potassao Tartratis, 3\j. Sodae Bicarbonatis, 9ij. Fiat pulvis. Signa. To be dissolved in half a tumbler of cold water. R. Acidi Tartarici pulverizati, gr. xxv. Signa. — Dissolve in an equal quantity of water with the above, and mix them both together. To be taken while in a state o of effervescence. This is a very popular medicine, and justly so ; it is a gentle aperient, and may be taken by persons whose stomachs would reject any of the ordinary saline preparations. Soda Powders. $c. Soda; Bicarbonatis, 5ss. Signa. — To be dissolved in a wineglassful of cold water. CATHARTICS. 47 R. Acidi Tartar ici, gr. xxv. Signa. — Dissolve in the same quantity of sweetened water, flavored with two drops of essence of lemon. Mix the two solutions, and drink in a state of effervescence. These effervescing drinks, in addition to their laxative effects, allay thirst, check sickness of stomach, and diminish febrile heat. Stevens's Saline Powders. R. Sodae Bicarbonatis, 3ss. Sodii Chloricli, 9j. Potassae Chloratis, gr. vij. Misce. This powder was administered by Dr. Stevens in half a tum- bler of tepid water, or a little thin beef tea, in cholera, and re- peated every half hour until the patient recovered from the collapse. PURGATIVE PILLS. Griffitts's Cathartic Pills. R. Pulveris Jalapge, Rhei, Saponis, aa 3ss. Hydrargyri Chloridi Mitis, gr. xxv. Antimonii et Potassae Tartratis, gr. jss. Aqn.33 destillatas, quantum sufficit ut fiat massa. Divide in pilulas xxv. Signa. — Two of these pills may be taken at once, and repeated in two hours, if not sufficient. This combination of purgatives with the tartrate of antimony, forms an excellent antibilious remedy ; and, in cases of fever, prepares the alimentary canal for the reception of other reme- dies. Pills of Blue Mass, Aloes, &c. R. Pilulas Hydrargyri, Pulveris Jalapas, Aloes, aa gr. xv. Syrupi, q. s. ut fiat massa. Divide in pilulas xij. Signa. — Three may be taken at night, and the same dose re- peated in the morning, if the first is ineffectual. 48 CATHARTICS. Pills of Blue Mass, Soda, &c. R. Pilules Hydrargyri, gr. ix. Pulveris Eliei, Sodas Bicarbonatis, aa gr. xij. Syrupi Khei Aromatici, q. s. ut fiat massa, in pilulas xij. dividenda. Signa. — One, twice or three times a day, as an alterative, in derangement of the liver. Dr. Hartshorne. Pills of Blue Mass, and Colocyntli. R. Pilulas Hydrargyri, Extracti Colocynthidis Compositi, aa gr. v. ' Olei Cari, gtt. ij. Misce, et fiant pilulas ij. These constitute an active cathartic. Pills of Calomel and Colocyntli. R. Extracti Colocynthidis Compositi, gr. xlviij. Hydrargyri Chloridi Mitis, 9j. Misce, et divide in pilulas xx. Signa. — Two or three of these pills will generally act as a ca- thartic. Pills of Extract of May -Apple and Podopliyllin. K. Extracti Poclophylli, 3ss. Podopliyllin {Merrill, Parrish), gr. x. Misce, et flat massa in pilulas x. dividenda. Signa. — Give one pill every three hours. Podopliyllin is a composite principle, lately reintroduced into notice by W. S. Merrill, of Cincinnati, and Edward Parrish, of Philadelphia. It is spoken of as a chologogue cathartic. It certainly does operate promptly, and sometimes harshly on the bowels, in the dose of one or two grains. Editor. Anti- Gout Pill. H. Extracti Colchici Acetici, Colocynthidis Compositi, aa gr. x. Morphia Muriatis, gr. ijss. Misce, < >4 fiat massa in pilulas x. dividenda. This lb a useful anti-gout pill; one adapted to mitigate an actual paroxysm. One pill should be given every two hours, until the bowels and kidneys arc acted on. Kobert Dick. CATHARTICS. 49 Pills with Extract of Butternut and Jalap. R. Extracti Juglandis, 3ss. Pulveris Jalapas, 9j. Saponis, gr. x. Misce, et nant pilulse xv. Signa. — Three or four of these may be taken for a dose, and if they do not operate, two or more may be safely administered. The extract of butternut, either alone or in combination, is highly recommended as a cathartic in fevers, dysentery, &c. Pills of Compound Extract of Golocynt\ <£*c, commonly called FoikergiWs Pills. R. Extracti Colocynthidis Compositi, 3iss. Antimonii Oxidi, Ed. 5ss. Misce, et divide in pilulas xxx. — One of these pills will gene- rally produce a free evacuation ; but two or more may be taken when required. Pills of Compound Extract of Cohcynth, &c. R. Extracti Colocynthidis Compositi, 9j. Resinse Jalapse, Ed. gr. vj. Pulveris Scammonii Compositi, Lond. gr. x. Hydrargyri Chloridi Mitis, gr. x. Antimonii et Potassae Tartratis, gr. j. Saponis, gr. v. Olei Cinnamomi, gtt. iv. Misce, et divide in pilulas xv. Signa. — One, two, or three to be taken at bedtime. Dr. Meigs. MtcheWs Pills. R. Pulveris Rhei, Biv. Aloes, 9ij. Hydrargyri Chloridi Mitis, gr. iv. Antimonii et Potassae Tartratis, gr. ij. Fiat pulvis, et adde — Saponis, in pulverem, 9ij. Aquae, q. s. ut flat massa. Divide in pilulas xl. Signa. — Take one pill every night as a laxative, or three pills as a purgative. J. K. Mitchell. 50 CATHAETICS. Pills of Elaterium. R. Elaterii, gr. ij. Extracti Gentiana?, £ss. Misce, et divide in pilulas xvj. Signa. — Give one pill every three hours, until free purging takes place. Elaterin, the active principle of this drug, can now be procured in a state of purity; and as it is more certain in its effects, a formula is subjoined under the head of purga- tive wines and tinctures. Pills of Groton Oil. R. Olei Tiglii, gtt. ij. Micoe Panis, q. s. ut fiant pilulae iv. Signa. — One every hour until they operate. This powerful remedy has lately been restored to the materia medica. One drop is a full dose, and frequently less will answer every purpose. The following is a more certain and less drastic mode of ex- hibiting Croton Oil. Pills of Croton Oil and Colocynih. R. Olei Tiglii, gtt. ij. Extracti Colocynthidis Compositi, gr. xij. Misce, et divide in pilulas iv. Signa. — Give one pill every two hours. Another Form. R. Extracti Colocynthidis Compositi, gr. 1. Saponis, gr. x. Olei Tiglii, gtt. ij. Misce, flat massa in pilulas, xij. dividenda. Signa. — Take one pill occasionally. Brodie. Antibilious Pills. R. Pilulse Cathartics Composite, No. iij. One pill often acts as a laxative, and three as a purgative. Each pill contains one grain of calomel. Peristaltic Persuaders. R. Pulveris Phei, 3j- Ipecacuanha, gr. x. Olei Cari, gtt. x. Pulveris Acacia3, q. s. Fiat massa, et divide in pilulas xx. Signa, — Take two pills at bedtime, in obstinate constipation. CATHARTICS. 51 Dr. Chapman also highly recommends the use of ten drops of the wine of colchicum root, every four hours, in the same complaint. Chapman. VAKIOUS ALOBTIC PILLS. Pills of Aloes with Soap. R. Pilulse Aloes, No. v. Each pill contains two grains of aloes. Pills of Aloes and Assafetida. R. Pilulse Aloes et Assafcetidse, No. iij. Each pill contains one and a third grains of the respective ingredients. Rufush Pills. R. Pilulse Aloes et Myrrhse, No. iij. Each pill contains two grains of aloes, one of myrrh, and half a grain of saffron. Pills of Rhubarb, Aloes, and Myrrh. R. Pilulse Ehei Composite, No. iij. Each pill contains two grains of rhubarb, one and a half grains of aloes, and one grain of myrrh. Aperient Pills. R. Pulveris Aloes, Ehei, aa 5j- Ipecacuanha, gr. vj. Saponis, 9j. Aquae, q. s. Fiant pilulse lx. As a simple aperient, one may be taken every night at bed- time ; but where a full purgative effect is desirable, the dose is two or three. Pills with Aloes, Gentian, &c. R. Pulveris Aloes, 5j. Extracti Gentianse, Jss. Olei Cari, gtt. x. Syrupi, q. s. ut flat massa, in pilulas singulas grana quatuor pendentes, dividenda. Signa. — Take two or three pills for a dose. 52 CATHARTICS. Pills with Aloes, Guaiacum, &c. R. Pulveris Guaiaci, 3j- Aloes, gr. xxxvj. — Rhei, gij. Terebinthinee Canadensis, quantum sufficit ut fiat massa in pilulas xlviij. dividenda. Signa. — One to be taken every three hours. This combination forms a highly stimulating cathartic. Hooper's, Anderson's, Webster's, and Morrison's Pills, which enjoy so high a reputation with the public, depend in a great measure for their efficacy on the presence of aloes. Pills of Rhubarb and Sulphate of Iron. B. Pulveris Ehei, 5iss. Ferri Sulphatis, 5ss. Saponis, 9ij. Aquae destillatae, q. s. ut fiat massa in pilulas xl. dividenda. The intention of these pills is obviously to remove costive- ness, and impart tone to the bowels. They were a favorite me- dicine with Dr. Griffitts, late of this city. Three or four may be taken for a dose at bedtime. Pills of Ox Gall R. Fellis Bovini inspissati, 3y- Olei Cari, gtt. x. Magnesias Carbonatis, q. s. ut fiat massa, in pilulas xxxvj. dividenda. Signa, — Take two pills three times daily. Clay. Ox gall has again been brought forward as a remedy in dys- pepsia and obstinate constipation. Its advocates claim for it certainty of action, attended with little pain or griping. PURGATIVE CONFECTIONS AND ELECTUARIES. Lenitive Electuary. li. C< afectionis Senna?, 3j. Signa. — Take a piece the size of a marble, night and mornin< in costiveness. CATHAETICS. 53 Confection of Sulphur. B. Sulphuris loti, 3iss. Confectionis Sennas, iij. Potassas Mtratis, 5j- Syrupi Aurantii Corticis, q. s. ut fiat confectio. Signa. — One or two drams may be taken once or twice a day. In hemorrhoidal affections. Electuary of Senna and Figs. B. Pulveris Sennas, 3ss. Pulp as Ficus, quantum sufncit ut fiat electuarium. Signa. — A piece the size of a marble, night and morning, in costiveness. Electuary with Jalap, Nitrate of Potash, &c. B. Pulveris Jalap as, Potassas Bitartratis, Mtratis, aa Iss. Confectionis Sennas, 5j. Syrupi, q. s. ut fiat electuarium. Of which a bolus the size of a hazel-nut may be taken three or four times a day. This preparation once gained considerable celebrity as a popular remedy for hemorrhoids. Confection of Sulphur, Guaiac, &c. B. Sulphuris, §ij. Potassas Bitartratis, ^j. Pulveris Ghiaiaci, 3j. — — — - Khei, 3ij. Spiritus Myristicas, f5ij. Mellis, quantum sufiicit, ut fiat electuarium. Signa. — Take one or two teaspoonfuls morning and evening. This preparation has long been used successfully in England in the treatment of chronic rheumatism. PURGATIVE EMULSIONS. Oleaginous Mixture. B. Pulveris Acacias, 3iij. Aquas, fjij. Olei Eicini, Ij. Aquas Cinnamomi, vel Menthas Viridis, f 3j. Misce secundum artem. Signa. — Take a tablespoonful every two hours. 54 CATHARTICS. Sugar is generally prescribed, but the mixture remains more uniform without it. The compounder should mix the gum arabic with sufficient water to form a thick mucilage, and then rub in small portions of the oil and water until the whole is suspended. Finally, add the cinnamon or mint-water, and shake well together. 'o v Another Form for Children. B. Olei Eicini, 3ij. vel 3ss. Yitellum ITnius Ovi, Aquae Foeniculi, Menthae Yiridis, aa Oj. Fiat emulsio. Signa. — Give a teaspoonful morning and night to a child three months old. Another Form. R. Mucilaginis Acaciae, f^j. Olei Eicini, 3j. Aquae Menthae Yiridis, f 3ij. Mix the oil and mucilage, add the mint-water, and shake well together. Signa. — Take a tablespoonful every two hours. Mixture of Oil of Turpentine. tt. Olei Terebinth inae, f^j. Pulveris Acaciae, 3iij- Aquae Menthae Yiridis, f^iv. Misce. Signa. — A tablespoonful every two hours until it ope- rates. This preparation must be made in the same manner as the oleaginous mixture. Mixture of Oil of Turpentine. K. Olei Terebinthinae, fsj. Yitellum Unius Ovi, Tere simul, et adde gradatim — Misturao Amygdalae, f|iv. Syrupi Aurantii Corticis, f5ij. Spiritfis Lavandulae Compositi, f3jss. Olei Cinnamomi, gtt. iv. Misce, et fiat emulsio. Signa. — Take a tablespoonful every two hours. CATHARTICS. 55 Oleaginous Mixture with Oil of Turpentine. R. Olei Eicini, f^iss. Vitellum Ovi, j. Sacchari, 3ij. Olei Terebinthinas, flss. Aquas Menthas Viridis, fjiv. Misce optime. Signa. — A large tablespoonful may be taken every hour or two, according to circumstances. This preparation is much used by some of our best practi- tioners in cases requiring a brisk and stimulating cathartic. It has also been recommended as a purgative after the effects of an overdose of opium have been partially subdued by preliminary remedies. Mixture of Croton Oil. R. Olei Tiglii, gtt. j. vel ij. Mucilaginis Acacias, Aquas destillatas, aa f^j. Misce. Signa. — To take a teaspoonful every two hours until it operates. Saponaceous Solution of Croton Oil. R. Olei Tiglii, gtt. viij. Potassas, gr. yj. Aquas destillatas, fsij. Fiat solutio. Signa. — From three to six drops may be given for a dose. This is a substitute for the soap of croton oil proposed by the French, which is more troublesome to make. Mr. Conwel states that four drops of this oil rubbed on and round the umbilicus, will produce a cathartic effect ; even the odor of it has been known to excite the alimentary canal, either as an emetic or purgative. PURGATIVE MIXTURES. Solution of Sulphate of Magnesia, and Tartar Emetic. R. Magnesias Sulphatis, 3j. Antimonii et Potassas Tartratis, gr. ss. Aquas destillatas, fSiij. Succi Limonis recentis, f^j. Misce, et fiat solutio. — A tablespoonful to be given every two hours until it operates. Or one-half may be taken as a pur- gative dose. 56 CATHARTICS. Solution of Epsom Salts vriih Nitric Acid. ' R. Magnesias Sulphatis, 3ss. Tincturae Jalapae, f5j. Acidi Mtrici, gtt. ij. Aquae Menthae Viridis, f §ij. Misce. Signa. — To be taken for a draught. The nitric acid is said to destroy in a great measure the bitter taste of the salt. Mixture of Carbonate of Magnesia, &c. R. Magnesias Carbonatis, 5ss. Sulphatis, 3iij- Spiritus Ammonias Aromatici, f3j. Tinctures Ehei, f 3ss. Hyoscyami, f 3ss. Aquas Menthae Yiridis, f^iv. Fiat mistura. Signa. — A large tablespoonful to be taken two or three times a day. Dr. Meigs. Mixture of Magnesia and Rhubarb. R. Magnesias, 3ss. Pulveris Rhei, gr. ij. Sacchari, 3j- Tincturae 01 ei Menthae Piperitas, gtt. vj. Aquae destillatas, f Jiss. Fiat mistura. Signa. — A teaspoonful to be given every two hours to children, until it operates. This preparation is designed for the bowel complaints of chil- dren, in which it is very serviceable. Laudanum can be added according to the age and condition of the patient. Magnesia and Blue Pill. R. Magnesias, 3iss. Acacias, Sacchari, aa q. s. Aquae, f^iv. Pilulae Ilydrargyri, gr. iv. vel viij. Olei A nisi, gtt. iv. Misce. Signa. — To take a tablespoonful every two hours until it operates freely. An alterative cathartic. CATHAETICS. 57 Magnesia and Golchicum. B. Magnesias, 3j- Sacchari, Acacias, aa q. s. Aquas destillatas, f si v. Yini Colchici Eadicis, gtt. xl. Fiat mistura. Signa. — To take a tablespoonful every two hours until it operates. This preparation is much used in gouty and rheumatic affec- tions. Laudanum can be added if requisite. Scudamords Mixture of Golchicum and Epsom Salts. R. Magnesias, 9iv. Magnesias Sulphatis, |j. Aquas Menthas Yiridis, f 3v. Aceti Colchici, fjfss. Syrupi, fgj. Fiat mistura. — Dose, one, two, or three tablespoonfuls, repeated every two hours, until four or six evacuations are produced in twenty-four hours. Chiefly used in gouty paroxysms. Solution of Sulphate of Ver atria. B. Veratrias Sulphatis, gr. j. Aquas destillatas, f Jij. Fiat solutio. Dose, a dessertspoonful. This solution is said to be a good substitute for the Eau Medicinale of Husson, in gouty affections. Magendie. Solution of Gitrate of Magnesia. B. Liquoris Magnesias Citratis, f^xij. Signa. — Take one-half at a draught, and repeat in two hours, if necessary. From its resemblance to lemonade in taste, this constitutes one of the most pleasant laxatives now in use. A child five years old, may take a wineglassful as a dose. The country practitioner can make a good approximation by neutralizing carbonate of magnesia with citric acid, in the pro- portion of fourteen parts of the former to twenty parts of the latter, and flavoring the solution with lemon sirup. Half an ounce of the neutral salt of citrate of magnesia con- stitutes a dose. 58 CATHAETICS. Fluid Extract of Senna. R. Extracti Sennae Fluidi, f ,lj. Signa. — Give a tablespoonful. Charles Ellis. The fluid extracts, of which a few are officinal, are intended to combine strength, smallness of dose, facility of administration, and permanency, in one preparation. They have become quite popular with the profession in most of the large cities, and hence there is an obvious propriety in making them officinal. The fluid extract of senna is a safe, and tolerably certain purgative. Fluid Extract of Rhubarb. B. Extracti Ehei Fluidi, fgj. Signa. — Give half a teaspoonful night and morning. One fluidram of the extract represents one dram of rhu- barb. Sulphate of Potash and Jalap Mixture. B. Potassae Sulphatis, 3ij. Aquae, f Jvss. Tincturae Jalapas, f 3ss. Fiat solutio. Signa. — Take a tablespoonful every two hours ; a mild purgative, and deobstruent. PUKGATIVE INFUSIONS AND DECOCTIONS. Infusion of Senna, Sulphate of Magnesia, &c. B. Sennae, oSS. Mannae optimae, Magnesias Sulphatis, aa Ij. Cardamomi, 3ij. Misce. Signa. — To be infused in a pint of boiling water until cold, and half a teacupful given every hour until it operates. Infusion and Tincture of Senna, Salts, &c. B. InfusL Sennae, f 3yj. Tincturae Sennae, f 3ij. Mannae, 3ij- Magnesiae Sulphatis, *ss. Aqua; Menthae Viridis, destillatae, aaf^iss. Misce. Signa. — One-half to be taken for a dose, and repeated if it does not operate. This was a very common prescription of the late Mr. Abcrnethy, of London. CATHAETICS. 59 Infusion of Senna and Manna. R. Sennae, 3yj. Mannae, %j. Cardamomi, £ij. Misce. Signa. — To be infused in a pint of boiling water until cold ; one-half to be taken at once ; and if insufficient, the remainder in two or three hours. This infusion will keep longer if a little tincture of senna be added to it. Decoction of Prunes and Senna. R. Pruni, £iij. Infusi Sennse, Oiij. Decoque ad libras duas. In making this decoction, the coriander seed directed in the officinal infusion of senna, had better be omitted until near the close of the process. This forms a good laxative for pregnant women. Infusion of Senna with Rhubarh, &c. R. Sennas, 3yj. Mannas, Ij. Ehei contusi, 5ij- Cardamomi, 5ij. Misce. Signa. — To be infused in a pint of boiling water for one hour. Half a teacupful given every hour till it operates. Decoction of Aloes, &c. R. Extracti Glycyrrhizae, Sss. Potassae Carbonatis, 9ij. Aloes, 1 Myrrhae contritaa, >aa 3j. Croci, J Tincturas Cardamomi Composite, f 5iv. Aquae destillatae, Oj. Boil down all the ingredients, except the last, with the water to twelve fluidounces, and strain ; then add the compound tinc- ture of cardamom. The dose of this decoction is from half an ounce to an ounce and a half. It is a mild, warm cathartic. 60 CATHARTICS. PUKGATIYE WINES AND TINCTUKES. Wine of Colchicum Root. R. Yini Colchici Kadicis, f 3ss. Signa. — Ten or twenty drops of this may be taken in sugar and water, morning, noon, and night. The preparations of colchicum not unfrequently produce violent vomiting, and require to be continued with great caution. Used in rheuma- tism and gout. There are two vinous preparations of colchicum, the wine of the root or corm, which is a saturated one given as above, and the wine of the seeds, which is only about half as strong, and may be given in the dose of a teaspoonful. The two should be carefully designated in prescriptions by their respective termi- nations, " Kadicis," and " Seminis." Tincture of Yeratria. R. Yeratrise, gr. iv. Alcoholis, f E}. Fiat tinctura. — This may be given in doses of ten, fifteen, or twenty drops, in a wineglass of water. It is designed as a substitute for the Yinous Tincture of Colchicum, in dropsies, gout, rheumatism, &c. The Tincture of Yeratria is recommended as an external application in the diseases above mentioned. For this purpose also the ointment is proposed. Yeratria is extremely poisonous, and, therefore, to be taken with great caution. Tincture of Elaterin. R. Elaterin, gr. j. Alcoholis, f 3J. Solve, dein adde — Acidi Nitrici, gtt. iv. Misce. Signa. — Dose, twenty to forty drops in cinnamon water. Morris. Tincture of Croton Oil. R. Olei Tiglii, gtt. iv. Tinctura- Myrrhoo, f^j. Misce, ra x attended with imminent danger of suffocation, be lias afforded immediate relief by tbe above draught. DIURETICS. 73 Tincture of Colchicum and Digitalis. R. TiDcturas Colcliici Seminis, Digitalis, aa fjj. Spiritus ^Etheris Nitrici, f5j. Misce. Dose, twenty drops on a lump of sugar. Given as a diuretic in dropsy and hydrothorax. Hildenbrand. Mixture of Carbonate of Potash, Squill, &c. R. Potassae Carbonatis, 3j- Succi Limonis, q. s. ad saturandum, Tincturae Scillas, f£ss. Opii, gtt. xxx. Aquae Cinnamomi, f ifiv. Misce. Signa. — A tablespoonful every two or three hours throughout the day. The vinegar or oxymel of squill, if preferred, may be substi- tuted in this preparation. We use the tincture because it is more uniform, and less liable to spontaneous changes. Mixture of the Acetates of Potash and Ammonia, R. Liquoris Ammonias Acetatis, f^ij. Potassas Acetatis, 3ij. Misce. Signa. — A tablespoonful every three hours for a dose. Mixture of Buchu and Acetate of Potash. R. Infusi Buchu, f3viij. Potassas Acetatis, 3ij- Misce. Signa. — Take a wineglassful three or four times a day. This is an excellent diuretic combination, and its value may be farther enhanced by the addition of sweet spirits of nitre. Mixture with Urea. R. Ureas, 3j- Aquas, fjijss. Syrupi Aurantii Corticis, f^ss. Fiat mistura. Signa.- — Take a tablespoonful every six hours. Its action as a diuretic should be aided by the free adminis- tration of diluents, as well as by keeping the skin moderately cool. The dose may be augmented to a scruple or more. T. H. Tanner. 74 DIURETICS. Huf elancfs Diuretic Drops. R. Olei Juniperi, f 3ss. Spiritus .ZEtheris Nitrici, Tincturas Digitalis, aa f 3iij. Misce. Signa. — Give twenty or thirty drops every three hours. Use. This is one of the best diuretics, and may be em- ployed for some time without offending the stomach. HlTFELAND. Mixture of Buchu and Uva Ursi. R. Buchu, Uvas Ursi, aa ^ss. Aquae ferventis, Oss. Digere leni calore in vase clauso per dimidiam horam. Cola, et adde — Syrupi Senegas, f 3ss. Signa. — Take one or two tablespoonfuls every two hours. Used in blennorrhoea, atony, and paralysis of the bladder. Clarus. Mixture of Balsam Copaiba, B. Copaibas, Spiritus iEtheris Mtrici, aa f £ss. Pulveris Acacias, 3ij. ■ — Sacchari, 3j. Aquas destillatas, foiv. Spiritus Lavandulas Compositi, f5ij. Tincturas Opii, f3j. Fiat mistura secundum artem. Signa. — A tablespoonful three times a day. Chapman. This remedy is more especially used in gonorrhoea, and is considered by Professor Chapman as a specific in that disease. A preferable mode of exhibiting balsam copaiva, consists in dropping the quantity prescribed for a dose in a wineglass of water, and then adding to it a small quantity of the iinct. gen- tia/ncB comp. The balsam collects into a globule and is sur- rounded by the tincture, which, leaving its taste in the mouth, covers that of the nauseous balsam. DIUEETICS. 75 Mixture of Balsam Copaiba, Cubebs, &c. R. Copaibas, Pulveris Cubebas, aa sss. Acacias, 3ij. Sacchari, 3ij. Aquae, f^viij. Tinctures Opii Camphoratas, flss. Misce secundum artem. Signa. — A tablespoonful every tbree hours. We have found this remedy, in some obstinate cases of gonor- rhoea, more efficacious than the preceding formula. The tincture of cubebs may be substituted for the powder — and the tinct. opii acetat. fjj. for the paregoric, if desirable. Balsam copaiva is sometimes given by the French physicians in the form of enema, for the cure of gonorrhoea. Capsules containing it are also in common use. S. Gr. Moeton. Another Form. ' R. Copaibas, fajss. Mucilaginis Acacias, fjy. Olei Limonis, gtt. vj. Tincturas Cubebas, foj. Spiritus iEtheris Mtrici, f*ss. Fiat mistura. Signa. — Take a tablespoonful three times a day, in gonorrhoea. Kakdqlph. aa fiss. Compound Mixture of Copaiba, &c. R. Copaibas, Alcoholis, Aquas Menthas Piperitas Syrupi, Spiritus iEtheris Nitrici, f3ss. Fiat mistura. — To be taken during the day in four doses, fol- lowed by demulcent drinks. In chronic gonorrhoea. Mixture of Fluid Extract of Cut R. Extracti Cubebas Fluidi, f5ij. Mucilaginis Acacias, Syrupi Tolutani, aa flss. Spiritus Lavandulas Compositi, f3ij. Aquas, fiijss. Fiat mistura. Signa. — Give a tablespoonful every three hours in gonorrhoea. Editoe. CLASS IV ANTILITHICS AND LITHONTKIPTICS. Antilithics are those substances which arrest or prevent the formation of calculi in the kidneys or bladder. Lithontriptics are supposed to possess the power of dissolving calculous con- cretions, by acting on the substance which serves as the bond of union to the saline or acid particles composing the stone. To administer these remedies with any degree of success, re- quires a chemical knowledge of the ingredients which enter into the formation of the different calculi ; attention must also be given to the properties of the urine. As derangement of the digestive organs almost always co- exists with these foreign bodies in the urinary apparatus, we shall gain a very considerable advantage by combining the re- medies of this class with those which have a tendency to restore the healthy action of the stomach and bowels. When lithic or uric acid abounds in the urine, the alkalies will be found to produce the greatest benefit ; but where the salts are evidently of the calcareous or magnesian character, the muriatic, or some one of the mineral acids, will constitute the most appropriate remedy. POWDEES. Powders of Uva Ursi, Bark, and Ojjium. IJ. Pulveris Uva3 Ursi, Cinchonae, aa 3j- vcl 3ij- Opii, gr. iij. Miscc, ct divide in chartulas vj. — Of which one may be taken three or four times a day. The above is the original prescription of Dr. Ferriar, who advises the patient to drink two ounces of lime-water after each dose. AXTILITHICS AND LITHONTRIPTICS. 77 PILLS. Soap Pills. R. Saponis, 3j. Divide in pilulas xv. Signa. — One every two hours during the day. Pills of dried Carbonate of Soda. R. Sodas Carbonatis Exsiccatas, Saponis, aa 5j. Extracti Glycyrrhizas, Aquae, aa q. s. Fiat massa in pilulas xxx. dividenda. Signa. — Take three pills, three times a day, as an antilithic. Beddoes. SOLUTIONS, MIXTUKES, &c. Solution of Bicarbonate of Soda, &c. R. Sodas Bicarbonatis, 3j. Infusi Quassias, faiv. Tincturas Colombas, f^j. Misce. Signa. — A tablespoonful for a dose four times a day. Solution of Salaeratus. R. Potassas Bicarbonatis, gr. x. vel xv. Aquas Seltzer, f^vj. Misce. — Draught, to be taken three or four times a clay. Mixture of Bicarbonate of Soda, &c. R. Sodas Bicarbonatis, Jj. Misturas Amygdalae, fliv. Copaibas, fjij. Tincturas Opii, gtt. lx. Fiat mistura secundum artem. Signa. — A tablespoonful pro re nata. In acute pain of the bladder. In combination with each of these alkaline preparations, de- mulcent drinks may with benefit be freely employed. Carbonate of Potash and Lime-water, R. Potassas Carbonatis, 3ij- Aquas Calcis, Oij. Fiat solutio. — Of which a wineglassful may be taken every two hours, mixed with an equal quantity of new milk. 78 ANTILITHICS AND LITHONTEIPTICS. Mixture of Magnesia, dec. B. Magnesias Carbonatis, 3j. Infusi Gentianae Compositi, f^vj. Fiat mistura. — A wineglassful to be taken three times a day. This mixture is recommended by Mr. Brande, of London, as superior to the alkalies, in cases where uric acid abounds. Mixture of Muriatic acid in Barley-water. B. Acidi Muriatici, gtt. x. vel xx. Decocti Hordei, Sviij. Misce. Dose, a tablespoonful largely diluted, three or four times a day. — In stone, when the calcareous properties are most apparent. Nitric acid has been given with the same intention, but ap- pears to be less useful than muriatic. Oil of Turpentine. B. Olei Terebinthinae, f^ss. Signa. — From thirty drops to a large teaspoonful may be taken on sugar, and repeated pro re nata. See also the formula given under Diuretics. This medicine has been frequently given of late in the pas- sage of urinary calculi down the ureters. It is stated by Dr. Physick that this remedy, proportioned in its dose to the degree of suffering, affords more prompt relief than any other. Urethral Injection of Carbonate of Soda. B. So doe Carbonatis, 3j. Saponis, 3ij- Aquae destillatae, f^xij. Fiat solutio et cola. Signa. — Use as an injection, for softening uric acid deposits, and calculi. HoPITAL DE MONTPELLIER. CLASS V. DIAPHOKETICS. Duking- the exhibition of this class of medicines the patient must be confined to his bed ; and when diaphoresis is once excited, every precaution should be taken lest it be suddenly checked. Venesection should generally be resorted to when there is much arterial excitement with great heat of the skin, before we attempt to give diaphoretics. When the skin continues steadily hot and dry, all external warmth must be removed, and cold water freely applied to the temples, hands, feet, &c, while the room is to be kept cool by a free current of fresh air. Under these circumstances, cold water may be frequently and plenti- fully drunk by the patient. Diaphoretics given in conjunction with these general means, will act with much more certainty than if great heat of the surface is maintained by covering the patient with heavy bedclothes. If it be desirable to produce perspiration when the heat of the skin is not above the natural standard, we shall obtain our object most readily by placing the patient in a warm bed, giving him warm drinks freely, placing his feet in warm water, or applying hot bottles, or bags of sand, to the different parts of his body. The bags of sand accommodate themselves to the inequalities of the surface, and therefore form an excellent mode of applying heat externally. Warm bricks, covered with cloths, and wetted with vinegar, may also be used advantageously. Employed in this way they form a steam-bath. The same effect may be produced by con- ducting the vapor of alcohol through a tube, under the bed- clothes of the patient. In a few words, then, we have described the manner of pro- ducing diaphoresis under opposite states of the system. In the first instance we solicit, in the second we rather extort it. It may be proper to observe, that in the febrile affections the frequent change of linen about the patient is not only warrant- 80 DIAPHOEETICS. able, but absolutely necessary, whilst employing this class of remedies. "Where, however, we are desirous of producing what is em- phatically termed " a sweat" we should envelop the patient in a flannel shirt or gown, and avoid, as was before observed, every cause which may suddenly check the cutaneous discharge, and more especially purging and diuresis. In the treatment of ordinary fevers, we usually resort to articles recognized by the profession as being capable of pro- ducing perspiration, or sweating, soon after their exhibition ; while in chronic diseases, as syphilis, scrofula, and the cachectic state following the use or abuse of mercury, others are em- ployed which combine an alterative property with their tend- ency to the skin. It is therefore deemed advisable to make two sub-classes, viz. 1. Ordinary Diaphoretics, and 2. Alterative Diaphoretics. Sub-Class. I.— ORDINARY DIAPHORETICS. POWDERS. Dover* s Powder. E. Pulveris Ipecacuanhas et Opii, Jss. ve l sjj. Divide in pulveres vj. Signa. — Take one powder three times a day. The most material difference between the officinal powder and that of Dr. Dover, made public in 1733, is in the substitution of the sulphate of potash for saltpetre. The principal use of the former salt in this preparation, ap- pears to be to facilitate the minute division of the other two ingredients. Its crystals are extremely hard, and the prolonged trituration necessary to reduce them, renders the opium and ipecacuanha impalpable. It is one of the happiest and most useful combinations, having stood the test of time and experi- ence with undiminished reputation. To promote its operation, warm drinJcs may be freely taken, but not immediately after the dose, lest vomiting be induced. Antimonial Powder* R. Pulvis Antimonialis, Ed. 3j. Divide in chartulas vj. Signa. — One every two or three hours in sirup or molasses. In fevers. This powder, which has been introduced as the succedaneum DIAPHOEETICS. 81 of the celebrated Fever Powder of Dr. James has lately been pronounced inert by Mr. Kichard Phillips, chemist of London. Learning that it had produced no effect when largely exhibited, he determined to examine it chemically, and found it to consist of peroxide of antimony (which he says is inert), and the phos- phate of lime in mixture. But, as Dr. Paris observes, "it will be difficult for the chemist to persuade the physician he can never have derived any benefit from the exhibition of antimonial powder." Nitrous Powders. B. Pulveris Potassas Nitratis, Jj. Antimonii et Potassse Tartratis, gr. ss. Hydrargyri Chloridi Mitis, gr. yj. Fiant pulveres yj. Signa. — One to be taken every two hours in sirup or molasses. In febrile affections. The calomel may be omitted or employed, at the discretion of the practitioner. Powders ivilh Opium, Ipecacuanha, Calomel, and Nitre, E. Pulveris Opii, gr. iij. Ipecacuanhas, gr. yj. Hydrargyri Chloridi Mitis, gr. jss. Potassse Mtratis, 3ss. Fiant pulveres yj. Signa. — One to be taken every three or four hours. Powders ivitli Calomel, Opium, and Ipecacuanha. B. Pulveris Opii, gr. iv. Hydrargyri Chloridi Mitis, gr. xvj. Pulveris Ipecacuanhas, gr. viij. Divide in pulveres viij. Signa. — One to be taken every hour or two hours. •*< This combination is recommended by Professor Chapman in dysentery. From its evident diaphoretic tendency we have been induced to place it under this head. Poivders of Precipitated Sulphur et of Antimony, Calomel, &c. B. Antimonii Sulphureti Prascipitati, Hydrargyri Chloridi Mitis, aa gr. yj. Pulveris Gruaiaci, Jj. Fiant chartulae yj. Signa. — One to be taken morning and even- ing, with double or even triple proportion of the ingredients, if necessary. In cutaneous diseases. 6 82 DIAPHOKETICS. Socio, Powder of Guy's Hospital. R. Sodas Carbonatis exsiccatas, 3j. Hydrargyri Chloridi Mitis, gr. xij. Pulveris Cretas Compositi, Loncl. Jij. Misce. Signa. — Give three to eight grains at night for a week, ' in infantile gastric fever ; followed in the morning by five grains of rhnbarb mixed with ten grains of the sulphate of potash. Dr. Fordyce says of the above : "Had I been more ambitions of dying a rich man than of living a useful member of society, the powers of our antihectic powder in curing, as if by miracle, the hectic fever and the swelled bellies of child- ren in London, would have remained a secret while I lived." Golding Bird. Poivders ivith Guaiacum, &c. R. Pulveris Guaiaci, Potassas ISTitratis, aa £j. Ipecacuanhas, gr. iij. Opii, gr. ij. Fiant pulveres yj. Signa. — One to be taken every three hours in a little jelly or molasses. A stimulating diaphoretic, and particularly serviceable in acute rheumatism after the reduction of inflammatory symptoms. DIAPHORETIC MIXTURES. Neutral or Saline Mixture. li. Succi Limonis recentis, f 3iss. Potassse Carbonatis, q. s. ad saturandum, Sacchari, Jij- Antimonii et Potassae Tartratis, gr. ss. Aquae destillatas, f^iij. Misce. — A tablespoonful to be taken every two hours. In fevers. This preparation is one of our most agreeable diaphoretics. Its powers are decidedly increased by the addition of tartar emetic ; which, however, may be omitted, and the sweet spirits of nitre substituted, if preferred. Solution of Citrate of Potash. R. Potassse Citratis, ?5iij. Olci Limonis, gtt. ij. Sacchari, 5ij- Aquas destillat®, f.siv. Misce, — A tablespoonful to be taken every two hours. This DIAPHORETICS. 83 preparation is a good substitute for the preceding one, and is in several respects to be preferred. Spirits of nitre may be added. Effervescing Draught. R. Potassas Carbonatis, 5\j. Aquas destillatae, f^iv. Misce, et fiat solntio. R. Succi Limonis recentis, Aquae destillatae, aa fjij. Misce. Signa. — Mix two tablespoonfuls of the lemonade with one of the alkaline solution, and let it be drunk while effer- vescing, to be repeated pro re nata. This preparation differs from the neutral mixture more in the mode of exhibition than in any other important particular. It is of great value when irritability of the stomach precludes the use of ordinary diaphoretics. m Spirits of Mindereri. R. Aceti destillati, vel Acidi Acetici diluti, fSvj. Ammoniae Carbonatis, q. s. ad saturandum. Add the carbonate of ammonia gradually to the acid or vine- gar until it is saturated. Signa. — Take a tablespoonful every two hours. This excellent diaphoretic in inflammatory diseases, appears to have been first used by Boerhaave, in 1732. "With us it is generally prescribed in combination, under one of the following forms : — Spirits of Mindereri and Antimonial Wine. R. Liquoris Ammoniae Acetatis, f^ij. Aquae Cinnamomi, f^j. Yini Antimonii, f Jj. Aquas destillatae, f^ij. Fiat mistura. Signa. — A tablespoonful every two or three hours. Spirits of Mindereri, Siveet Spirits of Nitre, &c. R. Liquoris Ammonias Acetatis, fivj. Syrupi Limonis, fsij. Yini Antimonii, fojss. ' Spiritus iEtheris Mtrici, fjij. — f^ss. Tincturae Opii, gtt. xlv. Fiat mistura. Signa. — Take a tablespoonful every two hours. Eberle. 84 DIAPHORETICS. Solution of Citrate of Ammonia, &c. R. Succi Limonis recentis, f^j. Ammonia Carbonatis, q. s. ad saturandum. Sacchari, Jj. Aquae destillatse, Oiv. Fiat mistura. Signa. — A tablespoonful may be taken every two or three Hours, pro re nata. This preparation is seldom employed in the practice of this city. It may, however, be beneficially given as a pleasant sti- mulating diaphoretic. Sweet Spirits of Nitre, and Antimonial Wine. R. Spirit us ^Etheris ISTitrici, fjj. Yini Antimonii, f5ij. Misce. Signa. — A teaspoonful may be taken every hour or two hours, in barley-water, during the hot stage of intermit- tent and other fevers. Sweet Spirits of Nitre, with Antimonial Wine and Laudanum. R. Tincturae Opii, gtt. xxv. Spiritus iEtheris Nitrici, fjj. Yini Antimonii, gtt. xx. Aquae destillatse, f^ss. Fiat mistura. — To be given at a dose, and repeated pro re nata. Dr. Chapman observes, in his Therapeutics, that " this com- bination very frequently acts as a diuretic in dropsy, and has more than an once, within my knowledge, removed the effusion in this disease, under circumstances the least to be expected." Mixture of Saltpetre and Tartar Emetic. R. Potassse Nitratis, 3ij- Antimonii et Potassse Tartratis, gr. j. Pulveris Extracti Glycyrrhizae, Acaciae, aa 3ij- Aquae Foeniculi, destillatse, aa fsiijss. Fiat mistura. Signa. — Give a tablespoonful every two hours. This is proposed as a substitute for the nitrous powders, as being le 3 apt to offend the stomach than the same substances in a pulverulent form. Eberle. DIAPHORETICS. 85 Mixture with Guaiacum, &c. R. Pulveris Guaiaci Kesinae, 3ij- Potassae Mtratis, 3iss. Antimorrii et Potassas Tartratis, gr. j. Pulveris Acaciae, 3j- Extracti Grlycyrrhizae, 9j. Aquae destillatas, f^viij. Fiat mistura. Signa. — A tablespoonful three or four times a day. This preparation, if made without the extract of liquorice, is disposed to turn green, which gives it an unpleasant appearance, and sometimes induces the patient to refrain from it until the physician arrives. It is employed principally in rheumatic cases. Solution of Nitrate of Potash. R. Decocti Hordei, Oj. Potassas Mtratis, 3ij- Succi Limonis, f ^j. Fiat potus. — To be used warm as a common drink. Tincture of Tolu with Wine of Antimony. R. Tincturae Tolutanae, f 3 v. Pulveris Acacias, 3iij- Sacchari, 5j- Yini Antimonii, f 3j- Aquae Cinnamomi, f ^ij. Fiat mistura. Signa. — A tablespoonful three or four times a day. This is a stimulating diaphoretic, and will be found service- able in pectoral diseases accompanied with an excessive mucous discharge depending on debility of the bronchial membrane. Mixture with Aconite and Wine of Colchicum. R. Extracti Aconiti Alcoholici, gr. xij. Syrupi, f 3j. m Yini Colchici Seminis, f £ss. Fiat mistura. Signa. — Take fifteen drops every three hours. Used in acute and chronic rheumatism, gradually increasing the dose. "Weber. Ob DIAPHORETICS. Mixture with Aconite and Valerian, B. Pulveris Yalerianas, 3ss. Aquas bullientis, f lyj. Macera per horas duas et cola. Dein adde — Extracti Aconiti Alcoholici, gr. vj. Sjrupi, f jfss. Liquoris Ammoniae Acetatis, f Jj. Misce. Signa. — Take a tablespoonful every two hours. Used in nervous gout. Eichter. Mixture with Arnica. R. Arnicas Flo rum, 3ij. Aquae bullientis, f Jvj. Macera per horas duas, et cola. Dein adde — Pulveris Acacias, 3ij- Syrupi Aurantii Corticis, f Ij. Misce. Signa. — Take a tablespoonful every two hours in low nervous fever, as a stimulant diaphoretic. Berends. I have selected the above, out of thirty German prescriptions for arnica, as being one of the most simple, and perhaps one of the best forms, for administering an article, which has hitherto attracted little attention among us, although it is frequently pre- scribed by men of the highest standing in Germany. Editor. INFUSIONS. Infusion of Boneset. R. Eupatorii, ij. Aquas bullientis, Oj. Infuse for thirty minutes in a covered vessel; then decant and take a wineglassful every hour, till perspiration is freely in- duced. The infusion must be taken as hot as it can be drunk; otherwise it may produce vomiting. Infusion of Pipsisscwa. B. Cliiiimphihn, Sj. Aquae bullientis, Oj. Fiat infusum. — A teacupful every two hours. DIAPHOKETICS. 87 Infusion of the Asclepias Tuberosa, or Pleurisy Root. R. Eadicis Asclepiadis Tuberosae, contritae, Ij. Aquas bullientis, Oiss. Fiat infusum. Signa. — A teacupful to be taken warm, as fre- quently as the stomach will bear it. Chapman. Professor Chapman observes of this plant : " As a diaphoretic, I think it is distinguished by great certainty and permanency of operation, and has this estimable property, that it produces its effects without increasing much the force of the circulation, raising the temperature of the surface, or creating inquietude and restlessness." — Therapeutics, vol. i. p. 347. I have found the virtues of the pleurisy root to be better developed, by boiling one ounce in a quart of water down to a pint, and straining. Editoe. Sub-Class II.— ALTERATIVE DIAPHORETICS. PILLS. Pills of Red Sulphur et of Mercury, &c. B. Hydrargyri Sulphured Rubri, Pulveris Serpentarise, aa 5ss. Syrupi, q. s. Fiant piluke xij. Signa. — Two of these to be taken three times a day. They are alterative as well as diaphoretic, and are useful in herpetic and other obstinate cutaneous complaints. Pills of Sulphuret of Antimony, &c. — Plummets Pills. R. Hydrargyri Chloridi Mitis, Antimonii Sulphureti praecipitati, aa 5ss. Pulveris Guaiaci Resinae, 3j- Sacchari Faecis, q. s. ut fiant pilulae lx. Three pills to be taken night and morning. These pills were recommended by Professor Plummer, in lep- rosy, secondary syphilis affecting the skin, gleets, old ulcers, &c. &c. The decoction of guaiacum generally accompanies their use. 88 DIAPHORETICS. DECOCTIONS. Sirup or Rob Anti-syphiliiique of Laffecteur. B. Sarsaparillse, Arundinis Phragmitis, aa ^xxx. riorum Boraginis Officinalis, ^viij. Senna?, Kosas Albae, aa ^ij. Sacchari, Mellis, aa Ebyj. Aquas, q. s. Boil the sarsaparilla and marsh reed grass in nine pints of water for one honr ; strain off the decoction, and pour the same quan- tity of water on the residuum, which is to be boiled for two hours ; towards the end of the boiling add the borage flower, senna, and rose leaves, and then strain off, and to both decoc- tions add the sugar and honey, and boil the whole to the con- sistence of a sirup. The dose for a man is six tablespoonfuls, and for a woman four, taken without addition, at six in the morning. The sarsaparilla ptisan is then to be commenced, and is made as follows : — Boil Eij. of Sarsaparilla in three quarts of water, to two quarts, suffer it to infuse during the night, and strain it off' in the morning. This is to be drunk by the tumblerful, and several are to be taken during the day. The above preparation has been asserted, by the New York Medical Society, to be nearly identical with the noted Panacea of Swaim. It is believed that corrosive sublimate is often intro- duced into these nostrums at the discretion of the vender. That both the French and American have frequently salivated, is well ascertained. Decoction of Burdock. R. Kadicis Lappa?, 3iij. Aqua), Oiij. Kcduce the fluid by boiling to two pints, and strain. A teacup- ful may be taken for a dose, five or six times a day. In syphilis, scurvy, arthritic affections, &c. DIAPHORETICS. OV Decoction of Mezereon. R. Mezerei, Jvj. Aquas, Ovj. Eeduce by boiling to Ebiv., and near the end of the decoction, add Eadicis Glycyrrhizse, 3j. Strain, and give from one to four pounds per diem, as the stomach will bear it. In scrofula complicated with syphilis, &c. Compound Decoction of jSarsaparilla. R. Decocti Sarsaparillse Compositi, Oj. Give a teacupful four or five times a day. This preparation, a formula for which is to be found in almost every Pharmacopoeia, has long been celebrated in the sequelae of syphilis, and the disease produced by the improper exhibition of mercury. It is also much employed in rheumatism. The rules laid down in the Dispensatories for the preparation of the decoction should be closely observed. Decoction of Zittmann. This preparation has long been used successfully in Germany and England, and is now coming into notice in this country, as a valuable remedy in the treatment of secondary syphilis, com- plicated with a scrofulous diathesis. The formulas given below I have translated from a work published by Prof. Walther, of Leipzig, in 184:7, and which he says are copied from Zittmann's original prescription (nach der Originalvorschrift.) It will be seen that the strength of the decoction varies materially from the formulae heretofore published. Editor. R. Sarsaparilla, in chips, Ixij. Digest in a tinned vessel for 24 hours, with spring water, mxlviii., then add, inclosed in a small bag — Of Saccharine Alum, 1 gjss. " Calomel, 3ss. " Cinnabar, 3j. B oil down to Sbxyj . "When the boiling is nearly completed add — Of Senna, Siij. " bruised Aniseed, " Eennelseed each, 3ss. Remove from the fire and add — Of bruised Liquorice root, ^jss. And when cold, strain, and mark : The Strong Decoction. 1 Saccharine Alum consists of Alum four parts, and Kino one part. DORVAITLT. 90 DIAPHORETICS. R. To the dregs of the strong decoction, add, Sarsaparilla, in chips, Ivj. Digest for twenty -four -hours in spring water, Ifcxlviij. Then boil down to Ibxvi. When the boiling is nearly com- pleted, add — Of Lemon Peel, sliced, "] " Cinnamon, bruised, j-each3iij. " Cardamoms, " J - Eemove from the fire ; add — Of bruised Liquorice root, 3yj. When cold, strain, and mark : The Weak Decoction. Patients with constitutional, or secondary syphilis, or invet- erate skin diseases complicated with a scrofulous habit, are treated in the following manner : At night, the patient takes a purgative dose of calomel and jalap, or some other active ca- thartic, "and the next morning begins the regular course, by drinking one-half of a quart bottle of the strong decoc- tion, taking a glass of it warm every half hour, in bed to bring out the perspiration. In the afternoon, he takes a whole bottle of the weak decoction, cold, in divided doses ; and in the evening he drinks (cold) the remaining half of his bottle of strong decoction. This is repeated for four days. On the sixth, a pur- gative is again administered; and for the following four days the decoctions are used. On the eleventh, pills are again given, and then all treatment is suspended for a week. If the cure is not completed, the same process is again resorted to. The diet should consist of light broths, bread, and lean roasted meats." Although the above prescription cannot be defended on strict chemical and pharmaceutical grounds, yet the remarkable suc- cess attending its use in many of the hospitals of Europe, entitle it to notice. MIXTURES. Mixture of Muriate of Baryta and Iron. R. Barii Chloridi, 3ss. Aqua) Mentha? Piperita), fSijss. Tinctura) Ferri Chloridi, f oSS. Syrupi Aurantii Corticis, f 3J. Fiat mistura. Signa. — Take a tcaspoonful every three hours. Used in obstinate scrofulous diseases. Each dose contains about one grain of the chloride of barium, and seventeen drops of the muriate I tincture of iron. This corresponds in strength with a prescription by Fischer. DIAPHOEETICS. 91 Mixture with Buchu and Iodide of Potassium. R. Infiisi Bucliu, f Jviij. Liquoris Potassae, f 5j. Potassii Iodidi, Jss. Spiritus iEtheris Nitrici, f 3iij. Fiat mist ura. Signa. — Take two tablespoonfuls three times a day. Used in chronic rheumatism. S. Wright. Corrosive Sublimate Solution. R. Hydrargyri Chloridi Corrosiyi, gr. j. Solve in Aquam, flss. Dein adde — Syrupi Sarsaparillae Compositi, f svijss. Misce bene. Signa. — Take a tablespoonful three times daily. Used in chronic rheumatism, secondary syphilis, and various skin diseases. Editor. Sarsa/parilla Beer. R. Sarsaparillae contusae, ft>ij. Pulveris Gruaiaci Corticis, oviij. Ligni Guaiaci concisi, Anisi, Eadicis Glycyrrhizae contusae, aa ifiv. Mezerei, Ij. Sacchari Faecis, Bbij. Caryophylli contusi, Iss. Aquae bullientis, cougios iv. Mix these ingredients, and agitate the vessel thrice a day. When a fermentation has well begun it is fit for use, and may be taken in the dose of a small tumblerful twice or thrice a day. " This is the Spanish recipe for the Jarave or diet drink, some- what modified. If intended for old and obstinate complaints, as leprous affections, elephantiasis, various anomalous ulcerations and foul disorders of the skin, there may be added to the jug, after fermentation has well begun, tartrate of antimony twelve grains, corrosive sublimate eight or ten grains, muriate of am- monia one dram, dissolved previously in a little water. These remedies greatly increase the alterative powers of the vegetable infusion, and so effectually prevent its decomposition that it may be kept for a long time unaltered, even in a hot climate." — See Hancock on Sarsaparilla. Journal of the Philadelphia College of Pharmacy, vol. i. No. 4. CLASS VI EXPECTOEANTS. During- the administration of Expectorants the patient should be kept warm, and, if the complaint be violent, in bed. The dose of all Expectorants should be repeated sufficiently often to allay the irritation as much as possible ; for it is obvious that the act of coughing increases that very irritation which originally gave rise to it. POWDEKS, PILLS, AND LOZENGES. Powders of Myrrh, Ipecacuanha, &c. R. Pulveris Myrrhas, gr. xij. Ipecacuanha, gr. yj. Potassas Nitratis, 5ss. Misce, et divide in partes iv. One to be taken every fourth hour. A stimulating expectorant. — Paris's Pharmacologics Compound Powder of Ipecacuanha. R. Pulveris Ipecacuanhas, et Opii, 5ss. Divide in chartulas iij. Signa. — One, two or three times in 24 hours, mixed in sugar and water. , This, the Dover's powder, has been already introduced under the head of Diaphoretics, where, perhaps, it most properly be- longs; but it often proves of such decided advantage a's an expectorant, as to deserve an insertion here. EXPECTORANTS. 93 Powders with Nitrate of Potash, Calomel, Opium, &c. R. Potassae Nitratis, 3j- Hydrargyri Chloridi Mitis, gr. iij. Pulveris Opii, gr. iij. Ipecacuanhas, gr. iij. vel vj. Misce, et divide in chartnlas vj. Signa. — One every two or three hours in sirup or molasses. This preparation closely resembles the former, with the ex- ception that it contains calomel. All powders containing calomel, or other metallic preparations, should be given in sirup, as they sink when water is employed as the vehicle. Pills of Sulphate of Zinc and Myrrh. R. Zinci Sulphatis, gr. x. Pulveris Myrrhss, Jiss. Confectionis Kosse, q. s. ut flant pilulas xx. This prescription is taken from the Pharmacologia of Dr. Paris, who recommends two of the pills to be taken twice a day. It is principally used in pertussis ; but a more efficient direc- tion would be to reduce the myrrh to a dram, on account of the size of the pills, and to give a pill qyqtj two hours. Dr. Paris remarks, that the principal nostrums for hooping-cough are formed either of opium or sulphate of zinc. Pills of Conium, Ipecacuanha, &c. R. Extract! Conii, Pulveris Ipecacuanhse et Opii, aa gr. x. Misce, et flant pilulae v. — Of which two may be taken at bed- time. In pulmonary irritation, attended with rheumatic and other local pains. Pills of Tartar Emetic, &c. R. Antimonii et Potassae Tartratis, Pulveris Opii, aa gr. jss. Tragacanth.se, gr. x. Confectionis Kosse, q. s. ut flant pilulae xxv. Two to be taken night and morning. In chronic pulmonary catarrh. Dr. Pariset. 94 EXPECTORANTS. Pills of Squill, Ammoniac, &c. R. Pulveris Scillae, gr. xxx. Ammoniaci, 3iss. Extracti Conii, gr. xxx. Divide into xxx. pills ; of which, two may be taken twice a day. In asthma and chronic catarrh. Pills of Squill, Calomel, &c. R. Hyclrargyri Chloridi Mitis, gr. iij. Scillae recentis, Ammoniaci, aa 9j. Pulveris Ipecacuanhas et Opii, 3ss. Confectionis Eosas, q. s. ut fiat massa, et divide in pilulas xxx. One, three or four times a day. In troublesome cough. Dr. Latham. The recent squill is greatly preferred by some physicians. It is generally given in double the dose of the dried root. Pills of Calomel, Squill, &c. R. Hydrargyri Chloridi Mitis, gr. xxiv. Pulveris Scillae, 3ss. Antimonii et Potassas Tartratis, gr. vj. Pulveris Opii, gr. xviij. Syrupi, q. s. Fiant pilulas xxiv. Signa. — One every night. In catarrhal affections. Pills of Sulphate of Zinc. R. Zinci Sulphatis, 9ss. Confectionis Eosae, q. s. ut fiant pilulas xx. — One of these pills may be given three times a day. In phthisis and pertussis. Tar Pills. R. Picis liquidas, 3j. Pulveris Glycyrrhizas, q. s. ut fiant pilulas xxx. — One to be taken every three or four hours. Pills of Tar, Gentian, and Quassia. R. Picis liquidas, 3j. Extract] Quassia, gr. xx. Pulveris Gentianas, q. s. ut fiant pilulas xx. Signa. — To take morning, noon, and niorht. EXPECTOKANTS. 95 Tar may be advantageously made into pills with powdered gentian alone, and thus combine the tonic and expectorant effect. Pills of Myrrh, &c. B. Myrrhse, 5iss. Pulveris Scillse, 3ss. Extracti Hyoscyami, Bij. Aquas destillatas, q. s. ut fiant pilulas xxx. — Two to be taken night and morning. These pills are recommended by Dr. Paris, in phthisis and catarrh attended with great debility of the pulmonary organs. Pills of Gyanuret of Potassium. B. Potassii Cyanureti, gr. j. Amyli, gr. iv. Syrupi, q. s. ut fiant pilulae viij. Dose, a pill night and morning, watching its effect. See remarks on Prussic Acid, page 105. Wistar's Cough Lozenges. * B. Pulveris Acacias, Extracti Glycyrrhizas, Sacchari, aa 5ij. — : — . 9? 11 ' s r - ^*- Olei Anisi, gtt. iv. Misce, et adde — ■ Aquas destillatas, q. s. ut fiant trochisci lx. Signet. — One of these may be dissolved in the mouth three or four times a day. PJmetia Lozenges. B. Emetias Fuscas, gr. xxxij. Sacchari, jfij. Mucilaginis Acacias, q. s. Divide into lozenges, each weighing ten grains. One of these will produce more or less nausea in a child ; but if this is not desirable, they can be given in divided portions. Adults may take several at intervals of two hours, without the risk of vomitins;. 96 EXPECTORANTS. * Cubeb Lozenges. R. Pulveris Cubebas, 3ij. Balsami Peruviani, gr. vj. Syrupi Tolutani, fij. Extracti Glycyrrhizse, 3j. Acacias, q. s. Mix, and divide into lozenges of ten grains each. These are called Spitta's lozenges, and are celebrated for the relief they afford in coryza. Jackson's Pectoral Lozenges. R. Pulveris Ipecacuanhas, gr. x. Antimonii Sulphureti prascipitati, gr. v. Morphias Muriatis, gr. yj. Pulveris Acacias, "] Sacchari ? \- aa 3xj. Extracti Glycyrrhizas J Olei Sassafras, gtt. iv. Tincturas Tolutanas, f3iv. Syrupi, q. s. Fiat massa, in trochiscos cc. diviclenda. Each lozenge, weighing ten grains, contains of ipecacuanha gr. ^q, of precipitated sulphuret gr. ^ and of the muriate of morphia gr. -g 1 ^. Signa. — One of these to be dissolved in the mouth, when the cough is troublesome. S. Jackson. EXPECTOKANT SIEUPS. Sirup of Squills. R. Syrupi Scillas, fgj. Signa. — Take a teaspoonful every three hours. Sirup of Garlic. R. Syrupi Allii, f|j. Signa. — Give a teaspoonful to a child every three hours. This, like the sirup of squills, is an excellent expectorant, being somewhat stimulant in its character. Sirup of Senelea Snake-root. B. Syrupi Scncg.no, f.sj. Sign". — Take a teaspoonful every three hours as a stimulant expectorant. EXPECTORANTS. 97 Coxe's Hive Sirup. B. Syrupi Scilke Compositi, Oj. A small teaspoonful may be given to a child of one year old with croup every quarter, half, or one hour, according to the vio- lence of the disease, and until vomiting ensues ; then discon- tinue it. Sirups of Squills, Seneka, and Ipecacuanha. B. Syrupi Scillas, Senegas, aa fass. Ipecacuanhas, f Jj. Misce. Signa. — A teaspoonful every three hours. This is a favorite combination with some physicians, as it combines the expectorant qualities of the squill and seneka, with the relaxing effect of the ipecacuanha. Sirup of Assafetida. B. Assafcetidas, 3j. Aquas bullientis, Oj. Sacchari, Bbij. Triturate the assafetida in a mortar, with a portion of the boiling water, until a uniform paste is formed ; then gradu- ally add the remainder of the water, strain, and add the sugar, applying a gentle heat to dissolve it. Kichard Peltz. Dose, a teaspoonful every three hours, for a child five years old. Each nuidounce contains fifteen grains of assafetida. This preparation will keep a month in the hottest weather. Its taste is less nauseous than the milk of assafetida, and altogether, it is one of the very best modes of administering the fetid drug to children in hooping-cough, I am acquainted with. Editor. Sirup of Wild Cherry Bark. B. Syrupi Pruni Yirginianas, f^ij. Signa. — Take a tablespoonful every three hours. When well prepared, this represents the tonic and sedative properties of the wild cherry, which render this bark so pecu- liarly applicable to the treatment of phthisis. 98 EXPECTOBAXTS. Jackson's Pectoral Sirup. R. Sassafras Medullas, Jj. Acacias, 5J. Aquas, Oj. Macera per boras decern vel duodecim, dein adde — Sacchari, gxxj. Et solve sine calore, cola, et adde — Morphias Muriatis, gr. viij. Signa. — Take from a teaspoonful to a tablespoonful, according to circumstances, every three hours. It is intended that this preparation, when completed, shall measure two pints, and if it does not, the operator is to add the complement of water, so that each fluidounce shall contain one- fourth of a grain of the muriate of morphia. It is much em- ployed in Philadelphia. Samuel Jackson. EXPECTORANT MIXTURES. Brown Mixture. R. Pulveris Extracti GTycyrrhizas, Acacias, aa 5ij. Aquas ferventis, fjiv. Misce, flat solutio, et adde — Spirit us ^Etheris Nitrici, f3j. Yini Antimonii, f3ij. Tincturas Opii, gtt. xl. vel lx. Signa. — A tablespoonful for a dose, pro re nata. In catarrh. A preparation very similar to this is now officinal under the name of Mistura Glycyrrhizce Composita. Mixture with Sirup of Squill, d'c. R. Syrupi Scillas, flss. Tincturas Opii Camphoratas, f5ij. Vini Antimonii, f 3j- Pulveris Acacias, 3ss. Aquae destillatas, f^iij. Misce. Signa. — A teaspoonful every two or three hours. This is more particularly designed for children. EXPECTORANTS. 99 Mixture with Seneka, Squill, Tartar Emetic, &c. R. Decocti Senega, f aiv. Svrupi Ipecacuanha?, f 5J. Oxyniellis Scilla?, f3iij. Anthnonii et Potassa? Tartratis, gr. j. Fiat mistura. Signa. — A teaspoonful, pro re nata, for children of two years of age and upwards. In cronp. Mixture with SeneJca, Ammoniac, and Tola. R. Senega? contusa?, 5ij. Aqua? bullientis, f^viij. Coque ad f §vj. Cola, et adde — Syrnpi Tolutani, f sj. Ammoniaci, Jss. Misce. — A tablespoonfnl every two hours. In catarrh. Mixture of Extract of Conium, &c. R. Extract! Conii, 3j. Tinctura? Opii Camphorata?, f ^ss. Syrnpi Tolntani, f 5ss. Aqua? Eosa3, f liv. Misce. Signa. — From half to a whole teaspoonfal may be given once in four hours to a child a year old, watching the effect. Dr. Pearson, in his work on pertussis, recommends the above as a valuable formula. Mixture of Almond Emulsion, &c, R. Mistura? Amygdala?, f Ev. Vini Ipecacuanha?, Tinctura? Scilla?, aa f Jj. Syrnpi Tolutani, f 5yj. Misce. Signa. — Take a tablespoonfnl whenever the cough is urgent. White Linctus. R. Amygdala? clulcis, No. xv. Tragacantha?, 9j. Syrnpi, faj. Olei Amygdala?, fjij. Aurantii Ploris Aqua?, Lond. f 3ij. Aqua? destillata?, f iiv. Misce. Signa. — A tablespoonfnl for a dose, frequently through the day. In catarrh. 100 EXPECTORANTS. Mixture with Tartar Emetic and Laudanum. R. Antimonii et Potassas Tartratis, gr. j. Aquas destillatae, f |j. Tinctures Opii, "Ixx. Misce. Signa. — Give a teaspoonful, or a dessertspoonful ac- cording to the age of the child, in hooping-cough. Sir. Wm. Watson. Mixture with Sal Ammoniac, Squills, etc. B. Ammonias Muriatis, Iss. Pulveris Acacias, 3ij. Extracti Glycyrrhizas, 5hj. Aquas, f 3vjss. Spiritus iEtheris Nitrici, f 3jss. Aceti Scillas, f 3iij. Fiat mistura. Signa, — A tablespoonful every two hours. A stimulating expectorant and alterative. Goeden. Mixture with Naphthaline. K. Naphthalinas, gr. xyj. Alcoholis, q. s. Ut fiat solutio. Dein adde — Syrupi, f 3iv. Misce. Signa. — Take a tablespoonful every two hours. This is a stimulating expectorant, useful in chronic catarrh, humoral asthma, etc. Dupasquier. Mixture of Oil of Amber and Tolu. B. Olei Succini rectificati, gtt. Ixxx. Acacias, Sacchari, aa 3ss. Aquas destillatae, f §iv. Tinctures Tolutanas, f 3ij- Fiat mistura secundum artem. Signa. — A tablespoonful every two or three hours. In spasmodic cough. Mixture with Carbonate of Potash, d'c. U. Potassas Carbonatis, 3ij. Vini Antimonii, f 3j. Tincturse Opii, gtt. xl, Spiritfis Lavandulae Oompositi, f3ij« A'|u;c destillatse, f'siv. Fiat mistura. — And let a tablespoonful be taken every hour or two hours. EXPECTOEANTS. 101 Mixture with Bicarbonate of Soda, &c. R. Sodae Bicarbonatis, gr. xij. Yini Ipecacuanhas, gtt. xx. Tincturae Opii, gtt. iv. Aquae destillatae, f 3j. Misce. Signa. — Give a teaspoonful every two or three hours. This preparation is designed for children, and is chiefly used in pertussis. Cochineal Mixture. R. Potassae Carbonatis, 9j. Pulveris Cocci, 9ss. Sacchari, Jj. Aquae destillatae, f iiv. Fiat solutio. — Dose for children, a teaspoonful every two or three hours. A popular remedy in pertussis. Mixture with Tincture of Digitalis, &c. R. Tincturae Digitalis, f Jj. Opii, gtt. lx. Aquae destillatae, f oij. Misce. — A small teaspoonful may be taken three or four times a day. In haemoptysis and in incipient phthisis. Mixture of Assafetida, &c. R. Assafoetidae, 3j- Aquae, f §iv. Fiat mistura, et aclde — Tincturae Tolutanae, f^ss. Opii, gtt. xx. vel xl. A teaspoonful to a child every two hours, and a dessertspoonful (or more) as frequently to an adult. This preparation is of great value in pertussis and other spas- modic diseases of the chest. Tincture of Bloodroot. R. Tincturae Sanguinariae, f^j. Direct from 30 to 50 drops every three hours. This native product is one of the most powerful medicinal agents. It is violently emetic in large doses, but in the quantity 102 EXPECTORANTS. recommended is said to produce diaphoresis and effects analo- gous to those of digitalis. Its active principle is called sanguinarina. Mixture of Gum Ammoniac, &c. R. Ammoniaci, 3j- Aquae destillatae, f ^iv. Fiat mistura, et adde — Oxymellis Scillae, f 3ij. Tincture Opii Camphoratae, f Iss. A tablespoonful may be given every two hours. A stimulating expectorant. Mixture with Milk of Assafetida and Acetate of Ammonia. R. Assafoetidae, 5ss. Liquoris Ammonias Acetatis, Aquae Menthae Viridis, aa f ^ij. Fiat mistura. — A teaspoonful to children, and a tablespoonful to adults, in coughs, pro re nata. This simple solution of assafetida is frequently employed, and is found to answer every purpose of more complicated prescriptions. Mixture of Copaiba and Balsam Tolu, &c. R. Copaibae, Balsami Tolutani, Pulveris Acaciae, aa 3ss. Aquae destillatae, f^vj. Acidi Sulphurici ArOmatici, gtt. xx. Fiat mistura. — Dose, a tablespoonful, pro re nata. In chronic hooping-cough. "When there is hectic excitement, digitalis may be added. Tincture of Tolu iviih Digitalis ', &c. R. Tincturae Tolutanae, f *iss. Acidi Sulphurici Aromatici, f5ss. Tincturae Digitalis, f3j. Vini Antimonii, f.^ij. Mellis despumati, fjiss. Pulveris Extract! Glycyrrhizae, Jss. Acruae destillataB, fivj. Fiat mistura. Signa. — A tablespoonful to be given according to circumstances. EXPECTORANTS. 103 Mixture with Balsam Peru, dec. R. Balsami Peruviani, 5ss. Acaciae, q. s. Aquae Cinnamomi, destillatas, aa f Ess. Misce. Signa. — To be taken at once, and repeated three or four times a day. The different balsams were at one time almost proscribed from the class of expectorants, on account of their stimulating qualities. Copaiba, however, and some others of this class, are now much employed in diseases of the pulmonary mucous mem- brane ; and the author has himself prescribed it with great advan- tage in the peculiar hoarseness that follows measles. Ellis. Tar Beer. R. Strong Beer, one gallon. Tar, sufficient to saturate. Mix, and allow them to macerate for three days, with occasional agitation. Dose, one or two tablespoonfuls several times a day. Eobinson. Tar Water. R. Picis liquidae, Oij. Aquae, Cong. j. Mix them, and stir them together with a wooden rod for an hour ; then let the tar subside, strain the water and keep it in well-corked bottles. — A pint, or even two pints, may be taken daily; but in some cases the dose must be greatly diminished. Decoction of Tar and Bran, sometimes called Jew's Beer, or Wine of Tar. Water, three quarts, Wheat bran, one quart, Tar, one pint, Honey, half pint. To be simmered together for three hours, and when cool, add a pint of brewer's yeast, and let it stand for thirty-six hours. Then bottle it. Dose, a tablespoonful morning, noon, and night. Mixture of Gum Ammoniac and Nitric Acid, called Nitric Lac Ammoniac. R. Ammoniaci Dijss. Acidi Mtrici, f 3ij. Aquae, f^viij. Pour the nitric acid and water together, then add the compound 104 EXPECTORANTS. gradually to the gum, incorporating them well in a composi- tion mortar. A tablespoonful may be taken three or four times a day. This preparation is strongly recommended in protracted catarrh and phthisis pulmonalis, by Dr. J. Stuart, author of a treatise on Golds. Mixture of Spermaceti, dec. R. Cetacei, Jij. Sacchari, giij. Tincturas Opii Camphoratas, f 3ss. Aquas, Oviij. Eub the spermaceti and sugar together with the yelk of an egg, then gradually mix the water. — A tablespoonful for a dose, four or five times a day. In catarrh. Sirup of Tolu with Belladonna, dr. R. Extracti Belladonnas, gr. viij. vel xij. Yini Ipecacuanhas, fjj. Syrupi Senegas, f Ess. Tolutani, f *iijss. Misce. Signa. — To take a teaspoonful three or four times a day, freely using gum water acidulated with lemon-juice. In coughs. Infusion of Flaxseed, dec. B. Lini, %}. Eadicis Glycyrrhizas contusas, Ess. Aquas bullieutis, Oij. Macerate for two or three hours uear the fire, in a covered vessel ; strain, and add lemon-juice sufficient to make it agreeable. It may be given as a common drink in catarrh. Decoction of Iceland Moss. It. Cetrarias, 5J. Aquas, Ojss. Boil to one pint, and strain. This article once acquired great celebrity in coughs; but was overrated, and lost its reputation. It contains a bitter quality, winch is sometimes an advantage in dyspepsia and phthisis. If freed from this, by macerating before boiling, and throwing the first liquor away, as is sometimes done, the pre- EXPECTORANTS. 105 paration is reduced to a mere demulcent, and has no advantages over other members of that class. Prussic or Hydrocyanic Acid. As prussic acid rises to the top of an aqueous mixture, thereby rendering the dose very uncertain, we prefer directing the patient to drop the dose each time into a solution of gum Arabic or simple sirup. It should be kept covered from the light, and not allowed to be accessible to those unacquainted with its power, as even a strong inhalation will sometimes pros- trate an adult. Ellis & Morton. The physician should also know after what process the acid is made that he prescribes, and that it corresponds in strength with the officinal standard. In other words, that he is employ- ing the Acidum Hydrocyanicum diluturn of the U. S. Pharmaco- poeia, the dose of which is one or two drops, three times a day, in mucilage, or sugar and water, and augmented one drop daily until its action on the system is developed. Editor. Pectoral Mixture. R. Acidi Hydrocyanici diluti (one fluidram), f5j. Aquas destillatas, Oj. Sacchari, siss. Mat mistura. Signa. — A dessertspoonful may be taken morning and evening, and gradually increased (if necessary) to six or eight spoonfuls in the twent}^-four hours — shaking the vial each time. Magendie. Mixture with Prussic Acid. H. Acacias, Iss. Aquas, f ovijss. Eiat solutio, et adde — Syrupi Tolutani, f ^ss. Acidi Hydrocyanici diluti, gtt. xij. Eiat mistura. Signa. — Take a tablespoonful every three hours. This is "a medium dose," which I prefer in commencing the use of so poAverful a medicine. — S. Gr. Morton, Illustrations of Pul- monary Consumption, p. 132. In the former editions of this work, two formulas were given for the preparation of "Magendie's medicated solution of hyclro- cyanate of potassa." The following is more simple, and corre- sponds with them precisely in strength and dose. Editor, 106 EXPECTORANTS. Mixture of Hydrocyanate of Potash. R. Potassii Cyanureti (seven grains), gr. vij. Aquae destillatae, Oj. Fiat solntio, et adde — Sacchari, 3jss. Misce. Dose, a tablespoonful night and morning, watching its effect. Each dose contains one-fifth of a grain. The cyamiret of potassium is said to exercise the same power over the system as prussic acid, being equally active, but with the advantage of being a more uniform and permanent medi- cine. Mixture with Cyanuret of Potassium. B=. Potassii Cyanureti (half a grain), gr. ss. Aquae Lactucae, f^ij. Syrupi Altheae, f sj. Fiat mistura. Dose, a tablespoonful every two hours. Magendie. We cannot enjoin too much caution in the use of all the pre- parations of prussic acid, some of which are extremely variable in themselves, and all produce very unequal effects on different constitutions. It is questionable whether the practice of medi- cine has gained anything by their adoption into the Materia Meclica. Mixture with Tincture of Lobelia and Prussic Acid. E. Tincturae Lobeliae, f.^j. Acidi Hydrocyanici dilnti, gtt. j. vel ij. Misce. Signa. — To be taken at a dose, three or four times a day. Highly serviceable in asthma and (in smaller doses) in hoop- ing-cough. Livezey. Mixture of Gum Ammoniac, d-c. R. Misturae Ammoniaci, f^iij. Tincturae Castorei, f3ss. Syrupi Tolutani, f ,fss. Tincturae Opii, gtt. xx. vcl xxx. Aquae Cirmamomi, f 5j. Fiat mistura. Signa. — A small tablespoonful every three or four hours, in troublesome cough. Dr. Meigs. EXPECTOEAXTS. 107 Mixture of Morphia and Tolu. R. Oxymellis Scillas, fliss. Syrupi Tolntani, f^ss. Morphias Acetatis, gr. ss. vel j. Misce. Signa. — A teaspoonful may be taken every two or three hours, pro re nata. In phthisis, and other diseases attended with cough. Tolu with Morphia and Antimony. R. Mucilaginis Acacias, Oj. Syrupi Tolutani, f 3ij. Morphias Sulphatis, gr. i. vel ij. Antimonii et Potassas Tartratis, gr. i. vel ij. Misce. Signa. — A tablespoonful to be given every two hours. Moetcxn" on Consumption, p. 123. Decoction of Seneka SnaTceroot. R. Kadicis Senegas contuses, §j. Glycyrrhizas, Ess. Aquas destillatas, Ojss. Boil down to a pint, and strain. Dose, a tablespoonful. This decoction is prescribed in pectoral diseases, and espe- cially in croup. It is sometimes too pungent, and may require to be much diluted. Infusion of Tar and Hops. R. Picis liquidas, Ij. Aquas bullientis, Oij. Humuli, Iss. Misce et cola. Dose, a tablespoonful morning, noon, and night. INHALATION. Inhalation is a means of applying remedies directly to the lungs. A good instrument for this purpose is the Inhaler of Muclge ; but as a substitute the common teapot may be used, or a funnel inverted over a bowl. The substances usually se- lected for inhalation are, the steam of warm water ; the steam of vinegar, produced by pouring it into boiling water ; and various other articles next to be enumerated. 108 EXPECTORANTS. Inhalation of Balsam of Tolu. R. Balsami Tolutani, §j. Aquae bullientis, Oj. Misce. — To be inhaled. Ether is also used alone, or impregnated. When saturated with cicuta, and inhaled from a wineglass, it is adapted to pro- tracted catarrh, pneumonia, consumption, &o. Dr. Morton ad- vises Dr. Pearson's formula, which consists in keeping a dram of powdered cicuta in an ounce of ether for a week. A tea- spoonful or two of this impregnated fluid may be inhaled at a time, and repeated thrice per diem. — Morton on Consumption, p. 186. The latter practitioner has more recently recommended the following formula : — Ethereal Tincture of Iodine and Cicuta for Inhalation, R. Iodinii, gr. viij. Pulveris Conii, gr. xvj. jEtheris, fSij. Macerate the ingredients together for 24 hours or more. Half a teaspoonful at a time is to be breathed from a wineglass , grasped in the warm hand, and repeated twice or thrice a day. If it does not affect the head, the quantity inhaled may be gradually increased to a teaspoonful. S. Gr. Morton. The following is Dr. Scudamore's recipe for Iodine inhalation : — R. Iodinii, Potassii Iodidi, aa gr. vj. Aquae destillatae, f^v. 3vj. Alcoholis, f^j. Mix, and use for inhalation. I usually commence with a dram of this mixture, proceed- ing gradually to the extent of half an ounce (rarely more), putting two-thirds the dose for the first half of the time (10, 15, or 20 minutes), and the other third for the remainder, always adding thirty minims of a saturated tincture of conium, with an increase if the cough be very irritable. Occasionally, I add some saturated tincture of ipecacuanha ; and when the respira- tion is spasmodically affected, some ethereal tincture of lobelia inflata. Scudamore. Stramonium is particularly serviceable in asthma and con- sumption. The root, is cut, dried, and smoked from a common Fumigation with tar and turpentine is also much in use. It EXPECTORANTS. 109 is usually applied by placing the tar on a dish over coals, and suffering it slowly to evaporate ; but a far neater and more effectual mode is that practised by Sir Alexander Crichton, viz : " An ounce of potash is added to every pound of tar, in order that the latter may be deprived of its pyroligneous acid. The two ingredients being well mixed, should be first boiled for a few minutes in the open air, in order to disengage any impurities, and then be kept at a simmer in the room of the patient. This is effected by putting the mixture in an iron vessel, and placing the latter over a spirit-lamp, or some analogous contrivance. In this way, not only a chamber, but an entire house, is speedily pervaded by a most agreeable vapor, which, although it may at first excite some disposition to cough, both in healthy and sick persons, very soon, in a majority of cases, allays this symptom, and with it a great proportion of the patient's distress." — Morton, ut supra. The fumes of rosin were much employed by the late Dr. Par- rish, of this city ; he directed it to be put on a hot shovel, or coals, and allow the patient gradually to inhale it. To some persons it is very agreeable, while the lungs of others cannot tolerate it. In some cases of croup, the inhalation of ether or Hoffman's anodyne, will often procure prompt relief, and gain time for the application of general remedies. Chlorine gas has also been much used by inhalation, not pure, however, but mixed or diluted with atmospheric air. For this purpose a little acid of any kind may be dropped gently on a mixture of chloride of lime, by which means the chlorine is gradually disengaged, and is inhaled as it rises ; or the air of a room may be pervaded with it in like manner. It has been much commended in bronchitis and the kindred affections, but is getting into disuse from its manifest inefficiency. 1 1 Fumigation of Chlorine. R. Sodii Chloridi, flrij. Oxidi Mangaiiesii, ^v. Aquce, Ibj. Acidi Sulphurici, Ibj. Mix the salt and manganese, and add at proper intervals the acid and water, mingled. When used in the wards of hospitals or other infected apartments, the patients should be previously removed. For the method of preparing the different chlorides used as disinfecting agents, see Journal of the Philadelphia College of Pharmacy, vol. i. No. 4. CLASS VII EMMENAGOGUES. Emmenagog-ues are those medicines which promote the menstrual discharge, or restore it when entirely suppressed. Although by some authors the specific action of these medicines on the uterus has been questioned, if not denied, yet by others, of equal authority, it has been fully acknowledged. It must, however, be observed, that amenorrhoea occurs under opposite states of the system ; and when general debility appears to be the cause of the local disease, it may be advisable to accompany the emmenagogue with an active course of tonics. While, on the contrary, if the obstruction be the effect of a ple- thoric habit, bleeding, cathartics, &c, are essential prelimina- ries to the successful exhibition of a specific remedy. POWDERS AND PILLS. Powder of Hiera pier a. R. Pulveris Aloes et Canelhe, 3j- Divide in chartulas yj. — One, three times a day. Powder of Aloes, Canella Alba, d-c. K. Pulveris Aloes, Jjss. Canellao, gr. xviij. Serpentariae, gr. yj. — xij. Misce, divide in pulveres yj. iSigna. — One, every three or four hours, in sirup. This compound, another form of the hiera picra of the shops, forms a very good purgative, and is usually employed as an EMMENAGOGUES. Ill Powder of Madder. R. Pulveris Rubiae, 5ss. Signa. — A small teaspoonful to be taken morning, noon, and night, in sugar and water. There are three or four qualities of madder, which circum- stance may account for its frequent inertness. Powder with Savin, &c. R. Pulveris Sabinas, Zingiberis, aa £j. Potassse Sulphatis, 3ij. Fiant pulveres vj. Signa. — One to be taken twice a day. Powder with Savin and Cantharides. R. Pulveris Sabinae, 3j. Cantharidis, gr. ij. Misce, et divide in pulveres iv. Signa. — One to be taken every night on going to bed, watching its effect. Powder of Ergot. R. Pulveris Ergotae, 9ij. Divide in chartulas iv. — Of which one may be taken morning and night, in sugar and water. Drs. Chapman and Dorsey have placed this substance under the head of Emmenagogues, where it seems properly to belong. Powder with Savin and Borax. R. Pulveris Sabinae, Zingiberis, aa gr. vij. Sodae Boratis, gr. xv. Piat pulvis. This powder is to be taken twice a day, in amenorrhoea with a languid pulse. Thomson. Pills of Myrrh, Sulphate of Iron, &c. R. MyrrhaB, 9ij. Potassae Carbonatis, Jss. Ferri Sulphatis, 9ij. Saponis, 3ss. Piat massa, in pilulas xl. dividenda. — Of which two may be taken morning, noon, and night. In suppression of the cata- menia. 112 EMMENAGOGUES. Compound Pills of Iron, R. Myrrhae (in massa), 3ij. Potassas Carbonatis, 3j. Tere simul in pulverem, dein adde — Pulveris Ferri Sulphatis, 5j- Sacchari Communis, 3j- Fiat massa, et divide in pilulas lxxx. No fluid of any kind is to be used, the brown sugar giving a proper consistence. Two or three pills are given three times a day in amenorrhoea and chlorosis. Hulse. Hooper's Pills. R. Ferri Sulphatis, 3j- Pulveris Jalapse, gr. xv. Aloes et Canellse, 3j. Myrrhee, gr. viij. Syrupi, q. s. Fiat massa, et divide in pilulas 1. Of these pills two or three are taken at bedtime, for several nights successively. They purge smartly, and I presume it is by virtue of this property they operate so beneficially as an emmenagogue. Chapman. Pills with Digitalis, Myrrh, &c. R. Pulveris Digitalis, gr. x. Myrrhas, gr. xx. Ferri Sulphatis, gr. x. Syrupi, q. s. Fiat massa, et divide in pilulas x. Signa. — Take one pill three times daily. Dr. Ash well recommends these pills in amenorrhoea combined with epilepsy. Bkight. Pills of Aloes, Sulphate of Iron, &c. R. Ferri Sulphatis exsiccati, 9j. Pulveris Aloes, Bij. Caryophylli, gr. v. Terebinthina) Venetae, q. s. ut fiant piluhe xx. One to be taken three times a day. EMMENAGOGUES. 113 DECOCTIONS, INFUSIONS, &c. Decoction of Seneha. B. Eadicis Senegae contusae, 3j. Aquae, Oj. Aurantii Corticis, ^ss. Let the seneka simmer over a slow fire until the fluid be reduced one-third; add the orange-peel, cover until cool, and then strain. Dr. Chapman observes : " My rule, in the administration of the medicine in these cases (of* amenorrhoea), is to give about four ounces of the decoction, more or less, during the day, ac- cording to the circumstances of the case. But at the time when the menstrual effort is expected to be made, and until the dis- charge is actually induced, I push the dose as far as the stomach will allow, having given as much as two ounces every hour." — Therapeutics, vol. ii. p. 38. Infusion of Ergot. B. Ergotae contusae, gij. Aquae bullientis, f 3iv. Fiat infusum. — To be given by tablespoonfuls, in protracted par- turition occasioned by deficiency of contractile power in the uterus. For the same purpose the powder may also be given in doses of Bj., as well to assist in arresting uterine hemorrhage as to promote the expulsion of the placenta. Decoction of Madder. R. Pulveris Eubiae, %]. Aquae bullientis, Oj. Simmer for fifteen minutes, and add — Caryophylli contusi, 5j- Signa. — When cool, strain and give a wineglassful every three hours, a short time before the expected return of the menstrual discharge. — See'Dewees on Females, p. 74. Solution of Iodide of Potassium. R. Potassii Iodidi, 5j. Aquae destillatae, f^j. Fiat solutio. Signa. — Dose, five to twenty drops. 114 EMMENAGOG-UES. Injection of Aqua Ammoniaz, &c. B. Liquor is Ammonias, gtt. xx. Lactis, f3j. Misce. Signa. — This quantity to be thrown into the vagina three or four times a day, in amenorrhoea. Mixture of Camphor, &c. B. Camphors, 9j. Alcoholis, q. s. ut fiat pulvis, clein adde — Pulveris Acaciae, 3j- Sacchari, 5j. Aqua3 Cinnamomi, f Ej. Fiat mistura. This mixture would more properly appear under the head of Narcotics, but as Dr. Dewees considers it particularly efficacious in dysmenorrhea, we have given it a place with Emmena- gogues. He directs " one-half the above draught to be given the instant pain is experienced, and if not relieved in an hour or two, the remainder to be given." — Syst. of Midwifery, p. 158. Sirup of Ergot. B. Ergotas, gr. xx. Extracti Opii, gr. f . Syrupi, f 3viij. Misce. Dose, two tablespoonfuls pro re nata, in engorgement of the uterus. Lisfbanc. Mixture with Cantharides, Hartshorn, &c. B. Tincturae Gentianas Composite, f ojss. Cantharidis, f 3j. Spiritus Ammonias Aromatici, f Jiij. Misce. Signa. — Give a teaspoonful three times daily. Useful in chlorosis, and hysterical depression. * Ashwell. TINCTUKES. Tincture of Ergot. B. Ergotao, sijss. Alcoholis diluti, Oj. Macerate for fourteen days, and strain. This is the formula used in Guy's I Eospital. Dose, twenty drops to a dram. EMMENAGOGITES. 115 Tincture of Black Hellebore. R. Tincturae Hellebori, £§]. Signet. — Half a teaspoonful three times a day, gradually increas- ing the quantity and watching its effect. Tincture of Black Hellebore, Myrrh, &c. R. Tincturae Hellebori, f 3ss. Myrrhae, fjj. Cantharidis, f3ij. Fiat mistura. — Dose, thirty drops, three times a day, in a little sugar and water. Dewees's Tincture of Guaiacum. R. Pulveris Guaiaci, liv. Sodas vel Potassae Carbonatis, 3iss. Pulveris Pimentae, 3J. Alcoholis diluti, Oj. Misce. — "Digest for a few days. The volatile spirit of ammonia to be added pro re nata, in the proportion of a dram or two, to every four ounces of tincture." The above formula is different from that adopted in the Phar- macopoeias, for which reason we have inserted it here. Dr. Dewees remarks that, after nearly thirty -five years' experience with this tincture, he has never known it to fail in restoring the suppressed catamenia, when the suppression was an idiopathic disease. He gives it morning, noon, and night, in doses of a teaspoonful in a little sweetened milk ; and sometimes in a little Madeira, Sherry, or Teneriife wine. It is occasionally necessary to continue the medicine for some weeks, on which occasion, the dose must be judiciously augmented. — Syst. of Midwifery, p. 149. Volatile Tincture of Guaiacum and Copaiba. R. Tincturae Guaiaci Ammoniatae, f sj. Copaibae, f ^ss. Misce. Signa. — A teaspoonful two or three times a day. In cases of amenorrhcea connected with general debility. Saturated Tincture of Iodine. R. lodinii, 9ij. Alcoholis, f 3j. Spiritus Lavandulae' Compositi, f 3ij. Fiat tinctura. Signa. — From five to ten drops in sweetened water twice a day, gradually increasing it. 116 EMMENAGOGUES. "VVe are informed by M. Durand, apothecary of this place, that the above is a saturated tincture. It is prescribed in amenor- rhcea, gonorrhoea, leucorrhcea, &c. From its great activity it requires to be cautiously adminis- tered. Tincture of Cantharides. R. Tincturae Cantharidis, f Iss. Signa. — Take fifteen drops three times a day, in sugar and water. The late Dr. Dewees was much in the habit of prescribing this article in leucorrhcea, and suppression of the menses ; in- creasing the dose a few drops every third day, until symptoms of strangury were manifested, when he desisted altogether. Muriated Tincture of Iron, &c. R. Tincturae Ferri Chloridi, Aloes et Myrrhae, aa f 3ss. Castorei, f 3ij. Misce. Signa. — Take ten to thirty drops three times a day in a wineglassful of cold chamomile tea. Tincture of Hiera Picra. R. Pulveris Aloes et Canellae, 3jss. Spiritus Vini Gallici, Oj. Macera per dies decern et cola. Signa. — A teaspoonful may be taken three times a day in sugar and water. A popular and most efficient remedy in amenorrhcea. Compound Tincture of Aloes. R. Tincturae Aloes et Myrrhae, f Ij. Dose, a teaspoonful pro re nata. Emmenagogue Suppository. R. Olei Cacao, 3ij. Pulveris Aloe's, gr. ij. Castorei, gr. viij. Pulveris Assafcetidae, gr. viij. Fiat suppositorium. One to be employed daily for several days at the expected period of the menses. KiciiAiiD. CLASS VIII ANTHELMINTICS. Anthelmintics are medicines employed to destroy and bring away worms from the alimentary canal. They are also termed Yermifoges. The only unequivocal proof of the existence of worms in the alimentary canal is the ejection of some of them^er anum, or, as sometimes happens, by the mouth. When, in such cases, ver- mifuges are resorted to, they must be persevered in for several days, with the occasional intervention of an active cathartic. POWDERS AND PILLS. Calomel with Gamboge. R. Hyclrargyri Chloridi Mitis, gr. v. Pulveris Gambogise, gr. iij. vel vj. Misce. — For an adult. To be taken in sirup early in the morn- ing. Gamboge is sometimes given in doses of fifteen or twenty grains for the tape-worm, and is highly spoken of in such cases. Calomel with Pink-root. R. Hyclrargyri Chloridi Mitis, gr. iv. Pulveris Spigelise, gr. x. Misce. Signa. — To be taken two mornings in succession, and on the afternoon of the second day, followed by a dose of castor-oil, or senna and manna. — For children upwards of four years old. 118 ANTHELMINTICS. Pink-root with Savine, &c. R. Pulveris Spigelise, Sennae, aa 9ij. Sabinas, gr. xij. Fiant chartulas vj. — One every morning till three are taken, then give a dose of castor-oil ; if the effect is not produced, the remainder may be exhibited after the same manner. Common Salt with Cochineal. R. Sodii Chloridi, 5iij. Cocci pulverizati, gr. xv. Fiant pulveres vj. One every morning, following the last dose with some purgative medicine. Dr. Rush speaks in high terms of this preparation. Powder of Santonine. B. Santonin, gr. vj. Sacchari Lactis, gr. xv. Misce, et divide in pulveres vj. Signa. — Give one powder night and morning to a child five years old, for lumbrici. " In many cases the worms are passed, says Dr. Wells, on the following morning, but not unfrequently it is necessary to give a second dose on the succeeding evening." A case of poisoning from three grains in two doses, occurred in a child four years old. (iV. Y. Journ. Pharmacy, vol. i. p. 16.) Hence, it is necessary to exercise much caution in administering this powerful medicine. Editor. Powder of Male Fern. B. Pulveris Filicis Maris, ,ij. The following is ISTouffer's plan of treating cases of tape- worm : — " Give of the powder of the Male Fern root, from one to three drams, in a large cupful of any distilled water, early in the morning. If the stomach should reject it, the powder must be repeated again, as sood as the sickness has gone off, in the same quantity. When it has been upon the stomach about two hours, a strong cathartic bolus made of calomel and gam- boge (eight or ten grs. of the last, and five or six grs. of the first) must be taken, and worked off with a draught of green tea every now and then ; and its operation may be still farther promoted, if necessary, by half an ounce, or 3vj. of salts, dis- ANTHELMINTICS. 119 solved in warm water. Till the worm comes away, which generally happens on the same day, the patient is to take no- thing bnt broth. If, however, the worm should not be dis- charged, either wholly or in part, the powder is to be repeated with the same regimen the next day." It has been suggested, and with some probability, that the purge directed to follow this medicine is the most efficient of the two. To avoid the large doses necessarily given when the powder is used, an ethereal extract has been prepared, which represents all the virtues of the root in a small bulk. It is generally called the oil of fern {Oleum Filicis Maris), and is given in the dose of fifteen to twenty grains. It is made by exhausting Ej. of the freshly dried root by f Sviij. of ether, macerating, and distilling off the ether. — Dunglison, New Rem. p. 382, 6th ed. Oil, or Extract of Fern. B. Olei Filicis Maris, 3ss. Mellis Eosse, f ss. Misce. Signa. — Take one-half at bedtime, and the remainder early in the morning, on an empty stomach. If the worm does not come away in 6 or 8 hours after the last dose, administer some mild purgative. Radius. Carbonate of Iron, B. Ferri Subcarbonatis, Jj. Divide in chartulas iij. One powder to be taken before break- fast. Of this remedy, the late Professor Rush had a very favor- able opinion. He gave it in doses of from 5 gr. to Jss. to children of from one year old to ten, and sometimes in half- ounce doses, with safety and success. It is chiefly used in tape-worm. — See Observ. and Inquiries, p. 243. Pills of Venice Turpentine, Calomel, &c. B. Terebinthinse Yenetae, 3j- Extracti Hyoscyami, gr. iv. Hydrargyri Chloridi Mitis, gr. viij. Fiat massa, et divide in pilulas singulas, gr. ij. Of these, four are to be taken every three hours, and during the entire period, the patient is to take only weak broth, tea, or coffee. They are strongly recommended by some of the German practitioners in tape-worm. 120 ANTHELMINTICS. INFUSIONS, DECOCTIONS, &o. Infusion of Pink-root, &c, vulgo, Worm-tea. R. Spigeliae, 3ss. Sennse, 5ij- Mannas, 3j. Sabinae, 9ij. Foeniculi, 3ij- Aquas bullientis, Oj. Fiat infusum. Dose, a tablespoonful three times daily for three days, for a child four or five years old. If it purge too actively, it should be discontinued. Infusion of Pink-root. R. Spigelise, oj. Aquae bullientis, Oj. Fiat infusum. Of which a child may take a tablespoonful at a dose ; an adult from 3j. to §iv. The spigelia sometimes produces violent effects in children, whence the necessity of caution in its use. Decoction of the Bark of Pomegranate Root. R. Granati Eadicis Corticis, 3jss. Aquae, Ojss. To be boiled down to one-half, and given in doses of an ounce several times a day. " The efficacy of the bark of the root of the pomegranate, as a remedy for the tape-worm, is now well established in India." Paris, vol. ii. p. 173. Infusion of Kousso. R. Florum Brayerae Anthelminticae, Iss. Aquae Bullientis, f5x. Macera per horam dimidiam. Slgna. — The tea and flowers constitute a full dose. To be used for tape- worm. The only preparation necessary is, that the last meal of the preceding evening should be slight. The previous evacuation of the bowels by a mild purgative or a lavement, is also desira- ble. The mode of administering the remedy is as follows: "A little lemon-juice is to be swallowed, and the infusion being Btirred up, the whole is taken, liquid and powder, at two or three draughts, at short intervals, being washed down by cold ANTHELMINTICS. 121 water and lemon-juice. To promote the operation, tea (without sugar or milk) may be taken. In three or four hours, if the remedy has not operated, a dose of castor-oil, or a saline pur- gative, should be administered." Jon. Pereira. ELECTUARIES, MIXTURES, &o. Tin Electuary. R. Pulveris Stanni, Jvj. vel Ij. Sacchari Faecis, vel Syrupi, f^iv. Misce. — Two or three tablespoonfuls may be given early in the morning ; to be repeated until the whole be taken, and then followed by an active cathartic. The efficacy of this substance is said to be increased by com- bination with sulphur, by which means sulphuretted hydrogen is generated, and the worm destroyed by the offensive gas. Larger doses are sometimes prescribed. Cowliage Electuary. B. Spicularum Mucunse, 3j. Mellis liquicli, q. s. ut fiat electuarium. Dose, a teaspoonful to a child two or three years old ; to be given before breakfast in the mornings of three successive days, and then followed by a brisk cathartic. In lumbrici. Bolus with Calomel, Semen Contra, and Camphor. R. Hydrargyri Chloridi Mitis, gr. ij. Pulveris Artemisise Santonicae, gr. viij. Camphor se, gr. ij. ad yj. Syrupi, q. s. ut fiat bolus. To be repeated pro re nata in children of four or six years of age. Eatier's Formulary. Mixture with Oil of Wormseed. R. Olei Chenopodii, f Jjss. Picini, ^iij. Anisi, gtt. x. Misce, et adde — Syrupi Ehei vel Sennas, f Ij. Fiat mistura. Signa. — Shake the bottle well before using. Give a teaspoonful night and morning to a child two years old. 122 ANTHELMINTICS. Mixture of Wormseed Oil. R. Olei Chenopodii, f 5j. Sacchari, Acacias, aa 3iss. Aquas Menthas Piperitas, fsijss. Misce, secundum artem. A teaspoonful of this preparation may be given four times a day for two days in succession, and then purged off with castor-oil or salts. For children of three to eight years old. This is a vermifuge of considerable reputation in this country. It is generally used in lumbrici and ascarides ; though we have heard of its having been successfully given for taenia, but in much larger doses. Olive Oil and Ammonia. R. Olei Olivas, f^viij. Spiritus Ammonias Aromatici, fjij. Dose, three tablespoonfuls night and morning. This mixture is highly spoken of by some authors, and may be given in much larger quantities ; if it does not purge, it should be followed by some aloetic or other cathartic preparation. Extract of Pink-root and Senna. R. Extracti Spigelias et Sennas Fluidi, f^ij. Signa. — Give a child two years old a teaspoonful night and morning, until purging takes place. This preparation, originally devised by Prof. Procter, has been used successfully in Philadelphia, for the last ten years, in the treatment of lumbrici. Spirit of Turpentine Is recommended for tape- worm, in doses of sss. to Jij. daily, taken in honey. Dr. Chapman speaks highly of this remedy ; but it sometimes causes strangury, and requires caution. Spirit of Turpentine, Ether, &c. R. Olei Tcrebinthinas, f^ss. JStheiris, f.^ij. Pulveris Acacias, oSS. Aquas, Oj. Misce. Signa. — Two tablespoonfuls to be taken morning and evening. In taenia. Dit. Frank. ANTHELMINTICS. 123 The effect of turpentine requires attention, for in some con- stitutions it causes violent strangury, in defiance of every pre- caution. Patients should be put on their guard against this contingency. CLYSTEES. Aloetic Enema. R. Aloes, 3j- vel ij. Lactis, Oj. Fiat enema. — The half of this may be given to a child eight or ten years old. In ascarides. Enema of Camphor and Sweet Oil. R. Camphorse, 3j- Olei OlivaB, §ij. Misce pro enemate. This preparation is particularly adapted to ascarides. and should be freely thrown up the rectum for three or four successive nights. No remedy is more effectual than this in relieving the • intoler- able itching caused by those worms. Enemata are the most certain of all remedies in ascarides ; they may be made of various substances, such as solution of assafetida, of common salt, hepar sulphuris, pure olive oil, soap, aloes, &c. &c. For children, Jss. of aloes should be dissolved in half a gill of water ; to this add a tablespoonful of sweet oil, and administer the half of the mixture on going to bed. The other half the next night, if necessary. CLASS IX STIMULANTS. In the use of stimulants, it is for the most part advisable to begin with small doses, and augment them as circumstances may require. There are* cases, however, in which it is necessary to give them plentifully ah initio. It will be often requisite to change not only the stimulating substance, but the part of the body to which it is applied ; thus, when the stomach fails, the rectum and skin may be acted upon with advantage. PILLS, POWDEES, &o. Pills of Camphor, Cantharides, &c. R. Pulveris Cantharidis, gr. xviij. Opii, CamphoraB, aa gr. xxxyj. Confectionis Bosse, q. s. Ut fiant pilulae xxxyj. — Of which one may be taken every night on going to bed. In impotency from general debility. Pills of Turpentine and Guaiacum. R. Pulveris Guaiaci, Jj. TerebinthinaB Venetas, q. s. Ut fiant pilula3 xv. Signa. — One, three times a day. These pills have a powerful effect upon the urinary organs. They are employed in gleet and leucorrhoea, but frequently produce strangury. STIMULANTS. 125 Pills of Cayenne Pepper. B. Pulveris Capsici, 5j- Micas Panis, Aquas destillatas, aa q. s. Ut fiant pilulas xij. Signa. — One, three or four times a day. In debility of the stomach, from intemperance. Aromatic Pills. B. Ammonias Carbonatis, aa dj. Capsici, Caryophylli, Macis, Olei Cari, gtt. v. Extracti Gentianas, gr. xij. Syrupi, q. s. Ut fiant pilulas xx. — One every two hours in gout of the sto- mach. Dr. Parrisb. Antiseptic Pills. B. Camphor as, Potassas ISTitratis, Pulyeris Acacias, aa 9j. Fiat massa, in pilulas xv. diyidenda. Signa. — Dose, two pills every hour or two hours. Creasote Pills. B. Creasoti, gtt. x. Pulveris Ehei, 3j. Extracti Gentianas, gr. x. Fiat massa in pilulas x. dividenda. Signa. — Take one pill three times daily. Pills of Valerianate of Quinia. B. Quinas Yalerianatis, Dub. gr. xij. Pulveris Tragacanthas, gr. vj. Aquas, q. s. ut fiat massa in pilulas viij. dividenda. Signa. — Give one pill every hour or two in hemicrania. Editor. 126 STIMULANTS. MIXTURES AND INFUSIONS. Mixture of Carbonate of Ammonia, &c. R. Ammonias Carbonatis, 3iss. Pulveris Sacchari, Acaciae, aa 3iss. Spiritus Lavandulae Compositi, fgij. Aquae destillatae, vel Menthae yiridis, f oiv. Fiat mistura. Signa. — A tablespoonful for a dose, every two or three hours. If desirable, tinct. opii, gtt. xl. vel 1. may be added to the mixture. Draught with Valerian and Carbonate of Ammonia. R. Olei Valerianae, gtt. iij. Ammoniae Carbonatis, gr. x. . Aquae Cinnamomi, f Hjss. Syrupi, f 3ss. Fiat haustus. — To be taken every fourth hour. In nervous headache, and depression of spirits. Mixture with Oil of Turpentine. R. Olei Terebinthinae, gtt. cxx. Pulveris Acaciae, Sacchari, aa 5ij. Tincturae Opii, gtt. lx. Spiritus Lavandulae Compositi, f 3ij. Aquae Menthae Yiridis, f 3 v. Fiat mistura. Signa. — A tablespoonful for a dose every two hours. This remedy has gained great reputation in some of the low forms of fever. The author once employed it in the dose pre- scribed above, in passive hemorrhage from the bowels with com- plete success ; and in hemorrhage from the bladder, resulting from low fever, it has been given with equal advantage. Draught with Powdered Ginger, &c. R. Pulveris Zingiber is, gr. xv. Ammoniae Carbonatis, gr. viij. Spiritus Cinnamomi, Lond. f3ij. Aquae, f 3iss. Misce. — To be taken at once. In gout or cramp of the sto- mach. \ STIMULANTS. 127 Camphor Mixture. B. Camphoras, 3j. Pulveris Acacias, Sacchari, aa 3iss. Tincturse Opii, gtt. xl. Aquas Menthas Yiridis, f |iv. Fiat niistura. Signa. — A tablespoonful to be given every two hours. In reducing camphor to powder (which must be done before it can be formed into a mixture), it is necessary to add to it a few drops of alcohol ; or, what is still better, to add f 3ss. of the tincture of myrrh. This renders the camphor much more mis- cible with water, and does not detract from the value of the preparation. Camphor in Milk. R. Carnphorse, 5j. Lactis bullientis, f ^iv. Fiat solutio. — This preparation may be taken in the manner directed for the former one. Camphor Julep. R. Camphoras, 3j- Aquas bullientis, f Sviij. Fiat mistura. — This preparation should be set aside in a cov- ered vessel for half an hour, and then strained. A table- spoonful for a dose pro re nata. Many of the older practitioners are in the habit of using a hot camphor tea, in dysmenorrhea, under an impression that its virtues are better developed. It certainly is stronger hot than cold, but in neither case is it equal to the officinal camphor water (aqua camphoras) which contains three grains to the fluid- ounce when properly prepared. Editor. Camphor tuith Myrrh. B. Camphoras pulverizatas, 3j. Pulveris Myrrhae, 3ss. Sacchari, 3ij. Aquas, f 3yj. Misce. Signa. — A tablespoonful to be given every two hours. 128 STIMULANTS. Mixture with Camphor and Chloroform. B. Camphorae, 3ij. Chloroformi, 3j. Yitellus Unius Ovi, Aquae, f £iv. Fiat mistura. This mixture affords us the means of administering large doses of camphor, in as concentrated a form as it would be safe to give a local irritant. It can be diluted with water without precipitation. Each teaspoonful contains four grains. Smith. Camphorated Enema. B. Enematis Communis, Oij. (See page 62.) Camphorae, 3ij. Yitellus Unius Ovi. Misce. One-fourth part to be thrown up the rectum in the treatment of putrid fevers, pro re nata. M. Chaussier. Mixture of Camphorated Opium and Guaiacum. B. Tincturae Opii Camphor atae, Guaiaci Ammoniatae, aa f Ij. Fiat mistura. Signa. — Two teaspoonfuls every two hours. In misplaced and retrocedent gout. Aromatic Spirit of Hartshorn. B. Spiritus Ammonias Aromatici, f 3ij. Signa. — Twenty drops to be given in a wineglassful of water, pro re nata. In sudden exhaustion from any cause. Yeast Mixture. B. Cerevisiae Fermenti, f^x. Camphorae, 3ss. Spiritus JEtheris Nitrici, f gss. Fiat mistura. Signa. — Take a tablespoonful every hour or two hours. This was extensively used in the late typhus epidemic in Ireland, as a stimulant and antiseptic, and with the happiest results. Lamprey. Substitute for the Fetid Spirits of Ammonia. B. Spiritus Ammoniae, f3j. Tincturae Assafoetidae, f3vij. Misce. Signa. — Give a teaspoonful, in sweetened water, every four hours. An excellent stimulus in nervous debility and hysteria. STIMULANTS. 129 Mixture with DippeTs Animal Oil R. Olei Cornu Cervi, f 3j. Spiritus JEtheris Compositi, f 3iij. Misce. Signa. — Take twenty or thirty drops every three hours. Used in chorea, catalepsy, &c. Kichter. Emulsion of Phosphorus. R. Phosphori puri, gr. ij. Mucilaginis Acacias, q. s. Let these articles be carefully and effectually triturated in a mortar, and add gradually as much distilled water as will make an emulsion of 3vj. ; then add — Syrupi, f sj. Spiritus iEtheris Compositi, gtt. xxx. Fiat mistura. — Of which the usual dose is a tablespoonful every two, three, or four hours. This preparation was originally made by the celebrated Hufeland, and is now taken from Dr. Chapman's Therapeutics, p. 176, vol. ii. As the violence of the remedy, and its very great power, are generally known to physicians, we need hardly repeat the necessity there is for the greatest caution in its administration. The subjoined is one of the many formulas adopted in Europe. Lobsteirfs, Phosphorated Ether. R. Phosphori, gr. ij. Solve in ^Etheris, f ^ss. Tincturas Olei Menthee Piperita^, f 5ss. Signa. — Take from two to six drops in sugar every three hours. The bottle should be carefully stoppered, and covered with dark paper. Used in epilepsy, paralysis, and amaurosis. Foy. Tincture of Arnica. R. Arnicas Plorum, ^jss. Alcoholis, Oj. Macera per "dies quatuordecim et cola. Of this tincture, Mr. Wilde gives fifteen drops in a table- spoonful of the infusion of arnica, and a little of some cordial tincture, three times a day, for the relief of tinnitus aurium. After a few days, the dose should be increased one or two drops daily, until it reaches thirty drops. It is useful as a stimulant in atonic gout. "Wilde. 9 130 STIMULANTS. Mixture with Chlorinated Lime. R. Calcis Chlorinates, 3j. Aquas, f giij. Solve et cola. Dein adde — Syrupi Zingiberis, f 3j. Fiat mistura. Signa. — Take a tablespoonful every three hours. Chlorinated lime is stimulant and antiseptic, and has been used beneficially as such in typhoid, typhus, and scarlet fevers. * Linctus with Oil of Turpentine. R. Olei Terebinthinas, f3ij. Mellis optimi, f gj. Fiat linctus. — Dose, a teaspoonful night and morning, with a draught of warm tea. In sciatica. Infusion of Cayenne Pepper. R. Pulveris Capsici, 3iss. Aquas bullientis, Oss. Fiat infusum. Signa. — A tablespoonful for a dose in severe colic, or gout in the stomach. Infusion of Cloves. R. Caryophylli contusi, 3j. Aquas bullientis, Oss. Fiat infusum. Signa. — To be employed in the same cases, and in similar doses as the former. Mixture of Cubebs 1 &c. R. Pulveris Cubebas, 3ij. Sodas Carbonatis, 3ss. Mucilaginis Acacias, f3yj. Aquas Menthas Yiridis, f 3yj. Fiat mistura. Signa. — Take a tablespoonful every hour and a half. Mixture of Oxide of Bismuth, Cubebs, &c, ■ R. Pulveris Cubebas, 3ij. Bismuthi Subnitratis, 3ss. Mucilaginis Acacias, f gss. Syrupi, f 3vj. Aquas, f 3vj. Fiat mistura, Signa. — Take a tablespoonful four times a day. We have extracted the two preceding prescriptions from a STIMULANTS. 131 paper of Mr. John Fosbroke, surgeon, Ch.ittenh.am. See Medi- cal Recorder, for April, 1825. They are recommended, with other similar compounds, in various affections of the mucous membranes, yiz : of the bowels, bladder, trachea, &c. Mustard Whey. R. Lactis Vaccinas, Oj. Sinapis contusae, 3j. Simmer until the caseous part separates, then strain, and add — Yini Albi, f 3vj. Signa. — A draught of this whey may be taken every hour or two in low fever and in debilitated stomach. Wine Whey. R. Lactis Vaccinae, Oss. Vini Albi, fgij. vel fliij. Boil the milk, then add the wine, and strain. Grate a little nutmeg, and sweeten the clear whey to the taste. There are few mild stimulants more employed, or more useful than wine whey. Dr. Chapman speaks of it as possessing a kindred action with carbonate of ammonia. The dose to be regulated by the circumstances of the case ; from four ounces to ten or more during the day. Mixture with Wine, &c. R. Vitellum Unius Ovi, Olei Cinnamomi, gtt. x. Misce, et adde — Vini Albi, 1 -- f r Aquae Cinnamomi, j ^ Sacchari, 5j- Aquae destillatae, f 5J. Fiat mistura. Signa. — Give two or three tablespoonfuls, at short intervals, in convalescence from low fevers. Mixture with Brandy. R. Spiritus Vini Gallici, f 3ij. Lactis Vaccinae, f Hiv. Sacchari, 3ss. Myristicas, ad gustandum. Signa. — Take a tablespoonful every hour or two in low fevers. 132 STIMULANTS. Essences of Ginger. There are several popular and useful stomachics and stimu- lants now sold under this title. They are easily prepared by making a saturated tincture of the root, using strong or offici- nal alcohol, and then carefully concentrating the tincture by means of a water-bath. The Infusion of Ginger Is also an excellent stomachic, and may be employed with great benefit in debility of the stomach and bowels. CLASS X. NARCOTICS. Narcotics have been denominated sedatives, from their power of diminishing action ; anodynes, from their capability of alle- viating pain; and hypnotics, or soporifics, from their power of inducing sleep. A few words only will be necessary as general rules for their administration, and any peculiarities that indi- viduals of the class may possess will be noticed under the appro- priate prescriptions. It is well known they possess the power of fulfilling two indications ; namely, of exciting and depressing the nervous energy. To obtain the first of these results, it is necessary to begin with small doses, and repeat them frequently ; while in order to arrive at the second, a full dose must be given, and not re- sorted to again for a considerable length of time. We should also bear in mind that the system very soon becomes habituated to their action, and the doses must be continually enlarged when it is necessary to maintain their impression. The differ- ence between the susceptibility to their action when the body is in a morbid or healthy condition, should not be overlooked. PILLS. Pills of Opium. B. Pulveris Opii, gr. xij. Saponis, q. s. „ Misce, et divide in pilulas xij. — Of which one is the ordinary dose to produce sleep. In equal weights of powdered and soft opium, the former is much the more powerful, the latter containing a considerable proportion of water. This should be recollected in directing the medicine in the form of pills. An opium pill that has been made long enough to become perfectly hard and dry; will be retained by an irritable stomach when a fresh one would be rejected. 134 NAKCOTICS. Pills of Lupulin. R. Lupulinse, 3ss. Contunde in mortario, et divide in pilulas x. Signa. — Two pills may be given for a dose, and the quantity doubled if necessary. This substance, we are told by Dr. Ives, contains all the active properties of the hop. It is slightly narcotic, and is serviceable in irritable stomach, and as a preventive of noc- turnal erections in different forms of acute venereal disease. The lupulin is sometimes administered in powder, with two parts of white sugar. Pills of Sulphate of Morphia. R. Morphias Sulphatis, gr. ij. Confectionis Kosas, q. s. ut flant pilulas xij. Signa. — One may be given for a dose, pro re naia. One grain of either of the salts of morphia is usually estimated as equal to six of opium ; so that a pill of the above prescrip- tion will be equivalent to a grain of opium. The acetate and muriate of morphia are prepared in the same way, and given in the same dose. Pills of Lactucarium. R. Lactucarii, gr. xij. Confectionis Kosas, q. s. Divide in pilulas vj. Signa. — One for a dose, to be repeated in two hours, if sleep be not procured. The inspissated juice of the garden lettuce is said to act as a direct sedative, lessening the frequency of the pulse, diminishing the natural heat, and procuring sleep, without inducing the sub- sequent distressing effects which follow the use of opium. The thridace of the French appears to be prepared by a dif- ferent process from that employed in the preparation of the ] British lactucarium. The former is not so highly esteemed in this country as the latter. Pills of Henbane and Ipecacuanha. R. Extracti Ilyoscyami, gr. x. ru I \ cris Ipecacuanhas, gr. v. Misce, et divide; in pilulas x. — One every hour or two until relief ifl procured, watching the effect. In flatulence and irritability of the bowels. NAECOTICS. 135 Pills of Opium, Henbane, &c. R. Pulveris Opii, gr. iv. Extracti Hyoscyami, Conii, aa gr. xv. Fiat massa, in pilulas x. dividencla. — One every night when an anodyne is required. Pills of Extract of Henbane. R. Extracti Hyoscyami, 9j. Divide in pilulas x. — Of which one may be given every four hours, increasing the dose if necessary. This medicine, which is employed as a substitute for opium, does not constipate the bowels. Pills of Extract of Stramonium. R. Extracti Stramonii Foliorum, 3ss. Divide in pilulas xv. Signa. — One three times a day. The powdered leaves are also prescribed in similar doses. The extract of the seeds is given in the dose of a quarter to half a grain. Opiate Confection. R. Confectionis Opii, 3ss. To be given for a dose. — One grain of opium is contained in thirty-six grains of the officinal confection. Pills of Extract of Hemlock. R. Extracti Conii, 3j- Pulveris Conii, q. s. ; ut flat massa in pilulas xx. dividenda. One of these pills night and morning, may be taken at the com- mencement, gradually increasing them to two, three, four, or more, as the patient can bear them. The efficacy of narcotic plants is influenced by soil, climate, exposure, and cultivation ; and the extracts by the season when the plants are gathered, and the mode of preparing them. Phy- sicians would do well therefore to make themselves acquainted with the quality of the article they prescribe, inasmuch as there may be a fatal difference between two parcels of different ages, modes of preparation, &c. Pills of Camphor. R. Camphors, 3ss. Alcoholis, Acacise, aa q. s. Ut nant pilulae xv. — Dose, a pill every two or three hours. 136 NARCOTICS. Pills of Opium, Digitalis, &c. B. Pulveris Opii, Digitalis, aa gr. vj. Confectionis Kosa3, q. s. ut fiant pilulae xij. Signa. — One to be taken every four hours. In asthma, &c. Pills of Extract of Conium and Calomel. B. Extracti Conii, Bij. Hydrargyri Chloridi Mitis, gr. xv. Fiant pilulae xv. Signa. — One three times a day. In pseudo- syphilitic affections. Pills of Powdered Nux Vomica. B. Pulveris Nucis Vomicae, 9j. Confectionis Kosae, q. s. ut fiant pilulae x. Signa. — One to be given two or three times a day, closely watch- ing the effects. In paralysis. Pills of the Extract of Nux Vomica. B. Extracti Nucis "Vomicae, gr. x. Divide in pilulas xv. — One pill twice a day, gradually augment- ing the dose, and watching its effect. Pills of Strychnia. B. Strychniae, gr. ij. Confectionis Kosae, q. s. ut fiant pilulae xxiv. Of which one pill may be given once or twice a day, according to the idiosyncrasy of the patient. Strychnia forms with acids a variety of salts, which are gene- rally very soluble, and for this reason much more active than the alkali uncombined. The commencing dose of the salt should not be greater than that of the alkaloid. It should be borne in mind that the activity of this substance is increased by all acid drinks. — See Magendie's Formulary, edit. 5, p. 12. Pills of Camphor, Assafetida, &c. B. Camphorae in pulverem, 3\j. Pulveris Assafoetidae, 3ij. Extracti Belladonnas, 9ij. Opii, gr. x. Fiat massa, in pilulas Ix. dividenda. Commence with two pills a day, and gradually increase the quantity to six in the 24 1 k nirs. Used in hysteria. Debreyne. NAKCOTICS. 137 Pills with Aconite and Dover 's Powder. R. Extracti Aconiti, gr. vj. Pulveris Ipecacuanhas et Opii, gr. xij. Syrupi, q. s. Ut fiat massa, in pilulas vj. dividenda. Signa. — Take one pill three times a day in chronic rheumatism. Pills of Digitalin. R. Digitalinae, gr. j. Sacchari Lactis, gr. lx. Syrupi, q- s. Ut fiat massa, in pilulas xl. dividenda. Signa. — Take one pill twice a day, gradually and carefully in- creasing the dose, until the peculiar effects of digitalis are developed. The greatest care should be used in making these pills, to have the digitalin uniformly diffused through the sugar of milk. A safer way of administering it is in the form of solution. (See page 70.) MIXTUKES, TINCTUKES, &e. Opiate Mixture. R. Extracti Opii, gr. v. Sacchari, 3j- Aquae Cinnamomi, f ^vj. Eiat mistura. Signa. — A tablespoonful may be taken every two hours, so that the whole be consumed in twenty -four. In tetanus and colica pictonum. Anodyne Draught. R. Tincturae Opii, gtt. xv. vel xxv. Syrupi Papaveris, Lond. f3ij. Spiritus Cinnamomi, Lond. f3j. Aquae destillatae, f^iss. Misce. Signa. — Anodyne draught. Laudanum is very disa- greeable to some persons ; combined as above, the taste is disguised. Laudanum. R. Tincturae Opii, flss. Signa. — Dose, twenty -five drops. 138 KAECOTICS. As the regulation of closes for children is, to the young practitioner, one of the most difficult parts of prescribing, and as laudanum is an article so universally employed in their dis- eases, we subjoin the following graduated table from Dr. Dorsey's Syllabus, page 36, 1817. For a child at birth, or within a month after Under a year old From one to two years of age From two to five " From five to ten " From ten to fifteen " At fifteen years For an adult It is important in the employment of laudanum that it should be a saturated tincture and perfectly transparent. For these reasons it should be obtained from the apothecary in small quantities, as it is liable to deposit part of the opium ; hence the liquid near the surface is weaker. Infants have been de- stroyed by the exhibition of thick laudanum. Physicians, there- fore, should always examine the phial before trusting the nurse to give a dose to a child. |to 1 ( Irop. to 2 or 3 ( Irops 1 to 5 u 2 to 8 u 5 to 15 a 10 to 20 u 15 to 20 u 25 to 30 a Black Drop. R. Aceti Opii, f 3ss. Signa. — Give ten drops as a dose. This preparation is much stronger than laudanum, and has obtained celebrity from the fact that it equally promotes the ends of laudanum without affecting the head and stomach. When it cannot be had, Dr. Chapman states that, by giving the alco- holic tincture of opium in vinegar, we obtain nearly the same results. Paregoric Elixir. R. Tincturas Opii Camphoratse, f 3j. A teaspoonful of this in a little water is a close for an adult. It is principally employed as an expectorant. Sydenham's Laudanum, or Wine of Opium. E. Vini Opii, fgj. Signa. — Dose, twenty drops. Our officinal wine of opium, now so much used as an external application in chronic inflammation of the eyes, differs only from Sydenham's laudanum, in not having an ounce of saffron added to the pint. The other ingredients are the same. NARCOTICS. 139 Solution of Sulphate of Morphia. R. Morphiae Sulphatis, gr. j. Aquae destillataB, f 3j. Fiat solutio. — Dose, one or two teaspoonfuls. When morphia and its salts were first introduced, the for- mulae given by Magendie were generally adopted, and are still retained in New York, and some other places. These contain sixteen grains of the sulphate or acetate of morphia in a fluid- ounce of water, whereas the officinal solution has but one grain to the ounce. Practitioners settling in that vicinity should avoid confounding the two solutions. Editor. The sulphate of morphia has one superiority over the acetate, namely, that the latter when dissolved in water is decomposed, two salts resulting, the one soluble, the other not. 1 From this objection the sulphate is exempt. The muriate and nitrate of morphia possess no advantages over the sulphate and acetate. Codeia. The French chemists have also discovered in opium a princi- ple allied in its effects to morphia, and called Codeine. In dose of a single grain it proves highly anodyne, but distresses the stomach in larger doses. Its salts are given in somewhat smaller quantities. Magendie, 9vme ed. p. 80. Tincture of Opium and Oil of Turpentine. R. Tincturse Opii, f Jj. Olei Terebinthinas, f Iss. Misce. Signet-. — A teaspoonful diluted every hour or two may be given in delirium tremens, but even here its effect must be closely watched. The turpentine may be added or omitted at the discretion of the physician, and the quantity of laudanum in some cases may be doubled. We have successfully given two teaspoonfuls every hour until ifij. of laudanum were taken. We do not believe in the doctrine, however, that opium in this disease may be admi- nistered almost ad libitum without danger. On the contrary, we feel assured that death has been caused by its excessive use in delirium tremens. S. Gr. Morton. 1 This difficulty, however, is obviated by the addition of acetic acid to convert the insoluble morphia present into an acetate. Editor. 140 NARCOTICS. Tincture of Lupulin. R. Lupulinae purse, 3j. Alcoholis, f 3ij. Digest for six days in a close vessel. Strain, filter, and add a sufficient quantity of alcohol to make 3iij. of the tincture. Of this, from 3ss. to 3ij- m &y be taken for a dose, commencing with the smaller quantity. Tincture of Hops. R. Tincturse Humuli, f Ej. Signa. — Of this, a teaspoonful may be taken every two hours, as a narcotic in cases where opium is inadmissible. Hops are also given in the form of infusion : for which see Tonics. Inclosed in a bag, they have acquired some celebrity as a pillow. Camphor and Hoffman's Anodyne. R. Aquas Camphorae, f 3iv. Spiritus iEtheris Compositi, f 3ij. Misce. — Dose, a dessertspoonful every hour or two hours diluted. In nervous affections, and sleeplessness of fever. Tincture of Digitalis. R. Tincturae Digitalis, f 3ij. Of which ten drops may be given at first twice or three times a day, increasing the quantity gradually as the system be- comes accustomed to it. The peculiar character of this remedy should induce caution in giving it. Hemlock Mixture. R. Extracti Conii, 3ss. Syrupi Papaveris, Loud, f 3j. Aquae, f^vij. Misce. — A tablespoonful three or four times a day for a dose. Tincture of Extract of Nux Vomica. R. Extracti Nucis Vomicae, gr. iij. Alcoholis, fjj. Fiat tinctura. — This tincture to be given in doses of fifteen or twenty drops, in any kind of drink. This preparation, and the pills made of the resin of nux vomica, have been successfully used in general and local pa- ralysis. NARCOTICS. 141 Tincture of Strychnia. R, Alcoholis, f Ij. Strychnias, gr. iij. Fiat tinctura. — This tincture to be given by drops, from six to twenty in draughts of mucilage. Used for the same purposes as the above. Strychnia Mixture. R. Strychnias, gr. j. Acidi Acetici, gtt. ij. Sacchari, 3ij. Aquae destillatas, f Iij. Fiat solutio. Signa. — A teaspoonful morning and evening. Solution of Extract of Belladonna. R. Extracti Belladonnas, gr. iij. Aquae Cinnamomi, f Ij. Fiat solutio. Signa. — Two or three drops twice or thrice a day, to a child under a year old, and an additional drop for every additional year. Belladonna has been recently used in Germany as a preven- tive of scarlatina. The extract, if given for several days, pro- duces a scarlet eruption and affection of the fauces, analogous to those of scarlatina ; and it is pretended that this factitious disease is sufficient to prevent the access of the real one. Mixture with Magnesia^ Assafetida, <&c. R. Magnesias Carbonatis, 3ss. Tincturas Assafcetidas, gtt. Ix. Opii, gtt. xx. Saechari, 3j- Aquas destillatas, f Ij. Misce et flat mistura. — Twenty -five drops may be given to an in- fant of two or four weeks old ; in flatulent colic, diarrhoea, &c. This preparation was strongly recommended and much em- ployed by the late Dr. Dewees of this city. If the calcined magnesia be used, it unites with the resin of the assafetida, forms an almost solid mass at the bottom of the vessel, and defeats the object of the prescription. Tincture of Hemp. R. Extracti Cannabis, gr. xxiv. Alcoholis, flj. Fiat solutio. Signa. — Take ten drops every two hours. The above is the formula of Dr. O'Shaughnessy, of Calcutta, 142 NARCOTICS. who has had much experience with the gunjah, or Indian hemp. In cholera, he gave ten drops every half honr to check the vomiting ; in tetanus, a dram of the tincture, with the same interval, until the paroxysms ceased, or catalepsy was induced ; and in acute rheumatism, twenty drops until symptoms of in- toxication were manifested. Dr. B. H. Coates has tried it in a case of tedious labor, in which it seemed to have the effect of restoring the uterine con- tractions by acting " as musk, castor, or assafetida frequently do in other hollow viscera, by restraining excessive and irre- gular contractions, and enabling the contracting organ to com- bine its efforts more in conformity to a healthy order, and a useful tendency and result." The great uncertainty in the strength of the extract hereto- fore imported, has interfered with its introduction into practice ; but there is now (1853) to be had in Philadelphia, an extract which is decidedly narcotic in the dose of a quarter to half a grain. Editor. Mixture with Oil of Bitter Almonds. B. Olei Amygdalae Amarae, gtt. xx. Alcoholis, f3iij- Fiat solutio. Signa. — Take ten drops four times daily. Used in neuralgia, especially tic douloureux. Horn. CLYSTEES AND SUPPOSITORIES. Opium Enema. R. Pulveris Opii, gr. ij. Mucilaginis Acaciae, f Jss. Lactis tepifacti, fjij. Misce pro enemate. Opium Enema. B. Pulveris Opii, gr. iij. vel iv. Adipis, I}. Melt them together with a gentle heat, and when of a proper warmth, inject the mixture with a small syringe. Laudanum Enema. B. Tinctura3 Opii, gtt. 1. Infusi Lini, i'sij. vel f.$iv. Fiat enema. NARCOTICS. 143 It is generally supposed that three times the quantity of a medicine may be thrown into the rectum that may be taken into the stomach. As regards opium, however, we believe it to be too much, particularly in children. Indeed, it is an un- settled point in therapeutics, whether remedies act most power- fully upon the rectum or the stomach. Suppository of Opium. R. Pulveris Opii, gr. ij. Saponis, gr. iv. Misce bene. — Introduce into the rectum when an enema cannot be administered. Suppository of Opium and Rhatany. R. Olei Cacao, 3j. Extracti Krameriae, 9ij. Pulveris Opii, gr. v. Misce secundem artem, et fiant suppositoria x. Pancoast. Sup>p>ository of Hemlock. R. Cerae Albae, gr. xv. Olei Cacao, 3j. Extracti Conii, gr. x. Misce, s. a. The extract should be . softened and added to the other ingredients as they begin to cool. EXTERNAL USE OF NARCOTICS. Solution of the Extract of Belladonna. R. Extracti Belladonnas, 9j. Aquae destillatae, f ^iij. Fiat solutio. Signa. — To be applied to the eye in cataract, for the purpose of dilating the pupil and exposing the lens. Solution of Atropia. R. Atropiae, gr. ij. Alcoholis, f3j. Aquae destillatae, f 3vij. Fiat solutio. Signa. — Let a drop fall into the eye to dilate the pupil. This is equally efficacious in its action, and much more ele- gant, than the ordinary preparations of belladonna. — Dungli- son, New Remedies, 6th ed. p. 114. W. W. Cooper. 144 NARCOTICS. For internal use, ten drops of this solution represent one- thirtieth of a grain of the alkaloid. Solution of the Extract of Stramonium Seeds. This may be made of the same strength, and be used for dilat- ing the pupil in the same way, as the solution of the extract of belladonna. Solution of Opium in Lime-ivater, &c. R. Extracti Opii, gr. j. Liquoris Calcis, Olei Amygdalae, aa f 3iij. Fiat mistura. — Recommended by Dr. Sibergundi of Dorsten, in the treatment of sore nipples. It is to be applied to the parts on dossils of lint. Infusion of Hemlock. R. Conii, §ss. Aquae bullientis, Oj. Fiat infusum et cola. — To be applied as a wash to cancerous and scirrhous ulcers. A cataplasm is also employed for the same piirpose, made by mixing the powdered leaves with bread and water poultice. Infusion of Henbane. R. Foliorum Hyoscyami, 3ss. Aqua3 bullientis, Oj. Fiat infusum. — Employed as an external application to cancer- ous, scrofulous, and other indolent ulcers. Decoction of Stramonium in Milk. R. Foliorum Stramonii, 3ij. Lactis recentis, Ojss. Boil to a pint and strain. For gouty, rheumatic, and other painful swellings. Ointment of Belladonna. R. Extracti Belladonna), 3ij« A quoe destillatae, f Jij. Adipis, 3ij. Fiat unguentum. — A portion to be applied to the neck of the uterus in rigidity of that part occasioned by disease, or pre- vious to delivery. It is said to act on the same principle as it does in dilating the iris. The application to be made for some time by means of a syringe with a wide mouth. M. Ciiaussier. NARCOTICS. 145 Plaster of Opium, &c. B. Opii, Camphoras, aa 3ss. Emplastri Plumbi, 3ij. Melt the plaster, and having previously powdered the other articles, mix them gradually. For local pains. Plaster of Opium, &c. B. Pulveris Opii, Camphoras, Saponis, aa 3j. Tincturas Opii, q. s. ut fiat emplastrum. This plaster is employed in the same cases as the preceding one. Another, and the most common plan, is to spread theriaca andromachi 1 on leather of the size required, and cover it with powdered opium, sprinkling a little laudanum to promote its adhesion. Plaster of Opium and Camplwr. B. Pulveris Opii, 9ij. Camphoras, 5ss. Picis Burgundicas, Emplastri Plumbi, aa q. s. ut fiat emplastrum. This plaster is highly recommended in neural ffia. Graves. Liniment of Belladonna, Cherry Laurel, &c. B. Extracti Belladonnas, 9ij. Solve in — . Aquas Lauro Cerasi, Ed. f 3 ij . Dein adde — iEtheris, Oj. Misce. Signa. — Eub the liniment on the part, and apply flan- nels moistened with it. Useful in ueuralgia, in gouty and rheumatic pains, and for gathered breasts. Eanque. 1 The original Theriaca Andromachi is composed of seventy-two ingredients, pulverized and rubbed up with honey into an electuary. A preparation bearing the same name, and used for the same purposes, is now made in a much less ela- borate way. The word Theriaca is, at the present day, applied to any coarse sirup, as treacle or molasses. 10 146 NARCOTICS. Camphor and Chloroform Liniment. U. Camphorae, 3Jss. Chloroformi, fjij. Olei Olivas, f^ij. Fiat linimentum. Useful in rheumatic and neuralgic affections. W. B. Price. CLASS XI ANTISPASMODICS. Antispasmodics are those medicines which allay spasm, and compose the irregular actions of the nervous system. Some of the most powerful of them are derived from the class of Nar- cotics. Pills of Assafetida and Soap. R. Assafcetidas, 3j. Saponis, gr. x. Aquae, q. s. ut fiant pilulae xx. Two or four of these pills may be taken for a dose, and repeated pro re nata. Pilulae Aloes et Assafoetidae, Galbani Compositae, May be given in the same doses as those made with soap only. Opium Pills. As under Narcotics. (Page 133.) Pills with Castor and Salt of Amler. R. Castor ei, 3j- Acidi Succinici, 3ss. Extracti Gentianae, q. s. ut fiant pilulae xxiv. Dose, three pills night and morning. In hysteria. Pills of Musk, Camphor, &c. R. Moschi, 9ss. Camphorae, 3j. Ammoniaci, 9ij. Opii, gr. iv. Misce, et fiant pilulae singulae gr. iv. Signa. — The dose may be four or five in the twenty -four hours. In nervous diseases. M. A. Richard. 148 ANTISPASMODICS. Pills of Valerianate of Zinc. R. Zinci Yalerianatis, gr. xij. Confectionis Rosae, q. s. Ut fiat massa in pilulas xij. dividenda. Signa. — Give one pill every three hours. Used in neuralgia, and anomalous nervous affections. Bolus with Valerian and Rust of Iron. R. Pulveris Valerianae, 3j- Ferri Subcarbonatis, 9ss. Mucilaginis Acacias, q. s. ut fiat bolus. One, three times a day. Bolus with Musk and Camphor. R. Camphorae, gr. v. Moschi, gr. v. vel x. Syrupi, q. s. ut fiat bolus. Signa. — To be taken at once. This is a full dose, which, however, can be readily modified by the practitioner. To confine the aroma of musk, whether in the form of pills or otherwise, it should always be kept in phials. Bolus with Musk and Carbonate of Ammonia. R. Moschi, Ammonias Carbonatis, aa 9ss. Confectionis Rosae, q. s. ut fiat bolus. To be taken every third hour. In mortification accompanied with spasmodic action. Musk Mixture. R. Moschi optimi, 3ij. Sacchari, 3j- Pulveris Acaciae, 3j- Aquae destillatae, f ovj. Fiat mistura. Signa. — A tablespoonful to be given every hour or two hours. Mixture with Musk, &c. R. Misturae Moschatae, Ovj. (Sec preceding formula.) Tincturae Opii Camphoratae, f^ss. Valerianae Ammoniatae, f3j. Miscc Signa. — A teaspoonful three or four times a day. For children in pertussis. ANTISPASMODICS. 149' Tincture of Assafetida, Castor, &c. R. Tincturae Assafoetidae, Castorei, aa flj. Spiritus Ammonige Aromatici, f3j. Misce. — A teaspoonful may be taken in a glass of sweetened water for a dose. Hoffman's Anodyne and Laudanum. R. Spiritus iEtheris Compositi, f3iij. Tincture Opii, gtt. lxxx. Aquae Cinnamomi, f 3vj. Fiat mistura. Signa. — A tablespoonful every one or two hours. In hysteria, &c. Mixture with Assafetida, &c. R. Assafoetidae, 5j- Aquae Menthae Piperitae, f^iij. Fiat solutio, et adde — Tincturae Valerianae Ammoniatse, f3ij. Castorei, f 3iij. JEtheris, f3j. Signa. — A tablespoonful for a dose, largely diluted, every second hour. In hysteria. Oil of Valerian ivith Spirits of Hartshorn. R. Olei Valerianae, gtt. viij. Spiritus Ammoniae Aromatici, f 3j. Aquae, f Jiv. Sacchari, 3ij. Misce. Signa. — To take a tablespoonful every two or three hours shaking the phial. Infusion of Valerian. R. Valerianae, 3j. Aquae bullientis, Oj. Put them into a covered vessel and let them stand until cold. — Dose, a wineglassful every two or three hours. Tincture of Valerian and Hoffman's Anodyne. R. Spiritus iEtheris Compositi, Tincturae Valerianae, aa Oj. Misce. Signa. — A teaspoonful for a close, with water, pro re nata, shaking the phial each time. 150 ANTISPASMODICS. Mixture with Ether and Laudanum. R. JEtheris, f3ij. Sacchari, ' Acacias, aa 3iss. Tincturas Opii, gtt. lx. Aquas Cinnamomi, f gij. Misce. Signa. — A teaspoonful every hour. In cramp of the stomach, &c. Ethereal Solution of Chloride of Zinc. R, Zinci Chloridi, £j. Alcoholis, f5ij. iEtheris, f.fss. Solve, post aliquot dies decanta. Signa. — Take from four to eight drops, twice daily. Used in chorea, epilepsy, and anomalous nervous affections. HUFELAND. Embrocation of Oils of Cloves, Amber, &c. R, Olei Olivas, il]. Caryophylli, Succini rectificati, aa f,fss. Misce. Used as an embrocation in hooping-cough. Koche. Assafetida Enema. R. Tincturas Assafostidas, f5ij. Decocti Hordei, f^x. vel fsxij. Misce pro enemate. — Tinct. opii may be added pro re nata. In hysteria, spasmodic colic, &c. Music Enema. R. Moschi, gr. xij. Sacchari, 9ij. Spiritus Ammonias, gtt. xxx. Infusi Lini, f Jiv. Fiat enema. — For children with convulsions. CLASS XII. SIALAGOGUES. Those medicines which increase the salivary secretion are denominated Sialagognes. In forming these into a class in this place, we trespass on the arrangement of Dr. Chapman, bnt merely from a motive of convenience ; for we agree with him that such a class would be better expunged from the Materia Medica, at the same time that it appears necessary to introduce it here, in order to place the mercurial preparations in stronger relief than could otherwise be done. Pills of Calomel. R. Hydrargyri Chloridi Mitis, gr. xij. Confectionis Kosas, q. s. ut fiant pilulas xij. s Signa. — One, morning and evening, and, if necessary, until salivation is excited. Pills of Corrosive Sublimate. R. Hydrargyri Chloridi Corrosivi, gr. v. Aquas destillatas, gtt. xxx. vel xl. Confectionis Kosas, 9j. Pulveris Grlycyrrhizas, q. s. ut fiant pilulas xl. Of which, give one pill three or four times a day. In lues venerea. As salivation rapidly follows the use of corrosive sublimate, its effect must be watched. DwpuytrenJs Antisyphilitic Pills. R. Hydrargyri Chloridi Corrosivi, gr. ss. Extracti Cinchonas, gr. x. Opii, gr. ss. Pulveris Cinchonas, q. s. Ut fiant pilulas ij. — The two pills may be taken, one in the morning, and the other at night ; but as each contains a 152 SIALAGOGUES. quarter of a grain of corrosive sublimate, their action must be very closely watched. M. Dupuytren was partial to these pills in the treatment of syphilis. He thought the opium and cinchona promoted and beneficially modified the action of the sublimate. Pills with Corrosive Sublimate and Hemlock. R. Hydrargyri Chloridi Corrosivi, gr. yj. Solve in Aquae destillatae, q. s. et adde — Extracti Conii, 5j. * Pulveris Conii, q. s. ut fiat massa, in pilulas xlviij. dividenda. Sigma. — Give one pill three times a day. Used in lues venerea. The effect of the mercurial preparations upon children is sometimes very serious, and even fatal. So powerful upon them is the action of this medicine, that a profuse or even gen- tle salivation will sometimes produce mortification and destruc- tion to the jaw, cheek, and lip. This, however, does not often happen ; but to avoid it the gums should be frequently and carefully examined. It is, nevertheless, a fact, that a disease precisely similar in all its features occasionally attacks children who are badly clothed and fed, though no mercury has been given to them. Pills of Iodide of Mercury. K. Hydrargyri Iodidi, gr. v. Confectionis Rosas, q. s. Ut fiant pilulas xxx. Each pill will contain the sixth of a grain, which may be given three times a day. Double the quantity (two pills) is sometimes administered at first, but care should be taken not to push it too far. Compound Pills of Iodide of Mercury. U. Hydrargyri Iodidi, gr. ij. vel gr. iij. Extracti Opii, gr. ij. Lactucarii, gr. xij. Guaiaci Resinae, gr. xxiv. Misce, et fiant piluke xxiv. — Given by M. Ricord in the syphilis of children. He directs one pill for a child six months old, and two, three, or four pills for older children. Dunglison's New. Rem. p. 280. SIALAGOGUES. 153 Pills of Iodide of Mercury. R. Hydrargyri Iodicli, gr. j. Extracti Juniperi vel Glycyrrhizse, gr. xij. Pulveris Grlycyrrhizas, q. s. Ut fiant pilulae viij. — In adult patients, Magendie directs two to be given morning and evening, to be increased to three or four. Dunglison, ut supra. Pills with Calomel, Camphor, &c. R. Hydrargyri Chloridi Mitis, Camphorae, aa Bj. Pulveris Opii, gr. xij. Syrupi, q. s. ut fiant pilulae xx. Signa. — One or two to be taken morning, noon, and night, when calomel by itself causes purging. Blue Mercurial Pills. R. Pilulae Hydrargyri, 3ss. Divide in pilulas x. Signa. — One may be taken three or four times a day, according to circumstances. If they should occasion purging, half a grain of opium may be added to each pill. The mass directed in the American Pharmacopoeia contains one grain of mercury in every three grains. Pills of the Bed Oxide of Mercury. R. Hydrargyri Oxidi Eubri, gr. j. Pulveris Opii, gr. j. Olei Caryophylli, gtt. ij. Fiant pilulae iij. Signa. — One pill every night for a week. In venereal cases. This preparation, in a stronger formula, was used by the cele- brated John Hunter ; but from its harshness it is now generally superseded by milder medicines. Solution of Cyanuret of Mercury. R. Hydrargyri Cyanureti, gr. viij. Aquae, Oj. Fiat solutio. — This is the Liqueur anti-syphilitique of Chaussier, who prefers it to corrosive sublimate on account of its greater solubility and more speedy action. By giving a teaspoonful of the solution, we give one-sixteenth of a grain of the cya- nuret, which may be repeated morning, noon, and night, watching its effects. 154 SIALAGOGUES. Powder of Mercury and Chalk with Ipecacuanha. R. Hydrargyri cum Creta,, 9j. Pulveris Ipecacuanhas, Bss. Fiant chartulaa vj. Signa. — One night and morning in sirup. Commended by Dr. Paris, in dyspepsia, in which the biliary secretion is impaired. He prefers it under these circumstances to every other form of mercury. Masticatory with Pellitory, &c. B. Pulveris Pyrethri, Mastiches, aa 3j. Let these be dissolved together by a moderate application of heat ; then divide the mass into two equal parts. One of these lumps may be chewed at pleasure. In toothache, and pa- ralytic affections of the tongue. Mixture of Pellitory, Opium, &c. R. Eadicis Pyrethri contusae, Iss. Aceti destillati, f 3vj. Opii, gr. iij. Digest in a sand-bath for an hour. Signa. — A spoonful to be held in the mouth and frequently renewed. Used in the same cases as the former. There are several other substances, such as polygala senega, sal ammoniac, nitric acid, &c, which occasionally excite saliva- tion ; but they are seldom employed for that purpose. CLASS XIII TONICS. Toxics are those medicines which impart strength, to the system, without subjecting it to any preternatural excite- ment during their operation. They stimulate, however, in a secondary manner, by gradually increasing the force of the cir- culation, and by restoring the digestive and secretory functions to a more healthy state. Considerable perseverance is often necessary in giving any one of this class a fair trial; and when one fails, we may often resort with success to another. Much also may sometimes be gained by alternating them. [It is a well-known fact that some medicines possessed of tonic properties, in small or ordinary doses, have the singular power, when administered more freely, of producing such changes in the economy as to render them applicable to the cure of in- termittent disease. The numerous remedies, of this class, and their varied modes of exhibition, render it advisable, in a work of this kind, to have some mode of distinguishing them from ordinary tonics. For convenience of reference, therefore, two sub-classes have been made, viz: 1. Of Anti-Intermittents, and 2. Of Ordinary Tonics. Editok.] Sub-Class I.— ANTI-INTERMITTENTS. At the head of this class, stand confessedly Peruvian bark and its numerous preparations. POWDEES AND PILLS. Powder of Peruvian Bark. R. Pulveris Cinchonas, ^j. A dram (about a teaspoonful) to be taken every hour in port- wine, water, or milk, during the intermission of fever. 156 TONICS. Some practitioners suspend the bark till within a few hours of the expected paroxysm ; and a few others administer it during the hot stage of the disease. It is better to commence immedi- ately after the paroxysm has ended, and give a dose every hour, until the expected period of its return; and to continue it in smaller quantities for several days. Powder of Peruvian Bark and Cloves. R. Pulveris Cinchonas, Potassas Bitartratis, aa Ij. Pulveris Caryophylli, 3j. Misce. — Dose, a dram and a half every second hour. This compound will sometimes succeed when the bark alone fails. Powder of Peruvian Bark and Sulphate of Magnesia. R. Pulveris Cinchonae, Magnesias Sulphatis, aa £vj. Fiat pulvis, et divide in partes asquales iv. — One to be taken every two hours, when purging is required. Powder of Peruvian Bark, Snake-root, &c. R. Pulveris Cinchonas, 3ss. Serpentarias, Jj- Sodas Bicarbonatis, 9ij. Divide in chartulas iv. Signa. — One to be given every two hours. In obstinate inter mi ttents. If the bark should purge when given alone, a little opium may be added; when it oppresses the stomach, cloves, as in a former prescription ; if costiveness should follow, rhubarb or sulphate of magnesia. The alkali in the above preparation will correct acidity. Powder of Prussiate of Iron and Guaiacum. R. Fcrri Ferrocyanureti, Pulveris Guaiaci, aa 3j. Misce, et divide in chartulas xij. Signa. — One, three times a day. In obstinate intermittents. Pills of Sulphate of Quinia. R, Pilulas Quinias Sulphatis, No. x. Signa. — Take two pills every hour, in the apyrexia of inter- mittent fever, until eight or ten are taken. TONICS. 157 The officinal pill contains one grain. Sometimes it is desir- able to administer a larger quantity. In such cases, Mr. E. Par- rish, of this city, recommends the following form, viz : — B. Quinise Sulphatis, gr. xx. Acidi Sulphurici Aromatici, gtt. xv. "Drop the acid into the sulphate of quinia on a tile or slab, and triturate it with a spatula until it assumes a pilular consist- ence ; then divide into the required number of pills." Made in this way a three-grain pill is not inconveniently large. In prescribing quinia in the apyrexia of intermittents, and especially in that of neuralgia, it is often necessary to increase the dose beyond the officinal formula. For example, three, four, or five grains may be requisite in those cases in which the neu- ralgic paroxysms are violent and the intermission short ; and this quantity must be repeated every two or three hours, or even every hour. The principal inconveniences arising from the free exhibition of quinia are a painful sense of fulness, noise, and dizziness of the head, constriction of the chest, and purging. The latter may be checked by accompanying each pill with a few drops of laudanum, or by a tablespoonful of the simple aqueous infusion of camphor. If the affection of the head or chest be- comes severe, the medicine must be suspended or diminished in quantity. Pills of Sulphate of Quinia and Carbonate of Ammonia. B. Quiniae Sulphatis, gr. xij. Ammonias Carbonatis, gr. xxiv. Fiant pilulas xij. Signa. — One every hour, beginning six hours before the expected paroxysm. These pills are large, but they will act when quinia alone proves unavailing. Quinia may also be combined advantage- ously with the oil of black pepper, or other essential oils, in case of irritable stomach. Pills of Sulphate of Cinchonia. B. Cinchonise Sulphatis, Jss. Confectionis Kosas, q. s. Ut fiat massa, in pilulas xx. dividenda. Signa. — Take two pills every hour, in the apyrexia of inter- mittent fever, until eight are taken. Experiments made in the Pennsylvania Hospital, prove the sulphate of cinchonia to be an efficient substitute for quinia, in a somewhat larger dose. Editor. 158 TONICS. Pills of Salicine. R. Salicin, gr. xxiv. Mucilaginis Aeacise, q. s. Ut fiant pilulae viij. — A pill to be taken three or four times a day. Salicine possesses decided anti-intermittent powers. It has to be used, however, in doses double or treble those of the sul- phate of quinia. Pills of Pipeline. R< Piperin, gr. xij. Extracti Grentiange, q. s. ut fiant pilulae xij. One every hour during the apyrexia of fever. This is one of the preparations lately introduced into practice. It is a white crystalline substance procured from the black pep- per, and was thought to possess considerable febrifuge powers. It is stated by Pelletier, however, that its supposed virtues de- pend only on the acrid concrete oil with which it is associated, and that when perfectly pure it is quite inert. Pills of Arsenic, &c, R. Acidi Arseniosi, gr. j. Pulveris Opii, gr. iij. Saponis, gr. viij. Pulveris Grlycyrrhizse, q. s. ut fiat massa in pilulas xx. divi- denda. Signa. — Give one pill two, three, or four times a day, and in- crease gradually, according to circumstances, watching the effect. In intermittent fever, and local diseases of an inter- mittent character. Pills of Muriate of Ammonia, Arsenic, &c. R. Ammonias Muriatis, 3ss. Pulveris Opii, gr. viij. Acidi Arseniosi, gr. iv. Syrupi, q. s. ut fiant piluke xxxij. Of which one may be given three times a day. In intermittent fever. Each of these pills contains one-eighth of a grain of arsenious acid. The utmost care is requisite in compounding this and all other formulas for solid arsenic, at the same time that its specific tciiwii must be closely watched. TONICS. 159 Pills with the Sulphate of Copper. R. Cupri Sulpliatis, gr. iv. Extracti Cinchonae Rubrae, gr. xxxij. Syrupi, q. s. ut fiat massa, in pilulas xvj. dividenda. One to be taken three times a day. In obstinate intermittents. Pills of Extract of Baric, &c. R. Extracti Cinchonae Rubrae, Grentianae, aa 3j. Ferri Sulphatis, 3ss. Pnlveris Myrrhae, 5j- Olei Cari, gtt. x. Syrupi Zingiberis, q. s. ut fiant pilulas Ix. Signa. — Three to be taken three times a day. Pills of Sulphate of Copper and Opium. R. Cupri Sulphatis, gr. iij. Pulveris Opii, gr. iv. Acacias, gr. x. Syrupi, q, s. Ut fiat massa in pilulas xij. dividenda. Signa. — Give one pill every three hours in obstinate intermit- tents. This combination is sometimes serviceable, when quinia fails. Chapman. Pills of Sulphate of Bebeerine. R. Bebeerias Sulphatis, 3ij- Confectionis Rosas, q. s. Fiat massa, et divide^in pilulas xl. Signa. — Give two pills every two hours in intermittent fevers. This article has lately attracted attention in Edinburgh and Paris, and the experiments thus far reported warrant a more extended trial of its powers. Editoe. DECOCTIONS AND INFUSIONS. Decoction of Cinchona. R. Cinchonas Rubrae contusae, Ij. Aquae, Oj. Boil for ten minutes — and while hot add — Serpentariae Radicis, ^ss. Aurantii Corticis, 3ij- And suffer them to infuse for half an hour near the fire in a covered vessel. — Dose, a wineglassful every hour. 160 TONICS. If the bark is boiled longer than ten minutes, it deposits extractive and resinous matter, becomes paler, and is less effi- cient. The last ingredients are directed to be infused because their aromatic properties would be dissipated by decoction. Decoction of Bark, &c. R. Decocti Cinchonse Rubrae, f 3vj. Tincturae Cinchonae Composite, f£j. Acidi Sulphurici Aromatici, gtt. x. Misce. — A tablespoonful may be taken every hour or two hours pro re nata. By this preparation we obtain both the aqueous and alcoholic extracts of the bark. Infusion of Cinchona with Lirne-water. R. Pulveris Cinchonse Rubrae, ^ij. Liquoris Calcis, Oij. Misce, et fiat infusum. This infusion was formerly much employed. A wineglassful may be taken three or four times per diem, or once every hour, in intermittent and other forms of fever. Infusion of Bark. R. Pulveris Cinchonse Rubrse, ij. Acidi Sulphurici Aromatici, fjj. Aquae, Oj. Macera per horas decern et cola. Signa. — Take a wineglassful every two hours. This infusion represents the virtues of the bark more fully than either of the foregoing. Infusion of Boneset. R. Eupatorii, 3j. Aquae bullientis, Oj. Infuse for two hours, and strain. — Of this a wineglassful may be taken every one or two hours, cold. In intermittent fever. TONICS. 161 SOLUTIONS, MIXTUKES, &c. Solution of the Sulphate of Quinia. B. Quiniae Sulphatis, gr. viij. Acidi Sulphurici Aromatici, gtt. x. Aquae, f |j. Fiat solutio. A teaspoonful contains one grain of the salt. Mixture of Sulphate of Quinia. B. Quiniae Sulphatis, gr. xx. Acidi Sulphurici, gtt. j. Sacchari, 3j. Aquae Cinnamomi, f sijss. Misce. Signa. — A teaspoonful for a dose, every hour during the apyrexia of intermittents. By the addition of sulphuric acid, a super-sulphate of quinia is formed, which is soluble in the aqueous menstruum. Sulphate of Quinia in Sirup. B. Quiniae Sulphatis, gr. xyj. Syrupi Zingiberis vel Limonis, f 3ij. Misce. Signa. — A teaspoonful to be given every hour during the apyrexia. The French physicians employ a wine and tincture of quinia, which, however, are not superior to the compound used in this country. Both in Europe and America, and especially in Italy, the dose is carried to a much greater extent than we have directed. Eight, ten, fifteen, twenty, and even thirty grains have been given by the Italians, without manifest injury and with successful results. Such doses, however, are seldom ad- missible in this country ; and a cure can generally be accom- plished by giving sixteen or twenty grains in twenty-four hours, repeated in half doses for three or four successive days. Mixture with Ferrocyanate of Quinia. B. Quiniae Ferrocyanatis, gr. iv. Alcoholis, f 5j. Solve et adde — Aquae Camphorae, f £vij. Misce. — This preparation is said to be more active than the sul- phate, whence it should be given in less doses ; a teaspoonful 11 162 TONICS. of the solution (which will contain half a grain of the salt) may be taken every hour or two hours, according to circum- stances. Pills of the ferrocyanate of quinia are prepared with simple mucilage, and administered like the sulphate. The acetate, citrate, muriate, nitrate, and other salts of quinia, have also been employed in Europe, and occasionally in this country. They possess no advantages over the ordinary pre- parations, and are given in much the same quantity. Mixture with Sulphate of Quinia and Tartaric Acid. B. Quiniae Sulphatis, gr. vj. Acidi Tartarici, gr. iij. . Syrupi, flj- Misce. Dose, a teaspoonful. The advantages of this preparation, are increased solubility and diminished bitterness of the quinine salt. Casokati. Mixture of Sulphate of Quinia and Tannic Acid. B. Quiniae Sulphatis, gr. x. Acidi Tannici, gr. ij. Aquae, f 3yj. Syrupi Aurantii Corticis, f 5ij. Misce. Signa. — A teaspoonful every two hours. The object proposed in this formula by Dr. Thomas of Balti- more is to diminish the intense bitterness of the sulphate. This is accomplished by the formation (in part at least) of an inso- luble tannate. "Whether it is as efficient as a more soluble salt, remains to be proved. E. H. Thomas. Mixture with Tincture of Baric and Citrate of Potash. B. Succi Limonis, f 3jss. Potassae Carbonatis, 5j- Tincture Cinchonas, f £j. Aquae Cinnamomi, f S iij - Misce. Signa. — A tablespoonful every two hours. To pro- mote insensible perspiration while taking the bark. Sirup of Cinchonia. B. Cinchoniae Sulphatis, gr. xxiv. Syrupi, Oss. Fiat mistura. — A tablespoonful will contain a grain and a half of the salt, which is a full dose : to be repeated pro re nata. topics, 163 Mixture of Bed Barh in Bort Wine, &c. R. Pulveris Cinchonas Eubrse, 3ss. Theriacas Andromachi, 3j. Succi Limonis, f 3ij. Vini Rubri, f |iv. Misce. Signa. — A wineglassful every second hour during the apyrexia of intermittent fever. "We find this prescription strongly recommended in the N. A. Medical and Surgical Journal, by Dr. Meigs. Mixture with Decoction and Tincture of Bark, &c. R. Decocti Cinchonas Rubras, f 3iij. Tinctures Cinchonas Compositas, f ^j. Pulveris Cinchonas, 3ij. Syrupi, f 3ss. Fiat mistura. — A tablespoonful to be taken every one or two hours during the absence of fever. Mixture with Extract of Barh, &c. R. Extracti Cinchonas Rubras, 3j. Decocti Cinchonas Rubras, f Jvj. Tincturas Cardamomi, f £iv, Misce. — A tablespoonful for a dose, as above directed. Mixture of Fowler's Solution, &c. R. Liquoris Potassas Arsenitis, gtt. Ix. Tincturas Opii, gtt. xxx. Spiritus Lavandulae Compositi, f Jj. Aquas Cinnamomi, f 3iv. Piat mistura. Signa. — A tablespoonful for an adult, a tea-* spoonful for a child; to be administered every two or three hours, during the apyrexia of intermittents, watching the effect. Arsenical Mixture. R. Liquoris Potassas Arsenitis, gtt. x. Aquas destillatas, flj. Tincturas Opii, gtt. x. Spiritus Lavandulas Compositi, f Jss. To be taken at a dose. This mixture is recommended by Dr. Graves, when the simple arsenical solution irritates the stomach. 164 TONICS. Enema of Extract of BarJc, &c. R. Extracti Cinchonas Rubrae, 3ss. Aquae tepidae, f 3iv. Solve ; dein adde — Olei Olivae, f Sss. Tincturae Opii, gtt. x. Fiat enema. — To be administered every fourth hour. In inter- mittents. "When preferred, the powdered bark may be used, say 3ij. mixed with some of the decoction instead of common water. Bark is also employed externally in the form of a waistcoat, worn next the skin. A poultice made by mixing the powder and decoction into a paste, may be applied to the region of the stomach ; and lastly, the decoction is used as a semicupium. Enema of Quinia. Quinia is employed in enemata, and in this form has an imme- diate and powerful effect on intermittent fevers. From twelve to twenty grains of the sulphate of quinia, dissolved, in a tea- cupful of flaxseed or other mucilage, may be administered at Si time, and repeated in four or six hours. Sub-Class II.— ORDINARY TONICS. POWDERS AND PILLS. Powder of Carbonate of Iron. B. Ferri Subcarbonatis, 3j. Divide in chartulas vj. Signa. — One every six hours in mo- lasses. Chorea, neuralgia, &c. The dose may be carried as far as 3ss. every four or six hours, but must sometimes be preceded by antiphlogistic treatment. Powder of Colomba, Ginger, &c. K. Pulveris Colombaa, — Ferri Subcarbonatis, Rhei, Zingiberis, aa 5j- Misce, et fiant pulveres xij. — One to be taken three times a day, in molasses. tonics. 165 Iron by Hydrogen. B. Ferri Pulveris, £j. Divide in pulveres xij. Signa. — Take one powder three times a day in sirup or mo- lasses. This has been much used in anaemia and chlorosis. It is one of the best preparations of iron. Powder of Belladonna, Quinia, and Rhubarb. B. Pulveris Belladonnge Kadicis, gr. jss. Quinias Muriatis, gr. iv. Pulveris Rhei, gr. xv. Misce, et divide in pulveres x. Signa. — Take one powder morning, noon, and night. This has been employed successfully in engorgements of the liver and spleen, following intermittent fever. Schwabe. Powders with Ipecacuanha, Iron, &c. B. Ferri Subcarbonatis, gr. xlviij. Pulveris Ipecacuanhaa, gr. yj. Hydrargyri cum Creta", gr. xij. Misce, et divide in pulveres yj. Signa. — Take one powder twice a day. Used with decidedly good effect in chlorosis. Ashwell. Powder of Angustura Bark. B. Pulveris Angusturas, 3ss. Divide in chartulas yj. — Of which one may be taken three or four times a day, in water, or any other vehicle. This bark has been successfully administered in uterine hemorrhage. Powder of Colomba and Tartrate of Iron. R. Ferri et Potassas Tartratis, 9ij. Pulveris Colombae, Jss. Fiant pulveres iv. Signa. — One every three or four hours, in sirup. Powder with Rust of Iron, &c. B. Ferri Sulphatis, 9ij. Subcarbonatis, 3iss. Divide in pulveres xij. Signa. — One to be taken morning, noon, and night, in sirup or molasses. 166 TONICS. Pills of Protocarbonate of Iron. R. Pilula? Ferri Carbonatis, 3j- Ferri Subcarbonatis, q. s. Ut nant pilula? xx. Signa. — A pill to be -taken morning, noon, and night. This is one of the latest and best formulae for the chalybeate preparations. Lactate of Iron. This salt of iron has lately been introduced into notice, but it has no obvious advantage over the ordinary preparations. — The dose is from gr. v. to 9j. Pills of Cinchona and Camphor. R. Extracti Cinchonas Rubra?, Jj. Opii, gr.j. Camphora?, gr. xij. Pnlveris Cinchona?, q. s. Ut fiant pilula? xij. — One to be taken three or four times a day. Ratiek. Pills of Ammoniuret of Copper. R. Cupri Amrnoniati, 3j. Confectionis Rosa?, q. s. ut fiant pilulae xl. Signa. — One or two to be taken at bedtime. In epilepsy. Febrifuge Bolus. R. Pulveris Cinchona? Rubra?, 3j. Ammonia? Muriatis, Carbonatis, aa gr. xij. Antimonii et Potassa? Tartratis, gr. xviij. Syrupi, q. s. ut fiat massa et divide in partes xlviij. Signa. — One to be taken four times a day, during the apyrexia of fever. Hotel Dieu. Pills of Ammoniated Iron, ct-c. R. Ferri Amrnoniati, 9j. Pulveris Rhei, gr. viij. Confectionis Rosa?, q. s. ut fiat massa in pilulas viij. divi- denda. This formula is recommended in rachitis, and is to be con- tinued with one pill a day for a fortnight, and then intermitted for the same length of time, and again resumed. The object of this direction is to prevent the system from becoming habituated to the medicine. TONICS, 167 Pills of Sulphate of Iron and Quinia. R. Quiniae Sulphatis, gr. xij. Ferri Sulpliatis, gr. xxiv. Pulveris Opii, gr. iij. Syrupi, q. s. Misce, et fiant pilulas xij. Signa. — Take two pills three times daily. Used in chlorosis and anaemia. Kiekby. Pills of Iron and Quinia. R. Pilulas Ferri Carbonatis, 5ss. Quiniae Sulpliatis, gr. x. Fiat massa, et divide in pilulas xv. Signa. — One pill every four hours. Thomas. Pills of Iron, Bed Pepper, &c. R. Pulveris Aloes, Ferri Sulphatis, aa 9j. Mastiches, gr. x. Pulveris Capsici, 9j. Syrupi, q. s. Fiat massa in pilulas xx. dividenda. Signa. — Take one pill every four hours. In chlorosis. Copland. Mitchell" 1 s Tonic Pills. R. Extracti Quassias, 3ij. : Conii, gr. x. Ferri Subcarbonatis, gr. x. Liquoris Potassae Arsenitis, gtt. x. Fiat massa in pilulas xl. dividenda. Signa. — Take one pill three times daily. J. K. Mitchell. Pills of Nitrate of Silver. R. Argenti Mtratis, gr. iv. Pulveris Grlycyrrhizas, gr. xij. Syrupi, q. s. Fiat massa, et divide in pilulas xij. Signa. — Take one pill every three hours. Pills of Nitrate of Silver, &c. R. Argenti Nitratis, gr. v. vel x. Pulveris Opii, 9ss. Camphoras, Myristicas, aa 9j. Mucilaginis Acacias, q. s. ut fiat massa, et divide in pilulas xx. Dose, a pill morning and evening. In chorea and epi- lepsy. 168 TONICS. Pills of Iodide of Manganese. R. Potassii Iodidi, Manganesiae Sulphatis, exsiccatas, aa 5j« Mellis, q. s. Fiat massa in pilulas xxx. dividenda. Signa. — To be kept in a well-stopped bottle. Take one pill morning and night. The salts of manganese have recently been introduced as substitutes for the corresponding preparations of iron. Hannon. Pills of Iron and Gentian. R. Ferri Pulveris, 9j. Extracti Grentianas, 9ij. Fiat massa, et divide in pilulas xx. Signa. — Take one pill three times a day. Pills of the Sulphate of Iron. R. Ferri Sulphatis, 3j- Extracti Grentianas, q. s. ut fiat massa, et divide in pilulas xxx. One to be taken morning, noon, and night. In dyspepsia, &c. Pills of the Extract of Quassia. R. Extracti Quassias, Jj. Fiant pilulas xx. Of which one may be taken three or four times a day. This is one of the purest bitters, and when a simple tonic is required, a more appropriate preparation cannot be substi- tuted. Pills of Oxide of Zinc. R. Zinci Oxidi, Bij. Confectionis Kosas, q. s. ut fiant pilulas x. Signa. — One three or four times a day. In epilepsy, chorea, &c. Dr. Chapman speaks favorably of this medicine, and recom- mends to begin with the above dose, and gradually to increase it. Pills of the Nitrate of Bismuth. R. Bismuthi Subnitratis, 3j- Mucilaginis Acacias, q. s. ut fiant pilulas xxx. One to be taken every two hours. In dyspepsia. TONICS. 169 Pills of Nitromuriate of Gold. R. Auri Mtromuriatis, gr. v. Pulveris Glycyrrhizae, 3jss. Mucilaginis Acaciae, q. s. ut fiat massa, in pilulas lxxv. divi- denda. Signa. — One or two thrice a day. In syphilis, &c. This metal is placed under the head of tonics by Dr. Chap- man and we have followed his example. Although once much extolled, it is now seldom used. [By the term nitro-muriate, the author means what is now known as the chloride of gold. According to the Codex, it is prepared by heating in a sand-bath, "one part of fine leaf gold, with three parts of nitro-muriatic acid, and evaporating the solution carefully until the odor of chlorine is perceptible. It is then set aside to cool and crystallize." (Dunglison.) The preparations of gold are again coming into use. Editor.] Mustard Seed. R. Seminum Sinapis Albi, ^j. Signa. — A teaspoonful of the unbruised seeds two or three times a day. They are beneficial in costive habits, when the con- stipation depends upon a torpid state of the muscular coat of the intestines. — Paris on Diet, p. 187. Electuary of Cinchona, Bust of Iron, &c. R. Pulveris Cinchonas, Ferri Subcarbonatis, aa oj. Copaibas, q. s. ut fiat electuarium. To be made (by the patient) into pills of the ordinary size, of which four may be taken three times a day. Pills of the Oxide of Silver. R. Argenti Oxidi, gr. yj. Pulveris Glycyrrhizse, gr. xij. Syrupi, q. s. Ut fiat massa in pilulas xij. dividenda. Signa. — Take one pill three times daily. Used with much success in pyrosis. Also highly recom- mended in menorrhagia. 170 TONICS. INFUSIONS AND DECOCTIONS. Infusion of Sage, Boneset, &c. R. Sal viae, Eupatorii, aa £ss. Cascarillae, 3j. Infuse in three naif-pints of boiling water until cold. Dose, a wineglassful every three or four hours. In hectic fever. Infusion of Colombo, and Ginger. R. Colombae contusae, 3j. Zingiberis, 3ij. Aquae bullientis, Oj. Fiat infusum. — Give of the strained liquor (cold) a wineglassful every two hours. This infusion, freely used, is adapted to chronic diarrhoea. Infusion of Colomba, Rhubarb, &c. R. Cari contusi, Eadicis Colombae contusae, Ehei contusae, aa 9j. Aquae ferventis, Oviij. Digest for two hours, and strain. R. Liquoris colati, f^iijss. Tincturae Ehei, f3j. Syrupi Zingiberis, f3ij. Misce. — Dose, a teaspoonful to a tablespoonful for children, according to their age. In diarrhoea. Infusion of Wild-cherry Baric. R. Pruni Yirginiani, §j. Aurantii Corticis, 3ij- Aquae, Oj. Infuse the bark alone for six hours, and then add the orange- peel. A wineglassful may be taken every hour or two in consumptive cases, asthma, &c. Infusion of Virginia Snake-root. R. Serpentariae, 3j. Aquae bullientis, Oj. Infuse in a covered vessel for one hour. A wineglassful every hour or two hours, pro re nata. TONICS. 171 Infusion of Quassia, &c. B. Quassias, Serpentarias, Aurantii Corticis, aa Iss. Aquas bullientis, Oij. Fiat infusum et cola. — A teacupful to be taken cold, three times a day. Cold Infusion of Chamomile and Orange Peel. B. Anthemidis, 5J. Aurantii Corticis, ?ss. Aquas, Oij. Macerate for twenty-four hours. — Dose, a teacupful three or four times a day. The infusion of chamomile made with cold, is in general more grateful to the patient than when made with boiling water. The same remark applies to infusions generally, and they are also less liable to ferment. Infusion of Hops. B. Humuli, 3j. Aquas ferventis, Oj. Infuse for two hours, and strain by expression. Of this a wine- glassful may be taken three or four times a day. In dyspepsia. Compound Infusion of Gentian. B. Gentianas concisas, Iss. Aurantii Corticis, 3ij- Cardamomi, Jss. Aquas ferventis, Oj. Fiat infusum. Gentian is an excellent bitter. The above preparation is given in wineglassful doses, in debility of the digestive organs, &c. Decoction of Angustura Bark. B. Angusturas coutusas, 3j. Aquas, Ojss. Boil for fifteen or twenty minutes and strain. Of this decoction a wineglassful may be taken every two hours. 172 TONICS. Decoction of Dog-wood Baric. B. Cornus Floridae contusi, 3j. Aquae, Oj. Boil for twenty or thirty minutes, and strain. — A wineglassful may be given every hour, as a substitute for Peruvian bark in intermittents, or as an ordinary tonic, every two hours. Decoction of Baric and Valerian. B. Cinchonas Rubrae contusae, Ij. Boil in a pint of water for ten minutes, and strain. B. Valerianae contusae, ^j. Aquas bullientis, Oj. Infuse for one hour, and strain. — Add the decoction of bark to this infusion, and give a teacupful cold, three or four times a day. This was a favorite prescription with the late Dr. Parrish, in rheumatic and nervous headache and hemicrania. Acorn Coffee. B. Pulveris Glandis Quercus torrefactae, Ej. Aquae bullientis, Oj. Fiat infusum. — Three or four teacupfuls may be taken during the day, and augmented according to circumstances. The above is a favorite remedy with the Germans. "It is one of the most successful in mesenteric atrophy, commencing rachitis, glandular swellings, asthma, and cough. Continued for a long time, it is one of the most powerful means we pos- sess for destroying the scrofulous disposition." — Hufeland, Treatise on Scrofula, p. 215. MIXTURES, TINCTURES, &c. Griffith's Myrrh Mixture. B. Myrrhae, Sacchari, aa 3j. Potassae Carbonatis, gr. xxv. Tere simul, et adde gradatim — Aquae Rosae, f ,5vijss. Spiritus Lavandulae, f 3ss. Dein adde — Ferri Sulphatis crystal lizati, in pulverem contriti, 9j. Fiat mistura. — Dose, a tablespoonful according to circumstances. Given as a tonic in phthisis. TONICS. 173 Mixture of Sulphuric Acid, &c. R. Ferri Sulphatis, 9j. Acidi Sulphurici, gtt. iv. vel vj. Saccliari, 3j- Aquae, f ^iv. Misce. Signa. — A teaspoonful for a dose, to be repeated every two, three, or four hours, much diluted. Vinous Tincture of Gentian, &c. R. Pulveris Gentians, Corticis Aurantii, aa 3ss. Yini Eubri, Oj. Macerate for three days, and give a wineglassful two or three times a day. In dyspepsia. Mixture of Sulphate of Iron and Elixir of Vitriol. R. Ferri Sulphatis, gr. iv. Acidi Sulphurici Aromatici, gtt. xx. Aquae destillatae, f ^j. Fiat mistura. Signa. — A teaspoonful to be taken three times a day in a wineglass of water. Vinegar Draught. R. Acidi Acetici, f 5j. Tincturae Cardamomi Compositae, f 3ss. Syrupi, f 3ss. Aquae, f ^x. Misce. — To be taken in such portions as the stomach can bear. In sick headache. Tincture of Cinchona, Valerian, &c, R. Tincturae Cinchonas, Valerianae, aa f Ij. Cardamomi, f 3ij. Aquae Menthae Piperitae, f liv. Fiat mistura. — Of this mixture a tablespoonful may be given every third hour. It is especially designed as a tonic in nervous temperaments. 174 TONICS. Compound Tincture of Aloes, Gentian, &c. B. Aloes, Ij. Pulveris Zedoarias, Grentianas, Croci, Khei, Agarici, aa 5j- Syrupi, il'\y To be mixed into a quart of brandy. This is the celebrated Baume de vie, or Elixir of Life. It is a powerful tonic, and one of the most effectual febrifuge medicines. In intermit- tents, especially, it is justly celebrated. Dose, a tablespoonful three times a day, in water. Acidulated Tincture of Gentian, B. Tincturas Gentianas Composites, f %iv. Acidi Sulphurici Aromatici, f 3ss. Misce. — A small teaspoonful to be taken in sugar and water, three or four times a day. Huxharrts Tincture of Bark. B. Tinctures Cinchonas Composites, f 3j. Signa. — A teaspoonful for a dose, every two hours. In the same doses as the above may be taken, Tinctura Colombas — et Tinctura Gentianas Compositas. Muriated Tincture of Iron. B. Tincturas Ferri Chloridi, f By From five to twenty drops to be taken in a glass of cold chamo- mile tea, twice or thrice a day. In passive hemorrhage. Nitrate of Silver Mixture. B. Argenti Nitratis, gr. \ — j. A qua? dcstillatas, fiij. Pulveris Acacias, 9ij. Sacchari, 3ij. Fiat mistura. Signa. — A teaspoonful every two hours. Used in the diarrhoea of newly-weaned infants. This is ac- companied by the occasional injection of gr. £ of the salt in mucilage. HlKSCII. TONICS. 175 Solution of Acetate of Strychnia. R. Strychniae Acetatis, gr. j. Acidi Acetici, ^Ixx. Alcoholis, f 5ij- Aquae, f 3yj. Fiat mistura. Signa. — Take ten drops three times a day. Useful as a tonic, in all cases of nervous exhaustion. Maeshall Hall. Solution of Persesquinitrate of Iron. R. Liquoris Ferri Nitratis, f 3j- Syrupi, f 3j. Aquae, f3yj. Eiat mistura. Signa. — Give a teaspoonful every three hours. This preparation is very serviceable in all forms of diarrhoea, but more especially in chronic mucous diarrhoea, hemorrhage from the bowels, uterine hemorrhage, &c. Sirup of Proto-Nitrate of Iron. R. Sulphate of Iron, Iviij. Carbonate of Soda, 3x. "White Sugar, ^xx. Nitric Acid (sp. gr. 1.42) f 3 v. and f 3 v. Boiling Water, Simple Sirup, of each, sufficient. " Dissolve the sulphate of iron, and carbonate of soda, each in two pints of the water, filter, and add to each solution two ounces of simple sirup. Mix the solutions, and allow the precipitate to subside. Pour off the supernatant liquid, and wash the precipitated carbonate carefully with sweetened water, until the washings have no longer a saline taste. Collect the precipitate upon a fine muslin strainer, and with gentle pressure express as much of the water as possible. Transfer to a porcelain capsule, and add gradually the nitric acid, previously diluted with an equal measure of water. Mix the sugar with the solution, and dissolve over a water-bath, stirring from time to time with a glass rod. When done, the sirup should be made to measure thirty fluidounces, by the addition of a sufficient quantity of water. This sirup contains ten grains of dry nitrate of iron, to each fluidram, and the dose varies from twenty to forty drops." LlVEEMOEE. 176 TONICS. Prof. Procter has published another formula, Journ. Pharmacy, vol. 23, p. 315. This preparation is much used in Philadelphia as a substitute for the persesquinitrate of iron, and as the mode of making it is not generally known, the whole process is given. Editor. Sirup of Iodide of Iron. R. Liquoris Ferri Iodidi, f £ss. Signa. — Take twenty drops, every three hours, in sweetened water. This valuable preparation is tonic, alterative, and emmena- gogue. Sirup of Iodide of Iron and Manganese. R. Liquoris Ferri et Manganesias Iodidi, f Uss. Signa. — Take twenty drops every three hours, in sweetened water. This is used for the same purposes as the preceding. The salts of manganese are beginning to attract attention. The formula for its preparation, by Prof. Procter, will be found m the American Journal of Pharmacy, vol. 25, p. 198. CLASS XIV ALTERATIVES. Alteratives have been defined — medicines that re-establish the healthy functions of the animal economy, without produc- ing any active evacuation. This class of remedies, therefore, embraces numerous preparations which produce a slow but decided effect on the various secreting organs, sometimes with- out any sensible increase of the secretions themselves, but in other instances obviously augmenting or magnifying them. Such is the action of minute doses of mercury, iodine, and other substances upon the glandular apparatus. These medicines are generally classed with stimulants and tonics, some of them with narcotics, and others have been placed with those preparations to which they seem most allied when given in an overdose — sialagogues, for example. Without attempting to investigate this question farther than regards practical convenience, we proceed in this place to indicate the more active and important Alteratives ; merely premising the familiar truth, that medicines of almost every class of the materia medica become alteratives by being administered in very small doses at intervals of a few hours. PILLS AND POWDERS. Mercury. The mercurial preparations constitute the most decided and efficient medicines of this class. In addition to several formulas inserted under the head of Sialagogues, the following may be appropriately noticed in this place. Calomel Pills. R. Hydrargyri Chloridi Mitis, gr. ij. Confectionis Rosse, q. s. ut riant pilulee xij. Of which one may be taken every hour or two hours. In ma- rasmus, &c. &c. 12 178 ALTERATIVES. The use of calomel in minute doses has become very general, and deservedly so. In the hepatic and intestinal complaints of children, it is productive of the happiest results when carefully managed. In infants, for example, the sixteenth or eighth of a grain, repeated every hour or two hours, according to age and circum- stance, will often check diarrhoea, cholera infantum, and dysen- tery, which have resisted every other treatment. If the discharges are attended by pain and tenesmus, small doses of powdered opium or laudanum may be added ; but, as a general rule, the anodyne had better be given by injection. The preparation called blue-pill (pilula hydrargyri) is indicated in similar conditions, and is especially beneficial whenever an alterative is called for. A grain given at bedtime, or even a grain in divided portions through the day, will often produce the desired effect. Hence its extensive use in chronic and ob- scure derangements of the digestive organs, especially of the stomach and liver ; in the whole class of syphilitic affections ; glandular enlargements, &c. In like manner, all the mercurial preparations mentioned under the head of Sialagog-ues, become alteratives by cautious administration in doses more or less minute, and especially when they are given in conjunction with the preparations of sarsa- parilla. Pills of Calomel, Quinia, Opium, &c. R. Hydrargyri Chloridi Mitis, gr. vj. Pulveris Opii, gr. iij. Quinia3 Sulphatis, gr. xij. Syrupi, q. s. ut fiat massa in pilulae xij. dividenda. Signa. — One* night and morning. Pills of Blue Mass, Quinia, &c. R. Pilulae Hydrargyri, Quinios Sulphatis, Pulveris Aloes, aa gr. xij. Syrupi Khei Aromatici, q. s. ut fiant pilulae xij. ftigna. — One, three or four times a day. Either of the above prescriptions is adapted to the condition that follows bilious intermittent or remittent fever. They may be denominated tonic alteratives. ALTEKATIYES. 179 Pills of Red Iodide of Mercury. R. Hvdrargyri Iodicli Kubri, gr. ss. Extracti Juniperi vel (xlycyrrhizas, gr. viij. Divide in pihilas viij. Signa. — Two in the morning and two at night ; dose to be gradually and cautiously augmented. Corrosive Sublimate Pills. R. Hvdrargyri Chloridi Corrosivi, gr. j. Solve in aquam destillatam, dein adde — Micas Panis, Sacchari, aa gr. x. vel q. s. Ut fiant pilulas xx. Signa. — Take one pill every four hours as an alterative. DZONDI. Arsenic. Arsenic is a powerful alterative, and one that should be ad- ministered with the utmost circumspection. In addition to the formulae already given, the following may be found useful. Pills of the Arseniate of Iron. ■ R. Ferri Arseniatis, gr. iij. Extracti Lupuli, Ed. 5j. Pulveris Altheas, 3ss. Syrupi, q. s. ut fiat massa. To be divided into forty-eight pills, of which one is given daily. Prescribed by Dr. Biett in scrofulous, cancerous, and herpetic diseases. Asiatic Pills. R. Acidi Arseniosi, gr. j. Pulveris Piperis Mgri, gr. xij. Acacias, gr. ij. Aquas, q. s. Misce, et divide in pilulas xij. Signa. — Take one pill morning and night. Much used for tuberculous lepra. Biett. Iodide of Arsenic Pills. R. Arsenici Iodidi, gr. j. — ij. Extracti Conii, 9ij. Fiat massa, et divide in pilulas xvj. Signa. — Take one pill morning and night. Given in lepra, im- petigo, and cancerous disease. 180 ALTERATIVES. Pills of Iodide of Silver, R. Argenti Iodidi, Potassas Nitratis, aa gr. x. Tere simul ut fiat pulvis subtilis, dein adde — Pulveris Glycyrrhizae, 3ss. Sacchari, 3j. Mucilaginis Acacias, q. s. Ut fiant pilulae xl. Signa. — Take one pill three times daily. Used successfully in the gastric affections of the Irish pea- santry. C. Patterson. Pills of Bromide of Iron. R. Ferri Bromidi pulverizati, gr. xij. Confectionis Kosse, gr. xviij. Acacias, gr. xij. Mi see, et fiant pilulse xx. Two pills to be taken in the morn- ing, and two in the evening, or, one three times a day. In hypertrophy of the heart, and scrofulous affections. Dr. Eobert Dick strongly recommends the use of the bro- mide of iron in dyspeptics with strumous habits. Magendie. Pills of Calomel and Ox Gall. R. Hydrargyri Chloridi Mitis, 9j. Fellis Bovini inspissati, gr. xv. Saponis, gr. x. Extracti Taraxaci, 3ss. Fiat massa in pilulas xx. dividenda. Signa. — Take two pills at bedtime. These pills are alterative and deobstruent. Brucia. The alkaline principle called Brucia, or Brucine, is contained in the false Angustura bark, nux vomica, and St. Ignatius's bean. It possesses the properties of strychnia, but in less de- gree. It may be administered in doses of half a grain to a grain ; but the minimum dose should be first given, and the quantity gradually augmented. , ALTEKATIVES. 181 Pills of Brucia. B. Brucise, gr. xij. Confectionis Eosas, q. s. ut fiat massa. Divide in pilulas xxiv. Signa. — One pill to be taken four times a day, and gradually increased. Burnt Sponge. R. Spongiae Ustae, 3j. Sacchari 9j. Misce, et divide in chartulas vj. — One three times a day, gradu- ally augmenting the dose. In bronchocele. It is well known that iodine was first discovered in sea- weed and sponges ; and the latter having long had the reputation of being a cure for goitre, it was found that iodine was the active remedial agent. We give above a prescription for the use of Sponge as formerly in vogue, but now nearly superseded by the preparations of pure iodine. TINCTURES, MIXTURES, &c. Preparations of Iodine. That iodine is one of the most powerful alteratives at present known, there can be no question. There are few diseases de- pendent upon or connected with morbid secretion of the glandu- lar structures, but what are more or less modified by its use, while in others it acts as a direct curative agent. It is chiefly, however, in scrofulous, glandular, and cutaneous affections that it acts most beneficially, dispersing indurations of the glands, and restoring the secretions of the cutaneous and mucous appa- ratus ; whence its advantages in eruptive diseases, bronchitis, leucorrhoea, amenorrhoea, &c. &c. It has been found to restore suppressed hemorrhoidal and catamenial discharges, and when pushed too far, has even produced alarming hemorrhage of the lungs, nose, and uterus. These facts should make the practi- tioner extremely cautious in its administration, beginniug with small doses, and watching their effects. Should it produce any of the inconveniences already mentioned, or dizziness, nausea, purging, burning of the skin or swelling of the gums, it should be at once suspended, or given less frequently and in smaller doses. 182 ALTEKATIVES. Ethereal Tincture of Iodine. R. Iodinii, gr. vj. iEtheris, f5ij. Misce. — Thirty drops contain one grain of iodine. — Dose, ten drops two or three times a day, largely diluted. In cuta- neous and glandular diseases. Compound Tincture of Iodine. R. Iodinii, gss. Potassii Iodidi, Ej. Alcoholis, Oj. Fiat tinctura. — Dose, five to fifteen drops, pro re nata. Mixture of Iodide of Potassium, &c. R. Potassii Iodidi, gr. x. vel 9j. Magnesias Sulphatis, Iss. Potassae et Antimonii Tartratis, gr. ss. Aquas destillatae, f 3yj. Misce. Signa. — A teaspoonful three or four times a day. In scrofula. Saturated Tincture of Iodine. R." Iodinii, 9ij. Alcoholis, f 3j. Spiritus Lavandulae Compositi, f3ij. Fiat solutio. — This is Mr. Durand's saturated solution. The dose is ten or twenty drops, which may be gradually increas- ed, watching its effects. Iodine with Iodide of Potassium. R. Iodinii, gr. iij. Potassii Iodidi, gr. vj. Aquae destillatae, fsj. Solve. Signa. — Dose, six to ten or twenty drops thrice a clay in a draught of cold water. If it produce dizziness, pain in the bowels, or other unpleasant symptoms, diminish the quantity. The author of Illustrations of Pulmonary Consumption, strong- ly recommends this formula in catarrh, phthisis, &c. It has a powerful effect in glandular disease, and all affections of the mucous membranes. S. G. Morton. ALTERATIVES. 183 Mixture of Tincture of Iodine, &c. R. Tinctures Iodinii, f 5j. Mucilaginis Acacias, f |ij. Aquas destillatas, f ivj. Fiat mistura. Signa. — A tablespoonful every two hours. Em- ployed in cases of ulceration accompanied by purulent dis- charge from the meatus auditorius, and in the scrofulous dia- thesis. Solution of Iodide of Iron. R. Ferri Iodidi, Jj. Aquas destillatas, f Ij. Fiat solutio. — Dose, six to ten drops, morning, noon, and night, in a wineglass of cold water. Solution of Iodide of Potassium. R. Potassii Iodidi, gr. xxxyj. Aquas destillatas, f ^j. Fiat solutio. — Dose, ten to twenty drops, morning, noon, and night, in a wineglass of sweetened water. Each dose will contain between one and two grains of the iodide. Magendie. LugoVs Solution. R. Liquoris Iodinii Compositi, f Iss. Signa. — Give ten drops in sweetened water three times a day. Magendie 1 s Anti-epileptic Iodine Solution. R. Potassii Iodidi, 5iv. Iodinii, gr. ij. Aquas Menthas Piperitas, f ^vj. Fiat solutio. — Dose, a teaspoonful thrice per diem. Mixture with Iodide of Potassium. R. Potassii Iodidi, 3ss. Syrupi Zingiberis, f ^j. Aquas, f 3v. Fiat mistura. Signa. — Take a tablespoonful three times a day. Solution of the Ioduretted Hydriodate of Potash. R. Iodinii, 9j. Potassii Iodidi, 9ij. Aquas destillatas, f ^vij. Fiat solutio. — Dose, six drops, morning and evening, in a wine- glass of water. In scrofulous and scirrhous diseases. D.unglison's New Remedies, 6th ed. p. 598. 184 ALTERATIVES. Mixture of lodo-hydrar gyrate of Potash. R. Potassii Iodidi, gr. iijss. Hydrargyri Iodidi Kubri, gr. ivss. Aquae destillatae, f §j. Dissolve first the iodide of potassium, and then the biniodide of mercury, in the water. The compound salt in this solution may be assumed at eight grains, although there is a small ex- cess of the iodide of potassium. The dose is from two to five drops, containing from the thirtieth to the twelfth part of a grain, which may be repeated three times a da}^, much diluted. Dr. Channing. Ioduretted Sulphuric Ether. R. iEtheris, f$j. Iodinii, gr. vj. Solve. Signa. — Six drops constitute a dose. To be largely diluted when taken. Thirty drops of this solution contain a grain of iodine. Iodine Waters. The physicians of Europe, and especially of Paris, have made extensive and salutary use of iodine waters, both internally and externally. In these, the iodine is very much diluted, and gene- rally with the addition of more or less common salt. These waters are prepared on a large scale and with great precision by the pharmaceutists of Paris ; but they have been but partially introduced into this country. M. Magendie, however, gives formulas for some extemporaneous iodine waters, which may answer all the purposes of the more elaborate preparations. The following is an example : — R. Potassii Iodidi, gr. vj. Iodinii, gr. j. Aquae, Oij. Fiat solutio. — This solution is directed to be drank at meals, in place of common water. Donovan's Solution. R. Liquoris Arsenici et Hydrargyri Iodidi, f sss. Signa. — Give ten drops three times a day in sweetened water. Used in various skin diseases, and for venereal eruptions. Bromine. This substance, which is allied to chlorine and iodine, in its habitudes, is obtained from salt springs and other mineral waters. In medicine, it is chiefly used in combination with potassa. ALTERATIVES. 185 Solution of Bromine. R. Brominii, f Jss. Aquae, f ^ijss. Misce. Signa. — Dose, five drops three times daily. Pourche. Solution of Bromide of Potassium. R. Potassii Bromidi, 9j. — ij. Syrupi Aurantii Corticis, f 3j. Aquae, fliij. Fiat mistura. Signa. — Give a tablespoonful tliree times a day. Mixture of Iodine and Arsenic. R. Liquoris Iodinii Compositi, f 3ij. Potassae Arsenitis, f 3j. Misce. Signa. — Take five drops three times daily. Pearson's Solution. R. Sodae Arseniatis, gr.j. Aquae, f^j. Fiat solutio. Signa. — Dose, twelve to twenty drops, three times a day. Used in the scaly and other skin diseases. An arseniate of ammonia was introduced by Biett, and em- ployed by him in the same strength as the foregoing solution, i. e. one grain to the fluidounce, and given in the dose of twenty drops. Its virtues are similar to those of Fowler's and Pearson's solutions. Phosphate of Ammonia. R. Ammoniae Phosphatis, ^ss. Aquae destillatae, f §vj. Fiat solutio. — A tablespoonful to be taken every four hours. The preceding formula is that of Dr. Buckler, who recom- mends it in those cases of gout and rheumatism in which little acid is present in the urine ; as well as in all the chronic modi- fications of those diseases, especially when they are associated with chronic thickening of the white tissues. Strychnia. We have (under the head of Narcotics) noticed several pre- scriptions for using this extremely poisonous substance ; but as 186 ALTERATIVES. it is chiefly given as an alterative, we now add some additional modes of administration. Strychnia is much in vogue in the whole class of nervous diseases, paralysis, whether general or local, neuralgia, chorea, hysteria, &c. It is also employed in syphilis, amenorrhoea, dyspepsia, bronchitis, and, in fact, in all cases where an alterative course is indicated. Solution of Acetate of Strychnia. R. Strychnia? Acetatis, gr. iij. Alcoholis, f 3j. Aquae Cinnamomi, f 5vij. Misce. — Dose, five drops twice a day, cautiously increasing it. Dunglison, New Remedies, 6th ed. p. 664:. Tincture of Acetate of Strychnia. R. Strychnia? Acetatis, gr. jss. Alcoholis, flss. Fiat tinctura. — Dose, five to ten drops thrice per diem. In sy- philitic, pains of the bones, &c. Dungliscw, ut supra. A sulphate of strychnia is also in use. It is prepared like the acetate, of course substituting sulphuric acid. It has no advantages over the preparations already given, and is little used. See Magendie, Formulaire, 9eme ed. p. 30. Mixture of Brucia. R. Brucia?, gr. vj. Aqua? destillata?, f liv. Sacchari, 3ij- Fiat mistura. Dose half a tablespoonful night and morning. This and the following preparation are used in paralysis and the entire series of spasmodic affections. Tincture of Brucia. R. Brucia?, gr. xviij. Alcoholis, f Sj. Fiat tinctura. — From six to ten drops may be taken in a draught of water. Cod-Liver Oil ( Gadus Morrhud). This preparation, which is now divested in a great measure of its nauseous smell and taste, is given in closes of half an ounce, three or four times a day. To children, a tcaspoonful. It is of much service in all strumous affections, and in the ALTERATIVES. 187 chronic forms of gout and rheumatism. It may be taken alone, or in milk ; most persons prefer taking it on the froth of porter. Others swallow it in coffee, in lemon-juice, or with some of the aromatic waters. Dr. Bradshaw recommends a thin infusion of flaxseed, fla- vored with lemon-peel, and sweetened to please the palate. He says : " I pour a small quantity of infusion into a glass, on which is added the oil, and again another small quantity of infusion upon it. In this manner, the dose may be swallowed, and will slip down without offending the palate, and generally is well retained even by irritable stomachs." The same author says : " Another mode has been successful when many have failed, and will be found equally valuable : It is the yelk of an egg beat up with boiling water and sugar, with which may be mixed a dessertspoonful of brandy ; and on this the dose may be given without producing that nausea so frequently experienced when conveyed by other vehicles." In the Editor's experience, the form of emulsion has proved to be one of the least satisfactory modes of exhibiting this article. He is in the habit of administering it in the pure state, directing the patient to chew a piece of orange-peel before and after each draught ; or, what is equally effectual, to rinse the mouth, and gargle the throat with vinegar, before and after the dose. Mixture with God-Liver Oil. R. Olei Morrhuas, f 5ss. Liquoris Potassas, gtt. xl. Aquas Menthas Piperitas, f 3ss. Misce, et flat haustus. The draught to be washed down with a teaspoonful of lemon- juice to liberate the oil on the stomach. Dunglisojst, New Rem. 6th ed. p. 557. Peecival. Mixture of Iodine and God- Liver Oil. R. Iodinii, gr. jss. Olei Morrhuas, f Iv. Eub the iodine with a dram of the oil, and then carefully add the remainder. Signa. — Dose, a tablespoonful three times a day. The quantity of iodine can be increased without materially changing the appearance of the solution. FleischmanjST. 188 ALTERATIVES. Mixture with Corrosive Sublimate. R. Hydrargyri Chloridi Corrosivi, gr. ij. Aquae destillatae, f3yj. Spiritus Cinnamomi, Syrupi, aa f^j. Misce. — Dose, one or two large spoonfuls, twice or thrice a day. In venereal cases. Nitro-muriatic Acid. R. Acidi Nitrici, f 3ss. ■ Muriatici, fjj. Aquae, Oviij. Misce, et adde — Spiritus iEtheris Nitrici, fjj. vel. fjij. Fiat mistura. Signa. — From twenty drops to half a tea-spoonful to be given every three hours, in a wineglass of sweetened water. These acids, in the same proportions, are also employed as a bath in hepatic derangements. To accomplish this end, put a teaspoonful of the compound acid into a quart of warm water, and apply it to the region of the liver night and morning, by means of a soft sponge. Diluted Nitric Acid. R. Acidi Nitrici, fjss. vel fjj. Aquae, Oij. Sacchari, 3j. Fiat mistura. — One-eighth of this quantity may be taken daily, in divided doses. In lues venerea. Ferriar, Med. Hist. Mixture of Nitric Acid. R. Acidi Nitrici, f 3ss. Pulveris Acaciae, Sacchari, aa 3iij. Aquae, f Jviij. Fiat mistura. Signa. — A small tablespoonful largely diluted, and sweetened, pro re nata. Nitric acid may be prescribed as a tonic in the above form, or simply diluted with water. It is best taken through a quill, as the teeth suffer, when it comes in contact with them. It sometimes arrests the colliquative sweats of hectic fever when other remedies fail. ALTERATIVES. 189 Artificial Harrow gate Water. R. Potassse Sulphatis cum Sulphure, Ed. 3j. Bitartratis, 3ss. Magnesise Sulphatis, 3yj. Aquas destillatse, Oij. Solve. Signa. — One-half, taken in draughts, constitutes a dose. The above ought to be taken in the morning before break- fast, and be followed by a walk, to produce the desired effect. Antacrid Tincture. B. Pulveris Gnaiaci, Ej. Terebinthinse Canadensis, Ij. Hydrargyri Chloridi Corrosivi, 9j. Olei Sassafras, fjij. Alcoholis, f^viij. Dissolve the corrosive sublimate in one-half the spirit, and then add to it the other ingredients. — Of this from ten to twenty drops may be taken morning and evening, in wine or water, This form of exhibiting corrosive sublimate is employed by Dr. Emerson and other practitioners of this city, in lues vene- rea, &c. CLASS XV. ASTRINGENTS. - Doctor Cullen describes astringents to be " such substances as, applied to the human body, produce contraction and conden- sation in the soft solids, and thereby increase their density and force of cohesion." " And by the operation of this corrugating power," adds Dr. Murray, " either directly exerted on a part, or extended by sympathetic action, the morbid affections arising from a state of relaxation are supposed to be removed." In the use of this class of medicines a caution suggests itself; namely, that they should not be given to arrest evacuations that are critical, and designed by nature to relieve a plethoric state of the system, unless such an evacuation exists to an alarming extent. POWDERS, PILLS, &c. Compound Powder of Alum. R. Aluminis, 9j. Pulveris Kino, gr. v. Fiant pulveres v. Signa. — One every two hours. In obstinate diarrhoea. This compound, though much employed by some practitioners, contains substances which would be incompatible with each other if given in solution. In menorrhagia, &c. Powder of Sugar of Lead and Calomel. B. ITydrargyri Chloridi Mitis, gr. j. vel ij. Plumbi Acetatis, gr. ss. ad gr. j. Fiant pulveres iv. — One every three hours. In cholera infantum. The above dose is adapted to any period between ten and twenty months of age. Dr. T. D. Mitchell. ASTRINGENTS. 191 Powder of Sugar of Lead, Calomel, and Ipecacuanha. R. Hydrargyri Chloridi Mitis, Pulveris Ipecacuanhas, aa gr. ij. Plumbi Acetatis, gr. viij. Misce, et divide in pulveres viij. Signa. — Give one powder every three hours. Used in cholera infantum. The Editor, from his connection with a large charitable institution, has had repeated opportuni- ties of testing the various astringent preparations employed in this complaint, and he has found none to answer better than this formula, either as it stands, or with the addition of twenty- four grains of prepared chalk. The quantity of sugar of lead appears large, but experience proves that it may be given, both with safety and benefit, to a child from one to three years old. D. F. Condie. Powder with Alum and Opium. R. Aluminis, 3ss. Pulveris Opii, gr. iij. Fiant pulveres vj. Signa. — One to be taken every three or four hours. In diarrhoea. Powders of Nitrate of Bismuth, &c. R. Bismuthi Subnitratis, 3j- Pulveris Acacise, 3ss. Magnesia?, 9j. Misce, et divide in pulveres xij. Signa. — Give one powder every four or six hours. Used in the diarrhoea of phthisis. T. Thomson. Powders of Nitrate of Bismuth. R. Bismuthi Subnitratis, gr. iij. — vj. Sacchari, gr. x. Fiant pulveres vj. Signa. — Place a powder on the tongue of a child (one year old), three or four times daily. Used in the diarrhoea of children. Kecamier, Trousseau. 192 ASTRINGENTS. Pills of Acetate of Lead and Calomel, R. Plumbi Acetatis, £ss. Hydrargyri CKLoridi Mitis, gr. v. Confectionis Kosae, q. s. Ut fiant pilulae x. — One to be given every two, three, or four hours, according to circumstances. In hemorrhage, and espe- cially in hematemesis. Pills of Sugar of Lead and Opium. R. Plumbi Acetatis, 9j. Opii, gr.j. Misce, et divide in pilulas xij. — A pill to be taken every hour at first, and then every two hours. This is Dr. Graves's pre- scription for the treatment of cholera. Pills of Sugar of Lead and Opium. R. Plumbi Acetatis, gr. xij. Pulveris Opii, gr. vj. Confectionis Kosae, q. s. ut fiat massa in pilulas vj. dividenda. One to be taken for a dose, according to circumstances. In haemoptysis and other hemorrhages. Pills of Alum, Catechu, &c. R. Aluminis, gr. vj. Extracti Opii, gr. j. Catechu, gr. vj. To be divided into six pills, one of which is to be given every two, three, or four hours. In passive hemorrhage, and in atonic mucous discharges. Pills of Rhatany. R. Extracti Kramer iae, 9j. Pulveris Kino, q. s. Ut fiant pilulae viij. Signa. — A pill to be given every hour or two hours. In the profluvia. Pills of Creasote. R. Creasoti, gtt. x. Pulveris Glycyrrhizae, Mucilaginis Acaciae, aa q. s. Ut fiant pilulae xx. — Dose, a pill thrice in the day. In bron- chitis, neuralgia, &c. ASTRINGENTS. 193 Pills of Kino, Opium, &c. R. Pulveris Kino, gr. xx. Opii, gr. ij. Mucilaginis Acaciae, q. s. ut fiant pilules iv. Of which take one every four hours. In diarrhoea, pyrosis, &c. Mbnesia. This substance is the product of a tree that grows in Chili, but its botanical affinities are unknown. It is given in the form of extract, twelve or twenty grains daily, divided into three- grain pills. There is also a tincture of monesia, of which the dose is f 3j. twice per diem. In leucorrhcea, diarrhoea, monor- rhagia, &c. &c. Tannin Pills. R. Acidi Tannici, gr. viij. vel xij. Mucilaginis Acacia?, q. s. Ut fiant pilulae viij. One may be given every two or three hours. In gonorrhoea, &c. Pills of Tannin and Morphia. R. Acidi Tannici, 9j. Morphias Sulphatis, gr. j. Mucilaginis Acacise, q. s. Ut fiant pilulae x. One to be given every two or three hours. Blue mass may be added according to circumstances. In diarrhoea and dysen- tery. Pills of Gallic Acid. R. Acidi Gallici, 9j. Extracti Gentianae, gr. x. Syrupi, q. s. Fiat massa in pilulas x. dividenda. Signa. — Give one pill every three hours. Used in haematuria, and other hemorrhages. Bolus with Alum and Extract of Bark. R. Aluminis, Extracti Cinchonas Kubrae, 1 Myristicae, aa 9ss. Syrupi, q. s. ut fiat bolus. To be given in uterine and other hemorrhages, and repeated pro re nata. 13 194 ASTRINGENTS. MIXTUEBS, INFUSIONS, &o. Infusion of Matico. R. Matico concisi, 3j. Aquae bullientis, Oj. Macera per horas duas et cola. Signa. — Take a wineglassful every two or three hours. This has been used to check the discharge in haemoptysis, haematemesis, and dysentery. ParrlshUs Camphor Mixture. R. Aquae Camphorae, f^iij. Spiritus Lavandulae Compositi, f 3j. Sacchari, Jj. Fiat mistura. Signa. — Give a tablespoonful every two hours in diarrhoea and cholera morbus, adding ten drops of laudanum when there is much pain. Jos. Parrish. Camphor, Laudanum, and Nitric Acid, or Hope's Mixture. R. Aquae Camphor ae, f Jiv. Acidi Mtrici, gtt. iv. Tincturae Opii, gtt. xl. vel lx. Fiat mistura. — Dose, a tablespoonful every two hours. In diar- rhoea and dysentery. This is a well known and very efficacious preparation ana- logous to Hope's mixture. If the nitric acid is added in larger proportion, it is liable to defeat the object of the prescription. The original formula contained a fluidram of nitrous acid, forty drops of laudanum, and eight fluidounces of camphor water, and was given in doses of two fluidounces every three hours. Hope. Chalk Mixture. R. Cretae Praeparatae, 3iss. Sacchari, Acaciae, aa 3j. Aquae destillatae, f 5iv. Olei Cinnamomi, gtt. ij. Tincturae Opii, gtt. xl. vel lx. Mi see. — Dose, a tablespoonful every two hours. In diarrhoea and dysentery. When a strongly astringent chalk mixture is desirable, we add to the above formula Tinct. Kino, f3ij. or the same quantity of tincture of krameria, catechu, or nutgalls. ASTRINGENTS. 195 Jackson's Mixture. R. Spiritiis Lavandulae Compositi, Tincturae Camphor as, aa fiss. Spiritiis iEtheris Compositi, aa f3ij. Misce. Signa. — Give twenty drops at short intervals, in cholera morbus, and the early stages of cholera, to allay nausea and relieve pain. S. Jackson. Although this preparation is not strictly astringent, yet it may be classed with great propriety with Hope's and Parrish's mixtures. Infusion of Galls. B. Gallas contusae, 3ij. Aquas bullientis, f^x. Infuse for four hours, and strain. — To be taken in doses of a tablespoonful every hour or two hours. In diarrhoea. It may be rendered more agreeable by the addition of some aromatic. Infusion of Galls and Chalk. R. Acacias, Jj. Cretas Prasparatas, 3ij. vel fss. Infusi Gallse, f siv. Tincturae Opii, f 3ss. Piat mistura. — Dose, a tablespoonful every two hours. In diar- rhoea. Infusion of Logwood. R. Hasmatoxyli concisi, gss. Aquas bullientis, Oj. Infuse for two or three hours, and strain. Of this a table- spoonful is given to a child every two or three hours. In cholera and diarrhoea. Mixture of Extract of Logwood, &c. R. Extract! Hasmatoxyli, 5iij. Tincturae Catechu, f5ij. Aquas, flvij. Misce. Signa. — Two tablespoonfuls to be given once in three or four hours. In the advanced stages of diarrhoea and dysentery. 196 ASTRINGENTS. Mixture with Extract of Barh and Alum. R. Extracti Cinchona? Rubrae, 3ss. vel Jj. Aluminis, 9ij. Aquae Cinnamomi, f^iij. Syrupi, f^j. Misce. Signa. — Two teaspoonfuls every two hours. In low diseases accompanied with hemorrhage. Mixture with Tincture of Catechu, &c. R. Tincturae Catechu, flj. Opii, gtt. lx. Acacias, 5ij- Aquas Cinnamomi, f^vj. Misce. Signa. — A tablespoonful every two hours. In diar- rhoea. Greasote Mixture. R. Creasoti, gtt. vj. Mucilaginis Acacias, f^iv. Sacchari, 5j- Fiat mistura. — Dose, a tablespoonful diluted, every two or three hours. In hemorrhages. Alcoholic Solution of Creasote. R. Creasoti, gtt. j. Alcoholis, gtt. xvj. Misce. — A drop or two of this solution dropped into the cavity of an aching tooth, is said to afford immediate relief. Marinus. Electuary of Catechu and Opium. R. Electuarii Catechu, Ed. 3j. Suited to cases of diarrhoea, in teaspoonful doses. Ten scruples contain one grain of opium. Alum Whey. R. Lactis Vaccinae bullientis, Oj. Pulveris Aluminis, 3ij- Boil them until the coagulum separates, and strain. A cupful to be taken occasionally. In diabetes, &c. Peruvian Barh with Lime-iuater. R. Pulveris Cinchonas Rubra), sss. Liquoris Calcis, fsviij. Misce. Signa. — A tablespoonful every two hours, or oftcner if necessary. In diarrhoea and monorrhagia. ASTRINGENTS. 197 Sirup of Galls, Brandy, &c. B. Grallae contusae, Jij. Spiritiis Yini Grallici, fSviij. Mix. — Burn out the spirit ; then add — Corticis Cinnamomi, Macis, aa 5ij- While hot, add sugar by burning it over the inflamed brandy until a sirup is formed. Decant the pure sirup. Dose, a tablespoonful every two hours. In chronic and obstinate diarrhoea. Jos. Parrish. Solution of Sulphate of Copper, &c. B. Cupri Snlphatis, gr. iij. Acidi Sulphurici, gtt. x. Aquae destillatae, §j. velffij. Fiat solutio. Signa. — From twenty to forty drops to be given every one or two hours in sirup, pro re nata. In menor- rhagia. Mixture of Extract of Rhatany, &c. B. Extracti Kramer iae, Jj. Syrupi Papaveris, Lond. Aquae Kosae, aa fsij. Fiat solutio. Signa. — A teaspoonful for a dose, pro re nata. In passive hemorrhage and chronic dysentery. M. FOUQTJIER. Solution of Acetate of Lead. B. Plumbi Acetatis, gr. v. Aceti. gtt. v. Sacchari, 3j. Aquae, f|j. Fiat mistura. Signa. — Give a teaspoonful to a child every hour or two, to allay the vomiting in cholera infantum. D. F. Condie. Enema of Acetate of Lead, &c. B. Plumbi Acetatis, 9j. Tincturae Opii, gtt. Ix. Aquae tepidae, f %\]. Fiat solutio. — To be thrown up the rectum in uterine hemor- rhage. Dewees's Syst. of Mid. p. 420. CLASS XVI ABSORBENTS, OR ANTACIDS. Absoebents or Antacids form a class of remedies for correct- ing acidity in the stomach and bowels. As a general rule they should be preceded by an emetic or cathartic, or both. When a permanent effect is desired, they are usually combined with tonics, aromatics, and sometimes with narcotics. When given alone, they too frequently afford but transient relief. POWDERS AND PILLS. Compound Cretaceous Powder with Opium. B. Cretse Praeparatae, 3iss. Pulveris Cinnamomi, 3j- Piperis Longi, gr. viij. Opii, gr. yj. Divide in chartulas xij. — One three or four times a day. In diarrhoea. The above formula, with a slight alteration, is from the London Pharmacopoeia. Powder with CraVs Claws and Rhubarb. R. Chel as Cancrorum, 3j. Pulveris Rhei, 9ij. Misce, et divide in pulveres iv. — Of which one may be taken once or twice a day, according to circumstances. In acidity of the primaa via3. This preparation is called by the several names of crab's claws, eyes, and stones. It is a carbonate of lime united with some animal gelatine, which, like prepared oyster-shells, has little or no superiority over the prepared chalk. ABSORBENTS, OR ANTACIDS. 199 Powder with Magnesia, Fennel-seed, &c. B. Magnesias, -fss. Pulveris Fosniculi, Cinnamomi, aa 5j- Fiat pulvis. — Dose, a small teaspoonful three or four times a day. Poivder with Soda, Magnesia, &c. B. Magnesiae, Iss. Sodas Bicarbonatis, Pulveris Zingiber is, aa 9j. Misce. Signa. — A small teaspoonful occasionally. In cardi- algia. Poivder with Magnesia and Colombo. B. Magnesias, 3jss. Pulveris Colombas, Jj. Misce. — Divide in chartulas vj. — Of which one may be taken three times a day, in sugar and water. In cardialgia. Pills of Soda, Rhubarb, &c. B. Pulveris Ehei, Sodas Carbonatis exsiccatas, Extracti Gentianas, aa 9j. Hydrargyri Chloridi Mitis, gr. iij. Fiant pilulas xx. Signa. — Two occasionally. In dyspepsia. MIXTURES, SOLUTIONS, &o. Chalk Mixture. B. Cretas Prasparatas, 3iss. vel £rj. Sacchari, Pulveris Acacias, aa 3j. Aquas Menthas Piperitas, flvj. Piat mistura. — A tablespoonful for a dose every two hours. When administered in diarrhoea, astringents and laudanum are added. Solution of Salt of Tartar. B. Potassas Carbonatis, 3j. Sacchari, Jj. Aquas Menthas Piperitas, f £iv. Spiritus Lavandulae Compositi, f Jij. Tincturas Opii, gtt. xl. Misce. Signa. — A tablespoonful every hour or two hours. In sickness of the stomach occasioned by acidity. 200 ABSOEBENTS, OR ANTACIDS. The opium in the above prescription may be omitted at the discretion of the practitioner. Mixture of Salt of Tartar, Ammonia, Sc. R. Spiritus Ammonias Aromatici, f Jj. Potassas Carbonatis, Jij. Aquae Cinnamomi, f |iv. Misce. Signa. — A large teaspoonful for a dose pro re nata. In pyrosis. Lime-water and Milk, R. Liquor is Calcis, Lactis recentis, aa f ^iij. Misce. Signa. — One or two tablespoonfuls for a dose. In sick- ness of the stomach few remedies are more prompt in their effect. An antacid remedy admirably adapted to children, is prepared by pouring four ounces of boiling- water on a heaped teaspoonful of calcined magnesia, and giving a dessertspoon- ful of the clear solution every hour or two. It is highly aperient. Mixture with Ammonia, Magnesia, &c. R. Magnesias, 3j. Spiritus Ammonias Aromatici, fjj. Cinnamomi, Lond. f 3iij. Aquas, fsvj. Misce. Signa. — A tablespoonful every two hours. In the sickness accompanying pregnancy. Mixture of Magnesia, Camphor, &e. R. Magnesias, 3j- Camphoras, 5ss. Sacchari, Acacias, aa Jij. iEtheris, f Jss. Aquas destillatas, f liv. Misce. Signa. — A tablespoonful for a dose four or five times a day. In flatulency and irritable stomach. Mixture of Colombo, &c. R. Colombas, 3ss. Coque in Aquas, f 3viij. ad f 3 v. Cola et adde — Potassas Carbonatis, 9ss. Succi Limonis, f3iij- Tincturas Opii, gtt. xij. Misce. — Prom a tea to a tablespoonful may be given every hour. Anti-emetic. 201 A hot infusion of bruised Colombo, is preferable to the above decoction, inasmuch as it contains all the virtues of the root, without the starch. Editok. Anti-emetic Mixture. R. Tincturas Aurantii, Lond. f Jss. Aloes, Castor ei, aa f 3j. Misce. Signa. — Dose, from forty to fifty drops three or four times a day. In continued or chronic vomiting, occasioned by atony or spasm of the stomach, the above is strongly recommended by Hufeland in his Treatise on Scrofula. Mixture with Carbonate of Soda, &c. R. Sodas Carbonatis, 9iv. Infusi Grentiange Composite, Aquae Cinnamomi, aa f ^iij. Tincturae Cardamomi, f 3ss. Fiat mistura. Signa. — A tablespoonful every two or three hours. In acidity, flatulence of the stomach, &c. Dyspeptic Lye. Take of Hickory ashes, . ... . . .1 quart, Soot, 6 ounces. Boiling water 1 gallon. Mix, and let them stand for twenty -four hours, frequently stir- ring the ingredients. A teacupful may be given of this liquor (decanted), three times a day. It should be decanted always at the end of twenty -four hours, for, by standing on the materials a long time, the water acquires caustic proper- ties, and may do serious injury. This domestic remedy we have thought best to give, as we received it, in the English language. It deserves an insertion, from the circumstance that it was employed by the late Dr. Physick in his own case, and was of decided advantage when the usual alkaline remedies had failed. BOOK II. OF EXTERNAL APPLICATIONS CLASS XVII. CAUSTICS, OR ESCHAROTICS. Caustics or cauteries are divided into the actual and poten- tial. The first consists of fire itself; and the second, of those substances which destroy the living solids, either by excessive stimulation, or, as some suppose, by producing a chemical decomposition. Firing. A modified form of the actual cautery has attracted some attention in Europe, from its great efficacy in the relief of neuralgic and other pains, paralysis, sciatica, and chronic rheu- matism. Dr. Corrigan uses a simple instrument, consisting of a thick iron wire shank, two inches long, inserted in a small wooden handle, and having on its extremity, which is slightly curved, a button of iron a quarter of an inch thick, and half an inch in diameter, the whole instrument being only six inches long. The face of the button for application is quite flat. If the in- strument be larger than this, it will require too much time to heat it ; if smaller, it will not retain the heat a sufficient length of time. In using the instrument, it is necessary to hold the button over the flame of a spirit-lamp, keeping the forefinger, which holds the wire, at the distance of half an inch from the button. As soon as the finger feels uncomfortably hot, the in- strument is ready for use. It is applied as quickly as possible, the skin being tipped successively, at intervals of half an inch, over the whole affected part, as lightly and rapidly as possible, always taking care to bring the flat surface of the button fairly in contact with the skin. In this way, the process of firing a whole limb, or the loins, making about one hundred applica- tions, does not occupy a minute. You can ascertain at once whether the heat be sufficient. If you look sideways at the spots as you touch them, you will observe that each spot the 206 CAUSTICS, OR ESCHAROTICS. iron has touched immediately becomes of a glistening white. The iron is never redhot, and does not make an eschar. — Braithwaite's Retrospect, No. 13, p. 55. The use of the actual cautery as a caustic, extends back to the most ancient times, but the particular modes of its applica- tion belong more properly to the professed treatises on surgery than to a work of this kind. Caustic Potash. The causticum commune acerrimum is the pure potash ; when mixed with lime, its activity is lessened, and it is then called Causticum commune mitius. For the best mode of applying this substance, see the remarks on Issues. As this caustic spreads rapidly and eats deeply, care should be taken not to leave it on too long, when in the neighborhood of large blood- vessels. When, however, we wish to arrest its effects, they may be neutralized at once by vinegar, or vinegar and water. Common Caustic with Opium, Be. Potasses cum Calce, 3ij- Pulveris Opii, 3ss. Saponis Mollis, q. s. Misce. — This preparation is employed for the same purpose as the common caustic. Vienna Paste. R. Potassae, 3 v. Calcis, 5yj- Alcoholis, q. s. Ut fiat magma. The paste is spread on the part to be cauterized, and is al- lowed to remain for ten or fifteen minutes, while the surround- ing skin is protected by adhesive plaster. Lunar ' Caustic. This caustic is the Argenti Nitras deprived of its water of crys- tallization, fused and cast into moulds. Its mode of application is universally known. It is free from the inconvenience of the former. Burnt Alum. The Alumen Ustum is made by depriving this salt of its^ prater of crystallization by heat. It is applied in powder to the fungous granulation of ulcers ; and, mixed with an equal part of powdered sugar, is used to remove specks or nebulae of the cornea. CAUSTICS, OR ESCHAEOTICS. 207 Chloride of Zinc. This is a powerful escharotic, and is safe and certain in cases that require the destruction of a considerable thickness of the living tissues; "never causing violent pain in the affected parts, or any kind of irritative fever, or disorder of the digestive organs." " The chloride of zinc may be applied as a caustic by means of a moistened hair pencil, either alone or mixed with an equal portion of oxide of zinc, or sulphate of lime, or according to the following form : — Canquoinh Caustic Paste. R. Zinci Chloridi, partem, j. Farinas, partem, jss. Antimonii Ter chloridi, partem, ss. Aquas, q. s. Ut flat pasta." Duxg-lison's New Remedies, 6th ed. p. 694. Caustic Paste of Chloride of Zinc. R. Zinci Chloridi, Calcis Sulphatis, aa Iss. Misce. — This preparation is very liable to deliquescence, to pre- vent which a little flour may be added at the time of apply- ing it. Mineral Acids. The mineral acids are all escharotic, though seldom employed, on account of the difficulty of managing fluids when used in this way. Nitric acid, much diluted, is sometimes applied to foul ulcers in warm weather, to destroy the animalcules which are apt to be generated in such sores. Acid Nitrate of Mercury. R. Hydrargyri Pernitratis Liquoris, Dub. f Iss. This is a powerful caustic, and is much employed in England and on the Continent to destroy malignant ulcerations, par- ticularly those of a cancerous character. It is applied by means of a camel-hair pencil, and the parts are then covered with lint. White Oxide of Arsenic, or Arsenious Acid. R. Acidi Arseniosi, 9j. Aquas, f ^ij. Fiat solutio. 208 CAUSTICS, OR ESCHAEOTICS. This solution is occasionally applied to cancerous sores, and was formerly used in a powder or paste as an empirical remedy. But it is now seldom employed, from the circumstance . of its producing constitutional irritation. Sir Astley Cooper men- tions cases in which, from its absorption when applied to open sores, partial if not complete paralysis of the limbs was the consequence. Ointment of Arsenic. R. Acidi Arseniosi, 3j« Adipis, Cerati Cetacei, aa 3yj. Melt the cerate and lard over a slow fire, and then pour it on the white oxide of arsenic, and triturate it in a glass mortar until it is intimately united. Pliarm. Chirurg. — For cancers, &c. In hot weather, arsenic may be advantageously rubbed up with basilicon, to prevent its spreading on the sound parts. A scruple of the one to half an ounce of the other, makes a strong ointment. The same care is required in its use as in using the solution. Dubois's Arsenical Powder. R. Acidi Arseniosi, 5ss. Hydrargyri Sulphured Kubri, Ij. Sanguinis Draconis, 3ss. Fiat pulvis. — Chiefly used in the French hospitals as a caustic to cancerous affections. Katier. Arsenic is sometimes applied in the form of a paste made with water, which is carefully laid over the part to be removed, and renewed according to circumstances. When the slough forms, it should be dressed with a poultice, or with cerate spread on lint. It acts rapidly and requires watching, a N remark that applies equally to all these pastes. Solution of Muriate of Ammonia^ &c. R. Ammonias Muriatis, 3j. Aceti destillati, f 3ij. Aquas, f .liv. Fiat solutio. — To be applied to venereal warts. Bell on Venereal. Chromic Acid. This acid has lately been employed in Germany as an escha- rotic. It is said to be efficient, manageable, and less painful ISSUES AND SETONS. 209 than the ordinary applications. A concentrated solution is applied by means of a glass rod. The solid chromic acid has to be used with care, on account of its penetrating action. Moxa. This is another method of using the actual cautery; and, as it is engaging the attention of physicians, we insert the usual mode of applying it. The Chinese employ this remedy by means of the mugwort. They separate this soft, lanuginous substance by beating, and form it into a cone ; the base of this is attached, by being wetted, to the skin, and the point set on fire. Dr. Boyle recommends dipping cotton in a strong solution of nitrate of potash, and inclosing pieces of it thoroughly dried in paper cylinders, about one inch in diameter, and another inch in height. Dr. Burne employs wood in a state of dry rot, touchwood. This only requires to be shaped properly, and burns, he says, with certainty and steadiness, and is preferable to the other modes suggested ; some of which, as common cotton or lint, requiring the use of the bellows, and, when they have been dipped in nitre, demanding care to prevent the scintilla- tions from injuring the surrounding parts. The cylinders or cones of touchwood may be confined to the skin by a little adhesive plaster fixed to the edges. It has been proposed to place pieces of cold iron in the neigh- borhood of the part while the moxa is burning, in order to render the sensations more vague, and therefore less painful. Moxa is used in diseases of the spine, paralysis, &c. &c. Sub-Class.— ISSUES AND SETONS. These remedies are employed as substitutes for blisters, espe- cially when a permanent discharge is desired. There are three kinds of issues in common use, by either of which we may procure a discharge of purulent matter for any length of time that may be requisite. They are applied in dif- ferent situations, according to circumstances, and some one of the following parts is generally chosen : the nape of the neck ; the hollow of the deltoid muscle, and between the shoulders or over the ribs in front. In the inferior extremities they are most conveniently formed in the inside of the leg, either above or below the knee. u 210 ISSUES AND SETONS. 1. Blister Issue. To form this issue, it is merely necessary to apply a blister to any part in the usual manner ; the skin being thus removed, the discharge must be promoted by means of stimulating ointments, as unguentum cantharidis, ceratum resinae, ung. sabinae, etc. These may be alternated with mild liniments, in order to prevent the ulceration and consequent discharge from becoming excessive. 2. The Pea Issue. There are two modes of forming this issue ; the first is made by means of a lancet ; the part is merely taken in the thumb and finger, and an incision made by passing the lancet through the skin. The wound should be kept open by means of orange peas, the common pea, a bean, or a bit of orris root The second is formed with caustic potash. The following extracts from the Surgeon's Vade Mecum will exemplify the manner of forming the issue with caustic : — "The part is first to be covered with a piece of adhesive plaster, in the centre of which a circular hole has been cut of the size of the intended issue ; in this hole the caustic kali pur urn, made into a paste with soap, is to be placed. The whole is then to be covered with another plaster, secured by a bandage, and suffered to remain for ten or twelve hours. Generally, in two or three days an eschar begins to separate, when the opening should be filled with the substance made choice of." These substances are enumerated above. 3. TheSeton. To form this artificial discharge, take the seton needle, to which is attached a skein of silk, the latter being partially anointed with some oleaginous substance. The needle is to be passed completely through the part chosen for the operation, after which it is removed, and the ends of the silk left hanging from the wound. It should be dressed every day, or twice a day, with some mild ointment ; and if this be not sufficient to keep up the discharge, the more stimulating unguents may be used, as mentioned when speaking of the blister issue. CLASS XVIII. EPISPASTICS. " By the ancients, all the external applications which redden or inflame the skin were called Epispastics, and these were designated according to the several degrees of effect : the slightest, entitled phoenigmoi ; the next, sinopismi ; the more active, vesicatorii ; and the strongest, caustici" At the present day, the term is restricted to those articles which produce a serous discharge beneath the cuticle. The blister of common language. As a general rule, blisters should remain on the patient six or ei^ht hours, in order to insure their full effect. There are individuals, however, whose skins are so delicate, that a shorter application will answer every purpose ; in children, it is seldom necessary to leave them on longer than three or four hours. When they are applied to the scalp, twelve hours are almost universally required ; and Dr. Chapman directs the hair to be shaved, if possible, some hours before the application is made. The usual dressing, when a blister is taken off, is basilicon ointment, or simple cerate, according to the urgency of the case, or irritability of the system. In order to keep it open, the weak epispastic, or savin ointment, will be found sufficient. In acute disease, these remedies ought never to precede those means which have a tendency to reduce inflammatory action. It is generally admitted that, otherwise employed, they do harm ; although there are individuals of acknowledged experience who say " they can bring the patient to the blistering point at pleas- ure," and in pleurisy, and some other acute diseases, apply them soon after a free bleeding. Blisters should be placed as near the affected part as possible. In fevers, they are usually put on the inside of the forearms or legs, back of the neck, or be- tween the shoulders. When the system is very prostrate, they should be applied 212 EPISPASTICS. to the inside of the thighs, or the last two places mentioned ; for, when the circulation is languid in the extremities, they seldom draw well, and are even liable to produce gangrene by exhausting the little vitality that remains. When, from peculiarity of constitution, strangury is produced, we must take them off after three or four hours, and bathe the part with sweet oil, or apply a poultice, giving at the same time diluent drinks, such as flaxseed tea or barley water, with the sweet spirits of nitre ; camphor or parsley tea ; bladders also, half filled with warm water, should be applied to the pubes. An opium suppository or injection will be found very advan- tageous. A poultice of ground flaxseed or starch is often ser- viceable, and a warm bath affords a prompt relief. Prevention, however, is better than cure ; and in irritable constitutions, or in persons disposed to strangury, the blistering ointment, before being spread, should be rubbed up with three or four grains of opium, and three or four times as much camphor, before it is spread. This preventive seldom fails. Blisters are rendered much less irritating by covering them with a fine gauze, which, if it be pressed in close contact with the plaster, will not pre- vent or materially retard its operation. It is seldom necessary to keep a blister on longer than to redden the skin, when a sim- ple poultice will complete the vesication. In children, this pre- caution is imperative. Blistering Cerate. R. Cerati Cantharidis, q. s. Ut fiat emplastrum epispasticum, Qx6. Ejpispastic Ointment. R. Cerse flavse, Resinae, Adipis, aa 3vj. Melt over a slow fire, and add slowly— Pulveris Cantharidis 5vijss. Miscc, et fiat unguentum. In employing this ointment, or the preceding cerate, the margin of the blister should be covered with adhesive plaster, in order to confine it to its place, and prevent its creating un- necessary irritation. Another mode is to draw straps across it diagonally, which plan we generally prefer ; it prevents the blister from rising in the middle, and thereby partially defeat- ing its object. EPISPASTICS. 213 Instantaneous Vesication. The French practitioners have a process for raising an instant blister. A piece of linen or paper, being cut to the requisite size, is immersed in spirits of wine or brandy, or even Cologne water, oil of turpentine, or spirits of camphor, whichever is most readily obtained. It is then laid on the part to be blis- tered, taking care that the moisture does not wet the surround- ing surface. The flame of a lighted taper is then applied quickly over the surface of the paper so as to cause ignition, which is almost instantaneous. At the conclusion of this operation, the cuticle is found detached and raised from the true skin beneath. Cantharidin. This substance, more or less impure, has been used during the last few years, as a substitute for the common blistering cerate. The pure cantharidin is too expensive for general use, but an impure article, sufficiently concentrated for ordinary purposes, can be readily obtained. The cantharidin blistering tissues, and vesicating taffetas, now offered for sale, are of this character : — Ether Caniharidalis, or Green Oil of Flies. R. Pulveris Cantharidis, partem unam. iEtheris, partes duas. Digere per dies tres et exprime. If this extract be applied twice without any admixture, by means of a hair pencil, it produces, in children, free vesication in an hour or two ; and if applied three times in an adult, the same effect takes place in three or four hours. The ether eva- porates, and the remaining green fixed oil operates like the cantharides in substance. Oettinger. Colhdium Vesicans. R. iEtheris Cantharidalis (prepared as above), Collodii, partes aequales. Misce. It is computed that two scruples of this collodium are equal to four drams of common blistering plaster. It is applied by a brush two or three times over the affected part. Oettinger. 214 EPISPASTICS. Extract of Cantharides. During the past winter (1853), a simple aqueous extract of Spanish Flies, prepared bj Professor Procter, was used exten- sively in the Pennsylvania Hospital, and found to be a most efficient substitute for the blistering cerate. The application of it for six hours raised as free a blister as the cerate did in eight. Since the discovery, by the same gentleman, that cantharidin is soluble in oil, oleaginous extracts have been devised, thus proving the general correctness of Galen's plan of preparing an ointment by macerating the entire insect in melted lard for twenty -four hours, and then straining by expression. An olea- ginous extract, prepared by digesting the powdered flies in melted lard, is a most efficient substitute for the officinal cerate. CLASS XIX. RUBEFACIENTS. The substances called Rubefacients not unfrequently vesicate on very delicate skins. The term, therefore, is relative. They are employed for the same purpose as blisters, and are often good substitutes for them. Mustard Plaster. R. Pulveris Sinapis, §ij. Aquae tepidse, q. s. Ut flat cataplasma. It is a very general practice to use vinegar in making this plaster, but if the mustard be pure, the chemical reactions, on which the irritant properties chiefly depend, are better developed with water than vinegar. In fact, a high heat, or the use of a strong acid solution materially checks the process. The uses of the mustard poultice are too well known to re- quire description. It is frequently made by adding an equal quantity of wheat or rye flour ; this should always be done for children, or other persons of delicate skins. It cannot generally be borne longer than a half hour or hour. Garlic Cataplasm. The garlic cataplasm is employed with the same intention as the mustard, though much less active. It may be made by bruis- ing the cloves of garlic, and mixing them in a common poultice of bread and milk. Onions may be substituted for garlic. Cataplasm of Mustard, Pepper, &v. B. Seminum Sinapis contus. Ibss. Pulveris Piperis Mgri, Zingiber is, aa 3j. Aquas bullientis, q. s. ut flat cataplasma. To be applied to the region of the stomach in severe pain or sickness ; or to the soles of the feet when revulsion is required. 216 KUBEFACIENTS. Spice Plaster. R. Pulveris Caryophylli, Cinnamomi, Capsici, aa 3ss. Misce, et adde — ■ Farinae, Spiritus Yini Gallici, aa q. s. ut fiat cataplasma. Let the plaster, thus prepared, be applied hot to the epigastric region. Clove Plaster. Quilt some powdered cloves in flannel, and wring them out in hot brandy. Thus prepared, they form an excellent external application in colic, and in irritability of the stomach, &c. Warm Strengthening Plaster. R. Picis Burgundicae, ^v. Unguenti Cantharidis, 3j. Mat emplastrum secundem artem. — This plaster is very irritat- ing, and sometimes draws a blister. Mercurial Ointment, Camphor, &c. R. Unguenti Hydrargyri, Sj. Olei Terebinthinae, Camphoras, aa 3ij. Cerati Simplicis, 3j. Fiat unguentum secundum artem. Used as a rubefacient over the hypochondriac region, when blisters are precluded. Tartar-emetic Plaster. This may be made by sprinkling the powdered Tartrate of Antimony and Potash on the surface of a Burgundy pitch or adhesive plaster, or on one made by spreading basilicon, or simple ointment, on leather or linen. In either way the margin should be left clean. Tartar emetic requires a longer time to produce its effect than the ordinary blister ; the irritation is of a peculiar and very painful kind, and its effects must be watched with extreme care. Tartar-emetic Ointment. R. Antimonii ct Potassae Tartratis, 3j. Adipis, Sj. Miscc secundum artem. RUBEFACIENTS. 217 This ointment, when applied to the skin, is a slow but certain means of exciting an eruption. We have given the formula of Dr. Hannay, of Glasgow, in Scotland. The officinal formula is two drams to the ounce, a better strength for ordinary pur- poses. Tartar -emetic and Corrosive Sublimate. R. Antimonii et Potassae Tartratis, 3j. Hydrargyri Chloridi Corrosivi, gr. v. Aquae, f 5J. Spiritus Lavandulae Compositi, f Jj. Solve sales in aqua, dein adde spiritum. This solution is applied by wetting the ringers with it, and rubbing it on the part. The rubbing should be continued for five or ten minutes, and after some hours a pustular eruption will appear. — Dr. Hannay's essay, De Tartratis Antimonii usu externo, p. 26. It has been used in pertussis, dyspnoea, catarrh, &c, and in the removal of incipient tumors. It has been ascertained by the illustrious Jenner and others, that tartar emetic, employed for an undue length of time exter- nally, will produce violent effects on the system. We find in a note in Beck's Medical Jurisprudence, vol. ii. p. 283, that Dr. Francis mentions two cases wherein tartar-emetic ointment, excessively used, produced effects similar to those at times arising from the outward application of arsenic. Ma- gendie and Brodie ascertained by experiments upon animals, that inserted into wounds its effects resemble those produced by internal exhibition. Granville's Antidynous Lotions. These preparations act with great celerity, and are now in common use. They are formed of three ingredients, mixed in certain proportions, according to the urgency of the case. Yiz. 1. Of a saturated solution of ammonia; 2. Of the spirits of rosemary ; and 3. Of spirits of camphor. 1. The milder Ammoniated Lotion. B. Liquoris Ammoniae fortioris, f 3j. Spiritus Eosmarini, f 3yj. Tincturae Camphor ae, f 3ij. Misce. 218 RUBEFACIENTS. The stronger Ammoniated Lotion. R. Liquoris Ammonias fortioris, f 3x. Spiritiis Kosmarini, f 3iv. Tincturas Camphorae, f 3ij. Misce. The only point in which these formulas differ from the origi- nal ones by Dr. -Granville is in the preparation of the spirit of rosemary. Our pharmacopoeia directs the oil of rosemary to be dissolved in alcohol. " Dr. Granville had it prepared by taking two lbs. of the tips or small leaves of fresh rosemary, and eight pints of alcohol, which are infused together for twenty -four hours in a covered vessel, and after adding as much water as will first prevent the empyreumatic smell, distil over seven pints." As to the method of applying these counter-irritants, we shall use the words of their inventor, Dr. Granville. " First, impreg- nate with the colorless and transparent liquid, either a piece of linen folded six or seven times to the size of the part intended to be covered, or a piece of thick and coarse flannel ; and, sec- ondly, lay either of them on the spot, pressing with the hand at the same time, very steadily and firmly, the said linen or flannel, over which there should be placed a thick towel, doubled several times, so that not only the evaporation of the lotion may be impeded, but the hand employed in pressing the application to the part may not suffer damage from any evaporation, or from contact with the liquid. In some parts of the body more convenient than the others, the readiest and most effectual mode of pressing down the application is, by tying over it a towel or thick bandage ; but to this mode there is the objection that we cannot, under certain circumstances, infect the part as quickly and as often as required, so as to judge, from the effect of the application, when to stop, or how long to persevere in using it." 2 When applied to the temples, forehead, jaws, or chin, great care must be taken to prevent the effluvia from affecting the eyes and nostrils. The skin should be examined in a minute or two after the application, in order to see the effect produced. When the pain is severe after the lotion is removed, simple di- luent washes, and warm water, which is perhaps the best, will speedily allay it. Vesication will generally take place in from two to five minutes, and even in a minute in some persons ; but where cauterization is requisite, ten or twelve minutes may be necessary. The irritated or denuded surface may be dressed 2 Granville. Counter-Irritation, its Principles and Practice, p. 39. RUBEFACIENTS. 219 according to existing indications, with a simple poultice, tepid fomentations, cerate, or irritating ointments. Gondretfs Pommade Ammoniacale. R. Adipis, partes xxxij. Olei Amygdalae, partes ij. Liquoris Ammonias (sp. gr. 0.905), partes xvij. Melt the lard, mix the oil with it, and pour them into a wide- mouthed phial with a glass stopper ; then add the ammonia, close the bottle, mix the contents together by shaking, and keep the mixture in a cool place. If the skin is to be excited, perspira- tion to be re-established, or some subcutaneous engorgement to be dissipated, light and hasty practices accomplish these objects. If a rubefacient effect is desirable, spread the ointment thickly on linen, and apply it for one or two minutes. For vesication, continue the application for five or six minutes ; and, by a farther continuance, absolute cauterization is speedily produced. These powerful preparations are used in a great variety of diseases, and in all cases when speedy and powerful counter- irritation is demanded ; as in neuralgia and rheumatic affections generally, both acute and chronic ; spasms, convulsions, gout, paralysis, inflammatory diseases of internal organs, diseases of the heart, sprains, &c. &c. Solution of Caustic Potash. R. Potassae, 3iss. Aquas, faij. Fiat solutio. — Applied to the spine in tetanus. Dr. Joseph Hartshorne speaks in high terms of the beneficial effect of this solution in the above disease. The best mode of applying it, so as merely to produce a rubefacient action, is to tie a piece of sponge to a stick or common table fork, and ap- ply it from the nape of the neck to the sacrum. When the solution is strong, the effect is powerful. Tincture of Cayenne Pepper. R. Pulveris Capsici, 3ij- Alcoholis Diluti, f 3viij. Misce. — This preparation forms an excellent rubefacient in low fever. Dr. Chapman recommends it strongly in sciatica and other rheumatic affections. 220 RUBEFACIENTS. Turpentine Liniment. R. Olei Terebinthinas, f jfij. Olivae, fjij. Tincturas Camphorae, flj. Liquoris Ammoniae, f 3j. Fiat linimentum. Decoction of Turpentine and Cantharides. R. Pulveris Cantharidis, gj. Olei Terebinthinas, f ^viij. Digest together for three hours, then filter. This is the process usually followed by our apothecaries ; but we conceive thirty minutes' boiling would be qxiite sufficient, and the cantharides be less likely to be injured by the heat. It was first made by Dr. Hartshorne of this city, who has used it with great success in the typhoid state of fever. It is merely rubbed over the surface of the body. S. Gr. Morton. Liniment of Cantharides, &c. R. Camphor ae, 3iij- Solve in Decocti Cantharidis cum Terebinthinaf ^ss. — et adde — Unguenti Hydrargyri, Simplicis, aa 3j. Fiat linimentum. — This preparation is employed in low fever, when it is desirable to rouse the system, and at the same time affect it with mercury ; also in tumors. Liniment of Croton Oil. R. Olei Tiglii, Olivse, aa f £ss. Fiat linimentum. — Croton oil is one of our safest and most effi- cient rubefacients. Eubbed for a few minutes, or sometimes even for a few seconds, on the skin, it produces irritation and redness, followed in some hours by a pustular eruption. If the effect is too severe at first, it is readily counteracted by a poultice, preceded by washing with mild soap and water to remove the oil. In some persons the oil may be applied pure. Volatile Liniment. R. Olei Olivae, Liquoris Ammonias, aa f 3j. Mi sec. — Applied to the neck in inflammation of the throat. RUBEFACIENTS. 221 Soap Liniment, &c. B. Linimenti Saponis Cainphorati, ffij. Liquoris Ammonia, f oj. Tincturae Opii, fifss. Fiat linimentum. — To be used as above. Iodine Paint. B. Iodinii, gr. lxiy. Potassii Iodidi, gr. xxx. Alcoholis, f 3j. Mat solutio. King's College Hospital. Iodine is one of our best rubefacients and counter-irritants. This and the following formula furnish solutions that prove satisfactory in practice. Ethereal Solution of Iodine. B. ^Etheris, f §j. Potassii Iodidi, gr. xv. Iodinii, q. s. ad saturandum. Misce. " It is applied in the same way as the tincture, by means of a camel-hair pencil rubbed over the part, until it begins to produce a burning sensation in the part ; then cover it with a pledget of wadding so as to prevent evaporation." K. Thomson. Liniment with Croton Oil and Potash. B. Olei Tiglii, Liquoris Potassae, aa Ttlxv. Misce, et adde — Aquae Kosae, f ij. Fiat liniment am. This may be rubbed on the affected part twice or three times a day, until minute pustules appear. James Allen. Cowhage Ointment. B. Mucunae, gr. viij. Adipis, 5J. Fiat unguentum. The ointment must be rubbed in from ten to twenty minutes. The immediate effect is a sensation resembling stinging with nettles, but this passes off in less than half an hour. The skin generally becomes covered with white flat papulae which soon disappear. It is used in the same cases as tartar emetic or the Croton oil liniment. B latin. CLASS XX. ANOMALOUS EXTERNAL APPLICATIONS. It was the original intention of the Author of this work to arrange all the prescriptions, whether for internal or external use, under their appropriate therapeutic heads, and a few of the earlier editions conformed, more or less, to that view. But the introduction of a great number of new remedies, the true value of which can only be determined by careful trials, has caused much difficulty in arranging them properly in that respect. This remark is particularly applicable to the host of articles used, under various forms, in the skin diseases. To remedy this, and to facilitate reference as much as possible, the Editor of the tenth edition has added three new classes, of which the present constitutes one. Class XX. is arranged on a pharma- ceutical, rather than a therapeutical basis, and its subdivisions are named according to the form of preparation employed. Viz. Collyria, Injections, Gargles, Liniments, Ointments, Cata- plasms, Baths, Fomentations, and Fumigations. A.— COLLYRIA. These are preparations applied to the eyes. They are some- times dry, but generally liquid — consisting of infusions, decoc- tions, or distilled waters, with the addition of various sub- stances. POWDERS. Dry Collyrium of Oxide of Zinc and Sugar. R. Sacchari, Zinci Oxidi, aa partes sequales. Tere in pulvcrcm. M. Recamier. COLLYEIA. 223 Dry Collyrium of Bed Precipitate, &c. B. Saechari, 3ij- Hyclrargyri Oxidi Rubri, gr. x. Zinci Oxidi, 9j. Fiat pulvis subtilissimus. Dupuytrek This and the preceding powder are used in opacities of the cornea, by blowing them into the eye through a quill. Dry Collyrium of Opium, &c. B. Pulveris Opii, gr. iv. Hydrargyri Chloridi Mitis, Saechari, aa9j. Tere bene. These compounds are blown into the eyes for the removal of specks on the cornea resulting from inflammation. Poiuder of Blue Vitriol, &c B. Capri Sulphatis, Boli Armenia?, aa Ij. Camphoras, 3ij. Fiat pulvis. — Put Ij. of this powder into a pint of boiling water ; filter the solution, and mix 3j. of it with Sj. of clear water, and apply it to the purulent eyes of infants by means of a syringe, pro re nata. Cooper's Surgery. Lapis Divinus. B. Aluminis, "} Potassse Mtratis, Vaa ^j. Cupri Sulphatis, J Camphors, Jss. The alum, nitre, and sulphate of copper are to be fused together in a glazed earthen crucible, to drive off the water of crystallization, and the camphor is to be added near the end of the process. The cold mass is to be broken in pieces, and preserved in a closely stoppered bottle. This article is much employed on the Continent as an eyewash, in the strength of two grains and upwards to a fLuidounce of distilled water. SOLUTIONS AND MIXTURES. Alum Collyrium. B. Pulveris Aluminis, gr. xij. vel xx. Aquas Rosae, f liv. Fiat solutio. — To be applied to the eye in chronic inflammation. 224 COLLYKIA. Collyrium of Iodide of Potassium. R. Aquae Rosae, f^vj. Potassii Iodidi, gr. xxiv. Iodinii, gr. j. vel ij. Fiat collyrium. To be applied to the eyes three or four times in the day. In scrofulous ophthalmia, and ulcerations of the cornea and conjunctiva. Ryan. Collyrium of Green Vitriol. R. Ferri Sulphatis, gr. ij. Aquae, fgj. Fiat solutio. — Used in chronic ophthalmia. Collyrium of Suhacetate of Lead, &c. R. Liquoris Plumbi Subacetatis, gtt. xij. Yini Opii, gtt. xl. Aquae Rosae, f 3iv. Fiat collyrium. — This should not be used when there are ulcers on the cornea. Collyrium of Vinegar, &c. R. Aceti destillati, f 3j. Alcoholis, f iss. Aquae Rosae, fiviij. Fiat mistura. Signa. — To be applied to weak eyes, and to ophthalmia after depletion. Collyrium of Acetate of Zinc. R. Zinci Acetatis, gr. iv. Aquae Rosae, f 3j. Fiat solutio. — Used like the preceding. Opiate Collyrium. R. Pulvcris Opii, gr. j. Camphorae, gr. v. Mucilaginis Acaciae, fsj. Misce, et fiat collyrium. Alum Curd. R. Pulvcris Aluminis, 3ss. Albumen unius Ovi. Agitate them well until a coagulum be formed.— To be applied on a linen rag to inflamed eyes. It should be removed in three or four hours. COLLYEIA. 225 Collyrium of Nitrate of Silver: R. Argenti Nitratis, gr. j. vel ij. ad gr. xx. Aquae destillatae, ffij. Fiat solutio. — In acute ophthalmia, and to promote the absorp- tion of nebulae of the cornea. Collyrium of Sulphate of Cadmium, &c. R. Cadmii Sulphatis, gr. iij. Aquae Rosae, f^ij. Yini Opii, f 3j. Fiat mistura. — Used for opacities of the cornea, and in chronic ophthalmia. The quantity of sulphate of cadmium is gradually increased to four grains in an ounce. Feonmullee. Collyrium of Sulphate of Copper. R. Cupri Sulphatis, gr. vj. Camphorae, Jj. Aquae ferventis, f 3viij. Eub the camphor with the water, then strain, and add the sul- phate of copper. This is nearly the same as the formula recommended by Mr. Ware in the treatment of purulent ophthalmia. Strychnia Collyrium. R. Strychniae, gr. ij. vel iv. Acidi Acetici diluti, Aquae destillatae, aa f^j. Fiat solutio. — A drop or two, diluted or not according to cir- cumstances, to be applied to the eye several times a day. De. Ryan on Amaurosis. Collyrium of Corrosive Sublimate. R. Hydrargyri Chloridi Corrosivi, gr. ij. Aquae destillatae, f gviij. Fiat solutio. The above may be advantageously used in gonorrhoeal oph- thalmia, as also in that of a scrofulous character. 15 226 COLLYEIA. Collyrium of Opium and Camphor. R. Extracti Opii, gr. x. Camphoras, gr. vj. Aquas ferventis, f Ixij. Rub the camphor and opium well together in a mortar, and add the water. Then strain before using. Conradi's Collyrium. R. Hydrargyri Chloridi Corrosivi, gr. j. Decocti Cydonii, Lond. fjj. AqiT38 Rosas, f 3vj. Yini Opii, fjj. Fiat mistura. This collyrium is praised by most of the German oculists in cases of chronic ophthalmia. Bates's Camphorated Water. R. Cupri Sulphatis, Boli Armenias, aa gr. viij. Camphorse, gr. ij. Aquas bullientis, f 3 viij. Fiat infusum et cola. This is used as a lotion in the purulent ophthalmia of infants. Collyrium of Acetate of Ammonia and Camphor. R. Liquoris Ammonias Acetatis, f £ij. Aquas Camphoras, f 3vj. Misce. Signa. — For eyes requiring a mild astringent and stimu- lant application. Collyrium of Acetate of Ammonia wiiJi Opium. R. Liquoris Ammonias Acetatis, f 3ij. Aquas ferventis, f ,lvj. Extracti Opii, gr. x. Dissolve the extract of opium in the hot water, strain, and add the solution of acetate of ammonia. In acute ophthalmia, when considerable pain remains after depletion. Emo Wen t Co I lyr'u tm. R. Radicis Althcas, 3ij- Aquae destOlatse, Oj. [nfuse Cor three hours near the five, and strain. — In inflamma- tion of the conjunctiva accompanied with violent irritation. COLLYEIA. 227 Colly Hum of Poppies, &c. R. Decocti Papaveris, Lond. f Jiv. Aquae Kosae, Camphorae, aa f 3ij. Misce. — Either of the last two collyria is adapted to the early stages of ophthalmia. These collyria can be most successfully applied to the eyes by introducing the point of a small syringe into the outer angle, and gradually injecting them. An. Injection of Strychnia. R. Strychniae, gr. j. Acidi Mtrici, gtt. ij. Aquae, f^j. Fiat solutio. Signa. — Inject a dram three times a day after urination. Used in gleet. Johnson. C— GAEGLES AND MOUTH WASHES. Gargles, like injections, are astringent and stimulating ; and to be of any service must be frequently applied, and persevered in for some time. Gargle of Brandy. R. Spiritus Yini Gallici, Aquae, aa partes aequales. Brandy and water form an excellent gargle for some cases of inflamed fauces. Gargle of Galls and Alcohol. R. Infusi Gallae (Jij. ad Oss.) fovij. Alcoholis, f^j. Fiat gargarysma. — In relaxation of the uvula and soft palate. Should be applied with a camel-hair brush. Gargle of Infusion of Oak Bark. R. Corticis Quercus Albae, Ij. Aquae, Ojss. Boil to a pint, and strain ; then add — ■ Aluminis, 3ss. Spiritus Yini Gallici, f §ij. Misce. 234: GARGLES AND MOUTH WASHES. Gargle of Sulphate of Quinia, &c. R. Quiniae Sulphatis, gr. xij. Cupri Sulphatis, gr. xvj. Acicli Sulphurici Aromatici, f3j. Aquae, f^viij. Fiat mistura. Signa. — To be used three or four times a day, in obstinate sore throat. Jos. Hartshorne. Gargle of Borax, &c. R. Sodae Boratis, 3j. Tincturae Myrrhae, flss. Mellis despumati, f^j. Aquae Kosae, fSiv. Fiat gargarysma. — To be used as a gargle or mouth wash, in ptyalism or scorbutic affections of the gums. Gargle of Sulphate of Zinc, &c. R. Zinci Sulphatis, £j. Mellis, fiss. Tincturae Myrrhae, flj. Spiritus Yini Gallici, f|j. Aquae Eosae, fsvj. Fiat gargarysma. — To be applied to ulcerated gums, occa- sioned by excessive salivation. Water can be added if it be too strong. In mercurial sore mouth, common lead water forms a most soothing and useful application. It makes the teeth black — an effect, however, which is only temporary. Dr. Blake 1 s Toothache Solution. R. Aluminis (in pulverem subtilissimum triturandum), 3ij. Spiritus iEtheris Nitrici, f 5 vij . Fiat mistura. — Said by Dr. Blake, of London, to be an infallible cure for toothache, when not connected with rheumatism. Gargle of Alum. R. Aluminis, 3\j- Aquae, f3iv. Solve. — This is Dr. Cavarra's gargle for foelor oris, or offensive breath. GAEGLES AND MOUTH WASHES. 235 Gargle of Pomegranate. R. Granati Fructus Corticis, ess. Eosas Gallicas, 3ij- Aquas bullientis, f *vj. Fiat infustim. Cola et adde — ■ Mellis despnmati, f sj. Aluminis, 3ij- Fiat gargarysma. — For inflammation of the throat and fauces. Muriatic Acid Gargle. R. Infusi Cinchonas Eubras, f ^iv. Mellis despumati, f sj. Acidi Muriatici, gtt. x. vel xviij. Fiat gargarysma. — In chronic inflammation, when the pain and swelling have been reduced by depletion. Eatiee's Formulary. Detergent Gargle of Sulphuric Acid, &c. R. Decocti Hordei, f siv. Mellis despumati, f |ss. Acidi Sulphurici, gtt. x. vel xx. Fiat gargarysma. Eatiee. Mercurial Gargle. R. Hydrargyri Chloridi Corrosivi, gr. j. Mellis despumati, f -fss. Aquas destillatas, f 3iv. Fiat solutio. — For venereal sore throat. Eatiee. Acetous Gargle. R. Acidi Acetici, f 3ij. Ammonias Muriatis, 3j. Mellis, f^iss. Aquas, f ifxij. Fiat gargarysma. — For inflamed fauces. Ratiee. Astringent Gargle of Acetate of Lead, &c. R. Plumbi Acetatis, 3ss. Syrupi, fgj. Decocti Hordei, Oj. Fiat solutio. — In mercurial sore mouth, &c. Eatiee. 236 GARGLES AND MOUTH WASHES. Chloride of Lime Gargle. R. Calcis Chlorinatae, 3ij. Aquae, Oj. Solve et cola. Dein adde — Mellis, f 3j. Misce. — Used in ulceration of the mouth and throat. Disinfecting Mouth Wash. R. Calcis Chlorinatae, 5uj- Aquae destillatae, f 3ij. Tere simul et ultra. Dein adde — Olei Eosae, tflv. Alcoholis, f §ij. Mellis Eosae, f £ss. Misce. — Used in mercurial sore mouth. Cayenne Pepper Gargle. R. Tincturae Capsici, f Iss; Aquae Eosae, f iviij. Misce. — A stimulating gargle used in scarlet fever. Griffiths. Mel Mgyptiacum. R. Linimenti JEruginis, Lond. f gj. This is applied with a brush to venereal ulcers of the throat. Diluted with water (one dram to the ounce), it forms a detergent gargle. Gargle with Iodine and Opium. R. Tincturae Iodinii, f 3j. — ij. • Opii, f 3j. Aquae, f 3vj. Fiat gargarysma. Signa. — To be well shaken when used. This is employed three or four times daily in ulcerated sore throat. Solution of Iodide of Zinc. R. Zinci Iodidi, gr. x. — xxx. Aquae destillatae, f^j. Fiat solutio. Applied daily to enlarged tonsils, by a piece of sponge tied to a quill. J. J. Ross. LINIMENTS, LOTIONS, ETC. 237 Mixture of Sulphuric Acid and Honey. R. Acidi Sulplmrici, f 5ss. Mellis, f 5j. Fiat linhnentum. Used for aphthae, by toucliing tlie ulcerated surfaces frequent- ly witlra soft pencil. Wash of Sulphate of Copper, &c R. Cupri Snlphatis, 3ij. Pulveris Cinchonae, Iss. Aquae destillatee', f liv. Misce. Signa. — In the gangrenous sore mouth of children, applied to the full extent of the ulceration and excoriation. Dr. B. H. Coates. Sulphate of zinc is often employed in like doses, in this affection. Gargle of Alum, Sage Tea, and Honey. R. Foliorum Salvia?, Iss. Aquae bullientis, Oss. Fiat infusum, et cola, dein ad.de — Aluminis, §ss. Mellis, fsj. Fiat mistura. This domestic remedy is a very effectual one in cases of sore throat. Linctus with Muriatic Acid, &c. R. Acidi Muriatici, f Jss. Mellis, Aquae Kosas, aa f^j. Misce. Signa. — To be applied to scorbutic gums three or four times a day. D.— LINIMENTS, LOTIONS, &c. Lotion of Lime-water, Zinc, &c, R. Zinci Oxidi, gr. xij. Cupri Sulphatis, gr. iij. vel iv. Mellis, f3j. Liquor is Calcis, f Iij. Fiat lotio. — To be applied to phagedenic ulcers of the genitals. Vide Swediaur on Syphilis, 238 LINIMENTS, LOTIONS, ETC. Liniment of Lime-water and Linseed Oil (Carron Oil). R. Olei Lini, fliij. Liquoris Calcis, flvj. Fiat linimentum.- — To be applied to burns and scalds by means of a feather or soft rag. Lotion of Lime-water and Alcohol. R. Alcoholis, f^ij. Liquoris Calcis, Oss. Fiat mistura. — In the same cases as the above. Lotion of Goulard 's Extract of Lead, &c. R. Liquoris Plumbi Subacetatis, fjj. Tincturas Camphor as, f§iij. Aquas, Oj. Fiat lotio. — To be used as the former. This compound is much recommended by some of the French surgeons. Applied by means of lint to old ulcers. Lotion of Chloride of Zinc. R. Zinci Chloridi, gr. ij. Aquae destillatae, f Ij. Misce. — Applied on lint to chronic and indolent ulcers. Hancke. Lotion of Sulphur et of Potassium, &c. 1. R. Potassii Sulphureti, 3j. vel lij. Aquas, Oj. Misce. 2. R. Acidi Muriatici, f 3j. vel f lij. Aquas destillatae, Oij. Mix one ounce of each lotion with four ounces of warm water, and apply by means of a sponge. In psora. M. Alibekt. Lotion of Subacetate of Lead. R. Confectionis Eosas, 3j. Me] lis, Liquoris Plumbi Subacetatis, aa f sss. Tincturao Opii, gtt. lx. Misce. Signa. — Applied to painful venereal ulcers, and to chancres after the use of lunar caustic. LINIMENTS, LOTIONS, ETC. 239 Compound Lotion of Sulphur et of Potassium. R. Potassii Sulphur eti, gss. Saponis Yeneti, 3j. Alcoholis, f 3iv. Tincturae Myrrhae, f Iss. Liquoris Calcis, Oj. Fiat mistura secundum artem. — To be applied to the head night and morning, in tinea capitis. The hair must be shaved pre- vious to its employment. Solution of Phosphoric Acid. R. Acidi Phosphorici, 3j. Aquae destillatse, f iviij. Fiat solutio. Dr. Lentin, a German physician, has employed this solution on compresses applied to ulcers situated over carious bones. — Spill AN's Supplement to the British Pharmacopoeias. Astringent Fomentation. R. Eadicis Bistortse, Granati Fructus Corticis, aa §ij. Ammonise Muriatis, 3ij. Yini Rubri, Oj. Misce. Signa. — For indolent inflammatory swellings. Ratier's Formulary. Lotions of Prussic Acid. Prussic acid (Acidum hydrocyanicum dilutum) is used exter- nally, in the proportion of £ij. to Oj. of water, or other fluids. In cancerous ulcers ; dartre ; and injected into the vagina in can- cer of the uterus. — See Mag-endie's Formulary, edit. 5th, p. 66. Lotion of Corrosive Sublimate. R. Hydrargyri Chloridi Corrosivi, 5j- Aquae, f Ivj. Solve et adde — Ammonias Muriatis, Jij. Potasses Nitratis, ^ss. Fiat lotio. — Principally used as a wash in itch. Good's Study of Med. vol. iv. Yellow Wash. R. Hydrargyri Chloridi Corrosivi, gr. j. vel. iij. Liquoris Calcis, f 3j. Fiat solutio. 240 LINIMENTS, LOTIONS, ETC. For ordinary purposes one grain to the ounce will be suffi- cient. In phagedenic and venereal ulcers. Black Wash. R. Hydrargyri Chloridi Mitis, 5j. Liquoris Calcis, f IiV. Misce. Signa. — The bottle to be well shaken before using. This prescription is used in the same cases as the other. The red oxide in that, and the black oxide of mercury in this, are precipitated by the lime-water. They are sometimes adminis- tered in the form of injections in gleet and gonorrhoea. Lotion of Cyanuret of Potassium. R. Potassii Cyanureti, gr. xij. Misturae Amygdalae, f ivj. Fiat lotio. In lichen, and other chronic eruptions. Liniment of Chlorine. R. Chlorinii Liquoris, Dub. f 5j. Olei Olivse, fgj. Fiat linimentum. — Applied externally to itch, herpes, and tinea capitis. Dunglison's New Remedies^ 6th ed. p. 195. Iodine Liniment. R. Linimenti Saponis Camphor ati, f£j. Tincturse Iodinii, fjj. Misce. Creasote Liniment. R. Creasoti, gtt. x. Olei OhVe, f|rj. Fiat linimentum. — In herpes, &c. Creasote Lotion. R. Creasoti, gtt. x. Accti, f 3;j. Aqua3 destillatae, f $j. Fiat lotio. — Applied in phagedenic ulceration. An admirable wash for herpetic eruptions may be prepared by mixing half an ounce of Wethcrill's distilled creasote water with lour times the quantity of pure water. This may be ap- plied with safety to the skin of infants; but, if too active, it should be still farther diluted. LINIMENTS, LOTIONS, ETC. 241 Camphorated Oil. R. Camphors, %]. Olei Olivae, f Jiv. Tere simnl, et fiat solutio ; tunc adde — Olei Terebinthinae, f 3jss. To be applied by rubbing with, a piece of flannel. In deep- seated rheumatic pains. Epiihem with Tincture of Cantharides. R. Pulveris Cantharidis, 3j. Alcoholis, f liv. Digere cum leni calore per dies duas, cola et adde — Camphorae, ^ss. Signa. — To be rubbed on the parts affected. In paralysis. Epithem with Camphor and Carbonate of Ammonia. R. Tincturas Camphorae, f ^iv. Ammonias Carbonatis, ^ss. Olei Juniperi, Succini, aa f 3ij. Misce. — To be employed in the same cases as the former. Liniment with Camphor, &c. R. Tincture Camphorse, f |iij. Acidi Acetici, f ^j. Fiat embrocatio. — To be applied to bruises, rheumatic parts, &c. Liniment with Ammonia and Olive Oil; vulgo, Volatile Liniment. R. Olei Olivae, Liquoris Ammonias, aa f 3j. Misce. — Applied to the neck in inflammation of the throat. Liniment of Ammonia and Tartarized Antimony. R. Linimenti Ammonias, f 3j. Antimonii et Potassae Tartratis, 5j« Misce. — Applied to indolent tumors, and other swellings. Liniment of Oil of Amber, &e. R. Olei Succini, f 5ij. Olivae, f ^ss. Tincturae Opii, f 3ij. Spirit us Yini Grallici, f ^iij. Fiat linimentum, Signa. — To be rubbed between the shoulders. In pertussis. 16 242 LINIMENTS, LOTIONS, ETC. Liniment with Nux Vomica. R. Tincturae Nucis Vomicae, f 3j. Liquoris Ammoniae, f3ij. Misce. This is applied by friction in paralytic and nervons diseases. Magendie. Anti-psoric Lotion of Dupuytren. R. Potassii Sulphureti, 3iv. Aquas, Oj. Acidi Sulphurici, f 5iv. Misce. — To be applied two or three times a day on the parts covered with pustules, and with this treatment the simple bath is conjoined. Lotion of Myrrh. R. Tincturae Myrrhae, Liquoris Calcis, aa f 3j. Misce. This lotion is recommended by Dr. Kirkland for removing fungous flesh. Compound Opiate Liniment. R. Tincturae Opii, Spiritiis ^Etheris Sulphurici, Ed. Tincturae Camphorae, aa f^ij. Fiat embrocatio. — To be applied to rheumatic parts. Also, in odontalgia, pain in the region of the ear, &c. Opiate Liniment. R. Olei Olivae, f^ij. Tincturae Opii, f3ij. Liquoris Plumbi Subacetatis, f Sss. Misce. Embrocation of Acetate of Ammonia. R. Ammoniae Carbonatis, 3ij. Acidi Acetici, q. s. ad saturandum. Alcoholis diluti, Ojss. Mix the ammonia with the acid, and after effervescence ceases, add the spirit. In rheumatic affections ; or mixed with linseed meal, it may be used as a poultice to chronic inflammations of the joints, &c. 243 Compound Liniment of Petroleum. R. Petrolei Barbadensis, f 5j. Camphorae, Iss. Alcoholis, gtt. xl. Fiat linimentum. — Powder the camphor by adding the spirit, and then mix the whole in a mortar. Glycerin. This principle, which is demulcent and antiseptic, forms a very useful addition to lotions and gargles. It has been used ex- tensively by Mr. Startin, surgeon to the London Cutaneous In- stitution, and he has published several formulae for its employ- ment. Two of them are subjoined. Lotion with Borax and Glycerin. R. Sodae Boratis, 3ss. ad 3j. Aquae Eosae, f ^vijss. Grlycerinae, f^ss. Fiat mistura. Used for chapped hands, fissures of the lips, and irritation of the skin of any kind. Lotion of Ammonia, Glycerin, &c. R. Spiritus Ammonias Aromatici, f^j. Glycerinae, f 5ss. Tincturae Cantharidis, fjj. ad f 5ij. 1 Aquae Eosmarini, f^vij. Misce. Signa. — To be used with a wet hair-brush once or twice a day. Employed for alopecia following fevers, or for falling off of the hair, dryness or want of action of the scalp, thinness of the hair, &c. Startin. Solution of Tartar Emetic. R. Antimonii et Potassae Tartratis, 9j. Aquae destillatae, f§j. Fiat solutio. Used to cleanse foul ulcers, and to repress fungous growths, and venereal warts. Sir "W. Blizard. 1 When aromatic waters are prescribed, which are not officinal, the compounder can readily prepare them by rubbing two drops of the essential oil, with a few grains of carbonate of magnesia, and a fluidounce of water, and then filtering the solution through bibulous paper. Editoe. 244 LINIMENTS, LOTIONS, ETC. Solution of Tannin. R. Acidi Tannici, gr. v. • Aquae destillatae, f 3j. Fiat solutio. Used for sore nipples, by applying it to the part on lint covered with oiled silk. Druitt. Lotion of Green Vitriol. R. Ferri Sulphatis, Ij. Aquae, Oj. Fiat lotio. Used in erysipelas, by applying it to the part every two or three hours. Velpeau. Lotion of Borax and Morphia. R. Sodae Boratis, 3ss. Morphias Sulphatis, gr. vj. Aquae Eosae, f ivirj. Fiat lotio. Used in pruritus vulvae. "Wash the surfaces with soap and tepid water, and dry them before applying the lotion, which is to be done three times daily. C. D. Meigs. Lotion of Hyposulphite of Soda, &c. R. Sodae Hyposulphitis, 3j- ad ij. Aluminae Sulphatis, 3j- ad ij. Aquae Eosae, f ^vijss. Fiat lotio. To the above a tablespoonful of some flavoring ingredient, as the Eau de Cologne, may be added. Used in acne by wash- ing the part with a linen rag dipped in the solution twice or thrice a day. Startin. Laharraquds Disinfecting Liquid. R. Liquor is Sodae Ohlorinatae, f 3ij. This stimulant and antiseptic solution has been extensively employed in low forms of disease, as typhus, scarlatina maligna, &c. It is also used as a gargle, as an injection in coryza and ozaena, and as a wash for various foul ulcers. As a gargle or injection half a fluidram to an ounce of water, and as a wash one or two fluidrams to the ounce, are about the proper pro- portions. OINTMENTS. 245 E.— OINTMENTS. Ointment of Red Precipitate. B. Hydrargyri Oxidi Kubri, 3j. Terebinthinae Yenetse, Ej. Fiat unguentum. This preparation is applied to indolent sores, and is thought by some practitioners to be a specific in itch. Simple Iodine Ointment. B. Iodinii, gr. iij. Adipis, 5ij. Fiat unguentum. Used as the preceding preparation. Ointment of Iodide of Potassium. B. Potassii Iodidi, 3j. Cerati Simplieis, 3j. Fiat ceratnm. Applied to scrofulous swellings, when the skin is unbroken. It may also be used for tetter, and kindred eruptions. LugoVs Ointment of loduretted Iodide of Potassium. B. Todinii, gr. xij. Potassii Iodidi, 9iv. Adipis, iij. Fiat unguentum. — Used in scrofulous ophthalmia, ulcers, &c. Ointment of Iodide of Zinc. B. Zinci Iodidi, Jj. Adipis, 3j. Fiat unguentum. — A dram to be rubbed on twice a day. In tumors. Dr. Ure recommends the above as a substitute for the oint- ment of iodide of potassium in glandular swellings. Ointment of Iodide of Barium. B. Barii Iodidi, gr. iv. Adipis, Ij. Fiat unguentum. For scrofulous swellings. Biett. 246 OINTMENTS. Ointment of Iodide of Iron. R. Ferri Iodidi, 3iss. Adipis, Sj. Fiat unguentum. Ointment of Iodide of Sulphur. R. Sulphuris Iodidi, gr. xxv. Adipis, ij. Fiat unguentum. — In diseases of the skin. Magendie. Ointment of Iodide of Arsenic. R. Arsenici Iodidi, gr. iij. Adipis, ij. Fiat unguentum. In lepra, impetigo, and other cutaneous affections. Biett. Ointment of Iodine and Calomel. R. Iodinii, gr. x. Hydrargyri Chloridi Mitis, gr. xv. Adipis, 3j. The iodine to be first united to the lard, and then the calomel added. MM. Planck and Soubeiran, by whom this ointment is pro- posed, state that these are the only proportions that can be used, without leading to decompositions that will defeat the inten- tion. Ointment of Iodide of Mercury, &c. R. Hydrargyri Iodidi, gr. vj. Morphise Acetatis, gr. viij. Adipis, 3j. Fiat unguentum. Eecommended by the French physicians in glandular swell- ings. The morphia is supposed by them to prevent the un- pleasant effects of iodine when used as an ointment. Pelletan. Ointment of Red Iodide of Mercury. R. Hydrargyri Iodidi Kubri, 9j. Adipis, ijss. Fiat unguentum. — Used to accelerate the cicatrization of inve- terate venereal ulcers. An ointment may be made in the same proportions of the i> utiodide of mercury ; but should be used with more caution. OINTMENTS. 247 Ointment of Red Iodide of Mercury. R. Hydrargyri Iodidi Kubri, gr. xv. Adipis, iij. Olei Linionis, gtt. xx. Fiat unguentum. Employed as a curative application to syphilitic tubercles, chronic ulceration, and other sequelae of venereal. Its great activity requires caution in its use. Eatiek. Ointment of Toduretted Iodide of Potassium with Opium. R. Iodinii, gr. xyj. Potassii Iodidi, 5j. Tinctures Opii, f3ij. Adipis, iij. Fiat unguentum. — Applied to scrofulous and other ulcers. LUGOL. Ointment of Cyanuret of Mercury. R. Hydrargyri Cyanureti, gr. xij. ad xvj. Adipis, 3j. Fiat unguentum. — Used in herpes attended by inflammation and itching. Mercurial Ointment. R. Unguenti Hydrargyri, 3j. One dram of this ointment to be rubbed on the inside of the thighs, before the fire. Some physicians recommend the warm bath before using this ointment, while others consider it useless. We think the prac- tice occasionally beneficial. The hands of the person rubbing it on should be enveloped in a bladder, or gloves made of oiled silk. Mercurial Ointment with Camphor. R. Unguenti Hydrargyri, Ij. Camphoras, 3j- Misce. — To be employed as the former. White Precipitate Ointment. R. Hydrargyri Ammoniati, gr, xv. Potassae Nitratis, 3ss. Sulphuris, 3j. Bene terantur et adde — ■ Adipis, iij. Fiat unguentum. This ointment has long been celebrated in the cure of itch. 248 OINTMENTS. Anti-herpetic Ointment. R. Hydrargyri Sulphatis Flavi, 3j. Tincturae Opii, fjj. Sulphuris sublimati, 3ss. Adipis, Hj. Fiat unguentum. — In herpes, alternated with the simple water bath. Sulphur Ointment. R. Adipis, Sbj. Sulphuris sublimati, Hviij. Fiat unguentum. — Used in friction, three to six drams at a time. Mercurial Cerate. R. Unguenti Hydrargyri, Hi v. Cerati Simplicis, Hx. Fiat ceratum. — A dressing for venereal ulcers. Eatiee. Ointment of Belladonna. R. Extracti Belladonnas, 3ij. Aquas destillatas, fHij. Adipis, iij. Misce. — Employed by M. Chaussier as a direct application to the neck of the uterus, in cases of rigidity. Eatier. Ointment of Alum, Calomel, &c. R. Hydrargyri Chloridi Mitis, 3ij. Aluminis exsiccati, Plumbi Oxidi Semivitrei, aa Hss. Olei Terebinthinae, f3ij. Unguenti Simplicis, Hiss. Fiat unguentum. This ointment is particularly adapted to tinea capitis. It should be applied every night going to bed, and washed off in the morning: as soon as the child's head is dry, dust it over with powdered starch, which, in the evening, is again to give place to the ointment. The hair must be cut off previous to the application of the ointment. Ointment of Galls. R. Pulveris Gallae, 3j- vel 3ij- Adipis, 3j. Fiat unguentum. — In hemorrhoidal affections. OINTMENTS. 249 Ointment of Oxide of Zinc. R. Zinci Oxidi, Jj. Butyri recentis, 3yj. Fiat unguentum. — To be applied to the eyes in defluxions arising from relaxation or slight inflammation of the lids. Kentish? s Ointment. R. Cerati Kesinse, pxj . Olei Terebinthinse, f^ij. vel flss. Fiat unguentum. This preparation has long been celebrated in burns and scalds. Care is requisite to avoid touching the sound skin, for turpen- tine occasionally inflames it severely. Ointment of Bromide of Potassium. R. Potassii Bromidi, gr. xxxiv. ad Jj. Adipis, Ej. Fiat unguentum. Ointment with Goulard's Cerate, Calomel, &c. R. Cerati Plumbi Subacetatis, Simplicis, aa §ss. Hydrargyri Chloridi Mitis, Pulveris Opii, aa 3j. Misce. — Useful in various cutaneous eruptions. Jos. Parrish. Ointment of Rhubarb, Opium, &c. R. Pulveris Khei, gr. x. Opii, gr. v. Unguenti Simplicis, Hjss. Fiat unguentum. — In indolent ulcers. Ointment of Tar, &c. R. Unguenti Picis Liquidse, %]. Hydrargyri Mtratis, Iss. Fiat unguentum. — In tinea capitis. Ointment of Tar and Opium. R. Pulveris Opii, 3ij. Unguenti Picis Liquids, 3j. Fiat unguentum. For hemorrhoids. 250 OINTMENTS. KirhlanoVs Neutral Cerate. R. Emplastri Plumbi, iiv. Olei Olivsa, Cretse Prasparatas, Acidi Acetici, aa §ij. Plumbi Acetatis, 3jss. The plaster and oil are first to be melted over a gentle fire. The prepared chalk is then to be briskly stirred in, and when the mixture is sufficiently cooled, the vinegar and superacetate of lead are to be added, and the whole stirred until nearly cold. This cerate, which is not to be met with in the pharmaco- poeia, is well adapted to abraded irritable surfaces, and the later stages of burns. Aromatic Sulphur Ointment. R. Potassas Carbonatis, oSS. Aquae Kosas, f 3j. Hyclrargyri Sulphur eti Eubri, 5j. Olei Bergamii, fiss. Sulphuris sublimati et loti, Adipis, aa 3x. Misce secundum artem. — In scabies. Bateman's Synopsis. Ointment ivith Carbonate of Ammonia, &c. R. Ammonias Carbonatis, Jss. Unguenti Simplicis, 3ss. Fiat unguentum. — Applied to indolent ulcers of a scrofulous character. Ointment with Verdigris, &c. R. Cupri Subacetatis, "j Cupri Sulphatis, Vaa 3ij- Hydrargyri Oxidi Eubri, J Chloridi Corrosivi, 3j. Adipis, q. s. Ut fiat unguentum. This may be spread on lint, and one or two applications will be sufficient to destroy a very large mass of fungous granulations. B. C. Brodie. OINTMENTS. 251 Ointment of Ipecacuanha. B. Pulveris Ipecacuanhas, 3ij. Olei Olivse, f5ij. Adipis, 3ss. Misce, et fiat unguentum. Useful as a counter-irritant. Tuenbull. Ointment of Calomel and Tar. B. Hydrargyri Chloridi Mitis, 3j- Unguenti Cetacei, Lond. 3j. Picis Liquidse, 3ss. Fiat unguentum. — Used in lepra. A. T. Thomson. Ointment of Creasote and Charcoal. R. Creasoti, f3ss. Alcoholis, f3jss. Carbonis Animalis purificati, 3j- Unguenti Cetacei, Lond. 3jss. Fiat unguentum. Used in cases of burns and scalds. " For children under five years, the ointment should be weakened by mixing it with four times its bulk of spermaceti ; for children from five to ten years, with twice its bulk of spermaceti ; and so on, gradually increas- ing the strength of the ointment according to the age of the patient." S. Sutbo. Oxide of Silver Ointment. B. Argenti Oxidi, 3j- Unguenti Simplicis, 3j. Fiat unguentum. Used for sore nipples. Ointment of Slaked Lime, Zinc, &c. B. Calcis, 3j Camphorse, 9j. Unguenti Zinci Oxidi, ij. Fiat unguentum. This is the " topique contre acne" of the Hopital St. Louis. Citrine Ointment. B. Unguenti Hydrargyri Mtratis, 3j. 252 OINTMENTS. "When well prepared, this is one of our most efficient oint- ments in a great variety of cutaneous diseases. Depilatory Ointment. R. Sodae Carbonatis, 3ij. Calcis, 3j- Adipis, ij. Fiat unguentum. Used in porrigo. Biett. Veratria Ointment. R. Yeratrise, gr. x. Acidi Acetici, gtt. x. Adipis, fj. Fiat unguentum. » Yeratria has been used externally in neuralgia, and with the most marked success. Ointment of Nitrate of Silver. R. Argenti Mtratis, 3ss. Adipis loti, ^ss. Fiat unguentum. Used to smear over bougies in the treatment of gonorrhoea. Macdonald. Ointment of Tannin. R. Acidi Tannici, 3j- Adipis loti, 3ss. Fiat unguentum. Used for the same purposes as the astringents generally. Fronmuller. POWDERS. Sometimes the practitioner prefers dusting medicinal agents directly upon diseased surfaces, instead of incorporating them with lard in the form of an ointment. Hundreds of such for- mulae might be given, but we limit our selection to two or three. Powder of Verdigris and Calomel. R. Cupri Subacctatis, Hydrargyri Chloridi Mitis, afi 9j. Fiat pulvis subtilissimus.— For chancres and indolent ulcers. CATAPLASMS, ETC. 253 Powdered Rliubarh, &c. R. Pulveris Khei, Ipecacuanha, aa 3j- Fiat pulvis. — To be dusted on sarcomatous and watery tumors. Khubarb alone forms an excellent application to indolent ulcers. Powder of Savin, &c. B. Pulveris Sabinse, Cupri Subacetatis, aa 5j. Fiat pulvis. — To be dusted on sores accompanied with fungous excrescences. P.— CATAPLASMS. Cataplasm of Bread and Milk. Eemove the crust from a part of a loaf of stale bread, and crumble the bread into a bowl. Pour over it sufficient sweet milk to cover it, and simmer over a fire, occasionally stirring, until the bread is reduced to a pulpy consistence. The poultice is to be applied as warm as the patient can bear it. Water may be substituted for the milk without much if any disadvantage. Cataplasm of Flaxseed Meal and Bran. Take equal parts of ground flaxseed and bran. Pour boiling water upon them, and stir constantly until the poultice has a pulpy consistence. In the Northern and Middle States, it is customary to use the common flaxseed meal, which contains both the oily and muci- laginous principles ; but in New York city and some other places, the ground oil-cake is preferred. Equal parts of the latter and bran form an elegant poultice. Mush Cataplasm. This is made by stirring Indian meal, in small quantities, into water kept boiling in a pan, until the whole has acquired the proper degree of consistence. 254 Cataplasm of Yeast. R. Farinas, Ed. rbj. Cerevisias Fermenti, Lond. Oss. Misce. — This cataplasm is useful in stimulating foul ulcers and gangrenous wounds, and removing the unpleasant odor. It should be made with fresh yeast, and applied warm. Cataplasm of Charcoal. This cataplasm is made by stirring into the common bread and milk poultice as much finely powdered charcoal as it will bear. It is a very useful application to offensive ulcers ; removing in a short time the fetor, and giving them a more healthy aspect. Cataplasms of Slippery Elm. This poultice is made from the inner bark of the slippery elm ground into a fine powder, and moistened with hot water. Cataplasms are also made of carrots or turnips, by simply boiling them to softness, and beating them to a pulpy mass. Either furnishes a good poultice for cancerous and other painful sores. Emollient Cataplasm. R. Farinas Seminum Lini, Hordei, aa partes asquales. Aquas, vel Lactis, q. s. ut fiat cataplasma. The milk or water may be warmed if desirable. Applied to inflammatory tumors. Antiseptic Cataplasm. R. Cataplasmatis Emollientis, Sviij. Pulveris Kino, Camphorae, aa 3ij. Fiat cataplasma. — Applied to unhealthy wounds and ulcers. Hotel Dieu. Resolvent Cataplasm. U. Cataplasmatis Emollientis, 3iv. Plumbi Acetatis, 5j. Ammonias Muriatis, 3ss. Fiat cataplasma. — Applicable to tumors that require gentle ex- citement. Batter's Formulary. BATHS. 255 Cataplasm of Common Salt, &c. R. Pulveris Lini, Micse Panis, aa partes aequales. Liquoris Sodii Chloridi saturati, q. s. ut fiat cataplasma. To be applied to indolent strumous swellings, and enlargements of the joints. When it produces irritation or inflammation, the common bread and milk poultice must be substituted; and the other reapplied when circumstances permit. Iodine Cataplasm. R. Tincturse Iodinii, f^ss. Pulveris Lini, gj. Avenae Farinas, §iij. Aquae q. s. ut fiat cataplasma. Applied to indolent ulcers (especially those of a scrofulous cha- racter), and to tumors of the same class. G.— B A T H S . The ordinary application of cold, tepid, and shower baths, is too well known to require any particular notice. The hot bath should be of a temperature of 93 to 96 degrees of Fahrenheit. It is designed to alleviate general or local irritation, and to in- duce repose and sleep. It is especially adapted to fevers with deficient capillary circulation, rheumatism, herpetic eruptions, paralytic affections, &c. The lower temperature is best adapted to cutaneous complaints, and to bring on relaxation of the skin during febrile irritation ; the warmer temperature is suited to paralysis ; and, as a general rule, more heat is desirable to act upon deep-seated than on superficial diseases. Vapor Baths are produced by the evaporation of boiling water in a suitable apparatus. They are used, like ordinary warm baths, in rheumatic and cutaneous affections, and in every case wherein profuse perspiration is desirable. They are avoided in persons laboring under pulmonary or cardiac disease, and in exhaustion from any cause. Local Baths are admirably adapted to parts which are swelled and painful, and may consist of tepid water only, or their strength may be increased by the addition of saline, emollient, narcotic, or stimulant substances. Among these salt and mustard are preferable. 256 BATHS. Sulphurous Water, or Artificial Bareges Bath. R. Potassii Sulphureti, Ibj. Aquae, cong. xxx. Mix for a bath. In cutaneous eruptions. Sulphur eo- gelatinous Bath. R. Potassii Sulphureti, 3ij. vel 3iv. Aquae, cong. xxx. Add to this solution, Ichthyocollae, Ibj. vel Ibij. in Aquae bullientis solutae Bbx. This bath, according to Dr. Green {Diseases of the Shin, p. 240), " is preferable to the artificial Bareges bath, as it is neither irritating nor apt to occasion feverishness, which the common sulphureous water -bath is. A cheaper and not less efficacious gelatine may be procured by dissolving from a pound and a half to two pounds of parchment-clippings in water by long boiling, or by using a neat's or a calf's foot for the purpose." Emollient Bath. To an ordinary tepid water-bath, add a large cupful of thick gruel or paste, and mix it well with the water. These baths are suited to prurigo, eczema, lichen, and impetigo. Nitro-muriatic Acid Bath. R. Acidi Nitrici, f^iij. Muriatici, f^j. Mix, and add to the water of a tepid bath, which should then be about as sour as distilled vinegar. Corrosive Sublimate Bath. R. Hydrargyri Chloridi Corrosivi, 3ij- Aquae tepidae, cong. xxx. Mix for a bath. Prescribed by the French physicians in syphi- litic affections, when it is desirable to avoid the action of the medicine on the stomach. This plan is seldom resorted to, on account of the great risk of employing corrosive sublimate in such large quantity. AUcaline Bath. R. Potassae Carbonatis, 3iv. vel Sviij. Aqna3 tepidae, cong. xxx. Mix for a bath. For promoting desquamation from the skin, and to allay itching in various forms of prurigo. FOMENTATIONS. 257 Ioduretted Baths. No. 1. No. 2. No. 3. R. Iodinii, 3ij. 3iij. 3jv. Potassii Iodidi, 5iv. 3 v. 3viij. Aquas destillatas, f 3yj. f 3yj. f^yj. Fiant solutiones. One of these solutions, according to the strength required, is added to a tepid bath in a wooden tub. For children, the drams may be changed for scruples. Used in scrofula. Artificial Harroivgate Bath. R. Sodii Chloridi, Sbij. Magnesias Sulphatis, 3iij. Potassii Sulphureti, flbj. Aquas, cong. xxx. Mix for a bath. H.— F OMENTATIONS. Fomentation is a yet more restricted mode of applying fluids to the surface of the body, and is best accomplished by means of a sponge, flannel, or soft cloth. To be efficacious it should be often repeated, and not allowed to get cold. Stimulant Fomentation. R. Yini Eubri, Oij. Mellis, ^iv. Misce. — This is an active fomentation, adapted to parts in a low state of vitality. Eatier. Saponaceous Fomentation, R. Alcoholis, Oij. Saponis, Ij. Misce. — A resolvent in indolent tumors and in sprains. Eatier. Narcotic Fomentation. R. Opii, 3ij. Aquas, Oj. Solve. — For painful affections of the joints, as chronic rheuma- tism, &c. Eatiek. 17 258 FUMIGATIONS. Narcotic Fomentation. R. Dulcamaras, 3ij. Capsularum Papaveris, 3ij. Aquae ferventis, Oj. Fiat infusum. — Employed as a soothing application to irritable surfaces. Mustard Fomentation. R. Farinas Sinapis, 3iv. Aquae ferventis, Oj. Misce. — By wetting cloths in this fluid and applying them to the skin, irritation may be prolonged to any requisite degree. Tobacco Fomentation. R. Tabaci, 3ij. Aquae ferventis, Oj. Misce. — Employed in psora, but is apt to produce nausea and vomiting. Its use requires great care. I.— F UMIGATIONS. Fumigations are for the most part used to purify infected air by absorbing or otherwise counteracting deleterious gases. They are also employed in diseases of the skin, and may be sometimes substituted for a local bath. The ordinary process for fumigating apartments with chlorine, has been already described. (Page 109.) Fumigations of sulphur, cinnabar, and mercury, are also in common use for medicinal purposes, and are readily applied with a proper apparatus. Fumigating Powders. R. Sulphur is, £iij. Hydrargyri Sulphureti Rubri, 9ij. Iodinii, gr. x. Fiant pulveres vj. One of the powders to be used in the following manner: "If the disease is seated on the limbs, a tin case, or even a common jar, should be procured. A heated iron is to be placed at the bottom of this apparatus, with a grating above it to protect the foot or hand. One of the powders being placed on this heated iron, the limb is to be instantly put into the bath, the top of which should be covered over, to prevent the vapor from es- caping. The limb may be continued in the bath for from fifteen to twenty minutes, according to circumstances." Used in lepra, T. II. Burgess. BOOK III. OF DIETETIC PREPARATIONS, AND POISONS. DIETETIC PREPARATIONS. The importance of an acquaintance with those preparations of diet peculiarly designed for the patient during disease and convalescence, is so obvious that it requires little or no com- ment. It was remarked by the late Dr. Eush in his lectures, that a physician should spend six months in a kitchen before entering upon his practical career. As the medical attendant, therefore, is called upon frequently to give directions and rules for preparing the diet for the sick, we have inserted a few for- mulae for those articles which are in daily use. However ap- parently trifling such a class may appear to some persons, the physician will find that an attention to it will place the patient more completely under his own control, and inspire greater confidence in the relations and attendants. The rules to be ob- served in giving nourishment to the sick, will generally present themselves ; but there is one in particular which should not be overlooked. In all low diseases, the nurse should be directed never to give too much at once, but frequently to repeat a small proportion. The lapse of a very short time without food, will frequently, in cases of great prostration, reduce the patient very low, and may endanger his life. The rule is not inteuded to be applied to those chronic de- rangements of the digestive functions, which are to be remedied principally by a regulation of diet, and in which the old adage, " a little and often," has too frequently, we are convinced, been perniciously advised. Decoction of Barley ; or, Barley Water. Take of Pearl Barley, 2 ounces, Boiling Water 2 quarts. Before adding the boiling water, let the barley be well washed. Then boil it to one-half, and strain the liquor. A little lemon-juice and sugar may be added if desirable. To be taken ad libitum in inflammatory diseases. 262 DIETETIC PREPARATIONS. Rice Water. Take of Kice, .... .... 2 ounces, Let it be well washed, and add to it — Water, .2 quarts. Boil it for an hour and a half, and then add sugar and nutmeg as much as may be required. To be taken ad libitum. Eice, when boiled for a , considerable time, assumes a gelati- nous form, and, mixed with milk, is a very excellent diet for children. It possesses in some measure a constipating property, which may be increased by boiling the milk. Infusion of Flaxseed. As under Expectorants. (Page 104.) Mucilage of Gum Arabic. As an article of diet, the proper proportions are an ounce of Gum Arabic to a pint of boiling water. The solution is allowed to cool before it is used. Grum Arabic is very nutritive, and life can be sustained on it alone for some time. Decoction of Bran. Take of Fresh Wheat Bran, 1 pint, Water, 3 quarts. Boil down one-third, strain off the liquor, and add sugar, honey, or molasses, according to the taste of the patient. Bran tea may be made by using boiling water, and suffering the mixture to stand in a covered vessel for three or four hours. Sage Tea. Take of The dried Leaves of Sage, .... half an ounce, Boiling Water, 1 quart. Infuse for half an hour, and then strain. Sugar and lemon- juice may be added in the proportion required by the patient. In the same manner may be made balm and other teas. These infusions form very agreeable and useful drinks in fever, and their diaphoretic powers may be increased by the addition of sweet spirits of nitre or antimonial wine. Infusion of Malt. Take of Ground Malt, ....... 1 pint, Scalding Water, 3 pints. DIETETIC PREPARATIONS. 263 Infuse for two hours, and strain off the liqnor, to which may be added sugar or lemon -j nice, if required. This was a favorite preparation with the late Dr. Jos. Parrish, in inflammatory fevers. Lemonade. Take of Fresh Lemon Juice, 4 onnces, Fresh and very thin Peel of Lemon, . half an ounce, White Sugar, 4 ounces, Boiling Water, 3 pints. Let them stand until cold, then strain off for use. When em- ployed in fevers, a little nitrate of potash or sweet spirits of nitre may be added. It can be farther diluted to the taste of the patient. This preparation, when freely taken, sometimes produces pain in the bowels. It must therefore be used with some reserve as a daily drink. Water Gruel. Take of Oatmeal, 2 ounces, Water, 1 quart. Boil for ten or fifteen minutes and strain, adding sugar and salt to make it agreeable. Milk for Infants. Take of Cow's Milk, 1 part, Water, ........ 2 parts. Loaf Sugar as much as may be agreeable. It is necessary, when children are to be raised by the hand, to dilute the milk. These proportions may be altered as the child advances in age. The object is to make a diet as near the qualities of the maternal milk as possible. Rice Gruel. Take of Ground Eice, 1 ounce, Cinnamon, . . .1 dram, Water, 1 quart. Boil for forty minutes, adding the aromatic near the conclusion. Strain and sweeten. Wine may be added if necessary. 264 DIETETIC PREPARATIONS. Panado. Take of Wheat Bread, 1 ounce, Cinnamon, 1 dram, Water, 1 pint. Boil them until well mixed, then add a little grated nutmeg and sugar. Wine or butter may also be added if desirable. Compound Salep Powders. B. Salep, Tras;acantk, Sago, of each §iv. Cochineal, 3ss. Prepared Oyster-shells, Ij. To be carefully mixed and divided into powders of 3j- each. Stir one of these powders into a pint of milk, and boil them to- gether for ten or fifteen minutes. To be drank freely in dysentery and diarrhoea. These are the dysenteric powders of Dr. Castanello. A some- what analogous preparation which bears the same name, is pre- pared as follows : — R. Gum Arabic, Tragacanth, Arrowroot, Sago, Tapioca, of each 3ij. Mix them well together, and boil in a pint of milk, flavored with nutmeg or cinnamon. Used as a diet in dysentery, diarrhoea, &c. &c. Sago. Take of Sago, 2 tablespoonfuls, Water, 1 pint. Boil gently until it thickens, frequently stirring. Wine, sugar, and nutmeg may be added according to circumstances. Tapioca Jelly. Take of Tapioca, 2 tablespoonfuls, "Water, 1 pint. Boil it gently for an hour, or until it assumes a jelly-like ap- pearance. Add sugar, wine, and nutmeg, with lemon-juice, to suit the taste of the patient and the nature of the case. DIETETIC PREPARATIONS. 265 Jelly of Carrageen, or Irish Moss. Take of Carrageen, half an ounce, Fresh Milk, .a pint and a half. Boil them down to a pint; remove any sediment by filtering or otherwise, and then add the requisite quantity of sugar, with lemon-juice, or peach water, to give it an agreeable flavor. To be used freely. The moss, before being used, should be well washed in cold water to remove its saline taste. Arrowroot. Take of Arrowroot, 1 tablespoonful, Sweet Milk, , half a pint, Boiling Water, half a pint. Boil them a few moments over the fire. Sweetened with loaf sugar, it is one of the best aliments for children, especially when the bowels are irritable. The farinaceous substance called Carina is prepared by simply boiling in milk, and adding sugar. [Arrowroot is better prepared in the following manner : — Take of Arrowroot, . . . . .1 large tablespoonful, Cold Water, ..... sufficient, Boiling Water, .... half a pint. Mix the arrowroot with just sufficient cold water to soften the lumps, then pour on the boiling water, and stir continually until the solution is gelatinous and transparent. Sweeten to the taste. Editor.] Boiled Flour. Take of Fine Flour, a pound. Tie it up in a linen cloth as tight as possible, and after frequently dipping it in cold water, dredge the outside with flour till a crust is formed round it, which will prevent the water soak- ing into it while boiling. It is then boiled until it becomes a hard, dry mass. Two or three spoonfuls of this may be grated and prepared in the same manner as arrowroot, for which it forms an ex- cellent substitute. 266 DIETETIC PREPARATIONS. Vegetable Soap. Take one turnip, one potato, one onion. Let them be sliced, and boiled in one quart of water for an hour. Add as much salt as is agreeable, and pour the whole upon a piece of dry toast. This preparation forms an agreeable substitute for animal food, and may be given when the latter is inadmissible. Chocolate. Chocolate should be suffered to stand until cold, after having been made in the usual way. The oily parts thus collect on the surface and should be taken off. The liquid should then be boiled again, and sugar, &c. added. Beef Tea. Take of Lean Beef, cut into shreds, .... 1 pound, Water, 1 quart. Boil it for twenty minutes, taking off the scum as it rises. After it grows cold, strain the liquor. This preparation is more nourishing than ordinary broths, and very palatable. Another Plan for Beef Tea. "One pound of lean beef, free of fat, and separated from the bones in the finely chopped state in which it is used for mince meat, is uniformly mixed with its own weight of cold water slowly heated to boiling, and the liquid, after boiling briskly for a minute or two, is strained through a towel, from the coagulated albumen and flbrine, now become hard and horny. Thus we obtain an equal weight of the most aromatic soup, of such strength as cannot be obtained even by boiling for hours from a piece of flesh." This is to be seasoned to taste. Dr. Bejsteke. Essence of Beef. Take of Lean Beef, sliced, 1 pound. Put a sufficient quantity into a porter bottle to fill up its body, cork it loosely and place it in a pot of cold water, attaching the neck by means of a string to the handle of the vessel. Boil this for an hour and a half or two hours, then decant the liquor and skim it. DIETETIC PKEPAKATIONS. 267 To this preparation may be added spices, salt, wine, brandy, &c, according to the taste of the patient and nature of the dis- ease. Hartshorn Jelly. Take of Hartshorn Shavings, 4 ounces, Water, 1 quart. Boil over a gentle fire until one pint of the water be dissipated. Strain, and add lemon-juice, sugar, and wine. . This forms, either with or without the last-named ingredients, a very nourishing diet for convalescents ; and, when mixed with an equal portion of milk, is well adapted to the bowel complaints of children. Isinglass or fish glue may be used instead of the hartshorn shavings, if preferred. Golfs Feet Jelly. Take two calves' feet and add to them one gallon of water, which reduce by boiling to one quart. Strain it, and when cold; skim the fat entirely off. Add to this the white of six or eight eggs well beaten, a pint of wine, half a pound of loaf sugar and the juice of four lemons, and let them be well mixed. Boil the whole for a few minutes, stirring constantly, and then pass it through a flannel strainer. This forms a very nutritious article of diet for the sick and convalescent. The wine may be omitted or added at option. Chicken Water. Take half a chicken divested of all fat, and break the bones ; add to this half a gallon of water, and boil for half an hour. Season with salt. This water is directed by some physicians in the early stages of cholera. Taken warm it promotes vomiting and washes out the stomach. Suet Ptisan. Take of Sheep's Suet, 2 ounces, Milk, 1 pint, Starch, half an ounce. Boil slowly for half an hour. This may be used as a common drink in dysentery. 268 DIETETIC PREPARATIONS. Mucilage of Starch,. &c. Take of Starch, 1 ounce, Powdered Cinnamon, 1 dram, Gum Arabic, 1 ounce, Boiling Water, . . . ■ . . .3 pints. Boil until reduced one-third, and strain. The above may be taken for a common drink in dysentery. Wine and Mustard Whey. As under Stimulants. (Page 131.) Rennet Whey. Take of New Milk, 1 quart, Eennet, a large spoonful. Heat the milk and then add the rennet. Boil until the curd separates and is all taken off. To many persons this forms a very agreeable nutriment. Vinegar Whey. Take of Milk, 1 pint, "Vinegar, half an ounce. Boil for a few minutes, and separate the curd. Tartar Whey. Take of Milk, 1 quart, Cream of Tartar, half an ounce. Boil until the curd separates. OF POISONS Cases of poisoning are so sudden and so awful that no time is to be lost in administering relief. To do this with judgment and effect, it is requisite to be familiar with all the usual anti- dotes ; and of these, we have accordingly selected some which possess an acknowledged efficacy, omitting at the same time many others that are unworthy of confidence. For the purpose of convenience we have arranged the Poisons alphabetically, with the appropriate antidotes attached to each. But, as has been remarked when speaking of Emetics, our chief reliance in these cases is upon free vomiting, induced by those articles which are most speedy in their effect. Dr. Beck prefers sul- phate of zinc, whenever it can be procured, and adds, " but if vomiting be present, we may aid it by diluents or a vegetable emetic. Tartrate of antimony should never be given." Yet, even from this treatment, little can be expected when the dele- terious substance has remained long in the stomach ; and the stomach-tube and syringe will be indispensable. To protect the stomach and intestines from the direct opera- tion of poisons, it is generally recommended to give milk, lime- water, soap, or drinks sweetened with sugar or honey. Oils and other fatty substances are found to be injurious. When the vomiting has ceased, and retching and pain con- tinue, Mr. Hume advises the free administration of carbonate of magnesia with tincture of opium, suspended in water. ALCOHOL. Large quantities of alcoholic liquors, taken by persons unac- customed to their use, often produce fatal effects. The treatment in such cases is to evacuate the stomach as soon as possible ; but from the rapidity of absorption this may not always be effectual. The patient must be kept roused and 270 OF POISONS. cold affusion plentifully used. Large draughts of tea or coffee ought to be taken until the stomach is thoroughly evacuated. ALKALIES. Ammonia, potash, soda, and their carbonates, are seldom taken in poisonous quantities ; when it so happens, the best antidote is common vinegar ; it is always at hand, and its affinity for these substances is sufficiently strong to neutralize them. Also, a fixed oil, as olive oil, should be given in large quantity — seve- ral pounds being required where a large portion of the alkali has been taken ; it acts by rendering the vomiting easy and free, and partly by converting the alkali into a soap. ANTIMONY. The preparation of this mineral by which poisoning is com- monly produced is tartar emetic. This of itself produces violent vomiting, and therefore our first efforts should be directed to keeping up the emesis by means of mild diluents and mucila- ginous preparations. Its antidotes are the alkalies, tannin, bitter and astringent infusions, such as common tea, Peruvian bark, especially the yellow bark and its decoction — the admi- nistration of galls in powder, &c. &c. These decompose the antimonial salt. When the vomiting is excessive, opium by injection will assist in allaying it. AESBNIC. Until lately, there has been no known antidote to this dead]y poison, and our sole dependence has been upon mild diluents, albumen (such as the whites of eggs suspended in milk) or warm water and sugar. Yarious substances have been pro- posed as antidotes, but without success. It is best first (if vomiting has been delayed) to give an emetic of the sulphate of zinc, and milk should be drunk liberally both before and after vomiting has begun. The patient should never be al- lowed to exhaust his strength in retching, without some milk or other fluid in his stomach to act on. The iiydrated peroxide of iron, freshly prepared, was announced in the year 1834, by Dr. Bunsen, of Gottingen, as an antidote for poisoning by arsenic ; and its efficacy has been confirmed by MM. Orfila, Lesueur, Soubeiran, and Miguel, and also in this city by various chemists, and by experiments upon the inferior animals. The antidote is now officinal, and should always be kept on hand. OF POISONS. 271 The following direction will enable the most ignorant person to make use of this antidote until medical advice can be obtained. It must be administered as soon as possible after the discovery that arsenic has been taken, and as it causes no bad effect itself, should be given eveky five or ten minutes, until entire relief is obtained. It is said that twelve parts of it are neces- sary to neutralize one of arsenic. The dose for a grown person is a tablespoonful ; for children a teaspoonful. The bottle to BE WELL SHAKEN BEFORE EACH DOSE. IN CASES OF EMERGENCY, IT MAY BE PREPARED BY SIMPLY PRECIPITATING THE MURIATED tincture of iron by ammonia, and washing the precipitate. _ Should the patient survive (and the probability is in his favor if the antidote be faithfully given), the inflammatory symptoms must be combated on the general principles for treating inflam- mation. The diet should consist exclusively of milk, gruel, cream, rice, and similar bland articles. In a case of poisoning in this city, where half an ounce of the powdered arsenic had been taken and was followed by extreme thirst and vomiting, all the symptoms were allayed by freely taking the hydrated peroxide of iron. Only a slight gastritis followed, which was readily subdued. The oxide forms with the arsenious acid a proto-arseniate of iron. In place of the hydrated oxide, the rust of iron and precipi- tated carbonate should be resorted to in cases of emergency, possessing as they do, to a certain extent, the power of antidotes. Magnesia in large doses acts also as an antidote, and in several cases lately reported was used with complete success. When the poison has been taken in the form of Fowler's so- lution, Dr. Dunglison recommends copious draughts of lime- water to be used. BARYTA. The carbonate and muriate of this earth are poisonous, and the latter has been taken by mistake for Glauber's salts. In cases of poisoning with the carbonate, the alkaline sulphates should be given with a mixture of vinegar, and resort had to the stomach pump and emetics. The true antidote is sulphate of magnesia or soda ; with these a sulphate of baryta is formed, which is perfectly insoluble, and may be brought off by emetics and copious diluents, oleaginous or albuminous. COPPER. The sulphate (blue vitriol), and subacetate (verdigris), are the salts of this metal from which poisoning most frequently re- 272 of poisons. suits ; the latter often from the careless use of culinary vessels or mineral water fountains. Producing violent emesis, this should be encouraged, by the free use of tepid water, milk, and muci- lages. According to Orfila, albumen in the form of white of eggs is the best antidote, and sugar, formerly in much repute, acts only as an emollient. In the absence of eggs, milk or wheaten flour should be employed. Yinegar in all cases must be avoided. The French physicians have tried iron-filings, in consequence of the power possessed by this metal of reducing the salts of copper; and the results they obtained, in some experiments performed on animals, are such as to justify considerable con- fidence in the antidote. GOLD. The nitro-muriate of gold is a powerful poison. Its antidotes are sulphate of iron (which throws down the gold in a metallic state), the free use of mucilaginous drinks, and albuminous sub- stances. IODINE AND IODIDE OF POTASSIUM. Ten or twenty grains of Iodine sometimes, though not always, produce constriction of the fauces, nausea, vomiting, and severe colic pain'. The supposed antidote for these preparations is starch freely given, or, what answers the same purpose, flour mixed with water. Magnesia is also recommended. LAUDANUM. Laudanum, when taken in large quantity, must be withdrawn from the stomach by active emetics, or by tickling the fauces. The stomach-tube should then be used to remove whatever re- mains of the poison. The free use of vegetable astringents and strong coffee will then be serviceable. An important part of the after treatment is the maintenance of artificial respiration, besides which active stimulants are often required. Iodine, bromine, and chlorine are stated by M. Donnd, of Paris, to be antidotes for poisoning by nux vomica and opium. M. Orfila thinks that the decoction of galls may with propriety be used as an imperfect antidote, until the narcotic can be evacuated from the stomach. of poisons. 273 LEAD ' The acetate is the only preparation which is resorted to as a poison. The sulphate of magnesia or soda is its true antidote, as it converts the poison into a sulphate, which is inert ; also the alkaline carbonates and particularly the bicarbonates. Phos- phate of soda is also a good antidote. If the patient does not vomit, give an emetic of the sulphate of zinc, which will not only empty the stomach, but convert any remaining soluble lead into an insoluble sulphate. Milk or albumen should also be given in large quantities, as it has been found that the albuminous principle of milk is a very effectual precipitant of the oxide of lead ; a compound which, though not entirely inert, is far less active than the acetate, and tends to prevent the action of the poison as a corrosive on the stomach. MEKCUKY. All the preparations of this metal are poisonous, and corro- sive sublimate in particular. Our chief and only dependence, according to M. Orfila, is upon the albumen of eggs, copiously swallowed, or introduced through the stomach tube, which should be resorted to when the patient cannot swallow or vomit. Ene- mata of the same should also be used. If the albumen be taken in sufficient quantities, it decomposes the sublimate, forming a triple compound of albumen, muriatic acid, and calomel. If the remedy excites fresh vomiting, so much the better, and if symptoms of gastritis appear, they are to be treated in the usual way. M. Orfila has also established that a fatal dose of corrosive sublimate may be swallowed by animals with impunity, provided the white of egg, or any other kind of fluid albumen, be introduced shortly before or after into the stomach. Cases are also upon record which establish that it possesses an equal efficacy in man. The gluten of wheat flour is also strongly recommended on the same principle as an antidote to corrosive sublimate. To administer it, nothing more is requisite than to mix the flour with water. The quantity taken must be very considerable. It is said to reduce the muriate to the state of calomel. Gluten of wheat flour is also given in the form of an emul- sion with soft soap, by mixing partly in a mortar and partly with the hand, 5 or 6 parts of fresh gluten with 50 parts of soft soap. "When neither albumen nor gluten is at hand, milk forms a good substitute. 18 274 of poisons. The only other antidotes deserving of mention here are iron filings, meconic acid, and the hydrated proto-sulphuret of iron. The former was ^recommended by Dumas, and must obviously operate by bringing the mercury to the metallic state. The me- conic acid, particularly when combined with an alkaline base, affords, with corrosive sublimate, an insoluble and inert perme- conate of mercury. The meconates of the ordinary alkalies, however, can scarcely be obtained in sufficient quantity to be applied to such a purpose ; and from the smallness of the satu- rating power of meconic acid, it would be hazardous to admi- nister the quantity of opium which would be adequate to the decomposition of a few grains of corrosive sublimate, inasmuch as the muriate of morphia, which would be contemporaneously formed, is a narcotic medicine of very considerable energy. [The hydrated proto-sulphuret of iron was proposed by Mialhe, and confirmed by Orfila, who says that, if it be taken immedi- ately after the ingestion of the poison, it completely destroys the poisonous quality of corrosive sublimate.] MINERAL ACIDS. The first, because the most ready method of counteracting the action of the mineral acids, is the copious use of water, warm or cold, milk, oil, or mucilage, which, by simply diluting them, renders them less acrid, and at the same time assists the stomach in rejecting them. This course should be followed until the proper antidotes are prepared. These are the alkalies, alkaline earths and soaps; common pearlash or carbonate of potash ; carbonate of magnesia ; chalk ; and soap in solution. Calcined magnesia, though advised by some authors, is objec- tionable, inasmuch as the rapidity with which it would combine with acid in the stomach, might alone produce inflammation of that organ. The smallest quantity of nitric acid which is known to have destroyed life is two drams ; the smallest fatal dose of muriatic acjd, was one ounce. NARCOTICS. The remedies employed in all cases of poisoning from this class of substances, are nearly the same, viz. the most active emetics, as sulphate of zinc in large doses, alum and ipecacu- anha. In all cases where it is possible, the stomach-tube should be employed. After these evacuations, strong decoctions of coffee or the vegetable astringents, with cold affusion, are proper. Electro-magnetism is also serviceable, together with powerful stimulants. of poisons. 275 JSTITKE. This salt is often taken in mistake for Epsom or Glanber's salts. When this happens, vomiting should be excited as speedily as possible, followed by the free use of mucilaginous drinks, hot gin-toddy, brandy and water, &c. As there is no antidote to this poison, in case these means should fail we must resort to the stomach-pump. OPIUM. We cannot do better in this place than transcribe what Dr. T. E. Beck, of Albany, says of the antidotes to opium. " The experiments of Orfila have demonstrated that the ad- ministration of vinegar, or rather vegetable acids, previous to the evacuation of the poison by vomiting, will accelerate and aggravate the action of the opium ; but that when the opium has previously been expelled, water acidulated with vinegar, or any other vegetable acid, will tend to diminish and correct the effects. Coffee, when prepared in strong decoction or infusion, rapidly lessens the symptoms, but cannot be considered as an antidote. The result of his experiments led him to give the following directions for the treatment of a person poisoned by opium. Induce vomiting, if possible, with sulphate of zinc, or sulphate of copper ; but the administration of watery liquors with the view of promoting the vomiting, should be forbidden, as they dissolve the opium and promote its absorption. In order to insure the action of the emetic, the patient must be kept rousedhy discharging cold water over the head and breast; yet cold affusion must be avoided in the advanced stage, when the body is cold, and the breathing scarcely perceptible. To insure success, in every case the patient must be kept awake, either by dragging him up and down between two men, or by flagellation on the back and soles of the feet. Artificial respi- ration may be used in desperate cases with propriety. Bleed the patient immediately after the rejection of the poison, and repeat this if necessary. Afterwards administer alternately water acidulated with any vegetable acid and a strong infusion of coffee warmed — and in ten or twelve hours exhibit an enema, and let the arms and legs of the patient be well rubbed. Pur- gative clysters should be continued, if it be suspected that any of the opium still remains in the large intestines." — Beck, Med. Jurisprudence, vol. ii. p. 403. These remarks are applicable to the poisonous effects induced by other articles of the Narcotic class, as belladonna, hyoscyamus, stramonium, &c. Yet as 276 of poisons. these are not often taken with suicidal intentions, the quantity is seldom inordinately large. Emetics, if given soon after the poison has been swallowed, will at least remove a part of it ; after which the practitioner must necessarily be governed in the treatment by the nature of the peculiar poison, the amount taken and the patient's constitution. Stimulants are occa- sionally necessary from the first ; in other instances, depletion ; but more frequently, each is in turn called for. S. Gr. !M. OXALIC ACID. Death from this poison is generally sudden. Lime-water or a mixture of chalk and water is recommended by Dr. Thomp- son, for the purpose of converting the acid into oxalate of lime. The carbonate of magnesia, also, has been found by experiment to counteract the poison ; but the other alkalies must be avoided, as they act with an energy little inferior to the acid itself. It is advisable to avoid giving warm, water with a view to accelerate vomiting ; for dilution promotes the absorption of the poison. PHOSPHORUS. This substance acts so immediately and so powerfully in decomposing the animal tissues, that no available antidote has hitherto been suggested. A small portion is sufficient to de- stroy life. Nevertheless, large quantities ' of mild demulcent liquids should be exhibited to shield the alimentary canal, and magnesia to neutralize the phosphoric acid. PRUSSIC ACID. This deadly poison, in its purity, acts with such rapidity as to leave no time for the administration of antidotes. When taken in small quantities, much diluted, its action is less rapid, producing symptoms of excessive prostration, convulsions and coma. Cold affusion to the head has been found very effectual in such cases, and when applied before the convulsive stage has passed, has often succeeded. The head should be kept elevated, and the water poured from a height upon the occiput and spine. The inhalation of ammonia is the antidote most to be relied on, many experiments having proved its efficacy. It should not be used of too great strength, which would endanger inflamma- tion of the air-passages and stomach; the strong aqua ammonia, diluted with twelve parts of water, is recommended by Orflla. ( 'hlorine also possesses strong claims as an antidote, and from of poisons. 277 the results of his experiments, is believed by Orfila to be the best which has yet been proposed. Ether and chloroform have been recommended, and no doubt will eventually prove of great value from the rapidity with which they act. Cases of poisoning with the oil of bitter almonds, cherry laurel water, &c, containing Prussic acid, are not unfrequent, particularly among children, and after evacuating the stomach, require the same treatment as for Prussic acid. SILVER. The nitrate of this metal is sometimes taken by mistake ; its antidote is common salt, largely given, with copious draughts of mucilaginous drinks to promote vomiting. The salt produces an insoluble chloride which has no power on the system. Beck. TIN. When any of the salts of tin are taken, albumen of eggs, flour, or milk given freely, is the appropriate remedy. Milk forms a coagulum with the muriate of tin {Dyer's spirit), and renders it innoxious. ZINC. The sulphate of this metal is occasionally taken in an over- dose. Warm water and emollient drinks are proper in such cases ; but milk is particularly useful, from its power of decom- posing the sulphate ; also albumen, magnesia, &c. The crystallized sulphate of zinc very closely resembles the sulphate of magnesia, and has been mistaken for it ; a fact to be borne in mind by apothecaries and physicians. The following works have been consulted in arranging the preceding remarks on Poisons : A Treatise on Poisons, by Robert Christison, M. D. — Turner's Chemistry. — Manuel de Me"decine Legale, par A. Brierre de Boismont. — Orfila, Toxico- logic Generate. — Beck and Taylor's Medical Jurisprudences. — Henry, Thompson, &c. &c. — Costill's Treatise on Poisons. 1 1 A Practical Treatise on Poisons, their Symptoms, Antidotes, and Mode of Treatment. Dr. Costill's work embraces clear and concise views of the subject of which it treats, and constitutes an excellent manual for all practical purposes APPENDIX NO. I ON THE ENDERMIC USE OF MEDICINES. "The science of medicine," says Dr. Gerhard, 1 "has recently received an important auxiliary to its resources, by the disco- very that remedial substances when applied to the cutis, after the removal of the epidermis, produce their peculiar effects with nearly the same energy as if introduced into the aliment- ary canal. This mode of exhibition, which has received the name of the endermic method, or enderrnic medication, is always found much more efficacious than the ialatreptic method of Christien, or the administration of medicines by means of fric- tions on the cuticle." The endermic method requires the previous separation of the cuticle, which is best effected by a blister about four inches square. The cuticle should then be punctured or removed in very small patches, so that the medicine may come in contact with the vesicated surface. Substances used in this way must be applied in two or three times the quantity requisite when given by the mouth. " The remains of the substance applied are much less than the original quantity, and sometimes no trace of it can be perceived ; the whole appearing to be ab- sorbed or mingled with the secretions." "We avail ourselves of Dr. Gerhard's valuable paper for the following facts in relation to those medicines which act most effectually in the endermic method. Sulphate of Quinia. — A blister to be applied to the epigas- trium during the apyrexia ; and if the paroxysm returns before the quinia can be used, defer it until the next apyrexia. Ap- ply four grains of powdered quinia (either alone, or with an equal quantity of starch), four times a day, for two successive days. A less irritating plan, however, is to dissolve sixteen grains of quinia in two ounces of water, with which the blis- 1 North Amer. Med. and Surg. Journ. April, 1830. ON THE ENDERMIC USE OF MEDICINES. 279 tered surface is to be repeatedly wet during the day by means of a soft linen cloth. There is no occasion to remove the loose epidermis ; it is all-sufficient to puncture it in several places to allow the solution to touch the denuded surface. Morphia. — The acetate and sulphate act readily and effec- tually ; the latter is preferable, because more soluble and less irritating. It may be applied in powder, in solution, or in the form of cerate. The dose varies from half a grain to two grains, and its effects are speedily perceptible. Digitalis. — Dose, two grains three times a day. Aloes. — This medicine acts on the bowels with nearly the same certainty as if taken internally. Dose, ten grains, to be repeated, if necessary, in a few hours. Gamboge, owing to its solubility, purges freely in the ender- mic method. Dose, from five to eight grains. Rhubarb, jalap, elaterium and croton oil, contrary to what might be expected, do not produce catharsis, although they excite severe local irritation. Squills. — This medicine in powder, sprinkled on a blistered surface three times a day, in the quantity of four grains at each application, causes copious diuresis. Its power is increased by combination with digitalis, in the proportion of four grains of the former to one of the latter. Emetics from the vegetable kingdom all produce their effect in the endermic method; and tobacco does so without any pre- vious irritation of the skin. The same remark is applicable to mercury and iodine, which last is best applied in the form of ointment, made by rubbing a dram with an ounce of cerate. Emetics derived from the mineral kingdom exert no specific action. APPENDIX NO. II. ON THE USE OF ETHEE AND CHLOROFORM. The employment of anaesthetic agents has now become so general, and their great value so fully attested by many emi- nent physicians and surgeons in all parts of the world, that we shall here give a brief account of their uses and mode of application. Indeed, the discovery of a means by which to give complete insensibility to pain during the performance of tedious surgical and dental operations, as well as to mitigate the spontaneous sufferings attendant on many diseases, must be considered one of the most important in the annals of medicine. That pain is useful in indicating the seat and progress of disease, cannot be denied ; yet, on the other hand, its severity may exhaust life ; and to allay it is often the most difficult and necessary part the physician is called upon to perform. The inhalation of ethereal substances now gives the practitioner more or less control over these " ills that flesh is heir to," enabling him to alleviate some, and wholly to prevent others. Notwithstanding the benefit to be derived from its judicious use, this mode of inhalation is also capable of producing much evil in the hands of the unskilful and ignorant ; and it should, therefore, be employed by those only who are acquainted with its diversified operation. Ether and chloroform produce essentially the same effects, but the latter is much the more powerful and rapid in its action, and has the disadvantage of being a preparation of unequal strength. The progressive stages of etherization seem to be pretty much as stated by Mr. Sibson, viz : — 1. Cerebral excitement. 2. Cerebral derangement, staggering intoxication. ON THE USE OF ETHEK AND CHLOROFORM. 281 3. Cerebral sleep (sopor) ; pupils contracted ; dreams; reflex functions of the brain and spinal marrow still active. 4. Cerebral death (coma) ; reflex functions of the medulla and spinal marrow still active. 5. Death of spinal marrow ; cessation of respiration (heart's action generally still present). 6. Cessation of heart's action. He also says : " It is very important to be able to tell easily when the stage of safety — sopor, is about to merge into that of danger — coma. The action of the pupils is the key to this knowledge. Inhalation should not be continued one instant after the pupils, previously contracted, have begun to dilate. " If unconsciousness can be secured by sopor, the inhalation should not be carried on to produce coma. If complete muscu- lar relaxation be sought for, as in hernia, to facilitate taxis ; in dislocation, to make reduction easy ; and in tetanus, then it will be needful, in general, to urge the patient from sopor into coma ; but as soon as the muscular relaxation is secured, the inhalation should cease. When chloroform or ether is employed in chorea, delirium tremens, or other affections, it should never be urged beyond sopor. In neuralgia, it is not usually needful to pro- duce unconsciousness. Whenever the pain disappears the in- halation ought to cease." According to Dr. Snow, a necessary precaution for watching the effects of ether and chloroform is, that they possess an accu- mulative property; their influence sometimes increasing for twenty seconds after the inhalation is discontinued. It is sel- dom necessary to carry the process farther than the production of sopor ; in this dreamy state insensibility to pain is perfect, and in some persons much earlier. Many patients seem to be perfectly awake to all mental impressions, and even take an interest in the progress of the operation, without feeling the slightest pain, and, indeed, in some instances, experiencing agreeable sensations. The influence of these agents being transmitted by the blood, pervades the whole system simultaneously, and particularly excites the capillary circulation as evinced by the injected con- junctiva, increased lachrymal and salivary secretions, and tur- gidity of the face and neck, the redness of which, however, soon gives place to pallor. Although used heretofore only to produce general effects, it has lately been discovered by Mr. T. Nunneley, of Leeds, that local anaesthesia may be caused by these agents ; and that the brain and other parts of the body not subjected to their in- fluence remain unaffected. After an extensive series of ex- periments on different animals, he finds that, by immersion in a 282 ON THE USE OF ETHER AND CHLOROFORM. small quantity of the fluid, or by applying the vapor locally for a limited period, a limb may be rendered perfectly motion- less and senseless, and, what may be an additional advantage, fixed in any desired position. The benefits likely to be derived from this new and valuable discovery promise to be very great. As regards the mode of applying these vapors, the principal thing to be observed is, that they be freely diluted with atmo- spheric air. Many instruments for inhalation have been invented, but most of them have given place to a simple sponge ; and in the case of chloroform, a towel or handkerchief is perhaps as good as anything yet proposed. The degree of etherization does not depend so much upon the amount respired, as upon the peculiar constitution of the individual, and the physician is thus better able to regulate the amount, and judge of its effect. A dram of chloroform, or even half a dram, poured upon a hand- kerchief, and gradually brought close to the mouth and nose, will, in about two minutes, more or less, produce the required effect. Of ether, half an ounce may be poured upon a sponge, and more added from time to time if required. The full effect of ether is not generally obtained in less than four or five minutes. As regards their comparative merits, it may be said of chloroform that it is less pungent, and requiring a less amount is more easily inhaled ; but it is also said to have a greater tend- ency to produce involuntary muscular contraction, and exerts a more direct and powerful action on the heart than ether. As far as present experience goes, ether has been found the milder and safer of the two ; and in the case of children, from their greater susceptibility, should always be given in preference to chloroform; etherization, in them, occurring in about two minutes. According to Dr. Snow, the immunity from pain does not correspond exactly with the degree of narcotism, but is greater as the patient is recovering from the effects of the vapor, than in the corresponding degree, as he is getting under its influence ; this is more particularly the case with ether, which he considers to possess superior anaesthetic effects to chloroform in proportion to the narcotism produced. When ether is inhaled, the patient sometimes completely recovers his mental faculties, although insensibility to the operation still continues. The use of ether or chloroform is contra-indicated by the existence of any disease of the heart, tendency to engorgement of the lungs, or aneurism of any of the great vessels ; nor should it ever be used either during the existence of shock resulting from a severe injury. The existence of extreme debility is not always a contra-indi- cation ; for, acting as a stimulant, the inhaled vapor seems to ON THE USE OF ETHER AND CHLOROFORM. 283 possess a sustaining power, and has been successfully used in a state of great collapse, as well as for its sedative influence in low cases of typhus fever. Perhaps one of the most important uses of ether and chloro- form is that for the relief of stricture, and to render easy the introduction of the catheter ; here in old and sensitive cases as well as in retention of urine and the passage of calculi, they are invaluable. The physician in using these vapors should bear in mind that he is administering an agent of great power, of which he must carefully observe the effect ; for the life of the patient is in his hands. In some constitutions six or seven inspirations of chloro- form have produced complete insensibility, and we should always be on our guard lest alarming symptoms suddenly supervene. These are marked by suspended respiration ; livid skin ; widely dilated pupils; the eyes fixed, and the iris immovable. The patient should be immediately laid upon the floor, cold water dashed upon the face, and the vapor of ammonia applied to the nostrils. These will generally restore animation ; if, however, respiration has entirely ceased, it will be necessary to bring it about by artificial means. The abstraction of a few ounces of blood from the arm, or from the jugular vein, will also assist the renewal of the heart's action, by relieving distension. We should be careful, also, not to endeavor to make the patient swallow anything while in this state of insensibility, as cough might induce suffocation and hasten death. Besides sulphuric ether and chloroform, various other pre- parations have been found to possess anaesthetic properties ; as Aldehyde, Benzoin, Acetic Ether, Bisulphuret of Carbon, &c, but sufficient experiments have not yet been made to determine their relative value. As the action of chloroform depends upon its comparative purity, this may be tested by dropping it into the following mixture, viz. Sulphuric acid at 66° and distilled water, equal parts. When cool, this mixture will have a density by the areometer of 40°. (Sp. gr. 1.38.) Pure chloroform dropped into this liquid will fall to the bottom. 1 S. G. Morton, 1 French Journal of Pharmacy, 1848. INDEX. A. Absorbents and antacids, 198 Acacia, mucilage of, 262 Acetate of ammonia, lotion of, 242 and potash, 73 and assafetida, 102 and camphor, 226 and opium, 226 of lead, gargle of, 235 solution of, 197 enema of, 197 and calomel, 190, 192 and ipecacuanha, 191 and opium, 192 of morphia and tolu, 107 of potash and ammonia, 73 and buchu, 73 digitalis, &c, 71 of strychnia, solution of, 175, 186 tincture of, 186 of zinc, solution of, 231 collyrium of, 224 Acetic acid, gargle of, 235 Acid nitrate of mercury, 207 Aconite and Dover's powder, 137 and wine of colchicum, 85 and valerian, 86 Acorn coffee, 172 Alcohol as a poison, 269 Alkalies as poisons, 270 Alkaline bath, 256 Aloes, decoction of, 59 enema of, 123 pills of, 51 tincture of, 61 compound tincture of, 116 and assafetida, 51 and canella, 110 and gentian, 51, 174 and guaiacum, 52 and myrrh, 51 myrrh, and rhubarb, 51 sulphate of iron, &c, 112 Almond emulsion, 99 Alteratives, 177 Alum, burnt, 206 collyrium of, 223 ' curd, 224 gargle of, 234 powder of, 37 compound powder of, 190 whey, 196 and calomel ointment, 248 and catechu, 192 and extract of bark, 193, 196 and opium, 191 sage tea, and honey, 237 and sulphate of zinc, 39 and sweet spirits of nitre, 234 Amber, cloves, &c, 150 salt of, and castor, 147 American hellebore, tincture of, 39 Ammonise, liquor, injection of, 114 lotion of, 217 and tartar emetic, 241 Ammonia, fetid spirits of, 128 aromatic spirits of, 114, 128 and olive oil, 122 and glycerin, 243 and magnesia, 200 and salt of tartar, 200 and valerian, 149 Ammoniated iron, 166 Ammoniuret of copper, 166 injection of, 233 Ammoniac, mixture of, 102, 106 and nitric acid, 103 seneka, &c, 99 squill, &c, 94 Angustura bark, powder of, 165 decoction of, 171 Animal oil, 129 Anodyne collyrium, 227 draught, 137 Antacids, 198 Antacrid tincture, 189 Anthelmintics, 117 Anti-bilious pills, 50 Anti-emetic mixture, 201 Anti-gout pill, 48 Anti-herpetic ointment, 248 286 INDEX. Anti-intermittents, 1 55 Antilithics, 76 Antimonial powder, 80 wine, 39 and spirits of Min- der eri, 83 and sweet spirits of nitre, 84 and tolu, 85 Antimony, sulphuret of, 81 as a poison, 270 Antiseptic cataplasm, 254 pills, 125 Antispasmodics, 147 Antisyphilitic pills, 151 Aperient pills, 51 Apocynum, decoction of, 70 Aqua sappharina, 228 Armenian bole, 232 Arnica, mixture of, 86 tincture of, 129 Aromatic waters, mode of preparing, 243 pills, 125 Arrowroot, 265 Arsenic as an alterative, 179 as a poison, 270 Arsenical mixture, 163 Arsenious acid, 158 solution of, 207 ointment of, 208 compound powder of, 208 and sal ammoniac, 158 Arseniate of iron, pills of, 179 of soda, solution of, 185 Arsenite of potash, solution of, 163 Asiatic pills, 179 Assafetida, enema of, 150 mixture of, 101, 149 pills of, 147 sirup of, 97 and aloes, 51 and acetate of ammonia, 102 and camphor, 136 castor, &c, 149 magnesia, &c, 141 Astringents, 190 Astringent fomentation, 239 Atropia, solution of, 143 B. Balsam of Pei*u, mixture of, 103 and ox gall, 229 Bareges bath, 250 Barley water, 261 Bates's camphorated water, 226 alum water, 228 Baths, 255 Baryta as a poison, 271 Bebeerine, sulphate of, 159 Beef tea, 266 Belladonna, ointment of, 144, 248 solution of, 141, 143 cherry laurel, &c, 145 quinia. and rhubarb, 165 and tolu, 104 Bicarbonate of soda, mixture of, 77, 101 and calomel, 44 magnesia, &c, 199 quassia, &c, 77 and uva ursi, 65 of potash, solution of, 77 Bitartrate of potash. See Cream of Tartar Black hellebore, tincture of, 115 myrrh, &c, 115 Black drop, 138 wash, 240 Blistering cerate, 212 Blister issue, 210 Bloodroot, tincture of, 101 Blue mass and aloes, 47 and colocynth, 48 and extract of dandelion, 67 digitalis and squill, 67 and magnesia, 56 and quinia, 178 and soda, 48 Boneset, infusion of, 86, 160 sage, &c, 170 Borax, gargle of, 234 and glycerin, 243 and morphia, 244 and savine, 111 Brandy, gargle of, 233 mixture, 131 Bran, decoction of, 262 and flaxseed poultice, 253 Bread and milk poultice, 253 Bromide of potassium, solution of, 185 ointment, 249 Bromide of iron, pills of, 180 Bromine, 184 solution of, 185 Brown mixture, 98 Brucia, 180 mixture of, 186 pills of, 181 tincture of, 186 Buchu and acetate of potash, 73 and iodide of potassium, 91 and uva ursi, 74 Burdock, decoction of, 88 Burnt alum, 206 sponge, 181 Butternut and jalap, 49 Cainca, decoction of, 69 Calf s-foot jelly, 267 INDEX. 287 Calomel, pills of, 151, 177 injection of, 232 and acetate of lead, 190, 192 and alum ointment, 248 and camphor, 153 and colocynth, 48 and conium, 136 digitalis, &c, 67 digitalis and opium, 66 and gamboge, 117 Goulard's cerate, &c, 249 and iodine ointment, 246 and ipecacuanha, 38, 191 and jalap, 44 jalap, and rhubarb, 44 opium, and ipecacuanha, 81 and ox gall, 180 and pink-root, 117 quinia, and opium, 178 and rhubarb, 44 semen contra, &c, 121 and soda, 44 and squill, 66, 94 sulphuret of antimony, &c, 81 and tar ointment, 251 turpentine, &c, 119 and verdigris, 252 Camphor, enema of, 123, 128 in milk, 127 mixture of, 114, 127, 194 pills of, 135 julep, 127 assafetida, &c, 136 and acetate of ammonia, 226 and calomel, 153 and cantharides, 124 and carbonate of ammonia, 241 and chloroform, 128, 146 and cinchona, 166 and Hoffman's anodyne, 140 injection for ear, 228 laudanum, and nitric acid, 194 liniment, 241 magnesia, &c, 200 and mercurial ointment, 247, 216 musk, &c, 147, 148 and myrrh, 127 and opium, collyrium of, 226 and opium, plaster of, 145 Camphorated oil, 241 Canella, aloes, &c, 110 Canquoin's paste, 207 Cantharides, extract of, 214 liniment of, 220, 241 mixture of, 71 tincture of, 116 camphor, &c, 124 Cantharides, hartshorn, &c, 114 and savine, 111 and oil of turpentine, 220 Cantharidin, 213 Carbonate of magnesia, mixture of, 56, 78 of potash, mixture of, 100, 199 ammonia, &c, 200 and lime-water, 77 squill, &c, 73 of soda, injection of, 78 , mixture of, 201 pills of, 77 and calomel, 82 rhubarb, &c, 199 of ammonia, mixture of, 126 ointment of, 250 and musk, 148 and sulphate of quinia, 157 and valerian, 126 of iron, pills of, 166 Carrageen, 265 Castor, assafetida, &c, 149 and salt of amber, 1 47 Cataplasms, 253 Catechu, injection of, 229 electuary of, 196 mixture of, 196 and alum, 192 Cathartics, 43 Caustics, 205 Caustic potash, see Potash. paste of Canquoin, 207 Cayenne pepper, gargle of, 236 infusion of, 130 pills of, 125 tincture of, 219 iron and aloes, 167 Chalk mixture, 194, 199 and galls, 195 and opium, 198 Chamomile and orange peel, 171 Charcoal, poultice of, 254 and creasote ointment, 251 Cherry laurel, belladonna, &c, 145 Chicken water, 267 Chlorine fumigation, 109 liniment, 240 Chloroform, as an anaesthetic, 280 and camphor, 128, 146 Chlorinated lime, 130 gargle of, 236 mouth wash, 236 Chloride of iron, tincture of, 174 of gold, 169 288 INDEX. Chloride of zinc, as caustic, 207 injection of, 231 lotion of, 238 solution of, 150 Chocolate, 266 Chromic acid, 208 Cider mixture, 70 Cinchona, enema of, 164 extract of, 159 decoction of, 159, 160 infusion of, 160 mixture of, 163 powder of, 155 and alum, 193, 196 and camphor, 166 and citrate of potash, 162 and cloves, 156 and Epsom salts, 156 and lime-water, 160, 196 and port wine, 163 and rust of iron, 169 sal ammoniac, &c, 166 and serpentaria, 156 uva ursi, and opium, 76 and valerian, 172, 173 Cinchonia, sulphate of, 157, 162 Citrate of magnesia, 57 of potash, solution of, 82 and cinchona, 162 of ammonia, solution of, 84 Citrine ointment, 251 Cloves, infusion of, 130 plaster of, 216 and bark, 156 Cochineal, mixture of, 101 and common salt, 118 Cod-liver oil, 186 mixture of, 187 and iodine, 187 Codeia, 139 Colchicum, wine of root, 60 and aconite, 85 and colocynth, 48 and digitalis, 73 and elaterium, 72 and magnesia, 57 squill, and tobacco, 72 Collodium vesicans, 213 Collyria, 222 Colocynth and blue mass, 48 and calomel, 48 and colchicum, 48 and croton oil, 50 jalap, kc, 49 and manna, enema of, 62 Colombo, mixture of, 200 tincture of, 174 '.ri n;_r