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THE MEDICAL FORMULARY: BEING A COLLECTION OF PRESCRIPTIONS, DERIVED FROM THE WRITINGS AND PRACTICE OF MANY OF THE MOST EMINENT PHYSICIANS IN AMERICA AND EUROPE. TOGETHER WITH THE USUAL DIETETIC PREPARATIONS AND ANTIDOTES FOR POISONS. TO WHICH IS ADDED AN APPENDIX, ON THE ENDEMIC USE 01 MEDICINES, AND ON THE USE 0E ETHER AND CHLOROFORM. THE WHOLE ACCOMPANIED WITH A FEW BRIEF PHARMACEUTICAL AND MEDICAL OBSERVATIONS, / BY BENJAMIN ELLIS, M.D., LATE PROFESSOR OF MATERIA MEDICA AND PHARMACY IN THE PHILADELPHIA COLLEGE OF PHARMACY. ELEVENTH EDITION, CAREFULLY REVISED AND MUCH EXTENDED, BY ROBERT P. THOMAS, M. D., PROFESSOR OF MATERIA MEDICA IN THE PHILADELPHIA COLLEGE OF PHARMACY. "Morbos autem, non eloquentia sed remediis curari." — Cels. De Med. lib. i. PHILADELPHIA: BLANCHARD AND LEA, 18 64. r Entered according to the Act of Congress, in the year 1863, 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. 1J t, I3T PHILADELPHIA: C. SHERMAN, SON AND CO., PRINTERS. TO N. CHAPMAN, M.D., PROFESSOR OF THE INSTITUTES AND PRACTICE OF MEDICINE AND CLINICAL PRACTICE IN THE ETC. ETC. WHOSE TALENTS AND URBANITY ?IAVE RAISED HIM TO THE FIRST RANK IN THE PROFESSION, AND HAVE ACQUIRE© FOR HIM THE CONFIDENCE AND ESTEEM OF A LARGE AND ENLIGHTENED COMMUNITY, THIS WORK IS VERY RESPECTFULLY DEDICATED BY HIS OBLIGED FRIEND, THE AUTHOR ELLIS'S FORMULARY. The first and second editions were issued by the author. The third, fourth, fifth, sixth, seventh, eighth and ninth editions were revised by the late Samuel G. Morton, M.D. The tenth and eleventh editions have been issued under the editorial charge of Robert P. Thomas, M.D. PREFACE BY THE EDITOR, As the tenth edition of the Formulary has long been out of print, the Editor has been compelled to intro- duce into this edition a large amount of new matter, in order to bring the work up to the present advanced state of medical science. Many of the old standard formulas have been re- tained for their intrinsic merits. Others, which have not been sanctioned by an enlarged experience, have been dismissed. The additions have been made after a careful examination of the current medical and phar- maceutical works and journals ; and they also include a number of valuable prescriptions furnished from private sources. The table of doses has been carefully revised. A large and full index has been prepared to facilitate reference to any particular article the prescriber may wish to administer ; and the language of the Formu- lary throughout has been made to correspond with the nomenclature of the new national Pharmacopoeia, Philadelphia, November, 1863. PREFACE. The elegant and judicious formation of prescrip- tions is one of the difficulties which the young prac- titioner 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 pe- riod when he shall have undertaken the practical duties of his profession, 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 ad- vantageously arranged, many of the most important prescriptions employed 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 ad- vantages than any other, we have taken the liberty of adopting it as the basis of this Formulary. Vlll PIIEFACE. 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 practi- tioner, 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 formulas, the proportions of which msiy be either in- creased or diminished, according to the age, sex, con- stitution, or idiosyncrasy of the patient, all of which are to be taken into consideration when a prescrip- tion is directed, 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 unacquainted with the dead language ; and even those versed in the classics, may occasionally find words used in prescrijDtions 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 PREFACE. ix that they may be found useful in furnishing direc- tions necessary to be given to the nurse. 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 " Endermic 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 au- thors, periodical journals, manuscripts, and the con- tributions 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 possi- bly be found to contain. As a reason for not more frequently attaching the names of authors to the pre- scriptions, it may be observed that they are a kind of common medical property, which every physician feels himself privileged not only to employ, but mo- dify 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 encourage- 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. PREFACE. ment they have given to the undertaking. To Dr. Chapman we are particularly indebted for the kind- ness and interest he has manifested in its publication, and offer to him (the only return we can make) our warmest thanks. It is with particular pleasure we embrace this op- portunity of expressing our obligations to our friend Dr. S. G. Morton, whose intimate acquaintance with the subject, 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 pre- viously incurred. B. E. CONTENTS. PAGE Preface of the Editor, . v Preface of the Author, vii Introduction, xv Table of Drops, xvii Table of Abbreviations, xix. Table of Doses for Children, xx Table of the Doses of Medicines, xxi Tabular View of the Doses of the Principal Articles of the Materia Medica, » xxiii BOOK I. OF INTERNAL REMEDIES. Class I. Emetics, .... Powders, . Wines and Tinctures, Solutions and Mixtures, II. Cathartics, Powders, . Pills, Confections and Electuaries, Emulsions and Mixtures, Infusions and Decoctions, Wines and Tinctures, Enemata, . Suppositories, III. Diuretics, . Powders, . Pills, Infusions and Decoctions, Solutions and Mixtures, IV. Antilithics and Lithontriptics, Powders and Pills, . Solutions and Mixtures, 33 34 37 37 40 41 44 49 50 56 57 58 60 62 62 63 65 QS 75 75 76 Xll CONTENTS. Class V. Diaphoretics, .... 1. Ordinary Diaphoretics, . Powders, Solutions and Mixtures, Infusions, . 2. Alterative Diaphoretics, Pills, .... Decoctions, Mixtures, . VI. Expectorants, .... Powders, Pills, mid Lozenges, Syrups, .... Mixtures, .... Inhalation, VII. Emmenagogues, Powders and Pills, Fluid Preparations, . VIII. Anthelmintics, .... Powders, Pills, and Lozenges, Infusions and Decoctions, Electuaries and Mixtures, Clysters, . IX. Stimulants, Powders and Pills, Mixtures and Infusions, X. Narcotics, .... Pills, Mixtures, &c, . Clysters and Suppositories, External Use of Narcotics, XI. Antispasmodics, Pills, &c, . Mixtures, &c, XII. Sialagogues, XIII. Tonics, . 1. Anti-intermittents, Powders and Pills, Decoctions and Infusions, Solutions and Mixtures, 2. Ordinary tonics, Powders and Pills, Decoctions and Infusions, Mixtures and Tinctures, PAGE 79 80 80 83 88 89 89 91 91 95 98 109 113 113 116 121 121 124 125 128 130 130 131 140 140 144 152 153 158 158 159 163 167. 167 167 172 173 177 177 183 186 CONTENTS. Xlll Class XIV. Alteratives, Powders and Pills, Tinctures and Mixtures, XV. Astringents, Poivders and Pills, Mixtures and Infusions, XVI. Absorbents or Antacids, . Powders and Pills, Mixtures and Solutions, PAGE 192 192 195 207 20T 211 218 218 220 BOOK II. OF EXTERNAL APPLICATIONS XVII. Caustics or Escharotics, . Issues and Setons, XVIII. Epispastics, .... XIX. Rubefacients, .... XX. Anomalous External Applications, A. Collyria, Powders, Solutions and Mixtures, B. Injections, a. For the Ear, . d. For the Urethra, C. Vaginal injections, Inoculation and subcutaneous injection of cines, D. Gargles and Mouth Washes, E. Liniments, Lotions, &c, F. Ointments, . Powders, Gr. Cataplasms, . H. Baths, . I. Fomentations, K. Fumigations, medi- 225 231 233 237 244 244 244 246 252 252 254 259 260 262 266 276 287 288 290 292 293 BOOK III. OF DIETETIC PREPARATIONS AND POISONS. Dietetic Preparations and Beverages for the sick, Poisons, Appendix I. Endermic Use of Medicines, II. Use of Ether and Chloroform, Index, 297 308 319 320 326 INTRODUCTION. Befoke entering upon the main object of this work, it is necessary to notice a few circumstances which pertain more especially to Pharmaceutic Chemistry, 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 at- tention to prescriptions. In the first place, it is requisite to be well ac- quainted 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 quantity of the ingredient, but the in- gredient 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 drachm, A scruple, Libra, Uncia, Drachma, Scrupulus, lb, 12 ounces. 8 drachms. 3 scruples. 20 grains. XVI INTRODUCTION. In the manipulation of liquid substances, measures have, in most countries, superseded the use of weights. Particular names and symbols are given to the parts forming a gallon, in order to prevent their being con- founded with those denoting weights; as in the fol- lowing table : English Name. Latin Name. Symbol. Contains. A gallon, A pint, A fluidounce, A fluidrachm, Conoius, Octarius, Fluiduncia, Fluidrachma, C, or Cong. o, fg-. f3, 8 pints. 16 fluidounces. 8 fluidrachms. 60 minims (1^). The minims used in the table have been adopted in the United States Pharmacopoeia in place of drops ; and although we have only partially employed this measure in our prescriptions, yet we can readily per- ceive it to possess some important advantages over the ancient practice. The symbol (n#) is sometimes used by medical writers, though very improperly, to denote both minims and drops. 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 vial 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 the form of a mixture. Elias Durand, Prof. Procter, and Edward Parrish, of this city, have made various experiments to ascer- INTRODUCTION. XV11 tain the number of drops of different liquids equivalent to a fluidraclim ; and the results, which are of practical importance, are partly given in the following table : Acid, acetic (crystallizable), Acid, hydrocyanic (medicinal) Acid, muriatic, . Acid, nitric, . Acid, sulphuric, . Acid, sulphuric, aromatic, Alcohol (rectified spirit), Alcohol, diluted (proof spirit), Arsenite of potassa, solution of, Chloroform, Ether, sulphuric, . The essential oils, Syrup of acacia, . Syrup of squill, . Tincture of assafetida, of foxglove, of opium, .... Tincture of chloride of iron, Vinegar, distilled, Yinegar of colchicum, Yinegar of opium (Black Drop) Yinegar of squills, Water, distilled, . Water of ammonia (strong), Water of ammonia (weak), Wine, Teneriffe, . Wine, antimonial, Wine of colchicum, Wine of opium, . Drops. . 120 . 45 . 54 . 84 . 90 . 120 . 138 . 120 . 57 200-260 . 150 90-110 . 58 . 88 guaiac, of . 120 132-150 . 78 . 78 . 78 . 78 . 45 . 54 . 45 . 78 . 72 . 75 . 78 XV111 INTRODUCTION. Now it is evident from the preceding facts, that in giving one hundred and fifty drops of sulphuric ether (and proximately of any ethereal tincture), we give but a fluidrachm ; whereas, the same number of drops of medicinal hydrocyanic acid (one of the most poison- ous preparations of the Materia Medica), would be equal to something more than three fluidrachms. The same remark, it will be observed, is applicable to va- rious other preparations, which suggests a caution in rapidly increasing the dose of such medicines by drops. Whenever a tablespoonful of any liquid is ordered, it is considered to be equal to half an ounce by mea- sure ; and in the same way a teaspoonful is used for a fluidrachm. These measures are sufficiently accu- rate where no great precision is requisite. The prescriptions contained in this work are given in the Latin language, without other abbreviations than those in common use to denote the quantity of an ingredient. The directions for the administration of medicines are expressed in English. Prescriptions, as usually sent to the apothecaries, are much abbreviated, and the same course may be pursued with regard to those contained in this collec- tion. For the information of students who have not been in the practice of writing prescriptions, a Table of Abbreviations is subjoined. INTRODUCTION. XIX TABLE OF ABBREVIATIONS. Abbreviation. Latin Word. English Word. aa. Ana, 1 Of each. Ad saturand. Ad saturandum, Until saturated. Ad lib. Ad libitum. At pleasure. Aq. tepid. Aqua tepida, Warm water. Aq. ferv. Aqua fervens. Hot water. C. Congius, A gallon. Chart. Chartula, A small paper. Cock. Cochlear, A spoonful. Coeh. mag. Cochlear magnum, A tablespoonful. Coch. parv. Cochlear parvum, A teaspoonful. Colent. Colentur, Let them be strained. Collyr. Collyrium, An eye- water. Contus. Contusus, Bruised or broken. F. vel Ft. Fiat, vel fiant, Let there be made. Fol. Folium, vel folia, A leaf, or leaves. Garg. Gargarysma, A gargle. Gr. Granuin, vel grana, A grain, or grains. G-tt. Gutta, vel guttae, A drop, or drops. Haust. Haustus, A draught. Infus. Infustim, An infusion. M. Misce, Mix. Mass. Massa, A mass. Mist, Mistura, A mixture. 0. Octarius, A pint. Pil. Pilula, vel pilulss, A pill, or pills. Pulv. Pulvis, vel pulveres, A powder, or powders. Q. S. Quantum sufficit, A sufficient quantity. R. Becipe, Take. Bad. Badix, A root. S. Signa, Write. Ss. Semis, The half. Tinct. Tinctura, A tincture. The doses throughout this work are applicable adult age ? unless the contrary is specified. For the convenience of young practitioners, 1 This is not properly a Latin word, but the Greek preposition &»<&. XX INTRODUCTION. rules furnished by Gaubius and Dr. Young, for ascer- taining the proper doses of medicines for children, are given below. Gaubius takes the dose for an adult as unity, and for other ages, as follows : One year old, . . ^ Seven years old, . . i Two years old, . . i Fourteen years old, . J Three years old, . £ Twenty years old, . . f Four years old, . . i From 20 to 60 years old, 1 Dr. Young says : " For children under twelve years, the doses of most medicines must be diminished in the proportion of the age, to the age increased by 12." Thus, for a child of two years, — 2 : 2+12 : : the adult dose, or 1 : to the child's dose, or 7. Or, to state it 2 more simply, =1. Hence, m 2+12 T For one year, — -L J 1 + 12 13 2 " two years, —I J 2+12 7 " three " 8 = \ 3 + 12 5 " four " _ 4 — 4 c. SIX &c, &c. 4+12 4 6 + 12 3 At twelve, the dose is one-half that of the adult. TABLE OF THE DOSES OF MEDICINES, ARRANGED IN ALPHABETICAL ORDER. In preparing the following Table, a great object has been to present, at a glance, the minimum and medium doses of each medicine ; or, as sometimes happens in respect to the more familiar articles, the ordinary dose, as in many of the infusions and tinc- tures. It is necessary to premise that these prepa- rations are adapted to adult age ; nor can any precise rule be laid down which will be applicable to all the periods of life between that period and early infancy. Nothing but the cautious observation and judgment of the physician can possibly supply this deficiency. The best mode of giving active medicines to infants is in solution or suspension, so that the dose may be readily and safely graduated in reference to age, con- stitution, and disease. As the same medicine will sometimes be found in several different classes of the Materia Medica, its dose must be varied accordingly. Thus, ipecacuanha is both an emetic and diaphoretic, and the large dose we give for the former indication would not bear the necessary repetition for the second. Calomel is purgative and alterative; but in the table we only give the dose necessary to produce the first of these effects ; and so also of many other medicines. XX11 INTRODUCTION. Here again the formulas, as given under the several Classes, provide the necessary information in detail. We would also impress upon every practitioner, the vital importance of knowing the properties and strength of a medicine before prescribing it ; and this caution is especially requisite in directing those pre- parations which, in an overdose, produce distressing and sometimes fatal effects. No prescription of this kind should ever be copied at random, and without first satisfying one's self, by a little calculation, whether the proportions directed in it are safe and consistent; and we would farther insist that the use of every poisonous medicine should be commenced In a minimum dose, and gradually increased accord- ing to its effects on the system. It is often neces- sary, also, in these instances, to put the patient on his guard in case any inordinate or unusual symp- toms should arise, with a request that the prescrip- tion, in such contingency, may be taken in less quantity, at longer intervals, or discontinued. This precaution is all-important, for example, in the ad- ministration of alterative doses of the mercurial pre- parations ; for the same quantity that would have little or no effect on one person, might, and often does, produce a violent and deleterious effect on an- other. This remark is also equally applicable to the whole class of narcotic medicines. In truth, nothing but habitual circumspection in prescribing medicines, can render this art beneficial to the patient or honorable to the physician. TABULAR VIEW OP THE DOSES OF THE PRINCIPAL ARTICLES OF THE MATERIA MEDICA. Absinthium, 9j. ad ij. Acetonuni, gtt. x. ad xxx. Acetum, fjj. ad iv. Acidum Arseniosum, gr. y 1 ^. Benzoicum, gr. x. ad xx. Boracicum, gr. v. ad x. Gallicurn, gr. v. ad x. Hydrocyanicuni Dilutum, gtt. j. ad ij. Muriaticum Dilutum, gtt. xx. Nitricuui Dilutum, gtt. x. ad xx. Nitro-muriaticuin Dilu- tum, gtt. x. ad xv. Phosphoricum Dilutum, gtt. xv. ad xxx. Sulphuricum Dilutum, gtt. x. ad xx. Sulphuricum Aromati- cum, gtt. x. ad xx. Tannicum, gr. ij. ad vj. Tartaricum, 3J- Aconiti Folium, gr. j. ad ij. , Extractum Aleoholicum, gr. h Folii, Tinctura, gtt. x. ad xx. Radicis, Tinctura, gtt. iv. ad viij. either, gtt. 1. ad f 5j. - — - — , Spiritus Compositus, f 3J • iEtheris Nitrosi, Spiritus, fjj- Allium, Jss. ad Jj. Allii, Succus, f 3ss. , Syrupus, f 5j. ad ij. Aloe, gr. x. ad xx. Aloe et Canella, gr. v. ad xx. Aloes, Tinctura, f^ss. , Vinum, f^j. ad f^ss. Alumen, gr. x. ad xx. Exsiccatum, gr. v. ad x. Ammoniae Acetatis, Liquor, f^ss. adj. Carbonas, gr. v. ad x. Phosphas, gr. x. ad xx. Murias, gr. v. ad xv. Aromaticus, Spiritus, gtt. xx. ad fjj. Ammoniacum, gr. x. ad xx. Ammoniaci, Mistura, f^ss. Angustura, gr. x. ad xx. Angusturas, Infusum, f ^ij. Anthemis, 3 SS - a ^ j- Anthemidis, Infusum, f §j. ad ij. Antimonium Sulphuratum, gr. j. ad v. Antimonii, Oxidum, gr. iij. ad v. Oxysulphuretum, gr. ss. ad ij. et Potassae Tartras, gr. i adj. , Vinum, gtt. x. ad f3J- Antimonialis, Pulvis, gr. iij. ad x. XXIV TABLE OE DOSES. Apocynum, gr. x. ad xxx. Argenti Nitras, gr. £ ad $. Cyanidum, gr. j 2 . Iodiduni, gr. £ ad j. Oxiduin, gr. ^. Arnica, gr. v. ad xx. Arnicas, Extractum Alcoholicum, gr. ij. ad v. , Tinctura, gtt. xx. ad f Jj. Arseniosum, Aeidum, gr. y 1 ^. Arsenici Iodidum, gr. y 1 ^ ad &. Arseaici et Hydrargyri lodidi, Li- quor, gtt. v. ad x. Potassas Arsenitis, Liquor, gtt. x. Asclepias Tuberosa, gr. xx. ad 3J- Assafbetida, gr. iij. ad x. Assafostidas, Mistura, f^ss. , Tinctura, f Jj. Atropia, gr. T J- ad g V Atropias Sulphas, gr. g 1 ^ ad g 1 ^-. Auri Sales, gr. Jg ad T ^. Balsamum Peruvianuin, f^ss. Tolutanura, gr. x. ad xxx. Tolutanus, Syrupus, fgss. Tolutana, Tinctura, f 5J • Barii Chloridi, Liquor, gtt. v. Bebeerinas Sulphas, gr. iij. ad xx. Belladonnas, Folium, gr. j. Extractum, gr. J. , Extractum Alcoholi- cum, gr. |. , Tinctura, gtt. x. ad xx. Benzoinum, gr. v. ad x. Benzoini Composita, Tinctura, f 3ss. ad j. Bismuthi Subcarbonas, gr. iij. ad x. Subnitras, gr. iij. ad x. Brominium, gtt. ^ ad £. Brucia, gr. £. Buchu, gr. xx. ad xxx. , Extractum Fluidum, f3ss. adj. , Infusum, f ^ij. Cahinca, 9j. ad 3j. Calamus, 9j. ad 3j. Calcis, Liquor, f^ss. ad ij. Calcii Chloridi, Liquor, gtt. xxx. adf3J. Calx Chlorinata, gr. iij. ad vj. Creta Praeparata, gr. x. ad xxx. Testa Praeparata, gr. x. ad xxx. Camphora, gr. ij. ad x. Carnphoras, Aqua, f ^ss. , Spiritus, gtt. v. ad xx. Canella, gr. x. ad xxx. Cannabis, Extractum Purificatum, , gr. I ad j. — , Tinctura, gtt. x. ad xl. Cantharis, gr. j. ad ij. Cantharidis, Tinctura, gtt. x. ad xx. Capsicum, gr. v. ad x. Capsici, TiDctura, f 3 SS - Cardamomum, gr. x. ad xxx. Cardamomi, Tinctura, f3J- ■ — , Tinctura Composita, Carum, gr. xx. ad xl. Caryophyllus, gr. v. ad x. Caryophylli Oleum, gtt. ij. Cascarilla, gr. xx. ad xxx. Castoreum, gr. x. ad xx. Castorei Tinctura, gtt. xx. ad 1. Catechu, gr. x ad xxx. , Tinctura, f^j. ad ij Cerevisias Fermentum, f^ss. ad ij. Cetrariae, Decoctum, f^ij. Chenopodium, 9j. ad ij. Chenopodii, Oleum, gtt. v. ad x. Chimaphilas, Decoctum, f^ij- Chloroformum, gtt. x. ad xxx. Chondri, Decoctum, ad libitum. Cimicifuga, 3j. ad 3j. Cimicifugas, Extractum Fluidum, tt% xx. ad xl. Cinchona, gr. x. ad xx. Cinchonas, Extractum, gr. x. , Extractum Fluidum, ir^xx. ad fjj. , Tinctura, f3J. ad iv. TABLE OF DOSES. XXV Cinchonas, Tinctura Composita, fjj. ad iv. — - Flavas, vel Rubras, De- coctum, f^j. ad ij. Flavas, vel Rubras, ln- fusum, f^j. ad ij. Cinchonias Sulphas, gr. ij. ad x. Cinnamon] um, gr. x. ad xx. Cinnamomi, Aqua, f ^ss. , Oleum, gtt. j. ad ij. , Spiritus, gtt. x. ad XXX. j Tinctura, fjj. ad ij. Coccus, gr. j. ad x. Colchici, Radix, gr. ij. ad vj. Semen, gr. ij. ad vj. ■ Tinctura, f3ss. adj. Acetum, fgss. adj. Extractum Aceticum,gr. j. Radicis, Yinum, gtt. x. ad xx. Radicis, Extractum Flu- idum, itj>ij. ad v. Seminis, Vinum, f* 3 j - Calurnbas, Infusum, f Seminis, Extractum Flu- idum, ir^ij. ad vj. Colocynthis, gr. v. ad x. Colocynthidis, Extractum Com- positum, gr. x. Calumba, gr. x. ad xx. -, Tinctura, f3j- ad iv. Conii Folium, gr. iij. , Extractum, gr. ij. , Extractum Alcoholicum, gr. ij. ad v. , Extractum Fluidum, gtt. v. , Tinctura, gtt. xx. ad xxx. Copaiba, fjj. Copaibas, Oleum, gtt. x. ad xv. Coptis, gr. x. ad xxx. Coriandrum, £)j. ad Jj. Cornus Florida, gr. xx. ad xxx. Creasotum, gtt. j. Creta Prasparata, gr. xv. ad 3j. Crocus, gr. x. ad xx. Cubeba, Jss. ad iij. Cubebas, Oleoresina, irjjx. ad xxx. ; Oleum, gtt. x. ad xij. Cubebas, Tinctura, f3j. Cuprum Ammoniatum, gr. J ad $. Cupri Sulphas, gr. £ ad ij. Dippel's Animal Oil, gtt. v. ad x. Digitalis, gr. j. ad iij. , Extractum Alcoholicum, gr. I ad j._ , Infusum, f3ij- ad iv. -, Tinctura, gtt. x. Digitalin, gr. -£ . Donovan's Solution, gtt. v. ad xx. Dover's Powder, gr. x. Dracontium, gr. x. ad xx. Dulcamara, 3 SS - a d j- Dulcamaras, Decoctum, foij- Extractum, gr, v. ad x. Extractum Fluidum, fjss. ad j. Elaterium, gr. £. Elaterin, gr. J^. Ergota, gr. xx. Ergotas, Vinum, fjj. ad ij. , Extractum Fluidum, fjss. ad j. Ether, gtt. I. ad f3j. Eupatorii, Infusum, f^ij. Extractum Cannabis, gr. J ad \. Fel Bovinum, gr. v. ad x. Ferri Chloridi, Tinctura, gtt. x. ad xxv. Citras, gr. v. ad x. et Ammonias Citras, gr. v. et Ammoniae Sulphas, gr. v. et Ammonias Tartras, gr. v. et Potassas Tartras, gr. x ad xx. et Quinias Citras, gr. v. Ferrocyanidum, gr. iij. ad v. Iodidi, Syrupus, gtt. x. ad xl. Lactas, gr. j. ad iij. Nitratis, Liquor, gtt. viij. ad x. Phosphas, gr. v. ad x. Pyrophosphas, gr. iij. ad x. Subcarbonas, gr. x. ad 3 ] 'j- XXVI TABLE OF DOSES. Ferri, Carbonatis, Pilulse, gr. iij. ad v. Sulphas Exsiccata, gr. ij. ad v. Valerianas, gr. j. Vinum. f^ss. Ferrura Ainuioniatum, gr. v. ad x. '■ Redactum, gr. ij. ad v. Filix Mas, Jj. ad ij. Foeniculum, 9j. ad 3ss. Fceniculi, Aqua, f ^ss. Fowler's Solution, gtt. x. Galla, gr. x. ad xx. Gainbogia, gr. ij. ad iij. G-aultherise, Oleum, gtt. ij. ad v. Gentiana, gr. x. ad xxx. Gentianae, Extractum, gr. v. ad x. , Extractum Fluidum, f^ss.^ , Coinposita, Tinctura, f5J- adi J- Gillenia, gr. xx. ad xxx. Granati Fructus Cortex, gr. xx. ad xxx. Guaiaci Resina, gr. x. ad xx. .Tinctura, f3J- Ammoniata, Tinctura, Hrematoxyli, Extractum, gr. x. ad xx. Decoctum, f^j. ad ij. Hydrargyri Iodidum Viride, gr. i ad ij. Iodidum Rubrum, gr. i 16* Oxidum Nigrum, gr. i ad iij. Sulphas Flava, gr. i ad v. Sulphuretum Nigrum, gr. v. ad x. Sulphuretum Rubrum, gr. x. Hydrargyrum cum Creta, gr. v. ad x. • cum Magnesia, gr. v. ad x. Hyoscyami Folium, gr. v. ad x. ■ , Extractum, gr. ij. , Extractum Fluidum, gtt. v. ad x. , Tinctura, f 3ss. ad j. Helleborus, gr. v. ad xv Hellebori, Extractum iUcoholi- cum, gr. v. ad x , Tinctura, £tt. xxx. ad Hoffmann s Anodyne, f 3j. llordei, Decoctum, ad libitum. Humuli, Tinctura, fjij. Hydrargyri Chloridum Corrosi- Ignatise, Extractum Alcoholicum, gr. I ad \. Inula, 9j. ad 3j. Iodinium, gr. \ ad j. Iodinii, Tinctura, gtt. v. ad x. Coinposita, Tinctura, gtt. x. ad xx. Compositus, Liquor, gtt. v. ad x. Ipecacuanha, gr. ij. ad xx. Ipecacuanhas, Syrupus, f^j- ad ij. Extractum Fluidum, gtt. x. ad xxx. . , Vinum, fjj ; Ipecacuanhas et Opii, Pulvis, gr. x. Jalapa, gr. x. ad xx. Jalapas, Extractum, gr. v. ad x. , Resina, gr. j. ad iij. — , Tinctura, f3J- ad ij. vuin, er. I 2 ad — Chloridum Mite, gr. 2^ ad j. as an al- terative, gr. v. ad xv. as a purgative. — Cyanidum, gr ,',, ad \. Juglandis, Extractum, gr. xx. Juniperi, Baccae, 3J- aa " ij. , Oleum, gtt. v. ad xv. , Compositus, Spiritus, fgj. ad iv. Kino, gr. x. ad xx. TABLE OF DOSES. XXV11 Kino, Tinctura, f 5J* a ^ij- Kousso, Flores, ^ss. Krameria, gr. xx. ad xxx. Krameriae, Extractum, gr. x. ad xx. , Syrupus, f3j. ad iv. , Tinctura, f 3J. Lactucarium, gr. iij. ad x. Lactucarii, Syrupus, f 3J- Lappa, 3J- . Lauro-Cerasi, Aqua, fjss. ad j. Lavandulae, Oleum, gtt. ij. ad v. , Compositus, Spiritus, Liriodendron, 3 SS - ad ij. Lobelia, gr. v. ad x. Lobelias, Tinctura, gtt. xx. ad f3J- , Acetum, gtt. xx. ad xxx. Lugol's Solution, gtt. v. ad x. Lupulina, gr. v. ad x. Lupulinae, Tinctura, f3J- — ; , Extractuni Fluidum, gtt. v. ad x. , Oleoresina, gr. j. ad iij. Magnesia, Jss. adj. Magnesia? Carbonas, Jss. ad j. Citratis, Liquor, f^iv. ad xij. Sulphas, ^j. Magnolia, 3ss. ad j. Manganesii Oxidum, gr. iij. ad x. Iodidi, Liquor, gtt. x. ad xx. Sulphas, 9j. ad 3ij. Manna, ^ss. ad j. Mannite, ^j. Matico, 3 SS - a ^ ij- Matricaria, 3 SS - a ^ j- Menthae Piperita?, Oleuni, gtt. j. adij. , Spiritus, gtt. x. ad xx. , Aqua, f £ss. Menthae Viridis, Aqua, f^ss. _4 f Spiritus, gtt. x. ad xx. Mezerei, Decoctura, f^ij. Mistura Cretae, f^ss. adj. Monardse, Oleum, gtt. j. ad iij. Morphiae Acetas, gr. -& ad £. Murias, gr. £ ad £. Sulphas, gr. £ ad \. Sulphatis, Liquor, f^j. adij. Moschus, gr. x. Mucunae, Electuarium, 3J- a( i ^ss. Myrrha, gr. x. ad xx. Myrrhae, Tinctura, fjss. adj. Naphthalina, gr. ij. ad xv. Nucis Vomicae, Extractum Alco- holicum, gr. ss. ad j. Tinctura, gtt. v. ad xx. Nux Vomica, gr. iij. ad v. Oleum Amygdalae Amarae, gtt. \. Anisi, gtt. ij. ad v. Cajuputi, gtt. ij. ad v. Erigerontis Canadensis, gtt. v. ad x. Limonis, gtt. ij. ad iv. Morrhuae, f ^ss. Olivae, f^j. Pimentae, gtt. ij. ad v. Kicini, f gj. Rosmarini, gtt. ij. ad iij. Rutae, gtt. ij. ad iij. Sabinae, gtt. ij. ad iij. Sassafras, gtt. iv. ad vj. Succini Rectificatum, gtt. v. ad x. Terebinthinae, gtt. x. ad Tiglii, gtt. i ad ij. Opium, gr. j, Opii, Acetum, gtt. x. , Confectio, gr. x. ad xx. , Extractum, gr. ss. , Tinctura, gtt. xx. ad xxv. Acetata, Tinctura, gtt. xx. Camphorata, Tinctura, f3J. ad ij. , Deodorata, Tinctura, gtt. xx. ad xxx. , Vinurn, gtt. xx. ad xxv. XXV1U TABLE OF DOSES. Pareira, 3 SS - a ^ J- Petroleum, 3 SS - aa " j. Phloridzin, gr. x. ad xij. Piperis, Oleoresina, gtt. j. ad iij. Pix Liquida, 3ss. ad j. Plumbi Acetas, gr. j . ad iij . Iodiduin, gr. ss. ad iij. Nitras, gr. i ad J. Podophylli, Extractum, gr. v. ad xv. , Resina (Podophyllin), gr. i ad j. Potassas, Liquor, gtt. x. ad xx. Arsenitis, Liquor, gtt. x. Acetas, gr. x. ad xx. Bitartras, 3J- ad ij. Carbonas Pura, gr. x. Bicarbonas. gr. x. ad %ss. — Chioras, gr. x. ad xx. — Citras, gr. xx. ad xxv. — Citratis, Liquor, f^ss. — Nitras, gr. x. ad xv. — Sulphas, 3ss. ad j. — Tartras, 3J- a d ^ss. Potassii Broiuiduin, gr. iij. ad x. Cyanidum, gr. i ad |. Ferrocyanidurn, gr. x. ad xv. Iodidum, gr. iij. ad x. Sulphuretum, gr. ij. ad vj. Prunus Virginian a, 3ss. ad j. Pruni Virginianae, Infusuin, f^ij. Extractum Fluidum, f3ss. ad j. , Syrupus, f^ss. Pulvis Aromaticus, gr. x. ad xx. Doveri, gr. x. Quassiae, Extractum, gr. ij. ad v. , Tinctura, f3J. ad ij. Quercus Alba, et Q. Tinetoria, gr. xx. ad 3j. Quiniae Sulphas, gr. j. ad x. Valerianae, gr. j. ad v. et Ferri Citras, gr. iij. ad v. Rhamni Syrupus, f^ss. Rheum, ^j. ad 3ss. Rhei, Fluidum Extractum, f3ss. Rhei, Extractum Aleoholicum, gr. v. ad x. Aromaticus Syrupus, f3J. ad iv. , Tinctura, f^ss. -, Vinum, f3ij. Rubia, 9j. ad 3^s. Rubus Yillosus, et R. Canadensis, 9j. ad 3ss. Sabbatia, 3 SS - aa " j- Sabina, gr. v. ad x. Sabinaa Oleum, gtt. ij. ad iij. Salicin, gr. ij. ad x. Sanguinariae, Tinctura, f3-ss. adj. , Acetum, gtt. xx. ad xxx. Sanguinarinae Sulphas, gr. y 2 ad |, Santonin, gr. j. ad iij. Sarsaparillae, Extractum, gr. x. ad xx. Fluidum, Extractum, Compositum Decoc- tum, fgj. ad ij. Compositus, Syrupus, f jfss. Scammonium, gr. v. ad xv. Scammonii, Resina, gr. ij. ad vj. Scilla, gr. j. ad ij. Scillae, Acetum, f3ss. ad j. , Syrupus, fgj. Compositus, Syrupus, f 3ss. adj. Tinctura, gtt. x. ad xl. Senega, gr. x. ad xx. Senegae, Syrupus, f3J. ad ij. Extractum Alcoholicum, gr. j. ad iij. Senna, 3$s. ad ij. Senna?, Confectio, 3J- a d ij. Fluidum, Extractum, f 3J. ad f sss. Serpentaria, gr. x. ad xxx. Serpentariae, Tinctura, f 3J- Extractum Fluidum, gtt. x. ad xxx. Simaruba, 9j. ad 3J- Sinapis (as an emetic), 3ij- TABLE OF DOSES. XXIX Sodse Acetas, 3j. ad 3J- Boras, 9j. ad ij. Carbonas, gr. v. ad x. - Bicarbonas, gr. x. ad xx. Phosphas, ^ss. adj. Sulphas, ^ss. et Potassse Tartras, $ij. ad Sodii Chloridum, gr. x. ad 3ij. Spigelia, gr. x. ad 3J« Spigeliae, Extractum Fluidum, gtt. xx. ad f Jj . et Sennse, Extractum Flu- idum, fjj- ad f^ss. Spiritus iEtheris Nitrosi, f3j. Spiritus iEtheris Compositus, f3J- Spiritus Pyroxilicus, gtt. x. ad xl. Stanni Pulvis, J;ss. Stramonii, Folium, gr. j . ad ij . , Extractum, gr. j. , Extractum Alcoholi- cum, gr. i ad j. , Tinctura, gtt. xx. ad xxx. Strychnia et ejus sales, gr. J^ ad 1 12* Styrax, gr. x. ad xx. Sulphur, 9j. ad Jij. Sulphuris Iodiduin, gr. | ad j. Tabacum, gr. j. ad v. Tabaci, Vinum, gtt. x. ad xx. Taraxaci, Extractum, 9j. ad Jj. Extractum Fluidum, Terebinthina, 9j. ad ij. Testa Prseparata, gr. x. ad 1. Ulmi, Infusum, ad libitum. Uva Ursi, 3 SS - ad j. Uvse Ursi, Extractum Fluidum, gtt. x. adf3j. Valeriana, Jss. ad j. Valerian^ Extractum Fluidum, f 3ss. ad j. Extractum Alcoholi- cum, gr. iij. ad x. , Oleum, gtt. v. , Tinctura, fjj. ad ij. Ammoniata, Tinctura, f 3J- Veratrum Album, gr. j. ad iij. Viride, gr. j . ad iij . Veratri Viridis, Extractum Flu- idum. gtt. ij. ad v. Tinctura, gtt. v. ad viij. Veratria, gr. y 1 ^ ad i. Zinci Acetas, gr. j. ad ij. Chloridum, gr. I ad ij. Cyanidum, gr. yL ad 1. Oxidum, gr. ij. ad v. Sulphas, gr. j. ad x. Valerianas, gr. ss. ad ij. Zingiber, gr. x. ad xx. Zingiberis, Tinctura, f3J- Extractum Fluidum, gtt. x. ad xx. BOOK I. OF INTERNAL REMEDIES. LASS 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 rules 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 ad- ministering 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 ex- citability of the stomach is greatly diminished by a Narcotic, it is necessary to assist the emetic bv the addition of some ex- citant. 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 3 36 EMETICS. 7. Emetic of Common Salt. 1^. Sodii Chloridi, §.]• Signa. — Administer one-half in a teacupful of warm water, and repeat the dose in ten minutes. Salt frequently proves a prompt and efficient emetic, invi- gorating rather than depressing the powers of the system. 8. Powder of Sulphate of Copper. 3^. Cupri Sulphatis, gr. xij. Divide in pulveres iv. Signa. — Give one powder, in sweetened water, every fifteen minutes until vomiting is produced. 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 large draughts of warm water. All vegetable astringent infusions are incom- patible substances. 9. Powder of Sulphate of Zinc. 1^. Zinci Sulphatis, 5ss. Divide in pulveres iv. Signa. — One to be taken in molasses, and followed by a draught of warm water, every fifteen minutes. This medicine is very prompt in its operation, and is often employed in cases of poisoning. It is also used as a nauseating remedy in phthisis ; and both as an emetic and tonic in dys- pepsia. The stomach is said to be invigorated, rather than exhausted by its operation. 10. Powder of Ipecacuanha and Calomel. 3^. Pulveris Ipecacuanha, gr. viij ; Hydrargyri Chloridi Mitis, gr. v. Misce. This powder generally proves both emetic and purgative. It is often indicated in the commencement of the eruptive and other diseases of childhood. 11. Powder of Ipecacuanha and Rhubarb, 1^. Pulveris Ipecacuanha), Pulveris Khei, aa r 3y Misce. Signa. — To be taken in syrup. EMETICS. 37 More or less purging will generally follow the emetic opera- tion of this dose. It is used in congestive and other fevers. WINES AND TINCTURES. 12. Wine of Ipecacuanha and Tartarized Antimony. Jfy. Vini Ipecacuanhas, f gj ; Antimonii et Potassae 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. 13. Antimonial Wine. Ify. Vini Antimonii, f Sjj. Signa. — A teaspoonful to be taken by a child 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. In the croup of infants, twenty drops every fifteen minutes, until the medicine operates, is a safe dose. 14. Norwood's Tincture of American Hellebore. Tfy. Radicis Veratri Viridis, Sviij ; Alcoholis, Oj. Macera per dies decern, vel quatuordecim, et exprime. Signa. — Dose for an adult, six to eight drops every three hours. 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. 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, inflammation of the lungs, and typhoid fever. — Southern Med. and Surg. Journal, Jan. 1853. SOLUTIONS AND MIXTURES. 15. Mixture of Tartrate of Antimony, ly. Antimonii et Potassae Tartratis, gr. ij; Sacchari, 5j ; Aquae destillatae, f§ij. Misce, et fiat solutio. Signa. — A tablespoonful to be given every ten or fifteen min- utes, until it vomits freely. 38 EMETICS. 16. Mixture of Sulphate of Zinc and Alum. 3^. Zinci Sulphatis, 5jss; Aluminis, 5ss ; Aquae ferventis, Oss. Misce, et cola. Signa. — A 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. 17. Mixture of Emetia. 1^. Emetiae inipurae, gr. iv; Aquae destillatae, fSij; Syrupi, f §ss. Fiat solutio. Signa. — Give a dessert-spoonful 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 commercial emetia, which is much less energetic than the per- fectly white alkaloid. The best antidote for an overdose, is a strong infusion of nutgalls. Magendie. 18. Mixture of Ipecacuanha, Tartar Emetic and Squill. 1^. Pulveris Ipecacuanhae, 5ss; Antimonii et Potassae Tartratis, gr. j ; Tincturae Scillae, f Sj ; Aquae destillatae, fovij. Fiat mistura. Signa, — Four tablespoonfuls at first ; afterwards two table- spoonfuls every ten minutes until vomiting is induced. This mixture is recommended in dropsies previously to giving digitalis. 19. Infusion of Ipecacuanha. 1^. Pulveris Ipecacuanhae, 5>j ; Aquae bullientis, f ovj. Macera per horam unam, in vase leviter clauso, et cola. Signa. — Of this one or two tablespoonfuls may be given every half hour, until it excites vomiting. EMETICS. 39 20. Infusion of Lobelia or Indian Tobacco. Ify. Lobeliae, §ss ; Aqu?e 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 use ; but in asthma and some spasmodic affections, much bene- fit is often experienced. It should, however, be administered with extreme caution. 21. Compound Syrup of Squills. ]^. Syrupi Scillae Compositi, f gj. Signa. — Give thirty drops every quarter or half hour, to a child two years old as an emetic ; or ten drops every three hours as an expectorant. This is an officinal substitute for the hive syrup of Dr. Coxe. It has acquired much confidence from its efficacy in croup ; and should it not be sufficiently active in this violent disease, a grain of tartrate of antimony may be added to each fluid ounce. 22. Mixture of Syrup and Wine of Ipecacuanha. 1^. Syrupi Ipecacuanhas, f §j ; Vini Ipecacuanhae, f5\j- Signa. — Give a teaspoonful to a child three years old, every fifteen minutes until it proves emetic. The syrup of ipecacuanha, by itself, is too mild to act as an emetic, being rather designed as an expectorant. But in combination with the wine it provokes free emesis. CLASS II CATHARTICS. As a general rule it may be observed of cathartics tliat 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 quantity of their peculiar fluids. It seldom or perhaps never happens 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 becoming converted into a purgative salt. There are others, as aloes, that expend their principal force upon the rectum and large intestines, and for this reason are very advantage- ously 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 digestive 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 be 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. CATHARTICS. 41 The operation of these remedies may be very much acceler- ated 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 certainly by uniting small quantities of 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. POWDERS. 23. Powder of Calomel and Jalap. Iy. Hydrargyri Chloridi Mitis, gr. v; Pulveris Jalapse, gr. x. Misce. Signa. — To be given in molasses or syrup. 24. Powder of Calomel and Rhubarb. 1$;. Hydrargyri Chloridi Mitis, Pulveris Rhei, aa gr. v; Olei Cinnamomi, gtt. j. Misce. Signa. — To be given in molasses. 25. Powder of Calomel and Soda. -fy. Hydrargyri Chloridi Mitis, gr. viij ; Sodse Bicarbonatis, gr. xij. Misce. Signa. — To be given in molasses. This combination forms a safe and mild purgative. Nausea seldom follows its administration. 26. Poioder of Calomel, Jalap, and Rhubarb. Iy. Hydrargyri Chloridi Mitis, Pulveris Jalapge, Pulveris Bhei, aa gr. v ; Olei Cinnamomi, gtt. j. Misce. Signa. — To be given in syrup or molasses. 42 CATHARTICS. 27. Poioder of Rhubarb and Magnesia. It. Pulveris Rhei, 3j ; Magnesiae, 3ss ; Olei Cinnarnoini, gtt. j. Misce. Signa. — To be given in syrup or molasses. 28. Calcined Magnesia. Ify. Magnesiae, 5j- It. Magnesiae (Henry), Si- lt. Magnesias (Husband), 5j. R. Magnesiae (Ellis), 5j. Magnesia is an antacid, and laxative, much used in the dis- eases of women and children. The lightness and consequent bulk of the officinal powder, constitute serious objections to its use. To obviate these, Henry of England, and Thos. J. Hus- band, and Charles Ellis & Co. of this city, have severally pre- pared 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 drachm, in milk or water. The operation of magnesia, when it meets with no acid in the bowels, is promoted by giving the patient lemonade. 29. Poivder of Jalap and Cream of Tartar. Jfy. Pulveris Jalapae, 5j ; Potassae Bitartratis, 5vj- Misce, et divide in pulveres 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." N. Chapman. 30. Compound Poivder of Jalap and Gamboge. Ify. Pulveris Jalapae Compositi, 5iij ; Pulveris Gambogiae, gr. vj. Misce, et divide in pulveres vj. Signa. — Give one powder every two hours in molasses or syrup. CATHARTICS. 43 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 gamboge, as in the above formula. 31. Poivder of Sulphur and Cream of Tartar. 1^. Sulphuris loti, §ss ; Potassas Bitartratis, §j. Misce. Signa. — Mix in a sufficient quantity of molasses, and give a teaspoonful three or four times a day to children. Used in various 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. 32. Powder of Sulphur and Calcined Magnesia. Iy. Sulphuris prsecipitati, Magnesise, 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. N. Chapman. 33. Seidlitz Powders. ^. Potassse et Sodse Tartratis, 5\j ; Sodas Bicarbonatis, 3ij. Fiat pulvis. Signa. — To be dissolved in a wineglassful of cold water. 1^. Acidi Tartarici pulverisati, gr. xxxv. Signa. — Dissolve in a wineglassful of water and mix the two solutions. To be taken while in a state of effervescence. This is a very popular medicine, and justly so, as it is a gentle aperient, and may be taken by persons whose stomachs would reject any of the ordinary saline preparations. 34. Soda Powders. 1^5. Sodge Bicarbonatis, 5ss. Signa. — To be dissolved in a wineglassful of cold water. 44 CATHARTICS. 11. Acidi Tartarici, 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. 35. Stevens's Saline Powders. R. Soda* Bicarbonatis, oss ; Sodii Chloridi, 3j ; Potassoe Chloratis, gr. vij. Mi see. This powder was administered by Dr. Stevens in half a tum- blerful of tepid water, or a little thin beef tea, in cholera, and repeated every half hour until the patient recovered from the collapse. PILLS. 36. G-riffittss Cathartic Pills. R. Pulveris Jalaps, Pulveris Rhei, Saponis, aa 5ss; Hydrargyri Chloridi Mitis, gr. xxv : Antimonii et Potassa? Taruratis. gr. jss; Aquae destillatae, 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 anti- mony forms an excellent antibilious remedy ; and, in cases of fever, prepares the alimentary canal for the reception of other remedies. S. P. Griffitts. 37. Pills of Blue Mass, Jalap, and Aloes. It. Pilule Hydrargyri, Pulveris Jalapa\ Pulveris Aloes Socotrin«\ aa gr. xv : Syrupi, q. s. ut fiat massa. Divide in pilulas xij. Signa. — Three may be taken at night, and the same dose be repeated in the morning, if the first is ineffectual. CATHARTICS. 45 38. Pills of Blue 3Iass, Mkubarb, and Soda. 3^. Piluhe Hydrargyri, gr. ix ; Pulveris Rhei; Sodse Bicarbonatis, aa gr. xij ; Syrupi Rhei Aromatici, q. s. ut fiat ' massa, in pilulas xij dividenda. Signa. — One pill to be taken twice or three times a day, as an alterative, in derangement of the liver. Jos. Hartshorne. 89. Pills of Blue Mass and Colocynth. By. Pilulre Hydrargyri, Extracti Colocynthidis Compositi, aa gr. v; Olei Cari, gtt. ij. Misce, et fiant pilulae ij. These constitute an active cathartic. 40. Pills of Calomel and Colocynth. By. Extracti Colocynthidis Compositi, 31 j ; Hydrargyri Chloridi Mitis, 3j. Misce, et divide in pilulas xx. Two or three of these pills will generally act as a cathartic. 41. Pills of Colocynth and Podophyllin. By. Extracti Colocynthidis Compositi, 5ss ; Resinae Podophylli, gr. iij. Misce et divide in pilulas xij. Signa. — Two pills at bedtime. This is an excellent substitute for the officinal compound cathartic pill. One pill acts usually as a laxative, and three pills produce free purgation. R. P. Thomas. 42. Pills of Aloin and Podophyllin. By. Aloin, gr. xxiv ; Resinae Podophylli, gr. xij ; Oleoresinae Zingiberis, rrgjv ; Fiat massa et divide in pilulas xxiv. (Signa. — Dose, one pill as a laxative, two or three pills as a purgative. "The experience of numerous practitioners here and in Europe confirm the utility of aloin as a mild though pretty certain cathartic in doses of two to three grains." B. Parrish, 46 CATHARTICS. 43. Anti-Gout Pill It. Extract] Colchici Acetici ; Extracti Colocynthidis Coinpositi, aa gr. x ; Morphias Acetatis, gr. ijss. Fiat massa in pilulas x dividenda. This is a useful anti-gout pill, adapted to mitigate an actual paroxysm. One pill should be given every two hours, until the bowels and kidneys are acted on. Robert Dick. 44. BecquereV s Anti- Grout Pill. Iy. Quinias Sulphatis, 5\j ; Extracti Digitalis Alcoholici, gr. xv ; Extracti Colchici Acetici, 3ij. Fiat massa et divide in pilulas 1. Signa. — Take one pill every three hours. These pills are highly recommended by M. Trousseau, of Paris, in the treatment of gout. 45. Pills of Extract of Butternut and Jalap. Jfy. Extracti Juglandis, 5ss ; Pulveris Jalapas, 3j ; Saponis, gr. x. Misce, et fiant pilulas xv. Signa. — Three of these may be taken for a dose, and if they do not operate, two more may be safely administered. The extract of butternut, either alone or in combination, is highly recommended as a cathartic in fevers, dysentery, &c, from its tendency to act on the liver. 46. FothergiWs Pills. E*. Extracti Colocynthidis Compositi, 5jss; Antimonii Oxidi, oss. Misce, et divide in pilulas xxx. One of these pills will generally produce a free evacuation ; but two or more may be taken when required. During the last century, the antimonial preparations were held in high repute by the London physicians, and this combi- nation of an antimonial with active cathartics is still regarded with favor. CATHARTICS. 47 47. Mitchell's Aperient Pills. ~Ey. Pulveris Rhei, 3iv ; Pulveris Aloes Socotrinee, 3ij ; Hydrargyri Chloridi Mitis, gr. iv ; Antimonii et Potassse Tartratis, gr. ij. Fiat pulvis, et adde — Saponis, in pulverem contriti, 3ij ; Aquae, q. s. ut fiat massa. Divide in pilulas xl. Signet. — Take one pill every night as a laxative, or three pills as a purgative. J. K. Mitchell. 48. Pills of Elaterium. It. Elaterii, gr. ij ; Extracti Gentianae, gr. xiv. Misce, et divide in pilulas xvj. Signet. — Give one pill every three hours, until free purging takes place. Elaterin, the active principle of this drug, can now be pro- cured in a state of purity ; and as it is more certain in its effects, a formula is subjoined under the head of purgative wines and tinctures. 49. Pills of Oroton Oil. ]$. Olei Tiglii, gtt. ij ; Micas Panis, q. s. ut fiant pilulas iv. Signet. — 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 an- swer every purpose. The following is a more certain and less drastic mode of ex- hibiting the oil. 50. Pills of Croton Oil and Colocyntli. 1^. Olei Tiglii, gtt. ij ; Extracti Colocynthidis Compositi, gr. x. Misce, et divide in pilulas iv. Signet. — Give one pill every two hours, until a purgative effect is produced. 51. Another Form. Hfy. Extracti Colocynthidis Compositi, gr. 1 ; Saponis, gr. x ; Olei Tiglii, gtt. ij. Misce, fiat massa in pilulas xij dividenda. Signa. — Take one pill occasionally, as a laxative. Sir B. C. Brodie. 48 CATHARTICS. 52. Chapman 's Peristaltic Persuaders. Jfy. Pulveris Rhei, 5j ; Pulveris Ipecacuanha, gr. x ; Olei Cari, gtt. x ; Pulveris Acacise, q. s. ut fiat massa. Divide in pilulas xx. Signa. — Take two pills at bedtime, in obstinate constipation. N. Chapman. 53. Chapman's Anti-dyspeptic Pills. 1^. Pulveris Aloes Socotrinse ; Mastiches, aa 5ss ; Pulveris Ipecacuanha, gr. x ; Olei Fceniculi. TiJ^viij. Fiat massa et divide in pilulas xx. Signa. — Take one pill every night at bedtime. These are indicated in cases of dyspepsia attended by habit- ual constipation. N. Chapman. 54. Aperient Pills. 3^. Pulveris Aloes C a pen sis ; Pulveris Rhei, aa 5j ; Pulveris Ipecacuanha, gr. vj ; Saponis, 3j ; Aquae, q. s. Misce et 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. 55. Pills of Aloes and Gentian. 3^. Pulveris Aloes Capensis, 5j '■> Extracti Gentians, 5ss ; Olei Cari, gtt. x ; Syrupi, q. s. ut fiat massa, in pilulas singulas grana qua- tuor pendentes, dividenda. Signa. — Take two or three pills for a dose. The addition of a tonic increases the purgative action of aloes, and diminishes its tendency to griping. &6. Pills of Aloes, Guaiac, and Rhubarb. Ify. Pulveris Gua.iaci Resinse, 5j ; Pulveris Aloes Capensis, gr. xxxvj ; Pulveris Rhei, 5'j ; Terebinthinse 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. CATHAKTICS. 49 57. Pills of Rhubarb and Sulphate of Iron. 3^5. Pulveris Rhei, 5jss ; Ferri Sulpliatis exsiccatae, 5ss ; Saponis, 3ij. Aquae destillatae, q. s. ut fiat massa in pilulas xl dividenda. The intention of these pills is to remove costiveness, and impart tone to the bowels. Three may be taken for a dose at bedtime. S. P. Gkiffitts. 58. Pills of Ox G-all. 3$j. Fellis Bovini inspissati, 5ij ; Olei Cari, gtt. x ; Magnesiae Carbonatis, q. s. ut fiat massa in pilulas xxxvj dividenda. Signa. — Take two pills three times daily. Clay. 59. Another Form. 3^. Fellis Bovini inspissati, 3ij ; Pulveris Zingiberis, 3j. Fiat massa, in pilulas xx dividenda. Signa. — Take two pills every night at bedtime. This preparation has proved highly serviceable in some cases of habitual constipation, with an occasional tendency to bilious colic. Being a feeble cathartic with toDic properties, it may be used for a long time without detriment. CONFECTIONS AND ELECTUARIES. 60. Lenitive Electuary and Cream of Tartar. ]^. Confectionis Sennae, §ij ; Confectionis Aurantii Corticis, 5ij ; Potassae Bitartratis, 5\j. Misce et fiat electuarium. Signa. — Take a piece the size of a marble, night and morning. Used in habitual constipation. 61. Confection of Senna, Sulphur and Nitre. 3^. Sulphuris loti, §jss ; Confectionis Sennae, §ij \ Potassae Nitratis, 5j ; Syrupi Aurantii Corticis, q. s. ut fiat confectio. Signa. — One or two drachms to be taken twice a day. Used in hemorrhoidal affections. 4 50 CATHARTICS. 62. Electuary of Senna and Figs. R. Pulveri- Sennae, Ssa : Pulpae Ficus. quantum sufficit ut fiat electuarium. Signa. — A piece the size of a marble, night and morning, in costivene.-s. 63. Electuary of Jalap, Nitre, frc. R. Pulveris Jalapae, Potassae Bitartratis, Potassae Nitratis, aa §ss : Confectionis Sennae. 5j : Syropi, q. s. at fiat electuarium. Signa. — A bolus the . nut may be taken : times a day. This preparati ioed considerable celebrity as a popular remedy for hemorrhoids. 64. Electuary of Si - . :>.c, £c. ^j. Sulphuris Tori. §ij ; Potassae Bitartratis. .^j ; Pulveris Guaiaci Resinae. 5j ; Pulveris Rhei. oj ; Spiritus Myristicae, f 5y • Mellis, quantum sumo::, at fiat electuarium. Signa. — Take a teaspoonful morning and evening. Thi has long been used successfully in England in the treatment of chronic rheumatism. EMULSIONS AND MIXTURES. 65. Castor Oil or " 01 incus" Mixture. R. Pulveris Acacia?, 5iijj Aquae. fSij. Tere simul. et add ;tim — Olei Ricini. 5j- Dein adde, Aquae Cinnamomi, f.^i. Misce Becandam artem. Signa. — Take a tablespoonful every two hours. This is one of th< Lisagreeable modes of administering this nauseous but valuable medicine. CATHARTICS. 51 66. Another Form for Children. Ify. Olei Ricini, 5ij ; Vitellum unius Ovi; Aquae Foeniculi, Aquae Menthae Viridis, aa f Sj. Fiat emulsio. Signa. — Give a teaspoonful morning and night to a child three months old. 67. Mixture of Oil of Turpentine. ]^. Olei Terebinthinae, 5j ; Pulveris Acaciae, Sacchari, aa §ss ; Aquae Menthae Piperitae, f §iv. Misce. Signa. — A tablespoonful every two hours until it operates. This preparation must be made in the same manner as the oleaginous mixture. 68. Another Form. "Jfy. Olei Terebinthinae, oj ; Olei Cinnamomi, gtt. iv ; Vitellum unius Ovi. Tere simul, et adde gradatim — ■ Misturae Amygdalae, f§iv ; Syrupi Aurantii Oorticis, foij» Misce, et fiat emulsio. Signa. — Take a tablespoonful every two hours. 69. Oleaginous Mixture with Oil of Turpentine. Ify. Olei Ricini, ojss ; Vitellum unius Ovi ; Sacchari, 5'j ; Olei Terebinthinae, §ss ; Aquae Menthae Piperitae, f§iv. Misce secundum artem. Signa. — A large tablespoonful may be taken every hour or two* 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 pre- liminary remedies. B. Ellis. 52 CATHARTICS. 70. Mixture of Croton Oil. R. Olei Tiglii, t#lj ; Mucilaginis Acacise, Aquae destillatae, aa foj. Misce. Signa. — Take a teaspoonful every two hours until it operates. 71. Saponaceous Mixture of Croton Oil. It. Olei Tiglii, trgyiij; Potassae, gr. vj ; Aquae destillatae, f3\j« 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. Conwell states that four drops of croton oil rubbed on and around 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. 72. Mixture of Extracts of Podophyllum and Leptandra. i^. Extract! Podophylli Fiuidi {Tliayer), Extracti Leptandrae Fiuidi [TTiayer), aa f5ij ; Syrupi Zingiberis, f Sss. Misce. Signa. — Dose, a teaspoonful. The mandrake or May apple (Podophyllum peltatum), is the most certain and active of our indigenous cathartics. Culver's root (Leptandra Virginica) is also purgative with a reputed specific tendency to the liver. By a combination of the two, prompt and copious purgation is produced ; the action of the remedies, if given in large doses, being attended with nausea and griping unless they are combined with some aromatic or carminative. 73. Solution of Epsom Salts and Tartar Emetic, ~fy. Magnesiae Sulphatis, §j ; Antimonii et Potassae Tartratis, gr. ss ; Aquae destillatae, f Siij ; Succi Limonis recentis, fgj. Misce, et fiat solutio. A tablespoonful to be given every two hours until it operates. Or one half may be taken as a purgative dose. CATHARTICS. 53 74. Solution of Epsom Salts with Jalap and Nitric Acid. 1^. Magnesias Sulphatis, §ss ; Tinctures Jalapas, f 5j ; Acidi Nitrici, gtt. ij ; Aquae Menthas Viridis, f§ij- Misce. Signa. — To be taken for a draught. The nitric acid destroys in part the bitter taste of the salt. 75. Compound Mixture of Carbonate of Magnesia. 3^. Magnesias Carbonatis, 5ss ; Magnesias Sulphatis, 5iij ; Spiritus Ammonias Aromatici, f 5j ; Tincturas Rhei, f §ss ; Tinctures Hyoscyami, f5ss; Aquas Menthas Viridis, f giv. Fiat mistura. Signa. — A tablespoonful to be taken two or three times a day. C. D. Meigs. 76. Mixture of Magnesia and Rhubarb. 3^. Magnesias, 5ss ; Pulveris Rhei, gr. ij ; Sacchari, 5j ; Spiritus Menthas Piperitas, gtt. vj ; Aquas destillatas, f Sjss. 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 children, in which it is very serviceable. Laudanum can be added according to the age and condition of the patient. 77. Mixture of Magnesia and Blue Pill. Ify. Magnesias, Sjss ; Pulveris Acacias, Sacchari, aa 5\j ; Pilulas Hydrargyri, gr. viij ; Olei Anisi, gtt. iv ; Aquas, fgiv. Misce. Signa. — To take a tablespoonful every two hours until it ope- rates freely. An alterative cathartic. 54 CATHARTICS. 78. Mixture of Magnesia and Colchicum. Iy. Magnesiae, 5j ; Sacchari, Pulveris Acaciae, aa 5j > Aquae destiilatas, f§iv ; Vini Colchici Radicis, gtt. xl. Fiat mistura. Signa. — 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. 79. Scudamore s Mixture. R. Magnesiae, ^iv ; Magnesiae Sulphatis, §j ; Aquae Menthae Viridis, f §v ; Aceti Colchici, f S^s ; Syrupi, fgj. Fiat mistura. Dose, a tablespoonful every two hours. Chiefly used in gouty paroxysms. Sir C. Scudamore. 80. Acid Solution of Ver atria. ]fy. Veratriae, gr. j ; Acidi Sulphurici Aromatici, gtt. v ; Aquae destillatae, fS'j. Fiat solutio. Dose, a teaspoonful. This solution is said to be a good sub- stitute for the Eau Medicinale of Husson, in gouty affec- tions. Magendie. 81. Mixture of Fluid Extract of Butternut. 1^. Extracti Juglandis Fluidi (Thayer), f5j ; Syrupi Zingiberis, f 5ij ; Aquae, f'Sss. Misce. Signa. — Take one-half as a draught. The butternut is a mild cathartic, operating usually without pain or griping. It is adapted to cases of habitual constipation. 82. Purgative Mineral Water. Bf. Liquoris Magnesiae Citratis, f §xij. Signa. — Take a teacupful every two hours until it operates. CATHARTICS. 55 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 syrup. Half an ounce of the neutral salt of citrate of magnesia constitutes a dose. 83. Purgative Soda Water. 3^. Sodae Carbonatis Crystallisatae, Six ; Acidi Tartarici, 5vi ; Aquae, f §x ; Syrupi Limonis, fojss. Misce in ampulla vitrea et adjice — Sodae Bicarbonatis, 5ss. Signa. — To be taken by draughts of a wineglassful every two hours. Prof, J. Lawrence Smith published a formula for purgative soda water, as prepared by him on a large scale, from which the above is condensed. As a purgative, it is mild and certain, producing watery evacuations. 84. Fluid Extract of Senna, Ginger, fyc. Ify. Extracti Sennae fluidi, f 5ij ; Extracti Rhei fluidi, f 5j ; Syrupi Zingiberis, f 5v ; Aquae, fSj. Misce. Signa. — Dose, a tablespoonful. This is an efficient mixture, operating without much pain. The dose should be repeated every four hours until a purgative effect is produced. 85. Mixture of Sulphate of Potassa and Jalap. I$$. Potassae Sulphatis, 5\j ; Aquae, f §vss ; Tincturae Jalapae, f §ss. Mat solutio. Signa. — Take a tablespoonful every two hours. A mild pur- gative, and deobstruent. ? A . r i. :. . I " ?, INFUSIONS AND DECOCTIONS. V A Jr. -;.: ;-' A. : : .: .: A AA:*. — £''..::'■: L ■ ~ ::.:'.:. K. £ ...... A -. >. ' A-A~_:is. 0;. Macera per horam imam, cola, et adde — Magnesias Solphatis, §y. Solve. :. — A:".:::: -- - _ _~ ... . T - . -' - - - -Li- ST. i ■-' ;.;•; ;-' .>•; »'. ~. .: . >.:'r?. ■:■ ; . Enl Sennae, f5^j; In ::-:::- --l- - JY.sis PA IS"! . £.5:; : ..:.:. 5:; : A r S "/A- As. ~y-\ : A -.::e -■_ :"_::.t ir: As. A .: - A: .:".A: :-. "I f.yss. A : - : .- ;.:. — '.':.T-..A: :: :~ Tiirfi. :";: . A—. ii.i rfTriTrl A i: :. : t c ::, : : : " . : " : . : s ~ -\ ; :. ~~ .~ :■ ; zin : - t r -e-s :t:i t: : r. : : :"_r B. . S -: : . ..." ::- :.■:. : " :':■:■■. :~ •>'-. : :.: .:".." AT.:-. . .:. Aquae buUientif fgviij. >:; . — . :.7-._ .: : •; -e t.eAtL \: :-. A.v.:A-:: iiA A" AsAz- ' . '. - : - - - -.■ . : ... ' ;■-■..■.■. 1. : : - . x ;-. A': .'. .'::': .'-?''. ■ - - ; -' "'..'" A.' 7 : ':.:. E,. PrirA. 5:ij; I - S C: ',':..- :-> '.. 'A. -: : -A ... SigiML. — Dose, a wineglassfnl at bedtime. A. :: ."A: z :As ..:::::: :.. :A :■: A^r. A: ^A. "A:;-;' A :L~ : A :A.A ::::.>::: A — :.:.:.. '::..'. ~:~::r7 ':- ;-:::-?: unA". near the close of the process. This forms a good laxative Dregnant women. CATHARTICS. 57 90. Infusion of Senna, Rhubarb, and Manna. Ify. Sennse, 5vj ; Mannae, 5iv; Rhei contusi, Cardamomi, aa 5\j ; Aquae bullientis, Oj. Macera per horam unam et cola. Signa. — Dose, a wineglassful every two hours, until it operates. 91. Alkaline Mixture of Aloes. ^. Aloes Capensis, Sijss; Sodae Bicarbonatis, §vj ; Aquae, Oiv ; Spiritus Lavandulae Compositi, fSij. Misce. Macera per dies quatuordecim et cola. Signa. — Dose, a teaspoonful after each meal. This is an excellent preparation for Hospital or Dispen- sary practice. It is particularly serviceable in cases of dyspepsia, attended with acidity of the stomach and torpor of the liver and bowels. J. P. Mettauer. WINES AND TINCTURES. 92. Wine of ColcMcum Root and Laudanum. II. Yini Colchici Radicis, fSjss ; Tincturae Opii, f5\j- Misce. Signa. — Give twenty drops every three hours. The preparations of colchicum often occasion vomiting and purging, if given alone ; but when combined with small quantities of opium or morphia, as above, these effects are pre- vented, while the specific property of colchicum to control gout and rheumatism seems to be increased. Eisenman. 93. Tincture of Veratria. 1^. Yeratriae, gr. iv; Alcoholis, f§j. Eiat tinctura. This may be given in doses of ten, fifteen, or twenty drops, in a wineglassful of sweetened water. It is de- signed as a substitute for the wine of colchicum, in drop- sies, gout, rheumatism, &c. 58 ENEMATA. The tincture of veratria is also recommended as an ex- ternal application in the diseases above mentioned. Veratria is poisonous, and, therefore, to be administered with great caution. 91. Tincture of Elaterin. 1^. Elaterin, gr. j ; Alcoholis, f§j. Solve ; dein adde — Acidi Nitrici, gtt. iv. Misce. Signa. — Dose, twenty to forty drops in a tablespoonful of cinnamon water. Used as a hydragogue cathartic in drop- sies. Morries. ENEMATA. Enemata, used either as auxiliaries to, or substitutes for cathartics, very properly succeed that class of remedies. They are employed to fulfil other indications, and the different preparations will be noticed under their appropriate heads. It is usual to direct three times the quantity of the medicine to be given for an enema that is required for a dose by the mouth. For the purpose of procuring a dis- charge from the bowels, this rule may generally be ob- served ; but in some of the powerful remedies occasionally administered, as opium and tobacco, it might be attended with serious consequences. When using these active drugs, it is better to give only double the quantity. The bulk of the enema also varies according to the object we have in view. If purgation is to be effected, the subjoined proportions afford a good rule ; but if the remedial agent is to be retained for some time, a small amount is obviously indicated, lest the mere bulk of the injection cause an imme- diate discharge. The following are the proportions recommended by Pro- fessor Chapman in the ordinary enemata for persons of dif- ferent ages : A child between the ages of one and five years, from fgiv to fSyj. A youth of ten or fifteen years, half a pint; and an adult, from a pint to a quart, according to cir- cumstances. In all cases, a warm folded towel should be firmly pressed against the anus for fifteen minutes after the injection is thrown up. ENEMATA. 59 95. Castor Oil, Molasses, and Salt Enema. II. Olei Ricini, f§ij ; Syrup i Fusci, f§ij ; Sociii Chloridi, Sj ; lufusi Lini tepidi, Oj. Fiat enema. One-half to be administered at once, and the remainder in half an hour, if the first produces no evacuation. The chloride of sodium is an active ingredient. In fact, there is no better enema than simple salt and water at the ordinary temperature ; and sea-water fresh from the ocean answers the same purpose. 96. Soap Enema. II. Saponis Vulgaris incisi, Sj ; Infusi Lini tepidi, Oss. Misce pro enemate. This is an eifectual clyster in cases of flatulence and im- pacted feces. 97. Ox Gall Enema. 1^. Fellis Bovini spissati, 5\j ; vel Fellis Bovini recentis, f Sj ; Aquae tepidae, Oj. Misce. Signa. — Use for an injection, in cases of obstinate constipa- tion and hardened feces. 98. Enema of Oil of Turpentine. Tfy. Olei Terebinthinee, f Sss ; Vitellum unius Ovi. Tere simul, et adde, gradatim, Decocti Hordei tepidi, f §x. Used as a stimulating injection. Guy's Hospital Pharm. 99. Enema of Senna and Epsom Salts. ty. Infusi Sennse, Oj ; Magnesise Sulphatis, gij. Misce. — One-half to be exhibited as an enema, and the re- mainder if necessary in half an hour. 60 SUPPOSITORIES. 100. Enema of Tobacco. 1^. Tabaci, 5j ; Aquae bullientis, Oj. Macera per sextain horse partem et cola. One-quarter or one-half of this infusion may be used as an injection ; and, if necessary, the same quantity may be given in half an hour. Employed for strangulated hernia, obstinate colic, spasm of the urethra, and for the reduction of disloca- tions. Guy's Hospital Pharm. SUPPOSITORIES. (From Supporter e^ to put under.) Suppositories constitute a class of remedies that has hitherto been little used by American practitioners. They are solid ; round, cylindrical, or conical in form ; and intended for intro- duction into the anus. They are prepared by mingling seda- tive, astringent, or purgative medicines with cocoa-butter, suet, soap, or thick honey. When made with suet, or cocoa-butter, these substances should be melted, at a gentle heat, with an eighth or a twelfth of white wax, according to the season of the year. The medi- cinal agent is added, and the fluid mass poured into metallic cones, to cool and become solid. A suppository should weigh from twenty grains to two drachms, and be as large as the end of the little finger. Purgative suppositories are larger than those of an anodyne character. By the heat of the body, the suet or cocoa-butter is softened, and the remedial agent is thus permitted to develop its effects. Soap suppositories are formed by cutting soap into conve- nient shapes. Suppositories with honey are prepared by boil- ing down this substance, till it becomes sufficiently thick to retain its shape when cool. 101. Laxative Suppository. R. Saponis, §ij ; Sodii Chloridi, oj ; Mellis spissati, q. s. ut fiat massa, in suppositoria singu- las 5y pendentes, dividenda. Signa. — Introduce a suppository every morning. Spielmann. SUPPOSITORIES. 61 102. Another Form. Jfy. Pulveris Aloes Socotrinse, 5vj ; Sodii Chloridi, Saponis, aa Sjss ; Amyli, gviij ; Mellis, q. s. Contunde in massam, in suppositoria singulas 5ij pendentes, dividendam. In the original formula, the size of the suppository is not specified, that being left to the judgment of the prescriber. Cod. Hambebgensis. 103. Rhubarb Suppository. 1^. Saponis, 5iij ; Extracti Rhei Alcoholici, 5ss. Contunde in massam, et fiant suppositoria iij. Signa. — Use one suppository at bedtime. Radius. CLASS III DIURETICS. The rules for the administration of this class of remedies are few and simple. Where there is much arterial excitement, a judicious use of the lancet should precede the employment of diuretics, and the patient be kept cool to avoid perspiration. In order to insure the full effect of diuretics, diluent drinks should be freely given, and especially those containing some diuretic medicine. POWDERS. 104. Powder of Squill and Nitre. 1^. Pulveris Scillse, gr. vj ; Potassae Nitratis, 5j- Misce, et fiant pulveres vj. Signa. — One to be given three times a day in sugar and water. Some aromatic, such as cinnamon, may be added to this pre- paration if the stomach is irritable. Employed in dropsies. 105. Powder of Nitre, Cream of Tartar, and Tartar Emetic. Ify. Potassse Nitratis, §ss ; Potassre Bitartratis, Siv ; Antimonii et Potassse Tartratis, gr. j. Tere simul et fiat pulvis. Signa. — Take a teaspoonful three times daily. This combination is designed for cases of acute gonorrhoea. The free administration of saline diuretics in this disease often effects permanent cures. J. Neill. 106. Powder of Uva Ursi and Soda. Ify. Pulveris Uvae Ursi, 5jss ; Sodse Bicarbonafrs, 5j- Misce, et divide in chartulas xij. Signa. — One three times a day in sugar and water. In nephritic complaints and affections of the bladder. DIURETICS. 68 107. Poivder of Ergot and Cuhebs. 3^. Pulveris Ergotse, 3ij ; Pulveris Cubebse, §j ; Pulveris Cinnamonii, 5ss ; Sacchari, 5j. Divide in pulveres viij. Signa. — One maybe given three times a day. In leueorrhoea and gleet. Dr. Ryan. 108. Powder of Squill, Cream of Tartar, $c. 3^. Antimonii et Potassse Tartratis, gr. ij ; Pulveris Scillse, 5j ; Potassse Bitartratis, Sjss; Potassse Sulphatis, §ss. Fiat pulvis, et divide in partes xx sequales. Signa. — Take one powder four times daily. This combination produces copious watery stools, together with a considerable flow of urine ; properties that render it valuable in cases of general dropsy. Eberle. 109. Powder of Podophyllin and Cream of Tartar, 3^. Resinse Podophylli, gr. iv ; Potassse Bitartratis, 5hj« Misce, et divide in pulveres viij. Signa. — One powder every two hours. Profuse watery evacuations result from the employment of this compound. It also acts as a diuretic. V. C. Howe. 110. Powder of Colcliicum and Cream of Tartar. 3^. Pulveris Colchici radicis, 5ss ; Potassse Bitartratis, 5ij- Misce, et divide in pulveres vj. Signa. — One powder every four hours. This combination is very serviceable in acute rheumatism. Purging usually results from its employment. Sometimes the pulse becomes slow or irregular. J. Jackson. PILLS. 111. Pills of Squill and Calomeh 3^. Hydrargyri Chloridi Mitis, Pulveris Scillse, aa gr. xij ; Confectionis Rosse, q. s. ut fiant pilulse xij. 64 DIUKETICS. • Signa. — One night and morning, in dropsies depending upon visceral derangement. This preparation is one of the most celebrated of the diur- etics, especially when disease of the liver is the cause of effu- sion. When the calomel affects the mouth it should be omitted, and the squill combined with some other diuretic. 112. Pills of Digitalis, Calomel, and Opium. ]^. Pulveris Digitalis, gr. xij ; Hydrargyri Chloridi Mitis, gr. vj ; Pulveris Opii, gr. iv ; Confectionis Rosae, q. s. ut fiant pilulae xij. Signa. — One to be taken every eight hours. In hydrothorax and ascites. 113. Pills of Copaiba and Cubebs. 1^. Cerae flavag, gr. xv. Liquefac cum leni calore, dein adde — Copaiba, gr. xxx ; Pulveris Cubebae, 5j- Misce intime et divide in pilulas xxx. Signa. — Two pills every four hours. This furnishes a good mode of exhibiting copaiba and cubebs in small quantities, as in chronic diseases of the bladder, or irritability of the urethra. J. M. Maisch. 114. Pills of Extract of Dandelion and Blue Mass, 1^. Extracti Taraxaci, 5ss ; Pilulae Hydrargyri, gr. x. Misce et fiant pilulae x. Signa. — One to be taken morning, noon, and night. In dropsy complicated with disease of the liver. 115. Granules of Digitalin. Jfy. Digitalini, gr. j ; Sacchari, 5j ; Aquae, q. s. Fiat massa et divide in pilulas lx. Signa. — Take one granule four times daily. Prescribed in dropsy as a substitute for digitalis. Homolle. DIURETICS. 65 116. Pills of Digitalis, Squill, and Juniper. Tfy. Pulveris Digitalis, 3j ; Pulveris Scillae, 5ss ; Olei Juniperi, gtt. viij ; Syrupi, q. s. ut fiat massa, in pilulas xij dividenda. Signa. — Take one pill three times daily. Used in dropsy. Pearson. 117. Pills of Digitalis, Squill, and Blue Mass. Ify. Pulveris Digitalis, gr. v; Pulveris Scillae, gr. x ; Pilulae Hydrargyri, 5^s. Fiat massa, et divide in pilulas x. Signa. — Take one pill three times daily. This combination was highly recommended by the late Dr. Baillie, of London, as an alterative and diuretic in anasarca. INFUSIONS AND DECOCTIONS. 118. Infusion of Digitalis and Sweet Spirit of Nitre. 1^. Digitalis, 5j ; Aquae bullientis, Oss. Macera per horas tres, cola, et adde— Spirit us iEtheris Nitrosi, f§j. Signa. — Dose, for an adult, half a tablespoonful three times a day. The prostrating effect of digitalis should always be kept in mind by the practitioner; and the rule, that when it acts upon the stomach, the bowels, the pulse, or the kidneys, it should be discontinued, cannot, when we consider the power of the arti- cle, be too scrupulously observed. Ellis. 119. Infusion of Juniper Berries and Cream of Tartar. ^. Juniperi contusi, Sjss ; Aquae bullientis, Oj. Macera per horas duas, in vase leviter clauso, et cola. Dein adde — Potassae Bitartratis, Sj. Mi see. Signa. — Be careful to shake the bottle well before using. Of this, a teacupful may be taken four or six times a day; adding to each 40 drops of the sweet spirit of nitre. Em- ployed in general and local dropsy. 5 66 DIURETICS. 120. Another Form. R. Juniperi eontusi, giv : Aquae bullientis. f 5xij : Spiritus Juniperi (Holland Gin), fgiv. Macera per koras duodecim et exprime. Signa. — Take a wineglassful. mixed with a teaspoonful : cream of tartar, three times a day. This is an excellent mode of administering a favorite diu- retic, in cases of dropsy, in which a little stimulation would be admissible. W. PROCTER, Jr. 121. Infusion of Parsley Root. R. Petroselini. §j ; Aquae bullientis. Oj. Fiat infusum et cola. A teacupful may be taken with a teaspoonful of sweet spirit of nitre, every three or four hours. A popular and very useful remedy for strangury, arising from blisters. It is also an efficient diuretic in dropsies. 122. Infusion of Scabious or Fleabane. R. Eris:erontis. 5i '• Aquae bullientis. Oj. Macera per horas dnas, et cola. A pint of the tea should be taken dailv. Xitre or anv other diuretic may be added. Prescribed in calculous and ne- phritic affections, in strangury, irritable bladder. &c. 123. Infusion of Uva Ursi. R. Uv?e Ursi. 51 ; Aquae bullientis. Oj. Macera per horas duodecim. et cola. To be taken cold, from half a pint to a pint, daily. Chiefly used in gonorrhoea and irritable bladder. 124. Infusion of Dandelion, tie. R. Infusi Taraxaci. f§iv; Extracti Taraxaci. 5\j • Sod^e Carbonatis. 5s& ; Potass^ Tartratis, o : ij ; Tincturae Rhei, foiij ; Tincturae Hyoscjami, gtt. xx. Fiat mistura. Signa. — One-third part to be taken three times a day. Id dropsical and visceral affecti -. C. D. Mei DIURETICS. 67 125. Spirituous Decoction of Pipsissewa. Jfy. Chimaphilae, 5ij ; Aquae bullientis, Oj. Coque ad fovj, cola, et adde — Spiritus Juniperi Compositi, fSij. Misce. Signa. — Dose, a tablespoonful every two or three hours, with diluent drinks. In dropsy accompanied by debility. 126. Decoction of Cahinca. 1^. Radicis Caincae, §j ; Aquae bullientis, Oij. Coque ad Oj, et cola. Signa. — Dose, a tablespoonful three times a day. Used in dropsy. This root is derived from the Chiococca Anguifuga, a Bra- zilian plant, which has of late been extensively and effica- ciously employed in Europe. It occasions watery evacuations and diuresis, whence its use in dropsy. — Dunglison, Neiu Remedies, p. 148. 127. Decoction of Indian Hemp. 1^. Apocyni Cannabini, §ss ; Aquae, Ojss. Coque ad Oj, et cola. Signa. — Take a wineglassful three times a day. This has been found useful in general dropsy, acting as a hydragogue cathartic, and as a diuretic. The diuretic pro- perties of the decoction will be increased by the addition of an ounce of juniper berries to each pint. Griscom. The young practitioner must carefully distinguish between preparations of the native drug under consideration {Apocy- num Cannabinum), and the powerful, imported extract of Cannabis Sativa; as, unfortunately, they both bear the same trivial name of Indian Hemp. Dr. Hiram Corson remarks, " I have been in the practice of using the apocynum for more than twenty years, as a remedy for dropsy, and think highly of it." rS dit: z: : : ; . ll!". I'. ■;;:•::'.■ : " P : P \: . P : ". A quae b allien tis, Oiij. Coque, leni calore, ad Oj, et cola. Sigtva. — Take a wineglassfol every two hours. ira Brava has a great influence over chronic inflam- mation of the bladder, lessening very materially the secretion of the ropy mucus, which is itself a very great evil, and, I . diminishing the inflammation and irritability of the bladder also." S:?. 1 1 :::_. B LUTIONS AND MIXT 1 29. Tineture of Digitalin. E. Di ritalini, gr. ij ; jholis diluti, f Sj- Fiat solutio. .>:'/■ ;.:. — Z:P.~ :~l i~::;. ; :l r-T::::: ^::-r. :;::: ::~t= :A:>. i drops of this solution are equivalent to one-fiftieth of rrain of digitalin, and, consequently, the dose may be gradually increased until the peculiar effects of digitalis are i-rVr'. ::: t A 130. Odor Mixture. R. Juniperi contusi, Z r.z. . - - ; . ~~. -j- : -elini, aa 5j ; Sued fermenti pomorum, Oij- Macera per diem unam, et cola. — i i ineglassful may be taken three or four times a The above compound was recommended by the late Dr. Jos. Parrish, in cases of general dropsy which admit of stimula- a, and in which the urinary secretion is deficient. The cider Eh: .:". .1 'n AA :.:. 1 = :ur. :. Mixture of OH of Jumper. Pw. Olei JiiDi) Tincturae Digitalis, £ 3e. a. — Give thirty drops every three hours. DIURETICS. 69 This is the formula of the " diuretic drops," celebrated in Germany as a diuretic remedy, and used in all cases in which medicines of this class are indicated. Hufeland. 132. Diuretic Wine. 1^. Juniperi contusi, 5x ; Pulveris Digitalis, 5'j ; Pulveris Scillae, 5j ; Vini Xerici, Oj. Macera per dies quatuor, et adjice — Potassae Acetatis, 5hj. Exprime et cola. Signa. — Dose, a tablespoonful three times daily. This preparation is employed in'THotel Dieu de Paris," and is found to be an efficient diuretic. Trousseau. 133. Mixture of Juniper, Squill, S^c. Ify. Potassae Acetatis, 5v ; Potassae Bicarbonatis, 5j ; Aquae, foxij ; Tincturae Scillae, f 5j ; Spiritus Juniperi Compositi, f 5J. Fiat mistura. Signa. — Take two tablespoonfuls three times a day. Employed in dropsy. Brown. 134. Mixture of Digitalis, Acetate of Potassa, £c. 1^. Infusi Digitalis, f §iv ; Potassae Acetatis, 5'j ; Spiritus iEtheris Nitrosi, f 5ij ; Aquae Cinnamomi, f Sjss. Fiat mistura. Signa. — Take a tablespoonful every four hours. Recommended in the treatment of dropsy supervening upon cardiac disease. Kilgour. 135. Another Form. 1^. Infusi Digitalis, f giv ; Tincturae Digitalis, f 5j ; Potassae Acetatis, 5j ; Tincturae Opii, gtt. x. Fiat mistura. Signa. — Half a tablespoonful four times a day. 70 DIURETICS. 136. Mixture of Cantharides and Sweet Spirit of Nitre. 3^. Tincturae Cantharidis, Spiritus iEtheris JSTitrosi, aa gtt. lx ; Sacchari, 5j ; Aquae Menthae Viridis, f§ij. Fiat mistura. Signa. — A teaspoonful may be taken every three hours, desist- ing if strangury should supervene. A stimulant diuretic. Used in atony of the bladder. 137. Mixture of Oil of Turpentine. Tfy. Olei Terebinthinae, rrgc ; Pulveris Acaciae, Sacchari, aa 5j ; Aquae Menthae Viridis, fgiv. Fiat mistura. Signa. — A tablespoonful four or five times a day, aided by some diuretic drink. This remedy is used with great benefit in nephritic com- plaints, and especially in the passage of calculi through the ureters. 138. Mixture of Benzoic Acid, Sfc. Tfy. Acidi Benzoici, 3iv ; Spiritus Juniperi Compositi, foss; Syrupi Tolutani, f Sjss ; Aquae, fgij. Fiat mistura. Signa. — Give a dessert-spoonful every four hours. This combination is recommended in the phosphatic variety of gravel. It is also useful in the treatment of diabetes. 139. Mixture of Taraxacum, Cream of Tartar, frc. "Sf. Potassae Bitartratis, 5'j ; Mucilaginis Acaciae, f 5j ; Aquae, f gij ; Spiritus iEtheris Nitrosi, Extracti Taraxaci Fluidi, aa f §ss. Misce. Signa. — A dessert-spoonful every four hours. Used in dropsy attendant upon or associated with disease of the liver or portal system. DIURETICS. 71 140. Mixture of JElaterium, Colchicum, $e. R. Elaterii, gr. j ; Spiritus iEtheris Nitrosi, fgij ; Tincturae Scillse, f oSS ; Aceti Colchici, f 5ij ; Syrupi, f gj. Fiat roistura. Signa. — Take a teaspoonful four times a day in a little water. Dr. Ferriar recommends the above in the several forms of dropsy, and more especially in hydrothorax. 141. Mixture of Colchicum, Squill, and Tobacco. R. Oxymellis Colchici, Dub., Oxymellis Scillse, Phar. 1850, Vini Tabaci, aa f Sss. Misce. Signa. — Take a small teaspoonful in a little water four times a day. If requisite, sweet spirit of nitre may be added in the same quantity. This forms the diuretic drops of Dr. Ferriar, and requires to be given with great circumspection. 142. Hydragogue Draught of Dr. Ferriar. 1^. Gambogise, gr. iv ; Spiritus iEtheris Nitrosi, f 5j ; Tincture Sennse et Jalapse [Phar. 1850), f 5ij ; Syrupi Rhamni, Ed., Aquae Menthse Viridis, aa f gss. Misce et fiat haustus. Dr. Ferriar observes that, in some cases of hydrothorax attended with imminent danger of suffocation, he has afforded immediate relief by the above draught. 143. Tincture of Colchicum and Digitalis. Ify. Tincture Colchici, Tincturse Digitalis, Spiritus iEtheris Nitrosi, aa foj. Misce. Signa. — Dose, twenty drops on a lump of sugar. Given as a diuretic in dropsy and hydrothorax. HlLDENBRAND. 72 DIURETICS. 144. Mixture of Citrate of Potassa. Squill, fie. K. Potassse Carbonatis Purae, 5j ; Succi Limonis. q. s. ad saturanduni ; Tincturse Scilla?. fSss ; Tincturse Opii, tt^xxx ; Aqua? Cinnarnomi, f 5iv. Misce. Signa. — A tablespoonful every three hours throughout the day. The vinegar or oxymel of squill, if preferred, may be sub- uted in this preparation. We use the tincture because it is more uniform, and less liable to spontaneous changes. 145. Mixture of the Acetate of Potassa, and Spirit of Min- clererus. i[ . Liquoris Ammonias Acetatis, f§ij ; Potassas Acetatis. .ji/j. Misce. Signa. — A tablespoonful every three hours for a dose. Recommended for gravel and lithic acid deposits. 146. Mixture of Buchv. and Acetate of Potassa. R. Extracti Buchu Fluidi. f.5ss; Potassae Acetatis, 5ij ; Syrupi, f 5Jss ;. Aquae, f§iv. Misce. Signa. — A tablespoonful every four hours. This is an excellent diuretic combination, and irs value may he farther enhanced by the addition of sweet spirit of nitre. Morton. 147. Mixture of Urea. I$>. Ureas. 5j : Aqua?, fgijss ; ^ Syrupi Aurantii Corticis, f.^ss. I 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 • x CD %/ cool. The dose may be augmented to a scruple or more. Used in dropsy and albuminuria. T. H. Tanner. DIURETICS. 73 148. Mixture of Buehu and TJva Ursi. 1^. Extracti Buchu Fluidi, Extracti Uvae Ursi Fluidi, aa f 5\j ; Syrupi Acacise, f §ss ; Aquce Menthse Viridis, f Sj- Misce. Signa. — A dessert-spoonful every three hours. Used in blennorrhoea, atony, and paralysis of the bladder. 149. Mixture of Copaiba. 1^. Copaibae, oSS ; Spiritus iEtheris Nitrosi, f §ss ; Pulveris Acacia, 5y ; Sacchari, 5j ; Aquae destillatae, f §iv ; Spiritus Lavandulae Composite, f 5ij ; Tincturae Opii, f 5j. 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 compound tincture of gentian. The balsam collects into a globule and is surrounded by the tincture, which, leaving its taste in the mouth, covers that of the nauseous balsam. Ellis. 150. Mixture of Copaiba, Cubebs, $c. 1^. Copaibae, Pulveris Cubebae, aa Sss ; Acaciae, Sacchari. aa 5\j j Aquae, f gvij ; Tincturae Opii Camphoratae, f Sss. Misce secundum artem. Signa. — A tablespoonful every three hours. We have found this remedy, in some obstinate cases of gon- orrhoea, more efficacious than the preceding formula. The tincture of cubebs may be substituted for the powder, if desir- able. 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. G. Morton. 74 DIURETICS. 151. Another Form. R. Copaibae, ojss ; Mucilaginis Acaciae, f.5v; Olei Liruonis, gtt. vj : Tincturae Cubebse, f 5j ; Spiritus JEtheris Nitrosi, f §S8. Fiat mistura. Signa. — Take a tablespoonful three times a day, in gonor- rhoea. J. Randolph. 152. Compound Mixture of Copaiba. R. Olei Copaibas, f 5j ; Alcohol is, Aquae Menthae Piperitae, Syrupi, aa f .5ss ; Spiritua ^Etheris Nitrosi, foss. Fiat mistura. Signa. — To be taken during the day in four doses, followed by demulcent drinks. In chronic gonorrhoea. 153. Another Form. [Lafayette Mixture.) 1^. Copaibae, oj ; Liquoris Potassae, fSij- Tere simul et adjice — Spiritus iEtheris Nitrosi, f oj ; Spiritus Lavandulae Compositi, f o\j ; Syrupi Acaciae, f 5iv. Misce. Signa. — A tablespoonful three times a day. Used in gonorrhoea. 154. Mixture of Fluid Extract of Cubebs. R. Oleoresinae Cubebae, fSij ; Syrupi Acaciae, Syrupi Tolutani, aa f§ss; Spiritus iEtheris Nitrosi, fSij ; Aquae, fsijss. Fiat mistura. Signa. — Give a tablespoonful every three hours. Used in gonorrhoea. Thomas. CLASS IV. ANTILITHICS AND LITHONTRIPTICS. Antilithics are those substances which arrest or prevent the formation of stone in the kidneys or bladder. Lithontrip- tics are supposed to possess the power of dissolving calculous concretions, 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, requires a chemical knowledge of the ingredients which enter into the formation of the different kinds of stone ; attention must also be given to the properties of the urine. As derangement of the digestive organs almost always coexists with these foreign bodies in the urinary apparatus, we shall gain a very considerable advantage by combining the remedies 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 phosphatic or magnesian character, the muriatic acid, or some one of the mineral acids, will con- stitute the most appropriate remedy. POWDERS AND PILLS. 155. Powders of Uva Ursi, Bark, and Opium. 1^. Pulveris Uvae Ursi, Pulveris Cinchonye Flavse, aa 5\j ; Pulveris Opii, gr. iij. Misce, et 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, for urinary deposits, who advises the patient to drink two ounces 76 AXTILITHICS AFB LITHONTRIPTICS. of lime-water after each dose. It is designed to give tone to the digestive and urinary apparatus, and thereby to prevent the further formation of stone. 156. Pills of Carbonate of Soda and Soap. IJ*. Soda? Carbonatis exsiccate, Saponis, aa 5j ; Extract! Glycyrrhiza?, Aquae, aa q. s. ut fiat massa in pilulas xxx dividenda. Signa. — Take three pills, three times a day. Prescribed when lithic acid deposits are found in the urine. Beddoes. SOLUTIONS, MIXTURES, ETC. 157. Solution of Potassa, Tincture of Hops, §c. R. Liquoris Potassa?, fSss; Tinctura? Humuli, f 5jss ; Infusi Caluniba?, f §iv ; Syrup i Aurantii Corticis, f-Sy- Fiat mistura. Signa. — Take a tablespoonful three times daily. Employed in cases where the urine indicates an excess of lithic acid. II. Green. 153. Solution of Bicarbonate of Soda, 8fc. R. Soda? Bicarbonatis. 5j ; Infusi Quassia?, f§iv ; Tincture Calumba?, f 5j. Misce. Signa. — A tablespoonful four times a day. Used in the same cases as the preceding. 159. Mixture of Bicarbonate of Soda, S?c. R. Soda? Bicarbonatis. 5j « Mistura? Amygdala?, f 5iv ; Copaiba?, f oij ; Tinctura? Opii, gtt. lx. Fiat mistura secundum artem. Signa. — A tablespoonful every three hours. In acute pain of the bladder. In combination with each of these alkaline preparations, demulcent drinks may with benefit be freely employed. ANTILITHICS AND LITHONTRIPTICS. 77 160. Solution of Bicarbonate of Potassa. Ify. Potassoe Bicarbonatis, gr. x ; Aquae Acidi Carbonici, f Svss ; Syrupi, f§ss. Misce. Draught, to be taken three or four times a day. 161. Fluid Extract of Hydrangea Arbor escens. Ify. Radicis Hydrangese contusi, Sxvj ; Aqtue bullientis, Ovj. Coque ad Oss, cola, et adjice — Mellis, Oij. Coque ad Ojss, et adjice — Spiritus Vini Gallici, Oss. Signa. — Dose, a teaspoonful three times daily. This formula is furnished by Mr. Edward Parrish, based on one devised by Dr. S. W. Butler, who first called the atten- tion of the profession to the valuable properties of this root. In chronic catarrh of the bladder and gravel it has proved highly beneficial, as also in cases of stone. Indeed, in some instances, small stones have been passed during its employ- ment. Dr. W. L. Atlee, of Philadelphia, and Dr. J. C. S. Monkur, of Baltimore, report favorably of its use in cases of earthy deposits in the urine. 162. Mixture of Carbonate of Magnesia and Gentian. 3^. Magnesias Carbonatis, 5j ; Iufusi Gentianae Compositi, fSvj. Fiat mistura. Signa. — 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. 163. Mixture of Muriatic Acid. 3^. Acidi Muriatici diluti, f5j ; Decocti Hordei, f§viij. Misce. Signa. — Dose, atablespoonful largely diluted three times a day. Prescribed for the prevention of phosphatic deposits in the urine. Nitric acid has been given with the same intention, but appears to be less useful than muriatic. 78 ANTILITHICS AND LITHONTRIPTICS. 164. Mixture of Phosphoric Acid. It. Acidi Phosphorici diluti, f Sss ; Infusi CalumbsB, f 5vij ; Tincture Cardamomi Compositse, f §ss. Fiat mistura. Signa. — A tablespoonful in sweetened water every four hours. Used to correct pkosphatic deposits in the urine. Neligan. 165. Mixture of Oil of Turpentine and Ether. Tfy. Olei Terebinthinse, iEtheris, aa f5iv. Misce. Signa. — A large teaspoonful to be taken on sugar every half hour until relief is obtained. Oil of turpentine has been frequently given of late in the passage of urinary concretions 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. 166. Injection of Carbonate of Soda. It. Sodge Carbonatis, 5j ; Saponis, 5\j ; Aquae destillatse, f§xij. Fiat solutio et cola. Signa. — Use as an urethral injection, for softening uric acid deposits. Hopital de Montpellier. 167. Injection of Carbonate of Lithia. ]&. Lithise Carbonatis, 5j ; Aquae, Oj. Solve. Signa. — Use as an urethral injection. Mr. Alexander Ure recommends the carbonate of lithia as an injection into the bladder for the solution of uric acid de- posits. He suggests its special use for removing the sharp angular points and asperities of the broken fragments, where the practice of crushing is adopted. Dr. Garrod recommends the internal employment of carbo- nate of lithia in the uric acid diathesis, two to three grains being given in free solution three times a day. CLASS V. DIAPHORETICS. During 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 w T arm 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 producing 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 80 DIAPHORETICS. warrant able, but absolutely necessary, whilst employing this class of remedies. Where, however, we ore 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 dis- charge, and more especially purg'ng 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. Altera- tive Diaphoretics. Sub-Class I.— ORDINARY DIAPHORETICS. POWDERS. 168. Dover's Poivder. 3^. Pulveris Ipecacuanhse Compositi, 5ss. Divide in pulveres vj. Signa. — Take one powder three times a day. The most material difference between the officinal pow r der and that of Dr. Dover, made public in 1733, is in the substi- tution of the sulphate of potassa 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 pro- longed 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 experience with undiminished reputation. To promote its operation, warm drinks may be freely taken, but not imme- diately after the dose, lest vomiting be induced. 169. Dover s Poivder, Camphor, and Saltpetre. Tfy. Camphorae, redactae in pulverem, gr. v ; Potassse JSHtratis, gr. xx ; Pulveris Ipecacuanha Compositi, gr. x. Tere simul et fiant pulveres ij. Signa. — One powder to be taken at bedtime. DIAPHORETICS. 81 This excellent diaphoretic is serviceable in febrile cases complicated with irregular nervous action. Simpson. 170. James's Powder. 1^. Pulvis Antimonialis, Ed. 5j. Divide in chartulas vj. Signa. — One every two or three hours in syrup or molasses. Employed in febrile conditions. This powder, which has been introduced as the succedaneum of the celebrated fever powder of Dr. James, has lately been pronounced inert by Mr. Richard Phillips, chemist, of Lon- don. 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 phosphate of lime. 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 an- timonial powder." 171. Nitrous Poivders. Jfy. Potassae Nitratis, 5j ; Antimonii et Potassae Tartratis, gr. ss ; Hydrargyri Chloridi Mitis, gr. vj. Fiant pulveres vj. Signa. — One to be taken every two hours in syrup or mo- lasses. In febrile affections. The calomel may be omitted or employed, at the discretion of the practitioner. 172. Powders of Opium, Ipecacuanha, Calomel, and Saltpetre. It. Pulveris Opii, gr. iij ; Pulveris Ipecacuanhae, gr. vj ; Hydrargyri Chloridi Mitis, gr. jss ; Potassae Nitratis, 5ss. Fiant pulveres vj. Signa. — One to be taken every three or four hours. This is a valuable anodyne and alterative diaphoretic. 173. Poivders of Calomel, Opium, and Ipecacuanha. E*. Pulveris Opii, gr. iv ; Hydrargyri Chloridi Mitis, gr. ij ; Pulveris Ipecacuanhas, gr. viij. Divide in pulveres viij. Signa. — One to be taken every two hours. 6 82 DIAPHORETICS. This combination is recommended by Professor Chapman in dysentery. From its evident diaphoretic tendency we have been induced to place it under this head. 174. Powders of Sulphuret of Antimony, Calomel, §c. 3^5. Antimonii Sulphurati, Hydrargyri Chloridi Mitis, aa gr. vj ; Pulveris Guaiaci Resinse, 5j- Fiant pulveres vj. Signa. — One to be taken morning and evening. Double or even triple proportion of the ingredients may be used if necessary. Given in cutaneous diseases. 175. Soda Poivder of Guys Hospital. Ify. Sodae Carbonatis exsiccatse, 5j ; Hydrargyri Chloridi Mitis, gr. xij ; Pulveris Cretan Compositi, Lond. 5ij. Misce. Signa. — Give three to eight grains at night for a week, in infantile gastric fever; followed in the morning by five grains of rhubarb mixed with ten grains of the sulphate of potassa. Dr. Fordyce says of the above: "Had I been more ambitious of dying a rich man than of living a useful member of societ} 7 ", the powers of our antihectic powder in curing, as if by miracle, the hectic fever and the swelled bellies of children in London, would have remained a secret while I lived." Goldixg Bird. 176. Compound Powder of Guaiacum. Iy. Pulveris Guaiaci Resinse, Potassae JSFitratis, aa 5j ; Pulveris Ipecacuanhas, gr. iij ; Pulveris Opii, gr. ij. Fiant pulveres vj. 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 symp- toms. DIAPHORETICS. 83 SOLUTIONS AND MIXTURES. 177. Solution of Morphia and Wine of Ipecacuanha. Jfy. Morphias Acetatis, 5j \ Acidi Acetici diluti, f §j. Solve ; dein adde — Alcoholis diluti, f Svij ; Vini Ipecacuanhas, f§ij. Misce. This solution, devised by Dr. J. B. Coleman, is kept ready prepared in the stores of Trenton, N. J. It is employed as a liquid substitute for Dover's powder, as a diaphoretic and anodyne. Ten minims contain one-eighth of a grain of mor- phia, and one grain of ipecacuanha. 0. T. Bqnsall. 178. Neutral Mixture. Ify. Succi Limonis recentis, f §jss ; Potassae Carbonatis, q. s. ad saturandum ; Sacchari, 5'j ', Antimonii et Potassae Tartratis, gr. ss ; Aquas destillatae, fSiij. Misce. Signa. — A tablespoonful to be taken every two hours. 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 spirit of nitre be substituted, if preferred. 179. Solution of Citrate of Potassa. Ify. Potassae Citratis, 5iij ; Olei Limonis, gtt. ij ; Sacchari, 5'j ; Aquae destillatas, fSiv. Misce. Signa. — A tablespoonful to be taken every two hours. This preparation is a good substitute for the preceding, and Is in several respects to be preferred. Spirit of nitre may be added when indicated. 84 DIAPHORETICS. 180. Effervescing Draught. R. Potassae Carbonatis, 5y ; Aquae destillatae, f §iv. Solve. Jfy. Succi Limonis recentis, Aquae destillatae, aa fgij. Misce. Signa. — Mix two tablespoonfuls of the lemonade with one of the alkaline solution, and let the mixture be drunk while effer- vescing. To be repeated every two hours. 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. 181. Mixture of Spirit of Minder erus and Antimonial Wine. Iy. Liquoris Amnionic Acetatis, f §ij ; Aquae Cinnamomi, f oj ; Vini Antim'onii, f 5j ; Aquae destillatae, f §ij. Fiat mistura. Signa. — A tablespoonful every two or three hours. The excellent diaphoretic known as the spirit of Mindererus, appears to have been first used by Boerhaave, in 1732. With us it is generally prescribed in combination, as in the preceding or the following form. 182. Spirit of Mindererus, Sweet Spirit of Nitre, §c, 1^. Liquoris Ammoniae Acetatis, fSvj ; Syrupi Limonis, f Sij ; Vini Antimonii, f 5jss ; Spiritus iEtheris Nitrosi, f 5\j ; Tincturae Opii, gtt. xlv. Fiat mistura. Signa. — Take a tablespoonful every two hours. Eberle. 183. Mixture of Citrate of Ammonia. 1^. Succi Limonis recentis, f§j ; Ammoniae Carbonatis, q. s. ad saturandum ; Sacchari, oj ; Aquae destillatae, f giv. Fiat mistura. Signa. — A tablespoonful may be taken every three hours. This preparation is seldom employed in the practice of this DIAPHORETICS. 85 city. It may, however, be beneficially given as a pleasant stimulating diaphoretic. Ellis. 184. Sweet Spirit of Nitre and Antimonial Wine. Ify. Spiritus JEtheris Nltrosi, f5j ; Vini Antimonii, f5ij. Misce. Signa. — A teaspoonful may be taken every hour or two hours, in barley-water, during the hot stage of intermittent and other fevers. 185. Siveet Spirit of Nitre with Antimonial Wine and Laudanum. 1^. Tincturae Opii, gtt. xxv ; Spiritus iEtheris Nitrosi, f5j ; Vini Antimonii, gtt. xx ; Aquae destillatae, f§ss. Fiat mistura. Signa. — To be given at once, and the dose to be repeated every three hours. Dr. Chapman observes, in his Therapeutics, that "this com- bination very frequently acts as a diuretic in dropsy, and has more than once, within my knowledge, removed the effusion in this disease, under circumstances the least to be expected." 186. Mixture of Saltpetre and Tartar Emetic. 1^. Potassae ISTitratis, 5\j ; Antimonii et Potassae Tartratis, gr. j ; Pulveris Extracti Glycyrrhizae, Pulveris Acaciae, aa 5ij ; Aquae Foeniculi, Aquae destillatae, aa f §iijss. Fiat mistura. Signa. — Give a tablespoonful every two hours. This is proposed as a substitute for the nitrous powders, as being less apt to offend the stomach than the same substances in a pulverulent form. Eberle. 187. Mixture of Gruaiacum, Saltpetre, fyc. 1^. Pulveris Guaiaci Resinae, 5\j ; Potassae Nitratis, 5jss ; Antimonii et Potassae Tartratis, gr. j ; Pulveris Acaciae, Pulveris Extracti Glycyrrhizae, aa 5j ; Aquae destillatae, fSviij. Fiat mistura. Signa. — A tablespoonful three or four times a day. 86 DIAPHORETICS. This preparation, if made without the liquorice, is disposed to turn green, which gives it an unpleasant appearance, and sometimes induces the patient to refrain from it until the phy- sician arrives. It is employed principally in rheumatic cases. Ellis. 188. Mixture of Nitrate of Potassa. Ij*. Decocti Hordei, Oj ; Potassse Nitratis, 5\j ; Succi Limonis, f§j. Fiat potus. To be used warm as a common drink in doses of a wineglassful. Administered in this way, saltpetre proves an excellent dia- phoretic ; but if given in cold infusion its action is chiefly manifested on the kidnevs. 189. Mixture of Tolu with Wine of Antimony. 1^. Tincturse Tolutanse, f5v; Pulveris Acaciae, Sacchari, aa 5j ; Vini Antimonii, f 5j ; Aqu?e Cinnamomi, f5ij. 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. 190. Mixture of Gf-elsemium. ]^, Extracti Gelsemii Fluid i {Thayer), f5j ; Syrupi Limonis, f 5\j ; Aquce, f 5xiij. Misce. Signa. — Give a teaspoonful every two hours. The yellow jessamine (Gelsemium sempervirens) has a depress- ing and sedative influence upon the nervous centres, and it diminishes the force and frequency of the heart's action. It has been employed by practitioners in various parts of the United States with benefit in febrile diseases and rheumatism. In full doses it causes vertigo and impaired vision. DIAPHORETICS. 87 191. Mixture of Aconite and Wine of Colchicum. 1^. Extracti Aconiti Alcoholici, gr. xij ; Syrupi, f 5j ; Vini Colcbici Seminis, f§ss. Fiat mistura. Signa. — Take fifteen drops every three hours. Used in acute and chronic rheumatism, gradually increasing the dose. Weber. 192. Mixture of Aconite and Spirit of Minder erus. 3^. Tincturse Aconiti Radicis, tn^xxx ; Liquoris Ammonise Acetatis, f §ij ; Syrupi Limonis, f §ss. Misce. Signa. — Give a dessert-spoonful every three hours. Employed beneficially in acute rheumatism and pleurisy. In the latter disease, aconite often relieves the peculiar lanci- nating pain in a surprising manner. Its action should be care- fully watched. R. P. Thomas. 193. Mixture of Aconite and Veratrum Viride. It. Tincturse Aconiti Folii, f5v; Extracti Yeratri Viridis Fluidi, f 5j. Misce. Signa. — Give twelve drops every two hours. Under the combined influence of aconite and veratrum vi- ride, the force and frequency of the pulse in fevers or inflam- mations can be reduced with safety and rapidity. It is neces- sary, however, to watch the effects of these remedies. 194. Mixture of Arnica and Guaiac. l^j. Tincturse Arnicse, Tincturse Guaiaci Ammoniatse, aa f 5iij- Misce. Signa. — Take sixty drops four times daily, in sweetened water. Recommended in rheumatic gout and chronic rheumatism. American practitioners seldom prescribe arnica internally, owing, perhaps, to a want of familiarity with its properties. In Germany it is considered a stimulant diaphoretic, with a decided tendency to the brain. Schubarth. v r DIAPHORETIC- INFUS1 NS. I " ;- B: - . Ej Eupatorii. r> : Aquae bullientis, Oj. Macera per horam climidiam in vase leviter clauso et cola. Signa. — Take a wineglassful every hour, till perspiration - freely induced. The infusion must be taken as hot as it can be drunk ; otherwise it may produce vomiting. Used in colds, influenza, and intermittent fever. 196. Infusion of Pleurisy Moot. E. R:ii:::s A-:~t::L. ~ - i::::s. ~> : : A . t bullier. :>. ' — . Signa. — A teacupf ul to be taken warm, as frequently &£ the stomach will bear it. X. L Ei?:ay. Professor Chapman observes of this plant : "As :< diapho- retic, I think it is distinguished by great certainty and per- manency 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. -7 . Sub-Class II.— ALTERATIVE DIAPHORETICS. : ILLS. 197. Pills of Cinnabar and Serpentaria. B . H - ] 1 1 g ~ri Sulphureti Rubri, Pulveris Serpentariae, aa Sss ; Syrupi, q Fiant pilulse 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. 198. Plummers Pitts. B . Er.lrarg-vri Chloridi Mitis, * Antimonii Sulphurate a a ~ Pulveris Guaiaci Resinae, 5j ; 9 rupi fusci. q. s. ut fiant pilulae lx. Signa. — Three pills to be taken night and morning. These pills were recommended by Professor Plummer, in leprosy, secondary syphilis affecting the skin, gleets, old DIAPHORETICS. 89 ulcers, &c. &c. The decoction of guaiacum generally accom- panies their use. DECOCTIONS. 199. Decoction of Burdock. 1^. Radicis Lappae, oiij ', Aquae, Oiij. Coque ad Oij, et cola. Signa. — A teacupful may be taken five or six times a day. Used in syphilis, scurvy, arthritic affections, and rheu- matism. 200. Decoction of Mezereon. 1^. Mezerei, 5vj ; Aquae, Ovj ; Coque ad colaturae, Oiv. Sub finem coctionis, adde — Extract! Glycyrrhizae, Sj, et cola. Signa. — Give a wineglassful several times daily. Given in scrofula complicated with syphilis, and in various skin diseases. 201. Compound Decoction of Sarsaparilla. ]^. Sarsaparillae, contritae, 5iij ; Mezerei, concisi, 5\j ; Aquae, Oiij. Coque ad colaturae, Oij. Sub finem coctionis, adde — Extracti Glycyrrhizae, Sss. Signa. — A teacupful four times daily. This preparation or its equivalent, the " Decoctum Sarsa- parillae Compositum" of the Pharmacopoeia, has long been celebrated in the secondary forms of syphilis, and the diseases produced by the improper exhibition of mercury. It is also much employed in rheumatism and chronic skin diseases. SWEDIAUR. MIXTURES. 202. Mixture of Muriate of Baryta and Iron. 3^. Barii Chloridi, 5ss ; Aquae Menthae Piperitae, f Sijss ; Tincturae Ferri Chloridi, f Sss ; Syrupi Aurantii Corticis, f.5J. Fiat mistura. Signa. — Take a teaspoonful every three hours. 90 DIAPHORETICS. Used in obstinate scrofulous diseases. Each dose contains about one grain of the chloride of barium, and seventeen drops of the muriated tincture of iron. This corresponds in strength with a prescription by Fischer. 203. Mixture of Buchu and Iodide of Potassium. 1^. Tnfusi Buchu, f§viij ; Liquoris Potassae, f3j ; Potassii Iodidi, 5*s ; Spiritus iEtheris Nitrosi, f 3i5j. Fiat inistura. Signa. — Take two tablespoonfuls three times a day. Used in chronic and syphilitic rheumatism. S. Wright. 204. Sarsaparilla Beer. 1^. Sarsaparillae contusac, ibij ; Palveris Guaiaci Corticis, 5viij ; Guaiaci Ligni concisi, Anisi, Radicis Glycyrrhizse contusae, aa §iv ; Mezerei, §j ; Syrupi fusci, Oij ; Caryophylli contusi, §ss ; Aquae bullientis, Congios 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, somewhat modified. If intended for old and obstinate com- plaints, 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 anti- mony twelve grains, corrosive sublimate eight or ten grains, muriate of ammonia one drachm, dissolved previously in a little water. These remedies greatly increase the alterative powers of the vegetable infusion, and so effectually prevent its decom- position that it may be kept for a long time unaltered, even in a hot climate." — See Hancock on Sarsaparilla. Journal of the Pliiladelphia College of Pharmacy, vol. i, No. 4. CLASS VI. EXPECTORANTS. During the administration of Expectorants the patient should be kept warm, and, if the complaint be violent, in bed. The dose of all the Expectorants should be repeated sufficiently often to allay the irritation as much as possible; for it is obvi- ous that the act of coughing increases that very irritation which orginally gave rise to it. POWDERS, PILLS, AND LOZENGES. 205. Powders of Myrrh, Ipecacuanha, $c. 1^. Pulveris Myrrhse, gr. xij ; Pulveris Ipecacuanhoe, gr. vj ; Potassje Nitratis, 5ss. Misce, et divide in partes iv. Signa. — One to be taken every fourth hour. A stimulating expectorant used in chronic bronchitis, and the catarrh of elderly persons. — Paris's Pharmacologia. 206. Powders of Nitrate of Potassa, Calomel, Opium, fyc. l^s. Potassse Nitratis, gr. xxx ; Hydrargyri Chloridi Mitis, Pulveris Opii, Pulveris Ipecacuanha, aa gr. iij. Misce, et divide in chartulas vj. Signa. — One every three hours in syrup or molasses. All powders containing calomel, or other metallic prepa- EXPECTORANT.-. rations, should be given in syrup, as they sink when water is emr ed as the vehicle. Used in the same eases as the foregoing. _ 7. PUh f > Iphatt }f Z' Myrrh. R. Zinei Sulphatis. gr. x; Pulver : - Myrrhae, 5J8s; nfectionis Rosae, q. s. ut fiant pilule 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 drachm, on account of the size of the pills, and to give a pill every two hours. Dr. Paris remarks, that the principal nostrums for hooping-cough are formed either of opium or sulphate of zinc, or a combina- tion of the two. - 3. Pills of Hemlock and Dover'* Powder, E.. Extracti Conii. Pulveris Ipecacuanha? Compositi. aa gr. x. Misce, et nant pilule v. . — Fwo may be taken at bedtime. In pulmonary irritation, attended with rheumatic and other I pains. 209. PUh :~ Tartar Emetic and Opium. R. Antimonii et Potas~:e lartratis, Pulveris Opii. aa gr. js^ : Pulveris Trasacanthse, gr. x : Confection^ Rosae, q. s. ut fiant pilulse xxv. I. — Two to be taken night and morning. In chronic pulmonary catarrh. Dr. Pariset. 210. Pills of Squill. Ammoniac, and Hemlock. Pv.. Pulveris Scill Extracti Conii. a a 5sa ; Ammoniaci, 5j- et divide in pilulas xxx. Signa. — One pill every four hours. Like the officinal "Pilulae Scillae Composite. " this is an efficient expectorant combination, which may be prescribed h great benefit in chronic bronchitis, catarrh, and asthma. EXPECTORANTS. 93 211. Pills of Calomel, Squill, Ammoniac, $c. Iy. Hydrargyri Chloridi Mitis, gr. iij ; Scillas recentis, Ammoniaci, aa 3j ; Pulveris Ipecacuanhas Compositi, 5ss ; Confectionis Rosas, q. s. ut fiat massa, in pilulas xxx dividenda. Signa. — One four times a day. This formula is recommended by the celebrated Dr. Latham, of London, for the relief of troublesome cough. In this country it will generally be necessary to substitute dried squill in half of the quantity, owing to the difficulty of obtaining the fresh article. 212. Pills of Calomel, Squill, Tartar Emetic, Sfc. It. Hydrargyri Chloridi Mitis, gr. xxiv ; Pulveris Scillas, 5ss ; Antimonii et Potassas Tartratis, gr. vj ; Pulveris Opii, gr. xviij ; Syrupi, q. s. Fiant pilulas xxiv. Signa. — One every night. In chronic catarrhal affections. 213. Pills of Sulphate of Zinc. B*. Zinci Sulphatis, ^ss ; Confectionis Rosas, q. s. ut fiant pilulas xx. One of these pills may be given three times a day. In phthisis and pertussis. 214. Pills of Tar and Gentian, ]^. Picis liquids, 5j ; Pulveris Gentianas, q. s. ut fiat massa. Fiant pilulas xxx. Signa. — Take a pill morning, noon, and night. Tar is a mild, stimulant expectorant ; and is often employed, in different forms, in chronic bronchial affections and consump- tion. 215. Pills of Myrrh, Squill, and Henbane. ^. Myrrhas, 5j ; Pulveris Scillas, Extracti Hyoscyami, aa 5ss ; Aquas destillatas, q. s. ut fiat massa in pilulas xxx divi- denda. Signa. — Two to be taken night and morning. 94 EXPECTORANT S. These pills are recommended by Dr. Paris, in phthisis and catarrh attended with great debility of the pulmonary orgai 216. Wist i iges. Ify. Pulveris Acaci Extracti Glycyrrhizae, Sacchari, aa 5ij • Pulveris p i i . gr. vj : Olei Anisi. gtt. iv. Misce. et adde — Aquae destillatae, q. s. nt fiant trochisci Ix. Signa. — One of these may he dissolved in the mouth tb four times a day. These lozenges, which were originally prescribed by the late Prof. have Ions: be jrhlv esteemed for their demulcent and anodyne properties, and have been much em- plo; :h in general and domestic practice for the relief of cough. Mr. Edward Parrish recommends the substitution of sulphate of morphia, in equivalent quantity, for the opium. He also directs the lozenges when dry to be vara: itta tincture of Tola. These changes improve their flavor without impairing their efficiency. 217. Pectoral Lozenges of Emetia, 15*. Emetiae Fuscce. gr. xxxij ; Sacchari. §iv : Mucilaginis Acacias, q. s. ut fiant trochisci singuli grana x pendentes. One of these will produce more or less nausea in a child if this is not desirable, they can be given in divided portions. Adults may take one or two at intervals of two hours, w out the risk of vomiting. Given in cases of catarrh, hooping cough, &c. Magesdie. 218. Spittas Lozenges. ~By. Pulveris Cubebre, 5ij ; Balsami Peruvian i. gr. vj ; Syrupi Tolutani. f 5j ; Extracti Glycyrrhizae, 5j ; Acac're. q. s. ut fiat massa, in trochiscos singulos grana x pendentes, dividenda. These lozenges are celebrated for the relief they afford in hoarseness and coughs. Sputa. EXPECTORANTS. 95 219. Jackson s Pectoral Lozenges. Iy. Pulveris Ipecacuanhae, gr. x ; Antimonii Sulphurati, gr. v; Morphiae Muriatis, gr. vj ; Pulveris Acaciae, Sacchari, Pulveris Extracti Glycyrrhizse, aa 3xj ; Olei Sassafras, gtt. iv ; Tincturse Tolutanae, f 5iv ; Syrupi, q. s. Fiat massa, in trochiscos cc dividenda. Each lozenge, weighing ten grains, contains of ipecacuanha, gr. o' ; of the precipitated sulphuret, gr. ? ] ; and of the muriate of morphia, gr. 3^. Signa. — One of these to be dissolved in the mouth, when the cough is troublesome. S. Jackson. SYRUPS. As cough medicines have to be repeated at short intervals for the purpose of maintaining a gentle impression upon the pulmonary organs, it is desirable to administer them in the most agreeable form. Hence they are generally prescribed as syrups, the sugar in which serves the double purpose of cover- ing the taste and acting as a demulcent to the mucous mem- brane. The officinal syrups of garlic, squill, andseneka are given in a dose of a teaspoonful each. They are all slightly stimulant, and in large doses nauseant. The syrup of wild cherry bark is tonic, astringent and seda- tive. Its dose is a tablespoonful. The syrups of gum arabic, of almonds (orgeat), and of Tolu, are used chiefly as demulcents and flavoring agents. The compound syrup of squill (Coxe's hive syrup) exhibits the anomalous association of a sedative (tartar emetic) with two valuable stimulant expectorants, — squill and seneka. It is more often employed as an emetic for croup, than as an ordi- nary expectorant. 220. Syrups of Squills, Seneka, and Ipecacuanha, Ify. Syrupi Scillse, Syrupi Sencgae, Syrupi Ipecacuanha, aa, f §j. Misce. Signa. — A teaspoonful every three hours. 96 EXPECTORANT-. This is a favorite combination with many physicians, as it combines the expectorant qualities of the squill and seneka. with the relaxing effect of the ipecacuanha. Morton. 221. Syrups of Squill and Ipecacuanha, with Paregoric. Pv . Syrupi Seilla?. Syrupi Ipecacuanha?, Tincture Opii Camphoratae, aa fSj. - 1 - :e. — A teaspoonful every three hours. This preparation is more relaxing and soothing than the last. and may be given beneficially when the patient has a trouble- some cough, with deficient expectoration. '222. Syrup of Ipecacuanha, American Hellebore, H . Syrupi Ipecacuanha?, Sj ritus JEtheris Nitrosi, aa f§ss : Tinctura? Veratri Yiridis, TTgxv. Misce. Signa. — Fifteen drops every three hours. This formula was employed in a large number of cases of pneumonic and bronchial diseases in children, and found to be a most efficient sedative and expectorant. The above dose may be given to a child one or two years old. The pulse must always be watched during the administration of American hellebore. B. P. Schneck. 223. Syrup of Assafetida. It. Assafoetida?, oj ; Aqua? bullientis, Oj : Sacchari. tbij. Triturate the assafetida in a mortar with a portion of the boil- ing water, until a uniform paste is formed ; then gradually add the remainder of the water, strain, and add the sugar, applying a gentle heat to dissolve it. 3e, a teaspoonful everv three hours, for a child five vears old. Each fluidounce contains fifteen grains of assafetida. This preparation will keep a month in the hottest weather, taste is less nauseous than the milk of assafetida, and alto- gether, it is one of the very best modes of administering the fetid drug to children in hooping-cough, I am acquainted with. R. Peltz. EXPECTORANTS. 97 224. Another Form. ^. Assafcetidae, 5ss ; Magnesia Carbonatis, 5vj. Tere simul et adde gradatim — Aquae bullientis, f §x. Cola et adde — Sacchari, Sxv. Solve cum leni calore. Signa. — Dose, a teaspoonful. As this preparation should measure a pint, each fluidounce will contain fifteen grains of the fetid drug. J. A. Heintzelman. 225. Syrup of Wild Cherry Bark and Prussia Acid. ]^. Syrupi Pruni Virginianae, f giij ; Syrupi Tolutani, f gj ; Acidi Hydrocyanici diluti, rr#xvj. Misce. Signa. — Dose, a dessert-spoonful every three hours. When well prepared, this syrup represents the tonic and sedative properties of the wild cherry, which render this bark so peculiarly applicable to the treatment of phthisis. The addition of the prussic acid renders the preparation more sedative. R. P. Thomas. 226. Syrups of Garlic and Tolu with Paregoric. Ify. Syrupi Allii, Syrupi Tolutani, aa f §j ; Tincturae Opii Camphoratae, f 5ij« Misce. Signa. — Dose, half a teaspoonful every three hours for a child five years old. In general properties, garlic bears a close resemblance to squill. This combination may be given with great advantage in the advanced stages of catarrhal complaints of children. 227. Jackson s Pectoral Syrup. Ij«. Sassafras Medullae, 5j ; Acaciae, §j ; Aquae, Oj. Macera per horas duodecim, dein adde — - Sacchari, oxxj. Et solve sine calore, cola, et adde — Morphias Muriatis, gr. viij. Signa. — Take a teaspoonful every three hours. 7 98 EXPECTORANTS. 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 fluidonnce shall con- tain one-fourth of a grain of the muriate of morphia. It is much employed in Philadelphia. Samuel Jackson. 228. Another Form. Jfy. Syrupi Acacias, f oiv ; Morphias Muriatis, gr. j ; Olei Sassafras, gtt. j. Misce. Signa. — Dose, a teaspoonful every three hours. This is a convenient form for the extemporaneous prepara- tion of Jackson's Pectoral Syrup. 229. Substitute for Aubergiers Syrup. 1^. Syrupi Lactucarii, foij; Syrupi Acaciae, f Sjss ; Syrupi Aurantii Florum, f §ss. Misce. Signa. — A teaspoonful every three hours. This is a mild anodyne syrup, and is useful in bronchitis, catarrhus senilis, and consumption. MIXTURES. 230. Brown Mixture. ~Bp. Pulveris Extracti Glycyrrhizae, Pulveris Acaciae, aa 5ij ; Aquae ferventis, f Siv. Fiat mistura, et adde — Spiritus iEtheris Nitrosi, f 5j ; Vini Antimonii, f5y ; Tincturae Opii, trgxl. Signa. — A tablespoonful for a dose. A preparation very similar to this is now officinal under the name of Mistura Grlycyrrhizw Composita. It is used in ca- tarrh, bronchitis, consumption, &c. EXPECTORANTS. 99 231. Mixture of Syrup of Squill, $c. 1^. Syrupi Scillse, fSss ; Tincturae Opii Camphoratae, f oij ; Yini Antimonii, f oj ; Aquae destillatae, fSiij- Misce. Signa. — A teaspoonful every three hours. This is more particularly designed for children. 232. Mixture of Squill, Morphia, and JPrussic Acid. Jfy. Morphiae Muriatis, gr. j ; Acidi Muriatici diluti, tr^y ; Acidi Hydrocyanici diluti, Ttgxxx ; Syrupi Scillae, Aquae, aa f§j. Misce. Signa. — Dose, a teaspoonful when the cough is troublesome. Used in phthisis. T. Thompson. 233. Mixture of Seneka, Squill, Tartar Emetic, $c. Tfy. Decocti Senegas, f§iv; Syrupi Ipecacuanhae, f Sj ; Syrupi Scillae, f §ss ; Antimonii et Potassae Tartratis, gr. j. Fiat mistura. Signa. — A teaspoonful for children of two years of age and upwards. In croup. 234. Mixture of Seneka, Ammoniac^ and Tolu. I$*. Decocti Senegae, f Svj ; Syrupi Tolutani, f §j ; Ammoniaci, 5ss. Misce secundum artem. Signa. — A tablespoonful every two hours. In catarrh. 235. Mixture of Ammoniac and Squill. Jfy. Ammoniaci, Extracti Glycyrrhizae, aa 5ss ; Aceti Scillae, f §ss ; Aquae Foeniculi, f §vss. Fiat mistura. Signa, — A tablespoonful every two hours. 100 EXPECTORANT-. This is a stimulant preparation, useful in chronic bronchitis and senile catarrh. 236. Mixture of Hcmloclc, Paregoric, and Tolu. R. Extracti Conii Fluidi, fo\i ; Tineturae Opii Camphoratae, Syrupi Tolutani, a a f §^ • Aquae Rosa?, f §iv. Misce. Signa. — Thirty drops 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. 237. Almond Emulsion, Ipecacuanha, $c. R . Misturae Amygdalae, f §v ; Yini Ipecacuanha, Tincturse Scillaa, aa f 5ij ; Syrupi Tolutani, f §ss. Misce. Signa. — Take a tablespoonful whenever the cough is urgent Used in chronic bronchitis and consumption. 238. Mixture of Liverwort, Hemlock, and Orgeat Syrup. R. Extract! Hepaticae Fluidi [Thayer), f.^j; Extract! Conii Fluidi, f 5j ; Syrupi Amygdalae, f oiij. Misce. Signa,. — Give a dessert-spoonful every four hours. Liverwort is a mild expectorant and de-obstruent. It has ru found useful in chronic coughs and bronchitis. 239. Mixture of Syrups of Grillenia and Tolu. R. Syrupi Gilleniae (Par risk), Syrupi Tolutani, aa f §j. Misce. Signa. — Dose, a teaspoonful. The Gillenia has] long been celebrated as an indige.. emetic, and like ipecacuanha, as an expectorant in small doses. It is best adapted to cases in which expectoration is not fre established. EXPECTORANTS. 101 240. Mixture of Sal Ammoniac, Squills, $c. 3^. Ammonise Muriatis, §ss ; Pulveris Acaciae, 5\j ; Pulveris Extracti Glycyrrhizae, oiij ; Aquae, fovjss; Spiritus JEtheris Nitrosi, f5jss ; Aceti Scillae, foiij- Fiat mistura. Signa. — A dessert-spoonful every two hours. A stimulating expectorant and alterative, useful in the ad- vanced stages of bronchial disease. Goeden. 241. Mixture of Naphthaline. 1^. Naphthalinae, gr. xvj. Alcoholis, q. s. ut fiat solutio. Dein adde — Syrupi, fgiv. Misce. Signa. — Take a tablespoonful every two hours. This is a stimulating expectorant, useful in chronic catarrh, humoral asthma, &c. Dupasquier. 242. Mixture of Oil of Amber and Tolu. 3^. Olei Succini rectificati, f5j ; Pulveris Acaciae, Sacchari, aa §ss ; Aquae destillatae, f §iv ; Tincturae Tolutanae, f5ij- Fiat mistura secundum artem. Signa. — A tablespoonful every two or three hours. In spasmodic cough. 243. Mixture of Bloodroot, Wild Cherry Bark, S^e. Ify. Morphias Acetatis, gr. iij ; Tincturae Sanguinariae, f 5\j ; Vini Antimonii, Yini Ipecacuanhas, aa f 5iij ; Syrupi Pruni Virginianae, f§iij. Misce. Signa. — Dose, a teaspoonful. Used in catarrhal affections, bronchitis, and influenza. J. C. Ayer. 102 EXPECTORANTS. 244. Mixture of Wild Cherry, Morphia, 3j>e. I$t. Morphiae Acetatis, gr. ij ; Acidi Acetici diluti, f 5j ; Syrupi Pruni Virginianae, Syrupi Ipecacuanha?, Syrupi Tolutani, aa f Sj. Misce. Signa. — A teaspoonful every three hours. This is an excellent combination for the treatment of catar- rhal affections and chronic bronchitis. 245. Mixture of Tartar Emetic and Laudanum, ~Bf. Antimonii et Potassae Tartratis, gr. j ; Aquae destillatae, f Sj ; Tincturae Opii, trgxx. Misce. Signa. — Give a teaspoonful at bedtime to a child five years old* Prescribed in hooping-cough. Sir Wm. Watson. 246. Mixture with Bicarbonate of Soda, $>c, 1^. Sodae Bicarbonatis, gr. xij ; Vini Ipecacuanhae, rrgxx ; Tincture Opii, rrgiv ; Syrupi, Aquae destillatae, aa f §ss. Misce. Signa. — Give a teaspoonful every three hours. This preparation is designed for children, and is chiefly used in hooping-cough. 247. Cochineal Mixture. It. Potassae Carbon atis, 3j ; Pulveris Cocci, 3ss ; Sacchari, §j ; Aquae destillatse, f §iv. Fiat solutio. Signa. — Dose for children, a teaspoonful every two or three hours. An effectual remedy in hooping-cough. K. Chapman. EXPECTORANTS. 10 o 248. Mixture of Lobelia, Squill, and Belladonna. Ij*. Tincturae Lobeliae, Syrupi Scillae, aa f §j ; Extracti Belladonna?, gr. iv. Misce. Signa. — Dose, thirty drops four times daily. This combination has afforded great relief in hooping-cough, especially during the second stage. The dose specified is for a child five or six years old. W. Herbst. 249. Mixture of Assafetida, $c. 1^'. Assafoetidae, 5j ; Aquae, f §iv. Fiat mistura, et adde — Tincturae Tolutanae, f §ss ; Tincturae Opii, TTJ^xl. Signa. — A teaspoonful to a child every two hours, and a des- sert-spoonful (or more) as frequently to an adult. This preparation is of great value in pertussis and other spasmodic diseases of the chest. S. Gr. Morton. 250. Mixture of Bloodroot, Naphtha, $c. ]fy. Tincturae Sanguinariae, f Sj ; Tincturae Opii Camphoratae, f 5ij ; Spiritus Pyroxilici, Dub. f 5ss ; Potassae Nitratis, 5ss : Aquae, foj. Misce. Signa. — A teaspoonful every two hours. This is a modification of a formula of Dr. E. H. Sholl, who speaks in the most favorable terms of the value of bloodroot in pneumonia, croup, hooping-cough, &c. It is one of the most powerful medicinal agents. It is violently emetic in large doses, but in the quantity recommended is said to pro- duce diaphoresis and effects analogous to those of digitalis, 251. Syrup with Sulphate of Sanguinarina. Bs. Sanguinarinae Sulphatis, gr. j ; Aquae, f5j- Solve et adde — Syrupi, fSxv. Misce. Signa. — A teaspoonful every three hours. : ; excellent expectorant. In consequence of its acrid taste should be combined villi a large quantity of sy rup. If ear a sensation of warmth and uneasiness in the throat and sto- mach, hot acts as i sedative to the heart. 7. 3. ~z:2i- _ r _ _Y ■ - ~ " ."" " " " AT : •" - ' Llqnoiis Morphias Mnriatis. .£«?., f Sbj ; Aquae destiMafc- r : ' :jj. *•.'.; — I je -/'-':::' .'. •_:- -..iir5 Li.il— 3 ; t ; : : : r i . _ : : ~ : 'zlziz ~ :i : : : : : - - - tz -. :::;■.".: i . \-_ i in phthisi»L Lj-TCqck. l:»: Af _ •' — " '. .: . ". " : J- '.: ■-:■: :-i:. £. Ammoniac^ 5j ; Aquae dcstiEi i i I Rr. 7:;: :__-: i: i. t: • : if — Tincfturae Opii Camphorat^. : | Sigma. — -A tablespoonful may he grreit every two hoars. _-_-•.__...._: : ■ : . . . ..... ■ - ^ r __-:..-_:e ... -> -.• :>,.; N ; :. — A :-:' : : :_::_ :■: ; .:::. i~: i :". : _f r_ : :i.: :.. : This simple solution of assaietida was frequently employed by the elder physicians, and was found to answer every pur- i :-se ::~:re ::l-"_: ::i ".-•::."'.::- _ ' ' _Y ■ : B ' ' Z ~ B. . Cbpaihae, Balsami Tolutani, 3 li-rr.^ A: : . ..-. " " ": ; : Aquae -:s. 274. Inhalation of Tolu and Ether. R . Baisami Tolutani, partem, j iEtheris. partes, iij. Solve. Signa. — The solution should be placed in a wide-mouthed bottle, from which the patient is to inhale freely several times a day, in chronic catarrh, aphonia, and chronic affec- tions of the che~ Roziez z 3 7 ■:>. Ethereal Tincture of Iodine and Hemlock for Inhalation. I£. Iodinii, gr. viij : Pulveris Conii, gr. xvj ; Athens, f 5ij. :e et macera per horas viginti quatuor. Signa~ — 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 quan- tity inhaled may be gradually increased to a teaspoonful. Used in chronic bronchitis and consumption. S. G-. M:z.i::-. 276. Seudamores Iodine Mixture for Inhalation. Potassii Iodidi, aagr.vj; A: \:- r .r *::'.'. i:ce. :5~. :o-7 : A;.::i::is. 15;. Misce. I usually commence with a drachm of this mixture, pro- ceeding gradually to the extent of half an ounce (rar; more), putting two-thirds the dose for the first half of the time (10, 15, or 20 minutes), and the other third for the mainder. 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 respiration is spasmodically affected, some ethe- SlR C. SCTTDAMORB. o — _ I I Mixture of IJugoTs Solution and Sops for Inhalation. R . Liquoris Iodinii Compositi. f 5ij ; Tincturae Humuli, f 5iv. Miv:~. Signa. — A tablespoonful is added to two fluid ounces of hot water in an inhaler, or in a cup covered with an inverted funnel. The amount of inhalation will have to be d- mined in each case by the sensations produced. In some :ances great relief is afforded, but in others a sense of suffocation may occur, if the inhalation be prolonged. EXPECTORANTS. Ill 278. Inhalation of Tar. Jfy. Picis liquidae, §xvj ; Liquoris Potassse, f§j. Misce. " 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 on Consumption. Sir A. Crichton. 279. Rosin Inhalation. The fumes of rosin were much employed by the late Dr. Joseph Parrish, of this city ; he directed it to be put on a hot shovel or coals, and allow the patient gradually to inhale them. To some persons, rosin is very agreeable, while the lungs of others cannot tolerate it. 280. Arsenical Inhalation. I$j. Sodae Arseniatis, 5ss ; Aquse destillatse, f gv. Solve. Signa. — Arsenical solution. Thirty slips of bibulous paper of a determinate size (about six inches by four inches), are dipped into the arsenical solu- tion, and are then dried and rolled into the form of cigars. Thus prepared, each cigar represents a known weight of the arseniate, about one grain. " The patient, having lighted a cigar, draws the smoke into his mouth, and, by a gentle inspiration, permits it to enter the lungs. At first, he may take four or five inspirations, thrice daily ; and, as he becomes accustomed to the impression, he increases their number. "If there be much oppression, stramonium leaves maybe rolled up with the arsenicated papers." This inhalation has been of some service in consumption, but it is in old catarrhs, chronic bronchitis, and laryngeal disease, that its effects are the most striking. Trousseau. 112 EXPECTORANTS. 281. Mercurial Inhalation. It. Hydrargyri Oxidi rubri, 3j. Heat gradually on the point of a spatula, over a spirit-lamp, and conduct the fumes to the mouth or nostrils by means of an inverted glass funnel. Used in ozaena and syphilitic affections of the mouth or throat, as well as in chronic diseases of the air-passages. 282. Stramonium Inhalation. Stramonium inhalation is particularly serviceable in asthma. The leaves, deprived of their midribs, are dried, cut, and smoked in a common tobacco pipe. Persons unaccustomed to the remedy find one pipe sufficient, while others can bear three or four in the course of a day, during a fit of the asthma. The Parisian pharmaceutists prepare anti-asthmatic cigar- ettes, by moistening the stramonium leaves with a strong infu- sion of opium. The leaves are then dried, cut, and rolled in strips of paper, and the ends are twisted. Some patients are annoyed by the copious production of smoke in the combustion of stramonium. To obviate this in- convenience, M. Dannecy, of Bordeaux, waters the leaves (previously dried and spread out) with a solution of nitrate of potassa, in the proportion of three ounces of the salt to two pounds avoirdupois of the plant. By this process, the combustion is rendered more complete and less annoying, and the patient experiences additional benefit from the fumes of the saltpetre. In fact, many asthmatics have learned by practical experi- ence that no remedy affords more certain and prompt relief for their sufferings than the ignition in their chambers of slips of paper previously saturated with nitrate of potassa and dried. R. P. T. 283. Inhalation of Chlorine. 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 in- efficiency. CLASS VII EMMENAGOGUES. Emmenagogues are those medicines which promote the menstrual discharge, or restore it when entirely suppressed. Although by some authors the specific action of these medi- cines on the uterus has been questioned, if not denied ; yet by others, of equal authority, it has been fully acknow- ledged. It must, however, be observed, that amenorrhoea occurs under opposite states of the system ; and when general de- bility 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 plethoric habit, bleeding, cathartics, &c, are essential preliminaries to the successful exhibition of a specific remedy. POWDERS AND PILLS. 284. Powder of Aloes, Canella, and Serpentaria, 1^. Pulveris Aloes Barbadensis, 5j ; Pulveris Canellse, gr. xviij ; Pulveris Serpentarise, gr. xij. Misce, et divide in pulveres vj. Signa. — One every night, at bedtime, in syrup. This compound, which is one form of the hiera picra of the shops, forms a very good purgative, and is usually employed as an emmenagogue. 8 114 E M M E N A G G U E S. 285. Poivder of Savin, Sulphate of Potassa, $c. 1^. Pulveris Sabinae, Pulveris Zingiberis, aa 5j '•> Potassae Sulpha tis, 5\j. Fiant pulveres vj. Signa. — One to be taken thrice a day. Savin is an excellent stimulant enmienagogue, and when administered just before the menstrual period, often aids in producing the flow. 286. Powder of Savin and Oantharides. Jfy. Pulveris Sabinse, 5j ; Pulveris Cantharidis, gr. ij. Misce, et divide in pulveres iv. Signa. — One to be taken every night on going to bed, watch- ing its effects. Used in amenorrhoea. 287. Poivder of Savin and Ergot. Ij*. Pulveris Ergotae, Pulveris Sabinae, aa, 3ij. Misce, et divide in chartulas iv. Signa. — One may be taken morning and night. This is a good combination for aiding in the restoration of the menstrual discharge. 288. Powder of Savin, Borax, and Gringer. Jfy. Pulveris Sabinae, Pulveris Zingiberis, aa gr. vij ; Sodae Boratis, gr. xv. Fiat pulvis. This powder is to be taken twice a day, in amenorrhoea with a languid pulse. Thomson. 289. Compound Pills of Iron and Myrrh, fy. Myrrhae, 5ij ; Potassae Carbonatis, 5j. Tere simul, dein adde — Ferri Sulphatis, 5j ; Sacchari, 5j- Fiat massa, et divide in pilulas Ixxx. Two or three pills are given three times a day in amenorrhoea and chlorosis. Hulse. EMMENAGOGUES. 115 290. Hoopers Pills. It. Ferri Sulphatis exsiccatae, 5j ; Pulveris Jalapae, gr. xv ; Pulveris Aloes et Canellae, f 5j ; Myrrhae, gr. viij ; Syrupi, q. s. Fiat inassa, 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. N. Chapman. 291. Pills of Digitalis, Myrrh, and Iron. I^$. Pulveris Digitalis, gr. x; Myrrhae, gr. xx ; Ferri Sulphatis exsiccatae, gr. x : Syrupi, q. s. Fiat massa, et divide in pilulas x. Signa. — Take one pill three times daily. Dr. S. Ashwell recommends these pills in amenorrhoea com- bined with epilepsy. 292. Pills of Aloes, Sulphate of Iron, and Cloves. 1^. Ferri Sulphatis exsiccatae, &j ; Pulveris Aloes Socotrinae, 3ij ; Pulveris Caryophylli, gr. v ; Terebinthinae Venetae, q. s. ut fiant pilulae xx. Signa. — One to be taken three times a day. In amenorrhoea. 293. Pills of Citrate of Iron and Strychnia. 1^. Ferri et Strychniae Citratis, gr. 1; Extracti Gentianae, gr. x. Fiat massa, et divide in pilulas xxx. Signa. — One pill three times daily. This double salt is not officinal, and therefore liable to vary in strength. As made in Philadelphia, fifty grains of the compound salt contain one grain of strychnia. It is an ex- ceedingly valuable remedy in chlorosis and amenorrhoea. 116 EMMENAGOGUES. FLUID PREPARATIONS. 294. Decoction of Seneha SnaJceroot. Ify. Senegae contusae, §j ; Aquae, Oj. Coque ad fgxij, dein adde — Aurantii Amari Corticis, 5ss. Macera per horam dimidiam, et cola. Dr. Chapman observes : " My rule in the administration of this medicine in amenorrhcea is, to give about four ounces of the decoction, more or less, during the day, according to the circumstances of the case. Rut at the time when the men- strual effort is expected to be made, and until the discharge 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 7 p. 88. 295. Infusion of Ergot. II. Ergotae contusae, 5\j ; Aquae bullientis, f giv. Fiat infusum et cola. Signa. — To be given by tablespoonfuls every fifteen minutes in protracted parturition occasioned by deficiency of con- tractile power in the uterus. For the same purpose the powder may also be given in doses of twenty grains, as well to assist in arresting uterine hemorrhage as to promote the expulsion of the placenta. N. Chapman. 296. Mixture of Oil of Erigeron. "Sf. Pulveris Acaciae, Sacchari, aa 5ij ; Aquae, fgj. Tere simul, et adde gradatim — Olei Erigerontis Canadensis, 5j ?' Aquae Menthae Viridis, fgij. Fiat mistura. Signa. — A dessert-spoonful every two hours. Dr. E. Wilson and others report favorably of the use of this oil in menorrhagia, uterine hemorrhage, and irritable bladder. A. C. Rournonville. EMMENAGOGUES. 117 297. Decoction of Cotton Root. 3^. Gossypii Radicis contusi, Siv ; Aquae bullientis, Oij. Misce, coque ad Oj, et cola. Signa. — Dose, a wineglassful. When employed to promote uterine contraction, as a substi- tute for ergot, Dr. Bouchelle directs this dose to be repeated every twenty minutes. Dr. T. J. Shaw administers the same quantity every hour in dysmenorrhoea. He has great confi- dence in the emmenagogue properties of cotton root. 298. Decoction of Madder. 1^. Pulveris Rubiae, §j ; Aquae bullientis, Oj. Digere per horam dimidiam, et adde — Caryophylli contusi, 5j- Signa. — When cool, strain, and give a wineglassful every three hours, a short time before the expected return of the men- strual discharge. — See Dewees on Females, p. 74. 299. Mixture of Camphor. 1^. C amphorae, 3j ; Alcoholis, q. s. ut fiat pulvis. Dein adde — Pulveris Acaciae, Sacchari, aa 5j ; Aquae Cinnamomi, f§j. Fiat mistura. This mixture would more properly appear under the head of Narcotics, but as Dr. Dewees considers it particularly effica- cious in dysmenorrhoea, we have given it a place with Em- menagogues. 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 Mid- wifery, p. 158. 300. Mixture of Ergotine. Jfy. Extracti Ergotae Aquosi, gr. xv ; Syrupi Aurantii Corticis, f §j ; Aquae, foiij. Misce. Signa. — Dose, a tablespoonful. In uterine hemorrhage this dose should be given every ten or fifteen minutes, until arrested. The remedy has also proved serviceable in other forms of hemorrhage. BONJEAN. 118 EMMENAGOGUES. 301. Saturated Wine of Ergot. 1^. Ergotae contusae, oij ; Vini Xerici, Oss. Macera per dies decern, et cola. Signa. — Dose, a teaspoonful every two hours. Many practitioners of Philadelphia, who have been disap- pointed in the effects of the officinal wine, have found this preparation more reliable in the treatment of menorrhagia. and the hemorrhage attendant upon abortion. C. H. Needles. 302. Mixture of Cantliarides, Ammonia, and Gentian. Ify. Tincturae Gentianae Compositae, f ojss ; Tincturae Canthariclis, f 5j ; Spiritus Ammoniae Aromatici, f 5iij- Misce. Signa. — Give a teaspoonful three times daily. Useful in chlorosis and hysterical depression. S. ASHWELL. 303. Tinctures of Black Hellebore, Myrrh, and Cantharides. 1^. Tincturae Hellebori, f oss ; Tincturae Myrrhae, f oj ; Tincturae Cantharidis, f5ij- Fiat mistura. Signa. — Dose, thirty drops, three times a day, in a little sugar and water. Recommended in amenorrhoea. 304. Dewees's Tincture of Guaiacum. 1^. Pulveris Guaiaci Resinae, §iv ; Sodae vel Potassae Carbonatis, 5jss ; Pulveris Pimentae, oj ; Alcoholis diluti, Oj. Misce. " Digest for a few days. The volatile spirit of am- monia to be added 'pro re nata, in the proportion of a drachm 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 idio- EMMENAGOGUES. 119 pathic 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 Teneriffe 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. 305. Volatile Tincture of Gruaiacum and Copaiba. 1^. Tincturse Guaiaci Ammoniatse, f Sj ; Copaibae, f§ss. Misce. Signa. — A teaspoonful two or three times a day. In cases of amenorrhoea connected with general debility. 306. Saturated Tincture of Iodine. Tty . Iodinii, 3ij ; Alcoholis, f Sj ; Spiritus Lavandula Compositi, f5ij- Fiat tinctura. Signa. — From five to ten drops in sweetened water twice a day, gradually increasing the dose. We are informed by Mr. Elias Durand, a pharmaceutist of this city, that the above is a saturated tincture. It is pre- scribed in amenorrhoea, gonorrhoea, leucorrhoea, &c. From its great activity it requires to be cautiously adminis- tered. S. G. Morton. 307. Tinctures of Iron, Aloes and Myrrh, and Castor. 1^. Tincturse Ferri Chloridi, Tincturss Aloes et Myrrhse, aa f Sss ; Tincturse Castor ei, f5ij. Misce. Signa. — -Take thirty drops three times a day. This combination of iron and castor, with the elixir propri- etatis, is indicated in general debility and chlorosis, and the attendant suppression of the menses. It may be given in sweetened water, or in cold chamomile tea. 120 EMMENAGOGUES. 308. Tincture of Hiera Piera. fy. Pulveris Aloes et Canellae, Sjss; 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 amenorrhoea. 309. Ummenagogue Suppository. fy. Olei Theobromae, §ij; Pulveris Aloes Capensis, 5ss ; Castorei, Assafoetidse, aa 5y- Fiant suppositoria xxv. One to be employed daily for several days at the expected period of the menses. Richard. CLASS VIII. ANTHELMINTICS. Anthelmintics are medicines employed to destroy and bring away worms from the alimentary canal. They are also termed Vermifuges. The only unequivocal proof of the existence of worms in the alimentary canal, is the ejection of some of them per anum, or, as sometimes happens, by the mouth. When, in such cases, vermifuges are resorted to, they must be persevered in for seve- ral days, with the occasional intervention of an active cathartic. POWDERS, PILLS, AND LOZENGES. 310. Calomel with Gramboge. 3^. Hydrargyri Chloridi Mitis, gr. v ; Pulveris Gambogise, gr. iij. Misce. Signa. — For an adult. To be taken in syrup at bedtime. Gamboge is sometimes given in doses of fifteen or twenty grains for the tape-worm, and is highly spoken of in such cases. 311. Calomel with JPinJcroot. 15*. Hydrargyri 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. 122 ANTHELMINTICS. 312. Poivders of P 'micro ot, Savine, and Senna, Jfy. Pulveris Spigelire, Pulveris Sennas, aa 3ij ; Pulveris Sabinae, gr. xij. Fiant chartulse vj. Signa. — 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. 313. Poivders of Common Salt and Cochineal. 1^. Sodii Chloridi, 5iij 5 Cocci in pulverem redacti, gr. xv. Fiant pulveres vj. Signa. — One every morning for six days, following the last dose with some purgative medicine. Dr. Rush speaks in high terms of this preparation for the expulsion of the long round worms. 314. Powders of Santonin. 1^. Santonini, gr. vj ; Sacchari, gr. xv. Misce, et divide in pulveres vj. Signa. — Give one powder night and morning to a child five years old, for worms. " 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. (N. Y. Journ. Pharmacy, vol. i, p. 16.) Hence, it is necessary to exercise much caution in administering this powerful medicine. 315. Lozenges of Santonin. 1^. Santonini, 5j ; Sacchari, §j ; Mucilaginis Tragacanthse, q. s. ut fiat massa, in trochiscos lx dividenda. Signa. — Give one lozenge night and morning. Santonin is being extensively introduced as an efficient sub- stitute for all other anthelmintics. Its entire freedom from unpleasant odor or taste renders it peculiarly available in the treatment of worms in children. Its destructive effects on parasites are more manifest upon the long round worm than upon the other varieties. ANTHELMINTICS. 123 316. Powder of Male Fern. ^. Pulveris Filicis Maris, 5j. Signa. — Dose, a teaspoonful. The following is Madame Nouffer's plan of treating cases of tape-worm : " Give of the powder of the Male Fern root, from one to three drachms, in a large cupful of any distilled water, early in the morning. If the stomach should reject it, the powder must he repeated again, as soon as the sickness has gone off, in the same quantity. When it has been upon the stomach about two hours, a strong cathartic bolus (consisting of five grains of gamboge, twelve grains of calomel, and twelve of scammony) 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 of salts, dis- solved in warm water. Till the worm comes away, which generally happens on the same day, the patient is to take no- thing but 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 more efficient of the two. 317. Powder of Kameela. 3^. Rottlerse, 5\j- Divide in pulveres iv. Signa. — Take one powder every hour, in syrup or aromatic water. Kameela is a powder brushed off the capsules of an East Indian shrub, the Rottlera tinctoria. It is used in India as a dye for silks, imparting to them a fine yellow color. Dr. McKinross, in 1853, made known its powers in the treatment of tape-worm. Many British practitioners have since tried it, and confirm his favorable testimony. It may be given in powder, in doses of thirty to sixty grains ; or one or two teaspoonfuls of a tincture made by displacing four ounces of the powder in a pint of alcohol. In full doses, it causes purg- ing, with some nausea or even vomiting. 124 ANTHELMINTICS. 318. Lozenges of Precipitated Carbonate of Iron. EL. Vanillre, 5j ; Sacchari, 5xv. Tere siinul et adde — Ferri Subcarbonatis, §v ; Mucilaginis Tragacanthae, q. s. Contunde in massam, et divide in trochiscos singulos, gr. xx, pendentes. Signa. — One lozenge may be taken several times daily. This formula, devised by Mr. E. Parrish, furnishes to the practitioner a mode of administering the subcarbonate of iron to children in an agreeable and effectual form. Of this remedy, as an anthelmintic, the late Professor Rush had a very favorable opinion. He gave it in doses of from five to thirty grains to children of from one year old to ten, and sometimes in half ounce doses, with safety and success. — See Observ. and Inquiries, p. 243. 319. Pills of Venice Turpentine, Calomel, $c. II. Terebinthinae Venetae, 5j ; Extracti Jalapae, 5ss ; Extracti Hyoscyami, gr. iv ; Hydrargyri Chloridi Mitis, gr. viij. Fiat massa, et divide in pilulas singulas, gr. ij, pendentes. Signa. — Of these, four are to be taken every three hours ; and during the entire period of their use, the patient is to take only weak broth, tea, or coffee. Used in tape-worm. Hufeland. INFUSIONS, DECOCTIONS, ETC. 320. Compound Infusion of Pinkroot, or Worm-tea. 3^. Spigeliae contusae, §ss ; Sennae, 5\j ; Mannae, Sj ; Sabinas, 3ij ; Fceniculi, 5\j ; Aquae bullientis, Oj. Macera per horas duas et cola. Signa. — 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. ANTHELMINTICS. 125 Worm-tea has stood the test of many years' experience in Philadelphia, and has proved itself one of the most efficient agents for the expulsion of the long round worm. 321. Decoction of the Bark of Pomegranate Root. Jfy. Granati Radicis Corticis, §jss ; Aquse, Ojss. Coque ad Oj, et cola. Signa. — Take a wineglassful every two hours. This decoction is employed, almost exclusively, for the de- struction of tape-worm. " 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. 322. Infusion of Kousso. Jfy. Brayerse, §ss ; Aquse bullientis, f §x. Macera per horam dimidiam. Signa. — Dose, a teacupful every half-hour. 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 de- sirable. The mode of administering the remedy is as follows : "A little lemon-juice is to be swallowed, and the infusion being stirred up, the whole is taken, liquid and powder, at two or three draughts, at short intervals, being washed down by cold 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 purgative should be administered." Jon. Pereira. ELECTUARIES, MIXTURES, ETC. 323. Electuary of Tin. 1^. Pulveris Stanni, gj ; Syrupi fusci, f §iv. Misce. Signa. — Two tablespoonfuls may be given early in the morn- ing, to be repeated every two hours until the whole be taken, and then followed by an active cathartic. 126 ANTHELMINTICS. The efficacy of this substance is said to be increased by combination with sulphur, by which means sulphuretted hy- drogen is generated, and the worm destroyed by the offensive gas. Larger doses are sometimes prescribed. 324. Electuary of Coivhage. ty. Mucunse, 5j- Mellis despumati, q. s. ut fiat electuarium. /Signa. — Dose, a teaspoonful to a child two or three years old ; to be given before breakfast in the mornings of three suc- cessive days, and then followed by a brisk cathartic. In lumbrici. 325. Mixture with Oil of Wormseed. It. Olei Chenopodii, f 5jss ; Olei Ricini, §iij ; Olei Anisi, gtt. x. Misce, et adde — Syrupi Rhei Aromatici, fgj. Fiat mistura. Signa. — Shake the bottle well before using. Give a tea- spoonful night and morning to a child two years old. This mode of exhibiting the oil has been extensively tried in Baltimore, and has proved effectual. — Am. Jour. Phar- macy^ p. 306, 1850. 326. Another Form. 3^. Olei Chenopodii, f 5j ; Sacchari, Pulveris Acacise, aa 5ij ; Aquae Menthae Piperita, f §ijss. Misce secundum artem. Signa. — A teaspoonful of this preparation may be given four times a day for two days in succession, and then be purged off with castor oil or salts, for children of three to eight years old. This is a vermifuge of considerable reputation in this coun- try. It is generally used in lumbrici and ascarides ; though we have heard of its having been successfully given for tamia, but in much larger doses. S. G. Morton. ANTHELMINTICS. 127 327. Fluid Extract of Pinhroot and Senna with Santonin. ty. Extracti Spigelise et Sennse Fluidi, f §ij ; Santonini, gr. xvj. Misce. Signa. — Give a child, two years old, a teaspoonful night and morning, until purging takes place. This fluid extract, originally devised by Prof. Procter, has been used successfully in Philadelphia for the last ten years in the treatment of lumbrici. 328. Mixture of the Extract of Male Fern. Ify. Olei Filicis Maris, 5ss ; Mellis Rosae, oSS. Misce. Signa. — Take one-half at bedtime, and the remainder early in the morning, on an empty stomach. Used for tape-worm. If the worm does not come away in six or eight hours after the last dose, administer some mild purgative. The oil indicated in this prescription is in reality a fluid extract prepared with ether. Radius. 329. Linctus of Oil of Turpentine. 1^. Olei Terebinthinse, 5ij ; Mellis despumati, §j. Misce, et fiat linctus. Signa. — Dose, a dessert-spoonful. The late Prof. Chapman had great confidence in the oil of turpentine as a remedy for tape-worm, and was in the habit of giving it in large doses at brief intervals. B. Ellis. 330. Emulsion of Pumpkin Seeds. Tfy. Peponis, §ij. Decortica et contunde in massam cum Sacchari, oj- Dein adde gradatim — Aquae, fSviij. Misce. Signa. — The whole to be taken in two or three draughts, at short intervals, fasting. The efficacy of an emulsion of pumpkin seeds in expelling tape-worm is now established beyond doubt, as it has been ad- ministered repeatedly and successfully, both in the West In- dies and this country. The above is the formula of the late 128 ANTHELMINTICS. Dr. H. S. Patterson, who was among the first to introduce the remedy to the notice of American practitioners. The expressed oil of the seeds has also been tried in the dose of half an ounce, with a degree of success. CLYSTERS. 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, sulphur, pure olive oil, soap, aloes, kc. &c. For children, thirty grains 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. Or aloes may be given in mucilage, as in the following formula : 831. Aloetic Enema. It. Aloes Capensis, 5j ; Mucilaginis Ulmi, Oj. Fiat enema. Signa. — The half of this may be given to a child eight or ten years old. In ascarides. 332. Enema of Qamplior and Sweet Oil. It. Camphorse, 5j ; Olei Olivse, §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 intolerable itching caused by those worms. 333. Anthelmintic Clyster. "fy,. Hydrargyri Iodidi Rubri, gr. f ; Potassii Iodidi, gr. viij. Tere simul, et adde gradatim — Aquas destillatae, Oj. Signa. — Inject a wineglassful night and morning. The injections should be continued for two or three days, and be repeated once or twice at the end of two weeks. ANTHELMINTICS. 129 When thus employed, the remedy seldom fails in the removal of seat-worms (ascarides). The dose prescribed is for a child. Trousseau. 334. Arsenical Clyster. Tfy. Liquoris Potassse Arsenitis, rrgxxxij ; Aquse destillatse, f§viij. Misce. Signa. — Inject a wineglassful every morning for three days. Recommended for ascarides in children. Since the days of Coelius Aurelianus arsenical injections have not been used for the destruction of seat-worms, until their employment was recommenced in the Parisian hospitals a few years ago. Arsenic is one of the most reliable agents for the treatment of these parasites. Great care is obviously required in its employment. Trousseau. CLASS IX. S T I M U L A N T S. Ih 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 neces- sary to give them plentifully from the first. It will be often requisite to change not only the stimu- lating substance, but the part of the body to which it is ap- plied : thus, when the stomach fails, the rectum and skin may be acted upon with advantage. PILLS, POWDERS, ETC. 335. Pills of Camphor, Cantharides, and Opium. R. Pulveris Cantharidis. gr. xviij ; Pulveris Opii, Cainphorae. in pulverem cum alcohole redactse, aa gr. xxxvj ; Confectionis Rosa?, q. s. ut fiant pilulae xxxvj. Signa. — One may be taken every night on going to bed. In impotency from general debility. 336. Pills of Turpentine and G-uaiacum. R. Pulveris Guaiaci Resinae. 5j '• Terebinthinae Venetae, q. s. ut fiant pilula? 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. 131 337. Pills of Cayenne Pepper. Jfy. Pulveris Capsici, gr. xxiv; Extracti Gentianse, gr. xvj. Misce et fiant pilulse xij. Signa. — One, four times a day. Used in debility of the stomach, from intemperance. St. Bart. Hospital. 338. Creasote Pills. 1^. Creasoti, TTgnj ; Pulveris Hyoscyami Folii, gr. xij ; Confectionis Aromaticse, q. s. Fiat massa in pilulas xij, dividenda. Signa. — Take one pill three times daily. Used to allay the morning sickness in pregnancy. Pitschaft, 339. Pills of Valerianate of Quinia. 1^. Quinine Valerianatis, gr. xij ; Pulveris Tragacanthse, gr. vj ; Aquge, q. s. ut fiat massa in pilulas viij, dividenda. Signa. — Give one pill every hour. Used in hemicrania. The late Dr. Joseph Parrish was in the habit of treating hemicrania successfully, by a combination of Peruvian bark and valerian. This formula contains the active constituents of both remedies in a concentrated form. It has afforded prompt relief in numerous instances. MIXTURES AND INFUSIONS. 340. Mixture of Carbonate of Ammonia. 1^. Ammonise Carbonatis, 5j ; Sacchari, Pulveris Acacise, aa 5jss ; A quae Menthse Viridis, f §iv. Fiat mistura. Signa. — A tablespoonful every two hours. As carbonate of ammonia sustains the action of the heart, without stimulating the brain, it is resorted to whenever the vital powers begin to fail, in diseases of nearly every type. 132 STIMULANTS. 341. Draught with Valerian and Carbonate of Ammonia. Tfy. Olei Valerianae, gtt. iij ; Ammonite Carbonatis, gr. x ; Aquae Cinnamomi, f ojss ; Syrupi, f gss. Fiat haustus. Signa. — One half to be taken every fourth hour. In nervous headache, and depression of spirits. 342. Draught of Carbonate of Ammonia and Cringer. 1^. Pulveris Zingiberis, gr. xv ; Amnionic Carbonatis, gr. viij ; Tincture Cinnamomi, f 5ij ; Aquae, fsjss. Misce. Signa. — To be taken at once. In gout or cramp of the stomach. 343. Mixture of Valerianate of Ammonia. 1^. Acidi Valerianici, f 5j ; Aquae, f§iv; Ammonias Carbonatis, q. s. ad saturandum. Dein adjice — Extracti Valerianae Fluidi, f 5j. Misce. Signa. — A teaspoonful every three hours. Under the name of " Pierlot's Solution," the valerianate of ammonia has been prescribed in various diseases of the nervous system, such as morbid irritability, restlessness, hysteria, and neuralgia. Tufnell. 344. Elixir of Valerianate of Ammonia. Iy. Ammonias Valerian atis, 5j j Aquae Aurantii Florum, f §ij ; Syrupi, Spiritus Curacoa, aa f§j. Misce. Signa. — Dose, a teaspoonful. Used in hysterical affections and disorders of the nervous system. STIMULANTS. 133 345. Mixture of Valerian and Cajeput Oil. K^. Extracti Valerianae Fluidi, f5y J Olei Cajuputi, ff^xvj. Tere simul et adjice — Syrupi Acaciae, f 5vj ; Aquae Aurantii Florum, fgj. Misce. Signa. — Dose, a teaspoonful. This is a mild and effectual stimulant, with a specific ten- dency to the nervous system. It may be used beneficially to correct hiccough, twitchings of the muscles, restlessness. It is also employed in hysteria. 346. Mixture of Oil of Turpentine. ~Bp, Olei Terebinthinae, 5j ; Pulveris Acaciae, Sacchari, aa 5ij ; Tincturae Opii, gtt. lx ; Spiritus Lavandulae Compositi, f Sij ; Aquae Menthae Viridis, f §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. B. Ellis. 347. Camphor Mixture. J$s. Camphorae, in pulverem redactae, 5j; Pulveris Acaciae, Sacchari, aa 5jss ; Tincturae Opii, gtt. xl ; Aquae Menthae Viridis, f §iv. Fiat mistura. 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. Used in typhoid and nervous fevers, B. Ellis. 134 STIMULANTS. 348. Camphor Julep. R. Camphorae. in pulverem redacts, 5ss ; Aquae bullientis. f§viij. Macera per horam dirnidiam, in vase leviter clauso, et cola. Signa. — A tablespoonful for a dose. Many of the older practitioners were in tbe habit of using a hot camphor tea. in dysmenorrhcea, 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 cam- phor-water (aquae camphorae) which contains three grains to the nuidounce when properly prepared. 349. Camphor and Myrrh Mixture. It. Camphors, 5j ; Myrrhse, o^s. Tere simul et adde gradatim — Sacchari, oj ; • Aquae, f§vj. Misce. Signa. — A tablespoonful to be given every two hours, Chiefly used in dysmenorrhcea. 350. Mixture of Camphor and Chloroform. It. Camphorae, 5\j ; Chloroformi purificati, 5j ; Yitellum unius Ovi; Aquae, foiv. 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. 351. Solution of Camphor in Ether. It. Camphorae, 5ss ; iEtheris, foj. Solve. Signa. — Take ten drops every twenty minutes. Used in cholera morbus and cholera. " I have found nothing so effectual in giving relief to the nausea and vomiting of the early stages of cholera as small doses of this solution, frequently repeated." John Eberle. STIMULANTS. 135 352. Mixture of Paregoric and Ammoniated Guaiacum. Ify. Tincturae Opii Camphor atae, Tincturae Guaiaci Ammoniatae, aa foj. Fiat mistura. Signa. — Two teaspoonfuls in sweetened water every two hours. In misplaced and retrocedent gout. 353. Yeast Mixture, Tfy. Fermenti, f §x ; Camphoras, 5ss ; Spiritus iEtheris Nitrosi, f §ss. Fiat mistura. Signa. — Take a tablespoonful every two hours. This was extensively used in the late typhus epidemic in Ireland, as a stimulant and antiseptic, and with the happiest results. Lamprey, 354. Assafetida and Spirit of Ammonia, Ify. Spiritus Ammoniae Aromatici, f 5ij > Tincturae Assafoetidae, f5vj. Misce. Signa. — Give a teaspoonful, in sweetened water, every four hours. An excellent stimulus in nervous debility and hysteria. 355. Mixture of DippeVs Animal Oil apd Hoffman '$ Anodyne. Iy. Olei Cornu Cervi, f 5j ; Spiritus iEtheris Compositi, f Siij. Misce. Signa.— Take thirty drops every three hours in sweetened water. The disagreeable smell of the oil obtained from hartshorn or bones, has proved an almost insurmountable obstacle to its use by American physicians. Nevertheless, it is an excellent stimulant and antispasmodic, and as such is employed in Ger- many in the treatment of chorea, catalepsy, and epilepsy. RlCHTBE. 136 STIMULANTS. 356. Emulsion of Phosphorus. It. Phosphori, gr. ij ; Mucilaginis Acacise, 5j. Tere simul, et adde gradatim — Aqune, f 5v. Fiat emulsio, dein adde — Syrupi, fgj ; Spiritus ^theris Compositi, trgxxx. Fiat mistura. Signa. — The usual dose is a tablespoonful every three or four hours. Used in amaurosis, palsy, epilepsy, &c. Hufeland. As the violence of phosphorus as a 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 ad- ministration. The subjoined is one of the many formulas adopted in Europe. 357. Lobsteins Phosphorated Ether. 1^. Phosphori, gr. ij ; Solve in iEtheris, f §ss. Dein adde — Spiritus Menthae Piperita, f 5ss. Signa. — Take six drops on sugar every three hours. The bottle should be carefully stoppered, and covered with dark paner. Used in epilepsy, paralysis, and amaurosis. Foy. 358. Phosphorated Oil. Jfy. Phosphori concisi, gr. vj ; Olei Amygdalae Dulcis, Sj. Liqua cum leni calore. Post refrigerationem, cola. Signa. — Dose, ten drops every three hours in mucilage. Advised in chronic rheumatism and gout. It is also used externally by friction in the same complaints, and for con- tracted tendons. Ph. Borussica. 359. G-lycerole of Phosphorus. IJj. Phosphori concisi, gr. ij ; Glycerine, f§j. Solve cum leni calore. Signa. — Dose, ten minims. Used for the same purposes, and proposed as a substitute for the above phosphorated oil. J. L. Crawcour. STIMULANTS. 137 360. Mixture of A mica. 1^. Arnicae, 5\j ; Aquae bullientis, Oss. Macera per horas duas et cola. Dein adde — Tincturae Arnicae, f 5ij ; Tinctures Cardamomi, fovj. Misce. Signa. — A tablespoonful three times a day. Recommended for the relief of tinnitus aurium. The dose to be gradually increased. It is also useful as a stimulant in atonic gout. Wilde. 361. Mixture of Chlorinated Lime. ]^. Calcis Chlorinatae, Sj ', Aquae, fSiij. Solve et cola. Dein adde — Syrupi Zingiberis, foj. Fiat mistura. Signa.— Take a tablespoonful every three hours. Chlorinated lime is stimulant and antiseptic, and has been used beneficially in typhoid, typhus, and scarlet fevers. Reid. 362. Infusion of Cayenne Pepper and Salt. Jfy. Pulveris Capsici, Sss; Sodii Chloridi, 5j ; Aceti bullientis, Aquae bullientis, aa f Sviij. Macera per horam unam et cola. Signa. — Dose, a tablespoonful every two hours. This combination was employed in an epidemic of malignant scarlet fever in the West Indies with the happiest results. It was used both internally and as a gargle. Stephens. 363. Mixture of Soda and Oubebs. 1^. Pulveris Cubebae, 5ij ; Sodae Carbonatis, 5ss ; Mucilaginis Acaciae, f 5vj ; Aquae Menthae Viridis, f ovj. Fiat mistura. Signa. — Take a tablespoonful every hour and a half. Useful as an antacid and carminative. Fosbroke. 138 STIMULANTS. 364. Mixti - Bismuth and Cubehs. R. Pulveris Cubebse, 5; '• B'smuthi Subnitr at is, 5ss : Macilaginis Acacia?, f 5ss • Syrupi. f5vj : A jus, f5 . : mistura. v :na. — Take a tablespoonful four times a day. T\~e have extracte : 9 and the preceding prescriptions from a paper of Mr. John Fosbroke, surgeon, Chittenham. (See Medi d Fl reorder 7 for April. 1 x l" They are recommended in various affections of the mucous membranes, viz.. of the bowels, bladder, trachea, 365. 31u$tard Wh- E.. Li :::s Va seinae, Ojj ; Siuapis Albse contusie. 5;. Coque cum leni calore, ad perfectam casei separationem, cola et adde — 1 ini Xerici. f5yj- — A dra : t _: :: this whey may be taken every hour or two in low fever and in debilitated stomach. S66. Wine Whey, B.. Lavetifl Vaccinae bullientis, Oss ; Tini Xerici, f ^iv. Misce. et adde — S ichari 5; ; jristiae rasmre. :, . -. ad gratum saporem. Mis There are few mild stimulan:- m : re employed, or more useful than wine whey. Dr. Chapman speaks of it as [ : - rising a kindred action with carbonate of ammonia. The dose to be regulated by the circumstances of the case : from four ounces to a pint during the day. ~ Egg Mid* H. Vitellum unins 0?i; Olei Cinnamomi, gtt. x. itunde simul. et adde — Vini Xerici, Aquae Cinnamomi. aa f^JSE . Sacchari. 5j i Aquae destillat*. f.5;. Fiat mistura, x ma. — Give a wJneghuwfu^ a: short intervals, in convales- aice from low fevers. STIMULANTS. 139 368. Egg-Nog. 1^. Albumen et Vitellum unius Ovi ; Sacchari Albi, 5ij« Misce, et contunde in spumam. Dein adde — Vini Xerici, f §ss ; Aquae, f Sj ; Myristicae rasurae, q. s. ad gratum saporem. Misce. This delightful mixture is both stimulant and nutritious. In the formula, both the white and the yelk of the egg are directed to be beaten with the sugar ; but if it be desirable to have the preparation very light and delicate, it is better to beat the yelk to a froth and mix with the wine, sugar, and nutmeg, and then add to the mixture the white of the egg, previously beaten to a froth in a separate vessel. 369. Milk Punch. Hy. Spiritus Vini Gallici, f §ij ; Lactis Vaccinae, f Siv ; Sacchari, §ss; Myristicae rasurae, q. s. ad gratum saporem. Signa. — Take a tablespoonful every hour or two in low fevers. 370. Oleo-Saecharoles. Under the name of oleo-saccharum, M. Beral has introduced into European pharmacy a convenient mode of exhibiting the volatile oils. It is simply a combination of any volatile oil with sugar, the latter serving the double purpose of rendering the former soluble in water, and covering its taste. The pro- portions are,- — one drop of oil to one drachm of sugar. They are to be carefully mixed by trituration. They act as mild carminatives. CLASS X. NARCOTICS. Narcotics have been denominated sedatives, from their power of diminishing action ; anodynes, from their capability of alleviating 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 individuals of the class may possess will be noticed under the appropriate 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 resorted 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 difference between the susceptibility to their action when the body is in a morbid or healthy condition, should not be overlooked. PILLS. 371. Pills of Opium. 1^. Pulveris Opii, gr. xij ; Saponis, gr. iij. Misce, et divide in pilulas xij. Signa. — 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. NARCOTICS. 141 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. 372. Pills of Lupulin. 1^. LupulinsB, 5ss ; Contunde in mortario, et divide in pilulas x. Signa. — Two pills may be given for a dose, and the quantity be 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. 373. Pills of Sulphate of Morphia. 1^. Morphise Sulphatis, gr. ij ; Confectionis Rosse, q. s. ut fiant pilulse xij. Signa. — One may be given for a dose. One grain of either of the salts of morphia is usually esti- mated as equal to six of opium ; so that a pill of the above prescription 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. 374. Pills of Stramonium. 1^. Extracti Stramonii, gr. vj ; Pulveris Extracti Glycyrrhizae, q. s. Tere simul, et divide in pilulas xij. Signa. — Take one pill every two hours. Stramonium often manifests a marked controlling influence over neuralgic diseases and spinal irritation. To secure its full effects the system should be decidedly brought under its action, as manifested by dilated pupils or vertigo. 375. Pills of Lactucarium and Hemlock. 3^. Lactucarii, gr. xij ; Extracti Conii Alcoholici, gr. vj. Misce, et 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, dimin- ishing the natural heat, and procuring sleep, without inducing 142 NARCOTICS. the subsequent distressing effects which follow the use of opium. The thridace of the French appears to be prepared by a different process from that employed in the preparation of the British lactucarium. The former is not so highly esteemed in this country as the latter. 376. Pills of Henbane and Ipecacuanha. Tfy. Extracti Hyoscyami Alcoholici, gr. x ; Pulveris Ipecacuanha, gr. v. Misce, et divide in pilulas x. Sign a. — One every two hours until relief is procured, watch- ing the effect. Used in flatulence and irritability of the bowels. 377, JPills of Opium and Henbane. Ij*. Pulveris Opii, gr. v; Extracti Hyoscyami, gr. xv. Fiat massa, in pilulas x dividenda. Sigtia. — One every night when an anodyne is required. Henbane is a favorite anodyne remedy with English prac- titioners. When given in combination with opium, it modifies the unpleasant effects experienced by some persons from the use of the latter alone. 378. Pitts of Hemlock. Tfy. Extracti Conii, 5j ; Pulveris Conii q. s. ut fiat massa in pilulas singulas gr. ij pendentes, dividenda. Signa. — One pill every three hours. Used in scrofulous and cancerous affections. 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. Hemlock is more variable in strength than any of the narcotics, and hence the physician is often disappointed in its effects. Nevertheless, when of good quality, it is an excel- lent sedative narcotic. Stoerck. 379. Pills of Camphor and Opium. Iy. Camphors, in pulverem redacts, 3ij ; Extracti Opii, gr. viij. Mucilaginis Tragacanthae q. s. ut fiat massa in pilulas xvj dividenda. Signa. — Take two pills every night at bedtime. NARCOTICS. 143 Used for spasm of the urethra, and to prevent nocturnal erections. Ricord. 380. Pills of Opium and Digitalis. 3^. Pulveris Opii, Pulveris Digitalis, aa gr. vj. Confectionis Rosse q. s. ut fiant pilulae xij. Signa. — One to be taken every four hours. In asthma. 381. Pills of Extract of Conium and Calomel. Ify. Extracti Conii, 5ss ; Hydrargyri Chloridi Mitis, gr. v. Fiant pilulse xv. Signa. — One three times a day. Used in painful syphilitic affections. 382. Pills of the Extract of Nux Vomica. I$s. Extracti JSTucis Vomicae Alcoholici, Pulveris Extracti Glycyrrhizae, aa 3j. Misce, et fiant pilulae xl. Signa. — Take one pill three times daily. Recommended in general and local palsies, in paralysis of the sphincters, and for incontinence of urine. Radius. 383. Pills of Strychnia. 3^. Strychnine, gr. ij ; Confectionis Rosae q. s. ut fiant pilulse xxiv. Signa. — Of which one pill may be given once or twice a day, according to the idiosyncrasy of the patient. Used in paralysis. Strychnia forms with acids a variety of salts, which are generally soluble. 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. Maqendie. 384. Pills of Camphor, Assafetida, $c. Iy. Camphorse, Assafoetidse, aa 5j ; Extracti Belladonnae, 5ss ; Extracti Opii, gr. x. Contere in massam, et divide in pilulas lx. Signa. — One pill is given night and morning, or at shorter intervals, according to the urgency of the case. Used in hysteria. Debreyne. vj.7. : : :: : ?. B85. PiZfe of Aconite and Dower * Powder. Pi . Ex:r i :•:: Aconiti Alcoholiei, gr. vj ; Pulveris Ipecacuanhae Compositi, gr. xij ; - it fiat raassau in pilulas vj di videnda . Signa. — Take one pill three times a day. :z:::zvz zs. zz : E. . E i : - j : . •■• . Sacchari 5ij ; Aquae Cinnamomi, f §tj. :l:-,~. ::t — i:1t ': f ::: ; :-Z in :-ti:t-: :v_: . In tetanus and colica pictonum. Ellis. J87. Laudanum. Pw. Tir.::-:: :e 0: L\ : 5" •S':; .J. — I': ; r. ^r::"-:": inis. As the regulation of doses for children is, to the young ::::-. :■?:::: irr. :i: ;::_t:l: ; : lizi :•-".: iir:i :: ir^s ::/::::. z. .V- : as laudanum is an article so universally employed in their diseases, we subjoin the following graduated, table from Dr. For a child at birth or within a month after, § to 1 drop. UiZt: i 7^: ZZ From one to two years of age, From two to five From five to ten " From ten to fifteen Ai fifteen yea: For an adult. \ to 3 drops. lto 5 " 2 to 8 " :o 15 " 10 to 20 " :: ■• 25 to 80 « I: is important in the employment of laudanum that it should be of the proper strength 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 : c NARCOTICS. 14o hence the liquid near the surface is weaker, and the dregs correspondingly stronger. Infants have been destroyed by the exhibition of thick laudanum. Physicians, therefore, should always examine the vial before trusting the nurse to give a dose to a child. B. E. 388. Officinal Preparations of Opium. As each of the numerous preparations of opium presents some peculiarities, which, at times, renders it preferable to all others for internal exhibition, the following statement of the opium-strength of each may prove valuable as a guide in pre- scribing : 13 minims or 25 drops of laudanum (Tinctura Opii); 13 " or 25 " of the elixir of opium (Tinctura Opii Deodorata) ; 7 " or 10 " of black drop (Acetum Opii) ; 10 " or 20 " of the acetated tincture (Tinctura Opii Acetata) ; 80 " or 80 " of ammoniated tincture (Tinct. Opii Ammoniata, Ed.) ; 8 " or 15 " of wine of opium or Sydenham's lau- danum ( Vinum Opii) ; A tablespoonful of paregoric ( Tinct. Opii Camphor ata) ; Thirty-six grains of the confection (Oonfectio Opii) ; Half a grain of the extract (Extr actum Opii) ; and Ten grains of Dover's powder (Pulvis Ipecacuanhas Compo- situs), contain, respectively, one grain of opium. About five grains of opium, or a small teaspoonful of lauda- num, may be considered as equivalent to one grain of morphia, or of any of its salts. R. P. T. 389. Solution of Sulphate of Morphia. Ify. Morphise Sulphatis, gr. j ; Aquae destillatae, f Sj« Fiat solutio. Signa. — Dose, one teaspoonful. Used in the same cases as opium. When morphia and its salts were first introduced, the for- mulas 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 the acetate of morphia in a fluidounce of water ; whereas the officinal solution has but one 10 1-A6 NARCOTIC?. grain to the ounce. Practitioners should avoid confounding the two solutions. 390. Syrup of Sulphate of Marph E . Morphia? Sulphatis. gr. viij : Aquae destillata?. f§iv« Solve, et adde — Syrupi. fSiT : Spiritus JEtheris Compositi. f5j. Misce. Signa. — Dose, a teaspoonful. This is. virtuallv. of the same strength as the officinal solu- tion, and has the advantage of being more durable as -well as more palatable. J. T. Plummer. 391. Syrup oj . ieia. B.. Oodeiae, gr. xij ; Syrupi Acidi Citrici, f §iv. Misce. Signa. — Dose, a teaspoonful three times daily. Prescribed as an antispasmodic in hooping-cough, and as an anodyne in gastric and abdominal pains. This principle is allied in its effects to morphia. A single grain of it proves highly anodyne, but it distresses the stomach in larger doses. Such is the testimony of Magendie. Trous- seau observes that it does not possess a single special property which is not found in opium. 392. Mixture of Laudanum and Oil of Turpentine. B.. Tincturae Opii. f§j : Olei Terebinthinas, f-5^. Misce. na. — A teaspoonful. diluted, every hour or two may be given in delirium tremens, its effect being 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 two ounces of laudanum were taken. "We do not believe in the doctrine, however, that opium in this disease may be administered 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. NAKCOTICS. 147 393. Mixture of Lupulin. Ify. Tincturae Lupulinae, f§j ; Syrupi Amygdalae, f oj ; Aquae, foij« Misce. Signa. — Dose, a tablespoonful every two hours. Dr. Gr. B. Wood recommends the tincture of lupulin in the treatment of delirium tremens, both as an adjuvant to opium, and as a substitute for it. By checking vomiting, and quieting restlessness, it promotes sleep. 394. Mixture of Camphor Water and Hoffman s Anodyne. Iy. Aquae Camphorae, f§iij; Spiritus iEtheris Compositi, Syrupi Amygdalae, aa f §ss. Misce. Signa. — Dose, a dessert-spoonful every two hours. Used in nervous affections, and the sleeplessness of fever. 395. Propylamin Mixture, 3^. Propylamini, gtt. xxiv ; Aquae, fSvj. Misce. Signa. — Give a tablespoonful every two hours. This has been used successfully in cases of acute and chronic rheumatism in the Hospital of St. Petersburg. Awenakin. 396. Mixture of Chloride of Propylamin. Ify. Propylamini Chloridi, gr. xxxvj ; Sacchari, 5\j ; Aquae Menthae Piperitae, f§vj. Fiat solutio. Signa. — A tablespoonful every two hours. This preparation has been employed for rheumatism in the Pennsylvania Hospital, as an efficient substitute for pure pro- pylamin, which is liable to undergo change, unless carefully preserved. J. J. Levick. 148 NARCOTICS. 397. Elixir of Propylamin. Ify. Propylamini Chloridi, 3ij ; Aquae, fSiijss. Solve et adde— Syrupi, f oSS ; Spiritus Curagoae, f5j. Misce. Signa. — Dose, a teaspoonful. In this preparation the unpleasant odor and taste are over- come by the use of syrup and Curacoa cordial. Each flui- drachm contains one grain of the chloride of propylamin. R. H. Stabler. 398. Mixture of Iodide of Propylamin. Ify. Propylamini Iodidi, gtt. xxv ; Sacchari, 5ij ; Aquae Menthae Piperitae, f§vj. Misce. Signa. — A tablespoonful every two hours. Used, like the other preparations of propylamin, in the treatment of rheumatism. The presence of iodine is claimed as an important element in this combination. B. J. Crew. 399. Tincture of Strychnia. 1^. Alcoholis, fgj ; Strychnia, gr. iij. Mat tinctura. Signa. — This tincture is to be given by drops, from six to twenty, in draughts of mucilage. Used in general and local paralysis. Magendie. 400. Strychnia Mixture. Jfy. Strychniae, gr. j ; Acidi Acetici, gtt. ij ; Sacchari, 5\j ; Aquae destillatae, f§ij. Fiat solutio. Signa. — A teaspoonful morning and evening. Prescribed in palsies. It has also proved beneficial in the vomiting of pregnant women, when given in smaller quantities and at shorter intervals. Magendie. NARCOTICS. 149 401. Solution of Extract of Belladonna. I^. Extracti Belladonna, gr. iij ; Syrupi, f 5j ; Aquae Cinnamomi, f5vij. Fiat solutio. Signa. — Give three drops 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 pre- ventive of scarlatina. The extract, if given for several days, produces a scarlet eruption and affection of the fauces, analo- gous to those of scarlatina ; and it is pretended that this fac- titious disease is sufficient to prevent the access of the real one. S. G. Morton. 402. Mixture of Chloric Ether. Jfy. iEtheris Chlorici, f ojss ; Aquae Camphorae, f §ij ; Syrupi Amygdalae, f §ss. Misce. Signa. — A dessert-spoonful in water every three hours. As prepared by the manufacturing chemists of Philadelphia, chloric ether is of a uniform strength, and a reliable article. It is less narcotic than chloroform, but more stimulating. It has proved of great service in the treatment of many nervous and painful affections unattended by active inflammation. C. Evans. 403. Chloroform Mixture. Ify. Chloroformi purificati, 5ij ; Olei Cinnamomi, gtt. viij ; Spiritus Camphorae, Tincturae Opii, aa f 5jss ; Alcoholis, f5iij- Misce. Signa. — The dose ranges from five to thirty drops, in sweet- ened water. This preparation has proved highly serviceable in the relief of the pain and cramps of colic, cholera morbus, and cholera asphyxia. H. Hartshorne. 150 NARCOTICS. 404. Chloroform Mixture. R. Chloroformi, 5j ; Yitellum unius Ovi. Tere simul et adde — Sacchari, 5ij ; Aquae, foij* Fiat mistura. Signa. — Dose, a dessert-spoonful every two hours. Prescribed in gastrodynia, flatulent colic, and cholera mor- bus. Owing to the antiseptic properties of the chloroform, this mixture keeps well. It is used in the same cases as the preceding. 405. Mixture of Magnesia, Assafetida, and Laudanum. Ify. Magnesiae Carbonatis, 5ss; Tincturae Assafoetidae, gtt. lx ; Tincturae Opii, gtt. xx ; Sacchari, 5j 5 Aquae destillatae, fSj- Fiat mistura. Signa. — Twenty-five drops may be given to an infant of two to four weeks old. In flatulent colic, diarrhoea, &c. This preparation was strongly recommended by the late Dr. Dewees, and it is now much employed in this city, under the name of Dewees 's Carminative. 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, conse- quently the carbonate should be preferred. 406. Carminative for Infants. 3^. Magnesiae Carbonatis, 3j ; Vini Opii, gtt. xv ; Syrupi Acaciae, f 5iij ; Aquae Cinnamomi, f 5 v. Misce. Signa. — Shake well before using. Dose, ten drops for a child three days old. Used to relieve colicky pains, and to correct the green alvine discharges of infants. NARCOTICS. 151 407. Another Form (without opium). J$j. Cretse Preparatse, Sacchari, aa 5j ; Acacise Pulveris, 31) ; Aquae Cinnamomi, f§iv. Misce. Signa. — Give a teaspoonful two or three times daily. Used in acidity, flatulent colic, and diarrhoea of young children. Davis. 408. Tincture of Hemp. ^. Extracti Cannabis purificati, gr. xxiv ; Alcoholis, f§j. Fiat solutio. Signa. — Take ten drops every two hours. The above is the formula of Dr. O'Shaughnessy, of Cal- cutta, who has had much experience with the gunjah or Indian hemp. In cholera, he gave ten drops every half hour to check the vomiting ; in tetanus, a drachm of the tincture, with the same interval, until the paroxysms ceased, or cata- lepsy was induced ; and in acute rheumatism, twenty drops until symptoms of intoxication 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 here- tofore imported, has interfered with its introduction into prac- tice ; but there is now to be had, in Philadelphia, an extract which is decidedly narcotic in the dose of a quarter to half a grain. It may be given as a pill, or be rubbed into powder, as in the following form : 409. Powder of Hemp. 1^. Extracti Cannabis purificati, gr. v ; Sacchari Lactis, 5j- Tere simul et divide in pulveres xv. Signa. — One powder to be given every four hours. Although this formula is particularly recommended for use in gonorrhoea, yet it will be found a convenient mode of exhibit- 152 NARCOTICS. ing Indian hemp in a variety of complaints, as sciatica, neu- ralgia, tetanus, &c. M. D. Mooney. 410. Alcoholic Solution of Oil of Bitter Almonds. Tfy. Olei Amygdalae Amarae, trgxx ; Alcoliolis, f5iij- Fiat solutio. Signa. — Take ten drops four times daily. Used in neuralgia, tic douloureux, and other painful com- plaints. Horn. CLYSTERS AND SUPPOSITORIES. 411. Laudanum Enema. ]^. Tincturae Opii, gtt. 1 ; Infusi Lini Compositi, f §ij. Fiat enema. Used for obstinate vomiting, chronic dysentery, and painful affections of the pelvic viscera. 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 in relative doses, act more powerfully upon the rectum or upon the stomach. 412. Opium Suppository . Iy. Pulveris Opii, gr. ij ; Saponis, gr. iv. Misce bene. Signa. — Introduce into the rectum when a local anodyne is indicated. 413. Another Form. Tfy. Olei Theobromae, §ss ; Pulveris Opii, gr. xij. Liquefac cum leni calore. Misce, et fiant suppositoria xij. Signa. — One to be introduced into the bowel. This is a good form for securing the effects of opium, when the remedy cannot be borne by the mouth. S. W. Mitchell. NARCOTICS. 153 414. Suppository of Opium and Bhatany. 1^. Olei Theobromaa, §ss ; Extracti Krameriae, 3ij ; Pulveris Opii, gr. v. Misce secundum artem, et fiant suppositoria x. Used in piles, relaxation or descent of the bowel, fissure of the anus, &c. J. Pancoast. 415. Suppository of Morphia. ^. Olei Theobromae, Sss ; Morphias Sulphatis, gr. iij. Liquefac, et fiant suppositoria xij. The introduction of one of these into the bowel, every three or four hours, affords much relief in painful affections of the pelvic viscera, and, especially, in dysmenorrhoea, and cancer of the womb. Chordee can usually be controlled by the use of one at bedtime. They have also proved highly beneficial in arresting the pain attendant upon a threatened abortion. R. P. Thomas. 416. Suppository of Belladonna. Ify, Extracti Belladonnae Alcoholici, gr. ij ; Saponis, gr. iv. Fiat suppositorium. Recommended in painful affections of the womb or bladder. S. Ashwell. 417. Suppository of Hemlock, ]^. Olei Theobromae, 5j ; Extracti Conii, gr. x. Misce, et fiat suppositorium. Used in cancer of the rectum, womb, or bladder. EXTERNAL USE OF NARCOTICS. 418. Mixture of the Extract of Belladonna. ]^. Extracti Belladonnas, Glycerinae, aa 5j- Tere simul. Used for dilating the pupil in cataract, by rubbing around the eyebrow and on the temples. 154 NARCOTICS. 419. Solution of Atropia. R. Atropine, gr. ij ; Acidi Acetici, gtt. vj ; Aquae destillatae, f§j. Fiat solutio. Signa. — Let a drop or two fall into the eye to dilate the pupil. This is equally efficacious in its action, and more elegant than the ordinary preparations of belladonna. It is also much more prompt, a healthy iris being acted upon in ten to twenty minutes. W. W. Cooper. Three minims of this solution, containing one-eightieth of a grain of atropia, may be considered equivalent in activity to one-third of a grain of the extract, or fifteen drops of the tinc- ture of belladonna, for internal administration. R. P. T. 420. Mixture of Opium, Lime-water, ^c. R. Extracti Opii, gr. j ; Liquoris Calcis, Olei Amygdalae Dulcis, aa f 3iij. Fiat mistura. Recommended by Dr. Sibergundi of Dorsten, in the treat- ment of sore nipples. It is to be applied on dossils of lint. 421. Infusion of Hemlock. R. Conii, §ss ; Aquae bullientis, Oj. Fiat infusum. Signa. — Apply both the infusion and the leaves to cancerous and scirrhous ulcers. A cataplasm is also employed for the same purpose, made by mixing the powdered leaves with bread-and-water poultice. 422. Infusion of Henbane, R. Hyoscyami Folii, oss : Aquae bullientis, Oj. Fiat infusum. Employed as an external application to cancerous, scrofu- lous, and other indolent ulcers. NARCOTICS. 155 423. Dental Anaesthetic. 1^. Tincturae Aconiti Radicis, Chloroformi purificati, Alcoholis, aa f Sj ; Morphise, gr. vj. Misce. Signa. — Moisten two pledgets of cotton with the liquid, and apply to the gums for a minute or two, around the tooth. Employed to diminish the pain of extraction of teeth, and to deaden sensibility in the gums. Tefet. 424. Decoction of Stramonium in Milk. ^. Stramonii Folii, 5ij ; Lactis recentis, Ojss. Coque ad Oj. Employed for gouty, rheumatic, and other painful swellings, by applying both the boiled leaves and the milk to the affected part. 425. Ointment of Belladonna. 1^. Extracti Belladonnse, 5ij ; Adipis, §ij. Eiat unguentum. A portion to be applied to the neck of the uterus in rigidity of that part occasioned by disease, or previous 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 speculum with a wide mouth. Chaussier. 426. Sedative Application, ]^. Extracti Belladonnse, 5jss ; Tincturse Opii, rrgxl. Tere simul, et adde — Chloroformi Venalis, 5j. Misce. Signa. — For local application. A portion of this mixture is to be smeared over the seat of pain in neuralgia, or other local painful affections. Diday. 156 NARCOTICS. 427. Lotion of Atropia. 1^. Atropine, gr. yj ; Acidi Acetici, gtt. x ; Glycerinse, f5uj. Misce. Forty or fifty drops are to be applied by friction over the track of the nerve, three times daily, in facial neuralgia. 428. Anodyne Plaster, 3^. Emplastri Plumbi, 5ij ; Liquefac lento igne, et adde gradatim — Pulveris Opii, Pulveris Camphorae, aa 5ss. Fiat emplastrum. Used for enlarged joints, rheumatism, and local pains. The officinal "Emplastrum Opii" is employed for the same pur- poses. 429. Plaster of Opium and Camphor. i^. Pulveris Opii, Pulveris Camphorae, Saponis, aa 5j ; Tincturae Opii, q. s. ut fiat emplastrum. This plaster, spread upon cloth or kid of the requisite size, is employed in the same cases as the preceding. 430. Another Form. Ify. Pulveris Opii, 3ij ; Camphorae, 5ss ; Picis Burgundicae, §j ; Emplastri Plumbi, q. s. ut fiat emplastrum, ivXvj. This plaster is highly recommended in neuralgia. Graves. 431. Plaster of Opium and Belladonna. 1^. Extracti Opii, gr. xv ; Extracti Belladonna, 5j ; Glycerinae, trgxx vel q. s. Misce. Signa. — Spread on adhesive plaster 3x4 inches, leaving an adhesive margin all round. This is an excellent application to the face for toothache, or to other parts for the relief of neuralgia. NARCOTICS. 157 432. Liniment of Belladonna, Cherry Laurel Water, $e. 3^. Extracti Belladonnae, 3ij ; Aquae Amygdalae Amarae, f oij- Tere simul, dein adde — Athens, foj» Misce. Signa. — Rub the liniment on the affected part, and apply a flannel moistened with it, the whole to be covered with a piece of oiled silk. Useful in neuralgia, in gouty and rheumatic pains, and for gathered breasts. Ranque. 433. Camphor and Chloroform Liniment. "Sf. Camphorae, §jss ; Chloroformi Venalis, 5\j ; Olei Olivae, oij. Fiat linimentum. Useful in rheumatic and neuralgic affections. W. B. Price. 434. Chloroform and Soap Liniment. Jfy. Linimenti Saponis, f§ij ; Chloroformi Venalis, f5j. Misce. Employed like the preceding in rheumatic pains. The quantity of chloroform may be advantageously increased. Tuson. 435. Compound Chloroform and Aconite Liniment. 3^. Olei Ricini, 5ij ; Chloroformi Venalis, Spiritus Ammoniae, Tincturae Aconiti Radicis, aa f 5\j J Linimenti Saponis, f Sj. Misce. Employed in rheumatic pains, bruises, &c. W. Procter, Jr, CLASS XL 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 Narcotics. PILLS, ETC. 436. Pills of Assafetida and Soap. 1^. Assafoetidse, 5j ; Saponis, gr. x. Contunde in massam, et fiant piluiae xx. Signa. — Two of these pills may be taken for a dose. Used in hysteria, and as a mild laxative. 437. Pills of Oxalate of Cerium. Jfy. Cerii Oxalatis, gr. xv; Extract! Gentianse, gr. v. Fiat massa in pilulas x dividenda. Signa. — Take one pill an hour after each meal. Used to relieve the sick stomach of pregnancy. This article was brought into notice as a remedy by Prof. J. Y. Simpson, of Edinburgh, who uses it both in the pulverulent and the pilular form. He says, "I have seen it successful in curing vomiting in a larger proportion of cases than any other single remedy." 438. Pills of Castor and Succinic Acid. Ify. Castorei, 5j ; Acidi Succinici, 5ss ; Extract! Gentians, q. s. ut fiant pilulee xxiv. Signa. — Dose, three pills night and morning. In hysteria. ANTISPASMODICS. 159 439. Pills of Mush, Camphor, gc. Ity. Moschi, 3ss ; Camphorae, 9j ; Ammoniaci, 3ij ; Opii, gr. iv. Misce, et fiant pilulae singula gr. iv pendentes. Signa. — One pill to be given every three hours. In nervous diseases. M. A. Richard. 440. Pills of Valerianate of Zinc. Ify. Zinci Valerian atis, gr. xij ; Confectionis Rosae, q. s. ut fiat massa in pilulas xij divi- denda. Signa. — Give one pill every three hours. Used in neuralgia, epilepsy, and anomalous nervous tions. 441. Bolus of Mush and Camphor. 1^. Camphorae, Moschi, aa gr. v ; Syrupi Acaciae, q. s. ut fiat bolus. This excellent stimulant is given in the low stages of bi- lious, congestive, typhoid, or typhus fevers, a bolus being ad- ministered every two or three hours. Were it not for the gross adulterations of musk, and its exorbitant price, this remedy would doubtless receive more attention. To confine the aroma of musk, whether in the form of pills or otherwise, it should always be kept in vials. MIXTURES, ETC. 442. Mush Mixture. 1^. Moschi optimi, 5\j ; Sacchari, 5j ; Pulveris Acaciae, 5j ; Aquae destillatae, f 5vj. Fiat mistura, et adde — Tineturae Opii Camphoratae, f §ss ; Tineturae Valerianae Ammoniatae, foj. Misce. Signa. — A teaspoonful three or four times a day, For children in pertussis. 160 ANTISPASMODICS. 443. Mixture of Sumbul and Valerian. R. Tincturae Sumbuli (Rad. Sumb. Sij ad Alcoholis, Oj), Tincturae Valerianae, aa f oj. Misce. Signa. — Dose, a teaspoonful every two hours, in sweetened water. The sumbul, or musk-root of Asia, has attracted some at- tention in Europe as a mild stimulant, suited to the low forms of fever, controlling the nervous symptoms that arise during convalescence from fevers. It has been prescribed also for the relief of cramps, spasms, and hysteria. Granville. 444. Mixture of Assafetida, Castor, and Ammonia. R. Tincturae Assafetidae, Tincturae Castorei, aa f§j ; Spiritus Ammonia? Aromatici, f5j- Misce. Signa. — A teaspoonful may be taken in a glass of sweetened water for a dose. 445. Hoffman s Anodyne and Laudanum. Tfy. Spiritus iEtheris Compositi, f&ij ; Tincturse Opii, gtt. lxxx ; Aquae Cinnamomi, fo^j. Fiat mistura. Signa. — A tablespoonful every two hours. Given in hysteria, and to quiet restlessness and morbid vigilance. 446. Mixture of Assafetida. R/. Assafostidae electee, oij ; Vini Xerici, f 5 v. Tere simul, et adde gradatim — Aquae, f.5vij. Misce. Signa. — Dose, a tablespoonful for an adult, a teaspoonful for a child. This preparation corresponds in strength with the officinal milk of assafetida, containing fifteen grains in a fluidounce. The design of its proposer is to have the wine made up of the exact strength indicated, and to have it kept in a cool place ready for use. With care it may be preserved several months. ANTISPASMODICS. 161 The seven parts of water are not to be added to the one of wine of assafetida until a prescription is received. Used like the other preparations of assafetida as a laxative and carminative, and in nervous affections of various kinds. H. N. RlTTENHOUSE. 447. Mixture of Assafetida, Valerian, and Castor, 3^>. Assafoetidas, 5j ; Aquas Menthas Piperita, foiij. Eiat mistura, et adde — Tincturas Valerianas Ammoniatas, f 5ij ; Tincturas Castorei, f 5iij ; iEtheris, f5j. Signa. — A tablespoonful for a dose, largely diluted, every second hour. In hysteria. 448. Oil of Valerian with Spirit of Hartshorn, 1^. Olei Valerianae, Trgyiij ; Spiritus Ammonias Aromatici, f 5j ; Sacchari, 5\j ; Aquas, f §iv. Misce. Signa.- — Take a tablespoonful every three hours, 449. Mixture of Nitric Acid, Tfy. Acidi Nitrici, "n^xxxij ; Syrupi, fSiijss ; Tincturas Cardamomi Conrpositas, f§ss. Misce. Signa.— Dose, half a teaspoonful every three hours. Prescribed in pertussis, the quantity to be augmented in proportion to the age of the patient, and the severity of the paroxysms. H. Holmes. 450. Mixture of Ether and Laudanum, Jfy. iEtheris, f 5ij ; Cetacei, gr. iv. Tere simul, et adde gradatim — - Aquas Menthas Piperitas, f§ij; Tincturas Opii, f5j. Misce. Signa. — Dose, a teaspoonful. Prescribed in cramp of the stomach, colic, or other severe abdominal pains. It should be administered at short intervals* 11 162 AVTI8PA8M0D1 - 451. Mixture of I sifuga. R. Extracti Cimicifuga? Fluidi, S yrupi Acaciae, aa fSsa ; Aquae Amygdalae Amarse. f 5iij. Misce. — A teaspoonful every three hours. Black snakeroot is a remedy of much value in the treatment of diseases of the nervous system, and especially in chorea and hooping-cough. 452. Mixture of Skullcap. R. Extracti Scutellariae Fluidi (Thayer), Syropi, aa ffjss; Aquae Amygdalae Amarse, f§ij. Signa. — A dessert-spoonful every three hours. In the early part of the present century skullcap was sons - dered by many persons an absolute specific for the preven:: of hydrophobia. Its claims to this virtue are now obsolete. It has been tried in various diseases, chiefly those of a nervous character or involving the nerve-centres, such as delirium tre- mens, chorea, convulsions, and irritation from teething in chil- dren, with an amount of success justifying a mo: employment. 453. Assqfctida Zm R. Tinctura? Assafcetida?, foij ; Mucilaginis Ulmi, f^vj. Misce pro enemate. Administered in hysteria, spasmodic colic, &c A thir even one-half of this quantity may be safely and beneficially given to a young child in convulsions. 454. Musi Z R. Moschi, gr. xij ; Sacchari, 3ij ; Spiritus Ammonise. njjxxx : Infusi Lini Compositi, f 5iv. Fiat enema. 1. — Given in infantile convulsions. One-half bein£ in- jected at a time. CLASS XII. SIALAGOGUES. Those medicines which increase the salivary secretion are denominated Sialagogues. In forming these into a class in this place, we trespass on the arrangement of Dr. Chapman, but 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 prepara- tions in stronger relief than could otherwise be done. 455. Powders of Qalomel. Ify. Hydrargyri Chloridi Mitis, gr. ij ; Sacchari lactis, 3j. Tere simul et divide in pulveres viij. Signa. — Take one powder every two hours. When the practitioner wishes to obtain the alterative effects of mercury, it is better to administer very small doses, at short intervals. A larger quantity would probably act upon the liver, and secondarily, upon the bowels. 456. Pills of Corrosive Sublimate. Iy. Hydrargyri Chloridi Corrosivi, gr. vijss ; Amyli, 5j ; Syrupi Acacise, q. s. ut fiant pilulae lx. Signa. — Give one pill three times a day. Prescribed in constitutional syphilitic affections. Trousseau. 164 SIALAGOGUES. 457. Dupuytren s Antisyphilitic Pills. Ify. Hydrargyri Chloridi Corrosivi, gr. ss ; Extracti Cinchonse, gr. x ; Extracti Opii, gr. ss. Fiant pilulse ij. Signa. — The two pills may be taken, one in the morning, and the other at night ; but as each contains a 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. 458. Pills of Corrosive Sublimate and Hemlock. IJs. Hydrargyri Chloridi Corrosivi, gr. vj ; Extracti Conii, 5j ; Pulveris Conii, q. s. ut fiat massa, in pilulas xlviij divi- denda. Signa. — 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 gentle salivation will sometimes produce mortification and de- struction of 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. B. Ellis. 459. Pills of Iodide of Mercury. Jfy. Hydrargyri Iodidi Viridis, gr. v ; Confectionis Rosge, q. s. ut fiant pilulae xxx. Signa. — 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 the remedy too far. SIALAGOGUES. 165 460. Compound Pills of Iodide of Mercury. ]^. Hydrargyri Iodidi Viridis, Lactucarii, aa 5ss ; Extracti Opii, gr. ix ; Resinse Guaiaci, 5j- Misce et fiant pilulse xxxvj. Signa. — Take one pill three times daily. Highly recommended both in primary and secondary syphi- lis, the treatment being continued until mercurialization appears. Ricord. 461. Pills of Calomel, Camphor, and Opium. 1^. Hydrargyri Chloridi Mitis, Camphorae, aa 3j ; Pulveris Opii, gr. x ; Syrupi, q. s. ut fiant pilulse xx. Signa. — One to be taken morning, noon, and night, when calomel by itself causes purging. B. Ellis. 462. Pills of Blue Mass. 1^. Pilulge Hydrargyri, 5ss. Divide in pilulas x. Signa. — One to be taken night and morning. When used as thus prescribed, blue mass is one of our best alteratives in the treatment of syphilitic disease, and all other complaints where the mercurial impression is indicated. If eight or ten grains be taken at bedtime, one or two eva- cuations of the bowels will occur during the next day. 463. Pills of the Med Oxide of Mercury. ]^. Hydrargyri Oxidi Rubri, gr. j ; Pulveris Opii, gr. j ; Olei Caryophylli, gtt. ij. Fiant pilulge iij. Signa. — One pill every night for a week. In venereal cases. This preparation, in a stronger formula, was used and highly recommended by the celebrated John Hunter ; but from its harshness it is now generally superseded by milder medicines. 166 SIALAGOGUES. 464. Solution of Cyanide of Mercury. 1^. Hydrargyri Cyanidi, gr. viij ; Aquae, Oj. Fiat solutio. Signa. — A teaspoonful of the solution, containing one-sixteenth of a grain of the cyanuret, may be given morning, noon, and night, watching its effects. This is the Liquor Anti-syphilitique of Chaussier, who prefers it to corrosive sublimate, on account of its greater solubility and more speedy action. 465. Powder of Mercury and Chalk with Ipecacuanha. Ify. Hydrargyri cum Creta, 3j ; Pulveris Ipecacuanhae, 3ss. Fiant chartulse vj. Signa. — One night and morning in syrup. 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. 466. Masticatory of Pellitory and Mastich. 3^. Pulveris Pyrethri, Mastiches, aa 5j- Signa. — Let these be mixed together by a moderate applica- tion of heat ; then divide the mass into two equal parts. One of these lumps may be chewed at pleasure. Used in toothache and paralytic affections of the tongue. Walther. CLASS XIII. TONICS. Tonics are those medicines which impart strength to the system, without subjecting it to any preternatural excitement during their operation. They stimulate, however, in a second- ary manner, by gradually increasing the force of the circula- tion, 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 intermittent disease. The numerous remedies of this class, and their varied modes of exhibition, render it advisa- ble, in a work of this kind, to have some mode of distinguish- ing 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. Sub-Class I.— ANTI-INTERMITTENTS. At the head of this class stand, confessedly, Peruvian Bark and its numerous preparations. POWDERS AND PILLS. 467. Powder of Peruvian Bark. Iy. Pulveris Cinchonse Rubrse, 5j. Signa. — A teaspoonful to be taken every hour in port wine, water, or milk, during the intermission of fever. 168 TONICS. Some practitioners suspend the bark till within a few hours of the expected paroxysm ; and others administer it during the hot stage of the disease. It is better to commence imme- diately 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. If the bark should purge when given alone, a little opium may be added ; when it oppresses the stomach, cloves, as in the next prescription ; if costiveness should follow, rhubarb or sulphate of magnesia. 468. Powder of Peruvian Baric, Cloves, and Cream of Tartar, 1^. Pulveris Cinchonae Rubrse, Potassse Bitartratis, aa Sj ; Pulveris Caryophylli, 5j. Misce. Signa. — Dose, a teaspoonful in syrup every second hour. This compound will sometimes succeed in arresting mias- matic disease when the bark alone fails. 469. Powder of Peruvian Baric, Virginia Snake-root, and Soda. Jfy. Pulveris Cinchonse, Sss ; Pulveris Serpentarise, 5j ; Sodse Bicarbonatis, ^ij. Divide in chartulas iv. Signa. — One to be given every two hours. In obstinate intermittents. 470. Powder of Prussian Blue and Cfuaiae. Iy. Ferri Ferrocyanidi, Pulveris Guaiaci Resinse, aa 5j- Misce, et divide in chartulas xij. Signa. — One three times a day. In obstinate intermittents. 471. Pills of Sulphate of Quinia. Ify. Quinise Sulphatis, gr. xx; Acidi Sulphurici Aromatici, tn^xv. Signa. — " Drop the acid into the sulphate of quinia on a tile or slab, and triturate it with a spatula until it assumes a pilular consistence; then divide into the required number of pills." Made in this way a three-grain pill is not inconveniently large, E. Parrish. TONICS. 169 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, which is one grain in each pill. For example, three, four, or five grains may be requisite in those cases in which the neuralgic 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 becomes severe, the medicine must be suspended or diminished in quantity. 472. Pills of Quinia, Opium, and BlacJc Pepper. E*. Quinise Sulphatis, gr. xx ; Pulveris Opii, gr. ij ; Oleoresinae Piperis, rrgy ; Syrupi Acaciae, q. s. ut fiat massa in pilulas xx dividenda. Signa. — Give two pills every hour in the morning of an ex- pected chill. In ordinary intermittents the sulphate of quinia retains the first rank for promptness and efficiency in arresting the par- oxysm ; but in chronic cases it frequently fails. In the treat- ment of the latter, the present prescription will prove an excellent agent. 473. Poivders of Sulphate of Quinia and Tartar JEmetic. Ify. Quinias Sulphatis, gr. x ; Antimonii et Potassae Tartratis, gr. iij. Misce, et divide in partes vj aequales. Signa. — Give one powder every two hours. This preparation is commended as having been successful in intermittent fever, when quinia alone produced no favorable result. It causes vomiting and purging, and prevents the recurrence of the paroxysm. It should be given during the intermission. Gola. 474. Pills of Sulphate of Quinia and Carbonate of Ammonia. Ify. Quiniae Sulphatis, gr. xij ; Ammoniae Carbonatis, gr. xxiv ; Syrupi Acaciae q. s. Fiant pilulae xij. Signa. — One every hour, beginning six hours before the ex- pected paroxysm. Tifaese pills are lairds, tat the y wiE act when qninia alone :::"rt ix.-xi.x : - ; _r : . " . . .. . , -. . ii::::r. ! : . . XX. Terc saamL et fait pifebe xL %■*.— Take two pOls every three hoars. Dr. Gfwwmill has tried cMnMBimae f " I S E '. P It f 7 umbo and Pota%sio-tar irate of Iron. R. Ferri et P: lartratis, 3ij : Pulveris Calunibae, 5ss. Fiant pulveres iv. Signa. — One every three or four hours, in syrup. An excellent tonic, used in dyspepsia and chlor-: a :lers of Suhnitrate of Bismuth. R. Bisniuthi Sobnitratis, 5~ Sacchari. . Ifiaee et divide in pulveres x. la. — Give one powdeT three taniee lafly. sed in gi . chronic vomiting, and chronic diar- rhoea. Recamier. 507. Pills of YaUei's Mass. ' Q da Ferri Carbonatis, 5j ; Ferri Subcarbonatis, q. s. ut fiant pilulae xx. Signa. — A pill to be taken morning, noon, and night. This is one of the best of the chalybeate preparations, and may be used whenever it is desirable to introduce iron into the system. 508. Pills- of Lactate of Iron. R . Ferri Lactatis. 5j ; Extract: G-lvcvrrhiz^. " Mellis, q. s. ut fiat massa in pilulas xl dividenda. v :na. — Take one pill three times daily. U-ed in dyspepsia, anaemia, chlorosis, fee. This salt is well suited to the disr see :" childhood, a not unpleasant, and it can be administered in the form of a syrup. Ti u. . Pills of Cinchona and Camphor. R. Extracti Cinchona? Rubrae, 5j ; Estracti Opii, gr. j ; mphora?. gr. I Pulveris Cm |. s. ut fiant pilulae xij. v ;na. — One to be taken three times a da; Ratier. TONICS. 1T9 510. Pills of Ammoniated Copper. Iy. Cupri Ammoniati, 3j ; Confectionis Rosas, q. s. ut fiant pilulae xl. Signa. — One to be taken morning and evening. Prescribed in epilepsy. 511. Pills of Iron and Strychnia. Jfy. Strychnias, gr. j ; Ferri Redacti, gr. xxx ; Mucilaginis Tragacanthae, q. s. ut fiat massa in pilulas xxx dividenda. Signa. — One pill three times daily. This is an efficient combination, serviceable in the treat- ment of chlorosis and dyspepsia. 512. Pills of Extract of Ignatia, Aloes, and Opium. ~Bp. Extracti Ignatiae Alcoholici, gr. viij ; Pulveris Aloes purificatae, gr. vj ; Pulveris Opii, gr. ij ; Mucilaginis Acacias, q. s. ut fiat massa in pilulas xxiv dividenda. Signa. — One pill three times daily. Recommended in dyspepsia. If attended with constipation, the opium can be omitted. R. P. Thomas. 513. Compound Pills of Ammoniated Iron. ~$fy. Ferri Ammoniati, Galbani, aa 5j ; Assafoetidae, 5\j ; Castorei, 3j ; Tincturae Valerianae, q. s. Contunde in massam, et divide in pilulas singulas gr. iij pen- dentes. Signa. — Let two pills be given night and morning. Used successfully in a variety of chronic nervous diseases, hysteria, and anomalous nervous symptoms. Berends. 180 TONICS. 514. Pills of Citrate of Iron and Quinia. ~Bp. Ferri et Quiniae Citratis, 5ss ; Pulveris Acaciae, gr. x ; Mellis despumati, q. s. Fiat massa et divide in pilulas xx. Signa. — Take one pill every four hours. This preparation has been much employed in hemicrania^ chlorosis, and anaemia. It is one of the most valuable tonics. 515. Pills of Sulphate of Iron and Quinia. Tfy. Quiniae Sulphatis, gr. xij ; Ferri Sulphatis exsiccatae, gr. xxiv ; Pulveris Opii, gr. iij ; Syrupi, q. s. Misce, et fiant pilulae xij. Signa. — Take two pills three times daily. Used in chlorosis and anaemia. KiRKBY. 516. Pills of Vallet's Mass and Quinia. Jfy. Pilulae Ferri Carbonatis, 5ss ; Quiniae Sulphatis, gr. x. Fiat massa et divide in pilulas xv. Signa. — One pill every four hours. Given in hemicrania, and as a tonic in anaemia. Thomas. 517. Pills of Iron, Red Pepper, $c. ~Bji. Pulveris Aloes Socotrinae, Ferri Sulphatis exsiccatae, aa 3j ; Mastiches, gr. x ; Pulveris Capsici, 3j ; Syrupi, q. s. Fiat massa in pilulas xx dividenda. Signa. — Take one pill every four hours. In chlorosis. Copland. 518. Mitchell's Tonic Pills. Jfy. Extracti Quassiae, 5\j ; Extracti 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. Used in dyspepsia. J. K. Mitchell, TONICS. 181 519. Pills of Nitrate of Silver, Jfy. Argenti Nitratis, gr. iv ; Avenae Farinae, gr. iv ; Syrupi, q. s. Fiat massa, et divide in pilulas xij. Signa. — Take one pill every three hours. Given in epilepsy, gastrodynia, chronic gastritis, and obsti- nate vomiting. 520. Compound Pills of Nitrate of Silver. 1^. Argenti Nitratis, gr. v; Pulveris Opii, 3ss ; Pulveris C amphorae, Pulveris Myristicae, aa 3j ; Mucilaginis Acaciae, q. s. ut fiat massa, et divide in pilu- las xx. Signa. — Dose, a pill morning and evening. In chorea and epilepsy. 521. Pills of Iodide of Potassium and Manganese. Iy. Potassii Iodidi, Manganesii Sulphatis exsiccatae, 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. 522. Pills of Iron and Gentian. 3^. Ferri Redacti, 3j ; Extracti Gentianae, ^ij. Fiat massa, et divide in pilulas xx. Signa. — Take one pill three times a day. An excellent combination for "anaemic conditions of the system. 523. Pills of the Sulphate of Iron and Quassia. Iy. Ferri Sulphatis, 5j ; Extracti Quassiae, 5j- Fiat massa et divide in pilulas xl. Signa. — One to be taken morning, noon, and night. In dyspepsia, &c. 182 toxics. 524. Pills of Oxide of Zinc. R. Zinci Oxidi, 3ij ; Confectionis Rosas, q. s. ut fiant pilulge x. a. — One three or four times a day. In epilepsy, chorea, &c. Dr. Chapman speaks favorably of this medicine, and re- commends us to begin with the above dose, and gradually to increase it. 525. Pills of Lactate of Zinc. R. Zinci Lactatis, gr. xxx ; Syrupi Acacia, q. s. ut fiat massa in pilulas xx divi- dends. Signa. — Take one pill three times daily. Lactate of zinc has recentlv been introduced as an efficient agent in the treatment of diseases of the nervous system. It is particularly recommended in epilepsy. Herpix. 526. Pills of Kit ro muriate of Gold.. *3f. Auri Nitroniuriatis, gr. v; Pulveris Glycyrrhiza?, ojss; Mucilaginis x4cacia3, q. s. ut fiat massa, in pilulas lxxv dividenda. Signa. — One thrice a day. In secondary syphilis. 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. B. Ellis. By the term nitro-muriate, the author means what is now known as the chloride of gold. According to the Paris Cod, 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." 527. Electuary of Cinchona, Rust of Iron, A?c. Ify. Pulveris Cinchona Rubra?. Ferri Subcarbonatis. aa 5j ; Mollis, q. s. ut fiat electuarium. Signa. — To be made into pills of the ordinary size, of which four may be taken three times a day. TONICS. 183 528. Pills of the Oxide of Silver. 3^5. Argenti Oxidi, gr. vj ; Pulveris Acaciae, gr. vj ; Aquae, 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. B. Lane. INFUSIONS AND DECOCTIONS. 529. Infusion of Sage, Boneset, and Cascarilla. 3$5. Salviae, Eupatorii, aa 5ss ; Cascarillae, 5j ; Aquae bullientis, Oj. Digere per horas duas et cola. Signa. — Dose, a wineglassful every three or four hours. Used in hectic fever. 530. Infusion of Columho and Ginger. 3^. Calumbae contusae, oj ; Zingiberis contusae, 5ij ; Aquae bullientis, Oj. Fiat infusum et cola. Signa. — Give a wineglassful every two hours. "This infusion, freely used, is adapted to chronic diarrhoea. 531. Infusion of Columho, Rhubarb, Sfc. Ify. Cari, Calumbae contusae, Rhei contusi, aa 3j ; Aquae ferventis, f §iv. Digere per horas duas, cola, et adde — Tincturae Rhei, f 5j ; Syrupi Zingiberis, f 5ij. Misce. Signa. — Dose, a teaspoonful to a tablespoonful for children, according to their age. In diarrhoea. 184 TONICS. 532. Compound Infusion of Wild Cherry Bark. Jfy. Pruni Virginians, §j > Aurantii Coi;ticis, 5ij ; Aquae, Oj. Macera per horas sex et cola. Signa. — A wineglassful may be taken every hour or two in consumptive cases, asthma, &c. 533. Compound Infusion of Virginia Snake-root. Ify. Serpentariae, Contrayervae, contusae, aa 5v ; Aquae bullientis, Oj. Digere per horas duas, cola, et adde — Tincturae Serpentariae, f §ij. Misce. Signa. — Dose, a tablespoonful. Used in the convalescence of typhoid fever and other dis- eases of an asthenic type. Guy's Hospital Pharm. 534. Compound Infusion of Quassia. Jfy. Quassiae, Serpentariae, Aurantii Corticis, aa Sss ; Aquae bullientis, Oij. Fiat infusum et cola. Signa. — A teacupful to be taken cold, three times a day. 535. Infusion of Chamomile and Orange Peel. Jfy. Anthemidis, §ss ; Aurantii Amari Corticis, 5\j ; Aquae, Oj. Macera per horas decern et cola. Signa. — Dose, a wineglassful 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. B. Ellis. 536. Infusion of Hops. ^. Humuli, Sj ; Aquae ferventis, Oj. Digere per horas duas et exprime. Signa. — A wineglassful may be taken three or four times a day. In dyspepsia. TONICS. 185 537. Compound Infusion of G-entian. 1^. Gentianae contusae, §ss; Aurantii Dulcis Corticis, Cardamomi, aa 5j ; Aquae bullientis, Oj. Fiat infusum. Gentian is an excellent bitter. The above preparation is given in wineglassful doses, in debility of the digestive or- gans, &c. 538. Compound Decoction of Angustura Bark. Iy. Angusturae contusae, §ss ; Aquae, fSxij. Coque ad f§vj, et adde — Tincturae Cinnamomi, f 5ij ; Syrupi Aurantii Corticis, f §j. Misce. Signa. — Dose, a tablespoonful every three hours. This may be used in all cases in which a tonic and mild stimu- lant remedy is indicated. Berends. 539. Decoction of Dogwood Bark. Ify. Cornus Floridae contusae, oj ; Aquae, Oj. Coque per horam dimidiam, et cola. Signa. — A wineglassful may be given every hour, as a substi- tute for Peruvian bark in intermittents, or as an ordinary tonic, every two hours. 540. Decoction of Peruvian Bark and Valerian. 3^. Cinchonae Rubrae contusae, oj ; Aquae, Ojss. Coque per sextam horae partem, cola, et adjice — Valerianae contusae, §j. Macera per horam unam et cola. Signa. — Dose, a wineglassful four times daily. This was a favorite prescription with the late Dr. Joseph Parrish, in rheumatic and nervous headache and hemicrania. 541. Infusion of Acorns. Ity. Pulveris Glandis Quercus torrefactae, gj; Aquae bullientis, Oj. Fiat infusum. Signa. — Three or four teacupfuls may be taken during the day, and be augmented according to circumstances. 186 TONICS. 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. 21.5. MIXTURES, TINCTURES, ETC. 542. Griffith's Myrrh Mixture. Jfy. Myrrhae, 5j ; Sacchari, 5ij ; Potassae Carbonatis, gr. xxv. Tere simul, et adde gradatim — Aquae. Rosae, f ovijss ; Spiritus Lavandulae, f §ss. Dein adde — Ferri Sulphatis crystallizati, in pulverem contriti, Qj. Fiat mistura. Signa. — Dose, a tablespoonful every four hours. This preparation was formerly much used as a tonic in phthisis. 543. Mixture containing Protoxide of Iron. 1^. Ferri Sulphatis, 5j ', Magnesiae, gr. x ; Sacchari, gj ; Aquae Cinnamomi, foviij. Misce. Signa. — Take a tablespoonful every three hours. An efficient tonic in phthisis. Donovan. 544. Mixture of Ammonio- Tartrate of Iron. 1^. Ferri et Ammoniae Tartratis, 5\j ; Syrupi Aurantii Corticis, f §ij ; Tincturae Cardamomi, f §j ; Aquae, f §v. Fiat mistura. Signa. — A dessert-spoonful every four hours. Used in chlorosis and debility. The ammonio-tartrate is one of the most valuable of the ferruginous preparations. Its pleasant taste and ready solubility render it available in the treatment of the diseases of childhood. TONICS. 187 545. Mixture of Sulphate of Iron. 3^. Ferri Sulphatis, 3j ; Acidi Sulphurici, gtt. iv; Sacchari, 5ij ; Aquae, fgiv. Misce. Signa. — A teaspoonful for a dose, to be repeated every two, three, or four hours, much diluted. 546. Mixture of Sulphate of Iron and Elixir of Vitriol. 3^. Ferri Sulphatis, gr. iv ; Acidi Sulphurici Aromatici, tt^xx ; Aquae destillatae, fgj. Fiat mistura. Signa. — A teaspoonful to be taken three times a day in a wineglassJ^il of water. . 547. Mixture of Sulphuric Acid. Ify. Acidi Sulphurici Diluti, f 5iv ; Syrupi Aurantii Corticis, f Sjss ; Aquae Cinnamomi, f§j. Fiat mistura. Signa. — Take a teaspoonful three times a day in a wineglass- ful of water. Used in anaemia and debility. Sir Jambs Clark. 548. Mixture of Sulphuric and Nitric Acids. 1^. Acidi Sulphurici Diluti, f 5y ; Acidi Nitrici Diluti, f 5j ; Syrupi, f gij ; Aquae Menthae Piperitae, f giv. Misce. Signa. — Take a dessert-spoonful in water every three hours. Dr. W. J. Anderson and several other English practitioners have found the acid treatment effectual in arresting the watery discharges in diarrhoea, cholera morbus, and cholera. In the last disease, the doses should be larger, and more frequently administered. 188 TONICS. 549. Vinegar Draught. Ify. Aceti, f 5j ; Tincturae Cardamom! Compositae, Syrupi, aa f Sss ; Aquae, f §x. Misce, Signa. — To be taken in such portions as the stomach can bear. Used in sick headache. 550. Wine of Gentian and Orange Peel. 3^. Pulveris Gentianae, Aurantii Corticis Dulcis, aa Sss ; Vini Portensis, Oj. Macera per dies tres, et cola. Signa. — Give a wineglassful two or three times a day. In dyspepsia. • 551. Mixture of Cinchona, Valerian, $c. 1^. Tincturae Cinchonae, Tincturae Valerianae, aa f Sj ; Tincturae Cardamomi Compositae, f 5ij ; Aquae Menthae Piperitae, f§iv. Fiat mistura. Signa. — A tablespoonful may be given every third hour. This is especially designed as a tonic in nervous tempera- ments. 552. Elixir of Aloes, Zedoary, Gentian, $c. 3^. Pulveris Aloes Socotrinae, §j ; Pulveris Zedoariae, Pulveris Gentianae, Croci, Pulveris Rhei, Agarici, aa 5j ; Spiritus Vini Gallici, Oij. Macera per dies septem, cola, et adde — Syrupi, fgij. Misce. Signa. — Dose, a tablespoonful three times a day, in water. 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 intermittents, especially, it is justly celebrated. TONICS. 189 553. Mixture of Nitrate of Silver. 1^. Argenti Nitratis, gr. j ; Aquae destillatae, f §ij ; Sacchari, 5ij« Fiat mistura. Signa. — A teaspoonful every two hours. Used in the diarrhoea of newly-weaned infants. This is accompanied by the occasional injection of one-fourth of a grain of the salt in mucilage. Hirsch. 554. Fowler s Solution and Potassio- Tartrate of Iron. 3^. Ferri et Potassae Tartratis, gr. xvj ; Aquae Cinnamomi, f§j. Solve, et adde — Syrupi, fgj ; Liquoris Potassae Arsenitis, trgxxxij. Fiat mistura. Signa. — A teaspoonful three times daily, for a child one or two years old. Used in eczema infantile, and other skin diseases of early life. Erasmus Wilson. 555. Mixture of Muriated Tincture of Iron. 3^. Tincturae Ferri Chloridi, f5ij ; Glycerinae, fSxiv. Misce. Signa.— Dose, a teaspoonful every three hours. This old and valuable tincture still retains the first rank among the chalybeates. Its ferruginous taste is so much modi- fied by combination with glycerine as to remove the chief ob- jection to its use. Recommended as an astringent in diarrhoea, and other ex- hausting discharges ; and as a tonic, by Bell and Velpeau, in erysipelas. 556. Mixture of Ammonio- Citrate of Iron. 3^. Ferri et Ammoniae Citratis, 5ij ; Syrupi, fgj ; Aquae, fgiij. Fiat mistura. Signa.— Take a teaspoonful every four hours* Employed in amenorrhoea and chlorosis. It may be given., also, in less quantity, in the anaemia of childhood. 190 TONICS. 557. Mixture containing Peracetate of Iron. Ify. Tincturae Ferri Chloridi, f 5iij ; Liquoris Ammoniae Acetatis, f oiij ; Syrupi Aurantii Corticis, f oj ; Acidi Acetici, tt#x. Misce. Signa. — A dessert-spoonful four times daily. Prescribed as a ferruginous tonic for children, and for anaemia in adults. It has slight diuretic properties. J. F. Meigs. 558. Mixture of Per chloride of Iron and Nitric Acid. 1^. Tincturae Ferri Chloridi, Acidi Nitrici Diluti, aa f 5j ; Syrupi Zingiberis, f 5xiv ; Aquae Menthae Viridis, f §iv. Misce. Signa. — A tablespoonful every four hours. Recommended as an astringent and tonic in phthisis. R. Bennett. 559. Steel Wine. Iy. Ferri et Potassae Tartratis, §ss ; Vini Xerici, Oj. Solve, et cola. Recommended as a uniform and effectual substitute for the officinal vinum ferri. The dose is a tablespoonful, containing about four grains of the potassio-tartrate of iron. J. C. Pooley. 560. Mixture of Bestucheffe's Tincture and Valerian. 1^. Spiritus Ferri Chlorati iEtherei (Ph. Borus.), f 5ij ; Aquae Cinnamomi, Syrupi Aurantii Corticis, aa f 5j ; Infusi Valerianae, f §v. Misce. Signa. — Shake well, and take a tablespoonful every two hours. " Bestucheffe's Nervine Tincture," or " Lamotte's Golden Drops," as the preparation is variously called, is a favorite in Germany in the treatment of chlorosis, anaemia, and hysteria. SOBERNHEIM. TONICS. 191 561. Mixture of Pernitrate of Iron. ]$5. Liquoris Ferri Nitratis, foj ; Syrupi, f 5ij ; Aquae, f5v. Fiat mistura. Signa. — Give a teaspoonful every three hours. This preparation is very serviceable in all forms of diar- rhoea, but more especially in chronic mucous diarrhoea, hem- orrhage from the bowels, uterine hemorrhage, &c. v Neligan. 562. Mixture of Pyrophosphate of Iron. Ify. Ferri Pyrophosphatis, 5j ; Syrupi, Aquae Cinnamomi, aa f§ij. Misce. Signa. — Take a teaspoonful an hour after each meal. M. Robiquet called attention to the superior advantages of the pyrophosphate over other salts of iron. Its taste is less unpleasant, it is freely soluble in water, it agrees well with the stomach, and is easily assimilated. 563. Mixture of Iodide of Iron and Manganese. Ify. Liquoris Ferri et Manganesiae Iodidi, f oSS ; Grlycerinae, fSjss. Misce. Signa. — Take a teaspoonful every three hours. This is used as a tonic, alterative, and emmenagogue. The salts of manganese are beginning to attract attention. The formulas for their preparation, by Prof. Procter, will be found in the American Journal of Pharmacy, vol. xxv, p. 198. 564. Elixir of Pepsine. 3^. Pepsini (Boudault), 5jss ; Aquae, f5vjss; Vini Xerici, f 5xijss ; Alcoholis, f 5iij ; Sacchari, §j« Solve et cola. Signa.— A tablespoonful, containing fifteen grains of pepsine, is administered immediately after each meal, in cases of indigestion. Mialhb. CLASS XIV. ALTERATIVES. Alteratives are medicines that re-establish the healthy functions of the animal economy, without producing any active evacuation. This class of remedies, therefore, embraces nume- rous preparations which produce a slow but decided effect on the various secreting organs, sometimes without 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. 565. Calomel Pilh. Tfy. Hydrargyri Chloridi Mitis, gr. ij ; Confectionis Rosse, q. s. ut fiant pilulse xij. Signa. — One may be taken every two hours. 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. ALTERATIVES. 193 In infants, for example, the sixteenth or the eighth of a grain, repeated every hour or two hours, according to age and circumstance, will often check diarrhoea, cholera infantum, and dysentery, 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 (pilulae hydrargyri) is indi- cated in similar conditions, and is especially beneficial when- ever 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 obscure 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 Sialagogues, become alteratives by cautious administration in doses more or less minute, and especially when they are given in conjunction with the preparations of sarsaparilla. • 566. Pills of Calomel, Quinia, and Opium. Ijj. Hydrargyri Chloridi Mitis, gr. vj ; Pulveris Opii, gr. iij ; Quinise Sulphatis, gr. xij ; Syrupi, q. s. ut fiat massa in pilulas xij dividenda. Signa. — One night and morning. 567. Pills of Blue Mass, Quinia, and Aloes. Jfy. Pilulse Hydrargyri, Quinise Sulphatis, Pulveris Aloes Socotrinag, aa gr. xij ; Syrupi Rhei, q. s. ut fiant pilulae xij. Signa. — One three 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. 568. Pills of Med Iodide of Mercury. 1^. Hydrargyri Iodidi Rubri, gr. ss; Extracti Glycyrrhizae, gr. viij. Misce et divide in pilulas viij. Signa. — Two in the morning and two at night ; dose to be gradually and cautiously augmented. 13 194 ALTERATIVES. 569. Corrosvoi Sublimate Pills. Jfy. Hydrargyri Chloridi Corrosivi. gr. j. Solve in aqua destillata, dein adde — Micae Panis. Sacchari. aa gr. x vel q. s. ut fiant pilulae xx. Signa. — Take one pill every four hours as an alterative. DZOMDI. 570. Pills of the Arseniate of Iron. R . Ferri Arseniatis. gr. iij : Lupulinae. 5j. Fiat massa et divide in pilulas xlviij. Signa. — Give one pill night and morning. Prescribed by Dr. Biett in scrofulous, cancerous, and her- petic diseases. Arsenic is a powerful alterative, and should be administered with the utmost circumspection. 571. Asiatic Pv Yfy. Acidi Arseniosi, gr. j : Piperis. gr. xij. Tere simul in pulverem subtilissimum. et adde — Pulveris Aeaciae, gr. ij : Aquae, q. s. Misce, et divide in pilulas xvj. Signa. — Take one pill morning and night. Much used by Biett for tuberculous lepra. Par. Codex. 572. Iodide of Arsenic and Hemlock Pills. 1^. Arsenici Iodidi. gr. j ; Extracti Conii. 3ij. Fiat massa, et divide in pilulas xvj. Signa. — Take one pill morning and night. Given in lepra, impetigo, and cancerous disease. 573. Pills of Iodide of Silver. Iy. Argenti Iodidi. Potassae Nitratis. aa gr. x. Tere simul in pulverem subtilissimum, dein adde— Pulveris Glycyrrhizae, 5ss ; Sacchari, 3j ; Mucilaginis Acaciae, q. & Fiant pilulae xl. Signa. — Take one pill three times daily. ALTERATIVES. 195 Used successfully in the gastric affections of the Irish pea- santry. C. Patterson. 574. Pills of Bromide of Iron. 1^. Ferri Bromidi, gr. xij ; Confectionis Rosae, gr. xviij. Misce, et fiant pilulae xx. Signa.- — Two pills to be taken in the morning, and two in the evening, or one three times a day. In hypertrophy of the heart and scrofulous affections. Dr. Robert Dick strongly recommends the use of the bro- mide of iron in dyspeptics with strumous habits. 575. Pills of Calomel and Ox G-all. Ify. Hydrargyri Chloridi Mitis, 3j ; Fellis Bovini inspissati, gr. xv ; Saponis, gr. x, vel q. s. Fiat massa, in pilulas xx dividenda. Signa. — Take two pills at bedtime. These pills are alterative and deobstruent. 576. Burnt Sponge. Ify. Spongise Ustae, Sj ; Sacchari, 3j. Misce, et divide in chartulas vj. Signa. — One three times a day, gradually 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, ETC. 577. Preparations of Iodine. That iodine is one of the most powerful alteratives at pre- sent known, there can be no question. There are few diseases dependent upon or connected with morbid secretion of the glandular structures, but what are more or less modified by its ALTERATIVES. use, while urative agent. I: chiefly, however, in scrofulous, glandular, and cutaneous afl tious tha: beneficial! y, di g indurat: the glands, and restoring the secretion : the cutaneous a mucous apparatus ; whence its advantage- bronchitis, leucorrhoea, amenorrhoea* &c. &:. It fonnd to r suppressed hemorrhoidal : .tamen: charges, and when p ashed toe far, has 1 alarm hemorrhage of the lungs, nose, and uterus. The^ make the practitioner extremely cautk na in its administration, beginning with small doses, and watching their effc it produce any of the inconvieniences a mentioned, dizziness, nausea, purging, burning of the skin or swe. _ the gums, it should be at once suspended, or given less fre- quently and in smaller doses. 578. Ethereal Tincture of Iodine, R. I:-: :/. t ■. : _ r^ . ._ - . . - . - O . • na. — Dose, en drops two or three times a da largely diluted. Fifty drops contain one grain of iodine. Given in cutaneous and glandular diseases. Magendie. 579. Compound Tincture of Iodine. R. I: iinii. 5ss : I ss:: I:-l : .-ii. 5j : Alcoholis, Oj. Fiat tinctura. Signi. — Dose, five to fifteen drops in sweetened water. This is a good preparation of iodine, but in practice r. generally superseded by the simple tincture for external a and by Lugol's solution for internal employment, 580. Solution of Iodine with Iodide of Potassium. R. Ior.nii. gr. iij : Potassii Iodid gr. yj; •estillatif. :.' ; , Solve. Signa. — Dose, ten di thrice a day in a draugl. old wa If it produce dizziness, pain in the bowels, or onplea- »v . ;oms, dimiL e quantity. ALTERATIVES. 197 The author of Illustrations of Pulmonary Consumption, strongly recommends this formula in catarrh, phthisis, &c. It has a powerful effect in glandular disease, and all affections of the mucous membranes. S. Gr. Morton. 581. Mixture of Iodide of Potassium and Sarsaparilla. Jfy. Potassii Iodidi, 3ij ; Aquae, f oiij ; Sacchari, §j ; Extracti Sarsaparillae Fluidi, f §ss. Misce. Signa. — Dose, a tablespoonful three times daily. This valuable combination may be used in scrofula, secon- dary syphilis, and obstinate skin diseases. In fact it may be given advantageously in most cases requiring an alterative. 582. Mixture of Tincture of Iodine. Jfy. Tincturae Iodinii, f5j ; Mucilaginis Acaciae, f 5ij ; Aquae destillatae, f§vj. Fiat mistura. Signa. — A tablespoonful every two hours. Employed in cases of ulceration accompanied by purulent discharge from the meatus auditorius, and in the scrofulous diathesis. 583. Solution of Iodide of Iron. 3^. Ferri Iodidi, 5j ; Aquae destillatae, f gj ; Sacchari, 5\j. Fiat solutio. Signa. — Dose, six to ten drops, morning, noon, and night, in a wineglassful of cold water. The officinal solution — "Syrupi Ferri Iodidi" — keeps much better than an aqueous solution of the pure salt, and is there- fore generally preferred. Ten to twenty drops are given, di- luted with water. 584. LugoVs Solutions. Dr. Lugol, one of the first experimenters with iodine, an- nounced that its solubility in water could be increased to any desired extent by the addition of iodide of potassium. He devised three preparations of different strengths, viz. : 198 ALTERATIVES. No. 1. Or the solution for internal use. contain? of iodine. 1 part ; iodide of potassium, 2 parts ; and water. 20 parts. No. 2. The rubefacient solution, contains of iodine. 1 part : iodide of potassium. 2 parts; and water. 12 parts. {Formula 723.) No. 3. The caustic solution contains, of iodine. 1 part : iodide of potassium. 1 part: and water. 2 parts. [Formula 688.) The first of these has retained his name, and it alone should be dispensed upon a prescription calling for Lugol's solution. It is the compound iodine solution of the Pharmacopoeia, viz. : R. Liquoris Iodinii Compositi. f^ss. Signa. — Give ten drops, in sweetened water, three times a day. Used in goitre and scrofulous diseases. ■j^d. Magendies Anti-epileptic Iodine Solution. R. Potassii Iodidi. 5:v : Iodinii. gr. ij ; Aquae Mentha Piperitae, fsyj. Fiat solutio. Signa. — Dose, a teaspoonful thrice daily. Used in epilepsy and eatalepsy. 586. Mixture of Iodide of Potassium. R. Potassii Iodidi. oj ; Syrupi Zingiberis, f gj ; Aquae. f'5v. Fiat mistura. Signa. — Take a tablespoonful three times a day. Prescribed in secondary syphilis, lupus, and various cutane- ous diseases. 587. Mixture of Iodo-liydrar gyrate of Potassa. Ify. Potassii Iodidi. gr. iijsa : Aquae destillatae, f.5j. Solve, dein adde — Hydrargyri Iodidi Rubri, gr. ivss. The compound salt in this solution maybe assumed at eight grains, although there is a small excess of the iodide of potas- sium. 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 day, much diluted. Dr. Changing. ALTERATIVES. 199 588. Another Form. 1^. Hydrargyri Iodidi Viridis, gr. iij ; Potassii Iodidi, 5'j ; Tincturas Gentianae Compositae, Syrupi Sarsaparillae Compositi, aa f§ij- Fiat mistura. Signa. — A teaspoonful three times daily. An invaluable remedy in secondary syphilis, and various skin diseases, as well as an excellent alterative in follicular laryngitis and ulcerations of the epiglottis. Horace Green. 589. Syrup of Ioduretted Biniodide of Mercury. Ty. Hydrargyri Iodidi Rubri, gr. j ; Potassii Iodidi, 5j ; Aquae, f gj ; Syrupi, f §v. Misce. Signa. — A tablespoonful three times a day. This is employed like the two preceding formulas in secon- dary syphilis and obstinate skin diseases. Hopital Saint Louis. 590. Iodine Waters. The physicians of Europe, and especially of Paris, have made extensive and salutary use of iodine waters, both inter- nally and externally. In these the iodine is very much diluted, and generally with the addition of more or less common salt. These waters are prepared on a large scale and with great pre- cision 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 pre- parations. The following is an example : Tfy. Potassii Iodidi, gr. vj ; Iodinii, gr. j ; Aquae, Oij. Fiat solutio. This solution is to be taken at meals, in place of common water. 200 ALTERATIVES. 591. Another Form. 1^. Syrupi Ferri Iodidi, f 5ss ; Syrupi Acaciae, f 5ij ; Aquae Acidi Carbonici, fSviij. Misce. Signa. — Take one-half at a draught, and then carefully cork the bottle to retain the gas in the remainder. Dupasquier. 592. Mixture of Donovan s Solution. Iji. Liquoris Arsenici et Hydrargyri Iodidi, f 5ij ; Syrupi Zingiberis, f 5ss ; Aquae, f Siijss. Misce. Signa. — A dessert-spoonful an hour after each meal. Donovan. Donovan's solution affords a simple and efficient means of introducing into the system the three great alteratives. It has been found effectual in eradicating various chronic diseases, and especially the skin diseases of the scaly character, and venereal affections. 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, although it may be given in solution, as in the follow- ing prescription : 593. Solution of Bromine. f^. Brominii, f5ss ; Syrupi Amygdalae, f §ss ; Aquae, f Sij- Misce. Signa. — Dose, five drops three times daily. Given in scrofula. Pourche. 594. Bibrons Antidote. 1^. Brominii, 5v ; Potassii Iodidi, gr. iv ; Hydrargyri Chloridi Corrosivi, gr. ij. Misce. Signa. — Take ten drops in a tablespoonful of wine or brandy. ALTERATIVES. 201 As these salts are but slowly soluble in bromine, there would be no objection, in cases of emergency, to dissolving them in a little water before the addition of the bromine. According to the experiments of Prof. Bibron, Prince Paul of Wurtemberg, Dr. W. A. Hammond, and others, this bro- mine mixture has proved a valuable antidote to the bite of the rattlesnake. The dose should be repeated every fifteen or twenty minutes, until relief is obtained. 595. Solution of Bromide of Potassium. 1^. Potassii Bromidi, 3ij ; Syrupi Aurantii Corticis, f §j ; Aquae, fSiij. Eiat mistura. Signa. — Give a tablespoonful three times a day. The bromide of potassium is prescribed like the iodide, as an alterative, but is less efficacious. Huette and Thielmann recommend it in priapism, nymphomania, and satyriasis. Sir Charles Locock commends its efficiency in hysterical epilepsy, and directs it to be given in doses of five to ten grains, three times daily, for a week previous to, and during each menstrual period. 596. Solution of Bromine and Bromide of Potassium. Iy. Potassii Bromidi, 5ij+3ij ; Aquge, f§ij. Solve. Dein adjice — Brominii [by weight], §j ; Aquse, ad f jiv. Misce. This is recommended as a convenient standard formula for the use of bromine. It can readily be diluted to any extent by the addition of water. Each fluidrachm contains five grains of the bromide of potassium and fifteen grains of bromine. Bromine is an excellent remedy in the treatment of hospital gangrene. J. Lawrence Smith. 597. Mixture of LugoVs and Fowler s Solutions. 1^. Liquoris Iodinii Compositi, Liquoris Potassse Arsenitis, aa f5\j. Misce. Signa. — Take ten drops three times daily. Used in chorea, psoriasis, ptyriasis, and lepra. 202 ALTERATIVES. 598. Pearson s Solution. 1^. Sodae Arseniatis, gr. j ; Aquae, foj. Fiat solutio. Signa. — Dose, twenty drops three times a day. Used in the scaly and other skin diseases. It has less ten- dency than Fowler's solution to offend the stomach. 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. 599. Mixture of De Valangins Solution and Iron. 1^. Liquoris Arsenici Chloridi (Lond.), f 5v ; Tincture Ferri Chloridi, f 5iij ; Aquae destillatae, f§j. Misce. Signa. — Take forty drops three times daily, after meals. Arsenic in its various forms has long been held in repute as an alterative in lupus and cancerous affections. This combi- nation secures both a tonic and an alterative effect. In strength, De Valangin's solution is intermediate between Pear- son's and Fowler's solutions, five fluidrachms containing nearly one grain. T. Hunt. 600. Mixture of Sal Ammoniac. 1^. Ammoniae Muriatis, 5'j \ Sacchari, Sj ', Aquae Menthae Viridis, f.5iijss. Fiat mistura. Signa. — A tablespoonful every three hours. The German writers describe sal ammoniac as an excellent alterative and resolvent. Dr. Watson, of London, recom- mends it in facial neuralgia ; and Dr. Ebden, of Bengal, speaks highly of its use in nervous headache, clavus hysteri- cus, and neuralgic affections generally. 601. Solution of Phosphate of Ammonia. 1^. Ammoniae Phosphatis, §ss ; Aquae destillatae, f 5vj. Fiat solutio. Signa. — A tablespoonful to be taken every four hours. ALTERATIVES. 203 This is a formula of Dr. Buckler, who recommends it in those cases of gout and rheumatism in which lithic acid is present in the urine ; as well as in all the modifications of those diseases, especially when they are associated with chronic thickening of the white tissues. 602. Cod-liver Oil (Oleum Morrliuce). This preparation, which is now divested in a great measure of its nauseous smell and taste, is given in doses of half an ounce, three or four times a day. To children, a teaspoonful. The peculiar flavor which the best oil retains can be ren- dered less perceptible by introducing equal bulks of the oil and cherry-laurel water into a bottle, and shaking them well together. After subsidence the water is to be separated from the oil. It is of much service in all strumous affections, and in the chronic forms of gout and rheumatism. It may be taken alone, or in milk, or on the froth of porter. Some persons swallow it in coffee, in lemon-juice, or with some of the aromatic waters. Dr. Bradshaw recommends a weak infusion of flaxseed, flavored with lemon-peel, and sweetened to please the taste. 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 dessert-spoonful of brandy ; and on this, the dose may be given without producing that nausea so fre- quently 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 or take a mintdrop 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. 603. Mixture of Cod-liver Oil. 1^. Olei Morrhuae, §ss ; Liquoris Potassse, gtt. xl ; Aquae Menthae Piperitae, f gss. Misce, et fiat haustus. 204 ALTERATIVES. The draught to be washed down with a teaspoonful of lemon- juice, to liberate the oil on the stomach. Du: 6th ed., p. 557. Perci- 604. Another Form, for Children. R. Olei Morrhuse, 5j ; Yitellum unius Ovi. Tere simul et adde sradatim — Syrupi Aurantii Corticis. fSj ; Aquae Aurantii Florum, f 5ijss. Fiat emulsio. Signa. — Give a tablespoonful three times daily. Used in scrofulous affections, and in rickets. Te:7"Iau. 605. Mixture of Cod-liver Oil and Quinia. R . Quinine, gr. xvj ; Alcoholis. fo'-j- Fiat solutio. Dein adde — Olei Morrhuae, Oss. Solve cum leni calore. The quinia indicated in the prescription can be i pro- cured from a solution of the sulphate by the addition of am- monia. If the oil and quinia be gently heated in a water- bath, the solution takes place as the alcohol evaporates. Lymas. 606. Mixture of Cod-liver Oil and Iodine. R. Iodinii, gr. jss : Olei Morrhuae. $y. Tere simul. Signa. — Dose, a tablespoonful three times a day. The quantity of iodine can be increased without materially changing the appearance of the solution. Fleischmajsh. 1. Mixture of Cor Sublimate. R . Hydrargyri Chloridi Corrosivi, gr. ij : Aquae destillatre, f§ Aquae Cinnamomi, f§ Syrupi, f.5j. see. aa. — Dose, a tablespoonful thrice a day. This excellent alterative is often administered in compound ALTERATIVES. 205 syrup of sarsaparilla. It is better, however, to give it in a simpler form, to prevent any chemical change. It is particu- larly serviceable in the secondary forms of syphilis, and in syphilitic rheumatism. 608. Mixture of Nitro-muriatic Acid. 3^. Acicli Nitromuriatici, f5j ; Aquae, f'oviij. Misce, et adde — Spiritus iEtheris Nitrosi, f5ij- Fiat mi star a. Signa. — From twenty drops to half a teaspoonful to be given every three hours, in a wineglassful of sweetened water. This acid is also employed as a bath in hepatic derange- ments. For this purpose, put a teaspoonful of the 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. 609. Diluted Nitric Acid. Jfy. Acidi Nitrici, f5j ; Aquae, Oij ; Sacchari, gj. Fiat mistura. Sign a.— One-eighth of this quantity may be taken daily, in divided doses. In lues venerea. Nitric acid may be prescribed both as a tonic and an altera- tive in the above form. It is best taken through a quill, as the teeth suffer when it comes in contact with them. It some- times arrests the colliquative sweats of hectic fever when other remedies fail. Ferriar, Med. Hist, 610. Mixture of Hyposulphite of Soda. Iy. Sodae Hyposulphitis, 5ij ; Infusi Quassiae, f§vj. Fiat solutio. Signa.— A tablespoonful three times daily. In France the hyposulphite is employed in chronic cutaneous and scrofulous affections. It has likewise been used with ad- vantage in rheumatism. This particular formula was resorted to successfully in an obstinate case of yeasty vomiting, ac- companied with sarcinae ventriculi. R. Nbalb. 206 ALTERATIVES. 611. Artificial Harrowgate Water. It. Potassae Sulphatis cuin Sulphure (Ed.\ 5j ; Potassae Bitartratis, 5ss ; Magnesia Sulphatis, 5vj 5 Aquae destillatse, Oij. Solve. Signa. — One-half, taken in draughts, constitutes a full dose. The above ought to be taken in the morning, before break- fast, and be followed by a walk, to produce the desired effect. DUFFIN. 612. Falk's Ant acrid Tincture. ~2f. Pulveris Guaiaci Resin ge, §j ; Terebinthinae Canadensis, 5j ; Olei Sassafras, f oij ; Alcoholis, fSviij. Misce, macera per dies septem, et cola ; dein adde — Hydrargyri Chloridi Corrosivi, 3j. Misce. Signa. — Take twenty drops in wine, or sweetened water, night and morning. Dr. E. D. Fenner, of New Orleans, recommends this pre- paration in dysmenorrhea and the consequent sterility. Dr. G. Emerson, of Philadelphia, has found it a valuable alterative in secondary syphilis. CLASS XV. ASTRINGENTS. Doctor Cullen describes astringents to be "such sub- stances as, applied to the human body, produce contraction and condensation 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 sup- posed to be removed." In the use of this class of medicines a caution suggests itself, namely, that they should not be given to arrest evacua- tions that are critical, and designed by nature to relieve a plethoric state of the system, unless such evacuations exist to an alarming extent. POWDERS AND PILLS. 613. Compound Powder of Alum. ^. Aluminis, 3j ; Pulveris Kino, gr. v. Fiant pulveres v. Signa.-—OxiQ to be given every two hours. This compound, though much employed by some practi* tioners, contains substances which would be incompatible with each other if given in solution. Used in monorrhagia, obsti- nate diarrhoea, &c. 614. Oxide of Silver and Aromatic Powder* 3^. Argenti Oxidi, gr. xij ; Pulveris Aromatici, gr. xxx. Misce, et fiant pulveres xij. Signa.— One powder every three hours. 208 ASTRINGENTS. Sir James Eyre and Dr. Butler Lane extol highly the use of the oxide of silver in the various forms of passive hemor- rhage, and particularly in menorrhagia. 615. Powders of Sugar of Lead and, Calomel. 1^. Hydrargyri Chloridi Mitis, Plumbi Acetatis, aa gr. j. Fiant pulveres iv. Signa. — Give one powder every three hours. In cholera infantum. The above dose is adapted to any period between ten and twenty months of age. T. D. Mitchell. 616. Poivders of Sugar of Lead, Calomel, and Ipecacuanha. Iy, Hydrargyri Chloridi Mitis, Pulveris Ipecacuanha?, aa gr. ij ; Plumbi Acetatis, gr. viij. Mi see, et divide in pulveres viij. Signa. — Give one powder every three hours. Used in cholera infantum. 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. Coxdie. 617. Powders of Alum and Opium. "Bf. Aluminis, 5ss ; Pulveris Opii, gr. iij. Fiant pulveres yj. Signa. — One to be taken every three hours. In diarrhoea. 618. Powders of Subnitrate of Bismuth and Magnesia. Ify. Bismuthi Subnitratis, 5j ; Pulveris Acaciae, 5ss ; Magnesias, 3j. Misce, et divide in pulveres xij. Signa. — Give one powder every four hours. Used in the diarrhoea of phthisis, T. Thomson. ASTRINGENTS. 209 619. Powders of Subnitrate of Bismuth. 1^. Bismuthi Subnitratis, gr. vj ; Sacchari, gr. xij. 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. Recamier, Trousseau. 620. Powders of Subcarbonate of Bismuth. ~Bp. Bismuthi Subcarbonatis, gr. viij ; Sacchari Lactis, gr. xvj. Fiant pulveres viij. Signa. — Administer one powder every three hours. Recommended both for the mucous diarrhoea of children and for gastrodynia in adults, the properties of the subcarbo- nate being analogous to those of the subnitrate of bismuth. 621. Pills of Sugar of Lead and Calomel. Ify. Plumbi Acetatis, 5ss ; Hydrargyri Chloridi Mitis, gr. v; Confectionis Rosae, q. s. Fiant pilulae x. Signa. — One to be given every two hours. In hemorrhage, and especially in hematemesis. 622. Pills of Sugar of Lead and Opium. ~£y. Plumbi Acetatis, gr. xij ; Pulveris Opii, gr. vj ; Confectionis Rosae, q. s. ut fiat massa in pilulas vj divi- denda. Signa. — One to be taken every hour. Used in haemoptysis and other hemorrhages. It is also useful for checking the profuse perspiration in consumption. 623. Pills of Alum, Catechu, and Opium. ^. Aluminis, Catechu, aa gr. vj ; Extracti Opii, gr. j. Fiat massa, et divide in pilulas vj. Signa. — Give one pill every three hours. In passive hemorrhage, and in atonic mucous discharges. 14 210 ASTRINGENTS. 624. Pills of Rhatany and Rhubarb. Ify. Extracti Kramerise, 5j ; Extracti Rhei Alcoholici, 3j ; Syrupi Zingiberis, q. s. Eiat massa, et divide in pilulas xxx. Signa. — Take one pill every two hours. Prescribed in diarrhoea and chronic dysentery. 625. Pills of Creasote and Opium. Ify. Creasoti, gtt. v ; Pulveris Opii, gr. iij ; Pulveris Acacise, gr. vij. Tere simul, et divide in pilulas x. Signa. — One pill to be taken every three hours. Used in chronic diarrhoea, and in chronic bronchitis ; also employed for the relief of toothache, by pressing a pill into the cavity of a carious tooth. Blasius. 626. Pills of Kino and Opium. Jfy. Pulveris Kino, gr. xx ; Pulveris Opii, gr. ij ; Mucilaginis Acacise, q. s. ut fiant pilulae vj. Signa. — Take one every four hours. In diarrhoea, pyrosis, &c. 627. Pills of Opium and Tannic Acid. ~ty,. Acidi Tannici, gr. xx ; Pulveris Opii, gr. v ; Glycerinse, q. s. ut fiat massa in pilulas x dividenda. Signa. — One pill every four hours. Glycerin is a good excipient for tannic acid, reducing it in bulk, and thus enabling the prescriber to combine it with other articles in pills of a moderate size. This combination is very serviceable in affections of the bowels. 628. Pills of Tannin and Morphia. ~fy. Acidi Tannici, 3j ; Morphise Sulphatis, gr. j ; Mucilaginis Acacise, q. s. Divide in pilulas x. Signa. — One to be given every two hours. Blue mass may be added according to circumstances. In diarrhoea and dysentery. ASTRINGENTS. 211 629. Pills of Gallic Acid. ^. Acidi Gallici, 3j ; Extracti Gentianae, gr. x. Fiat massa, in pilulas x dividenda. Signa. — Give one pill ever y three hours. Used in hematuria, and other hemorrhages. Gallic acid is also employed beneficially in pyrosis, and in the night-sweats of consumption. MIXTURES, INFUSIONS, ETC. 630. Mixture of Monesia. Ify. Extracti Chrysophylli (Monesice), 5ss ; Aquae, f oiij • Tere simul, cola, et adde — Syrupi Acaciae, f§j. Misce. Signa. — Dose, a tablespoonful every four hours. The extract, imported from South America, under the name of monesia, is a mild stimulant and astringent. It is recom- mended in chronic dysentery, diarrhoea, and other abnormal or hemorrhagic discharges. Trousseau. 631. Infusion of Matico. ]^. Piperis Angustifolii, Sj ; Aquae bullientis, Oj. Macera per horas duas et cola. Signa. — Take a wineglassful every two hours. This has been used to check the discharge in haemoptysis, haematemesis, and dysentery, as well as in leucorrhoea and gonorrhoea. 632. ParrisJis Camphor Mixture. Iy. Aquae Camphorae, f Siij ; Spiritus Lavandulae Compositi, f Sj ; Sacchari, 5j. 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. 212 ASTRINGENTS. 633. Hopes Mixture, 1^. Aquae Camphorae, f§iv; Acidi Nitrici, tr^iv ; Tincturae Opii, trgxl. Fiat mistura. Signa. — Dose, a tablespoonful every two hours. In diarrhoea and dysentery. This is a well-known and very efficacious preparation analo- gous 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 fluidrachm of nitrous acid, forty drops of laudanum, and eight fluidouDces of camphor- water, and was given in doses of two fluidounces every three hours. Tuos. Hope. 634. Chalk Mixture. ^. Cretae Praeparatae, 5jss ; Sacchari, Pulveris Acacise, aa 5j ; Aquae destillatae, f §iv ; Olei Cinnamomi, tr^ij ; Tincturae Opii, trgxl. Misce. Signa. — Dose, a tablespoonful every two hours. In diarrhoea and dysentery. When a strongly astringent mixture is desirable, we add to the above formula two fluidrachms of the tincture of kino, or the same quantity of the tincture of krameria, catechu, or nutgalls. 635. Mixture of Prepared Oyster-shell. ~fy. Testae Praeparatae, 5\j ; Sacchari, Pulveris Acaciae, aa 5j ; Aquae, Aquae Cinnamomi, aa foij. Misce. Signa. — A teaspoonful every three hours for a child two years old. This corresponds with the officinal " chalk mixture," substi- tuting prepared oyster-shell for the chalk. In the " Children's Hospital" of this city this mixture has been successfully used for some years in the treatment of cholera infantum. It is ASTRINGENTS. 213 rendered more efficacious by the addition of one fluidrachm of paregoric, and three fluidrachms of the tincture of krameria, to every fluidounce of the mixture. T. H. Bache. 636. Jackson s Cholera Mixture, Jfy. Spiritus Lavandulae Compositi, Spiritus Camphorae, aa f 5ss ; Tincturae Opii, Spiritus iEtheris Compositi, aa f5ij« Misce. Signa.— Give twenty drops at short intervals in cholera mor- bus, and the early stages of cholera, to allay nausea and relieve pain. This prescription was frequently used in the cholera of 1832 by Professor Saml. Jackson with the most satisfactory results. 637. Decoction of G-alls. Jfy. Gallae contusse, 5\j ; Aquae bullientis, f 5x. Coque per sextam horse partem, et cola. A wineglassful of this is given every few minutes as an anti- dote, in cases of poisoning by any of the vegetable alkaloids, or by tartar emetic, sulphate of copper, sulphate of zinc, &c. &c. It may be rendered more agreeable by the addi- tion of an aromatic, and some sugar, for administration in diarrhoea. Dose, a tablespoonful. 638. Mixture of Extract of Logwood and Catechu. 1^. Extracti Haematoxyli, 5iij ; Tincturae Catechu, f 5ij J Sacchari, §j ; Aquae, fSvij. Misce. Signa. — A tablespoonful to be given once in three hours. In the advanced stages of diarrhoea and dysentery. 639. Blackberry Syrup with Aromatics. Jfy. Syrupi Rubi, fSij ; Spiritus Lavandulae Compositi, f 5ij ; Aquae Cinnamomi, f 5vj ; Aquae, fgj. Misce. Signa. — Dose, a teaspoonful for a child. 214 ASTRINGENTS. Employed with much benefit as a mild astringent and stimu- lant in cholera infantum, and the bowel complaints of children. R. P. Thomas. 640. Mixture of Ergot and Cinnamon. Iy. Extracti Ergotae Fluidi, Tincturae Cinnamomi, aa f oSS ; Syrupi, f 5j ; Aquae, f§ij. Misce. Signa. — Give a teaspoonful every three hours. Recommended in menorrhagia, and other hemorrhages. 641. Mixture of G-eranium Maculatum. 1^. Extracti Geranii Fluidi {Thayer), f5vj ; Tincturae Cinnamomi, f 5ij ; Syrupi Rosae Gallicae, f §ij- Misce. Signa. — Take a dessert-spoonful every two hours. The geranium is the best of the indigenous astringent roots, and may be beneficially employed in cases of diarrhoea and chronic dysentery. Its freedom from unpleasant taste renders it particularly valuable in the diseases of childhood. 642. Mixture of Tincture of Catechu and Laudanum. Jfy. Tincturae Catechu, f oj ; Tincturse Opii, f5j ; Pulveris Acaciae, 5ij ; Aquae Cinnamomi, ?5vj. Misce. Signa. — A tablespoonful every two hours. In diarrhoea. 643. Creosote Mixture. Ify. Creasoti, gtt. vj ; Alcoholis, f 5j ; Syrupi Amygdalae, f Sss ; Aquae, f§ijss. Fiat mistura. Signa. — Dose, a dessert-spoonful diluted, every two or three hours. Used in hemorrhages and to allay sick stomach. ASTRINGENTS. 215 644. Alcoholic Solution of Creasote. Jfy. Creasoti, Olei Caryophylli, aa gtt. j ; Alcoholis, f5j- Misce. A drop or two of this solution dropped into the cavity of an aching tooth, is said to afford immediate relief. 645. Solution of the Perchloride of Iron. ~fy. Ferri Chloridi, 5\j ; Aquae, f§j. Solve. Signa. — Apply with a brush. Used to arrest gangrene or hemorrhage resulting from dis- ease, or accident, or in consequence of surgical operations. If the solid perchloride of iron be kept in a bottle, a small portion of it, after a time, deliquesces into a thick brown liquid, which is constantly kept in a state of supersaturation, by the undeliquesced portions of the salt. This liquid, applied by means of a spun-glass brush to a bleeding surface, arrests the flow of blood almost instantaneouslv. J. Zachariah Laurence. 646. MonseVs Solution. Ity. Liquoris Ferri Subsulphatis, f§iv. Signa. — Apply as an astringent lotion. Like the solution of the perchloride of iron, this is a power- ful styptic and antiseptic. It has been extensively employed for arresting hospital gangrene, and for checking hemorrhages and abnormal discharges. 647. Alum Whey. I$$ . Lactis Vaccinae bullientis, Oj ; Pulveris Aluminis, 5\j- Coque per sextam horae partem, et cola. Signa. — A cupful to be taken occasionally. In diabetes and passive hemorrhages. Foy. 648. Mixture of Q-allic Acid and Morphia* Ify. Acidi Gallici, 5j ; Morphiae Acetatis, gr. j ; Alcoholis, f 5j ; Syrupi Tolutani, f 5iij ; Aquae, fSiijss. Misce. Signa. — Dose, a tablespoonful. 216 AST KIN GENTS. Used in the London City Hospital for checking night-sweats in consumption. Hutchinson. 649. Aromatic Syrup of Galls. E.. Pulveris Gallae, 5?s ; Pulveris Cinnamomi, Macis. a a 5ij '■> Spirit us Vini Gallici, f.^viij. Misce, et macera per horas viginti quatuor. Having been allowed to stand twenty-four hours, the result- ing tincture is filtered into a saucer. Then two ounces of sugar, in lumps, are suspended on wire gauze jmst above the surface of the liquid. The latter is set on fire, and the flame melts the sugar and converts it partly into caramel, which drops into the liquid beneath. When the combustion stops, the syrup is stirred and filtered for use. The dose is a ta- blespoonful for an adult. It is used in diarrhoea and chronic dysentery. Jos. Parrish. 650. Mixture of Extract of Bhatang, $c. B. . Extracti Krameriae, 5j ; Syrupi Papaveris, Lond., Aquae Rosse, aa f^ij. Fiat mistura. Signa. — A teaspoonful for a dose. Given in passive hemorrhage and chronic dysentery. M. Fouquier, 651. Solution of Acetate of Lead, E.. Plumbi Acetatis, gr. v; Aceti. gtt. v ; Sacchari. oj ; Aquae, ffg. Fiat mistura. Signa. — Give a teaspoonful to a child every hour or two, to allay the vomiting in cholera infantum. D. F. Condie. ASTRINGENTS. 217 652. Enema of Acetate of Lead, $c. Ify. Plumbi Acetatis, 3j ; Tincturae Opii, gtt. lx ; Aquae tepidse, fSij. Fiat niistura. Signa. — To be thrown up the rectum in uterine hemorrhage. W. Dewees. 653. Tannin Suppository. 3^. Acidi Tannici, 5j ; Olei Theobromse, Sss. Misce cum leni calore, et fiant suppositoria iv. Employed in cases of bleeding piles, fissures of the anus, and mucous discharges from the rectum. Trousseau. CLASS XVI. ABSORBENTS, OR ANTACIDS. Absorbents or Antacids form a class of remedies for cor- recting 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 and aromatics, and sometimes with narcotics. When given alone, they too frequently afford but transient relief. POWDERS AND PILLS. 654. Compound Cretaceous Powder with Opium. Ify. Cretse Praeparatae, 5jss ; Pulveris Cinnamomi, 5j ; Pulveris Piperis Longi, gr. viij ; Pulveris Opii, gr. vj. Divide in chartulas xij. Signa. — One three or four times a day. In diarrhoea. The above formula, with a slight alteration, is from the London Pharmacopoeia. 655. Powder of Crab's Claws and Rhubarb. ~fy. Chelae Cancrorum, 5j ; Pulveris Rhei, 3ij. Misce, et divide in pulveres iv. Signa. — One may be taken once or twice a day, according to circumstances. In acidity of the primge viae. 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. ABSORBENTS, OR ANTACIDS. 219 656. Poivder of Magnesia, Fennel-seed, and Cinnamon. 1^. Magnesise, §ss ; Pulveris Foeniculi, Pulveris Cinnamomi, aa 5j. Fiat pulvis. Signa. — Dose, a small teaspoonful three or four times a day. Given in dyspepsia, attended with acid eructations. 657. Powder of Magnesia, Soda, and Ginger. 1^. Magnesise, Sss ; Sodge Bicarbonatis, Pulveris Zingiberis, aa 3j. Misce. Signa. — A small teaspoonful occasionally. In cardialgia. 658. Powder of Magnesia and Columbo. Tfy. Magnesise, 5jss ; Pulveris Calumbge, 5j- Misce, et divide in chartulas vj. Signa. — One may be taken three times a day, in sugar and water. In cardialgia. 659. Powder of Charcoal, Carbonate of Magnesia, and Ginger, Ify. Carbonis Ligni, 5j ; Magnesise Carbonatis, 3ij ; Pulveris Zingiberis, 3j. Misce, et divide in pulveres iv. Signa. — One powder to be taken three times daily. Used in dyspepsia, accompanied with acidity. R. DUNGLISON. 660, Pills of Soda, Rhubarb, $c. Ify. Pulveris Rhei, Sodse Carbonatis exsiccatse, Extracti Gentianae, aa 3j ; Hydrargyri Chloridi Mitis, gr. iij. Fiant pilulge xx. Signa. — One pill an hour after each meal. Given in dyspepsia, attended with constipation. 220 ABSORBENTS, OR ANTACIDS. MIXTURES, SOLUTIONS, ETC. 661. Compound Chalk Mixture. 1^. Misturae Cretae, f §v ; Tincturae Catechu, Tincturae Opii Camphoratae, aa f §ss. Misce. Signa. — A tablespoonful every three hours. Prescribed in diarrhoea, accompanied by acidity or flatu- lence. 662. Mixture of Salt of Tartar. Iy. Potassae Carbonatis Purse, 5j ; Sacchari, 5y ; Aquae Menthae Piperitae, fSiv; Spiritus Lavandulae Compositi, f 5ij ; Tincturae Opii, trgxl. Misce. Signa. — A tablespoonful every two hours. In sickness of the stomach, attended with acidity. 663. Mixture of Salt of Tartar and Ammonia. Ify. Spiritus Ammoniae Aromatici, f 5j ; Potassae Carbonatis Purae, 5\j ; Syrupi Zingiberis, f 5vj ; Aquae, f giv. Misce. Signa. — -A large teaspoonful for a dose. In pyrosis and acid eructations. 664. Mixture of Lime-water and Milk. Tfy. Liquoris Calcis, Lactis recentis, aa fgiij. Misce. Signa.— One or two tablespoonfuls for a dose. In sickness of the stomach few remedies are more prompt in their effect. 665. Magnesia-water. 1^. Magnesiae, 5\j ; Aquae bullientis, f §iv. Misce. Signa. — Give a dessert-spoonful of the clear fluid every two hours. ABSORBENTS, OR ANTACIDS. 221 This is an excellent antacid remedy, adapted to children. It is highly aperient. B. Ellis. 666. Mixture with Ammonia, Magnesia, Sfc. Ify. Magnesiae, 5j ; Spiritus Ammoniae Aromatici, f 5j ; Spiritus Cinnamomi, f5nj; Aquae, f§vj. Misce. Signa. — A tablespoonful every two hours. In the sickness accompanying pregnancy. 667. Decoction of Qolumbo, Salt of Tartar, $c. 1^. Calumbae, Sss ; Aquae, foviij. Coque ad f §v, cola, et adde — Potassae Carbonatis Purse, gr. x ; Succi Limonis, f 5uj ; Tincturae Opii, gtt. xij. Misce. Signa. — From a tea to a tablespoonful may be given every hour. Anti-emetic. 668. Tonic Mixture with Carbonate of Soda. Ify. Sodae Carbonatis, 3iv ; Infusi Gentianae Compositi, Aquae Cinnamomi, aa f §iij ; Tincturae Cardamomi, f §ss. Fiat mistura. Signa. — A tablespoonful every two or three hours. In acidity, flatulence of the stomach, &c. 669. 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 stirring 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 pro- perties, and may do serious injury. 222 ABSORBENTS, OR ANTACIDS. This domestic remedy we have thought best to give, as we received it, in the English language. It deserves an inser- tion, from the circumstance that it was employed by the late Dr. P. S. Physick, in his own case, and was of decided ad- vantage when the usual alkaline remedies had failed. B. Ellis. BOOK II. OP EXTERNAL APPLICATIONS. CLASS XVI L 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. 670. Actual Cautery. The use of iron heated to a white-heat as a cautery extends back to the most ancient times. It is still occasionally em- ployed in the treatment of diseases of the spine and joints ; and also to arrest hemorrhage by searing incised or wounded surfaces. But the particular modes of its application belong more properly to the regular treatises on surgery than to a work of this kind. 671. 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 rheumatism. Dr. Corrigan, of Dublin, uses a simple instrument, consist- ing 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 instrument be larger than this, it will re- quire 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 dis- 15 226 CAUSTICS, OR ESCHAROTICS. tance of half an inch from the button. As soon as the finger feels uncomfortably hot, the instrument is ready for use. It is applied as quickly as possible, the skin being tipped succes- sively, 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 applications, 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 iron has touched immediately becomes of a glistening white. The iron is never red-hot, and does not make an eschar. — Braithwaite's Retro- spect, No. 13, p. 55. 672. Caustic Potassa. The Causticum commune acerrimum is the pure potassa, 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. 673. Vienna Paste (Potassa cum Calce). Iy. Potassse, 5v; Calcis, 5vj ; 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. 674. Vienna Paste with Opium, 1^. Potassae cum Calce, 5\j ; Pulveris Opii, 5ss ; Saponis Mollis, q. s. Misce. This preparation is employed for the same purpose as the common caustic. CAUSTICS, OR ESCHAROTICS. 227 675. Vienna Paste with Morphia. Tfy. Potassse cum Calce, partes iij ; Morphise Muriatis, partem j ; Aquae, q. s. ut fiat magma. Misce. The addition of the morphia modifies the painfulness of the caustic, without materially diminishing its activity. 676. Caustic of Filhos. X^. Potassae, partes ij ; Calcis, partem j. Misce. The caustic is fused, and run into leaden tubes like nitrate of silver. It is a convenient form for the application of & powerful caustic to uterine growths or ulcers. 677. Lunar Caustic, This caustic is the nitrate of silver (Argenti Nitras fusa) deprived of its water of crystallization, fused and cast into moulds. Its mode of application varies with the object in view. If designed as an antiphlogistic, or as a stimulant to old ulcers, it should be passed lightly and rapidly over the affected part. If used as a caustic, it should be pressed against the surface for a few seconds. The valuable and peculiar property of this caustic is the limitation of its action to the part to which it may be applied. 678. Burnt Alum. The Alumen Exsiccatum is made by depriving alum of its water 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 from the cornea. 679. 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 digest- ive organs." " The epidermis having been removed by nitrate of silver, the chloride of zinc may be applied as a caustic, by means of a moistened hair pencil, either alone or mixed with an equal 228 CAUSTICS, OR ESCHAROTICS. portion of oxide of zinc, or sulphate of lime, or according to the following form : 680. Canquoiris Caustic Paste. 1^. Zinci Chloridi, partes ij ; Farinas, partes iij : Antimonii Terchloridi. partem j ; Aquas, q. s. ut fiat pasta.'' This paste should be spread thickly on the diseased part. Dunglisom's Ne& Remedies, 6th ed. p. 694. 681. Caustic Paste of Chloride of Zinc. Ify. Zinci Chloridi. Calcis Sulphatis. aa 5?s. Misce. This preparation is very liable to deliquescence, to prevent which, a little flour may be added at the time of application. 682. Caustic Collodion. Tfy. Hydrargyri Chloridi Corrosivi. 5j ; Collodii, 5J. Solve. When this solution is applied with a camel's hair brush to the surface of nasvi materni. warts, condylomata. vXc. the ether evaporates and leaves a film of the caustic firmly at- tached to the naevus : ulceration occurs in a few days, a super- ficial slough separates and thus destroys the nasvus. without disfigurement. Macke. 683. Sulphuric Acid. The mineral acids are ail escharotic. though seldom employed. on account of the difficulty of mana^ino: fluids when used in this way. Sulphuric acid, mixed with saffron, is proposed by Velpeau as one of the most effectual caustics. Mr. James Syme directs it to be mixed with an equal weight of sawdust to obtain a proper consistence to prevent spreading : the surrounding parts being protected by the application of a solution of gutta percha in chloroform. Mr. Syme has also employed a saturated mixture of sul- phuric acid and dried sulphate of zinc. An ordinary quill pen is charged with the mixture and drawn over the tumor in different directions, by which means the skin is soon corroded. The application is continued from day to day until the whole sloughs out. CAUSTICS, OR ESCHAROTICS. 229 684. Acid Nitrate of Mercury. 1^. Liquoris Hydrargyri Nitratis, f 5j. This is a powerful caustic, and is much employed in Eng- land and on the Continent to destroy malignant ulcerations, particularly those of a cancerous character. It is applied by means of a camel-hair pencil, and the parts are then covered with lint. 685. Ointment of Arsenic. 3^. Acidi Arseniosi, 5j ; Adipis, Cerati Cetacei, aa 5vj. Signa. — Melt the cerate and lard over a slow fire, and then stir in the white oxide of arsenic, and triturate carefully in a glass mortar. Used to destroy cancerous tumors. Pharm. Chirurg. In hot weather, arsenic may be advantageously rubbed up with basilicon ointment, to prevent its spreading on the sound parts. A scruple of the former, to half an ounce of the latter, makes a strong ointment. 686. Arsenical Paste for Dentists. Ify. Acidi Arseniosi, gr. ij ; Morphise Sulphatis, gr. j ; Creasoti, q. s. Misce, fiat massa. Used to destroy the sensibility of a carious tooth before plugging. Having cleansed the cavity, fill it with a portion of the paste, secured with a pledget of cotton or a bolus of wax. J. D. White. 687. Dubois's Arsenical Powder, Tfy. Acidi Arseniosi, 5ss ; Hydrargyri Sulphureti Rubri, Sj ; Sanguinis Draconis, 5ss. Fiat pulvis. Chiefly used in the French hospitals as a caustic to cancer- ous affections. 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 230 CAUSTICS, OR ESCHAROTICS. spread on lint. It acts rapidly and requires watching, a re- mark that applies equally to all these pastes. 688. Caustic Glycerols of Iodine, ly. Potassii Iodidi, partem j ; Glycerinse, partes ij. Solve et adde — Iodinii, partem j. Fiat solutio. Employed in lupus, by painting the solution over the dis- eased part, and applying oiled silk or gutta percha paper to prevent evaporation. The application is attended by pain of variable intensity and duration. It has proved successful in obstinate cases, after other remedies had failed. Richter. Lugol's " caustic solution of iodine" corresponds in strength with the foregoing glycerole, water being substituted for the glycerin. It has long been a favorite remedy in lupus, and in tuberculous and hypertrophied conditions of the skin. 689. Solution of Sal Ammoniac. Jfy. Ammonise Muriatis, oj ; Aceti destillati, f §ij ; Aquae, f §iv. Fiat solutio. To be applied to venereal warts. Bell on Venereal. 690. Chromic Acid. This acid has lately been employed in Germany as an escha- rotic. It is said to be efficient, manageable, and less painful than the ordinary applications. A concentrated solution (5j-ij in water f §j) is applied by means of a glass rod. The solid chromic acid has to be used with care, on account of its pene- trating action. 691. 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 potassa, and inclosing pieces of it, thoroughly ISSUES AND SETONS. 231 dried, in paper cylinders, about one inch in diameter, and an inch in height. Dr. Burne employs wood in a state of dry rot, — touchwood. This only requires to be shaped properly, and it 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 pre- vent the scintillations from injuring the surrounding parts. Gun cotton, steeped in chlorate of potassa, and then tho- roughly dried and formed into cylinders, has also been recom- mended. 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, especially when a permanent discharge is desired. There are three kinds of issues in common use, by either of which a discharge of purulent matter may be procured for any length of time that may be requisite. They are applied in different 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 shoul- ders 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. 692. 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 appli- cations, as the cantharidal ointment, or the savin, or compound resin cerate. These may be alternated with mild liniments, in order to prevent the ulceration and consequent discharge from becoming excessive. 693. 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 232 ISSUES AND SETONS. 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 piece of orris root. The second is formed with caustic potassa. 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 potassa, 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. 694. The Seton. 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 JEpispastics, and these were designated according to the several degrees of effect : the slightest, entitled phoenigmoi; the next, sinapismi; the more active, vesicatorii ; and the strongest, causticV 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 eight 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 the 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 suffi- cient. In acute diseases, 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 acknow- ledged experience who say " they can bring the patient to the blistering point at pleasure ;" and in pleurisy, and some other acute diseases, apply them soon after a free bleeding. Blis- ters 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 between the shoulders. 234 EPISPASTICS. When the system is very prostrate, they should be applied to the inside of the thighs, or over the spine ; 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 pro- duced, 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 spirit of nitre, camphor, or parsley tea ; blad- ders also, half filled with warm water, should be applied to the pubes. An opium suppository or injection will be found very advantageous. A poultice of ground flaxseed or starch is often serviceable, and a warm bath affords prompt relief. Prevention, however, is better than cure ; and in irritable constitutions, or in persons disposed to strangury, the blis- tering ointment, before being spread, should be rubbed up with three or four grains of opium, and three or four times as much camphor. This preventive seldom fails. Blisters are rendered much less irritating by covering them with a fine gauze, which, if pressed in close contact with the plaster, will not prevent or materially retard its operation. It is seldom necessary to keep a blister on longer than to redden the skin, when a simple poultice will complete the vesication. In chil- dren this precaution is imperative. 695. Blistering Plaster. I$*. Cerati Cantharidis, q. s. ut fiat super alutam, emplastrum epispasticum, 6x6. 696. Blistering Ointment. 1^. Cerse Flavse, Resinse, Adipis, aa 5vj. Liquefac cum leni calore, et adde gradatim — Pulveris Cantharidis, 5vijss. Misce, 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. 235 697. Instantaneous Vesication. The French practitioners have a process for raising an in- stant blister. A piece of linen or paper, being cut to the re- quisite size, is immersed in spirit of wine or brandy, Cologne water, oil of turpentine, or spirit 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 sur- rounding 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. 698. Cantliaridin. 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 ordi- nary purposes, can be readily obtained. The cantharidin blistering tissues and vesicating taffetas, now offered for sale, are of this character : 699. Cantharidal lather or Green Oil of Flies. 1^. Pulveris Cantharidis, partem unam ; iEtheris, partes duas. Macera per dies tres et exprime. If this extract be applied undiluted twice, 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 evaporates, and the remaining green fixed oil operates like the canthari- des in substance. Oettinger. 700. Blistering or Cantharidal Collodion. ^. iEtheris Cantharidalis (prepared as above), Collodii, partes sequales. Misce. It is computed that two scruples of this collodion are equal to four drachms of common blistering plaster. It is applied by a brush two or three times over the affected part. Oettinger. Z6b EPISPASTICS. 701. Extract of Oantharides. During the winter of 1853, a simple aqueous extract of Spanish Flies, prepared by Professor Procter, was used ex- tensively in the Pennsylvania Hospital, and found to be a most efficient substitute for the blistering cerate. The appli- cation of it for six hours raised as free a blister as the cerate did in eight. Since the discovery, by the same gentleman, that cantha- ridin is soluble in oil, oleaginous extracts have been devised, thus proving the general correctness of Galen's plan of pre- paring an ointment by macerating the entire insect in melted lard for twenty-four hours, and then straining by expression. An oleaginous extract, prepared by digesting the powdered flies in melted lard, is a most efficient substitute for the offi- cinal cerate. CLASS XIX. RUBEFACIENTS. The substances called Rubefacients not unfrequently vesi- cate on very delicate skins. The term, therefore, is relative. They are employed for the same purposes as blisters, and are often good substitutes for them. 702. Mustard Plaster. R. Pulveris Sinapis Nigrae, §ij ; Aquae, q. s. ut fiat 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 devel- oped 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 gen- erally be borne longer than half an hour or an hour. If a mild rubefacient effect be desired, the mustard may be mixed with syrup or molasses, instead of water. When thus made, the plaster may be borne two or three hours. 703. G-arlic Cataplasm. The garlic cataplasm is employed with the same intention as the mustard, though much less active. It may be made by bruising the cloves of garlic, and mixing them in a common poultice of bread and milk. 704. Onion Poultice. Onions are often used in cases of croup, and in diseases of the chest in children, as revulsives and antispasmodics. Having 238 RUBEFACIENTS. been partially roasted, mashed, and spread between the folds of thin muslin, they are applied over the chest, and are per- mitted to remain as long as they retain their warmth and moisture. 705. Cataplasm of Mustard, Pepper, and Ginger. Ify. Sinapis Nigrae contusae, ibss ; Pulveris Piperis, Pulveris Zingiberis, aa Sj ; Aquae bullientis, q. s. ut fiat cataplasma. Signa. — 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. 706. Spice Plaster, Tfy. Pulveris Caryophylli, Pulveris Piperis, Pulveris Capsici, Farinae, aa oj ; Aquaa bullientis, q. s. ut fiat cataplasma. Signa. — Let the plaster, thus prepared, be applied hot to the epigastric region. Employed for the relief of flatulence and sick stomach. 707. Clove Plaster. Quilt some powdered cloves in flannel, and wring them out in hot whiskey or alcohol. Thus prepared, they form an ex- cellent external application in colic, and in irritability of the stomach, &c, 708. Warming Plaster. Jfy. Picis Burgundicae, §v. Liquefac cum leni calore, et adde — Cerati Extracti Cantharidis, §j. Tere simul, et fiat emplastrum. This plaster is very irritating, and sometimes draws a blis- ter if the application be long continued. 709. Mercurial Ointment, Camphor, $c. ^. Unguenti Hydrargyri, §j ; Olei Terebinthinae, Camphorae, aa 5ij ; Cerati Adipis, 5j. Misce, et fiat unguentum secundum artem. RUBEFACIENTS. 239 Used as a rubefacient over the hypochondriac region, when blisters are precluded. 710. Tartar- emetic Plaster. This may be made by sprinkling the powdered tartar emetic on the surface of a Burgundy pitch or adhesive plaster, or on one made by spreading basilicon, or simple ointment, on soft 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. 711. Tartar- emetic Ointment. Ify. Antimonii et Potassse Tartratis, 5j ; Adipis, Sj. Tere simul. This ointment, when applied to the skin, is a slow but certain means of exciting an eruption. The officinal formula is two drachms to the ounce, a better strength for ordinary purposes. Dr. Kramer speaks highly of its use in acute inflammation of the tympanic membrane. It is to be rubbed over the mas- toid process. Hannat. 712. Lotion of Tartar-emetic and Corrosive Sublimate. Iy. Antimonii et Potassse Tartratis, 5j ; Hydrargyri Chloridi Corrosivi, gr. v ; Aquae, f§j. Solve, et adde — Spiritus Lavandulae Compositi, f 5j- This solution is applied by 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, Be 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 MedicaUurisprudence, vol. ii, p. 288, that Dr. Francis mentions two cases wherein tartar emetic ointment, excessively used, produced effects similar to those at 240 aUBEJACIKSTS. times arising from the outward application of arsenic. Ifa- z - l:L.- iz : 3::-v.r ••::::i::r: :~ -x.7t777LtL75 ::::. iiizi'.i. :i/.: :Lirr:.ri :l:: ~:--I= ::= rzV::.5 :t5tZ.':1t :l:5t 7.:: ::■:.:■'• i i": ll" 7. :.. . :in it: in. "Tic. '-"-..-'.■:'. A "*: :." ;.;:.,.? n-: ::-."": «. of rosemary; and 3. CK spb 1. J",.-: '-.Ci>- _• E, . Aqua? Ammonia? Fortiori S: ::::':- J. : -tiiziz: J " " t-tzzz/- '.' -i:::::^. : 5 :.;. «J * _ 7 . T » A ' " t A 77 '_ " 77 ~ j :;:_:_"_-. : . T . : "?" _:::: .5 i. : riii::.r_; _r . "-. 1 :■ : Siiriri" Ciziiiir^, :.y : . ....^..7 . T • 7_7 ::_'.-:: :l: :l "^l::\l :lf>f :::r_:J; :f:: :"; : n "z- :rz - Li. *:~ I : -: :i~_t := Ll :*Zt ".:' -:i z_:z :: 'ir -'::;: :: :; — mary . Our Pharmacopoeia directs the oil of rosemary to he L:::'.~t : . — i* : :z:*_. I z ■>;•-. l~_1 7 'zi i i: 77-737-z ■• :~ :i£:l^ two lbs. of the tips or small leaTes of fresh rosemary, and eight Zf'—'.s .: !..:_:.. ~_z_ szf zz::—. :::::::: ::: — ti:~-: : :: hoars in a corered Tessel, and after adding as much water as w~L_ z:-: 'i'"::: :z" tL: - :^'— .::: -7_7... :::-:;_ :~7: ':-■:■': -: y \ - ■_»- As to the method of applying these counter-irritants, we ::i'.'. ~.-t :"z- - : : ; - :: .ZrZ ::..~t::::. !•?. 'r:i:~A. ■■ J::-: :l> ::rz:.i"T "'.::::t : ■:". irLrSi :z:i .ziLiz -ltl: "_ zz :. :::it: l 7:-r-.T ::' zzrZ : ': ". "- : z.z :: •■7-71 til:-." :•: :::•::: : : :'i- 7 -;: m .7 : to he 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, Tery steadily and firmly, the said linen or l-llt".. :^;-_:::::::: «i -•-.". '. "- -. 7" - :- : - :'z. :z : :—". : ziY.ei several times, so that not only the evaporation of the lotion may :-7 izitrie.:. : :: :': - z.iz : r7_t". ijz: iz 7 7t 5 -iz; :l-t i77.:ml:l to the part may not suffer damage from any evaporation, or from contact with the Squid. In some parts of the body more RUBEFACIENTS. 241 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, inspect 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." 1 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 maybe dressed, according to existing indications, with a simple poultice, tepid fomentations, cerate, or irritating ointments. 714. Grondret's Pommade Ammoniac ale, I$*. Adipis, partes xxxij ; Olei Amygdalae Dulcis, partes ij ; Aquae Ammoniae Fortioris, partes xvij. Melt the lard, mix the oil with it, and pour them into a wide-mouthed vial with a glass stopper ; then add the am- monia, close the bottle, mix the contents together by shaking, and keep the mixture in a cool place. If the skin is to be excited, perspiration to be re-established, or some subcutaneous engorgement to be dissipated, the pommade is applied by friction with the fingers. But if a rubefacient effect is desir- able, 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, abso- lute cauterization is speedily produced. This, and the preceding ammoniacal 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, amaurosis, dis- eases of the eyes, &c. &c. 1 Granville : Counter-Irritation, its Principles and Practice, p. 39. 16 242 RUBEFACIENTS. 715. Caustic Solution of Potassa. ^. Potassse, 3jss ; Aquae, f5\j- Fiat solutio. Applied to the spine in tetanus. Br. 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 apply it from the nape of the neck to the sacrum. When the solution is strong, the effect is powerful. 716. Concentrated Tincture of Cayenne Pepper. Jfy. Pulveris Capsici, Siv; Alcoholis, foxij. Macera per dies septem et cola. This powerful rubefacient is recommended as an embrocation for toothache and neuralgic affections. A. Turnbull. 717. Turpentine Liniment. Ify. Olei Terebinthinae, Olei Olivse, aa §ij ; Spiritus Camphorse, f Sj ; Aquae Ammonise, f5j. Fiat linimentum. This is a good combination, and it may be used in most cases in which a prompt rubefacient is indicated. It is an effective agent for the relief of tympanitis, whether occurring after dysentery or diarrhoea, or arising in the progress of low fevers. For this purpose it should be well rubbed over the abdomen several times daily. 718. Liniment of Cantharides. ~Bf. Pulveris Cantharidis, §j ; Olei Terebinthinse, foviij. Digere per horas tres in vase leviter clauso, et cola. This liniment was first made by Dr. Jos. Hartshorne of this city, who used it with great success in typhoid fever. It is merely rubbed over the surface of the body. S. G. Morton. RUBEFACIENTS. 243 719. Compound Liniment of Cantharides. 1^. C amphorae, 5iij- Solve in Linimenti Cantharidis, f 5ss ; et adde — Unguenti Hydrargyri, Unguenti Adipis, aa §j. Fiat linimentum. This preparation is employed in low fever, when it is desir- able to rouse the system, and at the same time affect it with mercury; also in tumors. S. G. Morton. 720. Liniment of Croton Oil. ^. Olei Tiglii, Olei Olivae, aa 5j. Fiat linimentum. Croton oil is one of our safest and most efficient rubefacients.. Rubbed for a few minutes, or sometimes even for a few seconds, on the skin, it produces irritation and redness, fol- lowed 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. 721. Volatile Liniment. 3^. Olei Olivae, Aquae Ammoniae, aa foj- Misce. Applied to the neck in inflammation of the throat. It is also used for sprains and bruises, and for enlarged glands. 722. Ammoniated Soap Liniment. Jfy. Linimenti Saponis, f §ij ; Aquae Ammonise, f§j ; Tineturae Opii, f Sss. Fiat linimentum. This may be beneficially employed in the same class of dis- eases as the volatile liniment. Iodine. Iodine is used in different forms as a rubefacient and counter- irritant. It produces local alterative effects when applied externally, and hence is much employed for the discussion of buboes, goitre, enlarged glands, and diseases of the joints. The officinal tincture is generally recommended, and is applied to the diseased part by a camel's hair pencil. The following formulas furnish solutions of different strengths, which prove satisfactory in practice. 244 RUBEFACIENTS. 723. LugoVs Rubefacient Solution. 1^. Iodinii, 5ss ; Potassii Iodidi, 5j ; Aquae, f5vj. Misce. Used for touching the free margins of the eyelids and nos- trils in scrofulous ophthalmia, and strumous affections of the mucous membrane. Lugol. 724. Iodine Paint, 1^. Iodinii, gr. Ixiv ; Potassii Iodidi, gr. xxx ; Alcoholis, foj. Fiat solutio. King's College Hospital. 725. Ethereal Solution of Iodine. I$*. ^Etheris, fgj ; 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's hair pencil rubbed over the part, until it begins to produce a burning sensation; then cover it with a pledget of wadding, so as to prevent evaporation." R. Thomson. 726. Liniment of Croton Oil and Potassa. fy. Olei Tiglii, Liquoris Potassae, aa rrgxv. Misce, et adde — Aquae Rosae, foj. Fiat linimentum. This may be rubbed on the affected part twice or three times a day, until minute pustules appear. James Allen. 727. Qowhage Ointment. 1^. Mucunae, gr. viij ; Adipis, 5> 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 papules, which soon disappear. It is used in the same cases as the tartar emetic, or the Croton oil liniment. Blatin. 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 this 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 has added the present class, which is arranged on a pharmaceutical, rather than a therapeutical basis, and its sub- divisions are named according to the form of preparation employed, viz. : Collyria, Injections, Gargles, Liniments, Ointments, Cataplasms, Baths, Fomentations, and Fumiga- tions. 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 medicinal substances. POWDERS. 728. Dry Collyrium of Oxide of Zinc and Sugar. 1^. Sacchari, Zinci Oxidi, aa partes aequales. Tere in pulverem. The ends of a quill having been cut off, a small quantity of 246 COLLYRIA. the powder is placed in the barrel, and is gently blown into the eye. M. Recamier. 729. Dry Colly rium of Red Precipitate and Oxide of Zinc. It. Sacchari, 5\j ; Hydrargyri Oxidi Rubri, gr. x ; Zinci Oxidi, 3j. Fiat pulvis subtilissimus. This, like the preceding powder, is used in opacities of the cornea, by blowing into the eye through a quill. DlTPUYTREN. 730. Dry Collyrium of Opium and Calomel. R. Pulveris Opii, gr. iv ; Hydrargyri Chloridi Mitis, Sacchari, aa 3j. Tere bene. This compound is blown into the eyes for the removal of specks on the cornea resulting from inflammation. 731. Lapis Divinus. 1^. Aluminis, Potassse Mtratis, Cupri Sulphatis, aa Sj : Camphorse, 5ss. The alum, nitre, and sulphate of copper are to be fused to- gether, 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 eye- wash, in the strength of two grains and upwards to a fluid- ounce of distilled water. SOLUTIONS AND MIXTURES. 732. Alum Collyrium. Ify. Pulveris Aluminis, gr. viij ; Aquae Rosse, foj. Fiat solutio. To be applied to the eye in chronic inflammation, as well as in the purulent ophthalmia of infants. Moorfield's Hosp. Pharm. COLLYRIA. 247 733. Collyrium of Iodine and Iodide of Potassium. ]^. Aquae Rosae, f ovj ; Potassii Iodidi, gr. xxiv ; Iodinii, gr. ij. Fiat collyrium. Signa.— To be applied to the eyes three or four times in the day. In scrofulous ophthalmia and ulcerations of the cornea and conjunctiva. It is also serviceable in removing metallic specks from the cornea, by forming a soluble iodide with the metal. Ryan. 734. Collyrium of Green Vitriol. I$*. Ferri Sulphatis, gr. ij ; Aquae, fSj. Fiat solutio. Used in chronic ophthalmia. 735. Collyrium of Subacetate of Lead and Wine of Opium. Ify. Liquoris Plumbi Subacetatis, TTgxij ; Vini Opii, rrgxl ; Aquae Rosae, f §iv. Fiat collyrium. This is an excellent eye-water, but it should not be used when there are ulcers on the cornea, as the lead might com- bine chemically with the base of the ulcer and form an in- delible mark. 736. Collyrium of Vinegar and Alcohol. Ify. Aceti destillati, f 5j ; Alcoholis, f §ss ; Aquae Rosae, fSviij. Fiat mistura. Signa. — To be applied to weak eyes. In chronic ophthalmias after depletion. 737. Collyrium of Acetate of Zinc. Tfy. Zinci Acetatis, gr. ij ; Aquae Rosae, f§j. Fiat solutio. This is one of the best eye-waters in common use. It may be employed with great benefit in recent cases of 248 COLLYRIA. inflammation of the eyes. It should be dropped into the eye twice daily. 738. Alum Curd. ^. Pulveris Aluminis, 3ss ; Albumen unius Ovi. Fiat coagulum. Signa. — To be applied on a linen rag to inflamed eyes. It should be removed in three or four hours. 739. Collyrium of Nitrate of Silver. Tfy. Argenti Nitratis, gr. j ; Aquae destillatae, fgj. Fiat solutio. Signa. — Used by dropping into the eye. In acute ophthalmia, and to promote the absorption of specks upon the cornea. 740. Collyrium of Sulphate of Cadmium. 1^. Cadmii Sulphatis, gr. iij ; Aquae Rosae, f §ij ; Yini Opii, f5j. 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. Fronmuller. 741. Camphorated Collyrium of Sulphate of Copper. ~fy. Cupri Sulphatis, gr. vj ; Aquae Camphorae, fSviij. Solve. Signa. — To be dropped into the eye. This is nearly the same as the formula recommended by Mr. Ware in the treatment of purulent ophthalmia. 742. Collyrium of Prussic Acid. ~Bf. Acidi Hydrocyanici Diluti, f5j ; Aquae destillatae, f5vij. Misce. A few drops are placed in the eye in irritable ophthalmia, as also to remove the conjunctival stains made by nitrate of silver. Moorfield's Hospital Pharm. COLLYRIA. 249 743. Collyrium of Gallic Acid and Opium. 3^. Acidi Gallici, gr. x ; G-lycerinae, 5ij ; Extract! Opii, gr. x ; Aquas, fgij. Misce et cola. Signa. — Apply a few drops to the eye night and morning. This is a mild astringent lotion, useful in cases of chronic ophthalmia. 744. Strychnia Collyrium. Of. Strychniae, gr. ij ; Acidi Acetici Diluti, Aquae destillatae, aa, f§j. Fiat solutio. Signa. — A drop or two, diluted or not according to circum- stances, to be applied to the eye several times a day. Dr. Ryan on Amaurosis. 745. Collyrium of Corrosive Sublimate. ]^. Hydrargyri Chloridi Corrosivi, gr. ij ; Aquae destillatae, f§viij. Fiat solutio. The above may be advantageously used in gonorrhoeal or scrofulous ophthalmia, as also to remove opacity of the cornea, after the subsidence of inflammation. 746. Collyrium of Opium and Camphor. ~Bf. Extracti Opii, gr. x ; Camphorae, gr. vj ; Aquae ferventis, f§xij. Tere simul et cola. The anodyne nature of this preparation is supposed to afford some advantage over ordinary lotions, in painful affections of the eye. 747. Conradis Collyrium. 1^. Hydrargyri Chloridi Corrosivi, gr. j ; Decocti Cydonii, Lond., f 5j ; Aquae Rosae, f .§vj : Vini Opii, f5j. Fiat mistura. '250 COLLYKIA. This collyriirm is praised by most of the German oculists in cases of chronic ophthalmia. 748. Bates's Camphorated Water. EL. Capri Sulphatis, Boli Armenia, aa gr. viij ; Camphors, gr. ij ; Aquae bullientis, f 5 viij. Fiat mfusimi et cola. This is used as a lotion in the purulent ophthalmia of infants. 749. Collyrium of Spirit of Mindererus and Camphor Water. It. Liquoris Ammoniac Acetatis, f 5ij ; Aquae Carnphorae, f5vj. Misce. Signa. — For eyes requiring a mild astringent and stimulant application. 750. Collyrium of Spirit of 3Iindererus with Opium. R. Extracti Opii, gr. x: Aquae ferventis, fgvj. Solve, cola, et adde — Liquoris Aninioniae Acetatis, fgij. Used in acute ophthalmia, when considerable pain remains after depletion. 751. Emollient Collyrium. R. Altheae contusae, 5\j • Aquae destillatae, Oj. Macera per horas tres, et cola. In inflammation of the conjunctiva accompanied vrith violent irritation. 752. Collyrium of Poppies and Camphor. R. Decocti Papaveris, Lond., f§iv; Aquae Rosae, Aquae Camphorae, aa foij- Misce. This is adapted to the early stages of ophthalmia. COLLYRIA. 251 753. Collyrium of Wine of Opium. ]^. Vim Opii, AqutB destillatae, aa f §ss. Misce. This is found beneficial in rheumatic ophthalmia, when all the febrile symptoms are gone, and little more than lingering redness with weakness of the eye remains, by being dropped into the eye twice daily. Mackenzie. 754. Collyrium of Qonia. 3^. Conise, partes ij ; Alcoholis, partes xiij ; Aquae destillatse, partes cc. Fiat solutio. Employed in scrofulous ophthalmia, with intolerance of light, by rubbing it around the orbits, or dropping it in the eye several times a day. Conia, the active principle of conium maculatum, is a viru lent poison, and therefore care is requisite, even in its exter- nal use. Fronmuller. 755. G-uthries Ointment. Iy. Argenti Nitratis, gr. ij ; Liquoris Plumbi Subacetatis, rrgxv ; Unguenti Cetacei, Lond., 5j- Fiat unguentum. " The manner of using the ointment, is by introducing be- tween the lids a portion, larger or smaller, as the case may seem to require, from the size of a large pin's head to that of a garden pea." Guthrie. 756. Ointment of Red Precipitate and Sulphate of Zinc, Ify. Hydrargyri Oxidi Rubri, gr. x ; Zinci Sulphatis, 3j ; Adipis, gij. Fiat unguentum. Recommended by Professor Dupuytren in obstinate chronic ophthalmia depending on a scrofulous diathesis . 252 INJECTIONS. B.— INJECTIONS. Injections are liquid compositions of emollient, astringent, or stimulating substances. The parts into which they are thrown are the external auditory passages, the canal of the urethra, the bladder, and the vagina ; and also into fistulous cavities, and into the tunica vaginalis in the case of hydro- cele. A. — FOR THE EAR. 757. Camphorated Injection of Qajeput Oil. Ify. Camphors, 5iv ; Olei Cajuputi, f ovij ; Olei Amygdalae Dulcis, f 5xv. Tere simul. Signa. — A few drops to be dropped into the ear, in cases of dulness of hearing, from hardened wax, or dryness of the membrane. Radius. 758. Goulard's Extract and Rose Water. 3^. Liquoris Plumbi Subacetatis, foj ; Aquae Rosae, foj. Misce. Signa. — This is to be dropped into the ear until the meatus is full, and be allowed to remain there for a few minutes. Used in otorrhcea. Wilde. 759. Mixture with Bates's Alum Water. I$5. Liquoris Aluminis Compositi, Lond., f5j ; Aquae Rosae, f§j. Misce. Used in otorrhcea, in the same way as the preceding. Wilde. 760. Mixture with Aqua Sappharina. Jfy. Liquoris Cupri Ammonio-Sulphatis, Lond., f5j ; Aquae destillatae, f§j. Misce. Like the preceding, this is used as an astringent in otorrhcea. Wilde. INJECTIONS. 253 761. Solution of Nitrate of Silver. 1^. Argenti Nitratis, gr. x ; Aquae destillatae, f §j. Fiat solutio. Used in simple otorrhoea by painting the meatus and mem- brana tympani with a fine camel's hair pencil, dipped in the solution, every second or third day ; and one of the three foregoing solutions is used in the interim, night and morning. Wilde. 762. Another Form. 1^. Argenti Nitratis, 5ss ; Aquae destillatae, f §j. Fiat solutio. This is recommended to be applied every third day to the outer half of the meatus, and adjacent portion of the concha, in chronic inflammation or thickening of the membrane lining the tympanic cavity. J. Toynbee. 763. Injection of Pyroligneous Acid. 1^. Acidi Pyrolignei, Dub., f 5ij ; Aquae destillatae, f§vj. Fiat injectio. Signa. — To be injected twice a day with a silver syringe, in purulent discharge from the ear. Buchanan. 764. Injection of Catechu. Jfy. Catechu, gr. xij; Aquae bullientis, fovj. Infunde et cola. Signa. — To be used four or five times a day. Buchanan. 765. Pyroligneous Acid, Ether, and Turpentine. 3^. Acidi Pyrolignei, Dub., Spiritus iEtheris Sulphurici, Ed., Olei Terebinthinae, aa partes aequales. Misce. Signa. — Introduce two drops into the meatus auditorius exter- nus every night, when the cerumen is deficient in quantity. Buchanan. 254 INJECTIONS. 766. Mixture of Oxgall and Peruvian Balsam. ~Bf>. Fellis Bovini, fSiij ; Balsami Peruviani, f 5j- Misce. Signa. — To be dropped occasionally into the ear to correct fetid discharges, syringing the ear every day with a weak solution of soap and water. Dr. Hugh Smith. 767. Injection of Creasote. 1^. Creasoti, gtt. ij; Alcoholis, gtt. x; Syrupi, f 5j ; Aquse, f5vij. Misce. To be used like the foregoing. 768. Solution of Sulphate of Cadmium. Ify. Cadmii Sulphatis, gr. viij ; Aquae, f§j. Fiat solutio. Used in otorrhoea, as an alterative and astringent to arrest the discharge. Lincke. B. — FOR THE URETHRA. When injections are employed in the cure of gonorrhoea, two circumstances merit especial attention, viz., the manner of injecting them and the frequency of using them. When the common syringe is used, the pipe should be perfectly smooth, short, and conical, so that it cannot pass more than a quarter of an inch into the urethra. The patient should oil the pipe before using it, seat himself on the edge of a chair, so as to avoid pressing the perineum, draw the penis forward on the syringe with the left hand, and throw up the injection to the seat of disease (previously ascertained) with the other. As respects the frequency of injecting, it may be observed, that five or six times a day are not too often, and that the cure will be retarded by using these remedies at longer intervals. We cannot forbear remarking that gonorrhoeal inflammation, situated near the extremity of the penis, can be often cured by a routine plan; but when seated higher up the canal, and affecting Cowper's glands or the prostate, it becomes a serious disease, the cure of which ought not to be undertaken by per- INJECTIONS. 255 sons ignorant of the structure of the parts and the nature of morbid action. 769. Nitrate of Silver. This article is extensively used, both in gonorrhoea and gleet. Some practitioners employ a weak solution, of two or three grains to the ounce of rose-water, twice a day. Others prefer ten grains to the ounce, and employ the injection every second or third day. Another class prefer an ointment of ten or twenty grains to the ounce, and smear this over a bougie, which is then passed into the urethra. In acute gonorrhoea, either of the latter plans will frequently arrest the disease in a few days. In gleet, perhaps, the first plan is preferable. 770. Injection of Opium. 3^. Extracti Opii, 3j ; Glycerinae, f oj ; Aquae, f§iij. Misce. Signa. — Use after every passage of urine. This affords great relief to the local pain and uneasiness, and causes a diminution of the discharge in gonorrhoea. F. J. BlJMSTEAD. 771. Injection of Corrosive Sublimate, $c. 3^. Zinci Sulphatis, gr. x ; Hydrargyri Chloridi Corrosivi, gr. ij ; Aquae Rosge, f oviij. Fiat injectio. In gleet. This powerful remedy should be employed with great caution. 772. Injection of Sulphate of Zinc and Laudanum. Iy. Zinci Sulphatis, gr. x ; Pulveris Acaciae, 5\j ; Tincturae Opii, f 5j ; Aquae destillatse, fSviij. Fiat injectio. In gonorrhoea virulenta. 773. Injection of Sulphate of Zinc and Acetate of Lead. Ify. Zinci Sulphatis, Plumbi Acetatis, aa gr. xx ; Aquae Rosae, f 51 v. Misce. Signa. — Shake the bottle before using. 256 INJECTIONS. Although mutual decomposition of the salts takes place, the resulting mixture forms an excellent injection for gonorrhoea. Ricord. 774. Injection of Muriate of Ammonia, $c. Ify. Ammoniae Muriatis, gr. j ; Hydrargyri Chloridi Corrosivi, gr. ij ; Aquae destillatae, f oiv. Fiat injectio. In chronic gonorrhoea. 775. Injection of Acetate of Zinc. Ify. Zinci Acetatis, gr. viij ; Aquae Rosae, f oiv. Fiat injectio. In gonorrhoea virulenta. For all these preparations, rose-water is an admirable men- struum ; it possesses the advantages of being slightly astrin- gent and rendered pure by distillation, and is therefore par- ticularly applicable to the formation of injections and collyria. 776. Injection of Qhloride of Zinc. 1^. Zinci Chloridi, gr. j ; Aquae, foj. Fiat solutio. This injection has been used in St. Bartholomew's Hospital, London, with much success, by Mr. Lloyd, in cases of gonor- rhoea. Mr. Weeden Cooke recommends the simultaneous em- ployment of the alkaline carbonates internally. 777. Injection of MonseVs Salt. Ify. Liquoris Ferri Subsulphatis, f 5ss ; Aquae, fovj. Solve. Signa. — Use for an injection. Recommended in gleet. Bumstead. 778. Injection of Sulphate of Iron. Ify. Ferri Sulphatis, gr. viij ; Aquae, fgj. Fiat solutio. LTsed in gleet. INJECTIONS. 257 779. Injection of Iodide of Iron. 1^. Ferri Iodidi, 5ss ; Aquae, fSviij. Fiat solutio. Used in blennorrhoea. Ricord. 780. Injection of Sulphate of Quinia, 3^. Quiniae Sulphatis, gr. viij ; Aquae, fgj ; Acidi Sulphuriei Diluti, q. s. ut fiat solutio. Used in gonorrhoea. Goddard. 781. Injection of Chlorate of Potassa. Jfy. Potassae Chloratis, 5ss ; Aquae, fgv. Fiat solutio. This has been used in a number of cases of gonorrhoea, speedily effecting a cure. A. S. Palmer. 782. Injection of Armenian Bole, $c« Jfy. Zinci Sulphatis, 3j ; Boli Araieniae, 3ij ; Pulveris Acaciae, 5ij ; Aquae Rosae, fSviij. Fiat injectio. In gonorrhoea. 783. Injection of Calomel, $c. Ify. Hydrargyri Chloridi Mitis, 5j ; Acaciae, 5\j 5 Tincturae Opii, f §ss : Aquae, fSviij. Fiat injectio. For gonorrhoea or gleet. 784. Injection of Sulphate of Copper* ly. Cupri Sulphatis, gr. vj ; Aquae destillatae, f Syj ; Tincturae Opii, f5j. Fiat solutio. To be thrown up the urethra in chronic gonorrhoea. 17 258 INJECTIONS. 785. Injection of Yelloiv Root (Hydrastis Canadensis). I$s. Kadicis Hydrastidis contuse, oj ; Aquae bullientis, Oj. Macera per horas duas, et cola, Signa. — Inject an ounce three times daily. Dr. D. M. McCann, of Martinsburg, recommends highly this injection in gonorrhoea. Dr. U. E. Ewing also speaks favorably of it ; but he directs a drachm of sulphate of copper to be dissolved in the infusion. 786. Injection of Tea. ty. Folii These Viridis, 5j ; Aquae ferventis, fsvj. Fiat infusum et cola. For an injection in gonorrhoea virulenta. 787. Injection of Copaiba. Ify. Copaibas, 5v ; Vitellum unius Ovi ; Extracti Opii, gr. j. Tere simul, et adde gradatim — Aquae, fSvij. Misce. Signa. — Inject a portion several times daily. This is an efficacious mode of treating gonorrhoea. Dallas. 788. Injection of Ammoniated Copper. 1^. Cupri Ammoniati, gr. v; Aquae Rosae, foviij. Fiat solutio. In chronic gonorrhoea. 789. Solution of Tannin. 1^. Acidi Tannici, gr. xxxij ; Aquae destillatae, foviij. Solve. Employed as a wash to chronic ulcers, and as an injection in obstinate blennorrhoea. — Beral, in Dunglison's JSfetv Re- medies, 6th ed. p. 45. VAGINAL INJECTIONS. 259 790. Injection of Strychnia. Iy. Strychniae, gr. j ; Acidi Nitrici, trgij ; Aquae, f§j. Fiat solutio. Signa. — Inject a drachm three times a day after urination. Used in gleet. Johnson. C — VAGINAL INJECTIONS. 791. Injection of Permanganate of Potassa. Ify. Potassae Permanganatis. gr. xx ; Aquae, Oj. Solve. Used in cancer of the womb for its alterant and deodorant effect, a small quantity being injected several times daily. D. F. Girwood. 792. Injection of Creasote. Ify. Creasoti, TTgxij ; Mucilaginis Tragacanthae, f>ij ; Aquae ferventis, f §xiv. Fiat mistura. Recommended for the removal of the fetid and vitiated se- cretions from the maternal passages in puerperal fever. Warm water is thrown up to wash out the vagina, and the injection is then used. It is employed in the same way for cancer of the womb. Mackenzie. 793. Injection of Labarraque's Solution. I$«. Liquoris Sodae Chlorinatae, f§j ; Aquae, f§x. Misce. Prescribed as a vaginal wash in cases of infection, produced by the decomposition of a retained placenta. Trousseau. 794. Injection of Mustard, ly. Pulveris Sinapis Albae, 5ij ; Aquae ferventis, Oj. Misce. Signa. — Inject a third part three times daily. Useful in amenorrhoea. S. Ashwell*. 260 INOCULATION AND 195. Vaginal Pessary oj 7 Acid. R. Cerae Alb*, 3v. Liquefac cum leni calore. et adde — Adipis, 5yj ; Acidi Tannici. 3ij. Tore bene et divide in pessoe Used in leucorrhoea and ,£:onorrheea of female-. V '. Vaginal Pessary of Al I Cateel B.. Olei Theobroinae. oij ; Aluminis. Pnlverifi Catechu, aa 5j- :e seenndum artera et divide in pessos yj. Useful in chronic vaginitis and leucorrhcea. OCULATIOX AND SUBCUTAlirEOUS INJECTION OF MEDICINES. Inoculation. — The introduction of medicines into the e by inoculation was proposed in 1^6 by M. Lafargue, and fa since been practised by M. Solon and M. Langenbeck. I latter has tried a number of experiments, whereby the value of this mode of medication has been fully proved. Inocula- tion is effected by making a number of punctures with a small lancet through the skin — including both the epidermis and the dermis. — and rubbing the medicine, previously dissolved in the smallest possible quantity of fluid, into the punctured pai me local irritation follows the or : .In this way, itions of morphia, strychnia. n osive sub- limate, and of the various narcotic extracts, have been employed with much success. The quantity of medicamen: :- Lis about able of what would be administered by the mouth. Inocu- ;ion has proved effectual in sciatica, neuralgia, and local qs ; but it has not, however, attracted much attention fi practical physicians. Subcutaneous Injection of medicines is more efficacious a inoculation, as in this way remedies can be more readily and certainly introduced. The operation is performed by means of a syringe capable of holding a fluidrachm, and having te perforated nozzle drawn to a point, by which the skm can penetrated by a gentle rotary motion. Or a delicate trocar SUBCUTANEOUS INJECTIONS. 261 and canula may be used. The trocar having been withdrawn, the injection is made by a syringe through the canula. After the operation there are usually some swelling, tenderness, or pain, and a diffused redness of the skin. These local pheno- mena soon pass away, and the symptoms characteristic of the medicine are manifested on the system. No unpleasant local results need be anticipated, unless the quantity employed be large, or the remedv be of an acrimonious character. In all cases, strong solutions are used, with a view of combining effi- ciency with smallness of bulk. Saturated solutions of tannin, and of the peracetate, perchlo- ride, and persulphate of iron, have been injected for the de- struction of naevi and small aneurisms. Dr. Alexander Wood, of Edinburgh, reported nine cases of neuralgia, in 1855, treated by injections of a strong solution of opium, over the seat of pain. In all relief was afforded, and in most a cure was effected. Dr. Horatio R. Storer injected, successfully, ten drops of a solution of the bimeconate of morphia (bimeconate, grs. x, alcohol, f 5j, and water, f 5xiij), beneath the mucous membrane of the gum for the relief of toothache in pregnant women. Dr. Scanzoni speaks favorably of the same preparation for neuralgia, and even for puerperal convulsions. Mr. Charles Hunter, of London, employed concentrated solutions of the acetate of morphia in cases of chorea, tic douloureux, delirium tremens, and hemicrania. The doses ranged from a half to three-fourths of a grain of the acetate. In every instance the peculiar effects of morphia were soon manifested. Drs. Courty and Cowdell report, severally, the injection of atropia, or its sulphate, in doses ranging from one-thirty-third to one-eighth of a grain in asthma, sciatica, and severe neural- gias. If the atropia be pure, these quantities are too large for ordinary use. Dr. Ignatius Danger, of Iowa, refers to twenty-three cases of intermittent fever cured by injections of sulphate of quinia. " He administered a solution of two to ten grains of sulphate of quinia in fifteen to thirty grains of water (with an addition of two to six drops of diluted sulphuric acid), according to age, constitution, duration of disease, and former treatment." 262 GARGLES AND MOUTH WASHES. D.— GARGLES AND MOUTH WASHES. Gargles, like injections, are astringent and stimulating ; and to be of any service must be frequently applied, and perse- vered in for some time. 797. G-argle of Brandy. 1^. Spiritus Vini Gallici, Aquae, aa partes aequales. Brandy and water form an excellent gargle for some cases of inflamed fauces. 798. Gfargle of White Oak Bark and Alum. Tfy, Quercus Albae contusae, §j ; Aquae, Ojss. Coque ad Oj, cola, et adde — Aluminis, 5ss ; Spiritus Vini Gallici, f §ij. Misce. Used in sore throat and chronic ulceration of the fauces. 799. G-argle of Sulphate of Quinia, $c, 1^. Quiniae Sulphatis, gr. xij ; Cupri Sulphatis, gr. xvj ; Acidi Sulphurici Aromatici, f 5j ; Aquae foviij. Fiat mistura. Signa. — To be used three or four times a day in obstinate sore throat. Jos. Hartshokne. 800. G-argle of Borax and Myrrh. 1^. Sodas Boratis, 5j ; Tincturae Myrrhae, f Sss ; Mellis despumati, f Sj ; Aquae Rosae, f§iv. Fiat gargarysma. To be used as a gargle or mouth wash, in ptyalism or scor- butic affections of the gums. « GARGLES AND MOUTH WASHES. 263 801. G-argle of Sulphate of Zinc, $e. Jfy. Zinci Sulphatis, 5j ; Mellis, f oss ; Tincturae Myrrhae, f§j ; Spiritus Vini Gallici, f §j ; Aquae Rosae, f§vj. Fiat gargarysma. To be applied to ulcerated gums, occasioned by excessive salivation. Water can be added if it be too strong. 802. Dr. Blake s Toothache Solution. ]^. Aluminis (in pulverem subtilissimum triturandi), 5\j ; Spiritus iEtheris Nitrosi, fSvij. Fiat mistura. Said by Dr. Blake, of London, to be an infallible cure for toothache, when not connected with rheumatism. 803. Gargle of Alum. 1^. Aluminis, 5ij ; Aquae, f§iv. Solve. This is Dr. Cavarra's gargle for foetor oris, or offensive breath. 804. G-argle of Pomegranate and Alum. 1^. Granati Fructus Corticis, §ss; Rosae Gallicae, 5\j > Aquae bullientis, f§vj. Fiat infusum. Cola et adde — Mellis despumati, f§j ; Aluminis, 5\j- Fiat gargarysma. For inflammation of the throat and fauces. 805. Gargle of Rhatany. 3^. Pulveris Krameriae, Pulveris Cinnamomi, aa 5j ; Aquae bullientis, fovij. Macera per horas duas, cola, et adde — Sacchari, 51J. Fiat gargarysma. A valuable astringent gargle in ordinary sore throat. _• - .i -ii ; i.:«": h : . z - ■ ■ i = £ _ -. 77 " A " ~ 7 £ 7 " B . Lif nsi Cnicfoonae Rafer* . : A 1 1 -His degpmnatL f Sj ; 7_ - '.: " 1 ::: :::: " J- : _ - . .: -=~i: _l ._:.!:: ::::cz::;.:. ££ £: - :£:i : . ; ~7.:::^ A _ £ ££ :ri-;-ri :j AiAt7j£. 7_::z: ; A • R. Deeoeti Hordel : ~ Mellis despumaiL I r Acidi SolpIiioricL iH£x- 7. i: ;£ _ .: _ -£.:. 7aai: A * __.'■- . : " " 7 " 7. . B. Hxdiargyii CMoridi Gorroeri, gr. j ; Mr_: • -- " : : ' A 7=77 - £ : A _ 7 :: -£:" 7. : '. ■ :: r :1: - ?. Aril £ A ; £ v.jo " \ A: ■:■-■'.■:■ A. - 7. A : ; 7 A :-. Ammoniac Minis: " M r 71; : ' • - j :: - ;£_••-_ A — - ■ fi£:££ ;.£::: 810. Ghoungle of A&ebate of Lead. B . Phnnbi Aeetafe _ t : ■ ::: A :: A:. \ -. Fiat sohnio. In mercurial sore month, kc. SVL Chhride of lime GhargJe. B. Caleis CMorinataB, oij; A 7 T £ - ^ 7."£ tT : £1. _'££. \A.- — Mellis, f §j. " " - ' . A : . - : : ~ - " A : . GARGLES AND MOUTH WASHES. 265 812. Disinfecting Mouth Wash. IJj. Calcis Chlorinate, 5iij ; Aquas clestillatse, f§ij. Tere simul et filtra. Dein adde — Olei Rosas, trgv; Alcoholis, f §ij ; Mellis Rosas, f §ss. Misce. Used in mercurial sore mouth. 813. Cayenne Pepper Gargle. 3^. Tincturae Capsici, f §ss ; Aquas Rosas, f§viij. Misce. A stimulating gargle used in scarlet fever. Griffiths. 814. Mel JEgyptiacum. 1^. Linimenti iEruginis, Lond., fSj. This is applied with a brush to venereal ulcers of the throat. Diluted with water (one drachm to the ounce), it forms a deter- gent gargle. 815. Gargle with Iodine and Opium. Iy. Tincturas Iodinii, Tincturae Opii, aa f 5j ; Aquas, fSvj. Fiat gargarysma. Signa. — To be well shaken when used. This is employed three or four times daily in ulcerated sore throat. 816. Lotion of Iodide of Zinc. 1^. Zinci lodidi, gr. x ; Aquas destillatae, f oj. Fiat solutio. Applied daily to enlarged tonsils, by a piece of sponge tied to a quill. J. J. Ross. 817. Mixture of Sulphuric Acid and Honey. Ify. Acidi Sulphurici, f 5ss ; Mellis, fgj. Fiat linimentum. 266 LINIMENTS, LOTIONS, ETC. Used for aphthae, by touching the ulcerated surfaces fre- quently with a soft pencil. 818. Wash of Sulphate of Copper, fie. Ify. Cupri Sulphatis, 5ij ; Pulveris Cinchonas Pallidas, §ss ; Aquae destillatas, f §iv. Misce. Signa. — In the gangrenous sore mouth of children, applied to the full extent of the ulceration and excoriation. B. H. Coates. Sulphate of zinc is often employed in like doses in this affection. 819. G-argle of Alum, Sage Tea, and Honey. Ify. Salvias, oSs; Aquas bullientis, Oss. Fiat infusum, et cola. Dein adde — Aluminis, 5ss; Mellis, fgj. Fiat mistura. This domestic remedy is very effectual in cases of sore throat. 820. Lotion of Muriatic Acid, fie. 1^. Acidi Muriatici, f5ss; Mellis, Aquas Rosas, aa f §j. Misce. Signa. — To be applied with a brush to scorbutic gums three or four times a day. E. — LINIMENTS, LOTIONS, ETC. 821. Lotion of Lime-ivater, Zinc, fie. R. Zinci Oxidi, gr. xij ; Cupri Sulphatis, gr. iij ; Mellis, f 5j ; Liquoris Calcis, fgij. Fiat lotio. Signa. — To be applied to phagedenic ulcers of the genitals. Vide Swediaur on Syphilis. LINIMENTS, LOTIONS, ETC. 267 822. Liniment of Lime-ivater and Linseed Oil (Qarron Oil). 3^. Olei Lini, foiij; Liquoris Calcis, fovj. Fiat linimentum. Signa. — To be applied to burns and scalds by means of a feather or soft raff. 823. G-um and Molasses Mixture. R. Pulveris Acacias, §iij ; Pulveris Tragacanthae, oj« Tere simul, et adcle gradatim — Aquae, f §x ; Syrupi Fusci, f§ij. Misce. Signa. — Apply over the burnt surface. Dr. T. H. Bache furnishes this, as the formula used in the Pennsylvania Hospital. By some of the surgeons this mix- ture is highly prized in the treatment of burns and extensive scalds. 824. Lotion of Permanganate of Potassa. 1^. Potassae Permanganatis, 5ss; Aquae, Oj. Solve. Under the name of "Condy's Fluid" a solution of the per- manganate has been extensively employed in the London hos- pitals in cases of burns, ulcers, and extensive suppurating surfaces, with relief to the pain and a total prevention of any foetor. 825. Liquid Deodorant. R. Spiritus Camphorae, Tincturae Myrrhae, aa f 5iij ; Linimenti Saponis, f 5\j ; Acidi Acetici Glacialis, tt£xx; Olei Picis Liquidae, f5j. Misce. This preparation, properly diluted, is an excellent applica- tion to sloughing or gangrenous parts, in consequence of its deodorizing properties. It is also of service in cases of diar- rhoea or dysentery, for purifying the air of the chamber. A teaspoonful added to each liquid stool is sufficient to remove the odor, especially if a towel moistened with the lotion be waved for a few moments in the room. T. Skinner. -68 LIBTIMBKTS, LOT 10X5. ETC. . Lotion of G- ' ' \et and Oampl R. Liquoris Plumbi Sabacetatis, foj ; Spiritus Camphorae, f§iij : :aa. Oj. Fiat lotio. This compound is inuch recommended by some of the French surgeons. Applied by means of lint to old ulcers and burns. 827. Another Form. R. Confectionis Rosse. oj*. Mellis, Liquoris Plumbi Subacetatis. aa f§ss; Tineturae Opii. ffRlx. :e. i. — Applied to painful venereal ulcers, and to chancres after the use of lunar caustic. 828. Lotion of Chloride of Zinc. R. Zinci Chloridi, gr. ij : Aquae destillata?. f§j. Misce. na. — Applied on lint to chronic and indolent nice] Kancke. 829. Lotion of Sulphuret of Potassiu R. Potassii Sulphureti, 5ij; Aquae, Oj. Solve. This lotion proves almost magical in its effects in cases of pityriasis. It may be applied with a brush or sponge. J. Nkill. 830. Lotion of Sulphur et of Potassium, Li; ■ R. Potassii Sulphureti, 5-- : Saponis. 5j : Alcoholis. f 5iv : Tineturae Myrrhae, f§88 : Liquoris Calcis. Oj. t mistura secundum artem. Signa. — To be applied to the head night and morning, in tinea capitis. The hair must be shaved previous to its emp: . y- ment. LINIMENTS, LOTIONS, ETC. 269 831. Lotion of Phosphoric Acid. Bi. Acicli Phosphorici Glacialis, 5j ; Aquae destillatse, fSviij. Fiat solutio. Dr. Len.tin, a German physician, has employed this solution on compresses applied to ulcers situated over carious bones. — Spillan's Supplement to the British Pharmacopoeias. 832. Lotion of Corrosive Sublimate, $c. Ify. Hydrargyri Chloridi Corrosivi, 5 j ; Aquae, f'svj. Solve et adde — Ammonise Muriatis, 5ij ; Potassse Nitratis, §ss. Fiat lotio. Principally used as a wash in itch. Good's Study of Med., vol. iv. 833. Yellow Wash. Tfy. Hydrargyri Chloridi Corrosivi, gr. j ; Liquoris Calcis, fSj. Fiat solutio. For ordinary purposes, one grain to the ounce will be suffi- cient. In phagedenic and venereal ulcers. 834. Black Wash. Tfy. Hydrargyri Chloridi Mitis, 5j ; Liquoris Calcis, f §iv. 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 ad- ministered in the form of injections in gleet and gonorrhoea. 835. Lotion of Cyanide of Potassium, 1^. Potassii Cyanidi, gr. xij ; Misturse Amygdalae, f§vj. Fiat lotio. In lichen, and other chronic eruptions. 270 LINIMENTS, LOTIONS, ETC. 836. Liniment of Ghlorine. ]^. Aquae Chlorinii, f5j ; Olei Olivae, f§j. Fiat linimentum. Applied externally to itch, herpes, and tinea capitis. Dunglison's New Remedies, 6th ed. p. 195. 837. Iodine Liniment. 1^. Linimenti Saponis, f oj ; Tincturae Iodinii, f5j« Misce. 838. Oreasote Liniment. Jfy. Creasoti, rrgx ; Olei Olivae, f§j. Fiat linimentum. In herpes, &c. 839. Oreasote Lotion. Ify. Creasoti, trgx ; Aceti, f 5\j ; Aquae destillatae, foij. Fiat lotio. Applied in phagedenic ulceration. 840. Camphorated Oil. ]^. Camphorae, §j ; Olei Olivae, f §iv. Fiat solutio ; tunc adde — Olei Terebinthinae, f ojss. Misce. Signa. — To be applied by rubbing with a piece of flannel. Used in deep-seated rheumatic pains. 841. Stokes's Liniment. — Linimentum Album. 1^. Olei Terebinthinae, fSiij ; Olei Limonis, f5j. Misce et adde, secundum artem— Vitellum unius Ovi ; Aquae Rosae, f §iij ; Acidi Acetici, f §ss. Tere simul. LINIMENTS, LOTIONS, ETC. 271 A stimulating liniment having been much prescribed in Baltimore under the above name, the College of Pharmacy of that city has adopted this formula. It is an efficient prepa- ration. 842. Liniment of Cantharides and Camphor. 1^. Tincturae Cantharidis, f §iv ; Camphors©, §ss. Misce. Signa. — To be rubbed on the parts affected. In paralysis. 843. Liniment of Camphor, Carbonate of Ammonia, Amber, $c. Jfy. Spiritus Camphors, f§iv ; Ammoniae Carbonatis, §ss ; 01 ei Juniperi, Olei Succini, aa f 5\j- Misce. To be employed in like manner, and in the same cases as the former. 844. Liniment of Camphor and Acetic Acid. Iy. Spiritus Camphorae, f§iij ; Acidi Acetici, f§j. Fiat embrocatio. To be applied to bruises, rheumatic parts, &c. 845. Liniment with Ammonia and Olive Oil; vulgo, Volatile Liniment. ty. Olei Olivse, Aquae Ammoniae, aa fgj. Misce, Applied to the neck in inflammation of the throat. 846. Liniment of Ammonia and Tartarized Antimony. Iy. Linimenti Ammoniae, f§j ; Antimonii et Potassae Tartratis, 5j- Misce. Applied to indolent tumors, and other swellings. 272 LINIMENTS, LOTIONS, ETC. 847. Liniment of Oil of Amber, £c. It. Olei Succini, foij ; Olei OlivEe, fgss ; Tincture Opii, foij I Spiritus Vini Grallici, foiij- Fiat linimentuni. Signa. — To be rubbed between the shoulders. In pertussis. 848. Liniment of Oils of Cloves, Amber, and Olives. Ify. Olei Caryophylli, Olei Succini rectificati, aa §ss ; Olei Olivse, Sj. Tere simul. Used as an embrocation in hooping-cough. Roche. 849. Liniment ivith Nux Vomica. X^. Tincturge !N"ucis Vomicae, f§j ; Aquae Amnionic, foij- Misce. This is applied by friction, in paralytic and nervous dis- eases. Magendie. 850. Anti-psoric Lotion of Dupuytren. Ify. Potassii Sulphureti, oiv ; Aquae, Oj ; Acidi Sulphurici Diluti, f5iv. Misce. Signa. — To be applied two or three times a day on the parts covered with pustules, and with this treatment the simple bath is conjoined. 851. Compound Opiate Liniment. Ify. Tincturae Opii, Spiritus iEtheris Sulphurici, Ed.; Spiritus Cainphorae, aa fgij. Fiat embrocatio. Signa. — To be applied to rheumatic parts. Also, in odontalgia, pain in the region of the ear, &c. LINIMENTS, LOTIONS, ETC. 273 852. Another Form. 1^. Tincturae Opii, Spiritus Caniphorae, Tincturse Cantharidis, ^theris, aa f §ss. Fiat embrocatio. Useful in intercostal and other pains. S. Ash well. 853. Liniment of Opium, Subacetate of Lead, $6. Ify. Olei Olivae, f Sij ; Tincturse Opii, f 5ij ; Liquoris Plumbi Subacetatis, f Sss. Misce. 854. Compound Chloroform Liniment. Ify. Chloroformi, iEtheris, Spiritus Camphorae, Tincturae Opii, aa f oj ; Tincturse Capsici, f gss. Misce. This forms an excellent embrocation for rheumatic pains, sprains, &c. 855. Liniment of Petroleum, Camphor, $c. ]^. Petrolei Barbadensis, f §j ; C amphorae, §ss ; Alcoholis, tt^xI. Fiat linimentum. Powder the camphor by adding the spirit, and then mix the whole in a mortar. G-lyeerin. This principle, which is demulcent and antiseptic, forms a very useful addition to lotions and gargles. It has been used extensively by Mr. Star tin, surgeon to the London Cutaneous Institution, and he has published several formulas for its em- ployment. Two of them are subjoined, viz. : 856. Lotion of Borax and G-lyeerin. 1^. Sodae Boratis, 5ss ; Aquae Rosae, f gvijss ; Glycerinae, f §ss ; Fiat mistura. 18 274 LINIMENTS, LOTIONS, ETC. Used for chapped hands, fissures of the lips, sore nipples, and irritation of the skin of any kind. Startin. 857. Lotion of Ammonia, Glycerin, frc. Tfy. Spiritus Ammoniae Aromatici, f 5j ; Glycerinae, f 5ss ; Tincturae Cantharidis, f3j ; *Aquae Rosmarini, f ovij. 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. 858. Glycerin Lotion, ]fy. Glycerinae, f 5ij ; Aquae Rosae, fgij. Misce. This is an emollient and soothing lotion, useful in erythema, chaps, excoriations, &c. — Druggists'' Circular . 859. Lotion of Morphia and Glycerin. Hi. Morphiae Acetatis, gr. iij ; Glycerinae, fgj. Solve. This is an elegant mode of preparing an anodyne lotion, the quantity of the salt varying with the indications of the case. The salts of nearly all of the alkaloids are soluble in glycerin, but the bases, or pure alkaloids, are insoluble in this fluid. 860. Lotion of Lead-water and Glycerin. Ify. Liquoris Plumbi Subacetatis, f 5j ; Glycerinae, f 5iij ; Aquae, fgvijss. Fiat solutio. This forms an astringent and sedative lotion, which is valu- able in the treatment of many of the skin diseases. — Lond. Hosp. for Skin Diseases. ! When aromatic waters are prescribed which are not officinal, the com- pounder can readily prepare them by rubbing two drops of the essential oi 1 with a few grains of carbonate of magnesia and a fluidounce of water, and then filtering the solution through bibulous paper. LINIMENTS, LOTIONS, ETC. 275 861. Lotion of Tannin and Glycerin. Ify. Acidi Tannici, gr. xv; Glycerinae, f§j. Solve. Used for sore nipples, by applying it to the part with a brush, or on lint covered with oiled silk. Some practitioners prefer a stronger solution, consisting of equal parts, by weight, of tannin and glycerin. 862. Lotion of Qreen Vitriol. Ify. Ferri Sulphatis, Sj ; Aquae, Oj. Fiat lotio. Used in erysipelas, by applying it to the part every two or three hours. Velpeau. 863. Lotion of Borax and Morphia, 1^. Sodae Boratis, §ss; Morphias Sulphatis, gr. vj ; Aquae Rosae, f§viij. 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. 864. Lotion of Sulphite of Soda, $c. 3^. Sodae Sulphitis, Aluminae Sulphatis, aa 5j; Aquae Rosae, 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 washing the part with a linen rag dipped in the solution twice or thrice a day. Startin. 865. Substitute for Aromatic Wine. "Sf. Vini Rubelli [Claret Wine), Spiritus Lavandulae Compositi, aa f§v ; Tincturae Opii, f §ss ; Aquae, f ^iijss ; Acidi Tannici, 5\j- Misce. 276 OINTMENTS. The aromatic wine of the Paris Codex is employed by Ricord and others as a stimulating lotion to buboes and chan- cres, and when diluted as an injection in leucorrhoea and go- norrhoea. The above is an efficient substitute for the original complex formula, and may be employed in similar cases. F. J. BUMSTEAD. F. — OINTMENTS. Ointments are usually prepared by rubbing together the medicinal agent and a sufficient quantity of lard to give a smooth uniform consistence. If intended for immediate use, no better excipient than lard can be found. But if kept on hand for some time, an ointment, thus made, becomes rancid or acrid. To prevent this chemical change, a number of plans have been proposed, the following among others : 866. Benzinated or Benzoated Lard, As an excipient, is used instead of pure lard. It is prepared by digesting at a moderate heat two drachms of powdered benzoin with a pound of lard. E. Mouchon. 867. Plasma, Is the name applied to a mixture of seventy grains of starch and a fluidounce of glycerin. These articles are mixed and gradually heated to 240° F., constantly stirring. This mix- ture is used as a basis for ointments. It dissolves most mate- rials which are soluble in water, and it can be washed readily from tender surfaces. G. F. Shacht. Mr. Startin's formula for a similar preparation is : Ij*. Tragacanthae electse, Sss ; Glycerinse, f 5j ; Liquoris Calcis, f §ij ; Aquse Rosse, q. s. ut fiat gelatina. Misce. This jelly is employed both as a basis for ointments and as an emollient application in various skin diseases. 868. Ointment of Red Precipitate. 3^. Hydrargyri Oxidi Rubri, 5j ; Terebinthinse Venetae, oj. Misce. . This preparation is applied to indolent sores, and is thought by some practitioners to be a specific in itch. OINTMENTS. 277 869. Iodine Ointment. Hy. Iodinii, gr. iij ; Adipis, 5\j- Fiat unguentum. Used in enlargements, painful joints, nodes, &c. 870. Iodine and Collodion. Jfy. Iodinii, Terebinthinse Canadensis, aa 5j ; Collodii, f§iv. Solve. Signa. — Paint over the diseased part with a brush. This preparation has proved very efficient in the discussion of tumors, swellings, painful joints, &c. It acts as a rubefa- cient, and even as a vesicant if the skin is tender. J. T. Shinn. 871. Ointment of Iodide of Potassium. 1^. Potassii Iodidi, 3j ; Cerati Adipis, §j. Fiat ceratum. Applied to scrofulous swellings when the skin is unbroken. It may also be used for tetter, and kindred eruptions. 872. LugoVs Ointment of Ioduretted Iodide of Potassium. 1^. Iodinii, gr. xij ; Potassii Iodidi, 3iv ; Adipis, Sij* Fiat unguentum. Used in scrofulous ophthalmia, ulcers, &c. 873. Ointment of Iodide of Zinc. Ify. Zinci Iodidi, 5j ; Adipis, Sj- Fiat unguentum. Signa. — A drachm 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. 278 OINTMENTS. 874. Ointment of Iodide of Barium. 1^. Barii Iodidi, gr. iv ; Adipis, Sj- Fiat unguentum. For scrofulous swellings. Biett. 875. Ointment of Iodide of Cadmium. Ify. Cadmii Iodidi, 5ss ; iEtheris, rrgxl. Tere simul, et adde — Adipis, Sj- Misce, fiat unguentum. Used in cases of enlarged glands, and nodes, and for chronic inflammation of the joints. This does not stain the skin like iodine or iodide of lead, and is not gritty like the ointment of iodide of potassium. A. B. Garrod. 876. Ointment of Iodide of Iron. Iy. Ferri Iodidi, 5jss ; Adipis, Sj. Fiat unguentum. 877. Ointment of Iodide of Sulphur. Tfy. Sulphuris Iodidi, gr. xxv ; Adipis, Sj. Fiat unguentum. Used in diseases of the skin. Magendib. 878. Ointment of Iodide of Arsenic. Iy. Arsenici Iodidi, gr. iij ; Adipis, Sj. Fiat unguentum. Used in lepra, impetigo, and other cutaneous affections. Biett. 879. Ointment of Iodine and Calomel. 1^. Iodinii, gr. x ; Hydrargyri Chloridi Mitis, gr. xv ; Adipis, Sj- The iodine to be first united to the lard, and then the calomel added. MM. Planck and Soubeiran, by whom this ointment is pro- OINTMENTS. 279 posed, state that these are the only proportions that can be used, without leading to decomposition. 880. Ointment of Iodide of Mercury and Morphia. ^. Hydrargyri Iodidi Viridis, gr. vj ; Morphise Acetatis, gr. viij ; Adipis, oj« Fiat unguentum. Recommended 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. 881. Ointment of Red Iodide of Mercury. Iy. Hydrargyri Iodidi Rubri, 3j ; Adipis, 5Jss. Fiat unguentum. Used to accelerate the cicatrization of inveterate venereal ulcers. 882. Another Form. Ij*. Hydrargyri Iodidi Rubri, gr. xv ; Adipis, gij ; Olei Limonis, rrgxx. Fiat unguentum. Employed as a curative application to syphilitic tubercles, chronic ulceration, and venereal eruptions. Its great activity requires caution in its use. Ratier. 883. Compound Ointment of Red Iodide of Mercury. Ify. Hydrargyri Iodidi Rubri, gr. vij ; Potassii Iodidi, 3j ; Adipis, 5j. Fiat unguentum. Used for the discussion of glandular and other tumors. C. C. HlLDRETH. 884. Ointment of Ioduretted Iodide of Potassium with Opium. ]^. Iodinii, gr. xvj ; Potassii Iodidi, 5j ; Tincturse Opii, f 5\j ; Adipis, §ij. Fiat unguentum. Applied to scrofulous and other ulcers. Lugol. 280 OINTMENTS. 885. Ointment of Cyanide of Mercury. 1^. Hydrargyri Cyanidi, gr. xij ; Adipis, gj. Fiat unguentum. Used in herpes attended by inflammation and itching. 886. Mercurial Ointment with Camphor. I$*. Unguenti Hydrargyri, Sj ; Camphorse, 5j- Misce. Signa. — One drachm of this ointment to be nibbed on the in- side of the thighs, before the fire. Used for buboes and venereal diseases. Some physicians recommend the warm-bath before using the ointment, while others consider it useless. We think the practice occasionally beneficial. The hands of the person rubbing it on should be enveloped in a bladder, or gloves made of oiled silk. B. Ellis. 887. Ointment of White Precipitate, Sulphur, $c. ^. Hydrargyri Ammoniati, gr. xv ; Potassse Nitratis, 5ss ; Sulphuris Sublimati, 5j. Tere simul et adde — Adipis, oij- Fiat unguentum. This ointment has long been celebrated in the cure of itch. 888. Compound Sulphur Ointment. Ify. Sulphuris Sublimati, oviij ; Hydrargyri Ammoniati, §ss ; Hydrargyri Sulphureti Rubri, oSS. Tere simul et adde — Olei Olivae, §iv ; Adipis, Bbj ; Creasoti, rrgxx. Misce. This ointment is employed in the London Hospital for Dis- eases of the Skin, in the treatment of scabies, favus, and ring- worm. Startin. OINTMENTS. 281 889. Anti-herpetic Ointment. 1^. Hydrargyri Sulphatis Flavse, 5j ; Tincturse Opii, f 5j ; Sulphuris Sublimati, 5ss ; Adipis, oj- Fiat ung uen turn. In herpes, alternated with the simple water-bath. 890. Sulphur Ointment. 1^. Adipis, ibj ; Olei Bergamii, f 5ij ; Sulphuris Sublimati, Sviij. Fiat unguentum. Used by friction, three to six drachms at a time, in itch. 891. Mercurial Cerate. Iy. Unguenti Hydrargyri, §iv ; Cerati Adipis, §x. Fiat ceratum. A dressing for venereal ulcers. Ratiek. 892. Ointment of Cyanide of Potassium, and Chloroform. 1^. Potassii Cyanidi, partes x ; Chloroformi Venalis, partes xij ; Adipis, partes lx. Fiat unguentum. Recommended in hemicrania and facial neuralgia. A portion to be well rubbed into the skin over the seat of suffering. Cazenave. 893. Ointment of Belladonna. Ify. Extracti Belladonnas, 5ij ; Glycerin ae, f 5\j ; Adipis, gij. Misce. Employed as a direct application to the neck of the uterus, in cases of rigidity. 282 OINTMENTS. 894. Ointment of Alum, Calomel ftc. Iy. Hydrargyri Chloridi Mitis, 5ij ; Aluminis exsiccati, Plumbi Oxidi, aa oss ; Olei Terebinthinse, f 5y ; Unguenti Adipis, §jss. 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. S. G. Morton. 895. Ointment of Calomel and Sulphate of Zinc. It. Hydrargyri Chloridi Mitis, Zinci SulphatiSj aa 3\j ; Adipis, Sj. Fiat unguentum. Used in the Royal Free Hospital, London, in the treatment of condylomata. V. De Meric. 896. Ointment of Oxide of Zinc. Iy. Zinci Oxidi, 5j ; Adipis Benzoati, §j. Fiat unguentum. This is a mild and very useful ointment for scalds, super- ficial inflammations, ulcers, &c. 897. Kentish's Ointment. Jfy. Cerati Resinse, o\j ; Olei Terebinthinse, f oij- Fiat unguentum. This preparation has long been celebrated in burns and scalds. Care is requisite to avoid touching the sound skin, for turpentine occasionally inflames it severely. 898. Ointment of Bromide of Potassium. ]$>. Potassii Bromidi, gr. xxx ; Adipis, gj. Fiat unguentum. Used for scrofulous tumors. OINTMENTS. 283 899. Ointment with Goulard's Cerate, Calomel, £c. Jfy. Cerati Plumbi Subacetatis, Cerati Adipis, aa 5ss ; Hydrargyri Chloridi Mitis, Pulveris Opii, aa 5j« Misce. Useful in various cutaneous eruptions. Joseph Parrish. 900. Ointment of Rhubarb, Opium, $c. Tfy. Pulveris Rhei, gr. x ; Pulveris Opii, gr. v ; Unguenti Adipis, Sjss. Fiat unguentum. In indolent ulcers. 901. Ointment of Tar, and Citrine Ointment. Ify. Unguenti Picis Liquids, Sj ; Unguenti Hydrargyri Nitratis, Sss. Fiat unguentum. In tinea capitis. 902. Ointment of Tar and Opium. Ijf. Pulveris Opii, 5ij ; Unguenti Picis Liquids, oj- Fiat unguentum. For hemorrhoids. 903. Ointment of Oil of Cade. Tfy. Olei Juniperi Oxycedri Pyrolignei, Sj ; Olei Anisi, gtt. iij ; Adipis, §ij. Fiat unguentum. The oil of cade is an empyreumatic product obtained by the destructive distillation of the Juniperus Oxycedrus. It has proved highly beneficial in many forms of skin dis- ease, especially in eczema and tinea. Devergie. 284 OINTMENTS. 904. Kirkland's Neutral Cerate. Tfy-. Emplastri Plumbi, oiv ; Olei Olivae, Cretae Prseparatse, Acidi Acetici Diluti, aa gij ; Plumbi Acetatis, 5jss. 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 acetic acid and acetate of lead are to be added, and the whole stirred until nearly cold. This non-officinal cerate is well adapted to abraded irritable surfaces, and the later stages of burns. 905. Aromatic Compound Sulphur Ointment. R. Potassaa Carbonatis, §ss ; Aquae Rosae, f oj ; Hydrargyri Sulphureti Rubri, §j ; Olei Bergamii, f gss ; Sulphuris loti, Adipis, aa §x. Misce secundum artem. Used in scabies. Bateman's Synopsis. 906. Naphthaline Ointment. 1^. Naphthaline, 3ij ; Adipis, Sj. Fiat unguentum. Recommended by Dr. Lodge, in the treatment of itch. Dr. Emery has found it effectual in cases of dry tetter, lepra, and psoriasis. 907. Ointment of Carbonate of Ammonia. 3^. Ammonias Carbonatis, 5ss ; Unguenti Adipis, gss ; Fiat unguentum. Applied to indolent ulcers of a scrofulous character. 908. Ointment with Verdigris, $c. 1^. Cupri Subacetatis, Cupri Sulphatis, Hydrargyri Oxidi Rubri, aa oij ; Hydrargyri Chloridi Corrosivi, 5j ? Adipis, 5v. Fiat unguentum. OINTMENTS. 285 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. Brodib. 909. Ointment of Ipecacuanha. ~Bf. Pulveris Ipecacuanhas, 5y; Olei Olivse, f 5y ; Adipis, Sss. Misce, et fiat unguentum. Useful as a counter-irritant. Turnbull. 910. Ointment of Calomel and Tar. Iy. Hydrargyri Chloridi Mitis, 5j ; Unguenti Cetacei, Lond., 5j ; Unguenti Picis Liquids, 5ss. Fiat unguentum. Used in lepra. A. T. Thomson. 911. Ointment of Qreasote and Charcoal. ~Bf. Creasoti, foss; Alcoholis, fojss; Carbonis Animalis purificati, 5j 5 Unguenti Cetacei, Lond., ojss. 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, gradu- ally increasing the strength of the ointment according to the age of the patient." S. Sutro. 912. Oxide of Silver Ointment. 1^. Argenti Oxidi, 5j; Unguenti Adipis, 5J. Fiat unguentum. Used for sore nipples. 913. Ointment of Slaked Lime, Zinc, $c. Iy. Calcis Hydratis, 5j; Camphors, 3j ; Unguenti Zinci Oxidi, 5J. Fiat unguentum. This is the "topique contre acne" of the Hopital St. Louis. 286 OINTMENTS. 914. Depilatory Ointment. It. Sodae Carbonatis, 5\j ; Calcis, 5j ; Adipis, Sj. Fiat unguentum. Used in porrigo. Biett. 915. Veratria Ointment. It. Veratrise, gr. x ; Acidi Acetici, ffgx; Adipis, oj- Fiat unguentum. Veratria has been used externally in neuralgia, in twitching and drooping of the eyelids, and in other nervous disorders, with the most marked success. 916. Veratria and Morphia Ointment. Iy. Veratrise, Morphiae Sulphatis, aa gr. x ; Adipis, gj. Fiat unguentum. Used in incontinence of urine, by rubbing a portion of the ointment on the perineum three times daily. T. Kennard. 917. Ointment of Nitrate of Silver. Iy. Argenti Nitratis, 5ss; Adipis loti, §ss. Fiat unguentum. Used to smear over bougies in the treatment of gonorrhoea. Macdonald. 918. Ointment of Tannin. Ify. Acidi Tannici, 5j ; Glycerinse, trgl ; Adipis, gj. Fiat unguentum. Used for the same purposes as the astringents generally. 919. Ointment of Tannate of Lead. f^. Plumbi Tannatis, 5j ; Unguenti Aquae Rosae, 5j. Fiat unguentum. OINTMENTS. 287 A sedative and astringent application to sore nipples, chapped surfaces, &c. M. Leon. 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- mulas might be given, but we limit our selection to two or three. 920. Powder of Verdigris and Calomel. Ify. Cupri Subacetatis, Hydrargyri Chloridi Mitis, aa 3j. Fiat pulvis subtilissimus. For chancres and indolent ulcers. 921. Powdered Rhubarb and Ipecacuanha. Hfy. Pulveris Rhei, Pulveris Ipecacuanhse, aa 5j« Fiat pulvis. To be dusted on sarcomatous and watery tumors. Rhubarb alone forms an excellent application to indolent ulcers. 922. Powder of Savin and Verdigris. Jfy. Pulveris Sabinse, Cupri Subacetatis, aa 5j- Fiat pulvis. To be dusted on sores accompanied with fungous excres- cences. 923. Powder of Sanguinarina. ]$*. Sanguinarinse Sulphatis, 5j. Tere in pulverum. Employed for the removal of venereal warts, hj dusting the surface of the warts thickly with the powder, and then apply- ing collodion to retain the powder in direct contact with the skin. 288 CATAPLASMS. G. — CATAPLASMS. 924. Bread-and-JIilJc Poultice. Remove 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. 925. Flaxseed Meal and Bran Poultice. 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 mucilaginous principles ; but in Xew York city and some other places, the ground oil-cake is preferred. Equal parts of the latter and bran form an elegant poultice. 926. Mush Poultice. 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. 927. Yeast Poultice. E.. Farinse, Ed.. ft)j; Fermenti, Oss. Misce. This cataplasm is useful in stimulating foul ulcers and gan- grenous wounds, and removing the unpleasant odor. It should be made with fresh yeast, and applied warm. 92*. Charcoal Poultice. 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 ; re- moving in a short time the fetor, and giving them a more healthy aspect. cataplasms; 289 929. Slippery Elm Poultice. 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. 930. Emollient Cataplasm. jfy. Lini Farinae, Hordei Farinse, aa partes aequales ; Aquae, q. s. ut fiat cataplasma. The water may be warmed if desirable. Applied to inflam- matory tumors. " Hotel Dieu. 931. Antiseptic Cataplasm. j^. Cataplasmatis Emollientis {vide supra, 930), Sviij ; Pulveris Kino, Camphorae, aa-5\j> Fiat cataplasma. Applied to unhealthy wounds and ulcers. H6tel Dieu. " 932. Resolvent Cataplasm. 1^. Cataplasmatis Emollientis (vide supra, 930), §iv ; Plumbi Acetatis, 5j ; Ammoniae Muriatis, 5ss. Fiat cataplasma. Applicable to tumors that require gentle stimulation. Batier's Formulary. 933. Cataplasm of Common Salt, $c. ^. Lini Farinae, Micae Panis, aa partes aequales. Misce, dein adcle gradatim— 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. 19 290 BATHS. 984. Iodine Cataplasm. 11. Tincturse Iodinii, f 5ss ; Lini Farinse, 5j ; Avenge Faringe, oiij ; Aqu^e q. s. ut fiat cataplasma. Applied to indolent ulcers (especially those of a scrofulous character), and to tumors of the same class. H. — BATHS. 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 Fahren- heit. It is designed to alleviate general or local irritation, and to induce 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 relaxa- tion of the skin during febrile irritation ; the warmer temper- ature 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. 935. Sulphurous Water, or Artificial Bareges Bath. Iv. Potassii Sulphureti, Ibj ; Aquae, Cong. xxx. Solve. In cutaneous eruptions. BATHS. 291 936. Sulphur eo-gelatinous Bath. 3$*. Potassii Sulphureti, oiv ; Aqucie, Cong. xxx. Fiat solutio et adde — Ichthyocollae, Ibj. In Aquae bullientis, Ibx solutae. This bath, according to Dr. Green (Diseases of the Skin, p. 240), " is preferable to the artificial Bareges bath, as it is neither irritating nor apt to occasion feverishness, which the common sulphurous 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 pur- pose." 937. Emollient Bath. R. Glycerinse, Sj ; Pulveris Tragacanthae, §j ; Aquae tepidae, Cong. xv. Misce. Useful in prurigo, eczema, lichen, impetigo, and other forms of cutaneous disease. Hosp. for Skin Diseases. 938. Nitro -muriatic Acid Bath. R. Acidi Nitrici, f5ij ; Acidi Hydrochlorici, f§iij ; Aquae, Cong. ijss. Misce. Used for syphilitic affections, and various obstinate skin diseases. St. George's Hosp. 939. Corrosive Sublimate Bath. R. Hydrargyri Chloridi Corrosivi, 5'ij j Aquas tepidae, Cong. xxx. Solve. Prescribed by the French physicians in syphilitic 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. 292 FOMENTATIONS. 940. Alkaline Bath. R . Potassa? Carhonatis Inrpura?. 5viij ; Aquae tepidre, Cong. xxx. Solve. For promoting desquamation from the skin, and to allay itching in various forms of prurigo. 941. Ioduretted Baths. No. 1. No. 2. No. 3. R. Iodinii, 5\j- 5i\j- 5*v- Potassii Iodidi, 5iv. 5^'. 5^iij- Aquae destillatag, ^5 v j« fovj- f$*j« Fiant solutiones. One of these solutions, according to the strength required, is added to a tepid bath in a wooden tub. For children, the drachms may be reduced to scruples. Used in scrofula. 942. Artificial Harrowgate Bath. R . Sodii Chloridi, ft>ij ; Magnesia? Sulphatis, oiij ; Potassii Sulphur eti, fbj ; Aquae, Cong. xxx. Solve. L— FOMENTATIONS. Fomentation is a more restricted mode of applying fluids t : 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. 943. Stimulant Fomentation. R. Yini Portensis, Oij ; Mellis, §iv. Misce. This is an active fomentation, adapted to parts in a low state of vitality. Ratier. 944. Saponaceous Fomentation. Py . Alcoholis, Oij ; Saponis, 5j. Misce. A resolvent in indolent tumors and in sprains. Ratier. FUMIGATIONS. 293 945. Anodyne Fomentation. 1^. Extracti Opii, 5j ; Aquae, Oj. Solve. For painful affections of the joints, as chronic rheumatism, &c. Ratier. 946. Fomentation of Bittersweet and Poppy. Tfy. Dulcamaras, 51'j ; Papaveris, Sij ; Aquas ferventis, Oj. Fiat infusum. Employed as a soothing application to irritable surfaces. 947. Mustard Fomentation. 3^. Sinapis Farinas, Siv ; Aquas ferventis, Oj. Misce. By wetting cloths in this fluid and applying them to the skin, irritation may be prolonged to any requisite degree. 948. Tobacco Fomentation. 1^. Tabaci, 5ij ; Aquas ferventis, Oj. Misce. Employed in psora, but is apt to produce nausea and vomit- ing. Its use requires great care. K — FUMIGATIONS. 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. 949. Fumigation with Sulphur ', Cinnabar ', and Iodine. !R. Sulphur is Prascipitati, 5iij ; Hydrargyri Sulphureti Rubri, 3ij ; Iodinii, gr. x. Fiant pulveres, vj. 294 FUMIGATIONS. 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 pi - tect 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 escaping. The limb may be continued in the bath from fifteen to twenty minutes, according to circumstan. Used in lepra. T. H. Burgess. 950. Mercurial Vapor Bath. R. Hydrargyri Oxidi NIgri, 5j ; vel Hydrargyri Oxidi Rubri. 5j ; vel Hydrargyri Sulphureti Rubri, 5j- Place the mercurial upon a plate suspended over a spirit- lamp : and suspend a small vessel containing boiling water over a second spirit-lamp. Both are to be deposited under a chair, on which the patient is seated, having an oil-cloth or a coverlet thrown around him in such wise as to envelop the apparatus, chair, and his entire person, excepting the face. When the lamps are lighted, mercurial fumes and steam are both generated, and mercury is thus directly applied to - whole surface of the body in a moist state. The bath should not continue longer than twenty minutes, when the patient should be rubbed dry and be removed to bed. This plan of medication is particularly serviceable in the treatment of constitutional syphilis, and obstinate skin diseases. L. Parker. 951. Chlorine Fumigation. It. Calcis Chlorinatse, %v? : Aquae, fo^iij- Misce et adde gradatim — Acidi Sulphurici, 5j- The irritant properties of chlorine preclude its employment in disease by inhalation, except in occasional cases of aphon but it is often used for disinfecting purposes. A small quan- tity may be set free in a sick-chamber, or the ward of an hos- pital, to remove offensive odors. BOOK III. OF DIETETIC PREPARATIONS, AND POISON DIETETIC PREPARATIONS AND BEVE- RAGES FOR THE SICK. 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. Bush, 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- mulas for those articles which are in daily use. However ap- parently trifling such a class may appear, the physician will find that an attention to it will place the patient more com- pletely under his own control, and inspire greater confidence in the relations and attendants. The rules to be observed in giving nourishment to the sick, will generally present them- selves ; 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 intended 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. 952. 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 freely in inflammatory diseases. 298 DIETETIC PREPARATIONS. 953. Rice Water. Take of Rice, ....... 2 ounces, Let it be well washed, and add to it — Water, ...... 2 quarts. Boil for an hour and a half, and then add as much sugar and nutmeg as may be required. To be taken freely. Rice, 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 pro- perty, which may be increased by boiling the milk. 954. Flaxseed Tea. Take of Flaxseed, . . . . . .1 ounce, Boiling Water, . . . . .1 pint. Pour the boiling water on the unbruised seed. Cover the ves- sel, and stand it near the fire for an hour or two. The seeds must not be crushed or boiled, lest the oil in the inte- rior should be extracted. Having strained the infusion, add to it a little lemon-juice, if no contra-indicating circumstances exist. Flaxseed tea is a mild demulcent, and is much used in dis- eases of the throat, chest, and urinary passages. 955. Toast Water. Cut a slice, half an inch thick, from a loaf of stale bread, re- move the crust, and carefully toast the slice on both sides. Place the toast and a small piece of orange- or lemon-peel in a suitable vessel, add a pint of boiling water, cover the vessel, and, when cold, strain off the water. This forms an agreeable drink in febrile diseases. 956. Apple Water. Slice two large apples, and pour over the slices a pint of boil- ing water. Infuse for an hour, decant, and sweeten with white sugar. 957. Currant Jelly Water. Boil together equal weights of white sugar and the juice of ripe currants, until the mixture gelatinizes by cooling, as shown by dropping a few drops on a cold plate. Remove the scum, and form the jelly in suitable vessels. DIETETIC PREPARATIONS. 299 A tablespoonful of this jelly, diffused through half a pint of cold water, makes a delightful acidulous drink, which is much relished by invalids. 958. 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. Gum Arabic is very nutritive, and life can be sustained on it alone for some time. 959. Bran Tea. Take of Fresh Wheat Bran, . ... 1 pint, Water, . . . . . . .3 quarts. Boil to two quarts, strain off the liquor, and add sugar, ac- cording to the taste of the patient. 960. 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, balm and other teas may be made. These infusions form very agreeable and useful drinks in fever, and their diaphoretic powers may be increased by the addition of sweet spirit of nitre or antimonial wine. 961. Infusion of Malt. Take of Ground Malt, . . . . . .1 pint. Scalding Water, . . . . .3 pints. Infuse for two hours, and strain off the liquor, to which may be added sugar or lemon-juice, if required. This was a favorite preparation with the late Dr. Joseph Parrish, in inflammatory fevers. 300 DIETETIC PREPARATIONS. 962. Lemonade. Take of Fresh Lemon Juice, . . . .4 ounces, 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 potassa or sweet spirit of nitre may be added. It can be further diluted to the taste of the patient. When fresh lemon-juice cannot be procured, an excellent lemonade can be prepared from lemon syrup made as follows : Dissolve ten drachms of tartaric or citric acid and eight pounds ox loaf sugar in a gallon of water. Then rub twenty drops of fresh oil of lemon with a portion of the syrup, and afterwards carefully mix it with the remainder. Lemonade, when freely taken, sometimes produces pain in the bowels. It must, therefore, be used with some reserve as a daily drink. 963. Oatmeal Gruel. Rub two ounces of oatmeal into a paste with a little water, and gradually add a quart of boiling water. Let the whole boil for fifteen minutes, stirring frequently. Add a little salt, remove from the fire, and sweeten to the taste. If no reason to the contrary exists, the flavor of the gruel is much improved by adding some nutmeg, with wine or brandy, or a few raisins. 964. Cornmeal Gruel. Indian meal gruel is made in the same manner as oatmeal gruel. It is necessary, however, to boil it a few minutes longer. 965. Rice Flour Gruel. Take of Ground Rice, ...... 1 ounce, Cinnamon, ...... 1 drachm, Boiling Water, . . . . .1 quart. Having rubbed the rice flour into a paste with a portion of the water, add the remainder gradually, and boil for forty minutes, adding the aromatic near the conclusion. Strain and sweeten. Wine may be added, if necessary. DIETETIC PREPARATIONS. 301 966. Panado. Take of Wheat Bread, ...... 1 ounce, Cinnamon, . . . . . .1 drachm, Water, ....... 1 pint. Boil them until well mixed, then add a little grated nutmeg, and sugar. Wine or butter may also be added, if de- sirable. 967. Compound Salep Powders (Castanello's Powders). Take of Salep, Tragacanth, Sago, each four ounces ; Cochineal, thirty grains ; Prepared Oyster-shells, one ounce. Mix carefully, and divide into powders of a drachm each. Stir one of these powders into a pint of milk, and boil them together for ten or fifteen minutes. To be drunk freely in dysentery and diarrhoea. These are the dysenteric powders of Dr. Castanello. A somewhat analogous preparation, sold under the same name, is prepared as follows : Take of Gum Arabic, Tragacanth, Arrowroot, Sago, Tapioca, each two drachms. 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. 968. Racahout des Arabes. Take of Dried Cocoa, in powder, 5iv; Potato Starch (or Arrowroot), Rice Flour, each 5x; Sugar, 5xv ; Vanilla, 5ss. Mix carefully. 302 DIETETIC PREPARATIONS. This is prepared for the sick by pouring half a pint of boil- ing milk on a tablespoonful of the powders, and boiling for a few minutes. 969. Diabetic or Bran Bread. Boil two or three quarts of wheat bran in two successive waters for ten minutes, each time straining through a sieve, and wash well with cold water until the water runs off clear. Squeeze the bran as dry as possible in a cloth, spread it thinly on a dish, and dry it in a slow oven. When per- fectly dry, grind it in a mill, and sift it through a fine sieve. Take six ounces of this ground bran, six eggs, three ounces of butter, and one pint of milk. Mix the eggs with a part of the milk, and warm the butter with the other portion. Then stir the whole well together, adding a little nutmeg or ginger, or any other agreeable spice. Immediately before putting into the oven, stir in seventy grains of bicarbo- nate of soda ; and then six drachms of dilute hydrochloric acid. Bake for an hour or until thoroughly done. As thus prepared, bran bread contains but a small amount of starchy matter. It has the further advantage of being quite palatable. Camplin. 970. 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 circum- stances. 971. Tapioca Jelly. Take of Tapioca, . . . . .2 tablespoonful-. 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. 972. Carrageen, or Irish Moss Blanc-mange. Take of Carrageeu, ..... half an ounce, Fresh Milk, . . . . .a pint and a half. Boil them down to such a cons'stence as to retain a form when DIETETIC PREPARATIONS. 303 cold ; remove any sediment by filtering, and then add the requisite quantity of sugar, with lemon-juice, or peach- water, to give an agreeable flavor. The moss, before being used, should be well washed in cold water, to remove its saline taste. 973. Iceland Moss Jelly. Take of •Iceland Moss, ..... two parts, Water, ...... twenty parts. Boil down to six parts and strain. Then add — Sugar, ...... four parts. Dissolve and set aside to cool. In consequence of its bitter principle, Iceland moss is more tonic than the other mosses. 974. Arrowroot. Take of Arrowroot, . . . . .1 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 and grate in a little nutmeg. 975. Tons les Mois, or Oanna Starch. This article is prepared like arrowroot. It is very delicate and valuable as a dietetic agent. When intended for infants, both this and the arrowroot are rendered more nutritious by the addition of fresh milk to the translucent jelly, made as directed above. In this case, how- ever, it is better to make the jelly more stiff by using a larger quantity of arrowroot, and then reducing it by milk to the proper consistence. 976. Maizena, or Corn Starch. To one quart of boiling milk add gradually four tablespoonfuls of the starch, previously rubbed into a paste with a little cold milk, add some salt and boil for five minutes, stirring briskly. Sweeten to the taste, and flavor with essence of vanilla, lemon, or orange. Then set aside to cool. 304 DIETETIC PREPARATIONS. 977. Boiled Flour. Take of Fine flour, ...... a pound. Tie it up in a linen cloth as tight as possible, and after fre- quently dipping it in cold water, dredge the outside with flour till a crust is formed round it, which will prevent the "water soakinsr into it while boiling. It is then boiled until it becomes a hard dry mass. Two or three tablespoonfuls of this may be grated and pre- pared in the same manner as arrowroot, for which it forms an excellent substitute. 978. Vegetable Soup. Take one turnip, one carrot, two potatoes, and one onion. Let them be sliced, and boiled in one quart of water for an hour. Add as much salt as is agreeable, flavor with a small por- tion of potherbs, 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. 979. 3Iutton Broth. Select two tender mutton chops, put them into a saucepan, add one quart of cold water and a little salt, cover the pan and cook slowly for two hours. Then skim off all the fat, and add one tablespoonful of rice, one white potato, one turnip, and a little parsley chopped fine. Simmer for three-quar- ters of an hour, then pour into a bowl and remove the chops and all of the remaining fat. This broth is nutritious and palatable. 980. Beef Tea. Take of Lean Beef, cut into shreds, . . .1 pound, Water, ...... 1 quart. Boil for twenty minutes, taking oiT the scum as it rises. Strain the liquor, and add salt according to the taste. This preparation is more nourishing than ordinary broths, and very palatable. 981. Lieblg's 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 DIETETIC PREPARATIONS. 305 inince 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 fibrin, 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. Beneke. 982. Essence of Beef. Put a sufficient quantity of lean beef, sliced, into a porter bottle to fill up its body, cork it loosely and place it in a pot of cold water, attaching the neck to the handle of the vessel by means of a string. Boil for an hour and a half or two hours, then decant the liquor and skim it. To this preparation may be added spices, salt, wine, brandy, &c, according to the taste of the patient and nature of the disease. 983. Hartshorn Jelly. Take of Hartshorn Shavings, . . .4 ounces, Water, ...... 1 quart. Boil over a gentle fire until one pint of the water be dissi- pated. Strain, and add lemon-juice, sugar, and half a pint of wine. This forms, either with or without the last-named ingredi- ents, 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 may be used instead of the hartshorn shavings, if preferred. 984. Calves Feet Jelly. Take a set of four feet, break them in small pieces, add to them one gallon of water, and reduce by boiling to one quart. Strain, and when cold, skim the fat entirely off. Add to this the shells and white of six eggs, well beaten, a pint of wine, 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 the jelly through a flannel strainer. This forms a very nutritious article of diet for the sick and convalescent. 20 306 DIETETIC PREPARATIONS, 985. G-elatine Jelly. Soak one ounce of gelatine for ten minutes in half a pint of cold water ; then add the same quantity of boiling water, and stir till the gelatine is dissolved, applying heat, if neces- sary. Add half a pint of good wine, the peel and juice of two lemons, and sugar, according to the taste. Then add the shell and white of one egg, well beaten together ; boil the jelly for five minutes, and strain while hot through a piece of felt or flannel. Set aside in a cool place until the jelly becomes stiff. This is both palatable and nutritious. 986. Blanc Mange. Boil one ounce of shred gelatine in a quart of milk for ten minutes, stirring constantly. Sweeten to the taste, flavor with peach-water, or essence of vanilla, and strain into a mould. 987. Chicken Water. Take one half of a chicken divested of all fat, and break the bones ; add to this half a gallon of water, and boil for half an hour. Strain, and 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. 988. Chicken Broth. Clean half of a chicken, nnd pour on it one quart of cold water; add a little sale, a.i \ one tablespoonful of rice. Cover the vessel closely, and boil ror two hours. Throw in near the end of the boiling a little parsley, chopped fine. Skim the broth before using. This is one of the most valuable articles of diet at the com- mand of the physician in the low stages of disease, when the patient's system requires support, but his digestive powers will not admit of solid food. 989. Suet Ptisan. Take of Mutton Suet, 2 ounces, Milk, 1 pint, Starch, ...... half an ounce. Boil slowly for half an hour. This may be used warm as a common drink in dysentery. DIETETIC PREPARATIONS. 307 990. Mucilage of Starch, $c. Take of Starch, ....... 1 ounce, Powdered Cinnamon, . . . .1 drachm, 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. 991. Mulled Wine. Take two drachms of bruised cinnamon, half a nutmeg, grated, ten bruised cloves, and half a pint of boiling water. Infuse one hour, strain, and add of hot port, or hot sherry wine (or of good domestic wine), one pint, and white sugar, one ounce. Mix. This is a mild stimulant drink, used in the convalescence from low forms of disease. Wine Wliey. (See Formula No. 366.) Mustard Whey. (See Formula No. 365.) 992. Rennet Whey. Take of New Milk, . . . . .1 quart, Rennet, . . . , .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. 993. Vinegar Whey. Take of Milk, ...... 1 pint, Vinegar, ..... half an ounce. Boil for a few minutes, and separate the curd. 994. 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. A general antidote for poisoning, in which the nature of the poison is unknown, consists of equal parts of calcined magne- sia, pulverized charcoal, and hydrated peroxide of iron, which are to be diffused in water, and be given freely. Although these articles are simple and innocent in their operation on the system, they will probably prove efficient, as one or another of them is an antidote to most of the mineral poisons. The albumen of eggs and tannic acid are also general anti- dotes of great value. The former neutralizing corrosive sub- limate and other salts, and the latter precipitating all of the vegetable alkaloids as tannates. OF POISONS. 309 ALCOHOL. Large quantities of alcoholic liquors, taken by persons un- accustomed 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 cold affusion plentifully used. Large draughts of tea or coffee ought to be taken until the stomach is thoroughly evacuated. ALKALIES. Ammonia, potassa, 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 — several pounds being required where a large portion of the alkali has been taken ; it acts partly 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 most commonly produced is tartar emetic. This of itself produces violent vomiting, and therefore our first efforts should be di- rected to keeping up the emesis by means of mild diluents and mucilaginous preparations. Its antidotes are the alkalies, tannin, and astringent vegetable infusions, such as common tea, Peruvian bark, infusion of galls, &c. &c. These decom- pose the antimonial salt. When the vomiting is excessive, opium by injection will assist in allaying it. AESENIC. Until the present century there was no known antidote to this deadly poison, and the sole dependence of the practitioner was upon mild diluents, albumen (such as the whites of eggs suspended in milk), or warm water and sugar. In the treat- ment of poisoning by arsenic, it is best first (if vomiting has been delayed) to give an emetic of mustard, or of the sulphate of zinc, and milk should be drunk liberally both before and after vomiting has begun. The patient should never be al- 310 OF POISONS. lowed to exhaust his strength in retching, without some milk or other fluid in his stomach to act on. The Hydrated 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. The following direction will enable the most ignorant person to make use of this antidote until medical advice can be ob- tained. 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 every five or ten minutes, until entire relief is obtained. It is said that twelve parts of it are necessary 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, or a solution of the persulphate of iron, by ammonia, and washing the precipitate. Should the patient survive (and the probability is in his favor if the antidote be given early and faithfully), the inflammatory symptoms must be combated on the general principles for treating inflammation. The diet should consist exclusively of milk, gruel, cream, rice, and similar bland articles for several days. In a case of poisoning in this city, where half an ounce of the powdered arsenic had been taken and was followed by ex- treme 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 hydrated oxide forms with the arsenious acid an inso- luble salt. 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 anti- dotes. Magnesia, in the gelatinous or hydrated state, if given in large doses, acts also as an antidote, and in several cases lately reported was used with complete success. It can be rapidly prepared by precipitating a solution of Epsom salts by ammonia. When the poison has been taken in the form of Fowler's solution, Dr. Dunglison recommends copious draughts of lime- OF POISONS. 311 water to be used ; but this should not preclude the employment of the hydrated oxide of iron. BARYTA. The carbonate of baryta and the chloride of barium are poisonous, and the latter has been taken by mistake for Glau- ber's salts. In cases of poisoning with either, the alkaline sulphates should be given freely, and resort be 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 eme- tics 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 results ; the latter often from the careless use of culinary vessels or mineral water fountains. Vomiting should be encouraged by the free use of tepid water, milk, and mucilages. 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. Vinegar 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 con- siderable confidence in the antidote. The iron decomposes the cupreous salt, and precipitates the copper in a metallic and consequently in an inert state. GOLD. The nitro-muriate or terchloride of gold is a powerful poison. Its antidotes are sulphate of iron (which throws down the gold in a metallic state), and albuminous substances, followed by the free use of mucilaginous drinks. IODINE. Ten or twenty grains of Iodine sometimes, though not always, produce constriction of the fauces, nausea, vomiting, and severe colic pain. Larger doses endanger life. The best 312 OF POISONS. antidote for its preparations is starch freely given, or. -what answers the same purpose, flour mixed with water. Magnesia is also recommended. Vomiting should be induced by mus- tard or some other prompt emetic. LAUDANUM. Laudanum, when taken in large quantity, must be withdrawn from the stomach by active emetics, such as mustard, sulphate of zinc, sulphate of copper, or alum, or by tickling the fauces. The stomach-tube should then be used to remove whatever remains of the laudanum in the stomach. This should be fol- lowed by a purgative, to carry off any of the poison that may have entered the bowels. The free use of vegetable astrin- gents and strong coffee will also 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. Donne, 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. (See Opium.) LEAD. The acetate is the only preparation which is resorted to as a poison. The sulphate of magnesia or soda is its true anti- dote, as it converts the poison into a sulphate, which is inert. The alkaline carbonates and bicarbonates and the phosphate of soda are also good antidotes. 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, a3 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 cor- rosive on the stomach. MERCURY. 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 OF POISONS. 313 should be resorted to when the patient cannot swallow or vomit. Enemata of the same should also be used. If the albumen be taken in sufficient quantities, it decom- poses the sublimate, forming a triple compound of albumen, muriatic acid, and calomel. If the remedy excites fresh vomit- ing, 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 con- siderable. It is said to reduce the sublimate 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. The only other antidotes deserving of mention here are a mixture of two parts of iron filings and one of zinc, meconic acid, and the hydrated proto-sulphuret of iron. The first was recommended by Dumas, and must obviously operate by bring- ing the mercury to the metallic state. The meconic acid, par- ticularly when combined with an alkaline base, affords, with corrosive sublimate, an insoluble and inert permeconate 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 saturating power of meconic acid, it would be hazardous to administer the quan- tity 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 immediately after the ingestion of the poison, it completely destroys the poisonous quality of corrosive sublimate. 314 OF POISONS. 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 alka- lies, alkaline earths and soaps, common pearlash or carbonate of potassa, 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 drachms ; the smallest fatal dose of muri- atic acid 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, alum, and mustard in large doses. In all cases where it is possible, the stomach-tube should be employed. After these evacuations, tannic acid or strong de- coctions of tea, coffee, or the vegetable astringents, with cold affusion, are proper. Electro-magnetism is also serviceable, together with brandy, ammonia, and other powerful stimu- lants, and artificial respiration. There is no positive antidote to any of the vegetable alka- loids. Tannic acid combines with all of them, and forms salts which are insoluble in water, but are soluble in vinegar and the gastric juice. Hence, the administration of this acid is beneficial, time being gained for the removal of the poison in the form of a tannate from the stomach. If not removed, the tannate will be dissolved by the gastric fluids. After emesis, charcoal may be given freely, as it possesses the singular pro- perty of absorbing and retaining coloring matters, vegetable acids, and the alkaloids. NITRE {Nitrate of Potassa). This salt is sometimes taken in mistake for Epsom or Glau- ber'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. OF POISONS. 31 •> 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. H. Beck, of Albany, says of the antidotes to opium. " The experiments of Orfila have demonstrated that the administration 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 con- sidered 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 sul- phate of zinc, or sulphate of copper ; but the administration of watery liquids 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 roused by 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 respiration may be used in des- perate 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 1 warmed, and in ten or twelve hours exhibit an enema, and let the arms and legs of the patient be well rubbed. Purgative 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 bella- donna, hyoscyamus, stramonium, &c. Yet as these are not often taken with suicidal intentions, the quantity is seldom inordinately large. Emetics, if given soon after the poison 1 Dr. H. F, Campbell reports a case in which an injection of twenty grains of caftein in an infusion of coffee was attended with the happiest effect. 316 of poisons. has been swallowed, will at least remove a part of it : after which the practitioner roust 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. As belladonna and opium manifest a different, and in some respects an opposite effect upon the brain, they have been recommended as antidotes to each other in cases of poisoning. This recommendation, however, should not interfere with the measures above described. It may be received as an adjuvant, but not as a substitute for the usual plan of treatment. 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 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 suesrested. 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 phosphorous and phosphoric acids which may be formed. 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 m OF POISONS. 317 to be relied on, many experiments having proved its efficacy. It should not be used of too great strength, which would en- danger inflammation of the air-passages and stomach ; the strong aqua ammonia, diluted with twelve parts of water, is recommended by Orfila. Chlorine also possesses strong claims as an antidote, and from the results of his experiments, is believed by Orfila to be the best which has yet been proposed. In all cases, artificial respiration should be kept up while there is a hope of sustaining or restoring life. 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, and other substances containing Prussic acid, are not unfrequent, particularly among children. After eva- cuating the stomach, these 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. 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 chloride of tin [Dyers spirit), and renders it innoxious. Lime-water or the alkalies would de- compose this salt and thus render it inert. VEGETABLE POISONS. See "Narcotics," and "Opium." ZINC. The sulphate of this metal is occasionally taken in an over- dose. Warm w T ater and emollient drinks are proper in such cases ; but milk is particularly useful, from its power of de- composing the sulphate ; also albumen, magnesia, &c. Vege- table astringents may be beneficially used. 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. APPENDIX. I. ON THE ENDEMIC USE OF MEDICINES. " The science of medicine," says Dr. Gerhard, 1 "has re- cently received an important auxiliary to its resources, by the discovery 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 alimentary canal. This mode of exhibition, which has re- ceived the name of the endermic method or endermic medica- tion, is always found much more efficacious than the iatroleptic method of Christien, or the administration of medicines by means of frictions 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 epi- gastrium during the apyrexia ; and if the paroxysm returns before the quinia can be used, defer it until the next apyrexia. Apply four grains of powdered sulphate of 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 1 North Amer. Med. and Surg. Journ., April, 1830. 320 ON THE USE OF ETHER AND CHLOROFORM. sixteen grains of the sulphate in two ounces of water, with which the blistered 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. G-amboge. owing to its solubility, purges freely in the ender- mic method. Dose, from fire to eight grains. Rhubarb, jalap, elateriicm 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 in- creased 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 drachm with an ounce of cerate. Emetics derived from the mineral kingdom exert no specific action. B. E. II. ON THE USE OE ETHER AXD 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 ap- plication. Indeed, the discovery of a means by which to give complete insensibility to pain during the performance of tedious surg- ical and dental operations, as well as to mitigate the spontane- ous suffering- attendant on many diseases, must be considered ON THE USE OP ETHER AND CHLOROFORM. 321 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, the 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. The progressive stages of etherization seem to be pretty much as stated by Mr. Sibson, viz. : 1. Cerebral excitement. 2. Cerebral derangement, staggering intoxication. 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 mus- cular 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 em- ployed in chorea, delirium tremens, or other affections, it should never be urged beyond sopor. In neuralgia, it is not usually needful to produce unconsciousness. Whenever the pain dis- appears the inhalation ought to cease." According to Dr. Snow, a necessary precaution for watching the effects of ether and chloroform is, that they possess an ac- cumulative property ; their influence sometimes increasing for 21 322 ON THE USE OF ETHER AND CHLOROFORM. 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 perfe 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 jeci ::ons, 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 anesthesia 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 small quantity of the fluid, or by applying the vapor locally for a limited period, a limb may be rendered perfectly mo- tionless and senseless, and, what may be an additional advan- tage, fixed in any desired position. The benefits likely to be derived from this new and valuable discovery promise to be verv 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 in- vented, but most of them have given place to a simple sponge : and in the case of chloroform, a towel or handkerchief is per- haps 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 drachm of chloroform, or even half a drachm, poured upon a handkerchief, 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 minute-. Afl regards their comparative merits, it may be said of chloroform that it is 1 pungent, and requiring a less amount is more easily inhaled : but it is also said to have a greater tendency to produce invol- ON THE USE OF ETHER AND CHLOROFORM. 323 untary 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 chloro- form ; 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 propor- tion 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 engorge- ment 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 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 chloroform have produced complete insensibility, and we should always be on our guard lest alarming symptoms sud- denly supervene. These are marked by suspended respira- tion, 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 ab- straction of a few ounces of blood from the arm, or from the 324 OX THE USE OF ETHER AND CHLOROFORM. 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 couorh miorht induce suffocation and hasten death. Besides sulphuric ether and chloroform, various other pre- parations have been found to possess anesthetic 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. 1-88.) Pure chloroform dropped into this liquid will fall to the bottom. 1 S. G. Morton. 1 French Journal of Pharmacy, 184^. GENERAL INDEX. • PAGE PAGE Absorbents, - . . 218 Injections, for the urethra, . 254 Alcohol, as a poison, . 309 for the vagina, . 259 Alkalies, as poisons, . 309 subcutaneous, . 260 Alteratives, .... . 192 Inoculation of medicines, . 260 Antacids, .... . 218 Iodine, as a poison, . 311 Anthelmintics, . 121 Issues, .... . 231 Anti-intermittents, . 167 Antilithics, .... . 75 Laudanum, as a poison, . 312 Antimony, as a poison, . . 309 Lead, as a poison, . . 312 Antispasmodics, . 158 Liniments, . 266 Arsenic, as a poison, . 309 Lithontriptics, 75 Astringents, . . 207 Lotions, . 266 Baths, . . • . . 290 Mineral acids, as poisons, . 314 Baryta, as a poison, . 311 Medicated pessaries, . 260 Beverages for the sick, . . 297 Mercury, as a poison, . . 312 Blisters, .... . 233 Mouth washes, . 262 Cataplasms, .... . 288 Narcotics, . 140 Cathartics, .... . 40 as poisons, . . 314 Caustics, .... . 225 Nitrate of potassa, as a poiso n, . 314 Chloroform, as an anesthetic, . 320 Nitrate of silver, as a poison, . 317 Collyria, .... . 245 Copper, as a poison, . 311 Ointments, . 276 Opium, as a poison, . 315 Diaphoretics, . 79 Oxalic acid, as a poison, . 316 Dietetic preparations, . . 297 Diuretics, .... . 62 Pessaries, medicated, . 260 Phosphorus, as a poison, . 316 Emetics, .... . 33 Poisons and their treatment, . . 308 Emmenagogues, . 113 Poultices, . 288 Endermic use of medicines, . . 319 Prussic acid, as a poison, . 316 Enemata, .... 58, 128 Epispastics, .... . 233 Rubefacients, . 237 Escharotics, .... . 225 Ether, as an anaesthetic, . 320 Setons, .... . 231 Expectorants, . 91 Sialagogues, . . . . 163 External applications, . 223, 245 Stimulants, . . 130 Suppositories, 60, 152 Fomentations, . 292 Syrups, .... . 95 Formulary proper, 33-307 Fumigations, . 293 Tartar Emetic, as a poison, . . 309 Tin, as a poison, . . 317 Gargles, .... . 262 Tonics, . 167 Gold, as a poison, . . 311 Vaginal injections, . 259 Inhalation, .... . 109 Vegetable poisons, . 317 Injections, for the rectum, . 58, 128 for the ear, . . 252 Zinc, sulphate, as a poison, . . 317 EM)EX 01 THE FOBMULABY PROPER. 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