V- ,0o J V ^> J. „ >> - ' '^^ -^ v* \* ^> »T l^ v. ,0 0, b o^ ;- % c * ^ C^ **■ ' **U- s ^ V »* BIDDLE'S MATERIA MEDICA MATERIA MEDICA PHYSICIANS AND STUDENTS. JOHN B. BIDDLE, M.D., LATK PKOFESSOB OF MATERIA MEDICA AND GENERAL THERAPEUTICS IN THE JEFFERSON MEDICAL COLLEGE, PHILADELPHIA. NINTH EDITION, ■ REVISED, REWRITTEN AND ENLARGED, IN" ACCORDANCE WITH THE SIXTH REVISION OF Z\)t i inSr [ Antiseptics, j Irritants, IV. Those which act topically. \ Demulcents, Colouring Agents, Anthelmintics. 54 MATERIA MEDICA — NARCOTICS. CLASS L— NEUROTICS. ORDER I. — NARCOTICS. Narcotics (from vaKpsu, to stupefy) are medicines which impair or destroy nervous action. The primary effect of nar- cotics is, however, of a stimulant character, and their thera- peutic efficacy is in a great degree due to this action. They are often administered, too, for a true narcotic or sedative influence on the motor, sensor, and intellectual functions. In diseased conditions, a marked tolerance of this class of med- icines is established, and they can be exhibited in large doses without inducing narcosis. They are employed, chiefly, to remove muscular spasm, relieve pain, allay cerebral or spinal irritability, and procure sleep. When employed to relieve pain, they are termed anodynes ; when employed to procure sleep, hypnotics or soporifics. When this class of medicines is resorted to for any length of time, with a view to a narcotic effect, their influence upon the system is much diminished, and constantly increased amounts are called for to maintain the same effect. OPIUM. Opium (from onog, juice) is the concrete juice of the un- ripe capsules of Papaver somniferum (Nat. Ord. Papaveracese). The opium-poppy is a native of Persia, but is cultivated in various parts of Asia, in Europe, and in the United States. It is an annual plant, w r ith a round, leafy stem, from two to four feet or more in height, and large four-petaled flowers. There are two prominent varieties of this species : the black poppy, with violet-coloured or red flowers, brown or blackish seeds, and globular capsules ; and the white poppy, with white flowers and seeds, and ovate capsules ; but these varieties run into each other under cultivation. The nearly ripe capsules (papaver) are from an inch and a half to two inches or more in diameter, and contain a good deal of opium. They are sometimes given to children in the OPIUM. 65 form of syrup, and are applied externally as an anodyne emol- lient, in the form of decoction. The seeds are destitute of nar- cotic properties, and are used in Europe as an article of diet, and for the manufacture of an oil. Opium is obtained from incisions in the half-ripe capsules. The juice, which exudes from the incisions, is allowed to evap- orate spontaneously, and is scraped off after drying, generally with more or less of the epidermis, and is sometimes sent into the market unmixed, as a choice variety. The opium of com- merce is, however, commonly made by adding the dried juice, obtained by incision, to an extract prepared by expression, or even from a decoction of the leaves, the whole being kneaded together, formed into cakes, and wrapped in fresh poppy-leaves. The commerce of the United States is supplied with opium almost exclusively from Asiatic Turkey. This is known in the market as Smyrna or Turkey opium, and comes in irregularly rounded or flattened cakes, covered with the capsules of a species of Rumex. A large amount of opium is produced in British India, for consumption in India and China, but it is not found in our markets. The Persian opium is another variety, but it does not reach the United States. Much opium was formerly obtained from Upper Egypt, in the neighbourhood of Thebes, but its production was for a long time abandoned, though within the last forty years again introduced. Successful attempts have been made with the cultivation of the poppy in England and other parts of Europe, which have resulted in the production of opium. During the civil war in the United States, a good deal of opium was made in the southern States, from poppies of almost every variety ; samples of this opium have yielded about the same amount of morphia as that obtained from Tur- key opium, and even in New England very good opium has lately been produced. The great source of our supply of opium has, however, long been, and still is, the Turkish dominions. The best opium should have a fine chestnut colour, an aro- matic, strong, peculiar smell and a dense consistence — becom- ing, however, harder and darker by being kept. It should be 56 MATERIA MEDICA — NARCOTICS. moderately ductile, break with a deeply-notched fracture, and, when drawn across white paper, should leave an interrupted stain. The taste is very bitter and somewhat acrid, and when chewed it excites irritation in the mouth and throat. It is inflammable, and imparts its virtues to water, alcohol and diluted acids, but not to ether. Chemical Constituents. — Opium contains a great variety of chemical constituents, the most important of which is the alka- loid Morphina (morphia). Other principles found in opium are the alkaloids, narcotina, codeia, narceia, paramorphia, pap- averina, opiania, cryptopia ; meconin, meconic and thebolactic acids, porphyroxin, gum, extractive, resin, oil, etc., but no tan- nin or starch, and, in very minute amounts, alkaloids, termed meconidia, laudamia, codamia, pseudomorphia, apomorphia (a derivative of morphia by HC1), lanthopia, rhoeadinia, rhcea- genia, laudanosia, protopia and hydrocotarnia. Morphia is the principle upon which the narcotic effects of opium essentially depend, and, with its salts, is officinal in all the pharmacopoeias. Morphia exists in opium chiefly in combination with me- conic acid. The morphia meconate is separated from the other constituents of the drug by successive macerations with water. Alcohol and water of ammonia are then added to the aqueous feolution, by which the salt is decomposed, the ammonia pre- cipitating the morphia and the alcohol seizing the colouring matter as soon as it is separated from the alkali. The crystals of morphia, which are formed, are afterwards boiled in alcohol, and the solution is filtered through animal charcoal. Good samples of opium, when dried, should yield not less than 12 nor more than 16 per cent, of morphia. Morphia (C 17 H 19 N0 3 .H 2 0) occurs in colourless, rhombic, prismatic crystals, without smell, but of very bitter taste. It is very slightly soluble in water and ether, nearly insoluble in chloroform, partially soluble in cold and more soluble in boil- ing alcohol. Acetic ether (ethyl acetate) is the best solvent for it. From the insolubility of the alkaloid the salts of mor- phia are preferred for medicinal use ; they are freely soluble in water and diluted alcohol, but are insoluble in ether and opium. 57 chloroform. Tests: 1. Concentrated nitric acid strikes with morphia and its salts a rich orange-red colour, slowly fading to yellow. 2. Iron chloride or tersulphate colours them deep hlue. 3. Iodic acid is deoxidized by morphia, and if a solu- tion of starch is added with heat, dark-blue starch-iodine is produced ; this is a very delicate test. 4. Sulphomolybdic acid (made by dissolving, with a gentle heat, 5 or 6 grains of ammonium molybdate in 2 drachms of strong sulphuric acid), when rubbed with morphia, produces an intense purplish or crimson colour, changing to green, and finally to sapphire blue. 5. Iodic acid in solution, mixed with carbon sulphide, pro- duces, when added to morphia, a pink or red colour, owing to the liberation of the iodine and its solution by the sulphide. 6. Alkaline solutions of chlorine give a deep red colour with morphia. Other tests are recommended, but these are the best. Narcotina (C 22 H 23 N0 7 ) exists in opium chiefly in the free state, and, being insoluble in water, is left behind when the drug is macerated in this menstruum. It occurs in white, tasteless, inodorous, needle-like crystals, which are soluble in ether, alcohol, and still more so in chloroform. At one time it was thought to possess a portion of the narcotic properties of opium, but it is now admitted to be inert in this respect. Its salts, which are bitter, have been used in India as stomachics, and as febrifuge tonics in the treatment of intermittent fever. Codeia (C 18 H 21 N0 3 ) exists in opium combined like morphia with meconic acid, and is extracted in the process for ob- taining the latter alkaloid, from which it may be separated by an alkaline solution, which dissolves the morphia and leaves the codeia. It occurs in colourless octohedral crystals, of a bitter taste, soluble in water, alcohol, ether and chloroform. It has been found to possess uncertain narcotic powers, one grain having failed to be hypnotic (Wood, H. C), while four grains have caused insomnia and slight delirium (British Med. Jour., 1874, 1, 478) ; again, five grains have produced no effect (Mitchell). Codeia has been used in gastrodynia and dyspepsia, in the dose of half a grain or more. It is, however, too expensive an article for general use. 58 MATERIA MEBICA — NARCOTICS. Narceia (C 23 H 29 N0 9 ) is obtained from the mother liquid left after crystallizing out the salts of morphia. Bernard affirms that it is the most certain hypnotic of all the opium alkaloids. Da Costa's experience shows that it has little effect on skin or pupil, and that its hypnotic action is uncertain or inert. Another observer states that to get its hypnotic effects it must be given in doses twice as large as morphia (Eulenberg). Its exact ac- tion is so far in doubt. Paramorphia, known also as Thebaia (C 19 II 2 jN0 3 ), has been found to be a tetanizing toxic agent, analogous in its effects to strychnia ; two grains, given hypodermically, have killed a dog. Papaverina (C 21 H 21 N0 4 ) is said to produce some soporific action, with a sedative influence on the pulse ; its strength is from one-eighth to one-fourth of that of morphia. Cryptopia (C 21 H 23 N0 5 ) is thought to produce a hypnotic in- fluence analogous to that of morphia, though a much feebler agent. The statements in regard to the last three alkaloids are conflicting. Apormorphia (C 17 H 17 N0 2 ), a recently-discovered alkaloidal derivative of morphia, soluble in water, possesses marked spe- cific emetic properties, acting very promptly and with much freedom from nausea ; y 1 - of a grain injected hypodermically, or \ of a grain taken by the stomach, will produce emesis in from 10 to 20 minutes, which is apt to recur once or twice at intervals of a quarter of an hour, but care should be exercised in its use. It is a valuable emetic when prompt evacuation of the stomach is required, as in narcotic poisoning, and has been used as an expectorant. Meconic acid is inert, but is interesting as affording the most delicate test for opium ; iron chloride or tersulphate strikes with even very diluted solutions of opium a blood red iron meconate, which is not dissolved by diluted acids or corrosive sublimate. Incompatible^. — Alkalies, and astringent infusions containing tannic acid, are incompatible with opium ; the former precipi- tate morphia from its soluble combination, while the latter form with it an insoluble compound. Many of the mineral salts are also decomposed by opium, as lead acetate (lead meconate and opium. 59 morphia acetate being formed when these articles are prescribed together). Physiological Effects. — Opium exerts a marked therapeutic action in the relief of pain, spasm, wakefulness, nervous irrita- bility, and certain forms of morbid discharge, especially from the alimentary canal, by a primary stimulant action, antecedent to any narcotic influence. In such conditions a tolerance of its effects is established, and very large amounts may be taken without inducing narcosis. Opium applied locally deadens the sensibility of the nerves of a part without influencing the brain (Trousseau et Pidoux, vol. ii.). In detail its physiological action in moderate doses is as follows — Nervous system : the cerebral functions are stimulated, accompanied by an agreeable exhila- ration of the intellectual faculties, followed by drowsiness, con- sciousness being .finally lost in sleep, the latter sometimes dis- turbed by dreams. On awakening there are commonly symp- toms of depression, as headache and nausea, also constipation. The reflex function of the spinal cord is diminished, and in lethal doses destroyed, death taking place from paralysis of the respiratory centre. Pupil : in full doses opium contracts the pupil ; but since the local application of morphia does not pos- sess this power, it follows that its action must be a constitutional one, being probably due to stimulation of the oculo-motor centres. Circulation : the heart's action becomes slower and fuller, the slowing being due to a depressing influence on the cardiac motor ganglia, at the same time the arterial tension is raised. Respi- ration : this act tends to become slower. Secretions : occasion- ally nausea;" constipation results from lessening of the intestinal secretions and arrest of peristaltic action; kidneys: urine slightly diminished ; salivary glands : the secretion from these glands is diminished ; in one word, all the secretions are lessened except that of the skin, which is heightened. According to Phillips the drug is probably eliminated in this way, but much, doubt- lessly, is carried off by the kidneys. In some persons an itching and miliary eruption of the skin occurs. Most of the opium alkaloids increase the excretion of urea. When a poisonous dose is taken, the stage of excitement is 60 MATERIA MEDICA — NARCOTICS. wanting; giddiness and stupour' rapidly come on, with diminution in the frequency, though not in the fullness, of the pulse ; and these symptoms are soon followed by an irresistible tendency to sleep, and finally by coma. The breathing is heavy and stertorous, the pulse slow and oppressed, and the pupils are contracted. If relief is not afforded, the pulse sinks, the mus- cular system becomes relaxed, and death ensues, preceded sometimes in children by violent convulsions. In adults gr. \-^ of morphia, and gr. iv. of opium, have caused death. In cases of poisoning from opium or its preparations, the stomach should be immediately evacuated by the stomach pump, if possible, or by emetics. Owing to the torpor of the stomach, emetics are to be given in double the ordinary doses, and the direct emetics are to be preferred, as zinc sulphate (20 to 30 grains) or copper sulphate (5 to 10 grains). A large tablespoonful of mustard flour, or of powdered alum, answers very well as an emetic. Every means should be taken to arouse the patient from his lethargy ; he should be kept awake, and made to walk as long as possible ; afterwards cold affusions, counter-irritation to the nape of the neck and ex- tremities, flagellation to the palms of the hands and soles of the feet, and, best of all when the coma is profound, the electro- magnetic battery should be resorted to. Artificial inflation of the lungs is also to be practiced. The use of strong coffee has proved efficacious ; and stimuli may be given to support the system. Of late years it has been found that belladonna exer- cises a powerful influence as a physiological antidote against narcotism from opium, these drugs acting in an opposite man- ner on respiration, brain, skin, pupil and circulation ; and the administration of this substance by the stomach, or, still bet- ter, the hypodermic injection of a solution of atropia, is one of the most available remedies that can be employed in poisoning from opium. The poisonous action of opium appears to be entirely directed to the nervous system, no local lesions being found after death. Opium is largely used as an habitual narcotic in Oriental countries, and to some extent in Europe and the United States. OPIUM. 61 The effects of indulgence in this species of intoxication are of the most destructive character upon both the physical and mental faculties. Medicinal Uses. — Of all the articles of the Materia Medica opium enjoys the widest range of therapeutic application. From its properties of assuaging pain and inducing sleep it is useful in almost all diseases; and it is positively contraindicated only where there is a tendency to apoplexy or coma, or where there exists an idiosyncrasy with respect to its effects. As an anodyne in painful and malignant ulcers, sprains, severe in- juries, and in resisting surgical shock, we have no substitute for opium ; and, as an hypnotic in mania-a-potu, and in the wake- fulness and cerebral irritability of fever, mania, etc., it is equally invaluable. From its power of relaxing muscular spasm it is our most efficient resource in tetanus, colic, and spasm of the stomach, bowels, biliary ducts, ureters, neck of the bladder, etc. In dysentery and cholera it forms the basis of every variety of treatment, partly for its diaphoretic effects, but principally for its action in arresting both the secretions and peristaltic motion of the bowels. In dysentery laudanum may be given per rectum in a starch decoction. In some cases of dysentery opium does harm by checking peristalsis, and so assisting to retain the dejections, thus allowing them to irritate and ferment (Med. and Surg. Hist, of the Rebellion, chap, on Dysentery). For the relief of the cough of pulmonary affec- tions opium has no equal in Materia Medica. In cerebro- spinal meningitis and in puerperal fever it has been found more successful than any other remedy. In gastric irritability, to check vomiting, in colica pictonum, peritonitis, rheumatism, gout, neuralgia, typhus, gangrene, convulsive diseases, diabetes, diarrhoea, etc., is is also constantly employed. Dr. Allbutt recommends the hypodermic use of morphia to relieve the dyspnoea of heart disease, and the editor can confirm his statement. In sunstroke good results have been obtained from morphia injections (Hutchinson). Morphia, exhibited hypo- dermically, will generally relieve a paroxysm of asthma, al- though without curative power. In the collapse of cholera 62 MATERIA MEDICA — NARCOTICS. great benefit has been derived from the hypodermic use of morphia (Dr. J. T. Gallagher) ; and Loomis has called atten- tion to its similar exhibition in ursemic convulsions. An ap- proaching paroxysm of malarial fever, pernicious or intermit- tent, may be prevented by the timely injection of morphia. Administration. — The ordinary dose of opium as an anodyne and hypnotic is one grain. Much larger doses are, however, called for in many diseases ; and when it is administered for a length of time, as a narcotic, the dose must be gradually increased. To infants and very old persons it is to be given with great caution. Opium is administered in the form of powder or pills. It is easily powdered when thoroughly dried, and the pills, as well as all the other preparations of opium, should always be made from the powder. The powder is sometimes used endermically, and is sprinkled on irritable ulcers. In the form of suppos- itories it is also applied to the rectum. The following are the officinal preparations of opium : Opii Pulvis (Opium Powder). Used in making most of the opium preparations. It should contain not less than 12 nor more than 16 per cent, of morphine, instead of 10 per cent., as directed by the U. S. P., 1870. This, as Dr. Squibb has pointed out, materially increases the strength of the prepara- tions made from it, and causes a great variation in their strength, depending on the percentage of morphine in the powdered opium ; thus laudanum Sj may contain from gr. 5*44 to gr. 7*25 of morphine. Opium Denarcotisatum (Denarcotised Opium). Opium freed from narcotina, etc., by means of ether, and containing 14 per cent, of morphine. Dose, gr. ss-ij. Pilulje Opii (Pills of Opium). Each pill contains a grain of opium. They are kept in the shops, as hard old opium pills are sometimes preferred in cases of irritable stomach. Extractum Opii (Extract of Opium). Made by evaporat- ing the aqueous solution. Dose, gr. J. Trochisci Glycyrrhiz^e et Opii (Troches of Liquorice and Opium). Much used in Philadelphia under the name of Wis- opium. 03 tars cough lozenges. Each troche contains one-twentieth of a grain of extract of opium. Emplastrum Opii (Opium Plaster). Made by mixing extr. opium with Burgundy pitch and lead plaster. Pulvis Ipecacuanha et Opii (Powder of Ipecac and Opium). This powder, well known under the name of Dover 's Powder, is made by rubbing up sixty grains of opium and ipecacuanha each, with a troyounce of sugar of milk, the latter being employed to promote the minute division and thorough intermingling of the opium and ipecac. Dover's Powder is a most valuable anodyne diaphoretic, extensively prescribed in diarrhoea, dysentery, rheumatism, bronchitis, pneumonia, etc. Dose, gr. x, containing gr. j of opium and ipecacuanha each. Tinctura Opii (Tincture of Opium). Laudanum. Con- tains 10 per cent, of powdered opium. It should be recollected that the opium from which these preparations are made con- tains from 2 to 6 per cent, more morphine than that formerly employed. This is the most commonly employed of all the officinal preparations of opium. When long kept, particularly if exposed to the air, it becomes thick from evaporation of the alcohol, and its strength is much increased. Dose, TT|xij, or about 25 drops, equivalent to a grain of opium. There are 120 drops in f3j. Laudanum is much used in the form of enema. Tinctura Ipecacuanha et Opii (Tincture of Ipecac and Opium) contains deodorized tincture of opium (100 parts, evaporated) mixed with fluid extract of ipecac (10 parts) and diluted alcohol (enough to make 100 parts). Dose, Tt[x-xx. Tinctura Opii Camphorata (Camphorated Tincture of Opium). Paregoric Elixir. Prepared by macerating opium (5j) in diluted alcohol (Oij), with benzoic acid (5j), oil of anise (gr. lx), glycerin (gr. 600), and camphor (5j). Dose, f§ss, or a tablespoonful, containing rather less than a grain of opium. A favourite preparation for children. 5 to 20 drops may be given to an infant. 64 MATERIA MEDICA— NARCOTICS. Tinctura Opii Deodorata (Deodorized Tincture of Opium) contains the same proportion of opium as laudanum. In pre- paring it, the narcotina as well as the odorous and many other injurious ingredients of opium are got rid of. A valuable preparation. Dose, the same as that of laudanum. Acetum Opii ( Vinegar of Opium). Black Drop. Black drop has the same strength of laudanum, and is to be given in the same dose. Vinum Opii (Wine of Opium). Sydenham s Laudanum. Prepared by macerating opium in stronger white wine, with cinnamon and cloves, and contains the same proportion of opium as laudanum. Dose, TT|xij, or about 25 drops. Morphia Sulphas (Morphia Sulphate), Morphine Acetas (Morphia Acetate), Morphle Hydrochloras (Morphia Hy- drochlorate), are the officinal salts of morphia, made by sat- urating the alkaloid with sulphuric, acetic, and muriatic acids. The sulphate and muriate occur in the form of snow-white feathery crystals, the acetate (which is not very stable) as a white powder. They have a bitter taste; are all freely soluble in water and alcohol, and produce analogous medicinal effects, the sulphate being, however, most soluble and most employed in this country. The salts of morphia possess the anodyne and hypnotic, but not the diaphoretic, properties of opium, and are considered less apt to produce headache, nausea, or consti- pation. They are peculiarly adapted to the hypodermic and endermic methods of application. Dose, one-sixth to one- fourth of a grain. This quantity is equal to opium 1 grain. Magendie's solution, used hypodermically, contains sixteen grains to f§i. Troches of Morphia and Ipecacuanha (Trochisci Morphise et Ipecacuanha) ; each troche contains ^ of a grain of mor- phia sulphate. Pulvis Morphia Compositus (Compound Powder of M07*- phine) (Tully's Powder). Contains morphine sulphate (1 part), mixed with camphor, liquorice, and calcium carbonate (of each 20 parts). CHLORAL. 65 CHLORAL. This interesting compound, although discovered by Liebig in 1832, has attracted attention as a therapeutic agent only since the statements of Liebrich, a physician of Prussia, published in May, 1869. It is prepared by passing dried chlorine gas through pure anhydrous alcohol, afterwards gently heating, when the liquid separates into two layers, the lower of which is chloral ; this is agitated with sulphuric acid, and purified by distillation, first over sulphuric acid and then over quicklime; the reaction, upon which the formation of chloral depends, in this process, is complicated, chloral and hydrochloric acids being the chief products. Anhydrous chloral (C 2 HC1 3 0) is a thin, limpid, oily, colourless liquid, greasy to the touch, with a fatty taste, and a strong pungent smell, producing lachryma- tion. Chemically, it is classed with the halogen aldehydes. It has a sp. gr. of 1*502, a boiling point of 203° F., and mixes in all proportions with water, alcohol, ether, and chloroform. Mixed with one-eighth its weight of distilled water, it combines to form a so-called hydrate (C 2 HC1 3 0,H 2 0), for it contains an entire molecule of water, which crystallizes in a mass of snow- white needles, soluble in their own weight of water; and, as pure chloral readily undergoes decomposition, the more stable hydrate is the form which is employed for medicinal use. It is incompatible with the alkalies, which decompose it into formic acid and chloroform. Chloral combines also with alcohol, forming a compound termed Chloral AlcaJwlate, which resembles the hydrate, but is distinguishable by its insolubility in water and its solubility in cold chloroform. Effects and Uses. — Chloral has decided antiseptic properties. Nervous system : in doses of 20 grains, chloral is a most reliable hypnotic. The sleep which it induces is usually quiet, natural and refreshing. Generally, no unpleasant effects follow its em- ployment, though occasionally headache and slight nausea super- vene. According to Hammond, chloral causes cerebral anaemia, and that the brain is in this condition when chloral sleep sets in. 5 66 MATERIA MED1CA — NARCOTICS. In medicinal doses, it is not a pain-relieving agent, in the way that opium is. In hypnotic doses, it slightly contracts the pupil. It has no special action on the secretions, but is probably eliminated by the kidneys. When larger amounts are given, the sleep is deeper, and may pass into coma ; the respiration is slower ; the pulse is reduced in fullness and frequency, the arterial tension being lowered ; the tem- perature is reduced ; the muscular system is relaxed ; and both sensibility and reflex action are abolished, the latter being brought about by a direct action on the spinal cord, since chloral does not affect the motor nerves or muscular contrac- tility. Large amounts may be taken without fatal results, as 460 grains have been given without unpleasant effects, though 20 grains, in three cases, have proved poisonous ; the symp- toms of poisoning are diminished frequency of the respiration and circulation, redness of the conjunctiva, contraction of the pupils, lividity of the lips, and falling of the jaw, with occa- sionally eruptions of the skin. Death takes place probably from sudden failure of the heart's action, which stops in dias- tole. The treatment of chloral-poisoning is much the same as that pursued in opium-poisoning ; artificial respiration is, how- ever, useless, and the heart's action is best restored by the ac- tion of strychnia on the cardiac ganglia. It is asserted that chloral is decomposed in the blood by the liberation of chloro- form ; but this is scarcely probable, and its effects are certainly not identical with those of chloroform. Chloral is a most valuable hypnotic remedy in all the forms of insomnia, in hysterical excitement, in acute mania, and in delirium tremens. As an antispasmodic, larger doses are re- quired, but it has been used with advantage in infantile con- vulsions, and even in puerperal and uremic convulsions, both by the mouth and hypodermically, and it is especially recom- mended in the relief of rigid os during labour. In sea-sickness it is highly recommended. In tetanus, much success has been obtained with chloral, in ten-grain doses every two hours. In whooping-cough, chorea, etc., it has also been employed with advantage, and as an antidote for strychnia. As an anodyne POTASSIUM BROMIDE. 67 it is available, but only in narcotic amounts. The ordinary dose of chloral is 20 grains, -which may be safely repeated every hour or two, till three doses have been taken or sleep occurs. An equal weight of chloral hydrate added to powdered camphor makes a valuable local anaesthetic liquid. Chloral is administered only in aqueous solution, and the addition of mucilage or syrup, particularly of the syrup of orange-peel, will disguise its unpleasant taste. It is not well adapted to the hypodermic method, as painful phlegmons some- times follow its repeated use. Locally, in dilution (gr. x to foi of water), or as an ointment (5ss to §i), it is a good stimu- lant and deodorizing application to foul and fetid indolent ul- cers ; as an injection in gonorrhoea (gr. xx to f§i of water), it answers well; and injected into subjects for the dissecting-room, and in the preservation of anatomical preparations, it has been also found useful (gr. xl to f.5i of water). Croton-Chloral Hydrate (C 4 H 5 C1 3 0,H 2 0) is made by the action of chlorine upon ethylic aldehyde, and, when pure, occurs in beautiful white, silvery crystals, with a sweetish melon flavour, only slightly soluble in water. Its action is similar to chloral, though thought to be feebler ; in addition it causes anaesthesia of the head. It is highly recommended as an anodyne in neu- ralgia, and also in chronic cough, in doses of from fifteen to twenty grains, dissolved in glycerin and syrup. POTASSII BROMIDUM — POTASSIUM BROMIDE. Potassium bromide (KBr) is prepared by adding a solution of pure potassium carbonate to a solution of ferrous bromide. The iron is precipitated, and the potassium bromide remains in solution, from which it is obtained by evaporation. It occurs as a permanent, colourless, anhydrous, crystalline salt, of a pungent, saline taste, very soluble in water, and slightly so in alcohol. When mixed with starch, a yellow colour is developed on the addition of chlorine. A bluish tint shows the presence of an iodide. Physiological Effects. — Local action : when applied locally to the pharyngeal mucous membrane, it is said to lessen the 68 MATERIA MEDICA — NARCOTICS. reflex irritability of the part. Nervous system : when applied locally to the motor nerves and spinal centres of the frog, potassium bromide destroys their functions. This action, how- ever, is probably due to the potassium which it contains (Ringer), and is shared by other potassium salts. When administered internally (in animals), the irritability of the brain is decreased, owing in great part to the anaemia, caused by the action of the drug upon the vasa-motor nerves which govern the calibre of the vessels. Reflex irritability is diminished, partly on account of the paralyzing influence exerted on the reflex functions of the cord, and in part from paralysis of the end-organs of the peripheral nerves ; on the latter account, also, cutaneous sen- sibility is lessened. It possesses a sedative action on the sympathetic system, giving rise to diminished cardiac action, decrease in the blood-supply to various organs, and slight reduction in the temperature of the body. Circulation : top- ically applied to the heart (and voluntary muscles), it destroys their functions, as in the case of the topical application to the nervous centres, and probably for the same reason. In very large doses, it lessens the frequency and force of the cardiac contractions, shortening the systole, prolonging the diastole, and, finally, paralyzing the heart in diastole. The tension of the arterial system is lowered. Respiration : it slows respira- tion and causes death by arrest of the respiratory centres (Ott). Temperature : in warm-blooded animals, toxic doses lower very decidedly the temperature, probably due to a direct checking of tissue changes. Secretion : at first the secretions and ex- cretions are diminished, but, later, they are increased in amount. If a very large dose is taken, they are increased primarily. No lachrymation, salivation or catarrh is produced, as after the administration of the iodides. After large doses, micturition is less frequent, because the vesical irritability is diminished, — not because the amount of urine is decreased. A very large dose may paralyze the sphincter and produce incontinence of urine. The amount of urea eliminated is diminished, as is, also, the amount of carbonic acid exhaled from the lungs. The perspiration is also decreased. POTASSIUM BROMIDE. 69 In man, the action of the bromides is similar to the action in animals ; the cerebral symptoms being, however, more marked, because of the greater development of the hemispheres. When long continued, potassium bromide exerts a very marked de- pressing effect upon the sexual functions, enfeebling the sexual vigor, and even diminishing the sexual appetite. These symp- toms pass away when the drug is withheld. When considerable doses are given for a long period, a train of symptoms is produced to which the name bromism is applied. These are mental weakness, great drowsiness, failure of memory, anaemia, malnutrition, and depression of spirits', with often impaired sensibility of the mucous and cutaneous surfaces, diminution of the sexual functions, and an eruption on the skin (generally on the face and back), usually of acne, which rarely suppurates, occasionally of eczema, and, very rarely, rupial ulcers may be seen. Elimination : potassium bromide is eliminated chiefly by the kidneys ; but, also, by the mucous membranes of the fauces, intestinal canal, and bronchi, by the skin, and by the salivary glands. Traces may be found in the urine ten minutes after its administration, but elimination is slow. No case of acute poisoning by potassium bromide has been reported. Antagonists and Incompatibles. — Acids, acidulous and me- tallic salts are incompatible with potassium bromide. It is antagonized in its physiological action by alcohol, ether, coffee, cold, digitalis, strychnia, belladonna, ergot, and other remedies which stimulate the vaso-motor nerves and induce arterial congestion. It is aided in its action on the brain by cannabis indica, chloral, opium, and similar remedies ; the depressing effects on the circulation are enhanced by aconite, veratrum viride, gel- semium, etc. Medicinal Uses. — From its action on the nervous system, potassium bromide is much used to quiet cerebral excitement, and for its sedative effect on the reflex centres of the cord. As a narcotic (by causing anaemia of the brain), it is much used in wakefulness, due to cerebral hyperaemia, or even when not more than the normal amount of blood is sent to the brain ; in 70 MATERIA MEDICA — NARCOTICS. wakefulness and wandering during convalescence from acute diseases ; and in sleeplessness due to worry, grief, dyspepsia, and overwork ; also in cases of night-horror in children, where they awake suddenly, and scream with fright, often for a con- siderable time, small doses of this salt and a light supper will frequently effect a cure; adults subject to nightmare will often find relief in the temporary use of potassium bromide ; to allay restlessness, remove delusions, calm delirium, and produce sleep in the early stages of delirium tremens, it is given in doses of grs. xx to grs. xxx every two hours until sleep is produced. It is more efficient in-the early. stages, and can be relied on with more certainty in the first than in subsequent attacks. Potassium bromide is often combined with other narcotics, as opium, chloral, etc., to aid their action, and even to modify their disagreeable effects. It will generally prove beneficial in women suffering from nervousness ; great despondency, amount- ing to a feeling of approaching madness ; irritability ; want of interest in their surroundings ; sleeplessness and harassing dreams, caused by overwork, want of change, grief, or worry. If the medicine does not succeed alone, it will when combined with a. change of scene. In some cases of hysteria, potassium bromide is a valuable remedy. In all forms of convulsions (epilepsy, chorea, convulsions of Bright's disease, convulsions of children, etc.) it will prove beneficial, by diminishing the reflex function of the cord. In epilepsy the bromides are pre- eminently of service, lessening the frequency of the attacks, if not absolutely preventing their recurrence. It is stated by Troussea and by Bartholow that it is less efficient in attacks of "petit mal than in those of severer form ; but Dr. A. Hughes Bennett has recently published a number of cases of the lighter variety, in the majority of which the bromides proved success- ful. It should be given in sufficient doses to prevent reflex retching or nausea, when the fauces are tickled (Voisin), and must be continued for years, with an occasional intermission of a week or two. Potassium bromide has been successfully used in the treatment of strychnia-poisoning ; it should be given in doses of 5y\ frequently repeated, as the case may require. It AMMONIUM BROMIDE. Yl has also been successfully used in tetanus. It has been recom- mended during dentition, to allay irritability and restlessness and prevent convulsions. In the reflex forms of vomiting, as the vomiting of pregnancy and of sea-sickness, and in migraine or sick headache (especially in the congestive forms), it is some- times beneficial. In the colic of infants, unaccompanied by diarrhoea, it is an excellent remedy, relieving pain and spasm* and producing sleep. It is used, too, to obtund the sensibility of the fauces, before the exhibition of the laryngoscope. From its sedative influence on the organs of generation, it is used with success in nymphomania, spermatorrhoea and mas- turbation. It decreases the flow of blood in menorrhagia. The flushes of heat, followed by sweating and prostration, occurring at the menopause, are generally cured by the use of potassium bromide. Administration. — Dose, grs. v-5j or more. In epilepsy it is given in doses of grs. xx-xxx, thrice daily, and continued for a long period, with occasional intervals of a week or two. If bromism occurs, stop the remedy for the time, and give tonics. The bromide rashes are easily cured by withdrawing the medicine, and giving liquor potassii arsenitis internally in small doses, and the local use of an ointment containing iodide of sulphur. Potassium bromide should be administered in solution, and preferably between meals. AMMONII BROMIDUM — AMMONIUM BROMIDE. Ammonium bromide (NH 4 Br) is prepared by mixing bromine with iron wire in distilled water, agitating the mixture until the liquid assumes a greenish colour, and then agitating water of ammonia with the mixture. By evaporation, a white, gran- ular salt is obtained, which, on exposure to the air, gradually becomes yellowish (in consequence of the liberation of hydro- bromic acid), has a saline, pungent taste, is very soluble in water, and moderately so in alcohol. Physiological Effects. — The action of ammonium bromide resembles, in many respects, that of the potassium salt. When applied locally to the motor nerves, spinal centres, heart, or 72 MATERIA MEDICA — NARCOTICS. voluntary muscles, it does not destroy their functions, and has less influence, when administered internally, on the circulation, respiration, and temperature. Medicinal Uses. — It has been used for the same conditions in which potassium bromide is given. Echeverrhia prefers the ammonium bromide in epileptic maniacal excitement, but states that it will fail unless combined with chloral, cannabis indica, or other narcotic, or, better still, with ergot. The combined use of ammonium and potassium bromide has been recommended by Brown-Sequard. Da Costa highly recommends its use in acute rheumatism. It has also been used with advantage in pertussis. Administration. — It is given in doses of gr. v-xxx, thrice daily, and is best administered in some bitter infusion. Sodii Bromidum [Sodium Bromide) (NaBr) may be pre- pared in a similar manner to potassium bromide. In its physiological effects it resembles potassium bromide, but is much feebler. It is used in the same diseases and in the same doses as is the potassium salt. Lithii Bromidum (Lithium Bromide) (LiBr) has been rec- ommended as the most efficacious of the bromides. S. Weir Mitchell has found it efficient in grs. x-xx doses, in some cases of epilepsy, after potassium bromide had failed. It has been used in gout, but not with much success. It contains a larger per cent, of bromine than do the other salts, and is very soluble. Calcii Bromidum (Calcium Bromide) (CaBr 2 ) has been employed for the same purposes and in the same doses as potassium bromide. LACTUCARIUM. Lactucarium (sometimes called lettuce-opium) is the con- crete juice of Lactuca sativa, the garden lettuce (Nat. Ord. Composite), and is obtained from incisions in the plant, in the stem, during the period of inflorescence. Another and inferior mode of procuring it is by expression and evaporation of the expressed juice. Two varieties are found in the market : Eng- lish lactucarium, which occurs in small, irregular lumps, of a reddish-brown colour externally, an opiate smell, and a bitter, BELLADONNA. 73 unpleasant taste, and German lactucarium (which is inferior), in four-sided pieces, from an inch to an inch and a half thick. The active principle, termed lactucin, is said to possess less hyp- notic power than the crude drug. Lactucarium prepared from the juice of the Lactuca elongata, American or wild lettuce, has been found to possess eifects similar to those of the officinal article. Effects and Uses. — Lactucarium possesses very feebly the anodyne and hypnotic qualities of opium, with a slight sedative action on the circulation, but it is an uncertain preparation. It may be given where opium disagrees from idiosyncrasy in the patient. Dose, gr. x. The syrup is the most eligible form of administration. Dose, two to four fluidrachms. BELLADONNA. Belladonnae Folia, Belladonna Leaves ; Belladonnas Radix, Belladonna Root. Atropa Belladonna, or Deadly Nightshade (Nat. Ord. Sol- anacese), is a European perennial plant, with herbaceous, branched, downy stems, about three or four feet high, large ovate leaves of a dull-green colour, and drooping, bell-shaped purple flowers. The whole plant possesses narcotic properties, but the leaves and root only are officinal. The root should be obtained from plants more than two years old ; the dried root is long, round, from one to seven inches in thickness, branched, of a reddish-brown colour, of little odour, and a feeble sweetish taste. The physiological properties of belladonna depend on the presence of an alkaloid termed atropia, combined with malic acid, which is found in all parts of the plant. It is officinal, and is prepared from the root by exhaustion with alcohol, afterwards adding sulphuric acid, precipitating with potassa, dissolving the atropia in chloroform, and then evaporating the chloroform. Atropia (C 17 H 23 N0 3 ) occurs in the form of yel- lowish-white, silky, prismatic crystals, without smell, but of a bitter, acrid taste, soluble in alcohol, more so in ether, still more so in chloroform, but only partially soluble in water. Auric chloride gives with atropia solution a yellow precip- itate, and cyanogen gas passed through its alcoholic solution 74 MATERIA MEDICA — NARCOTICS. strikes a deep-red colour. The best test is bromine, in hydro- brouiic acid, which produces a yellow amorphous precipitate, soon becoming crystalline ; the physiological test should also be applied by dilating the pupil of a rabbit or a cat by local application to the eye. It is a most energetic poison, produc- ing analogous effects to those of belladonna, but much more powerful. Latterly, atropia has been a good deal employed medicinally as a substitute for belladonna, on account of its greater certainty. The dose to begin with for internal use is about one-thirtieth of a grain in solution, one-sixtieth of a grain for hypodermic injection. As a collyrium to dilate the pupil, a solution of a grain in four fluidrachms of water, with a few drops of acetic acid, may be employed, and a drop of the solution applied to the eye. A tincture (atropia gr. j, diluted alcohol f §ss) is used for the same purpose — dose, for internal use, 8 drops. Atropia sulphate is also officinal ; it is obtained in the form of a white, slightly crystalline powder, very soluble in water and alcohol, but insoluble in ether ; dose the same as that of atropia. Physiological Effects of Belladonna. — Belladonna applied locally diminishes sensation and can be absorbed through the unbroken skin. Nervous system : in small doses it is a cere- bral exhilarant, tending to produce hallucinations and delirium and sometimes sopor, but it is not a true hypnotic. Belladonna dilates the pupil in whatever way exhibited. When dropped into the eye it brings about dilatation by paralysis of the end-organs of the third nerve and stimulation of the sym- pathetic. Internally it is also thought to cause pupillary dilatation by a local action. In large doses the excitability of the motor and the sensibility of the sensory nerves is impaired by this drug, while the contractility of the striated muscles remains unaltered. On the motor nervous centres it acts as a paralyzing and tetanic agent. Circulation : here the drug increases the heart's movements by stimulating the cardiac ganglia of the sympathetic and paralyzing the peri- pheral ends of the pneumogastrics. An increase in blood pressure also takes place. Respiration : belladonna increases BELLADONNA. 75 respiration by stimulation of that centre. Temperature : in small doses it increases temperature and in large reduces it. Secretion : belladonna checks the salivary secretion by para- lyzing the inhibitory nerves from the chorda tympani to the submaxillary gland, hence the dryness of the mouth and throat observed in the employment of this drug. Its effect on the urinary secretion is doubtful, except that it increases the solids, while it effectually checks the secretions of the skin by a local paralyzing action on the peripheral nerve end-organs ; upon the intestinal secretory apparatus its action is questionable, though it increases intestinal peristalsis. Atropia is eliminated by the kidneys. Belladonna, however used, has the power to check the secretion of the mammary glands. In larger doses it causes dilatation of the pupils, loss of vision, giddiness, constriction of the throat, difficulty of deglutition and articulation, increased heart-action, quickened respiration, elevation of temperature, marked diuresis, nausea, with occasional vomiting and purging, and sometimes a red eruption. When excessive doses are taken the temperature of the body falls, the muscular system is re- laxed, sensation is impaired, the pulse fails, and maniacal delirium sets in, followed by coma, syncope, and death, often preceded by convulsions. Dissections show that the action of the poison is not confined to the cerebro-spinal system, but that it is attended by inflammation of the digestive organs. Cases of poisoning from belladonna are to be treated by evacuation of the stomach, cathartics, and, if coma occurs, by the electro- magnetic battery. Opium and phy so stigma are the physio- logical antidotes, or hypodermic injections of solutions of the salts of morphia may be administered. As atropia and its salts are decomposed and rendered inert by prolonged contact with caustic alkalies, the solutions of potassa and soda are recom- mended as antidotes for belladonna, and are to be considered also as medicinally incompatible with it ; lime-solution is said to have the same action. Applied to the eyebrow, belladonna causes dilatation of the pupil ; and accompanying its mydriatic action are paralysis of accommodation and a diminished intra- ocular pressure. 76 MATERIA MEDICA NARCOTICS. Medicinal Uses. — Belladonna is one of our most highly es- teemed anodyne and antispasmodic remedies. It is destitute of hypnotic effect, and, on the contrary, has a tendency to occasion wakefulness. In the treatment of neuralgia it ranks at the head of the narcotics, and is extensively employed both alone and in combination with quinia sulphate. It should be given until dryness of the throat, dilatation of the pupil, and some disorder of vision are produced. Its powers of allaying spasm have been found very efficacious in the treatment of whooping-cough and asthma. In lead colic, spasmodic con- striction of the bowels generally, dysmenorrhoea, laryngismus stridulus, chorea, and tetanus, belladonna ranks among the best antispasmodic remedies. In spasmodic stricture of the urethra, the local application of belladonna ointment to the urethra by a bougie is very efficacious. In mania and many diseases of the cerebro-spinal system, especially epilepsy, it has been occa- sionally employed with advantage. As a stimulant to the cir- culatory system, it is now thought useful wherever collapse is threatened from failure of the circulation, and especially in syncope from cardiac disease. Its action on the kidneys ren- ders it useful in chronic Bright's disease ; and, by its influence in relieving irritability of the bladder, it is probably the best remedy for the nocturnal incontinence of urine of children. In constipation, iritis, and as a prophylactic against scarlatina, it is also resorted to. As a preventive of scarlatina, it was orig- inally proposed from its power of affecting the throat and skin, and respectable authority is not wanting in confirmation of its efficacy in this particular. It is used, too, in cases of poisoning by opium. Lately, hypodermic injections of -^ to e \ of a grain of atropia have been found useful in checking colliquative night sweats, especially in phthisis. In myalgia and lumbago the hypodermic injection of atropia gives speedy relief, and may be advantageously combined with morphia. As a topical remedy, belladonna is employed as an anodyne, and also to relieve rigidity of the os uteri in labour. The local use of atropia in diseases of the eye is of the greatest import- ance ; solutions of the alkaloid or its sulphate may be dropped STRAMONIUM. 77 into the conjunctival sac, to relieve pain and photophobia, to determine the refraction of the eye from its influence on accom- modation, in the diagnosis of suspected cataract, in operations for cataract, in iritis, prolapsus iridis, and ulcers of the cornea generally. Gelatine wafers, containing J$ to T ^ of a grain of atropia, are sometimes used to dilate the pupil for ophthalmo- scopic purposes. Homotr opine : obtained from tropine amygdalate, atropia having been split into tropine and tropic acid. It is similar in its effects to atropia, except that it retards the heart's action. Applied to the pupil, it quickly brings about wide dilatation, and moreover is unirritating, hence it is an acquisition in ocular therapeutics. Administration. — The dose of the powder of the root or leaves is gr. j, to be repeated and increased till dryness of the throat, dilatation of the pupil, and dimness of vision are pro- duced. It is most frequently exhibited in the form of extract (or inspissated juice) of the fresh leaves. Dose, \ to J a grain, to be repeated and increased. The tincture (5iv of the leaves to diluted alcohol Oij — dose, 15 to 30 drops) and the alcoholic extract are also officinal. The fluid extract of belladonna root contains a 5j of root in a f 5 of extract — dose, 2 to 5 drops. Suppositories of belladonna (made with alcoholic extract of belladonna 1 part and oil of theobroma 59 parts) contain each half a grain of extract. For external use, a plaster (emplastrum belladonnas) and an ointment (unguentum bel- ladonnas) are employed. STRAMONIUM. Stramonii Folia. Stramonium Leaves : Stramonii Semen, Stramonium Seed. Datura Stramonium, or Thorn-Apple, sometimes called Jamestown weed (Nat. Orel. Solanacese), is an annual indige- nous plant, which grows very abundantly in waste grounds in all parts of the world. It has a forked, branching stem, from three to six feet high, ovate, toothed leaves, large funnel-shaped white or purplish flowers, which appear in midsummer, and 78 MATERIA MEDICA — NARCOTICS. ovate capsules, filled with numerous kidney-shaped, brownish- black seeds. The odour of the plant is strong and disagreeable, and its taste bitter and nauseous. It loses these properties very much when dried, but the process does not appear to weaken its narcotic qualities. The leaves and seeds are offici- nal, but the seeds are most powerful from containing mostdaturia. Fig. 6 V»* The active principle of Stramonium is an alkaloid termed datu- ria, found combined with malic acid, which possesses properties analogous to those of atropia. Another alkaloid, stramonin, has been isolated (Trommsdorff), but its action has not been ascer- tained. The physiological effects of stramonium are closely allied to those of belladonna, with a more marked action on the secre- tions. From its common occurrence in every part of the country, cases of poisoning from this weed are very frequent, particularly with children, who are fond of swallowing the seeds. The treatment laid down for the relief of poisoning from belladonna is applicable to these cases. The medicinal uses of stramonium are similar to those of belladonna. It is prescribed internally in neuralgia, whooping- cough, mania, and epilepsy ; and in spasmodic asthma, cigar- ettes of the leaves are smoked with great relief. The practice HTOSCYAMUS. 79 is, however, dangerous in aged or apoplectic persons. Topi- cally, stramonium is used by oculists to dilate the pupils and diminish the sensibility of the retina to light ; and it is an excellent anodyne application, in the form of cataplasm and ointment, to inflammatory tumours, irritable ulcers, bed-sores, and hemorrhoids. Administration. — The dose of the powdered leaves is gr. ij ; of the seeds, a grain, to be repeated and gradually increased till narcotic effects are produced. Dose of the extract of the leaves, gr. j, to commence with ; of the extract of the seed, gr. J. The tincture (giv of the seed to diluted alcohol Oij, dose 20 to 40 drops), and the ointment made by mixing the extract of the leaves with lard, are also officinal. HYOSCYAMUS. Hyoscyami Folia, Hyoscyamus Leaves ; Hyoscyami Semen, Hyoscyamus Seed. Hyoscyamus niger, or Henbane (Nat. Ord. Solanacese), is a native of Europe, and is naturalized in the northern parts of the United States. It grows to the height of about two feet, with large sinuated, pale-green leaves, and flowers of a straw- yellow colour. The whole plant has narcotic properties ; but the leaves and seeds only are officinal. Henbane should be gathered when in flower. The active properties of the plant depend upon an alkaloid termed hyoscyamia (C 15 H 23 N0 3 ), nearly identical in its action with atropia, but more soluble in water. Dose, gr. -J^ to gr. j ; hypodermically, gr. g 1 ^ to Effects and Uses. — The effects of henbane on the system much resemble those of belladonna. They differ from those of opium in their comparatively feeble hypnotic effect, and in their relaxing influence on the bowels. In large doses it causes dil- atation of the pupil, delirium, loss of vision and, generally, sleep. It is eliminated by the kidneys. In cases of poisoning, the same treatment is to be pursued as for belladonna and stra- monium. Henbane may be used remedially, in the samedis- 80 MATERIA MEDICA — NARCOTICS. eases as belladonna and stramonium, than which it is, however, less active. It has been administered also, from the earliest days, to palliate cough, where opium is objectionable, from its constipating or nauseating influence. Hyosciamia is highly recommended (Lawson), in the dose of gr. j to gr. jss, to quiet the violence of mania. Externally, it is employed in the form of cataplasm or fomentation to painful swellings and ulcers ; and it may be used to dilate the pupil, in the same manner as belladonna. Dose of the powdered leaves, gr. v to gr. x ; of the seeds, somewhat less. The extract (an inspissated juice of the leaves) is the preferable form of administration ; it is of a dark-olive colour, and extremely variable quality. Dose, gr. ij to gr. v. Tincture (§iv to diluted alcohol Oij), dose foj- An alcoholic extract and a fluid extract (dose 10-20 drops) are also officinal. TOBACCO. 81 TABACUM — TOBACCO. Nicotiana Tabacum, or Virginia Tobacco {Nat. Ord. Sola- naceae), is a native of the warm countries of America. It is an annual plant, growing to the height of from three to six feet, with large oblong, pointed, hairy, pale-green leaves, and light-greenish, funnel-shaped flowers. The dried leaves are the portion used. They have a yellowish-brown colour, a strong, peculiar, narcotic odour, and a bitter, nauseous taste. The darker-coloured leaves are the strongest. The virtues of tobacco are imparted to alcohol and water, and depend on the presence of an alkaloid called nicotia (C 10 H 14 N 2 ), which is found in all parts of the plant. It is a colourless, oily, volatilizable, alkaline liquid, highly soluble in water, alcohol, ether, chloroform, the fixed oils, and oil of tur- pentine, of a feeble odour when cold, but irritant when heated, of an acrid, burning taste, and is a most energetic poison, rank- ing after prussic acid. From the dried leaves are also obtained a concrete volatile oil, termed nicotianin, which is probably the odorous principle of the plant, and an empyreumatic oil, which gives the peculiar smell to old tobacco pipes. Both of these principles are poisonous. Physiological Effects. — Local action : applied to the skin tobacco is readily absorbed. On persons unaccustomed to its use tobacco, in small doses, produces nausea, depression, and a feeling of wretchedness. Nervous system : tobacco expends its action on the spinal cord, and not upon the brain, and nicotia, in full doses, acts as a tetanizing agent on man. Nicotia con- tracts the pupil either locally or internally. The conductivity of the motor nerves is more or less abolished, and lastly that of the spinal cord, while the voluntary muscles remain unaffected. These remarks apply to lethal doses of the drug. Circulation : the blood of a person under the influence of tobacco has been found to present a crenated appearance of the red globlules. Tobacco is not a cardiac poison, since the application of nicotia to the cut-out heart will not stop its beats ; nevertheless it acts to slow the cardiac action and temporarily reduce blood pres- 82 MATERIA MEDICA — NARCOTICS. sure. It causes death by paralyzing the muscles of respira- tion. Intestines : tobacco has a relaxing influence upon this tract, and the injection of nicotia induces intestinal peristalsis. Nicotia is probably eliminated by the kidneys. In larger doses, it in- duces vomiting and purging, a sensation of sinking at the pit of the stomach, giddiness, disorder of vision, the pupils being contracted, depression of the circulation, great relaxation of the muscular system, coldness of the surface, and other symp- toms of prostration ; and, when excessive doses have been taken, these symptoms become more violent, and are followed by clonic convulsions, paralysis, and death. Cases of poison- ing are to be treated with the diffusible stimuli, after washing out the stomach, and strychnia is to be used hypodermically. The habitual use of tobacco as an exhilarant is well known. When taken to excess, it frequently develops disorders of the stomach, heart, and nervous system. Medicinal Uses.-^ Tobacco is employed in medicine chiefly with a view to its action on the muscular system — its anodyne properties being relatively feeble. In various spasmodic dis- eases, particularly in colic, ileus, strangulated hernia, consti- pation from spasmodic constriction, tetanus, spasm of the neck of the bladder and the glottis, and asthma, it is a remedy of great value. It has been also successfully applied to the treat- ment of poisoning by strychnia. Internally, tobacco is to be employed with caution, as it occasionally acts with dangerous energy. Stupes of an infusion of tobacco (half an ounce to a pint of water) have been found an efficacious application to wounds, in cases of traumatic tetanus. Administration. — Tobacco is not given by the stomach, owing to its emetic properties. It is usually administered by the rectum, in the form of infusion (5j-Qj of boiling water, one-third to be given at a dose), or tobacco-smoke may be intro- duced into the rectum. It may also be smoked for medicinal effect, or applied locally in the form of cataplasm. Ointment of Tobacco ( Unguentum Tabaci) is made by mixing a watery extract with lard ; it is a useful application to indolent ulcers and some cutaneous affections, particularly tinea capitis, but LOBELIA. 83 the external application of tobacco to abraded surfaces of con- siderable extent has occasioned dangerous consequences. The Wine of Tobacco (Vinum Tabaci) is occasionally used as a diuretic — dose 20-30 drops. The Oil is sometimes mixed with ointments. DUBOISIA. The leaves of the Duboisia myopceoides (Nat. Ord. Solana- ceae), a tree-like shrub of Australia. They are three to four inches long and one inch broad, entire, smooth and lance- olate. An alkaloid, duboisia, has been isolated (Gerrard and Petit, 1878), resembling atropia in action ; chemically, it differs from it in being coloured brown by sulphuric acid, and is more soluble in water. Its salts are readily soluble in water. Dose for ophthalmic purposes, gr. ij to iv to f§j water. Its physi- ological action is antagonized by opium and jphysostigma. Duboisia produces almost similar effects to those of atropia. The mental excitement, however, which it causes is followed by stupor. Its effect is best seen on the pupil, which it dilates no matter how exhibited. It differs from atropia in causing more rapid dilatation, total paralysis of accommodation, and in being less irritating. The use of duboisia is confined to ocular thera- peutics. (On Duboisia, Norris, Ringer, Seely, Weeker and Bancroft.) LOBELIA. Lobelia inflata, or Indian tobacco (Nat. Ord. Lobeliaceas), is a very common annual or biennial indigenous plant, growing to the height of from six inches to two feet, an erect, hairy stem, ovate, serrated leaves, pale-blue flowers, and ovoid, inflated cap- sules. All parts of it are active, but the leaves and tops only are officinal. Water and alcohol extract the virtues of lobelia, which contain a volatile alkaloid, lobelina (analogous to nico- tia), lobelic acid, fixed and volatile oil, gum, chlorophyl, etc. Lobelina is a yellowish liquid, lighter than water, of an aromatic odour, an acrid taste, soluble in water, but more so in alcohol and ether. 84 MATERIA MEDICA — NARCOTICS. Physiological Effects. — Lobelia produces effects on the sys- tem analogous to those of tobacco, acting in small doses as a sedative, nauseant, and diaphoretic. According to Ott's inves- tigations (Bost. Med. and Surg. Journ. 1875) the alkaloid pro- duced in the rabbit curious alterations of blood pressure, viz., Fig. 8. first a fall, followed generally by a rise, and lastly a very de- cided fall ; also slower respiration, paralysis, reduction of tem- perature, and death from asphyxia. Lobelia, like tobacco, retards the heart's action, and it is said increases the urinary flow. Lobelia, in an unexplained way, relieves bronchial spasm. ACONITE. 85 There are on record numerous cases of death from large doses of lobelia. Complete investigations of the action of lobelia have not yet been made. In large doses it is an energetic emetic ; and in still larger doses destroys life by paralyzing the respiratory centre in the medulla oblongata, the pupil being contracted. It was employed by the aborigines, and has always been a popular empirical remedy. Medicinal Uses. — Lobelia is sometimes classed among emet- ics, but its action in this particular is too violent for its safe administration. It is chiefly employed, by regular practition- ers, with a view to its antispasmodic properties, for the relief of asthma, angina pectoris, and cardiac dyspnoea, and is given in small doses, gradually increased until headache or nausea ensues. In asthma, Ringer advises lobelia to be given in large doses, viz., f5i of the tincture every hour, or even every half- hour. The chief drawback to its use is its uncertainty and the nausea and depression it produces. In asthma it possesses no curative power, seeming to be beneficial by reason of its anti- spasmodic and expectorant properties. It may also be used as an enema, to fulfill the same indications as tobacco. Administration. — Lobelia is given in substance, tincture, and infusion. The dose of the powder as an antispasmodic is gr. j to gr. iij ; as an emetic, gr. v to gr. xx. The best form, par- ticularly in asthma, is the tincture (giv to diluted alcohol Oij), which may be given in the quantity of f 5ss to j, to be repeated as occasion may require. Acetum Lobelia ( Vinegar of Lobelia), made with diluted acetic acid, is a good preparation, in which the- alkaloid is fixed by the acetic acid ; it is of the same strength, and may be given in the same doses, as the tincture. A C N I T U M — A C N I T E. Aconiti Folia, Aconite Leaves ; Aconiti Radix, Aconite Root. Aconitum Napellus, Aconite, Wolfsbane, or Monkshood (Nat, Ord. Ranunculacese), is a native of the mountainous parts of Europe and Asia. The leaves and root are both used, but 86 MATERIA MEDICA — NARCOTICS. the root is the more powerful. They are brought from Europe, India, and Japan, and other species of Aconitum than A. Napellus furnish some of the aconite of commerce. Their taste is bitterish and acrid, and when chewed they occasion a pecul- iar feeling of tingling and numbness in the tongue and interior of the mouth. These properties sere impaired by long keeping, and the plant loses its medicinal efficacy. The active principle of aconite is an alkaloid named aeonitia (C 33 H 43 N0 12 ), which is officinal. Two other alkaloids, pseudaconitia (C 36 H 49 NO n ) and napellina, have been found in it, but the chemistry of aconite is not well settled. Aconitia exists in combination with a peculiar acid termed aconitic, and is prepared from an aqueous solution of an alcoholic extract of aconite root, by the addition of sul- phuric acid (which converts the natural salt of aconitia into a sulphate). It is a white amorphous powder, with a tinge of yellow (though it has been obtained in crystals), without smell, of a bitter, acrid taste, and produces in the mouth a sense of numbness. It is partially soluble in water, and is readily dis- solved by alcohol and chloroform, less readily by ether. There is only one chemical test for aconitia, obtained by dissolving it in diluted phosphoric acid and evaporating, when a violet colour is produced ; in medico-legal cases, the physiological test, by producing numbness and tingling of the lips or skin, must be resorted to. As aconitia is easily decomposed, the commercial article is more or less impure. Aconitia is an exceedingly virulent poison, more powerful when pure than hydrocyanic acid. It is scarcely adapted to internal use, as even one-fiftieth of a grain has produced alarming results. As a topical agent in neuralgia and rheu- matism, it has been employed with great success in alcoholic solution (gr. i-ij to f5j) or as an ointment (gr. ij to lard 5j, rubbed up with alcohol, gtt. vj). Physiological Effects. — Aconite applied locally causes a sen- sation of numbness and tingling, induced, no doubt, by its be- numbing effect on the sensory nerves. Nervous system : taken in small doses aconite exerts no influence upon the cerebrum, ACONITE. 87 but its taste is pungent and benumbing, and it produces a feel- ing of numbness in the head, face, and extremities. Aconite has no action upon the motor nerves, the paralysis caused by it being due to abolishment, first, of the conducting power of the peripheral nerves, and, secondly, of their trunks, and lastly, ex- tending to the spinal sensory centres. The motor spinal centres are only involved when total palsy has set in. Circulation : ac- onite exerts a marked influence on the circulatory apparatus. Small doses reduce the heart's action and lower the arterial pres- sure ; lethal doses stop the heart in diastole. Aconite applied directly to the heart slows it so that it may be concluded that the drug is a cardiac poison acting on its motor ganglia. It is also believed to stimulate the cardiac inhibitory apparatus. According to the recent researches of Ringer and Murrell, aconite paralyzes all nitrogenous tissues, and it is in this way that the heart's beats are retarded. In other words, it acts directly against the heart's contained motor apparatus. Res- piration : these movements tend to become slow, and the tem- perature is lowered. Secretions : aconite increases the secretion of the skin and kidneys, and is probably eliminated by the latter. In larger doses, its effects are those of an acro-narcotic poi- son — gastric irritation, purging, contraction or expansion of the pupils, numbness or paralysis of the limbs, syncope, con- vulsions, and death. In case of poisoning, the stomach is to be thoroughly evacuated, and cardiac stimulants, externally and internally, are to be freely administered. Digitalis is advised by Fothergill. Medicinal Uses. — Aconite is a powerful and valuable rem- edy in the treatment of neuralgia, chronic rheumatism, gout, and other painful diseases, as might be inferred from its be- numbing effects on the system. From its influence on the cir- culation, it is employed to reduce inflammatory action, to mod- erate an excessively rapid pulse in scarlatina and other fevers, and as a remedy in hypertrophy and other cases of irregular or excessive action of the heart. It is contra-indicated when the heart is weak from any cause, as dilatation, or in valvular incompetency. In inflammatory diseases of the serous mem- 88 MATERIA MEDICA — NARCOTICS. branes, as pleurisy, pericarditis, also in pneumonia before the exudative stage, aconite is a potent remedy, and should be given till its effects are obtained. Aconite has done much good in relieving an attack of tonsillitis. In controlling abnormal car- diac action, aconite is perhaps the most available article we possess, but its employment requires caution. As a topical anodyne, in neuralgia, it has no superior. Administration. — The dose of the powdered leaves is gr. j to gr, ij ; of the root, gr. J to gr. i ; of the alcoholic extract of the dried leaves, gr. \ to gr. j ; of the tincture of the root, which ] s by far the best preparation (Sxij to alcohol Oij), 3 to 5 drops. These doses are to be repeated twice or thrice daily, and cau- tiously increased till the effects of the medicine are apparent. The tincture may be used externally ; but, for external appli- cation, the liniment (linimentum aconiti) or the plaster (em- plastrum aconiti) is to be preferred. CANNABIS AMERICANA — AMERICAN HEMP. CANNABIS IN DIG A — INDIAN HEMP (FEMALE PLANT). Cannabis sativa, or Hemp (Nat. Ord. Urticacere), is a native of Persia, and is cultivated in Europe and in the United States. Narcotic virtues were formerly thought to exist only in the Cannabis Indica, or Indian variety of the plant, but recent investigation seems to show that the hemp plants raised in the southern States, as Kentucky, are active, and might replace the East Indian drug. Gunjah is the dried compressed female flowers ; churrus is an impure resinous exudation, while bhang consists of the broken stalks and leaves made up with fruits ; it is known as hashish. The flowering tops of both varieties are officinal, but should be used only when unripe and green. By evaporating concentrated alcoholic solutions of these, Extracts are ob- tained (extr actum cannabis Americanos and extr actum cannabis Indicoi), which are the forms usually employed. Extract of hemp is of a dark olive-green colour, a fragrant narcotic odour, and a bitter, acrid taste. It is soluble in alcohol and ether, hops. 89 but not in water. The resin, which is the active principle, has received the name of cannabin. A volatile oil has been iso- lated, which has been decomposed into cannabene and canna- bene hydride. Effects and Uses. — Indian hemp is not used locally. Nerv- ous system : in medicinal doses it exerts a peculiar exhilarating effect upon the brain, the mental excitement induced by it being of an agreeable kind. In this condition ideas flow read- ily, and conception of time is lost. Sometimes the delirium in- duced by hemp causes the individual to do deeds of violence, but it does not act upon all alike. One of the symptoms is a sense of weight about the extremities, accompanied by a loss of muscular power, and often a cataleptic state ; there is also cuta- neous anaesthesia. Sleep follows the intoxicating effects of hemp, and the individual is unconscious of what has happened when recovery has taken place. The after-effects are those of depression. It has no action upon respiration, circulation, or the secretions. It is said to increase the appetite, and aphrodisiac properties have been attributed to it. It is un- known how it is eliminated. Though lethal doses of hemp have produced alarming symptoms, there are no recorded fatal cases. It has been chiefly extolled as an antispasmodic in traumatic tetanus, but has been employed with success in other spasmodic diseases, as chorea, hysteria, etc., to relieve cerebral irritability in diabetes, and as an anodyne in rheumatism, gout, neuralgia, etc. It has also been given with advantage as an hypnotic in both mania and mania-a-potu ; and its powers of exciting uterine contractions, and of checking uterine hemor- rhagic discharges, are highly spoken of. Dose, from half a grain to two or more grains. The tincture is made by dissolv- ing 5vi of the extract of Indian Hemp in a pint of alcohol ; forty drops of this are about equal to a grain of the extract. HUMULUS — HOPS. Hops are the strobiles of Humulus lupulus, or Hop-vine (Nat* Ord. Urticaceae), a climbing vine, indigenous in Europe, 90 MATERIA MEDICA — NARCOTICS. and probably also in North America, with serrated, rough leaves and greenish-yellow flowers. The medicinal portion is the fruit, or strobiles, which are also largely employed in the preparation of malt liquors, and are known as hops. Near their base are two small round, dark seeds, covered with aromatic glands or grains, which are the active portion of the hops, and are termed lupulin. They are separated by thresh- ing, rubbing, and sifting the scales, and constitute about a sixth part of the weight of hops. Lupulin (lupulinum) is officinal, and consists of rounded or reniform, rather transparent grains, of a cellular texture, and a golden-yellow colour. It is slightly soluble in water, and completely so in alcohol, and is composed of a volatile oil, a bitter principle termed lupulite, resin, tannic acid, and other matters. The scaly bracts contain a small portion of lupulinic matter. Effects and Uses.- — Hops are tonic and feebly narcotic. The narcotic properties probably reside in the volatile oil, and the tonic properties in the bitter principle. They are said, also, to possess antaphrodisiac and astringent properties, and sometimes prove diuretic. The odorous emanation is employed as an hypnotic by means of the hop-pillow. Internally, they are given to relieve restlessness, induce sleep, and allay pain, and are also much employed for their stomachic and tonic effect. The combination of tonic and hypnotic virtues renders hops an excellent remedy in mild forms of mania-a-potu. Topically, they are employed in the form of fomentation or poultice, in painful swellings and tumours. Administration. — Hops are given in the form of infusion (dose f§ij to f§iv) and tincture (dose f5j tof5iij)- The best preparation for internal use is Lupulin, in the dose of gr. v to gr. xij, in powder or pills. The tincture of lupulin (§iv to alcohol Oij) may be given in the dose of f5j to f o»j- The fluid extract is a concentrated tincture, containing the virtues of an ounce of lupulin in a fluidounce. The oleoresin also is officinal ; dose, gr. ij to v. BITTERSWEET. 91 D ULCAMARA — BITTERSWEET. The young branches of Solanum Dulcamara, the Woody Nightshade, or Bittersweet (Nat. Ord. Solanacese), a European Fig. 9. vine, naturalized in the United States, possess combined nar- cotic and diaphoretic properties. The active principle is a 92 MATERIA MEDICA — NARCOTICS. poisonous alkaloid termed solania (C 42 H 87 N0 15 ), which has been found also in Solanum tuberosum, or common potato, and S. nigrum, or black nightshade. In the dog 4J grs. of this alka- loid have produced death, hypodermically given, the symptoms being convulsive respiration, general convulsions and tetanic cramps (Fraas and Martin). Effects and Uses. — In small doses the most obvious effects of bittersweet are an increase in the secretion from the skin and mucous surfaces, with some diminution of sensibility. There are recorded cases of its having caused vomiting and cerebral con- gestion. Its action on the pupil is uncertain. In excessive doses it is an acro-narcotic poison. It is principally used in the form of decoction (Si boiled in a pint of water for fifteen minutes, and water enough afterwards added to make the decoction measure a pint),* dose, f§i-ij, in painful cutaneous affections, and also in chronic catarrh, rheumatism, and gout. A fluid extract (of which a f§j represents a §i of the stalks) is officinal. ACIDUM HYDROCYANICUM DILUTUM — DILUTED HYDROCYANIC ACID. Hydrocyanic acid, known also as cyanhydric acid and prussic acid, is derived from a variety of vegetable substances, as the bitter almond, peach kernels and leaves, wild cherry, cherry laurel, etc. It is employed in medicine only in a state of ex- treme dilution ; and the diluted acid is obtained by the action of sulphuric acid and water on potassium ferrocyanide, or, when wanted for immediate use, by the action of muriatic acid and water on silver cyanide. Diluted hydrocyanic acid is a colourless, volatile liquid, with a peculiar odour and a cooling, somewhat irritating taste. It undergoes decomposition if exposed to the light, and should be kept in bottles covered with black paint or paper ; but it is not * This is the usual formula for the decoctions, and is the mode of prepa- ration of all those which are stated to be of the strength of an ounce to a pint of water. DILUTED HYDROCYANIC ACID. 93 a stable preparation. It contains two per cent, of the anhy- drous or concentrated acid. The anhydrous acid (HCy or HNC) is a colourless, feebly acid, transparent, very volatile and decomposable liquid, with a powerful peculiar odour, and a cooling, afterwards burning taste. Both water and alcohol dissolve it readily. It consists of one eq. of cyanogen and one of hydrogen. Its presence in a suspected mixture may be detected by the addition of a solu- tion of silver nitrate, which throws down a white, curdy precipi- tate of silver cyanide, distinguishable by its exhaling the pecul- iar odour of prussic acid on the addition of muriatic acid, and by being wholly soluble in boiling nitric acid (the silver test is the most delicate, when applied to prussic acid in the state of vapour) ; or, by adding to the suspected solution a little liquor potassae, and then a mixed solution of ferrous -and ferric sul- phate, a dirty greenish-blue precipitate is thrown down, which, on the addition of a few drops of pure hydrochloric acid, be- comes Prussian blue ; or (the best liquid test) the hydrocyanic acid may be converted into ammonium sulphocyanide by the addition of ammonium sulphide, and the salt thus formed yields a deep blood-red colour upon the addition of any ferric salt (the sulphur test may be advantageously employed also as a vapour test) ; or, fourthly, by the copper test (which may be also used in the form of vapour) : the liquid is first rendered slightly alkaline by liquor potassse, and, on adding a diluted solution of copper sulphate, a greenish-white precipitate is thrown down. Physiological Effects. — Locally : hydrocyanic acid applied directly to the skin exerts a benumbing influence, and may be absorbed with the aid of friction ; to a mucous membrane or wound it is readily taken up. Nervous system : in small doses it produces no symptoms beyond a calming effect. Full doses cause giddiness, confusion of mind, and muscular feebleness. Whether large doses act on brain, vagus, or peripheral nerves is disputed. The convulsions which it produces are cerebral, for they do not occur in parts cut off from the cord (Wood, H.C.). In the frog, Kolliker finds that the direct application 94 MATERIA MEDICA — NARCOTICS. of hydrocyanic acid paralyzes the motor nerve trunks, and de- stroys the irritability of muscle, and upon the peripheral sensory nerves acts as a paralyzant. Since hydrocyanic acid produces asphyxia most rapidly in the form of vapour, Preyer concludes that it acts directly on the pulmonary ends of the vagi. That it acts directly on the nerve centres is supported by the experiment of Jones (N. Y. Med. Rec), in which the application of the acid to the medulla of an alligator caused quickly collapse of the lung. Circulation : prussic acid in small doses has a sedative action on the heart ; large doses arrest it in diastole. Applied directly to the heart it suspends its movements. Under prussic acid a temporary increase of the arterial pressure, followed by a permanent reduction, has been observed. Respiration : nothing short of 10-15 min. disturbs this act, while this amount renders it laboured and irregular. Large doses destroy life so quickly that the respirations cannot be counted. Prussic acid has no influence on secretion or temperature, save a slight augmenta^ tion of saliva. Elimination is rapid, taking place by the saliva, kidneys, and lungs. Opinions as to the action of prussic acid on the blood are contradictory. During life, under hydrocyanic acid, the venous blood is found to be of an arterial hue ; while in man and mammals, after death all the blood is dark coloured, probably from deficient abstraction of carbon dioxide.- Outside of the economy the addition of hydrocyanic acid to the blood produces a new body, formed from HCy and haemoglobin^ called cyanohsemoglobin (Hoppe-Seyler), which has no ozoniz- ing power, and it seems probable that the formation of this substance, if it takes place during life in the blood, may be one of the main factors in causing death. In a poisonous dose, hydrocyanic acid arrests life with fearful rapidity, and is one of the most energetic poisons known, one or two drops of the pure acid being sufficient to destroy a dog in a few seconds. When not immediately fatal, it produces great and sudden prostration, difficult and spasmodic respiration, dilata- tion and immobility, and sometimes contraction of the pupils, feeble pulse, diminution of temperature in the extremities, rise of temperature in the trunk at first, but afterwards fall of tern- DILUTED HYDROCYANIC ACID. 95 perature, and involuntary evacuations. It acts on both the voluntary and involuntary muscles, decreasing or arresting entirely their property of contractility ; both the sympathetic and cerebro-spinal nervous systems appear to be affected. The best antidotes are inhalations of ammonia or its carbonate, and (if the patient can swallow) alcoholic stimuli are to be employed, and at the same time cold and hot affusions and artificial res- piration are to be also resorted to. The subcutaneous injection of atropia sulphate has been proposed, acting as a physiological antidote, but its rate of diffusion is too slow to be of service. Medicinal Uses. — Hydrocyanic acid is a valuable agent in allaying spasm, pain, and nervous irritability, in a variety of disorders, and is much used to relieve cough, particularly in phthisis pulmonalis, and for its antispasmodic virtues in asthma and whooping-cough. It is, moreover, a most efficacious remedy in gastrodynia and in neuralgic affections of the bowels, and also in chronic vomiting. Topically, it is employed as an ano- dyne in neuralgia, and in various forms of cutaneous disease (f5i to iij to water Oj-Ojss), notably urticaria and prurigo. Dose of the officinal acid, one or two drops, to be repeated and-gradually increased by a drop till some effect is perceptible. When it is taken for a length of time, care should be observed to have the medicine, as renewed, of uniform strength ; and it is best, in using a fresh sample, to return to the minimum dose. Potassii Cyanidum (Potassium Cyanide), KCy, is used as a substitute for hydrocyanic acid, and has the advantage of being a more uniform chemical product, and less liable to undergo decomposition. It is made by heating together potassium ferrocyanide and potassium carbonate, and occurs in white, opaque, amorphous pieces, having a sharp, somewhat alkaline and bitter-almond taste, and an alkaline reaction ; its solution yields the odour of hydrocyanic acid when exposed to the air. It is deliquescent, very soluble in water, and sparingly so in alcohol. Its medicinal and poisonous effects are the same as those of hydrocyanic acid. Dose, gr. J- in half an ounce of distilled water, to be repeated and increased. The addition of 96 MATERIA MEDICA — NARCOTICS. a few drops of some vegetable acid frees the hydrocyanic acid, and the same effect is produced by the acids of the stomach. Lethal effects may be obtained by prolonged contact with the skin. It is also irritant, and will produce an eschar. Oleum Amygdala Amarus (Oil of Bitter Almond) con- tains hydrocyanic acid, and may be used for the same purposes. It is obtained by distillation from the kernel of the fruit of Amygdalus communis, variety Amara (Nat. Ord. Rosaceae), and is of a yellowish colour, with a bitter, acrid, burning taste, and the peculiar odour of the bitter almond, which is different from that of hydrocyanic acid. It is heavier than water, slightly soluble in it, and soluble in alcohol and ether. It contains benzoic aldehyde and hydrocyanic acid, which are de- veloped from a principle termed atnygdalin, and water, under the influence of an albuminous ferment termed emuhin : thus, amygdalin (C 20 H 27 NO n ) + water (2H 2 0) = benzoic aldehyde (C 7 H 5 OH) -f HCN + glucose (2C 6 H 12 6 ). The effects of this oil upon the system are closely analogous to those of hydro- cyanic acid, and its strength is about four times that of the diluted officinal acid. Dose, for internal use, a quarter to half a drop in emulsion ; as an external application, one drop to a fluidounce of menstruum. Bitter Almond Water (aqua amyg- dalae amarae) is used as a vehicle for narcotic medicines. Dose, half a fluidounce. Syrupus Amygdala (Syrup of Almond), made from both the sweet and bitter almonds, is slightly impregnated with the virtues of hydrocyanic acid, and is a pleasant vehicle for cough mixtures. CAMPHORA — CAMPHOR. Camphor is a peculiar concrete volatile oil derived from Camphora officinarum, the Camphor-Laurel (Nat. Ord. Laura- ceae), a large evergreen tree of China, Japan, and the island of Formosa. All parts of the tree are strongly impregnated with camphor, which is obtained from the roots and branches by sublimation. In this state it is known in commerce as CAMPHOR. 9V crude camphor, and consists of dirty-grayish grains adhering in crumbling masses. Japan camphor (called also Dutch cam- phor) has a pinkish colour, and is purer though coarser than the China camphor, but it is not brought to the United States. The crude camphor, as imported from Canton, is not found in the shops until it is purified by resublimation with quicklime, when it is termed refined camphor. This occurs in large hem- ispherical or convex-concave cakes, perforated in the middle. It is solid at ordinary temperatures, soft and somewhat tough, but may be readily powdered by the addition of a few drops of alcohol. It is translucent, has a strong, fragrant odour, and an aromatic, bitter, afterwards cooling taste. It is volatile, highly inflammable, lighter than water, and very slightly soluble in it, but soluble in alcohol, ether, chloroform, oils and acids. Water added to the spirit of camphor precipitates the camphor. A valuable camphor is known in the East, which is found in a concrete state in the cavities and fissures of the trunk of Dryobalanops camphora, a tree of Borneo and Sumatra. The Borneo camphor occurs in small fragments of crystals, which are transparent, brittle, and harder than the laurel camphor. An oil or liquid camphor is also obtained from the dryobala- nops, which is more highly esteemed in Oriental countries than the camphor itself. . Camphor is C 10 H 16 O, and is chemically nearly related to the terpenes (turpentine). Camphor forms substitution compounds w r ith bromine, chlorine, and iodine. When heated, it yields an oil called oil of camphor. By passing hydrochloric acid into oil of turpentine, a substance is obtained called artificial cam- phor. Camphor heated with zinc chloride yields cymol (C 10 H 14 ), and with nitric acid, camphoric aczV2(C 10 H 16 O 4 ) and camphor onic acid (C 9 H 12 5 ), the last two being oxidation products of camphor. Physiological Effects. — The topical action of camphor is irritant. After its absorption, its effects, in small doses, are moderately stimulant, exhilarant, and anodyne. In large doses, it causes considerable disorder of the cerebrospinal system, depression of the circulation, and diaphoresis ; and in 7 98 MATERIA MEDICA — NARCOTICS. excessive quantity it acts as a narcotico-irritant, occasioning burning heat in the stomach, violent cerebral convulsions, and maniacal delirium. There are no cases of death from camphor in healthy adults. It is also, in full doses, anaphrodisiac. Camphor is eliminated by the breath, skin, and urine. In cases of poisoning, after evacuating the stomach, opium, wine, etc., are to be administered. Medicinal Uses. — From its combined antispasmodic and diaphoretic powers, camphor is a valuable remedy in the treat- ment of dysentery, and is much employed in this disease, either in combination with opium or as a substitute for the latter. In the early stages of cholera, and in flatulent diarrhoea, it is also greatly prescribed. As a diaphoretic stimulant and anti- spasmodic, it is useful in the low stages of typhoid and typhus fevers, and in typhoid conditions of the system generally. In many forms of mental disorder it calms irritability, relieves despondency, and induces sleep. And it has no superior among the anodynes in allaying irritation or pain of the genito-urinary organs, as in dysmenorrhoea, uterine after- pains, strangury, and nymphomania. In chordee large doses are required — grs. 10 to 20. From its anodyne and sudorific properties, it is also applicable to the treatment of chronic rheumatism and gout. Externally, camphor is employed as an anodyne in rheumatism, and as a discutient in chronic inflam- matory affections. Powdered camphor, sniffed into the nostrils, is a good remedy in coryza and influenza. Administration. — The medium dose in substance is gr. v to gr. x ; but it may vary from gr. j to 3j. It is best given in emulsion, made by rubbing up the camphor with loaf sugar, gum arabic, myrrh, and water. The form of pill is objection- able, from the difficulty with which it is dissolved in the gastric liquors. Aqua Camphors (Camphor Water). Dose, f§j (containing about gr. iij) to f§ij or iij. The spirit is used chiefly as an embrocation, but it may be given internally, where the action of the alcohol- is not objectionable, in the dose of gtt. v to foj. Linimentum Camphors (Liniment of Camphor) consists ETHEREAL ANESTHETICS. 99 of camphor (1 part) dissolved in olive oil (4 parts) : a mild embrocation. Ceratum Camphors: is also officinal. Linlmentum Saponis [Soap Liniment) is made by digest- ing soap and camphor with oil of rosemary in alcohol and water. It is a yellow oleaginous liquid, and is used as an anodyne and gently rubefacient application in gouty and rheumatic pains, sprains, bruises, etc. Oleum Camphorje (Oil of Camphor), the volatile oil ob- tained from Camphora officinarum, is a light reddish-brown fluid, with the odour and taste of camphor. It has medicinal properties similar to those of camphor, but is more stimulant, and therefore especially adapted to affections of the stomach and bowels. Dose 2 or 3 drops. It is used also externally. A substance termed Monobromated Camphor is prepared by letting fall a stream of bromine upon powdered camphor till the latter is liquefied, then boiling the mixture in a water bath, and afterwards dissolving in alcohol and crystallizing. It oc- curs in long colourless, acicular crystals (C 10 H 15 OBr), having an odour of camphor and turpentine and a slightly bitter taste, insoluble in water, but soluble in alcohol, fixed and volatile oils, ether, carbon bisulphide, and chloroform. It is a substitution compound, one atom of bromine taking the place of one atom of hydrogen in ordinary camphor. It has been used in de- lirium tremens and hysterical and convulsive affections ; dose for an adult, 5 grains, repeated. ORDER II. — ETHEREAL ANESTHETICS. The term Anaesthetics (from a, non, and alaO^a^, sensation), properly speaking, includes all agents which diminish sensibil- ity and relieve pain. It has, however, been used to denominate a class of ethereal remedies which are applied by inhalation, and produce such a condition of temporary insensibility as to prevent pain during surgical operations and parturition. The vapours usually employed to produce anaesthesia are those of ether and chloroform. Many otner substances have, however, lately been introduced as anaesthetics. 100 MATERIA MEDICA — ANESTHETICS. ETHER ETHER. Ether is prepared by the distillation of alcohol and sulphuric acid, and is afterwards rectified by redistillation with solution of potassa. For inhalation, however, it is further purified by being shaken with water, by which it is freed from alcohol, and this, as well as acid contaminations, are afterwards removed by the agency of calcium chloride and freshly calcined lime. Thus purified, it.is designated as ^Ether Fortior — Stronger Ether. Although commonly termed sulphuric ether, in allusion to the sulphuric acid used in its preparation, yet ether contains no sulphuric acid. By the action of the acid upon alcohol, ether is formed by the substitution of ethyl (C 2 H 5 ) for one atom of hydrogen in alcohol (C 2 H 5 HO). Chemically, ether is ethyl oxide, (C 2 H 5 ) 2 0. Ether is a transparent, inflammable, colourless liquid, with a strong, fragrant odour and a hot, pungent taste. It wholly evaporates in the air, so rapidly as to cause a considerable degree of cold ; combines with alcohol and chloroform in every proportion, and dissolves in ten times its volume of water. The sp. gr. of pure ether is 0*713, of stronger ether, 0*728, of ordinary officinal ether, 0*750. The boiling point of stronger ether is about 98° F. Effects and Uses when sivalloived. — When taken into the stomach, ether produces a primary stimulant and secondary narcotic effect, the stage of excitement being, however, very transient. Before the narcotic effects set in, the heart's beats are increased, the face is flushed, and the skin becomes moist. It has long been employed as an antispasmodic and anodyne remedy in asthma, angina pectoris, hysteria, cramp of the stomach and bowels, spasm of the gall- ducts, etc.; and, from its combined stimulant and antispasmodic virtues, it has been found useful in the latter stages of typhus, attended by sub- sultus tendinum, etc. As a topical anodyne, ether is a very good application in nervous headache and earache ; applied by means of an atomizer, it causes local anaesthesia ; it has been ETHER. 101 also applied with advantage in aphthae, stomatitis, diphtheria, and other affections of the mouth and throat ; and, from its refrigerant effects, it has been used in the reduction of stran- gulated hernia, and as a cooling lotion in cerebral affections. If evaporation be repressed, when it is applied locally it acts as a rubefacient, and may be. employed for counter-irritation. Dose, f5ss to f5j, to be increased when habitually used. It may be incorporated with water by rubbing it up with sperm- aceti, in the proportion of two grains to a nuidrachm of ether, or it may be given in capsules of sugared gum. Effects and Uses when inhaled. — The first effects of the in- halation of ether are a sense of strangulation and cough, from its local irritant action. "When the vapour is absorbed into the system through the pulmonary surface, the nervous functions are successively and progressively affected. The mental fac- ulties and volition become first impaired; insensibility and unconsciousness rapidly supervene, during which susceptibility to pain is lost, and the patient lies in a trance-like sleep, resem- bling death. This condition is often preceded by one of excite- ment, during which patients sometimes weep, laugh, moan, sing, rave, or present pugnacious manifestations. In the beginning of etherization, the circulation is accelerated, but it is after- wards depressed. The period of full ether-narcosis lasts from five to ten minutes, and the patient ordinarily recovers without serious inconvenience, although headache, nausea, drowsiness, and languor sometimes ensue for a few hours. Occasionally, congestion of the brain or lungs, cataleptic rigidity with pro- longed insensibility, and, in females, hysterical phenomena, ensue after etherization ; but these effects are uncommon, and it is believed that death has never followed the use of ether, when care has been taken to admit atmospheric air into the lungs along with the ether. During the stage of insensibility, convulsive twitches or muscular rigidity are occasionally no- ticed ; the breathing is sometimes stertorous ; the iris becomes fixed ; the pupils are dilated ; the eyeballs are upturned ; and the orbicularis palpebrarum does not contract when touched. Insensibility to pain in some cases takes place before uncon- 102 MATERIA MEDICA — ANESTHETICS. sciousness ; and when patients are recovering from the latter state, the mental faculties are often completely restored, while insensibility to pain continues. A brief period of anaesthesia, lasting less than a minute, has been noticed to occur before complete insensibility, which may be taken advantage of for short operations. When ether-narcosis is fully established, the functions of the nerve centres are involved in the following order, viz., the cerebrum, the sensory centres of the cord, the motor centres of the cord, the sensory centres of the medulla oblongata, and lastly the motor centres of the medulla oblong- ata. The functions which continue to act are those presiding over circulation and respiration. Since the year 1846, the inhalation of ether, first resorted to in our own country, has been practiced very generally in all parts of the world, with the greatest success, for the prevention of pain in surgical operations ; and its use has been also extended with the happiest results to the relief of pain in labour. It should not be exhibited where disease of the heart or brain, or serious obstruction of the lungs, exists, or when from any cause there is unusual tendency to syncope, and precaution should be taken to guard against asphyxia ; but when adminis- tered with proper care and discrimination, it is attended with little or no danger or unpleasant results of any kind. The quantity of ether necessary to effect etherization is about two ounces ; and it may be conveniently applied by means of a cone of stiff paper, shaped so that its base will fit over the nose and mouth of the patient, and into which a nap- kin or small towel, or hollowed-out sponge, is placed ; the sponge should be first soaked in warm water, squeezed dry, and satu- rated with pure ether. It is then applied to the mouth and nostrils, the mouth being permitted occasionally to receive atmospheric air ; and, if irritability of the air-passages occur, this is to be gradually overcome. From three to five minutes are required to produce anaesthezation, and its occurrence is known by the closure of the eyelids (if they have been previ- ously open), failure to respond to questfons, and muscular m CHLOROFORM. 103 relaxation. The sponge is then to be removed, and may be reapplied from time to time if necessary. Etherization is less apt to produce nausea if practiced upon an empty stomach, and the administration of a little brandy and laudanum promotes its action. Etherization has been also resorted to in a variety of morbid conditions in which the administration of narcotics and anti- spasmodics has been found useful. It exerts a powerful control over the violent types of spasmodic disease, and has been pre- scribed with the greatest advantage in hysteria, tetanus, poison- ing from strychnia, asthma, chorea, convulsions, puerperal eclampsia, whooping-cough, dysmenorrhoea, and almost every description of spasm ; and as a relaxant in the diagnosis and reduction of dislocations. Local anaesthesia and congelation may be produced through the agency of the ether spray applied to a part by the atomizer. (See p. 48.) CHLOROFORMUM — CHLOROFORM. Chloroform is usually obtained from the distillation of alco- hol with chlorinated lime, and for medicinal use, Commercial Chloroform [Qliloroformum. Venale) is puri- fied by agitation with one-fifth of its weight of sulphuric acid, which destroys the contamination of chlorinated pyrogenous oil; and the sulphurous acid formed and the water present are after- wards removed by means of a watery solution of sodium car- bonate and of stronger alcohol and lime. The purest chloro- form for internal use is now made from chloral hydrate. Purified Chloroform (Qliloroformum Purificatwii) is a colourless, volatile liquid, of a bland, ethereal odour and a hot, aromatic, saccharine taste. It is not inflammable, is slightly soluble in water, and freely soluble in alcohol and ether. It has extensive solvent powers, dissolving camphor, the fixed and volatile oils, most resins and fats, iodine, bromine, the organic alkalies, etc. The purest chloroform has a sp. gr. of 1*5022. Officinal chloroform has a sp. gr. of 1*480, when it contains a little alcohol; and as usually found its sp. gr. is about 1*475, 101 MATERIA MEDICA — ANESTHETICS. when it contains more alcohol, and is less apt to become acid. The boiling point of pure chloroform is 142° F. It is chemi- cally classed with the triatomic haloid ethers, and is methenyl chloride, (CHC1 3 ). Chloroform is sometimes contaminated with chlorinated pyrogenous oil (a very injurious impurity) ; this may be detected and removed by strong sulphuric acid, which gives the chloroform a colour varying from yellowish to reddish- brown, according to the amount of impurity. The most deli- cate test for the presence of alcohol is the binitro-sulphuret of iron, which, when agitated with chloroform, will produce a brown tint if alcohol be present. Physiological Effects. — The effects of chloroform on the sys- tem are analogous to those of ether, but much more rapid and powerful. When inhaled, in the dose of a fluidrachm or more, it rapidly induces anaesthetic sleep, with great relaxation of the muscles, and the most complete insensibility to painful agents. The period at which insensibility occurs varies from fifteen seconds to two minutes ; and it continues usually between five and ten minutes, and may be prolonged considerably by re- newals of the inhalation. The patient usually recovers without recollection of what has occurred during the state of insensi- bility, and with few or no uncomfortable sequelae. Sensibility to pain is often very much obliterated even before consciousness is lost. The administration of chloroform has in some cases been at- tended with fatal syncope, due to heart-paralysis. This has ordinarily occurred with such rapidity as to render remedial interference unavailable ; but at the slightest approach of symptoms of the kind, the patient should be placed in a re- cumbent position, cold affusions should be applied, and, above all, artificial respiration, together with electro-magnetism, should be resorted to. Topically applied, and when its evaporation is prevented, chloroform acts as an irritant, and soon vesicates the skin — powerfully diminishing painful impressions during its applica- tion. Medicinal Uses. — Chloroform is prescribed by the stomach CHLOROFORM. 105 as an anodyne and antispasmodic, in all cases to which ether is applicable, and has the advantage of a more agreeable taste. It has been found particularly useful to relieve the pain and vomiting of cancer of the stomach, and also in colic and cholera. It has been also extolled as an antiperiodic in the treatment of inter- mittent fevers. Externally it is used as a topical anodyne, and also as a stimulating application to foul and indolent ulcers, and occasionally for its constitutional effects. The editor has used the deep injection of chloroform, gr. x-xx, in sciatica with good results, the injection being made over the nerve. Dose, from TT[xv to f5ss, in sweetened water or mucilage ; to be repeated. As an anti-neuralgic liniment, f5j to f§ij of camphor liniment ; or as a rubefacient and anodyne, undiluted, on linen, covered with oiled silk to 'prevent evaporation. As a wash or gargle, foj or ij to water Oj. The introduction of chloroform as an anaesthetic took place shortly after that of ether ; and from its greater intensity of action, its freedom from irritating effect on the bronchial mu- cous membrane, its more agreeable odour, and its non-inflam- mability, it has been extensively used, particularly in Great Britain, to the exclusion of ether. A very considerable num- ber of fatal cases have, however, occurred from the inhalation of this agent, where its administration did not appear in any way counter-indicated ; and it cannot be considered a perfectly safe remedy. It is employed as an anaesthetic, anodyne, and antispasmodic, to fulfil the indications to which ether is appli- cable ; but, except in cases where the inflammability of ether makes it objectionable, chloroform should be avoided. It is also used hypodermically. The dose for inhalation is a fluidrachm, to be repeated in two minutes if anaesthesia be not produced ; and its effects may be renewed from time to time without injury. It may be applied on a handkerchief, held near the nose or mouth, care being taken to allow a proper admixture of atmospheric air. A solution of chloroform in ether has been used in the United States, but, from the unequal volatilization of the two liquids, it must be difficult to modify their effects by combination. 106 MATERIA MEDICA — ANAESTHETICS. Spiritus Chloroformi {Spirit of Chloroform) is a solution of chloroform in diluted alcohol ; a convenient form for inter- nal exhibition. Dose, f5j. Linimentum Chloroformi [Liniment of Chloroform) is made by mixing 3 parts of chloroform with 4 parts of olive oil. Mistura Chloroformi [Mixture of Chloroform) is made by mixing chloroform, in which camphor is dissolved, with 5vi of water, by the intervention of the yolk of an egg. Dose, fgss-fgj.* Since the discovery of the anaesthetic properties of ether and chloioform, many other substances have been employed for the purpose of anaesthesia. Of these may be mentioned — I. Rhigolene, a petroleum naphtha obtained by the dis- tillation of petroleum. If is the lightest of all known liquids, having a sp. gr. 0*625, is highly volatile and inflammable, boils at 70° F., and in its composition is a hydrocarbon, containing no oxygen. It is nearly odourless, and has been employed to produce local anaesthesia through the agency of the atomizer, and is the most convenient, most rapid, and most easily con- trolled freezing liquid that can be used. Its name is derived from piyoQ, extreme cold. II. Methylene Bichloride. — This liquid (known also as dichloromethane) is most easily procured by the action of nascent hydrogen (developed from zinc, water, and sulphuric acid) upon chloroform. Its composition is CH 2 C1 2 . It is a colourless fluid, having a pleasant ethereal odour like that of chloroform, boils at 88° F., has sp. gr. 1*34, and mixes with ether and chloroform in all proportions. The vapour of meth- ylene bichloride is pronounced by Mr. Spencer Wells to be the * Under the name of chlorodyne, a combination containing chloroform is much used, for which the following is a formula: Muriate of morphia, 8 grains ; oil of peppermint, 16 minims ; stronger ether, a fluidounce ; extract of liquorice, 1\ troyounces ; pure chloroform, stronger alcohol, and molas- ses, each, 4 fluidounces ; diluted hydrocyanic acid, 2 fluidounces ; syrup, Yl\ fluidounces : dissolve the morphia and oil in the alcohol, and add the chloroform and ether, mix the liquorice, syrup and molasses, shake the two mixtures, and add the hydrocyanic acid ; dose, 5 to 10 minims, the vial to be well shaken. COMPOUNDS OF AMYL. 107 best known anaesthetic. Given properly diluted with air, in his hands (in an experience of more than a thousand cases) it has proved of uniform certainty and rapidity of effect, and free from any dangerous symptoms. It is used in about the same dose as chloroform, but has not been much employed in the United States. III. Methylic Ether, made by digesting methylic alcohol with strong sulphuric acid, is a gaseous substance, lately em- ployed. Under the name of methyl- ethylie ether, it has been used, dissolved in ethylie ether, and is said to produce rapid anaesthesia, without spasm, syncope, or asphyxia, during inhala- tion, or subsequent nausea One or two drachms may be intro- duced into a bag inhaler, and the gas is volatilized by means of a hand bellows. IV. Compounds of Amyl. — Various compounds of amyl (C 5 H n ), products derivable from the oxidation of starchy mat- ter, have been proposed as anaesthetics. Amylic alcohol, or fusel oil (amyl hydrate, C 5 H n HO), is one of the products of the alcoholic fermentation. It is a colourless, oily liquid, of a strong, offensive odour and an acrid, burning taste. When inhaled by animals, it has been found to produce muscular paralysis and convulsions. Recently amyl nitrite has come into use as a -therapeutic agent. Amyl nitrite is prepared by heating one part of strong nitric acid with two parts of recti- fied fusel oil until reaction just commences, when the fire is withdrawn. After the violent reaction has subsided, heat is again carefully applied. The distillate obtained below 212° F. is. rectified over potassium carbonate, with the precaution to col- lect only that portion distilling between 202° and 206° F. It is an amber-coloured, volatile, inflammable liquid, of sp. gr. 0*913, boiling at 182° F., with an odour and taste like that of ripe pears. Its composition is C 5 Ii n N0 2 . It is not a true anaesthetic, as it does not destroy consciousness unless a con- dition approaching death is produced. Effects and Uses. — The following effects are caused by the inhalation of amyl nitrite : flushing of the head, face, and oppression of the head, with vertigo, excited cardiac action. 108 MATERIA MEDICA — ANESTHETICS. diminished blood pressure, marked dilatation of the arterial system, due to paresis of their muscular walls, lowering of tem- perature, retarded respiratory movements, which tend to become slower as the administration is pushed, and eventually are ex- tinguished from a paralyzing influence on the respiratory centre ; at the same time there is complete motor paralysis. The violent action of the heart, it has been proved, is due to depression of the cardiac inhibitory nerves. On the reflex function and spinal mo- tor centres, amyl nitrite acts as a powerful paralyzer. It also lessens the functional activity of the muscles and nerves (H. C. Wood). Dilatation of the vessels of the retina has been ob- served by the ophthalmoscope. Amyl nitrite has the property of diminishing the oxidizing function of the red corpuscles, uniting with them to form a new compound, nitrite oxyhaemo- globin, and obtained as such by the investigator, Gamgee. Diabetic urine has been noticed in the rabbit under hypodermic injection of amyl nitrite. It has been employed to rouse the system in cases of syncope and prostration, as an antidote in chloroform-poisoning, and has been also found efficacious in re- lieving the pain of angina pectoris, in asthma, eclampsia partu- rientium, and many other convulsive diseases. The inhalation of the vapour of the nitrite has been found efficacious in arresting epileptic spasm, when its approach is indicated by the aura epileptica ; and also in tetanus, nausea marina, and strych- nia-poisoning. Dose, 5 to 10 drops; this amount may be in- haled dropped on a piece of cotton, or from a small open vial introduced into the nostril. Y. Carbon Tetrachloride (CC1 4 ). This liquid, when in- haled by man, produces loss of consciousness and anaesthesia, with great debility of the heart. On account of its deleterious influence upon the circulation it is not a safe anaesthetic agent. VI. Nitrous Oxide Gas was the substance by which an- aesthesia was in the first instance produced, in the hands of Mr. Horace Wells, a dentist of Hartford, Connecticut. It is made by the decomposition "of ammonium nitrate by heat. Its composition is N 2 0. It is a colourless, respirable gas, absorbable by water, and the solution, like the gas itself, has a ANTISPASMODICS. 109 faint, agreeable odour and sweet taste. This gas is both a pleasant and efficient anaesthetic, more rapid and at the same time more transitory in its action than either ether or chlor- oform, and free from disagreeable or serious consequences. During unconsciousness it causes considerable mental excite- ment, shown in various ways, as laughing, crying, etc., and lividity of the face. It is well adapted to employment in the extraction of teeth, or in short minor surgical operations, but its effects are too transient for the anaesthesia required in protracted operations. The amount necessary to produce an- aesthesia (one or two gallons), as well as the complicated apparatus required for its administration, constitute also an objection to its general use. It is best administered from an India-rubber bag, containing about eight gallons of the gas, furnished with a mouth-piece with two valves, one of which is designed for the throwing out of the respired gas. Water, im- pregnated with about five times its volume of nitrous oxide, has been used internally as a stimulant, in the dose of half a pint to a pint and a half during the course of the day. In experiments upon dogs, nitrous oxide water injected into the bowels has been found to act as a physiological antidote in cases of poisoning from chloroform, carbonic acid, hydrocyanic acid, and other agents. ORDER III. — ANTISPASMODICS. Antispasmodics are medicines that allay irregular nervous action. Their effects upon the economy in a state of health are not very decided, and are limited to a slight stimulation of the circulation and exhilaration of the mental faculties. Their influence is, however, strikingly shown in certain deranged conditions of the nervous system, particularly in those forms of spasm which depend upon idiopathic or primary nervous disorder, and are known under the designation of hysteria. They are also useful in many Varieties of mental disturbance, as wakefulness, hypochondriasis, and even insanity, and are often preferable to narcotics in the treatment of these cases, 110 MATERIA MEDICA — ANTISPASMODICS. from their comparative freedom of action on the brain. They are all distinguished by a powerful odour. ASAF03TIDA — ASAFETIDA. Asafetida is a gum-resinous exudation obtained from the root of Narthex asafoetida (Wat. Ord. Umbelliferse), and is derived from Southern Persia and Afghanistan. The plant has a long tapering root, the size of a man's leg, and an erect stem, from six to nine feet in height, rising from the midst of the leaves. It is thought by some botanists that the plant, from which Persian asafetida is obtained is Scorodosma foeti- dum. The drug is obtained from incisions made into the root, or by taking successive slices of it. The exuded juice is scraped off, hardened in the sun, and afterwards packed for exportation. It occurs in masses of varying size, consistence, and colour, but is usually whitish, intermixed with darker spots, and becomes reddish, and finally brown, by exposure to the air. It is some- times soft and adhesive, at other times hard and brittle, and is not readily pow T dered except at a low temperature. It breaks with a waxy lustre, and the best samples appear to be composed of irregularly-shaped tears. Its taste is unpleasant, bitter, and acrid ; its odour powerful, alliaceous, and fetid. Asafetida is a gum-resin united to an alliaceous volatile oil. The gum is dissolved by water, and the mucilage thus formed suspends the resin and volatile oil. The resin and volatile oil are soluble in alcohol ; but the tincture becomes milky on the addition of water, owing to the separation of the resin. The resin contains ferulaic acid (C 10 H 10 O 4 ) and umbelliferone (C 9 H 6 3 ). Physiological Effects. — Asafetida, when taken into the stomach, produces a local stimulant and carminative effect. After absorption, it proves a moderate excitant and exhilarant, and exerts a marked influence upon morbid conditions of the nervous system. Large doses Cause nausea and vomiting. It also stimulates the mucous secretions generally, and increases the peristaltic action of the bowels, inducing soft, offensive GALBANUM. Ill stools. Its volatile oil is absorbed, and the odorous principle is recognized in the secretions, especially in the perspiration. Medicinal Uses. — No medicine is more highly esteemed as a direct antispasmodic than asafetida. It is much resorted to in the various forms of hysteria, and is particularly valuable in relieving the mental depression which constitutes one of the protean types of this disorder. In other spasmodic diseases, as chorea, asthma, whooping-cough, etc., it is a favorite remedy with many practitioners ; and, from its combined expectorant and antispasmodic properties, it is particularly adapted to spas- modic pectoral affections. In certain diseases of the abdominal viscera, as flatulent colic and costiveness, asafetida is often useful as an antispasmodic and laxative enema. It is also pre- scribed as a stimulating emmenagogue when the uterine disor- der is attended with a disturbance of the nervous functions. Notwithstanding its disagreeable odour, this drug is largely used as a condiment in Asia; and even in the refined cookery of Europe its flavour is admired. Many persons take it habit- ually for its exhilarant effects ; and, when used as a medicine, it generally becomes acceptable. Administration. — Dose, gr. v to 3j, in pill. It is most fre- quently given in the form of mixture (mistura asafoetidte, — oij to water Oss) — dose, f §ss to f 5j, repeated, or as an enema, fgij to f 5iv. The mixture, from its whiteness and opacity, is sometimes called lac asafcetidce, or milk of asafetida. Pills of asafetida are officinal, each pill containing 3 grains of the gum-resin. The tincture (§iv to alcohol Oij — dose foj) is a good preparation, where the alcohol is not objectionable. A plaster is used externally in whooping-cough and catarrh ; it contains galbanum. Suppositories of asafetida are made by mixing with the tincture oil of theobroma. GALBANUM. Galbanum is a gum-resin obtained from Ferula galbaniflua and other species of Ferula {Nat. Ord. Umbelliferse), which grows in Persia. It is met with in the form of tears, or more 112 MATERIA MEDICA — ANTISPASMODICS. commonly in lumps, of a brownish colour, and has a peculiar balsamic odour and a hot, bitter, acrid taste. It is a gum- resin united to a volatile oil. From the resin are obtained umbelliferone and resorein. Its effects are similar to those of asafetida, but less active ; and it is chiefly employed externally, for its rubefacient properties, as a stimulant. The compound pills of galbanum are used as antispasmodic and emmenagogue ; they contain galbanum, myrrh, and asafetida, with a little syrup — dose, 3 to 5 pills. Galbanum forms the basis of the compound galbanum plaster, which contains galbanum, turpen- tine, Burgundy pitch, and lead plaster. AMMONIACUM — AMMONIAC. This is a spontaneous gum-resinous exudation obtained from Dorema ammoniacum [Nat. Ord. Umbelliferae), a plant of Persia. It comes in tears or lumps, of an irregular shape, yellowish on the outside, whitish within, is moderately hard and brittle, and has an unpleasant, bitter, and rather acrid taste, with a peculiar smell, somewhat like that of galbanum. It is a gum-resin, with a little volatile oil, the latter free from sulphur. Resorein, but no umbelliferone, is obtained from the resin. Its effects are similar to those of asafetida ; but it is seldom used except as an antispasmodic expectorant in chronic catarrh. Dose, gr. x to xxx. A mixture and plaster are officinal. The mixture has the same formula as mixture of asafetida; the plaster is made with ammoniac and acetic acid. A plaster of ammoniac with mercury is also officinal. VALERIANA — VALERIAN. Valeriana officinalis, or Wild Valerian (JSfat. Ord. Valerian- acese), is a perennial European plant, growing to the height of three or four feet. The root is the portion used, and consists of numerous long, slender, cylindrical fibres, attached to a rough, yellowish-brown, tuberculated head. When powdered, VALERIAN. 113 it is yellowish-gray. It lias a peculiar, powerful odour, of which cats are fond, and a bitterish, sub-acrid, aromatic taste. Water and alcohol extract its virtues, which' depend on the presence of a volatile oil, from which a colourless volatile acid, called valerianic, may be separated. This is generated in the oil by exposure. Effects and Uses. — The effect of valerian on the nervous system is not constant, for it is sometimes excitant and again calming. Tl'e hypodermic injection of valerian oil reduces the reflex excitability of the spinal cord, and antagonizes in frogs the tetanic spasms of strychnia. In medicinal doses, valerian improves digestion and appetite. Large doses occasion eruc- tations, colic and diarrhoea, excitement of the circulation, dia- phoresis, and increased urinary flow. It is much used as a nervous excitant and antispasmodic in the various forms of hysteria, and occasionally, also, in epilepsy, chorea, hemicrania, hypochondriasis, delirium tremens, etc. Dose of the powder, from 5ss to 5jss, three or four times a day ; of the infusion (oss to Oj of water), f §j to ij ; of the tincture (f§iv to diluted alcohol Oij), f 5j ; of the ammoniated tincture (f 5iv to aromatic spirit of ammonia Oij— an excellent preparation), f 5j to ij ; of the fluid extract, f 5j ; of the ex- tract (alcoholic), gr. x to xxx ; of the oil, 4 or 5 drops. Acidum Valerianicum (Valerianic Acid), (HC 5 H 9 2 ), which is found in valerian root, is usually prepared artificially by the action of bichromate of potassium and sulphuric acid upon amylic alcohol, and occurs as an oily, colourless liquid, of a caustic taste and strong odour, resembling, but different from, that of valerian. It is used for the manufacture of Ammonii Valerianas ( Valerianate of Ammonium). — This salt, made by combining valerianic acid with ammonia, occurs in snow-white quadrangular plates, of an offensive odour like that of valerianic acid, and a sharp, sweetish taste. It deli- quesces in a moist air, effloresces in a dry one, and is very soluble in both water and alcohol. Potassa and the mineral acids decompose it. It is much employed in neuralgia, nerv- ous headache, hysteria, chorea, epilepsy, etc. Dose, gr. ij-viij, 8 114 MATERIA MEDICA — ANTISPASMODICS. given in coated pills ; or an elixir, prepared with aromatics,* may be used. CYPRIPEDIUM. The root of Cypripedium pubescens and of Cypripedium parviflorum (Nat. Ord. Orchidaceag), common indigenous plants, known under the names of ladies' slipper and moccasin plant, are recognized by the U. S. Pharmacopoeia. The dried root is several inches long, bent, with a small knotted, dark head, and numerous fibres of yellowish-brown colour. It contains a volatile oil, volatile acid, and resin, and has been used as a substitute for valerian. Dose of the powdered root, gr. xv, three times a day. An infusion and tincture are also used ; by precipitating the tincture with water, an oleoresin is obtained, of which the dose is half a grain to three grains. SCUTELLARIA — SKULLCAP. The herb of Scutellaria lateriflora (Nat. Ord. Labiatse), an indigenous perennial herb, found in moist localities, growing to the height of one or two feet, is considered by many American practitioners to possess valuable antispasmodic qualities. An infusion (Sij to boiling water Oj) may be taken ad libitum ; and a fluid extract is also used. S. pilosoa and integrifolia have a more bitter taste, and have been used as tonics. DRACONTIUM — SKUNK-CABBAGE. Dracontium foetidum, Ictodes foetidus, Symplocarpus foetidus, or Skunk-Cabbage (Nat. Ord. Aracese), is an indigenous plant, growing in moist situations. The fresh root has a strong, fetid odour and an acrid taste. It contains fat, resin, gum, etc.; the acrid principle has not been isolated. It is stimulant, anti- spasmodic, and narcotic, and is employed in hysteria, asthma, chorea, chronic catarrh, etc. Dose, gr. x to xx, gradually in- creased. It is also given in the form of infusion. The leaves * Take of valerianate of ammonium, gi ; fluid extract of ranilla, f^ss ; cd. tinct. of cardamom, f^vi ; curacoa, fgij ; water, f^iv; mix. Dose, a teaspoonful three times a day. COFFEE. 115 are used in the country to keep up the discharge from blistered surfaces, and to stimulate indolent ulcers. The following vegetable substances, used as articles of diet, may be ranked also with antispasmodics : I. Thea — Tea, the dried leaves of Thea sinensis {Nat. Ord. Ternstromiacese), an evergreen shrub of China and Japan, whence the markets of the world are supplied. The most im- portant constituents of tea are essential oil (upon which the flavour depends), tannic acid, an alkaloid termed theina, and boheic acid. II. Caffea — -Coffee, the seed of Coffea Arabica (Nat. Ord. Rubiacese), a small tree which is a native of southern Arabia and Abyssinia, and is cultivated in various tropical and semi-tropical countries. Coffee contains an alkaloid, caff etna (C 8 H 10 N 4 O 2 ), methy-theobromine, which is identical with theina, and two peculiar principles, one resembling tannin, termed caffeo-tannic acid, and the other termed caffeic acid. The volatile oil, upon which the flavour depends, is developed by roasting. Coffee may be used for the general indications of antipasmodics, and is, besides, especially efficacious in relieving the sopor produced by opium-poisoning. Both tea and coffee lessen the urea in the urine. Coffee is relaxing, while tea is as- tringent, since it contains tannin. Caffeina (gr. J-iij) produces decided cerebral effects, as excitement, wakefulness, and halluci- nation, and, when exhaustion sets in, sopor. It increases the number of the heart's beats, raises the arterial pressure, followed by feeble action and diminished blood pressure. In frogs the motor and probably the sensory nerves are not affected by it. In- jected into dogs and cats, it produces tetanus (Aubert). Applied to a cut-out muscle it causes rigidity (coagulates the myosin) and abolishes the electrical contractility. Caffeina elevates and then lowers the animal temperature, and has decided diu- retic powers (Gubler). Grains 8 to 12, in man, have caused decided, cerebral effects, but no deaths have followed its use. Caffeina has been used as a cerebral stimulant in nervous head- ache (gr. j-ij), in cardiac dropsy (gr. v), and to antagonize 116 MATERIA MEDICA — ANTISPASMODICS. morphia narcotism. Caffeina citrate is the salt most in use. Caffeina valerianate is useful in hysterical vomiting, in the dose of 1 to 2 grains repeated. III. Theobroma — Chocolate (noticed more at length under the head of demulcents — see Oil of Theobroma) — contains a nitrogenous principle, theobromia, nearly identical in composi- tion with caffeina (C 7 H 8 N 4 2 ). IV. Erythroxylon Coca — Coca or Cuca (Nat. Ord. Erythroxylaceae). — The leaves of this plant have long been used as a masticatory by the Indians in Peru for the purpose of enabling them to undergo fatigue, hunger, and thirst. An alkaloid termed eoeaiana (C 17 H 21 N0 4 ) has been found in cocoa, also coeatannic acid. The most interesting effects of coca in man are, cerebral stimulation, lessening of the feeling of fa- tigue, the ability to remain for a long time without food, in- creased cardiac action and elevation of temperature. Coca lessens the excretion of urea, and is eliminated by the kidneys. Large doses cause muscular weakness, drowsiness and tinnitus aurium (Ott). Coca has been but little used in medicine, though its use is indicated in diseases requiring the checking of tissue waste, as phthisis. The fluid extract is the best preparation ; dose, f5ss-ij. V. Paullinia — Guarana. — This occurs in chocolate-col- ored cylinders, which are worked up from the fruit of Paullina sorbilis (Nat. Ord. Sapindacese), a plant of Brazil, where it is used to make a common and highly-esteemed beverage. It contains more caffeina than any other vegetable substance, and also a variety of tannic acid. It is recommended medicinally, as a tonic, astringent, and antispasmodic, and has been found especially useful in sick headache ; dose, one or two drachms, or an alcoholic extract may be given in doses of ten or twenty grains. A tincture and fluid extract can be used. VI. Mate. — Under this name the dried leaves of Ilex Paraguaiensis, a shrub of Paraguay, are extensively used in preparing a beverage throughout that region of country. Paraguay tea, as it is termed, has a balsamic odour and bitter taste, and contains a principle identical with caffeina and theina, and also tannic acid. MUSK. 117 MOSCHUS — MUSK. Class, Mammalia; Order, Ruminantia. Musk is a peculiar concrete secretion" obtained from Mos- chus moschiferus, the Musk Deer, an animal rather larger than the goat, and resembling the deer in its characters, which in- habits the mountainous portions of central Asia. The musk bag is found only in the male, and lies between the umbilicus and prepuce. It is an oval pod, about two and a half inches long and one and a half broad, flat on one side and convex and hairy on the other, and in a full-grown animal contains from 5jss to 5vj of a liquid secretion, which, when dried, is musk. Two kinds are known in commerce, the China and the Russia musk, the former of which is much the stronger. Musk occurs in grains or lumps concreted together, of a red- dish-brown colour, and has usually some hairs of the pod mixed with it. It has a powerful, diffusive, aromatic odour and a bitterish taste. It is inflammable, leaving a light spongy char- coal. On analysis, it yields ammonia, fat, cholesterin, gelatinous and albuminous principles, but the odorous principle . has not been isolated. It is partially soluble in water and alcohol, and completely so in ether. Owing to its high price, musk is greatly sophisticated. Sometimes artificial pods are met with, which may be distin- guished from the genuine by the absence of the remains of the penis, and of an aperture in the middle of the hairy coat. The musk itself is more frequently adulterated by mixture with dried blood and a variety of substances. Indeed, little if any genuine musk is found in the shops. Effects and Uses. — Musk is a powerful excitant and anti- spasmodic, without much effect on the cerebral functions. If a pure article could be obtained, it would have no superior as a direct antispasmodic in the treatment of essential nervous dis- orders — hysteria, epilepsy, chorea and hiccough — and as a com- bined excitant and antispasmodic in the latter stages of typhus, and in typhoid pneumonia. But it is now little prescribed, owing to the difficulty of procuring it good. 118 MATERIA MEDICA — ANTISPASMODICS. Administration. — It may be given in the form of bolus or emulsion. Dose, gr. x, to be repeated every two or three hours. A tincture is officinal ; dose, f5i. An article termed Artificial Musk is made by the ad- dition of one part of rectified oil of amber to three parts of nitric acid. It resembles musk both in sensible and medicinal properties, and it has been prescribed in its stead, in the same dose. . OLEUM SUCCINI — OIL OF AMBER. Amber, Succinum, derived from an extinct coniferous tree, Pinitis succinifer, is a fossil resin found in various parts of the world, and comes to this country from the shores of the Baltic. It is a hard, brittle substance, usually translucent, and of a pale golden-yellow colour, insipid and inodorous except when heated. By distillation it yields an oil, OIL OF amber (oleum suecini), which, when rectified, is employed medicinally. The oil is nearly colourless at first, but gradually becomes brown, has a strong, peculiar odour and a pungent, acrid taste. It is soluble in alcohol. An acid called succinic is also obtained from amber. ^Effects and Uses. — Topically,' it is an active rubefacient. Oil of amber is excitant and antispasmodic, and has been used in hysteria, epilepsy, tetanus, pertussis, hiccough, and amen- orrhoea. It is chiefly employed as an external application, and is a good remedy in pertussis and convulsions of children. Dose of the oil, gtt. v to gtt. xv, given in emulsion. For ex- ternal use it may be mixed with three or four parts of olive oil and brandy, with one part of laudanum added. OLEUM jETHEREUM — ETHEREAL OIL. This substance, known also as oil of wine, is a result of the distillation of alcohol with a large excess of sulphuric acid ; it is afterwards mixed with an equal volume of stronger ether. It is a transparent, nearly colourless, volatile liquid, of a TONICS. 119 peculiar aromatic, ethereal odour and sharp, bitter taste, sparingly soluble in water, but readily dissolved by alcohol or ether. Sp. gr. 0.91. It has antispasmodic properties, but is used in medicine only as an ingredient of the compound spirit of ether. SPIRITUS ^THBRIS COMPOSITUS — COMPOUND SPIRIT OF ETHER. This preparation, known as Hoffman s Anodyne, is a solu- tion of ethereal oil (f5vj) in ether (Oss) and alcohol (Oj). It is a colourless, volatile, inflammable liquid, having an aro- matic, ethereal odour and a burning, slightly sweetish, taste. It becomes milky on being mixed with water, owing to the pre- cipitation of the ethereal oil. Effects and Uses. — Hoffman's Anodyne has the antispas- modic and stimulant effects -of ether, and derives additional tranquilizing and anodyne properties from the ethereal oil present ; it is also an efficient carminative. It is much used in hysteria, and is often added to laudanum to prevent the nausea which the latter sometimes excites. Dose, f5j to f5ij, in sweetened water. ORDER IV. — TONICS. Tonics, called also corroborants, are medicines which produce a gradual and permanent increase of nervous vigour. It is only, however, in certain conditions of disease that they manifest this invigorating influence ; as, in state of health, they often act as irritants or even nauseants. Their local effects are similar to their general effects. They exalt the nervous functions of the parts to which they are applied, and increase their firmness and density. "When taken into the stomach they produce a twofold corroborant effect, improving the digestive powers by their local action, and strengthening the system generally by their cerebro-spinal influence. Tonics differ from stimulants only in the more permanent 120 MATERIA MEDICA — TONICS. character of their effects. The more powerful tonics are closely allied to the narcotics in their action, producing, in overdoses, giddiness, loss of sight and of hearing, convulsions, delirium, and even death. And this analogy is further illus- trated by the curative power of tonics in the relief of painful and spasmodic diseases, as neuralgia, rheumatism, chorea, and epilepsy. The articles of this class may be divided into vegetable and mineral tonics. The vegetable tonics are characterized by bitterness ; and it is said that they owe their bitterness and medicinal activity to a principle which has been termed bitter extractive. It is doubtful, however, whether any such proxi- mate principle has really been obtained. The mineral tonics unite astringent with tonic properties ; and the preparations of iron produce a further corroborant effect by increasing the red colouring matter of the blood. The therapeutic application of tonics comprises a diversified range of diseases. They are employed as stomachics in dys- pepsia, and as general corroborants in convalescence from acute diseases, in chronic affections accompanied by marasmus and cachexia, in exhaustion and debility, in typhus and gangrene, and in typhoid conditions of the system generally. But their most striking and valuable powers are shown in their febrifuge influence upon miasmatic diseases. The modus operandi here is obscure, but the curative agency is undoubtedly due to a powerful impression upon the central organs of the nervous system. The antineuralgic and antispasmodic properties of tonics have already been alluded to. They also enjoy consider- able reputation in the treatment of chronic bowel-complaints, where they act by restoring tone to the debilitated intestinal tube ; and, on the other hand, they are often useful as laxatives in torpid conditions of the alimentary canal. VEGETABLE TONICS. The vegetable tonics may be arranged into three sections, viz. : 1. The pure bitters. 2. The aromatic bitters, which QUASSIA. 121 contain a stimulant volatile oil, and are aromatic as well as tonic. 3. The astringent bitters, which contain tannic and gallic acids, and are both astringent and tonic ; this group contains cinchona, the most powerful and important of the vegetable tonics. The bitter principle is also found in many medicines belonging to other classes, as rhubarb, aloes, taraxa- cum, etc., and gives them tonic properties. SIMPLE BITTEES. , QUASSIA. Quassia is the WOOD of Simaruba excelsa {Nat. Orel. Simaru- bacese), a lofty tree of Jamaica and other West India islands. It is imported from the West Indies in billets of various sizes, which are found in the shops in the form of chips or raspings. It has no odour, but an intensely permanently bitter taste. Water and alcohol extract its virtues, which depend on a neutral principle termed quassin (C 10 H 12 O 3 ). The article originally known as quassia was the root and wood of Quassia amara, a shrub of Surinam, but this does not now reach our markets. It is thought to have possessed much more decided tonic properties than the drug now found in com- merce. Effects and Uses. — Quassia is a mild tonic, free from irri- tant or astringent effects, and is employed principally in dys- pepsia, want of appetite, and other stomachic aifections. It is much used to give additional bitterness to malt liquors. Dose, in powder, Sj to 5j> three or four times a day; but the best form of administration is that of infusion (5\j in water Oj), in doses of f ojss to f Siij ; the infusion is a good remedy for asca- rides, given by injection. An extract (aqueous) is given in the dose of gr. v, but it is principally used as an excipient for the administration of the mineral tonics. A fluid extract is also officinal. Of the tincture (Sij to diluted alcohol Oij) the dose is f5j to f5ij. 122 MATERIA MEDICA — TONICS. COPTIS — GOLDTHREAD. Coptis trifolia, or Goldthread (Nat. Ord. Ranunculacese), is a small evergreen, herbaceous plant, resembling the strawberry- vine, with perennial creeping roots, slender stems, round ter- nate leaves, and a single small white flower. It belongs to the northern regions of America and Asia, and abounds in swampy places in Canada and New England. The parts used are the Fig. 10. ROOTS, which should be gathered in autumn and carefully dried. They are of a bright-golden colour, and give the name by which the plant is commonly known. They contain the alkaloids ber- berina and coptina, but no tannin. The roots of a variety of coptis, derived from Assam, in Asia, Coptis teeta, have been introduced into Europe; they possess analogous properties to those of C. trifolia. Effects and Uses. — Goldthread is a pure and powerful bitter, similar in its effects to quassia, but much more palatable, and GENTIAN. 123 is a very good stomachic tonic. It is also employed in New England as a topical application in aphthous and other ulcera- tions of the mouth. It is usually given in the form of tincture (Sj to diluted alcohol Oj), in the dose of foj, and of infusion (oss to water Oj). Coptis is not, however, officinal. GENTIANA — GENTIAN. Gentian is the root of Gentiana lutea or Yellow Gentian (Nat. Ord. Gentianacese), a perennial plant of the mountainous parts of central and southern Europe, growing to the height of two or three feet, with broad, ovate, opposite leaves and handsome whorled yellow flowers. It is imported in cylindri- cal, branched, twisted pieces, of various sizes, marked by trans- verse annular wrinkles and longitudinal furrows. Its odour in the fresh state is peculiar and disagreeable, but, when dried, feeble; its taste is slightly sweetish and intensely bitter. Water and alcohol extract its virtues. It contains & fixed oil, an acid (gentisin or gentisic acid, C 14 H 10 O 5 ), pectin, grape sugar, and a bitter principle termed gentiopicrin (C 20 H 30 O 12 ), a glucoside, which is soluble in water and alcohol. Other species of gentian are employed as substitutes for the yellow gentian. The root contains no tannic matters (Maisch). Effects and Uses. — Gentian is a pure bitter, without either astringency or much aroma. In full doses it is more disposed to relax the bowels than the other simple bitters ; and, like others of the vegetable tonics, in excessive doses it is capable of producing narcotic effects. It is an admirable stomachic in dyspepsia and gastric disorders, and is also used in the various forms of constitutional debility. Administration. — In the form of powder, the dose is gr. x to 5ss. Compound tincture (tinctura Gentianae composita, gen- tian, §ij, bitter orange-peel, oj, cardamom, §ss, to diluted alcohol Oij), in the dose of f 3j to f5ij ; extract (aqueous), in the dose of gr. x to 5ss ; and fluid extract, in the dose of f5ss-j. 124 MATERIA MEDICA — TONICS. FRASEEA — AMERICAN COLUMBO. The root of Frasera walteri (Nat. Ord. Gentian aceae), an elegant plant of our southern and western States, may be used as a substitute for gentian and columbo. It contains the same active constituents as gentian, viz., gentiopicrin and gentisic acid. Dose, 5ss-5j j or an infusion (§j to boiling water Oj) may be given. It is not officinal. sabbatia. Sabbatia angularis, American Centaury, or Centaury (Nat. Ord. Gentianaceae), is a very common annual indigenous plant, Fig. 11. with an erect stem one to two feet high, opposite ovate leaves, and numerous terminal flowers of a rich rose-colour, nearly COLUMBO. 1-5 white in the centre. The herb should be gathered while in flower. It is not officinal. It has a very bitter taste, and yields its virtues to both water and alcohol. It contains a bitter principle, and erythrocentaurin (C 27 H 24 8 ). Effects and Uses. — Centaury is a pure bitter, with no as- tringency and very little aroma. It is an excellent stomachic, and may be used also as a general corroborant. It is said to act as an emmenagogue when given in warm infusion, and, like the bitters generally, has had anthelmintic properties ascribed to it. The best form of exhibiting it is infusion (§j to boiling water Oj), of which the dose is a wineglassful when cool ; of the powder 5ss to 5j may be given. CALUMBA — COLUMBO. Columbo is now generally ascribed by botanists to two spe- cies of plants known as Jateorrhiza palmata and Jateorrhiza Calumba (Nat. Ord. Menispermacese), designated by some writers still under the old name of cocculus palmatus, climb- ing plants of Mozambique, on the southeastern coast of Africa. The ROOT is the officinal portion, and is known in Africa under the name of Qalumb. It consists of fleshy tubers, with numer- ous offsets, which are the portions used, the main root being too fibrous. They are found in the shops in round pieces about a quarter of an inch thick, externally of a brown, wrinkled appearance, and internally yellow. The odour is slightly aro- matic, and the taste very bitter. Owing to the starch which is found in columbo, it is liable to be worm-eaten. It contains, besides a large proportion of starch, two bitter principles, eolombin (C 42 H 44 14 ) and berberina (C 20 H 17 NO 4 ), Columbia acid (CyH^Oy), but no tannin. Water and alcohol take up its vir- tues ; and, from its liability to attract moisture from the air, it should not be kept in the form of powder. Effects and Uses. — Columbo is a very agreeable demulcent tonic, particularly acceptable to the stomach, and hence well adapted to the convalescent stages of acute disorders of the bowels and of fevers. It is also a good preparation in the 126 MATERIA MEDICA — TONICS. sickness of pregnant women, and is one of the best of the stomachics in all cases where there is unusual delicacy of the stomach. In its native country it is much employed in the treatment of dysentery. Administration. — The dose of the powder is gr. x to gr. xxx. It is best given in the form of infusion (§ss to boiling water Oj, dose, fSj to f^ij), which should be used at once, as it is liable to spoil. Of the tincture (Siv to diluted alcohol Oiij), f5j to f5iv may be given. Of the fluid extract (a fluidounce of which contains a troyounce), the dose is f5ss-i. Columbo is often combined with aromatics, iron, and alkalies, and is sometimes added to purgative mixtures. Berberina (C 20 H 17 NO 4 ), the alkaloid found in columbo, is widely diffused in the vegetable kingdom, and is obtained from numerous plants of the natural orders Berber acew, Menisper- macece, and Banunculacece, as barberry, yellow-root, hydrastis, goldthread, and others. It has been employed, in the form of muriate and sulphate, as a tonic and febrifuge, in doses of from one to ten grains. C HIE AT A. The herb and root of Agathotes chirata (Nat. Ord. Gen- tianaceae), an East Indian plant, have been introduced into European and American practice under the name of Chirata, where it now ranks among the best simple bitters. Chirata contains a peculiar bitter neutral substance (a glucoside), termed chiratin (C 26 H 48 15 ), and opelic acid (C 13 H 20 O 10 ), which is amorphous ; in medicinal properties it resembles gentian, and may be used in the same way. AROMATIC BITTERS. SERPENTAKIA. The root of several species of Aristolochia are known under the name of Virginia Snakeroot. The most familiar is A. ser- SERPEXTARIA. 127 pentaria (Nat. Ord. Aristolochiacese), an herbaceous, indigenous plant, with a perennial root, composed of numerous slender fibres, arising from a knotty, brown head. A. reticulata is a variety found in the southwestern States. Virginia snakeroot is found in the shops in tufts of long, slender, matted fibres attached to a knotty, rugged head. Fie. 12. They are brittle, and of a yellowish-brown colour. The odour is aromatic and agreeable ; the taste somewhat pungent, bitter and aromatic. Water and alcohol extract its virtues, which depend on the presence of a volatile oil, a bitter 'principle, re- sins, and tannin. The roots of A. reticulata are very com- monly substituted for those of A. serpentaria, from which they 128 MATERIA MEDICA — TONICS. differ only in the larger size of their fibres. They are quite equal to the latter, and are thought even to contain a larger proportion of volatile oil. Effects and Uses. — Virginia snakeroot is a combined stimu- lant and tonic, with diuretic or diaphoretic properties, accord- ing to the mode of its administration. In full doses it irritates the alimentary canal, causing nausea, eructations, and colic. It is much used in the latter stages of fevers, and in other acute diseases, and is frequently combined with Peruvian bark in the treatment of intermittents. It may be administered in infusion (not officinal, §ss to boiling water Oj), dose fSj to f Sij, repeated. Of the tincture (Siv to diluted alcohol Oij) the dose is f5j to f5ij ; of the fluid extract, f5ss-f5j. Huxhams Tinc- ture contains serpentaria. ANTHEMIS — CHAMOMILE. Anthemis nobilis, or Chamomile {Nat. Ord. Compositse), is a small herbaceous, trailing European plant, cultivated exten- sively in both Europe and this country. The flowers are described by the U. S. Pharmacopoeia as the portion used, but the entire heads are really the commercial article. The flowers consist of small spheroids, with convex yellow disks and numerous white, spreading rays. In Europe the single heads are preferred, as the aromatic properties reside in the disks ; but in this country the cultivated double heads, which are not inferior in tonic virtues, are used. Chamomile flowers have a bitter, aromatic taste, probably due to anthemic acid, and a strong, peculiar odour, both of which are imparted to water and alcohol. They contain a volatile oil, bitter principle, a little tannic acid, oxesin, but no alkaloid has been obtained. Effects and Uses. — Chamomile, in small doses, is a mild, agreeable, aromatic tonic, and, in large doses, acts as an emetic. The cold infusion is much employed as a stomachic, and the hot infusion is given to aid the operation of emetics. The flowers, boiled in water, form a good fomentation to in- THOROUGHWORT. 129 flamed parts. The usual for"m of administration is the infu- sion (5ss to water Oj). Dose, as a stomachic, fgij, two or three times a day, cold ; as an emetic, hot, ad libitum. Cotula (Mayweed). Anthemis (or Maruta) cotula, Wild Chamomile, or Mayweed (Nat. Ord. Compositse), an herbaceous plant, indigenous in Europe, but extensively naturalized in the United States, resembles chamomile very closely, both in bo- tanical characters and in properties, and is used as a substitute for it in domestic practice. It contains volatile oil, valerianic acid, tannin, anthenaidina (?), and anthemic acid (?). It is not officinal. Matricaria (German Chamomile). The flowers of Mat- ricaria chamomilla (Nat. Ord. Compositae), an annual European plant, possess properties very similar to those of chamomile. They contain volatile oil, bitter extractive, tannin, and malates. They are not much employed in this country. EUPATORIUM — THOROUGHWORT. Eupatorium perfoliatum, Boneset, or Thoroughwort (Nat. Ord. Composite), is a very common indigenous plant, growing in wet grounds in every part of the United States. It has numerous herbaceous stems, with long, narrow leaves, per- forated by the stems. The leaves and tops are the officinal portion. They have a faint odour, a strongly bitter taste, are soluble in water or alcohol, and contain a bitter principle, eujpa- torin, a glucoside, gum, tannic acid, and a trace of volatile oil. E. teucrifolium, E. aromaticum, and other native species, are almost identical in their properties with E. perfoliatum. Effects and Uses. — Thoroughwort is a stimulant tonic, dia- phoretic and expectorant, and in large doses proves emetic and laxative. It is a good stomachic in dyspepsia, and, from its combined corroborant, expectorant, and diaphoretic properties, is an excellent remedy in epidemic influenza, and in the latter stages of pneumonia and bronchitis. It is used also with good effect in rheumatism, and in intermittent, remittent, and typhoid 130 MATERTA MEDICA — TONICS. fevers, and taeniacide powers have been attributed to it. It should be given in infusion (Sj to boiling water Oj), fgij of which may be taken cold, as a stomachic, three or four times a day, and in freer warm draughts as a diaphoretic. ^he fluid extract is officinal; dose f5i. ABSINTHIUM — WORMWOOD. The tops and leaves of Artemisia Absinthium, or Worm- wood (Nat. Ord. Composite), a European plant, naturalized in New England, are ranked among the aromatic bitters, but are not now much employed. They may be given in infusion (Sj to boiling water Oj — not officinal). Wormwood contains an essential oil (chiefly absinthal), a bitter principle termed absinthin (C 40 H 58 O 9 ), tannin, etc. The oil possesses powerful stimulant properties, in large doses pro- ANGUSTURA. 131 ducing epileptiform convulsions, and in lethal quantities is capable of causing fatal results. A liqueur termed absinthe, containing the oil in question, is much used in France, with highly pernicious effects. It enters into the composition of vinum aromaticum. MAGNOLIA. The barks of Magnolia glauca, Magnolia acuminata, and Magnolia tripetala (Nat. Ord. Magnoliacese), indigenous trees, remarkable for the beauty of their foliage and the size and fragrance of their flowers, are officinal, and rank with the aro- matic bitters. The barks of the trunk, branches, and root, are alike officinal ; but those of the last are the most active. They contain a volatile oil, tannin, resin, and a crystallizable bitter principle resembling liriodendrin. An extract of the fruit of M. umbrella yields magnolin. The aromatic property is impaired by drying, and is lost when the barks are long kept. They are used as gentle stimulant tonics and diaphoretics, in the low stages of fever, rheumatism, etc. An infusion may be given, but the best solvent is diluted alcohol. LIRIODENDRON — TULIP-TREE BARK. The bark of Liriodendron tulipifera, the Tulip-tree or American Poplar (Nat Oral. Magnoliacese), the well-known pride of the American forest, remarkable for its size, foliage, and beautiful tulip-shaped flowers, closely resembles those of magnolia in its medicinal properties, but is less aromatic and more stimulant. It contains a principle termed liriodendrin (in globules or needles), and tannin. It may be given in powder, in the dose of 3j to 5ij ; and in infusion, decoction, and tinc- ture. It is not officinal. ANGUSTURA. Angustura bark is derived from Galipea officinalis (Nat. Ord. Rutaceae), a small tree of the district of the country bor- 132 MATERIA MEDICA — TONICS. dering on the Orinoco river, in South America. It occurs in pieces of various lengths and sizes ; sometimes flat, sometimes slightly curved, but rarely entirely quilled. It has a disagree- able smell and a bitter, aromatic, somewhat pungent taste. It imparts its virtues to water and alcohol, and contains a volatile oil and a bitter principle termed cusparin, but tannin appears to be absent. An alkaloid, angosturine, is believed to have been isolated. The bark of Strychnos nux vomica has been sometimes mixed with Angustura bark, and is thence known as false angustura bark. Effects and Uses. — Angustura bark is a stimulant tonic, and in large doses acts on the stomach and bow r els. From its lia- bility to adulteration with the bark of Strychnos nux vomica, it has fallen into disuse, and it has no superiority over serpen- taria and others of the indigenous aromatic bitters. Dose, in powder, gr. x to 5ss ; of the infusion (5ss to boiling water Oj), foij? repeated. Augustura is not officinal. CASCARILLA. This is the bark of Croton eluteria [Nat. Ord. Euphor- biacese), a small tree of the Bahamas and other West India islands. It occurs sometimes in the form of small thin frag- ments ; sometimes in that of rolled pieces, one or two inches long, occasionally longer, and varying in size from that of a quill to that of the little finger. It has a warm, spicy, and bitter taste and an aromatic, agreeable odour, which is par- ticularly fragrant when it is burned. It yields its properties to alcohol, and partially to w T ater ; and contains volatile oil, resin, a bitter crystalline principle called cascarillin, and some tannin. Effects and Uses. — Cascarilla is a very pleasant aromatic bitter, causing neither vomiting nor purging, and hence agree- ing very well with the stomach. It may be given in powder, in the dose of 3j to 5ss ; but this is a less agreeable form than the infusion (§i to boiling water Oj). Dose foij. CINCHONA. 133 CANBLLA. This is the bark of Canella alba [Nat, Ord. Canellaceae), a large tree of the West Indies and South America. It comes in quilled pieces of a whitish-yellow colour, or in flat frag- ments which are thicker and darker. It has an aromatic odour and a warm, pungent, aromatic, and somewhat bitter taste. It imparts its virtues to alcohol, and partially to water ; and contains volatile oil (contains engenic acid), cannellin (mannite), resin, a hitter principle (not isolated), gum, etc. Effects and Uses. — An aromatic tonic, little employed ex- cept in combination. Pulvis aloes et canellce (powder of aloes and canella), popularly known as hiera picra, consists of aloes four parts, canella, one part ; dose, gr. x to 3j. It is not officinal. ACHILLEA YARROW. Achillea millefolium, Milfoil, or Yarrow (Nat. Ord. Com- posite Senecionidese), a perennial herb, possesses mild stimu- lant tonic properties, with some astringency. It contains a volatile oil, achillein (C 20 H 38 N 2 O l5 ), an amorphous alkaloid, tan- nin, and aconitic acid. The leaves and flowering tops are the portion to be employed. Of the infusion (gj to Oj) a wine-glassful or more may be given. The volatile oil has been used in the dose of 20 or 30 drops. Achillea is not officinal. ASTRINGENT BITTERS. CINCHONA. The name Cinchona (derived from the Countess of Chin- chon, w T ife of a viceroy of Peru) is applied to the bark of dif- ferent species of Cinchona (Nat. Ord. Rubiacese, Cinchonee), large trees which grow in the mountainous regions of the west- ern portions of South America, from the nineteenth degree of south latitude to about the tenth degree of north latitude. Three principal varieties of cinchona are known in commerce: 134 MATERIA MEDICA — TONICS. Cinchona Flava {Yellow Bark), called in commerce Calisaya Bark, derived from Cinchona calisaya ; Cinchona Pallida [Pale Bark), called in commerce Loxa and Lima Bark, de r rived from Cinchona condaminea and Cinchona micrantha ; and Cinchona Rubra [Red Bark), derived from Cinchona succiruhra. The Pharmacopoeia now recognizes, however, as officinal the barks of all species of the genus Cinchona, which contain at least three per cent, of the proper cinchona alkaloids. The latest authorities distribute the Cinchona into five groups, the types of which are C. officinalis, C. rugosa, C. micrantha, C. calisaya, and C. ovata. Cinchona is brought to the United States from the Pacific ports of South America. It is obtained by stripping the trunks and branches of the Cinchona trees during the dry season, and is dried by exposure to the sun, during which pro- cess the smaller pieces usually become quilled. 1. The Yellow or Calisaya Bark comes both in quilled and flat pieces. The former are from three or four inches to a foot and a half long, from a quarter of an inch to two or three inches in diameter, and of variable thickness. They have a brownish epidermis (with longitudinal wrinkles and transverse fissures), which possesses none of the virtues of the bark. The bark itself is one or two lines thick, compact, of a short, fibrous texture, and when broken presents shining points. The flat pieces, which are derived from the larger branches and trunk, are usually destitute of epidermis, are more roughly marked externally, and are of a browner hue than the quilled pieces. They are also less compact, less bitter, and of less medicinal virtue. The yellow bark is distinguished from the other barks by its much more bitter taste ; its comparative freedom from astringency; its brownish-yellow, somewhat orange colour, which is still brighter in the powder; and by con- taining a large proportion of quinia with very little cinchonia. 2. The Pale Bark comes in cylindrical pieces of variable length, sometimes singly, sometimes doubly, quilled, from two lines to an inch in diameter, and from half a line to two or three lines in thickness — the best kinds being about the size of CINCHONA. 135 a goose-quill. The exterior surface is rough, marked with fissures, and of a grayish colour, owing to adhering lichens. The interior surface is of a cinnamon colour, and, in the finer sorts, smooth. The colour of the powder is a pale fawn. The taste is moderately bitter and somewhat astringent; the odour feeble, but rather aromatic in the powder and decoction. The pale barks, of which there are two varieties, Loxa Bark and Huanuco or Lima Bark, contain a much larger proportion of cinchonia than of quinia ; and, from their yielding little quinia, have fallen into disuse in the United States. 3. The Reel Bark usually comes in large, thick, flat pieces ; sometimes also in quills from half an inch to two inches in diameter. They are covered with a reddish-brown, rugged epidermis, beneath which is a dark-red, brittle, and compact layer, the interior parts being woody and fibrous and of a lively brownish-red colour. The taste of red bark is bitter and astringent; its odour not different from that of the other barks; its powder is reddish. It contains considerable quantities both of quinia and cinchonia. Under the name of Cartagena Barks, several common varieties of cinchona were long brought to this country from the northern Atlantic ports of South America. They were of inferior quality, and were therefore not recognized by the Pharmacopoeias; but, since the reduced supply and consequent high price of the calisaya bark, large quantities of very good bark have been imported from New Granada, and are now used in the manufacture of quinia, under the name of Colombian barks. Within a few years, the cultivation of several varieties of cinchona trees has been successfully introduced into southern India and the islands of Ceylon and Java, and also into Jamaica, and the markets are now supplied with barks of very good quality from these sources. Chemical Constituents. — The most important constituents of cinchona are two alkaloid principles, termed quinia and cin- chonia, which exist chiefly in combination with an acid called kinic. These alkaloids are found in different proportions in 136 MATERIA MEDIGA — TONICS. the different barks, quinia being obtained from the yellow bark most abundantly, cinchonia from the pale bark, and the two principles in about equal proportion from the red bark. Two other valuable alkaloids, quinidia and cinchonidia, are found (also as hinates) most abundantly in the pale and Cartagena barks, but to a certain extent in all. By heat, the crystalliz- able alkaloids are converted into amorphous modifications, as quinia into quinicia and cinchonia into cinchonicia ; and re- cently other alkaloids, aricina, paricia, quinamia, and paytia, have been discovered in cinchona. Other principles found are cincho-tannic acid, colouring matter, hinovic acid, starch, fatty matter, and a trace of volatile oil. Gum is found in the pale bark, but not in the yellow or red bark. Quinia is obtained by heating the sulphate with an alkaline solution. Quinine Sulphas [Sulphate of Quinia) is prepared in the following manner : Powdered yellow bark is boiled in water acidulated with muriatic acid, by which the alkaloid is separated from its combination with kinic and other acids, to form a soluble muriate. By the addition of lime, this salt is decomposed, and quinia precipitated. The precipitate is washed with distilled water, and is separated from insoluble impurities by digestion in boiling alcohol, which is afterwards distilled off. To the residual brown viscid mass, mixed with distilled water and heated to the boiling point, sulphuric acid is added, in quantity sufficient to dissolve the quinia. The liquor is then boiled with animal charcoal, filtered, and set aside to crystal- lize. The alkaloid quinia may be obtained in the form of fine crystalline needles of a silky lustre, but usually occurs as a loose white powder ; it is inodorous, very bitter, soluble in 2000 parts of cold water and in 760 parts of boiling water, in little more than its weight of absolute alcohol, in about two parts of chloroform, and in 22.6 parts of ether, and also in the fixed and volatile oils. It unites with acids to form salts, the most important of which is the officinal salt, the sulphate. Its com- position is C 20 H 24 N 2 O 2 . Quinia and its salts may be distin- guished from all other vegetable alkalies and their salts (ex- cepting quinidia and quinicia) by forming an emerald-green CINCHONA. 137 precipitate when treated first with fresh chlorine-water and then with ammonia (Thalleioquin). Herapatli s test is by adding to quinia sulphate (gr. v) diluted acetic acid (f 5'0 with, alcohol (f 5ss) and tincture of iodine (8 drops), heating gently over a spirit lamp till it forms a clear light-brown solution, when, as the liquor cools, right-angled, quadrate, rhombic crystals are deposited, which by reflected light appear of a copper-green colour, resembling the elytra of Spanish flies. This precipi- tate, which is quinia iodosulpbate (C 20 H 24 N 2 O 2 SO 4 H 2 I 2 ), is termed Herapathite. Cinchonia is a white crystalline substance, less bitter than quinia, almost insoluble in cold water, very soluble in boiling alcohol, and slightly soluble in ether and the fixed and volatile oils. Its composition is O 20 H 24 N 2 O. It is distinguishable from quinia by striking a white precipitate when chlorine-water and afterwards ammonia are added ; with potas- sium ferrocyanide, a yellowish-white precipitate ensues. Cin- chonia being insoluble in ether, while quinia is soluble in that menstruum, the latter may by this means be readily separated from the former alkaloid. The medicinal properties of quinia and cinchonia are analogous, and cinchonia sulphate is now officinal. Quinidia is isomeric with quinia, but more crystal- lizable and less soluble in ether ; its salts strike a white precipi- tate with solution of potassium iodide. Ginclionidia is isomeric with cinchonia. It is usually found mixed with quinidia, the mixture being known as commercial quinidia. The commercial quinidia sulphate (which is more soluble in water and alcohol than quinia sulphate) may be used as a substitute for the latter salt. Incompatible 'S. — The alkalies and alkaline earths precipitate the alkaline principles of cinchona ; tannic acid, and the tinc- ture and compound solution of iodine, form with them insolu- ble compounds ; the ferric salts precipitate cincho-tannic acid ; solution of potassium arsenite is also incompatible with infu- sions and decoctions of cinchona. Physiological Effects. — Locally, cinchona and its alkaloids act as irritants, and have, besides, a marked antiseptic effect, arresting putrefaction and fermentation by a destructive influ- 138 MATERIA MEDICA — TONICS. ence upon fungi and infusoria. As the physiological action of cinchona depends on its contained alkaloids (chiefly quinia), the following account relates to the latter. Nervous system : quinia in medicinal doses stimulates the cerebral functions and in- creases the mental activity. Full doses (gr. xv-xx) induce a hypersemic condition of the brain, the first indications of which are upon the special senses, especially that of hearing, which undergoes subjective noises, as ringing and roaring in the ears (tinnitus aurium), with partial deafness, the latter rarely per- manent; amblyopia is an accompaniment, though less common. Doses of this size, continued, may produce a sense of fullness of the head, frontal headache and vertigo. Very large doses augment the above symptoms, accompanied by a slow weak pulse, dilatation of the pupils, convulsions, and stupor ; death in rare cases has followed quinia-poisoning, though immense doses of it have been taken with impunity. Quinia given to frogs reduces, and finally abolishes, the reflex excitability of the spinal cord. Its effect in this respect, on man, is as yet sub judice. Quinia in doses of gr. x-xx has the power, during labour, to cause uterine contractions. Circulation : in small doses quinia slightly accelerates the action of the heart ; while large amounts (gr. xl-lx) decidedly retard its beats and force. This slowing occurs after section of the vagi indicating a direct influence on its motor ganglia ; applied in solution to the cut-out heart it quickly stops its movements. The cinchona alkaloids are readily dissolved from the bark by contact with the gastric juice, and being diffusible and crystalline, quickly osmose into the blood; if, however, they pass into the small intestine from any cause, contact there with the alkaline fluids of that tube will precipitate them, and they will be discharged with the faeces. Upon the blood, quinia has several marked actions, as follows : it diminishes the number of white corpuscles, and re- tards their atnaeboid movements ; it hinders the carrying of oxygen to the tissues, and increases the proportion of red to white corpuscles (Cutler and Bradford). The absorption of quinia by the blood is aided by the carbon dioxide gas of that fluid. The production of acid in freshly drawn blood is dimin- CINCHONA. 139 ished by the addition of quinia solution (Binz). Temperature : in small doses in health no influence upon the animal heat has been noted; but in large amounts a moderate fall takes place (about J° F.). No complete explanation has as yet been given of this action, but it seems to be due to an interference with the oxidation processes in every part of the body. Secretions : cinchona produces upon the stomach a stimulant effect to the appetite and digestion, and, from the tannic acid which it con- tains, a slightly astringent effect not belonging to the salts of its alkaloids. If given too long, or if the stomach and bowels are in an irritable condition, it is apt soon to produce nausea, vomiting and even diarrhoea. Occasionally quinia causes a cutaneous eruption, as erythema, herpes, etc. A rare effect is renal and cystic irritation. Quinia, it is said, causes con- traction of the spleen (Piorry) ; this, however, has been denied. Large doses of quinia (gr. xxv-xl) decidedly diminish the amount of urea and uric acid in the urine, also the phosphoric acid. Elimination : quinia for the most part is eliminated by the kidneys, and it has been found in the urine twenty minutes after the injection of a large dose. According to Thau from J to J escapes in the first six hours. It is discharged partly as quinia and partly as isomeric modifications (quinicia). Medicinal Uses. — The most important therapeutic employ- ment of cinchona is as a febrifuge in the treatment of fevers of a miasmatic origin. Its efficacy in these diseases was first made known to the world by the Jesuit missionaries in Peru, from whom it was called Jesuit's powder. The type of miasmatic fever in which the powers of bark are most strikingly displayed is intermittent, the non-pernicious and uncomplicated forms of which it rarely if ever fails to control. It may be given in these cases from the very onset of the attack ; and if, owing to gastric irritability, it is rejected by the stomach, it should be introduced by the rectum. In remittent fevers, cinchona is scarcely less useful than in intermittens ; and most physicians who practice in miasmatic districts now concur in recommend- ing its early exhibition in these fevers, without waiting for a remission. In the pernicious or congestive forms of inter- 140 MATERIA MEDICA — TONICS. mittent and remittent fevers, the early administration of large doses of cinchona or the salts of quinia or cinchonia, in com- bination with stimulants, is imperatively demanded ; and the hypodermic injection of quinia sulphate may here be necessary. As a prophylactic against miasmatic fever, the use of the prep- arations of cinchona is very efficacious. We are still far from' an explanation as to the exciting cause of miasmatic fevers or the specific action of quinia against them, nor have the recent experiments of Klebs and Tommasi-Crudeli with the lacillus malarice contributed anything to our knowledge, since they have not been confirmed by those of Dr. Sternberg. In ery- sipelas, the author has found quinia sulphate scarcely if at all less efficient than in miasmatic fevers, and he believes it to be the most available remedy in puerperal fever. In typhus fever, the quinia salts, in full doses, are generally resorted to, in conjunction with the bromides, opium, and alcohol. In yellow fever, the declining stages of typhoid fever, the malig- nant exanthemata, gangrene, carbuncle, extensive suppurations, pyaemia, the typhoid forms of diseases generally, the hectic of phthisis, acute rheumatism, diarrhoea, dysentery, and chol- era, and various disorders of the nervous system, as neuralgia, tetanus, and chorea, cinchona and its preparations are con- stantly employed ; and, as they have been found to lessen the amount of uric acid and urea in the urine, they have been pre- scribed also in gout. By its contracting action on the gravid uterus, quinia sulphate exerts an influence in promoting normal labour, and will often prove useful in counteracting inertia of the uterus in parturition. A full dose of quinia will often abort an impending paroxysm of asthma. In surgical shock, as after grave operations, the administration of quinia is of the greatest utility. The power which the quinia salts possess of lowering fever temperature renders their use extremely valuable in conditions of pyrexia. In such states quinia is best given in a single large dose (5ss to 5i)> and since the elimination of the major portion of it takes place in the first six hours, it may be necessary to repeat this dose at the expiration of that time, if it is desirable to sustain its antipyretic effect. In Germany, CINCHONA. 141 the treatment of typhoid fever with large doses of quinia, gr. xx to xl, given in the evening, is in vogue. Cinchona is also much used as a stomachic and general tonic, but, where gastric susceptibility exists, as in convalescence from acute diseases, some of the simple bitters are preferable. Topically, cinchona is employed as an astringent and antiseptic. Administration. — The use of cinchona in powder, since the discovery and introduction of quinia sulphate, has been very much abandoned, owing to its bulk and disagreeable taste. When exhibited in this form, 5ss to 5i is the dose as a febri- fuge, given usually in divided amounts; as a tonic, 5i- The following officinal preparations are employed: infusion (51 of yellow or red bark to water Oj, to which aromatic sulphuric acid f 5j may be added), dose, f§ij, repeated ; extract (of yellow bark), dose, gr. x to gr. xxx, equivalent to 5j of bark ; fluid extract (yellow), dose, f 5i, equal to 5j of bark ; tincture (5vi of yellow bark to a mixture of three measures of alcohol with one of water, Oij), dose, f 5j to f 3iv ; compound tincture, or Hux- hanis tincture (containing red bark 5iv, bitter orange-peel oiij, serpentaria gr. 360, in a mixture of three measures of alcohol with one of water, Oijss), dose, f5j to f5iv. In prescribing bark, opium or port wine is often given with it, when it acts on the bowels. It is also occasionally combined with serpentaria. And, when the stomach will not retain it, it has been used ex- ternally in the form of cataplasmata, pediluvia, bark jackets, etc., though in such cases it may be administered by the rec- tum, and the endermic or even the hypodermic exhibition of the sulphate of quinia may be resorted to. Quinia Sulphas (Sulphate of Quinia). This salt is pre- pared by the process described at p. 136. It occurs in fine, silky, rather flexible needle-shaped crystals (interlaced among one another, or grouped in small star-like tufts), which are odourless, very bitter, and slightly efflorescent. It is soluble in 755 parts of cold and 30 parts of boiling water, readily soluble in alcohol, but insoluble in ether. Quinia is a tertiary base, and forms, with sulphuric acid, a basic, normal, and acid sulphate. Basic quinia sulphate 2(C 20 H 24 N 2 O 2 )SO 4 H 2 + 8 aq. 142 MATERIA MEDICA — TONICS. is the salt in common use. By the addition of dilute sulphuric acid to the basic salt normal quinia sulphate (C 20 H 24 N 4 O 2 .SO 4 H 2 -f 7 aq.) is obtained in four-sided prisms, which are soluble in 11 parts of cold water. Acid quinia sulphate (C 20 H 24 N 2 O 2 . u iSO 4 H 2 -f- 7 aq.) occurs as white prisms, freely soluble in water. Solutions of quinia and its salts possess the property of fluorescence and left rotatory power on polarized light. Quinia sulphate is decomposed by the alkalies and their carbonates, the alkaline earths, astringent infusions, the soluble salts of lead, acetates and tartrates generally, potassium iodide, and the compound solution of iodine. Various substances are mixed as adulterations with quinia sulphate. They may be detected by adverting to their relative solubility in different menstrua, as compared with the sulphate, or by chemical tests. Thus, gum and starch are left behind by alcohol ; salicin becomes red on contact with sul- phuric acid, etc. Effects and Uses. — The effects of sulphate of quinia on -the system are the same as those of cinchona, and, from its being less apt to disagree with the stomach, it has to a great extent superseded the use of the latter. See p. 137. Administration. — The ordinary dose of the sulphate of quinia, as a febrifuge, is gr. xvi, equal to about oj of bark, but as much as twenty grains, and even more, are often re- quired ; as a general tonic, gr. j to gr. vj. It may be given dissolved in some aromatic water, by the aid of aromatic sul- phuric acid, also as an enema, or hypodermically. (Glycerin is a good excipient for pills of quinia sulphate.) Quinia Bisulphas (Quinia Bisulphate), the normal quinia sulphate, is now officinal, and is preferred on account of its greater solubility. It may be given in the same doses as the ordinary sulphate. Many other salts of quinia than the sulphate have been introduced into practice, but few possess any advantage over these officinal salts. Quinia Valerianas (Quinia Valerianate) is obtained by dissolving freshly precipitated quinia in diluted valerianic acid. CINCHONA. 143 It occurs in transparent or white rhornboidal tables, of the peculiar repulsive odour of valerianic acid, and an acrid, bitter taste. Soluble in alcohol and ether, and partially soluble in water. It fulfils the indications of quinia and valerianic acid, and is therefore especially useful in nervous disorders. Dose, r. j to xx. Quinia hydrobr ornate is officinal, and being solu- ble in five times its weight of water, is recommended also for hypodermic use (Gubler). Quinia hydroclilorate is also officinal. Quinia sulphovinate, from its ready solubility, dissolving in twice its weight of water, is well adapted to hypodermic injec- tion. Quinia carbolate, citrate, phosphate, salicylate and sulpho- carbolate have all been used of late. Crude quinia is the impure quinia obtained from the man- ufacturer before separation from the insoluble impurities. It is a soft solid of resinous aspect, nearly free from bitterness, and may be given to children in the same doses as the sulphate. Chixoidixum [Chinoidin, quinoidin) is a substance ob- tained by precipitation, with an alkaline carbonate, from the mother-liquid left after the preparation of quinia sulphate. When moderately heated, it appears as a resinous mass, of a yellowish-white or brownish colour, which, according to Liebig, bears the same relation to ordinary quinia that uncrystallizable sugar bears to the crystallizable. The quinia in this prepara- tion is thought to be converted, by the action of heat, into an isomeric alkaloid termed quinicia ; and by the same action cinchonia is converted into an isomeric alkaloid termed cin- chonicia. It is considered equally efficacious with quinia, but requires doses rather larger than quinia sulphate, than which it is much more economical. Cinchonia Sulphas {Cinchonia Sulphate) is made from the mother-water remaining after the crystallization of quinia sulphate. Being the most soluble of the sulphates of the four alkaloids found in bark, it remains in solution after the quinia sulphate and the mixed cinchonidia and quinidia sulphate have 144 MATERIA MBDICA — TONICS. crystallized out. From the mother-water it is precipitated by solution of soda, then washed with alcohol, next reconverted into a sulphate, and boiled with animal charcoal to decolorize it. It occurs in short, oblique, shining prisms with dihedral sum- mits, of a very bitter taste, more soluble in water (54 parts) than quinia sulphate, readily soluble by alcohol, and sparingly so by ether. It rotates polarized light to the. right. By the addition of sulphuric acid it is converted into the more solu- ble neutral sulphate. It is now admitted to have the same re- medial properties as quinia sulphate, but requires about one- third larger doses. Quinidia sulphate and cinehonidia sulphate are now officinal. EUCALYPTUS GLOBULUS. The leaves of Eucalyptus globulus (Nat. Ord. Myrtacese), a lofty tree of Australia, commonly known as the Blue Gum- Tree, have within the last few years come into notice as a febri- fuge tonic. The fresh leaves are more active than the dried, and they owe their activity to a volatile oil, having the odour of oil of peppermint, which contains cymol (C 10 H 14 ) and two ter- penes, one, C 10 H 16 (unnamed), and eucalyptol (C 10 H 16 O) ; from eucalyptus are also obtained tannin, resin (crystallizable), and cerylic alcohol. Physiological Action. — The oil possesses a decided destructive action upon infusoria, and locally is an irritant. Nervous sys- tem : large doses of the oil in animals produce muscular weak- ness, loss of reflex irritability, and finally death from centric paralysis (cord and medulla). These effects are preceded by a period of excitement. In small doses in man it causes mental activity and a feeling of well being. The circulation and res- piration are both accelerated under eucalyptus. Secretions : the injection of the drug excites the salivary secretion, pro- motes the appetite, causes diaphoresis, and induces soft stools. It decidedly increases the elimination of urea (Gimbert). It is eliminated by the bronchial mucous membrane, kidneys and skin. DOGWOOD. 145 Eucalyptus has been given with contradictory results in mias- matic fevers, in doses of from 60 grains to half an ounce of the dried leaves, or less of the fresh ; the fluid extract is officinal, dose f5j, in some aromatic water. Eucalyptol (oleum eucalypti) has proved efficient in bronchitis and whooping-cough ; dose, gtt. v to x, in capsules or emulsion. Eucalyptus may be used as a tonic in gastric catarrh and dyspepsia, and its employment in vesical catarrh is recommended. The growth of plantations of eucalyptus in miasmatic districts has been found to diminish the spread of malaria. COKNUS — DOGWOOD. Fig. 14. Cornus Florida, or Dogwood (Nat, Ord. Cornacese), is an indigenous tree found in most parts of the United States, and growing in the Middle States to the height of from fifteen to 10 146 MATERIA MEDICA — TONluS. twenty feet. Its flowers are remarkable for large four-leaved white or pinkish involucres, which appear with us in May. The officinal portion is the bark of the root. It occurs in pieces of various sizes, more or less rolled, and of a reddish- gray colour. Its taste is bitter, astringent, and slightly aro- matic. It yields its virtues to water and alcohol, and .contains cornin (cornic acid), resin, tannic and gallic acids, etc. The barks of Cornus sericea, or swamp dogwood, and of Cornus circinata, or round-leaved dogwood, possess analogous prop- erties. Effects and Uses. — Dogwood is deservedly esteemed the best substitute for cinchona among the native astringent bitters. It is somewhat irritant, and not unfrequently disorders the stomach. Dose, in powder, 3j to 5j ; the fluid extract contains Si in f Si. salix — WILLOW. The bark of Salix alba, the White Willow [Nat. Ord. Sal- icacese), is ranked among the astringent bitters. It is little employed, however, except in the form of salicin, a neutral principle (C 13 H 18 O r ), which consists of white, slender, silky crystals, inodorous but very bitter, soluble in water and alco- hol, but not in ether; it ranks with the glucosides. Salicin is now believed to produce the same effects as salicylic acid (see that article), and is employed in the same therapeutic range, especially in acute rheumatism. It renders the sweat alkaline. Dose, 15 to 20 grains, frequently repeated. It has powerful anti-septic and anti-fermentative properties ; it is not toxic. Salicin is officinal under the name of salicinum. PRUNUS VIRGINIAN A — WILD-CHERRY. The Wild-cherry has long been known under the name of Prunus Virginiana, which is still retained by the Pharmaco- poeia. This name, however, belongs to another tree, the choke- cherry ; and the wild-cherry is now properly distinguished as NECTANDRA. 147 Cerasus serotina (Nat. Ord. Rosacea). The medicinal portion is the bark of the root and trunk, the former of which is the more active. It is found in the shops in pieces of various lengths and sizes, deprived of the epidermis and slightly curved, of a reddish-brown colour and a bitter, slightly as- tringent, aromatic taste. It contains a bitter principle (not isolated), resin, starch, and tannic and gallic acids, and yields on distillation a volatile oil, containing hydrocyanic acid, which does not pre-exist in the bark, but is formed by the action of water on amygdalin, through the agency of an albuminous principle termed emulsin, as in the bitter almond. The leaves also yield this oil. Boil- ing water impairs the virtues of the bark. Effects and Uses. — Wild-cherry bark is tonic, with some astringency, and at the same time exercises a sedative influence on the nervous and circulatory system, owing to the hydro- cyanic acid which is developed in it. It is used with excellent effect as a sedative corroborant in various forms of pulmonary irritation, particularly in the latter stages of pneumonia and in the hectic of phthisis. It is also a useful stomachic and tonic in a variety of cases. The proper form of administration is the infusion (Sss to cold water Oj), in the dose of f§ij, twice or thrice daily. Of the fluid extract (of which a fluidounce represents an ounce of the bark), the dose is foj-ij- Of the syrup, an agreeable preparation, the dose is f §ss. NECTANDRA. The bark of Nectandra rodiei (Nat. Ord. Lauracese), the Greenheart tree, a large tree of Guiana, has, within a few years, been introduced into medicine, under the name bebeeru bark. It occurs in large, flat, heavy pieces, of a grayish- brown colour on its outer surface and a dark cinnamon on the inner. It has an intensely bitter, somewhat astringent taste, and contains tannic acid, resin, gum, etc., and three alkaloids, which have been isolated, termed bebeeria (C 18 H 21 ISr0 3 ), nectan- dria (C 20 H 23 NO 4 ), and sipirina. Bebeeru bark is employed as 148 MATERIA MEDICA — DIGESTIVE FERMENTS. a febrifuge and tonic in South America, and bebeeria sulphate has been used in Europe and this country with some success in the treatment of intermittent fevers. The full dose is 3j-5j. Of bebeeria sulphate, as a tonic, gr. j to iij ; as an antiperiodic, gr. v to x. It is completely soluble in water. It is not officinal. DIGESTIVE FERMENTS. PEPSI NUM — PEPSIN. In connection with the subject of stomachic tonics, this article is entitled to brief mention. It is prepared from the rennets either of the calf, sheep, or pig, taken from the animal as soon as killed, the best process being Scheffer's. The mucous membrane of well-cleaned, fresh hogs' stomachs is scraped off, chopped fine, and macerated for several days in water acid- ulated with muriatic acid ; the strained and decanted clear liquid is mixed with -a saturated solution of sodium chloride in water, and the separated pepsin after several hours is drained on a muslin strainer, and submitted to strong pressure. Pep- sin, the ferment of the gastric juice, has the property, at 100° F. in an acid solution, of coagulating and dissolving albuminous principles. Two grains of pepsin, with an ounce of distilled water and TT|y of hydrochloric acid, will dissolve 100 grs. of coagulated white of egg at 98° F. in about four hours. Of saccliarated pepsin, grs. 10 are required to dissolve grs. 120 of coagulated albumen at 100° F. in five or six hours. Since alcohol impairs the digestive property of pepsin, preparations of it in wine are unreliable.. Acid solutions favor its action, especially hydrochloric acid, and it may be combined with this acid if deficiency of the gastric juice be suspected. Glycerin is the most reliable agent for preserving the ferment of pepsin (Liebriech). The alkalies and mineral salts precipitate pepsin from solution, and hence are incompatible. Pepsin is now a good deal used in dyspepsia and diarrhoea, and may be given in doses of 5 to 20 grains after each meal, suspended in syrup of orange peel to disguise its disagreeable taste, or taken on PREPARATIONS OF IRON. 149 bread. Of saccharated pepsin, the dose is gr. v to xx ; of vinum pepsinse, 5ss-i, an inferior preparation. Liquor pepsini is a solution of pepsin (40 parts) in hydrochloric acid (12 parts), glycerin (400 parts) and water (548 parts). It is prob- ably more efficient in cases of children than of adults. When nourishment is to be given by the rectum (as when food is re- jected by the stomach), the addition of pepsin and a little hydrochloric acid to animal broths for rectal injection is highly useful. Ingluvin is a preparation from the gizzard of the do- mestic fowl ; it is an aid to digestion : dose, gr. v to xv. PANCREATINUM — PANCREATIN. This is obtained, by Mattison's process, from the pancreas of recently-killed animals, which is dissected and macerated in water acidulated with hydrochloric acid for about forty-eight hours, then separated, and the solution of pancreatin is passed through a pulp filter until it is perfectly clear ; to this clear solution is then added a saturated solution of sodium chloride, and allowed to stand until the pancreatin is separated ; this is skimmed off, and placed upon a muslin filter and allowed to drain, after which it is washed with a less concentrated solution of sodium chloride, and then put under the press ; when all the salt solution is removed, and the mass is nearly dry, it is rubbed with sugar of milk, and dried without heat, after which it is diluted until ten grains emulsify two drachms of cod-liver oil. Saccharated pancreatin is employed to promote the di- gestion of fatty matters, and may be administered in the form of emulsion, or dissolved in diluted alcohol or glycerin, or as a powder ; it is a good addition to cod-liver oil. Dose, 5 to 10 grains. It is not officinal. MINERAL TONICS. FERRI PR^IPARATA — PREPARATIONS OF IRON. The preparations of Iron (Ferrum), termed Ferruginea, ChalybeateS) and Martial preparations, are the most important 150 MATERIA MEDICA — MINERAL TONICS. of the mineral tonics. Besides their local tonic-astringent ef- fect, and their general corroborant action on the cerebro-spinal system, which they possess in common with the other mineral tonics, they exercise a restorative influence on the composition of the blood, by increasing the number of its colouring parti- cles and the amount of its solid constituents. Iron is in fact a natural constituent of the blood, and is to be considered as a nutrient rather than a medicine. The effects of the chalybeates are best observed in conditions of the system in which there is a relative want of the red corpuscles of the blood. Under their use in such cases, while the digestive functions are promoted, the pulse becomes fuller and stronger, the skin assumes a healthy tint, the lips and cheeks become more florid, the tem- perature of the body is increased, and the muscular strength is greatly invigorated. On the other hand, the administration of the ferruginous preparations in health, or too long continued, produces symptoms of plethora, vascular excitement, and a tendency to congestion and hemorrhage ; though it may be doubted whether the blood will assimilate more than the nor- mal proportion of iron. The iron salts stain the teeth a dark colour, and possess an astringent taste. Taken with the food they assist the digestive process ; on an empty stomach they irritate. As a result of its oxidation in the stomach hydrogen is liberated, which combines with sulphur to form hydrogen sulphide. The red corpuscles of the blood act as carriers of oxygen, which they take up from the inspired air in the lungs, and it is now believed that the iron in the blood-corpuscles converts oxygen into ozone, a more active form of this element. Iron is an essential constituent of haemoglobin, and observation has proven that a course of iron in anaemia increases the number of red corpuscles to double or treble (Robuteau). According to Cutler and Bradford this increase does not take place in health. The state in which it exists in the blood-corpuscles is unknown. Absorption : from the stomach it is thought to be absorbed as an albuminate. Metallic iron is oxidized, after ingestion, by the help of water. The ferrous oxide and car- PREPARATIONS OF IRON. 151 bonate are rendered soluble by the hydrochloric acid of the gastric juice. Salts of the organic acids may be absorbed directly into the blood, the acidulous radical being burnt off and the basic iron remaining to combine with the red globules. Salts of the mineral acids, the nitrate, chloride, and sulphate, in doses not large enough to constringe the tissues, are ab- sorbed without change. Secretions : the astringent prepara- tions of iron lessen the secretions generally, especially the gastro-intestinal. The excretion of urea is increased. The ferric salts possess more activity than the ferrous. Elimina- tion : iron is eliminated by the bile, faeces and urine. The faeces are, during a course of iron, of a clavk colour. The diseases in which chalybeates are most serviceable are those which depend on a deficiency of the red corpuscles of the blood, as the various forms of ancemia, particularly where this is connected with irregularity of the uterine functions ; also, scrofula, tuberculosis, degeneration of the viscera, and cachec- tic states of the system, characterized by a pale, flabby con- dition of the solids. Many forms of nervous disorders, as neuralgia, chorea, hysteria, and epilepsy, are very decidedly controlled by the preparations of iron, and they probably con- stitute the best remedies in these affections, when attended with anaemia. Several of the preparations of iron are also much employed both as stomachics and astringents. The following are the officinal preparations of iron : Ferrum Reductum (Reduced Iron). Metallic iron is ob- tained for medicinal purposes in the form of an impalpable powder by reducing the ferric hydrate (officinally subcarbon- ate) by passing a stream of hydrogen gas over it. It is a light, tasteless, iron-gray powder, insoluble in water, but completely soluble in diluted sulphuric acid, and it should be kept in a well-stoppered bottle, owing to its great liability to oxidation. This preparation, sometimes called Quevenne's Iron, is a mild chalybeate, and is a favourite prescription with many practition- ers in the treatment of chlorosis and other varieties of anaemia. Dose, gr. v to gr. x, three times a day, in the form of pill made with sugar and gum. It is sometimes prepared with chocolate 152 MATERIA MEDICA — MINERAL TONICS. in the form of lozenges. It is well adapted to prolonged use. Ferri Oxldtjm Hydratum [Hydrated Oxide of Iron). This preparation [ferric hydrate) (Fe 2 6HO) is made by precipitating the ferric hydrate from its combination in any ferric salt by means of ammonia. Officinally, ferric sulphate is employed for this purpose. When dry, it is a reddish-brown powder, and is not considered an eligible preparation for medicinal use. It is furnished in the form of a freshly-precipitated, soft, moist, reddish-brown magma for use as an antidote to arsenious acid. Ferri Oxidum Hydratum cum Magnesia {Hydrated Oxide of Iron with Magnesia). In this preparation ferric hydrate is precipitated by means of magnesia, instead of am- monia. It is readily prepared, and is used as an antidote to arsenious acid. Ferri Carbonas Saccharatus [Saccharated Carbonate of Iron) [Saccharated Ferrous Carbonate) is obtained by the double reaction of ferrous sulphate and sodium bicarbonate, and is protected from oxidation by the addition of sugar. It is a greenish-gray powder, oxidizing slowly in the air, only partially soluble in water, but completely soluble in hydro- chloric acid. It is a valuable preparation. Dose, gr. v-xxx. Trochisci Ferri [ Troches of Iron) are made with hydrated oxide of iron, vanilla, sugar and mucilage of tragacanth ; each lozenge contains five grains of the iron. Fmplastrum Ferri [Plaster of Iron) is made with hydrated oxide of iron, lead plaster, Burgundy pitch, and. Canada tur- pentine. Massa Ferri Carbonatis [Pill of Iron Carbonate). — Vallet's Ferruginous Pill. To protect the ferrous carbonate (FeC0 3 ) from oxidation, it is prepared (as in the process last described) by dissolving the reacting salts in weak syrup instead of water ; honey and sugar being afterwards added to preserve it unaltered and bring it to the pilular consistence. This preparation is one of the most popular of the chalybeates. It contains nearly half its weight of ferrous carbonate. From PREPARATIONS OF IRON. 153 Ive to twenty grains of the pilular mass may be taken in divided doses through the day. Mistura Ferri Composita (Compound Mixture of Iron) is a mixture of ferrous carbonate (prepared by the reaction of ferrous sulphate and potassium carbonate) with myrrh, spirit of lavender, rose-water, and sugar, to resist oxidation. It is a favourite chalybeate in chlorosis and amenorrhoea. Dose, foj to foij, three times a day. Pilulce Ferri Compositce (Compound Fills of Iron) are pre- pared with sodium carbonate and ferrous sulphate with myrrh and syrup. Dose, from two to six pills three times a day. Both these preparations should be made only as wanted for use. Ferri Sulphas (Iron Sulphate), known, in its impure state, as green vitriol or copperas, is prepared for medicinal use by dissolving iron wire in diluted sulphuric acid, with heat. It is ferrous sulphate (FeS0 4 ,7H 2 0), and occurs in transparent, pale bluish-green crystals, of the form of, the oblique rhombic prism, of an acrid, styptic taste, soluble in water, but insoluble in alcohol. By exposure to the air they effloresce, absorb oxygen, and become yellowish- white, from the formation of ferric sulphate. When heated to 212°, they give out six of their seven equivalents of water, and are converted into a "grayish-white mass, known as the dried sulphate. The alka- lies and alkaline earths and their carbonates, silver nitrate, lead acetate, are incompatible with this salt. Iron- sulphate is one of the most active of the ferruginous preparations, but its local effects are powerfully astringent, and in a concentrated form it acts as an irritant poison. It is preferred to other chalybeates where there is much relaxation of the solids, with excessive discharges ; but it is not so well adapted to long- continued use, on account of its local irritant action. Topi- cally, it is employed in substance and solution as a styptic and astringent. Dose, gr. j to gr. v, in pill ; of the dried sulphate (ferri sulphas exsiccatus), gr. ss to gr. iij. Ferrous sulphate is also used as a deodorizer, acting by absorbing sulphur com- pounds. Ferri Sulphas Frcecipitatus (Precipitated Sulphate of Iron) 154 MATERIA MEDICA — MINERAL TONICS. {Precipitated Ferrous Sulphate). In this preparation the ferrous sulphate is precipitated from a solution of sulphuric acid and water by alcohol. Dose gr. j-v. Liquor Ferri Tersulphatis (Solution of Iron Ter sulphate). This preparation is made by dissolving ferrous sulphate in a mixture of sulphuric and of nitric acid, with water. The nitric acid furnishes oxygen, which converts the iron from a ferrous to a ferric condition. It is Fe 2 3S0 4 (ferric sulphate). This solution is a clear, reddish-brown liquid, nearly devoid of odour, and of a sour, very styptic, and somewhat acrid taste. Its chief use is in making ferric hydrate, and it should be kept on hand for the preparation of the antidote for arsenious acid. It may be used as a styptic, but for this purpose it is inferior to the next preparation. Liquor Ferri Subsulphatis (Solution of Iron Subsulphate). This solution, known as MonseVs Solution, is made in the same way as the last preparation, except that only half the amount of sulphuric acid is used, and an oxysulphate results (Fe 2 (S0 3 ) 3 + Fe 2 3 ). It has a syrupy consistence, a ruby-red colour, is inodorous, and has a very astringent but not acrid taste. It is a less irritant salt than the ferric sulphate, and may be used internally, in hemorrhage from the stomach and bowels, in the dose of from five to fifteen grains. Externally, it is one of the most efficacious styptics we can employ ; and has been injected into varicose veins with success for the cure of varicose ulcers, and, applied by means of the atomizer, has been found efficient in hemoptysis. Diluted with water, it is a good local applica- tion to inflamed mucous surfaces. Ferri Chloridum (Iron Chloride). This salt, which is ferric chloride (Fe 2 Cl 6 ), is made by heating iron wire with muriatic acid (by which ferrous chloride is formed), and after- wards converting the ferrous chloride into ferric chloride by heating it with muriatic and nitric acids. It occurs in frag- ments of a crystalline structure, an orange-yellow colour, in- odorous, of a strong chalybeate, styptic taste, deliquescent, and wholly soluble in water, alcohol, and ether. Internally, it is used chiefly in the form of the tincture. Externally, it is PREPARATIONS OF IRON. 155 applied as a styptic, and in solution, of various strengths, as an astringent. One part, gradually added to six parts of col- lodion, forms a yellowish-red, limpid liquid, of valuable styptic properties. Liquor Ferri Chloridi (Solution of Iron Chloride) is pre- pared by dissolving iron wire in muriatic acid, heating to the boiling point, then heating the liquid, after filtration, with muriatic acid and nitric acid, and afterwards adding distilled water. A reddish-brown liquid, having an acid and strongly styptic taste, and sp. gr. 1*405. It may be used internally for the purposes of the chloride, in doses of TT[ij-vi, diluted, and externally as a styptic. Tinctura Ferri Chloridi (Tincture of Iron Chloride) is made by mixing one part of solution of iron chloride with two parts of alcohol. It is a tincture of the chloride, though there is probably some reaction between the acid and alcohol, as the preparation has an ethereal odour. It is of a reddish-brown colour, and has a sour, styptic taste. It is one of the most effective of the chalybeates, acting locally as an energetic astringent and styptic, and, in large doses, as an irritant. Its indications, both general and topical, are very analogous to those of the sulphate, with the addition of some specific action on the urino-genital apparatus, which renders it appli- cable to the treatment of affections of these organs ; it is especially useful in erysipelas. Dose, TT|x to TTJxxx, gradually increased to f5j or f5ij, and taken in some mild diluent. Mistura Ferri et Ammonii Acetatis (Mixture of Iron and Ammonium Acetate) (Bashams Mixture) consists of tinc- ture of ferric chloride, diluted acetic acid, solution of ammo- nium acetate, elixir of orange, syrup and water. A most ex- cellent preparation, and of great benefit in chronic albuminuria and in chronic dropsies generally where iron is indicated. Dose, §ss-j. Ferri Iodidum Saccharatum (Saccharated Iodide of Iron) (Saccharated Ferrus Iodide). This salt is made by the addi- tion of iron filings to a mixture of iodine in distilled water, and sugar of milk is added t© prevent oxidation. By evap- 156 MATERIA MEDIC A — MINERAL TONICS. oration a yellowish-white or grayish powder is obtained, of a sweetish, ferruginous taste, deliquescent, and very soluble in water. Dose, gr. x-xxx. Syrupus Ferri Iodidi {Syrup of Iron Iodide), which is pre- pared by mixing iodine and iron wire in distilled water, and shaking the mixture until the solution has acquired a green colour, adding syrup, heating to 212°, straining, and, when the liquid has cooled, adding distilled water. It must be kept in well-stoppered two-ounce vials. It is a transparent liquid, of a pale-green colour, and furnishes an excellent alterative tonic, combining the effects of iodine and of iron, and is par- ticularly applicable to the treatment of scrofula, visceral en- gorgements, phthisis, etc. Dose, 20 to 40 drops, three times a day. Pilulce Ferri Iodidi [Pills of Iron Iodide) are made with iodine, reduced iron, sugar, gum Arabic, liquorice-root, liquor- ice, and an ethereal solution of balsam of tolu. They keep very well. Each pill contains about one grain of iron iodide and one-fourth of a grain of reduced iron. Ferri et Potassii Tartras {Iron and Potassium Tartrate) is prepared by the addition of ferric hydrate to a mixture of potassium bitartrate in distilled water. It occurs in trans- parent scales of a ruby-red colour, which are wholly soluble in water. The tartaric acid and potash, in combination in this preparation, render it less constipating than the other cha- lybeates ; and, from its agreeable taste, it is adapted to the diseases of childhood. It is, moreover, not incompatible with alkalies. Dose, gr. x to 5ss. Ferri Phosphas {Iron Phosphate) is obtained by the double reaction of solutions of ferric citrate and sodium phosphate, and is ferric phosphate. It occurs in bright-green transparent scales, insoluble in alcohol, but soluble in water; by exposure to the light it becomes darker. Dose, gr. v to gr. x, in pill. Ferri Pyrophosphas {Iron Pyrophosphate) {Ferric Pyro- phosphate) (Fe 4 3P 2 7 ,9H 2 0). It occurs in apple-green scales, of an acid, slightly saline taste, and is very soluble in water. A good chalybeate. Dose, gr. ij-v. Given also as a PREPARATIONS OF IRON. 157 Ferri Citras (Iron Citrate) may be prepared by the addi- tion of ferric hydrate to a solution of citric acid. It is ferric citrate (Fe 2 2C 6 H 5 7 ), and occurs in thin, transparent pieces, of a garnet-red colour, with a mild, acid, chalybeate taste, slowly soluble in cold water, but readily soluble in boiling water. Dose, gr. v to gr. x. It is officinal also in the form of solu- tion of iron citrate {liquor ferri citratis), a deep reddish-brown liquid, given in doses of 10 to 20 drops ; and it is by evaporat- ing this solution that the solid citrate is obtained. Liquor Ferri Nitratis (Solution of Iron Nitrate) is pre- pared by the gradual addition of diluted nitric acid to ferric hydrate. It is ferric nitrate (Fe 2 6N0 3 ), and is a pale, amber- coloured liquid, with a strong, astringent acid taste. It is tonic and astringent, agreeing very well with the stomach, and is employed in the treatment of chronic diarrhoea, haemat- emesis, hemorrhage from the bowels, and uterine hemorrhage, particularly when anaemic symptoms are present. Dose, gtt. x to gtt. xx, two or three times a day, in dilution. Syrupus Ferri Bromidi (Syrup of Ferrous Bromide) contains 10 per cent, of ferrous bromide. It may be given with advantage where a bromide and iron are both indicated, notably in chorea occurring in delicate girls at the age of puberty, and associated with anaemia (H. M.). Dose, f5j- Ferri Hypophosphis (Iron Hypophosphite) (Ferric Hypo- phosphite) (Fe 2 6H 2 P0 2 ) is obtained by the reaction of a solu- tion of sodium or ammonium hypophosphite with solution of ferric sulphate. It is a white, amorphous powder, insoluble in cold water, soluble in hydrochloric acid, incompatible with the soluble salts of mercury and silver, but has the advantage of not being decomposed by the cincho-tannic acid of cinchona. This is a good chalybeate in diseases of degeneration of the nervous tissue, and has been also given in phthisis; other hypo- phosphites are combined with it. Dose, gr. x-xxx, three times a day. Ferri Oxalas (Iron Oxalate) (Ferrous Oxalate) (FeC 2 4 . H 2 0) is made by the reaction of solutions of oxalic acid and ferrous sulphate. It occurs as a lemon-yellow, crystalline powder, al- 158 MATERIA MEDICA — MINERAL TONICS. most destitute of taste, slightly soluble in water, but easily acted upon by the diluted acids, and decomposed by the alka- lies and their carbonates. This chalybeate is of recent intro- duction, and has the advantage of being well borne by the stomach, of being readily absorbed, while it is nearly destitute of astringency, and not disposed to change like the ferrous salts generally. Dose, gr. ij-iij, in pill, three times a day. Liquor Ferri Acetatis {Solution of Ferric Acetate). Dose, 1T[x-xxx. Chiefly used in preparing Tinctura Ferri Acetata (Tincture of Ferric Acetate), a solution of ferric acetate in alcohol and acetic ether. Dose, TT|x-f 5ss, or more. Ferri Lactas (Iron Lactate) is made by mixing diluted lactic acid with iron filings. It is ferrous lactate, and occurs in greenish-white crystalline crusts or grains of a mild, sweetish, ferruginous taste, sparingly soluble in water, and insoluble in alcohol. Used in chlorosis, and has a marked effect in increas- ing the appetite. Dose, gr. x— xx, in pill, lozenge, or syrup. Ferri et Quinije Citras (Iron and Quinia Citrate). This salt is prepared by precipitating quinia from the sulphate by ammonia, and afterwards dissolving it in a hot solution of iron citrate. As found in the shops, it is a mechanical mixture of ferric citrate with a variable proportion of iron and quinia citrate. It occurs in thin, transparent scales, of a reddish or yellowish-brown colour, with a tint of green, not very soluble in water, and of a ferruginous, moderately bitter taste. It com- bines the virtues of its two bases, and is thought to have an especial agency in diminishing the formation of urea by the kidneys, whence its use in uraemia. Dose, gr. v-x. Liquor Ferri et Quinia Citratis (Solution of Iron and Quinia Citrate). Dose, f5j. Vinum Ferri Amarum (Bitter Wine of Iron) is a mixture of solution of iron and quinia citrate, tincture of sweet orange peel, syrup, and stronger white wine. Dose, f5j-ij- Ferri et Ammonii Citras (Iron and Ammonium Citrate) is made by adding water of ammonia to solution of iron citrate, and evaporating. It occurs in the form of garnet-red, trans- PREPARATIONS OF IRON. 159 lucent scales, of a slightly ferruginous taste, and is readily soluble in water ; it has antacid properties. Dose, gr. v-x. Vinum Ferri Citratis ( Wine of Citrate of Iron), a solu- tion of ammonio-ferric citrate in tincture of sweet orange peel, syrup, and stronger white wine. Dose, f5j- Ferri et Strychnine Citras (Iron and Strychnia Citrate) is made by mixing a solution of strychnia and citric acid in distilled water with a solution of iron and ammonium citrate in water, and evaporating. It occurs in garnet-red scales, of a bitter, ferruginous taste, readily soluble in water. An excel- lent tonic. Dose, gr. ij-iij, two or three times a day. Syrupus Ferri, Quinle et Strychnia Phosphatum (Syrup of the Phosphates of Iron, Quinia and Strychnia), an agreeable tonic. Dose, f 5j. Ferri et Ammonii Sulphas (Iron and Ammonium Sul- phate (NH 4 ) 2 Fe 2 (S0 4 ) 4 .24H 2 0). This salt, called also ammonio- ferric alum, is made by adding ammonium sulphate to a hot solution of ferric sulphate. It occurs in octahedral crystals, of a pale-violet colour and sour, astringent taste, efflorescent, and very soluble in water. Used in diarrhoea and chronic dysentery. Dose, gr. v-xv, two or three times a day. Ferri et Ammonii Tartras (Iron and Ammonium Tar- trate) (2(FeO)NH 4 C 4 H 4 6 .5H 2 0) occurs in transparent, gar- net-red scales, of a sweetish taste, soluble in water, insoluble in alcohol and ether. A mild chalybeate. Dose, gr. x-xxx. Ferri Valerianas (Valerianate of Iron) (Ferric Vale- rianate), a dark, tile-red amorphous powder, with a mildly styptic taste and an odour of valerianic acid; insoluble in cold water, but readily soluble in alcohol. Dose, gr. j-iij. Ferrum Dialysatum (Dialyzed Iron) has been lately intro- duced, and has proved one of the most valuable of the chalyb- eates. It is not apt to constipate, and may be given in doses of from 15 to 50 drops daily. Dialyzed iron is an antidote to arsenic in the stomach. To ensure its conversion into ferric hydrate in the stomach, its ingestion should be followed by a tablespoonful of sodium chloride. It is not officinal. Pills of aloes and iron and syrup of the hypophosphites with iron are officinal, and will be again referred to. 160 MATERIA MEDICA — MINERAL TONICS. CUPRI PR^PARATA — PREPARATIONS OF COPPER. Metallic copper is inert. The salts of copper act locally as caustics, irritants, and astringents, by their coagulating action on albumen ; applied to the sound skin they produce but little effect. They also constringe the tissues and lessen the blood supply to a part. In the blood they probably exist as albu- minates. Some observers have noted a gain in flesh, in animals and man, after a course of copper. Taken too long they give rise to symptoms similar to plumbic poisoning, viz., constipa- tion, paralysis, etc. When exhibited in small doses, they exert a corroborant influence over the cerebro-spinal system, and are employed to fulfill the indications to which tonics are appli- cable, as in the cure of ague, neuralgia, epilepsy, etc. In larger doses, they act as emetics by gastric irritation ; and in excessive doses, they produce gastro-intestinal inflammation and disorder of the nervous system ; death, in fatal cases, is usually preceded by convulsions, paralysis, and delirium. Copper is eliminated by the liver, intestines, and kidneys. Its salts are employed therapeutically, both as external and in- ternal remedies ; externally as stimulants, astringents, styptics, and caustics ; internally, as tonics, astringents, and emetics. In cases of poisoning from the cupreous compounds, the best antidote is albumen, as white of eggs, milk, wheaten flour. The potassium ferrocyanide is also very efficacious, forming with the cupreous compound an insoluble copper ferrocyanide. This salt (which throws down a mahogany-coloured precipitate), ammonia (which strikes an azure-blue colour), sulphuretted hydrogen or ammonium sulphide (which throws down a deep brownish-black precipitate), and metallic iron (on which metal- lic copper is deposited from a cupreous solution), are tests for the soluble salts of copper. Cupri Sulphas {Copper Sulphate). This salt, known as blue stone and blue vitriol, is obtained by roasting the native sulphide, or by combining cupric oxide (CuO) and sulphuric acid, and occurs also as a by-product in silver-refining. It is cupric sulphate (CuS0 4 ,5H 2 0). It occurs in fine prismatic, PREPARATIONS OF ZINC. , 161 blue crystals, which, by exposure to the air, effloresce slightly, and become covered with a greenish-white powder. It has a styptic, metallic taste, is entirely soluble in water, but insoluble in alcohol. It is employed as a tonic and nervine. It is an excellent remedy in obstinate intermittent fever, neuralgia, and essential nervous diseases, in doses of gr. \ to gr. j, or more, in pill, repeated so as not to occasion vomiting. As an astringent, it may be given in the same doses, and will be found extremely valuable in the treatment of chronic diarrhoea, dysentery, and enteritis, and chronic catarrh with profuse secretion. As an emetic, the dose is gr. iij to gr. v. Externally, it is used as an escharotic to fungous granulations, and in solution to arrest hemorrhages, mucous discharges, etc. Cuprum Ammoniatum [Ammoniated Copper) (Ammonio- copper Sulphate) is made by rubbing together copper sulphate and ammonium carbonate. It has a deep azure-blue colour, a styptic, metallic taste, and an ammoniacal odour. Its action is very similar to that of copper sulphate ; but it is used prin- cipally as an antispasmodic tonic in nervous disorders, — epi- lepsy, chorea, hysteria, spasmodic asthma, etc. Dose, gr. J, gradually increased. It is no longer officinal. Cupri Subacetas [Copper Subacetate), or Verdigris (Cu 2 02C 2 H 3 2 ), occurs in pale, bluish-green or green masses or powder. The dose is gr. J to gr. J ; but it is a powerful poison in an overdose, and hence is rarely given as a tonic. The pow- der is used as an escharotic, and an ointment is used. Copper subacetate is not officinal. ZINCI PR^PARATA — PREPARATIONS OF ZINC. Zinc in its metallic state is inert Its compounds are very analogous in their effects on the system to those of copper, but are less energetic. Topically some of the zinc salts (nitrate, chloride) act as powerful caustics, by reason of their affinity for water and power of coagulating albumen. The soluble zinc salts (sulphate, chloride) are readily absorbed, and probably exist in the blood as albuminates, while the insoluble salts 11 162 4 MATERIA MEDICA — MINERAL TONICS. (oxide, carbonate) are slowly taken up by the blood. Zinc is eliminated from the system by the bile, intestines, and urine. The tests for soluble zinc salts are ammonium sulphide, which throws down a white sulphide (the only white sulphide met with), the alkalies, alkaline carbonates, and potassium ferrocyanide, all of which give white precipitates. The zinc preparations are employed topically as caustics, astringents, and desiccants ; and internally as tonics, astringents, and antispasmodics, and in large doses as emetics. In cases of poisoning (which are, however, very uncommon), albumen, demulcents, and opiates are to be administered. Zinci Sulphas {Zinc Sulphate), or White Vitriol, is pre- pared by dissolving zinc in diluted sulphuric acid. It occurs in small, colourless, transparent, prismatic crystals, resembling those of sulphate of magnesium (ZnS0 4 ,7H 2 0). They have a metallic, astringent taste, are soluble in water and insoluble in alcohol, and produce their astringent effect by condensing the tissue and contracting the blood vessels. Dose, as a tonic, anti- spasmodic, and astringent, gr. j to gr. v ; as an emetic (acting by gastric irritation), it is the promptest and safest that can be given in cases of narcotic poisoning, in the dose of gr. x to gr. xx. Externally, it is much used as a caustic, and in solution as a collyrium or in gonorrhoea, in the strength of gr. ij-iij to water f §ij ; in otitis, gr. v to water f§i. Zinci Oxidum {Zinc Oxide) is made by roasting zinc in the air. This is an impure form, known as Commercial Oxide of Zinc {Zinci Oxidum Venale), sometimes called tutty. A purer form is obtained by exposing precipitated zinc carbonate to heat, which expels the carbonic acid and water. It is a yel- lowish-white powder (ZnO), insoluble in water but soluble in diluted sulphuric and hydrochloric acids. It has been given in diarrhoea, and as an antispasmodic tonic, in doses of gr. ij to iij, gradually increased to gr. viij or x, and is highly esteemed in the treatment of epilepsy ; but it is chiefly used externally as a dusting powder, or in the form of ointment (80 grains to ointment of benzoin 400 grains). Zinci Acetas {Zinc Acetate) is made by heating commercial PREPARATIONS OF ZINC. 163 zinc oxide in a solution of acetic acid and distilled water, and occurs in white micaceous crystals (Zn2C 2 H 3 2 ,2H 2 0), very soluble in water, and efflorescent in a dry air. It may be given internally as a tonic antispasmodic, in the dose of gr. j or ij, gradually increased ; but it is used chiefly as a topical astrin- gent in ophthalmia, gonorrhoea, leucorrhoea, etc., in the pro- portion of gr. ij to gr. vj, or more, to an ounce of water. Zinci Carbonas Pr^cipitatus {Precipitated Zinc Carbon- ate) is obtained by the double reaction of solutions of zinc sulphate and sodium carbonate. It is a soft white powder, a mixture of carbonate and hydrate (ZnC0 3 (Zn0 2 )3H 2 0), similar in its action to the oxide, but is chiefly used as a dusting pow- der, and to make a mild astringent and desiccant cerate (Sj to ointment Sv). Calamina Pr^parata (Prepared Calamine), obtained by heat from calamine, the native impure zinc carbonate, is a pinkish powder, used as a desiccant, and in the form of a cerate, called Turner's cerate. Calamine is so frequently adulterated that it is now dismissed from the Pharmacopoeia, though still much used. Liquor Zinci Chloridi (Solution of Zinc Chloride). The evaporation of this solution yields Zinci Chloridum (Zinc Chloride) (ZnCl 2 ), a whitish-gray, semi-transparent, deliquescent mass, having the softness of wax,' and soluble in water, alcohol, and ether. It has been employed internally in doses of gr. j or ij, as an antispasmodic tonic in chorea, epilepsy, and neuralgia. Its local action is that of a powerful caustic, and it is one of the best escharotics that can be exhibited, to produce healthy granulations in malignant or indolent ulcers, especially in lupus. It may be used as a lotion in the strength of gr. ij to f oj of water, or dissolved in a little alcohol, or in the form of paste, made with one part of the salt to two or four of flour. A solution of zinc chloride is employed as an antiseptic, and is also injected into the bloodvessels of anatomical subjects to preserve them for dissection. Burnett's Disinfecting Fluid is a solution of about 200 grains in a fluid- ounce of water. 164 MATERIA MEDICA — MINERAL TONICS. Zinci Iodidum (Zinc Iodide) (Znl 2 ) is made by digesting an excess of zinc with iodine diffused in water. It occurs in the form of a white deliquescent mass, or of fine needles, of a metallic, styptic taste, very soluble in water. It has been used internally, as a tonic, antispasmodic, and astringent, in doses of gr. i-ij, best exhibited in the form of syrup. Externally, it is a most valuable local stimulant and escharotic, equal if not superior in effect to the chloride, and is much used. Zinci Valeriana s (Zinc Valerianate) (Zn2C 5 H 9 2 ) is pre- pared by the double reaction of sodium valerianate and zinc sulphate. It occurs in white pearly scales, having a faint odour of valerianic acid, and a metallic, styptic taste. It dissolves in 160 parts of water and 60 of alcohol. Used in epilepsy and nervous affections, in the dose of one or two grains, repeated several times a day. ARGENTI PR^ PA RAT A — PREPARATIONS OF SILVER. In the metallic state, silver is wholly inert. The only prep- aration which is extensively employed is Argenti Nitras (Silver Nitrate). This salt (AgN0 3 ) is obtained by dissolving silver in diluted nitric acid. It is anhy- drous, and occurs in transparent, colourless, shining, heavy, rhombic plates, which have a strongly metallic and bitter taste, are wholly soluble in distilled water, and become blackened by the action of light in the presence of organic matters. Its so- lution yields with hydrochloric acid or sodium chloride a white precipitate, entirely soluble in ammonia. Physiological Effects. — The topical action of silver nitrate to mucous membranes is that of a caustic by reason of its coag- ulating action on albumen. This action does not extend deeply, since a superficial protecting pellicle is formed. When moist- ened and applied to the skin, a white stain is formed, which soon becomes black on exposure to light, by reduction of the silver to the metallic state. Nervous system : in animals, hypo- dermic injections of silver hyposulphite and albuminate have PREPARATIONS OF SILVER. . 165 caused paraplegia. In small doses, tetanic excitement, and in toxic, convulsions, were produced. On man the silver salts have caused vertigo, loss of memory, nervous depression, etc. The effects of silver on the nervous system are centric and not peripheral. Circulation : the intravenous injection of the sil- ver salts impairs the coagulability of the blood, which is found to be dark and pitchy in colour. Other symptoms noted by this method were probably due to the production of embolism and thrombosis. The silver salts do not -exert a toxic influence on the heart. The silver salts have a metallic, styptic taste. Small doses (oxide, gr. J, nitrate, gr. J) may be taken with considerable impunity by the stomach. But, in excessive quan- tity (of nitrate, gr. 3—5), it may occasion gastro-enteric irrita- tion, with disturbance of the nervous system; and in these cases, the antidote is common salt (sodium chloride), or any inert chloride, which produces, when in contact with the nitrate, sodium nitrate and silver chloride. Silver nitrate has been thought always to undergo conversion into a chloride in the stomach; but more probably it unites with albuminous matters, which render it soluble. In medicinal doses, it has a specific corroborant and antispasmodic action on the nervous system ; and, after prolonged use, since its elimination takes place slowly, produces a peculiar indelible blueness or slate colour of the true skin (argyria), due to a deposition of the metal in the tissues. This, it has been lately asserted, is preceded by a peculiar blue line on the gums, resembling that produced by lead poisoning. Prolonged use of the silver salts (in animals) causes a marked loss of weight. Elimination takes place by means of the bile, kidneys, and intestines. Medicinal Uses. — Internally, silver nitrate has been chiefly employed as an antispasmodic tonic in the treatment of epi- lepsy, and it is among the most reliable remedies that can be administered in this intractable affection ; but its effect in dis- colouring the skin is an objection to its protracted use. It is used also in locomotor ataxia, chorea, gastric ulcer, gastro- dynia, and chronic gastritis, and as an astringent in dysentery and diarrhoea, especially when tuberculous. But it is as an 166 MATERIA MEDICA — MINERAL TONICS. external agent that it is most resorted to. It is the most efficacious application that can be made to inflamed mucous membranes, and, either in the solid form or in solution, it is employed in every variety of inflammation of this tissue. It is also extensively used to produce healthy granulations in wounds and ulcers, to arrest the progress of erysipelatous inflammation and variolus pustules, in porrigo and other skin diseases, in strictures, and to destroy the virus of chancres and of poisoned wounds. Administration. — The dose of silver nitrate internally is gr. J, gradually increased to gr. J or i, three times a day, in pill made with some mild vegetable powder, and given soon after a little light food has been taken. For external use, solutions are made of various strengths, from gr. ij to 5ss in an ounce of distilled water. An ointment is also employed. Argenti Nitras Fusus {Fused Silver Nitrate, Lunar Caustic). For external use, in the solid form, nitrate of silver is melted and poured into small moulds. Argenti Nitras Dilutus {Diluted Silver Nitrate) consists of 50 per cent, each of silver nitrate and potassium nitrate. It is used externally. Argenti Oxidum {Silver Oxide) (Ag 2 0) is obtained by adding solution of potassa to a solution of silver nitrate. It is a tasteless, olive-brown powder, very slightly soluble in water. Its uses are analogous to those of the nitrate, and it is em- ployed in epilepsy, gastrodynia, chronic diarrhoea, uterine dis- ease, etc. It is considered to be free from liability to discolour the skin. Dose, gr. ss to gr. i, twice or thrice daily in powder or pill. BISMUTHI SUBNITRAS — BISMUTH SUBNITRATE. This salt is prepared by first forming bismuth nitrate by dis- solving bismuth in diluted nitric acid ; as metallic bismuth gen- erally contains arsenic, the nitrate thus formed is converted into the carbonate by the addition of solution of sodium car- BISMUTH SUBNITRATE. 167 bonate, whereby most of the arsenic is removed as soluble sodi- um arseniate ; the bismuth carbonate is next dissolved in nitric acid, and the bismuth nitrate is again formed ; a little water is added to the mixed solution of bismuth nitrate and arseniate; by which the subarseniate is deposited and separated ; the addition of a large amount of water causes a deposition of bis- muth subnitrate (oxynitrate) ; the supernitrate remaining in so- lution is lastly decomposed by ammonia, which takes most of the nitric acid, and precipitates the bismuth combined with the remainder in the form of subnitrate. Subnitrate of bismuth, known as pearl white and magistery of bismuth (BiON0 3 ,H 2 0), is a white, inodorous, tasteless powder, nearly insoluble in water. In large amounts (two drachms have produced death) it acts as a poison, with symptoms like those of arsenical poisoning, to which ingredient (arsenic) its toxic action is due. Its medicinal properties are tonic, sedative, and astringent. The bismuth salts are very insoluble, but it is absorbed to some extent, for it has been found in the urine, blood, etc. It is used chiefly to allay sickness and vomiting in chronic nervous affections of the stomach, to relieve the pain of gastralgia, and also as an astringent in subacute and chronic diarrhoea. Dose, gr. v to 3j, or even 5ss, in powder or pill. Externally, it is a good remedy in skin diseases, in the form of ointment. The bismuth subearbonate — bismuthi subearbonas (Bi 2 2 C0 3 ,H 2 0) — is recommended as a substitute for the subnitrate. It is thought to be more readily tolerated by the stomach, and is more soluble in the gastric juice, but it is less astringent. The ammonium and bismuth citrate — bismuthi et ammonii citras — which occurs i*n glossy, translucent, colourless scales, of a slightly acid, metallic, but not disagreeable taste, very soluble in water, is a good preparation as a nervine; dose, gr. ij. The valerianate has been used in neuralgia ; dose, half a grain to a grain, several times a day in pill. The test for a soluble salt of bismuth is a piece of paper wetted with a solution of potas- sium sulphocyanide, and dried, which will produce a yellow spot at the point of contact. 168 MATERIA MEDICA — MINERAL TONICS. CERII OXALAS — CERIUM OXALATE. This salt (Ce 2 (C 2 OJ 3 ,9H 2 0) is usually made by adding a solu- tion of ammonium oxalate to any soluble salt of cerium, and is obtained also from the mineral cerite. It occurs as a snow- white, granular powder, inodorous and tasteless, insoluble in water, alcohol, and ether, but dissolved by sulphuric acid. It resembles the salts of bismuth in its effects, and has lately been deservedly extolled in obstinate forms of vomiting, especially the vomiting of pregnancy. Its physiological action has not been investigated. In chorea and other neuroses it is also highly recommended. Dose, a grain three times a day, or oftener, in pill or suspended in water. The cerium nitrate has been also employed, and is more soluble. Dose, somewhat less. ACIDA MINERALIA — MINERAL ACIDS. The diluted mineral acids are usually classed with tonics ; but, although they exert a very considerable corroborant influ- ence on the system, their action is in many respects peculiar and distinctive. In the concentrated form they are corrosive. When properly diluted with water and swallowed in medicinal doses, they allay thirst, increase the appetite, stimulate diges- tion, and by duodenal irritation increase the flow of bile, and all possess great diffusive power. After absorption into the blood, they combine either with its alkaline bases or albumen, since an acid reaction of the blood is incompatible with life, and often produce a restorative effect in morbid conditions of the circulating fluid, and in their passage out by the secretions act as astringents. Acids given on an empty stomach check the secretion of the gastric juice, so that they should be ex- hibited after a meal, if it be desirable to promote the digestive process. They are employed — as tonics, usually in combina- tion with the vegetable bitters, in dyspepsia, especially when it is dependent on a deficiency of gastric fluid ; as antalkalines, to MINERAL ACIDS. 169 correct the morbid alkalinity of the blood in typhoid and other essential fevers, and in purpura, scurvy, and analogous blood diseases; as astringents and styptics, in hemorrhage from the stomach and bowels, and in colliquative discharges ; to allay febrile heat and cutaneous irritation ; in phosphatic lithiasis ; and locally, as escharotics ; and, in very dilute solution, they are injected into the bladder as lithontriptics. In cases of poisoning from the mineral acids, the alkaline earths and fixed oils are the proper antidotes. Acidum Sulphuricum (Sulphuric Acid) (H 2 S0 4 ), formerly called Oil of Vitriol, is obtained by burning sulphur, mixed with nitre, over a stratum of water contained in a chamber lined with sheet-lead. It is a dense, colourless, inodorous, cor- rosive liquid, of a strongly acid taste and an oily consistence, which unites with water in all proportions with the evolution of heat. When of the sp. gr. 1-845, it contains one equivalent of water. It should have, as directed by the Pharmacopoeia, the sp. gr. 1*843, when it contains 79 per cent, of anhydrous acid ; but it is never found of a sp. gr. over 1*835. The diluted acid is readily detected by a soluble barium salt, which precipitates a white insoluble barium sulphate ; veratria introduced into the diluted acid, and evaporated to dryness, leaves a crimson de- posit. In the concentrated form it is not employed internally, but is sometimes used externallv as a caustic, acting bv coagu- lating albumen, and its affinity for water and organic bases. Dilute sulphuric acid lessens thirst, aids digestion, and dimin- ishes the secretions of the bowels and skin. According to Gub- ler, it — and the other mineral acids — exists in the blood loosely combined with albumen, and that on reaction of the excretory organs this combination is broken up, the albumen remaining in the vessels and the acid passing out united with other bases. When swallowed, it acts as a violent corrosive poison, causing a burning pain in the mouth, throat, and stomach, and usually staining the lips, mouth, and fauces with white or black sloughs ; occasionally the action of the poison is spent upon the upper part of the larynx, and death takes place from asphyxia, with- out the entrance of the poison into the stomach. The proper 170 MATERIA MEDICA MINERAL TONICS. antidote is magnesia or chalk, or solution of soap, and mucil- aginous drinks should be afterwards freely administered. Acidum Sulphuricum Dilutum [Diluted Sulphuric Acid) contains two troyounces of sulphuric acid in a pint of acid diluted with distilled water. It is given as a tonic, refrigerant, and astringent, in the dose of from ten to thirty drops, three times a day, in water, and should be sucked through a tube to prevent injury to the teeth. This acid is a particularly valu- able remedy in typhus and typhoid fevers, colliquative perspi- rations, cholera, and choleraic diarrhoea ; and it is the best corrective for phosphatic lithiasis. Some observations have been made which seem to assign it prophylactic powers against epidemic cholera. It is used externally as a gargle and a wash to ulcers. Acidum Sulphuricum Aromaticum {Aromatic Sulphuric Acid), or Elixir of Vitriol, is made by digesting six troyounces of sulphuric acid in a pint of alcohol, then percolating a troy- ounce of ginger and a troyounce and a half of cinnamon with alcohol till a pint of tincture is obtained, and mixing the tinc- ture with the diluted acid. It is a reddish-brown liquid, with an aromatic odour and a pleasant acid taste ; and is an agree- able substitute for the diluted sulphuric acid, administered in the same doses. Acidum Sulphurosum {Sulphurous Acid) is made by heat- ing sulphuric acid with charcoal and distilled water. The sul- phuric acid is deprived of an equivalent of oxygen by the charcoal, and becomes sulphurous acid (H 2 S0 3 ). It is a colour- less liquid, having the smell of burning sulphur and a sulphur- ous, sour, and somewhat astringent taste. It has been only of late years employed in medicine, and is believed to have -a special influence in destroying parasitic life. It is readily ab- sorbed by the stomach, and is eliminated by the urine and faeces as a sulphate. Internally, it is very efficacious in sarcina ventriculi, or yeast vomiting ; dose, f 3j> largely diluted with water. Externally, it is used in skin diseases (particularly those of a parasitic nature, either animalcular or cryptogamous), diluted with two or three measures of water or glycerin. The MINERAL ACIDS. 171 sodium sulphite — sodii sulphis (Na 2 S0 3 ,7H 2 0) — is used as a substitute for sulphurous acid, which is developed from the salt by any of the organic acids. It occurs in white, efflores- cent, prismatic crystals, of a sulphurous taste, soluble in four parts of cold and one part of boiling water. Dose, 5j» three times a day ; a solution (5i-f§i of water) is a good local appli- cation in erysipelas. The sodium hyposulphite (Na 2 S 2 3 ,5H 2 0) is used for the same purposes. It occurs in white, tabular crys- tals, of a pearly lustre and sulphurous taste, which are very deliquescent, and very soluble in water and alcohol and insolu- ble in ether. Dose, gr. x-xx, three times a day, and for ex- ternal use, 5j dissolved in water fsj. Both the sodium sul- phite and hyposulphite have been found efficacious in intermit- tent and remittent fevers. The sulphite is perhaps the more efficacious salt. Potassii sulphis [potassium sulphite (K 2 S0 3 , 2H 2 0)) occurs in white, opaque fragments or powder, of a saline and sulphurous taste, very soluble in water; its uses and doses are the same as those of sodium sulphite. The magne- sium sulphite (MgSo 3 ,6H 2 0) is also employed in zymotic dis- eases, and is less unpalatable than the sodium salt, and besides contains a larger proportional quantity of acid. The sodium, potassium, and magnesium sulphites are employed in the treat- ment of purulent infection. Calcium and ammonium sulphites have been also recommended. The sulphides appear to possess the power of checking the formation of pus. On this ground they are highly lauded in boils, carbuncles, etc., by Dr. Ringer. Calcium sulphide (calxsulphurata), given in hourly doses, gr. -^, is the salt recommended. In eight cases of chancroidal bubo I found the use of calcium sulphide of apparent service in promoting their resolution. The dose employed was gr. J-J s. t. d. Acidum Nitricum (Nitric Acid) (HN0 3 ) is obtained by the action of sulphuric acid upon potassium nitrate. When pure it is colourless ; but as found in the shops it is usually of a straw colour, owing to the presence of nitric peroxide. It should have a sp. gr. 1*420 (when it contains 60 per cent, of anhydrous acid), and is a corrosive, sour liquid, evolving white 172 MATERIA MEDICA — MINERAL TONICS. fumes when exposed to the air. It may be recognized by giv- ing off orange-coloured fumes when added to metallic copper and other metals, by the morphia test (see p. 57), and by strik- ing a blood red colour with brucia ; diphenylamia has lately been found to be a delicate test, producing a permanent blue colour with nitric acid. Nitric acid is readily absorbed by the blood, and probably exists there either in the form of nitrates or combined with albumen (Gubler). Nitric acid stimulates the glandular apparatus of the intestinal canal, which seems to be due to a local action. It is probably eliminated as a nitrate by the kidneys. Locally, nitric acid is a powerful caustic, acting by abstracting water and combining with the alkaline bases of the tissues. It is employed, in the concentrated form, as an escharotic to destroy warts and stimulate indolent sinuses, and diluted, as an astringent wash or gargle. Cases of poisoning from this acid are to be treated with magnesia or soap and mucilaginous drinks In poisoning from nitric acid, the fauces and mouth are covered with yellow eschars, due to the forma- tion of picric acid. Internally, it is used in the form of Actdtjm Nitricum Dilutum {Diluted Nitric Acid), which contains three troyounces of acid in a pint of diluted acid. This is given as a substitute for sulphuric acid, but is more apt to disagree with the stomach ; it is also employed as an altera- tive in syphilis, and has been found useful in whooping-cough. Combined with laudanum and camphor-water, nitric acid is much used in the treatment of dysentery under the name of Hopes Camphor Mixture (camphor water fSviij, nitric acid f5i, laudanum 25 drops) ; dose, f §ss, repeated. Dose for in- ternal use, 20 to 40 drops, three times a day, reduced with water. Acidum Hydrochloricum (Muriatic Acid) is an aqueous solution of hydrochloric acid gas (HC1), of sp. gr. 1*160, and is obtained by the action of sulphuric acid on a solution of sodium chloride. It is, when pure, a transparent, colourless liquid, but has often a yellow colour, owing to the presence of chlo- rine, iron, or other contamination. It gives off dense white fumes when in contact with ammonia, and evolves chlorine gas MINERAL ACIDS. 173 when heated with manganese dioxide ; in the diluted state it produces, with solution of silver nitrate, a white precipitate, insoluble in boiling nitric acid, but soluble in ammonia. Lo- cally, it is an active caustic, abstracting water and uniting with the alkaline bases of the tissues. Strong baths of muriatic and the other mineral acids exert a powerful influence upon the skin. Hydrochloric acid is readily absorbed by the stomach, either as a chloride or joined with albumen. Hydrochloric acid, in small quantities, augments the digestive power of the gastric juice, since the acidity of that fluid depends on muriatic acid. Hydrochloric acid is chiefly eliminated by the urine. It has a corrosive taste and a suffocating odour, and is an active poison, though less irritating than sulphuric and nitric acids. Magnesia or soap is the proper antidote. It is used externally as a caustic, and as an application in diphtheria, ulcerative and gangrenous stomatitis, etc. ; internally, in the form of Acidum Hydrochloricum Dtlutum {Diluted Muriatic Acid), which contains four troyounces of acid in a pint of diluted acid. This is employed in typhoid and typhus fevers, malig- nant scarlatina, etc. ; also to counteract phosphatic deposits in the urine, to prevent the generation of worms, in syphilis, in dysentery, and in some forms of dyspepsia. Dose, twenty to sixty drops, which may be given in infusion of rose. Acidum Nitro-Hydrochloricum (JVitro- Muriatic Acid). This acid is made by mixing three troyounces of nitric acid with five troyounces of muriatic acid, the resulting reaction liberating chlorine, and forming chloronitrous acid and water, as follows : HN0 3 +3Chl=Cl 2 +NOCl (chloronitrous acid) +H 2 0. It has a deep golden-yellow colour, and emits the smell of chlorine, which is the chief active constituent. Internally, it is em- ployed as a stomachic tonic, and is thought also to be particu- larly efficacious in oxaluria and diseases of the liver and in syphilis. Rutherford's experiments on dogs show that it is a hepatic stimulant. It should not be given with mercurials. Externally, it is used as a bath, either local or general, in oxa- luria, syphilis, and chronic hepatitis, for which purpose one or two ounces of acid may be added to a gallon of water. Dose, 174 MATERIA MEDICA — ASTRINGENTS. from two to five drops, properly diluted, and carefully in- creased. Acidum Nitro Hydrochloricum Dilutum (Diluted Nitro- Muriatic Acid) contains four troyounces of acid in a pint of diluted acid ; dose, ten to twenty drops. ORDER V. — ASTRINGENTS. These are medicines which produce contraction and corruga- tion of the tissues by a local action. Their constitutional effects are somewhat analogous to those of tonics ; and, like them, they increase the tone and vigour of the body, and exercise a control over various disorders of the nervous system. But they are chiefly employed to cure relaxation of the fibres and tissues, to subdue inflammation of superficial parts, and to arrest hemor- rhage and excessive discharges from mucous membranes or other secreting surfaces. In checking morbid discharges from the bowels, astringents diminish the secretions from the intestinal canal, and restrain their peristaltic movements, accomplishing this by a local action. They are divided into Vegetable and Mineral astringents. Most of the former owe their astrin- gency to the presence of a principle termed tannic acid, and differ from tonics in the absence of bitterness. The mineral preparations usually classed among astringents are those of alum and lead, and are distinguished from the mineral astrin- gent tonics by their more decided astringency and a sedative action on the vascular system. VEGETABLE ASTRINGENTS. ACIDUM TANNICUM — TANNIC ACID. This acid, which is the active principle of the vegetable as- tringents, is usually extracted from powdered nutgall by the action of washed ether. The nutgall, made into a soft paste with ether, is enveloped in a canvas cloth, and is pressed be- TANNIC ACID. 175 tween tin plates ; the resulting cake is again mixed with washed ether and expressed ; and the expressed liquids are mixed, evaporated and dried ; the water seems to be the solvent which extracts the tannic acid. It is a light, feathery, non-crystal- line powder, of a yellowish-white colour and a strongly astrin- gent taste, is very soluble in water, and soluble, though less so, in alcohol and ether. It produces a white flocculent precipitate with solution of gelatine, a bluish-black "precipitate with ferric salts (ink), and white precipitates with solutions of the vege- table alkalies ; and these substances are to be, therefore, con- sidered incompatible with all the vegetable astringents. There is a variety of tannic acid (mimo -tannic acid) obtained from kino, catechu, and some other substances, which strikes a greenish black precipitate with the salts of iron, and is not con- vertible into gallic acid. Tannic acid is C 14 H 10 O 9 ; it is a glu- coside, yielding, like many other substances, glucose when boiled with diluted sulphuric or hydrochloric acid, the other product being gallic acid. The most recent investigators con- sider tannin to be the anhydride of gallic acid, in the way that S0 3 (sulphurous anhydride) is the anhydride of sulphuric acid (H,S0 4 ). Effects and Uses. — Tannic acid applied locally to mucous membranes is a powerful astringent, and is applicable to all the cases in which astringents are useful. Tannic acid precipitates peptones from watery solutions, but this does not take place in the presence of muriatic acid (Lewin). It checks the secre- tions of the mouth and stomach by constringing the calibre of the vessels, and it restrains intestinal peristaltis. Injected into the veins in large amount it coagulates albumen, causing fatal thrombosis. Introduced in the same way, more slowly, in moderate quantities, it exists as tannate of albumen, being held in solution by the alkaline carbonates (Lewin). It is now believed that, owing to its coagulating influence on albumen, tannic acid is not absorbed in the stomach, and cannot produce constitutional effects until converted into gallic acid ; but this is probably again changed in the blood into tannic acid. It is eliminated as tannic, gallic, and pyrogallic acids by the kid- 176 MATERIA MEDICA — ASTRINGENTS. neys and intestinal canal. It is used internally in the treat- ment of diarrhoea, dysentery, cholera, hemorrhage, colliquative sweats, etc. ; also as an enema in diarrhoea, dysentery, pro- lapsus ani, and fissure of the rectum ; and, as a topical applica- tion, in hemorrhages, inflammations, and morbid discharges from mucous membranes, ulcers, etc. It is perhaps the best form in which the vegetable astringents can be employed, owing to the certainty and minuteness of the dose in which it can be given. Dose, gr. j to gr. iij or iv, in pill, occasionally repeated. Troches of tannic acid are made by rubbing together tannic acid, powdered sugar, and powdered tragacanth, and forming a mass with orange-flower water ; each troche contains a grain of tannic acid. Suppositories of tannic acid contain each two grains of tannic acid. For external use, the glycerite of tannic acid (glyceritum acidi tannici) is employed ; it is made by rubbing together and dissolving at a gentle heat tannic acid in glycerin. Ointment of tannic acid (unguentum acidi tannici) is made by rubbing up 30 grains of tannic acid with a troy- ounce of lard. ACIDUM GALLICUM — GALLIC ACID. This principle is found in many of the vegetable astringents, but less uniformly than tannic acid, and is probably the result of changes which the latter has undergone. It is prepared by exposing a mixture of nutgall in water to the air, in a warm place, for a month, when the tannic acid is gradually converted into gallic acid by the absorption of a molecule of water, since the most recent experimenters (H. Schiff, Sac, and Lowe) have shown that tannic acid is the anhydride of gallic acid ; it is purified by being boiled in water and filtered through animal charcoal. Gallic acid is H 3 C 7 H 3 5 +H 2 0. It is distinguished from tannic acid by not coagulating albumen or gelatin. With ferric salts it forms blue-black precipitates, and it unites with organic and inorganic bases to form gallates. For internal use, gallic acid is preferable to tannic, since it does not coag- ulate albumen. It occurs in small silky, nearly colourless NUTGALL. 177 crystals, having a slightly acid and astringent taste, and is soluble in boiling water, and slightly so in cold water. Effects and Uses. — Gallic acid is a valuable astringent, which has of late been extensively employed in hemorrhagic disorders, as uterine hemorrhage, hemoptysis, hematuria, bloody diar- rhoea, etc. Both tannic and gallic acids have been found use- ful in albuminuria. Gallic acid has but feeble local astringent powers, and is probably converted into tannic acid in the blood. Given by the stomach, it is more efficacious than the latter acid. It may be given in doses of gr. ij to gr. v, in pill, every two or three hours. G-lycerite of gallic acid is made by the same formula as that of tannic acid, but neither is officinal. GALLA — NUTGALL. Nutgall is an excrescence found upon Quercus infectoria, the Gall Oak (Nat. Ord. Cupuliferae), a small tree or shrub of Asia Minor. The gall-nuts are produced by the puncture of the buds by a fly (Cynips quercusfolii or Diplolepis gallon tinc- torial) to form a nidus for its eggs. This occasions an irritation and flow of juices to the part, resulting in the formation of a tumour round the larvae, which, on attaining maturity, perforate the gall and escape. Galls are produced chiefly in Syria and Asia Minor, and are imported from the Levant. They are brought also from Calcutta, being collected to some extent in India. Galls are spherical, about the size of a hickory-nut, with small tubercles on their surface. The best are bluish or black externally and grayish within, without odour, and of a very astringent, bitter taste. They yield their properties to both water and alcohol, but best to the former, and contain tannic acid, 50 to 60 per cent., and gallic acid, 3 per cent. ; mucilage, sugar, etc. White galls are collected after they have been perforated by the insect, and are inferior in astringency, containing only 30 per cent, of tannic acid. Effects and Uses. — Galls are powerfully astringent, but are not much used internally. In the form of infusion or decoc- tion they are employed as enemata in diarrhoea and dysentery, 12 178 MATERIA MEDICA — ASTRINGENTS. and- also as gargles. Dose of the 'powder, gr. x to gi\ xx. The tincture (Siv to diluted alcohol Oij) may be given in the dose of f'5j to fSiij, but it is used chiefly as a chemical test. The ointment (5i to lard Si) is a favourite application in hemor- rhoids, and may be advantageously combined with opium (5ss to ointment 5j). CATECHU. Catechu, formerly called Terra japonica, is an extract of the wood of Acacia catechu, a small prickly tree of India (Nat. Ord. Leguminosae). Twelve or fifteen varieties of the drug are described by pharmacologists ; but it is usually met with in the shops in masses of various shapes and sizes, of a rusty-brown colour externally, and varying internally from a reddish or yellowish- brown to a dark-brown colour. The best is of a dark colour, and is easily broken into small angular fragments, with a smooth, glossy surface, bearing some re- semblance to kino. It is without smell, and has an astringent, bitter taste. It contains about 50 per cent, of catechu-tannic acid, which strikes a greenish-black precipitate with ferric salts, and about 30 per cent, of an extractive, called catechuic acid, or catechin, to both of which it owes its peculiar properties ; also, in small amount, quercitrin and catechu-red. Effects and Uses — This is one of the most powerful and valuable of the vegetable astringents, possessing also mild tonic properties. It is much employed in combination with other remedies in diarrhoea, dysentery, hemorrhages, and in all cases of immoderate discharge unattended with inflammatory action. It is best administered half an hour before meals. It is a good deal used in relaxed conditions of the mouth and throat, to relieve the hoarseness of public speakers, also in aphthous ulcerations of the mouth and spongy affections of the gums. Topically, it is employed as a styptic, and in solu- tion as an injection in gonorrhoea and gleet, etc. Dose of the powder, gr. x to 5ss in bolus or emulsion. Infusum Catechu Compositum (Compound Infusion of KINO. 179 Catechu) is made by adding boiling water (Oj) to powdered catechu (§ss) and cinnamon (5j) ; dose, f oj to f|>ij, three or four times a day. Of the tincture (Siij to diluted alcohol Oij, with cinnamon oij) the dose is f5j to f3iij- KINO. The term Kino is applied to the products of several trees. Five varieties are known. 1. East India kino, which is the most common, and is the INSPISSATED juice of Pterocarpus marsupium, a lofty tree of Malabar. 2. African kino, the original variety introduced into Europe, but not now met with; obtained from Pterocarpus erinaceus. 3. Botany Bay kino, the concrete juice of Eucalyptus resinifera, a large tree of Au- stralia. 4. Bengal or Palas kino, from the Butea frondosa. (All these trees belong to the Nat. Ord. Leguminosse.) 5. Jamaica and Caraccas kino, the extract of the wood and bark of Coccoloba uvifera, or Seaside Grape ( Nat. Ord. Polygona- ceae), a small tree of South America and the West Indies. East India kino is met with in small angular, shining frag- ments, of a dark-brown or reddish-brown colour, brittle, with- out smell, but with a very astringent taste. It contains kino- tannic acid, kino-red, pyrocatechin (a trace), and kino'in. South America kino comes in large masses, externally very dark, and internally of a deep reddish-brown colour. Jamaica kino is like the last, but contained in large gourds. Effects and Uses. — Kino is a powerful astringent, and is much used in diarrhoea, chronic dysentery, leucorrhoea, gonor- rhoea, hemorrhages, etc. Externally, it is employed as a styptic, and as a stimulant to indolent ulcers. Dose, of the powder, gr. x to 3ss ; of the tincture (5vj (mixed with an equal bulk of dry sand) to diluted alcohol foviij), f 5j or foij may be given, and it is frequently added to chalk mixture in diar- rhoea. It becomes gelatinous if kept for any time, but this may be prevented by mixing with f §iv of alcohol f oj of water and f 5j of glycerin, instead of the diluted alcohol of the of- ficinal formula. 180 MATERIA MEDICA — ASTRINGENTS. KRAMERIA RHATA NY. Rhatany is the root of Krameria triandra (Nat. Ord. Poly- galese), a shrub of Peru. It occurs in woody cylindrical pieces, of the thickness of a goose-quill to twice that size — many radi- cles being often united to a common head. They have a dark, reddish-brown bark and a tough central ligneous portion, of a lighter red colour. They are without smell, but have a very astringent, slightly bitter and sweetish taste, which is much stronger in the cortical than the ligneous portion ; and hence the smallest pieces should be preferred, as they contain the most bark. Rhatany yields a large pro-portion of kramero- tannic or rhatania-tannic acid and rhatanic red. It imparts its properties to both cold and boiling water, but more fully to alcohol. Effects and Uses. — Rhatany is powerfully astringent, with some tonic properties. It is much used in the treatment of diarrhoea, dysentery, hemorrhages, etc., and as an enema Trous- seau strongly recommends its u?e in fissure of the anus and in tenesmus due to chronic dysentery or hemorrhoids ; it is also used in hemorrhoids, leucorrhoea, etc. The powdered extract is an ingredient in many tooth-powders, and the tinc- ture is used also as an astringent mouth-wash. Dose of the powder, gr. xx to gr. xxx. But it is more employed in infusion (Si to boiling water Oj), dose, f Sj or f §ij ; watery extract, dose, gr. x to gr. xv ; fluid extract, dose, f 5ss-i ; tincture (gvi to diluted alcohol Oij), dose, f5j to f5ij ; and syrup, dose, f 5j to fgss. H^MATOXYLON^ — LOGWOOD. Logwood, or Campeachy wood, is the heart-wood of Haema- toxylon Campechianum (Nat. Ord. Leguminosse), a medium- sized tree of Campeachy and other maritime parts of tropical America, and now naturalized in the West Indies. The por- tion used in medicine, and also as a dye, is the heart-wood, from which the bark and white sap-wood are removed pre- vious to exportation. It is imported in billets of different WHITE OAK — BLACK OAK. 181 sizes, of a dark colour externally and a deep red internally ; in the shops it is kept in chips or raspings. It has a sweetish, astringent taste and a feeble, not unpleasant, smell. It con- tains tannic acid, a colouring principle called hcematin or hcematoxylin, volatile oil, resin, etc. Effects and Uses. — It is a mild astringent, useful in chronic diarrhoea and dysentery, and! particularly well adapted to the weakened condition of the bowels which follows cholera infan- tum, and is also much employed in the diarrhoea of phthisis. It is given either in decoction (Si to water Oij, boiled down to Oj), in the dose of f Sj to f§ij to adults, and f5j to f 5y to children ; or watery extract, in the dose of gr. x to 5ss, in solution. QUERCUS ALB A W HITE0AK. QUERCUS TINCTORI A BLACK OAK. The barks of several species of American oaks possess as- tringent properties, and are probably to be found in the shops, but the only officinal varieties are Quercus alba, White Oak, and Quercus tinctoria, Black Oak {Nat. Ord. Cupuliferae). The inner bark is the portion used, but the leaves and acorns also are astringent. White-oak bark is distinguished by its whitish colour. When prepared for use, it is deprived of its epidermis, and is of a light-brown colour and fibrous texture, with an as- tringent and bitterish taste. Water and alcohol extract its virtues, which depend mainly on the presence of querci-tannic acid, with a bitter principle termed quercin. Black-oak bark is more furrowed, has a darker colour, a more bitter taste, and stains the saliva yellow when chewed ; it is much employed as a dye, under the name of quercitron. It contains a larger pro- portion of querci-tannic acid than the white-oak bark, and a yellow colouring matter, quercitrin. Effects and Uses. — A decoction of white-oak bark is a good remedy in diarrhoea and hemorrhoids, and is employed as an enema in hemorrhoids and prolapsus and fissure of the anus, as a gargle in relaxation of the uvula, and as an injection in 182 MATERIA MEDICA ASTRINGENTS. leucorrhoea. It is used as a bath in the bowel complaints of children ; and a poultice of the ground bark is applied in gan- grene. Black-oak bark is too irritating for internal exhibition ; but for external use is a stronger astringent than the white- oak bark. Of the decoction of white oak (decoctum quercds albce) (Si to water Oj), f §ij may be taken frequently. GERANIUM. One of the most powerful of the indigenous astringents is Geranium maculatum, Crowfoot, or Cranesbill (JVat. Ord. Ge- Fig. 15. WITCHHAZEL. 183 raniacere), a perennial herbaceous plant, growing in moist ■woody situations, with an erect stem one to two feet high, pale- green, mottled leaves, and large purple flowers, which appear in April and May. The part used is the rhizome, which should be collected in the autumn. This, when dried, occurs in wrinkled, rough pieces, from a quarter to a half an inch in thickness, furnished with slender fibres, of a dark-brown colour externally and a pale flesh-colour within. It has an astrin- gent but not bitter taste and no smell, and contains tannic and gallic acid, with some mucilage. Effects and Uses. — This is an excellent simple astringent, agreeing very well with the stomach, and might be advantage- ously substituted for more expensive foreign drugs. It may be used internally to fulfill the indications of kino, rhatany, etc., in bowel complaints and hemorrhages, and topically as an ene- ma, gargle, injection, etc. It is also a valuable styptic. Dose, in poivde?*, gr. x to xx ; of the decoction (§i to water Oj), foj to f 5ij may be given ; this is not officinal. A decoction in milk is given to children. The fluid extract may be given in doses of 5ss-5i- HAMAMELIS — WITCHHAZEL. Hamamelis Virginica, or Witchhazel [Nat. Ord. Hamame- lace^e), is a shrub, from six to ten feet high, growing in the damp woods of the United States and Canada. The leaves are the officinal part of the shrub, and should be collected in autumn. They are bitter and astringent. The bark may also be used. Hamamelis contains tannic acid (8-10 per cent.), a volatile principle not yet accurately determined, etc. Effects and Uses. — Hamamelis is an astringent, and, accord- ing to Phillips, possesses probably a hemostatic and shrinking powder over veins, especially those of the skin and mucous mem- branes. It has been used with success in passive hemorrhages, in hsematemesis, haemophthisis, and in hematuria. It is very beneficial in hemorrhoids, checking the bleeding and reducing the size of the enlarged veins. For this purpose it may be 184 MATERIA MBDICA — ASTRINGENTS. given internally and used as an injection, beginning with 5j to water gij, and gradually increasing the strength. The injection should be taken morning and evening, and retained. It must be continued for some time (H. M.). It is also recommended in varicocele, and locally in inflammations and congestions. The fluid extract is the only officinal preparation; dose, 5ss-j. The following vegetable astringents deserve notice, though less frequently employed than the foregoing : Granati Fructus Cortex {Pomegranate Rind) (not offici- nal). This is the rind of the fruit of Punica granatum, the Pomegranate tree (Nat, Ord. Granatacese), a small tree of northern Africa, Syria, and Persia, now naturalized in the warmer portions of Europe, the West Indies, our Southern States, etc. The rind of the fruit is a powerful astringent, containing 28 per cent, of tannic acid, but is little used inter- nally, from its liability to occasion nausea. Dose, in poivder, gr. xx to 3ss ; but it is best given in decoction (a §j to water Oj), dose, fgj, Rosa Gallica (Bed Rose) ; Rosa Centifolia (Pale Rose). The petals of these two species of rose are officinal, but those of almost every other species of cultivated rose may be em- ployed for the same purpose as Rosa centifolia, which is not astringent. The red rose is a mild astringent, and is chiefly used in conjunction, with sulphuric acid in the infusum rosoe compositum — compound infusion of rose; dose, fSij to foiv. The confection is used as a basis for pills. Mel Rosoe (Honey of Rose), made with diluted alcohol and clarified honey, is used as an addition to gargles ; the syrup is added to mixtures. The pale rose is slightly laxative. Aqua Rosob (Rose Water), dis- tilled from the pale rose, is much employed in collyria, etc. TJnguentum Aqum Rosce (Ointment of Rose Water) is made by melting together expressed oil of almond, Siijss, spermaceti, §i, white wax, 5\j, and then gradually adding rose water, f§ij ; this is a very soothing application, much used under the name of cold cream. Diospyrus (Persimmon) (not officinal). The unripe fruit PREPARATIONS OF LEAD. 185 of Diospjros Virginiana {Nat, Ord. Ebenaceae), an indigenous tree, is employed in diarrhoea, dysentery, and uterine hemor- rhage, in infusion, syrup, and vinous and acetous tinctures. The bark is bitter and astringent. Rubus [Blackberry). The bark of the root of Rubus villosus and Rubus Canadensis (Nat. Ord. Rosacese), the former an erect, prickly shrub, and the latter a creeping brier, are very efficient mild astringents, which have been used with ex- cellent effect in bowel complaints, especially those of children. The astringency resides principally in the cortical portion, and hence the smallest roots should be preferred ; of the decoction (not officinal) (§j to water Oj), fgij may be taken frequently. The fluid extract may be given in doses of f5j-ij ; the syrup is made by adding Oss of the fluid extract to syrup Ojss. Dose, fgse. Castanea (Chestnut). The leaves of the Castanea vesca (Nat. Ord. Cupuliferse), a stately tree indigenous to both hem- ispheres, are officinal. They should be gathered in the autumn while still green. They contain tannin, etc., and are used principally in whooping-cough. Dose of the fluid extract, f5ss- ij. A large number of vegetable substances, both indigenous and foreign, have been used as astringents in addition to those enumerated, the astringent principle being the most common medicinal property with which plants are endowed. The fore- going list comprises the more important. MINERAL ASTRINGENTS. PLUMBI PR^PARATA — PREPARATIONS OF LEAD. Metallic lead is considered inert. The sulphide and sulphate are probably also inactive; but with these exceptions, all the compounds of lead possess more or less activity. When ap- plied locally in solutions not too concentrated, they coagulate albumen, contract the bloodvessels, and consequently blanch the tissues. When more highly concentrated solutions are ap- plied, they act as irritants, producing inflammation. When 186 MATERIA MEDICA ASTRINGENTS. administered in therapeutical doses, they act as astringents in the alimentary canal, checking secretion and causing constipa- tion. Rutherford states that lead acetate is the only drug which decreases the secretion of bile without causing purga- tion, and attributes this effect to a direct action on the liver. The lead preparations probably enter the blood as albuminates. After absorption they produce a diminution in the volume and frequency of the pulse and in the activity of the secreting functions, and frequently arrest sanguineous discharges, both natural and artificial. In excessive doses, several of the sat- urnine compounds are irritant and corrosive poisons, giving rise to gastroenteric imflammation, and sometimes to paraly- sis, coma, and collapse. The toxic dose of lead acetate is §i- ij. It is rarely fatal, owing to the vomiting it, produces. The proper antidote is sulphuric acid or some alkaline or earthy sulphate, in solution in a large quantity of diluent. The tests for lead are sulphuretted hydrogen and a solution of potassium iodide ; the former strikes a black and the latter a yellow pre- cipitate with soluble lead salts. The editor has ascertained that sulphuretted hydrogen will detect one part of a soluble lead salt in one million parts of water (Am. J. M. S., Oct., 1878). When the system becomes impregnated with lead, either from the too long-continued use of its preparations medicinally, from drinking water drawn through lead pipes, or from expo- sure to its influence in lead-factories, etc., a peculiar kind of chronic poisoning is produced, which shows itself in a variety of symptoms. The most usual form of lead-poisoning is colic, sometimes termed colica Pictonum, and painter s colic, which is characterized by sharp abdominal pains, with hardness and de- pression of the abdominal parietes, obstinate constipation, nau- sea, vomiting, etc. Dr. Earnest Harneck, from experiments on the lower animals, concludes that colica Pictonum is due to intense excitation of the intestinal ganglia by the lead, produc- ing arrest of peristalsis from spasm of the muscular coat, and recommends belladonna or atropina as affording speedy relief. Next in frequency is lead-arthralgy, in which there are severe pains in the limbs, attended by cramps, hardness and tension PREPARATIONS OF LEAD. 187 of the painful parts. Lead-paralysis is another, though less common, variety of the disease, and is characterized by a loss of voluntary motion, owing to the want of contractility of the muscular fibres of the affected parts. It most frequently affects the upper extremities, and the extensor rather than the flexor muscles. Occasionally, functional disease of the brain is also observed as one of the consequences of lead-poisoning. The absorption of lead into the system is recognized by a saturnine coloration of the gums, of the mucous membrane of the mouth, and of the teeth. In a series of experiments made by the editor, the fact was established that the emanations from fresh lead paint do not contain lead. It seems proven, therefore, that in order to induce saturnine poisoning, actual contact is necessary with paint or lead in some form (Am. J. M. S., Oct., 1878). The antidotal treatment of chronic lead-poisoning con- sists in the internal administration of solutions of sulphuric acid and of soluble alkaline and earthy sulphates, and in the use of baths of potassium sulphide, dissolved in warm water, by which the salts of lead, deposited on the skin, are converted into the insoluble sulphide. Potassium iodide is employed as an eliminative remedy. For lead-colic, a combination of ca- thartics and opiates has been employed ; but the best remedy is alum, in doses of 5j or 5ij, every three or four hours, dis- solved in some demulcent liquid. In the treatment of lead- palsy, strychnia and electricity may be used, but it is a very intractable form of the disease. The use of sulphuric acid lemonade is resorted to, by workmen in lead factories, as pre- ventive of lead-poisoning. Milk has been found also to answer the same purpose. By passing a strong solution of potassium or sodium sulphide, heated to the temperature of 212° F., through leaden pipes, the interior surface will become coated with an insoluble lead sulphide, and the water distributed through them wi-11 be free from contamination. Therapeutically, the preparations of lead are employed as astringents, sedatives, and desiccants. For internal use the acetate is almost exclusively employed. It is a most valuable remedy in hemorrhages, from its combined sedative and astrin- 188 MATERIA MEDICA ASTRINGENTS. gent influence, and is also very serviceable in fluxes from the raucous membranes, particularly of the bowels. Topically, lead-washes are employed to relieve superficial inflammation, to arrest morbid discharges, and as desiccants. They are ob- jectionable, however, as eye-washes, from their often forming precipitates of lead upon the cornea. VlvmbiAcet as (Lead Acetate). This salt (Pb2C 2 H 3 2 3H 2 0), known also as saccharum saturni or sugar of lead, is made by immersing lead in distilled vinegar, or litharge in pyro- ligneous or crude acetic acid. It occurs in colourless, needle- shaped crystals, which effloresce on exposure to the air. They have an acetous odour and a sweetish, astringent taste, and are soluble in both water and alcohol. The mineral acids and their soluble salts, the alkalies and alkaline earths, and vege- table astringents, are incompatible with acetate of lead. The lead salts are aided in their depressing action upon the circula- tion by prolonged cold, ergot, veratrum viride, etc. ; in their astringent effect on the tissues by the salts of zinc, copper, bis- muth, etc. ; and in their depressing influence on nutrition by mercury, antimony, copper, and other metals which increase tissue waste. Effects and Uses. — The effects of this salt are those of the saturnine preparations which have been already described. Its medicinal influence is sedative and astringent. In hemor- rhages it is employed internally, usually in combination with opium. This combination is also much resorted to in the treat- ment of diarrhoea, dysentery, and cholera, and may be pre- scribed with advantage to arrest the secretion of bronchitis and the night sweats of phthisis, and in the cure of internal aneu- rism. In yellow fever it is employed to check the hemorrhagic condition of the gastric mucous membrane. It is a dangerous remedy in chronic diseases, from the liability to lead-poisoning. As a topical remedy, acetate of lead, in aqueous solution, is extensively employed to relieve inflammation and diminish morbid discharges. Dose, gr. j or ij to gr. viij, two or three times a day. When applied to mucous membranes, the strength of the solution may be gr. ss to gr. j or ij to water f §j ; for PREPARATIONS OF LEAD. 189 phlegmonous inflammation, 5ij to water Oj. Suppositories of lead (suppositoria plurnhi) (not officinal) contain each 3 grains of acetate of lead ; for suppositories of lead and opium, see p. 63. Liquor Ploibi Subacetatis (Solution of Lead Subacetate). This preparation, frequently termed Goulard's Extract, is an aqueous solution of the diacetate of lead (Pb 3 2 2C 2 H 3 2 ), and is made by boiling acetate of lead and litharge in distilled water. It is a colourless liquid which is decomposed on ex- posure to the air, with the formation of insoluble lead carbonate, and occasions a dense white precipitate with solution of gum. In other respects it resembles a solution of acetate of lead. Uses. — It is chiefly employed, diluted, to promote the reso- lution of external inflammation and arrest discharges from suppurating, ulcerated, and mucous surfaces. It may be ad- vantageously employed in the moist varieties of eczema, and also in acute cases accompanied with much heat. The officinal dilution is liquor plumbi subacetatis dilutus, commonly known as lead-water, and consists of solution f5iij to distilled water Oj. Ceratum plumbi subacetatis, or Goulard's Cerate, is made by mixing melted white wax with olive oil, afterwards adding Goulard's extract and camphor dissolved in olive oil; it is an admirable dressing to excoriated and blistered surfaces, bums, scalds, etc. Linimentum plumbi subacetatis (liniment of sub- acetate of lead) is made by mixing olive oil with Goulard's extract. Plumbi Iodidum (Lead Lodide) (Pbl 2 ) is made by the double reaction of solutions of lead nitrate and potassium iodide. It is a bright-yellow, heavy, inodorous powder, volatilizable by heat, sparingly soluble in cold water, but more soluble in boiling water. It is used chiefly to reduce the volume of in- dolent tumours, and may be given internally in the dose of gr. iij-iv, or more, in pill; but it is principally employed externally in the form of ointment (oj to ointment 5vij). Plumbi Xitras {Lead Nitrate) (Pb2X0 3 ), made by dissolv- ing litharge in diluted nitric acid, occurs in white, nearly opaque, octahedral crystals, permanent in the air, of a sweet, 190 MATERIA MEDICA — ASTRINGENTS. astringent taste, and soluble in water and alcohol. It may be given internally, as a sedative astringent, in doses of gr. \ to gr. j, twice or thrice daily, in pill or solution. But its principal use is as a topical agent in the treatment of wounds, ulcers, and cutaneous affections. Dr. Fordyce Barker recommends it as an application to fissured nipples (gr. x in glycerin gj). The breast must be carefully washed before nursing. Ledoyens Disinfecting Fluid is a solution of nitrate of lead 5j in water Plumbi Oxtdum {Lead Oxide) (PbO), or Litharge, is pre- pared by blowing air through melted lead, and is obtained also in the process for extracting silver from argentiferous galenas. It occurs in minute yellowish or orange-coloured scales, insol- uble in water, and is never employed internally. It is some- times sprinkled over ulcers, but its chief use is in the prepa- ration of emplastrum plumbi, or lead plaster (called also diachylon), which is made by boiling litharge with olive oil in water, and is, chemically, a mixture of lead oleate and mar- garate. It serves as a basis for most of the other plasters. Emplastrum saponis (soap plaster), made by rubbing up soap with lead plaster, is an excellent discutient. Soap cerate is made by melting together soap plaster and yellow wax, and afterwards adding olive oil. Plumbi Carbonas (Lead Carbonate), or White Lead (2Pb C0 3 ,PbH 2 2 ), is manufactured in this country by exposing lead to the fumes of vinegar or acetic acid, carbonic acid being derived from the fermentation of tan, in which the pots con- taining lead are packed ; oxyacetate of lead, as formed, is converted into carbonate. It is a white powder, without smell or taste, and insoluble in water, and, as it occurs in commerce, is a compound of lead carbonate and hydrate (2PbC0 3 .Pb2HO). It is never administered internally, but it is employed as a dust- ing powder — though there is danger of its absorption. Un- guentum plumbi carbonatis (5j to ointment 5vij) is a good ap- plication to burns, etc. White paint is used for the same pur- pose, but when applied to a large surface it may produce lead- poisoning. ALUM. 191 A LUMEN — ALUM. Alum is a double salt, an aluminium and potassium sulphate (K 2 A1 2 4S0 4 .-4H 2 0). It is manufactured from aluminous schist, and sometimes bj the direct combination of its constituents. It crystallizes in regular octahedrons ; but it is commonly found in the shops in large colourless, transparent crystalline masses, without any regular form. It has an astringent and sweetish acid taste ; by exposure to the air it slowly effloresces ; it is soluble in cold water, and more so in boiling water; and when heated it undergoes the watery fusion, swells up, and gives out its water of crystallization, and is converted into a white, spongy mass, called dried alum. The alkalies and their car- bonates, lime solution, magnesia and its carbonate, tartrate of potassium, acetate of lead, and tannic acid are incompatible with alum. It is aided in its action by the vegetable and min- eral astringents. Besides the potassium alum, there are varieties in- which the potassium is replaced by some other base, as ammonium or sodium; the officinal alum was formerly the sulphate of alu- minium and ammonium, but this has been superseded by potas- sium alum. Physiological Effects. — The immediate topical effect of alum' is that of a powerful astringent, in virtue of a chemical action on the tissues. When it is applied to a part in large quantities, the astriction is soon followed by irritation ; and thus, taken internally in excessive doses, it gives rise to vomiting, griping, purging, and even inflammation of the gastro-enteric mucous membrane. After its absorption it acts as an astringent on the system generally, and produces astriction of the tissues and fibres, contraction of the capillaries, and a diminution of secre- tion, thus producing constipation. It is eliminated chiefly with the faeces. After large doses, Orfila detected it in the urine of dogs. Death has resulted in man from dried alum ojss. Medicinal Uses. — Alum is employed internally in hemor- rhages, chronic diarrhoea, colliquative sweating, diabetes, etc., and it is sometimes combined with cubeb in the treatment of 192 MATERIA MEDICA — STIMULANTS. gleet, gonorrhoea,' and leucorrhoea. It has also been given as an emetic in croup. Its use in lead-colic has been alluded to. As a topical remedy it is valuable as an astringent antiphlogistic in ophthalmia, diphtheria, tonsillitis, etc. ; to produce contrac- tion of the tissues, in relaxation of the uvula, prolapsus ani, etc. ; as a styptic in hemorrhages; and to arrest excessive se- cretion from the mucous surfaces. In hemoptysis and bron- chitis, a strong solution of alum may be applied by atomiza- tion. Dose, gr. x to 3j or 3ij, in powder or solution, or made into pills with some tonic extract, and combined with an aro- matic, as nutmeg, to prevent nausea. It may be agreeably given in the form of whey, prepared by boiling 5ij with milk Oj, and straining, of which the dose is f§ij- Topically, it is employed in the forms of powder, solution, and poultice, the latter of which is made by rubbing up whites of eggs with alum, and is applied to the eye in ophthalmia, between folds of linen. Dried alum (alumen exsiccatum) is employed internally in the dose of gr. v-x, and externally as a mild escharotic. Aluminii Sulphas (Aluminium Sulphate) (A1 2 3S0 4 ,18H 2 0) is employed externally as an astringent and antiseptic applica- tion to ulcers, an injection in gonorrhoea, etc. The aqueous solution is used to preserve bodies for dissection. A paste, made of a mixture of sulphate of aluminium and sp. nitrous ether, applied to the cavity of a carious tooth, is a good remedy for toothache. ORDER VI. — STIMULANTS. Stimulants are medicines which produce a rapid and tem- porary exaltation of the vital functions. Their influence is most conspicuous in conditions of morbid depression, when a marked tolerance of their action is established, and large amounts are borne. In health, when the powers of the system are at the normal standard, stimulants soon induce depression. Topically, they irritate and inflame the parts to which they are applied, and hence are classed with irritants. Stimulants are employed principally in disorders known as ALCOHOL. 193 asthenic, and in all conditions of the system attended with exhaustion. From their action in arousing the energies of the nervous system, they exercise a control over many nervous disorders, particularly those of a spasmodic nature. They are also frequently given with a view to their action on some one or other of the secretions. As stimulants to the gastrointes- tinal canal, they are administered to promote digestion (when they are called stomachics) and to dispel flatulence (when they are known as carminatives). Topically, they are employed as rubefacients, vesicants, etc. The more powerful and rapid stimulants are called diffusible. In overdoses, they act as violent narcotics and sedatives. The diffusible stimuli usually employed are vinous and spirituous liquors and the preparations of ammonia. Vegetable stim- ulants which contain a volatile oil are termed aromatics, and are usually given as stomachics and carminatives. Their volatile oils are also employed as local irritants. DIFFUSIBLE STIMULANTS. ALCOHOL. Alcohol is a product which results from a process termed the vinous fermentation, in substances containing grape-sugar. At a temperature of 80° F., the presence of a fermenting body converts a solution of grape-sugar into alcohol and carbonic acid. Starchy substances, being convertible into grape-sugar, also yield alcohol. Alcohol is obtained from vinous or fer- mented liquors by repeated distillation. It is, chemically, an ethyl hydrate (C 2 H 5 HO). Officinal alcohol should be of the sp. gr. 0*820. • It is a colourless, inflammable liquid, wholly vaporizable by heat, and unites in all proportions with water and ether. Contamination of fusel oil or amylic alcohol may be detected by agitation with concentrated sulphuric acid, when, if the alcohol becomes coloured, the presence of the impurity is indicated in proportion to the depth of the colour ; or solu- 13 194 MATERIA MEDICA — STIMULANTS. tion of nitrate of silver, with exposure to a bright light, will convert fusel oil into a black powder. Physiological Effects. — Alcohol is the intoxicating ingredient of all vinous and spirituous liquors. Locally, alcohol acts as an astringent by hardening the albumen and condensing the tissues. It evaporates rapidly, causing a feeling - of coolness. When evaporation is prevented, it acts as an irritant (due to absorption and paralysis of the cutaneous vessels), and may even produce inflammation. When inhaled it may produce anaesthesia, stupor and death. Nervous system : when taken internally, in small doses, it stimulates the cerebral hemispheres, possibly by the hyperemia induced ; in large closes it causes excitement with impaired co-ordination of ideas ; and in excess- ive doses it produces coma. Small doses stimulate the spinal cord, while larger amounts weaken the centres governing auto- matic motion and co-ordination, and lessen the sensibility of the cutaneous nerves, especially that of the fifth pair of cranial nerves. Large doses paralyze the vaso-motor nerves, giving rise to dilatation of the arterioles, flushing of the surface, and sensations of heat. In inflammatory diseases, medicinal doses contract the arterioles by giving tone to the vaso-motor system, and prevent the migration of white corpuscles (Farquharson). In toxic doses, the nervous centres are involved in the follow- ing order : 1. The gray matter of the convolutions and the higher functions of animal life (shown by disordered intellection). 2. The basic ganglia (shown by disordered sensation and motion). 3. The cerebellum (shown by disordered equilibration. This may be in part due to impairment of the muscular sense). 4. The spinal centres (shown by anaesthesia of the lower limbs, extending to the upper limbs and body, difficulty in performing automatic acts, impaired co-ordination, etc.). 5. The medulla oblongata (shown by labored breathing, and finally death from apnoea). Circulation : alcohol at first stimulates, but after- wards depresses, the cardiac^motor ganglia. . In small doses it increases the frequency of the cardiac beat, without affecting the force or rhythm, increasing the rapidity of the contraction and shortening the diastole (Parkes and Wollowicz), and also ALCOHOL. 195 elevating the arterial tension (Bartholow). This is soon fol- lowed by slowing of the heart and lowered arterial tension, and if the dose has been larger, by weak and irregular contraction. Large doses depress and paralyze the cardiac muscle (Wood, H. C). Respiration is at first quickened, but afterwards slowed. In alcohol-narcosis the breathing is very slow, and death may result from apnoea. Temperature : small doses slightly elevate the temperature. If large amounts have been taken, the temperature is depressed, owing to the radiation of heat from the dilated cutaneous vessels, to lessened oxidation of tissue, and, in alcohol-narcosis, or in the case of animals, to muscular inactivity. The power of resisting cold is lessened by the habitual ingestion of alcohol. Secretion : the secre- tions are at first increased, then diminished. Alcohol dimin- ishes the quantity of urea, uric acid, sodium chloride, phos- phoric and sulphuric acids excreted in the urine. Sugar is sometimes found in the urine after the ingestion of alcohol. Small doses stimulate the liver, while larger amounts alter the quality of the bile, which may be profuse or scanty. The amount of carbonic acid exhaled from the lungs is diminished. Stomach : small doses increase the flow of gastric juice, by producing hyperemia, and thus stimulate the appetite and digestion. Large doses check the gastric secretion, precipitate the pepsin, and cause anorexia and nausea. When taken habitually, it produces a slow interstitial inflammation of the mucous membrane with hyperplasia of* the connective tissue elements, which, contracting, compress the gastric glands. The secretion will then be much diminished, and the mucous mem- brane will be covered with a ropy, glairy mucus. Blood : alcohol must be in a certain state of dilution before it can be absorbed. It is said to precipitate the albumen in the blood, but it must be in too diluted a condition to accomplish this, nor are the consequences of an occasional indulgence sufficiently serious to warrant this statement. It diminishes the power of the red corpuscle to carry oxygen, and changes the blood by its effect on the liver and digestion. Fat in the blood of drunk- ards is increased from 8-65 parts to 11 '7 parts per 1000 (Le- 196 MATERIA MEDICA — STIMULANTS. cann). Scharlau found 30 per cent, more carbon in the blood of drunkards than in that of healthy persons. This is due to the avidity with which alcohol combines with oxygen, pre- venting the oxidation of the hydrocarbons. Muscular sys- tem : muscular power is weakened ; muscular sense diminished. Elimination : alcohol is eliminated unchanged by the kidneys, lungs, skin, and probably by the liver, traces having been de- tected in the bile by Dr. Percy. A portion of the alcohol (about oiij) disappears in the system, probably being oxidized. The symptoms of acute and of chronic poisoning by alcohol are too well known to need description. The treatment in cases of poisoning from alcohol is the same as that which is to be pursued in cases of poisoning from opium. Ammonia is a physiological antidote. Mania-a-potu is found in acute poison- ing from alcohol, and is due to the direct action of alcohol on a brain rather unaccustomed to its effects. It differs from de- lirium tremens, which is a delirium of trembling type found in chronic alcoholism. The habitual use of alcoholic narcotics in excess gives rise to a well-known train of mental and physical disorders : dyspepsia, visceral obstructions, cirrhosis of the liver, gout, dropsy, delirium tremens, paralysis, and even confirmed insanity. Medicinal Uses. — Alcohol, in the form of vinous and spirit- uous liquors, is employed to rouse and support the system in debility, asphyxia, syncope, the latter stages of acute attacks, typhoid and typhus fevers, asthenic and malignant diseases, exhausting hemorrhages and suppurations, gangrene, to coun- teract the effects of the bites of venomous reptiles, in delirium tremens, and in poisoning from digitalis, tobacco, and other narcotics; also as a stomachic in colic, flatulence, indigestion, nausea, etc. In typhoid and typhus fevers, alcohol probably acts as a physiological antidote to the blood-poison, and should be given in the very first stages of the fevers. Indeed, the early administration of the preparations containing alcohol furnishes our best means of counteracting the depressing action of disease in general. The true stimulant or supporting effects of alcohol probably depend upon its appropriation by the ALCOHOL. 197 system through oxidation or other agency. In disease, large quantities are administered which cannot be recovered in the excretions. But in health, when the powers of the economy are* at the normal standard, it probably circulates in the blood unchanged, and accumulates in the viscera or is eliminated by the secretions. In wakefulness due to cerebral anaemia, a little alcohol at bed time will often produce refreshing sleep. Alco- hol should be given with food. As a topical application, alcohol is used to produce cold by its evaporation ; as a styptic ; to harden the cuticle over delicate parts ; and as a stimulant. Mixed with white of eggs, it forms a good coating to bed-sores. Alcohol Dilutum (Diluted Alcohol), or Proof Spirit, con- sists of equal parts of alcohol and distilled water, and has a sp. gr. 0*928. It is used exclusively for pharmaceutical pur- poses. Vinum (Wine). The fermented juice of the grape consists of water and alcohol in varying proportions, with fixed and volatile acids, sugar, oenanthic acid and ether, tannic, malic, and other acids, bitartrate of potassium, etc. Wine loses most of its cream of tartar by age. It is employed medicinally in typhus and typhoid fevers, exhausting chronic diseases, exten- sive suppurations, gangrene, etc. In typh-fevers it consti- tutes our chief therapeutic resource, and may be administered to the amount of one or two pints in the twenty-four hours, either pure or in the form of wine-whey. This is made by adding from a gill to half a pint of white wine to a pint of boiling milk, separating the curd from the whey, and flavouring with sugar and spices. The officinal wines are Vinum Album ( White Wine), con- taining between 10 and 12 per cent, of absolute alcohol by weight ; Vinum Album Fortis (Stronger White Wine), con- taining between 20 and 25 per cent, of absolute alcohol ; and Vinum Rubrum (Red Wine), containing between 10 and 12 per cent, of absolute alcohol. Red wines are more astringent than white, as they contain more tannic acid. Port xoine con- tains tannic acid, and is used in dysentery, diarrhoea, etc., for its astringency. Madeira, which is the strongest of the white 198 MATERIA MEDICA — STIMULANTS. wines, is an excellent stimulant, but may be objectionable from its acidity. Champagne is a pleasant stimulant where gastric irritability is present. Madeira and port contain about 23 per cent, of alcohol; sherry, 19 per cent.; champagne, 13 per cent. As articles of diet, the stronger wines, when used in excess, often produce gout, dropsy, and diseases of the kidneys and liver ; and except in advanced age and in feeble constitu- tions, or where the tuberculous diathesis exists, cannot but be considered as objectionable. Spiritus Yini G-allici [Brandy) is obtained by the distil- lation of wine. It contains about 50 per cent, of alcohol, with water, volatile oil, tannic acid, colouring matter, etc. It is the best stimulus where a rapid and decided impression is called for, as in collapse, syncope, etc. ; and, from the tannic acid which it contains, is useful in bowel complaints. Spiritus Frumenti ( Whisky), obtained from fermented grain by distil- lation, is of about the same alcoholic strength as brandy, and may be substituted for it ; it does not contain tannic acid. Rum [Spiritus Sacchari), the ardent spirit obtained from sugar, is more sudorific than brandy. Gin [Spiritus Juniperi) is corn spirit flavoured with oil of juniper ; and owing to the oil of juniper which it holds in solution, it is an active diuretic as well as stimulant and stomachic. Arrack, the spirit of East- ern countries, is prepared from a fermented infusion of rice. Spiritus Myrcia [Spirit of Myrcia), bay rum, the spirit obtained by distilling rum with the leaves of myrcia acris, is a refreshing local application. The malt liquors are useful where permanent stimuli are called for, as in diseases tending to emaciation, chronic ab- scesses, etc. The best are porter and ale. Extractum Malti [Extract of Malt) is officinal. It is made by macerating and then digesting coarsely-powdered malt with water, straining and evaporating the fluid thus obtained to the consistence of a thick honey. It has a yellowish-brown colour and the sweet taste of malt. It contains some dextrine, sugar, bitter and aromatic substances, and is used as a tonic in debility and nervous exhaustion. It possesses little advantages over PREPARATIONS OF AMMONIA. 199 good malt liquors. It is used as a vehicle for cod-liver oil. It aids the digestion of starch by promoting its conversion into dextrine and glucose. It may be given in doses 5j-jv after meals. AMMONIA PR^PARATA — PREPARATIONS OF AMMONIA. Ammonia (sometimes termed volatile alkali) is a gaseous compound of hydrogen and nitrogen (NH 3 ), which is found abundantly as the result of the decay of organic substances, and is usually obtained by the action of lime on sal ammoniac (or ammonium chloride). It has a pungent odour, and is very solu- ble in water ; it is a powerful stimulant and local irritant, but is rarely used in medicine. Physiological Effects. — Locally, ammonia acts as an irri- tant, causing vesication, and, after prolonged contact, sloughing of the surface. When inhaled it produces inflammation of the laryngeal and bronchial mucous membranes, and may cause pneumonia. Nervous system : when injected into the veins of animals it causes convulsions, due to stimulation of the motor centres of the spinal cord and of its reflex functions. Circu- lation : after intravenous injection, a momentary fall in the arterial pressure takes place, followed by a decided and sudden rise (not due to any action on the vaso-motor nerves, as it occurs after section of the cord), and a corresponding increase in the rapidity of the pulse from stimulation of the accelera- tors of the heart (Wood, H. C). Blood : it prevents coagu- lation of the blood, assists in retaining the fibrogenous materi- als in solution, and impairs the function of the red corpuscles as oxygen-carriers. Respiration : when injected into the veins the respiratory act is greatly accelerated. Elimination : it is probably, to a great extent, oxidized in the system, and is eliminated as nitric acid, and perhaps as urea, by the kidneys. The effects just described are produced also by the following preparations of ammonia, which are employed as diffusible stimuli : 200 MATERIA MEDICA — STIMULANTS. Aqua Ammonite Fortior (Stronger Ammonia Water). This is an aqueous solution of ammonia of the specific gravity 0-900. It is a colourless liquid, wholly volatilizable by heat, of a caustic, acrid taste and a very pungent odour of ammonia ; and is too strong for medicinal use, internally, in its unmixed state, containing 28 per cent., by weight, of gaseous ammonia. It is a powerful corrosive poison, for which the diluted acids, as vinegar, lemon juice, etc., are the proper antidotes. It is used externally as a vesicant, and has. the advantage over canthari- des of a more speedy operation and non-affection of the urinary organs, but is a very painful application. Aqua Ammonia (Ammonia Water) has a specific gravity of 0*959, containing 10 per cent., by weight, of ammonia, and is employed as a stimulant, sudorific, antacid, and rubefacient. As a stimulant, ammonia is admirably adapted for speedily rousing the action of the vascular and respiratory systems, especially when it is an object at the same time to promote the action of the skin. For this purpose it is employed in low forms of disease, particularly in the typhoid exanthemata, in syncope, in asphyxia from narcotic poisons, and to counteract the effects of the. bites of venomous reptiles. In dyspepsia it is useful with a view to the relief of both acidity and flatulence. For internal use other preparations of ammonia are generally preferred, and this is used chiefly as a rubefacient. Dose, in- ternally, ten to thirty drops, largely diluted. As a rubefacient, the officinal liniment may be used. Spiritus Ammonlze (Spirit of Ammonia) is a solution of ammonia in alcohol. It is given as a stimulant, antispasmodic, and carminative, in the dose of ten to thirty drops, diluted with water. But a pleasanter preparation, with similar proper- ties, is Spiritus Ammonia Aromaticus (Aromatic Spirit of Am- monia). This is a solution of ammonium carbonate, oil of lemon, oil of nutmeg, and oil of lavender, in water and alcohol. It is a very agreeable antacid stomachic and stimulant, and may be given in the dose of thirty drops to f5j, or more, diluted with water. PREPARATIONS OF AMMONIA. 201 Ammonii Carbonas {Ammonium Carbonate) (NH 4 HC0 3 . NH 4 NH 2 C0 2 ) is prepared by subliming a mixture of ammonium chloride and chalk. It occurs in whitish, transparent masses, wholly dissipated by heat, of a pungent, ammoniacal odour, an acrid, alkaline taste, and is soluble without residue in water. On exposure to the air it becomes opaque, falls into powder, and deteriorates by the loss of ammonia. Effects and Uses. — Its indications are the same as those of solution of ammonia, to which it is preferred for internal ex- hibition as a diffusible stimulant. It is especially valuable in pneumonia, and by some therapeutists is relied on to the ex- clusion of other medication in this disease. It has also been recommended in threatened thrombosis, as in the puerperal state, etc. Dose, gr. v to xx, in pill, or preferably in solution with gum and sugar. Mixed with some aromatic oil (as that of bergamot or lavender), it is used as a smelling salt in syncope, hysteria, etc. Phosphorus is obtained from the phosphate of calcium of bone-ash, by removing the lime with sulphuric acid, and after- wards deoxidizing the residuum by heating with charcoal. It is a translucent, highly inflammable, nearly colourless solid, resembling wax, without taste, but having a peculiar garlicky smell; sp. gr. 1*8. It is insoluble in water, and dissolves sparingly even in the oils, ether, and alcohol, but is readily soluble in chloroform. It emits, when exposed to the air, white fumes, which are luminous in the dark. Physiological Effects. — Locally : when applied to the skin, phosphorus may produce inflammation, ulceration, or even gan- grene. The fumes of phosphorus are irritating to the conjunc- tival and respiratory mucous membrane, and may produce necrosis of the maxillae, if the person exposed has caries of the teeth. Nervous system : in small doses, phosphorus is a tonic and stimulant to the nervous system, aiding in the repair of waste. Circulation : it stimulates the circulation, increasing the frequency and fullness of the pulse, and producing dilata- tion of the cutaneous capillaries. Large doses depress and 202 MATERIA MEDICA — STIMULANTS. weaken the cardiac action. Temperature: it first elevates, then lowers, the bodily heat (the latter being due to the dilata- tion of the cutaneous capillaries, and consequent increase in radiation and evaporation from the surface). Secretion : it in- creases the urinary secretion and the relative proportion of urea excreted, and gives the urine an odour of violets. It stimulates the skin and increases the perspiration. In poison- ing from phosphorus, albuminurea and haematurea have been observed. Osseous system : it stimulates the formation of bone, especially of the compact tissue. Elimination : phosphorus passes out of the system by the liver and other glands, by the pulmonary mucous membrane, and by the skin. Poisoning : when taken in large doses, or for a considerable time, phosphorus acts as a gastro-intestinal irritant, causing vomiting, purging, and abdominal pain. The blood is rendered more fluid, coagulation prevented, and the corpuscles are altered in form and found to contain fat. Hemorrhages take place or ecchymoses form in the serous and cutaneous surfaces, due to the changes in the blood and to fatty degeneration of the capil- laries and arterioles. The liver undergoes fatty degeneration (giving rise to jaundice), as do also the other tissues, notably the muscles. Death has been caused by gr. jss of phosphorus. Antidotes : in cases of poisoning from phosphorus, after the administration of an emetic, magnesia should be given, suspend- ed in large quantities of mucilaginous drinks. Copper sulphate should be given in small doses, for its emetic action, and also as a chemical antidote. The bowels should be emptied, and the oil of turpentine administered as an antidote ; it should be old, as the real antidote is oxygen presented in the state of ozone in oxygenated oil of turpentine ; oxygenated water has been also used ; oils and fats are to be avoided. Uses. — In medicinal doses, phosphorus is a valuable stim- ulant and tonic to those tissues in which it is normally found, and has been employed with advantage in cases of nervous ex- haustion and degeneration of nerve tissue, and especially in neuralgia. It is administered with benefit in osteomalacia and rickets, and has proved useful in some cases of pernicious AROMATICS. 203 anaemia. It is one of the best remedies we possess in functional impotence, and Las been given in certain cutaneous affections, as lupus, psoriasis, etc. The dose of phosphorus is gr. gVrV The officinal preparations are: pUulm phosphori (phosphorus pills) ; each pill contains gr. y^ ; oleum phosphor alum (phos- phorated oil), a solution of phosphorus (1 part) in ether (9 parts) and almond oil (90 parts) ; dose, from 5 to 20 drops. The Phosphide of Zixc (P 2 Zn 3 ), prepared by subjecting fragments of zinc and phosphorus together to ebullition in a retort, through which a current of dry carbonic acid has been previously passed, has been lately employed in cases where the administration of phosphorus is indicated. It occurs as a gray, crystallized body, unaltered by moist air, and easily decomposed in the stomach, with the evolution of phosphuretted hydrogen. It has been found efficacious in eczema, psoriasis, and other cutaneous affections. Dose, about gr. 2V _ i- AROMATICS. Aromatics owe their virtues to the presence of oils obtained from them by distillation, and termed volatile oils (plea vol- atilia), sometimes also distilled and essential oils. These oils possess, in a high degree, the odour and taste of the plants from which they are procured. Locally, they are powerful ir- ritants, and, taken into the stomach in overdoses, act as acrid poisons. They pass partially into vapour at ordinary temper- atures, and are completely volatilized by heat; hence, decoc- tions and extracts are improper preparations of the aromatics. The distilled oils are inflammable, very slightly soluble in water, but soluble in alcohol and ether. Their ultimate con- stituents are, usually, carbon, hydrogen, and oxygen ; and on exposure to the air they gradually absorb oxygen, become thicker, less odorous, and of a deeper colour, and are finally converted into resins. The effects and uses of most of the members of this group are similar. In medicinal doses they are used as carminatives, and are combined with purgatives to prevent griping. Most of them are also useful as flavouring 204 MATERIA MEDICA — AROMATICS. ingredients. To many of the volatile oils emmenagogue vir- tues have been ascribed ; but these effects are only produced by poisonous doses. Locally, they are used as rubefacients, antiseptics, and to allay neuralgic pains. CAPSICUM. Capsicum or Cayenne pepper is the fruit of Capsicum fas- tigiatum and other species of Capsicum (Nat, Ord. Solanacese), American tropical plants, naturalized in most warm climates, and cultivated in our gardens. C. fastigiatum is a small shrub, with a crooked, branching stem, producing in each fork two or three fruits from one-half to three-quarters of an inch long, of a subconical form and crimson or yellow colour. These pods, when dried and ground, form capsicum, the best of which is the African. Powdered capsicum has a bright-red colour, which fades upon exposure to light, an aromatic, peculiar smell, and a bitterish, acrid, burning taste. A principle termed capsaicin, slightly soluble in water, but very much so in alcohol, ether, and oil of turpentine, exists in capsicum, associated with resin and fixed and volatile oil. Effects and Uses. — Locally, capsicum acts as an irritant, and vesication may be produced by prolonged contact with the skin. Circulation : it increases the action of the heart. Se- cretion: it stimulates the glands with which it comes in contact, and increases the flow of the saliva and the gastric and intes- tinal juices. Elimination: it passes out of the system by the kidneys, increasing the flow of urine, and sometimes producing vesical tenesmus and aphrodisiac effects. In large doses it acts as a gastro-intestinal irritant. Contra-indications : capsicum should not be given in acute inflammatory affections of the stomach, intestines or genito-urinary apparatus. Capsicum is principally employed as a condiment and stomachic, and is very useful in torpid conditions of the digestive organs, or as an adjunct to other remedies to rouse the susceptibility of the stomach. Its constitutional effect is not in proportion to its local effect, and it is therefore of no great efficiency as a dif- CINNAMON. 205 fusible stimulant. It has, however, been recommended in cynanche maligna and scarlatina anginosa. It is a good stomachic in the dyspepsia of drunkards. As a gargle, it is much employed in the sore throat of scarlatina, and also as a cataplasm to cause counter-irritation. Dose of the powder, gr. v to gr. x, in pill; of the tincture (5j to diluted alcohol Oij), H|x-5j ; of the fluid extract (f §j is equal to (nearly) §j of powdered capsicum), TT(v-x. The oleoresin is a powerful ru- befacient, and may be given internally in the dose of a drop. A plaster is also officinal. PIPER — BLACK PEPPER. Black pepper is the unripe fruit of Piper nigrum (Nat. Ord. Piperacese), a vine of the East Indies. The berries are gathered before they are quite ripe, and dried in the sun. They are wrinkled and black, in consequence of the drying of the pulp over the grayish-white seed, and in this state are known as black pepper. If permitted to ripen, and soaked in water till the outer coat is removed, they constitute ivhite pepper. Pepper has an aromatic, peculiar odour and a hot, spicy, pungent taste. Its properties are taken up' by alcohol and ether, and partially by water. It contains a volatile oil, an acrid resin, an alkaloid called piperina (C 17 H 19 N0 3 ), which has been used as an anti-intermittent remedy, etc. Effects and Uses. — The effects of pepper are similar to those of capsicum. It is a warm carminative stimulant, chiefly em- ployed as a condiment ; but it is also a useful stomachic, and a good adjunct to cinchona in the treatment of intermittent fevers. Dose, gr. v to gr. xx. Of the oleoresin the dose is 1-3 drops. Piperina is officinal. It may be prescribed in doses of gr. ij-iv. CINNAMOMUM — CINNAMON. There are two varieties of cinnamon — Ceylon cinnamon, which is the inner bark of the shoots of Cinnamomum zey- lanicum, a tree of Ceylon and Java ; and China cinnamon, or 206 MATERIA MEDICA — AROMATICS. cassia, the bark of the shoots of one or more undetermined species of Cinnamomum (Nat. Ord. Lauracese), trees of China. The most esteemed is the Ceylon cinnamon. To obtain this, the hark is peeled from branches which are three years old ; the epidermis is afterwards scraped off; the smaller quills are introduced into the larger ones, and they are then dried in the sun and made into bundles. It is found in the shops in long, cylindrical pieces, which are very thin and smooth, and of a yellow-brown colour and a splintery fracture. It has a fragrant odour and a warm, sweetish, aromatic, slightly astringent taste. Its constituents are volatile oil, tannic acid, mucilage, sugar, mannite, etc. The greater part, however, of the cinnamon brought to this country is the cassia cinnamon. It has the general appearance, smell, and taste, of true cin- namon ; but its substance is thicker, its texture coarser, its fracture shorter, its colour darker, browner, and duller, and its flavour less sweet and more pungent and astringent. Its properties are identical with those of the Ceylon variety. ^Effects and Uses. — Cinnamon is an aromatic stimulant, with a slight astringency. It is used chiefly as a carminative, and as an addition to other medicines. Dose, gr. x to 5ss ; of the tincture (§iij to 3 parts of alcohol with 2 parts of water Oij), the dose is f 5j to f5iij- Oleum cinnamomi (oil of cinnamon) is of a light-yellow colour, which deepens by exposure to the air, with the development of an acid, termed cinnamic ; dose, one or two drops. Aqua cinnamomi (cinnamon water) is used as a vehicle for other medicines. Spiritus cinnamomi (spirit of cinnamon) contains 10 parts of the oil dissolved in 90 parts of alcohol ; dose, ten to twenty drops. Cinnamon enters into a large number of preparations. MYRISTICA NUTMEG. MACIS MACE. These products are portions of the fruit of Myristica fra- grans (Nat. Ord. Myristicaceae), a tree of the Moluccas, culti- CLOVES. 207 vated also in Java and Sumatra and other parts of the East Indies, and introduced into the isles of France and Bourbon and several of the West India islands. It bears a pyriform fruit about the size of a small peach, which has a fleshy peri- carp, opened by two longitudinal valves. Within this is the arillus, a scarlet reticulated membrane, which, when dry, becomes yellow-brown and brittle, and is termed mace. The kernels of the fruit are the nutmegs. They are oval, of the size of an olive, of a grayish-brown colour, marked with furrows ; and to preserve them from the attacks of an insect, they are steeped in a mixture of lime and water. Mace has a pleasant, aromatic smell and a warm, bitterish, pungent taste. Nutmegs have a delightfully fragrant odour and a warm, aromatic, grateful taste. Nutmeg contains a volatile oil (con- sisting of myristicene, C 10 H 16 , and a little myristicoll, C 10 H 14 O), fixed oil, starch, proteids, etc. From mace, also, a volatile oil, etc., is obtained. Effects and Uses. — Nutmeg is one of the most agreeable of the aromatic stimulants, and is much employed for its carmin- ative virtues, also as a flavouring ingredient, and to obviate the griping effects of cathartics. It is said to have narcotic prop- erties, and hence may be useful in bowel complaints. Mace is chiefly employed as a condiment. Dose of either, 3j to 5ss. Oleum myristieoz {oil of nutmeg) is of a pale straw-colour; dose, 2 or 3 drops. Spiritus myristicai is made by dissolving 3 parts of the oil in 97 parts of alcohol ; dose, f 5j or f 5ij. CARYOPHYLLU S — C LOVES. Cloves are the unexpanded flowers of Eugenia caryophyl- lata (Nat. Ord. Myrtaceae), an evergreen tree of the Moluccas. They are from five to ten lines long and from one line to one line and half thick, the corolla forming a ball or sphere at the top, and the calyx a tapering, somewhat quadrangular base, resembling a nail, whence the common name, from the French clou. When good, they are of a dark-brown colour, with a yellowish-red tint; they have a strong, fragrant odour, a hot, 208 MATERIA MEDICA — AROMATICS. acrid taste, and, when pressed with the nail, should give out oil. They contain a highly pungent volatile oil, tannic acid, resin, etc., and two crystalline principles, termed caryophillin and eugenin ; the oil consists of a hydrocarbon (C 10 H 16 ) and a colourless oil termed eugenol or eugenic acid (C 10 H 12 O 2 ). Effects and Uses. — Cloves are among the most stimulating of the aromatics, but are used chiefly as a flavouring ingredient and as a condiment. Dose, gr. v to gr. x. The oil, oleum caryophylli, is pale or yellowish, becoming darker by age ; dose, 3 to 6 drops. P I M E N T A P I M E N T 0. Pimento, called also Allspice, is the unripe BERRiES # of Eugenia pimenta (Nat. Ord. Myrtaceae), a handsome evergreen tree of the West Indies and South America. It comes exclu- sively from Jamaica, and consists of round, brown, roughish berries, rather larger than black peppercorns, with an external hard, brittle shell, inclosing two dark-brown seeds. They have an aromatic, agreeable smell and a strong clove-like taste. They are principally used as a condiment. The oil, oleum pimento?, has a brownish-red colour, and consists of a hydro- carbon and eugenic acid * dose, 3 to 6 drops. Oleum Cajuputi (Oil of Cajeput). The volatile oil of the leaves of Melaleuca cajuputi (Nat. Ord. Myrtacese), a tree of the Moluccas, is a powerful diffusible aromatic stimulant, much employed in Eastern countries, and of late coming into use in the United States. It is a transparent oil, of a fine green colour, a lively, penetrating odour analogous to that of cam- phor and cardamom, and a warm, pungent taste. It is an admirable stomachic for the relief of nausea, and is used also as an antispasmodic stimulant in low fevers, spasmodic cholera, etc. ; dose, 1 to 5 drops. OLEUM TEREBINTHIN^] OIL OF TURPENTINE. Oil of turpentine, commonly called spirit of turpentine, is obtained by distillation from the turpentine of Pinus australis OIL OF TURPENTINE. 209 and other species of Pinus (Nat. Ord. Coniferse). When pure it is a limpid, colourless, volatile, and inflammable liquid, of a strong, penetrating, peculiar odour and a hot, pungent, bit- terish taste. It is lighter than water, very slightly soluble in it, less soluble in alcohol than most other volatile oils, and readily soluble in ether. Effects and Uses. — Locally, it produces irritation, and, shortly, inflammation of any tissue with which it comes in con- tact. Nervous system : moderate doses stimulate, while large amounts paralyze, the inhibitory reflex functions and vaso- motor system. Large doses cause giddiness, exhilaration, and finally (sometimes) coma. Circulation: moderate amounts increase the force and frequency of the pulse and elevate the blood pressure ; while, after large doses, the pulse is feeble and rapid, arterial tension is decidedly lowered, and the heart is finally paralyzed. Respiration is at first increased, but after- wards diminished, as to frequency. Secretion : when given in moderate doses, it stimulates the kidneys and increases the amount of urine. In large doses the urine is diminished, often bloody and sometimes suppressed. Gastro-intestinal tract : in large quantities it causes vomiting and purging, with pain and a sense of heat. Genito-urinary system : large amounts produce strangury, priapism, and constant efforts at micturition. Elimination : it is eliminated by the broncho- pulmonary mucous membrane and by the kidneys. The lethal dose is not determined. Oil of turpentine is contraindicated in cardiac hypertrophy, atheroma of the vessels, and acute in- flammatory diseases of the kidney. It is incompatible with cardiac depressants. Its action is aided by alcoholic and dif- fusible stimuli. Oil of turpentine is stimulant, diuretic, blen- norrhetic, and anthelmintic, and externally, rubefacient. As a stimulant, it is a very valuable remedy in typhoid fever, particularly where the abdomen is tympanitic, the tongue dry, and the bowels are ulcerated. It is employed also with ad- vantage in morbid discharges from mucous membranes, hemor- rhages, rheumatism, nervous disorders, atonic dropsy, gleet, 14 210 MATERIA MEDICA — AROMATICS. nephritic and calculous affections, and as an anthelmintic in taenia. Enemata of the oil of turpentine are particularly ser- viceable for the relief of tympanites. Externally, it is used for purposes of counter-irritation. Dose, as a stimulant or diuretic, five to thirty drops, re- peated ; as an anthelmintic or as an enema, f§ss to f§ij. ZINGIBER — GINGER. Ginger is the rhizome of Zingiber officinale (Nat. Ord. Zin- giberaceae), a perennial herbaceous plant, growing to the height of two or three feet. Its native country is unknown; but it has been cultivated in Asia from time immemorial, and was early introduced into the tropical regions of America. Ginger- root occurs in flattish, jointed, branched or lobed pieces, which rarely exceed four inches in length. In the young state, the roots are preserved in sugar, and form a very pleasant sweet- meat. When old, they are taken up, scalded in hot water, and dried, when they are known as black ginger. Sometimes they are scraped previously to being dried, and are then called white or Jamaica ginger. The former comes from the East Indies ; the latter from the West Indies. The powder of black ginger is yellowish-brown ; that of white ginger yellowish- white. Both varieties have a powerful odour and a warm, pungent, aromatic taste. They impart their virtues to water and alcohol, and contain a pale-yellow volatile oil, resin, starch, etc. Effects and Uses. — Ginger is a pungent, aromatic stimulant, much employed as a stomachic in flatulency, and spasm of the stomach and bowels. It is used also as a condiment, and to correct the unpleasant taste and nauseating qualities of other medicines. A paste made of the powder and warm water is used as a counter-irritant. Dose, gr. x to gr. xx, in pill. The officinal preparations are : tincture — dose, 5ss-i ; fluid extract — dose, 20 to 30 drops ; syrup — used as a vehicle for other medicines ; oleoresin — dose, 1 to 2 drops ; and troches CALAMUS. 211 (made by mixing the tincture with tragacanth. sugar, and a little syrup of ginger). CAUDA MO MUM — CARDAMOM. Cardamom is the fruit of Elettaria cardamomum (Nat. Ord. Zingiberacese), a perennial plant, from six to nine feet high, found in the mountainous parts of Malabar. Three varieties of Malabar cardamoms are known in commerce : shorts, short-longs, and long-longs, all furnished by the same plant. They are ovate-oblong, from three to ten lines long, coriaceous, ribbed, and of a grayish or brownish-yellow colour, and contain a number of blackish or reddish-brown seeds, which have a pleasant, aromatic odour and a warm, aromatic, agreeable taste. They yield a colourless volatile oil, a fixed oil, starch, etc. Effects and Uses. — Cardamom is a very agreeable aromatic, devoid of acridity, and is much employed as a stomachic and carminative, and as an adjuvant and corrective of other med- icines ; dose, gr. v-x. The tincture (ojv to diluted alcohol Oij) is the preparation chiefly used; dose, f3j or f5ij. The com- pound tincture contains cardamom, and also caraway, cinna- mon, cochineal, diluted alcohol, and glycerin. Pulvis Aromaticus (Aromatic Powder) consists of cinna- mon and ginger, each two parts, cardamom and nutmeg, each one part. Dose, gr. x to xxx. CALAMUS. The rhizome of Acorus calamus (Nat. Ord. Aracese), an indigenous marshy plant, with long, sword-shaped, radical leaves (giving out a delicious fragrance when rubbed), is a valuable aromatic stimulant, with some tonic properties. It is found in the shops in somewhat flattened pieces, deprived of their epidermis, wrinkled, and of a yellowish colour, and has a strong, fragrant odour and a warm, bitterish, aromatic taste. 212 MATERIA MEDICA — AROMATICS. Fig. 16. It contains volatile oil, aeorin (probably a glucoside), resin, starch, etc. Dose, 3j to 5j- A fluid extract is officinal ; or it ma j be given in infusion (5j to boiling water Oj) — not officinal. GAULTHERIA. Gaultheria procumbens, Partridge-berry, Deer-berry, or Tea- berry {Nat. Ord. Ericaceae), is a small indigenous evergreen plant, with reddish stems, a few inches in height, bright-green BITTER ORANGE PEEL — SWEET ORANGE PEEL. 213 leaves, and white, ovate, five-toothed flowers, followed by scar- let berries. The leaves are the officinal portion, and contain a very stimulant volatile oil (oleum gaultherice), which, when first distilled, is colourless, but gradually becomes reddish, and Fig. 17. is distinguished as being the heaviest of the volatile oils ; and, also, arbutin, ericolin, urson, tannin, sugar, etc. The officinal preparations are the oil and the spirit (containing 3 parts of the oil in 100 of the preparation). An infusion of the leaves is in very general popular use as a carminative and stomachic. AURANTII AMARI CORTEX — BITTER-ORANGE PEEL. AURANTII DULCIS CORTEX — SWEET-ORANGE PEEL. The rind of the fruit of Citrus vulgaris, or Bitter Orange, and Citrus aurantium, or Sweet Orange (Nat. Ord. Auranti- acese), is much employed as a flavouring addition to other medicines. They contain volatile oils, hesperidin (C 10 H 16 — a 214 MATERIA MEDICA — AROMATICS. bitter crystalline glucoside), etc. The flowers (aurantii flores) yield a delightful volatile oil termed oil of neroli (officinal). The following are the officinal preparations : orange-flower water {aqua aurantii florum), an agreeable vehicle, possessing slight antispasmodic virtues ; syrup of orange flowers and syrup of orange peel are used as excipients and vehicles for medi- cines of unpleasant flavour ; oil of orange peel ; fluid extract of bitter-orange peel ; spirits of orange peel ; elixir of orange. peel. The tincture of bitter-orange peel and tincture of sweet-orange peel may be given in doses of f 5i-ij- The following aromatics, of the natural order Labiate, are pleasant carminatives and stomachics : Lavandula [Lavender). The elowers of Lavandula vera, a small European shrub, cultivated in our gardens, about two feet high, with fragrant blue flowers, which are gathered in June, and dried in the shade. They have an agreeable, fra- grant odour and a pungent, bitter taste. They contain volatile oil, resin, a little tannin, etc. The oil (oleum lavandulce florum), which is of a pale-yellow colour, or the oil of lavender (oleum lavandulce — a volatile oil distilled from the whole herb), may be used in the dose of from one to five drops. But the preferred preparations are the spirit (spiritus lavandulce) and the compound spirit (spiritus lavandulce compositus), which contains also oil of rosemary, cinnamon, cloves, nut- meg, and red saunders ; dose, f5j. Mentha Piperita (Peppermint) and Mentha Viridis (Spearmint) are European plants, naturalized in the United States. The leaves and tops are employed ; they have an aromatic odour and a pungent, somewhat bitter taste, fol- lowed by a sensation of coolness. Mentha viridis contains a volatile oil, gum, resin, etc. ; Mentha piperita a volatile oil (con- sisting of C 10 H 13 O and a crystallizable substance termed men- thol, C 10 H 20 O), a little tannin, resin, etc. One to five drops of the oils may be given ; but they are usually administered in the form of spirit in the dose of ten to twenty or forty drops. A water is also used. The oil of peppermint is the stronger of OIL OF THYME. 215 the two, and is strongly recommended asan anodyne applica- tion in allaying neuralgic pains in herpes zoster (Meredith : London Practitioner, August, 1882). Troches of peppermint are made by rubbing up oil of peppermint with sugar and mucilage of tragacanth. Peppermint also enters into the com- position of vinum aromaticum. Rosmarinus (Rosemary). Rosmarinus officinalis, or Rose- mary, a European evergreen shrub, cultivated in our gardens, contains a very stimulant volatile oil, which is chiefly used as an ingredient of rubefacient liniments. It is also used in making spiritus odoratus (cologne water). The leaves are used. They enter into vinum aromaticum. Hedeoma [Pennyroyal). Hedeoma pulegioides, or Penny- royal, is an indigenous annual plant, about a foot high, with oblong- lanceolate, serrated leaves, and small, pale-blue flowers, arranged in axillary whorls. The leaves and tops are used, which contain a light-yellow essential oil, similar in properties to the mint oil, but somewhat more powerful. Origanum. The herb of Origanum vulgare, or common Marjoram. The essential oil is an ingredient in stimulating liniments, but is not officinal. Origanum enters into vinum aromaticum. Marrubium (Horehound). Marrubium vulgare possesses combined stimulant, tonic, and expectorant properties, and, in large doses, proves laxative. It is used chiefly in cough syrups and candies. The leaves and tops are employed. Salvia (Sage). The leaves of Salvia officinalis, a European plant, cultivated in our gardens, are used as a condiment, and may be used, in infusion (§ss to boiling water Oj), as a gargle in sore throat and relaxed uvula ; they are slightly tonic and astringent, as well as aromatic. It is an ingredient of vinum aromaticum.. Oleum Thymi (Oil of Thyme). The oil distilled from the Thymus vulgaris is often substituted for oil of origanum, and is used as an external application. The oil of thyme consists of cymene (C 10 H 14 ), thymene (C 16 H 16 ), and thymol (0 10 H u O), occurring in highly aromatic white crystals, which has been 2l6 MATERIA MED1CA — AROMATICS. found a valuable antiseptic and antifermentative agent. (See Antiseptics.) The following aromatic seeds are derived from plants of the natural order Umbelliferse : F(ENICULUM {Fennel). The fruit of Foeniculum vulgare, a European plant, cultivated in our gardens. It may be used in infusion ; the dose of the oil is 5 to 15 drops. Fennel water is officinal. Carum [Caraway). The fruit of Carum carvi, a Euro- pean plant, cultivated in this country. Dose of the oil, 1 to 10 drops. Anisum (Anise). The fruit of Pimpinella anisum, orig- inally a native of Egypt, but now cultivated throughout the south of Europe. Dose of the oil, 5 to 15 drops. Anise water (aqua anisi) and spirit of anise are officinal. Coriandrum (Coriander). The fruit of Coriandrum sa- tivum, an annual plant of the south of Europe. The oil is officinal. Illicium (Star Anise). The fruit of the Illicium anisatum (Nat. Ord. Magnoliaceae), an evergreen tree of China and Japan, is officinal. It contains a volatile oil (which is chem- ically identical with the oil of anise, but has a slightly different odour and taste), fat, resin, etc. (Maisch). The oil possesses analogous properties to those of the oil of anise, and is much used as a substitute for it. vanilla. This is the fruit of Vanilla planifolia (Nat. Ord. Orchida- cese), a climbing plant of Cuba and Mexico, cultivated also in various parts of tropical America, in the Mauritius, Reunion, and Java. The pods, when gathered, are yellow, but by ex- posure to the sun - they assume a dark copper colour. They are cylindrical, somewhat flattened, wrinkled, six or eight inches long, three or four lines thick, and contain a soft black pulp, in which numerous small black seeds are embedded. ACONITE. 217 Vanilla has a strong characteristic, highly pleasant odour and a warm, aromatic, sweetish taste ; the interior pulpy por- tion is most aromatic. The odorous principle of vanilla is vanillin (C 8 H 8 3 ) ; it is thought that this is developed in the curing of the pod, as it is found only in the interior and not in the exterior fleshy portion. It is a mild diffusible stimulant, chiefly used, however, as a perfume and flavouring ingredient. The tincture is officinal. ORDER VII. — SEDATIVES. Sedatives are medicines which diminish the frequency of the action of the circulation. Their therapeutic influence is, prob- ably, of a stimulant character ; while abating irritability and relieving irregularity of the action of the heart, their primary effect is to restore its force and tone when morbidly depressed. They are employed therapeutically to reduce excitement of the vascular system. With sedatives may be included also the medicinal agents termed refrigerants, comprising nearly all the neutral alkaline salts, as well as those in which the acid predominates, and the vegetable acids. These substances have little power of dimin- ishing the ordinary or healthy temperature ; but they lower febrile heat, allay thirst, restore the secretions, and in this way are very useful adjuvants in the treatment of febrile com- plaints. ACONITUM — ACONITE. Aconite (the root of the Aconitum napellus) is one of the most highly valued sedatives which we possess. The leaves are not used. The officinal preparations are the abstract (gr. j equals gr. ij of the powdered root) ; extract (alcoholic) ; fluid extract (VT^ j corresponds (nearly) to gr. j of the powder) ; and the tincture. Aconite has been considered under the head of Narcotics. See page 85, et seq. 218 MATERIA MEDICA — SEDATIVES. VEEATRUM VIRIDE — AMERICAN HELLEBORE. Veratrum viride, known as American Hellebore, Swamp Hellebore, Poke-root, Indian Poke, etc. \Nat. Ord. Melantha- cese), is a swampy plant, indigenous to the eastern portion of the United States, growing to the height of from three to six feet. It has a perennial thick, fleshy root, the upper portion of which is tunicated, the lower solid and beset with numerous rootlets ; the stem is annual, furnished with bright-green leaves, and terminates in a panicle of greenish-yellow flowers ; the leaves gradually decrease in size as they ascend, the lower being from six inches to a foot long, oval, acuminate, plaited, nerved, and embracing the stem at their base, the upper leaves oblong-lanceolate. The rhizome and rootlets are the officinal portions. The rhizome is an inch or two in length, thick and fleshy, with numerous yellow rootlets, and is found usually in the shops in slices or fragments, externally of a blackish colour and internally of a dingy-white colour. It is inodorous, but has a bitter, acrid taste, which leaves a permanent impression on the mouth and fauces. For use, attached portions of the dried stem should be rejected, as they are inert. The most recent analysis of this rhizome shows it to contain veratroidia and jervia (the latter found also in V. album), rubi- jervia, pseudojervia, with resin and oily matter. Some author- ities state that it contains also veratria, but this is still an open question. Veratroidia is a white, uncrystallizable pow- der, of a bitter taste, leaving a tingling sensation in the fauces, soluble in alcohol, ether, chloroform, and carbon bisulphide ; jervia is a white, tasteless powder, which will crystallize from an alcoholic solution, insoluble in water and ether, and freely soluble in alcohol and chloroform. Physiological Action. — Veratroidia is an emetic, and some- times a cathartic, and a depressant to the circulation. Nervous system : in animals poisoned by veratroidia, twitching and finally convulsions are-produced ; the reflex spinal centres are at first depressed, afterwards paralyzed. Circulation: applied directly to the heart, it paralyzes the cardiac muscle. When AMERICAN HELLEBORE. 219 Fie:. 18. given hypoderrnically to animals, it at first lessens the rapidity of the pulse and lowers the arterial pressure (due to stimulation 220 MATERIA MEDICA —SEDATIVES. of the inhibitory nerves) ; soon, however, the heart's beat be- comes greatly increased in force, but not in frequency, and the blood pressure falls to normal ; then suddenly the pulse becomes very rapid, and the cardiac force is lessened (due to peripheral paralysis of inhibitory nerves), and the tension rises much above the normal (caused by increasing asphyxia) (Wood, H. C). Respiration : in animals poisoned by veratroidia, death is caused by asphyxia, due to paralysis of the respiratory muscles. Muscular system : there is great muscular weakness in poisoned animals. Gastrointestinal tract: veratroidia is an irritant, causing violent vomiting and purging in poisoned animals. Jervia produces general weakness (without, however, vomit- ing or purging), lowering of arterial pressure and slowness of the pulse, profuse salivation, and finally convulsions. Locally, jervia is a feeble irritant. Nervous system : the effects of jervia are similar to those of veratroidia, but, in addition, the vaso-motor nerves are paralyzed. Circulation : when applied directly to the heart (of the frog), it paralyzes it. When an animal is poisoned with jervia, the frequency of the pulse is diminished, and the arterial pressure falls greatly, due to the direct action of the drug on the cardiac muscle, as well as to paralysis of the vaso-motor centres. Respiration: death takes place from asphyxia. The alkaloids exist, in both V. viride and album, in but small proportions, and can scarcely be profitably extracted. The effects of veratrum viride are similar to those of its alkaloids. It is an active local irritant. Taken internally, it somewhat promotes the flow of urine, and in doses of about five grains, proves emetic. In continued doses it produces a marked sedative action on the circulation, irrespective of the nausea induced, which indeed may be prevented by careful administration. The temperature of the body is much lowered. It has not generally proved laxative. No fatal effects are recorded from its use — stimulants invariably counteracting any excessive sedation. Recovery has taken place after f §j of the tincture had been swallowed. VERATRIA. 221 Uses. — Within a few years past, this medicine has been largely used in our southern States in inflammatory and febrile aifections, particularly typhoid fever and pneumonia, with a view to its sedative action ; as the danger, however, in pneumonia is chiefly from failure of cardiac power, the use of veratrum in this disease requires caution. It has been also used in cardiac affections and in gout, rheumatism, and neural- gia. It has been recommended lately in puerperal eclampsia, on account of its depressing influence on the reflex centres of the cord, by Dr. N. L. Guice, of Mississippi. He gives it hypodermically, in doses sufficiently large to reduce the pulse to 60 or 80 beats per minute and maintain this effect. A few drops of the tincture repeated every hour or two, according to the condition of the pulse, will abort an ordinary "cold in the head," if given early enough (H. M.). Dose, of the poivder, gr. i-ij to begin with ; of the tincture, 8 or 10 drops ; of the fluid extract, 4 or 5 drops. Veratria (C 32 H 52 N 2 8 ) is usually obtained from Cevadilla, the seed of Asagraea officinalis (Nat. Ord. Melanthaceae), an herbaceous plant of Mexico. It is made by evaporating a strong tincture of the seeds to the consistence of an extract, from which the alkaloid is dissolved by diluted sulphuric acid, and afterwards precipitated by magnesia. For purification, it is dissolved in alcohol, from which it is evaporated, again con- verted into a sulphate, decolourized by animal charcoal, and finally precipitated by ammonia. When pure it is white, but it is usually a grayish or brownish-white powder, without odour, but very irritant to the nostrils, and of a bitter, acrid taste, producing a sense of tingling or numbness in the tongue ; scarcely soluble in cold water, but readily soluble in alcohol. It has an alkaline reaction, and strikes an intensely red colour with concentrated sulphuric acid. The most delicate test for veratria is Trapp's — a permanent lilac-red colour, resembling a solution of permanganate of potassium, afforded by boiling it in muriatic acid. Physiological Effects. — Locally, veratria acts as an irritant, producing heat, pain, numbness, and perhaps redness in the 222 MATERIA MEDICA — SEDATIVES. part to which it is applied. Nervous system : the reflex ex- citability of the spinal cord is diminished in animals after the administration of a large dose (Ott). Veratria acts as a direct poison upon nerves (Ott, Wood, H. C, and others), but whether it affects the nerve trunk or its end-organs is still sub judice. Circulation and blood : in animals, small doses stimulate the excito-motor cardiac ganglia and increase the frequency of the cardiac beat ; large doses stimulate the pneu- mogastric nerve, and as the excito-motor ganglia become ex- hausted, the cardiac beat is slowed. It also poisons -the cardiac' muscle. The blood pressure is, at first, elevated, then lowered, and the blood is rendered less coagulable. Respiration and temperature : small doses increase, while larger doses dimin- ish, the frequency of the respiratory movement, and the tem- perature is lowered. Excretion: the excretions from the skin and kidneys are increased. Gastro-intestinal tract : in large doses it is an irritant poison, causing severe vomiting and purging. Muscular system : muscular irritability is at first exalted (producing convulsions), but is afterwards entirely lost. Elimination : it is eliminated by the kidneys. Stimulants and ethereal inhalation would be the proper treat- ment in case of poisoning. „ Uses. — Veratria has been used internally, in nervous dis- orders, dropsies, gout, rheumatism, etc., in doses of gr. y 1 ^ to ■J repeated ; but it is most used externally, in the form of oint- ment (gr. xx to lard a troyounce), or dissolved in alcohol, as an application to rheumatic, paralytic, or neuralgic parts. Oleatum veratria? (oleate of veratria) consists of veratria 2 parts to 98 parts of oleic acid. PULSATILE A — P ASQUE-FLOWER. The herb of Anemone pulsatilla, Anemone pretensis and Anemone patens {Nat. Ord. Ranunculacese), found in both hemispheres. It should be collected soon after flowering and carefully preserved, but should not be kept more than a YELLOW JASMINE. 223 year. It contains an acrid, volatile oily substance, easily con- verted into anemonin, C 15 H 12 6 , and amnionic acid, C 15 H 14 7 (Maisch). Physiological Effects. — Locally, fresh pulsatilla is an irri- tant, and after prolonged contact with the skin may cause in- flammation or even gangrene. When the powder is inhaled it produces itching of the eyes, colic, vomiting, diarrhoea, etc. (Phillips). Nervous system : motor and sensory paralysis are produced, but how they are produced has not been ascertained (Bartholow). After poisonous doses there are dilatation of the pupil, sopor, coma, and convulsions. Circulation : Pulsa- tilla is a cardiac depressant and lowers the arterial pressure. Respiration and temperature : it slows the respiration (Clarus) and reduces the temperature. Gastro-intestinal tract : it is an irritant poison, in large doses producing vomiting and purging. Elimination probably takes place through the kidneys. In- compatibles: caustic alkalies, tannic acid, and the metallic salts. Medicinal Uses. — Pulsatilla may be used in catarrhal in- flammations of the mucous membranes unaccompanied with gastro-intestinal disturbance (Bartholow). It is, however, rec- ommended by Phillips in certain forms of dyspepsia, seen in persons of phlegmatic, temperament, accompanied with great nervous depression, loss of appetite, thickly-coated white tongue, nausea, flatulence, heartburn, cold, clammy extremi- ties, etc. It is useful in acute meningitis, whether cerebral or spinal (Bartholow). It has also been recommended in func- tional amenorrhoea, when the menses are delayed or scanty, in suppressio mensium from fright or chill, and in functional dysmenorrhcea when the discharge is scanty. Dr. Piffard rec- ommends very small doses, frequently repeated, in epididy- mitis. The powdered herb may be given in doses of grs. ij-v, or an extract or tincture may be made. GELSEMIUM — YELLOW JASMINE. Gelsemium sempervirens, Yellow or Carolina Jasmine {Nat. Ord. Loganiacese), is a beautiful climbing plant of our south- 224 MATERIA MEDICA — SEDATIVES. ern States, with a twining, smooth, and shining stem, peren- nial, dark-green leaves, and beautiful, very fragrant flowers, of a deep-yellow colour. The rhizome and rootlets are officinal. The true root is hard and woody, slightly undulated in outline, sparingly branched, externally of a pale-brown colour, smooth, and furnished with a thin scurfy cuticle, slightly cracked lon- gitudinally. The stem is rougher externally, and is distin- guished from the root by a small central cavity, representing the pith. The stem should be rejected. The root has a bitter and pleasant flavour, and an odour somewhat between those of seneka and green tea. It contains an alkaloid, termed gelse- mia or gelsemina, combined with an acid called gelseminie (identical with sesculin), a volatile oil, and acrid resin, etc. The alkaloid is a powerful poison, an amount of gelsemium estimated to contain one-sixth of a grain of gelsemina having proved fatal to an adult woman. Effects and Uses. — Gelsemium has been found to possess valuable sedative properties, diminishing the pulse and press- ure, reducing the temperature of the body, lessening respira- tion, and dilating the pupils, with little or no nauseating or purgative effect. It paralyzes first the motor and then the sensory ganglia. In overdoses, it has rapidly produced death, with great muscular relaxation, want of co-ordination in the movements, double vision, dilatation of the pupils, failure of the pulse and respiration, coldness of the surface, and finally unconsciousness preceding death. It has been used in fevers, inflammations, essential spasmodic affections, as tetanus, and as an hypnotic in delirium tremens and other forms of morbid wakefulness, and as an anodyne in odontalgia and facial neu- ralgia. Bartholow recommends gelsemium in acute inflamma- tions of the lungs and pleura, especially in pneumonia and pleurisy. He gives the fluid extract Tt|v~ x every two hours " to maintain a constant effect within the limits of safety." The tincture of gelsemium is the form which has been here- tofore employed, in the close of 20 to 50 drops; but the fluid extract should be preferred, dose 5 to 10 drops ; a fluidrachm of this has proved fatal. ARNICA. 225 ARNICA. Arnicae Flores, Arnica Flowers ; Arnicse Radix, Arnica Root. Arnica montana, Leopard's Bane (Nat, Ord. Compositae), is a perennial herbaceous plant, found in northern Germany and other northern countries of Europe, and also in the northwest- ern portions of America. The flower heads and the rhi- zome and rootlets are the officinal portions. Both contain volatile oil, arnicin, resins, etc. ; the root contains, in addition, inulin and tannin. Effects and Uses. — Locally, arnica is a stimulant and often an irritant to the skin. The internal effects of this drug are not well understood. Large doses cause headache and dilata- tion of the pupils ; poisonous doses paralyze the nervous sys- tem, and death ensues from collapse. Small doses are said to increase the cardiac action, but this has been doubted (Wood, H. C). Large doses depress the action of the heart, lower the arterial pressure, and depress the respiration and temper- ature. Small doses are said to excite the action of the skin and kidneys. In large amounts it is an irritant to the gastro- intestinal tract, producing nausea, vomiting and purging of a choleraic character. Large doses also cause great muscular weakness. It may be used internally, in fevers and acute inflammatory affections, as a sedative and antipyretic (Bartholow). In mania with a tendency to imbecility, when the excitement has diminished, and in melancholia, it is highly recommended (Bartholow, Schroder Van der Kolk, quoted by Phillips). In delirium tremens with depression it is of great value (Bartho- low). It has also been used in the treatment of rheumatism with success. In this country, however, it is principally used externally, in the form of fomentation or lotion, for the relief of bruises, sprains and local paralysis. The extract of the root (alcoholic) is given in doses of gr. v-x. The fluid extract of the root is given in doses of TT]v-xx. This is chiefly used, however, in making a plaster (emplastrum arnicce). The tinc- ture of the root and the tincture of the flowers . may be given 15 226 MATERIA MEDICA SEDATIVES. in doses of TT|y-xxx. They are often used externally com- bined with soap liniment. In applying arnica externally, the irritating qualities of the drug should be borne in mind. PHYTOLACCA. Phytolacca Bacca, Phytolacca Berry; Phytolacca Radix, Phytolacca Root. Phytolacca is the fruit and ROOT of the Phytolacca decandra (Wat. Ord. Phytolaccacese), commonly known as Poke-Berries and Poke-Root. It is a perennial herb, indigenous to North America, growing to the height of four to eight feet, and found in waste places. The young stems, collected in the spring and boiled, are sometimes eaten at table. The root contains resin, starch, tannin, etc. ; the berries contain sugar, gum, colouring matter, etc. No active principle has been isolated. Effects and Uses. — Phytolacca paralyzes the motor centres of the cord and medulla. In overdoses it causes dimness of vision, coma and sometimes convulsions (Stille' and Maisch), and death is produced by paralysis of the respiratory centre. Phytolacca depresses the cardiac action and also the respira- tion (Bartholow), and produces nausea and vomiting, which does not take place for an hour after the drug is administered, and which is accompanied by great depression. Purging also takes place, and Rutherford found it to be a powerful hepatic stimulant, increasing the secretions of bile. It is eliminated by the kidneys. Phytolacca has been used with success as an alterative in the treatment of rheumatism, and has been especially recommended when the rheumatism is of syphilitic origin (Stille' and Maisch). It has also been used, both internally and by injection, in the treatment of hemorrhoids. It is useful in inflammations of the breast to allay the inflammation and prevent suppuration, and possibly may exert a like influence on other inflamed glands (Bartholow). It is recommended as a local application to leg ulcers and eczema, and also in scabies and tinea capitis (J. Bigelow, quoted in Piffard's Mat. Med. and Therapeutics of the Skin). STAPHISAGRIA. 221 It should not be used as an emetic, because of the great de- pression which it induces. Dose of the powder, gr. j-xxx ; or a tincture (ojv-Oj) or fluid extract may be used, dose, TTjy-5j. For local use, an ointment may be prepared (5j-oj). These preparations are not officinal. STAPHISAGRIA. Staphisagria, Stavesacre or Licebane is the SEED of the Delphinium staphisagria [Nat. Ord. Ranunculaceee), a beautiful biennial plant, with terminal racemes of blue flowers, native of southern Europe. It contains two alkaloids, delphinia (C 24 H 35 NO 20 ) and staphisaina (C 16 II 23 N0 2 ); also fixed oil, etc. Physiological Effects. — When applied to the skin delphinia acts as a rubefacient and even irritant. When delphinia is given internally to animals it causes convulsions, and finally clonic spasm ; the reflex centres of the cord are paralyzed (Cayrade, quoted by Yon Boeck in Ziemssen's Cyclopaedia) and cutaneous anaesthesia is produced (Falck and Rorig), and finally the respiratory centre is paralyzed, causing death from asphyxia. The effects on the circulation are most marked. It slows the cardiac action and paralyzes the heart by a direct action on the muscle and nervous supply of the heart (Falck and Rorig, L. Van Praag and others, quoted by Von Boeck, op. cit.). It causes dyspnoea and slows the respiratory move- ments. Delphinia paralyzes the voluntary muscles. It causes salivation and induces vomiting (an early symptom), due to irritation of the end-organs of the pneumogastric nerve. It is eliminated by the bowels and kidneys, producing constipation and difficult urination during excretion (Albers, Schroff). Staphisaina also causes death by asphyxia ; but its action on the nervous system and circulation is said to be less marked. Medicinal Uses. — Staphisagria has been used with some success in the reflex vomiting of pregnancy and sea-sickness. Phillips recommends it in obstinate facial neuralgia, ophthalmia tarsi, and as an emmenagogue in amenorrhcea. It is chiefly used, however, as a local paraciticide in phthiriasis and scabies. 228 MATERIA MEDICA SEDATIVES. Dose of the powder, gr. j-iij ; or a tincture (1 part to alcohol 5 parts — dose, TT[x-xv) or fluid extract may be made. The ointment (digest 5ij of bruised seed in lard gj and strain while hot) is the best form for external use. None of these prepa- rations are officinal. ANTIMONII PRJ1PARAT A — P REPARATIONS OF ANTIMONY. Antimonii Oxidum {Antimonious Oxide) (Sb 2 3 ) is a heavy grayish-white, insoluble powder, having the general therapeutic properties of the antimonials, and though not quite certain in its effects — as its solubility depends on the amount of hydro- chloric acid which may exist in the stomach — it is believed to produce the sedative operation of tartar emetic, with less nausea and derangement of the stomach. Dose, gr. ij-iij, repeated. Antimonii et Potassii Tartras (Antimonium and Po- tassium Tartrate). This salt, familiarly known as tartar emetic and tartarized antimony, is prepared by boiling water and cream of tartar with oxide of antimony. It occurs in colourless, transparent, rhombic, octahedral crystals, which become white and opaque from efflorescence on exposure to the air. When pure its powder is perfectly white ; but it is to be preferred in the crystalline state, as in this form it is less liable to adulteration. When dropped into a solution of sulphuretted hydrogen or ammonium sulphide, the crystals should have an orange-coloured deposit formed on them, which is antimonious sulphide, and is distinguished from arsenious sulphide and all other precipitates by forming with hot concentrated muriatic acid a solution from which, when added to water, a white curdy precipitate of antimonious oxychloride is thrown down. The metal itself should, however, always be reduced, as by Marsh's test (see Arsenious Acid) ; antimoniuretted hydrogen is ob- tained, which burns with a bluish flame ; and if a piece of cold white porcelain be held low down in the flame, the metal is deposited in the form of a dull black spot (surrounded by a PREPARATIONS OF ANTIMONY. 229 grayish ring), soluble in ammonium sulphide, which does not dissolve arsenic, and insoluble in a solution of sodium or cal- cium hypochlorite, which readily dissolves arsenical spots. The powder of tartar emetic is sometimes adulterated with cream of tartar, which may be detected by adding a few drops of a solution of carbonate of sodium to a boiling solution of the antimonial salt, and if the precipitate formed be not redissolved, no potassium bitartrate is present. Tartar emetic (2KSbC 4 H 4 7 ,H 2 0) is inodorous ; has a nau- seous, metallic taste ; is soluble in 15 parts of cold and 3 parts of boiling water ; insoluble in pure alcohol ; and is decom- posed by the alkalies, alkaline carbonates, and the vegetable astringents. Physiological Effects. — Tartar emetic is a powerful local irritant. Applied to the skin, it occasions an eruption of pus- tules, resembling those of variola or ecthyma. When taken into the stomach, in full doses, it causes vomiting, purging, griping pains, etc., and in excessive quantity it acts as an irritant poison, and has produced death, with great prostration, syncope, diminution of reflex irritability, and even convulsions and delirium : very large doses have, however, been given medicinally with entire safety. The proper antidote is tannic acid; and opium, stimulants, and demulcents should be also administered. The constitutional effects of tartar emetic, when taken internally in small doses, are an increase in the secre- tions and exhalations generally, especially from the skin ; the amount of carbonic acid exhaled by the lungs is increased ; the amount of urine excreted is lessened, but the urea is much in- creased (Ott) ; after large doses albuminurea is often seen ; in somewhat larger doses, these effects are accompanied with nausea and vomiting, relaxation of the tissues (particularly the mus- cular fibres), a feeling of great feebleness and exhaustion, and at first a stimulant, later a powerful sedative, action on the circulation and respiration, the cardiac action becoming slow, weak and finally irregular, and the arterial tension being low- ered. It acts on the heart by depressing the excito-motor nerves and paralyzing the cardiac muscle. After poisonous 230 MATERIA MEDICA — SEDATIVES. doses the red blood corpuscles are altered in form, and, together with the albumen, are diminished in amount, in the blood of animals ; the fibrin is increased (Ott). The temperature of the body is lowered. In small, repeated doses, continued for some time, it produces fatty degeneration of the liver. It is eliminated by the bile, milk, perspiration and urine, also by the bronchial mucus and the intestinal secretions. Elimination is slow. The minimum fatal dose for an adult is gr. ij ; for a child, gr. f (Phillips). Medicinal Uses. — Tartar emetic is employed therapeutically as an emetic, nauseant, sedative, sudorific and expectorant, and locally as a counter-irritant. It is to be used with great caution on account of the prostration which it produces, and should never be given to young children, nor when gastro- enteric inflammation is present. It should only be used in sthenic cases in robust adults. As an emetic, it creates more nausea and depression than any other substance ; and hence, while other emetics are to be preferred to it, when our object s merely to evacuate the contents of the stomach with as little constitutional disturbance as possible, it is of value when vom- iting is resorted to as a means of making an impression on the system and thereby checking the progress of disease. As a nauseant, tartar emetic was employed to relax the muscular system in the reduction of dislocations, strangulated hernia, etc., but has been superseded by anaesthetics. It is sometimes used to relax the rigidity of the os uteri in labour. As a sed- ative antiphlogistic, in large doses it is a most powerful remedy in the treatment of acute inflammation, with fever, from its combined action in reducing the frequency of the circulation, moderating the heat of the skin, and promoting diaphoresis. When given in this way, at intervals, tartar emetic ceases to produce emesis, owing to tolerance of the medicine, especially in pneumonia, in which disease it has been extensively resorted to. It is probably inferior to other sedatives, as aconite, etc. In the early stages of acute lar- yngitis and bronchitis, it is a remedy of great value. From gr. yV to gr. J may be given every two hours, in gradually PREPARATIONS OP ANTIMONY. 231 increasing doses, until some amelioration of the symptoms takes place, when the doses are to be again decreased. As a diaphoretic, it is very useful, in small doses (as from gr. y 1 ^ to gr. J, repeated), in continued fevers, inflammation from wounds, injuries, etc. ; and as an expectorant, in the same doses, it is employed in various pulmonary affections with advantage. As a local irritant, it is sometimes applied to the skin in the form of aqueous solution, ointment, or plaster, in chronic diseases of the chest, affections of joints, etc.; but this is rarely needed, and is in many cases injurious. Administration. — The dose of tartar emetic, as an emetic, is gr. j or ij, and it is frequently combined with ipecacuanha. As a sedative antiphlogistic, gr. J or J to gr. j or ij. As a nauseant, gr. \ to \, and as a diaphoretic and expectorant, gr. T 1 ^ t° \, may be given in solution, and in each case repeated every two or three hours. It is advantageous combined with small doses of morphia, when decided diaphoresis is aimed at. Vinum Antimonii (Antimonial Wine) is a solution of tartar emetic (gr. xxxij) in boiling distilled water (fsj) and stronger white wine (foxv). It is employed as an expectorant and sudorific, in the dose of from 10 to 30 drops, frequently re- peated ; and as an emetic for children, in the dose of 30 drops to f oj? repeated every quarter of an hour. Other emetics are to be preferred. Antimonii Sulphidum (Antimonious Sulphide), the native sulphide, purified by fusion, and Antimonii Sulphidum Puri- ficatum (Purified Antimonious Sulphide), the finely-powdered sulphide washed repeatedly with water, macerated in ammonia water, and again repeatedly washed in distilled water, are used in making the other preparations. Antimonium Sulphuratum (Sulphurated Antimony) is prepared by boiling the purified sulphide of antimony with a solution of soda, and adding diluted sulphuric acid to the strained solution ; the sodium sulphate which is formed being afterwards washed away with hot water. It is a reddish- brown, odourless, almost tasteless, insoluble powder, and is chemically a mixture of antimonious sulphide (Sb 2 S 3 ) and 232 MATERIA MEDICA — SEDATIVES. oxide (Sb 2 3 ). Its effects are analogous to those of tartar emetic; but it is chiefly employed as an alterative in cutaneous affections, secondary syphilis, etc., usually in conjunction with mercurials. Dose, as an alterative, gr. j to iij ; as an emetic, gr. v to xx. Pilulce Antimonii Composites {Compound Pills of Antimony), sometimes called Plummers Pills, contain equal parts of sul- phurated antimony and of calomel, mixed with twice the amount of guaiac and mucilage of tragacanth each. They are used as an alterative in syphilitic, rheumatic and cutaneous affections. Six* grains of the mass contain a grain of calomel and antimony each. Pulvis Antimoniaiis. — An antimonial powder is prepared in imitation of the celebrated James's powder, by mixing anti- monious oxide (1 part) with precipitated calcium phosphate (2 parts). It is a white, gritty, tasteless, odourless powder. It was formerly much employed in fevers. Dose, gr. iij-viij. POTASSII NITRAS — POTASSIUM NITRATE. This salt, commonly called nitre and saltpetre (KN0 3 ), occurs in both the inorganic and organic kingdoms of nature. It is obtained, for medicinal use, principally by the purification of the native nitre of India ; and it is found also in saltpetre caves in various parts of the United States, associated with calcium nitrate, from which it is separated by lixiviation. It is artificially produced in several parts of Europe, in nitre beds or saltpetre plantations, by bringing together decayed organic animal and vegetable matters. And it is manufactured sometimes by the double decomposition of sodium nitrate and potassium chloride. Nitre is refined by re-solution and crystallization of the crude nitre. As purified for medicinal use, it is found in the shops in large transparent, colourless crystals, of the form of six-sided striated prisms, with dihedral summits, which are unalterable in the air. They have no odour, a sharp, cooling taste, are wholly soluble in water, and insoluble in pure alcohol. They have no water of crystal- POTASSIUM NITKATE. 233 lization, but frequently have a portion of the mother liquid mechanically lodged in the spaces of the crystals, which may be driven off by heat, and the salt fused and cast into moulds, when it is termed sal prunelle. Physiological Effects of the Potassium Preparations. — As the effects of the potassium salts are largely due to their base, it will be more convenient to consider them together, pointing out any differences when the various preparations are consid- ered. Locally, some of this group, as potassa fusa, abstract water from the tissues, dissolve albumen and saponify fats, and hence are caustics. The nitrate is a violent irritant when applied to mucous membranes or raw surfaces. Nervous system : in large doses, they may produce coma. They act on the spinal centres, lowering reflex excitability and causing paralysis of the lower extremities when given in large amounts. Circulation : all the potassium salts are cardiac poisons, their activity being due to the potassium and varying with the amount of the base they contain. In moderate doses they slow the heart and increase the arterial pressure, while in large doses they both diminish the frequency of the cardiac pulsations and lower the blood pressure. Animals poisoned by them die from cardiac paralysis (the heart being arrested in diastole), caused by direct action on the cardiac muscle and also by paralysis of the cardiac ganglia. Blood : after large doses, or when taken for some time, the blood is found to be less coag- ulable (the fibrin being diminished), the white corpuscles rel- atively increased, and the venous blood lighter in colour (Phil- lips). After large doses of the nitrate or chlorate, the blood becomes dark and refuses to take up oxygen, and the haem- oglobin is decomposed (Bartholow). The compounds with the vegetable acids increase the alkalinity of the blood. Tem- perature is reduced by large doses, especially when the nitrate or chlorate has been given. Secretion : the alkaline potas- sium compounds, like alkalies in general, when applied to the orifices of glands with acid secretions, increase, but when ap- plied to glands with alkaline secretions, diminish, their secreting power (Ringer). This does not apply to the nitrate. They 234 MATERIA MEDICA SEDATIVES. increase the water of the urine and the urea and lessen the amount of uric acid. If the bicarbonate is given during fast- ing, the acidity of the urine will be increased, but the urine will be alkaline if it is administered during digestion. The alkalinity of the urine is most marked after the ingestion of the salts with the vegetable acids (as the tartrate, citrate, etc.). The nitrate and chlorate do not aifect the reaction of the urine. Gastro-intestinal tract : when alkalies are given on an empty stomach, the secretion of the acid gastric juice is increased; if given when gastric digestion is in progress, they neutralize the acidity of the secretion. In large amounts, potassa or the chlorate, nitrate, carbonate or chloride excites violent inflam- mation, causing vomiting, purging, etc. Nutrition : alkalies in small doses improve digestion, aid in saponifying fats, and promote oxidation of tissue, but when administered for too long a time, especially if given in large doses, they cause emaciation and pervert nutrition. Elimination : the potassium salts are eliminated chiefly by the urine, but to some extent also by the other secretions. The salts with the vegetable acids, during their passage through the system, are converted into carbonates and are eliminated under this form. Potassium nitrate and chlorate are eliminated unchanged in the urine and as sulphates in the feces. In excessive doses, nitre may act as a fatal poison, producing irritation of the alimentary canal and derangement of the nervous system ; the symptoms are burning pain in the throat and stomach, bloody stools, a tendency to syncope, collapse, and death, sometimes preceded by dilated pupils, insensibility, and convulsions. There is no antidote for it, and cases of poisoning are to be treated by demulcents, opiates, stimulants, etc., after evacuation of the contents of the stomach. Medicinal Uses. — Nitre is not as much used as it was for- merly. It may be given as a refrigerant and sedative remedy in fevers, inflammations, hemorrhages, etc. In fevers it is sometimes prescribed with calomel and tartar emetic, under the name of nitrous powders (nitre gr. x, tartar emetic gr. J, cal- omel gr. J- to J). In large doses it was given formerly in POTASSIUM CITRATE. 235 acute rheumatism, and this practice has been revived with success in France. Dose, gr. x to 5ss. From 5iv to 5vj are given in twenty-four hours, in acute rheumatism, and the quan- tity is increased to oviij, x, or xij. The fumes of paper impreg- nated with nitre are used with advantage in spasmodic asthma. Sodii Nitras (Sodium Nitrate). This salt, commonly called cubic nitre, is found in large deposits in South America, chiefly in Peru, but also in Bolivia and Chili. . The crude salt occurs in rather soft and pliable lumps, of white, yellow or gray colour ; it is often purified in Peru by solution, crystalliza- tion, and desiccation, but it is usually refined after importation. It occurs in colourless rhombohedral crystals, slightly deli- quescent, and wholly soluble in water (NaN0 3 ), without odour, and of a sharp, cooling and bitter taste. ^Effects and Uses. — Sodium nitre has been little used in med- icine, its employment having been limited chiefly to dysentery, in which it is highly praised by German physicians, in amounts of from half a troyounce to a troyounce, in mucilaginous solu- tion, during the day. Its effects are analogous to those of potassium nitre. The sodium salts are not as powerful cardiac poisons, neither do they affect the temperature nor act on the nervous system to the same extent. They impede coagulation, but do not alter the blood corpuscles. refrigerants. POTASSTI CITRAS — POTASSIUM CITRATE. This salt (formerly known as Salt of Riverius) is made by saturating a solution of citric acid with potassium bicarbonate, and evaporating to dryness. It is white, granular, inodorous, of a saline, slightly bitterish but not unpleasant taste, del- iquescent, and wholly soluble in water (K 3 C 6 H 5 7 ). It is an excellent refrigerant diaphoretic, much employed in febrile affections. Dose, gr. xx-xxv ; 5vj are usually dissolved in water Oss, and f 5ss of the solution is administered every hour 236 MATERIA MEDICA — SEDATIVES. or two. The salts of the alkalies with vegetable acids, as cit- rates, tartrates and acetates, during their passage through the body are converted into carbonates. Liquor Potassii Citratis [Solution of Potassium Citrate) may be made by dissolving citric acid t^ss and potassium bicarbon- ate grs. 330 in water Oss ; dose, f §ss. Mistura Potassii Citratis [Mixture of Potassium Citrate, or Neutral Mixture) is made by saturating fresh lemon-juice with potassium bicarbonate ; or, when the lemon-juice cannot be had, a solution of citric acid, flavoured with oil of lemon, may be used as a substitute. This preparation contains some free car- bonic acid, which renders it more grateful to an irritable stom- ach than the ordinary solution of the citrate. Under the name of effervescing draught the potassium citrate is often prepared extemporaneously (fresh lemon-juice foss with an equal meas- ure of water, added to a solution of potassium carbonate 5\j in water fojv), and is given in the state of effervescence; it is an excellent remedy for irritable stomach, with fever. LIQUOR AMMONII ACETATIS — SOLUTION OF AMMO- NIUM ACETATE. This solution, termed also Spiritus Minder eri, or Spirit of Mindererus, is made by saturating diluted acetic acid with ammonium carbonate, and is a solution of ammonium acetate (NH 4 C 2 H 3 2 ). When pure it is a colourless liquid, with a saline taste ; it should always be made freshly when dispensed. The physiological effects of the ammonium salts have already been considered (vide p. 199). In small doses it is refrigerant ; in larger doses, diaphoretic, diuretic, and perhaps resolvent. It is employed in febrile and inflammatory affections, some- times in conjunction with nitre or one of the sedatives, some- times with camphor and opium. Given in full doses, frequently repeated, it is one of the best means of removing the effects of drunkenness. Dose, f 5^s to foj, every two, three or four hours, in sweetened water. VEGETABLE ACIDS. 237 SPIRITUS ^THERIS NITROSI — SPIRIT OF NITROUS ETHER. This preparation, commonly known as Sweet Spirit of Nitre, is a solution of nitrous ether (C 2 H 5 N0 2 ) in alcohol. Spirit of nitrous ether is a volatile, inflammable liquid, of a pale-yellow colour, inclining slightly to green, has a fragrant, ethereal odour, free from pungency, and a sharp, burning taste, and mixes with water and alcohol in all proportions ; sp. gr. 0*823 to 0*825. It contains five per cent, of nitrous ether. It should not be long kept, as it becomes strongly acid by age. Effects and Uses. — Sweet spirit of nitre is antispasmodic, refrigerant, diaphoretic and diuretic. As a diaphoretic, small doses should be given, largely diluted and frequently repeated. It is much used in febrile affections, and, from its diuretic prop- erties, is often combined with other diuretics in the treatment of dropsies. From its pleasant taste and smell it is very ac- ceptable to children. Dose, foss to f5j, frequently repeated. The inhalation of sweet spirit of nitre has produced dangerous and even fatal effects : pallor of the face, livid discolouration of the lips and fingers, weakness of the pulse, muscular prostra- tion, prsecardial oppression, and headache, are the symptoms described. A case is recorded in which death was attributed to the inhalation of the ether from a broken bottle in a sleeping apartment. The same symptoms may be produced by excessive doses. A CI DA VEG ETA B ILIA — VEGETABLE ACID?. The vegetable acids are refrigerant, and, when properly diluted, form useful drinks in fevers, etc. Those chiefly em- ployed are aeidum aceticum (acetic acid), acidum citricum (cit- ric acid), and acidum tartaricum (tartaric acid). Effects and Uses. — Applied to a raw surface or (if sufficiently concentrated) to the mucous membranes, they act as irritants. Acetic acid is the most powerful, and will, when applied to the skin, cause blanching from contraction of the capillaries. Citric 238 MATERIA MEDICA — SEDATI\ ES. acid is the least irritant. After large doses the cardiac beat is slowed and weakened, but this is possibly due to the result- ing gastro-enteritis (Bartholow). The alkalinity of the blood is diminished. The general law regarding the action of acids on secretion holds good in the case of the vegetable acids, viz., that when applied to the orifices of glands secreting an acid fluid they diminish, while when applied to glands secreting an alkaline fluid they increase, their secreting power. Thus they increase the saliva and the intestinal secretion. The ingestion of the vegetable acids increases the acidity of the urine. They also increase the excretion of both the water and the solids of the urine, particularly free uric acid (and may thus lead to cal- culus). Their continued use causes abdominal pain, flatulence and diarrhoea. In large doses they may produce gastro-enter- itis. They are mostly converted into carbonic acid in the sys- tem, and are eliminated by the kidneys and intestinal mucous membrane. Acetic Acid (HC 2 H 3 2 ) is employed internally only in the form of diluted acetic acid (strong acid 17 parts to distilled water 83 parts). Externally, strong acetic acid (sp. gr. 1*048, and containing 36 per cent, of monohydrated acid) or glacial acetic acid (nearly absolute acetic acid — sp. gr. 1-058) is em- ployed as an escharotic to remove warts, in the cure of lupus, etc. Acetic acid is less used internally as a refrigerant than citric acid, from its liability to produce colic and diarrhoea, except in typhus, scarlet, and other malignant fevers, owing to its supposed possession of antiseptic virtues. Vinegar and water is one of the best injections for the cure of gonorrhoea in the female. Spongings with vinegar and water are useful to relieve the heat of the skin in fevers, and the vapor is grateful to the sick. Concentrated acetic acid is a corrosive poison, for which the alkalies and their carbonates, soap, etc., are the antidotes. Citric Acid may be agreeably administered in the diluted juice of lemons, limes, sour oranges and tamarinds. When these cannot be obtained, a solution of citric acid (3j to water Oj) may be substituted. Citric acid is manufactured from lemon or lime juice, by saturating it with calcium carbonate VEGETABLE ACIDS. 239 and afterwards decomposing the calcium citrate, which is formed, by the addition of sulphuric acid. It occurs in colour- less crystals (H 3 C 6 H 5 7 ,H 2 0), having the form of rhomboidal prisms with dihedral summits, freely soluble in water, and solu- ble in alcohol ; 5ixss, added to distilled water Oj, form a solu- tion of the average strength of lemon-juice. In the dose of f3j every hour or two, lemon-juice, limonis succus (the juice of the fruit of Citrus limonum), has been employed with suc- cess in acute rheumatism and gout, and, though an uncertain remedy, is occasionally of undoubted efficacy: Of late years, however, it has given place to more reliable modes of treatment. Properly- diluted and mixed with sugar, it forms the delightful refrigerant known as lemonade. Lemon-juice (or, still better, lime-juice) is the most efficient known remedy for scurvy. It has also proved of advantage in jaundice and torpor of the liver. Syrwp of citric acid consists of 3ij of powdered citric acid and oil of lemon XX\iv rubbed up with syrup Sj, and after- wards dissolved in syrup oxxxj, at a gentle heat. Lemon syrup, which is pleasanter, is made by dissolving sugar t548 in strained lemon-juice Oj mixed w T ith water Oj, at a gentle heat. Spirit of lemon (sometimes called essence of lemon) is made by dissolving oil of lemon f§ij (obtained from the rind of the fruit) in alcohol Oij, and adding freshly-grated lemon-peel tSj ; dose, f5i-ij- Tartaric Acid is the acid of grapes, and is extracted from tartar or crude cream of tartar. It is a white crystallized solid, in the form of irregular six-sided prisms (H 2 C 4 H 4 6 ), and is found in the shops as a fine white powder. It is soluble in water and alcohol. Being cheaper than citric acid, it may be used as a substitute for that acid. It is employed in making Seidlitz powders. Tartaric acid yields a precipitate (cream of tartar) with a solution of car- bonate or other neutral salt of potassium, while citric acid yields none. 240 MATERIA MEDICA — SPINANTS. ORDER VIII. — SPINANTS. Under the term Spinants, or Spastics, are comprised med- icines which are employed to excite muscular contraction, or whose ultimate effect is the production of motor paralysis, and may, accordingly, be divided into excito-motors and depresso- motors. Of the first class, the most important articles are vegetable substances containing the alkaloids strychnia and brucia, which are employed therapeutically in torpid or para- lytic conditions of the muscular system ; ergot, which is used to excite muscular contraction of the uterus ; and digitalis, which is given for its tonic effect on the heart. The latter class contains such remedies as conium, physostigma, cocculus indicus, woorara, etc. EXCITO-MOTORS. NUX VOMICA. Strychnos nux vomica, or Poison-Nut (Nat. Ord. Logan- iacese), is a middling-sized tree of the coast of Coromandel and other parts of India, which bears a round, smooth berry, the size of a pretty large apple, of a rich orange colour, and con- taining numerous seeds imbedded in a juicy pulp. The seeds are the officinal portion ; but the bark also is poisonous, and is known as false angustura bark, from its having been confounded with angustura bark. The seeds are round, peltate, less than an inch in diameter, nearly flat, or convex on one side and con- cave on the other, and surrounded by a narrow annular stria. They have two coats : a simple fibrous outer coat, covered with short, silky hairs, of a gray or yellowish colour, and a very thin inner coat, which envelopes the nucleus or kernel. This is hard, horny, of a whitish or yellowish colour, and of very dif- ficult pulverization. The seeds have no odour, but an intensely bitter taste, which is stronger in the kernel than in the invest- ing membrane. They impart their virtues to water, but more readily to diluted alcohol, and contain two active alkaloid prin- NUX VOMICA. 241 ciples, strychnia (which is officinal) and brucia, both of which exist in combination with an acid called strychnic or igasuric ; another alkaloid, termed igasuria, much more soluble in water than the two first named, has been lately extracted from nux vomica. Strychnia (C 21 H 22 N 2 2 ) is obtained by the following pro- cess : Nux vomica is digested and boiled in water acidulated with muriatic acid, and the resulting strychnia and brucia muriate is decomposed by milk of lime. The strychnia is sep- arated from brucia and impurities by boiling alcohol, from which it is deposited when cool, the brucia being left in solu- tion. It is then converted into a sulphate by the addition of diluted sulphuric acid, next decolourized by purified animal charcoal, and again precipitated by solution of ammonia. Thus obtained, it occurs as a white or grayish white powder (but may be made to crystallize in the form of white, brilliant rhombic prisms), of an intensely bitter taste, almost insoluble in water, slightly soluble in cold alcohol, but readily soluble in boiling alcohol. The usual test for strychnia is the potassium bichromate, which, added to a solution of strychnia in concen- trated sulphuric acid, produces a violet colour, which after a time changes to wine-red, and then to reddish yellow. A still more delicate test is a solution of potassium permanganate (gr. 1) in sulphuric acid (grs. 200). In both these tests the reagent is nascent oxygen. Lead binoxide, manganese per- oxide, and potassium ferrocyanide, act in the same way. The presence of morphia in excess may disguise the colour test; here chloroform should be used to separate the strychnia from morphia. When gently heated with a saturated solution of iodic acid, strychnia gives a rose-pink tint. The physiological test should be always resorted to : if a small frog be placed in an ounce of water containing yj-g- of a grain of strychnia salt, in two or three hours it will undergo tetanic spasms, and soon die. . The effects of strychnia are similar to those of nux vom- ica, but more violent ; its local action is that of an irritant. It is employed for the same purposes as nux vomica, and should be given in very minute doses, as gr. ^ to T x g to begin with, to 16 242 MATERIA MED1CA SPINANTS. be gradually increased arid repeated. The salts of strychnia may be also employed in the same doses, but they are more soluble, and therefore more active. For endermic use, gr. -fa of strychnia may be applied ; it is best used in amaurosis hypo- dermically, fa of a grain to begin with. Strychnia Sulphas {Strychnia Sulphate) is made by dis- solving a mixture of strychnia in distilled water, with diluted sulphuric acid, and evaporating. It occurs as a white salt, in colourless, prismatic crystals, efflorescent, odourless, very bitter, readily soluble in water, sparingly soluble in alcohol, and in- soluble in ether. It responds to the tests for strychnia, and may be used for the same purposes and in the same doses. Brucia (C 23 H 26 N 2 4 ), which is not officinal, resembles strych- nia in its action, but is much weaker. It is convertible into strychnia by oxidizing agents, a point of importance in forensic analysis. Physiological Effects. — Strychnia increases the reflex excita- bility of the spinal cord, and thus produces convulsions. It probably stimulates the motor nerves, though this is not cer- tain. After death, galvanization of the motor trunks causes little or no contraction in response, due to direct action on and exhaustion of the motor trunks (Wood, H. C). It stimulates the vaso-motor centres of the brain and spinal cord (Ott). Death is due to asphyxia. In very small and repeated doses, nux vomica has a tonic and diuretic effect, and sometimes op- erates slightly on the bowels and skin. In somewhat larger doses, the stomach is often disturbed ; and in still larger doses, the muscular system becomes disordered. A sense of weight and weakness in the limbs, and increased sensibility to external impressions of all kinds, manifest themselves, with depression of spirits and anxiety ; the limbs tremble, and slight convulsive movements of the muscles appear. If the medicine be con- tinued, convulsive paroxysms of the whole muscular system ensue, with erotic desires, painful sensations in the skin, and occasionally eruptions ; the heart is slowed and the blood pressure increased, probably through vaso-motor spasm. In paralytic patients the effects of the medicine are principally KUX VOMICA. 243 observed in the paralyzed parts. When taken in excessive doses it produces tetanus, asphyxia, and death, the intellect being usually unaffected up to the fatal termination. There is no chemical antidote, unless, perhaps, tannic acid and the ioduretted potassium iodide. The stomach should be emptied and the physiological antidote given. Chloral is the best physiological antidote. It acts chiefly by lowering the activity of the parts which conduct the excitation to the spinal cord, preventing the too frequent repetition of the tetanic spasms and lessening their intensity (Schmidt's Jahrb., June, 1881, quoted in Am. J. Med. Sc, April, 1882). In grave cases artificial respiration should also be resorted to. The anti- dotism between strychnia and chloral is not reciprocal. Opium, conium, ether, chloroform, extract of Indian hemp, camphor, calabar bean, bromide of potassium, or atropia, may also be exhibited as physiological antidotes. Dr. Kratter announces that strychnia is excreted entirely unaltered by the urine, the excretion beginning within one hour and ending within forty- eight hours after administration. The entire amount taken can be demonstrated in the urine (Sep. Abd. "Wien. Med. Wchft. 8, 9, 10, 82, quoted in Med. and Surg. Report. Phila., Nov. 18, 18h2). Medicinal Uses. — This medicine is our chief resource in torpid or paralytic conditions of the motor or sensitive nerves or of the muscular fibre. When, however, paralysis is the result of inflammation of the nervous centres, it is injurious, and accelerates organic changes. It is most beneficial in those forms of paralysis which are independent of structural lesion, as lead palsy or paralysis from drunkenness. In paralysis arising from cerebral hemorrhage — after the absorption of the effused blood and the paralysis remains, as it were, from habit — the cautious employment of nux vomica is often attended with advantage. In amaurosis, free from cerebral complication, it is very useful ; and it is occasionally serviceable in other ner- vous affections. It has also been found beneficial in chorea, constipation, dysentery, cholera, diarrhoea, impotence, inconti- nence of urine, eczema, and spermatorrhoea; in combination 244 MATERIA MEDICA — SPINANTS. with other remedies, in ansemia, chlorosis, etc. ; and in small doses it has been used with excellent effect as a general tonic, where there is loss of nerve-power, and as a stomachic in dys- pepsia, and to relieve the vomiting of pregnancy. Administration. — Dose, of the powder, gr. ij or iij, in pill, several times a day, and increased till an effect is produced ; of the abstract, gr. j equals gr. ij of the powder ; of the extract (alcoholic), gr. J to gr. j, to be repeated and increased ; of the fluid extract, TT^ j equals (nearly) gr. j of the powder ; of the tincture, gtt. v to xx, and this is sometimes used as an embro- cation to paralyzed parts. A tolerance of nux vomica and strychnia is rapidly established in the system. IGNATIA. The seed of Strychnos Ignatii, or St. Ignatius' Bean, a tree of the Philippine Islands, contains a large proportion of strych- nia, some brucia, etc., and possesses medicinal properties anal- ogous to those of nux vomica. It may be given to fulfill the same remedial indications as nux vomica. An abstract and a tincture are officinal. Rhus Toxicodendron (Poison- Oak). The fresh leaves of Rhus toxicodendron, or Poison-Oak (Nat. Ord. Terebinthacese), an indigenous shrub from one to three feet high, and other spe- cies of Rhus, possess properties somewhat analogous to those of nux vomica, and have been employed with success in paralysis. They contain toxicodendric acid, to which their poisonous and medicinal activity is due. Dose, gr. j to gr. iij, or more, to be repeated and increased. In cases of poisoning, the irritation of the skin is relieved by glycerite of carbolic acid or alkaline solutions. ERGOTA-— ERGOT. Ergot is a fungus growing from the diseased ovary of Secale cereale, or Rye (Nat, Ord. Graminacese). The U. S. Phar- ERGOT. 245 macopceia styles it the Sclerotium of Claviceps purpurea (Nat. Ord. Fungi), replacing the grain of Secale cereale. Its predisposing cause is unknown, and it is not peculiar to rye. many other grasses being subject to it, as abortion in grazing Fig. 19. animals has been frequently produced by their eating grasses affected with ergot. The ergot usually projects out of the glum or husk of the plant, beyond the ordinary outline of the spike or ear. It should not be collected until some days after it has 246 MATERIA MEDICA — SPINANTS, begun to form, as it is thought not to possess full activity until about the sixth day of its formation. As found in the shops it consists of cylindrical or somewhat prismatical tapering grains, curved like the spur of a cock, of a purplish colour externally, and of a yellowish or grayish-white colour within. Its smell is peculiar and nauseous ; its taste is at first faint, but becomes bitterish, acrid and disagreeable. It yields its virtues to water and alcohol, and does not keep well, being liable to the attacks of a minute worm. It deteriorates much more rapidly in powder than when in grain, in the former con- dition soon becoming inert. Numerous analyses have been made of ergot, but there is still uncertainty as regards its active principles. The recent investigations of Dragendorff seem to show that the specific effects of the drug depend in a high degree upon a proximate principle of an acid character, to which the name of sclerotic acid is given. It is odourless and tasteless, soluble in water and boiling alcohol, but not at all in cold alcohol. Good ergot contains about 4 to 4*5 per cent, of the acid. Ergot also con- tains scleromucin (2 to 3 per cent.), sclererythoin, scleroiodin, picrosclerotin (poisonous), sclerocrystallin, and scleroxarithin (inert), and an alkaloid, ergotinine (Maisch). Physiological Effects. — The effects of ergot are not well understood, especially as regards its action on the nervous sys- tem. In medicinal doses it acts most conspicuously on the cir- culation and on the female system, in which it excites powerful contractions of the uterus. After labour has commenced, in ten or twenty minutes from its administration, it increases the violence, frequency and continuance of labour pains, which usually never cease until the child is born. Administered be- fore labour, it frequently originates the process, though its effects in this respect are less constant. And even on the unimpregnated uterus it produces painful contractions, and evinces an influence over morbid conditions of the organ by checking uterine hemorrhage and expelling polypi. Ergot in- duces contraction of the unstriped or involuntary muscular fibre wherever found, causing contraction of the blood-vessels ERGOT. 247 everywhere, and it is thus available generally as a remedy in cerebral and spinal congestions, hemorrhages, tumours, mor- bid growths and enlargements. In large doses it produces vomiting, purging, increased peristalsis, and a marked sedative effect on the circulation, slowing the heart, probably by direct action on the cardiac muscle, and causing an enormous rise in the blood pressure, through the contraction of the arterioles and stimulation of the vaso-motor centres of the cord and medulla; decided toxic doses lower the blood pressure, by depressing the heart and vaso-motor centres (Wood, H. C). In excessive quantities it acts as an acro-narcotic poison on both sexes. When it is used for a length of time as an article of food it produces a peculiar morbid condition, termed ergot- ism, which assumes two forms, one attended with convulsions, the other with dry gangrene of the limbs. Medicinal Uses. — The chief employment of ergot is to pro- mote the action of the uterus in parturition when its expulsa- tory efforts are feeble and inefficient. It is, however, admissible only when there is a proper conformation of the pelvis and soft parts, when the os uteri, vagina, and os externum are dilated or readily dilatable, and when the presentation of the child is such as to offer no great mechanical impediment to delivery. It is also useful when from any cause it is important to accel- erate delivery; in women subject to flooding, given just before delivery; to promote the expulsion of the placenta, when it is retained from a want of contraction of the uterus ; to expel clots, hydatids, polypi, etc. ; to restrain uterine hemorrhage, whether puerperal or non-puerperal ; to excite and promote abortion, etc. ; and locally as a styptic. It is now much em- ployed, also, in hemorrhages generally, in gonorrhoea, dysmen- orrhea, paralysis of the bladder, purpura, diabetes insipidus, and several other diseases ; lately, with marked success, in hypertrophy of the prostate ; by hypodermic injection, in the cure of aneurism and varix, and of fibroid tumours of the uterus ; and also in paralysis dependent upon congestion of the spinal cord. By many, ergot is believed to exercise a dangerous sedative influence on the child during labour (owing 248 MATERIA MEDICA — SPINANTS. to the interference of the passage of blood from the placenta during violent uterine contraction), and its use may occasionally produce foetal death, which a timely resort to the forceps would have prevented. Administration. — Ergot may be given in labour, in the dose of 3i, in poivder, every twenty minutes, till its effects are pro- duced, or three doses are taken ; in other diseases the dose is from three to five grains. It may be safely given, in chronic diseases, for a long period, without danger of ergotism ; the indication of the maximum dose having been reached is the production of uterine colic, w T hen the dose should be dimin- ished. The fluid extract is the best preparation (f§i repre- senting ergot t§i) ; dose, 20 to 30 drops.* The wine (vinum ergotae) contains powdered ergot, 15 parts, in 100 by weight of the preparation. Dose, f5j to f5ij. The preparations used under the name of ergotin are of uncertain strength. USTIL AGO. Ustilago maydis {Nat. Ord. Fungi), Corn Smut or Corn Ergot, is a fungoid growth upon the Zea mays or Indian Corn (Nat. Ord. Graminaceae). It is found in irregular masses, growing upon all parts of the plant, but most frequently upon the fruit, and consisting of a blackish gelatinous membrane, inclosing numerous dark globular and nodular spores. It has a disagreeable odour and taste, and contains a fixed oil, a crys- talline principle, etc. (Maisch). Its effects are supposed to resemble those of ergot, and it has been successfully used in the same class of cases. GOSSYPII RADICIS CORTEX — BARK OP COTTON ROOT. Gossypium herbaceum (Nat. Ord. Malvaceae) is a native of Asia, cultivated extensively in tropical and semi-tropical coun- * For hypodermic use, the fluid extract should be reduced by evaporation to one-sixth of its weight, and sixty grains of this extract should be dis- solved in four fluidrachms of water ; four minims of this aqueous solution represent one grain of extract and six grains of ergot. DIGITALIS. 249 tries, and with great success in the South Atlantic and Gulf districts of the United States. By cultivation, different varie- ties of this plant have been produced. The root should be collected immediately after the cotton is harvested, and the root-bark should be of a yellowish-brown colour externally, internally much lighter ; w r hen chewed, it has a slightly sweet- ish, astringent taste. It contains chromogene (when fresh), becoming a red resin, a yellow resinous colouring matter, fixed oil, gum, sugar, tannic acid, etc. It has long been recognized by southern physicians as possessing decided influence in ex- citing uterine contractions. Dr. J. C. Martin, however, from experiments on frogs, rabbits, and guinea-pigs, concludes that it has no action on the motor or sensory nerves, nor on the reflex functions; that the circulation and muscles are unin- fluenced by it, and that it possesses no oxytocic properties (Am. J. Med. Sc, Jan. 1882). A decoction (made by boiling 5iv of the inner bark of the root in* a quart of water to a pint) has been used in doses of a wineglassful, repeated. The only officinal preparation is the fluid extract (which, when first pre- pared, is of a brownish-yellow colour, changing, however, to a bright red) ; dose, f 5>j. Cotton, the well-known filamentous substance separated from the seed of the varieties of gossypium, is a useful application to burns and parts affected with erysip- elas and rheumatism. DIGITALIS. Digitalis purpurea, or Purple Foxglove (Nat. Ord. Scroph- ulariacese), is a biennial European plant, cultivated in our gardens, with an erect stem three or four feet high, large ovate-lanceolate, crenate, downy and veiny leaves, of a dull green colour, and handsome bell-shaped crimson or purple flowers, arranged in a long terminal spike. The seeds and leaves are both active, but the latter only are employed, from plants of the second years groivth ; and those from the European wild plants are preferred, as the cultivated variety is thought to be inferior in virtue. The petioles are removed, i50 MATERIA MEDICA SPINANTS. and the leaves are then dried in baskets, in a dark place, in a drying-stove. When dried, they have a dull-green colour, with a faint odour and a bitter, nauseous taste, and afford a fine deep-green powder. Both leaves and powder should be preserved in well-stoppered bottles, covered externally with dark-coloured paper, and kept in a dark cupboard. And, as their medicinal activity is impaired by keeping, they should be renewed annually. They contain a neutral principle termed digitalin, which possesses properties similar to those of the leaves ; also some inosit, pectin, resin, etc. Digitalin is a white or yellowish-white powder, odourless, but of a very bitter taste ; readily soluble in alcohol, chloro- form and acids, but nearly insoluble in water and ether ; dose, from q\ to g 1 ^- of a grain. Commercial digitalin, however, usually contains other principles mixed with pure digitalin, and it is best to prescribe digitalis. Physiological Effects. — Nervous system : in toxic doses, digitalis lowers reflex activity by exciting Setschenow's in- hibitory reflex centre, and, after a time, paralyzing the spinal cord (Dr. A. Weil quoted by H. C. Wood), causes prostration, muscular tremors, and sometimes convulsions. Circulation : it lessens the number of cardiac pulsations, prolonging the diastole, energizing the systole, and finally paralyzing the heart in systole ; this is produced by direct stimulation of the cardiac muscle, and possibly of the contained motor ganglia, as well as of the peripheral inhibitory fibres of the pneumogastric. Moderate doses cause a rise in the arterial pressure, probably by contracting the arterioles, through stimulation of the vaso- motor centres of the cord ; after large doses the pulse becomes dicrotic from irregular ventricular contraction ; toxic doses, or, when the heart is much depressed, a sudden change from the recumbent to the erect position, may cause a frequent, weak and small pulse, with lowered blood pressure. The influence of digitalis over the pulse is more marked in weak and debili- tated persons than in those who are robust and plethoric. Its effects, too, in this particular are more easily obtained in the recumbent than in the erect posture, owing to the less force DIGITALIS. 251 required in the former position to carry on the circulation. In the repeated use of small doses of this medicine, a cumula- tive effect is sometimes observed : its powers are not manifested for a certain time, and effects are suddenly produced, which are attributable to the whole amount administered, giving rise to dangerous and even fatal syncope. In morbid conditions of the circulation, where it is irritable, abnormally quick, or irregular, digitalis is considered to exercise a primary medicinal effect in steadying the pulse and restoring its force and regu- larity, while it diminishes morbid frequency. Where the tem- perature of the body is abnormally increased, digitalis, in large doses, will diminish it. As regards its diuretic action, it is probably rather indirect than direct, and is most conspicuous where dropsical effusions are removed under its influence. Brunton has, however, recently shown that in dropsies it acts directly on the Malpighian tufts, independent of the blood pressure. It increases the amount of solids eliminated in the urine, except that of urea and uric acid, which are diminished under its use. "When too long continued, or taken in excessive doses, digitalis acts as an acro-narcotic poison, producing vomiting, purging, severe abdominal pains, vertigo, disordered vision, dilated pupils, syncope, and finally delirium and stupor, death being usually preceded by convulsions. In such cases, after evacuating the stomach, the diffusible stimuli, as brandy and carbonate of ammonium, should be administered. Opium, aconite, etc., antagonize to some extent the action of digitalis ; the most complete antagonism exists between digitalis and sapo- nine, the active principle of Saponaria officinalis (Kohler, quoted by Bartholow). The quantity of digitalis, however, that may be given, especially in disease, without destroying life, is consid- erable. Chemical analysis affords no certain tests of the pres- ence of digitalis or its active principle, and in cases of sus- pected poisoning the physiological test is to be resorted to. In the celebrated Pommerais case, the criminal was condemned from the evidence derived from the administration of an extract obtained from the stomach and bowels of the deceased party, to small animals, in whom were produced vomiting and marked 252 MATERIA MEDICA — SPINANTS. diminution of the number of heart-beats, with intermittent and irregular action. Medicinal Uses. — From its action on the circulation, digi- talis has been used in fevers, inflammations, and hemorrhages, where bloodletting is inadmissible, as in hectic fever, tubercular hemoptysis, etc. In fevers accompanied by a high temperature, as scarlatina and typhoid fever, it is specially useful. In the treatment of diseases of the heart and great vessels it is a remedy of the greatest value, but is to be prescribed with dis- crimination. In dilatation of the heart, in fatty degeneration, and in failure or irritability of heart-action generally, digitalis, by increasing the force of the cardiac contractions and by abating irregular movement, is always useful ; in uncomplicated hypertrophy it is objectionable. In valvular, especially mitral, disease, as well as aortic constriction, if the heart's action be feeble, it is indicated. It is greatly esteemed in the treatment of dropsy ; and in the varieties of this disorder resulting from heart disease it is more employed than any other remedy, from its combined cardiac and diuretic influence. It is a val- uable remedy in acute desquammative nephritis, especially when dropsy is present, and also in granular degeneration of the kidney under like circumstances. In delirium tremens, digitalis has lately been given in large doses, with excellent effect. It is thought that a physiological antagonism exists between digitalin and the alkaloids aconitia and delphinia. Administration. — Digitalis may be given in powder, of which the dose is gr. j two or three times a day, to be gradually in- creased. The officinal preparations are the abstract, gr. i of which equals gr. ij of the powder ; the infusion, dose f 3ij-jv ; the tincture, dose ttly-f 5j > ^ e ex ^ rae ^ (alcoholic), dose gr. \, gradually increased ; the fluid extract, dose TT|J to begin with. If digitalis produce wakefulness, a little opium may be com- bined with it. CIMICIFUGA. Cimicifuga racemosa, Black Snakeroot, or Cohosh (Nat. Ord. Ranunculacese), is a very common indigenous perennial plant, CIMICIFUGA. 263 growing to the height of from four to eight feet, with ternate leaves, oblong-ovate, incised and toothed leaflets, and small white flowers disposed in a long raceme. The rhizome and rootlets are the parts employed. The rhizome is a rugged, blackish-brown caudex, from a third of an inch to an inch in thickness, often several inches in length, furnished with numer- ous slender rootlets. Internally its colour is whitish ; it has a peculiar faint, disagreeable odour and a bitter, somewhat astringent, taste. It imparts its virtues to boiling water, and contains a neutral crystalline principle, gum, starch, two resins, 251 MATERIA MEDICA SPINANTS. tannic and gallic acids, and a volatile oil. The active principle has not yet been isolated. Effects and Uses. — The effects of cimicifuga are not very accurately known. After large doses, vertigo, dilated pupil, and often hypnotic and anodyne effects are seen. On the cir- culation its effects are similar to, but less powerful than, those of digitalis (Bartholow), as it slows the cardiac beat, while in- creasing the strength of its contraction, and raises the arterial tension. It is undoubtedly an active stimulant of the secre- tions, particularly those of the skin, mucous membranes and kidneys. It acts also on the uterus and unstriped muscles like ergot, but less powerfully. It increases the sexual appetite of the male and promotes the menstrual flow of the female (Bar- tholow). It has been employed with advantage as an expec- torant in chronic bronchial affections, and even in caseous pneumonia and phthisis. In fatty heart it is safer than dig- italis, and may be used in dilated heart, languid circulation, and oppressed breathing (Bartholow). It has also been used as a diaphoretic in rheumatism and as a diuretic in dropsies. " Puerperal mania, hypochondriasis and convulsions, due to menstrual irregularities, have been cured by cimicifuga" (Bar- tholow). As an antispasmodic in chorea it enjoys a high rep- utation. It often gives relief in the congestive forms of dys- menorrhea, and is employed too, occasionally, to promote the expulsion of the placenta after delivery, in the relief of after pains, and in menorrhagia. It is a good remedy in subnivolu- tion of the uterus. A saturated alcoholic solution has been used, with good effect, as an application to the eye in ophthalmia. Administration. — Dose, in powder, 3j-5j (not officinal). Of the fluid extract or tincture the dose is f5^s-j or ij. DEPRESSO-MOTORS. CONIUM. Conium maculatum, or Hemlock (Nat. Ord. Umbelliferse), is a biennial European plant, naturalized in many parts of the CONIUM. 2oo United States. Its stem is erect, from three to five feet high. The leaves are large and bright green; the flowers are small, white, and arranged in umbels. The whole plant is narcotic and virulent, and has a fetid, heavy odour. The full-grown fruit (gathered while yet green, and carefully dried) is the only portion used. It has a yellowish-gray colour, a feeble odour, and a bitterish taste ; it is roundish-ovate, a line and a half in length by a line in breadth, and striated. The active principle of hemlock is an alkaloid termed conia (C 8 H 15 N), which exists in larger proportion in the seeds Fig. 21. than in the leaves. It is a colourless, transparent, volatile, oily fluid, of a peculiar repulsive, suffocating, mouse-like odour and a bitterish taste, sparingly soluble in water, and freely so in alcohol,* ether, and chloroform, and undergoes decomposition upon exposure to the air. It is a highly energetic poison, even in very small doses ; the dose of it is gr. ^ E . Another alkaloid, eonhydrina, has been isolated ; both probably exist as malates. Conia combines with acids to form salts and with water a hy- drate. A new 7 principle, methylconia, has been obtained. '2.56 MATERIA MEDICA — SPINANTS. Physiological Effects. — Local action : conia applied to a part may produce paralysis. Nervous system: hemlock has but little influence upon the cerebral hemispheres, for in cases of poisoning from it consciousness has been preserved to the last. A medicinal dose induces the following effects : a sense of muscular fatigue and feebleness of the legs is felt, the eye- lids droop, and vision becomes impaired, accompanied by dila- tation of the pupil. In lethal doses conium causes paralysis, which is due to a paralyzing influence on the terminal extrem- ities of the motor nerves. On the sensory nerves it has no in- fluence, while its action on the cord is doubtful. The circula- tion is not influenced by hemlock ; the respiratory movements are not altered unless a poisonous dose has been taken, when the respiratory centre is paralyzed and death ensues from as- phyxia. Temperature : some lowering of the animal heat has been noted, but this, lately, has been denied by Lautenbach. Secretions : conium has no action on the glandular organs.' Elimination : hemlock is eliminated in part* by the urine, as it has been found there. In large doses it causes nausea, vertigo, dimness of vision, relaxation of the muscles ; and in poisonous quantities, dilatation of the pupils, difficulty of speech, delirium or coma, paralysis, and finally convulsions and death. It has no direct hypnotic effect. Like woorara, its characteristic physiological effect is the production of pure motor paralysis, beginning in the extremities and extending to the trunk, involving chiefly the terminal nerve-endings. In cases of poisoning, alcoholic stimuli are to be given, and as physiological antidotes, the tetanizing agents, as strychnia. Medicinal Uses. — It is employed as a general and topical anodyne, to relieve the pain of malignant tumours; and, even if destitute of the deobstruent powers which have been ascribed to it, it certainly exerts a remarkably palliative influ- ence upon painful chronic indurations. It has also been recom- mended as an antispasmodic in whooping-cough, asthma, paral- ysis agitans, and as an anodyne in neuralgia; as an adjuvant to other remedies in mania, especially melancholia; to moderate irritability of the sexual organs; in diabetes; to relieve the CALABAR BEAN. 257 blepharospasm of many acute inflammations of the eye ; and it is used externally as a cataplasm to cancers and other irritable ulcers. Conium is quickly absorbed, and is eliminated with equal rapidity ; hence its effects are speedily induced, and are of brief duration. It is the cicuta of Hippocrates, Galen and Pliny, and is supposed to have been the poison administered to Socrates and Phocion. Administration. — The dose of the powder, gr. ss-j. The ex- tract (alcoholic) may be given in the same doses. An abstract is also officinal. A tincture (dose, f5ss, f5j) and a fluid ex- tract are also used ; of the fluid extract, a fluidounce of which contains a troyounce of the seeds, and in preparing which muriatic acid is employed to fix the alkaloid conia, the dose is four or five minims. The preparations of conium are uncertain, from the fact that the active principle is very volatile and easily escapes ; the leaves contain but a small amount of it, wmich is easily driven off, even in the act of desiccation. Probably the best preparation is the fluid extract ; this is now given in larger doses than those for- merly laid down. PHYSOSTIGMA — CALABAR BEAN. This is the seed of a perennial climbing plant of the western coast of Africa, which has received the name of Physostigma venenosum (Nat. Ord. Leguminos?e). The seed is about the size of a large horse-bean, irregularly kidney-form in shape, with a hard, brittle integument, and of a dark chocolate-brown colour. The inner kernel is by far the more active portion. Alcohol, but not water, extracts its medicinal virtues. It yields an active alkaloid, termed eserina or physostigmina, sparingly soluble in water, but more soluble in alcohol, ether and chlor- oform ; and recently another alkaloid, termed calaharia, which is believed to be a tetanizing agent, has been found in it in variable amount. The dose of eserina is gr. y 1 ^ to g 1 ^. The Calabar bean has long been used among the negroes of western Africa as an ordeal to determine tbe guilt or inno- 17 258 MATERIA MEDICA — SPINANTS. cence of accused individuals, whence its name, the ordeal bean of Calabar. Physiological Effects. — It has been found, in full medicinal doses, to produce giddiness, torpor, paleness and coolness of the surface, weak and irregular pulse, relaxation of the muscular system, and drowsiness, but not stupor. An interesting effect of its action is a remarkable power of contracting the pupil, whether taken internally or applied externally ; it seems probable that this is accomplished by a local peripheral action — i. e., paraly- sis of the sympathetic terminals and stimulation of the oculo- motor fibres in the iris ; and it also contracts the ciliary mus- cle, which regulates the accommodating power of the eye. Nervous system : the brain is not direetly affected by Calabar bean, the paralysis induced by it being clue to a depressant action upon the spinal cord. In proof of this statement can be offered the fact that the muscular contractility and irrita- bility of the motor and sensibility of the sensory nerves re- mains unimpaired in cases of poisoning by physostigma. The local application of a strong solution abolishes the functions of both kinds of nerves (Fraser). Lethal doses of physostigma cause total loss of reflex activity in the. cord. Circulation : small doses of physostigma retard the heart's action by length- ening the diastolic pause, while toxic doses arrest it in dia- stole, but before the movements are extinguished there is a marked fall in blood pressure. The stoppage is probably due to paralysis of the cardiac ganglia. Respiration : toxic doses of physostigma cause slowing of these movements, and eventually they are abolished, death ensuing from asphyxia. Intestines : Calabar bean increases decidedly intestinal peristalsis. Increase of the salivary secretion has been observed. A poisonous dose of physostigma in man causes nausea, giddiness, muscular weakness and tremors, diminished heart action, abolition of reflex action, slow respiration, myosis and paralysis. It is allied in its effects to woorara and conium, but differs from them in its tendency to produce muscular twitchings, and con- traction of the pupil. In cases of poisoning, after emptying the stomach, the hypodermic administration of a solution of COCCULUS INDICUS. 259 atropia is. the best physiological antidote. Chloral mitigates the symptoms. Medicinal Uses. — Calabar bean has been found highly effi- cacious in traumatic tetanus, but it must be given in doses large enough to attain decided effects. Dr. Fraser advises the exhibition of the drug, hypodermically, in severe cases. It has been used also with success in chorea, and in poisoning from strychnia, and spasmodic cholera. In ophthalmic sur- gery its employment is obvious, either to produce contraction of the pupil or to increase the power of accommodating the eye to distances. The dose of the kernel is laid down as two or three grains, to begin with, gradually increased. By exhausting the kernel with alcohol, an extract (alcoholic) is obtained, of which the dose is gr. J. A good form of administration is the tincture (100 parts contain 10 parts of the powder) ; dose, 1 to 10 drops ; or a solution in glycerin may be used. Userina itself, or as a salt, one part to a thousand in solution, may be applied to the eye. Physostigmina? salicylas is now officinal. Gel- atine disks are now much used. COCCULUS — COCCULUS INDICUS. This is the dried seed of Anamirta cocculus (Nat, Ord. Menispermacese), a climbing shrub of India. The fruit is a one-celled berry, of a dark purplish colour, with a soft pulp, and a single seed the size of a pea, containing a bitter kernel. The active properties reside in a peculiar white, crystallizable bitter principle termed picrotoxin, which is partially soluble in water, and very soluble in alcohol, chloroform and ether. Pic- rotoxin is not precipitated by the reagents for the alkaloids, and does not neutralize acids. In the shell, an alkaloid termed men- ispermia has been found, and a neutral principle of the same composition as the alkaloid, termed paramenispermia. Effects and Uses. — Cocculus Indicus is an acrid cerebro- spinal narcotic, capable, in large doses, of producing death by tetanic fixation of the respiratory muscles. Its cerebral 260 MATERIA MEDICA — SPINAKTS. effects are variously described, such as stupor, giddiness and vertigo. In doses sufficient to produce cerebral effects it is apt to nauseate. Cocculus Indicus is a tetanizing agent, this con- dition being followed bj convulsions, paralysis and coma. The chief action of the drug appears to be that of an excitant of the centres located in the medulla oblongata. The convulsions can be brought on in an animal from which the brain has been removed, and the reflex functions are suspended by it. During the convulsive stage the heart's action increases, while in the stage of coma it becomes slow, and after death it is found to be in diastole. Picrotoxin induces decided diaphoresis. It has not been much used internally, except in the night sweats of phthisis (Murrell) in doses of gr. T J-g- to g 1 ^ of picrotoxin, with good results; but in the form of decoction or ointment it is employed to destroy lice and other parasites, and for the cure of tinea and porrigo of the scalp. It is said to prevent the secondary fermentation of malt liquors, into which it is some- times introduced as an adulteration. Cocculus Indicus is not officinal, but the alkaloid picrotoxin (picrotoxinum) is among the articles added to the Pharmacopoeia of 1880. wo OR A R A. This substance, termed also ivoorari, woorali, and curare, has long been known as a powerful poison prepared by the Indians in South America, and of late years has been employed as a medicine. Its source is unsettled, but it is generally consid- ered to be an extract from the bark of Strychnos toxifera and S. cogens. It is brought from the banks of the Orinoco, and occurs in the form of dark-brown or grayish lumps or powder, of an intensely bitter taste, and, when triturated, of a powerful odour. An alkaloid termed cur aria has been extracted from woorara. It is said to exist as a sulphate (Sachs). Effects and Uses. — Woorara, topically, is an irritant. Woo- rara is ranked with the motor depressants, and is considered to destroy life by more or less rapid paralysis of the respiratory muscles. A peculiarity of its action is that it is comparatively VIBURNUM. 261 innoxious when taken by the stomach, being either not absorbed at all in this viscus, or so slowly as to allow of its elimination by the kidneys before dangerous accumulation in the blood. Hence, for therapeutic purposes, it must be employed either endermically to a blistered surface or by hypodermic injection. Woorara kills the intra-muscular motor nerve-endings without affecting the muscular irritability, and destroys the reflex func- tion of the spinal cord : in other words, the paralysis induced by it is peripheral and not centric ; eventually, however, the paralyzing action of woorara extends to the nerve-trunks and centres. The cerebrum is only secondarily involved. Arti- ficial respiration retards the poisonous effects of the dru£, Woorara stimulates and then paralyzes the accelerator cardiac nerves. Other effects of woorara are elevation of temperature, increased nasal, salivary and intestinal secretions, and diabetic urine (in animals). The elimination of curaria has been dis- tinctly shown to take place, in part, by the kidneys. Woorara, or curaria, is only applicable to the treatment of those affections which therapeutically require motor depressants to antagonize the disease process. Among the most prominent of these are tetanus and hydrophobia. In tetanus good results have been obtained from its use in large doses, while from hydrophobia there are two reported cases of recovery. It has also been employed in chorea and epilepsy. The dose of woo- rara is from y 1 ^ to I of a grain. Of curaria, from gr. ^-^j to T -l^, hypodermically. Caution must be enjoined, as the samples vary. VIBURNUM. Viburnum is the bark of Alburnum prunifolium, commonly known as the Sloe or Black Haw (Xat. Orel. Caprifoliaceae). a small tree growing in thickets in the southern and western States, with opposite, oval, obovate, sharply serrulate leaves about two inches long, and short slightly marginal petioles. It has small white flowers in terminal cymes, appearing in May ; and small blue-black edible drupes containing a flattish smooth putamen. The bark is in thin pieces or quills of a purplish- 262 MATERIA MEDICA— SPINANTS. brown colour, with scattered warts and minute black dots ; collected from the old wood it is grayish-brown, the thin corky layer easily removed from the green layer ; the inner surface is whitish and smooth ; it breaks with a short fracture; is with- out smell, and of a bitter, astringent taste (Stille and Maisch, Maisch). It contains valerianic acid, a brown bitter resin, a greenish-yellow bitter principle, tannin, etc. Effects and Uses, — The physiological effects of viburnum are not understood. It probably acts as a sedative to the spinal centres, especially those governing the uterine functions ; whether it influences the circulation or the blood supply to the uterus, or what action if any it has on the sympathetic gan- glionic system are questions for the future to determine. It is said that no disagreeable after effects attend its use. Vibur- num is highly recommended as a sedative in cases of threat- ened abortion whether accidental or due to the action of drugs, and is said to be especially serviceable where a tendency to abortion exists from habit. In these cases 5j may be given every two or three hours as long as the abortion is threatening. It is also recommended to allay the severity of after-pains, and is one of the numerous remedies which have been used for the relief of the vomiting of pregnancy. It has also been used with success in monorrhagia and metrorrhagia, depending on anaemia, debility or other systemic cause, and in monorrhagia accompanied with nervous symptoms appearing at the climac- teric period. It has been given in dysmenorrhoea with profuse discharge, and may be combined with other remedies in the treatment of neuralgic dysmenorrhoea. The fluid extract is officinal, and may be given in doses of f5ss-j. GRIN DELIA. Grindelia is the leaves and flowering tops of the Grin- delia robusta (Nat. Ord. Compositse), an herbaceous perennial plant growing to the height of one or two feet, indigenous to the Pacific coast. It resembles the common sunflower in its general appearance, and contains volatile oil and resin (Maisch). SUMBUL. 263 Effects and Uses. — In large doses, grindelia has a decided hypnotic effect, during which the pupils are dilated and reflex action, motion and sensation are depressed. The cardiac action is slowed by grindelia, as are also the respiratory movements. It stimulates the gastro-intestinal mucous membrane, promoting the appetite and digestion, and is eliminated by the kidneys and broncho-pulmonary mucous membrane (Bartholow). It irritates the kidneys and increases the secretion of urine. Grindelia is very highly recommended in the treatment of asthma, especially in the uncomplicated spasmodic form, but has also proved useful when complicated with bronchitis, etc. In many cases of hay asthma and hay fever it has proved of much benefit. It is useful in pertussis, and is also recommended in acute and chronic bronchitis and pneumonia. It is administered advan- tageously in chronic pyelitis and chronic cystitis, acting on the mucous membrane as it is eliminated (Bartholow). Dr. H. M. Fiske recommends its internal and local use in iritis. It has been used as an injection in vaginitis and as a local application in poisoning by rhus toxicodendron, the latter with varying results. The fluid extract is officinal, and may be given in doses of TT]x-f5j. .SUMBUL. Sumbul is the root of the Ferula sumbul (JS T at. Ord. Um- belliferEe), a perennial plant, growing to the height of eight feet, with large triangular, tripinnate radical leaves and a few small cauline leaves. It is a native of Turkestan and eastern Siberia. The root reaches us through Russia, and is met with in transverse slices from one to five inches in diameter and three-quarters to two inches thick. It is light, spongy, annu- lated, with a thin brownish bark and a whitish interior, with numerous dots of brown-yellow resin and irregular, easily sep- arated fibres ; of a strong musk-like odour and a bitter, bal- samic taste. The root of the Dorema ammoniacum is sometimes flavoured with sumbul, but may be distinguished from it by being firmer, denser, and of a yellow or reddish tint (Stille and 264 MATERIA MEDICA — SPINANTS. Maisch). Sumbul root contains a volatile oil, a soft resin, angelic and valerianic acids (Maisch). Effects and Uses. — The physiological effects of sumbul are not accurately known. It probably acts as a sedative to the brain and spinal cord. It was originally introduced into Russia as a remedy for cholera, and is still used there in asthenic dys- entery and diarrhoea. In England it has been used in dysmen- orrhoea, hysteria, epilepsy and various allied nervous disorders. Mr. Murawieff recommends it in chronic bronchitis in old and debilitated patients, in humid asthma, atonic dyspepsia, hypo- chondriasis and hysteria, and Phillips has seen it prove useful in chronic bronchitis and in certain stages of phthisis. He also recommends it in severe cases of facial, sciatic or ovarian neuralgia, and in the restlessness of pregnancy. Boehm (Ziemssen's Cyclopaedia) speaks favourably of it in delirium tremens. It is not much used in this country. The tincture may be given in doses of TT[x-f5j. EMETICS. 265 CLASS II. — ECCRITICS. ORDER I. — EMETICS. Emetics (from f/^w, I vomit) are medicines which are em- ployed to promote vomiting ; when they are used merely to excite nausea, they are termed nauseants. When an emetic is administered, usually within fifteen or twenty minutes after- wards a feeling of distress, relaxation and faintness is experi- enced, with coolness and moisture of the skin and a small, feeble, irregular pulse. These symptoms increase till the con- tents of the stomach are ejected. During the act of vomiting, the face becomes flushed, the pulse is full and frequent, and the temperature of the body is increased. After vomiting is over, the skin is moist, the pulse soft and feeble, the patient becomes languid and drowsy, and, under peculiar circumstances, alarm- ing and even fatal syncope has been induced. Emetics act either directly on the centres of the medulla which govern the act of vomiting, or by the local irritation they produce, which, being conveyed to the centre probably by filaments of the pneumogastric nerve, produces vomiting in a reflex manner. In the former case, vomiting is produced by the drug, no matter in what manner it enters the system, and it is therefore called a systemic emetic ; in the latter, vomiting is only pro- duced by the introduction of the substance into the stomach, and it is hence called a local emetic. Dr. Marshall Hall gives the following summary of the mechanism of vomiting : " During the act of vomiting, 1, the larynx is closed ; 2, the cardia is opened ; and 3, all the muscles of expiration are called into action ; but, 4, actual expiration being prevented by the closure of the larynx, the force of the effort is expended upon the stomach, the cardia being open, and vomiting is effected." Susceptibility to the action of emetics differs in different individuals and in different diseases. In fevers, and where gastric irritation is present, their influence is increased ; and, on the other hand, when the brain is oppressed by disease or 266 MATERIA MEDICA — EMETICS. by narcotic medicines, the stomach is exceedingly insensible to their action. Emetics are employed therapeutically — 1, to evacuate the stomach, for the purpose of removing poisons, undigested food, etc. ; and, with this view, the emetics should be selected which occasion least nausea and distress ; 2, to expel foreign bodies lodged in the throat or oesophagus ; 3, to excite nausea, and thereby depress the vascular and muscular systems ; 4, to re- lieve spasm, as in spasmodic croup ; 5, to promote secretion and excretion, etc. ; and, 6, sometimes to break up «, train of morbid association, by giving a shock to the system, as in the forming stages of certain fevers, as typhus and scarlatina, and of delirium tremens. They are improper in congestion of the brain, pregnancy, hernia, etc. The act of emesis is promoted by the free use of tepid drinks ; excessive vomiting may be checked by demulcents, opiates, counter-irritation to the stom- ach, etc. VEGETABLE EMETICS. IPECACUANHA. Ipecacuanha is the root of Cephaelis ipecacuanha (Nat. Ord. Rubiacese), a small shrubby perennial plant of Brazil, where it grows to the height of about five or six inches. The roots, as met with in the shops, are in pieces about the size of a quill, several inches long, of an irregular, twisted, contorted shape, with numerous circular rings or rug8e, from which they have been termed annulated. When broken, they are seen to consist of two distinct parts — a thin ligneous axis or centre, which is nearly inert, and a thick cortical layer, which has an herbaceous, acrid, rather bitter taste and a slightly nauseous odour. A distinction is made of black, red and gray ipecacu- anha, from differences in the colour of the epidermis ; but they are all derived from the same plant, and are the same in prop- erties and composition. The black is the most common variety in our market. The powder is of a light grayish-fawn colour, and has a peculiar nauseous odour, which in some persons ex- IPECACUANHA. 267 cites violent sneezing, in others dyspnoea. Ipecacuanha im- parts its virtues to both water and alcohol, but they are injured by decoction. Its emetic property depends on the presence of an alkaloid, termed emetia (C 28 H 40 N 2 O 5 ), which exists in com- bination with ipecacuanhic acid. Emetia is a whitish, inodor- ous, slightly bitter substance, sparingly soluble in water and ether, and very soluble in concentrated alcohol and chloroform. It produces vomiting in the dose of gr. J, and in overdoses may occasion dangerous and even fatal symptoms. Occasionally a Figr. 22. sophisticated root, that of Psychotria emetica, derived from New Granada, is found in the markets ; this is not annulated, but longitudinally striated, and contains less than half the quantity of the emetia found in the genuine root (1J per cent.). Physiological Effects. — Locally, powdered ipecac is an irri- tant to raw surfaces and to the mucous membranes, causing violent sneezing, etc. When rubbed into the sound skin it 268 MATERIA MEDICA — EMETICS. causes pustulation and even ulceration. Nervous system : it stimulates the centre of the medulla oblongata which presides over the act of vomiting, and somewhat diminishes the reflex activity of the cord. Toxic doses (in animals) generally cause death by paralyzing the respiratory centres. The nerves prob- ably remain unaffected. Circulation : moderate doses probably do not affect the circulation; very large doses injected into the jugular vein of dogs have killed by cardiac paralysis. Tem- perature : in the mouth and on the surface the temperature falls in cases of emetia poisoning, but in the intestines it rises (from the irritant action of the poison). Secretion : repeated small doses relax the skin and increase the perspiration, saliva and the bronchial and gastric mucus. Rutherford states that it has the power of stimulating the secreting apparatus of the liver (in dogs), and that the consequent increased secretion of bile is normal in composition as regards the biliary matters proper. It also increases the secretion of intestinal mucus. Gastric-intestinal tract : it is an irritant to the stomach, pro- ducing vomiting by local irritation as well as by direct action on the medulla. Elimination takes place by the gastrointes- tinal mucous membrane, and also by other secretions. Post- mortem appearances : after death from ipecac, the stomach is found intensely congested ; the lungs are generally congested, and patches of hepatization are often found ; sometimes, how- ever, the lungs are exsanguine. Medicinal Uses. — In full doses, ipecacuanha is a mild and certain emetic, well adapted to the treatment of spasmodic croup and acute bronchitis in children, and to all cases where a simple evacuation of the stomach is desired. In smaller doses it produces nausea, depression of the pulse, expectoration and diaphoresis, and with these views it is employed in the treat- ment of pulmonary affections, dysentery, and inflammatory dis- orders generally. In still smaller doses it is useful as a tonic and stomachic. Ipecacuanha was first introduced as a remedy in dysentery, and, after being for a time laid aside, has been again used with marked success. It is also used with advant- age in the vomiting of sick headache, and will sometimes, when BLOODROOT. 269 given in small doses, frequently repeated, arrest the nausea and even the vomiting of pregnancy. Administration. — Dose, as an emetic, gr. xv to gr. xx ; as a nauseant, gr. ss to gr. ij, three or four times a day; as an expect- orant or diaphoretic, gr. \ to gr. \, repeated ; as a tonic, gr. ■fa, repeated. The fluid extract is used as an addendum to ex- pectorant and diaphoretic mixtures, foj representing Sj of the root; as an emetic, dose f oss-i ; the wine (vinum ipecac- uanha?) contains fluid extract 7 parts in stronger white wine 93 parts; dose, as an emetic, foss-i; fluid extract, 5 parts, mixed with simple syrup), 95 parts, makes syrwpus ipecacuanha?, an excellent preparation for children — foj containing gr. xxx of ipecacuanha ; for a child a year or two old, f 5ss-j may he given as an emetic, and v-xx drops as an expectorant. Pulvis ipecacuanha? et opii (formerly called pulvis ipecacuanha? com- p>ositus, or Dover s powder) contains powdered ipecac and opium each gr. j, sugar of milk gr. viij (see Opium, p. 63). Troches of ipecacuanha (contain also sugar, tragacanth, and syrup of orange peel), each troche contains ipecac gr. J. Troches of morphine and ipecac each contain morphine gr. fa, ipecac gr. fa, with sugar, oil of gaultheria and mucilage of tragacanth. SANGUINARI A — B LOODROOT. The rhizome of Sanguinaria canadensis, or Bloodroot [N'at. Ord. Papaveraceae), a small indigenous plant, with radical, cordate, lobate leaves and a handsome white eight-petalled flower, which appears in early spring, is usually classed with emetics. When dried it is in flattened pieces, much wrinkled and contorted, of a reddish-brown colour, with a faint narcotic odour and a bitterish, very acrid taste. It yields its virtues to water and alcohol, and loses them rapidly by keeping. An alkaloid, sanguinarina (C 19 H 17 N0 4 ), has been obtained from it, which possesses the properties of the root. Effects and Uses. — Bloodroot is an acrid emetic, and, in large doses, an acro-narcotic poison. Locally, it acts as an irritant, and upon fungous surfaces as an escharotic. When 270 MATERIA MEDICA — EMETICS. inhaled, the powder causes violent sneezing. In large doses it causes collapse, dilated pupil, and sometimes convulsions of spinal origin, and diminishes reflex activity. After nauseat- ing doses the pulse and arterial pressure are increased, but Fig. 23. when enough is taken to produce vomiting the pulse is slow and irregular and the arterial tension is lowered. After poison- ous doses the respiration becomes shallow and slower, and death takes place from asphyxia, due to paralysis of the res- piratory centre. APOMORPHIA HYDROCHLORAS. 271 Sanguinaria produces salivation and increases the secretion of the gastric mucous membrane. It stimulates the liver and intestinal glands, increasing the secretion of bile, but at the same time rendering it more watery (Rutherford). It is an active systemic emetic, causing much depression and irritation of the mucous membrane (Bartholow ; Robert Mead Smith, quoted by H. C.,Wood). It is not much used as an emetic, but is occasionally employed with this view in croup and diph- theria, or as an expectorant in pulmonary affections. In duo- denal catarrh and secondary catarrhal jaundice it has been used with advantage. It has also been used as an emmena- gogue in amenorrhcea. Dose, as an emetic, gr. x to xx, in pill, or in infusion (tgss to boiling water Oj — not officinal), of which f 5ss is the dose. Tincture — dose as an emetic, f 5iij or iv ; as an expectorant, TT]y-xxx. The vinegar (acetum) contains ten per cent, by weight of the powdered drug. The fluid extract is also officinal. APOMORPHIJ2 HYDROCHLORAS. Apomorphia is an artificial alkaloidal substance (C 17 H 17 N0 2 ) obtained by heating morphia with hydrochloric acid under pressure, the acid subtracting one molecule of water from a molecule of morphia, and leaving apomorphia (C 17 H 19 N0 3 =H 2 + C 17 H 17 N0 2 ). When apomorphia is treated with hydrochloric acid it combines to form the officinal salt. When pure it is a white powder, but it absorbs moisture readily, becoming green. Physiological Action. — In animals, in large doses, it at first stimulates the nerve centres and afterwards paralyzes them. Convulsions are produced, but their origin is not determined. Apomorphia is a poison to the muscular system. Small doses increase the cardiac action and elevate the pressure, but when large doses are taken, the cardiac movements are probably slowed and the pressure diminished. Very large doses may have a decided sedative action on the circulation (in man), and even induce syncope. Large doses at first increase the number 212 MATERIA MEDICA — EMETICS. of the respiratory movements, but afterwards diminish them : poisonous doses cause death by asphyxia. This is due to the action of the drug on the respiratory centre. Apomorphia is chiefly of interest therapeutically on account of the emesis which follows its administration. It is a prompt and efficient systemic emetic, causing vomiting within a half hour after it is taken, which is repeated two or three times at intervals of about fifteen minutes, and is attended by little nausea and usually little or no depression. Medicinal Uses. — Apomorphia may be used as an emetic hypodermic-ally or by the stomach, in cases of narcotic poison- ing or where it is desirable to evacuate the contents of the stomach promptly. It has also been used as an expectorant in both acute and chronic bronchitis, and in suffocative catarrh of infants. Trousseau recommends it in haemoptysis. Dose of the hydrochhrate (the same as that of the pure drug) gr. J g hypo- dermically, or J or perhaps \ by the stomach. It should be given cautiously, on account of the depression which occasion- ally accompanies its action. Sinapis {Mustard). The powdered seeds of Sinapis nigra and Sinapis alba [Nat. Orel. Cruciferse), in doses of from a tea- spoonful to a tablespoonful, are very useful emetics, particularly in atonic conditions of the stomach. Tobacco and Lobelia act as emetics in large doses, but their employment is attended with danger, owing to the great prostration which they produce (see pp. 81, 83). Squill also possesses emetic powers, but it is too irritating for use in this respect. mineral emetics. Tartar Emetic. Dose, gr. j to gr. ij (see p. 228 Zinc Sulphate. Dose, gr. x to gr. xx (see p. 162). Copper Sulphate. Dose, gr. iij to gr. v (see p. 160). Alum. Dose, a teaspoonful (see p. 191). Yellow Subsulphate oe Mercury or Turpeth Mineral. Dose, gr. ij to gr. v (see Mercuric Preparations). CATHARTICS. ORDER II. — CATHARTICS. Cathartics (from nadaipo, I purge), termed also purgatives. are medicines which produce evacuations from the bowels. Some operate by increasing the peristaltic motion of the intes- tines ; others stimulate the mucous follicles and exhalants, and occasion watery evacuations, whence they are termed hydra- gogues. The more violent of the hydragogues, if given in overdoses, produce inflammation of the alimentary canal, characterized by violent vomiting and purging, abdominal pain and tenderness, cold extremities and sinking pulse. From their activity they are denominated drastics. Different cathar- tics affect different parts of the alimentary canal unequally, some acting more particularly on the upper portion, some on the lower, and others affecting all parts equally. Mer- curial preparations purge chiefly by inducing a flow of bile from the liver. Cathartics may be arranged in five groups : 1. Laxatives, which gently evacuate the contents of the bowels, without causing any obvious irritation or affecting the general system. 2. Saline cathartics, which increase both the peristaltic action of the bowels and the effusion of fluids from the mucous surface, but are devoid of any excitant action on the general system, and are therefore adapted to the treatment of febrile and inflammatory cases. 3. Mild acrid cathartics, which are acrid, but not sufficiently violent in their local action to cause inflammation. 4. Drastics, comprising the more powerful and irritating cathartics, which, in large doses, act as acrid poisons. 5. Mercurial cathartics. Cathartics are employed therapeutically — 1. To evacuate the bowels in constipation, and remove noxious matters, as retained feces, undigested food, morbid secretions, worms, poisons, etc. 2. To depurate the blood, as in typhus fever, uraemia, etc. 3. To relieve inflammation, congestion and plethora, by the depletion of the bloodvessels, which results from increased secretion and exhalation from the gastrointes- tinal canal. 4. To promote absorption. 5. To affect remote 18 274 MATERIA MEDICA — CATHARTICS. organs, particularly the brain, through the agency of revul- sion and counter irritation. 6. To stimulate the secretion of the liver and pancreas, by irritating the orifice of the ductus communis choledochus. 7. In the treatment of diarrhoea. 8. To relieve spasms of the bowels. 9. To restore the catamenia, by the irritating influence which they exert on the pelvic ves- sels. The more active cathartics are contraindicated in cases of inflammation or ulceration of the gastro-intestinal mucous membrane, peritonitis, the advanced stages of typhoid fever, pregnancy, etc. The operation of cathartics is promoted by the addition of small doses of emetics and of the bitters. By combining those which act upon different portions of the alimentary canal, their operation is rendered less irritant, without any diminu- tion of purgative efficiency. The griping and nauseating tendency of the drastic cathartics may be corrected by the addition of aromatics ; carbonic acid water is a grateful vehicle for administering the saline preparations. Cathartics operate most speedily and favourably when given on an empty stom- ach, and susceptibility to their action is diminished during sleep, and increased by exercise. Mild diluent beverages promote their operation. In the event of hypercatharsis, opium should be administered by the mouth or the rectum. LAXATIVES. Several articles of diet have a laxative operation on the bowels, and are useful in cases of habitual costiveness, as most of the ripe and dried fruits — -particularly tamarinds, peaches, apples, raisins, figs and prunes — West India molasses, honey, bran, cracked wheat, Indian meal and oat meal, etc. The following medicinal substances are usually arranged under the head of laxatives, and are employed in cases where we wish to open the bowels with the least possible irritation, — as in children and pregnant women, in inflammation or sur- gical operations about the abdomen and pelvis, in typhoid fever, hernia, piles, affections of the rectum or womb, etc. MANX A. 275 T A M A R I N D U S — TAMARIND. This is the preserved pulp of the fruit of Tamarindus Indica [Nat, Ord. Leguminosae), a large tree of the East Indies, cultivated extensively also in the tropical portions of America. It comes to the United States chiefly from the West Indies. The preserved pods, as found in the shop, consist of a dark-coloured adhesive mass, formed of pulp, fragments of the pods, seeds and syrup, of a sweetish acidu- lous taste. They contain a good deal of citric acid, with some tartaric and a little malic acid. An infusion of the pulp (§ss to boiling water Oj), sweetened, makes a pleasant refrigerant and laxative drink ; half an ounce to an ounce of the pulp is a good laxative. ' It enters into the confection of senna. MANNA. Manna is the concrete saccharine exudation, in flakes, of Fraxinus ornus and of Fraxinus rotundifolia (Nat. Ord. Olea- ceae), small trees of Sicily and southern Italy. It is obtained from incisions into the stems of the trees. The best kind is produced during the height of the season, when the juice flows vigorously, and from the upper stems, where it is less fatty. It is called flake manna or manna cannulata, and consists of pieces from one to six inches long, one to two inches wide, and from half an inch to an inch thick, of irregular form, but more or less stalactitic, hollowed out on one side (from the shape of the tree or substance on which they are concreted), of a white or yellowish-white colour, an odour like that of honey, and a sweet, afterwards rather acrid, taste. A common manna, called common manna, or manna in sorts, is obtained from incisions later in the season, and from the lower stems. It occurs in small pieces, which seldom exceed an inch in length, and are softer, more viscid and darker than the flake manna. A still inferior variety is termed fat manna, and consists of small, soft, viscid fragments, of a dirty yellowish-brown colour, mixed with a few pieces of the flake manna. Manna is 276 MATERIA MEDICA — CATHARTICS. soluble in both water and alcohol, and contains a white crys- talline, saccharine principle, termed mannite (C 6 H 14 6 ), not sus- ceptible of the alcoholic fermentation (found also in mushrooms, the olive tree and other plants), some sugar, and a resin to which it probably owes most of its purgative effect. Effects and Uses. — In moderate doses manna is nutritive ; in larger, mildly laxative. It is given principally to children, to whom its sweet taste renders it acceptable; and it is some- times combined with the more active cathartics. It may be taken in substance, or dissolved in warm milk or water. Dose for an adult, Sj to §ij ; for children, 5j to 5iij. VIOLA TRICOLOR. Viola tricolor is the wild-grown flowering herb of Viola tricolor, Heartsease or Pansy (Nat. Ord. Violaceae), an an- nual or biennial herb, native of Europe and northern Asia, naturalized in the United States and cultivated in our gardens. The stem is nearly smooth, and grows to the height of one-half to one foot ; the leaves are alternate, petiolate, ovate or oblong, crenate, and have prominent pinnatifid stipules. The flowers are on long peduncles, and have the corolla partly yellowish, blue and purple. It is without smell, and has a bitter, sub- acrid taste. It contains a bitter principle, resin, etc. Effects and Uses. — Heartsease is a mild laxative, sometimes proving diuretic and diaphoretic. It was formerly much used as a depurant, and was considered one of the most potent sub- stances for this purpose. It is occasionally given as a mild laxative to children, but its use is generally restricted to cases of eczema, psoriasis, pityriasis, etc. In these cases it is said to act almost like a specific. Piffard, who has used it exten- sively, recommends an infusion (V. tricolor, §i ; senna leaves, Sss ; boiling water, Oij), of which a tumblerful may be given twice a day for two or three days, after which the dose should be diminished. He finds it particularly serviceable in the second stage of eczema, with sero-purulent exudation and crusting. The fluid extract (Squibb's) may also be given ; CASTOR OIL. 277 in acute eczema, dose for a child, tTLJ— v once or twice daily; in chronic eczema, TT1x-xv ; for an adult the dose is foss-j. It should be taken in water, half an hour before meals. Some- times it temporarily increases the severity of the eczema. In these cases it should be discontinued for a day or two, or the dose may be lessened. CASSIA FISTULA — PURGING CASSIA. This is the fruit of Cassia fistula (Nat. Orel. Leguminosae), a large tree of Egypt and the East Indies, now naturalized in the West Indies and South America. It consists of long woody, dark-brown pods, about an inch in diameter and nearly two feet in length, which contain numerous seeds imbedded in a soft black pulp. The pulp is the part used, and has a faint nauseous odour and a sweet, rather pleasant, mucilaginous taste. It is, in small doses, a mild, agreeable laxative, but its chief use is as an ingredient in the confection of senna. Dose, SjtoSj. • Oleum Oliv^ {Olive Oil). The well-known fixed oil obtained from the fruit of Olea europsea, or Olive Tree [Nat. Orel, Oleaceae), is nutritive, demulcent, emollient and laxa- tive. It is frequently prescribed as a constituent of laxative enemata. Oleum Amygdalae Expressum (Expressed Oil of Almond) is used for the same purposes as olive oil. OLEUM RICIXI — CASTOR OIL. Castor oil is the fixed oil obtained from the seed of Ricinus communis, or Palma Christi (Nat. Orel. Euphorbiacese), a small perennial tree of India, now naturalized in many warm climates, and cultivated extensively in the United States. In India it attains a height of thirty or forty feet, but in this country it is an annual plant, about five or six feet in height, with round, thick-jointed, furrowed stems, of a purplish colour 278 MATERIA MEDICA — CATHARTICS. above ; large peltato-palmate leaves, divided into seven or nine segments, on long round footstalks, and prickly, three-celled capsules, with a seed in each cell. The seeds are ovate, about the size of a small bean, and of a gray colour, marbled with reddish-brown spots and stripes. They possess considerable acridity, and in large quantities have produced death. They consist of a thin outer pellicle, an inner hard, blackish shell — both of which are inert — and a white oleaginous kernel, which contains the acrid principle. Castor oil is obtained by expression, by decoction, and by the agency of alcohol. The first method is the best, and is that which is pursued in this country, where large quantities are made, both for home consumption and exportation ; heat should not be employed in preparing it, as it renders it rancid. Thus procured, it is nearly colourless, or of a pale-yellow colour, of a thick, viscid consistence, a faint, unpleasant odour and a mild, nauseous taste, and becomes rancid and thick by exposure to the air. It is not soluble in water, but is ex- tremely soluble in alcohol, readily so in ether, and forms soaps with alkalies. Its composition is not well understood ; its con- stituents would seem to be mainly ricinolein (a saponifiable oil resembling olein), and a little stearin, palmitin, and an acrid principle. Effects and Uses.- — Castor oil is a mild and tolerably certain laxative, operating, when pure, in from four to six hours after its administration, without uneasiness in the bowels. It does not stimulate the liver nor increase the secretion of bile, but purges by a mild irritant action on the intestines (Rutherford). It is admirably adapted to all cases where a free evacuation of the bowels is desired, without abdominal irritation, as in dysentery, pregnancy, typhoid fever, etc., and is an excellent purgative for children. The leaves are said to possess galae- tagogue properties, and are applied to the breasts, in the form of decoction, to induce the secretion of milk. Administration. — For adults the dose is f§ss to fgj ; for children, foj to f§ss. To cover its unpleasant flavour it is sometimes taken floating on spirit, coffee, mint-water, com- SULPHUR. 279 pound spirit of ether, etc., or made into an emulsion, or mixed with the froth of porter or a little oil of bitter almond. Flaxseed Oil and Melted Butter are laxative in the same doses as castor oil. SULPHUR. Sulphur exists in both kingdoms of nature. It is procured by the purification of native sulphur and by the decomposition of the native sulphides. The sulphur of commerce is gener- ally obtained in the former way, chiefly from Sicily, and is termed crude sulphur. It comes also from Romagna, in Italy, and from California, and very recently considerable deposits of sulphur have been found in the island of Saba, one of the Dutch West Indies. After importation it is purified by subli- mation, and is known as sublimed sulphur — sulphur sub- limatum. It is sometimes sublimed in the form of an impal- pable powder, when it is called the floiuers of sulphur. Some- times it is cast in wooden moulds, and forms the roll sulphur or brimstone of commerce. Sublimed sulphur contains more or less sulphuric acid, and for medicinal use it is further puri- fied by washing, when it constitutes the sulphur lotum or washed sulphur of the Pharmacopoeia. As met with in the shops, it is a fine bright-yellow powder, with a feeble odour and taste, insoluble in water, but soluble in alcohol, ether, chloro- form, alkaline solutions, and the oils ; and when perfectly pure it is wholly volatilized by heat, and ought not to change the colour of litmus paper. Effects and Uses. — In small and repeated doses sulphur is a gentle stimulant to the skin and mucous membranes, and in larger doses it acts as a mild purgative, without exciting the pulse or occasioning griping. It is probably absorbed by being converted in the small intestine, by the alkali of the bile, into a sulphide. After its continued use the intestinal gases give off sulphuretted hydrogen. It is employed in the cases to which laxatives are applicable, and also as an alterative dia- 280 MATERIA MED1CA — CATHARTIC. phoretic in chronic cutaneous diseases, rheumatism and gout, and as an expectorant in pulmonary affections. It is consid- ered a specially useful laxative in hemorrhoids. To increase its cathartic effect it is often combined with cream of tartar or magnesia. Externally, it is a valuable remedy in various skin diseases, particularly scabies. Administration. — Dose, 5j to oiij or 5iv, in syrup, treacle or milk. Externally, it is applied in the form of vapour bath or ointment. Unguentum sulphuris consists of 3 parts of sul- phur and 7 parts of benzoinated lard rubbed together until thoroughly mixed. Unguentum sulphuris alkalinum {alka- line sulphur ointment) consists of sulphur, 20 parts, potassium carbonate, 10 parts, water, 5 parts, and benzoinated lard, 65 parts, rubbed together until thoroughly mixed. Sulphur Pr^ecipitatum (Precipitated Sulphur, or Lac Sulphuris) is prepared by boiling together sulphur, slaked lime and water, and afterwards precipitating the sulphur by muriatic acid. It is a finer and softer powder than sublimed sulphur, is of a paler yellow colour, with a grayish tint, and is not gritty between the teeth. When exposed to the air, how- ever, it is liable to become contaminated with sulphuric acid, and, as found in commerce, it is often adulterated with sulphate of calcium. Its effects, uses and doses are the same as those of sublimed sulphur. Potassa Sulphurata (Sulphurated Potassa), or Liver of Sulphur, is prepared by rubbing together one part of dried sulphur with two parts of potassium carbonate, afterwards melting the mixture, and pouring it when cold into a bottle. Its composition is variable and uncertain, but it should contain about 50 per cent, of potassium sulphide. When freshly and carefully prepared it is of a liver colour, has an acrid, alka- line, disagreeable taste, and forms an orange-yellow solution with water. This preparation and the other sulphides proba- bly act like sulphur. They are perhaps in part decomposed by the acids of the stomach, but any liberated sulphur must be again combined with the alkali of the bile. Taken in large quantities sulphurated potassa is considered to be a corrosive MAGNESIA. 281 poison, capable of producing fatal gastro-enteric inflammation. The sulphides are considered to be expectorant, diaphoretic and alterative. They have been especially recommended in the scrofulous abscesses of children — the calcium sulphide being preferred. Dose for an adult, gr. ij-x, several times a day. They are used externally in scaly skin diseases in the form of ointment (5ss to Si of lard) and of baths. SALINE CATHARTICS. MAGNESIA MAGNESIA. MAGNESIA PONDEROSA — HEAVY MAGNESIA. Magnesia, sometimes called calcined magnesia, from the mode in which it is prepared, is procured by exposing magnesium carbonate to a red heat, till the carbonic acid is wholly expelled. It is a light, fine, white, colourless, odourless powder (MgO), of a feeble, earthy taste, very slightly soluble in water, and more soluble in cold than in hot water. Heavy magnesia is a white, fine, dense powder, chemically identical with magnesia and differing with it only in the degree of ag- gregation of their molecules. Henry's Magnesia, a patent English medicine, has the advantage over the ordinary magne- sia of greater density and softness, and more ready miscibility with water, and corresponds to the officinal magnesia ponderosa. Magnesia prepared by Husband, and Ellis, of Philadelphia, is very similar in properties to Henry's. Effects and Uses. — Magnesia is antacid and laxative. A good deal of its cathartic effect is the result of its combination with the free acids of the stomach and intestines, in which soluble magnesian salts are formed. When taken in large quantities, and for too long a period, it sometimes accumulates in the bowels; and hence it is best to increase its solubility by giving it with lemonade. It is an excellent laxative where much acidity exists in the stomach, and is particularly useful in infantile cases. As an antacid it is employed in heartburn, , sick headache and nephritic complaints. Dose, as a laxative, 282 MATERIA MEDICA — CATHARTICS. 5j ; as an antacid, 3j, in water or milk. Of Henry's, half the quantity. MAGNESII CARBONAS — MAGNESIUM CARBONATE. Magnesium carbonate, sometimes called magnesia alba, is prepared by decomposing magnesium sulphate with an alka- line carbonate. As found in the shops it is a combination of magnesium carbonate and magnesium hydrate (4MgCo 3 , Mg2HO,5H 2 0). It occurs in the form .of light, white cubical cakes or powder; is inodorous, almost insipid, and nearly in- soluble in water, but soluble in carbonic acid water. Its effects and uses are nearly the same as those of calcined magnesia ; but from its effervescence with the acids of the stomach, it is apt to create flatulence, though sometimes, on this account, more acceptable to delicate stomachs. Dose, as a laxative, 5j to 5'j ; as an antacid, gr. x. MAGNESII SULPHAS — MAGNESIUM SULPHATE. This salt, commonly called Epsom Salt, from its having been first procured from the Epsom mineral water in England, occurs in native crystals, and is a constituent of sea-water and many saline springs. It is obtained in England from dolomite, or magnesian limestone; and also from bittern, or the residual liquor of sea-water, from which common salt has been sepa- rated. In this country it is extensively manufactured at Bal- timore and Philadelphia, by the action of sulphuric acid on magnesite, the silicious magnesium hydrate. It is usually met with in small acicular crystals, which are colourless, trans- parent and odourless, but have an extremely bitter taste. They effloresce on exposure to the air, are very soluble in water, and insoluble in alcohol. The chemical composition of the salt is MgS0 4 ,7H 2 0, one atom of magnesium having taken the place of two atoms of the hydrogen of sulphuric acid, the salt thus formed being joined with seven molecules of water of crystallization. SODIUM SULPHATE. 283 Effects and Uses. — Epsom, salt is a mild, safe, refrigerant purgative, which, from its cheapness, is b.y far the most com- monly employed of all cathartics. It produces free, watery purgation, with very little irritation of the intestines, stimulat- ing the intestinal glands, but not affecting the liver. Recently it has been found that hypodermic injections of small amounts of magnesium sulphate in solution will produce several watery stools. It is sometimes combined with senna, sometimes with bitter infusions, and is most agreeably administered in solution in carbonic acid water. Dose, Sj. LIQUOR MAGNESII CITRATIS — SOLUTION OF MAGNESIUM CITRATE. Magnesium citrate is employed medicinally only in solution, with slight excess of acid, and in the effervescing state. It is prepared according to the following formula: citric acid gr. 400 are dissolved in water fSjv, and in this solution magnesium carbonate gr. 200 are stirred until dissolved: this solutionis filtered into a strong twelve-ounce bottle, containing syrup of citric acid f oij ; to this are added potassium bicarbonate gr. xxx, and water enough to nearly fill the bottle, which must be closed with a cork, secured with twine; the mixture must be occasionally shaken to insure the solution of the bicarbonate. The effervescing solution has a pleasant acid taste, without anything disagreeable. It is a very grateful cathartic, and is much employed as a substitute for Epsom salt, but is more apt to produce slight griping. Dose, from a half to a whole bottle. SODII SULPHAS — SODIUM SULPHATE. Sodium sulphate, commonly called Glauber s Salt, is a con- stituent of many mineral springs, and is prepared in various chemical processes. It occurs as a residuum in the manufac- ture of hydrochloric acid, made by adding sulphuric acid to sodium chloride, and it is obtained from sea-water in the winter 284 MATERIA MEDICA — CATHARTICS. season. It is found in colourless, six-sided, very efflorescent crystals, which are inodorous, but have a cooling, saline, very bitter taste. It is soluble in water — more readily in hot than in cold water — and is insoluble in alcohol. Its chemical com- position is Na 2 SO 4 ,10H 2 O, two atoms of sodium having dis- placed two atoms of hydrogen in sulphuric acid, and the re- sulting salt containing also ten molecules of water of crystal- lization. Its effects and uses are very similar to those of Epsom salt, but it is more bitter and nauseous, and is now little used. It is a mild hepatic stimulant, according to the experiments of Rutherford on dogs. The effects of the sodium salts have al- ready been considered (vide page 236). It has an anaplastic ac- tion on the blood, due to the sodium which it contains. Dose, oj ; in an effloresced state, 5ss. MANGANII SULPHAS — MANGANESE SULPHATE. This salt (formerly officinal as manganesii sulphas) is made by heating the native black oxide with concentrated sulphuric acid, and consists of one equivalent of sulphuric acid and one of manganous oxide (MnS0 4 ,4H 2 0). It occurs in rhombic, prismatic crystals, of a pale-rose or pink colour, transparent, and of an astringent, bitterish taste. It is very soluble in water, insoluble in alcohol. In its effects it is said to resemble Glauber s Salt, acting also as a cholagogue. Dose, as a purgative, 5i-ij« As a tonic it has been given in doses of gr. v-xx. SODII PHOSPHAS — SODIUM PHOSPHATE. This salt is prepared by digesting powdered burnt bone with diluted sulphuric acid, and decomposing the resulting monocal- cic phosphate with sodium carbonate. It is disodic phosphate, and occurs in large rhombic, colourless, transparent, very ef- florescent crystals (Na 2 HP0 4 ,12H 2 0), which are wholly soluble POTASSIUM SULPHATE. 285 in water and insoluble in alcohol, and have a pleasant saline taste, resembling that of common salt. Effects and Uses. — Sodium phosphate is a mild saline ca- thartic, well adapted, from its agreeable taste, to the cases of children and delicate persons, but too expensive for general use. It is a hepatic stimulant, increasing the amount of bile secreted, although making it more watery, and having a very slight irritant action on the intestinal mucous membrane (Ruth- erford). It increases the alkalinity of the blood and dimin- ishes the amount of urea excreted. It is a constituent of the blood in health, and has been recommended in cholera as a res- torative of deficient saline matters to repair the drain on the system caused by chronic suppurations, and also in diseases where there is a deficiency of phosphatic matter in the bones. In all catarrhal conditions of the gastro-intestinal mucous membrane, notably in catarrhal jaundice, sodium phosphate is of the greatest utility. It is highly recommended also in chronic infantile diarrhoea with pasty stools (Routh). Dose, as a cathartic, 5vj to 5xij, in broth or soup. As an alterative, 3j or 3ij, three or four times a day. POTASSII SULPHAS — POTASSIUM SULPHATE. This salt exists in both kingdoms of nature, and is obtained artificially from the residuum of the distillation of nitric acid from potassium nitrate and sulphuric acid. It occurs in small hard, colourless, inodorous crystals (K 2 S0 4 ), of a saline, bitter taste, which have no water of crystallization, and are unalter- able in the air. They are moderately soluble in water, and are insoluble in alcohol. Effects and Uses. — The physiological effects of the potas- sium salts have already been fully considered (vide p. 233). In small doses it is considered a mild and safe cathartic ; but in large doses it has proved a violent and even fatal poison, pro- ducing symptoms of cholera. It is thought to act as a lacti- fuge, or represser of milk, and is administered with this view in France. Dose, as a cathartic, gr. xv to 5j or 5ij ; but it is 286 MATERIA MEDICA — CATHARTICS. little employed in this country. From its hardness and dry- ness it is useful to promote the trituration and division of powders. POTASSII BITARTRAS — POTASSIUM BITARTRATE. This salt, well known as Cream of Tartar, and termed also acid potassium tartrate, is the monopotassic tartrate (KH C 4 H 4 6 ), one atom of hydrogen of tartaric acid being displaced by one atom of potassium. It exists in many vegetable juices, particularly the juice of grapes, from which it is obtained. It is deposited in an impure form, during fermentation, on the sides of wine-casks, and in this state occurs in crystalline cakes, of a reddish colour, known as argol or crude tartar. This is purified by solution and crystallization, and forms a w T hite crystalline mass or powder, termed cream of tartar. It is without smell, has an acidulous and gritty taste, is very slightly soluble in water, and insoluble in alcohol ; when heated in a close vessel, it is converted into black flux, a compound of charcoal and potassium carbonate. Effects and Uses. — In small doses it is diuretic and refrige- rant ; in larger doses, cathartic ; and in excessive doses it will produce gastro-intestinal inflammation. It is employed to form a refrigerant drink, and as a gentle aperient in fevers ; and as a diuretic and hydragogue cathartic in general dropsy de- pending on valvular disease of the heart, and in desquamma- tive nephritis. Dose, as an aperient, 5ss or 5j ; as a cathartic, Sss to oj ; as a diuretic, 3ss to 5j, in repeated doses. It enters into the compound powder of jalap. POTASSII TARTRAS — POTASSIUM TARTRATE. This salt, formerly called Soluble Tartar, is obtained by saturating the excess of acid in cream of tartar with potassium carbonate, and is the dipotassic tartrate (2K 2 C 4 H 4 6 .H 2 0), two atoms of potassium replacing two atoms of hydrogen of the acid. Two molecules of the salt are joined to one molecule of RHUBARB. • 287 water of crystallization. It occurs in white deliquescent crys- tals or grains of a saline, somewhat bitter taste, and is very soluble in water. It is a gentle cathartic and diuretic, at present not much used. Dose, §ss to Sj. POTASSII ET SODII TARTRAS — POTASSIUM AND SODIUM TARTRATE. This salt, commonly called Rochelle Salt, is made by satu- rating the excess of acid in cream of tartar with sodium car- bonate. It occurs in large transparent, colourless, prismatic, slightly efflorescent crystals, of a mildly saline and bitter taste, readily soluble in cold water, and still more so in hot water (KNaC 4 H 4 6 ,4H 2 0). It is a mild and pleasant aperient, well adapted to gouty cases and cases of uric acid lithiasis, but it renders the urine alkaline, and should not therefore be given to persons suffering with phosphatic deposits in the urine. Dose, oss to 5j. It is usually exhibited in the form of pulvis effervescens compositus (compound effervescing powder), or Seidlitz powder, which consists of Rochelle salt (5ij) and so- dium bicarbonate (3ij) in a blue paper, and tartaric acid (gr. xxxv) in a white papej. They are taken, dissolved in half a pint of water, while the liquid is in a state of effervescence, and form a very agreeable mild aperient, and are very accept- able to the stomach. They should not be kept in a damp place. MILD ACRID CATHARTICS. RHEUM- — RHUBARB. Rhubarb is the root of Rheum officinale, and of other spe- cies of Rheum (Nat. Ord. Polygonaceae). It is not known with certainty what species yields the officinal rhubarb, but it is believed to be derived chiefly from R. officinale, a perennial plant with a tall stem, from near the thick base of which numer- ous orbicular-ovate five or seven-lobed leaves grow, attaining sometimes a length of blade equal to four feet. It is a native 288 MATERIA MEDICA — CATHARTICS. of Thibet. Several varieties of rheuin are cultivated in Europe and this country, the leaf stalks of which make excellent tarts. Rhubarb is prepared for the market by being cleansed, de- prived of its cortical portion, cut into pieces, pierced through the centre, strung upon a cord, and dried in the sun. Three principal sorts were long known : Chinese, Russian or Turkey, and European. The first two were obtained, by different routes, from central Asia. 1. Chinese rhubarb is the common variety, and is imported principally from Canton. It occurs in roundish pieces, sometimes flattened, of a dirty brownish-yellow colour externally (the cortical portion appar- ently scraped off), having a ragged fracture (which presents red, yellowish and white veins), and is often perforated with holes, with portions of the cord on which it was dried occa- sionally remaining. It has a peculiar odour, an astringent, somewhat bitter taste, is gritty when chewed, and tinges the saliva of a yellow colour ; its powder is yellowish, with a reddish- brown tinge. 2. Russian rhubarb had probably the same source as the Chinese, but it was selected with greater care, and was rigorously inspected by the Russian government. It was carried in caravans through Russia to St. Petersburg, whence it was exported. The pieces are irregular in shape, and are often angular, from the cortical portion having been cut off and not scraped. They are less heavy and compact than the Chinese, of a livelier colour both externally and internally, and are perforated with larger holes, which have been made for the purpose of inspection. The taste and smell are very like those of the Chinese, but are more aromatic ; the powder is bright yellow. Russian rhubarb has, however, within a few years past disappeared as an article of commerce, the Russian government having abandoned the inspection long practiced on the frontiers of Bucharia, whence the supply was derived. 3. European rhubarb is of uncertain quality, and is seldom found in the shops. The kind most frequently met with is English rhubarb, which is thought to be derived from Rh. rhaponticum, and generally comes in pieces five or six inches long and about an inch thick, and is called stick rhu- RHUBARB. 289 barb. It is lighter, more spongy and redder than the Asiatic varieties, with a feebler odour and less bitter taste, and when broken exhibits a more compact and regular marbling. Lately the production of English rhubarb has much increased, and its quality has improved. Rhubarb imparts its virtues to both water and alcohol, but they are impaired by long boiling. Its most important chemi- cal constituents are chrysophan, chrysophanic acid (C 15 H 10 O 4 ) (an orange-yellow crystalline substance, which is probably the active ingredient of goapowder, and will be considered in the article chrysarobin — vide Rubefacients), erythoretpi, emodin, pJioporetin, aporetin, rheotannic (C 26 H 26 14 ) and rheumie (C 20 H 16 O 9 ) acids. It is supposed that the therapeutical prop- erties of the drug depend chiefly on the conjoint operation of these principles. Effects and Uses. — In small doses, rhubarb is an astringent tonic. In larger doses, it is a slow and mild cathartic, occa- sionally causing griping and accelerating the pulse, but never inflaming the mucous membrane of the alimentary canal like the drastics. It tinges the milk and urine yellow. It increases the secretion of bile, which, however, is unaltered in composi- tion (Rutherford). It is much employed as a purgative in diarrhoea, in which it is particularly useful from its secondary astringent effect, and in dyspepsia attended with costiveness, where it acts both as a stomachic and laxative. It is not adapted to febrile or inflammatory cases. In the bowel com- plaints of children, rhubarb deservedly enjoys great popu- larity, and it is also highly esteemed in infantile scrofula. Made into a cataplasm and applied to the abdomen, it acts as a purgative on children. Administration. — Dose, as a stomachic laxative, gr. v to gr. x ; as a purgative, 3j to 5j. The following are the officinal preparations : Extract (alcoholic), dose, gr. x to gr. xxx ; ■fluid extract, dose, f 5ss, containing half a drachm of rhubarb ; mixture of rhubarb and soda contains sodium bicarbonate, fluid extract of rhubarb and spirit of peppermint, each 30 parts, water enough to make 1000 parts— an excellent prepa- 19 290 MATERIA MEDICA — CATHARTICS. ration where rhubarb is indicated, combined with an antacid, especially adapted to children — dose for a child f 3ss-j, for an adult f3j-f§ss or more; aromatic tincture of rhubarb contains also cinnamon, cloves and nutmeg, and is used in making the aromatic syrup ; sweet tincture of rhubarb contains also liquo- rice, anise and cardamom; tincture of rhubarb and senna (Warner's gout cordial), tincture of rhubarb and aloes and tinc- ture of rhubarb and gentian are no longer officinal ; the dose of all the tinctures is f gss to f Sj, and they are chiefly adapted to low forms of disease and persons accustomed to the use of stimulants spills of rhubarb, each pill contains rhubarb gr. iij, soap gr. j ; compound fills of rhubarb, each pill contains rhu- barb gr. ij, aloes gr. jss, myrrh gr. j, oil of peppermint gr. -^ ; compound powder of rhubarb (containing 25 parts of rhubarb, 65 parts of magnesia and 10 parts of ginger) ; syrup contains also cinnamon, potassium carbonate, sugar and water; aro- matic syrup (contains aromatic tincture 10 parts, syrup 90 parts, much used in infantile cases under the name of spiced syrup of rhubarb) — dose for an infant f 5i ; and wine contains rhubarb 10 per cent, and calamus 1 per cent, in stronger white wine — dose f 5i-f oss. Roasting impairs the cathartic power of rhubarb, and is said to increase its astringency. Juglans {Butternut). The inner bark of the root of Junglans cinerea, or Butternut (Nat. Ord. Juglandacese), an indigenous forest tree, found throughout New England, the middle and western states and Canada, possesses cathartic properties resembling those of rhubarb. It is of a fibrous texture, a white colour, gradually changing to a dark brown, a feeble odour and a bitter, somewhat acrid, taste. It contains nucine, C 36 H 12 O 10 (composed of juglandicacid and juglone), some tannic acid, fixed and volatile oils, resin, etc. It is not given in substance; the extract (watery) is officinal, of which the dose. is gr. v-x as a laxative, and gr. x-xxx as a decided cathartic. ALOES. 291 A L E — A L E S. Aloes is the inspissated juice of the leaves of Aloe soco- trina (Nat. Orel. Liliacese), a succulent herbaceous plant, grow- ing in warm countries. Aloes obtained from other varieties of aloe is used, but the Pharmacopoeia only recognizes Aloe soco- trina as the source of officinal aloes. The finest kinds are ob- tained by exudation ; those prepared by expression and by boiling are inferior. Three principal varieties are known in commerce : Cape, Socotrine and Barbadoes aloes, the first two of which are the most used in the United States. 1. Cape aloes (Aloe capensis\ which is much the most common, is ob- tained from the Cape of Good Hope, where it is collected in- discriminately from A. spicata and other species. It has a shining, resinous appearance, is of a deep-brown colour, with a greenish tint, translucent at its edges, and has a glossy or resinous fracture. Its powder is greenish-yellow; its odour is strong and disagreeable, but not nauseous. 2. Socotrine aloes (Aloe socotrina), when genuine, is the choicest variety. It is produced in the island of Socotra, on the eastern coast of Africa, from A. socotrina, and occurs in pieces of a yellowish or reddish-brown colour, becoming darker on exposure to the air, with a smooth and conchoidal fracture, the interior being lighter-coloured than the exterior. Its powder is golden-yel- low ; its odour peculiar, but not unpleasant, and its taste bitter and disagreeable, but aromatic. Hepatic aloes is prob- ably an inferior variety of Socotrine, and is seldom met with in our shops. It is of a reddish-brown colour, but darker and less glossy than the Socotrine. 3. Barbadoes aloes (Aloe bar- badensis) comes from the West Indies, the product chiefly of A. vulgaris ; it is imported in gourds. Its colour is not uniform, varying from a dark-brown or black to a liver colour. It has a dull fracture ; makes an olive-yellow powder ; and is dis- tinguishable by its particularly disagreeable, nauseous odour. The taste of all the varieties of aloes is intensely bitter and very tenacious. Aloes yields its virtues to water and alcohol. A neutral 292 MATERIA MEDICA — CATHARTICS. crystalline principle, termed aloin, has been extracted from it, which is supposed to be the cathartic principle. The resin of aloes, when exhausted of aloin, possesses no purgative properties. Effects and Uses. — Aloes, in small doses, is tonic, and in large doses purgative. As a cathartic it is remarkable for the slowness of its operation and its special action on the large intestine and the pelvic viscera generally. Hence it is objec- tionable in cases of disease of the genito-urinary apparatus, pregnancy, etc. ; and, on the other hand, is useful in amenor- rhoea. It stimulates the hepatic secretion also. It is principally employed in cases of dyspepsia accompanied by costiveness, dependent on a torpid condition of the large intestine or liver. It is also useful as a revulsive in cerebral affections, and has proved efficacious as an anthelmintic. It was once thought that it was objectionable in hemorrhoids, but this affection being how considered to depend upon relaxation of the veins of the rectum, aloes has been administered in it upon theoretical views, and with very good results. As a purgative it holds an intermediate rank between rhubarb and senna. Administration. — Dose, gr. v to gr. x-xx, in pill ; it is usu- ally given in combination with other cathartics. Aloes is so often mixed with impurities that, for medicinal use, it is best employed under the form of aloe purificata {'purified aloes), which is prepared by straining and evaporating an alcoholic solution of Socotrine aloes. The officinal preparations are : Pills of aloes, consisting of equal parts of aloes and soap, one pill containing aloes gr. ij ; pills of aloes and mastic, 4 parts of aloes to 1 part of mastic and red rose, each (the Lady Webster pill, each containing aloes gr. ij); pills of aloes and asafetida, one pill contains of aloes, asafetida and soap gr. j J each, useful in flatulent constipation ; pills of aloes and myrrh, or Rufuss pills, aloes 4 parts, myrrh 2 parts, and aromatic powder 1 part, made into pills with syrup, em- ployed in amenorrhoea, each pill containing aloes gr. ij ; pills of aloes and iron, equal parts of aloes, dried iron sulphate and aromatic powder, made into pills with confection of rose, each pill contains aloes gr. j, very useful in amenorrhoea; tine- SENNA. 293 ture (aloes and extract of liquorice (of each 10 per cent.) in diluted alcohol), dose, f 5j to f§ss ; tincture of aloes and myrrh (aloes and myrrh (each 10 per cent.) in alcohol); wine of aloes (aloes (10 per cent.), cardamom and ginger (each 1 per cent.) in stronger white wine). SENNA. Senna consists of the leaflets of several species of Cassia (Nat. Ord. Leguminosse), small shrubs which grow in the trop- ical regions of Asia and Africa. The species recognized as officinal are C. acutifolia and C. elongata; and besides these, C. obovata, C. lanceolata and C. ^ethiopiea are also generally received as sources of the drug. The commercial varieties of senna which are found in the United States are the Alexan- dria, the Tripoli, the India and the Mecca senna. 1. Alexan- dria senna, which comes from the port of this name in Egypt, is made up chiefly of the leaflets of C. acutifolia (which are yellowish-green, acute in shape, and less than an inch in length), intermingled with the pods, leafstalks, flowers, etc., of this plant. It contains also leaflets of C. obovata, known by their rounded, obtuse summits ; and is, moreover, occasionally adulterated with the leaves of Cynanchum oletefolium, distinguishable by their greater length, thickness and firmness from the genuine leaves. 2. Tripoli senna, brought from Tripoli, consists of the leaflets of C. sethiopica, which are shorter, less acute, thinner and more fragile than those of C. acutifolia, and are generally much broken up. 3. India senna is produced in Arabia, but comes into commerce through the ports of Hin- dostan. It consists of the leaflets, intermixed with the leaf- stalks and pods, of C. elongata, and is readily recognized by the long, narrow, jiike-UJce shape and dark hue of the leaflets. A finer variety of India senna, cultivated at Tinnevelly, in Hindostan, has been known for some years past, which is dis- tinguishable from the common sort of India senna by the bright-green colour of the leaflets. 4. Mecca se?inais a variety lately introduced, and consists of leaflets, intermediate in length 294 MATERIA MEDICA — CATHARTICS. between those of C. acutifolia and C. elongata, and has in mass a yellowish, tawny hue. Its source is not known with cer- tainty, but it is probably the product of C. lanceolata. Cassia obovata has been lately found growing wild in abundance in Jamaica. Commercial senna is prepared for use by separating the leaflets from the stalks, adulterations, etc. ; the pods possess cathartic properties, but are less active than the leaves. The odour of senna is faint and sickly; its taste bitter, sweetish and nauseous. It imparts its virtues to water and alcohol, its infusion being of a reddish-brown colour. The chemical com- position of senna has long been an unsettled point. By the latest analysis it has been found to contain a glucoside, cathar- tic acid, which is insoluble in water, stronger alcohol and ether, but which enters readily into watery solution with alka- line and earthy bases, in which state it exists in senna; this is actively cathartic. Catharto-mannit, smnacrol and chrys- ophanic acid have been also obtained; and there is probably another purgative principle which has not been isolated. Effects and Uses. — Senna is a prompt, efficient and safe cathartic, well adapted to febrile and inflammatory cases; it operates on the entire tract of the intestinal canal, and pro- duces watery, feculent discharges. Prof. Rutherford found that senna was a mild hepatic stimulant, and rendered the bile more watery. Its tendency to gripe may in a great measure be counteracted by combining aromatics or neutral salts with it ; the addition of bitters promotes its cathartic activity. Administration. — The dose in powder is 5ss to 5ij ; but it is usually given in infusion (a troy ounce to boiling water Oj with coriander 5j), one-third for a dose, repeated. Confectio sennce (made with senna, coriander, sugar, figs and pulp of prunes, tamarinds and purging cassia) is an excellent mild cathartic, much used for pregnant women; dose, 5\j. Of the fluid ex- tract the dose is f5i to f§ss; the compound infusion (black draught) contains senna, manna, magnesium sulphate and fennel; dose, foss to fSj or more. Syrup of senna contains senna, sugar, alcohol and oil of coriander; dose, f3j. Pulvis FRANGULA. 295 glycyrrhizce compositus (compound powder of liquorice) con- sists of senna, liquorice, fennel, washed sulphur and sugar. It is an excellent purgative ; dose, a teaspoonful of the powder. LEPTANDRA. The rhizome and rootlets of Leptandra virginica, Culver's Root, or Culver's Physic (Nat. Ord. Scrophulariacese), an herbaceous perennial plant, three or four feet high, with leaves in whorls, and a long spike of white flowers, are ranked as a cholagogue cathartic. It consists of a dark-brown rhi- zome, from two to four lines in thickness, several inches in length, with numerous long, slender radicals. The odour is feeble and disagreeable, the taste bitterish and somewhat nau- seous and acrid. Water and alcohol extract its virtues, which depend on leptandrin. It also contains resin, saponin, tannin, mannit, etc. It is only a feeble stimulant to the liver and in- testinal glands, according to the investigations of Rutherford. Dose of the powdered root, gr. xx to 5j ; of an impure resin (made by precipitating a tincture of the root with water), gr. ij-iv; an extract and fluid extract also have been used. FRANGULA. The bark of Rhamnus frangula, or Alder Buckthorn (Nat. Ord. Rhamnaceae), is a mild purgative of some value. Fran- gula is a shrub growing to the height of ten feet or more, found in wet places along the northern coast of Africa, through- out Europe, and in Siberia. It has alternate oval leaves, slightly pointed at the apex, greenish flowers in axillary clus- ters and small red berries, which finally become black and contain two or three roundish-angular seeds. The bark comes in small quills, grayish or blackish-brown externally and marked with numerous small whitish, transversely elongated warts; inner surface is smooth, pale, brownish-yellow. It has no smell and a sweet and bitterish taste. It contains frangulin (C 20 H 20 O 10 ), emodin, resin, tannin, etc. 296 MATERIA MEDICA — CATHARTICS. When fresh the bark is an active emetic and hydrogogue ca- thartic, possessing irritant qualities, but it loses much of its acridity in drying, and it is therefore recommended by the Pharmacopoeia that it should be collected at least a year be- fore it is used. When dried it is a mild acrid cathartic, prov- ing also somewhat diuretic. It is also an anthelmintic of con- siderable value. The fluid extract may be given in doses of f5ss-j. CASCARA SAGRADA. Cascara sagrada or Chittem Bark is the bark of Rhamnus purshiana (Nat. Ord. Rhamnaceae), a small tree found on the Pacific slope, growing to the height of ten to twenty feet, with elliptic denticulate leaves, rather large white flowers in umbellate clusters and three-lobed, three-seeded black drupes. The bark comes in thin quills, with a grayish periderm, under- neath which it is of a reddish-brown colour ; the inner surface is smooth and yellowish. It is without smell, but has a bitter taste. It contains three resins which are probably the pur- gative principles. Effects and Uses. — Cascara bark is a good and efficient cathartic, acting probably by increasing the peristalsis of the lower bowel. It appears also to be a tonic to the unstriped muscular fibres. It is highly recommended in habitual consti- pation on account of its tonic effects. Dose of the fluid ex- tract, TT]x-f 5ss, beginning with the smallest dose three times a day and gradually increasing until a free morning evacua- tion is produced, after which the dose should be carefully de- creased, giving just sufficient to produce the necessary morn- ing evacuation. Cascara sagrada is not officinal. SAMBUCUS — ELDER. Several portions of Sambucus canadensis, our indigenous common elder (Nat. Ord. Caprifoliacese), a well-known shrub, from six to ten feet high, found in all the Atlantic States, pos- JALAP. 297 sess medicinal properties. The floivers, which are officinal, are employed internally as a diaphoretic, externally as a dis- cutient. The inner bark, which is without smell, and has a taste at first sweetish, afterwards slightly bitter, acrid and nauseous, and contains a resin, with valerianic acid and other principles, is a hydragogue cathartic, and in large doses emetic. It is deemed a valuable remedy in dropsy, particularly in dropsy dependent on albuminuria, in which affection specific alterative virtues are attributed t® it. It is given in decoction (an ounce boiled with two pints of water to a pint) ; dose, f §iv. An infusion in cider is popularly employed. DRASTIC CATHARTICS. JALAPA — JALAP. Jalap is the tuber of Exogonium purga, or Ipomsea jalapa (Nat. Ord. Convolvulaceae), a climbing plant of Mexico, which derives its name from the city of Jalapa, near Vera Cruz. The tubers are imported usually entire, but sometimes in slices. When entire, they vary in size and shape from a walnut to a large pear, are hard and heavy — externally, brown and wrinkled, and internally, grayish, with brown concentric rings ; they are often furrowed with vertical incisions, made to promote drying. They have a heavy, rather naujseous smell and a sweetish, subacrid, disagreeable taste. They yield their virtues partly to water, partly to alcohol, and com- pletely to diluted alcohol. In the shops jalap is kept in the state of powder, which is of a yellowish-gray colour. Its active principle is a resin, which consists of two portions, both of which are cathartic ; one is soft and soluble in ether, the remainder is the glucoside convolvulin (C 62 H 100 O 32 ), insoluble in ether ; it contains also gum and starch, which is apt to be attacked by worms, the worm-eaten pieces becoming thus the most active. Effects and Uses. — Jalap is a powerful hydragogue cathar- tic, operating with great promptness, and often causing much 298 MATERIA MEDICA — CATHARTICS. pain. Rutherford found that jalap was a powerful hepatic stimulant, increasing the flow of bile, which at the same time was rendered more watery. It also increases the secretion of the intestinal glands to a marked degree. In overdoses, it may produce dangerous hypercatharsis. It is employed as a hydragogue in dropsy, when it is often combined with cream of tartar ; as a revulsive in cerebral and other affections, and to increase the activity of calomel in bilious fever. Dose, gr. xv to xxx ; in combination, gr. x. Of the abstract, gr. j equals gr. ij of the powder. The compound powder of jalap (pulvis jalapos compositus) contains one part of jalap and nearly two parts of cream of tartar. The resin is extracted by solution in alcohol, and afterwards precipitated from the tincture by water ; dose, from four to eight grains. BRYONIA BRYONY. Bryonia is the root of Bryonia alba and B. dioica (Nat. Ord. Cucurbitacese), climbing perennial vines, with rough, five-lobed, toothed, alternate leaves and cymes of three or four small greenish flowers, and black or red berries containing six large spotted seeds. The root is found in the shops in trans- verse sections about two inches in diameter, with a grayish- brown, rough, thin bark, the central portion being w T hitish, with small woody bundles arranged in circles, and projecting, radiating lines. It is without smell, but has a bitter taste. The active principle is probably bryonin (C 48 H 80 O 19 ), a neutral principle. Effects and Uses — Bryonia is a powerful hydragogue ca- thartic, resembling jalap in its action, but much more violent. It also acts on the kidneys, increasing their secretion. In large doses it has produced fatal gastro-intestinal inflamma- tion. Should symptoms of its irritant action appear, the drug should be discontinued and opiates and stimulants administered. In dropsies it may be used as a drastic cathartic, with a view of also acting on the kidneys. Phillips recommends it in the stage of effusions in pleuritis and pericarditis, in pleuro-pneu- MAY-APPLE. 299 monia, and where the joints are stiff and painful from rheum- atic affections. The tincture is the only officinal preparation ; dose, f 5ss-j or more. PODOPHYLLUM — MAY-APPLE. Podophyllum peltatum, May-apple or Mandrake (Nat. Ord. Berberidacese), is a very common indigenous herbaceous plant, Fie. 24. with a long creeping perennial root, and an upright stem about a foot high, separating at the top into two petioles, each supporting a large peltate leaf, divided into five or six lobes. At the fork of the petioles it bears a single flower, which ap- pears in May, the fruit ripening in September. The rhizome and rootlets are the parts used. The rhizome is found in the 300 MATERIA MEDICA — CATHARTICS. shops in wrinkled, jointed, cylindrical pieces, about two lines in diameter, of a brown colour externally, and yellowish within, having a tuft of about ten nearly simple fragile rootlets on its under surface. The powder is yellowish-gray, and has a sweetish smell ; its taste is at first sweetish, afterwards bitter, acrid and nauseous. Diluted alcohol is the best solvent of podophyllum, which has been found to contain, with the alka- loid berberina, two resinous cathartic principles, both soluble in alcohol, but one only soluble in ether, which is much the more active. Effects and Uses. — This is an active hydragogue cathartic, with an especial determination to the upper portion of the alimentary canal, and a pretty decided cholagogue action, which, according to Rutherford, is due to stimulation of the hepatic secreting apparatus, and is greater when purgation is not profuse, and vice versa. He also concludes that purgation is due to intestinal irritation. It is an ingredient in several cathartic nostrums. Dose, in powder, $j ; of the abstract gr. j equals gr. ij of the powder ; a fluid extract is also officinal ; of the extract (alcoholic), gr. v to gr. xv ; of the resin, gr. \ to g r - J- CHELIDONIUM. Chelidonium majus, known also as Celandine or Tetterwort (Nat. Ord. Papaveracese), is a perennial herb growing in waste places, indigenous to Europe, but naturalized in North America. The stem is about two feet high, and hairy ; the leaves are alternate, the upper ones sessile, light-green above and glau- cous beneath, lyrately pinnatifid, the pinnae ovate-oblong, obtuse, coarsely crenate or incised. The flowers appear from May to September, are of a bright golden-yellow colour, and arranged in small axillary umbels on long peduncles. Cheli- donium contains two alkaloids, chelerythrine (C 19 H 17 N0 4 , iden- tical with sanguinarine) and chelidonine (C 19 H 17 N 3 3 ), com- bined with chelidoninic acid, which appears to be identical with succinic acid. Effects and Uses. — The physiological action of this drug EUONYMUS. 301 lias not been investigated. It has been- used as a hydragogue cathartic, and is said to possess narcotic properties. Binz and Phillips both believe that it has a stimulating effect upon the hepatic secretions, and class it with podophyllum and iris. Dose of the powder, gr. x-5j ; or it may be given in extract or infusion. There are no officinal preparations. IRIS. The rhizome and rootlets of Iris versicolor, or Blue-flag {Nat. Ord. Iridaceae), are used as a powerful hepatic stimulant. The Blue-flag is found in the swampy meadows of North America, having sword-shaped leaves and a stout stem, bearing a few blue flowers, appearing late in the spring of the year. The rhizome is horizontal and jointed ; is long and cylindrical in its lower half, broad near its upper extremity, and termi- nated by a circular scar, annulated from the leaf-sheaths, of a grayish-brown colour, with long rootlets crowded near the broad end. It has a slight odour and a nauseous, acrid taste (Maisch). It contains a resin to which probably its medicinal qualities are due. Effects and Uses. — In large doses the fresh plant causes violent vomiting and purging, with much depression ; in smaller doses it is a cholagogue and diuretic (Phillips). These quali- ties are impaired by drying. Rutherford found that iridin (an impure oleoresin) was a powerful hepatic stimulant, pro- ducing less intestinal irritation than podophyllin, but greater purgation than euonymin. It was also a decided stimulant to the intestinal glands. It is highly recommended in jaundice of malarial origin, and may be given with advantage in tor- pidity of the liver, dropsy and intestinal disorders. The fluid extract may be given in doses of TT|xx-f5j. An extract is also officinal. EUONYMUS. Euonymus or Wahoo is the bark of Euonymus atropurpureus {Nat. Ord. Celastracese), a handsome shrub of the northern 302 MATERIA MEDICA — CATHARTICS. and middle portions, of the United States, found in shady woods. " Its branches are slightly quadrangular ; the leaves opposite, petioled, elliptic-ovate, serrate, and pointed ; the flowers dark-purple, in loose cymes of three to six, and appear in June." The fruit matures in the autumn, and consists of pendulous capsules of a bright crimson colour. The bark, as seen in the shops, is of a grayish colour, mottled with blackish patches on its outer surface, which is detached in thin and small scales ; inner surface tawny and smooth. It is without smell, and has at first a sweetish taste, which afterwards be- comes bitter and acrid. It contains a bitter principle, euony- min, resins, euonic acid, etc. Effects and Uses. — Euonymus is an excellent cathartic, in- creasing the intestinal secretions to some extent, and acting as a powerful hepatic stimulant. It may be advantageously used in cases of torpor of the liver and intestines. The extract is the only officinal preparation ; dose, gr. iij-v. S C A M M N I U M — SCAMMONY. Scammony is a resinous exudation from the root of Con- volvulus scammonia (Nat. Ord. Convolvulacese), a twining plant of Syria. The finest kind is the product of exudation from the sliced root; but most of the drug which reaches us is probably obtained by expression, or by evaporation of a decoc- tion of the root. It comes from the Levant. Genuine scam- mony, termed Virgin Scammony, occurs in light irregular friable pieces, of various shades of colour from dark-ash to dark-olive, covered with a whitish-gray powder, and breaking with a bright-greenish fracture; they should not effervesce with an acid. The scammony of the shops, which is always more or less adulterated, is in hard, heavy, saucer-shaped cakes, from four to six inches in diameter (sometimes broken into pieces), of a dark-ash or slate colour. The powder is light-gray ; the smell disagreeable, like that of old cheese, the taste at first feeble, afterwards bitterish and acrid. Scammony is a gum-resin, the resin constituting from 80 to 90 per cent. COLOCYNTH. 303 of the weight of good scammony. The active medicinal prin- ciple is scammonin (C 34 H 56 ]6 ), a colourless, tasteless resinous substance, having a peculiar faint, sweetish smell, and soluble in alcohol and ether. A factitious scammony made in France, and known as Montpellier Scammony, is occasionally imported into the United States. It is blacker than the genuine article, has a feeble balsamic odour and a very bitter, nauseous taste. Effects and Uses. — Scammony is an energetic hydragogue cathartic, operating sometimes with great violence, and seldom given except in combination with other cathartics. Dose, gr. v to gr. xv of the pure drug, gr. x to gr. xxx of the drug of the shops ; of the resin, gr. iv to gr. viij. Scammony resin is of pleasanter smell and taste than jalap resin, produces less griping, and is less apt to cause vomiting. It is much used in the form of compound extract of colocynth. COLOCYNTHIS — COLOCYNTH. Colocynth is the fruit (deprived of its rind) of Citrullus colocynthis or Bitter Cucumber {Nat. Ord. Cucurbitacese), an annual plant of the south of Europe and parts of Asia and Africa, resembling the common watermelon. The fruit has a thin but hard rind, but is peeled and dried for exportation, and comes to us from the Levant. It consists of light whitish, spongy balls, about the size of a small orange, filled with nu- merous seeds. For medicinal use the pulp only is employed, and the seeds, which are inactive, are rejected. The pulp has a feeble odour and a nauseous, intensely bitter taste. It yields its virtues to both water and alcohol, and contains a peculiar glucoside termed colocynthin (C 56 H 84 23 ), resin, colocyn- thitin, etc. Effects and Uses. — Colocynth is a hepatic stimulant, in- creasing the amount of the biliary constituents as well as render- ing the bile more watery and at the same time stimulating the intestinal glands (Rutherford). It is a violent hydragogue cathar- •304 MATERIA MEDICA — DRASTIC CATHARTICS. tic, acting sometimes very harshly even in small doses, and in overdoses producing dangerous, and occasionally fatal, enteric inflammation. Its chief use is to unload the bowels in obstinate constipation. The dose is gr. v to gr. x. It is seldom, how- ever, administered alone. The extract (alcoholic) is used chiefly in the preparation of the compound extract, which contains also aloes, resin of scammony, cardamom and soap ; this is a favour- ite prescription, but it is apt to gripe, and it is well to combine some aromatic with it, as a little oil of cloves or capsicum : dose, gr. v-x. CAMBOGIA — GAMBOGE. Gamboge is a gum-resin procured from Garcinia hanburii (Nat. Ord. Guttiferse), a tree of Siam and Cochin-China. The juice is said to be collected, as it exudes from the wounded bark of the tree, in cocoa-nut shells, and is afterwards rolled into cylinders, or transferred to earthen jars to dry ; it is some- times also received into the hollow joints of the bamboo. It is imported from Canton and Calcutta, and occurs in cylin- drical rolls from one to three inches in diameter, of an orange colour, known as pipe gamboge, or in irregular masses (which are less pure), weighing two to three pounds or more, called cake or lump gamboge. Good gamboge is opaque, brittle, in- odorous, nearly insipid, and breaks with a vitreous fracture ; its powder is bright-yellow. It is a gum-resin, forming a yel- low, opaque solution with water and a golden-yellow solution with alcohol ; it contains from 20 to 25 per cent, of gum and from 75 to 80 per cent, of a resin termed cambogic acid (C 20 H 23 O 4 ). Effects and Uses. — Gamboge is a powerful hydragogue, and in overdoses has proved fatal. Sometimes it vomits, and in large amounts has produced death merely from depression. It is employed in obstinate constipation ; in dropsies, combined with cream of tartar or jalap ; and has been given to destroy taenia. Dose, gr. ij to gr. vj. It is usually prescribed with other and milder cathartics, to promote and accelerate their ELATERIN. 305 action. Compound cathartic pills (pilulse catharticse composi- te) are made by mixing compound extract of colocynth (gr. 130), extract of jalap and calomel (of each, gr. 100), and gam- boge (gr. 25), and with water forming a pilular mass, to be divided into 100 pills. Three of the pills, containing 10J grains of the mass, represent 4 grains of compound extract of colocynth, 3 of extract of jalap and calomel each, and {■ grain of gamboge. ELATERINU M — E L A T E R I N. Elaterin (C 20 H 28 O 5 ) is a neutral principle extracted from elaterium, a substance deposited by the juice of the fruit of Ecballium elaterium, or Squirting Cucumber (Nat. Ord. Cu- curbitacese), an annual vine of the south of Europe, now cul- tivated in England. The fruit has the shape of a small oval cucumber, and, when fully ripe, separates from the peduncle, and throws out its juice and seeds with considerable force, through an opening in the base. Pure elaterium is obtained by slicing the fruit and allowing the juice to drain through a sieve. The juice deposits a sediment, which dries in very light, thin, nearly flat, pulverulent, greenish-gray cakes, and is the genuine elaterium. It is almost inodorous, and has a bitter, acrid taste. The commercial elaterium, which is obtained chiefly from England, is made by expression. The drug is to •be considered inferior when it is dark-coloured, much curled and hard. Elaterium yields its virtues to alcohol and no.t to water. Elaterin, its active principle, crystallizes in beautiful colourless, needle-shaped crystals, without smell, but of a bitter, sharp taste, insoluble in water, but readily soluble in alcohol. Effects and Uses. — Elaterium is a hydragogue cathartic of great violence of operation, and in overdoses has frequently proved fatal. It has also a diuretic action. It is a very effi- cient remedy in the treatment of dropsies, and is also a useful revulsive in cerebral affections ; but in administering it con- siderable caution is required. Elaterin proves powerfully cathartic in doses of J^ to t 1 ^ °f a g ra i n - 20 806 MATERIA MEDICA — CATHARTICS. Trituration of elaterin (trituratio elaterini) consists of elat- erin 10 parts and sugar of milk 90 parts, thoroughly tritu- rated ; dose. gr. J-j. It is safest to begin with a small dose. OLEUM TIGLI I — C ROTON OIL. Croton oil is a fixed oil obtained from the seeds of Croton tiglium (Nat. Ord. Euphorbiacese), a small tree of the East Indies. The croton seeds resemble the castor seeds in shape and size, and consist of a blackish shell, sometimes covered with a yellowish-brown epidermis, and enclosing a yellowish oily kernel. They are highly irritant and cathartic, but are not imported into this country. They contain a volatile oil, a fixed oil, resin, acetic, butyric and valerianic acids, together with an acid termed tiglinic (C 5 H 8 2 ). The croton oil of the shops is obtained by expression, and is a mixture of the fixed oil proper, the resin and tiglinic acid. A principle termed crotonol is said to produce the peculiar inflammation of the skin. The oil is made in both India and England, the Indian oil being of a pale straw colour, and the English red- dish-brown ; the latter is the variety now found in the shops. It has a viscid consistence, which is increased by age, a faint, peculiar odour and an extremely acrid, pungent taste ; it is soluble in ether and the volatile and fixed oils, and partially so in alcohol. Physiological Effects. — Croton oil, taken internally, is a powerful hydragogue purgative, occasionally increasing also the secretion from the kidneys. One or two drops are usually sufficient to produce active catharsis, but sometimes as much as eight or ten drops may be taken without affecting the bowels. It operates very speedily, often causing evacuations in half an hour, and is apt to produce considerable sedation of the vas- cular system. In overdoses it has frequently proved fatal, destroying life rather by its depressing influence on the func- tions of organic life through the nervous system than by a local irritant action. Rubbed on the skin, croton oil causes MERCURIAL CATHARTICS. 307 rubefaction and pustular or vesicular eruption ; and rubbed over the abdomen it will sometimes purge. Medicinal Uses. — Croton oil, from the smallness of the dose required and the speediness of its action, is an extremely valuable purgative in obstinate constipation, and in cerebral disorders, particularly coma. As a counter-irritant, it has been employed in pulmonary and laryngeal affections, diseases of the joints, etc. Dose, one or two drops made into pill with bread-crumb. For external use, it may be diluted with one or two parts of olive oil or oil of turpentine. MERCURIAL CATHARTICS. The preparations of* mercury employed as cathartics are calomel and blue fill. Their purgative effects depend partly on the increased flow of bile which they occasion, and partly on the stimulus which they give to secretion from the mucous follicles of the intestinal canal and from the pancreas. They probably do not increase the amount of bile secreted, but by irritation of the orifice of the duct they cause reflex contraction of the ducts and the gall-bladder, and consequently expulsion of that already secreted. They are rarely employed alone, owing to the slowness and uncertainty of their action, but are usually combined with or followed by other cathartics (as jalap, senna, rhubarb, compound extract of colocynth, or some of the saline preparations). The mercurial cathartics are usually administered with a view of combining a purgative action with an effect on the secretions, particularly that of the liver ; also as anthelmintics and as revulsives in cerebral and other affec- tions. They are well adapted to infantile cases, from the facility of their administration, and are especially beneficial in the ephemeral febrile attacks to which children are subject ; they, moreover, rarely produce salivation in children. Hydrargyri Chlorldum Mite (Mild Chloride of Mercury, or Calomel). (Noticed at length under the head of Alteratives.) Dose, as a cathartic, gr. vi to xij, in pill or in powder, with syrup or molasses ; to be followed, in from four to six hours, 308 MATERIA MEDICA — CATHARTICS. by some other cathartic. Sometimes, when it is exhibited with a view to a full action on the liver, gr. J to ij may be given every hour or two, until the whole purgative dose is taken ; or it may be administered at bedtime, with an aperient draught the next morning. For children, larger doses are required in proportion than for adults : gr. iij-vj may be given to a child from three to six years old. Calomel occasionally causes griping pain in the bowels, with bilious vomiting ; this is attributable, not to any irritant qualities in the medicine, but to the acrid character of the bile secreted. Calomel is an ingredient of the compound cathartic pills. Massa Hydrargyri (Mass of Mercury), commonly called blue pill or blue mass (see Alteratives), is analogous in its cathartic action to calomel, but milder and less certain. It is given in about the same doses and in the same combinations, etc. ENEMATA. In cases of irritability of the stomach — or with the view of hastening the action of cathartics taken by the mouth — or to remove feculent accumulations in the lower bowels — or to relieve tympanites — or for the purpose of revulsion, or the removal of ascarides, cathartic enemata are frequently admin- istered. When it is desired simply to open the bowels mechanically, tepid water, flaxseed tea or other demulcent infusion may be employed. The common laxative enema consists of a table- spoonful of common salt, molasses and lard or olive oil, each, in two-thirds of a pint of warm water ; castor oil or Epsom salt may be added to increase the cathartic effect. Senna tea or some other cathartic infusion is often employed. To relieve flatulency, oil of turpentine (f Sss to f§j, in emulsion) or milk of asafetida (f §ij to f Siv) may be given. The latter is an excel- lent preparation in infantile cases. For the removal of ascarides infusion of quassia is an excellent enema. In some cases, as in- vagination of the intestines, or even in hernia, much good may be accomplished by the gradual distension of the bowel by means ENEMATA. 309 of forced enemata of warm water. This is accomplished by means of a long flexible rubber tube, one end of which is armed with a rectal tube having a blunt conical point and sev- eral large openings to admit of the free passage of the water. The other end of the flexible tube is attached to a large funnel, and the tube has a stop-cock upon it. By elevating the funnel and filling it with water, a continual stream can be thrown into the bowel, the force being regulated by the height at which the funnel is held and by the stop-cock. In this way from five to ten pints of water can be thrown into the bowel, filling the large intestine and even passing the ileocoecal valve. The injec- tion should be conducted slowly and carefully. Several cases of invagination have been reported where the symptoms sub- sided under this treatment, the invaginated portion of the in- testine having slipped back to its proper place during the dis- tension. This method should not be resorted to when there is reason to think that sphaselas of the bowel is taking place, as it might result in a rupture. ORDER III. — DIAPHORETICS. Diaphoretics (from Sca^opeo), I transpire), called also sudorifics, are medicines which promote transpiration from the skin. The action of the cutaneous exhalants may be increased by various means. The mere introduction of a large quantity of fluid into the system will produce sweating, if the system be kept warm. Exercise and a warm temperature, by determining a flow of blood to the cutaneous vessels, act in the same way. Nause- ants occasion diaphoresis by relaxing the orifices of the cu- taneous vessels ; stimulants, by exciting them to increased secretion. Diaphoretics are employed therapeutically for their evacuant, revulsive and alterative effects, and to promote ab- sorption. Different classes of diaphoretics are required for dif- ferent morbid conditions. 1. Nauseating Diaphoretics. — Most of the emetics, in nause- ating doses, produce a powerfully relaxing diaphoretic action, and are much employed, with this view, in inflammatory cases, 310 MATERIA MEDICA — DIAPHORETICS. when not contraindicated by the presence of gastric irritability. The Preparations of Antimony (see p. 228) and Ipecacu- anha (see p. 266) are chiefly resorted to as nauseating diapho- retics. Ipecacuanha is often given as a diaphoretic, in combination with opium, in the form of Dover s Powder (see p. 63). 2. Refrigerant Diaphoretics. — The saline and ethereal prep- arations classed as refrigerants (see p. 235) produce a gentle relaxing diaphoretic action, unattended with nausea. They are used to allay febrile excitement and reduce the temperature of the body. 3. Stimulating Diaphoretics. — This group includes the diffu- sible stimulants, aromatic substances generally, of every class, and many narcotics, particularly opium and camphor. They are contraindicated in high inflammation, but are very serv- iceable in rheumatic and pulmonary affections, after vascular excitement has been reduced, and in all diseases where the surface of the body is cold. Opium, in the form of Dover's Powder, may be employed in inflammatory cases, where other stimulating diaphoretics are inadmissible, and is given with advantage in an early stage of acute rheumatism, dysentery and catarrh, unless tire action of the pulse be very strong, when this should be previously moderated. The operation of the diaphoretic stimulants is promoted by the free use of warm diluent drinks, and warm covering to the body. PILOCARPUS — JABORANDI. Pilocarpus is the leaflets of Pilocarpus pennatifolius (Nat. Ord. Rutaceae), a shrub of some of the northern provinces of Brazil, growing to the height of about five feet, with a long cylindrical root, about three-quarters of an inch in thickness, and imparipinnate leaves about nine inches long, with from three to five pairs of opposite, oblong-lanceolate, grayish-green leaflets, with an odd terminal one, which are dotted with a number of pellucid glands. There are several plants known in South America under the name of Jaborandi, and the variety JABORANDI. 311 brought here is from Pernambuco. The leaflets have a charac- teristic odour (resembling a mixture of Indian hemp, matico and cubeb) and a warm, sharp, aromatic taste. They yield jrilocarpina (C^H^IS^OJ, an alkaloid of a bitter, nauseous, astringent taste, soluble in water, alcohol, ether, chloroform and diluted acids ; they contain also a volatile oil. Physiological Effects. — The action of jaborandi has been studied by Ringer, Murrell, Langley, Harnack and Meyer, and many others, with the following results. It paralyzes the vaso-motor nervous system, and rapidly increases the circulation, but the pulse is soon slowed and the arterial tension is greatly increased. The temperature, as a rule, rises at first, but coin- cident with the profuse sweating, is lowered. It is a power- ful diaphoretic, increasing both the watery and solid ingredi- ents of the sweat enormously, probably by a direct action on the peripheral endings of the nerves. The amount of urea eliminated by the skin is especially increased. The sweat is said to be acid at first, becoming neutral and finally alkaline. It also causes salivation, which is sometimes very profuse, in which case the diaphoretic effect is less marked, and vice versa. The sialagogue effect probably depends on a direct action of the drug on the glands. The gastric and bronchial secretions are also increased. These effects continue for from three to six hours. Disturbance of the vision, contracted pupils, uneasi- ness of the head, and after a time vomiting, generally accom- pany these eccritic results, often followed by drowsiness. In much of its action, especially on the secretions, an antagonism exists between jaborandi and belladonna. Jaborandi appears to stimulate the nutrition of the hair (Wood, H. C). It is eliminated by the secretions on which it acts. Medicinal Uses. — Jaborandi should not be given in affec- tions of the gastro-intestinal mucous membrane, nor in weak heart due to disease of the cardiac muscle or ganglia or of the valves (Bartholow). In cases of pleuritic effusion, especially after the subsidence of the inflammatory symptoms, jaborandi or its alkaloid often quickly removes the exudation. In renal dropsy and in uraemia it is often invaluable on account of its 312 MATERIA MEDICA — DIAPHORETICS. diaphoretic effects and because it increases the elimination of urea by the skin. It has also been used with success in puerperal convulsions due to kidney disease, in humid asthma and bronchorrhoea, in some cases of parotitis, and as an agent to increase the secretion of milk. It is recommended in polyurea and in squammous affections of the skin, and has been used lo- cally and hypodermically with success in alopecia (Bartholow). In diphtheria it has been used with varying success, but on the whole the evidence can scarcely be considered in favor of its employment. Dose of the fluid extract, f 5ss-j ; of pilocarpine hydrochlorate, gr. J— ss. Children bear proportionally large doses. ALTERATIVE DIAPHORETICS. Under this head are comprised a class of diaphoretic medi- cines which produce a gradual and nearly insensible increase of the cutaneous secretion, and are supposed to promote the elimination of noxious matters from the blood through the vessels of the skin. They are employed chiefly in chronic rheumatic and cutaneous affections, and in secondary syphilis. SARSAPARILLA. The name of Sarsaparilla is applied to the roots of Smilax officinalis, S. medica and other species of Smilax {Nat. Ord. Smilacese), twining prickly shrubs of Mexico, Guatemala and the warm countries of South America. The roots consist of numerous wrinkled, slender pieces, of the average thickness of a writing quill, several feet long, springing from a common head or rhizome, and are frequently found in the shops with por- tions of the stem attached. Several varieties are known : 1. Honduras sarsaparilla, the most common variety in the United States, comes in bundles two or three feet long, composed of several long, thin roots, folded lengthwise, of a dirty grayish or reddish-brown colour. 2. Jamaica sarsaparilla, which is probably derived also from Central America, comes in shorter SARSAPARILLA. 313 bundles, and is known by the r,ed colour of the epidermis. 3. Vera Ortiz sarsaparilla comes in large, loose bales, bound with cords or leather thongs, containing the roots folded on themselves, consisting of a head with numerous long radicals. 4. Brazilian or Rio Negro sarsaparilla comes in cylindrical bundles, each of which is closely wrapped by a flexible stem, with fewer rootlets than the Honduras variety; it is distin- guished by the amylaceous character of its interior structure. 5. Guatemala sarsaparilla resembles the Brazilian. Sarsaparilla roots are several feet in length, about the thickness of a goose-quill, cylindrical, more or less wrinkled longitudinally, and consist of a whitish-brown or pink cortical portion covered with a thin gray, brown or red epidermis, and inclosing a- layer of whitish ligneous fibre and a central pith. The cortical portion is more active than the interior portion ; the central medulla contains a good deal of starch. Sarsapa- rilla, in the dried state, is nearly inodorous, but its decoction has a strong smell. It has a mucilaginous, slightly bitter taste, and when chewed for some time produces a persistent acrid impression on the mouth ; this acridity of taste is the criterion of good sarsaparilla. Water and diluted alcohol extract its virtues. It contains an alkaloid called smilacine or paralline, a volatile oil, starch, mucilage, resin, extractive, etc. The Vera Cruz and Jamaica varieties contain the most smilacine, and are therefore the best for medical purposes. Effects and Uses. — The physiological effects of sarsaparilla, beyond a slight diaphoretic action, are not very obvious ; in large doses it occasionally produces nausea and vomiting. Its efficacy in eradicating various morbid symptoms is believed in by some, though denied by others ; and its mode of action, though obscure, is popularly attributed to a purifying influence on the blood through the function of the skin. It is employed in tertiary syphilis, particularly where the disease resists or is aggravated by the use of mercury ; also in chronic rheuma- tism, skin diseases, and cachectic conditions of the system generally. Administration. — Dose, of the powder, 5ss three or four 314 MATERIA MEDICA — DIAPHORETICS. times a day — never used, however, in this form. The com- pound decoction is made by boiling sarsaparilla 10 parts, sas- safras, guaiacum wood and liquorice root each 2 parts, and mezereon 1 part, in 100 parts of water, then macerating, and, after straining, adding water enough to make the decoction measure 100 parts ; dose, f §iv-vi three times a day. The compound syrup (which contains also guaiacum wood, pale rose, senna, liquorice root and the oils of sassafras, anise and gaul- theria) is a favourite preparation ; corrosive sublimate should not be given w T ith it, as it is decomposed into calomel. Dose, foss three times a day. Of the fluid extract, the dose is f5ss. The compound fluid extract contains the ingredients of the compound decoction, except the guaiacum ; dose, f5j three or four times a day. • GUAIACI LIGNUM — GUAIACUM WOOD. GUAIACI RE SIN A — GUAIAC. Guaiacum Wood, or Lignum Vitaz, and Guaiac are products of Guaiacum officinale and G. sanctum (Nat, Ord. Zygophyllaceae), large evergreen trees of South America and the West Indies. The WOOD, which is remarkable for its hardness and density, is imported in logs or billets, covered with a thick gray bark ; the outer portion or sap-wood is of a pale-yellow colour, the inner of an olive-brown. The heart-wood is the officinal portion: it is usually kept in the shops in the state of shavings or raspings ; they are inodorous unless heated, and when chewed for some time they have a bitterish, pungent taste. Guaiacum wood yields its virtues to alcohol, and partially to water ; they depend on the guaiac contained in the wood. Guaiac is a peculiar resin, obtained from Guaiacum officinale by spontaneous exudation, by incision, by dry heat, or by de- coction of the comminuted wood. It comes in large, irregular, semi-transparent, brittle pieces, of varying size — externally of a deep green or olive colour, and internally red. It has a slight balsamic odour, which is rendered stronger by heat, and MEZEREON. 315 though at first nearly tasteless, leaves a hot, acrid sensation in the mouth and throat. Water dissolves it partially, alcohol completely. It contains guaiaeonic and guaiaretio acids, guaiac beta-resin, gum, ash, guaiacic acid, colouring matter, etc. (Hadelich, quoted by Fluckiger and Hanbury). Most oxidizing agents, as nitric and chromic acids, etc., produce a blue, then green, and finally a brown colour with tincture of guaiacum. Effects and Uses.— Guaiacum wood and guaiac are stimu- lant diaphoretics, also increasing the secretion of bronchial mucus, and in large doses cathartic. They are principally used for their alterative virtues in chronic rheumatism, con- stitutional syphilis and skin diseases ; guaiac has been used as a laxative. Bartholow recommends strongly .5ss doses of the tincture every four hours in tonsillitis. They are considered also to possess emmenagogue properties, and are employed in amenorrhoea and dysmenorrhea. Administration. — Guaiacum wood is used only as an in- gredient in the compound decoction and syrup of sarsaparilla and in the compound pills of antimony. Dose of guaiac, gr. x to gr. xxx, in pill or emulsion, -sometimes combined with alka- lies. The tincture (20 parts in 100 of the tincture) and am- moniated tincture (20 parts to ar. sp. of ammonia q. s. to make 100 parts) are much used in chronic rheumatism ; the former is given also in amenorrhoea ; dose, f 5j three or four times a day. They are decomposed by water, and should be admin- istered in mucilage, syrup or milk. MEZEREUM — MEZEREON. Mezereon is the bark of Daphne mezereum and other spe- cies of Daphne {Nat. Ord. Thymelacese), European shrubs which grow to the height of four or five feet. The root-bark is the part employed in Great Britain, but the bark of our shops, which is brought from Germany, is the stem-bark. It comes in strips from two to four feet long and an inch or less in breadth, folded in bundles or wrapped in the shape of balls. It has a thin, grayish or reddish-brown, wrinkled epidermis 316 MATERIA MEDICA — DIAPHORETICS. and a tough, pliable, whitish inner bark. When fresh it has a faint, nauseous smell, but when dry it is nearly inodorous. Its taste is at first sweetish, afterwards highly acrid. It yields its virtues to water and alcohol, and contains a neutral crystal- line bitter glucoside called daphnin, and a resin to which it owes its acridity. Effects and Uses. — The topical action of mezereon is irritant and vesicant. When swallowed in large quantities it is highly acrid ; in medicinal doses it promotes the action of the secret- ing and exhaling organs, particularly the skin and kidneys. It is employed chiefly in conjunction with sarsaparilla (in the compound decoction, etc.) as an alterative diaphoretic in rheumatic, syphilitic and cutaneous affections. As a masti- catory, it has been chewed for the relief of paralysis of the muscles of deglutition. The fluid extract is the best prepara- tion for internal administration ; dose, 10 minims. An extract is also officinal ; the ointment is used as a stimulating applica- tion to blistered surfaces and indolent ulcers. MENISPERMUM. Menispermum is the rhizome and rootlets of Menispermum canadense, Yellow Parilla or Canada Moonseed (Wat. Ord. Menispermacese), a climbing plant of North America. The rhizome contains berberine, starch, etc. It is supposed to be a diaphoretic, diuretic, tonic and alterative, and to possess virtues similar to those of sarsaparilla, and it may be given in corresponding doses. According to the experiments of Ruth- erford, it is an intestinal, but not a hepatic, stimulant. There are no officinal preparations. CALENDULA — MARIGOLD. Calendula is the fresh flowering herb of Calendula officinalis, or Marigold (Nat. Ord. Composite), a European plant, cultivated in our gardens. It contains a volatile oil, a bitter principle, calendulin, etc. It is supposed to be a stim- STILLINGIA. 317 ulant, alterative, diaphoretic, diuretic, vulnerary and resolvent. It formerly enjoyed a high reputation in the treatment of can- cerous affections, but now is not much used. It is said to be efficacious in certain forms of chronic vomiting, and externally, to promote resolution of ulcers, wounds and contusions. It may be given in doses of gr. viij to 5j. A tincture is officinal, of which the dose is f 5ss-j. It may be used externally, diluted with water 20 parts. SASSAFRAS. This is the bark of the root of Sassafras officinale (Nat. Ord. Lauraceae), an indigenous tree of middling size. The bark is found in the shops in small irregular pieces, of a cin- namon colour, sometimes invested with a brownish epidermis. It has a highly fragrant odour and a sweetish, aromatic taste. Its virtues are extracted by water and alcohol, and it contains a little tannic acid and a volatile oil (oleum sassafras). Effects and Uses. — Sassafras bark is a mild stimulant alter- ative diaphoretic, used chiefly in combination with sarsaparilla. Its principal virtues are probably aromatic. Dose of the oil, 2 to 10 drops. (For Sassafras Pith, see Demulcents.) STILLINGIA. The root of Stillingia sylvatica (Nat. Ord. Euphorbiacese), commonly called Queen s Delight, a perennial plant, growing to the height of two feet in our south Atlantic States, is highly esteemed by southern physicians as an alterative diaphoretic in secondary syphilis, scrofula, cutaneous affections and chronic rheumatism. Dose of the powder, 15 to 30 grains. The fluid extract is officinal, and may be given in the dose of f5ss. A decoction and tincture are extemporaneously prepared. 318 MATERIA MEDICA — DIURETICS. ORDER IV. — DIURETICS. Diuretics (from dia, thoroughly, and ovpeu, I make water) are medicines which excite the secretion of urine. The flow of urine may be promoted indirectly by increasing the quantity of fluid taken into the stomach, or by the removal of causes which check its secretion, or by mental emotion, a cool tem- perature, etc. It is promoted directly by the use of medicinal agents which specifically affect the kidneys ; they are termed diuretics. A large proportion of diuretic medicines are found among the agents which influence other secretions, particularly diaphoretics. The functions of transpiration and urination are to some extent vicarious, and the same articles will prove dia- phoretic or diuretic, as their action may be directed to the skin or kidneys. External warmth and warm drinks determine the action of such medicines to the skin ; and, on the other hand, if the skin be kept cool, and cool diluents freely administered, the secretion from the kidneys is promoted. Blennorrhetics, or medicines which have a special action on the mucous membranes, exert also a diuretic influence — prob- ably the result of the stimulating impression which they make on the mucous membrane of the urinary passages. When the action of the kidneys is obstructed by disease of the heart, sedatives prove diuretic, by their tranquillizing influence on the action of the heart. In cases of obstruction of the portal sys- tem, mercurials increase the efficacy of the diuretics proper ; and also cathartics, by stimulating the flow of bile and the pancreatic juice. The principal therapeutic employment of diuretics is to pro- mote the absorption of dropsical effusions. They are also use- ful in nephritic disorders attended with obstructed secretion ; to wash out calculi from the pelvis of the kidneys, ureters and bladder ; in gravel, with the view of rendering the urine more dilute ; and they may be resorted to as evacuants, to reduce inflammation. As diuretics act by becoming absorbed, they should be DIURETICS. 319 administered in a very diluted state to prevent a cathartic effect. The following groups of medicines, noticed under other heads, are employed also as diuretics : 1. The Saline and Ethereal Refrigerants (see p. 235). 2. The Alkaline Carbonates (see Antacids)', and the Alka- line Salts which contain a vegetable acid., as the acetates, citrates and tartrates. The acid potassium tartrate, or cream of tartar (see p. 286), is a very active diuretic. Potassii Acetas [Potassium Acetate). This salt (KC 2 H 3 2 ), formerly termed sal diuretieus from its decided diuretic action, is made by saturating acetic acid with potassium bicarbonate. It occurs, when pure, as a white, foliaceous, satiny mass, of a warm pungent taste, very deliquescent, and wholly soluble in water and alcohol. The physiological effects of the potassium compounds have already been fully considered (see p. 233). In small doses it is diuretic, and in larger doses gently cathartic. It is a good deal employed as a diuretic in dropsies, as an antacid in acute rheuma- tism, as a preventative of the formation of uric acid calculi, and it has also been found useful as an alterative in cutaneous affections. As is the case with all the alkaline salts contain- ing vegetable acids, the acid of this salt is decomposed in the system into carbonic acid. Although increasing the flow of urine, potassium acetate diminishes the amount both of uric acid and of urea in the secretion. Hence it is valuable in gout, and, like colchicum, it may perhaps check the actual for- mation of uric acid in the system. Dose, 3j to 5j three or four times a day. Sodii Acetas [Sodium Acetate) is prepared from crude pyroligneous acid, which is saturated with cream of lime, and the solution of calcium acetate thus formed is decomposed by sodium sulphate ; repeated solution and crystallization, with fusion, furnish a pure salt in the form of white or colour- less striated prisms (NaC 2 H 3 2 ,3H 2 0), which effloresce in dry air, are wholly soluble in water, tolerably soluble in alcohol, and have a sharp, bitterish, not disagreeable taste. Its effects 320 MATERIA MEDICA — DIURETICS. and uses are analogous to those of potassium acetate, over which it has the advantage of not being deliquescent. Dose, ■3i "to Si. 3. Sedatives (seep. 217); and Digitalis (see p. 249), which is very much employed in cardiac dropsies in combination with squill. 4. Blennorrhetics (see p. 330), particularly the oleoresins. 5. Most of the Stimulating Diaphoretics. SPECIAL DIURETICS. SCILLA — SQUILL. Squill is the bulb of Urginea scilla (Nat. Ord. LiliaCeae), a perennial plant which grows on the shores of the Mediterra- nean. It has fibrous roots attached to a roundish-ovate bulb, from which both the leaves and flower-stem spring directly, the latter appearing first ; the leaves are broad-lanceolate, and from twelve to eighteen inches long ; the stem is about two feet high, and bears pale yellowish-green flowers. The fresh bulb is pyriform, of the size of the fist to that of a child's head, and consists of thick, fleshy, concentric scales, attenuated at their edges, and attached to a rudimentary stem ; the outer scales are very thin and papery. Two kinds of squill bulbs are met with, the white and the red, which differ only in the colour of their scales, and are identical in medicinal virtues. Both abound in a viscid, acrid juice, which is very much dimin- ished by drying, with little loss of medicinal power. For im- portation, squill is usually sliced and dried, and is found in the shops in white or yellowish-white pieces, which when dry are brittle, but when moist, flexible. They absorb moisture readily, and should be kept in well-stoppered bottles. They have a feeble odour, a bitter, nauseous, acrid taste, and yield their virtues to water, alcohol and vinegar. The active principles found in squill are scillipicrin, scillitoxin and scillin. The first two are said to act on the heart, and the last to produce numbness and vomiting (Merck, quoted by Maisch). Physiological Effects. — In small doses, squill promotes secre- SQUILL. 321 tion from the mucous membranes and the kidneys — its diuretic effect being much the most marked and constant. Husemann states that the diuretic effects of squill are due to its influence on the blood pressure, which it increases ; but clinical experi- ence teaches that it stimulates the kidneys. In larger doses it excites nausea, vomiting and occasionally purging; and in excessive doses it acts as an acro-narcotic poison, gr. xxiv having proved fatal. The symptoms are violent vomiting and purging, abdominal pains, bloody or suppressed urine, reduc- tion of the pulse, with collapse, or death may be preceded by convulsions. After evacuation of the stomach, opiates and demulcents are to be administered, and, if syncope or collapse occur, alcoholic stimuli. Medicinal Uses. — Squill is employed principally in the treatment of dropsy; it should not be used, however, in cases complicated with degeneration of the kidneys or inflammation of the bladder. Digitalis is much prescribed in combination with squill in the treatment of cardiac dropsies, and calomel is often added with a view to its action on the absorbents. As a blennorrhetic expectorant, squill is an excellent remedy in chronic and subacute bronchial affections ; it is, however, im- proper in the early stages of inflammatory cases. As an emetic, squill is too dangerous for general use ; but it forms an ingredient in some emetic preparations administered in croup. Administration. — Dose, as a diuretic or expectorant, gr. j, repeated and gradually increased till nausea supervenes. Gr. *vj to gr. xij will vomit. Of the vinegar (acetum scilla?), the dose is tt[xxx to foij ; of the fluid extract, TT|J ; of the syrup, f 5j ; of the compound syrup, known as hive syrup (which is prepared by percolation, by first making a solution of senega and squill in diluted alcohol and water, converting it into a syrup, and dissolving it in tartar emetic, one grain of which is contained in every ounce of the syrup), 10 drops to f 5j, accord- ing to the age ; of the tincture, 20 to 40 drops. 21 322 MATERIA MEDICA — DIURETICS. COLCHICUM. Colchici Radix, Colchicum Root; Colchici Semen, Colchicum Seed. Colchicum autumn ale, or Meadow-Saffron {Nat. Ord. Melan- thaceae), is a small biennial, bulbous plant, which grows wild, in moist meadows, in England and other temperate parts of Europe. The bulb, or corm as it is botanicallj termed, appears in midsummer as the lateral offset from the corm of the pre- ceding year, and sends up the flower-stem in the autumn — the leaves and fruit following in the succeeding spring. The leaves are broadly lanceolate, about five inches long ; the flowers, of a lilac or light-purple colour ; and the fruit, oblong, elliptical and three-celled. The corms and seeds are the portions used medicinally. The corms are gathered in July, just before the sprouting of the flower from the young corm. They are somewhat like tulip-bulbs in appearance, but solid, and not composed of scales. They are covered by an external brown membrane and an inner reddish-yellow one, and are an inch and a half to two and a half inches in length, with a longitudinal groove. Internally they are white, fleshy and solid, and contain an acrid, bitter milky juice. As found in the shops they are in the dried state, sometimes whole, but usually cut into trans- verse slices, about an eighth of an inch thick, with a notch on one side, and deprived of the outer brown membrane. They have a hircine odour and a bitter, hot and acrid taste. The seeds are brown, about the size of black-mustard seeds, in- ' odorous, and have a bitter, acrid taste ; they are less apt to be injured by drying than the corms. Colchicum corms and seeds yield their virtues to vinegar and alcohol ; they both contain an alkaloid, soluble in water, readily so in alcohol, but insoluble in ether, termed colchicia or colchicine (C 17 H 23 N0 6 ), on which the medicinal activity de- pends. Colchicia, in the saline form, is converted into another isomeric principle, termed colchicein, and resins (colchicoresin and beta-colchicoresin), but not probably with loss of medicinal effect. Colchicia makes with concentrated nitric acid a violet COLCHICUM. 323 solution, becoming yellow by dilution with water ; with concen- trated sulphuric acid it produces an intensely yellow colour. Physiological Effects. — Colchicum is a local irritant. Taken internally, in small doses, it stimulates the secretions generally ; in larger doses it produces nausea, vomiting and purging, and commonly a reduction of the frequency of the pulse ; in ex- cessive doses it is an acro-narcotic poison, producing death by a sedative action on the heart, the cerebral functions being usually unaffected. The amount of urea and uric acid ex- creted in the urine is much increased after the administration of colchicum. It increases the secretion of bile, which at the same time is rendered very watery. Tannic acid is a partial antidote; opiates, demulcents and stimulants are to be given. Although placed among the diuretics, colchicum does not evince a more decided action on the kidneys than on other secretions, as those of the skin, liver and mucous membranes. Medicinal Uses. — Colchicum has long enjoyed a high reputa- tion in the treatment of gout ; and, although its modus medendi is obscure, it is universally admitted to possess a more decided control over the disease than any other remedy. It is usually administered in repeated doses till an effect is produced on the bowels, though purging does not promote its curative effect. Epsom salts and magnesia are often combined with it, as in the celebrated Scudamores draught (magnesia, gr. xv to xx ; magnesium sulphate, 5j to 5ij ; wine of colchicum seed, f 5j to f3ij 5 in any pleasant vehicle). An excellent combination in the treatment of gout is colchicum (ivine of the seed, f oi), with potassium iodide (3ij), dissolved in cinnamon water (f §viij) ; dose, f §ss three times a day until purgation is pro- duced. Quinine and digitalis are also often given advantage- ously, with colchicum, in gout.* When it is desired to act on the kidneys and skin rather than the bowels, opiates are some- times added. In rheumatism it is also employed, but it has little control over this disease. Dr. Woodbury, however, has * Lartigue's celebrated gout-pills are : acetic extract of colchicum root, 2 grains ; extract of digitalis, 1 grain ; compound extract of colocynth, 20 grains, to be mixed and divided into five pills — one to be taken at night. 824 MATERIA MEDICA — DIURETICS. recently reported cases where hypodermic injections of XY\y of a solution of colchicine ( T \ per cent.) gave speedy and perma- nent relief in acute rheumatism, after the salicylates had failed (Phila. Med. Times, Dec. 2, 1882). It has been occasionally resorted to as a diuretic in dropsy, as a sedative in febrile and inflammatory diseases, as an anthelmintic, as an expectorant, and in some nervous affections. Administration. — Dose of the corm or seeds, in powder, gr. ij to gr. viij ; the seeds are to be preferred. The liquid prepa- rations, which are more generally used than the powder, are : the wine of the root (yinum colchici radicis), TT|x to f5ss; wine of the seed (vinum colchici seminis), dose, f 5ss-j ; tincture of the seed, dose, f3ss to f oi- An extract of the root (acetic) is also employed — dose, gr. i-ij; and a fluid extract of the seed and also of the root — doses, 4 to 12 drops. The alkaloid col- chicine (not officinal) has been recommended as the best form of administration in doses of gr. ^ in pill or somewhat less by hypodermic injections. ERIGERON. Three varieties of Erigeron are used, but none are officinal : E. canadense, or Canada Fleabane, E. heterophyllum, or Va- rious-leaved Fleabane, and E. Philadelphicum, or Philadelphia Fleabane (Nat. Ord. Composite). They are herbaceous indi- genous plants, two or three feet high, with ovate or lanceolate toothed leaves and white, blue or purple flowers. The haves and tops are used. Canada erigeron, which is found in the northern or middle States, has an agreeable odour and a bitter, acrid, somewhat astringent taste. It contains bitter extractive, tannic and gallic acids and volatile oil, and is diu- retic, tonic and astringent. The oil of erigeron (oleum erigerontis), distilled from the fresh flowering herb of E. cana- dense, is officinal. It possesses haemostatic properties, and has been used in hemorrhagic dysentery and uterine hemor- rhage — dose, 5 to 10 drops ; a fluid extract of Canada erigeron (not officinal) may be given in the dose of f5i-iv. Various- INDIAN HEMP. 325 leaved and Philadelphia Fleabane, popularly known as scab- ious, common plants all over the United States, have an aromatic odour and a slightly bitterish taste. Their most striking medicinal action is diuretic, and they have long been favourite remedies in dropsical and nephritic affections. An infusion or decoction to the amount of a pint (containing a troyounce of the herb) may be taken daily. APOCYNUM — INDIAN HEMP. Fig. 25. Apocynum cannabinum is an indigenous herbaceous plant (Nat. Ord. Apocynaceae), growing to the height of two or three feet, with oblong-ovate leaves and small greenish, campanulate 326 MATERIA MEDICA — DIURETICS. flowers. The root is the officinal portion ; it is of a yellowish- brown colour when young, and of a dark-chestnut when old, has a strong odour and a nauseous, acrid, bitter taste. The fresh root, when wounded, pours out a milky juice, w T hence the plant is sometimes termed milk-weed. It yields its virtues to water and alcohol, and contains gallic and tannic acids, gum, resin, a bitter principle, etc. Although the entire root is officinal, the bark of the root is probably alone active. A. an- drosaemifolium, or Dogsbane, is possessed of much the same properties as A. cannabinum. Effects and Uses. — Indian Hemp (which is not to be con- founded with Cannabis Indica, p. 88) is diuretic, diaphoretic, sedative, and, in continued doses, emeto-cathartic. It is chiefly employed in the treatment of dropsy, in which its action is often powerfully efficacious. It should be given in amounts just sufficient to produce diuresis, as a cathartic effect it is not desira- ble. The best form of exhibition is infusion (tgss to boiling water Oj, or the same amount may be dissolved in gin Oj) ; dose, f 5ij-iv three or four times a day. TARAXACUM — DANDELION. Fig. 26.. Taraxacum dens-leonis, or Dandelion (Nat. Ord. Composite), is a small herbaceous, perennial plant, common to most parts of the world, and found abundantly throughout the United States. It has a fusiform root, which sends up numerous long COUCHGRASS. 327 sinuated, bright-green leaves, and flower-stems about six inche3 high, bearing golden-yellow flowers. The root is the officinal portion, and should be gathered in the autumn. In the fresh state it is several inches long, branched, fleshy, of a light- brown colour externally, whitish within, and abounds in a milky juice; the fresh root is preferable for use. When dried it is shrunken, wrinkled and brittle. It is without smell, but has a bitter taste. Boiling water extracts its virtues, which probably depend on a peculiar bitter crystallizable principle termed ta- raxacine, soluble in water and alcohol. It also contains tarax- acerin, resin, etc. Effects and Uses. — Taraxacum is diuretic and slightly ape- rient, with some tonic action, and a slight determination to the liver. It is a valuable remedy in hepatic dropsies, and is also employed in dyspepsia accompanied by derangement of the liver. It may be given in the form of infusion (oij to boiling water Oj — not officinal) — dose f oij three times a day ; extract (an inspissated juice, which should not be kept above a year) — dose, 9j to 5j three times a day ; fluid extract — dose, f 3i-ij three times a day. TRITICUM — COUCHGRASS. The rhizome of Triticum repens or Couchgrass (Nat. Ord. Graminacese), a perennial weed, native of Europe and North America, growing in fields and in waste.places, with a long stiff", pale-yellow rhizome, which should be gathered in the spring, and is found in the shops, freed from the rootlets, cut into short lengths and dried, without odour, but having a slightly sweetish taste (Fluckiger and Hanbury), contains triticin, which resem- bles inulin and several sugars, and appears to be a feeble diu- retic. It is a remedy of some value in catarrh of the bladder attended with much mucous discharge (Whitla), and may be used to allay irritation of the urinary passages. The fluid ex- tract is officinal, and may be given in doses of f5ss-j. 328 MATERIA MEDICA — DIURETICS. JUNIPERUS — JUNIPER. . The fruit or berries of Juniperus communis {Nat. Ord. Coniferse), an evergreen European shrub, naturalized in the United States, are used as adjuvants to the more active diuret- ics, and in large doses produce strangury and bloody urine, and prove emmenagogue. When dried they are about the size of a pea, of a blackish-purple colour and a sweetish, terebinthin- ate, aromatic taste ; they are given in infusion (tgj to boiling water Oj). Their virtues depend on a volatile oil (oleum ju- niperi) (C 10 H 16 ), the dose of which is from 5 to 15 drops two or three times a day. The corn-pound spirit (containing also the oils of caraway and fennel, dissolved in alcohol and water) is a pleasant addition to stimulating diuretic and blennorrhetic combinations, and a good stomachic and carminative ; dose, f5i-ij. The spirit is made by dissolving 3 parts of the oil in 97 parts of alcohol; dose, f3i-ij. SCOPARIUS — BROOM. Sarothamus scoparius, or Broom (Nat. Ord. Leguminosae), is a common European shrub, cultivated in the United States, from three to five feet high, with numerous bright-yellow flowers. The tops of the branches are the officinal portion, but the seeds are also used. The twigs are pentangular (with small oblong, downy leaves), of a bright-green colour, a strong, peculiar odour when bruised, and a bitter, nauseous taste. Two principles are found in broom-tops — scoparin (C 21 H 22 O 10 ), a neutral, crystallizable body, supposed to be the diuretic con- stituent, and a volatile alkaloid, sparteia (C 15 H 26 N 2 ), said to be narcotic ; it also contains volatile oil, tannin, etc. Effects and Uses. — Broom is an efficient diuretic, in large doses producing free purging. It is a valuable and reliable remedy in dropsy, best given in decoction, half an ounce to a pint of water, boiled down to half a pint, of which an ounce may be given every hour or two till the bowels are disturbed. A fluid extract (not officinal) is used in doses of f5$s-i. CANTHARIDES. 329 CANTHARIS — CANTHARIDES. The properties, etc., of cantharides will be noted fully under the head of Irritants (subdivision JEpispastics). Taken inter- nally, they sometimes prove diuretic, and generally excite irri- tation of the genito-urinary passages, as strangury, priapism, etc. ; and in overdoses act as an acro-narcotic poison. They are employed in atonic dropsies, incontinence of urine, amen- orrhoea, seminal weakness, impotence, etc. Dose, gr. i-ij twice a day, in pill. They are most commonly administered in tincture; dose, gtt. x or more three or four times a day till strangury supervenes. The following medicines, though less frequently resorted to than the foregoing, possess very decided diuretic properties, and may be employed with advantage in the treatment of drop- sical and nephritic affections : The rhizome and rootlets of Hydrastis canadensis, or Yellow Root {Nat. Ord. Ranunculacese), a small indigenous plant, with yellow, fugacious flowers and a red fruit resembling raspberries, contain the alkaloids berberina (previously noticed) and hydrastia (C 22 H 23 N0 6 ), also xanthopuccina, starch, etc. It is contorted, rugose, of a bright-yellow colour, and has a strong, somewhat narcotic odour and a bitter taste. It is tonic as well as diuretic, and is a very efficacious diuretic in promoting the discharge of calculi from the kidneys. Accord- ing to Rutherford, it is a hepatic stimulant of considerable power, and a feeble intestinal stimulant. The fluid extract may be given in doses of f3ij-jv; or the tincture, dose Tt|x-f5j. The root of Petroselinum sativum, or Parsley (Nat. Ord. Umbelliferse), a European plant, cultivated in our vege- table gardens for its leaves. Parsley contains a peculiar prin- ciple termed apiol, or parsley camphor, which separates from the oil, during distillation, in long white, efflorescent needles, having a faint smell of parsley, insoluble in water, but soluble in alcohol and ether. It has been used in amenorrhoea of func- tional origin, especially when due to anaemia, and in neuralgic 330 MATERIA MEDICA — BLENNORRHEAS. dysmenorrhoea, in the dose of 4 grains morning and evening. It is not officinal. ORDER V. — BLENNORRHETICS. Blennorrhetics (from (3Xewa, mucus, and pew, I flow) are medicines which promote the secretion of the mucous mem- branes. They are employed therapeutically in morbid con- ditions of those membranes, with a view to the restoration of healthy action in cases of deficient, abnormal or excessive secretion. When administered with the object of stimulating the secre- tion of mucus from the bronchial or laryngeal membrane, this class of agents is termed expectorants. They are prescribed in the subacute and chronic forms of bronchitis and laryngitis, and in the declining stages of the acute forms of those affec- tions and pneumonia. In the early or inflammatory stages of acute bronchitis and laryngitis the stimulating expectorants are inadmissible until expectoration has been established. The blennorrhetics are less employed in gastro-enteric affec- tions than in those of other mucous membranes, owing to their tendency to produce catharsis. Several of the oleoresins are, however, used with advantage in certain forms of chronic diarrhoea, and the oil of turpentine is highly esteemed in the treatment of the diarrhoea of typhoid fever. The oleoresinous articles of this group are extensively em- ployed in diseases of the urino-genital mucous membranes, — gonorrhoea, gleet, leucorrhoea, incontinence of urine, cysti- tis, etc. The following are the articles chiefly resorted to for their influence on the mucous membranes : SENEGA. Polygala senega, or Senega Snakeroot [Nat. Ord. Polyga- laceae), is a small indigenous plant, found in all parts of the United States, but most abundantly in the South and West. SENEGA. 331 It has a perennial branching root, several erect annual stems about a foot in height, alternate lanceolate leaves, and small whitish flowers arranged in a terminal spike. The root is the officinal portion. It occurs in the shops in twisted pieces, vary- ing in thickness from the size of a quill to that of the little finger, attached to a knotty head, and marked with a ridge along their whole length and numerous annular protuberances. The cortical portion is hard, resinous, of a yellowish-brown colour, and contains the active qualities of the root. The cen- tral ligneous portion is white and inert. The odour of senega Fijr. 27. is peculiar and disagreeable, but faint in the dried root ; the taste is at first mucilaginous and sweetish, but afterwards be- comes acrid and very irritating. The virtues of senega are extracted by cold and hot water and alcohol. It contains a 'polygalic acid, on which its ac- tivity chiefly depends ; this resembles saponin, a glucoside found in soapwort and other plants. Effects and Uses. — Senega, in small doses, is an active ex- citant of the mucous membranes and secretions generally, and 332 MATERIA MEDICA — BLENNORRHETICS. in large doses proves emetic and cathartic. It is prescribed chiefly as a stimulating expectorant in chronic and subacute bronchial affections, and in the latter stages of acute bronchitis, pneumonia, etc. As an ingredient in the compound syrup of squills it is much employed in the treatment of croup, but, except in some such combination with tartar emetic or other emetic nauseant, it is scarcely admissible in the early stages of this disease. Senega is thought also to possess emmenagogue properties, and is highly extolled by many practitioners in the treatment of amenorrhoea. It has been occasionally used as a diuretic in dropsies, and in emeto-cathartic doses has been found useful in rheumatism. Administration. — Dose, in powder, gr. x to 3j ; but the abstract is to be preferred, of which gr. j is equal to grs. ij of the powder. The fluid extract may be given in the dose of TT[x-xx ; and a syrup is also used, in the dose of f 5i-ij- QUILLAIA. Quillaia, or Soap-bark, is the bark of the Quillaia sapon- aria [Nat. Ord. Rosacea), a tree of South America. The bark is found in the shops in large flat pieces, brownish-white, with small patches of brownish cork on the outer surface, but other- wise smooth ; without smell, but having a very acrid taste ; the powder is sternutatory (Maisch). It contains saponin (C 32 H 54 12 ), which in watery infusion foams like soap, and is believed to be identical with polygaiic acid (senegin). Quillaia is supposed to be blennorrhetic and diuretic, and may be given in various forms of dropsy and in chronic bronchitis. A fluid extract mixed with glycerin forms an admirable local applica- tion to some cases of acne (Pifford). Dose, gr. xv-xxx in in- fusion three times a day. ALLIUM — GARLIC. Allium sativum (Nat. Ord. Liliacese) is a small perennial, bulbous plant, which grows wild in the south of Europe, and TURPENTINE. 333 is cultivated in all parts of the world. The bulb is the portion used. As found in the shops, it is somewhat spherical in form, about an inch in diameter, with a portion of the stem attached, covered with a white, membranous envelope, and consists of five or six smaller bulbs, of a curved, oblong shape, called cloves of garlic. They have a strong irritating, characteristic odour and a bitter, acrid taste. Water, alcohol and vinegar extract their virtues, which depend on an essential oil, which is of a yellow colour, very volatile and irritating ; it consists of oxide and sulphides of a peculiar radical termed allyl (C 3 H 5 ). Effects and Uses. — Garlic is a local irritant and rubefacient, and, taken internally, quickens the circulation and stimulates the secretions generally. It is a good deal employed as an expectorant in chronic and subacute catarrhal affections, par- ticularly in infantile cases, and occasionally as a stomachic in flatulence, and as a diuretic in atonic dropsies. Externally it is used as a revulsive rubefacient to the feet, as a resolvent of indolent tumours, and as a liniment in infantile convulsions. Administration. — A clove may be swallowed entire, or cut into small pieces. Dose of the fresh bulbs, 5i-ij, in pill ; of the juice, f 5ss, mixed with sugar ; of the syrup (the only officinal preparation), f5j, for children. SCILLA — SQUILL. Squill, already noticed among diuretics, is one of the most powerful and valuable stimulating expectorants in the Materia Medica. (For properties, doses, preparations, etc., see p. 320.)* TEREBINTHINA — TURPENTINE. The term turpentine is applied to liquid or concrete vegetable juices, consisting of resin combined with a peculiar essential oil, called oil of turpentine. Two kinds of turpentine are recog- nized by the U. S. Pharmacopoeia : 1. The common American white turpentine, which is procured chiefly from Pinus austra- lis (Nat. Ord. Conifers), a large indigenous evergreen tree of 331 MATERIA MEDICA — BLENNORRHETICS. our southern States, where it is called Long-leaved Pine, Yellow Pine and Pitch Pine, and in part also from Pinus tseda, found in Virginia, and other species of Pinus. 2. Can- ada turpentine (Terebinthina canadensis), kept in the shops under the name of Canada balsam or balsam of fir, the prod- uct of Abies balsamea, the American Silver Fir or Balm of Gilead Tree (Nat. Ord. Coniferge), a handsome tree about forty feet in height, inhabiting the northern portions of North America. Many other varieties of turpentine are known in commerce, as Bordeaux turpentine, Venice turpentine, Chian turpentine, etc. White turpentine comes from North Carolina and other southern States, and is collected from excavations made in the trunks of the trees, into which the turpentine runs in the mild weather. It is yellowish-white and somewhat translucent, semi-fluid in summer, firm and hard in winter, but becoming permanently hard by exposure to the air, and has a peculiar aromatic odour and a warm, pungent, bitterish taste. Canada turpentine comes from Canada and Maine. It is procured by breaking the vesicles which are found between the bark and wood of the trees and collecting the liquid contents in a bottle. When fresh it has the consistence of honey, but gradually solidifies by age. It is yellow, transparent, tenacious, of a peculiar pleasant, terebinthinate odour and a slightly bitter, acrid taste. Chemical Constituents. — The turpentines yield, by distilla- tion, a volatile oil, known as oil of turpentine, and leave a residue consisting exclusively of resin. Both the oil and resin are officinal. The turpentines are inflammable, nearly insolu- ble in water, but almost wholly soluble in alcohol and ether. Physiological Effects. — The local operation of the terebinth- inates is irritant. When applied to the skin they produce a rubefacient effect, and when swallowed in large doses, promote the peristaltic motion of the intestines. Taken internally, in small doses, they are absorbed, and prove excitant to the vas- cular system and the secretions generally, especially the mucous membranes; they communicate a violet odour to the urine. TURPENTINE. 335 In large doses they cause pain in the loins, strangury and bloody urine. The activity of the terebinthinates depends on their volatile oil {vide p. 209). Medicinal Uses. — Turpentine is employed chiefly in diseases of the various mucous membranes, as gonorrhoea, gleet, leucor- rhoea, cystorrhoea, chronic bronchitis and chronic mucous diar- rhoea. It is also used in rheumatic complaints, and in iritis and sclerotitis ; and, in cathartic doses, in cases of ascarides, constipation and colic. Administration. — Dose, as a blennorrhetic, 3j to 5j, in pill, emulsion or electuary ; as an anthelmintic or cathartic, half a troyounce to an ounce, in emulsion. The white turpentine is generally used in this country. Oleum Terebinthlm (Oil of Turpentine) (C 10 H l6 ), com- monly called spirit of turpentine, is the active principle of turpentine, obtained by distillation. It is a limpid, colourless, volatile and inflammable liquid, of a strong, penetrating, pecul- iar odour and a hot, pungent, bitterish taste; very slightly soluble in water, less soluble in alcohol than the volatile oils generally, and wholly soluble in ether ; exposed to the air it absorbs oxygen, with the formation of resin. This oil has been already noticed under the head of aromatic stimulants (p. 208). Its effects have been already considered (p. 209), and its me- dicinal uses are the same as those of turpentine, for which it is usually substituted in practice. Locally it acts as a rube- facient. When swallowed in large doses, as f 5i-ij, it commonly passes off by the bowels ; and, taken in small doses, it is ab- sorbed, and stimulates the circulation and the secretions of the mucous membranes, kidneys and skin. It often produces strangury and considerable irritation of the urinary-genital passages. Poisonous ■ effects from the oil of turpentine are rare, as it generally passes off by the bowels ; it may, however, produce severe vomiting and purging, bloody or. suppressed urine, intense irritation of the urino-genital organs, uncon- sciousness, with dilated pupils, and even death. In large doses it is employed as an anthelmintic and cathartic, and is much o36 MATERIA MEDICA — BLENNORRHETICS. used as a clyster for the relief of tympanites. In small doses it is much prescribed in chronic discharges and hemorrhages from the various mucous membranes ; in the latter stages of typhoid fever as a combined stimulant and blennorrhetic ; as a diaphoretic in rheumatism and neuralgia ; in infantile diabetes, nephritic disorders, dropsy, etc. As a rubefacient, it is a val- uable counter-irritant in numerous diseases ; turpentine stupes are highly efficacious in catarrhal affections. Dose, gtt. v-xxx, repeated, as a blennorrhetic stimulant; fgss-fSj, as & cathartic enema or anthelmintic, in emulsion. Linimentum terebinthinm (oil of turpentine 35 parts, melted with resin cerate 65 parts) is used as an application to burns and scalds. Pix Liquida [Tar) is an impure turpentine, procured, by burning, from the wood of Pinus palustris and other species of Pinus. It is a brownish-black, viscid, semi-liquid substance, of a peculiar empyreumatic odour and a bitterish, resinous, somewhat acid taste ; soluble in alcohol, ether and the volatile and fixed oils. It consists of resin united with acetic acid, oil of turpentine and various volatile empyreumatic products. By distillation it yields pi/roligneous acid and oil of tar, the residuum being pitch. The oil of tar contains, besides oil of turpentine, creasote (see Antiseptics) and other principles. Effects and Uses. — Tar resembles the turpentines in its effects, and is employed in chronic catarrhal affections and other diseases of the mucous membranes. Its vapour has been employed in bronchitis ; and externally it is an excellent application in tinea capitis, psoriasis and other cutaneous affections. Dose, 5ss to 5j several times a day, in pill or electuary. The syrup contains six per cent, of tar, and is a good prep- aration. The ointment (unguentum picis liquids) is made by mixing equal parts of tar and melted suet. Resina (Resin), commonly called rosin, is the residue after the distillation of the oil from turpentine. It is a yellowish- brown, semi-transparent, solid, brittle substance, with a slight terefeinthinate odour and taste — insoluble in water, soluble in COPAIBA. 337 ether, alcohol, and the essential oils, readily uniting by fusion with wax and the fixed oils, and forming soluble soaps with alkalies. When agitated with water, in a state of fusion, it becomes opaque and white. It is not used internally, but is extensively employed in the formation of plasters and ointments, to which it communicates great adhesiveness and slightly stim- ulant properties. Ceratum resince (resin cerate), commonly called basilicon ointment, is made by melting resin (35 parts), lard (50 parts) and yellow wax (15 parts) together ; it is an excellent mild stimulant application to burns, blistered surfaces, etc. Com- pound resin cerate (not officinal) may be made by melting 12 troyounces of resin, suet and yellow wax, each, with 6 troy- ounces of turpentine and 7 troyounces of flaxseed oil — a good stimulant cerate, very popular under the name of Desh- hrs Salve. Emplastrum resince (resin plaster), made by melting 1-i parts of resin with 80 parts of lead plaster and o* parts of yellow wax, is the well-known adhesive plaster, used to retain the edges of wounds in contact, to produce extension in the treatment of fractures, to protect excoriated surfaces, to promote absorption, etc. COPAIBA. Copaiba is an oleoresix obtained from several species of Copaifera (Nat. Ord. Leguminosae), large trees peculiar to South America. C. Langsdorffii, a native of Brazil, is now recognized as the principal source of copaiba, and most of the copaiba of commerce is probably derived from the ports of Para and Maracaibo, in Brazil; Central America also yields copaiba. The juice is obtained from incisions in the stems of the trees ; as it at first exudes it is clear, colourless and very thin, but soon acquires a thicker consistence and a yellowish hue. As found in the shops it is a clear, transparent liquid, of the con- sistence of olive oil, of a pale-yellow colour, a peculiar agree- -mell and a pungent, nauseous, acrid taste. By ex- posure to the air it acquires a deeper colour and denser con- sistency. 388 MATERIA MEDICA — BLENNORRHETICS. Copaiba is insoluble in water, but soluble in alcohol, ether and the volatile and fixed oils ; with alkalies and alkaline earths it forms a soap. It is chemically an oleoresin, with a minute portion of acetic acid. The volatile oil is officinal. The resin possesses acid properties, and is called copaivic acid. By exposure to the air copaiba gradually becomes darker and thicker, and finally hard and brittle, owing to the volatilization and oxidation of its oil. Copaiba was formerly called a balsam, but this title is incorrect, as it contains no btizoic or dnnamio acid. Effects and Uses. — The effects of copaiba are analogous to those of the terebinthinates. In large doses it proves cathartic and occasionally emetic, and in small doses it is absorbed, communicating its peculiar odour to the secretions and exhalations, and stimulating the secretions from the mucous membranes and kidneys; it is also a gentle excitant to the cir- culatory system. The urine of persons who have taken copaiba for some time yields a precipitate with nitric acid, like albumi- nous urine, by the action of the acid on the resin. The resinous precipitate, however, is soluble in alcohol, which does not dis- solve coagulated albumen. Elimination takes place slowly. Occasionally copaiba causes symptoms of strangury when given in large doses. It sometimes produces an eruption on the skin. Copaiba is employed in diseases of the mucous membranes, particularly those of a chronic character, as chronic bronchitis, chronic diarrhoea, leucorrhoea, gonorrhoea, . gleet, catarrh and irritation of the bladder, etc., and, like tur- pentine, in rheumatism and iritis. As a remedy in gonorrhoea it has long enjoyed great popularity, and is given wit^ advant- age even in the earliest stages of the disorder. Administration. — Dose, gtt. xx to foj three time* - day in emulsion, with some aromatic water,* or in pills (massa co- paibce), made by mixing 94 parts of copaiba with 6 parts of * Chapman's Copaiba Mixture is, copaiba and spirit of nitrous ether, each half a fluidounce, powdered gum arabic and sugar, each a drachm, com- pound spirit of lavender, 2 fluidrachms, tincture of opium, a fluidrachm. distilled water, 4 Huidounces ; dose, a tablespoonful three times a day. CUBEB. 339 magnesia, or inclosed in capsules of gelatin ; the pills are ab- sorbed with difficulty. It is also administered as a clyster, in emulsion. Cubeb is frequently prescribed with copaiba in the treatment of gonorrhoea. Oleum Copaiba (Oil of Copaiba) (C 15 H 24 ), obtained by dis- tillation from copaiba, is usually colourless, with the odour and taste of copaiba, and produces the same effects on the system. Dose, gtt. x-xv, in emulsion or dropped on sugar. CUBEB A — CUBEB. Cubeb is the unripe fruit of Cubeba officinalis (Nat. Ord. Piperaceae), a climbing perennial plant of Java and other parts of the East Indies. The berries are gathered for use when unripe, and are dried. They are about the size of a small pea, of a blackish or grayish-brown colour, a reticulated surface, and furnished with a stalk two or three lines long. The shell is hard, and contains a blackish seed, which is white and oily within. The odour of cubeb is aromatic ; the taste warm, acrid and camphoraceous. The berries deteriorate by age, most rapidly in powder, owing to the escape of their volatile oil. Their most interesting constituents are a volatile oil (which is officinal) (C 30 H 48 ), a principle called cubebin, and res- inous matter ; the resinous matter consists of both a hard and a soft resin, the former insoluble in ether, the latter soluble in ether, of acid reaction, and termed cubebic acid. The oil is carminative and stimulant, and the blennorrhetic and diuretic propertied of cubeb reside chiefly in the resin; cubebin is inert. Effec and Uses. — In large doses cubeb, like the other oleoresih f produces more or less gastro-enteric disturbance. In small doses it produces a stomachic effect like that of black pepper ; after its absorption it acts as a gentle excitant to the vascular system, with a very decided stimulant action on the mucous surfaces, particularly those of the urino-genital ap- paratus ; it also frequently proves diuretic. It is eliminated chiefly by the urine, increasing the excretion of uric acid, and 840 MATERIA MEDICA — BLENNORRHETICS. under its use the urine yields a precipitate with nitric acid. An eruption, like urticaria, sometimes follows the administra- tion of both copaiba and cubeb. It is used chiefly in the treat- ment of gonorrhoea, and should be given in the early stage of the disease. In other mucous discharges, as chronic catarrh with profuse secretion, leucorrhoea, gleet, cystitis, etc., cubeb has been also employed with advantage. Administration. — Dose of the powder, 5i-iij three times a day, in gonorrhoea ; in chronic mucous disorders smaller doses are given. The OIL is often employed, but it does not possess the full virtues of cubeb — dose, gtt. x-xij, to be repeated and gradually increased ; it may be taken in emulsion, or dropped on sugar, or made into gelatinous capsules with oil of copaiba. The oleoresin contains both the volatile oil and resin, with a portion of cubebin, and is an excellent preparation — dose, tT^v-xxx, suspended in water ; of the tincture, the dose is £ 5i-ij three times a day ; of the fluid extract, the dose is f 5ss-i. Troches of cubeb are made with the oleoresin, oil of sassafras, extract of liquorice and gum arabic, mixed with syrup of tolu. Each troche contains gr. J of oleoresin. OLEUM SAN TALI — OIL OF SANTA L. The oil of Santal or oil of Sandal Wood is a volatile oil distilled from the wood of Santalum album (Nat. Ord. San- talacese), a small tree found in tropical Asia. The oil is pale, yellowish and thick, readily soluble in alco- hol when fresh, having an aromatic odour resembling the smell of the wood, and a pungent, spicy taste. It has been highly recommended in the treatment of gonorrhoea, in which disease its effects seem to be similar to those of copaiba, but it is not so apt to disagree with the stomach. It occasion- ally (in about four per cent, of the cases) produces vertigo, when the dose should be lessened or the medicine discontinued. It is very expensive, and is often adulterated with oil of cedar. It may be given in doses of TtLv-xx three times a day on a PAREIRA. 341 lump of sugar, in mucilage, in alcohol and cinnamon water or in gelatine capsules. MATICO. This name is given to the leaves of Artanthe elongata (Nat. Ord. Piperaceae), a shrub of Peru. They are from two to six inches long by about an inch in breadth, oval-lanceolate and acuminate in shape, crenate, strongly veined or reticulated, bright-green on the upper surface, paler beneath, of a pleasant, aromatic odour and a strong, spicy, slightly astringent taste. The stalks and spikes of the plant are generally mixed with the leaves, more or less compressed into a lump of a greenish colour. Matico contains chlorophyll, resin, volatile oil, and a bitter principle, soluble in water and alcohol, termed maticin. Effects and Uses. — Matico is a pleasant, aromatic tonic, with a special determination to the mucous membranes. It is used as an alterative stimulant in the entire circle of diseased mucous membranes, especially those of the urinary passages. It is also used internally as a haemostatic, and locally as a styptic Dose, of the powder, 5ss-j three times a day. An infusion (not officinal) may be made by dissolving a troyounce in a pint of boiling water — dose, a wineglassful ; of the fluid extract, the dose is f5ss-j ; of the tincture, f 5j-ij may be given. PARE IB, A. Pareira or Pareira Brava is the root of Chondodendron tomentosum (Wat. Ord. Menispermacese), a native of Brazil. It comes to us in large, wrinkled, twisted or forked cylindrical pieces, of variable thickness and length, covered with a thin, grayish-brown bark. The interior is ligneous, yellowish, porous, inodorous, and of a sweetish, nauseous, bitter taste. It imparts its virtues to water, and contains a bitter alkaline principle termed cissampelina (C 18 H 2r N0 3 ), resin, fecula, etc. The stem is sometimes found in the shops mixed with the root ; it is inert. Effects and Uses. — Pareira brava is an excellent remedy in 342 MATERIA MEDICA — BLENNORRHETICS. chronic diseases of the urinary passages, particularly chronic inflammation or irritation of the bladder, with morbid secretion. It is thought to be also tonic, aperient and diuretic. Dose, in substance, 5ss to 5j- But it is more conveniently given in infusion (atroyounce to boiling water Oj — not officinal) — dose, f5i-ij ; the fluid extract is much used— dose, from half a fluid- rachm to a fluidrachm.* BUCHU. This is the name given to the leaves of Barosma betulina and other species of Barosma (Nat. Ord. Rutacese), shrubby plants, growing at the Cape of Good Hope. As found in the shops, buchu leaves are from three-quarters of an inch to an inch and a half long, from three to five lines broad, elliptical, lanceolate-ovate or obovate, sometimes pointed, sometimes blunt, notched and glandular at the edges, and of a green colour, paler on the under surface. Three varieties are known, viz. : short or round buchu (derived from B. betulina), medium- sized (from B. crenulata), and long buchu (from B. serratifolia). They have a strong, aromatic odour and a bitterish taste, like that of mint. Water and alcohol extract their virtues, which depend on a volatile oil and bitter extractive. Effects and Uses. — Buchu is a gentle stimulant to the secre- tions generally, particularly to the kidneys and urinary mucous membranes ; it may be made to act also as a diaphoretic. It is employed in chronic catarrh of the urethra and bladder, nephritic complaints, retention or incontinence of urine; as a diuretic in dropsies, and as a diaphoretic in rheumatic and cutaneous complaints. Dose, of the powder, gr. xx-xxx ; of the fluid extract, f o^s— f oj- U V A U R S I. Arctostaphylos uva ursi, or Bearberry (Nat. Ord. Ericaceae), is a small trailing evergreen shrub, with coriaceous, obovate * A good prescription in irritable bladder is fluid extract pareira brava, f^i, compound spirit of juniper, f 3jij, benzoic acid, ^i, sulphate of mor- phia, gr. j ; dose, a teaspoonful three times a day. UVA ITRSI. 343 leaves (somewhat like the box leaves and red-whortleberry leaves), about half an inch in length, pale rose-coloured flowers appearing from June to September, and small red berries which ripen during the winter. It is found in the northern parts of Asia, Europe and America. The leaves are the only part used. When dried they have a faint hay-like odour Fig. 28. and a bitterish, astringent taste. They yield their virtues to water and alcohol, and contain tannic and gallic acids, ursone, a crystallizable glucoside termed arbutin, a bitter substance termed ericolin, extractive, resin, gum, etc. Effects and Uses. — Uva ursi is astringent, tonic and diu- retic, and exercises a particular control over discharges from mucous surfaces; hence its employment in catarrh of the bladder, chronic bronchitis with profuse discharge, etc. It is applicable also to the ordinary uses of the vegetable astringents. Dose of the powde?; 9j to 3ij three times a day. The fluid extract may be given in the dose of foss-foj. 344 MATERIA MEDICA — BLENNORRHETICS. CHIMAPHILA PIPSISSEWA, Chimaphila umbellata, Pipsissewa, Wintergreen, or Ground- Holly (Nat. Ord. Ericaceae), is a small indigenous evergreen plant, common to the northern parts of Europe, Asia and America, and found abundantly in woody situations in all parts Fig. 29 of the United States. It has an erect stem three to ten inches high, lanceolate, somewhat wedge-shaped, serrated, dark-green leaves arranged in irregular whorls, and beautiful five-petalled flowers, of a white colour tinged with red and a very agreeable MYRRH. 345 perfume, which appear in June. The leaves are the officinal portion. In the fresh state they have a fragrant smell when bruised, which they lose after drying. Their taste is bitterish and astringent, but somewhat aromatic. They contain arbutin, ericolin, ursone, tannic acid, etc. Chimaphila maculata, or Spotted Pipsissewa, possesses properties analogous to those of C. umbellata, from which it differs principally in the character of its leaves. They are of a deep olive-green colour, mixed with greenish-white ; and the flowers are of a pure white, and appear in July. Effects and Uses. — Pipsissewa is a tonic, astringent, diuretic and blennorrhetic, resembling buchu and uva ursi in its effects, but being a more active diuretic, and is used in the disorders of urinary organs to which they are applicable, and, from its diuretic properties, in dropsy, especially when attended with debility of the digestive organs. It is sometimes given in decoction (Sj to water Oj — not officinal), of which Oj may be taken in twenty-four hours. The fluid extract may be given in doses of foss-j. MYRRHA-s-MYREI. Myrrh is a gum-resinous exudation from Balsamodendron myrrha (Nat. Ord. Burseracese), a small shrubby tree of Arabia Felix and Africa. Most of the myrrh of commerce is probably derived from the eastern coast of Africa. The juice exudes spontaneously and concretes upon the bark. It is im- ported from Bombay, and occurs in small, semi-transparent, reddish-yellow fragments or tears — sometimes agglutinated to- gether in large masses — of irregular shape and size, an agree- able, peculiar odour and a bitter, aromatic taste. It is brittle and pulverizable, has a resinous fracture, and makes a light- yellowish powder. Inferior kinds of myrrh are darker and less translucent and odorous. Myrrh is a gum-resin (the resin being termed myrrhic acid), containing also a little volatile oil. It forms with water an emulsion, and is soluble in alcohol and ether. Effects and Uses. — Myrrh is a stimulant expectorant and 346 MATERIA MEDICA — BLENNORRHETICS. emmenagogue. It is prescribed in chronic catarrhal and asth- matic affections in which a combined corroborant and expecto- rant effect is desirable, and also in chlorosis, amenorrhea, etc. Chalybeates and aloes are frequently united with it in uterine affections. Locally, it is a good application to spongy gums, aphthous sore mouth, etc. Administration. — -Dose, gr. x to 5ss in powder or pill, or suspended in water, as in mistura ferri composita (see p. 153). The tincture is employed chiefly externally ; dose, internally, f f >ss to f5j. Pills of aloes and myrrh, compound galbanum jnlls and compound iron pills are officinal emmenagogue pre- parations of myrrh. BENZOINDM — BENZOIN. Benzoin is a balsamic resin obtained from Styrax benzoin, or Benjamin Tree (Nat. Ord. Styracese), a tall tree of Sumatra, Java, Borneo and Siam. It is obtained by incisions in the bark, from which it readily exudes, afterwards hardening by exposure to the sun and air. Two kinds are known, the more valuable consisting chiefly of whitish tears, united by a reddish- brown connecting medium, and called benzoe amygdaloides, the other of brown or blackish lumps, without tears, known as benzoe in sortis (benzoin in sorts). Benzoin has a fragrant odour, a feeble, slightly aromatic taste, is soluble in alcohol and ether, and is precipitated from its alcoholic solution by water. Its chief constituents are resin and benzoic acid, which places it among the balsams ; it contains also a trace of extractive and of volatile oil, and sometimes cinnamic acid. Effects and Uses. — This drug owes its virtues chiefly to benzoic acid, which will be considered under the head of Antiseptics. Benzoin is a topical irritant, and, after ab- sorption, stimulates the mucous passages, espec^lly the aerian membranes. It resembles myrrh in its effects, but is rather more acrid and stimulating. It is adapted to chronic bronchial affections, but is seldom employed alone. As a fumigation in chronic laryngitis it has been recommended BALSAM OF PERU. 317 by Trousseau and Pidoux. Dose, gr. x to 5ss. The tincture of benzoin and the compound tincture (containing benzoin, purified aloes, storax and balsam of tolu dissolved in alcohol) are used as stimulating expectorants and in bowel complaints ; dose, f5ss to foij. As benzoin has the property of obviating the rancidity to which lard is liable, this is a very useful vehicle for medicated ointments. Adeps benzoinatus is made by melt- ing together powdered benzoin 2 parts and lard 100 parts. Benzoin is much used in fumigating pastiles. STY RAX — STORAX. Storax is a balSi\m prepared from the bark of Liquidam- bar orientale (Nat. Ord. Hamamelacese), a native of Asia Minor. It is obtained by steaming the bruised bark and then express- ing it, and occurs in yellowish or brownish lumps, light and friable, yet more or less tenacious, of a fragrant odour and a warm taste. It contains a volatile oil termed styrol (C 8 H S ), resin, with cinnamic acid, and is therefore a balsam. Alcohol and ether are its proper solvents. It is almost always more or less adulterated. Effects and Uses. — It is used as a stimulant expectorant, chiefly in the compound tincture of benzoin ; dose, gr. x-xx. BALSA MUM PERUVIANS M — BALSAM OF PERU. Balsam of Peru is an empyreumatic liquid balsam obtained from Myroxylon pereirse (Nat. Ord. Leguminos^e), a tree of Central America. It is obtained from incisions in the bark, and is collected on rags inserted in the openings, which are afterwards boiled in water, when the balsam settles at the bot- tom, and the water is poured off. A white balsam, obtained from the {ruit of this tree by expression, and a tincture of the fruit in rum, are also known in Central America. Balsam of Peru has the consistence of honey, a dark, reddish-brown col- our, a pleasant smell, a warm, bitterish, acrid taste, and is soluble in alcohol and partially so in boiling water. It is 348 MATERIA MEDICA — BLENNORRHETICS. heavier than water. Its constituents are resin, essential oil and einnamic and benzoic acids. Effects and Uses. — It is a stimulating blennorrhetic and tonic, employed occasionally in chronic catarrh, asthma, gon- orrhoea, leucorrhoea, etc., but not much used in this country. Externally it is applied to indolent ulcers. Dose, f3ss, in emulsion. BALSAMUM TOLUTANUM — BALSAM OF TOLU. Balsam of Tolu is a semi-liquid balsam obtained from Myroxylon toluifera (Nat. Ord. Leguminosae), a tree of the neighbourhood of Cartagena. It is procured from incisions in the trunk of the tree, and concretes in the vessels in which it is received. It has a soft, tenacious consistence, varying with the temperature, and by age becomes hard and resin-like. It is shining, translucent, of a reddish-brown colour, a fragrant odour and a warm, sweetish, pungent taste. It is inflammable, entirely soluble in alcohol and essential oils, and, like the other balsams, yields its acid to boiling water. Its ingredients are resin, volatile oil and einnamic and benzoic acids. Effects and Uses. — It is a stimulant blennorrhetic and tonic, useful in chronic catarrhal affections, and, from its agreeable flavour, much employed as an ingredient of cough mixtures. The vapour of an ethereal solution of this balsam is inhaled with advantage for the relief of cough. Dose, gr. x-xxx, in emulsion, frequently repeated. The tincture (tinctura tolu- tana) is added to cough mixtures; dose, f5i-f5ij- The syrup (syrupus tolutanus) is used as a vehicle for other medicines. Balsam of tolu is an ingredient of the compound tincture of benzoin. The following gum-resins, previously noticed among anti- spasmodics, are employed as expectorants : Asafcetida (Asafetida). (See p. 110.) Ammoniacum (Ammoniac). (See p. 112.) Galbanum. (See p. 111.) SAVINE. 349 ORDER VI. — EMMENAGOGUES. Emmenagogues (from e^^via, the catamenia, and ayuyoc, ex- citing) are medicines which promote the menstrual discharge. This discharge may be suppressed from various causes, and hence very opposite classes of remedies are employed to restore it. Thus, when amenorrhea depends on anemia, the prepa- rations of iron are the most effectual emmenagogues ; on the other hand, when it occurs in connection with plethora, blood- letting and e vac u ANTS are resorted to. There are probably no articles which exert any specific influence upon the cata- menia, as the discharge from the uterus is not one of the excretions through which medicinal agents pass out of the sys- tem. Medicines, however, which excite the pelvic circulation and stimulate the organs in the neighbourhood of the uterus have a tendency to increase or excite the menstrual discharge. They are — 1. The drastic cathartics, as Aloes (p. 291), etc. 2. Many of the stimulating diuretics, particularly Petrose- linum (or its active principle, Apiol) (p. 329), and Canthar- ides (p. 829). 3. Some of the blennorrhetics, particularly Senega (p. 330). 4. GrUAiACUM (p. 314), usually classed with the diaphoretics. Indirectly, the menstrual discharge is frequently promoted by— 1. Chalyheates, which are the best emmenagogues in chlo- rotic and anemic cases. 2. Mercurials, which prove emmenagogue from their influ- ence in exciting the secretions generally. The following articles are employed exclusively as emmena- gogues : SABINA — SAVINE. Savine is the TOPS of Juniperus sabina (Nat. Ord. Coniferae), a small evergreen bushy shrub of the south of Europe. They resemble closely the tops of Juniperus virginiana, the indige- 350 MATERIA MEDXCA — EMMENAGOGUES. nous Red Cedar, which are sometimes substituted for savine in the shops. The latter has a greenish colour, a strong, peculiar, heavy odour and a bitter, nauseous, resinous taste. Its vir- tues depend on a volatile oil, which is officinal. Physiological Effects. — Savin e is a local irritant. Taken internally, in medicinal doses, it stimulates the circulation and secretions, with a very decided action on the uterus. In large doses it will cause vomiting, purging, abdominal pain, sup- pressed or bloody urine, with symptoms of nervous depression, as shown in unconsciousness, stertorous breathing, perhaps convulsions, and death, usually from collapse ; fatal results have sometimes occurred from its use to provoke premature labour. Medicinal Uses. — Savine is employed internally almost ex- clusively as an emmenagogue, and is considered one of the best medicines that can be used to stimulate the action of the uterine vessels. Pereira pronounces it " the most certain and powerful emmenagogue of the whole Materia Medica." It has been successfully used in menorrhagia depending on relaxation of the uterine tissues (Wood, H. C). It has been also rec- ommended in chronic rheumatism, and as an anthelmintic. Topically, it is used to keep up the discharge from blisters, to destroy warts, etc. Dose, in powder, gr. v-x ; but it loses much of its oil by drying ; of the fluid extract the dose is TTjy-x. Ceratum sabince (25 parts of fluid extract added to 90 parts of resin cerate) is used to make perpetual blisters. Cleum Sabine {Oil of Savine) (C 10 H 16 ) is the preparation principally used internally. Dose, gtt. v-x. Ruta (Rue) (not officinal). The leaves of Ruta graveolens (Nat. Ord. Rutacese), a perennial European plant, with tri- pinnate leaves, obovate leaflets and yellow flowers, are ranked among emmenagogues, and are used, popularly, to provoke abortion. Their action is similar to that of savine, than which, however, they are less powerful. Dose, gr. xv-xxx two or three times a day. Of the oil (oleum rutoe) the dose is gtt. ij-v. It is the only officinal preparation. ALTERATIVES. oC/1 CLASS III. — HEMATICS. ORDER I.— H^EMATINICS. This order (from ai/ianva, the red colouring matter of the blood) includes only the Preparations of Iron, or Cha- lybeates. The chalybeates increase the number of blood- corpuscles, or the amount of hsematin in the blood, and are employed therapeutically in diseases dependent on a deficiency of these elements. They belong eminently to Jicematics (or medicines which occasion changes in the condition of the blood) ; but as they possess also general and local tonic effects, independent of their action on the blood, they have been classed and treated of among the mineral tonics (see p. 149). ORDER II. — ALTERATIVES. Alteratives may be defined to be medicines which produce such a modification of the nutritive processes as enables the vital principle to restore healthy action in morbid conditions of the system. Their effects are chiefly owing to a correcting influence on the quality of the circulating fluid. Thus, in in- flammations they diminish the abnormal quantity of fibrin in the blood, render its red corpuscles less disposed to aggregation, and decrease the number and adhesiveness of its white globules. In part, also, their curative operation is of a substitutive char- acter, by setting up an antagonistic action which takes the place of diseased action in the system. Under the influence of alteratives the secretions and ex- halations are increased, the textures softened, inflammatory action is arrested and morbid growths and deposits are absorbed. The exudation of plastic or coagulable lymph is checked, and, as a consequence, also the formation of false membranes. Visceral and glandular enlargements and indu- CD O rations are diminished and often disappear, and phlegmonous inflammation of every kind is opposed. If pushed too far, the alteratives soften and even destroy 352 MATERIA MEDICA — ALTERATIVES. the textures, impoverish the blood so as to interfere with the functions of nutrition, and produce a condition of marasmus and cachexia. Their principal therapeutic employment is as antiphlogistic s or resolvents. The mercurials are chiefly employed in acute inflammations ; the preparations of iodine in chronic inflam- mations. In the treatment of acute inflammatory affections, mercurials are among the most important of our resources — especially in such as have a tendency to terminate in effusions of coagulable lymph. The iodic preparations are adapted to inflammations of a chronic character, and are particularly ser- viceable in indurations or enlargements of glands and organs, and in affections of the bones and fibrous tissues. By their substitutive or antagonistic action alteratives are highly efficacious in the treatment of many diseases. In this way syphilis is cured by the use of mercury, and intermittent fever by the use of arsenious acid. Owing to the injurious results which follow the prolonged exhibition of alteratives, they are to be administered with caution, and their effects closely watched. HYDRARGYRt PR.EPARATA — PREPARATIONS OF MERCURY. Metallic mercury or quicksilver is obtained principally from the sulphide (native cinnabar). The chief supply of quicksilver was long derived from Spain and Austria, but the markets of the United States are now furnished from New Almaden, in California. Mercury is an odourless, tasteless, volatile liquid metal, of a whitish colour. Its atomic weight is 199*7; its symbol is Hg. While it retains the liquid metallic state, mercury is inert ; but when taken internally it sometimes combines with oxygen in the alimentary canal, and thus becomes active. In the state of vapour it frequently proves injurious, in some instances exciting salivation, ulceration of the mouth, etc., in others inducing a peculiar affection of the nervous system termed PREPARATIONS OF MERCURY. 363 shaking palsy {tremor mercurialis), which is often attended with loss of memory, vertigo and other evidences of cerebral disturb- ance, and sometimes terminates fatally. Workmen in quick- silver are liable to this affection. It is supposed by some chem- ists that the activity of mercurial emanations is owing to the oxidation of the metal before it is inhaled ; by others, that, in the finely- divided state in which it exists as a vapour, it is in itself poisonous. All the compounds of mercury possess activity. Some of them are violent caustic poisons ; all of them are more or less irritant. When the mercurials are taken internally, their effects vary with the quantity administered. In small and re- peated doses, their influence is first shown in an increase of the activity of the secernents and exhalants. The cutaneous, mu- cous, biliary, salivary, urinary and probabty also the pancreatic secretions are all increased in amount, and at the same time the absorbent system becomes more active, so that accumula- tions of fluids, morbid enlargements, indurations, etc., will often disappear. Mercury increases the flow of bile. Most of the mercurial preparations probably accomplish this merely in a mechanical manner, i. e., by causing reflex contraction of the gall bladder and ducts, due to the irritation of the mucous membrane of the duodenum ; but corrosive sublimate would seem, from the experiments of Rutherford and Yignal, to have considerable power as a stimulant of the hepatic secretory apparatus. When mercury is given in larger doses, these effects are more intense. The mucous membrane of the mouth and the salivary glands not only take on increased secretory action, but become irritated and inflamed. The gums first show the mercurial influence, and are tender and tumefied ; the whole mouth soon becomes sore ; the tongue is swollen ; and the saliva and buccal mucus flow abundantly, sometimes to the extent of several pints a day. At the same time the breath acquires a peculiar fetidity, and the patient perceives a metallic taste in the mouth. The resolvent action of mercury is now still more obvious than when its impression is milder, and considerable emaciation 354 MATERIA MEDICA — ALTERATIVES. usually ensues from the absorption of fat. These effects, which are termed sialagogue (from the excessive flow of saliva). are commonly produced for the cure of diseases, and, as a general rule, gradually subside, leaving the health unimpaired. When, however, the use of mercury is pushed too far, or it is administered to persons peculiarly susceptible of its action, a train of very serious symptoms ensues — as excessive salivation, ulceration of the mouth, sloughing of the gums, loosening of the teeth, and occasionally necrosis of the alveolar processes. A peculiar febrile condition called mercurial fever, diarrhoea, skin diseases, neuralgia, rheumatism, disorder of the nervous system, and marasmus, are other symptoms which are fre- quently noticed after the abuse of mercury. % After its absorption mercury produces several important changes in the quality of the blood. Exceedingly minute doses given for some time, but not too frequently repeated, increase the proportion of red corpuscles in the blood. The bodily weight is also increased. Immediately upon the estab- lishment of salivation, the blood exhibits an inflammatory crust; but at a later period it loses colour, consistence and coagu- lability, and the relative proportion of albumen, fibrin and cor- puscles is diminished. This antiplastic action on the blood renders mercurials valuable as antiphlogistic remedies. Medicinal Uses. — Liquid metallic mercury was formerly administered to remove mechanical obstructions of the bowels, but its use has been abandoned. The preparations of mercury are employed therapeutically with various objects: 1. As indirect tonics and cholagogues, — with a view to their action on the secretions, — in dyspepsia and constipation accom- panied with torpor of the liver, in gout, rheumatism, chronic skin diseases, etc. Blue pill, mercury with chalk, and calomel, are employed with this view ; the two former are preferred as least irritating. 2. As antiphlogistics. Mercury was formerly given in nearly all cases of sthenic inflammation with a tendency to plastic effusion. At present, however, its use as an antiphlo- gistic is principally restricted to acute inflammation of the se- PREPARATIONS OF MERCURY. SOD rous membranes of sthenic type during the stage of exudation, and after the plastic effusion has ceased to be poured out, with a view to prevent its organization and facilitate absorption. In this way it is given in pleuritis, pericarditis and peritonitis, and with a similar view in pneumonitis and iritis. Many writ- ers however, relying on other remedies, deprecate the use of mercurials in the treatment of these diseases, with the exception of iritis, in which they are universally acknowledged to be of benefit. Minute doses of mercurials, frequently repeated, are highly recommended in acute glandular affections about the throat and neck, as tonsillitis, parotitis, etc. (Bartholow). In acute sthenic dysentery, a mercurial — especially calomel — may often be given with advantage. When given with a view to their antiplastic effects, it is no longer thought necessary to cause pro- fuse salivation : it is sufficient to produce constitutional effects as manifested by a metallic taste in the mouth, slight tumefaction of the gums and slight tenderness of the teeth when knocked together forcibly. During the maintenance of this condition the patient should use warm clothing, avoid exposure to cold and take light and nourishing food. If salivation or ulceration occur, astringent gargles, as brandy and water, solutions of chlorinated soda or lime, alum, etc., may be employed. In cases of sloughing sores, nitrate of silver or the mineral acids should be applied. Gastro-enteric irritation is to be treated with laxa- tives and opiates. The mercurial cachexia requires change of air, generous diet, tonics, etc. When the system is contami- nated with mercury, it may be eliminated by the use of potas- sium iodide, which forms soluble compounds with the mercury retained in the economy. Mercurials are contraindicated in all asthenic inflammations, serous exudations, or where much debility exists. 3. As antisyphilitics. Mercury has long been regarded as the only reliable antisyphilitic agent. It has no direct cura- tive influence on the primary symptoms ; but after the system has been contaminated with the syphilitic virus, mercury is the most certain and rapid means of destroying it. Wherever the hard chancre, with distinct induration (which is always in- 3o6 materia medica — ALTERATIVES. dicative of constitutional taint), is present, mercurials should invariably be administered ; and in the treatment of secondary and of hereditary syphilis, a mercurial course is an indispens- able preliminary to other antisyphilitic medicines. In tertiary syphilis small doses of corrosive sublimate are often combined with potassium iodide with better eifects than when the iodide is given alone ; mercurials may be used not only internally, but by inunction and by fumigation, for Dr. Furbringer has shown that, although metallic mercury will not pass through the skin, yet when rubbed into the sebaceous follicles the se- baceous matter converts it into a soluble mercurous compound, which is then readily absorbed. Blue pill and calomel are the antiplastics principally resorted to ; but other preparations, as the iodides, are, employed in syphilis. In administering mercurials for their sialagogue action, we sometimes observe a cumulative effect : they may be exhibited, particularly to children, for some time without re- sult, when suddenly the most violent symptoms of mercurial saturation will be developed. 4. As purgatives. The employment of calomel, blue pill, and mercury with chalk, as cathartics and anthelmintics, has been previously noticed (see p. 307). The following are the preparations of mercury which are employed medicinally : 1. Metallic Mercury.-— When intimately mixed with pul- verulent or fatty bodies, mercury loses its liquid character — is said to be hilled, extinguished or mortified — and acquires medicinal activity. Its activity is probably owing to its reduc- tion to a state of minute division, which enables it to enter into combinations in the stomach. The officinal preparations of metallic mercury are : Massa hydrargyri (mass of mercury), nnguentum hydrargyri {mercurial ointment), emplastrum hy- drargyri {mercurial plaster), emplastrum ammoniaci cum Jiy- drargyro (ammoniac plaster ivith mercury), hydrargyrum cum cretd (mercury with chalk). 2. Oxides. — Hydrargyri oxidum flavum (yellow oxide of mercury), unguentum hydrargyri oxidi flavi (ointment of PREPARATIONS OF MERCURY. 357 yellow oxide of Mercury), hydrargyri oxidum rubrum (red oxide of mercury), unguentum hydrargyri oxidi rubri (ointment of red oxide of mercury). 3. Chlorides. — Hydrargyri chloridum mite (mild chloride of mercury, or calomel), hydrargyri chloridum corrosivum (cor- rosive chloride of mercury, or corrosive sublimate). 4. Iodides. — Hydrargyri iodidum viride (green iodide of mercury), hydrargyri iodidum rubrum (red iodide of mercury). 5. Hydrargyri cyanidum (cyanide of mercury). 6. Hydrargyrum ammoniatum (ammoniated mercury), un- guentum hydrargyri ammoniati (ointment of ammoniated mer- cury). 7. Hydrargyri subsulphas flavus {yellow subsulphate of mer- cury). 8. Hydrargyri sulphidum rubrum (red sulphide of mer- cury). 9. Nitrates. — Unguentum hydrargyri nitratis (ointment of nitrate of mercury), liquor hydrargyri nitratis (solution of nitrate of mercury). Massa Hydrargyri (Mass of Mercury). This preparation, generally known as blue pill, is made by rubbing mercury (33 parts) with honey of rose (34 parts) and glycerin (3 parts) till all the globules disappear ; then adding powdered liquorice (5 parts) and marsh mallow (25 parts), and beating the whole into a mass. The trituration is now generally effected by machinery — usually by steam power. It is a soft, dark-blue mass, of a convenient consistence for making into pills. The mercury is in a state of minute division, and is chemically unaltered, though, perhaps, a very small portion of it is in a state of oxidation. The preparation changes colour from being kept, becoming of an olive and even reddish tint, in consequence of the further oxidation of the metal. As it is often adulterated, it is important that it should be purchased of a reliable house. Effects and Uses. — In full doses (gr. v-xv) blue pill acts as a laxative ; when given for this purpose it is usually followed in a few hours by a saline cathartic. In doses of gr. i-ij-iij, 358 MATERIA MEDICA— ALTERATIVES. repeated at proper intervals, it is employed as an alterative or antiphlogistic, and is the favourite preparation for exciting salivation in chronic affections. When it moves the bowels, opium is combined with it. It may be plear intly given sus- pended in mucilage or syrup. Unguentum Hydrargyri {Mercurial Oint ent) (called also blue ointment) is made, by rubbing mercury ,vith compound tincture of benzoin and mercurial ointment, r! n adding suet and lard, previously melted together, and cr dnuing to rub until the globules disappear. It is an unctt 5, fatty body, of a bluish-gray colour, consisting of equal ,v eights of fatty matter and finely-divided mercury. A very i ill portion of mercurous oxide is pei aps present, and, as the ointment becomes darker by age, ?* further oxidation of the mercury probably takes place. Effects and Uses. — Mi -curial ointment, when either swal- lowed or rubbed into tht integuments, produces the consti- tutional effects of mercury ; locally, it has but lit j irritant effect. It is scarcely ever used internally in the United States or Great Britain, though in France it is highly esteemed as a sialagogue, in the dose of gr. ij, repeated. ExternaMy it is used to mercurialize the system by friction ; to disj e non- malignant tumours; as a dressing to syphilitic 'i destroy pediculi ; and to prevent suppuration and small-pox. • Emplastrum Hydrargyri {Mercurial Plaster) i, rubbing Svj of mercury with 5ij of olive oil and ? previously melted together, till the globules disappea 1 adding oxij of melted lead-plaster. It is used as a • <>f venereal and other enlargements, to prevent pitting pox, etc., and is applied to the side in chronic hep may induce salivation. The plaster of ammoniac i cury {emplastrum ammoniaci cum hydrargyro) is mixing with heat 60 grains of olive oil with 8 grain limed sulphur, then adding 3 troyounces of mercul this mixture adding 12 troyounces of ammoniac, p digested with dilute acetic acid and strained; it is m ti ul- ulating than the foregoing. PREPARATIONS OF MERCURY. 359 Hydrargyrum cum Creta (Mercury with Chalk) (called also gray 'powder) is prepared by rubbing 38 parts of mer- cury with 50 parts of prepared chalk and 12 parts of sugar of milk, till all the globules disappear. It is a grayish powder, containing mercury chiefly in a state of minute division. In full doses it is m gentle laxative, milder even than blue pill ; in smaller doses^t is an excellent alterative; and the chalk renders it antao'il It is employed chiefly as an alterative in infantile cases. Uid)ose, for adults, gr. v-xx ; for children, gr. ij or iij to gr. - ■ or x, in powder, and not in pills, as in the latter form the mercury becomes squeezed out of the chalk. The chlorides gl nitro-muriatic acid jare incompatible with all the metallic preparations of mercury .d- Hydrargyri Oxidum Rubrum kited Oxide of Mercury). This is mercuric oxide (HgO). It is made usually by dissolv- ing mercury in diluted nitric acid, wi^h a gentle heat, by which mercuric nitrate is formed ; and the^ nitric acid is afterwards decompose: and driven off by calcination. The red oxide of mercury, which is commonly called red precipitate, occurs in small shining scales, of a brilliant red colour, with a shade of orange. It has an acrid taste, and is nearly insoluble in water. Its efft are those of a powerful irritant, and when taken in- ti ^en in small doses, it excites vomiting and piiro-ino; : loses, gastro-enteritis. It is rarely or never used (dose, gr. yg-g); externally it is applied as an either in powder or ointment, to chancres, indolent 'i Unguentum hydrargyri oxidi rubri (ointment of \f mercury) consists of red oxide (1 part) mixed with ) parts) : it is a very useful stimulating ointment in ilcers, porrigo, ophthalmia, etc. gyri Oxidum Flavum (Yellow Oxide of Mercury) ■)j mixing a solution of corrosive sublimate with solu- totassa ; potassium chloride is formed in solution, and j oxide (HgO) is precipitated as an orange-yellow fliich, on being heated, assumes a red colour. The xdde is without odour, of an acrid taste, is very slightly solu n water, and is insoluble in cold alcohol and ether. 3G0 MATERIA MEDICA — ALTERATIVES. This preparation is preferred for some purposes to the red oxide, owing to its greater purity, and especially to its oc- curring in the form of a completely amorphous powder, exhibit- ing no evidence of crystalline particles even under the micro- scope. This gives it a superiority, as a local application to the conjunctiva in diseases of the eye, over the red oxide, which, from the crystalline character of its particles, causes more or less irritation. Unguentum hydrargyri oxidi flavi (ointment of yellow oxide of mercury) consists of yellow oxide 1 part, mixed with ointment 9 parts. Oleatum hydrargyri (oleate of mercury) consists of yellow oxide 1 part, dissolved in oleic acid 9 parts by means of heat. Yellow wash (a favourite application to phagedoenic venereal ulcers) consists of yel- low oxide of mercury suspended in a weak solution of calcium chloride, and is made by adding corrosive sublimate 5j to lime solution Oj. Black wash (a favourite application to chancres and other sores) is an impure mercurous oxide (Hg 2 0) in a weak solution of calcium chloride, and is made by adding calo- mel 5j to lime solution Oj. Hydrargyri Chloridum Mite (Mild Ohloride.of Mercury). This preparation (mercurous chloride), well known as calomel (Hg 2 Cl 2 ), is made by subliming. a mixture of mercurous sulphate and sodium chloride (common salt) ;■ a double decomposition takes place, by which mercurous chloride and sodium sulphate are formed. The mercurous sulphate is previously obtained by boiling mercury in sulphuric acid, and afterwards triturating the resulting mercuric sulphate with mercury. Calomel, as thus procured in mass, is liable to contain a little corrosive sublimate. It should be reduced to powder, and washed re- peatedly with boiling distilled water until the absence of a white precipitate with ammonium hydrate shows that the cor- rosive sublimate has been removed. With a view of obtaining calomel in a state of very minute division, its vapour is con- densed in a receiving vessel filled with steam, whereby it takes the form of a very fine powder, and is perfectly free from cor- rosive sublimate. The calomel thus prepared (known as JewelVs or Howard's calomel) is finer and more active than can be ob- tained by levigation and elutriation. PREPARATIONS OF MERCURY. 361 Calomel, as usually manufactured by sublimation, is in the form of white fibrous, crystalline cakes. It may be obtained in the shape of quadrangular prismatic crystals. As found in the shops it is a light-buff or ivory-coloured powder, tasteless, inodorous, insoluble in water, alcohol and ether, unalterable in the air, but blackening by long exposure to light. It should be kept in bottles painted black or covered with black paper. Jewell's calomel is a perfectly white powder. When pare, calomel is completely vaporizable by heat ; it strikes a black colour, free from reddish tinge, with solutions of the fixed alkalies ; and should not, when digested with water, form a white precipitate with ammonia, unless it contain corrosive sublimate. Incompatibles. — The alkalies, alkaline earths, alkaline car- bonates, soaps and hydrosulphates are incompatible with calo- mel. Nitro-muriatic acid should not be prescribed with it, for fear of generating corrosive sublimate. Preparations contain- ing hydrocyanic acid, and potassium, ammonium or sodium chloride, produce the same change. It is asserted that calo- mel is converted into corrosive sublimate in the stomach by the muriatic acid which it encounters, but there are many reasons for rejecting this hypothesis, and more probably it unites with the albuminous peptones, forming a compound which is soluble in the gastric fluid. Effects and Uses. — Calomel produces the effects of the mer- curials already described, causing bilious stools, not from direct stimulation of the liver, but probably in a reflex manner ; stim- ulating the intestinal glands, and in purgative doses proves also a valuable anthelmintic. Calomel agrees well with the stomach, and will often be borne when other purgatives would not be tolerated. From the certainty and mildness of its opera- tion it is more employed than any of the other preparations of mercury, although blue pill, which, if less certain, is milder, is preferred under some circumstances. Calomel has been fre- quently taken in very large doses without any bad effects; but cases are recorded in which, in excessive quantity, it has acted as an irritant poison. As a purgative it is employed in doses 362 MATERIA MEDICA— ALTERATIVES. of gr. vi-xij in fevers and many other affections ; gr. ss-j at bed time will often prove sufficiently purgative in the morning ; as an anthelmintic, in the same doses ; and in both cases it is to be followed in a few hours by a saline draught, castor oil or senna. Calomel is often given in combination with other cathartics, as jalap, rhubarb, aloes, scammony, colocynth and gamboge. As an antiphlogistic in inflammatory cases calomel is given in doses of gr. \ to gr. j, every one, two or three hours; as an eccritic,m these doses twice or thrice a day. In the dose of gr. y 1 ^— j, frequently repeated, it is one of the best means of checking obstinate vomiting. -It is sometimes added to other medicines to increase their action on the secretions, as diuretics, antimonials, etc. To children, calomel may be given in proportionally larger doses than to adults, and it rarely salivates them. In some cases of infantile diarrhoea, very minute doses of calomel, as gr. Jg, ^ 5 , J, every hour or two, are highly efficacious. Externally, calomel is applied in powder, as an errhine, in amaurosis ; and made into an oint- ment (5j to §j lard) it is an excellent application in a variety of cutaneous affections. Hydrargyri Chloridum Corrosivum {Corrosive Chloride of Mercury). This is mercuric chloride, commonly called cor- rosive sublimate (HgCl 2 ). It is made by subliming a mixture of sodium chloride and mercuric sulphate (which is previously obtained by boiling mercury with sulphuric acid) ; double de- composition takes place, resulting in the formation of mercuric chloride and sodium sulphate. Corrosive sublimate occurs in the form of white, semi-transparent, crystalline masses, per- manent in the air, inodorous, and of an acrid, styptic taste. It is soluble in 16 parts of cold water or 3 parts of boiling water, more soluble in alcohol, and still more so in ether. The aqueous solution, when exposed to light, is decomposed, with the precipitation of calomel and evolution of hydrochloric acid. It is incompatible with many of the metals, the alkalies and their carbonates, soap, lime-solution, tartar emetic, silver nitrate, the lead acetates, the sulphides and iodides of potas- sium and sodium, the sulphides generally, syrup of sarsa- PREPARATIONS OF MERCURY. 363 parilla, and with many vegetable substances (as the bitters) and albuminous liquids (as milk, etc.). The tests for detecting corrosive sublimate in solution are : 1. A solution of potassa, soda or lime throws down a yellow precipitate ; 2. Potas- sium carbonate, a brick-red precipitate ; 3. Ammonia, white ammoniated mercury ; 4. Potassium iodide, a bright scarlet-red mercuric iodide, readily soluble in excess of the precipitant ; 5. Stannous chloride, in small amount, a white precipitate of calomel — in excess, a dark-gray precipitate of metallic mercury ; 6. Sulphuretted hydrogen, or a sulphide, in minute amount, produces a whitish or gray precipitate, and in large amount a black sulphide ; 7. If the solution is acidulated with hydro- chloric acid, and bright copper-i'oW, wire or gauze is plunged into it, the copper becomes coated with a silvery-white deposit of mercury; or a slip of gold- fo\\, wound round a slip of zinc- foil, may be introduced into the liquid, when it will become covered with a silvery film of metallic mercury, and in both cases the metal may be afterwards obtained by sublimation in the form of globules. Physiological Effects. — In medicinal doses, as gr. yg-g? cor ~ rosive sublimate occasions a beneficial alterative effect, without any obvious activity. It is a true hepatic stimulant of consid- erable power, and feebly stimulates the intestinal glands. Its continued use may cause salivation, but it has less tendency to produce this result than any other preparation of mercury. Medicinal doses, if too large or too long continued, frequently produce gastro-enteric symptoms and the constitutional effects of mercury. In excessive doses corrosive sublimate is a vio- lent caustic poison, from its affinity for the albumen, fibrin and other constituents of the tissues. It acts very, rapidly, pro- ducing the most intense gastro-enteritis, with violent vomiting and purging, abdominal pain and tenderness, bloody stools, with death from collapse, or, after a time, with convulsions and coma. The urine is albuminous or bloody, diminished in amount or suppressed. The best antidote is albumen (in the form of white of eggs) ; or, if this is not attainable, gluten (in wheaten flour) or casein (in milk) may be substituted. JFer- 364: MATERIA MEDICA — ALTERATIVES. rous sulphide (if given immediately), and a mixture of iron filings (two parts) with gold dust (one part), also decompose corrosive sublimate. In cases of poisoning, the stomach must be evacuated as soon as possible, and the after-treatment consists in the free use of demulcents, opiates, and topical depletion. Medicinal Uses. — Corrosive sublimate is used chiefly as an alterative in secondary syphilis, both by the stomach and by hypodermic injection ; also in cutaneous and rheumatic affec- tions, and as a sorbefacient in old dropsies ; it is a good rem- edy, too, in chronic diarrhoea and dysentery with slimy and bloody discharges. In tertiary syphilis it is often combined advantageously with potassium iodide ; dose, gr. y^-J three or four times a day, in pill or solution. It has been used in secondary syphilis, hypodermically ; dose, gr. g 1 ^. Externally 'it may be used as a caustic. It is destructive to the lower forms of life, and hence may be used as an antiseptic in weak solution (1 part to 2000 parts of water, or about gr. j to f 5Jvss), instead of carbolic acid ; a weak solution (gr. J-i-ij to water f §j) is much employed as a wash to ulcers, an injection in gleet, a collyrium, etc. An ointment (gr. J-i-ij to lard 5j) is a good application in porrigo, tinea, eczema, pityriasis, and skin diseases generally of parasitic Origin. There is danger from the external appli- cation of corrosive sublimate to a large surface. Hydrargyri Iodidum Viride (Green Iodide of Mercury) is made by rubbing mercury and iodine together, with the addi- tion of a little alcohol. It is mercurous iodide (Hg 2 I 2 ), and is a greenish-yellow powder, insoluble in water and alcohol, but soluble in ether. By exposure to light it is partially decom- posed, and becomes of a dark-olive colour. Effects and Uses. — This mercurial exercises a specific influ- ence over the lymphatic and glandular systems, and is employed in syphilis and scrofula. Dose, gr. j, gradually increased to gr. iij or iv ; it should not be given with potassium iodide, which decomposes it into red iodide and metallic mercury. Ex- ternally it • is applied, in the form of ointment, to syphilitic ulcers, etc. PREPARATIONS OF MERCURY. 365 Hydrargyri Iodidum Kubrum (Red Iodide of Mercury) is mercuric iodide (Hgl 2 ). It is made by mixing solutions of potossium iodide and mercuric chloride, from which a double decomposition ensues, resulting in the formation of potassium chloride in solution, while red iodide of mercury is precipitated. It is a scarlet-red powder, which becomes yellow when heated, insoluble in water, but soluble in boiling alcohol and solutions of potassium iodide, sodium chloride, etc. It is a power- ful irritant and caustic, and is employed in the same cases as the green iodide, though much more energetic. It is useful in rheumatism, especially when of syphilitic origin. Dose, gr. Y 1 ^, gradually increased to gr. ¥ , in pill or alcoholic solution ; or, still better, dissolved in a solution of potassium iodide. Externally it may be used in the form of ointment (gr. xvj mixed with ointment §jj. Hydrargyri Cyanidum (Mercuric Cyanide). This salt is made by adding a solution of potassium ferrocyanide to sul- phuric acid, by which hydrocyanic acid is produced, and this, being received in a vessel containing water and red oxide of mercur}^, generates water and mercuric cyanide (Hg(CN) 2 ). It is found usually in the form of permanent prismatic white and opaque crystals, of a disagreeable styptic taste, soluble in water, but not in alcohol. It is an active poison, and is used as an antisyphilitic remedy, as a substitute for corrosive subli- mate, over which it has the advantage of not producing epigas- tric pain, and not being decomposed by alkalies and organic substances. Dose, gr. -Jg to J. Hydrargyrum Ammoniatum (Ammoniated Mercury). This preparation, commonly called ivJiite precipitate, is made by precipitating a solution of corrosive chloride of mercury by am- monia ; ammonium chloride is formed in solution, and ammo- niated mercury is thrown down. It is the chloride of mercuric ammonium. In symbols the reaction may be thus expressed : HgCl 2 +2NH 4 HO=NH 2 HgCH-NH 4 Cl + 2H 2 0. It is a per- fectly white powder, insoluble in water and alcohol, decomposed 366 MATERIA MEDICA ALTERATIVES. by boiling water, inodorous, and has an earthy, afterwards metallic, taste. It cannot be mixed with iodine, bromine or chlorine without decomposition. It is largely adulterated, chiefly with calcium sulphate. Its effects are poisonous, but it is used only as an external application, in the form of ointment {unguentum hydrargyri ammoniati, 1 part of am- moniated mercury to 9 parts of benzoinated lard), to cutaneous eruptions, and to destroy pediculi. Four grains, mixed with half an ounce of powdered sugar, makes a good snuff-powder in ozoena. Hydrargyri Subsulphas Flavus {Yellow Subsulphate of Mercury). This salt, commonly called turpeth mineral, from its resemblance to the root of Ipomcea turpethum, is made by throwing mercuric sulphate (as obtained from the action of sul- phuric acid on mercury) into boiling water; the mercuric sul- phate is instantly decomposed into a soluble acid salt and the insoluble yellow subsulphate — turpeth mineral — which is pre- cipitated (Hg(HgO) 2 S0 4 ). It is an inodorous, lemon-yellow powder, entirely dissipated by heat, of a rather acrid taste, and sparingly soluble in water. It has been employed as an alter- ative, in doses of gr. J-J ; as an emetic, in croup it is highly recommended in doses of gr. ij-v in syrup or honey, repeated in fifteen minutes if there has not been decided vomiting, and given throughout the attack whenever the breathing becomes suffocative from accumulations of mucus. It produces free vomiting without effort or subsequent depression ; it has been used in chronic enlargement of the testis, in the same doses; and as an errhine, in chronic ophthalmia and diseases of the head. In an overdose it is poisonous, forty grains having proved fatal. Hydrargyri Sulphidum Rubrum [Red Sulphide of Mer- cury), or cinnabar (which is found as a native combination), is manufactured by subliming a mixture of one part of sub- limed sulphur and five parts of mercury. It is mercuric sul- phide (HgS), and occurs in the form of heavy, brilliant, deep- PREPARATIONS OF MERCURY. 367 red crystalline masses, which are inodorous, tasteless, entirely volatilizable by heat, and insoluble in water and alcohol. It is not employed internally, but is used in the way of fumigation, in venereal ulcers of the throat and nose ; 5ss may be thrown on a red-hot iron and inhaled ; but the black oxide is a better substance for mercurial fumigation. Cinnabar is used as a paint, under the name of vermilion. UnguenTum Hydrargyri Nitratis (Ointment of Nitrate of Mercury). The nitrate of mercury is employed chiefly in the form of ointment. This preparation, known as citrine ointment, may be made by dissolving a troyounce and a half of mercury in 3J troyounces of nitric acid, and adding the solution to 16 troyounces of lard melted at 200°, stirring until effervescence ceases. The chemical changes which result here are not precisely known ; but mercuric nitrate (2(Hg2N0 3 ).H 2 0) is probably formed, with fatty acids and ela'idin. Citrine oint- ment has a fine yellow colour and an unctuous consistence; but if not very carefully made, it becomes greenish, hard and fri- able. It is an excellent stimulant and alterative application, much employed in porrigo, psoriasis, crusta lactea, impetigo, psorophthalmia, and a wide range of ulcerated and eruptive affections. It is best to dilute it, at first, with lard. Liquor Hydrargyri Nitratis (Solution of Nitrate of Mer- cury) (mercuric nitrate) (Hg2N0 3 ) is prepared by dissolving red oxide of mercury §iij 5\j in a mixture of nitric acid §iij grs. 315 in distilled water, gr. 585. It is a dense, transparent, nearly colourless liquid (sp. gr. 2*100), of a strongly acid taste, containing about 50 per cent, of mercuric nitrate in solution with some free nitric acid, and is employed as a caustic appli- cation in hospital gangrene, venereal and malignant ulcers, and, diluted, in cutaneous affections. o68 MATERIA MEDICA — ALTERATIVES. AURI ET SODII CHLORIDUM — AURIC AND SODIU.M CHLORIDE. Auric and sodium. chloride is a mixture of equal parts of gold chloride and sodium chloride (AuCl 3 NaC1.2H 2 0). It is an orange-coloured salt, without smell but having a nauseous me- tallic taste. It is very soluble in water ; also soluble in alcohol. Effects and Uses. — Locally it is a caustic. Internally it is a stimulant to the nervous system, especially to the spinal cord. It acts like the mercurials on the blood, reducing the oxidizing power of the red globules (Farquharson). It stimulates the glandular secretion and increases the secretion of urine and .of perspiration. Salivation, without tendency to ulceration, some- times occurs after prolonged use, but is less apt to occur after the use of this salt than after the other salts of gold (Martin, Schmidt's Jahrb., June, 1870). In large doses it causes violent gastro-enteritis. It is said to stimulate the sexual organs and to increase the catamenia. Large doses cause symptoms anal- ogous to those of poisoning by mercuric chloride. The same treatment is indicated. This salt is used chiefly as an alterative in chronic cases of tertiary syphilis and in scrofula. It is also recommended in nervous dyspepsia, duodenal catarrh, etc. In the chronic forms of Bright's disease, granular and fibroid kidney and the so- called depurative disease, Dr. Bartholow has seen remarkable improvement follow the use of small doses of this remedy. Dose, gr. ^q-jV- ^ * s Dest gi y en in pill or wafer. IODUM — IODINE. Iodine is an elementary, non-metallic substance, found in the vegetable, animal and mineral kingdoms of nature, as in marine plants, oysters, sponges, mineral springs, etc. It is chiefly manufactured from the residuum of kety (the impure soda obtained from the incineration of sea-weeds), in which it exists as a sodium iodide, by the action of sulphuric acid and man- IODINE. 369 ganese dioxide. It occurs in crystalline scales, of a bluish- black colour and metallic lustre, of a strong, peculiar odour and a hot, acrid taste. It is very volatile, evaporating even at common temperatures ; is freely soluble in glycerin, alcohol and ether, and but very slightly soluble in water (1 part in 7000 parts of water). Its solubility in water is very much increased by the addition of certain salts, as the potas- sium iodide, sodium chloride, etc. When heated its vapour has a rich violet colour, whence its name (from «<&%, violet). Iodine may be detected in very minute quantity by starch, which produces with it a deep-blue colour ; if in combination, the iodine must be first freed with a little nitric acid, or still better with chromic acid (which may be evolved by the addition of a single drop of very dilute solution of potassium bichro- mate, when starch and nitric acid have been employed ineffect- ually). Chloroform has also been proposed as a test. Physiological Effects. — Iodine is an antiseptic and antizy- motic, and is a protoplasmic poison, killing the lower forms of animal and vegetable life. It acts locally as an irritant; when applied to the skin it stains it yellow, and causes itching, red- ness and desquamation ; and when inhaled in the form of vapour, it excites cough and heat in the air passages. Taken internally, in medicinal doses, it causes a sensation of heat and burning in the stomach, and soon irritates that organ. It is readily absorbed by the mucous membranes generally, and is found in the b]ood principally in combination with the sodium of that fluid ; after absorption it frequently produces a remedial alterative and resolvent effect, without any obvious disturbance of the functions. In a physiological condition patients become thin under its use, though when iodine or the iodides are ad- ministered in syphilis, their alterative action on the nutrition produces emboripoint, due to the elimination of the syphilitic poison which has depressed nutrition and the consequent reac- tion of the system. It excites the secretions generally, increas- ing the flow of urine, slightly relaxing the bowels, often producing a marked irritant effect on the respiratory mucous membrane and salivary glands, and is readily and rapidly 24 370 MATERIA MEDICA — ALTERATIVES. eliminated from the blood, chiefly in the urine, but also by the mucous membranes generally. If administered in too large doses, or to persons of irritable stomach, it produces subacute gastro-enteritis ; and when continued for a long time it will produce gastro-enteric symptoms — headache, giddiness and other evidences of cerebro-spinal disturbance — marasmus — sometimes discoloration of the skin — occasionally salivation — and frequently a wasting of the mammce and testicles. This train of symptoms is termed iodism. In excessive doses it may act as an irritant poison, and has even produced death ; but such a result is rare. Enormous quantities have been taken with very slight effects. The antidote is starch. The absorption of iodine is shown by its presence in the blood and various secretions. Medicinal Uses. — Iodine has been used with success in some cases of vomiting of pregnancy ; a few drops of the tincture may be given for this purpose. It is a most valuable resolvent remedy in chronic visceral and glandular enlargements, indu- rations, thickening of membranes, tumours, etc. It is employed chiefly in bronchocele and scrofula, but it is useful in every variety of chronic tumour and enlargement ; also as an alter- ative in secondary syphilis and other chronic affections. It is highly recommended by the Germans in the treatment of typhoid fever, reducing the temperature and restraining diar- rhoea ; the compound solution or tincture may be given, largely diluted. Recently the value of iodine in malarial fevers has been conclusively shown, generally promptly arresting the attack. The compound tincture should be given in doses of TTjx-xv thrice daily (Dr. Anderson, quoted by Ringer). Its vapour has been inhaled with benefit in chronic bronchitis and phthisis. It is a valuable topical remedy, and is applied in the form of tincture, with the greatest advantage, to enlarged glands (especially when scrofulous), in the various cutaneous affections, lupus, erysipelas, rheumatism, gout, phlegmons, car- buncles, wounds, diseases of joints, poisoned parts, to prevent pitting in small-pox, as a counter-irritant to the chest in phthisis, chronic bronchitis and pleurisy, as an injection in IODINE. 371 hydrocele, in encysted bronchocele, and even into the pleural cavity in chronic pleurisy, etc., etc. The hypodermic injection of iodine may be used with excellent effect in hypertrophied tonsils, goitre, glandular and cystic tumours, etc. The tincture should be deeply injected into the part, and care must be taken not to throw the injection into a vessel. Iodine ranks also among the best of the disinfectants, being available from the ease of its application as well as its ready portability. Administration. — Iodine is rarely exhibited alone, but usu- ally in conjunction with potassium iodide (see p. 372). To avoid gastric irritation, it is best given after a meal, particu- larly when amylaceous substances have been taken, as it forms with them iodized starch. Dose, gr. J-J two or three times daily. Liquor iodi compositus — compound solution of iodine — sometimes known as LugoVs Solution (iodine 5vj, potas- sium iodide ojss, distilled water Oj), is the usual preparation in which iodine is administered internally ; dose, TT|v-xv three times a day, in sweetened water, and gradually increased. The tincture (tinctura iodi) (8 parts to alcohol 92 parts) is of a deep- brown colour, and undergoes a gradual change when kept long ; water precipitates the iodine from it, hence it is little employed internally ; dose, gtt. x-xx, repeated and increased. Exter- nally it is extensively applied to erysipelatous and poisoned parts, chilblains, in cutaneous affections, etc., etc. The com- pound tincture (iodine toss, potassium iodide t§j, alcohol Oj) is not officinal, but has the advantage over the tincture that it may be diluted with water without decomposition ; dose, gtt. xv-xxx. Iodine ointment (unguentum iodi) (made with iodine 4 parts, potassium iodide 1 part, water 2 parts, and benzoinated lard 93 parts) is employed as a local application in goitre, scrofulous tumefactions, etc. Iodine baths have been employed, with iodine and potassium iodide dissolved in water, in a wooden bath-tub, in the proportion of iodine gr. iij and iodide gr. vj to a gallon of water. Iodine is employed in medicine in various chemical combina- tions. The iron, lead and mercurial iodides have been noticed. Iodized starch (cimylum iodatum) has been highly recommended 372 MATERIA MEDICA — ALTERATIVES. as a dressing for syphilitic ulcers, etc. Zinc iodide (see p. 164) is employed as a tonic and astringent. Sulphur iodide (sul- phuris iodidum) is prepared by heating together iodine 4 parts and washed sulphur 1 part ; it is a grayish-black solid sub- stance, of a radiated crystalline appearance, having the smell and taste of iodine, decomposed upon exposure to the air and by boiling water and alcohol, insoluble in water, but soluble in 60 parts of glycerin ; it is used internally in scrofulous and cutaneous affections, in doses of gr. J-j, and externally in tinea capitis, lupus, lepra, acne, etc., in the form of ointment (not officinal) (gr. xxx to lard §j). POTASSII IODIDUM — POTASSIUM IODIDE. This salt is prepared by treating an aqueous solution of potassa with iodine in slight excess. By this process a mixture of iodide potassium and potassium iodate is obtained, and the iodate is afterwards deoxidized and converted into iodide by heat and mixture with powdered charcoal. Potassium iodide (KI) occurs in semi-opaque, white or transparent an- hydrous crystals^ permanent in a dry air, rather deliquescent in a moist one, of an acrid, saline taste, somewhat like that of common salt. It is wholly soluble in water and alcohol, and its aqueous solution dissolves iodine, forming ioduretted potas- sium iodide. It is frequently adulterated with other salts. It is incompatible with ammonium salts, sodium sulphate, nitrate, phosphate and borate, potassium and magnesium sulphates, sp. nitrous ether, soluble lead salts and the mercurials generally ; with potassium chlorate, if a mineral acid be added, a poison- ous potassium iodate is produced. Effects and Uses. — The effects of potassium iodide are analogous to those of iodine, but less energetic. Locally it acts as an irritant, and in large doses sometimes occasions nausea, vomiting, heat of stomach, and purging ; but it may be given in larger doses, and for a longer period, than iodine without causing gastro-enteric derangement. It stimulates the secretions, particularly those from mucous membranes, and AMMONIUM IODIDE. 373 very often produces coryza. Potassium iodide decidedly lessens the secretion of milk, and as it disturbs the function of the gland the relative quantity of the different ingredients fluctuates. Iodine appears in the milk very soon after the first dose of the salt is taken, and disappears as soon as the drug is stopped. It is found in combination with the casein of the milk, but the amount present bears no constant relation to the amount of the salt administered (Dr. Max Stumpf, Deutsches Archiv. fur klinische Med., Jan., 1882, quoted in Bost. Med. and Surg. Jour., Aug. 3, 1882). Its constitutional effects are powerfully alterative and resolvent, and it is employed in bronchocele, scrofula, secondary syphilis and other chronic diseases, par- ticularly those accompanied with enlargements or indurations. It is a most valuable antisyphilitic remedy when the bones and fibrous tissues are affected. In chronic rheumatism and gout, particularly where the fibrous tissues are attacked, it is of great efficacy. As a diuretic in serous effusions it has been found useful ; and in spasmodic asthma it often gives great relief. As an eliminative antidote in mercurial and saturnine poisoning its action has been already noticed. It has been recommended in hydrocephalus ; and has been found to exer- cise a beneficial operation in the treatment of aneurism. Administration. — Dose, gr. v-xv, or even more, three times a day, in solution. Very much larger doses may be required in tertiary syphilis. The compound syrup of sarsaparilla is one of the best vehicles to disguise its unpleasant taste. An ointment (5j with sodium hyposulphite gr. v to lard 5vij, with boiling water f 5ss) is employed for the same purposes as iodine ointment, and does not discolour the skin ; it is, however, of feebler efficacy. Ammonii Iodidum — Ammonium Iodide (NH 4 I) — is made by the double decomposition of potassium iodide and ammoni- um sulphate in hot aqueo-alcoholic solution. It occurs as a white, granular, very deliquescent salt, becoming yellowish- brown by exposure, very soluble in water and alcohol, of a taste like that of potassium iodide, but a little sharper. It has 374 MATERIA MEDICA — ALTERATIVES. been used in the same way as the latter salt. Bartholow recom- mends it highly in catarrhal jaundice after the acute symptoms have subsided (gr. j-iij every two or three hours), and in the early stages of cirrhosis of the liver. It is also very useful in chronic bronchitis, capillary bronchitis and in pneumonia, to promote the absorption of the exudation and prevent it from undergoing caseous degeneration. Sodii Iodidum — Sodium Iodide (Nal) — may be made by the double decomposition of iron iodide and sodium carbonate. It is a soluble, white, crystalline salt, used to fulfill the same indications as potassium iodide, than which it is said to be better borne. IODOFORMUM — IODOFORM. Iodoform is obtained by the action of chlorinated lime upon a heated alcoholic solution of potassium iodide, which yields calcium iodate and iodoform, the latter being separated by the solvent action of boiling alcohol. It is formyl ter- odide (CHI 3 ), and occurs in the form of small scaly yellow crystals, having a saffron-like odour and sweet taste, insoluble in water, but soluble in alcohol, ether, chloroform and the fixed and volatile oils. It is devoid of irritant action, and pro- duces the constitutional effects of iodine, besides an anodyne influence. Two hours after the internal administration of iodo- form, iodine is found in the urine. Large doses produce tetanic convulsions in animals. It has been used internally in syphi- litic rheumatism and various neuralgic affections, and Dr. Tho- mann has employed it with advantage suspended in glycerin as a hypodermic injection in recent syphilis with skin manifes- tations and lymphatic involvement. Dose, 1 to 3 grains three times a day, in pill. In the form of vapour it is said to pos- sess anaesthetic properties, but inferior to those of chloroform. Externally it acts as a powerful local anaesthetic, and has been found a good application to chancres and irritable ulcers, as bed sores ; it is used also to relieve the pain of cancerous sores, and for these purposes it may be dusted over the ulcerated surface, COD-LIVER OIL. 375 which is then to be dressed with glycerin spread upon lint. A saturated solution of iodoform in chloroform is serviceable in relieving the pain of neuralgia and gout ; an iodoform supposi- tory is also useful in painful diseases of the rectum and blad- der. As an antiseptic, Mikulicz (Wiener Med. Worchenschrift, 1881) found iodoform to be equal to carbolic acid, and less apt to produce constitutional disturbance from absorption. Poisoning, however, occurs in rare cases, with symptoms of a narcoto-irritant. As a dressing to open wounds he found it would check profuse discharge, prevent decomposition and stimulate healthy granulations. In treating deep wounds he recommends a pencil composed of iodoform 1 part with oil of theobroma 2 parts. The smell can be overcome by adding oil of bergamot TT[j to iodoform gr. x. In septic, gangrenous or sloughing wounds it forms an excellent dressing, and is very useful in chronic or irritable leg ulcers. In strumous disease it is almost a specific. The ointment consists of iodoform 10 parts rubbed up with benzoinated lard 90 parts. OLEUM MORRHUiE — COD-LIVER OIL. This is a fixed oil obtained from the liver of Gadus morrhua, the common cod — a well-known fish of the northern Atlantic — and also from the livers of several other species of Gadus. It is prepared by subjecting the livers to heat, either in boilers with water or by means of steam externally applied, and afterwards draining off the liquid portion, from which the oil separates on standing. It is said to be sometimes procured also by expression. Three varieties are known, the white or pale-yellow, the brownish-yellow, and the dark-brown. They differ chiefly in the mode of preparation — the pale being pre- pared from fresh livers, the dark-brown from those' which are collected at sea and have undergone putrefactive decomposi- tion, and the brownish-yellow from those in which putrefaction has only partially commenced. The pale oil is the purest : the dark oil is the most offensive to the taste and smell, and the least acceptable to the stomach. 376 MATERIA MEDICA — ALTERATIVES. Cod-liver oil is of the consistence of lamp-oil, and has a pe- culiar odour, resembling that of shoe-leather — which is usually prepared in the United States with this oil — and a fishy-acrid taste. These sensible properties are probably the best tests of the genuineness of the oil, and it should be rejected if the smell and taste of shoe-leather are wanting, or if those of lamp-oil or fish-oil are very perceptible. The sp. gr. of the best oil is about 0-920. The oil undergoes a gradual change from ex- posure to the air, and should therefore be kept in full and well- stoppered bottles. It is scarcely soluble in water, somewhat so in alcohol, readily soluble in ether, chloroform and glycerin. It contains a great variety of chemical constituents, the most important of which are fatty acids, several biliary 'principles, a peculiar brown substance called gaduin (which is not, however, supposed to be the active ingredient), iodine, chlorine and traces of bromine. Cod-liver oil may be distinguished from other oils by the agency of sulphuric acid, a drop of which, when added to fresh cod-liver oil, on a porcelain plate, causes a centrifugal move- ment in the oil, and gives rise to a fine violet colour^ soon passing into yellowish or brownish-red. This reaction is at- tributable, however, to the bile contained in the oil. By re- action with ammonia, in distillation, the peculiar volatile prin- ciple trimethylamia * (the odorous principle of pickled herring) is developed. Physiological Effects. — Cod-liver oil, like all fats, is appro- priated in the small intestine, and not in the stomach. Its prolonged use, in doses which allow it to be retained by the * Trimethylamia (C 3 H 9 N), made from herring pickle, is a colourless liquid, of a strong fishy odour and a disagreeable, acrid taste, freely soluble in alcohol, ether and water. It is a powerful irritant and even caustic. Taken internally, it depresses the action of the heart and temperature of the body, and is said to diminish the amount of urea excreted. It has been used with success in the treatment of acute rheumatism and gout, in the dose of 2 to 4 drops every two hours, in some aromatic water : overdoses will produce decided gastro-intestinal irritation. The chloride, which is a deliquescent salt, crystallizing in long needles, is less irritant and a better preparation ; dose, gr. ij-v every two or three hours. COD-LIVER OIL. 377 digestive tube, produces very marked beneficial effects in a wide range of chronic diseases, dependent on a vitiated con- dition of the functions of digestion, assimilation and nutrition. Its modus medendi is not well understood, some therapeutists believing it to act merely as a nutritive agent, valuable from the readiness with which it is assimilated ; others attributing its curative powers to an alterative action from the iodine and bromine or other principles which it contains. Its effects are, however, probably due merely to its nutrient action, in sup- plying a sufficiency of molecular base for interstitial growth. The biliary principles which it contains promote its absorption and appropriation by the system. The most striking feature of its action on the economy is increase of weight ; and usually, where it fails to increase the weight, it is of little service. It is believed, also, to diminish the formation of uric acid in the system, and hence may be useful in gout. In large doses, cod-liver oil produces nausea and diarrhoea, and these effects occasionally follow the use of medicinal doses. Medicinal Uses. — Cod-liver oil has long been known as a remedy in rheumatic diseases ; and within the last forty years it has come into extensive use as an alterative in tuberculous and scrofulous affections. In the treatment of phthisis pul- monalis it is now looked upon, in Great Britain and the United States, as superior to any other agent, and as possessing an undoubted power of arresting the progress of both the general and the local symptoms of this disease. Although efficacious in all the stages of phthisis, its value is most conspicuous in the earlier stages, especially before the formation of true tubercles. Over the different forms of scrofula it exercises also a very decided control — particularly glandular enlarge- ments, ulcers, diseases of the joints and spine, ophthalmia, etc. In the various cutaneous affections, tertiary syphilis, chronic rheumatism and gout, and the entire circle of chronic disorders in which there is a tendency to marasmus, and where the nutrition is defective, cod-liver oil is employed with benefit. Its good effects are most conspicuous in proportion to the youth of the patient. 378 MATERIA MEDICA — ALTERATIVES. Administration. — Dose, a tablespoonful two or three times a day ; though, if unacceptable to the stomach, it is best to begin with smaller, as teaspoonful doses. The addition of a little ether (as from 12 to 20 drops to a teaspoonful of oil) promotes its digestion. It must be persevered with for a long time before its good effects appear. It is best given in some aro- matic water, or a little ardent spirit, or the froth of porter ; and it may be rendered more agreeable to the stomach by combination with one of the mineral acids. The union of the oil with lime-water, just enough to form a soap, often renders it acceptable to delicate stomachs, and it may be flavoured with oil of bitter almond. If it produce diarrhoea, astringents should be administered with it. It is used as a clyster in cases of ascarides and lumbricoides ; and externally, in cuta- neous affections and opacity of the cornea. Phosphorated cod- liver oil is made by the direct addition of phosphorated oil (see p. 203) to the amount of cod-liver oil required to furnish the desired strength of phosphorus. ARSE Nil PR^EPARATA — -PREPARATIONS OF ARSENIC. Metallic arsenic is inert, though when swallowed it may prove powerfully poisonous by becoming oxidized and con- verted into arsenious acid. It is not used in medicine. Acidum Arseniosum [Arsenious Acid) (As 2 3 ), sometimes called ivliite arsenic, arsenic oxide or arsenic, is obtained prin- cipally as a secondary product in the roasting of cobalt ores (the cobalt arsenides) in Saxony and Bohemia. It is after- wards purified by sublimation ; and when recently prepared, occurs in glassy, colourless, transparent masses of a vitreous fracture, which gradually becomes white and opaque, progress- ively from the surface inwards. It is kept sometimes in the shops in the form of a fine white powder ; but in this state it is liable to adulteration with chalk or calcium sulphate, and it should therefore be always purchased in masses. It is entirely volatilized by heat, at a temperature not exceeding 400° ; has PREPARATIONS OF ARSEXIC. 379 no smell and little or no taste; is soluble in water (more readily when transparent than opaque), and also in alcohol and oils. Cold water dissolves from y^j-g-th to ^-g^th part of its weight of arsenious acid, or about gr. ss to f §j. If boiled for a short time with water, about H V tQ P art ^^ De dissolved ; if boiled for an hour, J^-th part will be dissolved, or about gr. xij to f 5j. Tests. — Owing to the frequent use of arsenious acid as a poison, a knowledge of the means of detecting its presence is of great importance. In the solid state it may be recognized in the first place by its volatility (heated- over a spirit-lamp, it passes off as a white, inodorous vapour, and is deposited on a cool surface as an amorphous powder or in octahedral crystals) ; secondly, when thrown on burning charcoal it is deoxidized, and gives out the garlicky odour of metallic arsenic ; and thirdly, if heated in a glass tube with charcoal or black flux, it sublimes and condenses in the form of a brilliant steel-gray ring or mirror. In aqueous solution arsenious acid may be detected by the following reagents : sulphuretted hydrogen or ammonium sulphide produces a lemon or sulphur -yellow arsenic trisulphide, which may be distinguished from antimonial and stannic sulphides by being soluble in a solution of ammonium carbonate and insoluble in diluted hydrochloric acid ; the addi- tion first of ammonia and then of silver nitrate produces a canary-yellow silver arsenite ; and the addition of ammonia and then of cwpric sulphate produces an apple or grass-green cupric arsenite ; 100 grains boiled with diluted hydrochloric acid, and then treated with sulphuretted hydrogen, yield a de- posit of arsenic trisulphide weighing 124 grains. The arsenic trisulphide may be reduced and made to yield metallic arsenic, if heated with soda flux or potash flux. The most delicate test, however, of arsenious acid in solution is that of nascent hydro- gen, termed Marsh's test. When the acid is submitted to the action of nascent hydrogen (evolved by the action of diluted sulphuric acid on pure zinc), it is deoxidized, and unites with the . hydrogen to form arseniuretted hydrogen gas. This gas has a garlicky odour, and is recognized by its burning with a bluish- white flame which deposits on a plate of cold glass or porcelain, 380 MATERIA MEDICA — ALTERATIVES. held over the jet, a lustrous steel-gray or brownish-black spot or mirror of metallic arsenic, surrounded by a faint white ring of arsenious acid ; the metallic spot deposited is distinguishable from antimony, obtained by a similar process, by the addition of a drop or two of fuming nitric acid, with heat, which dis- solves both metals, the solutions yielding on evaporation white residues, but the arsenical residue, touched with a drop of strong solution of silver nitrate, assumes a brick-red colour, while the antimonial residue remains unchanged ; and also the arsenic can be dissolved by a solution of sodium or calcium hypochlorite, which does not affect antimony. Another test is that of Reinsch, and consists in boiling a solution of the acid with hydrochloric acid and copper-foil or wire, when the latter acquires a steel-gray coating of metallic arsenic, passing as it increases into black. When arsenious acid is dissolved with liquid organic substances, it should first be separated from in- soluble matters by filtration, and the metallic arsenic may be then obtained by Reinsch' s 'process, and the liquid or sublim- ing tests afterwards applied. If the poison be mixed with solid organic substances, they should be cut up and boiled with "water acidulated with hydrochloric acid, and the solution afterwards filtered and again boiled, etc. Physiological Effects. — Arsenious acid acts locally as an escharotic by destroying the vitality of the parts to which it is applied. In medicinal doses it stimulates the digestive and nutritive functions, as is shown by the well-known results of arsenic-eating among the peasantry of Austria. Its physio- logical effects are not, at first, very obvious. When continued for some time, it generally produces more or less heat and dry- ness of the throat and stomach, with nausea, increased secre- tion from the bowels and kidneys, irritation of the conjunctival and nasal mucous membranes, and a peculiar swelling of the face termed oedema arsenicalis ; after the latter symptom ap- pears, the medicine should be suspended. No matter how administered, or by what channel it enters the system, arsenic- shows a marked selective affinity for the gastro-intestinal and mucous tracts. Small doses increase the cardiac action and PREPARATIONS OF ARSENIC. 3«1 the activity of the capillary circulation ; large doses cause pal- pitation, small, quick and irregular pulse, with flushed face and cold extremities; poisonous doses depress the circulation and (in the lower animals) paralyze the heart in diastole. Arsenic, if too long continued or given in an excessive dose, decreases the number of globules in the blood, decomposes the haemoglobin and renders it less coagulable (Brodie, quoted by Phillips). Small doses stimulate, while larger doses depress, both the respiratory centre and the pulmonary end-organs of the pneumogastric. At first the urine is increased, but if the drug be continued it is diminished, and may be bloody or albu- minous. In too long -continued or too large medicinal doses. arsenious acid sometimes produces a sort of chronic poisoning, characterized by disorder of the digestive apparatus, conjunc- tivitis, oedema, salivation, a cutaneous eruption, loss of the hair and nails, paralysis, convulsions, and, if its use be perse- vered in, coma and delirium may result, terminating in death. In excessive doses arsenious acid is a violent poison, usually destroying life by gastro-enteritis, in from one to two or three days. When very large quantities are taken, it sometimes acts on the cerebro-spinal system, producing death by narcotism in a few hours. Occasionally gastroenteric and cerebro-spinal symptoms both occur. Two grains of arsenious acid have proved fatal, though much larger amounts have been taken with impunity ; very large quantities often cause emesis, which removes the poison from the stomach. Dissections in cases of poisoning from this agent reveal red- ness (sometimes accompanied with extravasations of blood), ulceration, softening, effusion of lymph, and even gangrene, in the alimentary canal. Congestions of the broncho-pulmo- nary mucous membrane and of the lungs themselves are often observed, and acute fatty degeneration of the liver, spleen, kid- neys, etc., is often seen, even when the poisoning has existed for a few hours only. The blood is often fluid and dark- coloured. The absorption of arsenious acid into the system, after its administration, is shown by its presence in the blood, viscera, bile, urine, etc., a few minutes after it has been taken. 382 MATERIA MEDICA — ALTERATIVES. It is rapidly eliminated by the urine, and also by the bile, and even the skin, tears and saliva. After it has ceased to appear in the excretions, the administration of potassium iodide will cause it to reappear, showing that a part of it remains deposited in the tissues. Recently arsenic has been found to be deposited in the nervous system : thus, if in fresh muscle 1 part is found, the proportion in liver is 10*8 ; in brain, 36*5 ; in spinal cord, 37*3 (ScolosubofF, Annales d'Hygiene, Jan. 1876, quoted by Phillips). Antidotes and Treatment in cases of Poisoning. — The evac- uation of the contents of the stomach by emetics or by the stomach-pump, if seen very soon after swallowing the poison, should be the first object in these cases. Demulcent drinks are to be also freely given. The hydrated oxide of iron should be administered, as soon as it can be procured, in the state of pulp or magma. It is prepared by the action of an alkaline solution on a ferric salt. Water of ammonia is directed by the U. S. Pharmacopoeia to be added to a solution of the tersulphate of iron (see p. 152). The hydrated oxide of iron is a soft, moist, reddish-brown magma, which acts as an antidote to arsenious acid by forming with it an insoluble, inert ferrous arseniate (Fe 3 2As0 4 ). The dose is about twelve times the supposed amount of poison taken, and it should be given in the fresh and pulpy state, as it gradually loses its antidotical virtues when kept. The hydrated oxide of iron with magnesia is also directed to be kept in the shops as an antidote to arsenic. It should be administered in the same manner as the hydrated oxide of iron, and possesses the advantage of a tendency to act on the bowels. The subcarbonate of iron also acts as an anti- dote, but this is much less powerful than the pulpy hydrate. Light magnesia (which has not been too strongly calcined) and freshly-precipitated gelatinous magnesia may be also used as antidotes. The after-treatment consists in the use of de- mulcents, opiates, and, if necessary, stimulants. Medicinal Uses. — Arsenious acid is a very valuable alter- ative remedy, but it must be exhibited with caution. It is em- ployed with the greatest success in the treatment of miasmatic PREPARATIONS OF ARSENIC. 383 affections, as intermittent fevers, especially such as have resisted the use of cinchona, or have frequently reappeared; in chronic cutaneous affections, particularly the scaly diseases (lepra, eczema squamosum, psoriasis and pityriasis), but it should not be given while any acute inflammatory symptoms are pres- ent, or where there is much itching, burning or heat of skin, as under these circumstances it is apt to increase the affection. It is used also in certain affections of the nervous system, chorea in particular, over which it exercises a marked control ; in chronic rheumatism, in phthisis, in the tertiary forms of syphilis, in irritable dyspepsia, gastric ulcer, diarrhoea, bronchitis, and as a tonic generally. As an external application, arsenious acid has been applied to indolent sinuses, lupus, onychia maligna, etc., either pure or mixed with several parts of sulphur; its use is, however, attended with danger of constitutional effects. It is an ingredient of various empirical compounds employed in the treatment of cancer. Administration. — Dose, gr. y 1 ^ to yV, in pills with bread- crumb, three times a day, to be reduced when conjunctivitis appears, and suspended after the establishment of the oedema arsenicalis ; and after being taken a fortnight, it should always be intermitted for a day or two. It is less apt to occasion gas- tric irritability when given immediately after a meal. The usual and safer form of exhibiting this remedy is that of solu- tion with potash. Liquor Potassii Arsenitis (Solution of Potassium Ar- senite), or Fowler s Solution. This is prepared by boiling 1 part of arsenious acid and potassium bicarbonate, each, in 10 parts of distilled water, 3 parts of compound spirit of lavender, and afterwards water enough to make the solution weigh 100 parts. It is a transparent liquid, of an alkaline reaction, and has the colour, taste and smell of spirit of lavender. It is a solution of the potassium arsenite (HK 2 As0 3 ), and is decom- posed by the reagents which act upon arsenic, and is incom- patible with infusions and decoctions of cinchona. Its effects and uses are analogous to those of arsenious acid, though some practitioners have denied their therapeutic identity. The treat- 384 MATERIA MEDICA — ALTERATIVES. . went in acute poisoning is the same as that for arsenious acid. Dose, gtt. v to gtt. x, and even gtt. xx, three times a day. Each fluidrachm contains arsenious acid gr. -f^. Sodii Arsenias (Sodium Arseniate) is made by melting together arsenious acid, sodium nitrate and sodium carbonate, then dissolving the fused salt in boiling water, and afterwards crystallizing. In this process the arsenious acid is oxidized into arsenic acid by the nitric acid of the sodium nitrate, and then combines with the soda of both salts to form colourless transparent prismatic crystals (Na 2 HAs0 4 ,7H 2 0), slightly efflorescent, very soluble in water, of a somewhat saline, slightly acrimonious taste. This salt is employed to fulfill the thera- peutic indications of the other arsenical preparations, and has the advantage of a somewhat milder local action. Dose, gr. y S -J. It is prescribed sometimes externally in the form of baths, in chronic nodose rheumatism and gout, 5ss-3ij or 5iij in each bath. It is generally used internally in the form of Liquor Sodii Arseniatis (Solution of Sodium Arseniate), made by dissolving 1 part of sodium arseniate (rendered an- hydrous at a heat not exceeding 300°) in 100 parts of distilled water; dose, gtt. x-xx. Cigarettes made of paper saturated with a solution, two or three times the officinal strength, are smoked in asthma. Liquor Acidi Arseniosi (Solution of Arsenious Acid) (formerly called solution of arsenic chloride) (AsCl 3 ) is made by boiling 1 part of arsenious acid with 2 parts of muriatic acid and 25 parts of distilled water, until the acid is dissolved, and adding to the solution, when cold, water enough to make it weigh 100 parts. Dose, the same as that of Fowler's Solu- tion, than which it is thought to be less apt to disturb the stomach. Arsenii Iodidum (Arsenic Iodide) (Asl 3 ), made by rubbing 5 parts of iodine and 1 part of arsenic together, is an orange-red crystalline, volatilizable solid, wholly soluble in water, and has been used both internally and externally in skin diseases. Dose, gr. \ three times a day ; for external use, gr. iij to lard 5J. DILUTED PHOSPHORIC ACID. 385 Liquor Arsenii et Hydrargyri Iodidi [Solution of Ar- senic arid Mercuric Iodide). This solution, known as Dono- van s Solution, is prepared by dissolving 1 part of arsenic iodide and mercuric iodide, each, in enough distilled water to make the solution weigh 100 parts. It is merely an aqueous solution of the two iodides (Asl 3 and Hgl 2 ). It has a pale- yellow colour, a slightly styptic taste, and is incompatible with the salts of morphia. Effects and Uses. — This is a highly valuable alterative prep- aration in the various forms of papular and scaly cutaneous affections and in obstinate syphilis. It was introduced by Mr. Donovan, of Dublin, in 1839, and has been a good deal em- ployed in the United States. Dose, gtt. v to gtt. xx or more three times a day. ACIDUM PHOSPHORICUM DILUTUM — DILUTED PHOS- PHORIC ACID. The diluted acid is the only form in which phosphoric acid is employed internally. It is prepared by adding 20 parts of phosphoric acid (previously prepared by boiling phosphorus in nitric acid and water and driving off the nitrous compounds by heat, and contains 50 per cent, each of orthophosphoric acid (H 3 P0 4 ) and distilled water), to 80 parts of distilled water. It is a colourless, syrupy liquid, without smell, but having a sour taste, and contains 10 per cent, of orthophosphoric acid. Effects and Uses. — In its effects diluted phosphoric acid re- sembles the mineral acids (vide p. 168, et seq.), especially sul- phuric acid, but is less irritant to the stomach. Moderate doses stimulate the circulation and improve digestion, while large doses depress the circulation and are capable of causing gastro- enteritis. It has been used as a tonic and alterative in scrofu- lous affections and rachitis, but in the latter disease the phosphates are justly preferred. It may be used in dyspepsia. It is an excellent adjuvant to cough mixtures. As it contains no free phosphorus, it should not be given to produce the medicinal effects of that drug (Farquharson). Dose, TTLx-xxx, diluted. 25 386 MATERIA MEDICA — ALTERATIVES. GALCII PHOSPHAS P R JECI P IT AT U S — PRECIPITATED CALCIUM PHOSPHATE. This salt is made by reacting upon bone-ash with hydro- chloric acid, which dissolves the calcium phosphate in the bones, and gives it up again on the addition of water of am- monia. It is a white, inodorous, tasteless, insoluble powder, sometimes called the bone phosphate of calcium (Ca 3 2P0 4 ). It is an important and valuable medicine, not only in diseases of deficient ossification, as ununited fractures, caries of the bones, rickets, etc., but in all conditions of defective cell-growth and malnutrition, from its undoubted influence in promoting natural cell-growth and nutrition. Thus it is employed (often in connection with other phosphates, as those of iron, sodium and potassium) in scrofula, phthisis, anaemia, diarrhoea, chronic bronchitis, abscesses, and wasting diseases of every kind. On account of its insolubility it is apt to form intestinal concre- tions. Dose, 5 to 10 grains, and it may be well given dusted into a little milk. A better (because more soluble) preparation is the syrup of calcium lacto-phosphate (syrupus calcii lacto-phosphatis), containing lactic acid, calcium phosphate, orange-flower water, sugar, hydrochloric acid, ammonia water and water. An emulsion containing 50 per cent, of cod-liver oil with syrup of lacto-phosphate is an excellent preparation ; dose, a teaspoonful to a tablespoonful. CALCII HYPOPHOSPHIS — CALCIUM H YP PHO SPHITE. This salt is prepared by boiling phosphorus in a mixture of calcium hydrate in boiling water; phosphoretted hydrogen escapes, and calcium phosphate and hypophosphite are formed in the liquid, from which the insoluble phosphate and resid- uary lime are separated by filtration, and the hypophosphite (CaH 4 2P0 2 ) is afterwards crystallized out in the form of white, pearly crystals, of a nauseous, bitter taste, soluble in 6 parts of water, and insoluble in alcohol. All the soluble sulphates and carbonates produce precipitates with this salt. calcium hypophosphite. 387 Potassii Hypophosphis — Potassium Hypophosphite (KH 2 P0 2 ) — is prepared by mixing solutions of calcium hypo- phosphite and potassium carbonate. It occurs in white, opaque, confused crystalline masses, having a disagreeable, bitter taste, very deliquescent and very soluble in water and alcohol, but insoluble in ether. Sodii Hypophosphis — Sodium Hypophosphite (NaH 2 P0 2 H 2 0)— is prepared by mixing solutions of calcium hypophosphite and crystallized sodium carbonate, and crystallizes in white tables of a pearly lustre, very deliquescent (but less so than potassium hypophosphite), very soluble in water and alcohol, and insoluble in ether. The hypophosphites have been lately introduced in the treat- ment of phthisis under an impression that they prove useful by furnishing phosphorus to the tissues. They more probably act by stimulating cell-growth and nutrition, and may be given to fulfill the same indications as the precipitated calcium phosphate. The soluble salts of mercury and silver are incompatible with them. Dose, 10 to 30 grains three times a clay. The calcium hypophosphite is the most eligible salt, but they are often given together in the form of syrup. Syrupus Hypophosphitum — Syrup of Hypophosphites — consists of calcium hypophosphite 35 parts, sodium and potas- sium hypophosphites each 12 parts, dissolved in water by the aid of citric acid 1 part, and flavoured with spirit of lemon 2 parts and sugar 500 parts ; the whole to weigh 1000 parts. It is a good preparation to fulfill the indications of the hypophos- phites. Dose, f 5j-ij. Syrupus Hypophosphitum cum Ferro — Syrup of Hypo- phosphites with Iron — contains ferrous lactate 1 part, dis- solved in syrup of hypophosphites 100 parts. It is used for the same purposes and in the same doses as the last prep- aration. Ferric hypophosphite was noticed with c'l (see p. 157). 388 MATERIA MEDICA — ALTERATIVES. CALCII CHLORIDUM — CALCIUM CHLORIDE. This salt (CaC0 2 ) is prepared by neutralizing hydrochloric acid with chalk or white marble, and adding a little chlorinated lime and slacked lime. It is a colourless, translucent salt, very deliquescent, readily soluble in both water and alcohol. It should not be confounded with chlorinated lime, which is also sometimes called "chloride of calcium." It resembles the cal- cium preparations generally in its effects, and is highly recom- mended in all strumous affections of children, as glandular enlargements, colliquative diarrhoea, etc. It is also given with benefit in wasting diseases generally and in consumption. Dose, gr. v-xx. AMMONII CHLORIDUM — AMMONIUM CHLORIDE. This salt, formerly termed muriate of ammonia, and often known as sal ammoniac, is obtained from the gas-liquor of coal gas works (usually by neutralizing the ammonia with hydro- chloric acid), and also in the preparation of animal charcoal from bones. It is brought in the crude state from Calcutta, for use in the arts, and in the refined state, for medicinal employment, from England. It occurs in white, translucent, tough, fibrous, hemispherical, convex-concave cakes (NH 4 C1), about two inches thick, difficult to powder, inodorous, of a pun- gent, saline taste, slightly deliquescent, very soluble in water, and less so in alcohol. For medicinal use it is purified by the addition of water of ammonia to a solution of chloride, and occurs as a snow-white crystalline powder, soluble in 2J parts of cold and in its own weight of boiling water, and soluble also in alcohol. Effects and Uses. — The physiological effects of the ammo- nium salts have been considered under the head of Ammonia Preparations (vide p. 199). The local action of ammonium chloride is that of an irritant. In large doses it purges. In small doses, after absorption, it proves a powerful resolvent alterative, diminishing the solid constituents of the blood, with AMMONIUM PHOSPHATE. 389 an increased flow of the secretions generally; it has an especial action upon the mucous membranes, promoting nutritive changes and epithelial exfoliation. Under its use the solids of the urine are increased, except uric acid, which is slightly diminished. Even in very large amounts it is not considered poisonous. It is not much employed in Great Britain or the United States, but is extensively used in Germany as a refrigerant in mild fevers attended with stoppage of the secretions ; as a resolvent in organic enlargements ; in amenorrhoea, and in catarrhs, urethritis, etc. It is also used in bronchitis and pneumonia as an expectorant. Of late this salt has been used with advantage in muscular rheumatism and in neuralgia ; and its resolvent powers are highly spoken of in fibroid tumours of the uterus. It has been highly recommended in torpidity of the liver, chronic hepatitis, etc., but according to experiments by Rutherford and Vignal it does not increase the secretion of bile, although they found it stimulated the intestinal glands. Dose, gr. v-xxx every two or three hours, in powder or mu- cilaginous solution. Externally it is used in solution (imme- diately upon being dissolved) as a refrigerant lotion (§i to half a pint of water), in cutaneous affections and indolent ulcers (5i to half a pint of water), and also as a discutient and vul- nerary. Troches of ammonium chloride each contain ammo- nium chloride gr. ij with sugar, tragacanth and syrup of tolu. AM MO Nil PHOSPHAS — AMMONIUM PHOSPHATE. This salt enjoys considerable reputation as an alterative. It is made by adding stronger water of ammonia to diluted phos- phoric acid, evaporating and crystallizing ([NH 4 ] 2 HP0 5 ). It occurs in transparent, colourless crystals, having the form of six-sided tables, of an alkaline, somewhat saline taste, soluble in water, and insoluble in alcohol. As usually found in the shops it is a mixture of the neutral and of the acid ammonium phosphate. Effects and Uses. — It has been used in this country as a remedy in gout and rheumatism, and is highly esteemed. In 390 MATERIA MEDICA — ALTERATIVES. combination with ammonium carbonate and aromatic spirit of ammonia, it has been also used with advantage in diabetes. Dose, gr. x-xl three or four times a day, dissolved in an aro- matic water. POTASSII CHLORAS — POTASSIUM CHLORATE. This salt is prepared by various processes : a good one is by reacting upon solution of caustic potassa, mixed with lime, with a stream of chlorine ; the chlorine is converted into chloric acid by oxygen from the lime, and the acid combines with the potassium to form potassium chlorate (KC10 3 ). It is a white, anhydrous salt, crystallizing in rhomboidal plates of a pearly lustre, and is inodorous, and of a cool, saline taste. It is but little changed by exposure to the air ; is soluble in 16 parts of cold water or 2 parts of boiling water. It is said to be solu- ble in all the animal fluids without decomposing them or under- going change itself. Effects and 'Uses. — In its effects potassium chlorate resem- bles the other potassium salts (vide p. 233), especially the nitrate. Potassium chlorate, when taken internally for some time, gives a bright arterial tinge to the venous blood, reduces the volume and frequency of the pulse, and largely increases the secretion of urine, by which it passes out of the system un- changed. It has been pointed out by Dr. Jacobi that when given for some time this salt produces irritation of the kidneys and finally chronic tubal nephritis. The appetite is improved under its use, and salivation is an occasional effect. Large doses may be taken with impunity, but excessive quantities are said to have produced fatal gastro-enteric imflammation. Fatal cases of poisoning from this salt have been reported, ap- parently from blood poisoning, the heart and large vessels having been found filled with coagula. As it contains a large supply of oxygen, it was at first employed with a view to its oxidizing influence in contaminated conditions of the blood, as in malignant fevers, syphilis, etc. ; and whatever the modus medendi, it is still considered a valuable alterative in typhus, POTASSIUM BICHROMATE. 391 scarlatina, etc. Probably its most positive remedial effects are seen in various forms of stomatitis, follicular, mercurial and gangrenous. It is used also in diphtheria, croup, cyanosis, asthma and even neuralgia. Externally, in solution, it is an admirable wash or gargle in stomatitis, ozoena, the sore throat of scarlatina, subacute and chronic pharyngitis, diphtheria, and fetid, ulcerated surfaces generally ; mixed with sugar, the powder is an excellent application in the aphthous sore mouth of children. Dose, internally, fifteen to thirty grains every three or four hours, in some pleasant vehicle. Troches of po- tassium chlorate (trochisci potassii chloratis) are made by rub- bing together potassium chlorate, sugar, tragacanth, spirit of lemon and with water forming a mass ; each troche contains 5 grains of potassium chlorate. For external use, 5y-iv may be dissolved in half a pint of water. POTASSII BICHROMAS — POTASSIUM BICHROMATE. The chief ore from which salts containing chromium are obtained is chrome ironstone, found in Sweden and in south- eastern Pennsylvania. By roasting the powdered ore with potassium carbonate and nitre, the (yellow) potassium chromate is obtained, and by acidulating a solution of this with sul- phuric acid, the (red) bichromate is formed (K 2 Cr 2 7 ) ; it sep- arates in orange-red, anhydrous, tabular crystals, soluble in water, insoluble in alcohol, and of a cooling, bitter taste. Effects and Uses. — It is an irritant caustic, acting in over- doses as a corrosive poison, for which the proper antidotes are magnesia, soap and the alkaline carbonates. In small doses it is alterative, and has been used in syphilis with encouraging- results. In large doses it is emetic. Externally it is a good application, in powder or in saturated solution, to syphilitic warts, excrescences, etc. Dose, as an alterative, gr. J daily, in pill, with some bitter extract ; as an emetic, gr. j. 392 MATERIA MEDICA — ANTACIDS. ORDER III. — ANTACIDS. Antacids are medicinal agents employed to neutralize acids in the blood, primse vise and secretions. The alkalies and alkaline earths and their carbonates are the substances in- cluded in this division. The alkalies, in the concentrated state, destroy organization and act as corrosive poisons ; they are administered internally only in a state of extreme dilution. The alkaline carbonates produce a less intense chemical action on the tissues than the alkalies ; and the bicarbonates are less active than the monocarbonates. The alkaline earths, par- ticularly magnesia, are less energetic in their local action than the alkalies proper ; and their carbonates manifest little or no- chemical influence upon the tissues. When swallowed in a state of dilution, the alkaline prepara- tions combine with the free acids which they encounter in the stomach. The salts which are thus formed, unless carried off by the bowels, are absorbed into the blood, and are thrown out by the secretions, especially by the kidneys. It must be re- membered that, as already stated (vide p. 233), alkalies in- crease acid and diminish alkaline secretions, when in contact with the orifices of the glands which secrete them. In like manner, acids increase alkaline and diminish acid secretions (Ringer) (vide p. 238). While in the intestines, besides neu- tralizing acids, the alkalies also promote the digestion and absorption of fatty substances, by forming with them an emul- sion. After absorption they exert a liquefacient action on the blood, and render the urine alkaline. Their long-continued use disorders the functions of digestion and nutrition, produces a chronic deterioration of the blood, and sets up a cachectic condition somewhat analogous to scurvy. In the concentrated form the alkalies are employed as es- eharotics. The various alkaline preparations are administered, internally ', in the diluted form — 1. As antacids, in dyspepsia accompanied with excess of acid in the primae vise, and they are probably also of advantage in dyspeptic cases, by pro- moting the digestion of fatty matters. As dyspepsia with ANTACIDS. 393 acidity probably depends frequently on fermentation of the ingesta, due to deficient secretion of acid gastric juice, the administration of alkalies would prove of advantage, not by neutralizing the acid in the stomach, but by correcting the deficiency of the secretion on which the dyspepsia depends (H. M.). If the condition, on the other hand, depends on a profuse secretion of acid, then the administration of alkalies can do nothing more than palliate, by neutralizing, the excessive acid- ity. When alkalies are given before meals, they will increase the acid secretion of the gastric mucous membrane ; given after meals they neutralize the excess of acid. Acids given before meals decrease the amount of acid secreted by the stomach : while, if given after meals, they will supply the place of the acid of the gastric juice, should there be a deficiency in that secretion. The vegetable tonics and aromatics are frequently combined with antacids, very advantageously, in the treatment of dyspepsia. 2. To relieve irritability of the stomach and check vomiting. 3. As antidotes in cases of poisoning from acids. 4. As antilithics, to neutralize lithic acid when it is separated in undue quantity by the urine ; and also as lith- ontriptics, or solvents of calculi, especially lithates. They are improper when there is a tendency to the deposition of phos- phates ; and in treating cases of uric acid deposit it is un- necessary to render the urine more than neutral, as, if it be made alkaline, the phosphates formed may be deposited round the uric acid calculi. 5. In the treatment of acute rheumatism and gout, where they act by neutralizing the excess of acid with which the blood is charged in these diseases. 6. To re- lieve irritability of the urinary organs — ardor urinse in gonor- rhoea — cutaneous irritation — uterine irritation — pruritus ani, etc. — especially when these conditions of irritability are depend- ent, as is often the case, on excess of acid in the system. 7. As diuretics (see p. 319). 8. As antiplastics and resolvents, in in- flammation. And, 9. By many therapeutists, in diabetes mellitus. The antacid preparations should be administered in a state of large dilution, with a view to facilitate their absorption, and to prevent an irritant and purgative action on the bowels. 394 MATERIA MEDICA — ANTACIDS. POTASSII PRil PAR AT A — POTASSIUM PREPARATIONS. The preparations of potassium employed as antacids are the Solution of Potassa, Potassium Carbonate and Pota^ iurri Bi- carbonate. The general effects of the potassium preparations are those previously described (vide p. 233). They increase both the solid and watery portions of the urine, and in large doses ren- der it alkaline. Under their use, however, the uric acid, either free or combined, is greatly diminished, and, it is asserted, is converted into oxaluric acid, which is metamorphosed into oxalic acid and urea. Liquor Potassa (Solution of Potassa) is prepared by the action of lime on a solution of potassium bicarbonate; the lime abstracts carbonic acid from the bicarbonate, and precipitates as calcium carbonate, leaving the potassium hydrate in solu- tion ; or it may be made, more directly, by dissolving potassa, 56 parts, in distilled water, 944 parts. Solution of potassa is a limpid, colourless liquid, without smell, of a very acrid, caus- tic taste, an alkaline reaction, and imparts a soapy feeling to the fingers when rubbed with it; sp.gr. 1*036; it contains 5 per cent, of potassium hydrate (KHO). Effects and Uses. — The antacid, diuretic, antilithic and re- solvent properties and indications of this preparation have been described above. It is more irritant to the stomach than the potassium carbonates, and is therefore less eligible for pro- tracted use. In excessive quantity it may act as an irritant and corrosive poison ; oils and vegetable acids should be ad- ministered as antidotes. Dose, gtt. x-xx, largely diluted with sweetened water or mucilage. Externally it is used in a diluted state as a stimulant lotion. Potassii Carbonas (Potassium Carbonate — Potassii Car- bonas Pura, U. S. P. 1870, commonly called Salt of Tartar). This salt is prepared by calcining potassium bicarbonate, which is thus deprived of a molecule of carbonic acid and reduced to the state of carbonate (2KHC03=H 2 C0 3 +K 2 C0 3 ). Potas- sium carbonate occurs in the form of a white, coarse, granular SODIUM PREPARATIONS. 395 powder, cf a nauseous, alkaline taste and an alkaline reac- tion, veiy soluble in water, but insoluble in alcohol. It is very delitescent, forming, if long exposed to the air, an oily liquid wiv-h. the water which it attracts. Acids, acidulous salts and nauj other substances are incompatible with it. It is employed as an antacid, antiplastic, diuretic, antilithic, etc.. in the dose of gr. x-xx, in some sweetened aromatic water. It h'as been found specially useful in torpor of the liver and in whooping-cough. In large quantities it acts as a corrosive poison, for which oils and vegetable acids are the antidotes. Potassii Bicarbonas (Potassium Bicarbonate) is made by passing carbonic acid through an aqueous solution of purified pearlash (a more or less impure potassium carbonate), obtained from wood-ashes by lixiviation, and somewhat purified by solution in water, filtration and evaporation, till it is fully saturated. It occurs in transparent, colourless crystals, having the shape of irregular eight-sided prisms with two-sided summits (KHCO3). They are inodorous, of a slightly alkaline taste, permanent in the air, soluble in water and insoluble in alcohol. The effects and uses of this salt are the same as those of the carbonate, but it is pleasanter in taste and less irritant to the stomach. It is much used in gout and uric acid lithiasis. Dose, 3j to 5j- It is a good remedy in acute rheumatism, in which as much as an ounce to an ounce and a half may be given during the day, with opium to relieve pain. SODII PR^PARATA — SODIUM PREPARATIONS. The sodium preparations are analogous in effects to those of potassium. Being less irritant and less depressing, they are better anti-dyspeptics, and for the relief of acidity of the primse vise. They are inferior in gout and uric acid lithiasis, as they are less powerful solvents of this acid. Their elimi- native action as diuretics is also more feeble. LiQUOfi Sod^: [Solution of Soda) is prepared by the action of lime on a solution of sodium carbonate. It is a colourless liquid, having an extremely acrid taste and a strong alkaline 896 MATERIA MEDICA — ANTACIDS. reaction. It has sp. gr. 1*059, and contains 5 per cent, of sodium hydrate (NaHO). The dose and administration are the same as those of liquor potassse. The preparations of sodium generally employed as antacids are the carbonates. # There are several sources of carbonated sodium. The native carbonate (called natron) is found in Egypt, Hungary and other countries. Impure soda, obtained from the ashes of marine plants, is termed barilla or help — barilla when it is derived from phenogamous plants growing near the sea, and kelp when procured from cryptogamic plants growing in the sea. Sodium carbonate is now, however, chiefly made by artificial means from sodium sulphate, which is obtained in part from the manufacturers of chlorinated lime, but principally by the action of sulphuric acid on sodium chloride. The sodium sulphate is fused with ground limestone and coal, and forms a black mass called British barilla, which contains a mixture of sodium carbonate and calcium sulphide — Na 2 S0 4 +C 4 +CaC0 3 =CaS+Na 2 C0 8 +4CO. It is afterwards purified by lixiviation, calcination and other processes. Within a few years past, caustic soda and the carbonates and other sodium salts have been manufactured near Pittsburgh, in Pennsylvania, from cryolite (a sodium and aluminium fluoride) (3NaF,AlF 3 ), which is found in an immense deposit in Green- land, and largely imported into Philadelphia. Cryolite con- tains about 35 per cent, of soda, which is separated from it by mixing it with lime and subjecting it to heat, when it is decom- posed into insoluble calcium fluoride and soluble sodium alumi- nate, with a little sodium carbonate and hydrate, all of which are separated from the fluoride by lixiviation with hot water, carbonic acid being afterwards passed through the solution to form sodium carbonate, the alumina being deposited. Another new and cheap process of manufacturing soda has been lately introduced, termed the ammonia process, in which sodium chloride is converted directly into sodium carbonate by the use of ammonium carbonate ; the ammonium chloride farmed is decomposed by calcium hydrate, and the ammonia is again converted into carbonate by the excess of carbonic acid, SODIUM PREPARATIONS. 397 obtained by heating the sodium carbonate. Recently, too, sodium carbonate has been found in large amount in a lake in Nevada. Sodii Carbon as [Sodium Carbonate) crystallizes in large oblique, rhombic prisms (Na 2 C0 3 ), which are transparent, very efflorescent, of an alkaline, disagreeable taste, soluble in water but insoluble in alcohol. When heated they undergo the watery fusion and part with their water of crystallization, which is entirely expelled at a red heat. Perfect crystals have ten equivalents of water of crystallization. It is apt to con- tain sodium sulphate and common salt as impurities. Acids, acidulous salts, lime-solution, earthy and metallic salts, etc., are incompatible with sodium carbonate. Effects and Uses. — Sodium carbonate is less irritant and has a milder and more agreeable taste than potassium carbonate. Its effects are otherwise similar, and it is administered in the same cases. In overdoses it is a corrosive poison, for which oils and acids are the antidotes. Dose, gr. x to 5ss in powder, or dissolved in some bitter infusion. Owing to the variable quan- tity of water of crystallization which it contains, as kept in shops, it is best given in the dined state. Sodii Carbonas Exsiccatus (Dried Sodium Carbonate). — This salt is deprived of its water of crystallization by heat, and occurs in the form of a white powder. Dose, gr. v-xv in pill, made with soap and aromatics. Sodii Bicarbonas (Sodium Bicarbonate) is prepared by saturating the carbonate with carbonic acid. In the process followed in this country the water contained in the carbonate, which is liberated during the process 'of its saturation, is drained off. Thus obtained, the crystals have the form of the carbonate, retaining only one equivalent of water, but are opaque and porous. They occur usually in granular masses, or in the form of a white, opaque powder, which contains vari- able amounts of soda not fully saturated with carbonic acid, and is known as sodii bicarbonas venalis (commercial so- dium bicarbonate). This is purified for medicinal use by per- colation with distilled water, and the purified salt occurs as a 398 MATERIA MEDICA — ANTACIDS. snow-white powder, soluble in 13 parts of water, of a mild, slightly alkaline taste. It is a permanent salt (NaHC0 3 ). By exposure to heat it gradually parts with its carbonic acid, and at a red heat is converted into the anhydrous carbonate. The effects and uses of this salt are the same as those of the carbonate, but it is less irritant and of more agreeable taste. It has been used as a liquefacient in infantile croup in the dose of gr. j every five minutes, to promote the expulsion of false membrane. Dose, for an adult, gr. x to 5ss, which may be pleas- antly taken is carbonic acid water, or made into lozenges with sugar and mucilage of tragacanth. Sodium bicarbonate is an ingredient of Seidlitz powders (see p. 287). Troches of sodi- um bicarbonate are made by mixing sodium bicarbonate with sugar and nutmeg, and making a mass with mucilage of traga- canth, each troche containing 3 grains of bicarbonate. Sodium bicarbonate may be sprinkled with advantage over burns and scalds ; equal parts of it and common salt make a good appli- cation to the bites of bees, hornets, spiders, etc. LITHII PR.EPARATA — LITHIUM PREPARATIONS. Lithia is found in several minerals, as lepidolite, etc., but in minute amount. It is extracted chiefly by the agency of sul- phuric acid,; the sulphate is converted into a chloride by a solution of barium chloride, and from the chloride, the car- bonate (lithii carbonas) (Li 2 C0 3 ) is prepared by the addition of ammonium carbonate. It is a white powder, of a mild alka- line taste, soluble in 100 parts of water, more soluble in car- bonic acid water, ancl insoluble in alcohol. The lithium salts act on the system in a similar manner to the other alkalies. They are said to render the urine more alkaline than do the other members of this group. Lithium carbonate is a very valuable antacid in gout and rheumatism, from the fact of its low combining number and the great solu- bility of the lithium urate, thus enabling the carbonate to act powerfully in eliminating uric acid from the system. It prob- ably also diminishes the formation of uric acid, and the author MAGNESIUM PREPARATIONS. 399 has found it highly efficacious in the cure of gout. It is a good diuretic. Dose, 4 to 5 grains two or three times daily, largely diluted, and best given in carbonic acid water. Lithii Citras (Lithium Citrate) (Li 3 C 6 H 5 7 ), a deliquescent white powder, soluble in 25 parts of water, is made by adding a solution of citric acid to the lithium carbonate. It is con- verted into a carbonate in the system, and is, therefore, possessed of the same properties, but is more refrigerant. Strong solutions of lithium salts have been found useful exter- nally in removing gouty enlargements. Lithii Benzoas (Lithium Benzoate) (LiC 7 H 5 2 ) is prepared by the gradual addition of benzoic acid to a heated watery solution of the carbonate, and evaporating. It may be ob- tained in the form of glistening pearly scales, of a soapy feel and a cool, sweetish taste, soluble in three and a half parts of water at 60°. The ready solubility of this salt and its free- dom from deliquescence, and the benzoic acid which it contains in combination, give it especial value in the treatment of the various forms of disease dependent upon uric acid deposits. Dose, 3 to 5 grains repeated. AMMONII PR.EPARATA — AMMONIUM PREPARATIONS. The preparations of ammonium (previously noticed under the head of Stimulants, p. 199) are administered as antacids, in cases in which a stimulant action is not objectionable. Spiritus ammonia? aromaticus (aromatic spirit of ammonia) is the preparation usually employed, and is an excellent ant- acid carminative in heartburn attended with flatulence, nausea with syncope, etc. Dose, gtt. xxx-f 5j- M A G N E S 1 1 PR.EPARATA — MAGNESIUM PREPARA- TIONS. Magnesia (p. 281) and its Carbonate (p. 282) are employed as antacids in dyspepsia, sick-headache, gravel, etc., particu- larly where a laxative effect is also desirable. Dose, gr. 400 MATERIA MEDICA — ANTACIDS. x-xxx. Troches of magnesia are made by mixing magnesia, nutmeg, sugar, and forming with mucilage of tragacanth a mass, each troche containing 3 grains of magnesia. CALCII PRJEPARATA — CALCIUM PREPARATIONS. The preparations of calcium employed as antacids are Lime- solution, Precipitated Calcium Carbonate, Prepared Chalk and Prepared Oyster-shell. They are very useful in cases of acidity or irritability of the stomach, but their action on the bowels is the reverse of that of magnesia, and hence they can hardly be administered where there is a tendency to constipa- tion. They are also much employed in diarrhoea, and occa- sionally as alterative resolvents in glandular enlargements, as antispasmodics in nervous disorders, and to relieve irritability of the bladder from calculus. Liquor Calcis [Solution of Lime, Lime-water) is a satu- rated solution of lime in distilled water. It is a colourless, inodorous liquid, of a disagreeable alkaline taste, Containing about 0*15 per cent, of calcium hydrate (Ca2HO). By ex- posure to the air it gradually absorbs carbonic acid, with the formation of insoluble calcium carbonate. It should, there- fore, be kept in full, well-stoppered bottles, or they should contain some undissolved lime. Effects and Uses. — Lime-solution combines antacid and as- tringent properties, and is applicable to all the cases in which antacids are proper, where an astringent effect on the bowels is not objectionable. It it an excellent remedy in gastric irrita- bility, attended with nausea and vomiting, and may be given mixed with an equal part of milk, which disguises its unpleasant taste. A diet of milk and lime-solution is very useful in dys- pepsia accompanied with vomiting of food. Lime-solution is employed also in diarrhoea after inflammation has been sub- dued, in diabetes, and as an alterative resolvent in glandular affections. Externally it is used as a wash in tinea capitis, prurigo, scabies, etc., as an application to foul ulcers, and as an injection in leucorrhoea and gleet. Atomized inhalations of ANTISEPTICS. 401 lime-solution have been found useful in diphtheria and mem- branous croup. Dose, internally, f §ss to f 5iij-iv several times a day; for children, f5j« Linimentum caleis (lime liniment) (equal parts of lime-solution with cottonseed oil, sometimes called carron oil) is an invaluable liniment in burns and scalds, and in small-pox. Calcii Carbonas Pr^cipitatus . {Precipitated Calcium Carbonate) (CaC0 3 ) is made by mixing boiling solutions of calcium chloride and sodium carbonate. It is a fine white powder, insoluble in water, and free from grittiness, but pos- sessing no superiority over prepared chalk. Creta Pr^parata (Prepared Chalk) (CaC0 3 ) is made from chalk or whiting by levigation and elutriation. It occurs in little white conical loaves, which are tasteless, odourless, in- soluble in water, but more soluble in carbonic acid water. Its effects are those of an absorbent, antacid and desiccant astrin- gent. It is used in dyspepsia and gout attended with an ex- cess of acid in the system ; also in diarrhoea ; and as it forms soluble calcium salts with the acids of the stomach, its em- ployment has been suggested in rachitis. Dose, gr. x-xxx, in powder or suspended in water with gum and sugar. Pulvis cretce compositus (compound chalk poivder) is made by mixing prepared chalk (30 per cent.) with powdered gum arabic and sugar. Mistura cretce (chalk mixture) consists of compound chalk powder (20 parts) mixed with water and cinnamon water (40 parts of each) ; dose, f oss, repeated. Laudanum and tinc- ture of kino or of catechu, and aromatics, are often added to this mixture in the treatment of diarrhoea. Troches of chalk are made by mixing prepared chalk, gum arabic, nutmeg and sugar, and forming a mass with water : each troche containing 4 grains of prepared chalk. 26 402 MATERIA MEDICA — ANTISEPTICS. CLASS IV.— TOPICAL MEDICINES. ORDER I. ANTISEPTICS. Antiseptics (avri, against, and ayirrdg, putrid) are remedies which prevent fermentation and decomposition by a poisonous influence on the protoplasmic germs on which those processes depend. The theory of putrefaction which, based upon the researches of Pasteur, has been steadily gaining ground and is now almost universally adopted, refers the changes which take place in decomposing matter to the agency of organized germs ever present in the atmosphere, which, finding a suitable nidus in putrescible material, grow and multiply, producing chemical decomposition as a result of their presence. As in many diseases (e. #., relapsing fever, diphtheria, etc.) certain organized germs have been found to take an essential part in the diseased process, if not to produce it, and as their presence is suspected in many diseases in which as yet they have not been demonstrated to exist, the importance of a group of agents which are destructive to these low forms of life can hardly be exaggerated. The extent to which this group of remedies will destroy disease germs in the body without injuring the vitality of the human being cannot be definitely laid down. Certain it is that as yet we possess very few specifics in medicine, especially against the zymotic diseases, which would appear a priori to be especially the class to which antiseptics would apply. Yet as antiseptics are also antipyretics, they are not without use in the diseased economy, even if they do not cut short the morbid process. When applied topically they are of great value not only as deodorants and disinfectants, but also as antiseptics in dressing wounds, ulcers, etc., as in Mr. Lister's antiseptic method or its various modifications. They are also useful to prevent the spread of disease when added to the excreta of patients suffer- ing from contagious affections. Many of the antiseptics have already been discussed, as sul- POTASSIUM PERMANGANATE. 403 phurous acid and the sulphites, quinine, alcohol, iodine and solutions of many of the metallic salts, and it now remains to study those remedies which are used specially as topical anti- septic agents. P O T A S S 1 1 PEKMAN6ANAS — POTASSIUM PERMAN- GANATE. This salt is made by mixing together equal parts of man- ganese dioxide and potassium chlorate, dissolving in a little water, evaporating to dryness, and exposing to a nearly red heat ; potassium chlorate yields oxygen, which converts man- ganese dioxide into permanganic acid, and this combines with the potassium which displaces the hydrogen of the acid to form potassium permanganate (K 2 Mn 2 8 ). It occurs in the form of slender prismatic crystals of a deep purple colour, inodorous and of a sweetish, astringent taste. It dissolves readily in water, making a beautiful lilac solution, which is readily de- colourized by Fowler's arsenical solution. Effects and Uses. — There is little experience as regards the action of this salt when administered internally, although al- terative effects are attributed to it (and probably with reason) in poisoned conditions of the blood, as in malignant fevers, diph- theria, pyaemia, erysipelas, puerperal fever, etc. It is, how- ever, as a powerful disinfectant that it now claims chief atten- tion, and it now ranks at the head of this class of agents in destroying fetid odours and poisonous organic emanations. Its power in this respect is due to the evolution of oxygen in its more active form, ozone. It is used externally in dressing foul and fetid or gangrenous ulcers, particularly in hospital gangrene, as an application to carbuncles, as a gargle in diphtheria, etc. It may be sprinkled in powder on gangrenous surfaces or ap- plied in solution of the strength of half an ounce, an ounce or two ounces to a pint of water. As a disinfectant and deo- dorizer, a solution of from one to ten grains to an ounce of water may be exposed in saucers or sprinkled on the floor, or thrown into the air in spray by the atomizer. One to three 404 MATERIA MEDICA — ANTISEPTICS. grains may be given internally in solution through the day. Condys Fluid contains gr. ij to the fSj. AQUA CHLORI — CHLORINE WATER. This is an aqueous solution of chlorine, which is generated by heating hydrochloric acid 40 parts, diluted with water 25 parts, with manganese dioxide 10 parts. The chlorine is con- ducted by suitable tubes, through water 50 parts, into a bottle containing distilled water 400 parts, with which it is agitated, and the chlorine water is afterwards transferred to a well- stoppered bottle, made impervious to light. It should be kept in a cool place, protected from the light, but it is soon decom- posed. It contains at least 0-4 per cent, of the gas. It occurs as a greenish-yellow liquid, having an astringent taste and the suffocating odour of the gas. Its employment internally is chiefly in essential malignant fevers, as scarlatina and typhus, also in syphilis and diseases of the liver, and as an antidote for hydrocyanic acid. Dose, f5i-iv, diluted. It is now seldom used internally. Externally it is used, diluted, as a wash in skin diseases, as an antiseptic, and by inhalation in bronchial affections. Chlorine acts as a disinfectant and deodorizer, chiefly by its affinity for the hydrogen of moisture and the liberation of oxygen ; its gaseous form gives it advantages in this respect. Solutions containing chlorine and other anti- septics are useful applications to suppurating surfaces, by pre- venting the decomposition of pus, and thereby pyaemia. In case of poisoning by chlorine, albumen is the best antidote. CALX CHLORATA — CHLORINATED LIME. This preparation, often called chloride of lime, is prepared by passing chlorine over calcium hydrate till saturation is effected, and is said to be principally a mixture of calcium hypochlorite and chloride (CaCl 2 2 and CaCl 2 ). It occurs as a loose, grayish-white powder, or friable lumps, dry or but slightly moist, readily soluble in water, of a bitter, caustic CARBOLIC ACID. • 405 taste and a faint odour of chlorine. Exposed to air and moisture, it slowly yields hypochlorous acid (HCIO), and this soon breaks up into water, chloric acid (HC10 3 ) and free chlor- ine, and the chloric acid again yields chlorine; 25 percent, of chlorine should be furnished by good chlorinated lime. It has been used as an alterative in typhus, malignant scarlatina, syphilis, etc., in doses of from one to five grains, in solution, several times a day ; and as a wash, externally, one part dis- solved in a hundred parts of water ; or as a paste. It is chiefly, however, as a disinfectant that it is employed. Its effects are essentially those of chlorine, like which it decom- poses hydrosulphuric and hydrocyanic acids, and should not be given with mercurials. Liquor Sod^j Chlorate [Solution of Chlorinated Soda) (NaCl,NaC10), sometimes termed Labarraque 's Disinfecting Liquid, is made by decomposing a solution of sodium car- bonate by one of chlorinated lime. It is a transparent, greenish-yellow liquid, with a faint smell of chlorine, a sharp saline taste and an alkaline reaction. It has been used inter- nally, to fulfill the same indications as chlorinated lime, in doses of thirty drops to a teaspoonful, diluted, several times a day. It is useful, also, in dilution of various strengths, as an external application to every form of fetid ulcer, and it is a most valu- able and powerful disinfectant. Bromine (vide Escharotics) and iodine are antiseptics, acting in a manner similar to chlorine. They are seldom used for this purpose. ACIDUM CARBOLIC UM — CARBOLIC ACID. This substance, termed also phenic acid or phenyl hydrate, is a product of the distillation of coal-tar oil. Crude Carbolic Acid (Acidum Carbolicum Crudum) is made by treating the impure coal-tar of commerce with a satu- rated solution of potash, when it is resolved, on the addition of water, into a light oil and a heavier alkaline liquid ; the latter is separated and neutralized with muriatic acid, and the 406 MATERIA MEDICA — ANTISEPTICS. impure carbolic acid, which is disengaged, is afterwards dis- tilled from dried calcium, to remove water, when upon exposing the distillate to a low temperature, carbolic acid congeals in the form of a colourless crystalline mass. In its pure state it is solid at ordinary temperatures, crystal- lizing in long rhomboidal needles, white or colourless, of a pecul- iar empyreumatic odour like that of creasote (but not identical with it) and an acrid, burning taste ; if even slightly impure, it has a reddish colour, or will acquire it upon exposure. Its sp. gr. is 10-65, and it deliquesces upon exposure, and readily assumes the liquid state in the presence of a little water, with- out dissolving in it. When quite pure it melts at 106° F., forming an oily-looking, colourless liquid, which boils at 359° F. It is soluble in 20 parts of water, and very soluble in alcohol, ether, acetic acid, glycerin (commercial and absolute) and the fixed and volatile oils. Carbolic acid may be recog- nized by the following tests : " 1st, by its peculiar smell ; 2d, by the formation of yellow picric acid with nitric acid of 36° B. ; 3d, by the production of a blue or green colour " (Salkowski's test) " when treated with a small quantity of ammonium hydrate and a trace of a solu- tion of a hypochlorite ; 4th, by a lilac colour produced on the addition of a small quantity of ferric sulphate ; 5th, by a yel- lowish-white precipitate with bromine water " (Witthaus). The last three tests are very delicate. 6th. The most delicate test is that suggested by Plugge : " when a liquid containing carbolic acid is boiled with a little solution of mercurous nitrate containing a trace of nitrous acid, a reduction of the mercurous salt takes place and the liquid becomes of an in- tensely red colour." This test is said to detect 1 part of car- bolic acid in 200,000. Carbolic acid in solution coagulates albumen and precipitates nitro-celloluse from collodion, which distinguishes it from creasote. Although it combines with salifiable bases, it does not act as an acid upon colours, and is chemically phenyl hydrate (C 6 H 5 HO). Physiological Effects. — Carbolic acid is a protoplasmic poi- son destructive to all forms of life, whether vegetable or animal. CARBOLIC ACID. 407 "When applied to the skin it produces a white superficial eschar, becoming brownish. When applied in a concentrated form it causes very great local anaesthesia, extending inward for some depth to the tissues with which the acid has not come in contact. Nervous system : after poisonous doses have been given to animals, there is paralysis of the posterior extremi- ties, extending to the anterior, and finally reflex tetanic convulsions. In man a poisonous dose produces vertigo, con- tracted pupils, and stupor with sometimes tremors, never, however, amounting to convulsions, as in the lower animals. The convulsions are probably of spinal origin — certainly not peripheral. The reflex activity is at first increased, then abol- ished. The nerves and muscles are not paralyzed, but after death they are found to be more readily exhausted than normal. Circulation : the heart is at first depressed, afterwards accel- erated (caused by stimulation and exhaustion of the vagi). In slow cases of poisoning, death is produced by diastolic arrest. The arterial pressure is reduced on account of the paralysis of the vaso-motor centre of the cord. Dr. Prudden (Am. J. M. Sc, January, 1881) has shown that in strong solution it paralyzes, while in weak solution it renders sluggish the movements of the w T hite corpuscles in frogs. Carbolic acid probably enters the blood as an alkaline carbolate. Respira- tion is aifected early in the poisoning, the movements being much increased in frequency but very shallow ; this increase is due to stimulation partly of the peripheral vagi and partly of the respiratory centre (Salkowski). Temperature is some- what reduced. Elimination takes place by all the secretions, especially by the urine, saliva and breath. When a small amount only is taken, it is probably all excreted as an alkaline carbolate ; but when the amount is larger, a portion is oxidized in the system and escapes under different forms, especially as oxalic acid in the urine. These products of oxidation gener- ally colour the urine dark brown or black, and as this is one of the first signs of poisoning, the urine should always be watched when carbolic acid is being administered or when it is applied to a large surface. Post-mortem appearances : after death 408 MATERIA MEDICA — ANTISEPTICS. from a concentrated solution of the acid, hard, white, dry spots surrounded by a circle of inflammation are found on all the mucous membranes with which the acid comes in contact, even as far down as the intestines in some instances. All the viscera are filled with dark, imperfectly-coagulated blood, and some- times there is fatty degeneration of the liver and kidneys. The external application of carbolic acid has destroyed life. As a chemical antidote in cases of poisoning a saturated solu- tion of saccharate of calcium has been recommended. Atropia is the physiological antagonist of carbolic acid ; enough should be given to counteract the depressing effect of the acid upon the respiration and circulation, and diluents should be freely administered to aid in its elimination (A. C. Post, quoted by Bartholow). Medicinal Uses. — Carbolic acid is used internally to check vomiting, as an astringent in diarrhoea, in sarcina ventriculi, as an anthelmintic, and in zymotic diseases, as small-pox, typhoid fever, scarlatina, erysipelas^ diphtheria, etc. It has also been given internally with some success in cholera, cholera morbus and diabetes of hepatic origin. In phthisis and gangrene of the lungs it has been found of service, and combined with iodine in chronic malarial poisoning it. is highly recommended (Bar- tholow). Carbolic acid spray is used as an inhalation in chronic nasal catarrh, hay asthma, chronic bronchitis, whoop- ing cough, phthisis, gangrene of the lungs, etc., with a view of destroying germs, stimulating the mucous membrane to healthy action and correcting fetor. Deep-seated injections into the tissues of a two per cent, solution of carbolic acid, as recom- mended by Huter, have been practiced with success in ery- sipelas (Aufrecht), abscesses, etc., and are thrown into the cavity of joints in synovites and into bursse in ganglion, etc. Extraordinary care must be taken not to inject the acid into a blood-vessel. Dr. R. J. Levis injects pure carbolic acid (the crystals liquefied by heat) t5ss-j into the sac of tunica va- ginalis after evacuating its contents, for the radical cure of hydrocele. This treatment is followed at the Out-Patient Surgical Department of the Jefferson College Hospital with almost unvarying success. CARBOLIC ACID. 409 As an external application its uses are still more important. It is employed in the concentrated form as a caustic in condy- lomata, lupus, etc., and to produce local anaethesia for minor surgical operations, as opening abscesses, felons, etc., and in various forms of dilution as an application in diphtheria, in cutaneous eruptions (especially those of organic origin), as a dressing to foul ulcers, abscesses and sinuses, to compound fractures, to carbuncles, to burns and scalds, to suppurating surfaces with a view to the prevention of pyaemia, .and, from its influence in coagulating albumen, as an haemostatic. Under the belief that carbolic acid destroys the organic floating germs which produce inflammation and suppuration upon wounded surfaces, washings and dressings with solutions of this acid (1 part to 40 parts of water) have been much employed, as first suggested by Professor Lister, of Edinburgh. It is also a most valuable disinfectant. The dose, internally, is one or two grains, or, if liquefied by heat, one or two drops, in sweetened water or glycerin. For disinfectant purposes, the crude liquid acid (which contains from 70 to 90 per cent, of car- bolic and cresylic acids jointly, with impurites derived from coal-tar) answers very well. Sodium and potassium carbo- lates have been also employed. Ointment of carbolic acid (unguentum acidi carbolici) contains 10 per cent, of carbolic acid in ointment. Sodii Sulpiio-carbolas [Sodium Sulpho-carbolate) (NaC 6 H 5 S0 4 2H 2 0) is a colourless, transparent salt occurring in rhombic prisms, permanent in the air, soluble in about 5 parts of water, and also in glycerin and alcohol. It is obtained by adding sodium carbonate to a solution of barium sulpho-carbolate (previously obtained by adding barium carbonate to sulpho-car- bolic acid (made by dissolving one part of crystallized carbolic acid in an equal amount by weight of strong sulphuric acid (C 6 H 6 HO + H a S0 4 =C 6 H 5 HS0 4 +H 2 0), and stirring until effer- vescence ceases and then filtering). Potassium, magnesium and calcium sulpho-carbonates have also been employed ; they may be given as antiseptics in cholera and zymotic diseases gener- ally. Prof. Bartholow recommends them as excellent topical 410 MATERIA MEDICA — ANTISEPTICS. applications to inflamed mucous membranes, and has seen good results attend their use in tonsillitis, aphthae of children, catarrh of the nares and gonorrhoea. Sodium sulpho-carbolate is a good remedy for flatulence ; dose, gr. x-xv. The lead sulpho-car- bolate might be used where the lead acetate is indicated and the corrective action of carbolic acid is called for, while its solubility in glycerin and alcohol adapt it to external application. CREASOTUM — CREASOTE. Creasote is a complex substance obtained from wood-tar by dry distillation, or from crude pyroligneous acid ; the best is made from beechwood-tar. It contains phenol (C 6 H 5 HO), cresylol (C 6 H 4 (CH 3 )HO), creasol (C 8 H 10 O 2 ) and other sub- stances obtained from wood-tar. When pure it is a colour- less, oleaginous liquid, with a caustic, burning taste and a penetrating, disagreeable characteristic odour, like that of smoked meat. Its sp. gr. (U. S. P.) is 1-035-1-085, but when pure is 1*08. After exposure to light for a long period it becomes , wine-yellow ; if it turns red, it is not fit for me- dicinal use. It forms two solutions with water, one of 1 part to 80 parts of water, the other of 1 part of water to 10 parts of creasote ; and it is soluble, in all proportions, in alcohol, ether, naphtha and acetic acid. Crude phenol is often sub- stituted for creasote ; the latter may be distinguished by its insolubility in commercial glycerin ; by not precipitating nitro- cellulose from collodion when mixed with it ; by giving a green colour with ferric chloride and alcohol (phenol gives a brown colour) and by giving a green colour passing to brown with ferric chloride and ammonium hydrate (phenol giving a violet colour) (Witthaus). A remarkable property of creasote is its power of preserving meat, whence its name (from Kpeag, flesh, and o^>;«, I save). Effects and Uses. — Creasote possesses many properties in common with carbolic acid. It is eliminated by the bronchial mucous membrane (which it stimulates as it passes out, and hence is a good expectorant), by the kidneys, etc. It is not SALICYLIC ACID. 411 much used because of the difficulty of procuring the pure drug. In large doses is an acro-narcotic poison, resembling carbolic acid, but with more marked nervous symptoms. In small doses it is styptic and astringent, and, though not very nearly allied to the vegetable astringent articles which contain tannic acid, it is, perhaps, more generally administered for its astringent than for any other properties. It is an excellent remedy in hiematemesis, and is also employed in haemoptysis and other hemorrhages. It is very efficacious in allaying vomiting and gastric irritability, and has been exhibited for its astringent virtues with good effect in diarrhoea, diabetes and chronic bron- chitis, and as a nervine in epilepsy, hysteria, neuralgia, etc. Externally it is applied, in various degrees of dilution, to indo- lent, sloughing and foul ulcers; in several cutaneous affections ; as a gargle in putrid sore throat ; and for the relief of deaf- ness. In the concentrated form it is a good styptic in capil- lary hemorrhages, and is applied with effect to the hollows of carious teeth, for the removal of the pain of toothache. In cases of poisoning from creasote the same treatment is to be resorted to as in poisoning by carbolic acid. Dose, internally, lT|j-iij, frequently repeated, in pill or diluted with mucilage. For external use, from two to six drops, or more, may be added to a fluidounce of distilled water. Aqua Creasoti (Creasote Water) (1 part to distilled water 99 parts). Dose, f5j-iv. ACIDUM SALICYLICUM — SALICYLIC ACID. This acid, although known for nearly half a century as a derivative of salicin (see p. 146), has been employed only re- cently as an article of the Materia Medica. It has been pre- pared from the flowers of Spircea ulmaria or Meadow-Sweet, and from the oil of gaultheria (where it exists as methyl salicylate), and by the oxidation of salicin. It is now made by combining pure carbolic acid with caustic soda, and treating this compound with dry carbonic acid under the influence of a 412 MATERIA MEDICA — ANTISEPTICS. gradually-increasing heat, when one-half of the carbolic acid distills over, while the other half, into the molecule of which carbonic acid enters, remains behind as sodium salicylate ; from a hot aqueous solution of this, saturated with muriatic acid, salicylic acid (C 6 H 4 {§ooh} is obtained in the form of minute, broken, acicular crystals (having usually the appear- ance of a pale-pinkish granular powder), which are bleached with great difficulty. It is odourless and nearly tasteless, having, however, a sweet and astringent after-taste, with slight acridity in the fauces. It is practically insoluble in cold water, but quite soluble in boiling water, a hot aqueous solution re- taining when cold, in proportion to its coldness, from 1 part in 250 to 500 parts of the solution. The addition of 2 parts of sodium sulphite or 1 part of ammonium phosphate, or 3 parts of sodium phosphate, renders it much more soluble in water. It is freely soluble in alcohol, ether and glycerin. Dissolved in water, a fine violet colour is produced on the addition of ferric chloride. • Physiological Effects. — In its effects salicylic acid is allied to carbolic acid, possessing probably greater powers as an anti- septic, and in arresting the putrefactive and fermentative pro- cesses, while it is devoid of smell or notable taste, is not volatile, and is also, in quantities necessary for effective action, free from irritant or poisonous influence. When given internally in full medicinal doses buzzing and roaring in the ears, with fullness in the head, are experienced, which are much increased after the administration of large doses, amounting even to deafness and accompanied by headache and partial blindness. If an excess- ive dose is taken all the symptoms are intensified, and great restlessness, followed by delirium, involuntary evacuations, stupor, and in the lower animals convulsions, are observed. The action of salicylic acid upon the ear (as well as the similar action of quinine) has been investigated with varying results. Kirchner concludes that these remedies produce intense conges- tion of the tympanum and labyrinth (due to vaso-motor dis- turbance), which may lead to changes in the nerve filaments ; while Weber-Liel and Guder found anaemia of these parts as SALICYLIC ACID. 41o the result of the ingestion of the drug (Med. Rec. Oct. 28, 1882). The heart-beat is at first increased in frequency, but after- wards slowed ; excessive doses cause the pulse to become slow and laboured. The blood pressure is at first elevated (from the action of the acid on the heart and on the vaso-motor centres), then lowered. Blood : Prudden (Am. J. M. Sc, lxxxii. 82), from experiments upon frogs, verified on rabbits and on the human blood, concludes that salicylic acid restrains emigration, and in strong solutions is inimical to the life, in weak solutions to the activity-, of the white blood corpuscles. Respiration is at first quicker and deeper than normal (from the action of the drug on' the vagi and to some extent on the respiratory centre) ; later it becomes slow and laboured, and death results from as- phyxia. Temperature : non-toxic doses have little or no effect upon the normal temperature ; in fever, however, salicylic acid causes a marked reduction in the body heat which lasts for several hours. Secretion : full doses cause free diaphoresis which is sometimes exhausting. The urine is sometimes in- creased, sometimes diminished, and often contains albumen. It somewhat increases the secretion of milk, and the amount of sugar in that secretion seems to be augmented (Dr. Max Stumpf, Deutsches archiv. fur klinische Med., Jan., 1882, quoted in Bost. Med. and Surg. J., Aug. 3, 1882). Gastro- intestinal tract : large amounts cause nausea and often vomit- ing. Absorption and elimination : it is probably absorbed as a sodium salicylate, and is eliminated principally by the urine partly unchanged, and partly as salicyluric and (possibly) oxalic acid. Elimination takes place slowly. After the ingestion of large quantities the urine will be coloured green from an in- crease of the indican (Wood, H. C). Medicinal Uses. — For its antipyretic effect salicylic acid has been used in fevers with varying success. In acute rheumatism, especially in robust patients, it is pre-eminently of value, re- ducing the temperature, relieving the joint affection and ameli- orating the pain ; but whether it shortens the duration and decreases the frequency of cardiac complications and relapses 414 MATERIA MEDICA — ANTISEPTICS. is still disputed. In rheumatic hyperpyrexia it is ■ i alue, but should not be relied on to the exclusion of othc means of reducing temperature. In gonorrhoeal rheum atisn *nd gout where no kidney complication exists it is also of s ,r ice, and has been recommended in typhoid and eruptive fev v vsemia, puerperal fever, diphtheria, etc. ; although not as "-re in these diseases as in rheumatism, and, indeed, ha^ 3e con- demned by some as being of no avail. It has no ci rativ fleet upon malarial fevers, but if given just before the ex -ted paroxysm it will prevent its occurrence (Bartholow). it : ? strongly recommended in acute tonsillitis in doses of f v. x every two to four hours (Dr. Edward Mackey, Brit. Me< J^ Oct. 14, 1882). As an antizymotic to prevent fermentation of the ingesta it is recommended in gastric catarrh, gastric dila- tation, sarcina and allied complaints. Bartholow strongly recommends it in gastralgia. As an anthelmintic salicylic acid has been used with success against tape-worm, and also internally and locally against ascarides. Externally it has been used in the moist stages of eczema and eczema rubrum with good results. As a detergent and desiccant it may be sprinkled dry on wounds or ulcers in the form of powder, or mixed in various proportions with some inert powder, as starch ; or a solution, 1 part to 300 parts of water, may be used as a substitute for the antiseptic carbolic dressing ; the stronger solution with sot" ,m phosphate, 1 part to 50 parts of water, is used to wash or spray foul surfaces, or as an application in diphtheria ; a solution of a grain to f§i of water is a good injection in gonorrhoea and collyrium in conjunctivitis ; dose, gr. x-5j. Whether em- ployed internally or externally it passes rapidly into the urine, and gives the iron chloride a blue or violet reaction. The acid retains its antiseptic properties only so long as it remains in the free state. Sodii Salicylas (Sodium' Salicylate) is a white crystalline powder, without smell and having a sweetish, alkaline taste (2NaC 7 H 5 3 .H 2 0). It is less irritant to the stomach than salicylic acid, and is preferred for internal use. Locally it is BORIC ACID. 415 recomme i. ;1 in solution (sodii salicyl. 5ij> tr. opii 5ij, water 5viij) to. aieve the suffering produced by gouty hands and feet and t . ..eumatic joints (Dr. E. Mackey, Brit. Med. J., Oct. 14, 1882 Dr. Baudon anoints the surface three times a day in variola a. sodium salicylate 5j to cold cream 5J. This lessens supp" >n and removes the odour. L ±} j alicylas {Lithium Salicylate) is also officinal, and is us .', Eternally to fulfill the indications of salicylic acid. The salt- ^re given in doses corresponding to that of the acid. ■ <§ ACIDUM BORIC UM — BORIC ACID. A: ■ Boric or Boracic Acid (H 3 B0 3 ) exists in nature in volcanic regions, notably in Tuscany. In this region, which was for- merly the main source of supply of this acid, jets of steam, called suffioni, escape through fissures in the hillsides, and are made to pass through a series of shallow basins along which water is slowly flowing. The water becomes charged with boric acid, which is converted into borax. A boiling concen- trated solution of borax is slowly decomposed with an excess of sulphuric acid, and on cooling, boric acid is obtained in transparent six-sided crystalline plates, unctuous to the touch, odourless, slightly bitter, soluble in cold water, more so in alcohol and very soluble in" boiling water. The supply to the U jjfeed States is now derived almost exclusively from Borax Lake in California, about one hundred miles north of San Francisco. Effects and Uses. — Boric acid is anti-putrescent and deodor- ant, arresting fermentation and proving very poisonous to the lower forms of life. Neumann found by experiments on dogs, verified on rabbits and young pigs, that boric acid causes a decided fall in the temperature of the body. Large doses caused diarrhoea and vomiting. Three per cent, solutions injected into the serous cavities caused no inflammation, but when large amounts were injected the animal died from paraly- sis of the motor nerves and muscles (N. Y. Med. J., Jan. 27, 1883, quoted from Lancet). 416 MATERIA MEDICA — ANTISEPTICS. Mododewkow reports two fatal cases of poisoning with boracic acid. In one case a pleuritic cavity and in the other a lumbar abscess were washed out with a five per cent, solution of the acid, some of which remained in both cases. The symptoms were, persistent vomiting, hiccough, erythema beginning on the face, slight temporary rise of temperature, diminished cardiac power ending in paralysis. He suggests morphine and stimu- lants in like cases (Am. J. Med. Sc, April, 1882, quoted from Wratsch, No. 31, 1881). Boric acid is used externally as an antiseptic in the treat- ment of wounds, burns, ulcers, abscesses, phlegmonous ery- sipelas, eczema, etc. It has also been used with advantage in inflammation of the mucous membranes, as aphthae, diphtheritic inflammations of the mouth, etc. It may be dusted into the external auditory meatus in inflammation of that canal, and has been used with advantage in inflammation of the conjunc- tiva. Used as an injection, it appears to shorten the duration of gonorrhoea (H. M.). SOD II BORAS — SODIUM BORATE. Borax occurs as a native product in several localities, the most important of which for a long time was Thibet, in Asia ; it is also made artificially by the direct combination of native boric acid with soda. Borax (Na 2 B 4 O 7 ,10H 2 O) occurs in the form of hexahedral prismatic crystals, terminated by trian- gular pyramids, of a sweetish alkaline taste and an alkaline reaction. It is wholly soluble in water, and slowly effloresces, and has the property of rendering cream of tartar very soluble in water. Effects and Uses. — Borax is a mild refrigerant and diuretic, and locally an antiseptic, and has emmenagogue virtues attrib- uted to it. Dose, gr. xxx. It has been given in infantile diarrhoea as an enema, and is used externally in cutaneous affections (3j to water Oj as a wash in pruritus and in acne punctata), but especially as a detergent in aphthous affections of the mouth in children, mixed with equal parts of sugar. A BENZOIC ACID. 417 piece of borax slowly dissolved in the mouth will often cure acute hoarseness. Grlyceriie of sodium borate may be made by rubbing up sodium borate oij in glycerin Oss ; honey of sodium borate may be made by mixing 5j with clarified honey tSj. Both these preparations are used chiefly as applications to the mouth and throat, but are not officinal. ACIDUM BENZOIC UM — BENZOIC ACID. Benzoic Acid (HC 7 H 5 2 ) is obtained from benzoin by sublimation, or by the action of alkalies ; it is also made in Germany from hippuric acid. As obtained by sublimation, it occurs in white, soft, feathery hexagonal crystals, of a silky lustre, and not pulverulent. It has more or less of the agreeable odour of the balsam, a warm, acrid and acidulous taste, is inflammable, sparingly soluble in cold water, rather soluble in boiling water, but perfectly soluble in alcohol, alka- line solutions and fixed oils. It is a constituent of the balsams. Effects and Uses. — Benzoic acid is a local irritant, destroy- ing minute organisms, possessing decided antiseptic properties, and acting on the general system as a stimulant, with a par- ticular direction to the mucous surfaces. In large doses it increases the circulation and respiration, and is said to be a more powerful antipyretic than salicylic acid. It stimulates the cutaneous and bronchial secretions, and increases the acidity of the urine. In its passage through the system it abstracts nitrogen from the elements of urea, and passes out with the urine in the form of hippuric acid ; hence its use in ursemic poisoning, also in the treatment of ammoniacal urine. It has been used in diphtheria, erysipelas, etc., with a view to its antiseptic effects, and as an expectorant in chronic bronchial affections. Locally it is used as a dressing for wounds, ulcers, etc., and to prevent animal fats from becoming rancid. Dose, gr. v-xx. Sodii Benzoas (Sodium Benzoate) (NaC 7 H 5 2 .H 2 0) is a white amorphous powder, which effloresces on exposure to the 27 418 MATERIA MEDICA — ANTISEPTICS. air, and has a faint odour of benzoin and a sweetish, astringent taste. It has been used as a substitute for salicylic acid, being less powerful as an antipyretic, but is a safer remedy. It has been used extensively in phthisis, with a view to its antiseptic qualities ; also in diphtheria, scarlet fever and the eruptive fevers generally, whooping-cough, etc. ; and in acute rheum- atism as an antipyretic. From 5j-iij may be given in twenty- four hours. Ammonii Benzoas (Ammonium Benzoate) (NH 4 C 7 .H 5 2 ) is made by adding water of ammonia to an aqueous solution of benzoic acid, and occurs in the form of minute white, shining, thin, four-sided laminar crystals, with a slight odour of ben- zoic acid and a bitterish, saline, somewhat balsamic taste and slightly acrid but persistent aftertaste. It is soluble in water and alcohol, and, when heated, sublimes without residue. It is incompatible with the ferric salts. This salt, when taken internally, is probably decomposed by the gastric acids, and produces the constitutional effects of benzoic acid, for which it may be substituted ; the ammonia renders it stimulant and antacid, and acceptable to irritable stomachs. Dose, 10 to 20 grains. THYMOL. Thymol (C 10 H 13 HO), called also cymylic phenol, is a solid crystalline substance found in the volatile oil (oleum thymi) distilled from the Thymus vulgaris (vide p. 215). It is sep- arated by fractional distillation ; that portion of the oil which distills above 392° F. is agitated with a concentrated solution of caustic soda, and the thymol liberated from the resulting solution by hydrochloric acid. It is purified by rectification, and occurs as large colourless rhombohedral crystals, having an aromatic odour and a hot, aromatic taste ; slightly soluble in water, but very soluble in ether and alcohol. Effects and Uses. — Thymol is a powerful antiseptic. Its effects are analogous to carbolic acid, and like that agent, when locally applied it produces paralysis of the cutaneous end- organs of the sensory nerves (Lewin ; Bartholow). When RUBEFACIENTS. 419 given internally it produced tinnitus aurium, deafness, re- duction of temperature, and often diarrhoea, sometimes nausea and vomiting. In several cases it caused violent delirium and collapse ; profuse diaphoresis took place, and the urine was of a dark-green colour, but free from albumen ; the sweating was not as marked as that produced by salicylic acid, nor was the antipyretic effect as great. Thymol is very expensive and con- sequently is not much used. As an antiseptic in inflammations and ulcerations of the mouth it is very useful, and has been used as an inhalation to diminish the expectoration of phthisis, etc. Locally it is used to fulfill the same indications as carbolic acid. Prof. Da Costa recommends crystallized thymol internally in small-pox, in doses of gr. ss, and as a gargle in diphtheria. ORDER II. — IRRITANTS. Irritants are medicines which are employed to prpduce irri- gation or inflammation of the parts to which they are applied. They maybe subdivided into Rubefacients, Epispastics, Sup- purants and Escharotics. Rubefacients are used merely to produce redness of the skin. Epispastics, or Vesicants, cause the exhalation of a serous fluid under the cuticle. Suppurants produce a crop of pustules. Escharotics have a chemical action on the tissues with which they are placed in contact, and decom- pose or destroy them. RUBEFACIENTS. Rubefacients are employed to remove congestion and inflam- mation, to rouse the capillary system in cases of local torpor, to relieve pain and spasm, and as stimulants to the general system in coma, syncope, asphyxia, etc. They are adapted to cases in which a sudden and powerful, but transient, action is called for ; but they may be also employed where a slight and long-continued action is desired. In removing congestion and inflammation, rubefacients act by stimulating the capillary vessels of inflamed parts, and thereby restoring their tone and 420 MATERIA MEDICA — IRRITANTS. elasticity. They are useful chiefly in the forming stages or in light grades of inflammation. They are very serviceable local anodynes when applied to painful parts — acting by a substitu- tive influence. As general stimulants, their efficacy in rousing the system depends partly on their action on the capillary circulation, and partly on the pain which they produce. They are most valuable in the coma or asphyxia resulting from poisons, drowning, etc., and are inferior to blisters in the cere- bral oppression which occurs in fevers, inflammations of the brain, etc. Rubefacients are usually applied till pain and redness super- vene. If kept too long on the skin, many of them will pro- duce vesication and even gangrene ; and in cases of coma par- ticular caution is required, as the patient may not feel them till dangerous inflammation has occurred. SINAPIS — MUSTARD. • Mustard seeds are obtained from two varieties of Sinapis — S. nigra, or Black Mustard, and S. alba, or White Mustard (Nat. Ord. Cruciferae), small annual European plants, culti- vated in our gardens. S. nigra has become naturalized in some parts of the United States. Black-mustard seeds are small, globular, of a deep-brown colour externally, and inter- nally yellow. They are inodorous, except in powder ; and when rubbed with water exhale a very strong, pungent smell. Their taste is bitterish, hot and pungent. White-mustard seeds are larger, yellowish externally, and of a less pungent taste, owing to the presence of a mucilaginous substance in their skin. The powder of both varieties (commonly called flour of mus- tard) is yellow, and is often adulterated with coloured wheaten flour. Both varieties yield their virtues wholly to water, and very slightly to alcohol. Chemical Constituents. — Mustard seeds yield, upon pressure, a fixed saponifiable oil, which contains oleic acid and a peculiar acid termed eruic (HC 22 H 41 2 ). From the black seeds a very pungent volatile oil, containing sulphur, is afterwards obtained MUSTARD. 421 by distillation ; it does not pre-exist in the seeds, but is the re- sult of the action of water upon a peculiar principle called sinnigrin or potassium myronate (C 10 H 18 NS 2 KO 12 ). It is allyl sulphocyanide (C 3 H 5 CyS), is colourless or pale-yellow, rather heavier than water, of a very pungent odour and an acrid, burning taste, and is the principle to which the black seeds owe their activity. From the white seeds no volatile oil is obtained ; but when treated with water they yield an acrid fixed principle, which is analogous in properties to the volatile oil of the black seeds. It is the result of the reaction of ivater upon sinalbin (C 30 H 44 N 2 S 2 O 16 ), a peculiar ingredient of the white seeds. The development of the volatile oil in the black seeds, and of the acrid fixed principle in the white seeds, is supposed to depend upon the presence of an albuminous constituent called myrosyn, which acts the part of a ferment in determining a reaction between water and the peculiar principles of the seeds. Myrosyn is rendered inert by heat, alcohol and the acids; and water, of the ordinary temperature, is therefore the proper men- struum of mustard. Effects and Uses. — Mustard is an acrid stimulant. In small quantities it is stomachic ; in larger doses it proves -emetic ; and in excessive doses it will produce gastro-enteric inflamma- tion. When applied to the skin it is a rapid and powerful local excitant, speedily producing redness and pain, and if long con- tinued it will develop vesication, ulceration and even sphacelus. Mustard seeds, swallowed whole, have been used as a laxative in dyspepsia, in the dose of a tablespoonful once or twice a day, mixed with molasses : the white seeds are preferred ; the prac- tice is, however, of doubtful value, as they may become en- tangled in the appendicula vermiformis. When mustard is employed internally, however, it is chiefly as an emetic, in cases of torpor of the stomach, particularly after narcotic poisoning ; and by its stimulant action, mustard often rouses the gastric susceptibility when other emetics fail. Dose, as an emetic, from a large teaspoonful to a tablespoonful of the bruised seeds or powder. Its use in smaller quantity, as a condiment and stimulant of the digestive organs, is well known. In the form 422 MATERIA MEDICA — IRRITANTS. of whey (tgss boiled in milk Oj) it has been given as a diuretic in dropsy. The most general use of mustard is, however, as a cutaneous stimulant, in the form of cataplasm (termed a sinapism). This is made by mixing flour of mustard with a sufficient quantity of tepid water to give it proper consistence, and it may be diluted with wheat or rye flour if a weaker effect is desired. Sinapisms are used when a speedy and powerful rubefacient effect is required ; they should be kept on till pain and redness are produced, usually from a quarter of an hour to an hour, and in cases of insensibility their effects should be carefully watched. They are applied spread on linen, and covered with gauze to prevent adhesion to the skin. Mustard is the most active and at the same time the most easily con- trolled of the rubefacients ; a mild but permanent effect may be kept up by the addition of a teaspoonful to a tablespoonful of mustard to a poultice of Indian meal or flaxseed, with a tablespoonful or two of capsicum. For ready use there is now kept in the shops charta sinapis (mustard paper), which is prepared by mixing black mustard (in powder) with enough solution of gutta-percha to give it a semi-liq.uid consistence, and then applying the mixture by a brush to a piece of stiff paper ; each square inch contains about gr. vj of mustard. Before being applied to the skin it should be dipped for about fifteen seconds in warm water. Oleum sinapis volatile (volatile oil of mustard), the vol- atile oil obtained from black mustard by maceration with water and subsequent distillation, possesses the properties of mustard. It is very irritant. It is used in making Linimentum sinapis compositum (compound liniment of mustard), which is composed of volatile oil of mustard (3 per cent.), extract of mezereum (2 per cent.), camphor (6 per cent.), castor oil (15 per cent.) and alcohol. CAPSICUM. Capsicum has been previously noticed as an aromatic stim- ulant (p. 204). It is an efficient rubefacient, useful in rheum- BURGUNDY PITCH. 423 atism, low fevers, etc. ; the plaster, tincture or oleoresin may be used. OLEUM TEREBINTHINiE — OIL OF TURPENTINE. The Oil of Turpentine (vide pp. 208 and 335) is a speedy and efficacious rubefacient, and sometimes produces a vesicular eruption. It is employed in low forms of disease attended with coldness of the surface ; as a counter-irritant in inflam- mation ; and as a stimulating liniment in rheumatic and para- lytic cases. It is often diluted with olive oil. LINIMENTUM AMMONIA — LINIMENT OF AMMONIA. This preparation, called also Volatile Liniment, consists of 8 parts of water of ammonia (vide p. 200) and 7 parts of cotton- seed oil. It is an excellent application, as a counter-irritant, in affections of the throat and chest, etc. PIX BURGUNDICA — BURGUNDY PITCH. This is the prepared resinous exudation from Abies excelsa, or Norway Spruce (Nat. Ord. Coniferse), a lofty evergreen tree of Europe and northern Asia. Abies picea, or the European Silver Fir, is said to be also a source of the drug. It is ob- tained by stripping off the bark and detaching the flakes of resinous matter which form upon the surface of the wound ; they are afterwards melted in boiling* water and strained. Burgundy pitch is collected principally in Germany and France, and derives its name from Burgundy, in the latter country. After it is imported into the United States it is generally remelted and strained to free it from impurities ; and as found in the shops it is a hard, brittle, opaque sub- stance, of a yellowish or brownish-yellow colour and a weak terebinthinate taste and smell ; when applied to the body it softens and becomes adhesive. It contains resin and a much smaller proportion of volatile oil (C 10 H 16 ) than turpentine. 424 MATERIA MEDICA — IRRITANTS. A spurious Burgundy pitch is made by melting together pitch, resin and turpentine, and agitating the mixture with water. Effects and Uses. — This is a gentle rubefacient, producing a slight degree of inflammation and serous effusion, without separating the cuticle. It occasionally produces a papillary or vesicular eruption ; and sometimes, though rarely, occasions painful vesication and even ulceration. It is applied in the form of plaster to the chest in chronic and sub-acute pulmo- nary disorders, to the loins in lumbago, to the joints in chronic articular affections, and for the relief of local rheumatic pains in other parts. Emplastrum picis Burgundies [Burgundy pitch plaster) consists of 9 parts of Burgundy pitch melted with 1 part of yellow wax, which is used to give consistence to the pitch. Umplastrum picis cum cantharide [pitch plaster with can- tharides) consists of 92 parts of Burgundy pitch melted with 8 parts of cerate of cantharides; this is commonly called the warming plaster, and is a more active rubefacient than Bur- gundy pitch, though it does not usually blister. The iron plaster, galbanum plaster and opium plaster all contain Burgundy pitch. PIX CANADENSIS — CANADA PITCH. This is the prepared resinous exudation from Abies cana- densis, or Hemlock Spruce [Nat. Ord. Coniferae), a very lofty evergreen tree of Canada and the northern parts of the United States. The pitch (sometimes called hemlock gum) is a spon- taneous exudation on the old trees. The portions of bark upon which it hardens are stripped from the tree and boiled, and the melted pitch is skimmed from the surface of the water. It undergoes a further purification in the shops by melting and straining, and is found in hard, brittle, opaque masses, of a dark yellowish-brown colour, a weak, peculiar odour and scarcely any taste. It is more readily softened by heat than Burgundy pitch, and is therefore sometimes a less convenient EPISPASTICS. 425 application. Its constituents are resins and a minute portion of volatile oil. Its effects and uses are the same as those of Burgundy pitch. Emplastrum picis Canadensis [Canada pitch plaster), some- times called hemlock pitch plaster, consists of 9 parts of Canada pitch melted with 1 part of yellow wax. Many other acrid substances are occasionally employed as rubefacients. Ginger (vide p. 210), Black Pepper (vide p. 205) and Garlic (vide p. 332) are particularly deserving of mention. A gentle counter-irritant, often used to the epigas- tric region to relieve vomiting, is the spice plaster, which is made by mixing two ounces of powdered ginger with an ounce of powdered cloves and cinnamon, each, and two drachms of capsicum, adding half a fluidounce of tincture of ginger and honey enough for proper consistence. EPISPASTICS. Epispastics, called also Vesicants and Blisters, are medicines which, when applied to the skin, produce inflammation, accom- panied by effusion of serum beneath the cuticle. Many of the rubefacients will blister if kept on the skin a sufficient length of time ; and, on the other hand, the action of vesicants may be made not to extend beyond rubefaction. The inflammation of the skin caused by vesicants is erysipelatous in its charac- ter, and may result in suppuration, and even sloughing or gan- grene. In inflammation of the dermoid tissues, as rubeola and scarlatina, in typhus under certain circumstances, and in ex- treme infancy, vesicants may produce serious consequences. This class of agents is employed — 1. As local stimulants, in the cure of internal inflammations. Different explanations have been offered of the antiphlogistic influence of blisters, some therapeutists ascribing it to a derivative or revellent ac- tion, by determining vascular and nervous energy to the seat of their operation, but it is more probably due to a stimulant effect extended to the capillary vessels of the inflamed organ, 426 MATERIA MEDICA — IRRITANTS. and experience has shown that, for the relief of internal in- flammation, they cannot be applied too near the affected organ. In affections of the head, blisters are pre-eminently useful. 2. To substitute a healthy therapeutic inflammatory action, which subsides spontaneously, for a morbid action existing in the part to which they are applied. In this way vesicants are used for the cure of various cutaneous eruptions. 3. To relieve pain, which they do partly by a stimulant and partly by a substitu- tive influence. 4. To break up a train of morbid associations by the powerful impression which they make on the nervous system, as in the cure of intermittent fever, spasmodic diseases, etc. 5. To stimulate the absorbing or secreting vessels of parts contiguous to the seat of their application ; in this way they are useful in promoting the absorption of dropsical effu- sions, in the treatment of ununited fracture, etc. 6. As gen- eral stimulants, in typhoid conditions of the system, coma, syncope, etc. 7. As local stimulants, in threatened gangrene, paralysis, etc. 8. As evacuants, chiefly for the purpose of local depletion. 9. In retrocedent gout, and in retrocession of the exanthematous eruptions. 10. To prepare a surface for the endermic application of medicines. CANTHARIS — CANTHARIDES. Cantharis vesicatoria, termed also Lytta vesicatoria, the Spanish Fly, is . a cylindrical insect, from six to ten lines in length by two or three in breadth, with a large cordate head, an oblong body, and elytra, or wing-cases, of a beautiful shining golden-green colour. It is found most abundantly in Spain, Italy and the south of France, but occurs in all the temperate parts of Europe, and in western Asia. The Spanish flies swarm on certain trees and shrubs, and may be detected at a considerable distance by their strong fetid odour, which resembles that of mice. They make their appearance in May and June, and are collected in these months by persons pro- tected by masks and gauntlets, who beat or shake them from the trees on which they lodge, and receive them, as they fall, CANTHARIDES. 427 upon linen cloths spread underneath. They are plunged into hot vinegar and water, or exposed to the vapour of boiling vinegar, and are afterwards dried in the sun or by drying - stoves. When perfectly dry they are packed in canisters, which are carefully closed so as to exclude atmospheric moist- ure. They are usually imported into this country from some Mediterranean port. A highly-esteemed variety comes from south Russia, through St. Petersburg, which is distinguished by the larger size and copper colour of the flies. In the dried state, cantharides retain their form, colour, odour, etc. ; their taste is acrid, burning and urinous ; their powder is of a grayish-brown colour, interspersed with shining green particles. If exposed to moisture they are soon de- composed, most speedily when powdered. As, moreover, the powder is liable to adulterations, they should be always pur- chased whole, and should be powdered as they are wanted for use. They are liable to be attacked by mites, which destroy the interior soft parts : the best mode of preserving them is to expose them, in bottles, to the heat of boiling water, which destroys the eggs of the insect. A little camphor or ammonium carbonate, or a few drops of strong acetic acid or of chloro- form, added to the flies, are also recommended as preservatives. The most important constituents of cantharides are a volatile oil, upon which the odour depends, and a neutral crystalline substance, termed cantharidin, which is the vesicating principle. Cantharidin is inodorous, tasteless, soluble in ether, chloro- form, the oils, acetic acid and boiling alcohol, and nearly in- soluble in water and cold alcohol ; but notwithstanding the insolubility of cantharidin, watery and alcoholic solutions of cantharides possess the medicinal properties of the insect, — the cantharidin being rendered soluble by combination with a yellow colouring matter in the insect. Cantharidin (C 10 H 12 O 4 ), by the aid of heat, in the presence of water, may be made to combine with the alkalies, the cantharidin becoming converted into cantharidic acid (C 10 H 14 O 5 ). Physiological Effects. — Cantharides are an acrid stimulant. Taken internally, in small doses, they excite the secretion of 428 MATERIA MEDICA — IRRITANTS. the kidneys, and sometimes produce more or less irritation of the genito-urinary passages, evinced by strangury, priapism, pain and occasionally the discharge of bloody urine. In large doses they produce violent gastro-enteric and genito- urinary inflammation; and in excessive doses prove fatal, with convulsions, tetanus, delirium and other cerebro-spinal symp- toms. Twenty-four grains have occasioned death. In cases of poisoning, after the stomach has been emptied, opiates, demul- cents and stimulants are to be resorted to; but oils are to be avoided. Applied to the skin, cantharides produce inflamma- tion, which terminates in the secretion of serum* under the cuticle. Even when they are externally applied their constitu- tional effects, as strangury, tenesmus, etc., are frequently manifested. Medicinal Uses. — The indications which cantharides are capable of fulfilling, when administered internally as a diuretic, emmenagogue, etc., have been already noticed (see tincture, p. 329). Their chief use is as an external application, to produce blisters ; but they are sometimes employed also externally as rubefacients, for the purpose of local or general stimulation in low forms of disease. Cantharides are preferred to all other substances as epispastics, and they are used for all the medi- cinal purposes that are within the range of this class of medi- cines. The following are the forms under which Spanish flies are used externally : Ceratum cantharidis (cantharides cerate), commonly known as blistering cerate, is made by mixing powdered cantharides (35 parts) with melted wax and resin (each 20 parts), and lard (25 parts). This is the preparation usually employed to raise a blister. It can be applied without the aid of heat, and should be spread on soft leather or linen or adhesive plaster, and covered with gauze or unsized paper. From four to twelve hours is the period for which the cerate should be applied ; on the scalp a longer application may be required. For an ordi- nary impression, and where the cutaneous sensibility is not impaired by disease, it need not be kept on more than four or CANTHARIDES. 429 five hours. In cases of children less time is required for the application of the cerate, and great caution is necessary in applying it to infants. A poultice of bread and milk or flax- seed meal should be afterwards applied, which usually produces vesication if the action of the blister has not extended beyond rubefaction. If it be desirable to heal the blistered surface immediately, cotton-wadding or cerate may be placed over it, after the serum has been allowed to escape. To maintain the discharge, the cuticle should be removed and basilicon ointment applied ; if the surface require further irritation, the ointments of savine, mez^ereon or cantharides may be used. The open or per- petual blister is, how T ever, not required for ordinary antiphlogis- tic purposes ; and indeed, as a general rule, the blistered surface should be allowed to heal as speedily as possible. In case of excessive pain, a poultice of bread-crumb and lead- water, with morphine sulphate gr. J mixed in it, or a starch poultice or lime liniment, is a soothing application. Gf-oulard's Cerate is an excellent application to heal obstinate ulcers from blisters. For the relief of strangury, diluents and diuretics are proper, as flaxseed tea, with sweet spirit of nitre, decoction of uva ursi, etc., and an opium or morphia suppository if the symptoms are severe. Ceratum extracti cantharidis {cerate of extract of cantharides) differs chiefly from the common cerate in being made with an alcoholic extract of the flies instead of the flies themselves ; it is said to be more active than the former prep- aration. To prepare it, 30 parts of cantharides are to be per- colated to exhaustion with stronger alcohol, evaporated to the consistence of a soft extract, and mixed with 15 parts of resin, 35 parts of yellow wax and 35 parts of lard (melted together). Ethereal, alcoholic, hydro- alcoholic and watery extracts of can- tharides have been suggested as substitutes for the hlistering cerate, and, mixed with wax and spread on thin cloth or paper, are termed vesicating taffetas. Linimentum cantharidis {lin- iment of cantharides) consists of cantharides (15 per cent.) dissolved in oil of turpentine ; it is a prompt stimulating lin- iment in low fevers, and may be applied to the skin to prepare it for the action of the blistering cerate. Collodium cum can- 430 MATERIA MEDICA — IRRITANTS. tharide {collodion ivith cantharides), or cantharidal collodion, is made by percolating cantharides with commercial chloroform until the cantharides are exhausted, evaporating the liquid thus obtained, and dissolving the residue in flexible collodion. It should be kept in a cool place. It furnishes a very convenient mode of blistering a sm all irregular surface, and is applied by means of a camel's-hair brush, in successive layers, which should be covered with a piece of oiled silk. Charta can- tharidis {cantharides paper) is made by boiling gently a mix- ture of 8 parts of white wax, 3 parts of spermaceti, 4 parts of olive oil, 1 part of Canada turpentine and cantharides each, in 10 parts of water, and, after filtration, passing strips of paper over the surface of the mixture, which, when dry, are cut into rectangular strips. The cantharidal preparations are used externally to promote the growth of the hair. Dupuytren s Pomatum is a tincture made with cantharides, 5i, and alcohol, f §i, incorporated with nine parts of lard. CANTHARIS VITTATA — POTATO FLIES. Several" species (not officinal) of cantharis are found in the United States, and are good substitutes for C. vesicatoria. C. vittata, or the Potato Fly, is most used. It resembles the Spanish fly in shape, but is rather smaller, being about six lines in length, with black elytra or wing-cases, and inhabits chiefly the potato plant. It contains cantharidin. AQUA AMMONIA — WATER OF AMMONIA. Stronger Water of Ammonia {vide p. 200) may be used for the purpose of speedy vesication. It is more rapid, but much more painful, than cantharides. Five parts of this, mixed with spirit of camphor 2 parts and spirit of rosemary 1 part, has been used as a prompt vesicant, under the name of Gran- ville's Lotion. A piece of flannel, saturated with the liniment, is applied to the skin, which it will generally blister in from three to ten minutes. Gondrefs Vesicating Ointment is made ESCHAROTICS. 431 by melting together 2 parts of expressed oil of almond and 32 parts of lard, and adding to this mixture 17 parts of stronger water of ammonia ; it will vesicate in ten minutes. Ammonia is applied locally as an antidote to the poison of venomous reptiles and insects. SUPPURANTS. OLEUM TIGLII — CROTON OIL. Croton Oil (vide p. 306), when rubbed on the skin, pro- duces rubefaction, accompanied by a pustular eruption. It is used as an application to the throat and chest in sub-acute or chronic laryngeal and bronchial affections, and to rheumatic joints. It may be applied undiluted, or mixed with one, two or three parts of olive oil or oil of turpentine, according to the susceptibility of the skin. UNGUENTUM ANTIM0NII — ANTIMONIAL OINTMENT. This ointment consists of 1 part of antimonium and potas- sium tartrate mixed with 4 parts of lard. The peculiar eruptive effects of tartar emetic have been already noticed (p. 228 and 231). It may be used in the form of ointment or solution, in the same cases as croton oil, but it is a more pain- ful and permanent application. ESCHAROTICS. Escharotics (from Ecxapa, an escJiar), called also Cauterants, are medicines which destroy the structure and vitality of the parts to which they are applied. The eschar which their ap- plication produces is followed by inflammation and suppura- tion of the surrounding tissues, by which the slough is separated from the living parts. They are employed — 1. To effect the destruction of morbid growths, warts, condylomata, polypi, fungous granulations, etc. 432 MATERIA MEDICA — IRRITANTS. 2. To decompose the virus of rabid and venomous animals, and of chancres and malignant pustules, and to prevent their absorption. 3. For the cure of violent inflammation, by their substitutive action, as when they are applied to the mucous or cutaneous surfaces, in gonorrhoeal ophthalmia, erysipelas, poisoned parts, carbuncles, etc. 4. To stimulate indolent sinuses, ulcers, etc., where their influence is also of a substi- tutive character. 5. To open abscesses ; though for the open- ing of abscesses of internal viscera, as of the liver, the method of aspiration is to be preferred. 6. To form issues. 7. To remove morbid heterologous growths, as lupus, cancer, etc. ARGENT I NITRAS FUSUS — FUSED SILVER NITRATE. Lunar Caustic (described at length p. 164-166) is the most commonly employed of the caustics. It has the advantage of not liquefying when applied, and its action is therefore con- fined to the parts with which it is brought in contact, and is superficial. It is used to remove fungous granulations in wounds and ulcers, to destroy warts, to alter the action of indolent ulcers, sinuses, and fistulse, to subdue the inflamma- tory action of paronychia, erythema, etc., to arrest the progress of erysipelas and cancrum oris, to cut short variolous pustules, to cure skin diseases by a substitutive action, and in inflam- mations of mucous membranes. In dilutions of various strengths it is resorted to in every variety of inflammation of the mucous membranes ; when a full impression is desired, a solution of gr. xx-xxxin distilled water foj may be employed; for ordinary purposes, gr. ij to water foj. The diluted silver nitrate (vide p. 166) is also used externally.- POTASS A. Caustic Potassa is prepared by the rapid evaporation of Solu- tion of Potassa (vide p. 394) with heat. While in the state of fusion, it is received into cylindrical iron moulds, and it occurs in the form of sticks, of a brownish, grayish or bluish colour, POTASSA. 433 a fibrous fracture, the odour of slacking lime, and a caustic, urinous taste. It dissolves in alcohol and in less than its weight of water, and attracts both moisture and carbonic acid rapidly from the air. It is more or less impure as found in the shops. By digestion in alcohol it is freed from impurities insoluble in this menstruum (as the potassium carbonates), and it may be afterwards obtained quite white and pure by evap- oration ; it is then termed alcoholic potassa. The potassa of the shops is a hydrate, consisting of the elements of water and potassa. Effects and Uses. — It is the most powerful known escharotic, and differs from lunar caustic in extending its action to a con- siderable depth beneath the surface to which it is applied. It is used chiefly to form issues, to destroy the virus of chancres and of malignant pustules and that from the bites of venom- ous reptiles and rabid animals, and sometimes also to arrest the sloughing of carbuncles, and, from its deep-reaching action, it is preferred to lunar caustic in these cases ; applied to the cutaneous surface, in cases of phlegmon, threatened carbuncle, etc., it will sometimes avert the progress of inflammation. It is a good application in cases of rodent ulcer, the superficial forms of epithelioma generally, and in lupus, the diseased tissue having been removed with the knife as thoroughly as possible previous to the application of the caustic. When it is applied to the skin, this should be covered with linen spread with ad- hesive plaster, having a hole the size of the spot to be cauter- ized. A solution (ojss to f§ij of water) is used as a rube- facient. Potassa cum Calce (Potassa with Lime) is prepared by rubbing up equal parts of potassa and lime. It is a grayish- white powder, which is sometimes made into a paste with a little alcohol, and is termed Vienna Paste ; it has been also formed into sticks. The presence of lime renders this a milder, less deliquescent and more manageable caustic than potassa ; it is a favourite application to chancres. 28 434 MATERIA MEDICA — IRRITANTS. SODA. Caustic Soda is prepared by the rapid evaporation of Solu- tion of Soda (vide p. 395) until ebullition ceases and the soda melts ; when it has congealed, it is broken into grayish-white, opaque, brittle fragments, which are very corrosive, very sol- uble in water, soluble in alcohol, and deliquescent, though, unlike potassa, it does not become permanently liquid, but after a time effloresces. It is employed for the same cauterant purposes as potassa, than which it is somewhat milder in action. London Paste is made by rubbing up equal parts of soda and lime. ACIDUM CHROMICUM — CHROMIC ACID. Chromic Acid (Cr0 3 ) is obtained by the reaction of sulphuric acid upon a solution of potassium bichromate. It is properly chromic anhydride, and occurs in the form of anhydrous, deep- red, needleform crystals, of an acid, metallic taste ; they are deliquescent, 1 and very soluble in water, with which they form an orange-yellow solution. Effects and Uses. — This is an eschar otic of great power, decomposing the tissues by its rapid oxidizing action. Used in the form of paste, or solution more or less diluted, it is a most efficacious application to lupus, morbid growths and ex- crescences, as syphilitic condylomata, etc. It gives less pain than other caustics ; but it is to be used with caution, especially near delicate parts like the eye, as its action is deeply pene- trating. The solution may be made of the strength of from 100 grains up to a troyounce to a fluidounce of water ; and is to be applied by means of a pencil or glass rod. Solutions of chromic acid in glycerin, which have been used, are liable to explode if the reagents are mixed too quickly ; the glycerin should be added drop by drop. ACIDUM ARSENIOSUM — ARSENIOUS ACID. This is a powerful escharotic (vide p. 378), and is occasion- ally applied in lupus, onychia maligna, cancerous ulcers, and ZINC CHLORIDE. 435 to change the action of indolent sinuses ; but its use is attended with danger. When used, it should be applied freely, as a large amount causes such rapid death of the tissues that ab- sorption is rendered impossible. It may be diluted with one or more parts of sulphur. BROMUM — BROMINE. Bromine is an elementary body, bearing close chemical affin- ities to iodine. It is a constituent of sea-water and of many mineral springs. In Europe it is obtained principally from the mother liquors of the salt mines of Stassfurt, in Germany ; in this country, from saline springs in western Pennsylvania, Ohio and West Virginia, in which it exists as magnesian bromide. It is a volatile, dark-red liquid (sp. gr. 3), of a caustic taste and a strong, disagreeable smell, sparingly sol- uble in water, more soluble in alcohol, and still more so in ether. Its effects on the system, considered chemically, are similar to those of chlorine. It decomposes hydrogen com- pounds, forming hydrobromic acid, and separating the elements combined with the hydrogen ; hence it is a deodorant and dis- infectant. On account of these properties, and because it is a liquid, it is a severe, rapid and thorough caustic. The vapour is intensely irritant to the mucous membrane, causing, when inhaled in sufficient quantity, laryngitis, bronchitis and pneu- monia. In the stomach it is a corrosive poison. In acute coryza, chronic nasal catarrh, ozena and hay asthma, a small quantity of a solution (5ss) in alcohol (Sjv) may be inhaled from a wide-mouthed vial with good result (Bartholow). Locally, in hospital gangrene, after removing the slough, it is the best escharotic. It is also used as a caustic in chancre and various forms of cancer, especially carcinoma uteri. ZINCI CHLORIDUM — ZINC CHLORIDE. This is also a powerful escharotic {vide p. 163) ; and, in addi- tion to its corrosive properties, it appears to exercise a greater 436 MATERIA MEDICA — IRRITANTS. influence over the vital action of neighbouring parts than some of the other caustics. The separation of its eschar leaves very healthy and vigorous granulations, and it is one of the best applications that can be made to intractable, indolent ulcers and sinuses. It will cure lupus. LIQUOR HYDRARGYRI NITRATIS — SOLUTION OF MERCURIC NITRATE. This preparation {vide p. 367), termed also the acid nitrate of mercury, is a valuable caustic application to malignant ulcers, hospital gangrene, chancre, etc. HYDRARGYRI CHLORIDUM CORROSIVUM — CORROS- IVE CHLORIDE OF MERCURY. Corrosive Sublimate is more frequently used as a stimulant wash than as a caustic. For its properties, uses and modes of application, see p. 362. POTASSII BICHROMAS — POTASSIUM BICHROMATE. This salt, already noticed under the head of alteratives (vide p. 391), is a good caustic application, in saturated solution or in powder, to syphilitic and other vegetations. ACIDA MINERALIA — MINERAL ACIDS. The mineral acids (vide p. 168) are powerful escharotics, but are inconvenient for many uses, on account of the extension of their action beyond the point of application. On the other hand they can be made to reach the bottoms of sinuses and fistulse, which are inaccessible to the solid caustics. Nitric acid, for such purposes, has no equal in the list of escharotics ; it is used also to destroy warts. Properly diluted, the mineral acids are employed in injections, gargles, etc. ; and in the form of ointment, in skin diseases. Copper Sulphate (vide p. 160) and Alum (vide p. 191) MINERAL ACIDS. 437 are mild escharotics, but are used chiefly to remove fungous granulations in ulcers. The actual cautery and moxa have been alluded to under the head of Heat (vide p. 24). Under this head may be considered sapo viridis and chrys- arobin, two remedies which, although not used as escharotics, are applied to the skin in certain of its diseases for their local irritant effect. The former has decided caustic properties, due to the potassa which it contains. Sapo Viridis — Green Soap — is a soft greenish, jelly-like soap, prepared from potassa and the fixed oils, very soluble in water and alcohol. Like all soaps, especially soft soaps, it is a caustic, and was introduced into medical practice by Pro- fessor von Hebra in the treatment of various cutaneous affec- tions, especially of the scaly variety. It is useful to remove the infiltrated patches of eczema rubrum, and for this purpose should be well rubbed in with a piece of flannel until all traces of the soap have disappeared, when the flannel is wet with w r ater and the rubbing again performed ; the surface should be then washed with clean water and carefully dried, when it will be found red and angry-looking, with here and there a minute point from which serum is oozing. Between the applications ointments are to be applied. Sapo viridis is also much used to remove scales and crusts, as in psoriasis, seborrhcea, etc., and in various other skin affections. Tinctura saponis viridis [tincture of green soap) consists of 65 per cent, of green soap and 2 per cent, of oil of lavender dissolved in alcohol. It is milder in its action than green soap, and is used to fulfill the same indications. Chrysarobinum — Chrysarobin, often improperly called Chrysophanic Acid — consists of a mixture of principles extracted from araroba or goa-powder, a substance found in the clefts of Andira araroba (Nat. Ord. Leguminosse). It has also been obtained from different species of rhubarb. It is an orange-yellow powder, crystallizing in needles, insoluble in water, only slightly soluble in alcohol, and possesses neither taste nor smell. 438 MATERIA MEDICA — DEMULCENTS. Effects and Uses. — When applied locally, it is an irritant to the skin, causing irritation and inflammation accompanied with swelling, itching, pain, heat and sometimes a papular eruption, especially when applied about the head and face. The action is not always limited to the part to which it is applied, but extends to the healthy skin in the vicinity. Ob- servers do not agree respecting the internal effects of this drug. It is principally used as an external application in cases of skin disease due to vegetable parasites, and in psoriasis, in which disease the scabs soon disappear and the patches become white under its use. It stains the skin yellow, and should never be applied to the head or face on account of the liability to swelling and oedema of the eyelids. It has also been used internally. An ointment made by rubbing 10 parts of crys- arobin with 90 parts of benzoinated lard is officinal. ORDER III. — DEMULCENTS. Demulcents, or Lenitives, are medicines which soften and relax the tissues, and, when applied to irritated or inflamed surfaces, diminish heat, tension and pain. They consist chiefly of gum or mucilage, or of a mixture of these with saccharine and farinaceous substances, and form with water viscid solutions. Their constitutional effects are principally nutritive, though perhaps, to some extent, they relieve irritation in distant organs by modifying the acridity of the secretions. Demulcent solutions are administered internally — 1. To sheathe and protect the gastro-enteric surface from the injurious effects of irritating substances, particularly acrid poisons. 2. To relieve irritation and inflammation of the alimentary- canal, as in gastritis, enteritis, diarrhoea and dysentery ; and for this purpose they may be administered by either the mouth or rectum. 3. In catarrhal affections, in which they are probably useful in part by the transmission of their lubricating and soothing effects on the fauces and oesophagus by reflex action to the laryngeal and bronchial membranes, and in part by modifying the acridity of expectorated matters. 4. In affec- WATER. 439 tions of the urinary passages, as ardor urinre, cystitis, etc., and in these cases they act chiefly by diminishing the acridity of the secretions. 5. As agreeable drinks, to quench thirst and promote the action of the secreting and exhaling organs in febrile affections. Their effects in these cases are owing partly to the water which they contain, to which they are added merely for the sake of flavour, and partly also to the nutrient which they furnish. When administered with the ob- ject of increasing the proportion of the fluid parts of the blood, demulcents are termed Diluents. 6. As light diet for the sick. 7. For pharmaceutical purposes, to suspend substances insol- uble in water, etc. Externally, mucilaginous solutions are employed extensively to relieve the heat, swelling and pain of inflammation, wounds, burns, etc. ; to hasten suppuration where inflammation is too far advanced for resolution ; to cleanse foul and scabby ulcers ; to promote suppuration from granulating surfaces, etc., etc. Mucilaginous and amylaceous substances are applied to inflamed and ulcerated parts, mixed with water so as to form soft masses, termed cataplasms or poultices. These are useful vehicles of heat and moisture to the skin, and are used also as local appli- cations in rheumatism and gout, and for the relief of internal inflammation, as when applied to the chest and abdomen in pleurisy, bronchitis, peritonitis, dysentery, etc. Applied ex- ternally, this class of medicines is termed Emollients. AQUA — WATER. Water has important medicinal as well as pharmaceutical uses. The Pharmacopoeia directs it to be employed in the purest attainable state, which is rain or snow water ; for phar- maceutical purposes, distilled water (aqua desiillatd) should be used. Pure water is a transparent liquid, without colour, taste or smell ; but owing to its extensive solvent powers, in the natural state it is more or less contaminated with foreign mat- ters. It is now considered to be a compound by volume of 2 atoms of hydrogen and 1 of oxygen (H 2 0). 440 MATERIA MEDICA — DEMULCENTS. Effects and Uses. — Water is necessary for the solution and digestion of our food ; in either insufficient or excessive amount it may prove injurious. Thus, without a proper supply of water, not only the absorption of soluble matters in the stomach is interfered with, but also the passage of undigested substances into the intestines; and besides, some articles, as sugar, do not undergo the fermentation necessary for digestion. On the other hand, an excess of water taken into the stomach impairs diges- tion by over-dilution of the gastric juice, and will occasion the acetous fermentation of saccharine articles. Water is eliminated from the system by the intestines, skin and lungs, but chiefly by the kidneys ; and it is believed, in large amounts, to increase not only the water, but the solid constituents, of the urine ; hence its use as a diuretic. As it promotes both the metamor- phosis and construction of tissue, it may produce a valuable alterative effect in morbid taints of the system, and prove a useful adjunct to more active eliminative agents. Water is the basis of all drinks administered to relieve the thirst of fever and moderate the undue viscidity of the blood which is present in inflammation ; it must not be permitted in excess, however, as undue amounts may produce nausea, flatulence, and even vomiting and diarrhoea. The uses of water, as an external agent, have been noticed under the head of heat and cold. Carbonic Acid Water (H 2 C0 3 ). Water impregnated with a quantity of carbonic acid, equal to five times the bulk of the water (which may be obtained from sodium bicarbonate or from marble, by means of diluted sulphuric acid) often proves useful in allaying nausea and vomiting, and is also a good vehicle for some of the neutral purgative salts which are of unpleasant taste. It is no longer officinal. ACACIA — GUM ARABIC. Gum arabic is a gummy exudation from Acacia verek and other species of acacia (Nat, Ord. Leguminosse), thorny or prickly trees or shrubs of Africa and Arabia. The gum exudes either through natural cracks in the bark or through incisions GUM ARABIC. 441 made to facilitate its exudation, and hardens on exposure. The most abundant yield is in the hot and dry weather, and is obtained from the sickliest trees. Several commercial varieties are known, as Turkey, Barbary, Senegal, India, etc., of which the most important are Turkey gum and Senegal gum. 1. Turkey gum (Kordofan gum) comes from the Levant or other parts of the Mediterranean, and is the kind usually found in the shops. It consists chiefly of small, irregular fragments, interspersed with larger pieces of a whitish colour, which is sometimes slightly tinged with yellow or reddish-yellow. It is lighter-coloured, more brittle, more readily soluble, and purer than other varieties, and is generally characterized by innumer- able minute fissures pervading its substance. 2. Senegal gum comes from the western coast of Africa. It occurs in roundish or oval unbroken pieces, larger, less brittle, and breaking with a more conchoidal fracture than those of Turkey gum, some- times whitish, but generally yellowish, reddish or brownish- red. 3. Barbary gum comes from Morocco ; it is derived, in part at least, from A. nilotica, and consists of two kinds, one resembling the Turkey, the other the Senegal gum. 4. India gum, though brought from India, is collected on the north- eastern coast of Africa and in the ports of the Red Sea. It is in pieces of varying size, colour and quality, and is often contaminated with Bassora gum, which is insoluble in water, Gum is also imported into England from the Cape of Good Hope and from Australia. All the varieties are more or less transparent, hard, brittle and pulverizable, and form a white powder. They are inodorous, with a feeble, slightly sweetish taste, and when pure dissolve wholly in the mouth. When kept in a dry place they undergo no change by time. Chemical Constituents. — Gum arabic consists almost wholly of a peculiar proximate principle, usually termed G-um, but latterly designated by chemists as Arabin. It is soluble in hot or cold water, forming a viscid solution called mucilage, and is insoluble in alcohol, ether and the oils. Alcohol precipitates gum from its aqueous solution ; lead subacetate (which is a delicate test), lead nitrate and solution of iron chloride also 442 MATERIA MEDICA — DEMULCENTS. precipitate it from solution. Arabia (gummic or arable acid) (C 12 H 22 O n ) is combined with about 3 per cent, of lime, forming a soluble salt, calcium gummate. Gums of inferior transparency and solubility contain bassorin, an inert principle, insoluble in water and alcohol. Effects and Uses. — Gum arabic is extensively employed, internally, as a demulcent in gastro-enteric inflammation, diarrhoea, dysentery, cases of acrid poisoning, etc. ; as a lubri- cant to the fauces in catarrhal affections, and also as a vehicle for anodynes and expectorants in cough mixtures ; and as a diluent in fevers and inflammatory cases. It is not now con- sidered to be digestible, and can scarcely rank (as formerly supposed) with nutrients. It is usually administered in solu- tion (.§i to boiling water Oj, to be given when cool) ; in cases of irritation of the fauces it may be taken into the mouth and allowed slowly to dissolve. For pharmaceutical purposes gum arabic is much used to suspend insoluble substances in water, and in making pills and lozenges. Mucilago acacias {mucilage of gum arabic) is used in making pills, emulsions, etc. ; it becomes sour by keeping. Syrupus acacias {syrup of gum arabic) (25 per cent, of mucilage of acacia mixed with 75 per cent, of syrup) is used for the same purpose. Mistura amygdala? {almond mixture) is made by dissolving a mixture of 6 parts of blanched sweet almonds, 1 part of gum arabic and 3 parts of sugar in 100 parts of distilled water ; it is a pleasant demulcent and vehicle for other medicines. By dissolving equal parts of sugar and gum arabic in water and evaporating, an agreeable demulcent is obtained, known as gum pectoral, which is sold as an imitation of jujube paste. TRAGACANTHA — TRAGACANTH. This is a gummy exudation from Astragalus gummifer and other species of astragalus (Nat. Ord. Leguminosae). They are small shrubs found in Persia, Asia Minor and countries bordering on the Levant, with numerous branches covered with imbricated scales and beset with spines. Tragacanth exudes FLAXSEED. 443 spontaneously in the hot weather, and hardens, as it exudes, in forms of various shapes. It occurs in irregular tortuous flakes or filaments, of a whitish or yellowish-white, or occasionally a slightly reddish colour, somewhat translucent, resembling horn in appearance. It is hard and fragile, but very difficult of pul- verization, and has no smell and very little taste. When heated with water it swells and forms a paste, and if agitated with an additional quantity it forms a uniform mixture, from which it is, however, almost entirely deposited upon standing a day or two. It contains two constituents, one soluble in water, resembling arabin, but not identical with it, combined with calcium, the other termed tragacantliin (C 12 H 20 O 10 ). Effects and Uses. — Tragacanth is seldom given internally, on account of its difficult solubility. It is useful in suspending heavy insoluble powders, and answers better than gum arabic to impart consistence to lozenges. Mucilago iragacanthce (mucilage of tragacanth) — tragacanth 6 per cent, with gly- cerin 18 per cent, in water — is used in making pills and troches, and for the suspension of heavy insoluble metallic sub- stances. LIXUM — FLAXSEED. This is the seed of Linum usitatissimum, or Common Flax (Nat. Ord. Linacese), an annual plant, of the height of two feet, originally a native of eastern countries, but naturalized in Europe, and cultivated in all parts of the world. The seed and oil are both officinal. The seeds are about a line in length, oval, smooth and glossy, of a brown colour externally and yellowish-white within ; a variety of flax is cultivated in Ohio, the seeds of which are greenish-yellow. Flaxseeds are ino- dorous, and have an oily, mucilaginous taste. They contain 30 or 35 per cent, of fixed oil, a large proportion of mucilaginous matter, vegetable albumen, and various other ingredients ; the mucilaginous matter, which is found chiefly in the husks of the seeds, consists, about one-half, of a principle soluble in cold water, resembling arabin, and about one-third, of a principle insoluble in water. The oil (oleum lini or linseed oil) is 444 MATERIA MEDICA — DEMULCENTS. obtained by expression from the interior part of the seeds ; it is laxative in the dose of f Sj-ij, but it is chiefly used exter- nally, mixed with an equal amount of lime-water, as in the old " carron oil." Effects and Uses. — Decoction is an improper mode of pre- paring a demulcent solution of flaxseed, as boiling extracts part of the oil ; but it answers very well when it is used as a laxative enema. Ground flaxseed forms a much-used emol- lient poultice, which is prepared by adding the meal to boiling water, constantly stirring, until it makes a thin and smooth dough. The cake, remaining after the expression of the oil, retains the mucilaginous and albuminous constituents of the seed, and forms a food for cattle, under the name of oil-cake. This is used for making poultices, but it is inferior to the meal made from the seeds which have not been deprived of their oil. OLEUM GOSSYPII S EM IN IS — COTTON-SEED OIL. This is a fixed oil expressed from the seed of Gossypium herbaceum [vide p. 248) and other species of gossypium. It is subsequently purified by being bleached with alkalies and with sulphuric acid, and is finally obtained as a clear, pale- yellow oily liquid, without odour and having a bland, nut-like taste. It contains olein and palmitin. It is very bland, and may be used as a substitute for almond or olive oil. It is used externally as an ingredient of linimentum ammonite (vide p. 423), linimentum calcis (vide p. 401), linimentum camphoros (vide p. 98) and linimentum plumbi subacetatis (vide p. 189). ULMUS SLIPPERY-ELM BARK. This is the inner bark of Ulmus fulva, or Slippery Elm (Nat. Ord. Urticacese), a lofty indigenous tree which is found throughout the United States north of Carolina, and grows most abundantly west of the Allegheny Mountains. The inner bark is prepared for use by the removal of the epidermis ; it is MARSHMALLOW. 445 found in the shops in long flat pieces, of a fibrous texture, tawny on the outer surface and reddish on the inner, of a peculiar but not unpleasant smell and a very mucilaginous taste. It affords a light grayish, fawn-coloured powder. A large quantity of mucilaginous matter is contained in it, which is yielded readily to water, also some tannic acid. Much of the bark lately brought into the market is inferior, containing but little mucilage ; it is less fibrous and more brittle than the genuine bark. Effects and Uses. — Slippery-elm bark is a valuable demul- cent, extensively and advantageously employed in dysentery, diarrhoea, genito-urinary diseases, catarrhs, etc. It is also highly nutritious. Externally it is an excellent emollient ap- plication, in the form either of infusion or of poultice made with the powder. It has been also recommended for the dila- tation of strictures and fistulae, and, made into a spongy mass, as a tent to dilate the os uteri. The infusion — mucilago ulmi {mucilage of slippery-elm bark) (§j to boiling water Oj) — may be used ad libitum. SASSAFRAS MEDULLA — SASSAFRAS PITH. Sassafras pith is the pith of the stems of Sassafras officinale (vide p. 317). It occurs in light, spongy, whitish, slender, cylindrical pieces, of a mucilaginous taste. It abounds in a gummy matter, which it yields readily to water, forming a limpid, viscid mucilage. This mucilage (5j to boiling water Oss) is a pleasant demulcent drink in dyspeptic, nephritic and catarrhal affections, and is much used as a soothing applica- tion in ophthalmia. ALTH^A — MARSHMALLOW. The root of Althaea officinalis (Nat. Ord. Malvaceae), an herbaceous European plant, occasionally found, too, on the borders of salt marshes in our own country, with ovate, soft, velvety, crenate leaves and pretty flesh-coloured flowers, is 446 MATERIA MEDICA — DEMULCENTS. much used in Europe as a demulcent. The roots of other Malva- ceae are often substituted for those of the officinal roots. These are imported in pieces, three or four inches in length, of nearly the thickness of the finger, light, easily broken, white exter- nally, of a peculiar faint smell and a mild, mucilaginous, sweetish taste. The chief constituents of marshmallow are mucilage and starch, the former soluble in cold water, the latter requiring boiling water. It contains also asparagin (C 4 H 8 N 2 3 ,H 2 0), a crystalline principle found in asparagus shoots and other plants. Uses. — Marslimallow decoction is employed as a demulcent in inflammatory and irritated conditions of the mucous mem- branes of the respiratory, digestive and urinary organs, and poultices made of the bruised or powdered root are used ex- ternally. The si/i* up is the only officinal preparation. OLEUM SESAMI — OIL OF BENNE. This is a fixed oil expressed from the seed of Sesamuni indicum (Nat. Ord. Pedaliacese), an annual plant, growing to the height of four or five feet, with ovate-lanceolate, lobed leaves, reddish-white axillary flowers, and an oblong capsule containing small oval yellowish seeds. It is a native of India, but is now raised throughout Asia and in Egypt and Italy, also in South Carolina and in the neighbourhood of Philadel- phia. The seed contains a fixed oil, and the leaves yield to cold water a large quantity of mucilage resembling that of sassafras pith. This is a highly-esteemed demulcent drink, used in cholera infantum and infantile bowel complaints. The seeds are eaten as food by the negroes in Carolina, in broths, puddings, etc. The oil, which is inodorous, of a bland, sweet- ish taste, and keeps well, may be used internally or externally as a substitute for olive oil. CYDONIUM — QUINCE- SEED. This is the seed of Cydonia vulgaris (Nat. Ord. Rosacea), a native of Europe, but cultivated in the United States for the LIQUORICE-ROOT. 447 fruit. The seeds are ovate, angular, reddish-brown externally, white within, inodorous, insipid and abound in mucilage. They are used externally, in solution (mucilago cydonii), two drachms to a pint of boiling water. GLYCYRRHIZA — LIQUORICE ROOT. This is the root of Glycyrrhiza glabra {Nat. Orel. Legu- minosse), a small herbaceous perennial plant,- of the countries around the Mediterranean. It is imported from Sicily and Spain ; and a portion of the Sicilian root is said to be the pro- duct of G. echinata. As found in the shops liquorice root is in long wrinkled pieces, often worm-eaten, varying from a few lines to more than an inch in thickness, externally grayish-brown, internally yellowish, without smell, and of a sweet, mucilagi- nous, sometimes slightly acrid taste. The best pieces are of the brightest yellow internally. The powder is grayish-yellow, or, if it is powdered with the epidermis removed, pale sulphur- yellow. The Russian liquorice of commerce is said to be derived chiefly from G. glandulifera ; the root has a reddish tint and a scurfy surface, which distinguish it from the smoother one of G. glabra. The constituents of liquorice root are, a peculiar transparent yellow, uncrystallizable sugar, termed glycyrrhizin (C 16 H 24 6 ) (which is scarcely soluble in cold water, but soluble in boiling water and alcohol, and is a glucoside, splitting up, when warmed with a dilute acid or upon being boiled, into glycyrretin and sugar), starch, aspar- agin, an acrid resin, etc. Effects and Uses. — A decoction of liquorice root (a troy- ounce boiled for a few minutes in water Oj) is a useful demul- cent in dysenteric, catarrhal and nephritic affections; it is also added to decoctions of acrid substances, to cover their taste and acridity. It should be made of the root deprived of its cortical part, which is acrid and without demulcent virtues; by long boiling the acrid resin is extracted. The powder is used in making pills (see p. 33). A fluid extract is officinal, and is a useful addendum to cough mixtures and to disguise the taste of ammonium carbonate or chloride. 448 MATERIA MEDICA — DEMULCENTS.' Glycyrrhizinum Ammoniatum (Ammoniated G-lycyrrhizin) is prepared by macerating and then percolating liquorice root with water of ammonia, precipitating with sulphuric acid, washing the precipitate and dissolving in water of ammonia and spreading on glass plates to dry. It may be used for the same purposes as the other preparations. Extractum Glycyrrhiz^: {Liquorice) is made by the evaporation of a decoction of the half-dried root. It comes to this country chiefly from Leghorn and Messina, and in part, also, from Spain ; good liquorice is prepared, too, in New York and England. Crude liquorice, when good, occurs in black, flattened, cylindrical rolls, about an inch in diameter, which are dry, brittle, with a shining fracture, of a very sweet, pecul- iar, slightly acrid taste, and are quite soluble in water. It is, however, much sophisticated, and for internal use is generally refined by dissolving the impure extract in water and water of ammonia, without ebullition, straining the solution and evap- orating ; sugar is often mixed with it, and sometimes mucilage or glue. Refined liquorice (extractum glycyrrhizce purum) is in small cylindrical pieces, not thicker than a pipe-stem. Liquorice is a pleasant demulcent, much used as an addition to cough mixtures and lozenges and to acrid infusions and decoc- tions. Mistura glycyrrhizce composita (compound mixture of liquorice), commonly called brown mixture, consists of pure liquorice, gum arabic, sugar, each half a troyounce ; paregoric, f^ij ; antimonial wine, foj ; sweet spirit of nitre, f 5ss ; water, f Sxij ; dose f §ss. Liquorice enters into the com- position of several troches already noticed. CETRARIA — ICELAND MOSS. Cetraria islandica, or Iceland Moss (Nat. Ord. Lichenes), is a foliaceous, erect lichen, from two to four inches high, found in the northern latitudes and mountainous districts of the new and old continents. It is obtained principally from Norway and Iceland, but is said to be abundant also in New England. As found in the shops it consists of irregularly- IRISH MOSS. 449 lobed and channelled coriaceous leaves, fringed at their edges with rigid hairs, of a brownish or grayish-white colour, darker on the upper surface, and sometimes marked with blood-red spots. It is almost odourless, and has a bitter, mucilaginous taste; its powder is whitish-gray. It gives up its virtues to boiling water, and consists chiefly of a kind of amylaceous matter (which is coloured blue by iodine, and is termed lich- enin — C 12 H 20 O 10 ), and a bitter principle termed cetrarin or cet- raric acid (C 18 H 16 8 ) ; it contains, besides, other principles. Effects and Uses. — Iceland moss is a demulcent tonic, and is also highly nutritious. It is adapted to cases requiring a light aliment combined with a mild and acceptable tonic ; and from its demulcent properties has a soothing influence in inflammations of the various mucous membranes. It is chiefly used in chronic affections of the pulmonary and digestive organs, in the form of decoction (decoctum cetrarice), which may be taken ad libitum. By maceration in water or a weak alkaline solution, Iceland moss may be deprived of its bitter principle ; and it is then used as a mild nutritive demulcent. CHONDRUS — -IRISH MOSS. Chondrus crispus, Carrageen or Irish Moss {Nat, Ord. Algae) is a marine alga found chiefly on the west coast of Ireland, and also on the coast of New England ; it is prepared for use by washing, bleaching and drying. It is also prepared from Chondrus mammilosus. As found in the shops it consists of fronds from two to three or four inches long, mostly yellowish or dirty-white, but intermixed with purplish-red portions, nearlv inodorous, and of a mucilaginous taste. It swells up in warm water, and is almost entirely dissolved when boiled. Its chief constituent is a peculiar mucilaginous principle, for which the term Carrageenin has been proposed ; and it contains also some mucus, resins, etc. Effects and Uses. — It is a very agreeable nutritive demul- cent, useful in bowel complaints and pectoral affections. It may be given in the form of decoction (half a troyounce to 29 450 MATERIA MEDICA — DEMULCENTS. water Ojss boiled to Oj) flavoured with lemon juice and sugar ; or it may be made with milk or cream into blanc-mange, which forms an excellent light diet for the sick. By saturating two superimposed layers of wadding with a solution of chondrus, and drying them in a stove after they have been submitted to strong pressure, a sheet of the consistence of cardboard is produced, which, when soaked in hot water, makes an excellent poultice. AMYLUM — STARCH. This term is applied by the Pharmacopoeia to the fecula of the seed of Triticum vulgare, the well-known wheat [Nat, Ord. Graminacese). It is a proximate principle, however, which pervades the vegetable kingdom, being found in various parts of plants, especially in seeds, tubers and bulbous roots. It is obtained by bringing the substances in which it exists to a state of minute division, agitating or washing them with cold water, straining or pouring off the liquid, and allowing it to stand until the fecula which it holds in suspension has subsided. It occurs as a white, opaque, odourless, tasteless powder, or in columnar masses of a crystalline aspect, and produces a pecul- iar sound when compressed between the fingers. It is insoluble in alcohol, ether and cold water. Examined under the micro- scope, starch is seen to consist of minute cells or granules, varying in size and shape in the different varieties of amylaceous substances. The envelope of these granules is insoluble in cold water, but is ruptured by heat, so that the interior portion is exposed and becomes dissolved ; hence starch is said to be insoluble in cold, but soluble in boiling, water. Starch is C 6 H 10 O 5 . By the action of heat, or by long boiling with diluted sulphuric or muriatic acid, it is converted into dextrin, an isomeric soluble principle, and by the same process this may be converted into grape sugar. The same change takes place in grains, after germination, through the agency of a nitro- genous principle termed diastase. The test for starch is iodine, which forms with starch-solution a rich blue iodide ; LARD. -451 with bromine starch strikes an orange precipitate ; nitric acid converts it into oxalic acid. ^Effects and Uses. — The starchy or farinaceous articles form an important group of nutrients. Their assimilation is effected by the albuminous principles of the digestive tube (salivin, pancreatin, etc.), which change starch into grape sugar. This is converted in part into fatty tissue, and is partly fer- mented into lactic acid, which acts as a calefacient. Starch is used externally as a dusting powder to excoriated surfaces, as an emollient poultice, and in solution as a vehicle for laudanum as an enema. It is the antidote for iodine. Glycemtum Amyli (Glycerite of Starch) [Plasma) contains 10 per cent, of starch thoroughly mixed with glycerin and dissolved by the aid of heat. It is an excellent vehicle for astringent applications in ophthalmic surgery (Bartholow), and is an excellent application to allay the heat, burning and itch- ing of* the skin in scarlatina and small-pox ; in the latter it is particularly pleasant to the patient, and has as much effect in preventing pitting as any other application (H. M.). It is used as a substitute for ointments, and is a good excipient for pills. Amylum iodatum {iodized starch) has been already spoken of (vide p. 371). Ichthyocolla (Isinglass), prepared from the swimming bladder of Acipenser huso (the sturgeon) and of other fishes, is the purest form of gelatin. Court plaster is made by coat- ing oiled silk with a solution of isinglass. Gelatin is also used as an article of diet, and is employed in pharmacy to make capsules for the administration of disagreeable liquid medicines, and as a coating for pills. For external use, the animal fats are employed as emollients. Adeps (Lard) is the prepared fat of Sus scrofa (the hog) ; the internal fat of the abdomen is preferred, which is washed, melted and strained. Below the temperature of 90° it occurs as a soft, white solid, which for medicinal use should be free 452 MATERIA MEDICA — DEMULCENTS. from saline matter. It consists of olein and stearin. It is used in pharmacy as an addition to poultices, and as an inunction in the exanthemata, particularly scarlatina. Cerate (ceratum) is made by melting together 7 parts of lard and 3 parts of white wax, Unguentum {ointment) is made by melt- ing together 4 parts of lard and 1 part of yellow wax. Lard oil (the olein of lard) is a good vehicle for anodyne enemata. Adeps benzoinatus (benzoinated lard), formerly termed henzoinated ointment, consists of benzoin 2 parts in 100 parts of lard. Sevum (Suet) is the prepared fat of Ovis aries (the sheep). It is composed almost exclusively of stearin, but also contains some palmitin, olein and hircin. Cetaceum (Spermaceti) is a peculiar concrete substance obtained from Physeter macrocephalus (the spermaceti whale). It consists almost entirely of cetyl palmitate (C 16 H 33 C 16 H 31 2 ) or cetine, but recently has been shown to contain also ethers of stearic, myristic and laurostearic acids ; and of the alcohols lethal (C 12 H 26 0), methal (C 14 H 30 O), ethal (C 16 H 34 ) and stethal (C 18 H 38 0). Spermaceti cerate (ceratum cetacei) is made by melting together 10 parts of spermaceti and 35 parts of white wax, and then adding 55 parts of olive oil, previously heated. Ointment of rose-water (see p. 184) contains sper- maceti. Cera Flava (Yellow Wax) is a peculiar concrete sub- stance prepared by Apis mellifica (the honey bee). Cera Alba ( White Wax) is yellow wax bleached. They are used chiefly in making cerates, ointments and plasters. ACIDUM OLEICUM — OLEIC ACID. Oleic acid (HC 18 H 33 2 ) exists in nature combined with glycerin as olein. It is obtained in an impure state as a OIL OF THEOBROMA. 453 secondary product at stearin candle manufactories. To purify the acid, it is cooled to 14° F. and expressed ; the solid por- tion melted and treated with lead protoxide ; the lead oleate is dissolved out by ether, decanted, and shaken with hydrochloric acid, which decomposes it ; the ethereal layer is decanted and evaporated. The oleic acid thus obtained is still contaminated with a little oxyoleic acid, which is difficult to separate. Oleic acid is a yellowish oily liquid, which becomes brownish and rancid by exposure to the air, without smell or taste, soluble in alcohol, ether and cold sulphuric acid, but insoluble in water. The oleates of the alkaline metals are soft soluble soaps ; those of the earthy metals are insoluble in water, but soluble in alco- hol and ether. Oleic acid is used principally in preparing the oleates of ver- atrine [vide p. 222) and of mercury {vide p. 360). OLEUM THEOBROMA — OIL OF THEOBROMA. This oil, commonly known as Batter of Cacao, is the fixed oil expressed from the seed of Theobroma cacao (Nat. Orel. Sterculiacese), a handsome tree, from twelve to twenty feet in height, growing in Mexico, the West Indies, Central America and South America. The fruit is an ovate-oblong capsule or berry, half a foot in length, with a thick, coriaceous, ligneous rind, inclosing a whitish pulp, in which numerous ovate seeds are embedded, about the size of an almond. Separated from the matter in which they are enveloped, these constitute the chocolate-nuts of commerce (see p. 116). They contain fixed oil {cacao butter), theobromia, and other matters. Theobromia is a nitrogenous alkaloid, analogous to caffeina. Cacao butter is obtained by expression, decoction or the action of a solvent. It occurs in whitish or yellowish oblong cakes, of the con- sistence of tallow and of an agreeable odour and taste. It contains a large proportion of stearin, also palmitin and olein. It is used in pharmacy for coating pills, and also largely in preparing suppositories, for which it is well adapted from its consistence and blandness. 454 MATERIA MEDICA — DEMULCENTS. GLYCERINUM — GLYCERIN. This is a substance which exists in oils in combination with the fatty acids (stearic, margaric, oleic, etc.), and is liberated from them when they unite with bases in the process of sapon- ification. It was first obtained in the process for making lead plaster, by mixing litharge (lead protoxide) with olive oil and boiling water, by which the fatty acid unites with the lead and is precipitated, and the glycerin remains in solution. It is freed from any lead it may contain by means of a stream of sulphuretted hydrogen gas, and is afterwards filtered through animal charcoal ; or, as it is now usually made more directly, by decomposing fats and distilling by steam under high pressure. Glycerin (C 3 H 5 3HO), or Glyceric Alcohol, is the hydrate of Glyeeril, Grlycil, or Propenyl, and is a triatomic alcohol. It is a thick, syrupy liquid, colourless or straw- coloured, unctuous to the touch, inodorous, and of a sharp, sweet taste. When pure its sp. gr. is 1*26, when it contains 95 per cent, of absolute glycerin ; the Pharmacopoeia directs its sp. gr. to be 1*25. It is soluble in oils, alcohol and water, but is insoluble in ether and chloroform, and does not evap- orate when exposed to the air, but absorbs one half its weight of water. It has remarkable solvent properties, dissolving iodine, bromine, the alkalies, tannic and other vegetable acids, a large number of neutral salts, and many organic principles. Officinal solutions of medicinal substances in glycerin are termed glycerites (glycerita). Effects and Uses. — Glycerin is a bland and unirritating sub- stance. It has the capacity of diffusing itself freely over and through organic matter, incorporating itself between organic molecules, by which it is absorbed and appropriated. It has been used internally as a nutrient and demulcent, and has been deemed of value in cachectic, strumous and asthenic conditions in children, but the weight of opinion is against its efficacy as an alterative. It is as a topical application that it is chiefly employed. As an enema in dysentery, to soften hardened mucus in the air passages, in various cutaneous affections, in PETROLEUM OINTMENT. 455 diphtheria, in deafness attended with dryness of the meatus, and as a vehicle or solvent for active medicines, glycerin is a valuable article. Guzzo (Gaillard's Med. J., March, 1882) recommends the following treatment to prevent extensive cicatrization following burns : apply to the whole burned sur- face a piece of lint thickly spread with cold cream and covered with a compress two inches thick saturated with glycerin (freshly wet from three to six times a day ; the whole dressing to be changed daily), and covered with a dry compress and bandage. This treatment failed in only one of fifty-two cases (Archiv. Dermat., Oct. 1882). Grlyceritum amyli (glycerite of starch) has been already considered (vide p. 451). G-lyceritum vitelli (glycerite of yolk of eggs) (glyconin) is made by mixing thoroughly 45 parts of fresh yolk of eggs with do parts of glycerin. It is a good vehicle for the admin- istration of cod-liver oil, a few drops of some aromatic being added as a flavouring ingredient. PETROLATUM — PETROLEUM OINTMENT. Petrolatum is a mixture of hydrocarbons obtained by dis- tilling the lighter and more volatile portions from American petroleum, and purifying the remainder. Mineral oils have been known from time immemorial, and were obtained by the ancients from Sicily, the Ionian Islands and Persia ; later they were found in various parts of Europe, ^Asia and North America, but did not become an important article of commerce until 1859, when the first oil-well was sunk near Titusville, in Pennsylvania (Witthaus). Petrolatum is a yellowish, trans- parent, semi-solid fatty substance, melting at from 104° to 125° F., insoluble in water and cold alcohol, more so in boiling absolute alcohol; readily soluble in ether, chloroform, oil of turpentine, benzoin and the fixed and volatile oils. It consists principally of the hydrocarbons of the marsh-gas series. It has been introduced into the Pharmacopoeia as a substitute for vaseline, cosmoline, and other copyrighted preparations, which 456 MATERIA MEDICA — DEMULCENTS. consist of mixtures of paraffine and the heavier petroleum oils, and, like them, possesses the advantage over the animal oils and fats of not becoming rancid. Effects and Uses. — When taken internally, in large doses, petroleum is said to cause giddiness and oppression, with pal- pitation and headache. It seems to be well borne by the stomach, and causes no diarrhoea. It is principally used ex- ternally as an unguent in scarlet fever and cutaneous affections, and forms an admirable basis for other ointments. It is an excellent dressing for wounds. Dr. H. L. Byrd, of Baltimore (Medical Progress, Nov. 4, 1882), speaks highly of cosmoline, gr. viij-xv every two to four hours internally, and petroleum externally, in diphtheria and measles. The same treatment in whooping-cough lessens and loosens the mucus, mitigates the violence of the paroxysms of coughing and shortens the dura- tion of the disease. He believes it acts by destroying germs, and that given internally twice daily it is a prophylactic in diphtheria and whooping-cough. PYROXYLINUM — PYROXYLIN. Pyroxylin, or Soluble Gun Cotton, is made by adding cotton to a mixture of nitric acid gradually added to sulphuric acid, and allowing it to macerate ; it is to be washed first with cold water, and then with boiling water, and after being drained on filtering paper it is dried by means of a water- bath. Pyroxylin has the appearance of ordinary cotton, but is harsh to the touch. It is insoluble in water, nearly so in alcohol, but, when freshly prepared, it dissolves in ether, forming collodion ; it is liable to decomposition if kept for some time. COLLODIUM — COLLODION. This is a solution of pyroxylin (4 per cent.) in stronger ether (70 per cent.) and stronger alcohol (26 per cent.). Col- lodion is a slightly opalescent, syrupy liquid, with a strong ethereal smell. By long standing it deposits a layer of fib- SOLUTION OF GUTTA-PERCHA. 457 rous matter, and becomes more transparent ; this layer should be reincorporated by agitation before the collodion is used. When applied to the skin the solvent evaporates, and it forms a colourless, transparent, flexible and strongly contractile film. In this way it proves antiphlogistic by driving the blood away from a part, limiting effusion and promoting absorption, and at the same time acts as an admirable emollient by protecting an inflamed surface from the action of the air. It is a useful application to ulcers, fissures and skin diseases, and erysipe- latous parts. Marked improvement has followed its daily use in that disfiguring keloid of the face which sometimes follows small-pox (H. M.). It is used also in surgery as a substitute for adhesive plaster, and in pharmacy as a vehicle for other medi- cines. Iodized collodion (a very good solution of iodine for external application) contains from ten to twenty grains of iodine in a fluidounce of collodion. Collodium Flexile {Flexible Collodion) is made by mixing 92 per cent, of collodion, 5 per cent." of Canada turpentine and 3 per cent, of castor oil. This is a softer, more pliable and more elastic preparation, useful in cases where the strongly contractile power of ordinary collodion is objectionable. It is a good application in eczema. Collodion, in all forms, is to be kept in well-stoppered bottles. Collodium Stypticum {Styptic Collodion) contains 20 per cent, of tanniG acid, 5 per cent, of alcohol, 20 per cent, of stronger ether and 55 per cent, of collodion. It is an excel- lent styptic application. LIQUOR GUTTA-PERCHA SOLUTION OF GUTTA- PERCHA. This is a solution of 9 per cent, of gutta-percha in 91 per cent, of purified chloroform. In preparing it lead carbonate is employed to free it from colouring matter. It is a clear, colourless or nearly colourless solution, and should be kept in well-stoppered glass vials. By the evaporation of the chloro- form, this proves an admirable application to inflamed or 458 MATERIA MEDICA — DEMULCENTS. abraded parts, in skin affections, chaps, etc. ; also an excel- lent protective coating to parts threatened with bed-sores or liable to excoriation. LIQUOR S0DII SILICATIS — SOLUTION OF SODIUM SILICATE. This solution (commonly known as Solution of Soluble Glass) is made by fusing together fine sand and dried sodium carbonate, and dissolving the product in hot water. It is a semi-transparent, colourless, viscid liquid, without smell but having a sharp, alka- line taste, which, on drying, becomes a transparent glass-like mass. It has been used as a local application in erysipelas, but is chiefly used in making permanent dressings in the treat- ment of fracture. For this purpose it should be thoroughly applied to successive, layers of the dressing to the part and allowed to harden. SACCHARUM — SUGAR. Sugar is a principle diffused through the vegetable world under many forms, all distinguished by a sweet taste. They are divided into two chief groups — Cane Sugar and Grape Sugar. Cane sugar is the product of Saccharum oflicinarum (Nat. Ord. Graminacese), a native of tropical countries, cultivated most successfully in the West Indies, and to some extent in Louis- iana. It has a general resemblance to Indian corn. (Cane sugar is made also in France from the beet-root.) The juice of the sugar-cane is extracted by crushing and expressing the stalks ; it is then boiled with quicklime, strained, and reduced by evaporation to a thick syrup, which is cooled and granu- lated in shallow vessels. Raw sugar is refined by the agency of animal charcoal. When pure, cane sugar is white, crystal- lized in translucent, double oblique prisms, very sweet, soluble in one-third its weight of water, in alcohol, but not in ether. At a heat of 320° F. it melts and cools into a glassy, amor- phous mass, known as barley sugar ; from a strong solution HONEY. 459 it can be made to crystallize slowly upon a string as rock candy. The uncrystallizable portion, which is drawn off in the granu- lation of sugar, is molasses or treacle, a dark, brownish-black syrupy liquid. Grape sugar is the sugar of grapes and other acid fruits ; it is also found in the liver and blood of mammalia, and in the urine of diabetes mellitus. It may be procured artificially by acting on starch with diluted sulphuric acid. It occurs as whitish or grayish-white, non-crystalline masses, or as a dense transparent syrup. Cane sugar (C 12 H 22 O n ) combines with alkalies to form saccha- rates. Grape sugar (C 6 II 12 6 H 2 0), when boiled with an alkali, is transformed into the acid of molasses, melassic acid ; mixed with solution of potassa and a weak solution of cupric sulphate, it attracts oxygen, and causes the precipitation of a reddish cuprous oxide (Cu 2 0). Effects and Uses. — Sugar, especially in the form of barley sugar, is an excellent demulcent to relieve catarrhal irritation ; much of the cough-relieving action of cough-syrups is due to the sugar they contain. It abates thirst, and is used to flavour refrigerant drinks. Tor pharmaceutical purposes sugar is much employed, for its agreeable taste, and also as a preserva- tive of vegetable substances, and to protect mineral medicines from oxidation. Molasses is slightly laxative as well as de- mulcent. MEL — HONEY. This saccharine liquid, the familiar product of the bee {Apis mellifica), best used in the form of mel despumatum {clarified honey), is a slightly laxative article of food, and is used in pharmacy, and as an agreeable demulcent ingredient in gargles. Saccharum Lactis {Sugar of 31ilk) (C 12 H 22 O n ,H 2 0), the saccharine principle of milk, obtained from whey, is used as a bland non-nitrogenous article of diet. By fermentation sugar of milk gives rise to lactic acid {acidum lacticum), a limpid, syrupy liquid, of a pale-wine colour, which has been used in 460 MATERIA MEDICA — COLOURING AGENTS. certain forms of dyspepsia, and for the removal of phosphatic deposits in the urine, in the dose of 5i-iij during the day. Sugar of milk is used in preparing the abstracts and to ensure the admixture of powders, as pulvis ip)ecacuanhce et opii. CARBO LIGNI — CHARCOAL. Although not strictly ranking with demulcents, the medicinal uses of charcoal may, perhaps, be appropriately noticed under this head. Charcoal is prepared by the exposure of wood to a red heat without access of air. For medicinal purposes the charcoal prepared from young willow-shoots for the manufac- ture of gunpowder is preferred. It is a black, shining, brittle, porous substance, without odour or taste, and insoluble in water. Effects and Uses. — It is employed internally as an absorbent of acrid secretions, in dyspepsia (in which it is often very use- ful), in gastric irritation, diarrhoea and dysentery ; dose, from one to four teaspoonfuls. Externally it is used with effect to absorb the offensive gases given off from foul sores, in the form of poultice, mixed with flaxseed meal, or with bread-crumb, which is better from its porosity ; dry charcoal is sprinkled with advantage over sloughing ulcers, and appears to promote the separation of the sloughs. ORDER IV. — COLOURING AGENTS. These are employed exclusively for pharmaceutical purposes. The following articles enter into officinal preparations, to which they are intended to communicate their peculiar colour: CROCUS — SAFFRON. This is the stigmas of Crocus sativus {Nat. Ord. Iridacese), a small perennial plant, a native of Greece and Asia Minor, but now cultivated all over Europe and in our own country. In Lancaster county, Pennsylvania, it has been raised to COCHINEAL. 461 considerable extent. The stigmas are an inch or more in length, of a rich deep-orange colour, a peculiar aromatic odour and a warm, pungent, bitter taste; they contain a principle termed saffranin or polychroite (C 48 H 60 O 18 ). Saffron is now admitted to possess little, if any, medicinal activity, and is used only to impart colour and flavour to officinal preparations. The tincture contains ten per cent, of saffron. S ANT ALUM RUBEU3I — RED SAUNDERS. This is the wood of Pterocarpus santalinus, a large tree of India and Ceylon (Nat. Ord. Leguminosse). It comes in roundish or angular billets, internally of a blood-red colour, externally brown, of little smell or taste ; in the shops it is found in the form of chips, raspings or coarse powder. It contains a resinoid matter, santalin (C 8 H 16 3 ), pterocarpin (C 17 H 16 5 ) and santalic acid. It is employed solely to give colour to spirits and tinctures. COCCUS — COCHINEAL. This is an insect, termed Coccus cacti, of Mexico and Cen- tral America, naturalized in Teneriffe and other places. The female insect, dried, constitutes the article of the shops. It occurs in the form of roundish or somewhat angular grains, about an eighth of an inch in diameter, convex on one side, concave or flat on the other, and wrinkled. Two varieties are distinguished, one reddish-gray, the other nearly black, known as silver grains and black grains. It has a faint, heavy odour and a bitter, slightly acidulous taste ; its colouring principle is carminic acid (C 17 H 18 O 10 ). Cochineal has had antispasmodic virtues attributed to it, and has been used in whooping-cough, especially in combination with potassium carbonate; dose, to infants, a third of a grain three times a day. It is employed chiefly, however, to colour tinctures and ointments. 462 MATERIA MEDICA — ANTHELMINTICS. ORDER V. — ANTHELMINTICS. Anthelmintics are medicines which promote the destruction and expulsion of worms from the alimentary canal. They act in different ways ; some weaken or destroy the worms by a direct poisonous influence, others by mechanical means. The drastic cathartics have an anthelmintic effect from the in- creased secretion and exhalation which they induce from the alimentary canal. S PIG ELI A. Spigelia, called also Pinkroot, is the rhizome and rootlets of Spigelia marilandica, or Carolina Pink (Nat. Ord. Logan- iaceae), an herbaceous indigenous plant, found chiefly in our southern and southwestern States. The rhizome is horizontal, thick, bent, purplish-brown, branched on upper side with cup- shaped scars, on the lower numerous thin, brittle, light-coloured rootlets. (It must not be confounded with the underground portion of the Phlox Carolina (also called Carolina pink).) The stems are numerous, from a foot to a foot and a half high, of a purplish colour, furnished with sessile, opposite, ovate- lanceolate leaves, and terminate in spikes, bearing funnel- shaped flowers, of a rich carmine colour externally and orange- yellow within, which appear from May to July. The rhizome and rootlets, as found in the shops, consist of numerous slender, wrinkled, branching, brownish fibres attached to a dark-brown caudex, and have a faint, peculiar smell and a sweetish, slightly bitter taste ; their activity is diminished by time. Boiling water extracts its virtues, which are thought to depend upon a bitter principle; it contains also volatile oil, resin, a little tannic acid, and other matters. Effects and Uses. — In ordinary doses spigelia often proves anthelmintic without any sensible effect on the system. In larger doses it purges and sometimes vomits ; and in excessive doses it operates as a narcotic poison, producing vertigo dilated pupils, convulsions and death. It is less apt to occa- SPIGELIA. 463 sion narcotic effects when it acts on the bowels, and hence it is usually combined with or followed by cathartics. As an anthel- mintic against lumbrici (or round worms) it is considered the most reliable article we possess. Fig. 30. Administration. — Dose of the powdered root, 5i-ij for an adult ; for a child three or four years old, gr. x-xx, to be repeated night and morning for three or four days, and fol- 464 MATERIA MEDICA — ANTHELMINTICS. lowed by a brisk cathartic ; calomel is sometimes combined with it. The fluid extract contains in a fluidounce a troyounce of spigelia ; dose for a child two years old, ten drops. Under the name of worm tea, preparations containing spigelia and cathartics are kept in the shops, as in the following formula : spigelia §ss, manna §i, senna and fennel, each 5>j\ savine 3ij ; to be infused in a pint of boiling water, and a tablespoonful given to a child two years old, three times a day. CHENOPODIUM WORM SEED. Fig. 31. Wormseed is the fruit of Chenopodium ambrosioides, or Jerusalem Oak (Nat. Ord. Chenopodiacae), an indigenous herbaceous perennial plant (found most abundantly in the SANTONICA. 465 southern states), from two to five feet high, with alternate oblong-lanceolate, sinuated and toothed yellowish-green leaves, with numerous small flowers of the same colour arranged in long terminal panicles. Wormseed, as found in the shops, is in small spherical grains, not larger than a pin's head, of a dull greenish-yellow or brownish colour, a peculiar offensive smell, and a rather aromatic, pungent taste. Their sensible and medicinal properties are owing to a volatile oil (Oleum Chenopodii), obtained by distillation. Effects and Uses. — Wormseed is a very efficient anthelmintic, particularly adapted to the expulsion of lumbrici from chil- dren. Dose, 3i-ij for a child two or three years old, in molasses, night and morning, for three or four days, to be fol- lowed by a brisk cathartic. The oil is more used than the fruit ; dose, gtt. v-x for a child, in emulsion with sugar. The expressed juice of the leaves and a decoction made with milk are also used. SANTONICA. The unexpanded flowers of Artemisa maritima (Nat. Ord. Composite), a native of Persia, and of other species of artemi- sia, are used as an anthelmintic (in the dose of 10 to 80 grains), under the name of Levant Wormseed. They resemble small seeds in appearance, are about a line in length, oval, obtuse at both ends, of a greenish-brown colour, a strong, somewhat tere- binthinate odour, and a bitter, camphoraceous taste. They contain volatile oil, resin, and a peculiar principle termed san- tonin, which is prepared by digesting santonica and lime in diluted alcohol, adding acetic acid, crystallizing, boiling with alcohol, digesting the tincture with animal charcoal, filtering and crystallizing. Santonin (Santoninum) is a neutral principle (C 15 H 18 3 ), and occurs in colourless shining, flattened prisms, without smell, nearly tasteless at first, but after a time bitter ; it becomes yellow on exposure to the light. It is nearly insoluble in cold water, soluble in 250 parts of boiling water, in 43 parts of cold and 3 parts of boiling alcohol, and in 160 parts of 30 466 MATERIA MEDICA — ANTHELMINTICS. ether. This is the anthelmintic constituent of santonica, and is a most efficient anthelmintic for lumbrici; but in large doses it is capable of producing serious if not fatal poisoning in man. The symptoms are (occasionally but not invariably) vomiting, giddiness, stupor, coldness of the skin, with clammy perspiration, dilated pupils, and, finally, tetanic convulsions. A remarkable effect of santonin, even in moderate amounts, is a change in the field of vision, so that objects are seen as if through a yelloiv medium. When allowed to remain in the system, santonin is supposed to be converted into a substance termed xanthopsin, which is eliminated through the kidneys, producing a yellow discoloration of the urine ; and probably it is this transformation which gives rise to the poisonous symp- toms occasionally noticed. Hence, santonin is best administered with calomel or other purgative. Dose, gr. ss-v two or three times a day, in the form of syrup. Sodii Santoninas {Sodium Santoninate) (2NaC 15 H 19 4 7H 2 0) is made by adding santonin, as long as it is dissolved, to a hot solution of caustic soda and allowing the liquid to evaporate slowly. Trochisci Sodii Santoninatis ( Troches of Sodium Santoni- nate)', each troche contains sodium santoninate gr. j with sugar, tragacanth and orange-flower water. AZEDARACH. ■ This is the bark of the root of Melia azedarach, or Pride of China (Nat. Ord. Meliacese), an Asiatic tree, cultivated ex- tensively as an ornamental tree in our southern states. It has a bitter, nauseous taste, and yields its virtues to boiling water; but as it is used only in the recent state, it is not found in our shops. Its effects are said to resemble those of spigelia. The decoction is the preferred form of administration (four troy ounces to water Oij, boiled to Oj) ; dose for a child, f gss every two or three hours, till it affects the stomach and bowels ; or night and morning for several days. . ASPIDIUM. 467 ASPIDIUM. Aspidium filix-mas, or Male Fern, and A. marginale (JS r at. Ord. Filices) are plants found in both hemispheres, from Greenland to Natal and from Japan to Peru, though not in- digenous in the eastern United States. They have a peren- nial horizontal root, from which spring numerous annual oval, lanceolate, acute, bright-green pinnate fronds or leaves, from a foot to four feet in height, grouped together in the form of a base ; the leaflets are deeply lobate, oval, crenate at their edges, and gradually diminish from the base of the pinna to the apex. The rhizome is the portion used. It is a long, cylindrical caudex, covered with portions of the stipes, and as found in the shops it is generally broken into fragments, of a brown colour externally, internally yellowish-white or greenish, with a peculiar feeble odour and a sweetish, bitter, astringent, nauseous taste. It deteriorates by keeping. It contains felicic acid (C ]4 H 18 5 ), on which its medicinal proper- ties are said to depend ; also volatile oil, fixed oil, resin, tannic and gallic acids, etc. ; and ether is the best solvent to extract its virtues. Effects and Uses. — Aspidium possesses tonic and astringent properties ; but its chief use is to cause the expulsion of taenia, which it destroys by a specific action. Its efficacy in this respect has been long and well attested, but it is most used to destroy the Swiss variety of taenia (borthriocephalus latus). Recently a fatal case of poisoning by aspidium has been re- ported, with symptoms of choleraic diarrhoea. The patient was given ovj of an ethereal extract by mistake. The post-mortem appearances were intense congestion of the stomach, with ec- chymoses beneath the mucous membrane and blood clots on the mucous surface. Dose, of the powder, 5i-iij, in electuary or emulsion, night and morning for one or two days. The oleoresin {pleoresina aspidii) is the best preparation ; it is a dark, thick liquid, of a bitterish, nauseous, slightly acrid taste; dose, f 5ss to f 5i night and morning for a day or two, to be followed by a cathartic. The administration of the taenia- 468 MATERIA MEDICA — ANTHELMINTICS. cide agents should always be preceded by a twenty-four hours' fast. GRANATUM — POMEGRANATE. The bark of the root of Punica granatum (see p. 184) is used for the expulsion of taenia. It is a powerful styptic, and may act in this way. It is given in decoction (two troyounces to water Oij, boiled to Oj); dose, f5ij or more. Oleum Terebinthin^e (Oil of Turpentine) (see p. 335) is used as a remedy for taenia and other worms. Dose, foj, com- bined with or followed by castor oil. Calomel (see p. 360) is a valuable anthelmintic, given in cathartic doses. Brayera (Koosso). The female inflorescence of Brayera anthelmintica (Nat. Ord. Rosaceae), a native of Abyssinia, have been introduced into European practice as a remedy for taenia, under the name of Koosso. They occur in broken, compressed clusters, of a greenish-yellow colour, a fragrant balsamic odour, and a faint taste which after a time becomes acrid and dis- agreeable. They are said to impart their virtues best to hot water, and to yield gum, resin, fatty matter, tannic acid, and about three per cent, of a peculiar principle termed Jcosin, a yellow crystalline body, without smell or taste, to which its anthelmintic properties are attributed. They are given best upon an empty stomach, after a previous evacuation of the bowels, in infusion, 5«s of the powder with Oss of boiling water. Extractum Brayera? Fluidum (Fluid Extract of Brayera) ; dose, f5ij-jv. KAMALA. This is the glands and hairs obtained from the capsules of Mallotus philippinensis {Nat. Ord. Euphorbiaceae), a small tree of Hindostan and the East India islands. It is an orange-red, granular, inflammable powder, with little smell or taste, insol- PUMPKIN-SEED. 469 uble in cold and nearly so in boiling water ; soluble in boiling alcohol and ether. It consists chiefly of resinous substances, to one of which, soluble in ether, and considered the active constituent, the name of rottlerin (C 22 H 20 O 6 ) has been given. Uses. — Kamala (formerly called Bottler a) is a highly- esteemed tseniacide in India, and has been lately introduced into Europe and our own country. Dose of the powder, 5i-ij, suspended in syrup. A tincture (six troy ounces to alcohol Oj) is given in the dose of f 5i-iv. Castor oil should be taken after the medicine. PEPO — PUMPKIN -SEED. The seed of Cucurbita pepo, or common Pumpkin, is proba- bly the most efficacious remedy known in the expulsion of tape- worm. These seeds are oval, flattish, grooved, 9 lines long by 5 or 6 in breadth, of a light brownish-white colour, a sweetish, oily taste and aromatic smell. They owe their activity to a principle soluble in ether, chloroform, and especially alcohol. One or two troyounces of the fresh seeds, deprived of their outer envelope, beaten to a paste with finely-powdered sugar, and diluted with water or milk, should be taken after a twenty- four hours' fast, and followed in two or three hours by a dose of castor oil. A fluid extract, made with alcohol and glycerin, is probably the best preparation; dose, fSss-i. APPENDIX SIGNS AND ABBREVIATIONS USED IN PRESCRIPTIONS. R, Recipe, take. aa, Ana (ava), of each. lb, Libra, librae,, a pound, pounds. %, Uncia, uncise, an ounce, ounces. 3, Drachma, drachmae, a drachm, drachms. ^, Scrupulus, scrjipuli, a scruple, scruples. 0, Octarius, octarii, a pint, pints. f^, Fluiduncia, fluiduncise, a fluidounce, fluidounces. f^, Fluidrachma. , fluidrachmse, a fluidrachm. fluidrachms. TT^, Minium, minima, a minim, minims. Ad 2 Vic, Ad duas vices, at two takings. Ad Lib., Ad libitum, at pleasure. Add., Adde, addantur, add, let be added. Altern. Horis, Alternis horis, every other hour. Aq. Destil., Aqua destillata, distilled water. Aq. Ferv., Aqua fervens, hot water. Aq. Fluvial., Aqua fluvialis, river water. Aq. Font., Aqua fontana, spring water. Aq. Pluv., Aqua pluvialis, rain water. Bis Ind., Bis indies, twice a day. Bull., Bulliat, bulliant, let it or them boil. Cap., Capiat, capiendum, let the patient take it, it must be taken. Chart., Charlula, chartulse, a small paper, or papers. Cochleat., Cochleatim, by spoonfuls. Coch. Mag., Cochleare magnum, a tablespoonful. Coch. Med., Cochleare medium, a dessertspoonful. Coch. Parv., Cochleare parvum, a teaspoonful. Col., Cola, coletur, strain, let it be strained. Collyr., Collyrium, an eye-water. Comp., Compositus, compounded. Cong., Congius, Congii, a gallon, gallons. C M. S., Cras mane sumendus, to be taken to-morrow morning. C. N., Cras node, to-morrow night. Decoc, Decoctum, a decoction. De D. in D., De die in diem, from day to day. Dieb. Alter , Diebus Alternis, every other day. Dil., Dilue, dilutus, dilute, diluted. Dim., Dimidius, one-half. Div., Divide, divide 472 APPENDIX. D., Doses, a dose. Elec, Electuarium, an electuary. Enem., Enema, enemata, a clyster, clysters. Exhib., Exhibeatur, let it be administered. F. H., Fiat haustus, let a draught be made. Fil., Filtra, filter. Ft., Fiat,fiant, let there be made. Garg., Gargarysma, a gargle. Gr., Granum, grana, a grain, grains. Gtt., Gutta, guttse, a drop, drops. Guttat., Guttatim, by drops. Haust., Haustus, a draught. Ind., Indies, daily. Inf., Infunde, pour in. Infus., Infusum, an infusion. Inj., Injiciatur, let it be injected. Jul., Julepus, julepum, a julep. M., Misce, mix. Mane, in the morning. Mist., Mistura, a mixture. Mic. Pan., Mica panis, crumb of bread. No., Numero, in number. Omn. Hor., Omni hord, every hour. Omn. Bid., Omni biduo, every two days. Omn. Bih., Omni bihora, every two hours. Omn. Man., Omni mane, every morning. Omn. Nocte, Omni node, every night. Omn. Quadr. Hor., Omni quadrante horse, every quarter of an hour. Ph., Pharmacopoeia. Pocul., Poculum, a cup. P. R. N., Pro re natd, as the symptoms may call for. Pulv., Pulvis, a powder. Q. P., Quantum placeat, as much as you please. Q. S., Quantum sufficiat, enough. Quor., Quorum, of which. Redig. in Pulv., Redigatur in pulv er em, let it be reduced to powder, Repet., Repetatur, repetantur, let it or them be repeated. S., Signa, write. S. A., Secundum artem, according to art. Semih., Semihord, half an hour. Sign., Signatura, a label. Ss., Semis, a half. Sum., Sume, sumendus, let it be taken. Tabel., Tabella, a lozenge. Troch., Trochiscus, a lozenge. Trit., Tritura, triturate. A COMPARISON BETWEEN THE DRUGS OF THE CHINESE AND UNITED STATES MATERIA MEDICO, WITH A SHORT ACCOUNT OF CHI- NESE MEDICINE. Information concerning the drugs in use by the Chinese is difficult to obtain because the facts in regard to them are scattered and badly arranged in the profuse literature of the country and its people. Much of the knowledge used in making this " drug comparison " has been taken from a " Chinese Materia Medica and Natural History," by Smith, which, as the author states in his preface, derives its original information from the great Chinese Herbal, or native Materia Medica. This work, known as the Pen Ts'au, 1 and to be hereafter so designated, was compiled by Li Shi Chin, a district magistrate of the province of Hupeh, and published about 1597. It was not a com- pilation alone, for it contained original observations and showed evi- dence of a comprehensive mind. It is usually bound in forty octavo volumes, divided into fifty-two chapters, containing 11,896 form- ulae. The first two volumes contain theories of anatomy and med- icine ; in other portions observations on practice are contained, and lastly, there is an index. Each article is treated in a pharmaceutical, descriptive and medicinal manner. 2 The contents are arranged in sixty- two great orders and sixteen divisions, viz. : (1) water, (2) fire, (3) earth, (4) minerals and metals, (5) herbs, (6) grain and pulse, (7) vege- tables, (8) fruits, (9) trees, (10) garments and utensils, (11) insects, (12) scaly animals, (13) mailed and shelly creatures, (14) birds, (15) beasts, and (16) man. Each article in the sixteen divisions is treated separately and fully. Water is divided into aerial and terrestrial : fire is considered under eleven heads, viz., bambo, moxa, etc. : earths include soots, ink, the secretions of various animals : the chapter on minerals and metals includes metallic substances and their oxides : herbs include nine families, viz., odoriferous, marshy, noxious, aquatic, hill plants, etc., and medicinal plants: grain and pulse com- prise four families, hemp, wheat, rice, etc. : vegetables, pungent 1 Middle Kingdom, vol. 1, p. 288. 2 Chinese Mat. Med. and Nat. History, see preface. 474 APPENDIX. plants, leeks, mustard, ginger, bamboo sprouts : fruits consist of the plum, peach, citron, melon, etc. : of trees there are six families, viz., the camphor, pine, elm, willow, bamboo, etc. : the chapter on gar- ments and utensils contains an account of such garments and utensils as are used in medicine : the chapter on insects includes bees, the silk- worm, etc. : of the scaly animals spoken of there are dragons, crabs, tortoises, fishes, etc. : the chapter on birds describes the water fowl, sparrows, etc. : and in the chapter on beasts are included wild and domestic animals. Besides the Pen Ts'au there is a miscellaneous work in three volumes, the Uhr Ya, 1 which ranks high as an authority on natural history. In Peking 2 there is a medical school which affords instruction to numerous students. It would seem to be rather a medical hall than school, practitioners not being brought up in the school, but attending it after having obtained some knowledge of medicine. It is under the charge of a president and deputies, the duties of the latter con- sisting in directing the medical art to cure. Instruction in medicine does not appear to be an object any further than it is to be gained by practical experience. 3 There is no recognized system of instruction. A man intending to become a doctor reads the books he thinks most de- sirable, generally those containing the experience of any old practitioner, no diplomas being required. Medical practitioners in China are, as a rule, well educated, because those studying medicine are mostly disap- pointed literati — that is, young men who have competed for literary rank and prizes at the great examinations held in Peking, and failed. 4 These men, and others too, claim the title of doctor as soon as they have read what they consider to be a sufficient number of books on medicine, without proving to any one that they are entitled to the degree. 5 The Chinese make no division of medical practice, and therefore are in no sense of the word specialists, the same individual often acting as surgeon, physician and apothecary. That this is true in all cases is doubtful, for Lochardt states that some are obstetricians, while others treat rheumatism and fevers. 1 Chinese Repository, vol. 7, p. 45. 2 Ibid., vol. 4. 3 Medical Missionary in China, Lochardt. 4 Chinese Repository, vol. 1, p. 181. 6 Staunton's Embassy, vol. 2, p. 534. APPENDIX. 475 *A11 diseases are classified under nine headings, viz.: (1) those affecting the pulse violently, (2) those affecting it a little, (3) diseases arising from cold, (4) female diseases, (5) cutaneous diseases and sores, (6) diseases requiring bleeding, (7) diseases of the eye, (8) diseases of the mouth and teeth, (9) diseases of the bones. It will be seen that diseases of the pulse take up two of the nine divisions, 2 for the Chinese lay great stress on the frequent and minute examination of the pulse, 3 thinking that it portrays the condition of the liver and other important organs. That the Chinese were not ignorant of counter-irritation and deple- tion is apparent; for, according to *Remissat, they understood blood- letting, cupping and the effects of baths upon the system. 5 The great obstacle to the progress of the Chinese in the art of medicine is their want of anatomical knowledge. Their lack of accu- rate information in this branch of medicine is ridiculous as well as lamentable. Nor is it to be wondered at, when one takes into con- sideration the fact that they do not practice dissection. It will not be out of place here to insert extracts from a translation of a Chinese anatomical work 6 : — " The bladder has charge of accumulated water." " It is the receptacle of the saliva." " The water drunk permeates into the bladder, while the dregs and dirt flow into the large intes- tine." " The seventh vertebra has a small heart connected to its side," probably alluding to the vertebral artery. " The brain con- sists of one piece." " At one expiration the blood moves three inches, and the same during inspiration." " The lungs take charge of the food ; the superabundant food is taken charge of by the small intes- tine." " The kidneys regulate our strength, and from them all our clever ideas originate." " The ileo-caecal valve is the impeded door- way." This is a strange mixture of fact and fiction. At first one would suppose, from the statement that the bladder has charge of the accu- mulated water, that they possessed some correct physiological and anatomical knowledge ; but, in the next sentence, to be told that the same receptacle contains the saliva indicates at once their ignorance. 1 Chinese Repository, vol. 4. 2 Chinese Repository, vol. 1, p. 181. 3 Melanges Asiatiques, tome 1, p. 245. 4 Ibid., t. 1, p. 25. 5 Ibid., t. 1, p. 245. 6 Translation of four anatomical diagrams, Harland, 1846. 476 APPENDIX. 1 0ne authority states that their entire anatomical knowledge is founded on metaphysical speculation and not on fact. Classification of Medicines. — The Chinese group their drugs in accordance with their names, with the part or organ into which they enter, their properties, if hot or cold, their taste and smell, uses and doses. 3 Sixty or seventy of these herbs are frequently combined in a dose, and the practitioner attempts to foretell the precise time of recovery. Tonics. — Medicines which warm and strengthen the viscera, viz., ginseng, dates, beef, honey, liquorice root, cassia, cinnamon and aloes. Astringents. — Nutmegs, galls, poppy seeds, pomegranate skin, charcoal, burnt straw, bones and tusks of dragon, oyster shells, quince seeds and iron filings. Resolvents.— Gringer, onions, leeks. Medicines which disperse wind : mint, cassia, mimosa pods, tigers' bones, snakes' skins, camphor. Medicines which reduce heat : yam, black pulse, curd. Emetics : white hellebore, bluestone. Warm resolvents : nutmeg, pepper, cloves, sandal wood, benzoin, resin, barley, mustard seeds. Mild resolvents : betel-root, duck-weed and orange-peel. Purgatives. — Rhubarb, sodium sulphate, warm water, catechu, (?) bears' gall, human ordure. Mild aperients : wormwood. Medi- cines which affect the blood : to warm it, wine, germander, brown sugar, cassia wood j to cool it, saffron, elm-tree root, cinnabar. Astrin- gents of the blood : madder, turmeric, dragon's blood, arrowroot, old copper cash, goats' ordure, cantharides. Miscellaneous. — To kill worms : asafetida, betel-root, quicksil- ver (native calomel). To kill poisons : castor-oil seeds, resin, ivory shavings, elephants' skin, a preparation of toads. To expel poisons : burdock seeds, dried earthworms. Poisons : croton-oil seeds and arsenic. This list comprises 442 medicinal agents. Vaccination. — Small-pox becomes epidemic in certain portions of China at different periods, and single cases occur in the treaty ports. The disease frequently is very fatal, thousands of persons being car- ried off by its ravages. The prevention of small-pox by means of vac- cination was unknown to the Chinese until they came in contact with 1 Chinese Repository, vol. 1, p. 181. 2 Medical Missionary in China, Lochardt. 3 Chinese Repository, vol. 1, p. 181. APPENDIX. 477 foreigners. x That there was a method of holding it in check known to them is shown by the fact that they practiced inoculation in the tenth century of the Christian era. Authorities differ as to who in- troduced vaccination: 2 according to one, it was first brought from Manilla by a Mr. Hewitt, a Portuguese, to Macao, in 1805; 3 ac- cording to another, Sir G. Staunton, 1813, translated into Chinese an account of vaccination and sent it to the court at Peking; 4 and lastly. Dr. Pearson, of the East India Company, gets the credit of first introducing it in 1820. The mode of procedure in inoculation is to pulverize the scab taken from a small-pox patient and to blow the powder up the nostril of the child. In the case of a boy, the left nostril is selected ; of a girl, the right. Here is a translation of a document on vaccination found posted on the walls about Foochow : " Vaccination was introduced hither from Europe. It is practiced by 'planting' three ' seeds' of virus upon a spot upon the left and right arms above the elbows. This spot is called the cold-dispelling pool, and on it is formed the virus and the scab, there being no eruption upon the body generally. The result is effected in ten days, and no failure can possibly take place, whilst security is obtained from any natural and original attack of small-pox, or from a second attack if the patient has already had it. Children vaccinated in this way need not be afraid of exposure to cold, thun- der, chills, heat, etc., nor need they take any medicine whatever, or avoid any particular kinds of nourishment, but may play about just as usual." 5 Pharmacy. — The active principles of drugs are extracted by re- peated boilings — true decoctions. Tea is an exception to this rule. Infusions are made and the art of percolation is understood. When sweating is called for, medicines are given in the liquid form. To make tinctures they ferment the substance to be administered, al- though tinctures are made by dissolving the substance in alcohol. Vegetable remedies, like rhubarb and gentian, are taken in pill or de- coction. In comparing the drugs of the two Materise Medicse in the following 1 Staunton's Embassy, vol. 2, p. 154. 2 Chinese Repository, vol. 2, p. 447. 3 Melanges Asiatiques, t. 1, p. 249. 4 Middle Kingdom, vol. 2, p. 190. 5 Chinese Customs, Medical Reports, Sept. 1877, p. 89* 478 APPENDIX. pages the expression " no account is given of it" frequently occurs ; this is to be understood as meaning that no allusion has been made to the drug in question, botanically or medically, by Chinese writers, so far as the writer is able to discover. Opium. — Known since the Mongol dynasty (a. d. 1281), opium has been long cultivated in China. In the Ming dynasty it came into more general use (a. d. 1368). The Pen Ts'au describes its collection from the poppy, after flowering, in an intelligent way, and mentions the fact of its regular sale as a drug. It was then given as an astrin- gent and sedative in dysentery, catarrh, dysmenorrhea and spermat- orrhoea. At the present time this practice has ceased, and the use of the drug is branded with all the infamy and illegality attached to the opium habit. The poppy is extensively cultivated in Sechuen : according to Dr. Jamieson's analysis it yields about 6*94% of morphia. 1 Opium was introduced into China in the eighth or ninth century. Belladonna. — It is doubtful whether the Atropa belladonna is met with in China; though it may have been confused with the Solanum nigrum. The Pen Ts'au describes a solanaceous plant, the use of which produces profound anaesthesia. According to 2 Waring it is found in western Asia. Chloral. — Unknown. The patent medicine " chlorodyne," im- ported into China, is recommended to missionaries, who are wont to dabble in physic. Aconitum. — Several species of aconite are met with in China, mostly the tuberous roots of A. variegatum, A. sinense ; they grow in Kiagnan and Chekiang. Their poisonous properties are known. The Chinese believe that by the use of pigs' dung and a long period of domestication the species become less poisonous. The roots were formerly used to poison military arrows. They are only used in med- ical practice after being so prepared as to diminish their poisonous properties ; the roots are known to be sedative. Hyoscyamus Niger. — Hankow samples of the drugs going by this name have consisted of flowers of Andromeda polifolia and azalea. Narcotic properties are referred to these flowers. Identification is not certain. According to 3 Waring it grows in western Asia. Solanum Dulcamara.- — Not clearly distinguished from S. nigrum 1 Tke Poppy Plague, 1876, p. 1. 2 Pharmacopoeia of India, p. 171. 3 Pharmacopoeia of India, p. 177. APPENDIX. 479 by the Chinese. It is officinal as a diuretic, alterative and tonic. The stalks and leaves are used in the treatment of swellings. The habitat is temperate Asia (Waring, p. 179). Cannabis Indica. — No such drug has been met with in Chinese works ; according to Dr. Tatarinov, however, it has been identified. Datura Stramonium. — The D. alba is a common weed in China. 1 It is said to have been rained from heaven. It. differs but little from the D. stramonium. The flowers are used as a wash in skin affections. The leaves, according to Dr. Waring, contain daturia, an active poisonous alkaloid. Hoffman and Schultes have applied a name to D. stramonium, but such name is unknown to the Chinese. Tobacco. — This is not indigenous, 2 but was probably introduced by way of Japan or Manilla in the sixteenth or seventeenth century (Mayer's Researches in Hongkong, Notes and Queries, May, 1867). 3 It is not mentioned in the Pen Ts'au. It now grows in most of the provinces, and its acrid and expectorant properties are well understood by the Chinese. The cut leaf is used as a haemostatic. The smoking habit is confined to the Cantonese. The Chinese do not chew it. Conium Maculatum. — No account is given of it. Lobelia Inflata. — A species of lobelia would seem formerly to have yielded a kind of tobacco. The L. chinensis is mentioned by Burnett (p. 380). Humulus. — No account is given of it. Prussic Acid. — Unknown. Potassium Cyanide. — Unknown. Amygdalus Amara. — The fruit of the Amygdalus communis is not clearly distinguished by the Chinese from that of the peach or apricot. The bitter almond is known to be poisonous, and the sweet variety is similarly confounded. Almonds are said to be heating, sedative, anti- spasmodic and pectoral, besides tending to longevity. The flowers, leaves and branches are officinal ; the root is said to be antidotal to the poison of the fruit. This is a favorite belief of Chinese doc- tors, who regard the root as the polar antagonist of the stem and everything borne on it. Camphora Officinarum. — 4 A native drug growing abundantly 1 Eitel, Handbook of Chinese Buddhism, p. 71. 2 Middle Kingdom, vol. 1, p. 287 ; Staunton's Embassy, vol. 2, p. 174. No tradition of its introduction. Indigenous, Burnett, Flor. China, p. 383. 3 Chinese Repository, vol. 9, p. 638. 4 Grows throughout Formosa. Treaty Ports of China and Japan, p. 320 480 APPENDIX. in Fuhkien and in Canton province. It is an important article, of com- merce. As obtained from the sublimed chippings it is impure. The Pen Ts'au gives directions for subliming it in copper vessels. It is not so strong as the English drug, but more volatile, and it is compared in its nature to nitre. It is reputed to be stimulating, diaphoretic, sedative and anthelmintic. *An oil is obtained. Physostigma. — No account is given of it. Woorara. — No account is given of it. Cocculus Indicus. — No account is given of it. Ether. — The Chinese know nothing of ether. The coined word means " fluid brought from the west of lightest possible weight." Chloroform. — Not known. Asafetida. — The narthex asafetida grows in the vicinity of Can- ton, and is much adulterated. The Chinese have. a proverb that "of asafetida there is none genuine, of skull-cap there is none sophisti- cated." Anthelmintic, antispasmodic and carminative properties are attached to it. It is said to assist the digestion of all meats. A sub- stitute for this drug is made by boiling garlic and a human placenta in water, and from this by evaporation an extract is made. Ammoniac. — No account is given of it. G-albanum. — No account is given of it. Cypripedium. — No account is given of it. Scutellaria. — The S. viscidula, the common Chinese skull-cap, is met with all over China. The root is credited with demulcent, ex- pectorant and febrifuge virtues. The seeds are also officinal. Musk. — The musk deer inhabits certain provinces of China (Ho- nan, Yunnan). Chinese authors believe musk to be antispasmodic. It is occasionally used as a poison by suicides. Castoreum. — The Pen Ts'au gives some description of the beaver, but no account is given of its medicinal virtues. Quassia. — No account is given of it. Gentian. — This "dragon's gall plant" is probably the Gr. asclepi- adea of botanists. The root is used, and is brought from Shensi. The taste is bitter ; it is given in night-sweats and haematuria. All bitter medicines are set down by Chinese physicians as antirheumatic and antiphlogistic. Coptis. — Not mentioned. Columbo. — Not mentioned. 1 Treaty Ports of China and Japan, p. 320. Much used in Chinese medicine. APPENDIX. 481 Chamomile. — The Anthemis nobilis is not met with ; the A. apifolia is used in its place. The Chinese are fond of fumigating and steam- ing sore eyes with infusions of the flowers. Eupatorium. — No account is given of it. Magnolia. — Different species are known, the M. rubra, etc. The part used is the bark, which is given as a tonic and in fevers. The Pen Ts'au states that all diseases of the nose are benefited by prepara- tions of the drug. The seeds or cones are used in fistula ani. Angustura, Cascarilla, Canella. — No account of these barks is given. Achillea. — No account is given of it. Cinchona. — Not known to the Chinese faculty. The Panax gin- seng is the cinchona of China. Eucalyptus. — No account is given of it. Cornus Florida. — No account is given of it. Salix. — Many species are found in Hupeh, but the willow is confused with other genera, viz., the populus and tamarix. Of the leaves a kind of tea is made ; the bark is used in dysentery, dropsy, and locally to bruises. Prunus Virginiana. — Cultivated and wild varieties of the prunus genus are met with in the central provinces. The root bark has been used as an antifebrifuge. Nectandra. — This bark is not mentioned. Pepsine. — The Chinese use the lining membrane of the fowl's gizzard, peeled off and dried, in dyspepsia, diarrhoea, etc. The male bird is used for preparing the drug for female patients, and vice versa. Here the Chinese would seem to have anticipated the use of pepsine. Iron. — Iron ore is found in many provinces. A kind of vinum ferri is directed in the Pen Ts'au to be used as a cordial. Iron washes in anal diseases are prescribed in a vague way. The iron salts are known, to be tonic and astringent. Iron filings, levigated, are given with other drugs in convulsive diseases. Iron rust mixed with paint, in. Chinese pharmacy, is applied to sores. Other salts are known, as ferrous sul- phate, ferric oxide. Copper. — Many salts of copper are found,. but metallic copper is not employed. The Chinese have opposite notions to our own in regard to the effect of the two metals copper and iron upon the human system. They consider copper to be more wholesome, and recommend that food for the sick should be cooked in. copper vessels. The Chinese under- 31 482 APPENDIX. stand the powerful effects of this metal. x It has been used as an emetic in opium poisoning. According to the Pen Ts'au, a sort of vinum cupri is used in dysentery and chlorosis. The iron and cop- per sulphates are not well distinguished. Zinc. — Zinc is not carefully distinguished from lead, tin, antimony or pewter. Of all its salts the Chinese are most familiar with calamine. The Pen Ts'au alludes to Persian zinc ; zinc oxide, or tutty (from the Tamul word tutum), is a new salt to the Chinese. The Chinese word " tau" stands for either an oxide or sulphide; from this nomenclature it is seen how crude are their notions of chemistry. The astringent properties of zinc are not well known. Silver. — Met with in many of the provinces. Silver is said by 2 Li Shi Chin to be sedative and astringent to the uterine organs. Bismuth. — Can find no account of it or its salts. Cadmium. — Not known. Sulphuric Acid. — Unknown to the Chinese. Hydrochloric Actd. — Unknown to the Chinese. Nitric Acid. — Unknown to the Chinese. Oxalic Acid. — Unknown to the Chinese. Tannin. — Unknown to the Chinese. Nut galls are obtained from the Rhus semi-olata in Shingking. They are known to be astringent, and are used by tanners. They enter into an imperial electuary, highly rated and only obtainable as a gift from the throne. The Chinese use oak bark as an astringent, especially to chancres and swellings. Catechu. — Imported from the East Indies. Is said to have for- merly been grown in Yunnan province. It is known to be astringent. Kino. — It is doubtful whether the tree yielding kino grows in China; possibly gum lac, obtained from a tree of southern China, is the true kino. 3 Mr. Eitel understands this substance to be similar to Bengal kino. Bhatany. — Not known. HiEMATOXYLON. — Not known. Quercus. — Different species grow throughout the country ; an as- tringent tea is made of the leaves ; the bark is also used. Geranium, Uva Ursi, Chimaphila. — Unknown. Pomegranate. — The fruit is largely eaten j the flowers with iron 1 Chinese Mat. Med. and Nat. His., Smith, p. 72. 2 Compiler of the Chin-Herbal, or Pen Ts'au. 3 Author of Hand-Book of Buddhism. APPENDIX. 483 are used to make a hair-dye ; the root and peel are used as astringents in diarrhoea, etc. Carbolic Acid, Salicylic Acid, Creasote. — Unknown. Lead. — The best known of the soft metals in China; it is regarded as the progenitor of the five metals. Chinese works allude to the poisonous properties of lead as producing paralysis, jaundice and con- stipation. Sedative, antiphlogistic and anthelmintic effects are vaguely ascribed to this metal. It is prescribed in the Pen Ts'au for tooth- ache, dyspepsia, etc. At present it is but little used. Alum. — * Found in argillaceous schist, alum is mainly used to purify water. Its astringent properties are known. A pill of alum and wax is used. Alcohol. — The 2 fermentative process has long been known by the 3 Chinese (b. c. 2000 years). The art was perfected during the Mongolian dynasty (1127-1280 A. D.). A spirit termed samshiu, or thrice-distilled spirit, is made from cereal * grains. The Chinese are not addicted to drunkenness. Their alcoholic beverages, however, stimulate quickly, reddening the face. Only one distillation is made for common liquor. Ammonia. — Sal ammoniac is found in Ning-hai, Kansuh. It is liable to be confused with nitre, borax and sodium sulphate. In Chinese practice it is used as a sedative and mild escharotic. Arnica, Phosphorus. — No account is given of either. Arnica japonica is described in Icones Plantarum Japonicarum, and Flor. Japon, p. 137. Capsicum Annuum. — This plant grows in central China. 5 Other varieties are C. inense, C. frutescens. There is no mention of the fruit in the Pen Ts'au. Piper Nigrum. — Black pepper is imported from the East Indies. Unsuccessful attempts have been made to cultivate it. It is used as a stimulant and stomachic. Cinnamon. — The C. aromaticum is found in Cochin China. It is used more as a condiment than as a medicine. Cassia buds are rec- 1 Chinese Repository, vol. 2, p. 447. 2 Chinese Repository, vol. 10, p. 126. Eteih made an alcoholic liquor in the reign of Ta Ju, b. c. 2205 ; for so doing he was banished. The grape is not indigenous. 3 The Middle Kingdom, vol. 2, p. 75. 4 The grape is not pressed for wine. History of China, p. 17. 2 Burnett's Flora of China. 481 APPENDIX. oniinended in the Pen Ts'au in eczematous affections behind the ear, called " moon sores," supposed to be brought on by lunar influences. The Chinese think that cinnamon affects the uterus. Mace. — Is said originally to have come from central Asia, but now grows near Canton. It is not much used as a spice. Internally it is given as an astringent and anti-vinous remedy. Cloves. — Chinese works speak of the tree growing in Canton province. The male flowers are supposd to be the efficacious ones ; they are known to be carminative and stimulating. Pimento. — No account is given of it. Ginger. — Largely grown in Hupeh and Kiangsi. In the green state it is eaten as a condiment. Stomachic properties are attached to the root. Cardamom. — This is said to come to China from southern India, but is now grown in Canton province. It is thought to do good in affections of the stomach. Part used, the seeds. Acorus Calamus. — Met with in China ; is used in medical prac- tice. Gaultheria. — No account is given of it. Mint. — Several species are found in China, viz., M. hirsuta, M. crispa and M. canadensis (Burnett) j all are used as carminatives. Lavender — No account of it is given. Fennel. — The anise and sweet fennel are confounded in the Pen Ts'au, as is caraway. Vanilla. — No account is given of it. Digitalis. — x The root of a species of fox-glove is brought from Honan, and is used as a blood purifier. Veratrum. — The V. nigrum is the only one of this group (Melan- thacese) which has been identified. It is known to be an active poison by the Chinese. Gelsemium. — No account is given of the G. sempervirens, but the Jasminum sambac is found. The roots of the jasmine plants are known to be powerfully sedative. Antimony. — An ore of lead found near Chefoo yields antimony. The Pen Ts'au states that wine allowed to turn sour in pewter cups becomes poisonous. Potassium Nitrate. — Found efflorescent on the soil in Manchu- ria; it is collected and purified by solution, filtration and crystallization. 1 Digitalis Chinensis : Burnett, Flora of China, p. 382. APPENDIX. 485 Potassium nitrate is confused with sodium sulphate. The Pen Ts'au recommends saltpetre in the same way as it is used by us. Borax. — Found as a deposit on the shores of the lakes of Thibet. For medicinal use it is refined. It is said to prevent drunkenness if taken beforehand. Antiphlogistic, resolvent and expectorant properties are attached to this drug, the effects of which are better understood than any drug in the Chinese Materia Medica. Spiritus iETHERis Nitrosi. — Unknown. Vegetable Acids. — No account is given of the preparation of these. Acetic, Tartaric, Citric. — No mention of the lemon is made in the Pen Ts'au. Nux Vomica. — Originally came from central Asia, but is now brought from Sechuen. The seeds are used to poison dogs; it is forbidden to sell them to unknown persons. They are recommended as useful in fevers, throat affections and abdominal enlargements. Ergot. — The Chinese do not cultivate rye. Maize and rice occa- sionally become ergotized. Some of these grains are said to have produced abortion. Ipecacuanha. — Not indigenous in China. The heroic doses used in Indian practice in dysentery are not well borne by the Chinese. Sanguinaria, Gillenia, Tamarindus. — No account of these is given. Castor Oil. — ^he Ricinus communis grows in Hupeh, but is said to be of foreign origin. The leaves are applied to swellings as a discu- tient, and administered internally as an expectorant. The seeds are used locally (crushed), combined with the oil of the seeds. The pulp is rubbed into the palms in palsy, on the temples in headache, and introduced into the meatus urethras in stricture. The pulp is rubbed on the soles of parturient women to hasten the birth of the child and to expel the placenta. It is stuffed into the ears and rubbed over the top of the head in prolapsus uteri ; with the oil it is applied to burns and scalds. Manna. — No account is given of the 2 Fraxinus ornus. Tamarix chinensis is said to produce manna. Cassia Fistula. — This plant is not mentioned in the Pen Ts'au, nevertheless the natives of Kwangsi gather the pods for the sake of 1 Flora of China, 354. Seldom used as a laxative. 2 Burnett gives the Fraxinus chinensis, p. 384, Flora of China. 486 APPENDIX. their purgative pulp and seeds. The drug is unknown in central China. Dr. Williams states that the Chinese cassia is less active than the American. Sulphur. — Has been obtained from the volcanic districts of Tur- fan, from Tangut and from Sechuen. Sulphur springs are met with near Chefoo. Japanese sulphur has long been utilized in China. The ordinary article is met with in crystalline masses of a pale-yellow colour, and is known by the Chinese to be injurious. It is used in rheumatism, fevers, dysentery, in impotency and in worms. It is used locally with camphor, muricia seeds and chaulmugra seeds in the treatment of itch and pediculi. Magnesium Sulphate. — A mineral salt is alluded to in the Pen Ts'au as present in bittern. It is described as yellowish- white, being bitter, cooling and purgative. Sodium Sulphate. — This salt was first brought to notice by a Tauist priest, A. d. 627-50. He pointed out that the salt had peculiar powers ; that its use would cause longevity and immunity from dis- ease. *It is prepared as follows : " ten catties 2 [of the salt are dissolved in a picul] 3 of water and exposed to the moon's rays during one night. This process is repeated with liquorice root, and then the saline product is heated in a vessel which is first luted down and then carefully closed , the heat being reapplied. The resulting solution is then filtered, ex- posed for three days to let the fire pass off from it, and is then to be finally mixed with liquorice powder." It is prescribed in fevers and as a mild escharotic. Rochelle Salt. — No account is given of it. Rheum. — Rhubarb is indigenous in China, and grows in Hupeh, 4 Shensi and Sechuen, but the latter produces the best root. The Chinese drug, in its native country, is a powerful one, causing severe purging and prostration. The Pen Ts'au places it at the head of poisonous plants. The Chinese use rhubarb as a laxative, stomachic, astringent and diuretic. The stalks are not eaten. The leaves are said to be insectifugal. The Chinese consider the outside world dependent on them for rhubarb, and obliged to resort thither to relieve them- selves of an otherwise irremediable constipation. 1 Chinese Materia Medica and Natural History, p. 200. 2 l£ lbs. avoirdupois. 3 133 lbs.: History of China, p. 15. 4 This province is famed for it. History of China, p. 15, APPENDIX. 487 Juglans Cineria. — No account of the butternut is given. The bark of the 1 J. regia is used as an astringent. Aloe. — Grows in the vicinity of Canton, according to the Pen Ts'au. One of its Chinese names means elephant's gall. It is known to be laxative. It is mostly now employed as a wash combined with liquor- ice in lepra, etc. Senna.— The true senna is known to grow in China. The leaves of other species of cassia are employed with like effects. Jalap. — The true jalap-root is not found in China. Podophyllum. — No account is given of it. Scammony. — No account is given of it. Colocynth. — No account is given of the Citrullus colocynthis. Ac- cording to Chinese authors a certain kind of melon (botanical name not stated) should be eaten with caution, as it frequently brings on severe diarrhoea. Gamboge. — Is found in Cochin China. The Chinese think it a substance vomited by serpents. Chinese draughtsmen use gamboge as a pigment ; it has no medicinal use. The Pen Ts'au puts it down as poisonous. Its action is too violent for Chinese practice. Elateritjm. — No account is given of the Momordica elaterium, but the M. balsamina is found. This plant ripens and bursts, and may then be used in place of elaterium. Croton Oil. — C. tiglium is met with in China. Several species are described in the Pen Ts'au. The entire fruit is officinal. Among the Chinese the oil of the seeds is put to the same uses as with us. 2 Burnett speaks of the C. tiglium and other species. Pilocarpus. — No account is given of jaborandi. Sarsaparilla. — Known and described by the Chinese. The part used is the root. It is set down as tonic and diuretic. It has been used since the Ming dynasty in the treatment of syphilis. Mezereum. — No account is given of it. Gtuaiac, Sassafras, Erigeron, Colchicum, Apocynum. — No account is given of these. Scilla. — 3 The true squill is not met with in China. Taraxacum. — Found in China. 4 The plant is stated to be the 1 Flora of China, Burnett, p. 348. 2 Ibid., p. 353. 3 Icones Plantarum Japonicarura, scilla Japonica crescit in Niphon in- sularum Japonicarum maxima. 4 Flora of China, Burnett. 488 APPENDIX. Lontodon chinense. The shoots are eaten. Tonic virtues and the property of causing longevity are ascribed to this plant by the Pen Ts'au, but nothing is said of its diuretic effects. Juniper. — The medicinal properties of this coniferous plant are not understood by the Chinese. Carrot. — Grows wild in China. It is used as a food, and reputed to be tonic. Broom.- — Nothing is said of it in the Pen Ts'au. Cantharis. — The true Spanish fly is not met with in China. Other kinds of flies are collected and dried for use ; for example, the Mylabris schonhein. This is used in syphilis; it is also the great remedy of the Chinese for hydrophobia. The bite of the mad dog is supposed to impregnate the bitten person ; and a little dog, the product of the bite, is sought for in the urine, rendered bloody by a large dose of mylabris. When this condition is brought about recovery is considered certain. The mylabris is also used to produce abortion. It enters into a preparation of bats' dung employed in eye diseases. The insect has all the properties of the cantharis. Senega, Cimicifuga. — No account is given of either. Allium Sativum. — Is indigenous, being cultivated as a garden vegetable. Stimulant, antispasmodic and stomachic properties are re- ferred to it. It is supposed to prevent goitre and pestilential diseases. Cubeb. — This is not indigenous. J The plant grows in China, but is thought to have been introduced into Canton province from Sumatra or Java. The Pen Ts'au describes a berry, the account of which leaves no doubt that the cubeb has been used in China. Copaiba. — No account is given of it. Turpentine. — 2 An extract obtained by heat from coniferous trees of Cambodia is described in the Pen Ts'au. It was used locally in skin diseases. Matico, Pareira, Buchu. — No account is given of these. Myrrha. — The Balsamodendron myrrha and the mode of collect- ing the gum-resin is detailed in the Pen Ts'au. The tree is said to grow in the south of China. It is employed as an astringent and sedative. Benzoin. — Imported into China from the East Indies. It is pre- 1 Chinese Repository, vol. 2, p. 459. 2 Pinus chinensis, found near Ningpo : Treaty Ports of China and Japan, p. 349. APPENDIX. 489 scribed in the Pen Ts'au to be used against worms. If benzoin is pure, the Chinese believe that its fumes will charm mice out of their holes. Styrax. — The trees yielding styrax. obtained from different species of liquidambar, grow throughout China. Plasters are made of the gum for the treatment of the sores of leprosy, sinuses, etc. It enters into a suppository, described in the Pen Ts'au, for constipation. Styrax is used per orem as a stimulant and anti-hemorrhagic remedy. Balsam of Peru and Tolu. — No account is given of these balsams. Sabina, Ruta — No account of either is given. Burnett mentions (p. 377) the Ruta angustifolia. Rubia. — Is used as a dye. The plant grows in Hupeh. Emmen- agogue properties are referred to the root in the Pen Ts'au. Accord- ing to Chinese testimony the root is, to some extent, poisonous, with a determination to the uterine organs. Mercury. — Found in many of the provinces; is called "water silver." The metal is set down in medical works as deleterious. The power to make one immortal was anciently affirmed of it. The Chinese have been fond of the study of alchemy, including the changes undergone by mercury in the fire. Now these studies have been discontinued ; but before the Christian era they had made considerable progress in them. Metallic mercury is sometimes taken by prostitutes to prevent concep- tion. In making mercuric oxide " no woman, dog or fowl may look on during the operation." Cinnabar is termed the " immortal elixir," the equivalent of the philosopher's stone of the West. This ore was investigated, according to the Rev. J. Edkins, by Chinese alchemists as early as the Christian era. Cinnabar is considered to be at the head of all metals and minerals, and to be capable of transmutation in equal periods of two hundred years into any of the five principal metals, ending with gold. Children were formerly dosed with this drug as soon as born, possibly with an idea of warding off congenital syphilis. Small quantities are worn in bags by children to drive away spirits and chorea. In a portion of China the entire population on the fifth day of the fifth month (a 'festival) take a small dose as a prophylactic. Calomel. — The writer finds no positive statement that it was known in ancient Chinese practice. It is said to be a native mineral in Cleyer's Specimen Medicinae. Lochardt mentions it. l An- 1 Chinese Repository, vol. 18, p. 507. 490 APPENDIX. other authority states that the Chinese apply calomel ointment to ulcers. Iodine. — No account of this element is given. According to Chinese writers sea-weed has been used in the treatment of goitre, this disease being common in Sechuen province. The iodides are unknown ; they are largely used in the Medical Mission hospitals. Bromine. — No account is given of it. Iodoform. — Not known. Oleum Morrhile — ^he cod has not been met with in Chinese waters. The Chinese, so far as known, do not extract the oil from the liver of any fish, but they prepare an oil from the entrails of a species of fish. Cod-liver oil does not act well on the Chinese. Arsenic. — Found in Kiangsi province, it occurs in crystalline masses of a grayish or yellowish colour. It is frequently sublimed, and accord- ing to the Pen Ts'au the action of the fire is supposed to develop the poison in the mineral. Both the mineral and its fumes are known to be poisonous. None of the arsenical preparations can be sold in the shops without there being witnesses as to the propriety of the sale. If the druggist ignorantly -or carelessly breaks this regulation he re- ceives eighty blows ; if fatal effects result, the buyer and seller are de- capitated j if not fatal, both are strangled. Some such system might not be out of place in civilized countries. Tonic, alterative and in- secticide properties are ascribed to this mineral. According to the Pen Ts'au white arsenic has been used to cure ague. A compound powder of arsenic is used ; it contains muricia seeds, croton beans, sal ammo- niac, crude arsenic, bitumen and oil of muricia seeds. This mixture is to be put into the ground for seven weeks, and then taken up and divided into small pieces. It is used as a caustic to destroy proud flesh, tumours, etc. This is the favourite mode of dealing with such cases by Chinese surgeons. Arsenic is forbidden in eruptions and sores. Calcium, Salts of. — Calcic carbonate is found in Tung-chau-fu, and is confused with gypsum. It is sprinkled upon burns and scalds. Im- pure calcic oxide is obtained from kilns. A preparation of lime and oil (bearing striking similarity to can-on oil) is described in the Pen Ts'au for burns. Calcic sulphate is reputed to be astringent. Mortar and putty are officinal in the Pen Ts'au. The calcium salts are but little used in Chinese medicine now. 1 Chinese Mat. Med. and Nat. His., p. 159. APPENDIX. 491 Ammonium. — Sal ammoniac is brought from the province of Kansuh. Nitre (NaNo 3 ), borax and sodic sulphate are confounded with it. Its chief use is in dissolving corneal opacities. It is also known to act as a sedative, deobstruent, and as a mild escharotic. Potassic Salts. — Soda and potash salts have never been carefully distinguished by Chinese writers. A kind of pearl ash is mentioned in the Pen Ts'au as obtained by burning certain polygonaceous plants. There is some carbonate in this, which is recommended in dyspepsia. Sodic Salts. — Sodium carbonate, the product of the soil, is ob- tained from Mongolia and Thibet. Sodium sulphate is found in Sechuen, and is often confounded with nitre. The sodium salts are used as salines and as purgatives. According to a Tauist priest (a. d. 627-50) sodium sulphate has the power of causing longevity and im- munity from diseases. The Chinese have no soap in general use, and do not understand the chemical combination of an alkali and oil. *In Manchuria an animal alkali is found. Lithium Salts.— No mention is made of lithium. Sinapis. — S. alba is not indigenous in China, but brought from Asia to the province of Sechuen. S. nigra is indigenous. It is sup- posed to act as well on the lungs as on the stomach. Burgundy Pitch. — The Pen Ts'au refers to the product of conif- erous trees. It would seem that the preparation of pitch was not understood. Zinc— The Chinese do not carefully distinguish zinc from tin? lead, antimony and pewter. They do not well understand the astrin- gent properties of zinc salts, except calamine. Tutty (ZnO), from ' tutum," a Tamul word, is unknown. Water. — The Pen Ts'au places water at the head of all medicinal agents, and fully discusses its conditions and uses. It is placed in the front of the sixteen divisions of all known substances, being divided into the celestial and terrestrial kinds. The hydropathic system seems to have been in vogue in the time of the great surgeon 2 Hwa-to, who practiced the use of the cold douche. The haemostatic properties of water are insisted on, especially in uterine hemorrhage- In cases of poisoning by carbonic acid gas and by the excessive use of alcohol cold compresses have been laid on the chest to excite respiration. The local application of water to the eyes has been intelligently de- 1 Treaty Ports of China and Japan, p. 484. 2 Han dynasty, b. c. 202 to a. d. 221. 492 APPENDIX. scribed. Hot water is often drunk by the Chinese as an antidote, diuretic and laxative, and sea water is recommended in scaly eruptions. The water in which the five precious metals have been boiled, viz., gold, silver, copper, iron and tin, is a popular domestic remedy in ac- cidents of any kind. Acacia. — A gummy extract is obtained from different species of acacia, which is employed as a plaster, and as a retentive agent in fractures and sprains. Tragacanth. — No account is given of it. Linum. — Not indigenous ; the seeds are confused with sesamum. Ulmus. — 1 U. chinensis and U. pumila are stated to be Chinese species of the elm. The bark is the part used. Both this and the sawdust enter into the composition of incense. Demulcent properties are referred to this bark. Althea. — It is doubtful whether the A. officinalis is found in China. Sesamum. — The S. indicum is extensively cultivated in China for the sake of its seeds, which are used in Chinese confections. Two sorts of seeds are known — the white and black. An expressed oil is obtained from these, which keeps well, and is well adapted as a sub- stitute for olive oil. Cydonium. — The C. japonica grows in Sechuen. The seeds are demulcent, and are used in diarrhoea. Liquorice. — Two kinds are known : the Grlycerrhiza glabra and the Gr. echinata. They are found in Shanshi, Kansuh, and in Sechuen. Liquorice root stands next to ginseng in importance in Chinese phar- macy. It enters into a large number of prescriptions as an adjunct. It is also used to allay thirst, fevers, and distress of breathing. It is thought to have the power of rejuvenating those who consume it for a long period. The Chinese do not make an extract of the root. Irish Moss. — No mention is made of the Chondrus crispus. Sev- eral species of marine algae are found from Shantung to southern China, also along the Corean and Japanese coasts, which are used as food. Iceland Moss — No mention is made of it. Amylum. — The Pen Ts'au states that starch is prepared from wheaten flour by washing and separation. Maranta. — The best native arrow-root comes from the provinces 1 Flora of China, Burnett. APPENDIX. 493 of Kiangsi and ChehkiaDg. The process by which it is made is not mentioned in the Pen Ts'au. Canna. — No mention is made of it. Tapioca. — The writer can find no account of it. Sago. — The Chinese account in the Pen Ts'au seems to point to a sago palm, but of what species is not known. This work credits the article with nutritive properties. Barley. — The Hordeum distichon is the common kind met with. The uses of barley as food for man and beast and as a source of spirit are indicated in the Pen Ts'au. Writers quoted in this work ascribe to it tonic and demulcent properties. Rice. — Forms the bulk of Chinese food. Before eating, the Chi- nese steam the grain. Rice ashes are used as an alkaline remedy in urinary diseases. Maize. — Introduced probably from Japan, is largely cultivated in all parts of China. It is used as an article of diet. Salep. — No account is given of it. Isinglass. — Is made from fish and also from sea-weed. The Pen Ts'au speaks of isinglass plaster for wounds. Lard. — Obtained from the hog by the Chinese. Lard is but little used in the preparation of ointments by the Chinese. Suet. — Made from the fat of sheep. Reputed to be of service in coughs, but the Chinese dislike to use animal fats. This has led to the discovery and employment of many vegetable oils. Spermaceti. — The whale is known to the Chinese, but so far as ascertained this substance is not spoken of in their books. Wax. — Known to the Chinese as the product of an insect. A kind of wax bolus is brought from Canton and is much used as a pec- toral dose. White wax is taken internally after accidents. Oleum Theobrom^e. — No mention is made of it. G-LTCERTN. — Unknown. Collodion. — Unknown. Since its introduction it finds great favour with the Chinese, who are fond of sealing up wounds. Sugar. — Has been known for ages by the Chinese. It is stated that the too free use of sugar damages the teeth and digestive apparatus. Honey. — This was formerly confounded with sugar. It was much used as a pill excipient, and has been applied to the eye in cataract. Saffron. — Originally brought to northern China from Thibet. It is given in incipient small-pox to bring out the eruption, and in men- strual diseases. 494 APPENDIX. Santalum. — The wood of the Pterocarpus santolinus is used as a tonic and astringent. On account of the red colour of the wood it is supposed to act on the blood. The tree grows in Canton and Yunnan provinces. *An oil is made from the wood. Cochineal. — Is not mentioned in the Pen Ts'au. Is imported into southern China, the Cantonese having learned its use as a dye. Spigelia. — Not mentioned. Chenopodium. — Five varieties are described in the Pen Ts'au, though the C. anthelminticum is not given. Cooling, lenitive, de- mulcent and insecticide properties are ascribed to the seeds. Santonica. — The Artemisia cina is not spoken of. Many species of artemisia are given in the Pen Ts'au, some of which are used, es- pecially the A. dracunculus, which is used in vermes. Azedarach. — The Melia azedarach is common in the province of Hupeh. The root and bark are used in the treatment of skin diseases. The seeds of the fruit are used in fevers, fluxes, vermes and urinary diseases. The root has emetic properties. Mucuna. — No account is given of it. Filix Mas. — No account is given of it. 2 Found in shady localities in Asia. Brayera. — No account is given of it. Kamala. — No account is given of it. 3 Burnett mentions two species. Pepo. — The seeds of the Cucurbita pepo are eaten as a dessert with tea. Nothing is said about their anthelmintic virtues. SOME MEDICINES PECULIAR TO THE CHINESE MATERIA MEDICA. Ginseng. — A drug of great reputation; in point of importance and uses corresponds to our cinchona. It is the root of an araliaceous plant — the Panax ginseng. It is brought from Shingking and Pehehi- hli provinces. The plant grows also in Manchuria and Corea. The portion used is the root, which comes to market about the size of a man's finger, with small rootlets attached. These are yellowish, semi- transparent, and of a sweet, mucilaginous taste. The trade in this drug is large. Its effects are alterative, tonic, stimulant and demul- cent, and it is prescribed in almost every severe disease. The leaves are said to be expectorant and emetic. 1 Chinese Repository, vol. 2, p. 469. 2 Pharmacopoeia of India, p. 259. 3 Flora of China, p. 253. APPENDIX. 495 Birds' Nest. — This expensive article, which is used as food for the wealthy and as medicine by the sick, ranks after ginseng in import- ance. It is the gelatinous nest of a species of swallow found in Java, Borneo, etc., the bird seemingly constructing the nest out of sea-weed. They are thus described : " Externally resembling ill-concocted fibrous isinglass, and of a white colour inclining to red ; their thickness is little more than that of a silver spoon, and their weight from J to J ounce." They are sold in all Chinese drug shops. The birds' nest, as an article of diet or physic, is of recent origin, for no mention is made of it in the Pen Ts l au. They appear only on the tables of the rich or on grand occasions, and according to our taste are overrated. 2 J. B. Young alludes to birds' nest soup as an inferior ragout. Areca. — The fruit of the Areca catechu, a tree varying a good deal in height, which, according to the Pen Ts'au, grows in Yunnan, Kwangsi, and in the island of Hainan. The nuts average from f of an inch to 1 inch in length. They yield a large proportion of tannin and gallic- acid. Tonic, astringent and anthelmintic virtues are ascribed to the nut. Bat's Dung. — A coarse brown powder like tea dust. Used inter- nally in ophthalmic affections, dyspepsia, ague, cough and offensive per- spirations (on the principle, set a thief to catch a thief), and is applied locally with sugar to foul ulcers. Bear's Gall. — Is obtained as a soft black bolus of an aromatic- flavour. It is hard to procure, and expensive, and is used homeopath- ically as an anthelmintic, astringent, and in hepatic affections. Dragon's Bones. — A fossil ivory. Is powdered, and given in fevers, fluxes, chorea and spermatorrhoea. Dragon's Blood. — A misnomer. Is a gum brought from Java and Borneo, and is said to be met with in southern China. Chinese medical writers ascribe to it astringent virtues. Dragon's Spittle. — A costly gummy substance found floating in the sea or obtained from the belly of a fish inhabiting the Indian Ocean. The dragon is said to cough up this substance. The Chinese ascribe to it wonderful healing powers. Dragon's Teeth. — Are fossil teeth, found in the marly beds in the vicinity of Shanghai. They are thought to act on the liver. Dung of the Sparrow. — This mixed with peppercorns, powdered. 1 Chinese Commercial Guide, p. 82. 2 Around the World with Grant, vol. 2, article on Canton. 496 APPENDIX. and spirits of wine added, is said to diminish the pain in opening abscesses. Dung of the Magpie. — The nest is burnt, and the ashes given in nervous diseases. Dung of the Pigeon. — Is employed in veterinary practice (a matter of congratulation to feel that mankind alone does not require such physic). The dung of other birds is also used. Tiger's Bones. — All are set down in the Pen Ts'au as having medicinal properties. The tibiae and skull bones are esteemed for making a tincture, used in rheumatism, ague and debility. Dew. — Dew collected on the morning of the first day of the eighth month, and mixed with native ink, is said to be good for headaches, applied to the temples. Snakes. — The flesh, skin, head and tail of several kinds of snakes are used in Chinese medicine. The skin of the white spotted snake is employed in leprosy. Rhinoceros Horn. — The horns of strong beasts are thought to be tonic and alterative. Balsam Seeds. — Balsam seeds are directed to be taken by a woman in childbirth, the soles of her feet, at the same time, being rubbed with as many castor-oil beans as she is years of age. Fowls. — Black-boned fowls are much prized for making soup for those suffering from lung diseases. Elephant's Hide — This is taken as a remedy by those having wounds difficult to heal. SUMMARY. I. That the various vegetable remedies of China are not found, as a rule, south of the equator, and the reverse. This is especially true of South American drugs. II. That the use of arsenic in the cure of malaria has been known for a considerable period to the Chinese. (See p. 490, this article ; also Chinese Repository, vol. 18, p. 507.) III. That the application of the cold douche in bringing about consciousness in cases of poisoning by alcohol, etc., has been known to the Chinese since the Christian era. IV. That they were in the habit of administering sarsaparilla in syphilis. APPENDIX. 497 Authorities Referred to. — The Chinese Repository, 20 vols., 1832-1851. Chinese Materia Medica and Natural History, Shang- hai, 1870, Smith. Melanges Asiatiques, Remusat, 2 vols., 1825. Eitel, Hand-book of Chinese Buddhism. Icones Plantarum Japoni- carum, Thunberg, with flor. Japan, 1794. Treaty Ports of China and Japan, Mayer, 1867. Translation of four anatomical diagrams, Harland, 1846. The Poppy Plague, 1876. The Middle Kingdom, 2 vols., 1876. Pharmacopoeia of India, Waring. History of China, 1823. Lochardt's Medical Missionary in China. Staunton's Em- bassy, 2 vols., 1797. Flora of China, Burnett, in 3d volume of an Historical and Descriptive Account of China, 1836. 32 INDEX Abbreviations, table of, 471 Abies balsamea, 334 canadensis, 424 excelsa, 423 picea, 423 Absinthe,' 131 Absinthin, 130 Absinthium, 130 Abstract of aconite, 217 conium. 257 digitalis, 252 ignatia, 244 jalap, 298 nux vomica, 244 podophyllum, 300 senega, 332 Abstractum aconiti, 217 conii, 257 digitalis, 252 ignatiae, 244 jalapae, 298 nucis vomicae, 244 podophylli, 300 senegee, 332 Acacia, 440 catechu, 178 nilotica, 441 verek, 440 Aceta, 37 Acetic acid, 238 diluted, 238 glacial, 238 Acetum lobelise, 85 opii, 64 sanguinariae, 271 scillae, 321 Achillea, 133 infusion of, 133 millefolium, 133 oil of, 133 Achillein, 133 Acid acetic, 238 aconitic, 86, 133 anemonic, 223 angelic, 264 anthemic, 128, 129 arabic, 442 aromatic sulphuric, 170 arsenious, 434 benzoic, 346, 348, 417 boheic, 115 Acid boracic, 415 boric, 415 caffeic, 115 caffeo-tannic, 115 cambogic, 304 cantharidic, 427 carbolic, 405 carminic, 461 catechuic, 178 catechu-tannic, 178 cathartic, 294 cerylic, 144 cetraric, 449 chelidoninic, 300 chromic, 434 chrysophanic, 437 cincho-tannic, 136 cinnamic, 206, 346, 347, 348 citric, 238 cocatannic, 116 columbic, 125 copaivic, 338 cornic, 146 cresylic, 409 cubebic, 339 cyanohydric, 92 diluted acetic, 238 hydrocyanic, 92 hydrochloric, 173 muriatic, 173 nitric, 172 nitro-hydrochloric, 173 nitro-muriatic, 173 sulphuric, 170 phosphoric, 385 eruic, 420 eugenic, 208 euonic, 302 felicic, 467 ferulaic, 110 gallic, 176, 177 gelseminic, 224 gentisic, 123, 124 glacial acetic, 238 guaiacic, 315 guaiaconic, 315 guaiaretic, 315 gummic, 442 hydrochloric, 172 ipecacuanhic, 267 juglandic, 290 500 INDEX. Acid kinic, 135 kinovic, 136 kramero-tannic, 180 lactic, 459 lobelic, 83 margaric, 454 meconic, 58 mino-tannic, 175 muriatic, 172 myrrhic, 345 nitrate of mercury, 357, 367, 436 nitric, 171 nitro-hydrochloric, 173 nitro-muriatic, 173 cenanthic, 197 oleic, 452, 454 ophelic, 126 phenic, 405 phosphoric, 385 polygalic, 331 potassium tartrate, 319 prussic, 92 pyroligneous, 336 querci-tannic, 181 rhatania-tannic, 180 rhatanic, 180 rheo-tannic, 289 rheumic, 289 salicylic, 411 santalic, 461 sclerotic, 246 stearic, 454 succinic, 118 sulphuric, 169 sulphurous, 170 tannic, 174, 177, 181, i83, 185 tartaric, 239 tiglinic, 306 toxicodendric, 244 valerianic, 113, 129 Acida mineralia, 168, 436 vegetabilia, 237 Acids, mineral, 168, 436 vegetable, 237 Acidum aceticum, 238 dilutum, 238 glaciale, 238 arseniosum, 378, 434 benzoicum, 417 boricum, 415 carbolicum, 405 crudum, 405 chromicum, 434 citricum, 238 gallicum, 176 hydrochloricum, 172 dilutum, 173 hydrocyanicum dilutum, 92 lacticum, 459 nitricum, 171 Acidum nitricum dilutum, 172 nitro-hydrochloricum, 173 dilutum, 174 oleicum, 452 phosphoricum dilutum, 385 salicylicum, 411 sulphuricum, 169 aromaticum, 170 dilutum, 170 tannicum, 174 tartaricum, 239 valerianicum, 113 Acipenser huso, 451 Aconite, 85, 217 Aconitia, 86 Aconitic acid, 86, 133 Aconitum, 85, 217 napellus, 85 Acorin, 212 Acorus calamus, 211 Actual cautery, 24, 437 Acupuncture, 19 Adeps, 451 benzoinatus, 452 Adhesive plaster, 337 ^Esculin, 224 ^Ether, 100 fortior, 100 Agathotes chirata, 126 Age, influence of on medicinal ef- fects, 44 Alcohol, 193 amylic, 107, 193 diluted, 197 dilutum, 197 Alcoholic extract of cantharides, 42* hyoscyamus, 80 potassa, 433 Alder buckthorn, 295 Algae, 449 Alkaline carbonates, 319 salts, 319 Alkali, volatile, 199 Allium, 332, 425 sativum, 332 Allspice, 208 Allyl, 333 sulphoxiyanide, 421 Almond mixture, 442 Aloe, 291 purificata, 292 Aloes, 291, 349 Barbadoes, 291 Cape, 291 hepatic, 291 Aloe socotrina, 291 spicata, 291 vulgaris, 291 Aloes purified,. 292 socatrine, 291 INDEX. 501 Aloin, 292 Alteratives, 53, 351 Alterative diaphoretics, 312 Althaea, 445 officinalis, 445 Alum, 191, 272, 436 ammonio-ferric, 159 dried, 191, 192 whey, 192 Alumen, 191, 2*72, 436 exsiccatum, 192 Aluminii sulphas, 192 Aluminium sulphate, 192 Amber, 118 American columbo, 124 hellebore, 218 hemp, 88 poplar, 131 silver fir, 334 white turpentine, 333 Ammonia, 117, 199 preparations of, 199 Ammoniac, 112, 348 Ammoniac plaster with mercury, 356,358 Ammoniacum, 112, 348 Aminoniae aqua, 200 fortior, 200, 430 linimentum, 423 praeparata, 199, 399 spiritus, 200 aromaticus, 200, 399 Ammoniated copper, 161 glycyrrhizin, 448 mercury, 357, 366 tincture of guaiac, 315 valerian, 113 tinctures, 35 Ammonii acetatis liquor, 236 benzoas, 418 bromidum, 71 carbonas, 201 chloridum, 388 purificatum, 388 iodidum, 373 phosphas, 389 prseparata, 399 sulphis, 171 valerianas, 113 Ammonio-cupric sulphate, 161 Ammonio-ferric alum, 159 Ammonium alum, 191 benzoate, 418 carbonate, 201 chloride, 388 iodide, 373 phosphate, 389 preparations, 399 sulphite, 171 Amygdalin, 96, 147 Amygdalus communis, 96 Amyl nitrite, 107 Amylic alcohol, 107, 193 Amylum, 450 iodatum, 371, 451 Anaesthetics, 53, 99 Anamirta cocculus, 259 Andira araroba, 437 Anemone patens, 222 pretensis, 222 Pulsatilla, 222 Anemonic acid, 223 Anemonin, 223 Angelic acid, 264 Angosturine, 132 Angustura, 131 false, 132, 248 Animal fats, 451 Anise, 216 star, 216 water, 216 Anisum, 216 Anodyne, Hoffman's, 119 Antacids, 53, 319, 392 Anthelmintics, 53, 462 Anthemic acid, 128, 129 Anthemis, 128 cotula, 129 nobilis, 128 Anthenaidina, 129 Antilithics, 393 Antimonial ointment, 431 preparations, 310 powder, 232 wine, 231 Antimonious oxide, 228 sulphide, 231 purified, 231 Antimonii oxidura, 228 et potassii tartras, 228, 272 sulphidum, 231 purificatum, 231 prseparata, 228 sulphuratum, 231 Antimonium and potassium tartrate. 228, 272 Antimony, pills of, 232 preparations of, 228 sulphurated, 231 tartarized, 228 wine of, 231 Antiseptics, 53, 402 Antispasmodics, 53, 109 Apiol, 329, 349 Apis mellifica, 452, 459 Apocynaceae, 325 Apocynum, 325 androsaemifolium, 326 cannabinum, 325 Apomorphia, 58 502 INDEX. Apomorphia hydrochlorate, 271 Apomorphiae hydrochloras, 271 Apomorphinas hydrochloras, 271 Aporaorphine hydrochlorate, 271 Aporetin, 289 Apothecaries' weight, 40 measure, 42 Apples, 274 Applications of medicines to the skin, 45 to mucous membranes, 47 to serous membranes, 50 to ulcers, wounds, etc., 50 Approximate measures, 42 Aqua, 439 ammonias, 200, 430 fortior, 200, 430 amygdalae amarae, 96 anisi, 216 aurantii riorum, 214 camphorse, 98 chlori, 401 cinnamomi, 206 creasoti, 411 destillata, 439 fceniculi, 216 menthae piperitae, 214 viridis, 214 rosae, 184 Aquae, 34 Arabin, 441 Arabic acid, 442 Aracese, 114, 211 Araroba, 437 Arbutin, 213, 343, 345 Arctostaphylos uva ursi, 342 Argenti nitras, 164 fusus, 166, 432 dilutus, 166, 432 oxidum, 166 praeparata, 164 Argol, 286 Argyria, 165 Aricina, 136 Aristolochia reticulata, 127 serpentaria, 126 Aristolochiaceae, 127 Arnica, 225 montana, 225 flowers, 225 root, 225 Arnicae flores, 225 radix, 225 Arnicin, 225 Aromatic bitters, 120, 126 powder, 211 spirit of ammonia, 200, 399 sulphuric acid, 170 syrup of rhubarb, 290 Aromatic wine, 131, 215 Aromatics, 193, 203 Arrack, 198 Arsenic, 378- preparations of, 378 oxide, 378 white, 378 Arsenii et hydrargyri iodidi liquor. 385 iodidum, 384 prasparata, 378 Arsenious acid, 378, 434 Arseuite of potassium, solution of, 383 of sodium, 384 Artanthe elongata, 341 Artemisia absinthium, 130 maritima, 465 Arteriotomy, 17 Artificial camphor, 97 musk, 118 Asafetida, 110, 348 Asafoetida, 110, 348 Asagraea officinalis, 221 Asaparagin, 446 Aspidium, 467 filix-mas, 467 marginale, 467 Aspiration, 20 Aspirator, 20 Astragalus gummifer, 442' Astringent bitters, 121, 133 Astringents, 53, 174 mineral, 174, 185 vegetable, 174 Atomization of fluids, 48 Atomizers, 49 Atropa belladonna, 73 Atropia, 73 sulphate of, 74 Aurantiaceae, 213 Aurantii amari cortex, 213 dulcis cortex, 213 flores, 214 Auric and sodium chloride, 368 Auri et sodii chloridum, 368 Azedarach, 466 Balm of Gilead tree, 334 Balsam of fir, 334 Peru, 347 Tolu, 348 Balsamodendron myrrha. 345 Balsams, 346, 347, 348 Balsamum Peruvianum, 347 Tolutanum, 348 Bandages, 19 Barbadoes aloes, 291 Barbary gum, 441 Barberry, 126 INDEX. 503 Barilla, 396 Bark of cotton root, 248 Barley sugar, 458 Barosma betulina, 342 crenulata, 342 serratifolia, 342 Basham's mixture, 155 Basic quinia sulphate, 142 Basilicon ointment, 337 Bassora gum, 441 Bassorin, 442 Baths, 25 of iodine, 371 nitro-hydrochloricacid, 173 sodium arseniate, 384 Baunscheidtismus, 20 Bay rum, 198 Bean of St. Ignatius, 244 Bearberry, 342 Bebeeria, 147 sulphate, 148 Bebeeru bark, 147 Bee, 452, 459 Beet-root sugar, 458 Belladonna, 73 leaves, 73 root, 73 Belladonna? folia, 73 radix, 73 Benjamin tree, 346 Benne oil, 446 Benzoate of ammonia, 418 lithium, 399 Benzoe amygdaloides, 346 in sortis, 346 Benzoic acid, 346, 348, 417 aldehyde, 96 Benzoin, 346 Benzoinated lard, 452 ointment, 452 Benzoinum, 346 Berberia, 122, 125, 126, 300, 316, 329 Berberidaceae, 299 Berberina, 122, 125, 126, 300, 316, 329 Berberine, 122, 125, 126, 300, 316, 329 Beta-colchicoresin, 322 Bhang, 88 Bicarbonate of potassium, 395 sodium, 397 Bichloride of methylene, 106 mercury, 357, 362, 436 Bichromate of potassium, 391, 436 Bismuth, citrate of, 167 subcarbonate of, 167 subnitrate of, 166 valerianate of, 167 Bismuthi et ammonii citras, 167 subcarbonas, 167 subnitras, 166 Bisulphate of quinine, 142 Bitartrate of potassium, 286 Bitter almond water, 96 cucumber, 303 orange, 213 wine of iron, 158 Bittern, 282 Bitters, aromatic, 120, 126 astringent, 121, 133 simple, 120 Bittersweet, 91 Black draught, 294 drop, 64 ginger, 210 haw, 261 mustard, 420 nightshade, 91 oak, 181 pepper, 205, 425 snakeroot, 252 wash, 360 Blackberry, 185 Blennorrheas, 53, 318. 320. 330, 349 Blistering cerate, 428 Blisters, 419, 425 Bloodletting, 17, 18 Bloodroot, 269 Blue gum-tree, 144 mass, 308, 356, 357 ointment, 356, 35£ pills, 308, 356, 357 stone, 160 vitriol, 160 Boheic acid, 115 Bone-ash, 201 phosphate of calcium. 386 Boneset, 129 Boracic acid, 412 Borate of sodium, 416 Borax, 416 Bordeaux turpentine, 334 Boric acid, 415 Borneo camphor, 97 Botanv Bay kino, 179 Bran, 274 Brandy, 198 Brayera, 468 anthelmintica, 468 Brazilian sarsaparilla, 313 British barilla, 396 Bromide of ammonium, 71 calcium, 72 lithium, 72 sodium, 72 potassium, 67 ' Bromides, 67 Bromine, 405, 435 Bromism, 69 Bromum, 4C Broom, 328 Brown mixture, 448 504 INDEX. Brucia, 241, 242, 244 Brucine, 241, 242, 244 Bryonia, 298 alba, 298 diorca, 298 Bryonin, 298 Bryony, 298 Buchu, 342 Buckthorn, 295 Burgundy pitch, 424 plaster, 424 spurious, 424 Burnett's disinfectant fluid, 161 Burseraceae, 345 Butea frondosa, 179 Butter melted, 279 of cocoa, 453 of nutmeg, 207 Butternut, 290 Cacao butter, 453 Caffea arabica, 115 Caffeic acid, 115 Caffeina, 115, 116 citrate, 116 valerianate, 116 Caffeo-tannic acid, 115 Cajeput oil, 208 Calabar bean, 257 Calabria, 257 Calamina prseparata, 163 Calamine, 163 Calamus, 163 Calcii bromidum, 72 Calcii carbonas prsecipitatus, 401 chloridum, 388 hypophosphis, 386 phosphas prsecipitatus, 386 praeparata, 400 sulphis, 171 Calcined magnesia, 281 Calcium, chloride of, 388 Calcium, precipitated carbonate of, 401 hypophosphite of, 386 precipitated phosphate of, 386 preparations of, 400 sulphide of, 171 sulphite of, 171 sulpho-carbolate, 409 Calendula, 316 officinalis, 316 Calendulin, 316 Calisaya bark, 134 Calomel, 307, 357, 360, 368 Caior, 23 Calumb, 125 Calumba, 125 Calx chlorata, 404 snlphurata. 171 Cambogia, 304 Cambogic acid, 304 Camphor, 96 artificial, 97 laurel, 96 liniment, 98 mixture, Hope's, 172 monobromated, 99 water, 98 Camphora, 96 officinarum, 96 Camphorated tincture of opium, 63 Camphoric acid, 97 Camphoronic acid, 97 Canada balsam, 334 fleabane, 324 moonseed, 316 pitch, 424 plaster, 425 turpentine, 334 Candy, rock, 459 Cane, sugar, 458, 459 Canella, 133 alba, J33 Canellacese, 133 Cannabin, 89 Cannabis Americana, 88 Indica, 88, 326 sativa, 88 Canabene, 89 hydride, 89 Cantharidal collodion, 430 liniment, 429 Cantharidin, 427, 430 Cantharides, 329, 349, 426 cerate of, 428 paper of, 430 Cantharidic acid, 427 Cantharis, 329, 349, 426 vesicatoria, 426 vittata, 430 Cape aloes, 291 Caprifoliacese, 261, 296 Capsaicin, 204 Capsicum, 204, 422 African, 204 fastigiatum, 204 Caraccas kino, 179 Caraway, 216 Carbo ligni, 460 Carbolate of potassium, 409 quinia, 143 sodium, 409 Carbolic acid, 405 crude, 405 ointment of, 409 Carbon, tetrachloride of, 108 Carbonate of ammonium, 201 calcium, precipitated, 401 iron, pill of, 152 INDEX. 505 Carbonate of lead, 190 lithium, 398 magnesium, 282, 399 potassium, 394 pure, 394 sodium, 397 dried, 397 zinc, precipitated, 163 Carbonates of sodium, 396 Carbonic acid water, 440 Cardamom, 211 Cardamomum, 211 Carminatives, 193 Carminic acid, 461 Carolina pink, 462 jasmine, 223 Carrageen, 449 Carrageenin, 449 Carron oil, 409 Cartagena barks, 135 Carum, 216 carvi, 216 Caryophyllin, 208 Caryophyllus, 207 aromaticus, 207 Cascara sagrada, 296 Cascarilla, 132 Cascarillin, 132 Cassia, 293 acutifolia, 293 aethiopica, 298 cinnamon. 206 elongata, 293 fistula, 277 lanceolata, 293 obovata, 293 Castanea, 185 vesca, 185 Castor oil, 277 Cataplasmata, 39 Cataplasms, 39, 422, 439 Catechin, 178 Catechu, 178 Catechuic acid, 178 Catechu-tannic acid, 178 Cathartic acid, 294 Cathartics, 53, 273 Catharto-mannite, 294 Caustic potassa, 432 soda, 434 Cauterants, 431 Cautery, actual, 24, 437 galvano, 27 Cauterization, 24 Cedar, red, 350 Celandine, 300 Celastraceae, 301 Centaury, 124 American, 124 Cephaelis ipecacuanha, 266 Cera alba, 452 flava, 452 Cerasus serotina, 147 Cerata, 39 Cerate, 39, 452 blistering, 428 of calamine, 163 of cantharides, 428 carbonate of zinc, 163 extract of cantharides, 429 lead, subacetate, 189 sabine, 350 spermaceti, 452 resin, 337 Turner's, 163 Cerates, 39, 452 Ceratum, 39, 452 camphorse, 99 cantharidis, 428 cetacei, 452 extracti cantharidis, 429 plumbi subacetatis, 189 resinae, 337 sabinae, 350 Cerii oxalas, 168 Cerite, 168 Cerium, nitrate of, 168 oxalate of, 168 Cerylic acid, 144 Cetaceum, 452 Cetine, 452 Cetraria, 448 islandica, 448 Cetraric acid, 449 Cetrarin, 449 Cetyl palmitate, 452 Cevadilla, 221 Cayenne pepper, 204 Ceylon cinnamon, 205 Chalk, 401 mixture, 401 prepared, 401 Chalybeates, 149, 349, 351 Chamomile, 128 German, 129 wild, 129 Champagne, 198 Chapman's copaiba mixture, 338 Charcoal, 460 Charta cantharidis, 430 potassii nitratis, 235 sinapis, 422 Chartae, 33 Chelerythrine, 300 Chelidonine, 300 Chelidoninic acid, 300 Chelidonium, 300 majus, 300 Chenopodiaceae, 464 Chenopodium, 464 506 INDEX, Chenopodium ambrosioides, 464 Chestnut, 185 Chian turpentine, 334 Chimaphila, 344 maculata, 344 umbellata, 344 China camphor, 97 cinnamon, 205 musk, 117 Chinese rhubarb, 288 Chinoidin, 143 Chinoidinum, 143 Chirata, 126 Chiratin, 126 Chittem bark, 296 Chloral, 65 alcoholate, 65 Chlorate of potassium, 390 Chlorhydric acid, 172 diluted, 173 Chloride of ammonium, 388 calcium, 388 gold and sodium, 368 iron, 154 solution of, 155 tincture of, 155 lime, 388, 404 zinc, 163, 435 solution of, 163 Chlorinated lime, 404 soda, solution of, 405 Chlorine, 404 water, 404 Chlorodyne, 106 Chloroform, 103 commercial, 103 liniment, 106 purified, 103 Chloroformum, 103 purificatum, 103 venale, 103 Chocolate, 116 Chocolate-nuts, 453 Cholagogues, mercurials as, 307-, 356 Cholesterin, 117 Chondodendron tomentosum, 341 Chondrus, 449 crispus, 449 mammilosus, 449 Chromic acid, 434 anhydride, 434 Chromogene, 249 Chrysarobin, 437 Chrysarobinum, 437 Chrysophan, 289 Chrysophanic acid, 289, 294, 437 Churrus, 88 Cicuta, 257 Cimicifuga, 252 racemosa, 252 Cinchona, 133 calisaya, 134 condaminea, 134 flava, 134 micrantha, 134 officinalis, 134 ovata, 134 pallida, 134 rubra, 134 rugosa, 134 succirubra, 134 Cinchonia, 134, 135, 137 sulphate, 143 Cinchonise sulphas, 143 Cinchonicia, 137, 143 Cinchonicine, 137, 143 Cinchonidia, 136, 137 sulphate, 144 Cinchonidiae sulphas, 144 Cinchonidina, 136, 137 Cinchonidinae sulphas, 144 Cinchonidine, 136, 137 sulphate, 144 Cinchoniae sulphas, 143 Cinchonina, 134, 135, 137 Cinchoninae sulphas, 143 Cinchonine, 134, 135, 137 sulphate, 143 Cincho-tannic acid, 136 Cinnabar, 352, 366 Cinnamic acid, 206, 346, 347, 348 Cinnamomum, 205 zeylanicum, 205 Cinnamon, 205 cassia, 206 Ceylon, 205 China, 205 water, 206 Cissampelina, 341 Citrate of bismuth, 167 bismuth and ammonium, 167 caffeina, 116 iron, 157 wine, 159 and ammonium, 158 and quinia, 158 solution, 158 and strychnia, 159 lithium, 399 magnesium, solution of, 283 potassium, 235 mixture of, 235 solution of, 235 quinia, 143 Citric acid, 238 syrup of, 238 Citrine ointment, 357, 367 Citrullus colocynthis, 303 Citrus aurantium, 213 limonum, 239 INDEX. 507 Citrus vulgaris, 213 Clarified honey, 459 Classification of med Claviceps purpurea, 245 Climate, influence of, on medicinal effects, 42 on plants, 31 Cloves, 207 Clysters, 50 Coca, 116 Cocaiana, 116 Cocatannic acid, 116 Coccoloba uvifera, 179 Cocculus, 259 Indicus, 259 palmatus, 125 Coccus, 461 cacti, 461 Cochineal, 461 Codamia, 56 Codeia, 56, 57 Cod-liver oil, 375 phosphorated, 378 Coffea Arabica, 115 Coffee, 115 Cohosh, 252 Colchicein, 322 Colchici radix, 322 semen, 322 Colchicia, 322, 324 Colchicina, 322, 324 Colchicine, 322, 324 Colchico-resin, 322 Colchicum, 322 autumnale, 322 root, 322 seed, 322 Cold, 23, 24 bath, 25 compresses, 25 cream, 184 pack, 25 Colica Pictonum, 186 Collodion, 456 flexible, 457 styptic, 457 with cantharides, 430 Collodium, 456 flexile, 457 stypticum, 457 cum cantharide, 430 Collyria, 47 Colocynth, 303 Colocynthin, 303 Colocynthis, 303 Colocynthitin, 303 Colombin, 125 Cologne water, 215 Colouring agents, 53, 460 Columbo, 125 American, 124 Commercial chloroform, 103 sodium bicarbonate, 397 Composite, 72, 128, 129, 130, 133, 225, 262, 316, 324, 326, 465 Compound cathartic pills, 305 chalk powder, 401 decoction of sarsaparilla, 314 effervescing powder, 287 extract of colocynth, 287 fluid extract of sarsaparilla, 314 infusion of catechu, 178 rose, 184 senna, 294 iron mixture, 153 pills, 153, 346 jalap powder, 286 liquorice mixture, 448 liniment of mustard, 448 mixture of glycyrrhizae, 448 iron, 153, 346 liquorice, 448 pills of antimony, 232 galbanum, 112, 346 iron, 153 rhubarb, 290 plaster of galbanum, 112 powder of jalap, 298 liquorice, 295 morphia, 64 rhubarb, 290 resin cerate, 337 solution of iodine, 371 spirit of ether, 119 juniper, 328 lavender, 214 syrup of sarsaparilla, 314 squill, 321, 332 - tincture of benzoin, 347 cardamom, 211 cinchona, 141 gentian, 123 iodine, 371 Compounds of amyl, 107 Compressed pills, 33 Condy's fluid, 404 . Confectio rosae, 184 sennae, 275, 277, 294 Confection, rose, 184 senna, 275,277, 294 Confectiones, 33 Confections, 33 Conhydrina, 255 Conia, 255 Coniferee, 208, 328, 333, 334, 349, 423, 424 Conine, 255 Conium, 254 maculatum, 254 508 INDEX. Conserves, 33 Convolvulaceae, 297, 302 Convolvulin, 297 Convolvulus scanimonia, 302 Copaiba, 337 Copaifera, 337 Langsdorfii, 337 Copaivic acid, 338 Copper, ammoniated, 161 preparations of, 160 subacetate of, 161 sulphate of, 160, 272, 436 Copperas, 153 Coptina, 122 Coptis, 122 teeta, 122 trifolia, 122 Coriander, 216 Coriandrum, 216 sativum, 216 Corn ergot, 248 smut, 248 Cornacese, 145 Cornic acid, 146 Cornin, 146 Cornus, 145 circinata, 146 Florida, 145 sericea, 146 Corroborants, 119 Corrosive chloride of mercury, 357, 362, 436 sublimate, 357, 362, 436 Cosmoline, 455 Cotton, 249 root, bark of, 248 Cotula, 129 Court-plaster, 451 Couch-grass, 327 Cowling's scheme for doses, 44 Cox's hive syrup, 321 Cranesbill, 182 Cream of tartar, 286, 319 Creasol, 410 Creasote, 336, 410 water, 411 Creasotum, 410 _ Cresylic acid, 409 Cresylol, 410 Creta prseparata, 401 Crocus, 460 sativus, 460 Croton eluteria, 132 oil, 306, 431 tiglium, 306 Crotonol, 306 Crowfoot, 182 Cruciferae, 272, 420 Crude carbolic acid, 405 liquorice, 448 Crude quinine, 143 tartar, 286 Cryolite, 396 Cryptopia, 58 Cubeb, 339 Cubeba, 339 officinalis, 339 Cubebic acid, 339 Cubebin, 339 Cubic nitre, 235 Cuca, 116 Cucumber, bitter, 303 squirting, 305 Cucurbita pepo, 469 Cucurbitaceae, 298, 303, 305, 469 Cultivation, influence of, on plants, 42 Culver's root, 295 physic, 295 Cupping, 18, 19 . dry, 18 wet, 18 Cupri prasparata, 160 subacetas, 161 sulphas, 161, 272, 436 Cupric sulphate, 160, 272, 436 Cupuliferas, 177, 181, 185 Cuprum ammoniatum, 159 Cups, 18 Curare, 260 Curaria, 260 Curarine, 260, 261 Cusparin, 132 Cyanide of potassium, 95 mercury, 357, 365 Cyanohydric acid, 92 Cydonia vulgaris, 446 Cydonium, 446 Cynanchum oleaefolium, 293 Cymene, 215 Cymol, 97, 144 Cymylic phenol, 418 Cynips querctisfolii, 177 Cypripedium, 114 pubescens, 114 Dandelion, 326 Daphne mezereum, 315 Daphnin, 315 Darkness, 23 Datura stramonium, 77 Daturia, 78 Deadly nightshade, 73 Decimal system, 41 Decocta, 35 Decoction of azedarach, 466 broom, 328 cetraria, 449 blackberry, 135 cotton-root bark, 249 INDEX. 509 Decoction of elder, 297 erigeron, 325 geranium, 183 haematoxylon, 181 Iceland moss, 449 Irish moss, 449 liriodendron, 131 logwood, 181 pipsissewa, 345 pomegranate, 184, 468 rubus, 185 sarsaparilla, compound, 314 white oak, 182 Decoctions, 34 Decoctum cetrariae, 449 sarsaparillae compositum, 314 Deer-berry, 212 Delphinia, 227 Delphinine, 227 Delphinium staphisagria, 227 Demulcents, 53, 438 Denarcotised opium, 62 Deodorized tincture of opium, 64 Depresso-motors, 241, 254 Deshler's salve, 337 Dextrin, 450 Diachylon, 190 Dialysed iron, 159 Dialysis, 35 Diaphoretics, 53, 309 alterative, 312 nauseating, 309 refrigerant, 310 stimulating, 310 Diastase, 450 Dieulafoy's aspirator, 20 Diffusible stimulants, 193 Digestion, 34 influence Digestive ferments, 148 Digitalin, 250 Digitalis, 249, 320 purpurea, 249 Diluents, 439 Diluted acetic acid, 238 alcohol, 197 hydrochloric acid, 173 hydrocyanic acid, 92 muriatic acid, 173 nitric acid, 172 nitro-muriatic acid, 174 phosphoric acid, 385 solution of subacetate of lead, 189 silver nitrate, 166, 432 sulphuric acid, 170 Diospyros, 184 Virginiana, 185 Diplolepis gallag tinctoriae, 177 Disease, influence of, on medicinal Disinfecting fluid, Burnett's, 163 Condy's, 403 Ledoyen's, 190 solution, Labarraque's, 405 Dispensatory, 28 Displacement, 34 Distilled oils, 203 water, 439 Diuretics, 53, 318 special, 320 Dogwood, 145 round-leaved, 146 swamp, 146 Dogsbane, 326 Dolomite, 282 Donovan's solution, 385 Dorema ammoniacum, 112, 263 Doses, modifying effects of, 31 of medicines, 43 Dover's powder, 63, 269, 310 Dracontium, 114 foetidum, 114 Drachm, 40 Drastic cathartics, 279, 349 Drastics, 272 Draught, black, 294 effervescing, 236 Scudamore's, 323 Dried alum, 192 sodium carbonate, 397 Drops,, 42 Dryobalanops camphora, 97 Duboisia, 83 myopceoides, 83 Dulcamara, 91 Dupuytren's pomatum, 430 Dutch camphor, 97 East India kino, 179 Ebenaceae, 185 Ecballium elaterium, 305 Eccritics, 53, 265 Effects of medicines, 30 Effervescing draught, 236 Egyptian opium, 55 Elaterin, 305 Elaterinum, 305 Elaterium, 305 Elder, 296 Electricitas, 23, 25 Electricity, 25 faradic, 26 frictional, 26 galvanic, 26 induced, 26 magnetic, 26 static, 26 voltao-magnetic, 26 Electuaries, 33 Elettaria cardamomum, 211 510 INDEX. aurantii, 214 of orange, 214 of vitriol, 170 simple, 214 Ellis' magnesia, 281 Elm, 444 Elutriation, 32 Emetia, 267 Emetics, 53, 265, 309 mineral, 272 vegetable, 268 Emetine, 267 Emmenagogues, 53, 349 Emodin, 289, 295 Emollients, 439 Emplastra, 39 Emplastrum aconiti, 88 ammoniaci, 112 cum hydrargyro, 112, 356, 358 arnicae, 225 asafoetidae, 111 belladonnae, 77 capsici, 205, 423 ferri, 152 galbani compositum, 112 hydrargyri, 356, 358 ichthyocollae, 451 opii, 63 picis Burgundicae, 424 Canadensis, 425 cum cantharidae, 424 plumbi, 190 resinae, 337 saponis, 190 Emulsin, 96 Emulsions, 34 Endermic application of medicines, 46 Enepidermic application of medi- cines, 45 Enemata, 50, 308 cathartic, 308 forced, 308 laxative, 308 Epidermic application of medicines, 46 Epispastics, 419, 425 Epsom salt, 282 Ergot, 244 of rye, 244 corn, 248 Ergota, 244 Ergotin, 248 Ergotinine, 246 Ericaceae, 212, 342, 344 Ericolin, 213, 345 Erigeron, .324- Erigeron heterophyllum, 324 Philadelphicum, 324 Errhines, 47 Erucic acid, 420 Erythoretin, 289 Erythro-centaurin, 125 Erythroxylaceae, 116 Erythroxylon, 116 coca, 116 Eschar, 431 Escharotics, 419, 431 Eserina, 257, 259 Eserine, 257, 259 salicylate, 259 Essence of lemon, 239 peppermint, 214 spearmint, 214 Essential oils, 203 Ethal alcohol, 452 Ether, 100 stronger, 100 Ethereal anaesthetics, 99 extract of cantharides, 429 oil, 118 refrigerants, 319 tinctures, 35 Ethyl hydrate, 193 Eucalyptol, 144, 145 Eucalyptus, 144 globulus, 144 resinifera, 179 Eugenia caryophyllata, 207 pimenta, 208 Eugenic acid, 208 Eugenin, 208 Eugenol, 208 Euonic acid, 302 Euonymin, 302 Euonymus, 302 atropurpureus, 302 Eupatorin, 129 Eupatorium, 129 aromaticum, 129 perfoliatum, 129 teucrifolium, 129 ' Euphorbiaceae, 132, 277, 306, 317, 468 European opium, 55 rhubarb, 288 Excito-motors, 240 Exogonium purga, 297 Expectorants, 330 Expressed oil of almond, 277 Extract of aconite, 88, 217 fluid, 217 American hellebore, fluid, 221 hemp, 88 arnica, 203 belladonna, 77 alcoholic, 77 INDEX. 511 Extract of bittersweet, 92 fluid, 92 blackberry, fluid, 185 brayera, fluid, 468 broom, fluid, 328 buchu, fluid, 342 butternut, 290 calabar bean, 259 Canada fleabane, fluid, 324 cascara sagrada, fluid, 296 chimaphila, fluid, 345 cimicifuga, fluid, 254 cinchona, 141 fluid, 141 colcbicum, acetic, of root, 324 fluid, of root, 324 of seed, 324 colocynth, 304 compound, 304 columbo, fluid, 126 conium, 257 fluid, 257 couch grass, fluid, 327 cotton-root bark, fluid, 249 cubeb, fluid, 340 dandelion, 327 fluid, 327 digitalis, 252 fluid, 252 dogwood, fluid, 146 ergot, fluid, 248 erigeron, Canada, fluid, 324 euonymus, 302 frangula, fluid, 296 gentian, 123 fluid, 123 geranium, fluid, 183 ginger, fluid, 210 Goulard's, 189 hamamelis, fluid, 184 hydrastis, fluid, 329 hyoscyamus, 80 alcoholic, 80 fluid, 80 Indian hemp, 88 ipecacuanha, fluid, 259 iris, 301 fluid, 301 jaborandi, fluid, 312 jalap, 276 juglans, 290 koosso, fluid, 468 krameria, 180 fluid, 180 leptandra, 295 fluid, 295 liquorice root, 448 fluid, 449 refined, 449 logwood, 181 Extract of lupulin, fluid, 90 matico, fluid, 341 May-apple, 300 fluid, 300 mezereon, 316 fluid, 316 nux vomica, 244 opium, 62 pareira, fluid, 342 pepo, fluid, 469 pilocarpus, fluid, 312 pipsissewa, fluid, 345 podophyllum, 300 fluid, 300 pumpkin-seed, fluid, 469 quassia, 121 rhatany, 180 fluid, 180 rhubarb, 289 fluid, 289 sarsaparilla, fluid, 314 fluid, compound, 314 savine, fluid, 350 senega, fluid, 332 senna, fluid, 294 serpentaria, fluid, 12 , 8 spigelia, fluid, 464 squill, fluid, 321 stillingia, fluid, 317 stramonium leaves, 79 seed, 79 taraxacum, 327 fluid, 327 triticum, fluid, 327 uva ursi, fluid, 327 valerian, 113 fluid, 113 wahoo, 302 wild cherry, fluid, 147 yellow jasmine, fluid, 224 Extracta, 37 fluida, 37 Extracts, 37 Extractum aconiti, 88, 217 fluidum, 217 arnica? radicis, 225 fluidum, 225 aurantii amari fluidum, 214 belladonnas, 77 alcoholicum, 77 fluidum, 77 brayerae fluidum, 468 buchu fluidum, 342 calami fluidum, 212 calumbaa fluidum, 126 cannabis indicee, 88 fluidum, 88 capsici fluidum, 205 castanese fluidum, 185 chimaphilas fluidum, 345 512 INDEX. Extractum cimicifugae fluidum, 254 cinchonae, 141 fluidum, 141 colchici, 324 radicis fluidum, 324 seminis fluidu colocynthidis, 304 compositum, 304 conii alcoholicum, 257 fluidum, 257 cornus fluidum, 146 cubebae fluidum, 340 digitalis, 252 fluidum, 252 dulcamarae fluidum, 92 ergotae, 248 fluidum, 248 erythroxyli fluidum, 116 eucalypti fluidum, 145 euonymi, 302 eupatorii fluidum, 130 frangulae fluidum, 296 gelsemii fluidum, 224 gentianae, 123 fluidum, 123 geranii fluidum, 183 glycyrrhizae, 448 fluidum, 447 purum, 448 gossypii radicis fluidum, 249 grindeliae fluidum, 263 guaranae fluidum, 116 haematoxyli, 181 hamamelidis fluidum, 184 hydrastis fluidum, 329 hyoscyami alcoholicum, 80 fluidum, 80 ipecacuanb.ee fluidum, 269 iridis, 301 fluidum, 301 juglandis, 290 krameriae, 180, 181 fluidum, 180 leptandrae, 295 fluidum, 295 lupulini fluidum, 90 malti, 198 matico fluidum, 341 mezerei, 316 fluidum, 316 nucis vomicae, 244 fluidum, 244 opii, 62 pareiras fluidum, 342 physostigmatis, 259 pilocarpi fluidum, 312 podophylli, 300 fluidum, 300 pruni Virginianae fluidum, 147 quassiae, 121 Extractum quassias fluidum, 121 rhei, 289 fluidum, 289 rubi fluidum, 185 sabinae fluidum, 350 sanguinariae fluidum, 271 sarsaparillae fluidum, 314 compositum fluidum, 314 scillae fluidum, 321 Scutellariae fluidum, 114 senegae fluidum, 332 sennae fluidum, 294 serpentariae fluidum, 128 spigeliae fluidum, 464 stillingiae fluidum, 317 stramonii, 79 fluidum, 79 taraxaci, 327 fluidum, 327 tritici fluidum, 327 uva ursi fluidum, 343 Valerianae fluidum, 113 veratri viridis fluidum, 221 viburni fluidum, 262 zingiberis fluidum, 210 Eye-washes, 47 False angustura bark, 132, 240 Faradic electricity, 26 Faradization, 26 Fasting, influence on medicinal ef- fect, 45 Fat manna, 275 Felicic acid, 467 Fennel, 216 oil, 216 water, 216 Fern, male, 467 Ferri carbonas saccharatus, 152 carbonatis, massa, 152 chloridi, liquor, 155 tinctura, 155 chloridum, 154 citras, 157 citratis, liquor, 158 et ammonii acetatis, mistura, 155 et ammonii citras, 158 et ammonii sulphas, 159 et ammonii tartras, 159 et potassii tartras, 156 et quiniae citras, 158 et strychniae citras, 159 hypophosphis, 157, 387 iodidi, syrupus, 155 iodidum, saccharatum, 155, 371 lactas, 158 nitratis, liquor, 157 oxalas, 157 oxidum hydratum, 152, 382 cum magnesia, 152, 382 INDEX. 513 Ferri phosphas, 156 prseparata, 149 pyrophosphas, 156 subsulphatis, liquor, 154 sulphas, 153 exsiccatus, 153 praecipitatus, 153 tersulphatis, liquor, 154 valerianas, 159 Ferric acetate, 158 solution of, 158 tincture of, 158 chloride, 154 solution of, 155 tincture of, 155 citrate, 157 solution of, 158 hydrate, 152 hypophosphite, 157, 387 nitrate, solution of, 157 phosphate, 156 pyrophosphate, 156 sulphate, solution of basic, 154 normal, 154 valerianate, 159 Ferrous bromide, syrup of, 157 carbonate, saccharated, 152 iodide, pills of, 156 saccharated, 155 syrup of, 155 lactate, 158 oxalate, 157 sulphate, 153 dried, 153 precipitated, 153 Ferruginea, 149 Ferrum, 149 dialysatum, 159 reductum, 151 Ferula galbaniflua, 111 sumbul, 263 Ferulaic acid, 110 Figs, 274 Filices, 467 Filix mas, 467 Fir, balsam of, 334 silver, 423 Flake manna, 275 Flax, common, 443 Flaxseed, 443 meal, 443 oil, 279, 443 Flea-bane, Canada, 324 Philadelphia, 324 various-leaved, 344 Flexible collodion, 457 Flour of mustard, 420 Flowers of orange, 214 of sulphur, 279 Fluid extract of aconite, 217 33 Fluid extract of belladonna, 77 bitter-orange peel, 214 brayera, 468 broom, 328 buchu, 342 calamus, 212 calumba, 126 Canada fleabane, 324 capsicum, 205 cascara sagrada, 296 castanea, 185 chestnut leaves, 185 chimaphila, 345 cimicifuga, 254 cinchona, 141 coca, 116 colchicum root, 324 seed, 324 conium, 257 cornus, 146 cotton-root, 249 couchgrass, 327 cubeb, 340 dandelion, 327 digitalis, 252 dogwood, 146 dulcamara, 92 ergot r 248 erigeron, 324 erythroxylon, 116 eucalyptus, 145 eupatorium, 130 frangula, 296 gelsemium, 224 gentian, 123 geranium, 183 ginger, 210 glycyrrhiza, 447 gossypium, 249 grindelia, 263 hamamelis, 184 heartsease, 276 hydrastis, 329 hyoscyamus, 80 ipecac, 269 iris, 301 jaborandi, 312 koosso, 468 krameria, 180 leptandra, 295 liquorice root, 447 lupulin, 90 matico, 341 mezereon, 316 nux vomica, 244 pansy, 276 pareira, 342 pepo, 469 Phytolacca, 227 pilocarpus, 312 514 INDEX. Fluid extract of podophyllum, 300 prunus virginiana, 147 pumpkin-seed, 469 quassia, 121 rhubarb, 289 rubus, 185 sanguinaria, 271 sarsaparilla, 314 compound, 314 savine, 350 Scutellaria, 114 senega, 332 senna, 294 serpentaria, 128 skullcap, 114 spigelia, 464 squill, 321 staphisagria, 228 stillingia, 317 taraxacum, 327 triticum, 327 uva ursi, 343 . valerian, 1 13 veratrum viride, 221 viburnum, 262 wild cherry, 147 Fluid extracts, 39 Fluidrachm, 42 Fluidounce, 42 Fly, potato, 430 Spanish, 426 Foeniculum, 216 vulgare, 216 Fonticuli, 19 Forms in which medicines are used, 31 Formyl, terchloride of, 103 teriodide of, 374 Fowler's solution, 383 Foxglove, 383 Frangula, 295 Frangulin, 295 Frasera, 124 Walteri, 124 Fraxinus ornus, 275 rotundifolia, 275 Friction electricity, 26 Frictions, 19 Frigus, 24 Fumigation, 40 Fungi, 245, 248 Fused silver nitrate, 432 diluted, 432 Fusel oil. 107, 193 Gaduin, 376 Gadus morrhua, 375 Galbanum, 111, 348 Galipea officinalis, 131 Gall-oak, 177 Galla, 177 Gallic acid, 176, 177 Gallon, 42 Galls, 177 black, 177 white, 177 Galvanic electricity, 26 Galvano-cautery, 27 Gamboge, 304 cake, 304 lump, 304 pipe, 304 Garcinia Hamburii, 304 Gargarismata, 47 Gargles, 47 Garlic, 332, 425 Gas, nitrous-oxide, 108 laughing, 108 Gases, 40 Gaultheria, 212 procumbens, 212 Gelatin, 451 Gelsemia, 224 Gelsemina, 224 Gelseminic acid, 244 Gelsemium, 223 sempervirens, 233 General blood letting, 17 Gentian, 123 yellow, 123 Gentiana, 123 lutea, 123 Gentianaceae, 123, 124, 126 Gentianin, 123 Gentiopicrin, 123, 124 Gentisin, 123 Gentisic acid, 123, 124 Geraniacese, 182 Geranium, 182 maculatum, 182 German chamomile, 129 Gin, 198 Ginger, 210, 425 black, 210 Jamacia, 210 white, 210 Glauber's salt, 283 Glyceric alcohol, 454 Glyceril hydrate, 454 Glycerin, 452, 454 Glycerinum, 454 Glycerita, 38, 454 Glycerite of borate of sodium, 417 carbolic acid, 409 gallic acid, 177 sodium borate, 417 starch, 451, 455 tannic acid, 176 yolk of eggs, 455 Glycerites, 38, 454 INDEX. 515 Glyceritum amyli, 451, 455 vitelli, 455 Glycil hydrate, 454 Glyconin, 455 Glycyrrhiza, 447 echinata, 447 glabra, 447 glandulifera, 447 Glycyrrhizin, 447 ammoniated, 448 Glycyrrhizinum ammoniatura, 448 Goa-powder, 289, 437 Gold and sodium chloride, 368 Golden sulphur of antimony, 231 Goldthread, 122 Gondret's vesicating ointment, 430 Gossypii radicis cortex, 248 Gossypium, 249 herbaceum, 248 Goulard's create, 189 extract, 189 Grains, 40 Graminaceae, 244, 248, 327, 450, 458 Granatacese, 184 Granati fructus cortex, 184 Granatum, 468 Granulation, 31 Granville's lotion, 430 Grape, seaside, 179 sugar, 458, 459 Gray ipecacuanha, 266 powder, 356, 359 Greenheart tree, 147 Green iodide of mercury, 364 soap, 437 vitriol, 153 Grindelia, 262 robusta, 262 Ground flaxseed, 444 Ground-holly, 344 Guaiac, 314, 349 wood, 314 beta-resin, 315 Guaiaci lignum, 314 resina, 314 Guaiacic acid, 315 Guaiaconic acid, 315 Guaiacum, 314, 349 officinale, 314 sanctum, 314 wood, 314 Guaiaretic acid, 315 Guarana, 116 Guatemala sarsaparilla, 313 Gum, 441 ammoniac, 112 arabic, 440 Barbary, 440 India, 440 pectoral, 442 Gum, Senegal, 441 Turkey, 440 Gummic acid, 442 Gun-cotton, 456 Gunjah, 88 Guttiferae, 304 Gutta-percha, solution, 457 Habit, influence of, on medicinal ef- fects, 45 Haematics, 53, 351 Hgematin, 181 Haematinics, 53, 351 Hsematoxylin, 181 Haematoxylon, 180 campechianum, 180 Hamamelaceae, 183, 347 Hamamelis, 183 virginica, 183 Haschisch, 88 Haw, black, 261 Heartsease, 276 Heat, 28, 437 Heavy magnesia, 281 Hedeoma, 215 pulegoides, 215 Hellebore, American, 218 swamp, 218 Hemlock, 254 gum, 424 spruce, 424 • pitch plaster, 425 Hemp, American, 88 Indian, 88, 325 Henbane, 79 Henry's magnesia, 281 Hepatic aloes, 291 Herapathite, 137 Herapath's test, 137 Hesperidin, 213 Hircin, 452 Hiera picra, 133 Hirudo decora, 18 medicinalis, 18 Hive-syrup. 321 Hoffman's anodyne, 119 Hog, 451 Homotropine, 77 Honduras sarsaparilla, 312 Honey, 459 bee, 452, 459 clarified, 459 of rose, 184 of bora Honeys, 37 Hope's camphor mixture, 172 Hops, 89 Horehound, 215 Hot iron, 24 Howard's calomel, 360 516 INDEX. Huanuco barks, 135 Humulus, 89 lupulus, 89 Husband's magnesia, 281 Huxham's tincture, 141 Hydragogues, 273 Hydrargj'ri chloridum corrosivura, *357, 362, 436 mite, 307, 357, 360, 468 cyanidum, 357, 365 iodidum rubrum, 357, 365, 371 viride, 357, 364, 371 oxidum flavum, 356, 359 rubrum, 357, 359 nitratis unguentum, 357, 367 liquor, 357, 367, 436 prseparata, 352 subsulphas flavus, 272, 357, 376 sulphidum rubrum, 357, 366 Hydrargyrum ammoniatum, 357, 365 cum creta, 356, 359 Hydrastia, 329 Hydrastis, 329 canadensis, 329 Hydrate of chloral, 65 Hydrated oxide of iron, 152, 382 with magnesia, 152, 382 Hydro-alcoholic extract of canthar- 'ides, 429 Hydrochlorate of apomorphia, 171 of morphia, 64 of pilocarpine, 312 of quinine, 143 Hydrochloric acid, 172 diluted, 173 Hydrocyanic acid, 92, 96, 147 diluted, 92 Hydrobromate of quinine, 143 Hygienic remedies, 17 Hyoscyami folia, 79 semen, 79 Hyoscyamia, 79, 80 Hyoscyamus, 79 leaves, 79 niger, 79 seed, 79 Hypnotics, 54 Hypodermic application of medi- cines, 46 Hypophosphite of calcium, 386 iron, 157, 387 potassium, 387 sodium, 387 Hypophosphites, syrup of, 387 with iron, syrup of, 387 Hyposulphite of sodium, 171 Iceland moss, 448 Ichthyocolla, 451 Tctodes foetidus, 114 Idiosyncrasy, influence of, on medi- cinal effects, 44 Igasura, 241 Igasuric acid, 241 Igasurine, 241 Ignatia, 244 Ilex Paraguaiensis, 116 Illicium, 216 anisatum, 216 Imagination, influence of, 45 Imponderable remedies, 17, 23 India gum, 441 opium, 55 senna, 293 Indian corn, 248 hemp, 88, 325 poke, 218 tobacco, 83 Induced electricity, 26 Infusia, 34 Infusion of absinthium, 130 apocynum, 326 angustura, 132 bloodroot, 271 brayera, 468 calamus, 212 cascarilla, 132 catechu, compound, 178 chamomile, 129 cinchona (red and yellow), 141 columbo, 126 coptis, 123 dandelion, 327 digitalis, 252 elder, 297 erigeron, 325 eupatorium, 130 frasera, 124 heartsease, 276 hops, 90 Indian hemp, 326 juniper, 328 koosso, 468 krameria, 180 liriodendron, 131 magnolia, 130 matico, 341 pansy, 276 pareira, 342 prunus Virginiana, 147 quillaia, 332 sabbatia, 125 sanguinaria, 271 Scutellaria, 114 senna, 294 compound, 294 serpentaria, 128 tamarind, 275 taraxacum, 327 thoroughwort, 130 INDEX. 517 Infusion of tobacco, 82 wild cherry, 147 wormwood, 130 yarrow, 133 Infusions, 34 Infusum brayerae, 468 cinchonae, 141 digitalis, 252 pruni Virginianae, 147 sennas compositum, 294 Inhalation, 40 Ingluvin, 149 Inosite, 250 Injections, 50, 308 Intravenous injections, 51 Iodide of ammonium, 373 arsenic, 384 and mercury, 385 iron, 155, 371 lead, 189,371 mercury, 357, 364, 365, 371 potassium, 372 sodium, 374 sulphur, 372 zinc, 164, 372 Iodine, 368, 405 Iodized collodion, 457 Iodoform, 374 Iodoformum, 374 Iodum, 368, 405 loduretted potassium iodide, 372 Ipecac, 266,310 Ipecacuanha, 266, 310 Ipecacuanhic acid, 267 Ipomoea jalapa, 297 turpethum, 366 Iridaceae, 301, 460 Iridin, 301 Iris, 301 versicolor, 301 Irish moss, 449 Iron, 149 " and ammonium citrate, 158 acetate, mixture of, 155 sulphate, 159 tartrate, 159 bromide, syrup of, 157 carbonate, mass of, 152 saccharated, 152 potassium tartrate, 156 quinine citrate, 158 solution of, 158 strychnine citrate, 159 bitter wine of, 158 chloride, 154 citrate, 157 compound pills of, 153 dialyzed, 159 dried, sulphate of, 152 hydrated, oxide of, 152 Iron hypophosphite, 157 iodide, pills of, 156 saccharated, 155 syrup, 156 lactate, 158 mixture, compound, 153 oxalate, 157 phosphate, 156 syrup of, 156 pills of aloes and, 159, 292 pills of iodide of, 156 plaster, 152 precipitated sulphate of, 153 preparations of, 149 pyrophosphate, 156 quinine and strychnine phos- phates, syrup of, 159 Quevenne's, 151 reduced, 151 saccharated carbonate, 152 iodide, 155 solution of acetate of, 158 chloride of, 155 citrate of, 157 nitrate of, 157 subsulphate of, 154 tersulphate of, 154 sulphate, 153 syrup of bromide of, 157 iodide of, 156 tincture of acetate, 158 chloride, 155 troches, 152 valerianate, 159 wine of citrate of, 159 with magnesia, hydrated oxide of, 152 Irritants, 53, 192, 419 Isinglass, 451 Issues, 19 Jaborandi, 310 Jalap, 297 Jalapa, 297 Jamaica ginger, 210 kino, 179 sarsaparilla, 312 James' powder, 232 Jamestown weed, 77 Japan camphor, 97 Jasmine, Carolina, 223 yellow, 223 Jateorrhiza calumba, 125 palmata, 125 Jerusalem oak, 464 % Jervia, 218 Jesuit's powder, 139 Jewell's calomel, 360 Juglandaceas, 290 Juglandic acid, 290 518 INDEX. Juglans, 290 cinerea, 290 Juglone, 290 Juice of garlic, 333 Juices, 37 Jujube paste, 442 Juniper, 328 Juniperus, 328 communis, 328 sabina, 349 Virginiana, 349 Kamala, 468 Kelp, 368, 396 Kinic acid Kino, 179 red, 179 tannic acid, 279 Kinoin, 179 Kinovic acid, 136 Kosin, 468 Koosso, 468 Kordofan gum, 44 i Krameria, 180 triandra, 180 Kramero-tannic acid, 180 Labarraque's liquid, 405 Labiatae, 114, 214 Lac asafcetidae, 111 sulphuris, 280 Lactate of iron, 158 Lactic acid, 459 Lacto-pbospbate of calcium, 386 Lactuca saliva, 72 Lactucarium, 72 English, 72 German, 73 Laetucin, 73 Ladies' slipper, 114 Lady Webster pill, 292 Lantbopia, 56 Lard, 451 benzoinated, 452 oil, 452 Lartigue's pills, 323 Laudamia, 56 Laudanum, 63 Laughing-gas, 108 Lauraceae, 96, 205, 317 Laurostearic ether, 452 Lauracese, 147 Lavandula, 214 vera, 214 Lavements, 50^ Lavender, 214' Laxatives, 273, 274 Lead acetate, 186 arthralgy, 186 carbonate, 190 Lead cerate of subacetate, 189 colic, 186 iodide, 189, 371 ointment of, 189 liniment of subacetate, 189 nitrate, 189 ointment of, carbonate, 190 iodide, 190 oxide, 190 plaster, 190 paralysis, 187 preparations of, 185 solution of subacetate, 189 diluted, 190 sugar of, 188 subacetate, cerate of, 189 liniment of, 189 solution of, 189 diluted, 190 sulpho-carbolate, 409 water, 189 white, 190 Ledoyen's disinfecting fluid, 190 Leeches, 18, 19 Leguminosae, 178, 179, 180, 257, 275, 277, 293, 328, 337, 347, 348, 437, 440, 442, 447, 461 Lemon-juice, 239 essence, 239 oil, 239 peel, 239 rind, 239 spirit, 239 syrup, 239 Lenitives, 438 Leopard's-bane, 225 Leptandra, 295 Virginica, 295 Leptandrin, 295 Lethal alcohol, 452 Lettuce-opium, 72 Levant wormseed, 465 Licebane, 227 Lichenes, 448 Lichenin, 449 Light, 23 magnesia, 281 Lignum vitae, 314 Lime, chloride, 388, 404 chlorinated, 404 liniment, 401 solution, 400 Lime-juice, 239 sulphurated, 171 syrup of, 239 water, 400 Liliaceae, 291, 320, 332 Lima bark, 134 Limonis cortex, 239 succus, 239 INDEX. 519 Linimenta, 38 Linaceae, 443 Liniment of aconite, 88 of ammonia, 423 of calcium, 401 of camphor, 98 of cantharides, 429 of chloroform, 106 of lead subacetate, 189 of mustard, compound, 422 of turpentine, 336 soap, 99 Liniments, 38 Linimentum aconiti, 88 ammonias, 200, 423 calcis, 401, 444 camphorae, 98 cantharidis, 429 chloroformi, 106 plumbi subacetatis, 189 saponis, 99 sinapis compositum, 422 terebinthinae, 336 Linseed oil, 279, 443 Linum, 443 usitatissimum, 443 Liquidambar orientale. 347 Liquids, 31, 32 Liquor acidi arsenici, 384 ammonii acetatis, 236 arsenii et hydrargyri iodidi, 385 calcis, 400 ferri acetatis, 158 chloridi, 155 citratis, 157 et quiniae citratis, 158 nitratis, 157 subsulphatis, 154 tersulphatis, 154 gutta-perchas, 457 hydrargyri nitratis, 357, 367, 436 iodi compositus, 371 magnesii citratis, 283 pepsini, 149 • plumbi subacetatis, 189 dilutus, 189 potassae, 394 potassii arsenitis, 383 citratis, 236 sodas. 395 chloratae, 405 sodii arseniatis, 384 silicatis, 458 zinci chloridi, 163 Liquores, 34 Liquorice, 448 powder, compound, 295 root, 447 Liriodendrin, 131 Liriodendron, 131 Liriodendron tulipifera, 131 Litharge, 190 Lithii benzoas, 399 bromidum, 72 carbonas, 398 citras, 399 praeparata, 398 salicylas, 415 Lithium benzoate, 399 bromide, 72 carbonate, 398 citrate, 399 preparations, 398 salicylate, 415 Lithontriptics, 393 Liver of sulphur, 280 Lobelia, 85, 272 inflata, 85 Lobeliacea?, 83 Lobelic acid, 83 Lobelina, 83 Local bloodletting, 18 Loganaceas, 223, 240, 462 Logwood, 180 London paste, 434 Long leaved pine, 334 Lotion, Granville's, 430 Loxa bark, 134 Lozenges, 33 Lugol's solution, 371 Lunar caustic, 166, 432 Lupulin, 90 Lupulinum, 90 Lux, 23 Lytta vesicatoria, 426 Mace, 206 Maceration, 34 Macis, 206 Madeira wine, 197 Magistery of bismuth, 157 Magnesia, 281, 399 alba, 282 calcined, 281 Ellis', 281 heavy, 281 Henry's, 281 Husband's, 281 ponderosa, 281 Magnesii carbonas, 282, 399 citratis liquor, 283 praeparata, 399 sulphas, 282 sulphis, 171 Magnesite, 282 Magnesium, carbonate, 282, 399 citrate, solution of, 283 preparations, 399 sulphate, 282 sulphite, 171 520 INDEX. Magnesium sulpho-carbolate, 409 Magnetic electricity, 26 Magnolia, 131 acuminata, 131 glauca, 131 tripetala, 131 umbrella, 131 Magnoliaceae, 131, 216 Magnolin, 131 Magendie's solution, 64 Maisch's table, 43 Male fern, 467 Mallotus philippinensis, 468 Malt, extract of, 198 liquors, 198 Malvaceae, 248, 445 Mandrake', 299 Mangani sulphas, 284 Manganese sulphate, 284 Manganesii sulphas, 284 Manna, 275 cannulata, 275 fat, 275 in flakes, 275 in sorts, 275 Mannite, 276 Margaric acid, 454 Marigold, 316 Marjoram, wild, 215 Marrubium, 215 vulgare, 215 Marshmallow, 445 Marsh's test for arsenic, 379 antimony, 228 Martial preparations, 149 Maruta cotula, 129 Mass, blue, 308, 357 of copaiba, 338 of mercury, 308, 356, 357 Massa copaibse, 338 ferri carbonatis, 152 hydrargyri, 308, 356, 357 Mate, 116 Materia Medica, definition of, 17, 28 Maticin, 341 Matico, 341 Matricaria, 129 chamomilla, 129 Mattison's pancreatin, 149 May-apple, 299 Mayweed, 129 Meadow-saffron, 322 sweet, 411 Measures and weights, 40 apothecaries', 42 approximate, 42 wine, 42 Mecca senna, 293 Mechanical remedies, 17 Meconic acid, 56, 58 Meconidia, 56 Meconin, 56 Medicated waters, 34 Medicines, definition of, 27 Mel, 459 despumatum, 459 rosae, 184 Melaleuca cajuputi, 208 Melanthaceae, 218, 221, 222 Melia azedarach, 466 Meliacese, 466 Mellita, 37 Melted butter, 279 Menispermaceae, 125, 259, 316, 341 Menispermia, 259 Menispermum, 316 canadense, 316 Mentha piperita, 214 viridis, 214 Menthal, 214 Mercurial cathartics, 273, 307 fever, 354 mass, 356, 357 ointment, 356 plaster, 354, 358 oleate, 360 Mercurials, 349, 352 Mercuric chloride, 357, 362, 436 cyanide, 357, 365 iodide, 365, 371 nitrate, solution of, 357, 367, 436 oxide, red, 356, 359 yellow, 356, 359 subsulphate, 160, 357, 366 sulphide, 357, 366 Mercurous chloride, 307, 357, 360, 468 iodide, 364, 371 Mercury, ammoniated, 357, 365 corrosive chloride of, 357, 362, 436 cyanide, 357, 365 green iodide, 357, 364, 371 mass of, 308 metallic, 352, 356 mild chloride of, 307, 357, 360, 468 nitrate of, 357 ointment of, 358 ammoniated, 365 nitrate of, 367 red oxide, 359 yellow oxide, 359 oleate of, 360 preparations, 352 red oxide of, 359 iodide of, 357 ; 365, 371 solution of nitrate of, 357, 367, 436 INDEX. 521 Mercury, sulphide of, 357, 366 subsulphate of, 272, 357, 366 with chalk, 307, 356, 359 yellow oxide of, 359 Methal alcohol, 452 Methy-theobromine, 115 Methyconia, 255 Methyl salicylate, 411 Methylene bichloride, 106 Methylic ether, 107 Metrical system of weights, 41 compared with troy weights, 42 Mezereon, 315 Mezereum, 315 Mild acrid cathartics, 274, 287 chloride of mercury, 307, 357, 360, 464 Milfoil, 133 Milk of asafetida, 111 of sulphur, 280 sugar of, 459 Milkweed. 325 Mimo-tannic acid, 175 Mindererus, spirit of, 236 Mineral acids, 168, 436 astringents, 174, 185 oils, 455 tonics, 120, 149 Minims, 42 Mistura ammoniaci, 112 amygdalae, 442 asafoetidae, 111 chloroformi, 105 cretae, 401 ferri composita, 153, 346 et ammonii acetatis, 155 glycyrrhizae composita, 448 potassii citratis, 236 rhei et sodas, 289 Misturae, 33 Mixture, ammonia, 112 asafetida, 111 chalk, 401 chloroform, 106 copaiba, Chapman's, 338 Hope's camphor, 172 neutral, 236 of iron and ammonium acetate, 155 of iron, compound, 346 of liquorice, compound, 448 of potassium citrate, 236 of rhubarb and soda, 289 Mixtures, 33. 35 Moccasin plant, 114 Modus operandi of medicines, 29 Molasses, 459 Monobromated camphor, 99 Monkshood, 85, 217 Monsel's solution, 154 Montpelier scammony, 303 Moonseed, Canada, 316 Morphia, 56 Morphiae acetas, 64 hydrochloras, 64 sulphas, 64 Morphina, 56 Morphine, 56 acetate, 64 hydrochlorate, 64 sulphate, 64 Moschus, 117 moschiferus, 117 Motor-depressants, 254 excitants, 241 Moss, Iceland, 448 Irish, 449 Moxa, 24, 437 Mucilage, 441 of acacia, 442 of gum arabic, 442 of cydonium, 447 of slippery elm, 445 of sassafras pith, 445 of tragacanth, 443 Mucilago aeacise, 442 cydonii, 447 sassafras, 445 tragacanthse, 443 ulmi, 445 Mucous membranes, application of medicines to, 47 Muriate of ammonia, 388 Muriatic acid, 172 diluted, 173 Musk, 117 deer, 117 Mustard, 272, 420 black, 420 flour, 420 seed, 420 white, 420 paper, 422 whey, 422 Myrcia acris, 198 Myristic ether, 452 Myristica, 206 fragrans, 206 Myristicaceee, 206 Myristicene, 207 Myristicol, 207 Myronate of potassium, 421 Myrosyn, 421 Myroxylon pereirae, 347 toluifera, 348 Myrrh, 345 Myrrha, 345 Myrrhic acid, 345 iMyrtaceae, 144, 207, 208 522 INDEX. Napellina, 86 Narceia, 56, 58 Narcotics, 53, 54 Narcotina, 56, 57 Narthex asafcetida, 110 Natron, 396 Nauseants, 265 Nauseating; diaphoretics, 309 Nebulization of fluids, 48 Nectandra, 147 rodiei, 147 Nectandria, 147 Nervous sympathy, doctrine of, 29 Neurotics, 53, 54 Neutral mixture, 236 Nicotia, 81 Nicotiana tabacum, 81 Nicotianin. 81 Nightshade, black, 91 deadly, 73 woody, 91 Nitrate of cerium, 168 lead, 189 mercury, 367, 436 potassium, 232 silver, 163 fused, 164, 432 sodium, 235 Nitre, 232 crude, 232 cubic, 235 papers, 235 refined, 232 sweet spirit of, 237 Nitric acid, 171 diluted, 172 Nitrite of amyl, 107 Nitro-hydrochloric acid, 173 diluted, 174 Nitro-muriatic acid, 173 diluted, 174 Nitrous oxide, 108 Nitrous powders, 234 papers, 235 Norway spruce, 423 Nucine, 290 Nutgall, 177 Nutmeg, 206 Nux vomica, 240 Oak, black, 181 Jerusalem, 464 white, 181 Oatmeal, 274 Occupation, influence of, 45 CEnanthic acid, 197 Officinal, definition of term, 28 Oil cake, 444 carron, 401 castor, 277 Oil, cod liver, 375 croton, 306, 431 ethereal, 118 flaxseed, 279 lard, 452 linseed, 279, 443 olive, 277 phosphorated, 203 sweet, 277 of almond, expressed, 277 amber, 118 allspice, 208 anise, 216 benne, 446 bitter almond, 96 cajeput, 208 camphor, 97, 99 Canada erigeron, 324 caraway, 216 cardamom, 211 caryophyllus, 208 cedar, 340 chenopodium, 465 cinnamon, 206 cloves, 208 copaiba, 338, 339 coriander, 216 cubeb, 339, 340 erigeron, 324 eucalyptus, 145 fennel, 216 garlic, 333 gaultheria, 213, 411 ginger, 210 hedeoma, 215 illicium, 216 juniper, 328 lavender, 214 flowers, 214 lemon, 239 mace, 207." marjoram, 215 mustard, volatile, 420, 422 neroli, 214 nutmeg, 207 orange flowers, 214 peel, 214 pennyroyal, 215 peppermint, 214 pimento, 208 rosemary, 215 rue, 350 sandal-wood, 340 santal, 340 sassafras, 317 savine, 350 spearmint, 214 tar, 336 theobroma, 453 thyme, 215, 418 INDEX. 523 Oil, tobacco. 83 turpentine, 208, 333, 334. 335. 423. 463 valerian. 113 vitriol, 169 wine. 118 wormseed, 465 yarrow. 133 Oils,* distilled. 203 essential, 203 volatile. 203 Ointment, 39. 452 alkaline sulphur, 280 basilicon, 337 citrine. 357, 367 Gondret's vesicating, 430 sulphur. 280 of ammoniated rnercurv, 357, 366 antimony, 431 belladonna, 77 calomel, 362 carbolic acid. 409 carbonate of lead, 190 chrvsarobin, 438 galls, 178 iodide of lead, 189 potassium, 373 sulphur, 372 iodine, 371 iodoform, 375 lead carbonate, 190 iodide, 189 mercuric iodide, 365 nitrate, 357, 367 mercury, 356, 358 mezereon, 316 nitrate of mercury, 357, 367 nutgall, 178 oxide of zinc, 162 Phytolacca, 227 potassium iodide, 373 red iodide of mercury, 356, 365 oxide of mercury, 356, 360 precipitate, 360 rose-water, 184 staphisagria, 228 stramonium, 77 subacetate of copper, 161 sulphur, 280 iodide, 372 sulphurated potassa, 280 tannic acid, 176 tar, 336 tobaccoj 82 veratria, 222 veratrine, 222 vellow oxide of mercurv, 357, 360 precipitate, 360 Ointment, zinc oxide, 162 Ointments, 39 Olea Europcea, 277 volatilia, 203 Oleaceae, 275, 2*77 Oleates, 453 Oleic acid, 452, 454 Olein, 452 Oleate of mercury, 360 veratria, 222 veratrine, 222 Oleatum hydrargyri, 360 veratria;, 222 veratrinae, 222 Oleoresin of aspidium, 461 black pepper, 205 capsicum, 205, 423 cubeb, 340 ginger. 210 lupulin, 90 male fern, 467 Oleoresina aspidii, 467 capsici, 205, 423 cubebee, 340 lupulini, 90 piperis, 205 zingiberis, 210 Oleoresinae, 38 Oleoresins, 38 Oleum adipis, 452 Eethereutn, 118 amygdala; amarse. 96 expressum, 277 anisi, 216 aurantii corticis, 214 floruui, 214 cajuputi, 208 cari, 216 caryophylli, 208 chenopodii, 465 cinnamoni, 206 copaiba;, 338, 339 coriander, 216 cubebae, 339, 340 erigerontis, 324 eucalypti, 145 fceniculi, 216 gaultherise, 213, 411 gossypii seminis, 444 hedeomse, 215 juniperi, 328 lavandulae, 214 florum, 214 limonis, 239 lini, 443 mentha? piperita;, 214 viridis, 214 morrhuae, 375 myristicae, 207 olivae, 277 524 INDEX. Oleum phosphoratum. 203 picis liquidae, 336 pimentae, 208 ricini, 277 rosmarini, 215 rutae, 350 sabinae, 350 santali, 340 sassafras, 317 sesami, 446 sinapis volatile, 420, 422 suecini, 118 terebinthinae, 208, 333, 334, 335, 423, 468 theobromse, 453 thy mi, 215, 418 tiglii, 306, 431 Valerianae, 113 Olive oil, 277 tree, 277 Ophelia chirata, 126 Ophelic acid, 126 Opiania, 56 Opii pulvis, 62 Opium, 54 denarcotisatum, 62 plaster, 63 Orange flower, 214 water, 214 peel, 214 Orchidaceae, 114, 216 Ordeal bean. 258 Origanum, 215 vulgare, 215 Ovis aries, 452 Ounce, 40 Oxalate of cerium, 168 iron, 157 Oxide of antimony, 228 arsenic, 378 ethyl, 100 lead, 190 silver, 166 zinc, 162 Painter's colic, 186 Pale bark, 134 rose, 184 Palma Christi, 277 Palmitin, 452 Pancreatin, 149 Pancreatinum, 149 Pansy, 276 Papaver, 54 somniferum, 54 Papaveraceae, 54, 269, 300 Papaverina, 58 Paper of cantharides, 430 mustard, 422 potassium nitrate,. 235 Papers, 33 Paraguay tea, 116 Paraffine, 456 Paramenispermia, 259 Paramorphia, 56, 58 Paregoric elixir, 63 Pareira, 341 brava, 341 Paricia, 137 Paricina, 137 Parilline, 313 Parsley, 329 Partridge-berry, 212 Parts to which medicines are ap- plied, 45 Pasque-flower, 222 Paste, London, 434 Vienna, 434 Paullinia, 116 sorbilis, 116 Paytia, 137 Paytina, 137 Peaches, 274 Pearlash, 395 Pearl white, 167 Pectin, 250 Pedaliaceas, 446 Pennyroyal, 215 Pepper, black, 205, 422 cayenne, 204 red, 204, 422 white, 205 Peppermint, 214 water, 214 Pepo, 469 Pepsin, 148 Pepsinum, 148 saccharatum, 149 Percolation, 34 Percolator, 34 Permanganate of potassium, 403 Persian opium, 55 Persimmon, 184 Petrolatum, 455 Petroleum oils, 456 ointment, 455 Petroselinum sativum, 329, 349 Phaeoretin, 289 Pharmaceutical modifications, 30 Pharmacological remedies, 17, 27 Pharmacology, 28 Pharmacopoeia, 28 Pharmacy, definition of, 28 Phenic acid, 405 Phenol, 410 cymylic, 418 Phenyl hydrate, 405 Philadelphia fleabane, 324 Phlebotomy, 17 Phlox Carolina, 462 I>~BEX. e of ammonium, 389 calcium. 386 iron. 156 quinia. 143 limn, 884 Phosphide of zinc. 203 Phosphorated cod-liver oil. I ": oil. 203 Phosphoric acid, diluted. 385 Phosphorus. 1 11 Phytolacca. 226 berries 226 iecandra. 226 root. 226 Phytolaccacea?. 226 Phytolacca bacca. 226 radix. 226 -rter macrocephalus. Physostigma. 257 venenosum. 25? a jstigmina. 257. '-' '. : jstigminae salicylas. 259 Physostigmine. 257 E»licy] tc ..-. \-.\-. 24S .:.. 2E 260 Picrotoxinum. 11 I Pill of carbonate of iron, 152 soap, compound. 62 Pills. 31 blue. 308. 356. " compound cathartic. \ Is compressed. 33 Lady Webster, '.' - igue s gout. 323 Plummer's. 232 a 292 of &'.:-; ::: and Bsafetj "... 292 and iron. 159, 292 and mast:: . - and myrrh. ... 54€ -ony. compound. 232 . Ill i&rtic, compound. 305 ferrous iodide. 156 : .mum. compound. 112. 346 iodide of iron. 156 iron, compound. 153. 346 phjr .: : . i£ 203 m. 62 rhubarb. 290 compound. I E . Pilocarpina. 311 : .\rpinae hydrochloras. 312 urpine 31 1 >chloi te, 312 .\rpus. 310 pencatifolius. 310 Pilula ferri carbonais. 152 Piluli saponis composita. 62 Pilula?. 31 aloes. 292 et asafoetida?. . I ■'. et ferri. 159. .1 . et mastiehes. . , : . et myrrhee. 292. 346 antimonii composita?. 232 asafoetida?. Ill cathartica? compo=.: e £05 ferri composita?. 153. 346 iodidi. 156 galbani compos:::e. 112. 346 opii. 62 phosphor:. . ; \ rhei. 290 composita? . Pimenta. 208 Pimento. 203 Pimpinella anisum. 21€ Pinkroot. 462 Pinitus succinifer, 118 Pine, long-leaved, 334 pitch. 334 yellow, 334 Pint.' 4 : Pinna australis. 208. 333 palostris ta?da. 334 Pipe gamboge, 304 Piper. 205, 425 nigrum, 205, 425 Piperacea?. 205, 339, 341 Piperina. 205 Piperine. 205 Pipsissewa. 344 spotted, 345 Pitch. 336 pine. 334 plaster with cantharides 424 Pix Burguadica, 423 Canadensis, 424 liquida, 336 Plasma. 451 Plaster, adhesive. 337 court. 451 spice. 425 of aconite, 88 ammoniac, 112 ammoniac with mercury. 112, 356. 358 arnica, 225 asafetida, 111 belladonna, 77 Burgundy pitch. 424 Canada pitch. 425 capsicum, 205. 423 galbanum, compound. 112 hemlock pitch. 423 iron. 152 626 INDEX. Plaster, mercury, 356, 358 Potassium acetate, 319 opium, 62 alum, 191 pitch with cantharides, 424 and sodium tartrate, 287 warming, 424 bicarbonate, 395 Plasters, 39 bichromate, 391, 436 Plumbi acetas, 188 bitartrate, 286, 319 carbonas, 190 carbolate, 409 iodidum, 189, 371 carbonate, 394 nitras, 189 chlorate, 390 oxidum, 190 citrate, 235 praeparata, 185 mixture of, 236 subacetatis liquor, 189 solution of, 236 Plummer's pills, 232 cyanide, 95 Pneumatic method, 20 hypophosphite, 387 Podophyllum, 299 iodide, 372 peltatum, 299 ioduretted, 372 Poison-nut, 240 ointment of, 372 Poison-oak, 244 myronate, 421 Poke-berries, 226 nitrate, 332 root, 218, 226 permanganate, 403 Polychroite, 461 preparations, 394 Polygala senega, 330 sulphate, 285 Polygalaceae, 330 sulphite, 171 Polygaleae, 180 sulpho-carbolate, 409 Polygalic acid, 331 sulphuret, 280 Polygonaceae, 287 tartrate, 286 Pomatum, Dupuytren's, 430 Potato flies, 430 Pomegranate, 468 spirit, 107, 193 rind, 184 Pound, 40 Poppy, black, 54 Poultices, 39, 439 white, 54 Powder of aloes and canella, 133 Porphyroxin, 56 antimonial, 233 Port wine, 197 aromatic, 211 Porter, 198 compound chalk, 401 Potassa, 432 effervescing, 287 alum, 191 Dover's, 310 cum calce, 433 gray, 356, 359- solution of, 394 James', 232 sulphurata, 280 Jesuit's, 139 with lime, 433 nitrous, 234 Potassii acetas, 319 of ipecac and opium, 63, 269, 310 bicarbonas, 395 of jalap, compound, 298 birchromas, 391, 436 of liquorice, compound, 295 bitartras, 286, 319 of morphia, compound, 64 bromidum, 67 of opium, 62 carbonas, 394 of rhubarb, compound, 290 pura, 394 Tully's, 64 chloras, 390 Powders, 31 citras, 235 Seidlitz, 287, 398 cyanidum, 95 Precipitated calcium carbonate, 401 et sodii tartras, 287 phosphate, 386 hypophosphis, 387 ferrous sulphate, 153 iodidum, 372 sulphur, 280 nitras, 232 zinc carbonate, 163 permanganas, 403 Precipitation, 32 praeparata, 394 Preparations of ammonia, 199 sulphas, 285 of antimony, 228, 310 sulphis, 171 of arsenic, 378 sulphuretum, 280 of bismuth, 166 tartras, 286 of copper, 160 INDEX. 527 Preparations of lead, 185 of lithium, 398 of mercury, 352 of iron, 149, 349, 351 of potassium, 394 of silver, 164 of sodium, 395 of zinc, 161 Prepared calamine, 163 chalk, 401 Pride of China, 466 Proof spirit, 197 Propenyl hydrate, 454 Prunes, 274 Prunus serotina, 147 Virginiana, 146 Prussic acid, 92 Pseudaconitia, 86 Pseudomorphia, 56 Pseudojervia, 218 Psychotria emetica, 267 Pterocarpin, 461 Pterocarpus erinaceus, 179 marsupium, 179 santalinus, 461 Pulsatilla, 222 Pulveres, 31 effervescentes aperientes, 287 Pulverization of fluids, 48 Pulvis antimonialis, 232 aromaticus, 211 cretae compositus, 401 effervescens compositus, 287. 398 glycyrrhizas compositus, 295 ipecacuanha? et opii, 63, 269, 310 jalapae compositus, 286 morphise compositus, 64 rhei compositus, 290 Pumpkin, 469 seed, 469 Punica granatum, 184, 468 Purgatives, 273 Purging cassia, 277 Purple foxglove, 249 Pyrocatechin, 179 Pyroligneous acid, 336 Pyrophosphate of iron, 156 Pyroxylin, 456 Pyroxylinum, 456 Quaker button, 240 Quassia, 121 amara, 121 Quassin, 121 Queen's delight, 317 Querci-tannic acid, 181 Quercin, 181 Quercitrin, 178, 181 Quercitron, 181 Quercus alba, 181 infectoria, 177 tinctoria, 181 Quevenne's iron, 151 Quicksilver, 352 Quillaia, 332 saponaria, 332 Quinamia, 137 Quinamina, 137 Quince seed, 446 Quinia, 134, 235, 136 amorphous, 143 bisulphate, 142 carbolate, 143 citrate, 143 crude, 143 hydrobromate, 143 phosphate, 143 salicylate, 143 sulphate, 136, 141 sulphocarbolate, 143 sulphovinate, 143 Quinise bisiilphas, 142 hydrobromas, 143 hydrochloras, 143 sulphas, 136, 141 valerianas, 142 Quinicia, 137, 143 Quinicine, 137, 143 Quinidia, 135, 137 Quinidina, 135, 137 Quinidinse sulphas, 144 Quinina, 134, 135, 136 Quininse bisulphas, 142 hydrobromas, 143 hydrochloras, 143 sulphas, 142 valerianas, 142 Quinine, 134, 135, 136 bisulphate, 142 crude, 143 carbolate, 143 citrate, 142 hydrobromate, 143 hydrochl orate, 143 phosphate, 143 salicylate, 143 sulphate, 142 sulphocarbolate, 143 sulphovinate, 143 valerianate, 142 Quinoidia, 143 Quinoidin, 143 Race, influence of, 45 Rain-water, 439 Raisins, 274 Ranunculaceae, 85, 122, 222, 227, 25: Red bark, 135 cedar, 350 528 INDEX. Red iodide of mercury, 365 ipecacuanha. 266 oxide of mercury, 357, 359 pepper, 205, 422 precipitate, 359 rose, 184 saunders, 461 sulphide of mercury, 357, 366 Reduced iron, 151 Refined liquorice, 448 Refrigerant diaphoretics, 310 Refrigerants, 217, 235, 310, 319 Reinsch's test forarsenious acid, 380 Remedies, definition of, 17 division of, 17 hygienic, 17 imponderable, 17, 23 mechanical, 17 pharmacological, 17, 27 Resin, 333, 334, 336 cerate, 337 of copaiba, 338 of jalap, 298 of May-apple, 300 of scammony, 303 plaster, 337 Resina, 333, 334, 336 jalapse, 298 podophylli, 300 scammonii, 303 Resorcin, 112 Rhamnaceae, 295, 296 Rhamnus frangula, 295 purshiana, 296 Rhatania-tannic acid, 180 Rhatanic acid, 180 Rhatany, 180 Rheatannic acid, 289 Rheum, 287 officinale, 287 Rheumic acid, 289 Rhigolene, 106 Rhoeadinia, 56 Rhoeagenia, 56 Rhubarb, 287 Rhus toxicodendron, 244 Ricinolein, 278 Ricinus communis, 277 Rio Negro sarsaparilla, 313 Riverius, salt of, 235 Rochelle salt, 287 Rock candy, 459 Rosa centifolia, 184 gallica, 184 Rosacea^ 96, 147, 184, 185, 332, 446, 468 Rose red, 184 white, 184 Rose-water, 184 Rosemary, 216 Rosin, 336 Rosmarinus, 215 officinalis, 215 Rottlera, 469 tinctoria, 469 Rottlerin, 469 Rubefacients, 193, 419 Rubiacese, 115, 333, 266 Rubijervia, 218 Rubus, 185 Canadensis, 185 villosus, 185 Rue, 350 Rufus' pills, 292 Rum, 198 bay, 198 Russian musk, 117 rhubarb, 288 Ruta, 350 graveolens, 350 Rutaceae, 131, 310, 342, 350 Rye, 244 Sabbatia, 124 angularis, 124 Sabina, 349 Saccharated ferrous carbonate, 152 iodide, 155 pancreatin, 149 pepsin, 149 Saccharum, 458 lactis, 459 officinarum, 458 Saturni, 188 Saffranin, 461 Saffron, 460 Sage, 215 Sal ammoniac, 388 diureticus, 319 prunelle, 232 Salicaceae, 146 Salicin, 146,411 Salicinum, 146 Salicylate of lithium, 415 of physostigmine, 259 of quinia, 143 of sodium, 414 Salicylic acid, 411 Saline cathartics, 273, 281 diuretics, 319 refrigerants, 319 Salix, 146 alba, 146 Salkowski's test for carbolic acid. 406 Salt, Epsom's, 282 Glauber's, 283 Rochelle, 287 of Riverius, 235 of tartar, 394 INDEX. 529 Saltpetre, 232 Salve, Deshler's, 337 Salvia, 215 officinalis, 215 Sambucus, 296 Canadensis, 296 Sanguinaria, 269 Canadensis, 269 Sanguinarina, 269 Sanguinarine, 269 Sanguisuga officinalis, 18 Santalaceae, 340 Santalic acid, 461 Santalum album, 340 rubrum, 461 Santonica, 465 Santonin, 465 Santoninum, 465 Sapindacea?, 116 Sapo viridis, 437 Saponin, 332 Sarothamnus scoparius, 328 Sarsaparilla, 312 Sassafras, 317 medulla, 445 officinale, 317, 445 pith. 445 Saunders, red, 461 Savine, 349 Scammonin, 303 ' Scammonium, 302 Scammonv, 302 Scarifications, 18, 19 Scilla, 272, 320, 333 Scillin, 320 Scillipicrin. 320 Scillitoxin, 320 Sclererythoin, 246 Sclerocrvstallin, 246 Scleromucin, 246 Sclerotic acid, 243 Sclerotium, 245 Scleroxanthin, 246 Scoparin, 328 Scoparius, 328 Scrophulariaceae, 249, 295 Scruple, 40 Scudamore's draught, 323 Scutillaria, 114 laterifolia, 114 Seaside grape, 179 Season of gathering, influence of, on plants, 30 Secale cereale, 244 Sedatives, 53, 217, 320 Seidlitz powder, 287, 398 Semi-solids, 31, 38 Senega, 330, 349 Senegal gum, 441 Seneka, 330 34 Senna, 293 Sennacrol, 284 Serous membranes, application of medicines to, 50 Serpentaria, 126 Sesamum indicum, 446 Setacea, 19 Setons, 19 Sevum, 452 Sex, influence of, on medicinal ef- fects, 44 Sheep, 452 Sherry wine, 197 Sialagogues, 354 Signs and abbreviations, 471 Silver fir, 423 nitrate, 164 fused, 166, 432 diluted, 166 oxide, 166 Simaruba excelsa, 121 Simarubaceas, 121 Simple bitters, 120, 121 Sinalbin, 421 Sinapis, 272, 420 alba, 272, 420 nigra, 272, 420 Sinapism, 422 Sinigrin, 421 Sipirina, 147 Skin, applications of medicines to, 45 Skullcap, 114 Skunk cabbage, 114 Slippery elm, 444 bark, 444 Sloe, 261 Smelling salts, 201 Smilaceae, 312 Smilacine, 313 Smilax officinalis, 312 medica, 312 Smyrna opium, 55 Snakeroot, black, 252 seneka, 330 Virginia, 126 Soap bark, 332 cerate, 190 liniment, 99 plaster, 190 Socotrine aloes, 291 Soda, 434 Sodii acetas, 319 arsenias, 384 benzoas, 417 bicarbonas, 397 venalis, 397 boras, 416 bromidum, 72 carbonas, 397 exsiccata, 397 530 INDEX. Sodii hypophosphis, 387 hyposulphis, 171 iodidum, 374 nitras, 235 phosphas, 284 praeparata, 395 salicylas, 414 santoninas, 466 sulphas, 283 sulphas, 171 sulpho-carbolas, 409 Sodium acetate, 319 arseniate, 384 benzoate, 417 bicarbonate, 397 borate, 416 bromide, 72 carbonate, 396 dried, 397 carbolate, 409 hypophosphite, 387 hyposulphite, 171 iodide, 394 nitrate, 235 phosphate, 284 preparations, 395 salicylate, 414 santoninate, 466 sulphate, 283 sulphite, 171 sulpho-carbolate, 409 Soil, influence of, on plants, 31 Solanaceae, 73, 77, 79, 81, 83, 91, 204 Solania, 92 Solanum dulcamara, 91 nigrum, 92 tuberosum, 92 Solids, 31 Solubility, influence of, on medi- cines, 31 Soluble glass, solution of, 458 gun-cotton, 456 tartar, 286 Solution, Donovan's, 385 Fowler's, 383 Labarraque's disinfecting, 405 Lugol's, 371 Magendie's, 64 Monsel's, 154 of ammonium acetate, 236 of arsenic and mercuric iodide, 385 of arsenic chloride, 384 of arsenious acid, 384 of chlorinated soda, 405 of gutta percha, 457 of iodine, compound, 371 of iron acetate, 157 and quinine citrate, 158 chloride. 155 Solution of iron citrate, 157 nitrate, 157 subsulphate, 154 tersulphate, 154 of lime, 400 of magnesian citrate, 283 of mercuric nitrate, 357, 367, 436 of pepsin, 149 of potassa, 394 of potassium arsenite, 383 of potassium citrate, 236 of soda, 395 of sodium arseniate, 384 silicate, 458 of soluble glass, 458 of zinc chloride, 163 Solutions, 32, 35 Soporifics, 54 South American kino, 179 Spanish fly, 426 Sparteia, 328 Spastics, 240 Spearmint, 214 water, 214 Special diuretics, 320 Spermaceti, 452 cerate, 452 whale, 452 Spice plaster, 425 Spiced syrup of rhubarb, 290 Spigelia, 462 marilandica, 462 Spinants, 53, 240 Spiraea ulmaria, 411 Spirit of ammonia, 200 aromatic, 200. 39^ anise, 216 camphor, 98 chloroform, 106 cinnamon, 206 ether, compound, 119 gaultheria, 213 juniper, 328 compound, 32^ lavender, 214 compound, 214 lemon, 237 mindererus, 236 myrcia, 198 nitre, sweet, 237 nitrous ether, 237 nutmeg, 208 orange peel, 214 peppermint, 214 spearmint, 214 turpentine, 208, 333. 334, 335 proof, 197 Spirits, 36 INDEX. 531 Spiritus, 36 aetheris compositus, 119 nitrosi, 237 ammonias, 200 aromaticus, 200. 399 anisi, 216 aurantii, 214 camphorae, 98 chloroformi, 106 cinnamomi, 206 frumenti, 198 gaultheriae, 213 juniperi, 198, 328 compositus, 328 lavandulae, 214 compositus, 214 limonis, 239 menthae piperitae, 214 viridis, 214 mindereri, 236 myrciae, 198 myristicse, 207 sacchari, 198 odoratus, 215 vini Gallici, 198 Spruce, hemlock, 424 Norway, 423 Spurious Burgundy pitch, 424 Squill, 272, 320, 333 Squirting cucumber, 305 St. Ignatius' bean, 244 Staphisagria, 227 Staphisiana, 227 Star anise, 216 Starch, 450 Static electricity, 26 Stavesacre, 227 Stearic acid, 454 ether, 452 Stearin, 452 Sterculiaceas, 452 Sternutatories, 47 Stethal alcohol, 452 Stillingia, 319 sylvatica, 319 Stimulants, 53, 192 aromatic, 193, 203 diffusible, 193 Stimulating diaphoretics, 310, 320 diuretics, 349 Stomach, influence of, condition of, 45 Stomachics, 193 Storax, 347 Stramonii folia, 77 semen, 77 Stramonine, 78 Stramonium, 77 leaves, 77 seed, 77 Stronger ether, 100 water of ammonia, 200, 430 white wine, 197 Strychnia, 241, 244 Strychnia? sulphas, 242 Strychnina, 241, 244 Strychninas sulphas, 242 Strychnine, 241, 244 sulphate, 242 Strychnos nux vomica, 240 Ignatia, 244 Styptic collodion, 457 Styracese, 346 Styrax, 347 benzoin, 346 Styrol, 347 Sturgeon, 451 Subacetate of copper, 161 lead, solution of, 189 Subcarbonate of bismuth, 167 Sublimed sulphur, 279 Subnitrate of bismuth, 166 Subsulphate of mercury, yellow, 160, 357, 366 Succi, 37 Succinic acid, 118 Succinum, 118 Succus limonis, 239 Sudorifics, 309 Suet, 452 Sugar, 458 of lead, 188 milk, 459 Sulphate of aluminium, 192 aluminium and ammonium, 191 bebeeria, 148 cinchonia, 143 cinchonidia, 144 copper, 160, 272, 436 iron, 153 dried, 153 precipitated, 153 and ammonium, 159 magnesium, 282 manganese, 284 morphia, 64 potassium, 285 quinia, 136, 141 quinidia, 144 sodium, 283 strychnia, 242 zinc, 162 Sulphide of calcium, 171 of mercury, red, 357, 366 Sulphides, 171 Sulphite of ammonium, 171 calcium, 171 magnesium, 171 potassium, 171 sodium, 171 532 INDEX. Sulphites, 171 Sulphocarbolate of quinia, 143 calcium, 409 lead. 410 magnesium, 409 potassium, 409 sodium, 410 Sulphocarbolates, 409 Sulpbocarbolic acid, 408 Sulphocyanide of allyl, 421 Sulpbovinate of quinia, 143 Sulphur, 279 iodide, 372 lotum, 279 praecipitatum, 280 sublimatum, 279 Sulphurated antimony, 231 potassa, 280 Sulphuric acid, 169 aromatic, 170 diluted, 170 ether, 100 Sulphuris iodidum, 372 Sulphurous acid, 170 Sumbul, 263 Suppositoria, 38 Suppositories, 38, 50 of asafetida, 111 belladonn lead, 189 tannic acid, 176 Suppurants, 419, 431 Sus scrofa, 451 Swamp hellebore, 218 Sweet oil, 277 orange peel, 213 spirit of nitre, 237 tincture of rhubarb, 290 Sydenham's laudanum, 64 Symplocarpus fcetidus, 114 Syrup, 38 of almond, 96 blackberry, 185 calcium lactophosphate, 386 citric acid, 239 garlic, 333 ginger, 210 gum arabic, 442 hypophosphit'es, 387 with iron, 159, 387 iodide, 156 quinine and strychnine phos- phate, 159 ipecac, 269 iron bromide, 157 krameria, 180 lactucarium, 73 lemon, 239 niarshmallow, 446 prunus Virginiana, 147 Syrup of orange flowers, 214 peel, 214 rhatany, 180 rhubarb, 290 aromatic, 290 spiced, 290 rose, 184 sarsaparilla, compound, 314 senega, 332 senna, 294 squill, 321 compound, 321, 332 tar, 336 tolu, 348 wild cherry, 147 Syrupi, 37 Syrups, 37 Syrupus, 37 acaciae, 442 acidi citriei, 239 allii, 333 altheae, 446 amygdalae, 96 aurantii, 214 florum, 214 calcis lactophosphatis, 386 ferri bromidi, 157 iodidi, 156 quiniae et strychnia? phos- phatum, 159 hypophosphitum, 387 cum ferro, 159, 387 ipecacuanhse, 269 krameriaa, 180 lactucarii, 73 limonis, 239 picis liquidae, 336 pruni Virginianae, 147 rhei, 290 aromaticus, 290 rosae, 184 rubi, 185 sarsaparillae compositus, 314 scillae, 321 compositus, 321, 332 senegae, 332 sennae, 294 tolutanus, 348 zingiberis, 210 Tabacum, 81 Table for converting G. C. into f£, 42 apothecaries' weights and mea- sures into gram weights, 43 Tablespoon, 42 Tamarind, 275 Tamarindus, 275 Indica, 275 Tannate of iron. 175 Tannic acid, 174, 177, 181, 183, 185 INDEX. 533 Tar. 336 Taraxacerin, 327 Taraxacin, 327 Taraxacum, 326 dens-leonis, 326 Tartar, 239 cream of, 286, 319 crude, 286 emetic, 228, 272 salt of, 394 soluble, 286 Tartaric acid, 239 Tartarized antimony, 228, 272 Tartrate of antimony and potassium. 228, 272 iron and ammonium, 159 potassium, 156 potassium, 286 potassium and sodium, 287 Tea, 115 Paraguay, 116 worm, 464 Teaberry, 212 Teacup, 42 Teaspoon, 42 Temperament, influence of, on med- icinal effects, 44 Terebinthaceae, 244 Terebinthina, 333 canadensis, '334 Terra japonica, 178 Terrestromiacea?, 115 Test for arsenic, Marsh's, 379 Reinsch's, 380 for carbolic acid, Plugge's. 406 Salkowski's, 406 Heropath's, 137 Marsh's, 228 Trapp's, 221 Tetrachloride of carbon, 108 Thea, 115 sinensis, 115 Thebaia, 56, 58 Thebolactic acid, 56 Theina, 115, 116 Theobroma. 116 cacao, 453 Theobromia, 116, 453 Theobromine, 453 Therapeutics, definition of, 28 Thornapple, 77 Thorough wort, 129 Thynielaceae, 315 Thymene, 215 Thymol, 215, 418 Thymus vulgaris, 215, 418 Tiglinic acid, 306 Tinctura aconiti, 88, 217 aloes, 293 aloes et myrrhse, 293 Tinctura arnicae florum, 225 radicis, 225 asafoetidae, 111 aurantii amari, 214 dulcis, 214 belladonnas, 77 benzoini, 347 composita, 347 bryonias, 299 calendulae, 317 calumbae, 126 cannabis indica?, 89 cantharidis, 329 capsici, 205, 423 cardamomi, 211 composita, 211 catechu composita, 179 cimicifugae, 254 cinchonae, 141 composita, 141 cinnamomi, 206 colchici, 324 conii, 257 croci, 461 cuhebae, 340 digitalis, 252 ferri acetatis, 158 chloridi, 155 gallae, 178 gelsemii, 224 gentianae composita, 123 guaiaci, 315 ammoniata, 315 humuli, 90 hydrastis, 329 hyoscyami, 80 ignatise, 244 iodi, 371 ipecacuanhae, 269 et opii, 63 kino, 179 krameriee, 180 lobelia?, 85 matico, 341 moschi, 118 myrrhae, 346 nucis vomicae, 244 opii, 63 camphorata, 63 deodorata, 64 physostigmatis, 259 quassiae, 121 rhei, 290 aromatica, 290 dulcis, 290 sanguinariae, 271 saponis viridis, 437 scill OlV * \ v S ' Ar ■> n" \ ' •p ,v " * % . 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