. l^^M LIBRARY -oTcONGRESS. M Shelf ...*H.3. 18* JL UNITED STATES OF AMERICA, m H ^ : s ' H rig* h ■ 'J -v.* ■*y : I ■ B 1 ■ ■ H 4 MATERIA MEDIOA PHARMACY, PHARMACOLOGY AND THERAPEUTICS A New Series of Manuals FOR Medical Students. Price of each Book, Cloth, $3.00; Leather, $3.50. No. 1. PRACTICAL SURGERY. Third Edition. Illustrated. A Manual for Students and Physicians. By Wm. J. Walsh am, m. d., As- sistant Surgeon to, and Demonstrator of Surgery in, St. Bartholomew's Hospital ; Surgeon to Metropolitan Free Hospital, London, etc. Thoroughly lllustiated witii 318 fine wood engravings. 748 pages. No. 2. WINCKEL'S DISEASES OF WOMEN. By Parvin. [Second Edition Illustrated. A new Text-Book, including Diseases of the Bladder and Urethra. By Dr. Winckel, Professor of Gynaecology, etc., Royal University of Munich. The translation edited by Theophilus Parvin, m. d., Professor of Ob- stetrics and Diseases of Women and Children, Jefferson Medical College, Philadelphia. 152 Engravings, most of which are new. Enlarged, with many new Illustrations. 766 pages. No. 3. MIDWIFERY. Illustrated. By Alfred Lewis Galabin, m. a., m. d., Obstetric Physician to, and Lec- turer on Midwifery and the Diseases of Women at Guy's Hospital, London, etc. 227 Fine Engravings. 753 pages. No. 4. PHYSIOLOGY. Fifth Edition. Illustrated. By Gerald F. Yeo, m. d.,f. r. c. s., Professor of Physiology in King's College, London. Revised. 321 Carefully printed Illustrations, and a Glossary. 758 pages. No. 5. CHILDREN. Second Edition. By J. F. Goodhart, m. d., Physician to the Evelina Hospital for Children ; Assistant Physician, Guy's Hospital, London. American Edition. Revised and Edited by Louis Starr, m. d., Clinical Professor of Diseases of Children in the Hospital of the University of Pennsylvania; Physician to the Children's Hospital, Philadelphia. 50 Formulae, and directions for prepar- ing Artificial Human Milk, for the Artificial Digestion of Milk, etc. Second Edition, enlarged and re-arranged. 772 pages. No. 6. MATERIA MEDICA, PHARMACY, PHARMACOLOGY, AND THERAPEUTICS. A Handbook for Students. By Wm. Hale White, m. d., f. r. c. p., etc. Physician to and Lecturer on Materia Medica, Guy's Hospital ; Examiner in Materia Medica, Royal College of Physicians, London, etc. American Edition, Revised and Edited by Reynold W. Wilcox, m. a., m. d., Pro- fessor of Clinical Medicine at the New York Post-Graduate Medical School and Hospital ; Assistant Visiting Physician Bellevue Hospital, etc. 580 pages. No. 7. MEDICAL JURISPRUDENCE AND TOXICOLOGY. Third Edition. By John J. Reese, m. d., Professor of Medical Jurisprudence and Toxi- cology, University of Pennsylvania, etc. Enlarged. No. 8. DISEASES OF THE EYE AND THEIR TREATMENT. Fourth Edition. Illustrated. A Handbook for Physicians and Students. By Henry R. Swanzy, a. m., m. b., f. r. c. s. 1., Surgeon to the National Eye and Ear Infirmary ; Oph- thalmic Surgeon to the Adelaide Hospital, Dublin. Thoroughly Revised. Enlarged. 176 Illustrations. 500 pages. *** Other Volumes in Preparation. A complete illustrated circular with sample pages sent free, upon application. Price of each Book, Cloth, $3.00; Leather, $3.50. P. BLAKISTON, SON & CO., Medical Publishers and Booksellers, 1012 Walnut Street, Philadelphia. MATERIA MEDICA PHARMACY, PHARMACOLOGY AND THERAPEUTICS W. HALE WHITE, M. D., F. R. C. P. PHYSICIAN TO, AND LECTURER ON MATERIA MEDICA AND THERAPEUTICS AT, GUY'S HOSPITAL, LONDON; EXAMINER IN MATERIA MEDICA TO THE CONJOINT BOARD OF ENGLAND; AUTHOR OF A TEXT-BOOK OF GENERAL THERAPEUTICS EDITED BY REYNOLD W.3VILCOX, M. A., M. D, LL. D. PROFESSOR OF CLINICAL MEDICINE AT THE NEW YORK POST-GRADUATE MEDICAL SCHOOL AND HOSPITAL; ASSISTANT VISITING PHYSICIAN TO BELLEVUE HOSPITAL; FELLOW OF THE AMERICAN, AND OF THE NEW YORK ACADEMY OF MEDICINE, ETC. * /7J PHILADELPHIA P. BLAKISTON,' SON & CO. 1012 WALNUT STREET 1892 Copyright, 1892, by P. BLAKISTON, SON & CO. Made by The Jas. B. Rodgers Printing Co. b'l & 54 N. Sixth Street, Philadelphia. 1*^ in > -v •PREFACE In writing this book, I have derived help from the works of many authors, but especially from those of Mitchell Bruce, Lauder Brunton, Ringer, Shoemaker, Martindale and Westcott, Squire, and Elborne. . The Editor, in bringing this book into harmony with the United States Pharmacopoeia, has made free use of the w r orks of Potter, Wood, Hare, Bartholow, Biddle, and of the United States Dispensatory. The unofficinal preparations have received especial attention. For this section, he has consulted Lescher's Recent Materia Medica, Helbing's Modern Materia Medica, Davis' Pharma- cology of the Newer Materia Medica, and as well his own journal files, which comprise all the periodicals devoted to the subjects upon which this volume treats. CONTENTS. PAGE. Definitions 9 Pharmacy 10 Pharmacology and Therapeutics 30 Prescribing 33 Actions of Drugs 38 Drugs acting on Processes outside the Body 39 Drugs acting on the Blood 42 Drugs acting on the Cardiac Mechanism 45 Drugs acting on the Vessels 49 Drugs acting on the Skin 54 Drugs acting on the Urinary System 56 Drugs acting on Bodily Heat 61 Drugs acting on Respiration 63 Drugs acting on the Digestive Apparatus 68 Drugs acting on the Nervous and Muscular Systems . 87 Drugs acting on the Organs of Generation 101 Drugs acting on Metabolism 103 Pharmacopclial Inorganic Materia Medica — Group I. Water 104 II. The Alkaline Metals 108 III. The Alkaline Earths 131 IV. Lead, Silver, Zinc, Copper, Bismuth, Aluminium .... 140 V. Iron and Manganese 154 VI. Gold and Mercury 172 VII. Arsenic, Antimony, Chromium 184 VIII. Phosphorus 194 7 8 CONTENTS. FAGE. IX. Chlorine, Iodine, Bromine 198 X. Sulphur 209 XI. Acids 213 XII. Carbon and its Compounds 223 Pharmacopgeial Organic Vegetable Materia Medica — Group I. Drugs acting on the Nervous System 261 II. Drugs acting on the Heart 318 III. Drugs acting on the Respiratory Organs 337 IV. Drugs which are Antiperiodic and Antipyretic 347 V. Purgatives 366 VI. Volatile Oils 391 VII. Bitters 445 VIII. Astringents 455 IX. Demulcents 465 X. Parasiticides 477 XI. Diuretics 484 XII. Drugs acting upon the Uterus 48J XIII. Colchicum 491 XIV. Stearoptenes 494 XV. Drugs containing Important Acids 498 XVI. Flavoring Agents 504 XVII. Coloring Agents , 508 XVIII. Drugs whose Action is Mechanical 509 XIX. Drugs whose Action is Unknown 513 Pharmacg-pceial Organic Animal Materia Medica 522 Appendix No. I. Non-Pharmacopceial Remedies (Officinal in B. P.) 534 Appendix No. II. Non-Pharmacopceial Remedies . 565 Appendix No. III. Vegetable Natural Orders 591 Appendix No. IV. Latin Phrases used in Prescriptions ..... 597 Index 599 MATERIA MEDICA PHARMACY, PHARMACOLOGY AND THERAPEUTICS DEFINITIONS. Materia Medica is so wide a term that it is difficult to define. It includes the following; (a) Materia Medica proper, sometimes called Pharmacognosy. This is the knowledge of the natural history, physical characters, and chemical properties of drugs. (<£) Pharmacy. This is the science and art of the selection, preparation and combination of drugs. (V) Pharmacology. This is the science which treats of the action of drugs on the body both in health and disease. A subdivision of it is Pharmacodynamics, which is the science of the physiological action of drugs in health. The science which studies the effects of doses large enough to endanger life is Toxicology. (*/) Therapeutics is the science and art of allevi- ating or curing disease. Many authors do not include this under the term Materia Medica. Therapeutics is either — (i) Rational, when we have sufficient knowl- edge of the disease and the pharmacological action of 2 9 IO MATERIA MEDICA. the remedy to know why it should be of benefit, e.g. The use of digitalis for mitral disease. (2.) Empirical, when our knowledge is insuf- ficient to tell us why the remedy is efficient, e. g. The use of quinine for ague. Therapeutics ought not to be included in the term Materia Medica, for that treats only of drugs ; but Therapeutics, properly speaking, is concerned with all means of alleviation. General Therapeutics is a subdivision of Therapeutics; it is the science and art of alleviating disease by such remedies as are not drugs, e. g. diet, climate, baths, venesection, cupping, etc. In this work we shall consider only that part of Therapeutics which is concerned with drugs. A Pharmacopoeia is a book published by some authorized body, generally constituted by law. This book states how to prepare the medicines in common use and, the United States' Pharmacopoeia excepted, the doses in which they may safely be given. The pharmacopoeias and the authorities publishing them differ in different countries. The British Pharmacopoeia is published by the General Medical Council. The last edition appeared in 1885, and its supplement in 1890. The United States Pharmacopoeia is published by a convention consisting of delegates from incorporated Medical Societies, Medical Colleges, Colleges of Pharmacy and Pharmaceutical Societies, from the Medical officers of the Army, Navy, and Marine Hospital Service. The last edition appeared in 1882. As new drugs are discovered they are, if of use, included in new editions of the Pharmaco- poeia. Everything contained in the Pharmacopoeia is said to be " officinal." The abbreviation for "British Pharmacopoeia" is " B. P."; for "United States Pharmacopoeia" is "U. S. P." MATERIA MEDICA PROPER. As much of this as the student need know will be mentioned under each drug, PHARMACY. Pharmacy is for the most part carried out by the manufac- turing and dispensing chemist. The medical student should, PHARMACY. 1 1 however, be acquainted with the simpler processes, as he often is obliged to perform them. They are best learned in the dispen- sary. An elementary knowledge of chemistry will enable him to understand most of the terms used in pharmacy, but the following should be noticed. Alkaloids are bodies having the following characteristics : (i) They are the active nitrogenous principles of organic bodies. (2) They are compound ammonias, that is to say, one or more atoms of hydrogen in ammonia (NH 3 ) are replaced by various radicals. (3) They combine with acids to form crystalline salts without the produc- tion of water. (4) They are alkaline, turning red litmus paper blue. (5) Very few are liquid, such as pilocarpine, conine, nicotine, sparteine. (6) The solid ones are colorless except berberine. (7) They are sparingly soluble in water, readily so in alcohol. (8) The solutions are intensely bitter. (9) They are closely related to pyridene, and some may be synthetically prepared from pyridene bases. Names of alkaloids terminate in English in ine (quinine), in Latin in ina (quinina). Examples in U. S. P. : Atropine, Morphine, Strychnine, &c. Glucosides are bodies which when acted upon by acids, or certain ferments, split up into glucose and other substances (alco- hols, aldehydes, phenols), different in each case. Names of glucosides terminate in English in in (Salicin), in Latin in inum (Salicinum). Examples in U. S. P. are ^alicinum, Picrotoxinum, Santoninum. Fixed Oils are ethers of the higher fatty acids which at ordinary temperatures remain liquid. The usual fatty acids entering into the composition of fixed oils are oleic, palmitic, and stearic. Example : Olive oil consists of a mixture of a combination of oleic acid (CjgH^OJ with glyceryl (C 3 H.) and palmitic acid (C 16 H 32 2 ) with gly- ceryl. That is to say, ordinary olive oil is a mixture of two oils having the formulae C 3 H 5 (C 18 H 33 2 ) 3 and C 3 H 5 (C 16 H 31 2 ) 3 respectively. When acted upon by caustic alkalies or metallic oxides they form soaps (oleates, palmitates, or stearates of metals) and glycerine. This process is called saponification, e.g. C 8 H5(C 18 H, 3 2 )3+3NaHO=3NaC 18 H 33 2 +C 3 H 5 (OH) s . Hard soap. Glycerine. Oleate of sodium. 1 2 PHARMACY. Fixed Oils are obtained by expression from the fruits or seeds of plants, or from animal tissues. When pure they are usually yellow, they float on water, and cause a greasy mark on paper. They are called fixed because they cannot be distilled without decomposition. They are soluble in ether or chloroform. Those in U. S. P. are Oleum Amygdalae Expressum, Lini, Morrhuae, Olivae, Ricini, Tiglii. Fats are fixed oils which are solid at ordinary temperatures; if extracted' by expression, sufficient heat to melt them must be used. Examples in U. S. P. : Oleum Theobromae, Adeps. Volatile or Essential Oils only resemble fixed oils in being soluble in the same media. They do not leave a greasy mark on paper. They are mostly inflammable, and mostly lighter than water. They are highly aromatic, and sufficiently soluble in water to impart their odor and taste to it. They are prepared by distillation — that is, by passing a current of steam through the substance from which they are extracted, the steam is condensed, and the oil either floats to the top or sinks to the bottom of the water. Their composition varies very much. The simplest are mixtures of an elaeoptene with a stearoptene. Examples in U. S. P. : Oleum Anisi, Cinnamomi, Lavandulae, Terebinth- inae, &c. Elseoptenes are liquid hydrocarbons isomeric with terpene (C 10 H 16 ). Stearoptenes are oxidized hydrocarbons usually solid and crystalline. Those in U. S. P. are Camphora, Thymol. Resins are very complex bodies. They are among the pro- ducts of oxidization of volatile oils. They contain many indif- ferent substances and acids. They are soluble in alkalies, forming resin soaps. Hence the alkali in Tinctura Guaiaci Ammoniata, and Tinctura Valerianae Ammoniata. The U. S. P. resins are Resina Copaibae, Jalapae, Podophylli, and Scam- monii, Pix Burgundica, and Mastiche. PHARMACEUTICAL PROCESSES. 1 3 Oleo-resins are solutions of resins in volatile oils. Those in U. S. P. are Oleo-resina Aspidii, Capsici, Cubebae, Lupulini, Piperis, Zingiberis. Balsams are mixtures of oleo-resins with benzoic acid or cinnamic acid, or with both. Those in U. S. P. are Benzoinum, Balsamum Peruvianum, Balsamum To- lutanum, Styrax. Gums are exudations from the stems of plants containing one or more of: (a) Arabin or soluble gums, e.g. Acacia. (b) Bassorin or partially soluble gums, e.g. Tragacantha. (c) Cerasin or insoluble gum. Solutions of gum are precipitated by al- cohol. Gum-resins are exudations from plants consisting of a mix- ture of gums and resins. When they are rubbed with water the gum dissolves, and the resin remains mechanically suspended in the solution. The U. S. P. gum-resins are Ammoniacum, Asafoetida, Cambogia, Galba- num, Myrrha, and Scammonium. An Emulsion consists of finely divided particles of an oil, fat, or resin suspended in a liquid having a high specific gravity. When a heavy powder, e. g. subnitrate of bismuth, is suspended in such a liquid, the result is called a suspension. Mucilago Acacias and M. Tragacanthae are frequently used to form emul- sions. Mucilago Acaciae should be recently prepared. It is incompatible with perchloride of iron, borax, and subacetate of lead. Emulsions are coagulated by acids, an undue proportion of metallic salts, and spirituous liquids. PHARMACEUTICAL PROCESSES. Many of these, as filtration, precipitation, etc., need no explanation-, but the following require a few words. Levigation consists in reducing a drug to powder by tritur- ating it with a little water and drying the resulting paste. Elutriation consists in diffusing an insoluble powder in water, letting the heavier part settle, then decanting the superna- 14 PHARMACY. tant fluid. The heavier powder in this is allowed to settle, the fluid decanted, and so on until a fluid containing powder of the required fineness is obtained. Lixiviation consists in the extraction with water of the sol- uble matter of the ashes of anything which has been ignited, the solution being called a "lye." Dialysis. — In this process a mixture of colloid and crystal- loid solutions is placed in a cylinder, over the bottom of which a piece of parchment is tied. The cylinder is suspended in a vessel containing distilled water. The crystalline substances (the diffu- sate) pass out through the parchment into the water, the colloids (the dialysate) remain behind in the cylinder. In this way the excess of acidulous matter (the diffusate) is separated from Fer- rum Dialysatum (the dialysate), (not officinal). Maceration consists in leaving coarsely powdered solid organic substances, in contact for some time, at the temperature of the atmosphere, with a liquid. The resulting solution may be concentrated by heat. Percolation is a process for obtaining the soluble constitu- ents of a drug by the descent of a solvent through it. The drug to be percolated is packed in a tall vertical cylinder, tied over at its lower end with muslin. The percolating fluid is poured in at the top of the cylinder, and as it drops out through the muslin it is collected. In this way many tinctures and fluid extracts of vegetable drugs are prepared. Scaling. — Scale preparations are made by drying concen- trated solutions of drugs on glass plates. The solid left behind forms a thin film on the plate, and this film is broken up. Standardizing. — The Pharmacopoeia directs that certain preparations shall be standardized — that is to say, should yield a certain percentage of the alkaloid, the minimum quantity of which is stated. The standard preparations are: Opii Pulvis containing not less than 12 nor more than 16 per cent. Mor- phine. Opium containing not less than 9 per cent. Morphine. Cinchona Bark containing at least 3 per cent, total alkaloids. Cinchona Flava (or Rubra) containing at least 2 per cent. Quinine. WEIGHTS, MEASURES AND SYMBOLS. 1 5 WEIGHTS. MEASURES. SYMBOLS. Weights (Apothecaries' or Troy Weight). I grain . . Symbol, gr. 480 " = one ounce " § 12 ounces = one pound " ft) The Scruple (20 grains, symbol 9) is rarely used, and the Drachm (60 grains, symbol £ ) is commonly used- Measures of Capacity. I minim . Symbol, TTL 60 minims = one FLUID DRACHM " 5 8 fluid drachms = one fluid ounce . " § 16 fluid ounces == one pint ..... " O 8 pints == one gallon. ... " C Usually g and ^ are written fg and f§ when they stand for fluid drachms and ounces. Relations of Measures to Weights. I minim is the measure of 0.95 grains of water. I fluid drachm " " 56.96 " " I fluid ounce " " 455-69 " " I pint " " 7291.04 " " A 1 per cent, solution is approximately a grain in 100 minims. A fluid grain is the volume of one grain of water at 6o° F., that is to say it is a little over a minim (1.05 Vf[,). In the Pharmacopoeial description of the various proportions which several parts of a compound bear to one another, the word parts means parts by weight ; the term fluid parts signifies the volume of an equal number of parts of water. Metrical System. — This, which is as follows, is official on the Continent. WEIGHTS. I milligramme = 0.00 1 gramme. I centigramme = 0.0 1 " I decigramme = 0.1 " 1 gramme = weight of 1 cubic centimetre of distilled water at 4 C. • I decagramme = 1 0.0 grammes. [Abbreviation, grm. I hectogramme = 100.0 " I kilogramme = 1000.0 " Abbreviation, kilo. MEASURES. I millilitre = I cubic centimetre (abbrev., c.c.) = the measure of I grm. of I centilitre^ 10 c.c. = the measure of 10 grms. of water. water. I decilitre = 100 c.c. = " " 100 " " I litre — 1000 c.c. — " " 1000 " (1 kilo, of water.) 1 6 PHARMACY. Conversion of United States to Metrical System. WEIGHTS. I grain = 0.0648 grm. I ounce = 31.103 grms. 1 pound == 373- 2 5° " MEASURES. I minim = 0.0616 c.c. I fluid drachm = 3.70 " I fluid ounce = 29.57 " I pint = 473.11 " I gallon =3785.51 Conversion of Metrical to United States. WEIGHTS. I milligramme = 0.015432 grain. I gramme =a 15.432 grains. I kilogramme = 15342.34 " MEASURES. I cubic centimetre = 16.23 minims. I litre (1000 c.c.) = 33.81 fluid ounces. In prescribing on the Continent all liquids are weighed. The weight used for liquids and solids is grammes, and this word is not expressed. Thus — Mag. Sulph. 20.0 = 20 grammes of Sulphate of Magnesia. Hydrarg. Chi or. mit. 0.5 = half a gramme of mild Chloride of Mercury. Tinctura Rhei 1.5 = a gramme and a half of Tinctura Rhei. Domestic Measures. A tea-spoonful is about a fluid drachm. A dessert-spoonful is about two fluid drachms. A table-spoonful is about half a fluid ounce. A wine-glassful is about one and a half to two fluid ounces. A tea-cupful is about five fluid ounces. A breakfast-cupful is about eight fluid ounces. A tumblerful is about eleven fluid ounces. A drop is often taken as being about a minim, but drops vary so much in size that they should never be used for children, nor as a measure of powerful drugs. For example, the number of drops in a fluid drachm, of the United States syrup of acacia is 44, of water 60, of alcohol 146, of chloroform 250. ABSTRACTA, ACETA, AQVM. 17 PHARMACOPCEIAL PREPARATIONS AND THEIR DOSES. Most drugs are not, in their natural state, fit for administration. They are either too bulky, too nauseous, or contain noxious principles. Preparations suitable for administration are therefore prepared from them according to " offi- cinal " pharmacopceial directions. The doses of the various drugs and their preparations which may safely be given to an adult, are taken from the Tables for Doctors and Druggists, compiled by Eli H. Long, M.D., but these doses are often not rigorously adhered to in prescribing. They vary with the purpose for which the drug is required and the age of the patient (see Prescribing). The following is an account of the preparation of the pharmacopceial preparations, and the attempt has been made to arrange the doses so as to make them easy of remembrance. Abstracta. — Solid, dry powdered extracts of double the strength of the crude drug. They are prepared by spontaneous evaporation in an alcoholic tincture at a low temperature (not exceeding 122 F) mixing with it enough Sugar of Milk to make the product weigh one-half of the original weight of the drug, and then reducing it to a fine powder. There are eleven officinal in U. S. P. Abstractum Aconiti. — Belladonnae. — Conii. — Digitalis. Abstractum Podophylii. — Senegae. — Valerianae. Abstractum Hyoscyami. — Ignatise, — Jalapae. — Nucis Vomicae. The dose is one-half that of the crude drug. Aceta. — Solutions of the active principles of the drug ex- tracted from it by maceration or digestion with acetic acid (not vinegar). The U. S. P. contains four. Dose. Acetum Opii 3 — 2otTL — Sanguinariae 5 TTL — 3 Z ] Dose. Acetum Scillae 10 — 45TIX — Lobeliae 10 — 60TIX Aquae.— Aqueous solutions impregnated with some volatile substance. Mostly made by percolating through cotton impregnated with the substances. Those in the U. S P. made thus are — Dose. Aqua Fceniculi ~\ x , ~ — Anisi / — Cinnamomi ^ — I ^ Dose. Aqua Camphorae . . — Menthae Piperitae . — Menthae Viridis. . I., 1 1 1 8 PHARMACY, Three are made by distillation : Dose. Aqua Aurantii florum . indeterminate — Destillata " Dcse. Aqua Rosae indeterminate Two are simple solutions in cold water: Dose. Dose. Aqua Creosoti I — 4 ^ Aqua Amygdalae Amarae . . . 2 — 4 ^ Three are made by passing gases through water : Dose. Dose. Aqua Chlori 10 — 20UL Aqua Ammoniae Fortior . 3 — 6Vf[ — Ammoniae 10 — 2otY^ Cerata are ointments, but are of a much firmer consistence. They all contain wax (cera) and do not melt at temperatures be- low 104 F. Eight are officinal in U. S. P. Ceratum — Camphorae — Cantharidis Ceratum Cetacei — Extracti Cantharidis — Plumbi Subacetatis Ceratum Resinae — Sabinae Charta (papers). — Paper impregnated with an active com- pound and used as a plaster. The U. S. P. contains three : Charta Cantharidis, made from cantharides, ) • , ' > sized paper. — Sinapis, made from mustard, J — Potassii Nitratis, unsized paper. Collodia (collodions). — Solutions of pyroxylin in ether and alcohol. When applied externally a protective film is formed owing to the rapid volatilization of the solvent. The U. S. P. contains four: Collodium. Collodium Cum Cantharide. — Flexile. — Stypticum. Confectiones. Syn. Electuaries, boluses, conserves. — Pow- ders made into a paste with syrup, of such a consistency that the powders do not separate but the mass can be swallowed. The U. S. P. contains two: Confectio Rosae, used as a basis for pills. — Sennae dose, 1 — 25. Decocta. — Solutions of the non-volatile active principles of vegetable drugs, made by boiling the ingredients in distilled EMPLASTRA, EXTRACT A. 19 }- water 30 minutes, in a covered vessel, and straining with addi- tion of cold cold water. The U. S. P. contains — Dose. Decoctum Cetrarise — Sarsaparillae . . Co. . . Elixirs are alcoholic liquids containing aromatic oils. There is but one in the U. S. P. — Elixir Aurantii — which is used as a vehicle. Emplastra. — Plasters consist of tenacious, pliable, solid substances. They are only used for applications for the skin, to which they adhere at the temperature of the body. r Oxide of lead, olive oil, and water. Oleate of Lead Emplastrum Plumbi j AND Glycerine are formed. — Asafoetidae — Ferri — Galbani — Hydrargyri [- Lead plaster is the basis. — Opii — Resinse — Saponis — Belladonna v A . I Resin plaster, which is made from lead plaster is the — Armcae L r r ~ . . I basis — Capsici J — Picis Burgundicae ") w . , . fe v Wax the basis. Canadensis J — Ammoniaci cum ) ^ r -, -, ■, -, -, ., r • V Ulive oil and lead plaster the basis. Hydrargyro J — Ammoniaci Diluted acetic acid the basis. — Ichthyocollae Court plaster. — Picis Cum Cantharide Warming plaster. Extracta. — Concentrated preparations made by evaporating solutions of vegetable principles. The drug is first powdered, then percolated with the appropriate menstruum to exhaustion. The first third of the percolate is reserved, the remainder is evaporated at a temperature not exceeding 12 2° F., until its weight is ten per cent, of that of the drug used, then mixed with the reserve portion, and both are evaporated at or below the above-named temperature to a pilular consis- tence. The menstrua used are : (a) Alcohol ; Ext. Aconiti, Cannabis Indicse, Juglandis, Mezerei and Physostigmatis. 20 PHARMACY. (&) Diluted Alcohol; Ext. Arnicae Radicis, Belladonnae Alcoholicum, Cinchonae, Colocynthidis, Conii Alcoholicum, Digitalis, Euonymi, Hyos- cyami Alcoholicum, Iridis, Leptandrae, Nucis Vomicae, Podophylli, Rhei and Stramonii. (c) Water; Ext. Aloes Aquosum, Gentianae, Glycyrrhizae, Haema- toxyli, Krameriae, Malti, Opii and Quassiae. (d) Water and Aqua Ammoniae; Ext. Glycyrrhizae Purum. (e) Diluted Acetic Acid; Ext. Colchici Radicis. (_/) Inspissated Juice ; Ext. Taraxaci. (g) Evaporated Fluid Extract; Ext. Ergotae. (h) By mixing extracts with aromatics; Ext. Colocynthidis Com- positum. They are in the U. S. P. SOLID EXTRACTS. Dose. Extractum Aconiti . . . T ^ — ^ gr. — Physostigmatis . . . T ^ — y^ gr. — Belladonnae Alcoholicum^ — ^ gr. — Nucis Vomicae . . . -\ , -Opii j^-igr Cannabis Indicae Stramonii . . , : 3, 4 gr. X— l A g r - — Digitalis % — I gr. — Conii Alcoholicum . . ]/ z — I gr. — Colocynthidis . . . — Colchici Radicis . . — Hyoscyami Alcoholi- cum — Quassiae — Aloes Aquosum . . . — Leptandrae — Iridis Yt.— 2 gr. }* 3gr. 3gr. Dose. I— 5 gr. }*- iogr. Extractum Euonymi . — Gentianae .... — Podophylli .... — Arnicae Radicis . . . -j — Krameriae ..... J Co — Haematoxyli . . — Ergotae .... — Rhei — Cinchonae . . . — Taraxaci .... — Juglandis I — 2 g — Malti I — 45 — Glycyrrhizae .... Freely. Purum Freely. — Mezerei Externally. 5— io gr. 5—15 gr. 5-30 gr. Extracta Fluida. — Fluid extracts are permanent concen- trated solutions of vegetable drugs, of uniformly definite strength if the crude drugs are so, a cubic centimer (11116.23) in each case representing the medicinal powers of one gramme (gr. 15.43) of the drug, or approximately a minim of the fluid extract representing the active constituents of a grain of the drug. They are made by percolation and partial evaporation, the menstrum employed being usually alcohol, diluted alcohol, or alcohol and water in various proportions. They are in the U. S. P. — EXTRACTA. 21 FLUID EXTRACTS. Dose. Extractum Aconiti Fluidum ]/ 2 — 2 Tit — Digitalis y 2 — 3 tn — Belladonnae — Stramonii — Nucis Vomicae " I — 4 Vfi — Ipecacuanha ■< " *' •* ^ I emetic, IS — loVCl ji-sm — Sanguinariae j expect., I J I emetic, % — Veratri Viridis Fluid — Scillae — Colchici Seminis " — Conii " — Cannabis Indicae " — Capsici " — Colchici Radicis " — Lobeliae " — Gelsemii " — Zingiberis " — Mezerei " — Sabinae " — Hyoscyami " — Arnicae Radicis " — Podophylli « — Gentianae " — Krameriae u — Calumbae " — Lupulini " — Aromaticum " — Valerianae " — Senegae " — Iridis " — Serpentariae " — ■ Xanthoxyli " — Buchu — Cypripedii " — Pilocarpi " — Hydrastis " — Lactucarii " — Cinchonae " — Cornus " 30m 5m 1 z 2-81H 2-iont 5-iom 5-15 m 5-20 m 5-30IU - 10—30 in Dose. j 10— 30 m } 15-30 m j 5-60 m 1 10-60 m Extractum Calami Fluid. — Eupatorii " — Gossypii Radicis " — Grindeliae " — Guaranae " — Quassiae " — Rhei « — Rhois Glabrae " — Rosae " — Rumicis " — Stillingiae " — Uvae Ursi " — Viburni " — Leptandrae " — Geranii * " — Spigeliae " — Rubi " — Aurantii Amari " — Ergotae " — Hamamelidis " — Pareirae " — Pruni Virginianae " — Sarsaparillae Co. " — Sarsaparillae " — Castaneae " — Chimaphilae " — Chiratae " — Eucalypti " — Frangulae u — Matico " - — Cimicifugae " — Cubebae " — ■■ Scutellariae " — Dulcamarae " — Sennae " — Brayerae " — Taraxaci " — Erythroxyli " — Tritici " — Glycyrrhizae " ■%— ■ 3 - 2 3 23 l _^ . J — Digitalis I Infusum Cinchonae . . ) . _ „ z Infusum Brayerae — Pruni Virgin! anae — Sennae Compositum . I — 2 J ^ Two are made with Cold Water. Inf. Cinchonae, Pruni Virginianae. One is compound, viz. Inf. Sennae Co. One contains acid : Inf. Cinchonae. Infusions should be freshly made, as they readily decompose. Linimenta. — Applications of an oily or spirituous consist- ence, all of which are intended to be rubbed into the skin except Lin. Calcis. Linimentum Ammoniae .... Ammonia and cotton seed oil. — Calcis Solution of lime and cotton seed oil. — Camphorae Camphor and cotton seed oil. [oil. — Plumbi Subacetatis Solution of subacetate of lead and cotton seed — Belladonnas Fluid extract and camphor. — Cantharidis Cantharides and oil of turpentine. — Chloroformi Chloroform and soap liniment. — Saponis Soap, camphor, oil of rosemary, and alcohol. Sinapis Compositum .... J Oil of mustard, extract of mezereum, cam- I phor, castor oil and alcohol. — Terebinthinae Resin cerate and oil of turpentine. Liquores. — Solutions in distilled water of definite chemical bodies, except Liq. Gutta-Perchae, in which the substance in solu- tion is not a definite chemical body, and the solvent is chloro- form. The following are the doses of Liquors : MASS^E, MELLA, MISTURvE, MUCILAGINES. «3 Dose. ri V I — "l lotn Liquor Iodi Compositus — Arsenii et Hydrargyri Iodidi .... — Potassii Arsenitis — Ferri Acetatis . . Chloridi j- 2— ioTTL Nitratis Subsulphatis ... J Sodii Arseniatis . . . 3 — iotTL Acidi Arseniosi . . . 5 — ioTTL Used only externally : Liquor Ferri Tersulphatis. — Gutta-Perchae. — Hydrargyri Nitratis. — Plumbi Subacetatis. Dose. Liq. Ferri et Quin. Citratis ^ ism Citratis . . . — Sodae 5— 20^ — Potassae 5 — 30TII — Sodae Lhloratae .... y z — I 3 — Pepsini 1 — 4 3 — Magnesii Citratis .... 2 — 8 § — Ammonii Acetatis . . . % — I § — Calcis — Potassii Citratis . 83 Liquor Plumbi Subacetatis Dilutus. — Sodii Silicatis. — Zinci Chloridi. Massae consist of substances mixed so as to be of a con- sistency suitable for making pills. These are officinal in the U. S. P. Dose. Massa Hydrargyri ^ — 15 gr. — Ferri Carbonatis I — 5 gr. — Copaibae % — I 3 Mella. — Mixtures of some substance with clarified honey. The U. S. P. contains only two, one of these being simply honey purified. Mel Despumatum. Mel Rosae. Misturae. — Liquid preparations consisting of one or more drugs dissolved in water or suspended in a solution of gum or some other thick fluid. The mixture is usually flavored, and is for internal administration. Examples in U. S. P. Dose. Mistura Rhei et Sodae . . . % — 2 £ — Ferri Composita . . . y^ — 2 g — Magnesiae et Asafcetidae. ^ — 43 — Chloroformi ^ — Ferri et Ammonii Acetatis I I — . — Glycyrrhizae Co . . . .J ■4 3 Mistura Potassii Citratis — Cretae — Ammoniaci .... — Amygdalae .... — Asafoetidae .... Dose. 1-8 5 2-43 Mucilagines. — Mucilages are aqueous, viscid solutions of 24 PHARMACY. Mucilago Tragacanthae. — Ulmi. Oleum Sinapis Volatile — Amygdalae Amarae — Aurantii Corticis . — Tiglii — Florus — Anisi — Bergamii .... — Myristicae .... — Rutae — Cajuputi — Cari — Caryophylli .... — Cinnamomi . ■ , . . — Lavandulae .... — Florum — Limonis — Menthae Piperitae . — Menthae Viridis . . — Pimentae — Rosmarini .... — Sassafras — Thymi — Valerianae .... — Sabinae — Phosphoratum . . — Foeniculi — Gaultheriae .... Dose. gum or starch used for suspending insoluble substances. The U. S. P. contains five : Mucilago Acaciae. — Cydonii. — Sassafras Medullas. There is no fixed dose; it is usually £j. Oleata. — Oleates are solutions in oleic acid, intended for external application. The U. S. P. contains two : Oleatum Hydrargyri (io per cent, solution of yellow oxide of mercury in oleic acid). Oleatum Veratrinae (2 per cent, solution of veratrine in oleic acid). Olea. — There are many oils in the Pharmacopoeia. They are all obtained by distillation or by expression except Oleum Phosphoratum, which is a solution of phosphorus in almond oil. The U. S. P. olea are— Dose. Oleum Hedeomae . . . ^ — Ros* } — 5UI — Coriandri 2 — 5TTI — Chenopodii . . . . ^ — Santali I 2 — ioTTL — Juniperi J — Copaibae . . — Erigerontis — Succini ........ 5 — ioTf^ — Cubebae 5 — 2oTTL — Eucalypti . . — Terebinthinae . — Morrhuae 1 ■ — Amygdalae expressum J — Ricini j£ — 2 ^ — Lhii ^— 23 — Sesami indeterm. — Gossypiim Verminis . ^ -ouvf }^y- — Myriciae ...... ^ — Picis Liquidae ... V externally. — Theobromae .... J — Adipis . . — ^Ethereum \Y± 2lH 31H, 1- 5m } 5-15111 } 5-30111 > in pharmacy. PILULE, PULVERES, SPIRITUS. 25 Pilulae. — Solid spherical bodies containing medicinal agents, and intended to be swallowed whole. A mass of the consistence of firm clay is made by beating medicaments together in a mor- tar. This mass is, with a machine, divided up and rolled into pills. In order that they may not possess a disagreeable taste, they are varnished, gilded, or sugar-coated. Unless the constituents are very heavy, each pill should not exceed 5 grains in weight. Soap, bread crumbs, and confection of roses are common excipi- ents for pills. Glycerine is often added, for it attracts moisture and prevents the pill from getting hard. Pills are often kept in some powder, as lycopodium, to prevent their sticking together. The pills in the U. S. P. are — Dose. Pilulae Phosphori . . t ±q gr. in each — Opii 1 gr. in each — - Asafcetidae 3 gr. in each — Ferri Iodidi. ...... 1 — 2 — Catharticae Compositae . — Antimonii Compositae . — Aloes et Mastiches . . . — Rhei Compositae .... Dose. Pilulae Aloes .... — Aloes et Ferri . . — Galbani Compositae — Rhei — Aloes et Asafcetidae — Ferri Compositae . — Aloes et Myrrhae . } }.-s . 1— 6 . 2 — 10 Pulveres.— Powders are mixtures of finely powdered drugs. The best diluent for powders is sugar of milk, because of its hardness and insolubility. Dose. Pulvis Antimonialis . ; . }4 — 2 g r - — Ipecacuanhae et Opii. . 3 — i5gr. — Cretae Co. . 5 — 60 gr. — Morphinae Co 5 — I5gr. Pulvis Effervescens Compositus. Dose. Pulvis Aromaticus .... 10 — 30 gr. — Jalapae Co %— I 3 — Glycyrrhizae Co . . . . yi. — 2 5j — Rhei Co yi — I 3 Seidlitz Powder. (See Sodium Com- pounds.) Pulvis Ipecacuanhae et Opii is practically a trituration. Spiritus (spirits) are alcoholic solutions of volatile substances, which may be solids, liquids or gases. They are prepared by simple solution. 26 PHARMACY. Dose. Spiritus ^Etheris Compositus 5 — 6oTTL — Cinnamomi 10 — 30^ — ^Etheris ^ — 13 — Camphorae — Chloroformi .... — Juniperi. ..... \ %-* 1% — Lavandulae I — Myristicae J By solution with maceration : Vehicle. Spiritus Limonis . . , — Menthae Piperitae . . — Menthae Viridis . . . Dose. Spiritus Ammoniae Aroma- ticus ^ — 2g — Juniperi Compositus . . 1 — 3 3 — Anisi "> - V 1 — 2 Z — Gaultheriae J — Aurantii vehicle. — Myriciae externally. — Odoratus perfume. Dose. } 5-15 m •5— 15 gr- By gaseous solution : Spiritus Ammoniae IO — 60 tTL By chemical reaction : Spiritus ^Etheris Nitrosi J^ — 2 3 By distillation : Spiritus Frumenti indefinite. — Vini Gallici indefinite. Suppositoria. — Suppositories are conical solid bodies con- taining active drugs for introduction into the rectum or vagina. The basis is oil of theobroma (which is solid). Syrupi. — Syrups are fluid preparations of drugs flavored with sugar. There are ^ officinal in U. S. P. Examples : Syr. Aurantii, Syr. Rhei. The dose of all is about ig or rather more, excepting Syr. Ferri Bromidi, Ferri Iodidi, Scillae Compositus, when it is 5 to 30 fit- Tincturse. — Tinctures are solutions of the active principles of drugs in alcohol. They are prepared by — (#) Maceration; e.g. Tinct. Opii Camphoratae. (b) Percolation; e.g. Tinct. Lavandulae Co. (c) Maceration and Percolation ; e. g. Tinct. Opii. (d) Simple mixing of ingredients; e.g. Tinct. Ipecacuanhas et Opii. Tinctures containing only one active substance are simple. The rest are compound; e.g. Tinct. Catechu Composita. Some are compound although it is not expressed in their name ; e. g. Tinct. Aloes. TRITURATIONES. 27 Tinctura Aconiti . — Iodi — Cantharidis — Veratri Viridis . — Ipecacuanhae et — Arnicae Radicis • — Nucis Vomicae . — Opii — Opii Deodorata . Opii Dose. i-5 i-i5 2 — 10 3-i5 5—10 5—20 child 3- } — Opii Camphorata < F I adult I- — Belladonnas . . — Scillae .... — Stramonii . . — Cannabis Indicae — Digitalis . . . — Ferri Acetatis . — Lobelias . . . — Ferri Chloridi . — Capsici .... — Physostigmatis . — Ignatiae . . . — Colchici . . . — Conii .... — Gelsemii . . . — Rhei Dulcis . . — Moschi .... — Aloes .... — Myrrhae . . . — Arnicae Florum — Guaiaci .... — Guaiaci Ammoniata — Lavandulae Com- posita .... — Asafoetidae . . . — Matico ..... — Benzoini .... — Benzoinia Compos. -20 -4 !> X- m m m m m m m 3—20 ra m 3 \ 5-30 m 1 1 j } 5-60 m 10— 3° va x- 15-45 m Dose, Tinctura Chiratae . — Cimicifugae . . — Cinchonae . . . — Valerianae . . . — Valerianae Ammon — Quassiae . . . — Hydrastis . . . — Serpentariae . . — Krameriae . . . — Catechu Composita — Sanguinariae . . — Zingiberis . . , — Kino — Tolutana . . . — Croci .... — Humuli . . , — Cinnamomi . . — Aurantii Dulcis — Gallae .... — Aurantii Amari — Cardamomi . . — Cubebae . . . — Cinchonae Compo ita — Rhei — Calendulae . . — Calumbae . . . — Hyoscyami . . — Sumbul .... — Gentianae Composi — Rhei Aromatica — Aloes et Myrrhae — Bryoniae . . . — Vanillae .... — Saponis Viridis — Cardamomi Composita — Pyrethri \ K-2 3 51TI-4 3 1 — 2 3 Yz—i 3 \ 1—4 Z *-3 7, 1—5 3 Flavoring. Externally. 2—4 X Externally. Triturationes are intimate mixtures of substances with sugar of milk (Saccharum Lactis). There is but one officinal in U. S. P. 28 PHARMACY. Dose. Trituratio Elaterini ]/ z to I gr. Trochisci. — Lozenges or Troches are solid preparations for taking by the mouth, and consisting of the drug mixed with gum and sugar. Sixteen are officinal in U. S. P. Examples : Troch. Catechu, Troch. Sodii Santoninatis. The dose of each is from i to 6 in the course of the day. Unguenta. — Are soft and solid preparations consisting of a fatty substance mixed with an active drug. They are spread over the skin, or may be rubbed into it. They are only intended for external use. The basis is either lard, olive oil, wax, petrolatum, spermaceti, or paraffin. Benzoinated lard is often used to pre- vent decomposition. Twenty-six are officinal in U. S. P. Examples : Ung. Hydrargyri, Ung. Iodi. Vina. — Wines are weak tinctures, the drug being extracted with stronger white wines, containing 20 to 25 per cent, by weight of absolute alcohol. There are fourteen wines officinal in the U. S. P. With V. Antimonii and V. Ipecacuanhae the dose depends upon the pur- pose for which the drug is used. Dose. Vinum Ergotae . . . . -\ — Ferri Amarum ... I I — 43 — Rhei J — Album menstruum — Album Fortius .... " — Rubrum " — Aromaticum lotion. Dose. Vinum Colchici Radicis . 5 — 15TIX — Antimonii (expectorant) 5 — 6o / HX — Oph 3— 2ottl — Ipecacuanhae 1 — 6oTT[ — Colchici Seminis . . . . 10 — 3oTTL — Aloes ^ — 1 g — Ferri Citratis 1 — 23 The following non-phar?nacopceial preparations are used : Bougies. — Solid cylinders impregnated with various drugs, and used for introduction into the urethra or nose. They are made either of gelatine (to be dipped in warm water before use) or cacao butter (to be dipped in oil before use). Cachets, made of wafer paper, consist of two watch-glass-shaped halves. The drug is enclosed between them, and they adhere when moistened. The cachet is swallowed, and thus nauseous drugs are not tasted. Capsules of gelatine are used in the same way as cachets. Pills, cachets, VINA. 29 and capsules should be immediately followed by a glass of water to wash them down. Cataplasma (poultices). — Soft, pasty, external applications made with boiling water, having linseed (flaxseed) meal as a basis, applied warm. Lin- seed meal is the best basis for poultices on account of its mucilage, which retains moisture and emulsifies oily substances; but popularly it is often re- placed by bread, bran, oatmeal or starch. To make a poultice properly, the bowl in which it is mixed, the water, the spatula for mixing and spreading, the flannel or cheese-cloth on which it is laid, must all be as hot as is possible. The meal should be added gradually to the boiling water, which is continually stirred. The addition of oil or glycerine prevents the poultice caking, as it dries. It should not be spread so thick as to make it inconveniently heavy. Cigarettes. — The drug replaces the tobacco of an ordinary cigarette. Collunaria. — Fluids used as nasal douches. Collyria. — Fluids used as eye washes. Cremora. — Creams are preparations having glycerine, vaseline, or some similar substance as a basis, and used for external application. Emulsiones. — Mixtures in which the drug exists as an emulsion. Enemata (enemas or clysters). — Liquid preparations intended for injection into the rectum. When their object is to empty the bowel they are large in bulk; when it is wished that they should be retained they are small in bulk, and after injection a towel may be pressed against the anus. Essentias (essences) — Solution of volatile oils in rectified spirits, of a strength of I in 5. Fomenta.- — Fomentations consist of flannels wrung out in hot water, to which drugs may or may not have been added. Gargarisma is a fluid preparation used for gargling. Granules are small pills. Guttse. — Fluid preparations to be dropped into the eye. Haustus (a draught). — This term is used when only a single dose of a fluid preparation is required. Injectiones. — Concentrated neutral solutions for injection under the skin. Insufflationes. — Powders for blowing into the throat and larynx. Lamellae. — Small thin discs made with gelatine and glycerine, and used to drop into the eye. They each weigh ^th of a grain. Lanolinum is an ointment with hydrous wool fat as a basis. Linctus. — This has honey, treacle, or some other thick substance as a basis. It is to be swallowed slowly, being retained some time in the mouth. Lotiones. — Aqueous mixtures for external use, generally applied on lint, or washed upon the part. 30 PHARMACOLOGY AND THERAPEUTICS. Mollinum. — A mollinum is an ointment having for its basis mollin, a superfatted soap. Nebulae. — Solutions sprayed into the throat by means of an atomizer. Oxymella. — Oxymels are preparations containing honey and acid. Paste. — A preparation to be applied as an ointment. Pastillus. — Pastils are lozenges having gly co-gelatine as a basis. Pedes are small pills. Pessus. — Pessaries are solid preparations made like suppositories, and introduced into the vagina. Pigmentum. — A paint is a preparation adapted for painting on the skin, throat, &c. Succi. — These are expressed juices of plants, to which a third of their volume of rectified spirit is added, to preserve them. Tabellae. — Tablets of chocolate, each weighing two and a half grains. Vapores. — Inhalations are preparations arranged for the inhalation of volatile drugs. Vaselinum. — This term is applied to an ointment the basis of which is vas2iine. PHARMACOLOGY AND THERAPEUTICS. Before describing the actions and uses of drugs we must con- sider the manner, quantity and form in which to give them. MODES OF ADMINISTRATION OF DRUGS. (a) Into the blood-vessels by injection. This method is rarely used in man, excepting for transfusion of physiological saline solution. (6) Into the subcutaneous tissues by hypodermic injection. The skin of the patient, where it is lax, should be raised between the thumb and fore- finger of the operator's left hand; the skin of the external surface of the fore- arm is often selected. In his right hand he takes a perfectly clean syringe con- taining the quantity of fluid to be injected, and fitted with an aseptic, hollow, silver needle, which is thrust under the raised piece of skin, but not into the muscles, for about an inch, care being taken to avoid wounding a vein. The syringe is slowly emptied, then withdrawn, and the thumb pressed lightly upon the seat of injection for a few seconds. The advantage of this method is that the drug is surely and quickly absorbed. The fluid used must not contain solid particles, nor be irritating, or abscesses will result; it must be aseptic, and therefore, if it is not freshly prepared, it may contain a little carbolic acid — or, better still, boracic acid, for this is non-poisonous and non-irritating. The bulk injected should, if possible, be about five minims. For injections that are not in constant use it is advisable to keep the drugs in the form of lamellae, or soluble tablets, and to dissolve one in a few minims of water as required. DOSES. 31 (c) Into serous cavities by injection. This method is rarely used in man except when the object is to antiseptically wash out a serous cavity, as the pleura, which has been opened, or to produce adhesive inflammation, as in the injection of irritants into the tunica vaginalis. (d) Into mucous cavities. — Drugs are most frequently given by the mouth, to be absorbed from the mucous membrane of the stomach or intestines, but the rate of absorption is much slower than from the subcutaneous tissue, and will depend upon whether the drug is readily soluble in the gastro-intestinal secretions, and whether it is given on an empty stomach, in which case it will be quickly absorbed ; or on a full one, when it will be slowly absorbed. When it is intended that the drug shall act only in the intestine, pills, made purposely insoluble in the gastric fluids, are administered. Some drugs, given by the mouth and absorbed from the stomach, probably never reach the general circu- lation, as they are excreted in the bile by the liver. The drug must be in a pleasant, palatable form, and generally so combined as not to irritate. Drugs are sometimes given by the rectum — in a solid form as supposi- tories, in a liquid form as enemata or clysters ; but they are not dissolved nor absorbed here so quickly as in the stomach. For local effects they may be given by the urethra or vagina (injections, bougies, pessaries), or by the respiratory passages (vapors, cigarettes, sprays, or nebulae for inhalations ; insufflations for blowing into the throat and larynx; pigmenta, gargarismata, trochisci, for a local effect on the mouth and pharynx; nasal douches for the nose). For sprays an atomizer is required. Sometimes volatile drugs, as chloroform, ammonia, nitrite of amyl, are inhaled for their general effect. (*?) By the skin.— Some drugs may be absorbed from the skin if mixed with some fatty substance, especially lanolin. In this way mercury may be ab- sorbed by being rubbed in ; but drugs are chiefly applied to the skin as oint- ments, plasters, etc., for their local effect. They are also applied to the eye and ear as drops and washes. DOSES. The study of doses is termed Posology. In determining the dose the following considerations have to be borne in mind : 1. Age. — The adult dose is that for a person between twenty and sixty years old. For children under twelve add twelve to the age, and divide the age by the number thus obtained. Thus for a child aged eight the dose will be 2 = — of an adult dose. From twelve to sixteen years from | to \ the 8 + 12 5 . . J 3 2 adult dose is required, and from seventeen to twenty years from f to f . There are exceptions to this rule for individual drugs ; e.g. children take iron, cod- 32 PHARMACOLOGY AND THERAPEUTICS. liver oil, arsenic, and chloral very well, but they can take only very small doses of opium. Above sixty years of age the dose should slightly diminish as age in- creases. 2. Weight. — In pharmacological experiments the dose should always be expressed as a proportion of the weight of the animal. In man the weight is not often considered, for it depends so much upon bone and fat, which are not active tissues ; but, as a rule, women require rather a smaller dose of medicine than men. 3. Habit. — A man who is constantly under the action of a drug becomes very insusceptible to it. Thus an opium eater requires enormous doses of opium to produce any effect. A person who habitually takes purgatives requires very strong ones to open the bowels. 4. Idiosyncrasy. — The susceptibility to drugs varies very much. Some persons are salivated by minute doses of mercury, others bear it very well, and there is hardly a drug to which some people are not exceptionally indifferent or susceptible. 5. Time of Administration. — Drugs all act to greatest advantage when given so that their effect will be produced at its natural time. Thus soporifics act best when given in the evening, slowly acting purgatives when given over- night, quickly acting ones when given before breakfast, ergot when given during labor. 6. Mode of Administration. — We have seen that drugs are rapidly ab- sorbed from the subcutaneous tissues. Therefore a smaller dose is required for subcutaneous injection than when the same drug is given by the stomach, for there absorption is slow. It is slower still from the rectum, therefore the dose must be larger. Also certain drugs are excreted by the liver or destroyed in it when given by the stomach. Absorption takes place quickly from an empty, slowly from a full stomach. 7. Mental Emotion. — Sometimes if the patient's mind is particularly fixed on the action of the drug a small dose is powerful. For example, often if the patient is convinced he will sleep, a very small dose of morphia is all that may be required. 8. Temperature. — As the action of the drug on the organism is often partly chemical, the temperature must, in cold-blooded animals and excised structures, as muscle, etc., help to determine its action; but the temperature of man varies within so few degrees that this is not an important factor in medicine. g. Preparation of Drug. — A smaller dose of a soluble preparation, as a tincture, will be required than of a solid preparation, as a pill, which will have to be slowly dissolved before absorption, although in the latter case much depends upon the process of manufacture. 10. Rate of Excretion. — It is obvious that, other things being equal, for PRESCRIBING. 33 prompt action a smaller dose will be required of a drug that is rapidly excreted than of one which is slowly excreted. 11. Cumulative Action. — Sometimes it is found that if a person has been taking a drug regularly, but without the production of any toxicological symptoms, these will suddenly develop. This is said to be due to the cumula- lative action of the drug. It may be caused by the following circumstances : (#) The drug may be absorbed more rapidly than it is excreted. This is the cause of the cumulative action of mercury and lead, both of which are ex- creted with difficulty by the kidney. (<£) There may be a sudden arrest in the excretion of the drug. It is probable that digitalis and strychnine, when the quantity of them in the tissues reaches a certain amount, contract the renal vessels, and hence excretion is arrested. (c) It is possible that, owing to an alteration in the intestinal contents, a drug which was previously very slowly dissolved becomes quickly dissolved, and hence rapidly absorbed. 12. Disease. — The physiological action of drugs, and consequently the dose, are profoundly modified by disease. For example, a patient with peri- tonitis will bear enormous doses of opium. Antipyretics, which do not affect a normal temperature, powerfully depress a febrile temperature. PRESCRIBING. The more complex prescriptions consist of — (1) The Basis, or principal active ingredient (curare). (2) The Adjuvans, or that which assists its action (cito). (3) The Corrigens, or that which corrects its operation (tuto). (4) The Constituens, vehicle, or excipient, which imparts an agreeable form (jucunde). Thus the object of every prescription is to cure quickly, safely and pleas- antly. For example, in Pilula Rhei Composita the rhubarb is the basis, the aloes and myrrh form the adjuvans, and the peppermint is the corrigens to pre- vent the griping. In Mistura Cretae the cinnamon water is the vehicle. Many drugs do not require anything to assist their action or correct their operation. Incompatibility of ingredients should be particularly avoided in prescriptions. There are three kinds of incompati- bility : (a) Chemical Incompatibility ; e. g. glucosides should not be ordered with free acids, which decompose them; nor alkalies, alkaline salts, iodides, or bromides with alkaloids, for they precipitate them. 4 34 PHARMACOLOGY AND THERAPEUTICS. The following table, drawn tip by Professor Potter {Materia Medica, Phar- macy and Therapeutics, 3d Ed., p. 44g), shows the most important instances of solutions which mtitually precipitate each other. P means "forms a precipitate with'''' G .2 C 72 <" OS — u a v O OX) P P P Y p p a .2 OS u s .2 5 S bo £~ p p p Y p Y p p "o t/3 u . > C/> 7Z C t/3 O »- '13 -o rt potassium chlorate and the syrup of iodide of iron liberate iodine, dilute hydrocyanic acid and calomel form cyanide of mercury, potas- sium chlorate and potassium iodide form at the temperature of the body a poisonous compound, probably potassium iodate. If, in a mixture, incompatibles are inevitable, they should both be diluted with the vehicle before they are added to each other. The careful prescriber will avoid combining any of the above incompatible substances. (b) Physical Incompatibility, — This occurs when the mixture of the sub- stances will not form a clear solution ; e. g. insoluble powders and oils will not mix with water, the addition of which, to all spirits and all resinous tinc- tures, and to liquid extract of male fern, causes a precipitate; an acid and quinine mixture is flavored with liquorice, but the acid precipitates glycyr- rhizin; an alcoholic solution added to chloral causes all the chloral to rise to the top. In such cases the aqueous solution may be thickened so that the precipi- tate is suspended in it to form an emulsion, but even then the mixture must be shaken before a dose is taken. Mucilage of acacia, freshly made, is the best emulsifying agent. The substances incompatible with it are mentioned on p. 13. It should be made perfectly fresh. The addition of a little almond oil improves its appearance. I pt. of most fixed oils requires acacise ^f pt., water I pt. I pt. of balsam of Peru " 2 " I J^ I pt. of oil of turpentine "I "I Tragacanth is often used to form an emulsion or suspension, and some- times yolk of egg or milk are employed. Liquor Potassae much facilitates the admixture of fixed oils and water. Tincture of senega aids the emulsification of any oil, even in small quantities, Ttt x being sufficient for an ounce of a fixed oil. Light carbonate of magnesium is employed to aid the diffusion of an oil in water through which air is to be inhaled. The suspension of oil of turpen- tine in mucilage of acacia is a very common non-officinal example of an emul- sion. (c) Pharmacological Incompatibility; e. g. the combination of purgatives with astringents. Sometimes this is intentional, as in the occasional addition of atropine to a hypodermic solution of morphine. After the description of each drug, those that are incomptible with it will be enumerated. 36 PHARMACOLOGY AND THERAPEUTICS. THE PRESCRIPTION. The details of a prescription should be written in the follow- ing order : The first part is the Superscription , which is the sign R , an abbreviation for Recipe, " Take." The second part is the Inscription, consisting of the names of the drugs in the genitive case (the vehicle in the accusative if ad is used with it), and their doses in the accusative. The third part is the Subscription, that is to say, the directions to the dispenser. This in England and some other countries is written in Latin. The fourth part is the Signature, that is to say, the directions to the patient (from L. " Signetur," let it be labeled). This is written in English. The fifth part consists of the physician's name or initials at the bottom on the right, the patient's name at the bottom on the left, and under it the date ; thus : Superscription. — R . Inscription. — Tincturae Ferri Chloridi, giij (basis). Quininae Hydrochloratis, gr. xxx (adjuvans). Magnesii Sulphatis (corrigens). Glycerini, aa ^ij (corrigens). Infusum Quassias ad ^viij (excipient). Subscription. — Fiat mistura. Signature, — Take one table-spoonful three times a day, two hours after meals. A. B. C. (physician's initials). William Smith, Esq. (patient's name). 1 6th June, 1891 (date). Abbreviations. — Although abbreviations are objectionable, yet this pre- scription could be written thus : R. Tinct. Fer. Chlor., £iij. Quin. Hydrochlor., ^ss. Mag. Sulphat. Glycer., aa^ij. Inf. Quas. ad §viij. F. m. S. Take one table-spoonful thrice a day, two hours after meals. William Smith, Esq. A. B. C. 1 6th June, 1891. S, ss and/r are abbreviations for semi, a half, and aa for ana, of each. The medicine may be prescribed as a pill when it is required that the Ext. Col. ( Hyd. Chlor. ( Hyd. ( THE PRESCRIPTION. 37 patient shall carry it about with him, when only a small dose is needed, when it is desirable that it shall act slowly, when it is required to act on the lower bowel, when it is insoluble or nauseous, or when it is difficult to prescribe in the liquid form. Kaolin is the best basis for substances decomposed by con- tact with organic matter, as permanganate of potassium. Oils, and volatile, deliquescent or bulky substances should not be pre- scribed as pills, as they require much solid excipient ; nor should pills be used for substances required to act immediately. Abbreviations should be employed as little as possible. Serious mis- takes have happened because the abbreviations have been ambiguous. The following are especially to be avoided : Acid. Hydroc. (may be Acidum Hydrochloricum or Acidum Hydrocy- anicumh " Extractum Colchici or Extractum Colocynthidis). " Calomel, Corrosive sublimate or Chloral hydrate). " Hydrargyrum, Hydras, Hydriodas, Hydrochloras or Hydrocyanicus). Sulph. ( " " Sulphur, Sulphide, Sulphate, or Sulphite). Sometimes the signature is written in Latin, and it is often abbreviated. A list of such abbreviations is given in the appendix. In Great Britain and in the United States, it is always understood, unless otherwise stated, that the preparations are those of the Pharmacopoeia. Ad. — The prescriber should be careful in deciding whether or not to use this word before the vehicle. If it had been left out in the prescription just given, the bulk of the mixture would have been nearly lo)4 fluid ounces, and the amount of the ingredients in each dose would have been less than was in- tended. Dispensing the Prescription. — The dispenser should bear the following rules in mind: — (1) Read the prescription through first. (2) Next write the directions, so that they* have time to dry. (3) Solution by heat should not be used if more of the salt is ordered than will dissolve in cold water. In such case it must be suspended. (4) With fluids, measure them in such an order that the measure-glass shall be finally rinsed out with the vehicle. (5) Use glass scale pans. (6) Clean and put away everything directly after use. (7) If in the slightest doubt ask the prescriber. (8) If finally the prescription con- tains any insoluble matter, label " Shake the bottle." (9) If the medicine is very poisonous, label it as such and use a distinctive bottle. (10) If for out- ward application only, say so. (11) In dispensing substances chemically in- compatible, if there is any likelihood that the new body formed is dangerous, communicate with the prescriber before dispensing (y local action, and those which produce these effects through their action on the central nervous system. When a drug acts locally we cannot tell whether it acts on the muscle in the wall of the vessel, or on the nerve terminations. It of course follows that drugs acting on the heart, or on a large area, will considerably modify the blood-pressure. A. Drugs acting locally on Vessels. Drugs which, when locally applied to vessels, dilate them : (i) Liquor Ammoniae. (2) Nitrate of silver (strong). (3) Chloride of zinc (strong). (4) Nitrate of copper. (5) Sulphate of copper (strong). (6) Nitrate of mercury. (7) Arsenious acid. (8) Chloride of antimony. (9) Tartrate of antimony and potassium. (10) Iodine. (11) Bromine. (12) Chlorine. (13) Mineral Acids (strong). (14) Alcohol. 1 If prevented (15) Ether. \ from evaporat- (16) Chloroform. J ing. (17) Carbolic acid. (18) Creosote. (19) All volatile oils, as oil of tur- pentine, and many substances containing them, as mustard, horse radish root, etc. (20) Senega. (21) Chrysarobinum. (22) Ipecacuanha. (23) Capsicum. (24) Mezereon. (25) Croton oil. (26) Camphor. (27) Cantharides. (28) Phosphorus. (29) Warmth, however applied, but usually as a poultice. Irritants. — All the above, as they dilate the vessels, are often spoken of as vascular irritants. Rubefacients are drugs which, when locally applied to the skin, cause it to become red because of the vascular dilatation induced. All the above drugs are rubefacients. Vesicants. — Many of these drugs are sufficiently powerful DRUGS ACTING ON THE VESSELS. 5 1 irritants to cause inflammation. If this goes no further than the exudation of plasma from the vessels, and this plasma collects under the epidermis to form vesicles, the drug causing the pro- duction of vesicles is said to be a vesicant ; e. g. cantharides. Pustulants are such of the above drugs as are sufficiently powerful irritants to cause the inflammatory process to proceed to the passage of leucocytes through the walls of the capillaries. They collect in the vesicles, which consequently become pustules ; e. g. croton oil. Escharotics or caustics are the most powerful of all the above drugs. Their local application destroys the vitality of the part to which they are immediately applied, and sets up vascular dilatation of the surrounding area; e.g. strong nitric acid, chlo- ride of zinc, nitrate of silver, and arsenious acid. Counter-irritants. — It has been shown by experiments on animals that when the vessels of the skin are dilated by the appli- cation of an irritant, those of the subjacent viscera are often reflexly contracted. The same is probably true of man. An irri- tant is called a counter-irritant when it is applied to the skin with the object of altering the size of the vessels of the subjacent vis- cera. It is particularly to be remembered that the action is a reflex nervous one, and is in no way due to the withdrawal of blood into the dilated vessels of the skin. Drugs which, when locally applied to vessels, contract them. These may act in two ways, either by contracting the muscu- lar coat of the vessels, or by coagulating the albuminous fluids around them, the coagulum by its contraction constricting the vessels. Those which act on the i?iuscular coat of the vessels : (i) Cold, however produced ; hence rapidly volatilizing substances as ether. (2) Cocaine. (3) Lead salts. (4) Dilute solutions of silver salts. (5) Dilute sulphuric acid. (6) Alum. (7) Hamamelis. (8) Ergot. (9) Hydrastis. (10) Acetanilide. (11) Antipyrin. 5 2 PHARMACOLOGY AND THERAPEUTICS. Ergot when in the circulation causes powerful contraction of the muscular coat of the arteries. It is not quite certain if this is due to the local action of the ergot circulating through the vessels, or to its central action on the vaso- motor centre. Ergot applied to the outside of the vessels has no action on them. All the above, except the last two, are used in medicine to contract vessels. The following has been shown by experiments in the laboratory to cause contraction of small arteries through which they circulate. Salts of copper, zinc, tin, platinum, barium, all cause powerful contraction. Salts of lithium, calcium, strontium, magnesium, cadmium, nickel, cobalt, and iron cause slight contraction. Acetanilide and antipyrin act on the muscular coat of small vessels as powerfully as ergot. Those which coagulate the albuminous fluids around the vessels : (i) Tannic acid and all sub- stances containing it ; e. g. galls, krameria, kino, haema- toxylon, hamamelis, cinna- mon, eucalyptus gum, catechu, and probably bael fruit. (3) Silver salts. (4) Zinc salts. (5 ) Copper salts. (6) Alum. (7) Per-salts of iron. (8) Bismuth salts to a slight ex- tent. (2) Lead salts. B. Drugs which act on the Vaso-motor Centres. Drugs which, by their action on the vaso-motor centres, dilate the vessels : (1) Trinitrin (nitro-glycerine). (2) Nitrite of amyl. (3) Nitrite of sodium. (4) Spiritus Athens Nitrosi. (5) Belladonna. (6) Stramonium. (7) Hyoscyamus. (8) Alcohol. (9) Ether. (10) Chloroform. (11) Chloral. (12) Tartrate of Antimony and Potassium. (13) Aconite. (14) Ipecacuanha. (15) Lobelia. (16) Tobacco. (17) Veratrine. (18) Hydrocyanic acid. (19) Opium (slightly). Some of the substances, which in small doses contract the vessels by cen- tral action, in large doses dilate them ; viz. digitalis and squill. Drugs which, by their action on vaso-motor centres, cause contraction of vessels : (1) Digitalis. (2) Strophanthus. (3) Sparteine. (4) Squill. (5) Hamamelis. (6) Strychnine. (7) Lead salts (slightly). (8) Ammonia (slightly). (9) Ergot (probably). ASTRINGENTS, STYPTICS, EMOLLIENTS. 53 Also, for a very short early period of their action, some substances whose main action is to dilate the vessels by their central action ; viz. belladonna, stra- monium, hyoscyamus, alcohol, ether, chloroform, hydrocyanic acid and veratrine. Astringents are drugs which diminish the size of the ves- sels, and thus decrease the amount of exudation from them. Styptics, or Haemostatics, are drugs which stop bleeding. They comprehend all astringents, especially cold, lead and copper salts, hamamelis, ergot, hydrastis, tannic acid, and above all, per-salts of iron, for they coagulate the blood which is flowing from the vessel, and the clot prevents further bleeding. Matico leaves, because of the numerous hairs on their under surface, favor coagulation of blood when locally applied to a bleeding surface. Cobwebs act in the same way. Therapeutics. — Drugs which locally dilate vessels are con- tinually applied to stimulate sores to heal, and to promote ab- sorption of inflammatory products, as seen in the application of iodine over joints in certain forms of joint disease ; and as coun- ter-irritants in many forms of disease of deep-seated organs, as in the application of a blister in pleurisy. Drugs which by their central action cause dilatation of all the vessels of the body are used in certain forms of heart disease, as in the use of nitrite of amyl in angina pectoris; and some suppose that the good they do is brought about by dilating the vessels and so rendering the work of the heart easier. Drugs causing general vascular dilatation are also employed to cause dilatation of the vessels of the skin, with the object of thereby leading to an increase of perspiration and an increased radiation of heat. Alcohol, Spiritus ^Etheris Nitrosi, and Ipecacuanha amongst others are used in this way. The most important use of astringents is as styptics ; they are also used to check excessive discharges of all sorts, as in diarrhoea, leucorrhoea, etc., and in relaxed conditions of vessels, such as are often seen in pharyngitis. There is perhaps no better opportunity than this of mention- ing emollients and demulcents. Emollients are substances which soften and protect parts. The word is usually employed for substances applied to the skin. 54 PHARMACOLOGY AND THERAPEUTICS. Common emollients are substances soaked in warm water, as hot fomenta- tions and poultices, fats of various sorts, as lard and lanolin (hydrous wool fat), non-irritating oils, as olive oil, spermaceti, petroleum, vaseline, etc. Demulcents are substances which protect and soothe parts. They are generally applied to mucous membranes, especially when unduly dry, and thus they are often used for the mouth. Instances of them are gelatine, isinglass, glycerine, gum, honey, flaxseed, starch, and white of egg. Division V. — Drugs acting on the Skin. All those described in the last section act on the cutaneous vessels, but in addition we have — A. Diaphoretics, or drugs which increase the amount of perspiration. These may do so either by stimulating the sweat centres in the spinal cord, the nerves proceeding from the cen- tres to the glands, the terminations of the nerves in the gland, or the glandular cells themselves; or dilatation of the cutaneous vessels may, by the increase in the amount of blood and the greater warmth, stimulate the glands and lead to an increase of sweat. It is difficult to tell whether drugs acting on the vessels do not also act on the other parts of the mechanism ; and it is also difficult to decide whether a drug acts on the gland- cells or the terminations of the nerves, so we will consider diaphoretics under two headings, those which act centrally and those which act peripherally. These are differentiated by observing whether the drug acts after the spinal cord is destroyed, and on a part of the skin after the nerves going to it are cut. (a). Diaphoretics acting peripherally : Pilocarpine greatly increases the amount of sweat, acting in all probability on the nerve terminations in the gland- cells, but certainly not on the vessels. Local applications of warmth, and alcohol taken internally perhaps act in the same way in addition to their vascular action. (b). Diaphoretics acting centrally : (i) Nicotine. (2) Antimony salts. (3) Ammonium acetate. (4) Ammonium citrate. (5) Ipecacuanha. (6) Opium. (7) Camphor. DIAPHORETICS, ANHIDROTICS. 55 (<:). Diaphoretics whose mode of action is doubtful : Senega, cubebs, col- chicum, salicin, lobelia, arnica, citrate and acetate of potassium. All these, except the last two, are very feeble. When a diaphoretic acts very powerfully it is called a Sudorific. B. Anhidrotics, or Antihidrotics, drugs which diminish the amount of perspiration. The part on which these act is de- termined in the same way as in the case of diaphoretics, (a) Anhidrotics acting peripherally : Atropine is very powerful; it acts on the terminations of the nerves in the glands ; and hyoscyamus and stramo- nium probably act in the same way. The local application of cold has a sim- ilar action. (b) Anhidrotics the mode of action of which is doubtful : (5) Picrotoxine. (6) Zinc salts. (1) Acids. (2) Muscarine. (3) Nux vomica, (4) Quinine. (7) Salicylic acid. Therapeutics. — Diaphoretics are used for three purposes : either to increase the amount of sweat because that of the urine is failing, and for this purpose pilocarpine is largely used ; or in the hope that poisons may be excreted by the sweat, hence the use of pilocarpine in uraemia; or as mild antipyretics, in order to increase the loss of heat by increased evaporation ; for this purpose alcohol, ipecacuanha, acetate of ammonium, and opium were formerly much employed, but of late years much more efficient antipyretics have been discovered. Anhidrotics are used either for general conditions, as phthisis, or for local conditions, as sweating of the feet ; but they are not of great use in medicine. We do not know of any drugs which will alter the composi- tion of the sweat, except in so far as that certain drugs may be excreted in the sweat when taken internally, such are iodine, iodide of potassium, succinic, tartaric, and benzoic acids, the last in the form of hippuric acid. We have no knowledge of the effects of drugs on the sebaceous secretion. 56 PHARMACOLOGY AND THERAPEUTICS. Certain drugs when taken internally in large doses produce a rash on the skin, possibly because in the course of their excre- tion through the skin they irritate it. Such are — (i) Copaiba. (9) Quinine. (2) Cubebs. (10) Salicylic acid. (3) Bromides. (11) Arsenical salts. (4) Iodides. (12) Acetanilide. (5) Turpentine. (13) Antipyrin. (6) Belladonna. (14) Phenacetine. [skin. (7) Chloral. (15) Silver salts may discolor the (8) Opium. (16) Sulphonal. [lowing quite rarely produce an eruption : (1) Iron. (6) Digitalis. (2) Strychnine. (7) Sulphur. (3) Creosote. (8) Antimony. (4) Mercury. (9) Santonin. (5) Veratrum. (10) Cod Liver Oil. Division VI. — Substances acting on the Urinary System. 1 . Drugs increasing the quantity of urine secreted. — These are called diuretics. The kidney is a double organ with two distinct varieties of epithelium ; it is particularly well sup- plied with vessels and vaso-motor nerves, and is also profoundly under the influence of variations in the blood-pressure ; hence it is, with our present state of knowledge, impossible to say how many diuretics act, but the following table, modified from Dr. Lauder Brunton's work, shows the various ways in which they probably act, many in more ways than one. DIURETICS. 57 ' Increased car- j Digitalis, diac action \ Alcohol, Generally Raise arterial -I pressure General vascu- lar contraction r Act on vaso- motor centres r Contract effe- rent vessels Locally in L kidney Locally on kidney Dilate afferent J vessels [ Either act on f Digitalis, Strophanthus, Squill, Sparteine, Convallaria, Strychnine, Caffeine, Erythrophlceum, Cold to skin, < ? same as above, Broom, Buchu, Uva ursi, Juniper, Turpentine, Copaiba, Cantharides, vasomotor J Nitrit centres or lo- -{ At , , n Alcohol, cally on re- ' L nal vessels [_ Act on secreting nerves or renal cells Increase water excreted Increase water and solids ex- creted f Urea, I Caffeine, -j Sodio- Salicylate of Theobromine, L Calomel, Colchicum, Liquor potassse, Acetateof potassium nj Citrate of potassium, Nitrate of potassium Citrate of sodium, and other salines. Therapeutics. — Diuretics are used in cardiac and pulmon- ary diseases when, owing to the general vascular disturbance, the quantity of urine falls below the normal standard. Also in dis- eases in which there is excess of fluid in certain parts of the body; for example, pleuritic effusion and ascites, with the object of get- ting rid of as much fluid as possible by the kidneys. Lastly, in certain forms of kidney disease, although in these maladies it is always a question how far it is desirable to stimulate diseased or- gans. It is of great importance to remember that diuretics may act in many different ways, that there are many causes for dimi- 6 58 PHARMACOLOGY AND THERAPEUTICS. nution in the quantity of urine secreted, and that it is difficult to say in any particular case what is the cause of the decrease in the quantity secreted. Therefore it is usual to give diuretics in com- bination, in the hope that if one of them does not have the desired result another will. 2. Drugs diminishing the quantity of urine secreted. — These are such as produce acute inflammation of the kidney when given in large doses ; e. g turpentine, cantharides, phosphorus. They are never given for this purpose in medicine. Exalgine is reputed to diminish the quantity of urine. 3. Drugs rendering the urine acid. — There is only one drug that can do this effectually, and that is benzoic acid, for in its passage through the kidney it is converted into hippuric acid. Benzoic acid is, therefore, given when from any cause the urine undergoes alkaline decomposition anywhere within the urinary pas- sages. Salicylic acid will, to a slight extent, increase the acidity of the urine, as will very large doses of citric acid, tartaric acid, citrates and tartrates, and possibly saccharin. 4. Drugs which render the urine alkaline. — All salts of the metals, potassium, sodium, lithium, calcium, will do this; even the tartrates, citrates, and acetates, for they escape by the kid- ney as carbonates. Nitric acid is said to increase the amount of am- monia in the urine, and thus to render it slightly alkaline. Ammo- nium salts given internally do not render the urine alkaline, because they are decomposed in the body, urea probably being formed. Lithontriptics are drugs which prevent the deposition, in the urinary passages, of the solids of the urine. If this fluid be acid, uric acid often crystallizes out, forming gravel or uric acid calculus; less often oxalate of lime crystallizes, giving rise to oxalate of lime calculus. When there is any likelihood of the formation of either of these calculi alkalies should be given, espe- cially the lithia salts. If the urine is undergoing alkaline decom- position phosphates are liable to crystallize out. In this case the object will be to render the urine acid and aseptic. This will be attained by giving benzoic acid or benzoates, salicylic acid or salicylates, and urinary antiseptics. DRUGS ALTERING THE COMPOSITION OF THE URINE. 59 Therapeutics. — The chief use of alkalies is to diminish the acidity of the urine, so as to render the precipitation of uric acid unlikely; or to render it alkaline, so as to attempt to dissolve a uric acid calculus. We know of no drug which will dissolve an oxalate of lime calculus. Alkalies are also given to gouty subjects, partly to alkalize the blood, but also partly to alkalize the urines, for such persons are very prone to deposit uric acid in the urine. Urate of potassium is much more soluble than urate of sodium, and urate of lithium is even more soluble ; citrates and acetates are not likely to upset the digestion, consequently the drugs most used are the citrates of potassium and lithium. Copious draughts of water, by diluting the urine, aid in preventing the deposition of uric acid or oxalate of lime calculi. Natural alkaline waters are largely used. 5. Drugs preventing the urine from decomposing. — If the urine is retained in the bladder by stricture or from any other cause, it will undergo alkaline decomposition, and the same result may be brought about by the admixture of pus with the urine. This is generally due to inflammation of the pelvis of the kidney or the bladder. This decomposition of the urine may be prevented by giving drugs which in their excretion by the urine render it asep- tic. Such are — (1) Benzoic acid. (2) Salicylic acid. (3) Uva Ursi. (4) Copaiba. (5) Cubebs. (6) Oil of Sandal-wood. (7) Saccharin. (8) Many volatile oils. 6. Drugs altering the composition of the urine. — Almost any drug will do this, either because it is excreted in the urine, or because it sets up some changes in the body the products of which are excreted in the urine ; but here we shall only refer to certain striking ones. Turpentine, cantharides, and salicylic acid in large doses will cause blood to appear in the urine, because they set up inflammation of the kidney. Chlorate of potassium, amyl nitrite, acetanilide, pyrogallic acid, poisoning by the mushroom, Helvetia esculenta, and transfusion of animals' blood, break up red blood-corpuscles, and the products are excreted by the urine, rendering 60 PHARMACOLOGY AND THERAPEUTICS. it dark. Large doses of mineral acids, arsenic and naphthol are said occasion- ally to produce the same result. Phosphorus in large doses causes leucine and tyrosine to appear in the urine, and the urea is greatly increased. The saline diuretics increase the solids of the urine. The chrysophanic acid in rhubarb and senna makes the urine, if it is acid, a brownish color; if it is alkaline, a purplish red. Logwood renders alkaline urine reddish or violet. Santonin colors acid urine yellow or greenish-yellow, and alkaline urine reddish. Carbolic acid, naphthalin, creosote, and other pre- parations of tar, as well as the arbutin in uva ursi, chimaphila and gaultheria, make it dark greenish-brown. Picric acid makes it a bright yellow, and me- thyl violet a dark-blue. The urine of persons poisoned with carbonic oxide remains sweet for months. Poisoning by carbonic oxide, curare, amyl nitrite, and turpentine, and sometimes mercury, morphine, chloral, prussic acid, sulphuric acid, alcohol, lead compounds, and salicylic acid lead to the appearance in the urine of a body which like sugar reduces Fehling's copper solution. Some authorities state that the urine, after the administration of these drugs, does not contain glucose, but glycuronic acid ; for although it reduces blue copper solutions, it does not undergo alcoholic fermentation on the addition of yeast. The admin- istration of phloridzin, or phlorizin (glycoside from the bark of stem and root of the apple, pear, plum and cherry, which when continuously heated with dilute min- eral acids is resolved into glucose and phloretin), appears to lead to the produc- tion of genuine glucose in the urine. Other drugs cause a peculiar odor in the urine ; for example, the smell of violets is produced by turpentine. The aromatic odor of cubebs and copaiba can be detected in the urine after the administration of these bodies. Lead, if taken for long periods, produces chronic interstitial inflammation of the kidney. It is stated that rarely mercury will do the same. 7. Drugs acting on the bladder and urethra. — The only ones of any practical value are sedatives to the urinary tract. If the urine is decomposing, drugs preventing its decomposition come un- der this head. Other sedatives are opium, belladonna, hyoscyamus, pa- reira, buchu, and uva ursi, which are direct sedatives to the vesical and urethral mucous membrane. If the urine is excessively acid, alkalies are urinary sedatives. Urinary sedatives are used very largely in cases of cystitis and urethritis, whatever the cause may be. Local astringent and antiseptic injections are also employed. ANTIPYRETICS. 6l Division VII. — Drugs acting on the Bodily Heat. A. Antipyretics, or Drugs which decrease the Bodily Temperature. — There are few if any drugs which can lower the temperature in health. Some, it is true, will cause the temperature to fall below normal if given to a healthy man in large enough doses to induce severe collapse. The word antipyretic is limited to those drugs which bring down the temperature when it is raised owing to disease. We know that the greatest amount of heat is produced in the muscles, and that there is a special part of the corpus striatum presiding over this production ; that heat is lost mostly by radiation from the vessels of the skin and by the evap- oration of sweat, and that these vessels and the sudoriparous glands are under the control of the central nervous system. Heat is also lost by excretion through the lungs, skin, bowels and bladder. It is highly probable that there is a part of the cerebrum whose function it is to maintain the balance between the produc- tion and the loss. Also all parts of this complex mechanism are supplied with blood-vessels, alterations in the calibre of which must affect the activity of the parts they supply. There is every reason for believing that the part of the central nervous system which presides over the loss of heat (thermolysis), that which presides over the production of heat (thermogenesis), and that which presides over the balance between the production and the loss (thermotaxis), can, each of them, be influenced by afferent impulses reaching them from various parts of the body, and thus we see each of these three functions can probably be reflexly affected (see diagram on next page). Antipyretics which increase the loss of heat. — All sudorifics and all dilators of the cutaneous vessels act as antipyretics. Cold, such as a cold bath, increases the loss of heat by direct abstraction. Drugs which probably diminish the production of heat. — Our knowledge about these is at present uncertain, but it is very prob- able that phenacetine, antipyrin, and acetanilide diminish the production by their action on the corpus striatum ; and that quinine, salicylic acid, salicin, kairin and thallin also diminish the production ; but we do not know upon what part of 62 PHARMACOLOGY AND THERAPEUTICS. the thermogenetic apparatus they act. A cold bath not only abstracts heat, but, after it has been in operation some little time, diminishes the production. 'ess els of Skin SweafcGlaacZs Antimony, aconite, and digitalis are probably antipyretic through their effect on the circulation, but precisely how they act is not known. Sometimes the removal of some irritation which is acting reflexly may lower the tempera- ature. In this way purgatives are occasionally antipyretics. DRUGS ACTING ON RESPIRATION. 63 Therapeutics. — The sole use of antipyretics is to lower the temperature in fever. Drugs which increase the loss of heat were formerly popular as antipyretics, especially alcohol, nitrous ether, antimony, ipecac- uanha, and opium, but now they are not much used. Cold is more often employed, either by cold sponging, ice, or a cold bath. Sponging with hot water will, by the vascular dilatation and sub- sequent sweating it induces, reduce a febrile temperature. Of the drugs which probably alter the production, kairin and thallin are dangerous because of the collapse they may produce ; quinine and salicylic acid are rather uncertain, except in ague and rheumatic fever respectively. Acetanilide, antipyrin and phe- nacetine are most in demand. They are certain antipyretics, and they give rise to less fear of collapse than the others. Acetanilide is probably safer than antipyrin. Phenacetine is very safe, but it is not so powerful. They are quickly absorbed, and so they act promptly ; they are far more powerful antipyretics than any drugs which act by increasing the loss of heat, and these are very uncer- tain in their action, often not lowering the temperature at all. Another reason for preferring drugs which diminish thermogenesis is that it is much more rational to lower the temperature by de- creasing the production of heat than by increasing the loss, for then the production will, if anything, go on faster than before, in consequence of the attempt to compensate for the increased loss. Drugs which cause a rise of temperature. — Belladonna in poisonous doses may do this. How it acts is not known. Tuberculin, various albumoses, and certain animal poisons such as that of shell fish will cause a rise of temperature. Their mode of action is unknown. We know of no drugs acting on thermotaxis. Division VIII. — Drugs acting on Respiration. Respiration can be modified by such very various influences that it is difficult to decide upon the exact mode of action of any drug which affects it. For example, alterations in the blood and in the air will modify it ; the respiratory centre itself may be in- 64 PHARMACOLOGY AND THERAPEUTICS. fluenced, either directly, or refiexly from almost any organ in the body; or, again, the movements of the respiratory muscles them- selves may be interfered with ; and, lastly, respiration is much under the influence of the circulatory apparatus. Furthermore, the chief object in medicine is to remove the cause of the respir- atory difficulty rather than to act upon respiration itself. We have already spoken of those drugs which produce changes in the blood and the circulation, and the consideration of those modifications of the temperature, moisture, and pressure of the air which are of value in medicine, belongs to a book on general therapeutics. We will, therefore, now consider the respiratory drugs under the following heads : A. Drugs altering the Composition of the Air in- haled. — It is found convenient to administer some drugs, although they are not given for their influence on respiration, by making the patient inhale them ; such are anaesthetics and nitrite of amyl. Some drugs when inhaled are particularly irritating to the bronchial mucous membrane, causing dilatation of the vessels, increased secretion, and refiexly, cough from the stimulation of the sensory nerves of the bronchial mucous membrane. Such are cold dry air, iodine, bromine, chlorine, senega, ipecacuanha, sulphurous anhydride, nitric acid fumes, ammonia, and tobacco. These are rarely used therapeutically as inhalations, and their inhalation is to be particu- larly avoided in irritable conditions of the bronchi. The drugs which, when inhaled, are soothing to the bron- chial mucous membrane are — Hydrocyanic acid. Conium. Inhalations which are used to stimulate the bronchi, that is to say, to increase their vascularity, secretion, and muscular power, are — Carbolic acid, gr. 20. Cajeput oil, Ttl 20. Creosote, ^ss. Cubeb oil, gss. Tinctura benzoini composi- ta, gss. Oleum pini sylvestris, 3 ss. DRUGS ACTING ON RESPIRATION. 65 The amounts given after each are the quantities that should be added to a pint of water at 140 F. Inhalations which are used to disinfect foul secretions from the bronchial mucous membrane are those of — (1) Creosote. (2) Iodoform. (3) Mild solutions of benzoin. (4) Carbolic acid. (5) Sulphurous anhydride. (6) Oil of juniper. (7) Oil of cubeb. (8) Oil of eucalyptus. Inhalations for relieving spasm of the bronchial tubes are those of — (4) Ether. (15) Nitrite of amyl. (1) Conium. (2) Stramonium. (3) Chloroform. B. Drugs acting on the Respiratory Centre. — If the drug, when injected into the carotid artery, very quickly pro- duces its effect on respiration, it is concluded that it acts on the respiratory centre. Another experiment, often used to determine whether the drug acts on the centre, or on the vagal terminations in the lung, is to cut the vagi and to observe whether it acts sim- ilarly before and after the section. Drugs which directly stimulate the respiratory centre are — (1) Strychnine. (2) Ammonia (very powerful), (3) Apomorphine. (4) Belladonna. (5) Stramonium. (6) Hyoscyamus. Drugs which depress the respiratory centre are — (1) Physostigmine (very pow- (8) Aconite. (9) Veratrine. (10) Conium. (11) Caffeine. (12) Quinine. (13) Ipecacuanha. (14) Antimony salts (both the last very weak.) Alcohol, Ether, Chloroform, Caffeine, and Quinine slightly excite before they depress. erful.) (2) Chloral. (3) Chloroform. (4) Ether. (5) Alcohol. (6) Opium. (7) Hydrocyanic acid. 66 PHARMACOLOGY AND THERAPEUTICS. Therapeutics.— The drugs which excite the respiratory centre may be used when there is any difficulty in respiration, especially with the view of increasing the force of the respiratory act whilst other means are employed to get rid of the cause of the difficulty. They are, of course, most frequently required in diseases of the lungs, especially bronchitis. Ammonia and apomorphine are often employed, as they are also powerful ex- pectorants ; and belladonna is useful when there is too much secretion from the bronchial tubes. Substances which depress the respiratory centre are very little needed for this action ; but the centre for the reflex act of cough- ing is in the close neighborhood of the respiratory centre, and opium, hydrocyanic acid, conium, and ipecacuanha are often very valuable in allaying the continual hacking cough which so frequently accompanies disease of the heart and lungs. The drugs which relieve cough are very numerous, for it may be reflexly set up by irritation of so many peripheral parts, viz. nose, throat, pharynx, ear, teeth, larynx, trachea, bronchi, lungs, pleura, stomach, and liver ; and consequently its removal may depend upon the removal of peripheral irritation in any of these organs. C. Drugs affecting the Bronchial Secretion. (#) Those increasing it : (i) Apomorphine. (2) All alkalies, especially car- bonate and other salts of ammonium. (3) Cocillana. (4) Ipecacuanha. (5) Senega. (6) Squills. (7) Turpentine. (8) Camphor. (9) Benzoin. (10) Balsam of Peru. (11) " " Tolu. (12) Antimony salts. (13) Sulphur. (14) Iodine. (15) Tobacco. (16) Jaborandi. (17) Many volatile oils. (b) Those decreasing it (1) Acids. (2) Belladonna. (3) Stramonium. (4) Hyoscyamus. EXPECTORANTS. 67 (c) Those disinfecting it. — Drugs which, when inhaled, act in this way have already been mentioned. Copaiba, cubebs, and many volatile oils are excreted partly by the bronchial mucous membrane, and thus will disinfect the secretion. Therapeutics. — In bronchitis, remedies which increase the secretion are used when it is so viscid that it sticks to the tubes and cannot be coughed up ; and those which decrease it are em- ployed when it is too watery to be easily expectorated. The use of the disinfectants is obvious. D. Drugs relaxing Spasm of the Muscular Coat of the Bronchial Tubes, or Antispasmodics. — It is believed that in asthma there is a spasmodic contraction of the bronchial tubes, and as — (1) Stramonium, (2) Belladonna, (3) Hyoscyamus, (4) Grindelia, (5) Quebracho, relieve asthma, it is concluded that these drugs relax spasm of the muscular coat of the bronchial tubes. Stramonium is the most powerful. It is very likely, judging by their analogous action in other parts of the body, that the following drugs act in the same way: Chloroform, Ether, Opium, Chloral, Cannabis Indica, Amyl Nitrite, and Conium. Therapeutics. — Stramonium is of great use in asthma, and this and the other drugs may be employed for cases of bronchitis in which it is probable that the irritation caused by the inflam- mation of the tubes sets up spasm of them. Many of these muscular depressants in all probability depress the nerves at the same time. E. Drugs acting on the Vessels of the Bronchi. — These are the same as have been already described as act- ing on the vascular system generally. F. Expectorants. — The modes of action of drugs acting on the respiratory system are so complex that it is usual to regard most of them clinically simply as drugs which hinder or aid the 68 PHARMACOLOGY AND THERAPEUTICS. expectoration of the contents of the bronchial tubes. Those which aid it are divided into two groups, named after their ac- tion, not on the lungs, but on the circulation. I. Sti7nidating expectorants. — These are stimulants to the circulation gen- (8) Balsam of Tolu. (9) " " Peru. (10) Turpentine preparations, (n) Terebene. (12) Oleum Pini Sylvestris. (13) Nux vomica. (14) Sulphur. -These depress the general circulation, erally. They are — (1) Acids. (2) Ammonium salts. (3) Cocillana. (4) Senega. (5) Squills. (6) Benzoin. (7) Benzoic acid. 2. Depressing Expectoi'ants. They are — (1) Alkalies. (2) Antimony salts. (3) Ipecacuanha. (4) Lobelia. (5) Jaborandi. (6) Apomorphine. (7) Iodide of potassium. Therapeutics. — It is almost impossible to lay down any general directions. The prescriber must consider in any case be- fore him whether he wishes to stimulate or to depress the circula- tion, to increase or to diminish or to disinfect the expectoration, to stimulate the respiratory centre, to overcome spasm of the bronchial tubes, or to allay a hacking cough ; and he must com- bine his remedies according to the answer he makes to these ques- tions. Warmth to the chest and warm drinks are sedative, and increase the amount of secretion. Cold and cold drinks have an opposite effect. Division IX. — Drugs acting on the Digestive Apparatus. A. Drugs acting on the Teeth. — Soaps and powders are used for cleaning the teeth. The basis of most tooth powders is chalk, which acts mechanically ; charcoal is sometimes used in the same way. As the food is very liable to collect and decom- pose between the teeth, antiseptics, as quinine, borax, and car- bolic acid, are often mixed with tooth powders. Astringents, DRUGS ACTING ON THE DIGESTIVE APPARATUS. 69 such as rhatany and areca nut, are employed if the gums are too vascular. Mineral acids and alum are injurious to the teeth if used for a long time, and iron is liable to stain them, therefore these substances are best taken through a glass tube, and should not be used as gargles for long periods. Toothache may be relieved by local anodynes, as opium, creosote, or pure carbolic acid. The tooth is plugged with absorbent cotton soaked in one of these. A piece of clean cot- ton must be placed over the carbolized cotton to prevent the car- bolic acid from reaching the mouth. B. Drugs acting on the Salivary Gland. — Much at- tention has been devoted to the submaxillary gland of the dog, and there is no reason for supposing that the other salivary glands of that animal or of other creatures differ markedly from it. We know that the submaxillary gland is under the influence of the chorda tympani nerve, which contains vaso-dilator fibres, and also some which directly modify the secretion of the gland apart from the secondary effects, due to the alterations in the vessels, obtained when the chorda tympani is stimulated. This nerve has its cen- tre in the medulla, and is capable of being excited reflexly by stimulation of many nerves, even the sciatic, but especially by stimulation of the gastric branches of the vagus, and by the ter- minations in the tongue and mouth of the glosso-pharyngeal and gustatory nerves. The gland is also supplied with sympathetic branches which proceed from the cervical sympathetic trunk ; these are vaso constrictor, and can also modify the quality of the secretion, but we do not know so much about them as we do about the chorda tympani. Drugs which increase the amount of saliva have been called sialogogues ; those which decrease it, anti-sial- ogogues. It is clear that there are very many ways in which each of these might act, but here it will suffice to enumerate only those ways in which they are known to act. 1. Sialogogues acting either on the secretory cells or upon the terminations of the nerves in them. — Of these jaborandi has been most studied, and, by means of the experiments it has been proved to act either on the cells themselves or the terminations of the 70 PHARMACOLOGY AND THERAPEUTICS. nerves in them. It acts equally well after section of all the nerves going to the gland. It acts when it is injected directly into the gland bat it is prevented from reaching the general cir- culation. If it has been given, stimulation of the chorda or sym- pathetic produces no more effect on the amount of secretion than can be easily explained by the vascular effects. Sialogogues falling under this heading are — (i) Jaborandi, (2) Muscarine, (3) Compounds of Iodine, (4) Mercury, (5) Tobacco, (6) Physostigmine. The last two probably act also by stimulating the centre in the medulla, for section of the chorda tympani decidedly lessens the secretion caused by them. Physostigmine soon ceases to cause an increase of the secretion, for it tightly contracts the vessels of the gland. 2. Sialogogues acting reflex ly by stimulating the peripheral ends of afferent nerves, — Of these there are two important varieties: (a) Those stimulating the gustatory and glosso-pharyngeal nerves in the mouth : (5) Ether. (6) All pungent substances, as mustard, ginger, &c. (1) All Acids and (2) Acid Salts. (3) Chloroform. (4) Alcohol. (6) Those stimulating the vagus in the stomach : Most emetics, especially Antimony and Ipecacuanha. 3. Anti-sialogogues acting either on the secreting cells or the terminations of the nerves in them. — Of these atropine has been most studied, and it is proved to act directly on the gland by the fact that the administration of it prevents any increase of salivary secretion on stimulation of the chorda, although the vessels dilate as usual. It is highly probable that it acts upon the nerve termina- tions, because even after considerable doses, quite paralyzing the secretion of chorda tympani saliva, stimulation of the sympathetic will still induce secretion. Anti-sialogogues falling under this heading are — (1) Belladonna, (2) Hyoscyamus, (3) Stramonium, and (4) Nicotine in excess. SIALOGOGUES. 7 1 4. Anti-sialogogues acting reflex ly by depressing the peripheral ends of afferent nerves. — Alkalies, opium, and any substances which allay irritation of the mouth. Part of the effect of opium is due to its depressing action on the medullary centre. Therapeutics. — A deficiency in the amount of saliva secre- ted is seen most markedly in fever, when the mouth becomes very dry, and the patient complains of thirst. Sometimes it is a disease in itself, and the origin of this malady is then probably nervous. It is a prominent symptom of belladonna poisoning. In fever, acid drinks, especially those containing carbonic acid gas, lemonade, etc., are of use as sialogogues. Drinks which re- lieve this febrile thirst are called Refrigerants. For the disease known as " dry mouth " jaborandi has been used, and it will relieve the dryness due to belladonna poisoning. Excessive sali- vary secretion is hardly met with except as a symptom of poison- ing, especially by mercury or jaborandi. In some forms of indi- gestion the saliva has a very unpleasant taste, and may even be diminished in quantity, but then the indication is to treat the in- digestion. C. Drugs acting on the Stomach. — Strictly speaking, we ought to consider these under the following heads : — (a). Those drugs which, either by modifying the secretion of pepsin, or in some other way directly influence the conversion of proteids into peptone, parapeptone and albumose. (<£). Those which in- fluence the property possessed by the gastric juice of curdling milk. (r). Those which modify the secretion of acid. (*/). Those which modify the secretion of mucus. ( Preparation, 1. Unguentum Potassii Iodidi. — Iodide of potassium, 12; hy- posulphite of sodium, I ; water, 6 ; benzoinated lard, 8 1 . Iodide of potassium is contained as a solvent in all pharmacopceial prepa- rations of iodine. 2. SODII IODIDUM.— Iodide of Sodium. Nal. Source. — Made from a solution of soda, as iodide of potassium is made from a solution of potash. Characters. — A white, deliquescent, crystalline powder, with a saline taste. Freely soluble in water, glycerine and alcohol. Dose, 5 to 30 gr.,' or more. 3. AMMONII IODIDUM.— Iodide of Ammonia. NH 4 I. Characters. — A white granular salt in minute, crystalline cubes, very deliquescent. Solubility. — In I part of water, 9 parts of alcohol. Impurities. — Iodates. Dose, 2 to 10 gr., or more. 4. SYRUPUS ACIDI HYDRIODICI.— Syrup of Hydriodic Acid contains I per cent, of absolute hydriodic acid. Source. — 10 parts of iodine, 80 parts of alcohol, 150 parts of syrup, 500 parts of sugar, 5 parts of spirit of orange, and distilled water to 1 000 parts. Characters. — A transparent, colorless liquid, of sweetish, acidulous taste and an acid reaction. Sp. gr. 1.300. Dose, X to I fl - dr - iodides of potassium and sodium. 203 Action of Iodides of Potassium and Sodium. External. — They have none. They do not irritate, nor are they absorbed by the unbroken skin. Internal. — It is often taught that iodine (which is supposed to be converted into iodide of sodium in the alimentary canal), and iodide of potassium (which also becomes iodide of sodium), both have the same internal action ; but free iodine is much more irritant to the gastro-intestinal tract than either the potas- sium or the sodium salt, and it is said to produce sexual excite- ment; but iodides have not this action. Therapeutically con- sidered, the iodides of sodium, ammonia and potassium also produce entirely different results from iodine. It is not known how they act, nor even in what form they are absorbed. They have in certain diseases a profound effect on nutrition, and it is said that they cause an increased elimination of uric acid. Oc- casionally considerable general depression is produced by large doses of iodide of potassium ; but this is probably due to the potassium, and not to the iodine, and in this case the syrup of hydriodic acid can be substituted. The form in which iodides are eliminated is not known ; but when they are taken in excess, a series of symptoms, due no doubt to their elimination by the skin and mucous membranes, takes place. They are frequently seen in patients taking iodides, and they are known as Iodism. lodism. — The patient complains of heavy pain over the frontal sinus, running at the nose, sore throat, increased secre- tion of saliva, and an eruption on the skin, consisting of patches of erythema. The inflammation about the fauces may spread to the gums or down the trachea, setting up laryngitis, tracheitis and bronchitis. The susceptibility of people to poisoning by iodides varies very much. Therapeutics of Iodides of Potassium and Sodium. The most important use of iodides is for syphilis ; their value for the primary and secondary stages is comparatively slight, but they are invaluable for the tertiary stages, as they often cause the rapid absorption of nodes, gummata -and other syphilitic depos- 204 INORGANIC MATERIA MEDICA. its. The pharmacopoeial dose may often be exceeded: patients sometimes take two, three, or even four drachms a day. Large doses are especially used in syphilis of the nervous system. Chronic rheumatoid arthritis is often treated, and sometimes with benefit, by small doses of iodide of potassium continued for a long while, but probably iodide of iron is more useful. Gonor- rhoeal rheumatism is often treated with iodide of potassium. It frequently aids the absorption of chronic inflammatory products, even when they are not syphilitic. Therefore certain forms of joint disease, of pleurisy and of pulmonary consolidation some- times yield to treatment by this drug. The attempt has been made to cure aneurisms which are inaccessible to surgery by giving iodide of potassium for long periods, for it is thought that it aids the coagulation of blood in them ; but as at the same time the patient is always kept in bed, it is difficult to say how much of any improvement that may happen to take place is due to the iodide. It is a valuable expectorant, particularly the ammonium salt, and sometimes cures cases of bronchitis when other remedies have failed. Lately, chronic Bright' s disease has been largely treated with this drug. Lardaceous disease of the kidneys and other organs is benefited by it. The potash salt is recommended for asthma, and in some cases does much good. It is occasionally given to decrease the secretion of milk. Iodide of potassium causes an increased excretion of both lead and mercury if they exist in the body, and it is therefore of great value in cases of chronic poisoning by these metals. Iodide of sodium is not so much used, but it probably produces the same effects as the potassium salts, but does not cause so much depression. III. BROMUM. Bromine. Symbol, Br. Combining weight, 79.8. (Officinal.) Source. — Obtained from sea water and saline springs. Characters. — A darkish, brownish-red, volatile liquid, with a strong and disagreeable odor. Sp. gr. 2.990. Solubility. — I in 33 of water. Impurity. — Iodine. Action. Like that of chlorine and iodine. It is rarely used in medicine. BROMIDES. 205 1. POTASSII BROMIDUM.— Bromide of Potassium. KBr. Source. — Made from bromine, liquor potassae, and charcoal in the same way as iodide of potassium. Characters. — Colorless cubic crystals, readily soluble in water, with a saline taste. Incompatibles. — Acids, acid salts, metallic salts. Dose, 5 to 60 gr. 2. SODII BROMIDUM.— Bromide of Sodium. NaBr. Source. — Made with soda as bromide of potassium is made from potash. Characters. — A granular white powder or small monoclinic crystals. Solubility. — In about 12 of water. Incompatibles. — Those of potassium bromide. Dose, 10 to 60 gr. 3. AMMONII BROMIDUM.— Bromide of Ammonium. NH 4 Br. Source. — Made by neutralizing hydrobromic acid with liquor ammoniae and crystallizing. Characters. — Colorless prismatic crystals with a pungent saline taste. Solubility. — I in 1.5 of water. Incompatibles. — Acids, acid salts, and spirit of nitrous ether. Impurities. — Iodides; free bromine. Dose, 5 to 30 gr. 4. LITHII BROMIDUM.— Bromide of Lithia. LiBr. Characters. — A white granular salt very deliquescent, odorless, with a very sharp and somewhat bitter taste. Solubility. — Very soluble in water and in alcohol. Dose, 5 to 20 gr. 5. CALCII BROMIDUM.— Bromide of Calcium. CaBr 2 . Source. — From bromide of ammonium and milk of lime, by filtration and evaporation. Characters. — A white granular salt, very deliquescent, odorless, having a pungent, saline, and bitter taste, and a neutral reaction. Soluble in 0.7 part of water and I part of alcohol. Dose, 15 to 30 gr. 6. ZINCI BROMIDUM.— Bromide of Zinc. ZnBr 2 . Source. — From zinc dissolved in a solution of hydrobromic acid. Characters. — A white granular powder, very deliquescent, odorless, having a sharp, saline and metallic taste, and a neutral reaction. Very soluble in water and alcohol. Dose, 1 to 5 gr. 206 inorganic materia medica. Action of Bromides. External. — They have none. Internal. — Alimentary canal. — Solutions of any of the first three bromides, frequently painted on the throat, diminish its sensibility. Medicinal doses have no othe reffect on the alimentary canal. All bromides are quickly converted into bromide of sodium in the stomach and intestines, and they are readily ab- sorbed. Nervous system. — Bromides are powerful depressants to the nervous system, this action of the potash salt being most marked. Thus, if an animal be given large doses of any of them, irritation of the cortical motor areas, which before easily excited movements, fails to do so. Experiments also show that the reflex excitability of the cord is considerably diminished, and that the activity of the sensory mechanism is also impaired, for large doses of bromides given to frogs cause cutaneous anaesthe- sia. In man at least, not only the cortical motor area, but the brain as a whole is depressed, therefore these drugs are powerful hypnotics. It is probable that in addition to the brain and spinal cord the peripheral nerves are depressed, so that bromides are well worthy to be called powerful nervous depressants. The activity of the muscles is also diminished, not only by the action of the drugs on the nervous system, but by their direct action on them. Circulation. — Here also bromides are depressant; large doses exert a direct paralyzing influence on the heart, lessening the force and the frequency of the beat and producing stop- page in diastole; the potash having the greatest effect, the soda salt has less influence ; the ammonia salt influencing the heart but little. They are said to cause vaso-motor spasm, but the evidence of this is very unsatisfactory. Toxic doses produce a fall of temperature; this is probably in some way secondary to the de- pression of the circulation. Respiration is slightly depressed by bromides. Metabolism. — The amount of carbonic acid exhaled is greatly decreased by taking large doses of bromides. The amount of BROMIDES. 207 urine is increased ; particularly after the use of the lithium salt, the coloring matters, the sulphur, and the nitrogen in it are in- creased; but the phosphorus is decreased. Sexual organs. — If bromides are taken for a long time a fail- ure of sexual vigor is produced, and ultimately there is a great lessening of the sexual appetite. Bromides are therefore anaphro- disiacs. Elimination. — Bromides are rapidly eliminated by the kid- neys, skin, saliva, intestinal mucous membrane, bronchial mucous membrane, and in milk. Bromism. — If bromides are taken for too long a period, a series of symptoms of poisoning, to which the above name has been given, may appear. The hydrobromic acid, although con- taining a larger proportion of bromine, rarely gives rise to bromism. The earliest of them is a rash, consisting of red papules, chiefly on the face and back, exactly resembling some forms of acne. This is probably the result of the excretion of bromide by the skin. The next symptoms are a general lowering of the cutane- ous sensibility and also of that of the pharynx, then there is diminution of sexual power, the patient becomes low-spirited, easily fatigued, unfit for work, and his intellect is dulled. There may be a little conjunctivitis, and some increased secretion from the bronchi. Bromide of potassium owes its action largely to the bromine in it, but probably also, to a less extent, to the potassium. In man at least, the higher functions of the brain are depressed be- fore the lower, and these again before the spinal. Thus the de- pression takes place in regular order from above downwards, in the reverse order of the physiological development of the func- tions, and this is commonly the case with many drugs (see Law of Dissolution, p. 92). Those who take bromides habitually find themselves unable to sleep without them, and their intellect becomes obscured. These bad effects are intensified by the fact that gradually larger doses are required to produce sleep, and thus the unfortunate suf- ferer becomes more and more a slave to the drug. 2os inorganic materia medica. Therapeutics of Bromides. External. — None. Internal. — Alimentary canal. — Formerly the back of the throat was painted with a solution of a bromide before a laryngeal examination, but now cocaine is employed for this purpose. Nervous system. — Because of their depressing effect bromides are largely used for many nervous diseases. They are the most valuable drugs we have for the treatment of epilepsy, acting no doubt by diminishing the excitability of the cerebral cortex. They rarely cure, but often greatly diminish the number of fits. It is impossible to say in any given case whether bromides will do good, therefore they must be tried in all; petit mal is more difficult to influence than grand mal. The next most common use of bromides is as hypnotics. They are most useful when there is no organic cause to explain the insomnia, and therefore they are not employed when pain keeps the patient awake, but are given with great benefit in the insomnia of overwork, worry, or that connected with the climacteric period. The sleep in- duced is quiet and refreshing, without dreams, and therefore these drugs are of great value in nightmare, and in the night-screaming of children, which may be regarded as allied to nightmare. Also because of their depressant effect on the nervous system they are given in migraine, and often they are the only drugs which do any good for the intense headache of this disease. Large doses, often a drachm at a time, are given in delirium tremens, espe- cially in combination with chloral, and sometimes the patient seems quieter for this treatment. Not only the insomnia, but the other nervous symptoms that are common at the climacteric per- iod may be relieved by bromides. For their depressing power on centres below the cortex they are used, and with good results, in laryngismus stridulus, and have been given in whooping-cough, but the benefit is not marked. Some cases of tetanus have recov- ered after enormous doses of bromides. Here their value is, no doubt, due to their power of diminishing the reflex function of the spinal cord. Bromides have been given as antidotes for SULPHUR. 209 strychnine poisoning. Sometimes they succeed in cases of hysteria and neuralgia. Sexual functions — Because of its depressant effect bromide of potassium is given for spermatorrhoea and nymphomania. 7. ACIDUM HYDROBROMICUM D I LUTUM.- Diluted Hydro- bromic Acid. HBr. Source. — Hydrogen sulphide is passed through bromine mixed with water. H 2 S-|-2Br— 2HBr_|-S. The ac j^ j s distilled over and diluted with water. Characters. — A clear colorless acid liquid, with a strongly acid taste. Sp gr. 1.077. Contains 10 per cent, of absolute hydrobromic acid. Dose, yi to 1 fl. dr. Action and Therapeutics. The action of this acid appears to be the same as that of the bromides of the alkaline metals, but it is very rarely used for the same purposes. It has been employed with occasional success to relieve noises in the ears, and it is said to prevent the symptoms of poisoning by quinine; of this drug it is an excellent solvent. GROUP X. Containing Sulphur only. SULPHUR. Symbol, S. Combining weight, 32. Sulphur is officinal in three forms. 1. SULPHUR SUB LI MATUM.— Sublimed Sulphur. Synonym.— Flowers of sulphur. Source. — From crude sulphur by sublimation. Characters. — A fine, citron-yellow powder of a slight characteristic taste. Impurities. — Sulphurous and sulphuric acids, sulphide of arsenic, earthy matters. Dose, 15 to 60 gr. Preparation. 1. Unguentum Sulphuris. — Sublimed sulphur, 30 ; benzoinated lard, 70. 2. SULPHUR PRJECIPITATUM.— Precipitated Sulphur. Syno- nym. — Milk of sulphur. 2IO INORGANIC MATERIA MEDICA. Source. — Boil sublimed sulphur with slaked lime in water. i2S-|-3Ca H 2 2 =2CaS 5 -|-CaS 2 3 - r -3H 2 0. This gives a solution containing calcium sulphide and calcium hyposulphite. To it hydrochloric acid is added, and sulphur is thrown down as a very fine precipitate. 2CaS 5 -p-CaS 2 3 -|-6HCl— 3 CaCl 2 +6S 2 +3H 2 0. Characters. — A fine yellowish- white amorphous powder, almost tasteless. Impurity. — Sulphate of lime, which makes it gritty. Dose, 15 to 60 gr. 3. SULPHUR LOTUM.- Washed Sulphur. Source. — Sublimed sulphur diluted with water of ammonia and the precipitate washed with water. Characters. — A fine, citron-yellow powder, odorless and almost tasteless. Insoluble in water. Impurities. — Acids, arsenious acid, and arsenious sulphide. Preparation. 1. Unguentum Sulphuris Alkalinum. — Washed sulphur, 20; carbonate of potassium, 10 ; water, 5; benzoinated lard, 65. Washed sulphur is contained in Pulvis Glycyrrhizte Compositus. Action of Sulphur. External. — Sulphur itself has no action on the skin, but some of it is converted into sulphuretted hydrogen and that is a mild vascular stimulant causing slight dilatation of the vessels and in some persons eczema. It kills the Sarcoptes scabiei, and is therefore a parasiticide. Internal. — Alimentary canal. — It has no effect on the stom- ach, and most that is taken is passed out in the faeces unaltered. A certain amount is, in the intestine, converted into sulphuretted hydrogen and other sulphides. These cause a mild laxative effect, increasing the secretion of intestinal juice, and slightly stimulating the muscular coat, producing soft semi-liquid stools, sometimes accompanied by flatus of sulphuretted hydrogen, which, if in sufficient quantity, makes sulphur an undesirable laxative. Remote effects. — Sulphur is absorbed as sulphides and sulphur- etted hydrogen, which is a powerful poison, decomposing the blood and thus producing symptoms of asphyxia. It also para- SULPHUR. 211 lyzes the whole nervous and muscular systems, but sulphur is never given to man in sufficient doses to produce any remote effects. Patients taking sulphur get rid of some minute portion of it as sulphuretted hydrogen through the kidneys, the milk, the lungs, and skin. The breath occasionally smells of it, and silver ornaments next to the skin may be discolored. Therapeutics of Sulphur. External. — Sulphur is commonly used to kill the Sarcoptes scabiei, and thus to cure scabies. The skin should be well scrubbed with soft soap and hot water to lay open the burrows. Then it is thoroughly rubbed with the ointment. The patient should do this before bedtime, sleep in flannel, and wash the ointment off the next morning. This proceeding repeated three or four times will generally cure the disease. Sulphur ointment was formerly applied as a stimulant to ulcers, and was rubbed in for chronic rheumatism, but these modes of treatment are now rarely used, and their value is doubtful. Mineral water contain- ing sulphur is useful for chronic rheumatism, as, for example, that of Richfield Springs. Mild sulphur preparations are applied for acne. Internal. — Alimentary canal. — Sulphur is a very good laxa- tive, especially for children; as it produces a soft motion but no pain, it is useful for cases of piles or fissure of the anus. Washed sulphur is contained in compound liquorice powder, which is an excellent and popular laxative. One or two sulphur lozenges of the B. P., each containing five grains of precipitated sulphur and one grain of acid tartrate of potassium, taken at bedtime often secure an easy evacuation of the bowels the next morning, in per- sons liable to slight constipation. These lozenges have been recommended for constipation associated with hepatic disease. Remote effects.— Sulphur has been administered internally for all sorts of skin diseases, generally without any good result, but occasionally chronic eczema associated with much itching appears to be benefited by it, so that the sulphur lozenge is a suitable lax- ative for these cases. Sulphur has been also given for bronchitis, 212 INORGANIC MATERIA MEDICA. for chronic rheumatism, and rheumatic myalgia, but it is very- doubtful whether in these diseases there is much relief from this treatment. 4. POTASSA SULPHURATA.- Sulphurated Potash. Synonym.— Liver of sulphur. A mixture consisting for the most part of hyposulphite of potassium (K 2 S 2 3 ) and the sulphide of potassium (K 2 S 3 ). Source. — Heat in a crucible a mixture of sublimed sulphur and carbonate of potassium. 3K 2 C0 3 +8S=K 2 S 2 3 +2K 2 S 3 +3C0 2 . Characters. — Dull greenish-yellow solid masses, the freshly broken surfaces of which are liver-colored. Solubility. — In 2 parts of water. 5. CALX SULPHURATA. See Lime, p. 134. 6. SULPHURIS IODIDUM.— Iodide of Sulphur. SI. Source. — Heating I part of washed sulphur with 4 parts of iodine to liquefaction, when solid, after cooling, reduce the fused mass to pieces. Characters. —A grayish-black solid, generally in pieces, having the characteristic odor of iodine, an acrid taste and faintly acid reaction. Solubility. — Insoluble in water. Dose, 1 to 4 gr. Action of Sulphurated Potash, Sulphurated Lime, and Iodide of Sulphur. External. — These preparations are irritant, and are power- ful parasiticides for the Sarcoptes scabiei. Internal. — Nothing is known of their internal action. Therapeutics of Sulphurated Potash, Sulphurated Lime, and Iodide of Sulphur. External. —Either of the ointments will cure scabies, and the sulphurated potash ointment (B. P. — Sulphurated potash, 5 ; hard paraffin, 18; soft paraffin, 55 ;) is often used for this purpose in the same way as sulphur ointment. Both drugs have been used for many chronic skin diseases, but now they are not often em- ployed. They appear, however, occasionally to do good in cases of acne indurata. Baths containing sulphides in solution are considered by many to be very useful for chronic rheumatic arthritis and rheumatic myalgia. The famous natural sulphide baths are those of Aix-la-Chapelle. Aix-les-Bains, and there are ACIDS. 213 many others, which will be found described in works on general therapeutics; but as in all of them the water is warm, and warm water is beneficial for chronic rheumatism, and the sulphides exist in infinitesimally small quantities, it is very probable that the benefit is due more to the heat of the water than to its con- stituents. Internal. — Sulphides have been given for chronic rheu- matism, various skin diseases, and phthisis, but the evidence of good done is scanty. GROUP XI. Acids. Those acids which will be considered here may be divided into two classes. First, those which are strongly acid, the more powerfully acid being active caustics. They are Sulphuric, Nitric, Hydrochloric, Nitro -hydrochloric, Phosphoric, Acetic, Tartaric, Citric, and Lactic acids. Hydrobromic and hydriodic acids might be placed here, but they have already been c >n- sidered (see pp. 202 and 209). Second, those which, although feebly acid, are powerfully antiseptic. They are Boric and Sulphurous acids. Dilute hydrocyanic, carbolic, benzoic, gallic, tannic, oleic, and salicylic acids are not used as acids, and will be considered under other headings. Arsenious acid and chromic acid are not true acids ; they are anhydrides, and have already been considered [see pp. 184 and 193). Class I. 1. ACIDUM SULPHURICUM.— Sulphuric Acid. H 2 S0 4 . Source. — Produced by the combustion of sulphur, and the oxidization and hydration of the resulting sulphurous acid gas by means of nitrous and aqueous vapors. Characters. — A colorless liquid of an oily appearance, intensely acid and caustic. Sp. gr. I '840. Contains not less than 96 per cent, absolute sulphuric acid. Impurities. — Nitric acid, lead, arsenic. Incompatibles. — Alkalies, their carbonates, lead, and calcium salts. Preparations. 1. Acidum Sulphuricum Dilutum. — Sulphuric acid, 1 ; dis- tilled water, 9. Sp. gr. 1.067. Dose, 10 to 30 m. 214 INORGANIC MATERIA MEDICA. 2. Acidum Sulphuricum Aromaticum. — Sulphuric acid, 200; oil of cinnamon, 1 ; tincture of ginger, 45 ; alcohol, a sufficient quantity to make 1000; Sp. gr. 0.95. Dose, 5 to 15 m. It is contained in Infusum Cinchonse. 2. ACIDUM NITRICUM.— Nitric Acid. HN0 3 . Source. — Made from nitrate of potassium or nitrate of sodium by distill- ing with sulphuric acid. KN0 3 +H 2 S0 4 =rKHS0 4 -j-HN0 3 . Characters. — A colorless, fuming, very caustic and corrosive liquid. Sp. gr. 1.420. Contains 69.4 per cent, absolute nitric acid. Impurities. — Sulphuric acid, nitre, and lower oxides of nitrogen, giving ruddy fumes. Incompatibles. — Alcohol, alkalies, carbonates, oxides, sulphate of iron, acetate of lead. Preparations. 1. Acidum Nitricum Dilutum. — Nitric acid, 1; distilled water, 6. Sp. gr. 1.059. Dose, 5 to 30 m. 2. Acidum Nitro-hydrochloricum. — Nitric acid, 4; hydro- chloric acid, 15. 3. Acidum Nitro-hydrochloricum Dilutum. — Nitric acid, 4; hydrochloric acid, 15; distilled water, 76. Contains free chlorine, hydrochloric, nitric and nitrous acids, and other compounds dissolved in water. Dose, 5 to 30 m. 3. ACIDUM HYDROCHLORICUM.— Hydrochloric Acid. HC1. Source. — The fumes produced by the action of sulphuric acid on chlo- ride of sodium are dissolved in water. Characters. — A colorless, very acid, fuming liquid. Sp. gr. 1.160. Contains 31.9 per cent, absolute hydrochloric acid. Incompatibles. — Lead and silver salts, alkalies and their carbonates. Preparations, 1. Acidum Hydrochloricum Dilutum. Hydrochloric acid, 6; distilled water, 13. Sp. gr. T.049. Dose, 5 to 20 m. 2. Acidum Nitro-hydrochloricum Dilutum. See Nitric Acid. 4. ACIDUM PHOSPHORICUM. See Phosphorus. 5. ACIDUM ACETICUM. Acetic Acid. HC 2 H 3 2 . Source. — Obtained from wood by destructive distillation and purification. ACIDS. 215 Characters. — A clear, colorless liquid. Sp. gr. 1.048. Contains 36 per cent, of absolute acetic acid. Impurities.— Lead and copper, sulphuric, hydrochloric and sulphurous acids. Preparation. Acidum Aceticum Dilutum. — Acetic acid, 17; distilled water, 83. Dose, 1 to 8 fl. dr. 6. ACIDUM ACETICUM GLACIALE. — Glacial Acetic Acid. HCgHgOg. Source. — Distil dry acetate of sodium with strong sulphuric acid. NaC 2 H 3 2 +H 2 S0 4 ==:HC 2 H 3 2 +NaHS0 4 . Characters. — A colorless, very acid liquid, crystallizing below 6o° F. Sp gr. 1.056 to 1.058. Contains at least 99 per cent, absolute acetic acid. 7. ACIDUM CITRICUM.— Citric Acid. H 3 C 6 H 5 7 ,H 2 0. Source. — Found in the fruits of the lime {Citrus bergamia) and lemon [Citrus limonum). Chalk is added to the boiling juice, usually lemon juice. 2H 3 C 6 H 5 7 +3CaC0 3 =Ca 3 (C 6 H 5 7 ) 2 4-3C0 2 + 3H 2 0. The precipitated citrate of calcium is boiled with sulphuric acid. After filtration and evaporation, citric acid crystallizes out. Ca 3 (C 6 H 5 7 ) 2 -f3H 2 S0 4 =2H 3 C 6 H 5 7 +3CaS0 4 . Characters. — Colorless right-rhombic prisms, very soluble in water. Citric acid, like tartaric acid is often used to produce an effervescing mixture with the carbonates of ammonium, sodium or potassium, the two solutions being mixed immediately before taking. The carbonic acid gas which causes the effervescence is formed thus: — 3KHC0 3 +H 3 C 6 H 5 7 =K 3 C 6 H 5 7 +3C0 2 + 3 H 2 0. Incompatibles. — Tartrate of potassium, alkaline carbonates, acetates. Impurities. — Copper, lead, sulphuric and tartaric acids, mineral matters. Free citric acid is contained in Limonis Succus, Syrupus Limonis, Mistura Potassii Citratis. Dose, 5 to 30 gr. 8. SYRUPUS ACIDI CITRICI.— Citric Acid, 8 parts; water, 8 parts ; spirit of Lemon, 4 parts ; syrup, 980 parts. Dose, 1 to 4 fl. dr. 9. ACIDUM TARTARICUM.— Tartaric acid. H 2 C 4 H 4 6 . Source. — Boil acid tartrate of potassium with carbonate of calcium. 2K H,C 4 H 4 6 +CaC0 3 =CaC 4 H 4 6 -(-K 2 C 4 H 4 6 -hH 2 04-C0 2 . Chloride of cal- cium is now added. This precipitates more tartrate of calcium. K 2 C 4 H 4 6 -|- Ca0 2 =CaC 4 H 4 6 -|-2KCl. The tartrate of calcium is finally decomposed with sulphuric acid. CaC 4 H 4 6 -f-H 2 S0 4 =H 2 C 4 H 4 6 -j-CaS0 4 . Then evaporate the fluid to sp. gr. 1.25. Separate the sulphate of calcium crystals that form. Again evaporate, tartaric acid crystallizes out. 2l6 INORGANIC MATERIA MEDICA. Characters. — Colorless, transparent monoclinic prisms, longer than those of citric acid. Very soluble in water. Incompatibles. — Salts of potassium, calcium, mercury, lead, vegetable astringents. Impurities. — Lead, oxalic acid, lime, and tartrate of potassium. Dose, 10 to 30 gr. 10. ACIDUM LACTICUM. -Lactic acid. HC 3 H 5 3 . Source. — Ferment a mixture of sugar, sour milk, old cheese, chalk, and water. At the end of a week lactate of calcium is formed. It is separated and decomposed with dilute sulphuric acid. Characters. — A colorless syrupy liquid. Sp. gr. 1.212. Contains 75 per cent, of absolute lactic acid. Mixes well with water, alcohol, and ether. Impurities. — Mineral acids, sugar, lead, and iron. Preparation. 1. Syrupus Calcii Lactophosphatis. — (See Lime, p. 134). Action of Sulphuric, Nitric, Hydrochloric, Phosphoric, Acetic, Citric, Tartaric and Lactic Acids. External. — All these acids are powerful irritants when applied externally. The feeblest is citric. Its concentrated so- lution has no action on the sound skin, but is irritant to mucous membranes and abraded surfaces. Tartaric is stronger than citric acid ; it will act upon the unabraded skin, and applied to a sore it produces pain, a sensation of burning, and considerable vascular dilatation. The remaining acids are very powerful irri- tants, therefore even weak dilute solutions of them may produce considerable redness and perhaps vesication, and when the solu- tion is strong they are very energetic caustics ; sulphuric and phosphoric acids, having a powerful affinity for water, are espe- cially active. Sulphuric acid leaves the carbon untouched, there- fore it blackens ; nitric stains the skin a deep yellow, it does not redissolve the albumen it precipitates, and it is consequently lim- ited in its area of action ; nitro-hydrochloric is very powerful ; hydrochloric is the least active of the mineral acids ; glacial acetic acid is useful when a limited action is required. All the stronger acids unite with and coagulate albumen ; hence weak solu- tions, not strong enough to form a slough, which by its separa- ACIDS. 217 tion may cause bleeding, will, by coagulating the blood and so plugging the vessels, and by coagulating the albumen in the tis- sues and so constricting the vessels, act as astringents and haemostatics. Dilute solutions of acids are cooling to the flushed skin of fever, therefore they are called refrigerants. Internal. — Mouth. — All acids have a peculiar taste, and give rise to a feeling of roughness about the teeth. As the saliva is alkaline they increase the amount secreted, consequently by keeping the mouth moist they allay thirst. Stomach. — It is believed that, if given during a meal, acids will check the flow of gastric juice, as that is an acid secretion. When the amount of acid secreted by the gastric mucous mem- brane is deficient, acids taken after a meal, when all that the stomach can secrete has been secreted, aid digestion. Intestine. — Acids quickly become converted into neutral salts, and are probably absorbed as such. Some, especially sulphuric (diluted), preserve in the intestine their astringent action. They increase the amount of bile poured into the intestine, and are hence cholagogues ; this is especially the case with nitric acid. Nitro-hydrochloric acid is a very complex compound ; as far as is known it possesses the action of mineral acids generally. Remote effects. — Acids may render the blood less alkaline, but never acid. They do this by combining with some of the alkali of the plasma. Phosphoric acid is believed to increase the amount of phosphates in the red blood-corpuscles. It is probable that in their passage through the liver they check the formation of urea. The reason for this belief is that all these acids, except citric, acetic, tartaric and lactic, are excreted in the urine chiefly as ammoniacal salts. Nitric acid is stated to be excreted to a small extent as ammonia, and hence slightly to increase the alka- linity of the urine. Acetic, citric and tartaric acids are decom- posed in the blood, alkaline carbonates being formed, and the alkalinity of the urine is increased. This has already been dis- cussed {see p. 58). Lactic acid is either converted into a car- bonate of an alkali, or passed out as carbonic acid gas in solution in the urine. 19 2l8 inorganic materia medica. Therapeutics of Sulphuric, Nitric, Hydrochloric, Phos- phoric, Acetic, Citric, Tartaric and Lactic Acids. External. — Nitric acid is more often used as a caustic than the others, for, owing to their great affinity for water, it is diffi- cult to limit the action of sulphuric and phosphoric acids : and the remaining acids are not so powerful as nitric acid. It is em- ployed to destroy warts, condylomata, unhealthy phagedaenic sores, cancrum oris, etc., etc. Glacial acetic acid is used for small warts and corns. If this causes pain it may be diluted. Very diluted solutions are rarely employed for their irritant effects, but at some bathing establishments acid baths are used, but it is not proved that they do any good. Any well-diluted acid, especially sulphuric, may be applied to check slight bleed- ing, as that of leech -bites, piles, etc. Vinegar can always be ob- tained ; even this should be diluted. In fever the skin is often bathed with vinegar as a refrigerant, and very dilute sulphuric acid is used as a local astringent in the sweating of phthisis. Internal. — Mouth. — As acids damage the teeth they should be taken through a glass tube. Lemon juice or citric acid itself is often used to stimulate the secretion of saliva, and hence allay the thirst of fever patients. Lemonade is a favorite drink for this purpose. Lactic acid has been strongly recommended to dissolve off the membrane in diphtheria, but there is no evidence that this treatment benefits the patient. Equal parts of lactic acid and water may be applied with a mop, or a spray of a strength of 5J to 5j of water may be employed. Very dilute nitric acid has been used for the same purpose. Stomach and intestines. — Hydrochloric, and to a less extent nitro-hydrochloric acids are of the greatest value to that variety of dyspepsia in which the acidity of the gastric juice is deficient. They -should, as already explained, be given some little while after a meal. A very usual stomachic mixture consists of dilute nitro-hydrochloric acid combined with tincture of nux vomica, and some other stomachic, as compound tincture of gentian. Lactic acid has been used for the same purpose. Acids will often alleviate that form of indigestion in which the patient com- ACIDS. 219 plains of acid eructations and heartburn. For this purpose they should be given during a meal or before it. They then check the excessive secretion of acid and restrain fermentation. An acid mixture sometimes benefits the indigestion of pregnancy. Vinegar is often drunk to reduce obesity, but it only does so be- cause a long course of any acid will set up a mild gastritis, and thus hinder the digestion and absorption of food. Carbonic acid, taken in an effervescing mixture, is a common and very effica- cious gastric sedative, beneficial, therefore, in painful dyspepsia and in vomiting. Dilute sulphuric acid may be used as a haemo- static in bleeding from the stomach or intestines, but its action is feeble. It is, however, successful as an astringent in many cases of summer diarhoea. Nitric and nitro-hydrochloric acids, increasing the amount of bile poured into the intestine, are given, and sometimes with much benefit, when it is considered that dyspepsia is due to disordered function of the liver. Remote effects. — The remote effects of citric, tartaric, and acetic acids have already been described (p. 58). They are due to the increase in the alkalinity of the blood and the urine. Phosphoric acid is often given to weak, sickly, anaemic children with the view of improving the quality of the red blood-corpus- cles, and possibly aiding the growth of bones, but it has not been proved to have any great value. The same may be said of the vegetable acids when employed for scurvy, and of lactic and phosphoric acids when given for diabetes ; indeed, the latter is said to do harm. Lime juice was formerly a popular remedy for acute rheumatism, but it did little if any good. Sulphuric acid is by some said to be anhidrotic in the night sweating of phthisis, and had some reputation as a remote haemostatic, but it is rarely given now for these purposes. Rohrig found that acids diminished the tracheal secretion, and some physicians find that they diminish the secretions in bronchitis. We thus see that the remote effects of all acids, except citric, tartaric and acetic, are unimportant. Toxicology. All these acids are severe gastro-intestinal irritants when given in toxic doses. Tartaric, citric, and lactic are very rarely taken as poisons. The symp- 220 INORGANIC MATERIA MEDICA. toms produced by the whole class are severe burning pain extending from the mouth to the stomach, excoriation of the mouth with the formation of sloughs, great difficulty in swallowing, vomiting of dark-brown coffee -colored material and shreds of mucus, intense abdominal pain aggravated by the slightest move- ment, generally obstinate constipation, but if the bowels are open the motions are dark, from the blood contained in them. Some of the acid generally passes down to the larynx and causes swelling of that organ, and consequently dys- pnoea from obstruction to respiration. The patient becomes cold, collapsed, and covered with a cold sweat; his pulse is very feeble, and he suffers from great thirst. Post mortem. — The mucous membrane of the mouth and oesophagus is softened and corroded, and whitish-gray sloughs and haemorrhages may be seen here and there. The coats of the stomach are softened. It is often contracted, and it may be perforated, the aperture being irregular. If the acid escapes into the peritoneal cavity, it may act on almost any of the abdominal organs. Should the patient have lived long enough, there may be corrosion and inflammation of parts of the small intestine. The mucous membrane of the throat and larynx is inflamed and swollen. Treatment. — Alkalies should be given at once, e. g. soap and water, lime water, magnesia, washing soda ; and then demulcents, as milk, white of egg y oil, linseed tea. Do not use the stomach tube if sulphuric acid has been taken, otherwise wash out the stomach. Morphine may be injected subcutaneously for the pain, and brandy subcutaneously for the collapse. Class II. i. ACIDUM SULPHUROSUM.— Sulphurous Acid. H 2 S0 3 . Source. — Sulphuric acid is heated with charcoal, and the resulting sul- phurous anhydride is dissolved in water. 4.H 2 S0 4 -[-C 2 =4S0 2 -J-2C0 2 -f-4H 2 0. Characters. — A colorless liquid with a sulphurous odor. Sp. gr. 1.023. Contains about 3.5 per cent, of sulphurous acid gas. Impurities. — Sulphuric acid, mineral matters. Dose, y 2 to 2 fl. dr. Best given in Mistura Amygdalae. Action. External. — Sulphurous acid is strongly deoxidizing, and as it takes up oxygen so easily from organic bodies, it readily de- composes them, becoming itself converted into sulphuric acid, and hence is irritant, but not violently so, for the amount of sul- phuric acid in proportion to the water is slight. It is a disin- fectant and deodorant; for, in virtue of its property of absorbing oxygen, it destroys micro-organisms and arrests fer- mentation. When applied to the skin it is a parasiticide. ACIDS. 221 Internal. — It is believed to act as a disinfectant in the stomach and intestines, but it is very doubtful whether enough of it to have any appreciable action in this direction can be safely taken. Therapeutics. External. — Sulphurous acid is chiefly used as an antiseptic, disinfectant, and deodorant. Sulphurous anhydride is employed as a disinfectant for a sick room after a patient with an infectious disease has been in it. The chimneys and windows should be stopped up. A quarter- to half a pound or more of flowers of sulphur or, better, one or two sulphur candles, now to be found in pharmacies, are placed in an earthenware vessel and lighted. The door is shut, and the cracks around it pasted over. The room should be left untouched for six hours. Generally not enough sulphur is burned for this method to be efficacious. Sulphurous acid (3ij to 5j of water) is locally applied to cure ringworm. Foul sores may be washed with it. Internal. — Sulphurous acid is sometimes given internally with the object of preventing abnormal fermentation in the stomach and intestines in certain varieties of dyspepsia, but there is no clinical proof that it can do this, and it should be remem- bered that it is possible it may do harm by impeding the action of the normal ferments. 2. POTASSII SULPHIS.— Sulphite of Potassium. K 2 S0 3 ,2H 2 0. Source. — By passing sulphurous acid gas through a solution of carbonate of potassium. Characters. — White, opaque, obliquely rhombic, octahedral crystals, or a crystalline powder, somewhat deliquescent, odorless, having a bitter, saline and sulphurous taste, and a neutral or feebly alkaline reaction. Soluble in 4 parts of water, only sparingly soluble in alcohol. Dose, 2 to 10 gr. 3. MAGNESII SULPHIS. Sulphite of Magnesium. MgS0 3 ,6H 2 0. Source. — By double decomposition between magnesium sulphate and neutral sodium sulphite. Characters. — A white, crystalline powder, odorless, having a slightly bitter and somewhat sulphurous taste, and a neutral or slightly alkaline reac- tion. Soluble in 20 parts of water ; insoluble in alcohol. Dose, 10 to 30 gr. 22 2 INORGANIC MATERIA MEDICA. 4. SODII BISULPHIS, 5. SODII SULPHIS, and 6. SODII HYPOSULPHIS, See Sodium, p. 123. Action and Therapeutics. The sulphites have the same action as sulphurous acid, but are better for internal administration. 5. ACIDUM BORICUM.— Boric Acid, H 3 B0 3 . Synonym.— Bora- cic acid. Source. — Native, or made by the action of sulphuric acid on borax. Characters. — Transparent, colorless, six-sided plates, feebly acid. Solu- bility. — 1 in 25 of cold water, I in 3 of boiling water, I in 5 of glycerine, I in 5 of boiling alcohol. Dose, 5 to 15 gr. 6. SODII BORAS.— Borate of Sodium. Na 2 B 4 7 , ioH 2 0. Synonym.— Borax. Source. — Boil together boric acid and carbonate of sodium. Also found native. Characters. — Colorless, transparent, shining, monoclinic prisms of alka- line taste and reaction. Solubility.—! in 16 of cold water, I in I of glycerine. Dose, 5 to 30 gr. Action of Boric Acid and Borax. Both boric acid and borax have the power of destroying micro- organisms, and are thus disinfectant and antiseptic, but their exact value has not been satisfactorily determined. The action is extremely local. Solutions of boric acid will relieve itching. Neither substance produces any irritation. We know nothing of their internal action except that large doses are gastro-intestinal irritants. Therapeutics of Boric Acid and Borax. As they do not irritate, both these substances are largely used to keep wounds, ulcers, and sores sweet. The action is so local that they cannot be used to dress cavities. Boracic lint is em- ployed to dress wounds. It is made by passing lint through a hot saturated solution of boric acid. A saturated solution of boric acid (4 per cent.), or a watery solution of 1 in 40 of the prepara- tion known as boroglyceride — consisting of 92 parts of glycerine heated with '62 of boric acid, a tough, deliquescent mass, which CHARCOAL. 223 is readily soluble in alcohol and water — may be used as an anti- septic wash. Such solutions are used for ozaena, vaginitis, urethritis, and ophthalmia. Thompson's fluid (borax, 1 oz. ; glycerine, 2 fl. oz. ; water, 2 fl. oz.), in the proportion of J^ fl. oz. to 4 fl. oz. of warm water, is commonly employed to wash out the bladder in cystitis. The glycerine of the B. P., which is, borax, 1, water, 2, glycerine, 4, and the honey of borax, of the B. P., which is, borax, 2, glycerine, 1, clarified honey, 16, are excellent applications for aphthous states of the mouth, espe- cially in children. The following is a good wash for the mouth : Glycerine of borax, B. P., 3jj tincture of myrrh, 10 tt[ ; water to 5j. Borax has been given, occasionally with benefit, in epi- lepsy. In rare cases its use has caused psoriasis. Boric acid is not employed internally in medicine. GROUP XII. CARBON AND ITS COMPOUNDS. Class I. — Carbon. CARBO. Carbon. Symbol, C. Combining weight, 12. Carbon is officinal in three forms : 1. CARBO AN I MALI S. Synonyms. — Animal charcoal. Bone-black. Source. — Expose bones to red heat without access of air, and then pow- der them. Characters. — Dull, black-granularfragments in powder. Insoluble in water. Contains pure carbon 14 percent.; the residue consists chiefly of phosphate and carbonate of calcium. 2. CARBO ANIMALIS PURIFICATUS.— Purified Animal Char- coal. Source. — Digest animal charcoal with dilute hydrochloric acid. Filter, wash and heat the residue to redness in a closed crucible. Characters. — A dull black, odorless, tasteless powder. Should contain no salts. Dose, 20 to 60 gr. ; ]/ 2 oz. or more as an antidote. 224 INORGANIC MATERIA MEDICA. 3. CARBO LIGNI.— Wood Charcoal. Source. — Wood charred without access of air. Characters. — Black, brittle, porous masses, the shape of the wood. Dose, 20 to 60 gr. Action. External. — Dry charcoal absorbs gases and condenses them within its pores. It thus absorbs oxygen, and hence has an oxidizing power, parting with the absorbed oxygen to oxidize organic and other substances. Therefore it is disinfectant and deodorant. It attracts and oxidizes coloring matters, and consequently decolorizes them. Internal. — It has no known internal action, for it can only absorb gases when dry, and it is quickly wetted when taken in- ternally. It is passed in the faeces unchanged. Therapeutics. External. — Charcoal has been recommended as an antiseptic and deodorant for foul ulcers, etc., but it is of very little use, for the discharges soon moisten it. For the same reason the poul- tice of the B. P. (wood charcoal, 1 ; flaxseed meal, 3 \ bread crumb, 4; boiling water, 20), although some of the charcoal is put on dry, is a bad preparation. Charcoal is used in pharmacy as a decolorizing agent. Internal. — It has been given as a powder, as lozenges, and as biscuits, with the object of preventing fermentation in the stomach, but it cannot be any use after it is wetted. Garrod has shown that a table-spoonful or larger doses of charcoal frequently repeated, are antidotes against most active vegetable poisons, as opium, nux vomica, and aconite, for charcoal seems to have a special attraction for alkaloids. Animal charcoal is the best form to give as an antidote. Charcoal is used as a tooth powder. Class II. — Alcohol, Ether, and Chloroform. These substances produce local anaesthesia by evaporation. They are rubefacient if their vapor is confined. The stomach, heart, and central nervous system are first stimulated and then depressed by them. ALCOHOL. 225 ALCOHOL. Ethylic Alcohol. C 2 H 5 , OH. Alcohol is officinal in the seven following forms : 1. ALCOHOL. Source. — Macerate rectified spirit with carbonate of potassium to remove the water, then again with freshly fused chloride of calcium, and distil. Characters. — A colorless fluid, free from odor. Sp.gr, 0.820. Contains 91 per cent, by weight of alcohol. Boils at 172.4 F. Entirely volatilized. Impurities. — Resins or oils, detected by turbidity on dilution. Preparation. — Used to make chloroform. 2. ALCOHOL DILUTUM.— Diluted alcohol. Alcohol, 50; Dis- tilled Water, 50. Characters. — Contains 45.5 per cent, by weight of alcohol. Sp. gr. 0.928. 3. SPIRITUS VINI GALLICI. Synonym.— Brandy. Source. — Spirits distilled from French wine. Characters. — Pale amber color, peculiar flavor. Contains 39 to 47 per cent, by weight of alcohol, with a volatile oil and several ethers. Sp. gr, 0.925 to 0.941. 4. SPIRITUS FRUMENTI.— Whisky. Source. — Spirits distilled from fermented grain. Characters. — An amber-colored liquid of distinctive taste and odor. Sp. gr. 0.917 to 0.930. Contains 44 to 50 per cent, by weight of alcohol. 5. VINUM ALBUM.— White Wine. Source. — By fermentation from the unmodified juice of the grape, freed from seeds, stems and skins. Characters. — Pale color, with fruity, agreeable taste. Contains between 10 and 12 per cent, by weight of alcohol. Sp. gr. 0.990 to 1.010. 6. VINUM ALBUM FORTIUS.— Stronger White Wine. White wine, 7 ; alcohol, I . Contains 20 to 25 per cent, by weight of alcohol. 7. VINUM RUBRUM. Source. — By fermenting the juice of colored grapes in the presence of their skins. ■ Characters. — A deep-red alcoholic liquid, of fruity, moderately astrin- gent, pleasant taste. Sp. gr., 0.989 to 1. 010. 20 226 INORGANIC MATERIA MEDICA. Amount of Absolute Alcohol by Weight in various Important Substances. Alcohol Ethylicum (B. P.) . . . contains 98 to 99 per cent. Alcohol. .......... " 91 u Spiritus Rectificatus (B. P.) . . " 84 " Spiritus .Vini Gallici ...-■". 39 to 47 '« Whisky ........... " 44 to 50 " Rum, Gin, Strong Liqueurs . . " .40 to 50 " Alcohol Dilutum . ...... " 54.5 * Spiritus Tenuior (B. P.) .... " 49 " Vinum Album Fortius " 20 to 25 " Port " 15 to 25 " Sherry and Madeira. ...... 1. . . ". 15 to. 20 " Champagne " 10 to 13 " Burgundy .......... " 10 to 13 " Hock " 10 to 12 " Claret " 8 to 12 " Vinum Album . . . ..... " 10 to 12 " Vinum Rubrum ....... " 10 to 12 ~*' Vinum Aurantii (B. P.) . . . . " 10 to~i2 u Cider. ..... ..... " 5 to 9 "\ Strong Ale or Stout " 5 to 9 " Beer and Porter .......... " 2 to 5 . . " Kumyss ........... " I to 3 " Action of Alcohol. External. — It is a powerful disinfectant. If applied to the skin, alcohol quickly evaporates. It therefore cools the skin, which consequently becomes pale from the contraction of the small vessels ; owing to this less sweat is secreted. Alcohol is thus refrigerant, astringent and anhidrotic. But if evaporation is pre- vented in any way, such as by a watch-glass or a piece of gutta- percha, or the alcohol is rubbed in, it quickly absorbs water from the skin, and thus hardens it. Having thus passed through the epidermis it dilates the vessels, causes a feeling of warmth, and produces a rubefacient effect. It has the power of coagulat- ing albumen, but the coagulum quickly re-dissolves. Internal. — Mouth. — When concentrated, alcohol produces a feeling of warmth, or often even a burning sensation, in the mouth. If held there for some time the albumen of the su- ALCOHOL. 25 2 7 perficial tissues is coagulated, and the mucous membrane becomes whitish, congested, and opaque, but this appearance soon disap- pears, as the coagulum is re-dissolved by the fluids of the tissues. Directly the alcohol is put in the mouth there is an increased flow of saliva, and the pulse may be quickened ; these results are reflex, for they occur before there is time for the alcohol to be absorbed. Alcohol has a slight local anaesthetic effect. Stomach. — Here, also, if the alcohol is sufficiently concen- trated, there is a sensation of warmth or even of burning. If only small quantities are given, the gastric vessels dilate, the mu- cous membrane becomes red, and there is an increased secretion of gastric juice. All this can be seen to happen in cases of gastric fistula. The result of these effects is that the appetite is sharp- ened, and this explains the custom, common among many people, of taking a little alcohol immediately before meals, and also the common experience that alcohol taken during meals aids digestion. It also increases the activity of the gastric movements. Thus there are several ways in which moderate doses of alcohol may help the digestive process. In some cases it produces a local anaesthesia in the stomach, and so it may relieve gastric pain. It is to a slight extent decomposed into aldehyde and acetic acid, and consequently some of the pepsin, peptones, and proteids are precipitated. This hinders digestion, but usually not sufficiently to outdo the aid due to the vascular dilatation, the increased secretion, and the greater movement. The effect of large doses is very harmful. The activity of the gastric juice is destroyed, the gastric walls are inflamed, large quantities of mucus are poured out, and if the over-indulgence is continued chronic gastritis ensues, the gastric glands atrophy, and consequently we get the permanent dyspepsia of drunkards. A single dose of alcohol introduced into the stomach in a concentrated form, e. g. clear brandy, immediately produces im- portant reflex effects. The heart beats more rapidly and more forcibly, the vessels of the whole body dilate, especially those of the skin ; hence there is a feeling of warmth. The blood-pressure rises. These reflex effects are well seen in the im- 2 28 INORGANIC MATERIA MEDICA. mediate restoration of a fainting person by the ingestion of a single dose of brandy. Dilate alcohol, e. g. beer does not pro- duce them. They are quickly followed by the effects of alcohol upon the circulation due to the presence in the blood after ab- sorption. Intestines. — Here alcohol has a slight astringent effect, and consequently it may check diarrhoea. Blood. — Alcohol is absorbed more largely by the blood-vessels than the lacteals. It first increases and then diminishes the amoeboid movements of the white blood-corpuscles. It so acts on the red corpuscles as to prevent oxyhaemoglobin from readily yielding up its oxygen, consequently it diminishes the oxida- tion of the tissues. This, in habitual, drinkers of large quan- tities of alcohol, may lead to an imperfect combustion of fat, con- sequently it accumulates in the tissues, and obesity, which is often increased by the amount of saccharine matters alcoholic liquids contain, results. The skin acquires a velvety feeling. Alcohol is slightly antipyretic, lowering the temperature in fever. This is possibly due, in part, to general diminished oxi- dation. There has been much difference of opinion whether alcohol, while circulating through the body, is oxidized. It has now been shown that, to a considerable extent, it is, therefore it is a food. That alcohol is a food is also proved by the fact that the weight of the body will be maintained if a large amount of alcohol is taken, even if the rest of the food is very small in amount. If only moderate doses are drunk, very little alcohol leaves the body in the urine; with large doses the case is different. Circulation. — The effects upon the circulation refiexly pro- duced by stimulation of the mouth and stomach have already been mentioned. After alcohol is absorbed it influences the heart markedly. It beats more powerfully and more rapidly, the pulse becomes fuller; these results are due to a stimulating effect on the accelerator nerves. The vaso-motor system is acted upon, all the vessels of the body dilate, es- pecially those of the skin ; therefore, if he previously felt ALCOHOL. 229 cold, the person who has taken the alcohol feels warm. The blood-pressure rises, the increased action of the heart more than compensating for the vascular dilatation. The direct effects of alcohol on the circulation after absorption appear more slowly and last longer, but they are clearly similar to those due to the reflex stimulus from the stomach, and therefore they continue them. The result of the increased circulation through the vari- ous organs is that they work to greater advantage, hence the men- tal faculties are brightened for a time, the muscular strength seems increased, more urine is passed, and the skin perspires. The person who has taken the alcohol, in fact, usually feels gen- erally better for it. This is by no means always so; some per- sons have a headache or feel very sleepy immediately after alco- hol. This is probably because the vessels of the abdomen or skin have dilated so excessively that almost all the blood in the body is in them, and consequently there is very little in the brain. There are many individual peculiarities in the effects of alcohol. It has been repeatedly proved that these good results are but transitory. The heart, although at first stimulated, is more exhausted after the stimulation has passed off than it was before. This is true also of all the organs of the body stimulated by the increased circulation induced by alcohol. In many cam- paigns and arctic expeditions it has been found that although at first the men, after taking alcohol, could do more work, yet soon they felt so tired and exhausted, that on the whole they could do much more without than with the alcohol. Large doses of alcohol do not stimulate the heart at all ; they paralyze it, both reflexly from the stomach and after absorption. Enormous doses poured into the stomach kill almost immediately by reflex action. A drunkard who is "dead drunk" is, accurately speak- ing, one who is killed by the paralyzing effect of alcohol on the heart, but the phrase is often applied to any one who is very drunk. Skin. — Alcohol is a mild diaphoretic, partly because of its vaso dilator action, and perhaps also because of some direct in- 230 INORGANIC MATERIA MEDICA. flueiice on the sweat-glands. As just mentioned, the cutaneous vascular dilatation leads to a feeling of warmth if the patient's cutaneous vessels were previously contracted from cold. It may be that part of the antipyretic power of alcohol is due to in- creased radiation from the dilated vessels, and also to evaporation of the increased amount of sweat. If a person is in a cold atmos- phere, alcohol, by increasing the radiation from the skin, leads to the loss of so much heat that he may die from cold, although at first the increased cutaneous circulation, making him feel warmer, gives him a delusive feeling of warmth. Kidneys. — But little alcohol is passed in the urine, much of it being oxidized in the body, some eliminated by the lungs, and traces by the skin. It acts as a diuretic; probably this is a secondary result of its vascular effects. Nervous system. — Unless the dose be very large the whole nervous system is stimulated, perhaps to a slight extent directly, but chiefly as a secondary result of the vascular dilatation and cardiac stimulation. The highest functions are most affected. The person who has taken the alcohol talks more fluently and brilliantly, his wits are sharpened, he has a feeling of strength. If the dose has been large, the stage of exaltation of these or any other functions quickly passes into one of depression, the highest functions being affected first, and the stimulation and depression of function proceed regularly from the highest to the lowest. The action of alcohol thus illustrates both the fact that stimulation is usually succeeded by depression, and also the'" law of dissolution,' ' which (p. 92) states that functions which have appeared latest in the animal series or the individual are the most easy to influence, those which have appeared earlier are less easy to influence ; and so by regular sequence till we arrive at those functions which are first developed, which are the last to be influenced. The stimu- lation and subsequent depression of function, therefore, proceeds in a descending scale from the highest or least firmly fixed func- tion to the lowest or most firmly fixed. Thus the power of judg- ment is abolished very early by alcohol 5 this is so while the imagination, the emotions, and the power of speech, still remain ALCOHOL. 23I Stimulated ; but soon the power of imagination goes, the patient loses all command over his emotions, he cries and laughs irregu- larly, but this soon stops. Re next begins to lose control over his speech, talking incoherently and thickly; shortly afterwards he cannot talk at all, but can only make a noise. Muscular movements, which are not so highly developed as those of speech, are next affected ; delicate, lately developed movements, as writ- ing, feeding himself, etc., are for a time performed inco- ordi- nately, but soon they are paralyzed. Next the muscular move- ments developed before these are implicated, and the patient can- not undress himself or walk straight, and inco-ordination of these movements passes into the inability to do them at all. Next the activity of the reflex centres of the cord is abolished; the patient passes his urine 1 and feces involuntarily. Then the respiratory center, which was previously stimulated, becomes paralyzed, breathing is difficult, and the face is livid. Lastly, the heart, which was also at first stimulated, is paralyzed, £nd the patient dies. The depression of the reflex centers of the cord accounts for the fact that injuries which would kill a sober man do not kill a drunken one, for the heart and respiration, owing to the general central depression, are not affected reflexly by them. Therapeutics. , y , \ External.. — Four parts of alcohol to one of water form : the Lotio Spiritus of many pharmacopoeias.- Cotton* or lint 1 dipped in it are applied to sprained joints, bruises, etc. The- alcohol evaporates, cools the part, consequently the vessels contract, and inflammation may thus be checked^ At the; same time the local anaesthetic effect of the cold relieves the pain. In a similar way many varieties of headache may be> soothed by bathing the forehead with eau de Cologne. Brandy* or some other form of alcohol is often used to bathe the skin in * order to harden it, by abstraction of water, and thus prevent the formation of bedsores or cracked nipples. Spirit lotions dabbed ■ on the skin may, by means of the vascular contraction produced, : stop sweating. Alcohol rubbed in, as in the use of Linimentum 232 INORGANIC MATERIA MEDIC A. Camphorae, is commonly employed for its rubefacient effect, to aid the absorption of inflammatory products and relieve pain, as in chronic rheumatism, myalgia, etc. Internal. — Mouth. — A little brandy held in the mouth will be a local anaesthetic and relieve toothache. Alcohol is used as a gargle of port wine for its power of precipitating albumen and acting as an astringent in cases of chronic sore throat, excessive salivation, or inflammation of the gums. Stomach. — Because it increases the secretion of gastric juice, the vascularity and the movements of the stomach, alcohol aids digestion. It must only be taken in small quantities, for large amounts paralyze the secretion and cause gastritis, and ultimately lead to atrophy of the gastric glands. It should be given just before or during a meal. It is harmful in acute dyspepsia, but for the indigestion of the aged and feeble, or for those who are thoroughly exhausted by overwork, it is very valuable, as the stomach shares in the general exhaustion. It is also useful be- cause it increases the appetite. Owing to its anaesthetic property it may relieve painful dyspepsia, and may check vomiting, especially if taken with carbonic acid gas, as, for example, in the form of champagne or brandy and soda-water, and because it in- creases the activity of the gastric movements it may relieve flatu- lence. A single dose of strong spirits poured into the stomach is often employed with great benefit for its reflex stimulant effects on the circulation for those who have fainted, or who are collapsed from cold or any other cause. Intestines. — Brandy and water will often check diarrhoea. Perhaps this is owing to the astringent power of the brandy. Fever. — Alcohol has been largely used in all sorts of febrile conditions. We have seen that it impairs oxidation by its action on the red corpuscles, that it is oxidized and is therefore a food, and that it is mildly antipyretic and diaphoretic. These results would be beneficial in fever. On the other hand, the accelera- tion of the pulse would be distinctly harmful, although it must be remembered that very often, for some unexplained reason, alco- hol lowers the pulse in fever; the indigestion caused by the taking ALCOHOL. 233 of large quantities, and the liability to depression of the respira- tory and cardiac centers, would be very undesirable. The best rules are that while alcohol may be given often with immense advantage in fever, either to aid digestion, to slow the pulse, as a cardiac stimulant if the patient be much collapsed, or to produce sleep, yet it may, in any of the ways alluded to, do harm. There- fore, when it is being used, the effect must be carefully watched, and if the pulse becomes quick and feeble, or, as indicating gas- tric irritation, the tongue becomes dry and brown, or the skin be- comes hot and dry, or the breathing hurried, or the patient suf- fers from insomnia, the alcohol should be stopped. On the other hand, if the pulse becomes stronger and slower, the tongue and skin moist, the breathing tranquil, and the patient sleeps well, the drug is doing good, and may be continued. We have so many more powerful diaphoretics and antipyretics that alcohol is not often given for these purposes. Of all fevers it is most used for acute lobar pneumonia, and, speaking generally, it is most likely to be valuable when one object is to keep up the patient's strength for a few days only, till the termination of a specific fever of short duration ; but it is often given when it is quite un- necessary. Nervous system. — Alcohol may, as just mentioned, be used as a soporific in fever. Many persons who suffer from insomnia find that they can sleep better for a glass of whisky and water just before going to bed, no doubt because of its depressant action upon the highest centres. Kidneys and skin. — Alcohol is occasionally given as a diuretic. Gin is the best form, because it usually contains some juniper, which is also diuretic. Although but little alcohol is excreted by the kidneys, it seems to be particularly irritant to the urethra in cases of gonorrhoea and gleet, and some authorities consider that chronic Bright' s disease may be induced by alcohol. Almost the only use made of its diaphoretic effect is as a help to cure a cold in the head, for which purpose a strong glass of spirits and water may be taken immediately before going to bed. 234 INORGANIC MATERIA MEDICA. Toxicology. Large doses of alcohol will produce death, either instantly by reflex stoppage of the heart, or later by cardiac and respiratory depression after ab- sorption. Chronic poisoning causes so many diseases that it is really the part of a text-book upon medicine to enumerate them. Very often confirmed drunkards, particularly if they take much spirits, are very thin; this is probably due to the fact that strong spirits cause such marked indigestion that sufficient nourishing food is not absorbed. Other drunkards are fat, especially if they drink beer. Chronic gastritis, cirrhosis of the liver, gout, peripheral neuritis, delirium tremens, mania, and perhaps chronic Bright's disease, may all be directly due* to excessive indulgence in alcohol. It renders patients particularly liable to phthisis, and makes them bad subjects for withstanding any severe illness,, especially pneumonia, or to undergo severe surgical operations. CHLOROFORMUM VENALE. Commercial Chloroform. Chloroform. CHC1 3 . Source. — Heat water and alcohol in a still to ioo° F., then add chlorinated lime and slaked lime; chloroform distils over. It is believed that it is formed in the three following stages: — (i) Aldehyde and hydrochloric acid are formed. C 2 H 5 OH -{- Cl 2 = C 2 H 4 -f- 2HCI. (2) More chlorine acting on the aldehyde forms chloral and hydrochloric acid. C 2 H 4 + 6C1 = C 2 HC1 3 + 3HCI. (3) The slaked lime converts the chloral into chloroform and formate of lime. 2C 2 HC1 3 -f- Ca20H = 2CHC1 3 + Ca(CH0 2 ) 3 . The use of the slaked lime is considered to be superfluous and the process of the pharmacopoeia scarcely differs from this. - Characters. — A colorless, heavy liquid, sp. gr. 1.470, of a sweetish taste and a peculiar odor. It imparts a green color to flame. Solubility,- — 1 in 200 of water, in which it sinks in heavy drops; 10 in 7 of spirit; freely in ether, olive oil, or turpentine. Impurities. — Hydrocarbons, shown by darkening with sulphuric acid. Non-volatile compounds, shown by not completely evaporating, and by un- pleasant odor. Acids. Free chlorine. Preparations. i. Chloroformum Purificatum. — Purified chloroform. Source.— Take commercial chloroform, which should contain at least 98 per cent, of chloroform, 200 parts ; to which 40 parts of sulph- uric acid is added, with shaking for twenty-four hours. To the lighter liquid 10 parts of carbonate of sodium is added, previously dissolved in water. The chloroform is separated, mixed with two parts of lime CHLOROFORM. ' 235 and distilled at a temperature below 153 F>> until the residue, in the retort, is reduced to 2 parts. Characters.— A heavy, colorless, diffusive liquid of characteristic odor. Sp. gr. 1.485 to 1.490. Dose, 2 to 20 m. 2. Linimentum Chloroformi. — Commercial chloroform 40 ; soap liniment, 60. 3. Mistura Chloroformi. — Purified chloroform, 8; camphor, 2; fresh yolk of egg, 10; water, 80. Dose, i to 4 fl. dr. 4. Spirit us Chloroformi. Synonym. — Chloric ether. Purified chloroform, 10; alcohol, 90. Strength. — I in 10. Dose, Yz to 1 fl. dr. Action. External. — Chloroform in many respects acts like alcohol, but it is more powerful. Thus if allowed to evaporate on the skin it produces cold ; therefore the vessels at the point of appli- cation contract, and at the same time local anaesthesia is induced. If the vapor be confined, or if chloroform be rubbed into the skin, it acts as an irritant. The vessels dilate, the part becomes red, and there is a sense of heat. This rubefacient effect may pass on to vesication. Internal. — Mouth. — If concentrated, it produces irritation and a burning sensation. If dilute, it has a sweetish taste, which renders Aqua Chloroformi of the B. P. (o. 5 per cent. solu+ tion in water) a valuable vehicle for the administration of nauseous drugs. It reflexly gives rise to an increased secretion of saliva, and is a local anaesthetic. Stomach. — The action of chloroform is very like that of alcohol. Large doses cause marked gastro-intestinal irritation, Small doses produce a feeling of warmth, dilatation of the gastric vessels, an increased secretion of gastric juice, and more regular and more powerful gastric movements. It is perhaps slightly astringent to the intestines. Absorption. — It is absorbed into the blood from the stomach and intestines, and, if given as vapor, from the lungs, but it is 236 INORGANIC MATERIA MEDICA. very uncertain what changes it subsequently undergoes. Prob- ably most of it is decomposed, but some is certainly eliminated in the breath and some in the urine, and it has been stated that it may be found in the blood of those who have been poisoned by it. Nervous system. — Chloroform is an excellent instance of the law of dissolution (see p. 92), and also of the well-known fact that drugs which, in small doses stimulate any part, in large doses often depress it The phenomena resulting from the inhalation of chloroform are commonly divided into three stages First stage. — This is, at first, one of general stimulation, the highest functions being the most stimulated, usually unevenly, so that the patient is somewhat incoherent. The imagination is momentarily excited, and he experiences a general feeling of warmth and comfort spreading over the entire body. The mind, from the irregular excitation, is confused. Sight and hearing are stimulated, he experiences sensations of light and hears noises. The stimulation of all these higher functions is very transitory, and he quickly begins to lose consciousness; he may be aware that people around him are talking without knowing what they are saying, but soon he hears and sees nothing. Sometimes dur- ing the early part of this stage he may laugh or cry. The inabil- ity to see and hear is quickly followed by considerable blunting of general sensation. At the same time that these higher func- tions are being depressed the lower motor functions are excited ; he will kick and fight, throwing his arms and legs about, so that much strength maybe required to hold him down, and he will shout and talk incoherent nonsense very loudly. Almost coincidently the stimulation of the lower centres sets in ; the pulse is increased in frequency, and there is throbbing of the heart and great ves- sels. The first inhalation or two may produce a choking sensa- tion and a stoppage of breathing, which is often voluntary; but soon the respirations are increased in frequency. The blood- pressure at first rises a little, and the face may be flushed. The pupils usually dilate. Second stage. — This is best called that of depression. Some CHLOROFORM 237 authors call it the stage of excitement, because the excitation of the motor centres may be continued into it. It is important to remember that there is no sharp boundary line between the various stages, they pass insensibly into one another. In this stage the depression of the highest functions continues, so that the patient becomes completely unconscious, and he appears to be in a deep sleep. He sees, hears and feels nothing, hence chloroform is called a general anaesthetic. The excitement of the motor functions passes into depression, and he ceases to shout and strug- gle. Some of the reflex centres are depressed, so that when the cornea is touched the eye does not shut. The pupil is con- tracted. The stimulation of the cardiac and respiratory appar- atus gives way to depression, the pulse and respirations become less frequent and less strong. The vaso-motor centre is depressed, blood-pressure falls. As he cannot feel pain, and the reflex activ- ity is so lowered that the heart will not be reflexly inhibited by the shock of an operation, this is the period at which to operate safely. Third stage. — In this there is a total abolition of reflex excit- ability. Even the lowest reflex centres of the cord are depressed, so that the patient may pass his urine and faeces involuntarily ; all muscular tone is abolished, and consequently the muscles are quite flaccid. Some of them, as those of the arm, were probably in this condition towards the end of the second stage. The pupil is widely dilated, probably because of the commencing asphyxia. This is the period to which the administration is pushed to facilitate the reduction of dislocations, or to enable the abdominal viscera to be felt through the abdominal wall. If still more chloroform is given the depression of the cardiac, respira- tory and vaso-motor centres continues, the pulse becomes feeble and irregular, and the heart finally stops in diastole. At last not only its central nervous apparatus but its muscular tissue is de- pressed, so that it will not respond to mechanical stimulation. The respiratory movements become slight and irregular, with very long pauses between them, and as a result the patient is more or less asphyxiated. The blood -pressure gradually falls to zero. 2$8 INORGANIC MATERIA MEDICA. There has been much dispute as to whether chloroform kills by the heart or the respiration. In the United States it has been generally believed that death is from depression of the cardiac centres. The recovery from chloroform also illustrates the law of disso- lution. The lowest functions, such as muscular tone, are the first to reappear; but the patient does not usually regain his men- tal equilibrium for hours. With the exception of its local action on the skin and ali- mentary canal, and its last effect on the cardiac muscle, chloro- form acts entirely on the central nervous system. Even the peripheral nerves are not affected, unless it be just before death. Vomiting is very liable to occur during the administration of chloroform, and its advent is often made known by pallor and wide dilatation of the previously contracted pupil. Immediately before death the pupil may be either dilated or contracted. Therapeutics. External.— Chloroform is employed in the form of the lini- ment to produce rubefacient and irritant effects in cases of chronic rheumatism, myalgia, and chronic inflammations. Internal.— It may be used as a local anaesthetic for tooth- ache, the tooth being plugged with a piece of cotton soaked in chloroform. It disguises the taste of nauseous medicines, and therefore Aqua Chloroformi (see p. 235) is a very common vehicle, and Spiritus Chloroformi is much used as a flavoring agent. In the stomach it acts like alcohol, and is given in the same varieties of dyspepsia as are benefited by that drug. Small doses may be used as a cardiac stimulant. Inhalation.— It is inhaled to abolish sensations of pain, whether from surgical operations, biliary, renal, and intestinal colic, or parturition. In the last case but little need be given. It is also inhaled to relax muscular spasm, as in the reduction of dislocations or herniae, or for the relaxation of muscles for diag- nostic purposes, as, for example, when we wish to feel the ab- dominal viscera thoroughly, or to see whether a swelling is a CHLOROFORM. 239 phantom tumor; or, lastly, it is inhaled to relax spasm in cases of tetanus, hydrophobia, or other varieties of convulsions. The A.C.E. mixture, which consists of alcohol i vol., chloroform 2 vols., and pure ether 3 vols., is very commonly employed for all these purposes. The following points should be attended to in the administra- tion of chloroform : 1. The anaesthetizer must be skilled, and give his attention exclusively to the production of narcosis. . 2. The respiration and pulse should be carefully watched for any signs of failure. 3. The operation should never be begun till reflex action is profoundly depressed, that is to say, till the stage of muscular relaxation has commenced. Many patients have been lost from neglect of this precaution, for the stimulus of the knife has reflexly stopped the heart. It is a common and dangerous error to think that, because the operation is trivial, it may be begun early; most of the deaths from chloroform have taken place when the operation has been slight. 4. Great care must be exercised if the heart is fatty or feeble from any cause, or if the patient suffer from disease of the lungs, or if he be very old. 5. In operations about the mouth care must be taken to see that no blood gets down the trachea. 6. It is desirable to have the stomach empty, therefore no solid food should be given for some hours before the administra- tion. The patient's head must be so directed during vomiting that no vomited matters can get into the larynx. 7. False teeth should be taken out of the mouth. 8. The chloroform must be pure. 9. It should not be too concentrated. About 5 per cent, of chloroform to 95 per cent, of air is a good mixture. 10. The head should be a little raised, and the lower jaw held up so that- the tongue shall not fall back over the larynx. 1 1 . Special care must be taken when the operation necessi- tates awkward positions, especially if respiration is interfered 240 INORGANIC MATERIA MEDICA. with, as in the lateral position used in obstetrical, gynaecological and renal cases. 12. Chloroform should never be administered without an elec- tric battery and an hypodermic syringe, in good order, being at hand. Nitrite of amyl, ether, brandy and ammonia should be in readiness. If the breathing becomes very weak, or stops al- together, artificial respiration should at once be commenced, the tongue being pulled forward by forceps to allow free entry of air to the lungs. The face and abdomen should be flicked with wet towels, a capsule of nitrite of amyl may be inhaled, and ether or brandy injected subcutaneously. It is doubtful whether galvani- zation over the cardiac area is any use; perhaps it does harm. If symptoms of improvement do not appear at once the patient should be inverted. Artificial respiration should be maintained at least an hour or so, even if there is no sign of returning life ; and if there is the slightest evidence of a cardiac beat, or a single automatic respiratory movement, artificial respiration must be persevered in even for many hours. If the face be pale, the head should be lowered and nitrite of amyl is especially likely to be useful. In spite of all care in administration and the observance of all precautions, one death takes place in about three thousand administrations. iETHER. Ethylic Ether. Symbol, (C 2 H 5 ) 2 0. Synonym. — Sulphuric ether. Source. — Stronger alcohol is distilled with sulphuric acid. Hydrogen- ethyl sulphate (sulphovinic acid) and water are first formed. H 2 S0 4 -|-C 2 H 5 , OH=C 2 H 5 ,HS0 4 -[-H 2 0. This sulphovinic acid is further acted upon by alcohol. C 2 H 5 ,HS0 4 +C 2 H 5 ,OH=(C 2 H 5 ) 2 0+H 2 S0 4 . This process is theo- retically continuous, the sulphuric acid last formed again acting on fresh alco- hol as it is supplied. The ether is freed from water by re-distillation with calcium chloride and lime. Characters. — A colorless, light, volatile liquid, with a burning taste and peculiar odor. It is very inflammable, boils below I05 F., and burns with a white flame. Sp. gr. 0.750. Strength. — 74 per cent, of pure ether, and 26 per cent, of alcohol. Impurities. — Water, and fixed impurities. Dose, 5 to 60 m. ETHER. 241 Preparations. 1. ^ther Fortior. — Stronger Ether. (C 2 H 5 ) 2 0. Wash ether with water, let it stand with fresh lime and chloride of calcium, and distil. Characters. — A colorless liquid, sp. gr. 0.716 to 0.725 ; boils at 98.6 F. Should contain about 6 per cent, of alcohol and a little water, 2. Spiritus /Etheris.— Ether, 30; alcohol, 70. Dose, }£ to 1 fl. dr. 3. Oleum ^thereum. — Ethereal oil. A volatile liquid composed of equal volumes of heavy oil of wine and of stronger ether. Alcohol, 24 ; sulphuric acid, 54 ; distilled water, I ; stronger ether, a sufficient quantity ; by distillation. Characters. — A transparent, nearly colorless volatile liquid, of a peculiar, aromatic ethereal odor, a pungent, refreshing, bitterish taste, and a neutral reaction. Sp. gr. 0.910. Used to prepare spiritus aetheris compositus. 4. Spiritus ^theris Compositus. Synonym. — Hoffmann's anodyne. Stronger ether, 30 parts; alcohol, 67 parts; ethereal oil, 3 parts. Dose, ^ to 2 fl. dr. Action. External. — Ether evaporates very quickly, producing great cold, and consequently the part to which it has been applied becomes white from the contraction of the vessels. The cold is sufficient to cause such marked local anaesthesia that the pain of slight operations, performed upon the part anaesthetized, cannot be felt. To produce this result ether is best applied as a fine spray. If it be rubbed in, or evaporation be prevented, it, like alcohol or chloroform, is an irritant. Internal. — In the mouth and stomach also it acts like chlo- roform or alcohol. Thus ether causes a burning taste in the mouth, an increase of the saliva, of the gastric secretion and gastric movements, and dilatation of the vessels of the stomach. Con- sequently it is carminative and aids digestion. Directly it reaches the stomach it reflexly excites tfee heart, increasing the force and frequency of the pulse, and causing a rise of blood-pressure ; it is one of the best cardiac stimulants we have. In the same 242 INORGANIC MATERIA MEDICA. way it excites respiration. It is quickly absorbed, and its stimu- lating influence on the heart and respiration is continued. It is thus a good instance of a rapidly diffusible stimulant. It is also antispasmodic. Nervous system. — Ether is a powerful general anaesthetic. The phenomena and stages of ether anaesthesia are so like those of chloroform anaesthesia that the description already given (p. 236) will suffice. The following differences, however, should be noticed : (1) The heart is paralyzed with much greater difficulty by ether than by chloroform. (2) The same is true of the vaso-motor centre. (3) And also of the respiratory centre. (4) Ether is much more irritant to the respiratory mucous membrane, and hence is more liable to increase bronchitis in those already suffering from it. (5) With ether the stage of stimulation is more protracted, therefore there is more struggling, and the anaesthetic stage is not reached so soon. (6) Ether must be given nearly pure, about 30 per cent, of air to 70 of ethereal vapor ; hence it is more difficult to administer. (7) The smell of ether is more disagreeable, and lingers about the patient longer. (8) Ether being very inflammable cannot be used in the close neighborhood of an artificial light. Ether is more generally used as an anaesthetic in the United States. Therapeutics. External. — Ether, allowed to evaporate, may be used to cause local anaesthesia in cases of neuralgia. An ether spray is occasionally employed to produce local anaesthesia for small operations ; but as the ether makes the skin hard and brawny the operation must be quite superficial, and even then there is much subsequent tingling and pain. Internal. — Stomach. — It may be used for the same classes of ACETIC ETHER. 243 dyspepsia as chloroform or alcohol, and is often employed as a carminative to expel gas in flatulent dyspepsia. Heart, — Administered subcutaneously (dose, 10 — 15 Tt[) or by the mouth, ether is an excellent cardiac stimulant of great value in fainting, cardiac failure, or palpitation^ its advantage over chloroform and alcohol, being that it is more rapid in its action. It is very useful as an antispasmodic during an attack of asthma. Inhalation. — Ether is inhaled for the same purposes as chloro- form. There is great divergence of opinion which is the safer anaesthetic. All the published statistics in which the two are contrasted appear to show that ether is much safer, and this i s what might have been expected from the contrast between the two already given; but it is alleged that chloroform is often ad- ministered carelessly, and that with proper care it is as safe as ether. iETHER ACETICUS. Acetic Ether. Symbol, C 2 H 5 ,C 2 H 3 2 . Synonym. — Acetate of ethyl. Source. — A mixture of acetate of sodium, sulphuric acid and alcohol is distilled. C 2 H 5 ,OH+XaC 2 H 3 2 -|-H 2 S0 4 ==C 2 H 5 ,C 2 H30 2 + NaHS0 4 +H 2 0. The distillate is purified from acid and water by digestion with carbonate of potassium. Characters. — A transparent and colorless liquid, sp. gr. 0.889 to 0.897. Solubility. — I in 1 7 of water, freely in spirit or ether. It is used in spiritus odoratus and tinctura ferri acetatis. Dose, 20 to 60 m. Action and Therapeutics. It acts like ether, as a stimulant, antispasmodic, and carmina- tive, but has a pleasanter taste. Class III. — Nitrites. Spiritus Athens Nitrosi and Amyl Nitris. Both of these dilate the peripheral vessels, and increase the rapidity of the heart. SPIRITUS .ETHERIS NITROSI. Spirit of Nitrous Ether. Synonym. — Sweet spirits of nitre. This is a solution in spirit of several substances, the chief being ethyl nitrite, aldehyde, acetic acid, and acetic ether. In many commercial specimens there is very little ethyl nitrite. 244 INORGANIC MATERIA MEDICA. Source. — Distil a mixture of alcohol, nitric acid and sulphuric acid, and dissolve the distillate in alcohol. Characters. — Transparent, nearly colorless, mobile, inflammable, slightly acid liquid of an ethereal odor and a sweetish cooling taste. Sp. gr. 0.823 to 0.825. Incompatibles. — Iodide of potassium, sulphate of iron, tincture of guaia- cum, gallic and tannic acids, and emulsions. Impurity/ — Excess of acetic acid. Dose, y 2 to 2 fl. dr. Action. External. — Spirit of nitrous ether evaporates when it is ap- plied externally, and a slightly anaesthetic effect is produced. Internal. — It combines the action of the ether with that of the nitrites contained in it. Because of the ether it is a dif- fusable stimulant, a stomachic and a carminative. Be- cause of the nitrites it acts like nitrite of amyl ; but as the ethyl nitrite is so diluted, its action in this direction is feeble : thus it only moderately dilates the vessels, and except in poisonous doses probably does not affect the blood. The dilata- tion of the vessels leads to a diaphoretic effect on the skin, a diuretic effect on the kidney, and a lowering of arterial blood- pressure. The dilatation of the cutaneous vessels, the sweating, and perhaps the changes of the blood, produce a slight antipy- retic influence. It is obvious that in these effects the nitrites will to some extent be aided by the ether. Therapeutics. For its diaphoretic and slight antipyretic effects it is commonly given in mild febrile attacks, such as a common cold. It is also used as a diuretic in chronic Bright' s disease, and cardiac and pulmonary diseases accompanied by oedema. AMYL NITRIS. Nitrite of Amyl. Symbol, C 5 H n N0 2 . Source. — By action of nitric acid upon amylic alcohol. HN0 3 +C 5 H n ,OH =C 5 H 11 N0 2 - r -2H 2 0. Purify the distillate with carbonate of sodium. Characters. — An ethereal liquid of a pale-yellow color, and of ethereal, fruity odor and an aromatic taste. Sp. gr. 0.874. Volatilizes between 262 and 270 F. Soluble in ether, chloroform or alcohol, but not in water. NITRITE OF AMYL. 245 Impurities. — Free acid and nitrate of amyl. Dose, 2 to 5 m., cautiously inhaled from a handkerchief in which a glass capsule containing the nitrite of amyl has been crushed; ^ to 1 m. inter- nally, dissolved in spirit. Action. External.— Locally applied it diminishes the activity of the sensory nerves, but they quickly recover. Internal. — Nitrite of amyl is rarely given by the mouth, so the following account will refer to the effects of inhalation. Circulation.— From a. medical point of view by far the most important effects of nitrite of amyl are those produced upon the heart and vessels. Within a minute of inhalation the face flushes, the heart beats very rapidly and violently, there is a throbbing in the head, and the vessels, e.g. the carotids, may be seen to pulsate actively. Headache, giddiness, dilatation of the pupils, and increased respiratory movements quickly super- vene. All the vessels of the body rapidly dilate, hence the flush- ing. They may be actually seen to widen in the ear of a rabbit or in the retina. This is due to a direct action on the muscular coats of the arterioles, for it happens if the cord is destroyed. The blood-pressure and arterial tension, of course, fall very low. The increase in the rate of the pulse is unaccompanied by any alteration in the force of the beat ; it is apparently due to a depressing influence on the inhibitory vagus centre. In toxic doses the heart may be arrested in diastole from direct action on the cardiac muscle. Respiration. — The rapidity and depth of respiration are at first increased, probably from central stimulation; the respiratory centres are later depressed, the breathing becoming slower and shallower, and usually death finally occurs from paralytic asphyxia of central origin. Nervous system. — Many of the symptoms referable to the ner- vous system are secondary effects of the dilatation of the vessels of the brain and spinal cord. Such are the throbbing, sense of fullness, giddiness and headache noticed directly after inhalation. The headache may remain some time. If much has been inhaled 246 INORGANIC MATERIA MEDICA. there is unsteadiness of gait and general restlessness. The pupil dilates, and disturbances of vision are present. The motor cen- tres of the cord are profoundly depressed, therefore after large doses reflex actions are abolished. The function of sensory nerves, motor nerves, and muscles is depressed by the local application of the drug to them, but not after inhalation until shortly before death. Temperature. — Nitrite of amyl causes this to fall considerably, both in fever and health. The fall is due to the peripheral vas- cular dilatation, and if large doses are given, to the changes in the blood. Urine. — The drug probably escapes in the urine; it is slightl) diuretic, and may cause the excretion of a body reducing Fen- ling' s solution. Blood. — Outside the body nitrites greatly diminish oxidation, and the same takes place in the blood. After the inhalation of a considerable amount (more than is usually given to a man) the arterial and venous blood both become a uniform chocolate color. This is due to the formation of methaemoglobin. The blood can no longer absorb oxygen, and hence its oxidizing power is abolished. Therapeutics. Heart and blood-vessels. — Dr. Brunton in 1867 observed that in a case of angina pectoris the peripheral vessels were strongly contracted during an attack of pain. This induced him to make the patient inhale nitrite of amyl, and it was found that the ves- sels dilated and the pain passed off. Inhalation of nitrite of amyl is now used for all sorts of cardiac pain, especially when it comes on in paroxysms. Generally the drug affords relief in a minute or so after inhalation, but by no means always. We do not sufficiently understand the pathology of angina pectoris to know how it acts. It may be by dilating the peripheral vessels, but against that view is the fact that they are not always contract- ed during attacks of angina pectoris, and nitrite of amyl may relieve patients in whom the vessels are not contracted. The attacks of pain common in thoracic aneurism may be relieved by CHLORAL. 247 it. It is used to avert the pallor sometimes seen during the administration of chloroform. The peculiar hot flushes expe- rienced by some women during the menopause are benefited by inhalation of it. Nervous system.— -If it is inhaled when the aura is felt an epileptic fit may sometimes be prevented. Because in migraine the vessels of the head are contracted, it has been used, and sometimes successfully, for this complaint. Its depressing action on the cord has suggested its employment in tetanus and strych- nine poisoning. Occasionally the inhalation of nitrite of amyl relieves an attack of asthma. It has been given in whooping-cough, sea- sickness, and cholera, but without much good effect. CLASS IV.— Hypnotics. CHLORAL. Chloral. Synonym. — Hydrate of Chloral. Symbol, C 2 HC1 3 0, H 2 0. Source. — Anhydrous alcohol is saturated with dry chlorine, and thus chloral (C 2 HC1 3 0,H 2 0) is formed. It is purified by sulphuric acid, then by lime. Characters. — Colorless crystals of a pungent, peculiar odor, and a bitter taste. Easily melted by gentle heat. Solubility. — Freely in distilled water, alcohol and ether. Forms a fluid when rubbed up with an equal weight of camphor. Incompatibles. — All alkalies decompose it. Impurities. — Hydrochloric acid and oily impurities. Dose, 5 to 20 gr. ACTION. External. — It is a powerful antiseptic. Locally applied it is irritant, causing vesication. Internal. — Alimentary canal. — Unless diluted, chloral is a gastric irritant; large doses, therefore, may give rise to vomiting and purging. Blood. — It is readily absorbed, and circulates in the blood unchanged. It was formerly thought that as alkalies convert it into chloroform and formic acid, this change would take place in the blood, and consequently Liebreich suggested its use as an hypnotic. It is now known that this view is wrong, for no chlo- 248 INORGANIC MATERIA MEDICA. form can be found in the blood of chloralized animals, nor in the urine unless that fluid is alkaline, in which case chloral is decomposed by the alkali in the urine. Circulation. — Chloral depresses the heart, large doses having this action to a considerable degree. This is due to a local effect on the organ itself; probably both the muscular sub- stance and the nerves contained in it are affected. The pulse, which may at first be slightly quickened, soon becomes slow, fee- ble, and irregular, and the heart finally stops in diastole. The vaso-motor centre is depressed, and consequently the ves- sels dilate. As a result of these actions on the heart and the vessels the blood-pressure falls. Respiration. — -After large doses the respirations become slow and full, and after toxic doses they become irregular and shallow before finally ceasing. This is due to the action of chloral on the respiratory centre. Temperature.— Targe doses cause this to fall, probably by diminishing the production of heat. Brain.- — Chloral is a powerful hypnotic, acting directly on the brain. The stage of excitation, if it exists, is very short. Soon after taking a moderate dose the patient is overcome by sleep, which lasts several hours, and is indistinguishable from natural sleep. On waking there is neither confusion nor head- ache, and he feels refreshed. Large doses produce coma. The pupil is always contracted. Spinal cord. — At first the anterior cornua may be slightly stimulated, but Soon they are depressed, and there is consequently paralysis and loss of reflex excitability. The motor nerves and the muscles are not affected, nor are the sensory nerves unless the dose is very large, when there may be anaesthesia It will be observed that chloral is a powerful general de- pressant, chiefly of the cerebrum, but also of the respiratory centre, the vaso motor centre, the anterior cornua, the produc- tion of heat, and the heart. It is only because it depresses the cerebrum much earlier than any other part of the body that we can use it as an hypnotic. CHLORAL. 249 Therapeutics. External.— The compound with camphor has been em- ployed as a local anodyne for neuralgia, and may be applied to aching teeth. Internal. — Chloral is largely used for its hypnotic effect. Its great advantages over many other hypnotics are that doses sufficient to produce a deep sleep are not large enough to cause gastro-intestinal irritation, cardiac and respiratory depression, and the other harmful effects. Chloral is certain in its action ; it quickly produces sleep; and there are no bad after effects. Children take it well. It is especially useful in simple insomnia from overwork, worry, etc. Its disadvantages are that it does not relieve pain at all, and it should therefore not be used for insomnia due to this cause ; and that, as it depresses the heart and respirations, it must be given carefully in diseases of the heart and lungs. In febrile insomnia it is very valuable in the early stages, but must be given cautiously, later, when there is any danger of cardiac weakness. It does not relieve the distress and cough of diseases of the heart and lungs. It has been used as a cerebral depressant in delirium tremens, puerperal convulsions, and mania, but very large doses are required, and consequently the results must be watched with great care. From its action on the spinal cord, chloral has been used, and sometimes with success, in tetanus, whooping-cough, incontinence of urine and strychnine poisoning. Toxicology. Acute Poisoning. — As will be inferred from the action of chloral, the symptoms of poisoning by it are deep coma; a weak, feeble, irregular, slow pulse, which may become quick before death ; diminished frequency of respi- ration and consequent lividity ; and abolition of reflex movements The sur- face of the skin is cold, and the temperature is subnormal. Treatment. — Give emetics or wash out the stomach. Keep up the tem- perature by hot bottles, hot blankets, friction and massage. Prevent sleep by the injection of hot strong coffee into the rectum, shouting at the patient, hit- ting him, flapping with wet towels, bathing, etc. Give a subcutaneous injec- 22 250 INORGANIC MATERIA MEDICA. tion of strychnine, because of its stimulant action on the anterior cornua. Use inhalations of amyl nitrite to stimulate the heart, and artificial respiration if necessary. Chronic Poisoning. — The taking of chloral is a vice to which many persons are addicted. A craving for it is soon established. The chief symp- toms of chronic chloral poisoning are gastro-intestinal irritation, a great lia- bility to erythematous eruptions, dyspnoea dependent upon the cardiac and respiratory depression, and general weakness. There may be disturbance of the mental equilibrium, and persons have been known to become permanently weak-minded. A slightly larger dose than usual may be quickly fatal. Class V.— Antiseptics. Carbolic Acid, Sulphocarbolate of Soda, Creasote, and Iodoform. ACIDUM CARBOLICUM CRUDUM. Crude Carbolic Acid. Source. — A liquid obtained during the distillation of coal tar between the temperature of 3 3 8° and 374 F., and containing carbolic and cresylic acids in variable proportions, together with other substances. Characters. — A nearly colorless or reddish-brown liquid of a strongly empyreumatic and disagreeable odor, having a benumbing, blanching and caustic effect upon the skin and mucous membrane, and a neutral reaction. Used only externally. ACIDUM CARBOLICUM. Carbolic Acid. Symbol, C 6 H 5 HO. Synonyms, — Phenic acid, Phenol, or Phenyl alcohol. Source. — From coal tar oil by fractional distillation, and purification. Characters. — Colorless, interlaced, needle-shaped crystals of a distinctive, slightly aromatic odor. Treated with about five per cent, of water, they become fluid ; they are very hygroscopic, and hence soon become semi-fluid on expos- ure to air. Often reddish from the impurities aurin and rosolic acids, which form a red compound by the absorption of carbonic acid and oxygen. Melts at 96.8 to 107. 6° F. to an oily liquid. Does not redden litmus paper, coagu- lates albumen. Solubility. — 1 in 20 of water, freely in alcohol, fats, and oils. Dose, 1 to 2 gr. Preparation. 1. Unguentum Acidi Carbolici. — Carbolic acid, 10; ointment, 90. carbolic acid. 25 i Action. External. — Carbolic acid is a powerful antizymotic, rapidly destroying organized ferments, both animal and vegetable. Consequently it destroys those of septic diseases, hence it is antiseptic. It thus prevents the formation of the products of the decompositions which are set up by these organisms. For this reason it is disinfectant, and as the products of decompo- sition are generally foul-smelling, it is deodorant. It does not act so readily on unorganized ferments (enzymes), such* as pepsin and ptyalin, but in large doses it likewise destroys their activity. Carbolic acid is not so powerful an antizymotic as bi- chloride of mercury {see p. 177); for Evans (Guy's Hospital Reports, vol. xlvii) found that anthrax spores were not killed in twenty- four hours by a solution of 1 in 100, but were killed by a solution of 1 in 20 acting for twenty- four hours, but not when it acted for only four hours. The bacilli of anthrax were killed by solution of 1 in 100 acting for five minutes, 1 in 150 acting for a quarter of an hour, 1 in 1 75 acting for half an hour, but were unaffected by a solution of 1 in 150 acting for one minute, 1 in 1 75 acting for a quarter of an hour, 1 in 300 acting for an hour. Strengths of 1 in 40 and 1 in 20 are commonly employed in surgery. The solution in oil has no antiseptic properties. The power of carbolic acid to destroy low organisms makes it an effi- cient parasiticide against certain vegetable parasites infesting the skin. When applied to the skin in weak or moderately strong solu- tions, it produces local anaesthesia with a feeling of numb- ness, which lasts some hours. If concentrated it acts as an irritant and caustic, causing a burning pain, and in a few minutes a white spot appears, which becomes red when the acid is removed. If the application is prolonged a white eschar or slough results. There is no vesication. Internal. — Gastro-intestinal tract. — If concentrated, car- bolic acid produces the same effect on the mouth as on the skin, and is a powerful gastro-intestinal irritant {see Toxicology). In the stomach it is converted into a sulphocarbolate, and unless 252 INORGANIC MATERIA MEDICA. poisonous doses be given, it is so diluted by the gastric contents that it loses its antizymotic power. Blood — It is not known in what form carbolic acid circulates, probably as an alkaline carbolate. Circulation. — Medicinal doses have no effect. Large doses paralyze the vaso-motor centre in the medulla, and the blood- pressure falls. It is not until very large doses have been given that the heart is affected, and then its activity is depressed. * Respiration. — Small doses have no influence on respiration, but large ones accelerate it, probably from stimulation of the vagi. Ultimately respiration is paralyzed, and death results. Temperature, — This is unaffected by small doses of carbolic acid, but large doses cause it to fall, because they diminish the production of heat and increase its dissipation. Nervous system, — Carbolic acid is a cerebral depressant in large doses, for coma is produced by them ; they first stimulate the anterior cornua, producing convulsions, but subsequently de- press them, causing paralysis. Urine. — Much interest attaches to this, for even after moder- ate doses of carbolic acid, or absorption from surgical dressings, the urine may become dark. This is not due to blood, as was once thought, for Dr. Stevenson has shown that there is no increase of iron in the urine. After taking carbolic acid, salts of sulphocarbolic acid, and glycuronic acid, pyrocatechin and hy- drochinon appear in the urine. The last two are oxidated pro- ducts of carbolic acid. Pyrocatechin is a dark-colored body, and is, no doubt, often the cause of the dark urine ; but this can- not be the sole cause, for pyrocatechin can only exist in alkaline urines. The presence in the urine of these results of carbolic acid is recognized by distilling them over from it, and the sul- phates are usually absent. The distillate gives a blue color with neutral ferric chloride, and a white crystalline precipitate of tribromo-phenol with bromine water, showing the presence of sulphocarbolic acid. Some carbolic acid escapes in the other excretions; some is burned up in the body. When very large doses are given carbolic acid itself may appear in the urine. CARBOLIC ACID. 253 \ Therapeutics. External.— Carbolic acid is largely used as a deodorant and disinfectant for drains, bed-pans, soiled linen, surgical instru- ments, the surgeon's hands, etc. Carbolic lotion (i in 40) is used to wash wounds to keep them antiseptic, and carbolized gauze (which is unbleached cotton gauze medicated with half its weight of a mixture of carbolic acid 1, resin 4, paraffin 4) is em- ployed as a dressing for the same purpose. A spray of a solution of carbolic acid was formerly much used to keep the air around the wound antiseptic during an operation, but it is now discarded as unnecessary. Glycerine of carbolic acid (B. P., 1 to 4) is a* very efficient preparation to destroy the fungus of tinea tonsurans or tinea versicolor ; for the latter it should be diluted. Because of its anaesthetic effect a strong solution (1 in 20) will relieve itching from any cause. Carbolized vapor has been inhaled in phthisis, but by the time it reaches the lungs it is far too dilute to have any action on the tubercle bacilli. Internal. — Mouth. — The glycerine, if diluted, may be ap- plied as a stimulant to the mouth in aphthous stomatitis, or when any indolent ulceration is present. A gargle (4 TTL of acidi carbolici to 1 fl. oz. of water) is an excellent preparation. The glycerine has been used for diphtheria, but probably it does no good, except that being a local anaesthetic it soothes pain. A piece of cotton soaked in strong carbolic acid will relieve pain if placed in a decayed tooth, but care must be taken to prevent it from coming in contact with the soft parts by putting another piece of dry cotton over it. Stomach. — Carbolic acid has been given to relieve flatulence, because it was thought that it would prevent decomposition in the stomach ; but it is powerless to do this, owing to the degree to which the gastric contents dilute it. Some state that it checks vomiting and helps to cure dyspepsia, but it is not a remedy which is universally regarded as useful for these purposes. It may, how- ever, be tried in obstinate cases. It has been given internally as an antiseptic in phthisis, but it does no good, and those who give 254 INORGANIC MATERIA MEDICA. it forget that probably very little carbolic acid reaches the lungs. Toxicology. If carbolic acid is at all concentrated, immediately on swallowing it there is an intense burning sensation in the mouth, gullet, and stomach, and white eschars form in the mouth. The patient is collapsed, his skin is cold and clammy. The breathing becomes more and more feeble and shallow, and finally stops. The urine is darkish green. Reflex movements are abolished, and ultimately he becomes insensible and comatose. Post mortem. — There are white, hard sloughs, with perhaps inflammatory redness round them, in the mouth, oesophagus, and stomach. The blood is dark and coagulates imper- fectly. In some cases fatty degeneration of the liver and kidneys may be found. Treatment. ,-^-Any soluble sulphate, such as an ounce of magnesium sul- phate or half an ounce of sodium sulphate dissolved in half a pint of water, is the natural antidote, because sulphates and carbolic acid form sulphocarbolates in the blood, and these are harmless. Before the antidote is given, wash out the stomach or use some very quickly acting emetic, as apomorphine given hypodermically. Give stimulants freely, such as ether or brandy subcutane- ously. Apply hot water bottles and blankets if there are any signs of collapse. SODII SULPHOCARBOLAS. Sulphocarbolate of Sodium. Symbol, NaC 6 H 5 S0 4 .2H 2 0. Source. — Sulphocarbolic acid is formed by adding sulphuric acid to car- bolic acid ; carbonate of barium is then added, and sulphocarbolate of barium is thus precipitated. This is treated with water and sodium carbonate; a solution of sodium sulphocarbolate is formed, and barium carbonate is precipi- tated. The solution is evaporated to crystallization. Characters. — Colorless, transparent, rhombic prisms, odorless or nearly so, soluble in 5 parts of water. Dose, 5 to 30 gr. Action and Therapeutics of Sulphocarbolate of Sodium. This substance is like carbolic acid, antiseptic, and may be used externally for this purpose. Internally it is occasionally given in the hope of controlling gastric fermentation. CREASOTUM. Creasote. Source. — It is obtained by the distillation of Wood tar. It consists of a mixture in variable proportions of guaiacol (C 7 H 8 2 ) and creasol (C 8 H 10 O 2 ). CREASOTE. 255 Characters. — A colorless or slightly yellow liquid, with a very strong peculiar odor and a burning taste. Sp. gr., 1.035 to 1-085. Solubility. — Sparingly in water, freely in alcohol, ether and glacial acetic acid. Impurity. — Carbolic acid. Incompatible. — Explodes when mixed with oxide of silver. Dose, ]/ 2 to 2 m. Preparation. Aqua Creasoti. — Creasote, 1 ; distilled water, 99. Dose, 1 to 4 fl. dr. Action and Therapeutics. Before the introduction of carbolic acid, creasote was used ex- ternally as a stimulating antiseptic, a parasiticide and a slight local anaesthetic ; and internally it was given for vomiting and flatulence. An aching tooth may be relieved if it is plugged with cotton thoroughly moistened in creasote. The most impor- tant use of creasote is as a pulmonary antiseptic, administered by the mouth, hypodermatically or by inhalation. To Bouchard and Gimbert belongs the credit of bringing before the profession, the use of creasote in cases of tuberculosis. It can be admin- istered in the form of an emulsion with cod-liver oil and acacia ; or with the hypophosphites and cod liver oil; or with the syrup of wild cherry and acacia, two minims of the creasote being con- tained in a teaspoonful of the emulsion or in a mixture of glyce- rine and whisky. The dose should be one-half to one minim given thrice daily and increased to twenty to twenty-five drops in the twenty-four hours, by easy stages. Administered in the form of enteric pills (which will dissolve only in the intestinal fluids) a daily dosage of forty-five to fifty drops can be reached without inconvenience. This method is preferable to that of Sommerbrodt which consists in the administration of one minim of creasote in two minims of cod-liver oil in capsules. The method of hypodermatic injection in sterilized olive oil requires a special apparatus, is very tedious, somewhat painful and alto- gether irksome to patient and physician. By inhalation it is employed with equal parts of alcohol and spirits of chloroform, or in alcohol, one part to eight, in a perforated zinc inhaler, of 256 INORGANIC MATERIA MEDICA. which fifteen drops are placed upon a bit of cotton and used for fifteen minutes in every hour. If the best beechwood creasote is employed, no untoward results are likely to be obtained. If the dose is increased too rapidly there may occur some nausea, epigastric uneasiness or even vomiting. Disturbance of the kidneys has been feared but beyond an occasional pain in the back no other symptoms have been noticed, and chemical and microscopical examination of the urine has revealed nothing unusual. The stomach symptoms have been relieved by the patient placing himself upon his back, for an half hour after administration of the remedy. It is quite likely that the patients acquire a tolerance, for the daily dose of three hundred drops has been given for a considerable time with benefit. IODOFORMUM. Iodoform. Symbol, CHI 3 . Source. — Heat together alcohol, iodine, carbonate of potassium, and water. C 2 H 6 0+ 4 I 2 +3K 2 C0 3 =CHI,+KCH0 2 +5KI+2H 2 0+3C0 2 . Characters.— Small, lustrous, lemon-yellow, hexagonal crystals, with an insuppressible odor. Very slightly soluble in water and alcohol, freely in fixed and volatile oils, ether and chloroform. It contains more than 90 per cent, of iodine. Dose, 1 to 3 gr. Preparation. Unguentum Iodoformi. — Iodoform, 10; benzoinated lard, 90. Action. External. — Iodoform is antiseptic and disinfectant, if we may judge by the results obtained in clinical practice ; but the experimental evidence that it has no power to hinder the devel- opment of Staphy loc co cus pyogenes, Bacillus subtilis, and other micro-organisms is very strong, for all, except one or two experi- menters, state that it has no antiseptic properties. At present we have no explanation of these discrepancies. It is probable that much of its action is due to the free iodine that is given off from it, but in spite of this it is not irritant, but decidedly analgesic. It is readily absorbed from wounds. IODOFORM. 25 7 Internal. — Not much is known about the internal action of idoform. It is eliminated in all the secretions, but chiefly in the urine, as iodine, iodides, and iodates. They may be found in the urine for three days after administration of iodoform. Therapeutics, External. — Iodoform is much used as a local stimulant, an- tiseptic and disinfectant. The clinical testimony as to its value is overwhelming. Its anaesthetic influence diminishes the pain, if there is any, of the sores to which it is applied. It is an excellent application for all sorts of ulcers, sores and wounds, but especially for tubercu- lous and syphilitic ulcerations. Iodoform powder is usually sprinkled on them. Wounds are often painted with a solution of it in collodion. This is an excellent application. Mixed with subnitrate of bismuth, it is useful as an insufflation for ozaena, ulcers of the mouth and throat, and tuberculous ulcers of the larynx. It has been used in the form of a bougie for the urethra. The suppository (B. P., each, 3 grains in 12 of oil of theobroma,) is useful in painful conditions of the rectum. It is occasionally employed for pruritus, and to relieve the pain of neuralgia. Many attempts have been made to get rid of its odor; the best way is to dissolve it in volatile oil of camphor or balsam of Peru, or to add musk to it. Internal. — Iodoform has not been found to be of any use internally. It has been tried unsuccessfully in phthisis and many other conditions. Toxicology. Curious symptoms, often severe and sometimes ending in death, are occasionally observed after the application of iodoform to a raw surface. They are a quick pulse, gastro-intestinal irritation, fever, rapid collapse, mel- ancholia, hallucinations, dilated pupils, extensive erythema and perhaps ec- zema. These symptoms vary much in severity, and it is rare for more than two or three of them to be present at once. Stimulants, diaphoretics and sponging the skin with warm water are recommended. 258 INORGANIC MATERIA MEDICA. Class VI. — The Remaining Carbon Compound. ACIDUM HYDROCYANICUM DILUTUM. Diluted Hydrocyanic Acid. Symbol, HCN. Synonym. — Prussic acid. Source. — Distil a mixture of ferrocyanide of potassium, sulphuric acid and water, into alcohol and water. 2K 4 FeC 6 N 6 +3H 2 S0 4 =3K 2 S0 4 +6HCN +FeK 2 FeC 6 N 6 . The distillate is diluted with water until 100 gr. or no TTL treated with nitrate of silver yield 10 gr. of precipitated dried cyanide of sil- ver. It is then a 2 per cent, by weight solution. Scheele's prussic acid is a 4 or 5 per cent, solution. Characters. — A colorless, volatile, faintly acid liquid, having an al- mond-like odor. Very unstable ; to preserve it best, it should be kept in inverted blue stoppered bottles. Old specimens may be inert. Sp. gr. 0.997. Strength. — 2 per cent. Incompatibles. — Salts of silver, copper and iron, red oxide of mercury, and sulphides. Impurities. — Sulphuric and hydrochloric acids. Dose, 1 to 3 m. Action. External. — Hydrocyanic acid can pass through the epider- mis, and then it paralyzes the terminations of the sensory nerves ; thus it is a local anaesthetic and sedative. It is very rap- idly absorbed from raw surfaces, and may cause poisoning if applied to them. Internal. — Alimentary tract. — It is quickly absorbed by mucous membranes, and has the same anaesthetic and sedative effect on the mouth and stomach as on the skin. It must always be employed very dilute.' A single drop of the pure acid placed inside the eye of even a moderately large animal will kill it in- stantly. Blood. — If death takes place almost immediately after the administration of the drug, all the blood in the body is a bright arterial tint; but if death does not occur for some little time (within half an hour), the blood is of a dark venous color. The primary transitory reddening of the venous blood is due to the fact that the haemoglobin in it is oxidized ; we do not know the cause of this. The subsequent darkening of the arterial blood is due to the fact that it has lost its oxygen, and contains carbonic HYDROCYANIC ACID. 259 acid gas ; why this should be is not certain, but probably it de- pends upon the asphyxia consequent upon the action of hydro- cyanic acid on the respiratory centre. If blood be shaken up with prussic acid, after some time oxyhemoglobin is converted into cyanohaemoglobin, the oxygen being turned out. Prussic acid added to drawn blood alters the shape of the red blood- corpuscles. Neither of these actions is seen in life, for sufficient prussic acid to cause them would kill before they could take take place. Heart. — Large doses cause instantaneous diastolic arrest. As this is also true if the drug is applied locally, we may con- clude that large doses paralyze the heart directly. But prussic acid acts also on the cardiac centre in the medulla. A small dose will cause a slowing of the pulse from stimulation of the vagus centre, and the stoppage from larger doses is due both to the direct action on the heart and to that on the medulla. Vaso-motor system. — The vaso-motor centre in the medulla is first briefly stimulated, but soon profoundly paralyzed ; blood- pressure therefore falls very low. Respiration, — The respiratory centre is paralyzed even more readily than the cardiac or vaso-motor centres, conse- quently the respirations quickly diminish both in force and fre- quency. Unless the heart has been instantaneously stopped by a large dose, asphyxia is the cause of death, and the heart goes on beating after the respirations have stopped. Occasionally, if the dose be small, all three centres may be at first very transitorily stimulated, so that for a few seconds the pulse and respirations may be increased in frequency, and blood-pressure may rise. Nervous System. — Cerebrum. — Medicinal doses of prussic acid have no effect on the cerebrum. Toxic doses cause deep insensibility and coma. In man convulsions are rarely seen ; in animals they are common. It is not known how far the coma and convulsions are due to the direct effect on the brain, the altered circulation through it, or the asphyxia. Peripheral nerves and muscles. — In animals dead of prussic acid poisoning these are unexcitable. This paralyzing effect is due to direct action on the nerves and muscles themselves, for it does 260 INORGANIC MATERIA MEDICA. not occur in the peripheral part of a limb if it is connected with the rest of the body only by its nerve. In this case, as no blood is circulating through the distal part of the limb, no prussic acid reaches it; but if the acid be applied locally to the severed limb, the nerve and muscles are paralyzed. This explains the local anaesthetic effect of prussic acid. Shortly before death the spinal cord is paralyzed. The pupil is dilated. We do not know of any effect of prussic acid on the kidneys, nor how it is excreted. Therapeutics. External. — Lotions of a strength of about tttx of the diluted acid to ^j of water are valuable for allaying itching due to any cause. If the skin is abraded they must not be used. Internal.— Small doses, i to 2 Ttl of the diluted acid are used for their sedative effect on the nerves of the stomach, to allay vomiting, and to relieve gastric pain, whatever be their cause, and often with good effect. A useful way of giving it is in an effer- vescent draught. It is a common ingredient of cough mixtures, for by its depressing effect on the central nervous system it dimin- ishes reflex excitability, and is consequently most serviceable for a dry, hacking cough by means of which nothing is expectorated. Toxicology. With a large dose the symptoms usually begin in a few seconds ; it is rare for them to be delayed more than two minutes. The patient is perfectly insensible; the eyes are fixed and glistening, the pupils dilated, the limbs flaccid, the skin cold and clammy. The respiration is slow, deep and con- vulsive; the pulse almost imperceptible. Post Mortem. — There may be an odor of prussic acid about the body, which is very livid. The fingers are clenched, the jaws firmly closed, and there is froth at the mouth ; the eyes are fixed and glistening, and the pupils dilated. The stomach may be a little reddened; the blood is very dark. Treat7nent. — Wash out the stomach immediately. If emetics are avail- able, large doses must be given promptly, for every moment is important. Give ether or brandy and -^ gr. of atropine subcutaneously. Use inhalations of ammonia and artificial respirations. Part II.— ORGANIC MATERIA MEDICA. Section I.— PHARMACOPCEIAL SUBSTANCES DERIVED FROM THE VEGETABLE KINGDOM. The drugs comprehended in this section may be arranged in many ways ; but there are objections to each. Inasmuch as the medical student has to be well acquainted with the actions of these drugs in health and disease, those which act similarly will be grouped together. GROUP I. Drugs acting chiefly on the Nervous System. These may be classified as follows : Class I. — Acting on the cerebrum. A. Cerebral depressants or soporifics : Opium. Hop. Lettuce. B. Cerebral excitants : { Belladonna. -\ Also act on nerve endings t\ y • t Stramonium. V in glands and involuntary I Hyoscyamus. J muscle. [ Cannabis Indica. Caffeine. Class II. — Acting on the spinal cord. A. Exciting the cells of the anterior cornua. Strychnine. B. Depressing the cells of the anterior cornua. Calabar bean, Gelsemium. Class III. — Acting on the nerves. A. Depressing the motor nerves. Conium, Nicotine. B. Depressing the sensory nerves. Cocaine. c. Stimulating the secretory nerves. Jaborandi. OPIUM. Opium.-— The juice obtained by incision into the unripe capsules of Papaver somniferum, the white poppy (Nat. Ord. Papaveracece)^ and inspis- sated by spontaneous evaporation. Imported from Asia Minor. Any ordi- nary variety may be used to obtain the alkaloids; but the preparations of 261 262 ORGANIC MATERIA MEDICA. opium must be of such a strength that in its normal moist condition it shall yield not less than 9 per cent, of morphine. Characters. — Asia Minor opium. (Synonyms. — Smyrna, Turkey and Levant opium.) Rounded, irregular or flattened masses, commonly from 8 oz. to 2 lbs. in weight, usually covered with portions of poppy leaves, and scattered over with reddish-brown chaffy fruits of a species of Rumex. When fresh, it is plastic, moist, coarsely granular, reddish or chestnut-brown, but becoming harder by keeping, and darkening to blackish brown. Odor strong, peculiar, narcotic. Taste nauseously bitter. A fluid preparation reddens litmus paper, owing to the presence of meconic acid. Varieties. — The above is the only official opium of B. P. ; but the following are met with in commerce, and may be used to prepare the alkaloids : (a) Con- stantinople opium, small lenticular masses, j£ to ^ lb. in weight, and en- closed in a poppy leaf, but without the Rumex seeds. Sometimes the terms Turkey and Levant opium include this, (b) Egyptian opium. Flat, more or less circular cakes, two or three inches in diameter, reddish hue internally, covered with a leaf externally. Persian, Indian, English, French and Ger- man opiums are rarely met with in England. Composition. — (1) Alkaloids. — At least eighteen in number. Most are combined with meconic acid, some with sulphuric acid, and some are free. Some morphine salts and codeine are officinal. These two alkaloids and nar- ceine and thebaine are important. The following are the alkaloids existing in opium : Morphine (up to 12 per cent.). Cryptopine. Codeine (up to 0.6 per cent.). Hydroctarnine. Thebaine (up to 0.3 per cent.). Laudanine. Narcotine. Laudanosine. Narceine. Meconidine. Papaverine. Rhceadine. Pseudo-morphine. Codamine. Protopine. Gnoscopine. Oxynarcotine. Lanthoptine. (2) Neutral bodies. — Two in number : Meconin. Meconiasin. (3) Organic acids. — Two in number. Meconic acid is official in B. P. Meconic acid. Thebolactic acid. (4) Water, 16 per cent. (5) Mucilage, resin, albumen, glucose, fats, essential oil, caoutchouc, odor- ous substances, and salts of ammonium, calcium and magnesium. . Impurities. — Water, stones, fruits, leaves, starch, etc. Incompatibles. — Perchloride of iron gives a deep red color (due to OPIUM. 263 meconic acid). Salts of zinc, copper and arsenic, nitrate of silver, acetate and subacetate of lead, give precipitates of meconates, sulphates and coloring matters. All tannin-containing preparations precipitate tannate of codeine. Fixed alkalies, their carbonates and ammonia precipitate morphine and nar- cotine. The small amount of glucose in opium may cause it to explode when made into a pill with nitrate of silver. Dose, j( to 2 gr. 1. OPIUM DENARCOTISATUM. Source. — Powdered opium (containing 14 per cent, of morphine), 100 parts is macerated with 500 parts of stronger ether, the clear solution poured off, and macerated twice with 250 parts of the ether. The residue is dried and mixed with sugar of milk by trituration to weigh 100 parts. Strength. — It should assay 14 per cent, of morphine. Dose, ]i to 2 gr. Preparations. 1. Opii Pulvis. — Opium dried at a temperature not exceeding 185 F., and reduced to a moderately fine powder. Powdered opium, for pharmaceutical or medicinal uses, should contain not less than 12, nor more than 16 per cent, of morphine, when assayed by the process given under opium. Dose, ^ to 2 gr. 2. Extractum Opii. — Opium, 100; distilled water, 750; glycerine, a sufficient quantity ; by maceration, filtration and evaporation. Dose, y% to 1 gr. 3. Emplastrum Opii. — Extract of opium, 6; Burgundy pitch, 18 ; lead plaster, 76 ; water, 8. 4. Trochischi Glycyrrhizae et Opii. — Extract of glycyrrhiza, 200; extract of opium, 5 ; acacia, 200; sugar, 300; oil of anise, 3 grs. To make 100 troches. Dose, 1 to 4. 5. Vinum Opii. — Powdered opium, 10 ; cinnamon bark, 1 ; cloves, 1 ; stronger white wine to 100 ; by maceration and filtration. Dose, 3 to 20 m. 6. Pilulae Opii. — Powdered opium, 100 ; soap, 25 grs. To make 100 pills. Dose, 1 to 2. 7. Pulvis Ipecacuanhas et Opii. Synonym. — Dover's powder. Powdered opium, 10; ipecacuanha, 10; sugar of milk, 80. Dose, 3 to 15 gr. 264 ORGANIC MATERIA MEDICA. 8. Acetum Opii. Synonym. — Black Drop. Powdered opium, 10 ; nutmeg, 3; sugar, 20. Diluted acetic acid to 100; by maceration and percolation. Dose, 3 to 20 m. 9. Tinctura Opii. Synony??i. — Laudanum. Powdered opium, IO; alcohol, 4; water, 4; diluted alcohol to 100; by maceration and percolation. Dose, 3 to 20 m. 10. Tinctura Opii Camphorata. Synonym. — Paregoric. Pow- dered opium, 4; benzoic acid, 4; camphor, 4; oil of anise, 4; glycerine, 40; diluted alcohol to 1000; by maceration and percolation. Dose, 1 to 4 fl. dr. 11. Tinctura Opii Deodorata. — Powdered opium, 10; ether, 20; alcohol, 20; water to 100. By maceration, expression and evaporation. Dose, 3 to 20 m. 12. Tinctura Ipecacuanhae et Opii. — Deodorized tincture of opium, 100; fluid extract of ipecac, 10; diluted alcohol to 100. By evaporation and filtration. Dose, 3 to 15 m. It will be noticed that from extract of opium there are prepared Emplas- trum Opii, Trochisci Glycyrrhiza et Opii, and from the deodorized tincture is prepared, Tincturae Ipecacuanhae et Opii. The following list, in which the doses are arranged, may assist the stu- dent : Name. — Ext. Opii. — Pulvis Opii. — Opium Denarcotizatum. — Pulv. Ipecac, et Opii. — Tinct. Ipecac et Opii. — Vinum Opii. — Tinct. Opii. — Tinct. Opii Deodorata. — Acetum Opii. J — Tinct. Opii Camphorata. I — 4 fl. dr. — Pilulae Opii. I to 2. — Trochisci Glycyrrhizae et Opii. 1 to 4. — Emplast. Opii. Externally. Dose. %• -1 gr. x- -2gr. 3- 3- -15 gr. -15 m- 3— 20IH OPIUM. 265 MORPHINA.— Morphine. Symbol, C 17 H 19 N0 3 H 2 0. An alkaloid prepared from opium. Colorless or white, shining prismatic crystals, having a bitter taste and an alkaline reaction. Very slightly soluble in water. Dose, }£ to X S r - MORPHINE HYDROCHLORAS.- Hydrochlorate of Morphine. Symbol, C 17 H 19 N0 3 ,HC1,3H 2 0. Source. — (1st.) Take a cold concentrated watery solution of opium, precipitate the meconic acid and resins with chloride of calcium. The solu- tion contains hydrochlorate of morphine. (2nd.) Evaporate the solution till it is solid, press to remove coloring matter, exhaust with boiling water, filter, and again evaporate and press ; repeat this till the solution is nearly colorless. (3rd.) Complete the decolorization by digesting with charcoal. (4th.) Pre- cipitate the morphine with ammonia and wash. (5th.) Dissolve in hydro- chloric acid and crystallize out. Characters. — White, feathery, flexible, acicular crystals, with a silky lustre. Solubility. — 1 in 24 of water, 1 in 63 of alcohol, I in 8 of glycerine. Incompatibles. — Salts of lead, iron, copper, mercury and zinc ; alkaline carbonates; lime water; Liquor Potassii Arsenitis; all substances containing tannin. Dose, j4 to X g r - MORPHINE ACETAS.— Acetate of Morphine. C 17 H 19 N0 3 ,HC 2 H 3 2 , 3 H 2 0. Source. — Morphine is precipitated with ammonia from a solution of the hydrochlorate. It is dissolved in acetic acid and water, and the solution is evaporated. Characters. — A white powder. Solubility. — 1 in 12 of water. Many specimens are not so soluble as this. I in 68 of alcohol, I in 5 of glycerine. Dose, y s to X g r - MORPHINE SULPHAS.— Sulphate of Morphine. (C 17 H 19 N0 3 ) 2 H 2 S0 4 , 5 H 2 0. Source. — Morphine is precipitated from a solution of the hydrochlorate by ammonia, and is dissolved in sulphuric acid and water, and the solution is evaporated. Characters. — Colorless, feathery, silky needles. Solubility. — 1 in 24 of cold water, freely in hot water, sparingly in alcohol. Dose, y 8 to X gr. Preparations. 1. Pulvis Morphinae Compositus. — Synonym. — Tully's Pow- der. Sulphate of morphine, I; camphor, 20; glycyrrhiza, 20; preci- 23 266 ORGANIC MATERIA MEDICA. cipitated carbonate of calcium, 20 ; alcohol, a sufficient quantity. By trituration. Dose, 5 to 15 gr. 2. Trochischi Morphinae et Ipecacuanhae. — Sulphate of Mor- phine, 5; ipecac, 16; sugar, 2000; oil of gaultheria, 2 grains; mucilage of tragacanth, a sufficient quantity to make 200 troches. Strength. — To grai 11 °f morphine in each. Action. The action and uses of opium are due almost entirely to its morphine, and therefore they may be studied together. External. — Opium probably has no action when applied to the unbroken skin, but it has been said to be slightly anodyne. It can be absorbed from and relieve the pain of raw surfaces. Internal. — Alimentary canal. — Opium diminishes all the secretions of the body except the sweat. The mouth consequently becomes dry, and the patient feels thirsty, but after a small dose not markedly so. This effect is partly due to the direct action of the opium on the mouth, but to a less extent to its influence exert- ed after it has been absorbed. In the stomach and intestine, by the same double action, the secretion of the gastric and intestinal juices is diminished. The drug also paralyzes the peristaltic move- ments of the stomach and intestines. This is due to stimulation of the center of the nerves (splanchnics) which inhibit these move- ments. The result of the diminution of secretion and peristalsis, is that opium appeases hunger, often causes indigestion, almost always gives rise to constipation, and if vomiting or diarrhoea is present it will prevent it. These actions are also in part due to its general sedative influence on the nervous system. If pain exists in the abdomen or elsewhere opium is a powerful anodyne. Most of it is absorbed, but rather slowly. Blood. — Morphine for the most part circulates in the blood as such, and is excreted by the kidneys, but a small part of it is destroyed in the liver. The fate of the other alkaloids is not known, nor are we aware of any direct action of any of the constituents of opium on the blood itself. OPIUM. 267 Circulation. — In an ordinary healthy man small doses of opium do not affect the heart or vessels. Large doses first increase and then diminish the action of the heart, which finally stops in diastole. These effects can be produced by applying the drug to the organ, it therefore directly affects either the cardiac muscle or the nerves in it. But this local action is augmented by the less im- portant influence of opium on the vagal center ; this is at first stimulated, and about the time at which the heart itself is depressed, so that both these actions make the pulse slow. Just before death the vagus is depressed, but the heart itself is by that time so feeble that the pulse is not quickened. Patients rarely die from the effect of opium on the heart and its nervous apparatus, this being much less important than the influence on respiration. The vaso-motor system is not affected till towards the end of the symptoms due to toxic doses ; then the vessels dilate from the action of the drug on the vaso-motor centers in the medulla and cord. Respiration. — Opium is a direct poison to the respiratory center. Breathing therefore becomes difficult, and death takes place from asphyxia. Nervous system. — Brain. — The higher faculties are at first excited even by small doses. In a few persons there is no inco- ordination in this excitement. The intellectual power and men- tal vigor are increased, and therefore the drug is taken by some people to enable them to do their mental work. Usually, how- ever, the excitation does not affect the mind evenly ; generally the imagination is powerfully and pleasantly excited, much more so than the faculties of reason and judgment, which are a little dulled. The expression on the face is one of happiness and comfort, and this corresponds with the condition of the mind, which is in a state of peace, calm and happiness. This is soon succeeded by sleep, which is accompanied by pleasant dreams, generally of an impossible nature. With some persons, however, the sleep is quite dreamless. This, which is the beginning of the depression of the highest centers, is soon followed by depression of the others, the higher being influenced before the lower, so 268 ORGANIC MATERIA MEDICA. that soon the sleeper does not respond to any sound, light, or cutaneous stimulation, nor does he feel pain. It is this last fact that makes the drug so invaluable. The dose requisite to annul pain depends, of course, upon the severity of it. If a large amount is given, often there is no primary excitement, and then the first symptom that opium has been taken is drowsiness. On waking from sleep induced by opium some persons feel quite well, but usually there is a little languor, headache, and nausea. Opium eaters take it for its stimulant effect. It is given medicinally as an hypnotic and anodyne. The pupil is contracted; this is due to the effect of the drug on the pupillary center in the floor of the aqueduct of Sylvius. In man, just as the stimulation of the in- tellectual centers is brief, so is that of the cerebral motor centers, — in fact, it is often difficult to detect any evidence of it. Their subsequent depression is never so marked as that of the intellec- tual faculties ; for although there is languor and muscular weak- ness, and the patient always lies down, yet he can be walked about if he is supported. Vomiting is occasionally caused by transient irritation of the vomiting center, but soon it is de- pressed, and therefore emetics do not act well in cases of opium poisoning. The motor cells of the spinal cord are at first slightly stimu- lated, and consequently reflex excitability is exaggerated; but they are soon depressed, and it is difficult to obtain reflex movements. The excitability of motor and sensory nerves is, perhaps, a little increased at first, but in the later stages of opium poisoning they are depressed, the sensory before the motor. The muscles remain irritable to the last. Opium, in its action on the nervous system, illustrates the common fact that functions at first stimulated by a drug are usually subsequently paralyzed by it ; and it affords an excellent example of the law of dissolution, for higher functions, such as the intellectual and imaginative, are first affected ; motion is then disordered ; next the pupillary center, and then the medullary centers for respiration and cardiac action are implicated. The OPIUM. 269 spinal cord is influenced to a less degree, the nerves very slightly, and the muscles riot at all. In man the peculiarities of the action of morphine are its pre- dominating influence on the higher mental functions, and the slight affection of the motor and the vaso-motor centers, the cord, the nerves, and the muscles. In frogs, morphine produces violent convulsions, because its predominating action is to stimu- late the spinal cord. Birds are peculiarly insusceptible to mor- phine. Mammals are for the most part affected in the same way as man, sleep and death from asphyxia being the leading symptoms ; but in many of the lower mammals spinal symptoms are very marked. Kidneys. — Sometimes opium slightly increases, sometimes it slightly decreases the urinary flow. : Skin. — Opium is a mild diaphoretic. Metabolism. — Opium depresses the biliary function of the liver, for the person taking it secretes less bile. If he has glyco- suria, the amount of sugar he passes in the urine is diminished. General metabolism appears to be decreased also, for it is stated, that the amounts of uric acid and carbonic acid excreted are lessened, but some experimenters contradict this statement. Peculiarities. — There are few drugs which have such different effects upon different people. The above description states the manner in which most human beings are affected, but in some the stage of excitation is very evident, so that they become deli- rious and cannot sleep. In others, vomiting and indigestion are very marked. Some of these peculiarities are due, no doubt, to the varying composition of opium. Children are easily poisoned by it, and therefore only small doses should be administered to them ; women are more readily affected than men. Persons who take it habitually soon tolerate enormous quantities. It may pro- duce an erythematous eruption on the skin. Differences in action between opium and morphine. — (1) Mor- phine, being more readily absorbed, acts more quickly. It is especially suitable for. subcutaneous injection \ given in this way it acts very rapidly. (2) Opium is more liable to upset the diges- 270 ORGANIC MATERIA MEDICA. tion and to cause constipation, but this last fact often makes it the more valuable in many abdominal diseases. (3) Opium is the better diaphoretic. (4) Morphine is more certain in its action as an anodyne and soporific ; possibly this is because of the other powerful alkaloids in opium. (5) Opium is stated to act more powerfully in reducing the amount of sugar present in the urine in glycosuria. Therapeutics. External. — Hot fomentations or poultices sprinkled with laudanum are often applied to painful parts, but probably it is the heat and not the opium which relieves the pain. Linimentum Opii (B. P., tincture of opium and soap liniment; equal parts), rubbed into the skin diminishes the pain of chronic rheumatism and myalgia ; probably in this case the friction is more effica- cious than the opium. Locally applied to sores and ulcers, it may sooth the pain due to them. The ointment of galls and opium (B. P., powdered opium, 30 gr. to ounce of gall oint- ment) will often relieve the pain of piles and anal fissures, es- pecially if a mild laxative is given by the mouth. Internal.— Stomach. — Morphine is of great service for the pain of gastric ulcer, cancer, or even for simple painful dys- pepsia. A solution of morphine, (1 gr. to ounce of water, dose, 1 fl. dr.) is preferable to opium, as that may aggravate the indi gestion. Morphine is frequently combined with preparations of bismuth, and taken immediately before or after meals. Many forms of vomiting are relieved by morphine, because it decreases pain, peristalsis, and excessive secretion. Intestines. — Opium is invaluable for stopping many varieties of diarrhoea. If they will yield to any treatment, opium is most likely to be successful. Intestinal colic, being due to irregular ex- cessive perstaltic action, is generally relieved by opium, — and, indeed, so is abdominal pain of all sorts. In all inflammatory conditions of the peritoneum full doses of opium must be given, the object being so to paralyze the intestinal movements as to prevent the peritoneal surfaces rubbing against each other. It is the great mainstay in perityphlitis, acute peritonitis, and after OPIUM. 271 operations or wounds in the abdomen. Opium is far preferable to morphine for abdominal cases; if they are severe it must be boldly pushed, the patient being kept just drowsy with slightly contracted pupils, and it often does not matter if the bowels are not open for a month. The more recent practice, however, is to keep the bowels slightly open by the use of salines. Heart — Much skill is required to give opium properly in heart disease. The hypodermic injection of morphine is, on the whole, to be preferred to opium. The great indication for it is when cardiac pain and distress keep the patient awake. Often it acts like a charm, a quiet refreshing sleep being the result of a single injection. No doubt it is a cardiac depressant, but we have to set against this the exhaustion of pain and insomnia. Still, if the patient is very ill, these two factors must be carefully balanced. It likewise often relieves the pain of aneurism and intra-thoracic growths. Its depressant effect may be to some extent counterbalanced by combining belladonna with it. Vessels. — Opium is an excellent haemostatic. It is probably efficient after absorption, but its great value is in intestinal haem- orrhage, when it acts partly by stopping peristaltic movements. An excellent form in which to give it is the Pilula Plumbi cum Opio, (B. P., powdered opium and confection of roses, 1 part each, acetate of lead, 6 parts; dose, 3 to 5 grs.) Respiration. — It will be remembered that opium depresses the respiratory center ; therefore it, by diminishing the activity of the center for the reflex act of coughing, will often alleviate this distressing symptom, but it is only justifiable to give it when the irritation which reflexly sets up a cough is irremovable, as in intra-thoracic growth or aneurism, or when there is little or no lividity and yet the cough is violent, as is often the case in pleu- risy. The liability to lividity and asphyxia in many diseases at- tended with cough must never be forgotten. Thus opium is quite inadmissible in the last stages of bronchitis and pneumonia, and, as a rule, in even the earlier stages of these diseases other means of relieving the cough should be tried first; and if opium is given, it must be administered with great caution and judgment. 272 ORGANIC MATERIA MEDICA. A "linctus opiatus," a favorite remedy, is often given at night when a cough keeps the patient awake. It may consist of tinc- ture of opium, 2 Ttl; dilute sulphuric acid, 2 HI; treacle, 30 Tit; water to 3J- The object of the treacle is to sooth the pharynx locally. Opium must also be given cautiously for asthma, as there is in this disease a great liability to the growth of a permanent opium habit. Nervous system. — Brain.— -It is in its action on this organ that the marvellous value of opium is seen, its great function be- ing to relieve pain and to produce sleep when that is prevented by pain. For these purposes it is best given hypodermically as morphine, for that acts more quickly, more certainly, and is less liable to produce indigestion and excitement than opium. It would be a long list to give all the diseases the pain of which can be relieved by morphine; cancer and fractures are typical instances Morphine is very valuable for the insomnia of acute diseases; but it should never be prescribed for habitual sleepless- ness, for fear the patient should contract the habit of opium tak- ing — unless the disease causing the insomnia is incurable, when the use of opium is quite justifiable. It should not be given in gout, for that is often accompanied by granular kidneys; nor for hysteria, for often it does not relieve hysterical pains, and an opium habit may be formed. It is especially useful in renal and biliary colic, and for the after-pains of a confinement. In these cases it relieves the pain partly from its power as an anodyne, and also because by its paralyzing effect on unstriped muscle it relaxes the muscular contraction. This property also makes it valuable in some cases of spasmodic stricture of the urethra. It may be given as a sedative in delirium tremens and some forms of mania, but often such large doses are required that its use is not justifiable. Patients suffering great pain can take enormous doses without any symptoms of poisoning. Spinal cord. — It has been used for pains of locomotor ataxia and occasionally in convulsive diseases, but without much success. Kidneys. — It should always be remembered that morphine is excreted with difficulty, if the kidneys are diseased. There are OPIUM. 273 several cases recorded in which persons suffering from Bright's disease have been killed by quite small doses of opium. Skin. — Combined with ipecacuanha as Dover's powder, opium is commonly given as a mild diaphoretic, in cases of slight inflam- matory disorder, such as a common cold. Metabolism. — Opium is administered to persons suffering from diabetes, and the amount of sugar in the urine certainly dimin- ishes and the patient's general health improves, but, however, codeine is preferable. Opium can, in the opinion of many, con- trol all varieties of inflammation, therefore it is given for a cold in the head, for cystitis, pleurisy, etc. Occasionally persons taking opium suffer from retention of urine. We have indicated the occasions on which opium and morphine are respectively preferable. Toxicology. Acute poisoning. — There may be slight preliminary excitability ; but soon drowsiness sets in. This is followed by incapacity for exertion, sleep, and finally deep coma. The pupils are minutely contracted. At first the patient can be roused ; but soon no stimulation will do this. Reflex action is abol- ished. The skin is cold, the face and lips are livid, and towards the end bathed in sweat. The pulse is weak and slow. The respiration becomes slower and more irregular; at last it is stertorous, and the patient dies from asphyxia. Diagnosis of poisoning by opium. — 1. From alcoholic poisoning. — Often very difficult, especially if, as commonly happens, the man poisoned with opium has taken alcohol or had it given him. The pupils are more contracted in opium poisoning. The patient is more easily roused in alcohol poisoning. Examine the urine for morphine and alcohol. Get a careful history. 2. From cerebral hemorrhage. — If this is in the pons Varolii, the pupils may be very contracted and the diagnosis difficult, but look carefully for local para- lyses. Usually cerebral hemorrhage takes place into the internal capsule, and then the face and the limbs on one side are paralyzed. If the haemorrhage is a small one, and especially if it is in the pons, the temperature may be raised; if it is a very large one, the temperature falls for the first few hours, but may rise subsequently. If the pupils are unequal, the case is one of cerebral haem- orrhage. 3. From carbolic acid poisoning ■, in which there may be coma and contracted pupils. The acid produces white patches in the mouth, and the odor is characteristic. 4. From chlorofo?'m and ether poisoning, by the odor of the breath and of the vomited matters. 5. From urcemia, by the signs of 24 274 ORGANIC MATERIA MEDICA. Bright' s disease, especially albuminuria. 6. From diabetic coma, by the smell of the breath and the glycosuria. 7. From the comatose stage of an epileptic jit, by the history, the dilatation of the pupils, and the fact that the lividity does not deepen. 8. From the same stage of a fit in general paralysis of the insane and other nervous diseases, by the same symptoms. Post mortem. — The appearances after death from opium poisoning are those always found after fatal asphyxia. Treatment. — Wash out the stomach. Give prompt emetics (p. 76), as apomorphine subcutaneously. Always rouse the patient by walking him about, flapping him with a towel, pinching him, applying the faradic current, and putting ammonia to the nose ; a pint of strong coffee should be injected into the tectum, -^ gr. sulphate of atropine given subcutaneously, or 30 TTL °f tincture of belladonna by the mouth repeated every quarter of an hour. If the breathing is very difficult, artificial respiration should be employed. Ni- trite of amyl inhalations may be used. The treatment must be kept up for several hours if necessary. Antagonism. Atropine. — Atropine (alkaloid of belladonna) is a valuable antidote to morphine, because it powerfully stimulates the respiratory center. It also stimulates the cerebral convolutions and intestinal peristalsis, both depressed by morphine. It appears to be antagonistic to opium in other particulars, but is not really so. Thus, although it prevents perspiration and dilates the pupil, these effects are due to action on the peripheral nerve terminations, while morphine produces contrary results by acting on the central nervous system. Still it has been found that some of the undesirable effects that may follow the subcutaneous injection of morphine, such as indigestion, constipation and cardiac depression, may be avoided if T ^ to T i^ gr. of sulphate of atropine is injected at the same time. CODEIN A.— Codeine. C 18 H 21 N0 3 ,H 2 0. Source.— Obtained by evaporating the ammoniacal liquids, remaining after the precipitation of morphine by ammonia in the preparation of the hydro chlorate, treating the residue with water, precipitation with caustic pot- ash, and purifying by dissolving in ether and letting the codeine crystallize out. Characters. — Nearly colorless, more or less translucent, rhombic prisms. Solubility. — 1 in 80 of cold water, I in 17 of boiling water, I in 2 of alcohol, I in 2 of chloroform. Dose, j^ to 2 gr. Action and Therapeutics. It may produce tremors because it excites the cord more, and depresses the higher faculties less, than morphine. It is used to AP0M0RPHTNE. 275 diminish the glycosuria in diabetes, and as an analgesic. It is usually given as a pill. APOMORPHINiE HYDROCHLORAS.— Hydro chlorate of Apo- morphine. C 17 H 17 N0 2 ,HQ. Source — It is the hydrochlorate of an alkaloid obtained by heating mor- phine or codeine in sealed tubes with hydrochloric acid. The morphine loses one molecule of water, thus: C 17 H 19 N0 3 =C 17 H 17 N0 2 -f-H 2 0. Characters.— Small, grayish-white, shining needles, turning green on exposure to light and air; faintly acid. Solubility. — 1 in 6.8 of water, 1 in 50 of alcohol. Dose, 23- to i S T - hypodermically, Jj to T L gr. by the mouth. Action. External.. — None. Internal. — Gastro-intestinal tract. — Apomorphine is the most powerful emetic we possess. It does not act locally on the stomach, but solely on the vomiting center in the medulla. It is therefore, an indirect emetic. This is shown by the fact that when the drug is injected subcutaneously it produces violent vomiting if the vessels are so tied that none can reach the stom- ach, but not if they are so tied that it cannot reach the medulla. Circulation. — Therapeutic doses have no effect • beyond the depressing action which may be attributed to the vomiting. Large doses cause a rise in the rate of the pulse, probably from stimulation of the accelerator nerves, and with fatal doses the pulse-rate falls, because the drug directly paralyzes the cardiac muscle. Respiration. — This is at first stimulated by the act of vomit- ing. The effect of poisonous doses is doubtful ; probably they depress respiration. The physiological experiments show that it produces a watery discharge from the blood vessels of the respira- tory mucous membrane, which is found to be paler after the admin- istration of this remedy, and as well less cedematous. This effect is produced within a half hour after injection, and it is not in any respect the first stage of emesis. Nervous system. — The first result of toxic doses is to cause delirium. Finally there is paralysis of the motor nerves, and consequently of the muscles. 276 organic materia medica. Therapeutics. Vomiting action. — The advantages of apomorphine over the other emetics are that it is certain, prompt, and powerful; it can be given when emetics introduced directly into the stomach would not act, and it does not irritate the stomach. It is largely used in cases of poisoning. It is usually given hypodermically, 1 gr. being dissolved in 50 TTL of camphor water. This must be prepared extemporanously, as it will not keep. Expectorant action. — It is, when given by the mouth, a valu- able expectorant for bronchitis. In an adult ^ gr. will produce a watery expectoration within the time stated and this effect will last from two to three hours. It is particularly useful in the early stages of acute bronchitis, in chronic dry bronchitis, in chronic catar- rhal pneumonia, and in old tubercular patients who are harassed by an unproductive cough. HUMULUS. HOPS. — The strobiles of Humulus Lupulus (Nat. Ord. Urticacece). North America and Europe. Composition. — The chief constituents are — (1) Lupulin, a liquid alka- loid. (2) Lupulinic acid, 11 per cent., a bitter crystalline principle. (3) Val- erol, I per cent., an aromatic volatile oil giving the odor. (4) Resin, 9 to 1 8 per cent. (5) Tannin, 4 to 5 per cent. Incompatibles. — Mineral acids, metallic salts. Preparations. Tinctura Humuli. — Hops, 20; by maceration and percolation to 100. Dose, 1 to 2 fl. dr. Action and Uses. Hops are tonic and slightly narcotic, as well as probably diuretic. They have been used in dyspepsia, nervous tremors, wakefulness and in the delirium of drunkards. LUPULINUM. — Lupulin. A glandular powder, obtained from the dried strobiles of Humulus Lupulus. Characters. — A granular, bright, brownish-yellow powder, which when magnified is seen to consist of minute, globular, reticulated, translucent, shining glands. Odor and taste like hops. Dose, 5 to 30 gr. HOPS. 277 Preparations. 1. Extractum Lupulini Fluidum. — Lupulin, 100; by maceration and percolation with alcohol to 100 parts. Dose, 5 to 30 m. 2. Oleoresina Lupulini. — Lupulin, 100. By percolation with stronger ether and evaporation. Dose, 1 to 5 gr. Action. The volatile oil in hops is stomachic and carminative like other volatile oils. To a slight extent it reflexly excites the cir- culation. The bitter principle aids the stomachic influence. Hops are decidedly soporific. Probably it is the volatile oil that produces this effect. Therapeutics. The pharmacopoeial preparations of hop are not much used, but good beer, because of the hops contained in it, may with some persons aid digestion, and for this purpose is often given with meals to those whose digestion is feeble after a long illness, or from any other cause. The alcohol in the beer increases this effect. Many people find the soporific influence of beer very well marked. LACTUCARIUM. LETTUCE.— The flowering herb of Lactuca virosa (Nat. Ord. Composi- te}. Britain. It is too well known to need description. Composition. — The chief constituents of lactucarium, or the milky juice exuding from the lettuce, are — (1) Hyoscyamine, 0.02 per cent, {see Hyoscya- mus). (2) Lactucone, 42 per cent., a crystalline principle. (3) Lactucine, resembling mannite. (4) Lactucic acid. Preparations. 1. Extractum Lactucarii Fluidum. — By maceration with ether, with alcohol and water, evaporation. Dose, 5 to 60 m. 2. Syrupus Lactucarii. — Fluid Extract of Lactucarium, 5 ; Syrup, 95. Dose, 1 to 4 fl. dr. 278 « ORGANIC MATERIA MEDICA. Action and Therapeutics. Lettuce has been credited with mild hypnotic powers. Large doses of the extract may cause mental derangement, and will dilate the pupil. All these actions are due to the hyoscya- mine contained in the milky juice and in the extract. Different varieties of lettuce contain different proportions of hyoscyamine. It is more abundant in young plants than old ones. BELLADONNA. BELLADONNA FOLIA.— Belladonna Leaves. The fresh leaves, with the branches to which they are attached, of Atropa Belladonna (Nat. Ord. Solanacece). Synonym. — Deadly nightshade. Also the leaves separated from the branches, gathered from wild or cultivated plants when the fruit has begun to form, and carefully dried. Britain. Characters. — Leaves alternate below, in pairs of unequal size above, all shortly stalked, from 3 to 6 in. long, broadly ovate, acute, entire, smooth. The ex- pressed juice, or an infusion dropped into the eye, dilates the pupil. Resembling belladonna leaves. — Stramonium leaves, more wrinkled; hyoscyamus leaves, hairy. Composition. — The chief constituents are — (1) Atropine (q. v.), .06 to .3 per cent. (2) Belladonni?ie, another alkaloid, chemically closely allied to and having a very similar action to atropine. Probably it, hyoscyamine (q. v.), and daturine (q. v.), are all identical, and exist as malates in the plant. Recently it has been stated that atropine does not exist in belladonna in the na- tural state, but that it is a conversion product of hyoscyamine, which is the na- tural alkaloid of belladonna. Preparations. 1. Extractum Belladonnae Alcoholicum. — By percolation and evaporation with alcohol, glycerine is added. Dose, y s to y 2 gr. 2. Tinctura Belladonnae. — Belladonna leaves, 15; diluted alco- hol to 100. By maceration and percolation. Dose, 5 to 20 m. 3. Unguentum Belladonnae. — Alcoholic extract of belladonna, 10; diluted alcohol, 6; benzoinated lard, 84. Belladonnae Radix.- — Belladonna Root. The root of Atropa Belladonna, from plants growing wild or cultivated in Britain and carefully dried, or imported in a dried state from Germany. BELLADONNA. 279 -iaracters. — Rough, irregular branched pieces I to 2 fee: long, j£ to 2 in. thick, upper end marked by hollow bases of stems. Integument dirt}' gray or brownish, easily scraped by the nail; exposed surface white. Fracture short. Broken surface shows thin yellowish or pale brown cortex, separated by a dark line from a large central brownish portion, which is marked throughout by scat- tered dark dots without evident rays. Resembling belladonna root. — Pyrethrum root, which is unbranched, and has a burning taste and a radiate fractured sur- face. Scammony root is larger. Composition. — As of the leaves. Usually contains 0.4 to 0.5 per cent ::" alkaloids, chiefly atropine. Preparations. 1. Extractum Belladonnae Fluidum. — Belladonna root By percolation with alcohol, and evaporation. Dose. 1 to 3 m. 2. Linimentum Belladonnae. — Fluid extract of belladonna. 15 ; camphor. 5 3. Abstractum Belladonnae. — -Belladonna root, 200; sugar of milk and alcohol. By maceration anl evaporation, to 1 00. Dose. r 4 ' to 1 gr. 4. Emplastrum Belladonnae. — Belladonna root, 100; plaster, alcohol a sufficient quantity to 1 00. ATROPIN A. —Atropine. {Synonym. — Atropiaj C l: H :i X 0,. An alkaloid existing in the leaves and root of the belladonna plant as malare of atropine. Source. — The B. P. directs it to be made from the root thus: — (i) Make a tincture of the root by maceration and percolation with spirit (2) Add slaked lime : this splits up the malate of atropine, malate of lime being precipitated. (3) Filter, and add sulphuric acid to precipitate the excess of lime. 14^ Filter, concentrate by distillation, partially evaporate, add carbonate of potassium ; after six hours much coloring matter is precipitated. 5 Filter, add more carbonate of potassium : this sets tree the atropine. (6) Shake up with chloroform, which takes up the atropine in solution. (7) Withdraw the chloroform, evaporate, and atropine is left. It is purified by digestion with warm alcohol and animal charcoal. Characters. — Colorless acicular crystals, isomeric with belladonnine. Solubility. — 1 in 600 of cold, 1 in 35 of boiling water, 1 in I of chloroform. I in 3 of alcohol, I in 60 of ether, t in 52 of glycerine, and I in 1 5 :■: oleic ; It can be decomposed into tropin e and tropic acid, and reconstructed by their syntt- Incqmpatibues. — Caustic alkalies decompose it. Dose, rr ^ to ^ gr. 280 ORGANIC MATERIA MEDICA. ATROPINE SULPHAS.— Sulphate of Atropine. (C 17 H 23 N0 3 ) 2 H 2 S0 4 . Source. — Dissolve atropine in dilute sulphuric acid, and evaporate. Characters. — Nearly colorless, crystalline or pulverulent. Solubility, — I in 0.4 of water, solution neutral, I in 6.5 of alcohol. Dose, T ^ to Jq gr- Action. The action of belladonna and atropine is the same. Bxternal. — Atropine placed by itself upon the unbroken skin cannot be absorbed, but rubbed in with substances which are absorbed, such as alcohol, glycerine, camphor, etc., applied to a broken surface, it paralyzes the terminations of the sensory nerves, especially if pain is present. It is thus a local anaes- thetic and an anodyne. These are its chief actions, but to a much less extent it locally paralyzes the terminations of the motor nerves, first contracts and then dilates the vessels, and renders the secretions of the skin less active. Internal. — Gastro-intestinal tract. — It will be convenient to describe the effects of belladonna on all secretions when speak- ing of its action on nerves, and we need not mention here its influence on the muscular coat of the intestine, for that is second- ary to its action on the nervous system. Blood. — Atropine is quickly absorbed, but does not affect the blood. Its main action is on the nervous system, and that must be considered in detail. Secretory nerves. — The activity of the peripheral termina- tions of all the secretory nerves in the body is, as far as we know, depressed. These nerves fall under the following headings : (a) Mouth. — Even small doses of atropine make the mouth dry from lack of saliva and mucus. In health secretion of sub- maxillary saliva always follows stimulation of the chorda tympani nerve, and, as is well known, this is due to the fact that this nerve is the secretory nerve for this gland, and not to any vascu- lar dilatation. If atropine be given to an animal, stimulation of the chorda no longer causes an increased flow of saliva, how- BELLADONNA. 28 1 ever close to the gland the nerve is excited, the reason being that atropine has paralyzed the terminations of the chorda tympani. In the same way the terminations of the secretory nerves of the other salivary glands and the mucous glands are paralyzed, and hence the mouth is dry, because normal impulses cannot reach the cells of the glands. Stomach, liver, and intestines. — We do not know what influ- ence atropine has on the secretions of these organs. Sweat glands. — Atropine paralyzes the terminations of the nerves in the sudoriparous glands. Thus it causes the skin to become dry. Kidneys. — The effect of atropine on the amount of urine secreted is necessarily uncertain, as the urinary flow depends so much on the secretion of sweat. Bronchial mucous membrane — The secretion of bronchial and tracheal mucus, like that of the mouth, is diminished. Mammary gland. — The activity of the peripheral termina- tions of the secretory nerves in the cells of the mammary gland is inhibited, hence the flow of milk, if any is present, is ar- rested, and belladonna is called an antigalactogogue. Sensory nerves. — It has already been mentioned that bella- donna rubbed into the skin depresses the function of the termi- nations of the sensory nerves. It does the same when given by the mouth, but its action on sensory nerves — that is to say, its anaesthetic and anodyne action — is very inferior to that on the secretory nerves, and is not powerful enough for atropine to re- lieve pain when given internally. It is only used as a local an- odyne. Voluntary muscles and their nerves. — Voluntary muscles are quite unaffected even by toxic doses of atropine ; towards the end of a case of belladonna poisoning the motor nerves are slightly paralyzed. Involuntary muscles and their nemes. — The splanchnics are the inhibitory nerves of the intestinal movements, and if they are stimulated the peristaltic movements stop ; impulses are constantly descending these nerves to restrain these movements. If atro- 282 ORGANIC MATERIA MEDICA. pine in small doses is given to animals it is observed that the bowels are relaxed, because intestinal peristalsis is much increased, and that stimulation of the splanchnics is powerless to arrest it ; clearly the drug has paralyzed the terminations of the splanchnics in the involuntary muscles of the intestine. Some have found that very minute doses stop the peristaltic movements, others that large doses have this effect. Whether these results are due to stimulation of the terminations of the splanchnics is not known, nor is it easy to explain the discrep- ancies of the dose. In man it is most likely that moderate doses restrain excessive peristaltic action. Probably the nerve terminations in the muscles of the blad- der, ureters, urethra, vesiculae seminales, uterus and vagina are affected in the same way as those in the intestinal muscles, but this is not yet decided. The eye mid its nerves. — Atropine acts only on the termina- tions of the nerves in the involuntary muscles of the eye. If it be dropped into the eye or given by the mouth the pupil dilates widely, and cannot be made to contract by stimulation of the third nerve. That this dilatation is not due to any action on the muscular fibres of the iris themselves is shown by the fact that the atropinized pupil will contract if the muscle itself be stimula- ted. Therefore it must be that the terminations of the third nerve in the iris are paralyzed. The ending of this nerve in the ciliary muscle is affected in the same way, and consequently accommodation is paralyzed. It is certain that this mydriasis and defective accommodation is in no part central, as is the contraction of the pupil produced by opium. So strong is the local action of belladonna, that if atropine be dropped into the recently excised eye the pupil will dilate. When the third nerve is cut the pupil dilates, and if after this atropine be dropped into the eye it dilates still further. Some have concluded, from this and other reasons, that atropine also stimulates the termina- tions of the sympathetic in the iris ; but the reasoning is incon- clusive, and it is not at present proved that atropine can do this. The intra-ocular tension is increased by large doses. There is, BELLADONNA. 283 as a result of the paralysis of the ciliary muscle, disturbance of vision. Atropine does not act on the pupils of birds. The heart .and its nerves. — The main action of atropine is to paralyze the terminations of the vagus in the heart, and consequently the pulse is rendered more rapid, and cannot be slowed by strongly stimulating the vagus. If the rate of the heart has been lowered by muscarin, which can be shown to have a local stimulating influence on the terminations of the vagus in the heart, the application of atropine renders the heart quick again, the two drugs being, in their effect on the heart, exactly antagonistic. This quickening of the pulse from inhibition of the vagal cardiac terminal filaments is the chief action of atropine on the heart, but the following minor actions must be noticed. The vagus centre and the trunk of the nerve are also depressed, but to a much less extent. Before the pulse is quickened it is occa- sionally slowed for a short time by atropine ; this is probably owing to a brief excitation of the vagus centre, the vagus nerve, and its peripheral cardiac terminations. Some authorities believe that part ol the quickening of the pulse is due to a slight stimula- tion of the cardiac accelerator nerves, just as we have seen that some consider that the sympathetic fibres in the iris are excited ; but if the accelerator nerves are stimulated, this stimulation is quite subsidiary to the important paralysis of the vaginal termi- nations. Although the pulse is quickened by belladonna, its force is not diminished. Toxic doses abolish the function of the cardiac muscle, and the heart stops in diastole. Vaso-motor system and its nerves. — After a considerable dose of belladonna the skin is flushed, and a scarlatiniform erythe- matous rash may be present in belladonna poisoning. It is thus obvious that such a dose of belladonna relaxes the peripheral vessels. The exact cause of this has not definitely been made out, but it is extremely probable that it is largely a peripheral action, quite harmonizing with the peripheral action we have seen atropine to have on the involuntary muscles of the intestines, eye and heart ; that is to say, the vaso-constrictor nerve-filaments supplying the arterioles are paralyzed, and consequently the ves- 284 ORGANIC MATERIA MEDICA. sels dilate. The action of atropine on the medullary vaso-motor center is more marked than that on the cardiac medullary cen- ter ; but it is the same, — the center first being stimulated, and then depressed. This primary stimulation is sufficient to over- come the tendency of the peripheral vessels to dilate, so that bel- ladonna at first contracts them ; and as this stage of contraction lasts well into the period during which, owing to paralysis of the vagal terminations, the heart is accelerated, the blood-pressure rises considerably : subsequently it falls, the fall being due to the depression of the vaso-motor center and the peripheral action of belladonna on the vessels, causing their wide dilata- tion. Ultimately, when the heart itself is paralyzed, the blood- pressure is very low. The spinal vaso-motor centers are acted on as powerfully and in the same way as the medullary center. Respiration and its nerves. — Here also belladonna paralyzes peripheral nerve-filaments, in this case those of the vagus in the bronchial tubes. Both the afferent and efferent pulmo- nary vagal fibres are affected. The result is that the muscular coat of the bronchial tubes is relaxed, and that the secretions (the activity of the afferent fibres being depressed) do not irri- tate the nerves so much as before, and therefore cough is lessened. It will be remembered that the quantity of bronchial secretion is diminished. The medullary and spinal respiratory centers are influenced precisely as the vaso-motor, — that is to say, they are first stimulated, and so the respirations are quicker and deeper, then large doses paralyze them, and the breathing is slow and shallow. The patient becomes asphyxiated, and this contributes to the result in a fatal case. Temperature. — This is decidedly raised by toxic doses of belladonna (it maybe four degrees or more). This rise is inde- pendent of the blood-pressure and of the diminution of perspira- tion. It is said that heat-production is greatly exaggerated. The heat-loss is also increased, probably because the flushing of the skin leads to a greater loss by radiation. Spinal cord. — Except for the action on the vaso-motor and respiratory spinal centers, belladonna has little influence on the BELLADONNA. 285 spinal cord in man, but it has a well-marked tetanizing effect in frogs. It is said slightly to increase and afterwards diminish general reflex excitability. Cerebrum. — A considerable dose of belladonna causes delir- ium, showing that the higher centers are stimulated. Generally the stimulation takes place inco-ordinately. That it is powerful is indicated by the fact that in poisoning by belladonna the delirium will last for a long while. The subsequent quietude is not more than the exhaustion of the cerebrum from the continued delirium will explain. Belladonna rarely, if ever, produces gen- uine coma. Other symptoms that may be observed with large doses, and which are probably due to disorder of the brain, are staggering gait, giddiness, and occasionally convulsions. Elimination. — Atropine is probably eliminated entirely by the kidney. It will be seen that the dominant action of belladonna is to depress the activity of the terminations of nearly all varie- ties of nerves. In addition, it first stimulates and then depresses the three great medullary centers, and it is a deliriant. A summary of its effects on man will be given under the heading of Toxicology. Children can take considerable doses of belladonna without any symptoms of poisoning. Pigeons and rodents are peculiarly insusceptible to it. Therapeutics. External. — Belladonna is used externally to relieve all sorts of pain, — for example, that of neuralgia, pleurodynia, and chronic osteo-arthritis. The liniment is excellent for these purposes. A glycerine preparation (made by rubbing extract of belladonna i oz. with boiling water 2 fl. dr., and then adding gradually glycerine 3 fl. oz.), soothes the pain of acute inflammations. This, or the plaster (not officinal), or the ointment, is very efficacious in preventing the secretion of milk in women who do not for any reason nurse their infants. Pruritus and local sweating of various parts of the body, especially the feet, may sometimes be 286 ORGANIC MATERIA MEDICA. stopped by the application of belladonna. A solution of sul- phate of atropine, 4 gr., camphor water 3 j will dilate the pupil for ophthalmoscopic examination. Atropine is often used in ophthal- mic practice to paralyze the movements of the iris and ciliary muscle, to break down adhesions, and to prevent the formation of contractions of the iris. Internal. — Alimentary canal. — Belladonna has occasionally been employed to check salivation, and some use it to overcome constipation and colic. The extract is then given, and is com- monly combined with some purgative in a pill. Extract of bel- ladonna is often administered with opium in the form of a pill to patients suffering with typhlitis or peritonitis ; as it is given sev- eral times a day a large amount is taken, and this, as already ex- plained, probably paralyzes intestinal movements, and so aids the opium. Skin. — Sulphate of atropine (y^-gr.) injected subcutaneously, or one or two minims of the solution of Sulphate of Atropine, (1 part, camphor water 100 parts), by the mouth, will sometimes arrest sweating, and this treatment may succeed with the night sweats of phthisis. Circulation. — There are many cases of heart disease in which belladonna may advantageously be combined with other drugs. Whenever we wish to empty the ventricle completely it is useful, for it will be remembered that it increases the rapidity of the heart without diminishing the force. But its greatest value is to remove cardiac pain and distress, which it often does most effec- tually. It may be conveniently applied as a plaster over the car- diac region, or it may be given internally, usually as the tinc- ture. Respiration. — As belladonna relaxes the muscular coat of the bronchial tubes it is of great value in spasmodic affections of the respiratory passages. Thus, of all the numerous drugs that have been given for whooping-cough, it is the best. It is also very useful in asthma, and in bronchitis with asthma-like paroxysms ; in the last-named disease its powerful stimulation of the respira- tory center and its capability of diminishing the secretion will, BELLADONNA. 287 in properly chosen cases, render it particularly valuable. It is generally given as the tincture, and combined with other drugs. Genito-urinary diseases. — Belladonna is one of the favorite remedies for the nocturnal incontinence of children, and it occa- sionallv overcomes this trouble in adults when it is not due to organic diseases. Its power of relieving the spasm of involuntary muscle is well shown in the effectual manner in which the very painful vesical spasm which accompanies calculus, cystitis, and prostatitis may be benefited by it. It may be given internally as in the form of a suppository, or applied as a plaster to the perinaeum. It has been tried in many nervous diseases, but without any good results. Toxicology. If a person takes a moderate dose of belladonna he soon experiences. dry- ness of the mouth and throat, and as the food, therefore, cannot be properly lubricated, there is difficulty of swallowing ; the pulse may at first be a little slower than usual. The pupil is dilated ; accommodation is defective, and vision confused. The skin feels dry. If the dose has been a large one, these symptoms all come on qu : ckly; the conjunctivae and face, and perhaps other parts of the s" in are flushed, and the rate of the pulse is greatly increased, it may even be doubled. The patient staggers, feels giddy, and reels when he walks ; the throat soon becomes very hot, the skin still more flushed, the eyelids swell, and there may be a uniform erythematous rash. The temperature is often raised, the respirations are slow and deep. The pupils are very widely dilated. By this time the patient is quite delirious. There may be purging, but this is not common ; and sometimes he complains of a frequent desire to micturate, although he is unable to pass any urine. Death takes place from cardiac failure combined with asphyxia Post mortem. — The organs are all in a state of venous congestion, which is due to the asphyxia. If recovery takes place the patient may have no recollection of his illness. Treatment. — Give emetics (see p. 76) or wash out the stomach. Inject pilocarpine and stimulants subcutaneously. Employ artificial respiration. Antagonism. The antagonism between atropine and ?norphine has already been dis- cussed [see p. 274). It is clear that as pilocarpine stimulates the terminations of the secretory nerves in the salivary and sweat glands, and also excites the terminations of the third nerve in the iris and ciliary muscle, it is a diaphoretic, a sialogogue, and a myotic, and is in these respects antagonistic to atropine. 288 ORGANIC MATERIA MEDICA. Physostigmine also causes contraction of the pupil and spasm of the ciliary muscle by stimulation of the terminations of the third nerve, and it depresses the respiratory center almost from the beginning. In these points it is an antagonist to atropine. STRAMONIUM. STRAMONII SEMEN.— Stramonium Seed. The dried ripe seed of Datura Stra??ionium, the thorn-apple (Nat. Ord. Solanacece), cultivated in Europe. Characters. — One-sixth inch long, reniform, flattened, brownish-black, finely pitted, wrinkled. Odor disagreeable when bruised. Taste bitter. Composition. — The chief constituent is daturine. Symbol, C 17 H 23 N0 3 (o*02 to 0*03 per cent.), an alkaloid, in crystals, resembling atropine, but lighter and more feathery. It exists as a malate. It is certainly very closely allied to hyoscyamine, and some consider that the two are identical [see p. 289). Some specimens are said to consist of atropine and hyoscyamine mixed. Incompatibles. — Caustic alkalies, metallic salts, and mineral acids. Preparations. 1. Extractum Stramonii. — By maceration and percolation with diluted alcohol and evaporation. Dose, X to yi gr. 2. Tinctura Stramonii. — Stramonium seeds, 10 ; in diluted alco- hol, by maceration and percolation to 100. Dose, 5 to 30 m. 3. Extractum Stramonii Fluidum. — By maceration and perco- lation with alcohol and water, and evaporation. Dose, 1 to 3 m. 4. Unguentum Stramonii. — Extract of stramonium, 10; water, 5 ; benzoinated lard, 85. STRAMONII FOLIA.— The dried leaves of Datura Stramonium. Collected from plants in flower. Cultivated in Europe. Characters. — Ovate, petiolate, 4 — 8 in. long, dark green, unequal at base, sinuate-dentate, large irregular teeth or pointed lobes. Odor slightly narcotic. Taste saline and bitter. Resembling stramonium leaves. — Bella- donna leaves, but less wrinkled ; hyoscyamus leaves, hairy. Composition. — As of the seeds, but the proportion of daturine is very inconstant. Action. The physiological action of daturine is precisely that of atro- pine, and therefore that of stramonium is almost the same as HYOSCYAMUS. 289 that of belladonna; the differences being that stramonium re- laxes the muscular coat of the bronchial tubes more powerfully than belladonna, and it may cause the heart to be a little ir- regular. Daturine is generally thought to be more active than atro- pine. Therapeutics. There is no reason why stramonium should not be employed for the same purposes as belladonna, but it is rarely used, except in cases of asthma to relieve the spasm of the bronchial tubes. For this it is very valuable. Cigarettes of the leaves may be smoked, or the drug may be given internally. The following powder, which gives off dense fumes if burnt, is said to afford great relief for asthma: — leaves of Datura Stramonium and of Datura Tatula, Cannabis Indica, and Lobelia Inflata, all in powder, and of each 6 dr. ; nitre in powder, i oz. ; eucalyptus oil, 30 Tit. Mix thoroughly. HYOSCYAMUS. HYOSCYAMI FOLIA.— Henbane Leaves. The fresh leaves and flowers, with the branches to which they are attached, of Hyoscyamus niger (Nat. Ord. Solanacece) ; also the leaves separated from the branches, and flower- ing tops carefully dried. Collected from biennial plants growing wild or cultivated in the United States, when about two-thirds of the flowers are ex- panded. The leaves only are officinal in U. S. P. Characters. — Varying in length up to 10 in., with or without stalks, alternate, exstipulate, triangular-ovate or ovate-oblong, pale green, glandular- hairy, particularly underneath. Branches subcylindrical, and also glandular- hairy. Odor strong, heavy when fresh. Taste bitter, slightly acrid. The juice dropped in the eye dilates the pupil. Composition. — The chief constituents are — (1) Hyoscy amine, C 17 H 23 N0 3 , an alkaloid. It is very closely allied to, and probably the same as, the active alkaloids of belladonna and stramonium (see p. 288). It is also con- tained in many plants of the Natural Order Solanacece. According to most authorities it, like atropine, consists of tropic acid and tropine. There is in commerce an amorphous impure hyoscyamine, which is a dark brown ex- k tract-like fluid having a disagreeable odor. As it is much cheaper than the crystalline alkaloid it is often used. Probably it contains no hyoscyamine, but only hyoscine. (2) Hyoscine, This exists in the leaves. Characters : a white ?5 290 ORGANIC MATERIA MEDICA. crystalline alkaloid. It is most likely a derivative of hyoscyamine, and isomeric with it. It is the active constituent of commercial hyoscyamine. Only its salts are used. Incompatibles. — Vegetable acids, nitrate of silver, acetate of lead, alkalies. Doses. — Hyoscyamus leaves are not given as such. Pure hyoscyamine (rarely used), T ^ to ^g gT. or more. Commercial hyoscyamine, ^ to y£ gT. Hydrobromate or hydriodide (the favorite salts) of hyoscine, yj^ to yj^ gT. in aqueous solution or pill, or in an aqueous solution subcutaneously. Hyoscine and hyoscyamine should be given cautiously, as the activity of different specimens is very variable. Preparations. 1. Abstractum Hyoscyami. — By maceration, percolation or eva- poration with alcohol. Dose, 2 to 5 gr. 2. Extractum Hyoscyami Alcoholicum. By maceration, perco- . lation in diluted alcohol and evaporation. Dose, 1 to 2 gr. 3. Extractum Hyoscyami Fluidum. — By maceration and per- colation in alcohol and water, and evaporation. Dose, 5 to 15 m. 4. Tinctura Hyoscyami. — Dried leaves, 15; diluted alcohol to 100. By maceration and percolation. Dose, 1 to 4 fl. dr. HYOSCYAMINiE SULPHATIS.— Sulphate of Hyoscyamine (C J7 H 23 N0 3 ) 2 ,H 2 S0 4 . The neutral sulphate of an alkaloid prepared from Hyos- cyamus. Characters. — Small golden-yellow, or yellowish-white scales or crystals, or a yellowish- white amorphous powder, deliquescent, odorless, having a bitter and acrid taste, and a neutral reaction, very soluble in water and in alcohol. Dose, g 1 ^ to -Jq gr. Dissolved in water and given subcutaneously. Action. The action of hyoscyamus is almost identical with that of belladonna and stramonium, because of the identity of the hyoscyamine in hyoscyamus, the atropine in belladonna, and the daturine in stramonium. The following are the chief points of difference. (1) Hyoscyamus contains in addition hyoscine CANNABIS INDICA. 2pl in minute quantities. This is a powerful cerebral and spinal sedative, and therefore the excitation and delirium occasioned by the atropine in belladonna are not so evident when hyoscya- mus is given; indeed, that may, owing to the hyoscine in it, distinctly depress the higher functions of the brain. The heart is not quite so powerfully affected by hyoscyamus as by bella- donna, for hyoscine has a comparatively feeble cardiac influence. Still it is, of course, affected by the hyoscyamine, which acts like atropine. (2) Hyoscyamus increases the peristaltic contractions of the intestines more powerfully than belladonna, and at the same time it is more efficient in relieving the grip- ing of other purgatives. (3) Hyoscyamus has a more markedly sedative action on the urinary unstriped muscle than belladonna. Therapeutics. Hyoscyamus might be used for the same purposes as bella- donna, but is chiefly employed in combination with purgatives to diminish their griping action. It is also largely given to re- lieve vesical spasm in calculus, cystitis, and prostatitis, usually in conjunction with other urinary sedatives, as buchu, uva ursi, or benzoic acid if the urine is alkaline. It will be noticed that the doses of the preparations of hyoscyamus are larger than those of the corresponding preparations of belladonna. Hyoscine and commercial hyoscyamine may, if given cau- tiously, be employed as cerebral depressants, and are used in acute -mania, delirium tremens, febrile delirium, and insomnia, sometimes with good results. They are mostly given in asylum practice. Chorea, paralysis agitans, and other convulsive dis- eases have been treated with them, but the convulsions always recur when these drugs are discontinued. CANNABIS INDICA. INDIAN HEMP. — The dried flowering or fruiting tops of the female plants of Cannabis sativa (Nat. Ord. Cannabinece) , from which the resin has not been removed. India. Characters. — Masses \]/ z to 2^ in. long, consisting of the tops of alter- 292 ORGANIC MATERIA MEDICA. nate branches bearing the remains of flowers, leaves, and a few ripe fruits, and compressed by adhesive resin. Or, as straight, stiff, woody stems, several inches long, surrounded by branched flower-stalks. Rough, very brittle, dusky green. Odor, faint, narcotic. Taste, none. Composition. — The chief constituents are— (1) Cannabinon, an active principle. (2) Cannabinine, a volatile alkaloid. (3) Tetano-cannabine, an alkaloid. (4) Cannabin, a glucoside. (5 ) Cannabene, a volatile oil. (6) A resin, said to be very active. Incompatibles. — Water, which precipitates the resin. Preparations. 1. Extractum Cannabis Indicae. — By maceration and percola- tion in alcohol, and evaporation. Dose, yg to ^ gr. 2. Extractum Cannabis Indicae Fluidum. — By maceration, percolation in alcohol, which is distilled off, and evaporation. Dose, 2 to 5 m. 3. Tinctura Cannabis Indicae. — Powdered Indian Hemp, 20; Alcohol, by maceration and percolation, to 100. Dose, 5 to 20 m. Synonyms. — Haschisch is a confection of the drug. Gunjah, or ganga, is the dried leaves prepared for smoking. Churrus is the resin scraped off the leaves. CANNABIS AMERICANA. — American Cannabis. Cannabis sativa Linne (Nat. Ord. Urlicacece, Cannabinece), grown in the Southern United States and collected while flowering. Characters. — Stem about 6 feet long, rough; leaves apposite below, alternate above, petiolate, digitate ; the leaflets linear-lanceolate, serrate ; dioe- cious, the staminate flowers, in pedunculate clusters, forming compound racemes ; the pistillate flowers axillary, sessile and brachteate ; odor, heavy ; taste, bitter, slightly acrid. It has the same uses as Cannabis Indica, but is less active. Action. External. — None is known. Internal. — The effects of cannabis indica vary very much in different people. This is partly due to the uncertain strength of the preparations of the drug, and partly to individual peculi- arities, but generally the symptoms are somewhat as follow. After some time, usually from half an hour to two or three hours, CAFFEINE. 293 there is a pleasurable sensation of mild intoxication ; the patient is particularly gay, joyous, and pleased with everything; he will laugh and smile on the slightest provocation, and is himself able to say sharp, witty things. Pleasant ideas flit through his mind with wonderful rapidity, so that time seems to him much extended. Generally the ideas are quickly forgotten, but sometimes the memory of them remains after recovery. The eyes are bright, the pupils may be dilated. The limbs feel heavy, and there is a marked lowering of general sensibility, so that he scarcely feels a severe pinch ; this may pass on to complete anaesthesia. There may be headache. After a time sleep, which is often accompanied by delightful dreams, comes on. The drug is frequently taken in the East to produce the early pleasurable symptoms, but this habit is said to lead to loss of appetite and strength, trembling, and much weakness. Cannabis indica is reputed to occasionally produce sexual excitement, but this is probably incorrect. No details about its physiogical action are known. Therapeutics. It has been given with success in migraine and neuralgia, but it very often fails to afford relief. Its use as an hypnotic has been discarded. The tincture is very difficult to prescribe, be- cause of the voluminous precipitate of resin which falls on the addition of water. Mucilage must be used to suspend it, and the taste should be covered with spirit of chloroform. CAFFEINA. CAFFEINE.— Synonyms.— Theme, Guaranine. C 8 H 10 N 4 O 2 ,H 2 O. A proximate principle of feeble alkaloidal power usually obtained from the dried leaves of Camellia Thea, common tea (Nat. Ord. Ternstrcefniacece), or the dried seeds of Coffea arabica, common coffee (Nat. Ord. Rubiacecz), by evaporating aqueous infusions from which the astringent and coloring matters have been removed. Characters. — Colorless, silky, inodorous, acicular crystals. Solubility. — I in 75 of cold water, 1 in I of boiling water, I in 35 of alcohol, I in 400 of ether, 1 in 6 of chloroform. Tea contains 3 to 5 per cent, (hence the name theine). Coffee, 1.3 per cent, (coffee leaves contain much more). Guarana (the seeds of Paullinia sorbilis), 5 per cent, (hence the name guaranine) 294 ORGANIC MATERIA MEDICA. Mate (Paraguay tea, the leaves of Ilex paragnayensis), 1.2 per cent. It also exists in the kola nut (which is used as a beverage in Africa) ; this is the fruit of Sterculia acuminata. Caffeine is trimethyl-xanthine, theobromine is dime- thyl-xanthine, and both can be prepared synthetically from xanthine. It is a feeble alkaloidal body, its salts being very liable to split up. Incompatibles. — Iodide of potassium, salts of mercury, and tannic acid. Dose, i to 5 gr. or more. Action. External. — None. Internal. — Alimentary canal. — Excessive tea-drinking may cause indigestion, but this is probably induced by the tannin in the tea, and not by the caffeine. The teeth of tea tasters are very liable to decay. Coffee is, with some persons, slightly laxa- tive; it is not known to what ingredient this is due. Circulation. — Caffeine is freely absorbed. It produces no change in the blood. Experiments concerning its action on the heart are contradictory, but there appears no doubt that in man moderate doses increase the force of the cardiac contraction and the duration of the systole, the diastolic period being shortened ; as a consequence of this the blood-pressure rises. Toxic doses paralyze the heart. These effects are also produced by the local application of caffeine to the heart of the frog. Respiration. — This is not much influenced by caffeine. Medi- cinal doses are said to excite and toxic doses to depress it. Nervous system. — It is well known that tea and coffee stimu- late the cerebrum. This is due to the caffeine in them. The patient becomes wakeful, the mental activity and capability for work are increased, the reasoning powers being quite as much affected as the imagination. In this respect the cerebral stimu- lation of caffeine differs from that of opium, and also in that the excitation is not inco-ordinate, nor is it soon replaced by sleep. Very excessive tea-drinking causes trembling of all the muscles of the body, and makes the patient extremely "nervous." * In man the spinal cord and muscles are very little affected by caffeine, but in some frogs the spinal cord is decidedly stimulated, and convulsions occur; in other species the muscles are thrown CAFFEINE. 295 into a state of rigidity, which is clearly due to an action on the muscles themselves, for it follows the application of caffeine to an isolated muscle. Sometimes the muscle curve is altered in char- acter. It is believed that in man the powers of muscular endur- ance are increased by caffeine. Motor and sensory nerves are uninfluenced in all animals. Kidneys, — By means of the oncometer it has been shown that the first effect of a dose of caffeine is to cause a contraction of the kidney with a decrease in the urinary flow ; but soon the organ becomes larger than it was before the experiment, and the flow of urine is increased. Thus caffeine is a good local diuretic. Metabolism. — Many elaborate experiments have been made upon the action of caffeine on tissue waste ; they are all of them inconclusive, probably because it has no effect. Some say it de- creases, some that it increases the elimination of urea. Toxic doses may cause a slight rise of temperature. Therapeutics. Heart. — Caffeine has been most used in heart disease. It is given when, as in aortic or mitral obstruction, a purely stimulant effect is desired \ large doses, 10 or 20 grains a day of the citrate, are often easily borne, and may be combined with strychnine. Caffeine will not replace digitalis, for it does not slow the heart nor make it regular, and it shortens the diastole. It is, on ac- count of its diuretic action, especially valuable in cardiac cases in which there is dropsy. Tea and coffee are, in some persons, liable to produce irregularity of the heart. Kidney. — Small doses of caffeine are powerfully diuretic, and are therefore used in heart disease, ascites, pleuritic effusion, &c. As the drug acts directly on the kidney, it should be given cautiously in renal disease. Many patients so soon become used to it, that at the end of a week it has lost its power of producing diuresis. Nervous system.— Occasionally it cures migraine, but it is not so useful asantipyrin or exalgine {see Appendix). It may be rendered sufficiently soluble for subcutaneous ad- ministration by mixing it with a solution of salicylate of sodium. 296 ORGANIC MATERIA MEDICA. GUARANA. GUARANA. — Synonym. — Brazilian cocoa. — A dried paste made from the crushed or ground seeds of Paullinia sorbilis (Nat. Ord., Sapindacece). Eastern South America. Characters. — Sub-globular or elliptic cakes, or cylindrical sticks, hard, dark reddish-brown ; structure uneven, somewhat glossy, showing fragments of seeds invested with a black texture; odor slight, peculiar, resembling choco- late ; taste, astringent, bitter ; it is partly soluble in water, and in alcohol. Composition. — The chief constituent is guaranine, identical with caffeine {see p. 293). Preparation. Extractum Guaranae Fluidum. — By maceration and percolation with alcohol and water, and evaporation. Dose, }( to 1 fl. dr. Action and Therapeutics. Although there is no reason to believe that guaranine does not produce the same action on the nervous system, heart and kidneys as caffeine, yet it is rarely used except for sick headaches ; but in these cases it is sometimes of the greatest service. NUX VOMICA. NUX VOMICA. Synonyms.— St. Ignatius bean, Poison nut. The seeds of Strychnos Nux-vomica (Nat. Ord., Loganiacece). East Indies. Characters. — Disc-shaped, ]/& to 1 in. in diameter, ^ in. thick. Flat or concavo-convex. Margin rounded. On one surface a central scar, from which a ridge passes to the margin, and ends in a slight prominence. Exter- nally ashen-gray, glistening with short satiny hairs. Internally horny and slightly translucent. No odor. Taste, extremely bitter. Composition. — The chief constituents are — (1) Strychnine (q. v.), 0.2 to 0.6 per cent.; (2) Brucine, C 23 H 26 N 2 4 , 0.5 to 1.0 per cent. Colorless pris- matic crystals or pearly flakes. Very bitter, but less so than strychnine. Solu- bility. — 1 in 3200 of cold water, freely in alcohol. It has the same action as strychnine, but is considerably less powerful and slower in its effects. Strong sulphuric or nitric acid gives a blood-red color. (3) Igasuric acid, with which the strychnine and brucine are united. (4) Igasurine, an alkaloid closely resembling the other two, has been said to be present. Preparations. 1. Abstractum Nucis Vomicae. — By maceration and percolation in alcohol and water, and evaporation. Dose, ^ to 2 gr. NUX VOMICA. 297 2. Extractum Nucis Vomicae. — By maceration and percolation in alcohol and water, evaporation. Dose, }i to 1 gr. 3. Extractum Nucis Vomicae Fluidum. — By maceration and percolation in alcohol and water. Distil off the alcohol and evaporate. Dose, 1 to 4 m. 4. Tinctura Nucis Vomicae. — Nux Vomica, 20; alcohol and water to 100. By maceration, percolation and evaporation. Dose, 5 to 20 m. STRYCHNINA.— Strychnine. C 21 H 22 N 2 2 . Source. — (1) Make a fluid extract of powdered nux vomica by digesting with alcohol and water for twelve hours at a gentle heat. (2) Add acetate of lead to the extract, and thereby precipitate igasurate of lead and coloring mat- ter. (3) Filter off the fluid, which contains acetate of strychnine and brucine. (4) These are precipitated with ammonia. (5) This precipitate is dissolved in alcohol, distilled to a small volume, and set aside to crystallize. Strychnine is the first to crystallize, leaving the brucine in solution. Characters. — Minute, colorless, odorless, octahedral or prismatic crys- tals. Intensely bitter; can be tasted in a solution of I in 700,000 (but only to be tasted in weak solutions, as it is so poisonous). Solubility. — 1 in 6700 of cold, I in 2500 of hot water, I in 6 of chloroform, I in 40 of alcohol. Almost insoluble in absolute alcohol and in ether. Gives no color with nitric or sul- phuric acids. Add to a crystal strong sulphuric acid, and then add a particle of bichromate of potassium, a beautiful violet color, passing to brown and green, is formed. Resejnbling strychnine. — Salicylic acid (q. v.). Impurity.- Brucine, distinguished by tests. Dose, gL to T \ gr. in solution, or made in a pill with sugar of milk (to thoroughly divide it) and glycerine of tragacanth ; -^ to 2V & r * hypodermi- cally, or the nitrate soluble I in 70 of water may be used. STRYCHNINE SULPHAS.— Sulphate of Strychnine. (C 21 H 22 N 2 2 ) 2 H 2 S0 4 . Source. — By the action of diluted sulphuric acid on strychnine. Characters. — Colorless or white, shining, prismatic crystals, efflorescent, odorless, of an intensely bitter taste, and of a neutral reaction. Solubility. — In 10 parts of water and 60 of alcohol. Dose, J 7 to J- gr. Preparations. 1. Ferri et Strychninae Citras. (See Iron, p. 161.) 2. Syrupus Ferri, Quininae et Strychninae Phosphatum. {See Iron, p. 160.) 26 298 organic materia medica. Action. External. — Strychnine is a very powerful antiseptic. Brucine is a local anaesthetic. Internal. — Gastro-intestinal tract. — Being intensely bitter, nux vomica is a good stomachic, increasing the vascularity of the gastric mucous membrane, the secretion of gastric juice, and the movements of the stomach, just like calumba, gentian, or any other bitter ; consequently it aids digestion and sharpens the ap- petite. In the intestine it is a direct stimulant to the intestinal muscular coat, and by this means it increases peristalsis, and is therefore purgative. Blood. — Strychnine is absorbed into the blood, and circulates as such. If blood is mixed with strychnine and shaken with air, it contains more oxygen and less carbonic acid than it would have done had the strychnine been absent ; but there is no evi- dence that strychnine in small doses alters the oxidizing power of living blood. Spinal cord. — Strychnine causes convulsions. They are not cerebral, for they occur if the spinal cord is separated from the brain. They do not depend upon excitation of the motor nerves or muscles, for they are absent in a limb, the spinal anterior nerve-roots of which are cut. They do not depend up- on stimulation of sensory nerves, for they occur even if the pos- terior nerve-roots are cut. Therefore they must be spinal ; and this is proved by the fact that if all the vessels of the lower part of the spinal cord are ligatured just at their entry into the cord, so that this is the only part of the body deprived of its blood sup- ply, and strychnine is injected into the blood, convulsions occur in all the muscles except those the nerves of which spring from the part of the cord which the strychnine cannot reach. Again, if an animal be convulsed by strychnine, and a probe be slowly passed down the spinal canal, the convulsions will gradually cease from above downwards. Strychnine, therefore, enormously in- creases the excitability of the motor nerve-cells of the spinal cord. The result is that even the slightest stimulus, as a breath of air, acting reflexly, causes violent convulsions. NUX VOMICA. 299 Muscles and nerves. — Even with enormous doses the muscles and afferent nerves are unaffected. Towards the end of a case of poisoning the functional activity of the motor nerves is depressed. This is not due, as has been thought, to their exhaustion from the transmission of the impulses from the spinal cord which produce the convulsions, but it is the result of a direct paralyzing effect on the motor nerves themselves. Brain — The convolutions are quite unaffected. The centers in the medulla, which are really the continuation upwards of the anterior cornual cells of the cord, are powerfully stimu- lated, especially the respiratory center. The vaso-motor center is also considerably excited, and chiefly for this reason the blood-pressure rises from the very first. The cardiac center is but slightly affected. Circulation.— Strychnine stimulates the heart directly, either by its action on the cardiac muscle, or, as most authorities think, by stimulating the motor ganglia. The blood-pressure is raised, partly no doubt by the action on the heart, but also by the contraction of the vessels all over the body, which is brought about first by the direct excitation by the strychnine, of the medullary vaso-motor center, and subsequently by its asphyx- ial stimulation, and also by the increased peripheral resistance which must occur from the frequent contraction of all the muscles Respiration. — Respiration is rendered quicker and deeper because strychnine excites the spinal and medullary respiratory centers. The respiratory muscles are implicated in the general convulsions, with the result that the patient ultimately becomes asphyxiated owing to exhaustion of them, and to their prolonged contraction during the convulsive spasms. The heart continues to beat after death, which is entirely due to failure of respiration. The temperature is a little raised during strychnine poisoning. Special senses. — The hearing and sight are sharpened by strychnine. Elimination. — Part of the strychnine is eliminated unchanged in the urine ; the rest appears as strychnic acid. It is excreted 300 ORGANIC MATERIA MEDICA. very slowly, and therefore accumulates in the system. For a clinical account of strychnine poisoning see Toxicology. Brucine and thebaine act like strychnine, but methylbrucine, methylthebaine, and methylstrychnine do not influence the cord, but paralyze the ends of the motor nerves like curare. " Therapeutics. External. —Strychnine is so poisonous that its use as an antiseptic would not be safe. Internal. — Gastro-intestinal tract. — Tincture of nux vomica is very largely given with excellent results as a bitter stomachic and carminative, especially in cases in which the feebleness of digestion is merely part of generally feeble health. A mixture of dilute hydrochloric acid, gentian and nux vomica is of great service in these cases. As the digestion improves the general health improves. Because of its power to stimulate peristalsis nux vomica is a valuable drug for cases of constipation in which the contractile strength of the muscular coat of the intestine is weak ; usually this is part of a general weakness of the whole body. The constipation of anaemia, which can be very success- fully treated by a pill of extract of nux vomica and sulphate of iron, is a good instance of this variety of constipation. Circulation. — In cases of heart disease in which digitalis is inadmissible, nux vomica and strychnine are excellent cardiac stimulants, and for this purpose they may be combined with caffeine. Patients almost dead from failure of the heart in the course of chronic cardiac disease may sometimes be brought round by the subcutaneous injection of strychnine. Respiration. — Strychnine may be combined with expectorants because it stimulates the respiratory center ; and it is extremely serviceable when from any cause, such as severe bronchitis, the respirations are feeble and shallow. Nervous system. — It has been given for a number of nervous diseases, but with no constantly good results, for when the disease is not in the anterior cornua, strychnine is hardly indicated ; and if it is in this part of the cord, it is doubtful whether it is advisable to stimulate the part of the body which is diseased. NU-X VOMICA. 30I Toxicology. In about an hour after a poisonous dose the patient begins to feel uneasy from a sensation of impending suffocation. The tetanic convulsions then com- mence with great violence, nearly all the muscles of the body being affected at once. The limbs are thrown out, the hands are clenched, the head is jerked forwards and then bent backwards, and the whole body is perfectly stiff from the violence of the contractions. The pulse is very rapid ; the temperature may rise. Hearing and sight are acute. The convulsion lasts a minute or two, then the muscles relax, and the patient feels exhausted and sweats all over. The intermission is short, convulsions soon come on again, and again there is a re- lapse to the state of muscular relaxation. The convulsions now rapidly increase in severity, and owing to the violent contractions of the muscles of the back, the patient is in the position of opisthotonos, resting on his head and his heels. The abdominal muscles are as hard as a board, the chest is fixed, the face be- comes livid, the eyeballs are staring. The contraction of the muscles of the face causes a risus sardonicus; but those of the jaw are not affected till quite the end. Consciousness is retained to the last. The slightest noise or even a bright light will reflexly bring on the convulsions, which may jerk the patient out of bed. Ultimately he dies from exhaustion and asphyxia. The smallest dose of strychnine known to have killed is half a grain. Post mortem. — The usual appearances of death by asphyxia are seen. Strychnine poisoning is liable to be confounded with tetanus, but in this disease symptoms come on more slowly, the muscles of the jaw are implicated very early, and there is continuous muscular rigidity with paroxysmal exacer- bations, but never complete muscular relaxation. Treatment. — Give emetics (p. 76), or wash out the stomach if the case is seen early enough for the passing of the tube not to cause spasm. Also give plenty of animal charcoal or tannic acid, but continue the washing out. Inject large doses of bromide of potassium and hydrate of chloral per recttim. Use nitrite of amyl inhalations, and if possible artificial respiration. Antagonism. In a sense strychnine is antidotal to chloral and morphine, but it is not a strict antidote, for they act chiefly on the cerebrum. Still chloral is valuable in strychnine poisoning, and although the antagonism with Calabar bean and gel- semium is more accurate, as both depress the anterior cornua, yet they are of very little use in strychnine poisoning. Strychnine acts on all animals as on man, but chickens, guinea-pigs, and perhaps monkeys are less susceptible to it than other animals. 30 2 ORGANIC MATERIA MEDICA. IGNATIA. BEAN OF ST. IGNATIUS.— The seed of Strychnos Ignatii (Nat. Ord. Loganiacece.) Philippine Islands. Characters. — About i\ in. long, oblong or ovate, irregularly angular, dull, brownish or blackish, very hard, horny ; inodorous ; very bitter. Composition. — The chief constituents are : (i) strychnine, 1.2 per cent. ; (2) brucine, 0.5 per cent.; (3) igasuric acid; (4) a volatile principle. Preparations. 1. Abstractum Ignatiae. — By maceration and percolation with alcohol and water, evaporation and addition of sugar of milk. Dose, ^ to 1 gr. 2. Tinctura Ignatiae. — Ignatia, 10. By maceration and percola- tion with alcohol and water, to 1 00. Dose, 10 to 30 m. Uses. Ignatia is used for precisely the same purposes as nux vomica, but the preparations are stronger. PHYSOSTIGMA. CALABAR BEAN. — The seed of Physostigma venenosum (Nat. Ord. Leguminosce). Western Africa. Characters. — 1 to 1% in. long, % m - broad, y 2 in. thick. Oblong, slightly reniform, with a black furrow all along its convex border. Testa hard, brittle, roughish, deep brown, enclosing a closely adherent nucleus, which prin- cipally consists of two hard, white, brittle cotyledons separated by a cavity. Inodorous. No distinctive taste. Usually contains 0.12 per cent, of total al- kaloids. Composition. — The chief constituents are two alkaloids : ( 1 ) Physostig- mine or Esei'ine (see below) ; (2) Calabarine. Dose, )4 t° 2 g r « °f powdered beans. Preparations. 1. Extractum Physostigmatis. — By maceration, percolation in alcohol and evaporation. Dose, yL to Yz gr. internally, or rather less dissolved in 10 TTt of water and given subcutaneously. 2. Tinctura Physostigmatis. — By maceration, percolated with alcohol. Dose, 10 to 30 m. CALABAR BEAM. 303 PHYSOSTIGMINE SALICYLAS. PHYSOSTIGMINE SALICYLAS.— C 15 H 21 N 3 2 C t H 6 3 . The sal- icylate of an alkaloid prepared from Physostigma. Characters. — Colorless, shining, acicular or short, columnar crystals, gradually turning reddish, odorless, bitter. Soluble in 130 parts of water, 1 2 parts of alcohol. Dose, T1 L to 3-L gr. Action. External. — None. Internal. — Mouth. — After physostigmine is absorbed it in- creases the salivary secretion ; and this, according to some, is through its action on the centre in the medulla, according to others by its direct effect on the salivary cells. After a time the flow of saliva ceases, because the drug has so acted on the circu- lation as to constrict the vessels, and consequently the flow of blood through the salivary glands is diminished. Stomach and intestines. — The muscular coat of the stomach and intestines is stimulated by the direct action of the drug circulating through it. The result is that after a large dose vomiting and purging occur. Physostigmine is quickly absorbed. Circulation. — No influence on the blood is known. The effect on the heart is obscure, but it appears that the irritability of the peripheral terminations of the vagus is at first increased, and that consequently the heart is slowed. Very large doses are said to decrease the irritability of the vagus. In addition to its effects on the vagus, physostigmine powerfully stimulates the contractile force of the heart. The beat is therefore both more forcible and slower. Ultimately the organ is paralyzed and stops in diastole. The blood-pressure rises very much ; this is largely due to the increased force of the cardiac oeat, but perhaps partly to the irritation of the muscular coat of the arteries by physostigmine, for it stimulates most of the involuntary muscles in the body. Respiration is first quickened but soon retarded, and death takes place from asphyxia, Three factors at least are probably 304 ORGANIC MATERIA MEDICA. concerned in bringing about these results. The ends of the vagi in the lungs are stimulated, for if these nerves are cut and physo- stigmine is administered there is no primary quickening of re- spiration. Physostigmine, from its action on involuntary muscu- lar fibre, causes contraction of that in the bronchial tubes, with con- sequent constriction of them. Lastly and the most important, the activity of the respiratory centers in the medulla and cord is de- pressed. Nervous system. — Brain. — Even in fatal doses consciousness is unimpaired. The only part of the brain known to be affected is the respiratory centre. Spinal cord. — It is here that physostigmine produces its most characteristic effects. Reflex activity is inhibited ; by ex- clusion it can be shown that this is not owing to any influence on the nerves or voluntary muscles, therefore it is due to depression of the anterior cornua of the spinal cord. The most con- clusive proof of this is the direct application of the drug to the cord. There is then, at first, from the irritation, which is caused by almost any substance, a slight increase of reflex excitability, but this soon gives way to complete abolition of it. Later on the posterior part of the cord is also paralyzed, so that there is a diminution of cutaneous sensibility. Voluntary muscles and their nerves. — These are but slightly influenced. With very large doses the irritability of motor nerves and muscles is slightly depressed ; sensory nerves are unaf- fected. Involuntary muscles. — We have already seen that the involun- tary muscles of the intestines, stomach, and bronchial tubes are stimulated by physostigmine ; so also are those of the spleen, uterus, bladder and iris. It is not decided whether in all these instances it is the muscular fibres or the terminations of the nerves in them that are affected. Eye. — Physostigmine applied locally to the conjunctiva or in- troduced into the circulation causes contraction of the pupil, spasm of accommodation, and a diminution of intra- ocular tension. In the main these effects are due to irritation CALABAR BEAN. 305 of the terminations of the third nerve, and can be prevented by atropine. Some consider that the muscular fibres are also affected, and others that the peripheral sympathetic nerve-fibres in the iris are paralyzed. Secretions. — The saliva, sweat, tears, and buccal mucus are in- creased. The cause of this is unknown. The action of physostigmine is much more constant than that of Calabar bean, because the calabarine (which stimulates the cord) in the bean interferes with the action of physostigmine. Therapeutics. Involuntary muscles. — Because of its stimulating power on un- striped muscle Calabar bean has been recommended for chronic constipation, atony of the bladder, and chronic bronchitis with deficient power of expectoration, but it is rarely given for these purposes. Spinal cord. — Calabar bean has been largely used for tetanus, and some cases of recovery have been reported ; proba- bly it is the most efficacious drug we have for this disease. It must be administered boldly, ^ of a grain of the extract frequently repeated may be injected under the skin ; or if phy- sostigmine itself is preferred, the salicylate may be given subcu- taneously in doses of -g 1 ^ to ^ grain by the mouth, or i to 6TTL of a solution of i grain of the salicylate of physostigmine in i6otTL of water. The sulphate may be used in the same doses. Physo- stigmine has been given as an antidote for strychnine poisoning. Eye. — A solution of salicylate of physostigmine is dropped in the eye to break up adhesions of the iris, to diminish intra-ocular tension, and to prevent prolapse of the iris after wounds or ulcers of the cornea. It is also employed in glaucoma, in paralysis of the iris and ciliary muscles, and to prevent the entrance of light into the eye in photophobia. If used in solution, y^ to 2 gr. of the salicylate of physostigmine to gj of water is the usual strength. Antagonisms. It will be observed that in its actions on the pupil, on secretion, on the heart, and on respiration, physostigmine is antagonistic to atropine. In its ac- tion on the spinal cord and respiratory center it is antagonistic to strychnine. 306 ORGANIC MATERIA MEDICA. GELSEMIUM. GELSEMIUM. — Yellow Jasmine. The rhizome and rootlets of Gelse- mium sempei'virens (Nat. Ord. Loganiacece). From the south-eastern United States. Characters. — Nearly cylindrical, % to 6 in. long, % to j£ m - m diame- ter, small rootlets mixed with or attached to the larger pieces ; light yellowish brown externally, with longitudinal dark purple lines ; bark thin, with silky fibres in its liber ; body-axis pale yellow, porous, with medullary rays. Odor narcotic, aromatic. Taste bitter. Composition. — The chief constituents are — (i) Gelsemine, a powerful, yellowish- white, minutely crystalline, bitter alkaloid, soluble in alcohol and ether, sparingly in water. The hydrochlorate is the common salt. (2) Gelse- minic acid. (3) A volatile oil. Dose, 5 to 10 gr. Of hydrochlorate of gelsemine, -^ to -^ gr. Preparations. 1. Extractum Gelsemii Fluidum. — By maceration and percola- tion in alcohol and evaporation. Dose, 5 to 10 m. 2. Tinctura Gelsemii. — Gelsemium, 15 ; by maceration and per- colation in alcohol, to 100. Dose, ^ to 1 fl. dr. Action. External. — None. Internal. — Gelsemium produces no effect on the stomach or intestines Brain. — In poisoning by gelsemium consciousness is main- tained till the end ; the drug, therefore, has no power on the higher cerebral centers. Spinal cord. — The most marked symptom produced by gelse- mium is paralysis of all the muscles of the body ; and by a series of experiments, like those used for strychnine, this can be shown to be due to depression of the activity of the anteri- or cornua of the spinal cord. This is said to be followed by a depression of the sensory part of the cord, with consequent anaesthesia. The motor nerves and muscles are quite unaffected, even till death. The result of this action on the cord is that the patient may be unable to walk, or if he can, the gait is staggering ; GELSEMIUM. 307 his general sensibility is much impaired. Convulsions may be produced. The cause of these cannot be made out, for they ap- pear to be neither cerebral, spinal, nor peripheral. Eye. — Gelsemium soon causes disturbance of vision, then fol- lows diplopia, due to paralysis of the ocular muscles, and from the same cause the upper lid drops. The pupil is dilated. All these symptoms are probably owing to the paralysis of the motor cells in the floor of the fourth ventricle and the aqueduct of Sylvius, for these are the continuation upwards of the anterior cornual cells. Circulation. — The action of moderate doses is not marked. Toxic doses are powerfully depressant ; the force and rate of the pulse and the blood-pressure fall. This is owing to a direct action on the heart. How far these effects are due also to affec- tion of the medullary and spinal centres is not known. Respiration. — Soon after the administration of gelsemium the respiration becomes slower and more feeble ; ultimately it stops, death taking place by asphyxia. This is due to paralysis of the respiratory centers in the cord and medulla. Before death the temperature falls, and the skin is bathed in a cold sweat. Therapeutics. Gelsemium was formerly given as a circulatory depressant, but it is not now used, as its other effects are so harmful. Nor is it any longer prescribed for convulsive diseases, as tetanus, whoop- ing-cough, chorea, etc., as it was not found to do any good. It is occasionally used for neuralgia and migraine; how it acts is quite uncertain; the dose must be pushed, and often the drug fails. Sometimes it is employed to dilate the pupil and paralyze accommodation. It will do this when applied locally, for it is quickly absorbed from the eye. It has the advantage that its influence passes off rapidly. Discs of gelatine, each containing -^ gr. gelsemium, are made for application to the eye. CONIUM. CONIUM. — Hemlock. The full grown fruit of Conium maculatum, the spotted hemlock (Nat. Ord. Umbelliferce), gathered while yet green. United States. 308 ORGANIC MATERIA MEDICA. Characters. — About one-eighth of an inch long ; broadly ovate ; laterally compressed, gray-green, often divided into two mericarps, each with five crenate ribs, without oil-tubes, and containing a seed which is grooved on the face ; odor and taste slight. When triturated with a solution of potassa, conium gives off a strong, disagreeable odor. Resembling conium fruit. — Caraway, anise, dill, all known by having vittse (oil-tubes). Incompatibles. — Caustic alkalies, vegetable acids, and astringents. Composition. — The chief constituents are— (i) Conine, C 8 H 16 HN, the active principle; a yellowish, oily, strongly alkaline, liquid alkaloid, with a mouse-like odor and a tobacco-like taste. Solubility. — I in loo of water. It is easily obtained from the plant by distillation with alkalies. It is most abun- dant in the fruit. It is readily decomposed by light and heat, and the prepara- tions of conium are therefore of very varying strengths. Its salts are much more stable. (2) Methyl-conine, C 8 H U CH 3 N. A colorless, fluid alkaloid. ^3) Conhydrine, a nearly inert crystallizable alkaloid. ^4) Conic acid. Dose, 2 to 5 gr. in powder. Preparations. 1. Abstractum Conii. — Powdered conium, macerated with diluted hydrochloric acid and alcohol, percolated and evaporated. Dose, 1 to 3 gr. 2. Extractum Conii Alcoholicum. — Powdered conium, macer- ated and percolated with diluted alcohol, evaporated with dilute hydro- chloric acid, to pilular consistence to which five per cent, of glycerine is added. Dose, ^ to 1 gr. 3. Extractum Conii Fluidum. — Powdered conium macerated, percolated with diluted alcohol, evaporated with diluted hydrochloric acid. Dose, 2 to 5 m. 4. Tinctura Conii.— Powdered conium, 15; by maceration and percolation with diluted alcohol, to 1 00. Dose, X to 1 fl. dr. Action. External. — Conine has no influence on the unbroken skin, but it has been thought to be anaesthetic when applied to painful broken surfaces. This is doubtful, for in the first place we have no proof that it can be absorbed from sores; and, secondly, ex- periments show that enormous doses have to be given to depress the activity of sensory nerves. CONIUM. 309 Internal.— Gastro-intestinal tract. — It has no special action here, but it may occasionally give rise to vomiting and diarrhoea. Circulation. — Conine is absorbed into the blood, and circu- lates unchanged. As it paralyzes the terminations of the vagus it probably increases the rapidity of the cardiac beat, but this subject has not yet been satisfactorily worked out. Nervous system. — Nerves. — It is on these that conine and methylconine, the active principles of conium, chiefly act. Co- nine is much the more energetic. It powerfully depresses the functional activity of all the motor nerves in the body. This depression begins at their periphery, and gradually ascends till the whole nerve, from the periphery to the spinal cord, is incapable of responding to stimuli. This leads to paralysis of all the muscles of the body as far as voluntary and reflex motion are concerned, but they themselves are unaffected, retaining their irritability to local stimuli. The sensory nerves are not im- plicated unless the dose is very large ; then their conducting power is slightly impaired. Spinal cord. — This remains uninfluenced till quite late; then, if poisonous doses have been given, the function of its motor cells is feebly depressed, as is also that of the respiratory center in the medulla. As methylconine inhibits the reflex activity of the spinal cord earlier than conine, the exact period at which this effect comes on varies with different preparations. Brain. — Except for the respiratory center the whole of the brain is unaffected by conine. Consciousness is preserved until the stage of asphyxia. Eye. — Conine, when dropped into the eye, causes immediate contraction of the pupil reflexly from the conjunctival irritation. But soon the pupil dilates, and accommodation is paralyzed; the same usually happens when the drug is given internally. Pro- bably these results are owing to paralysis of the terminal portions of the third nerve, for well-marked ptosis, which is due to this cause, is present. Respiratio7i. — Owing to the profound paralysis of all the motor nerves, and the later depression of the respiratory center 3IO ORGANIC MATERIA MEDIC A. and motor part of the cord, death takes place from enfeeblement of respiration and consequent asphyxia. Conine is excreted unchanged, chiefly in the urine. Therapeutics. External. — Conium has been applied to painful ulcers and sores, but it is, for the reasons already given, doubtful whether it produces any good effect. It has also been employed for myalgia and rheumatism, but it is quite useless. Internal. — Conium is rarely given as a medicine for (a) the amount of conine extracted by any preparation is very variable ; (£) the amount of methylconine present is also very uncertain ; (V) conine is very volatile; (d) it is unstable, light and air mak- ing it inert. For these reasons it is probable that often the pharmacopoeial preparations contain no conine at all. Ounces of the succus, (which is the expressed juice of the leaves and young branches to which 25 per cent, of alcohol has been added), and which is believed to be the most reliable preparation, have frequently been swallowed without producing any effects. The preparations of the fruit are said by some to be more reliable than those of the leaves. Conium has been given in spasmodic dis- eases, as whooping-cough, in chorea, tetanus, asthma, and epilepsy, but in all it does little or no good. Toxicology. The symptoms produced by a poisonous dose are in strict accordance with the physiological action. The sufferer feels his legs to be heavy ; on attempting to walk he staggers, and finds he can hardly move them, and finally he has to lie down because he has no power over them. The arms become powerless, and lie motionless at his side. There is ptosis, and dimness of vision from paralysis of accommodation ; the eyes are fixed, the pupil is dilated. Swallow- ing becomes difficult. Respiration is labored, the voice is lost, and death takes place from asphyxia. Post mortem. — The organs are found congested with venous blood. Treatment. — Emetics (p. 76) and wash out the stomach. Give tannic acid and again wash it out. Stimulants subcutaneously. Warmth to the feet. Artificial respiration. TOBACCO. 311 TABACUM. TABACI FOLIA. — Leaf Tobacco. The commercial dried leaves of Nicotiana Tabacum (Nat Ord. Solanacece). America. Characters. — Large, up to 20 or more in. long, ovate, acute, entire? brown, brittle, glandular, hairy. Odor characteristic. Taste nauseous, bitter, acrid. Composition. — The chief constituents are — (1) Nicotine, C 10 H U N 2 (2 to 8 per cent.). A colorless, volatile, oily alkaloid, smelling and tasting like tobacco leaves, darkening with age. Soluble in water, more so in alcohol and ether. Turkish tobacco contains hardly any. (2) Nicotianin, a camphor. The existence of this body has been denied. (3) Salts and flavoring agents. Nicotine is decomposed by heat, consequently tobacco smoke contains none, but consists of small quantities of various pyridine compounds, as pyri- dine (C 5 H 5 N), picoline (C 5 H 7 N), lutidine (C 7 H 9 N), and colidine (C 8 H U N), and small amounts of hydrocyanic and acetic acids, creasote, sulphur, and carbon compounds. Action. Tobacco leaves, when taken internally, act entirely in virtue of their nicotine, which is one of the most powerful and rapid poisons known. External. — Nicotine is an antiseptic. Internal. — Gastro-iniestinal tract. — Nicotine in even minute doses (4- gr.) promptly produces symptoms of intense gastro- intestinal irritation. They are greatly increased salivary flow, burning pain in the mouth, oesophagus, and stomach, hor- rible nausea, quickly succeeded by vomiting and free purging. The marked characteristic of this gastro-intestinal irritation is the extreme collapse which accompanies it. Thus there are a rapid, very feeble pulse, intense muscular weakness, laborious respiration, partial loss of consciousness, occasional convulsions, icy extremities, and profound general collapse. A dose of nico- tine has been known to kill in three minutes. Circulation. — Nicotine disintegrates the red blood-corpuscles of freshly drawn blood, but has not this effect on living blood, although the spectrum of haemoglobin is altered, so that the corpuscles must be in some way affected. The action on the heart is obscure; the muscle itself is unaffected, but the rapid- running, feeble pulse shows that some part of the cardiac appa- 312 ORGANIC MATERIA MEDICA. ratus is powerfully influenced. The blood -pressure falls rapidly ; we are ignorant as to whether this is entirely due to the action of nicotine on the heart. Respiration. — This is paralyzed, how is not known. Death is partly due to asphyxia. Nervous system. — The cerebrum is probably very little affected by nicotine. The convulsions occasionally observed in man, and always in the frog, are due to spinal stimulation. All observers are agreed that ultimately the function of the motor nerves is entirely abolished. This explains the intense muscular weakness. Probably the sensory nerves, and certainly the muscles, escape. Eye. — A toxic dose taken internally, or the local application of nicotine to the eye, contracts the pupil. This will occur in excised eyes, and is therefore a local effect. It is most likely due both to sympathetic paralysis and irritation of the third nerve. Elimination. — Nicotine is probably eliminated in the urine, the secretion of which it increases. Therapeutics. Tobacco is never used therapeutically. Formerly it was em- ployed in the form of an enema of the leaves to relax muscular spasm, so as to facilitate the reduction of dislocations. This enema was also sometimes given as a purgative. Tobacco smoking, in those who are unaccustomed to it, pro- duces, to a greater or less degree, the symptoms of gastrointes- tinal irritation and collapse just mentioned. Even in those who are used to it the smoke may produce catarrah of the pharynx. Some persons find smoking after breakfast assists the daily action of the bowels. With many people it has an obscure effect, espe- cially among those who lead sedentary lives, in stimulating the brain and producing a peaceable, calm state of mind. Over-indulgence in it may lead to loss of appetite and atrophy of the optic nerve. ERYTHROXYLON. COCA. — Cuca. The leaves of Erythroxylon Coca (Nat. Ord. Erythroxy- lacea). South America. ERYTHROXYLON. 3 1 3 Characters. — Shortly stalked, oval or lanceolate; 2 to 3 inches long; entire, usually blunt and emarginate, smooth, midrib prominent, numerous faint anastomosing veins, and a curved line either side of the midrib. Green above, paler underneath. Faint tea-like odor, bitter taste. Composition. — It contains three alkaloids, viz., (1) cocaine, 0.2 per cent.; (2) ecgonine; (3) hygrine, which is aromatic. Also (4) coca tannin and (5 ) coca wax. Different specimens vary very much in strength of cocaine. Fresh specimens are stronger than those that have been kept. v Dose, 1 to 4 dr. of the leaves infused in hot water. Preparation. Extractum Erythroxyli Fluidum. — By maceration and percola- tion in diluted alcohol, and evaporation. Dose, 1 to 4 fl. dr. Action. External. — Cocaine (see Appendix) has no action on the unbroken skin, but if injected subcutaneously or applied to mucous membranes — as, for example, those of the eye, nose, mouth, rectum, vagina — it produces complete local anaes- thesia, so that small operations can be performed without the patient feeling them. A 5 or 10 per cent, solution of the hydrochlorate is strong enough to thus paralyze the sensory nerves. Much larger doses must be applied to motor nerves to paralyze them. Internal. — Gastro-intestlnal tract. — When cocaine is taken internally, the gastric mucous membrane experiences its anaes- thetic influence. Therefore the sensation of hunger is deadened, and persons taking cocaine can go a long time without feeling the want of food ; but the drug is not a food, for the body rap- idly wastes. Because of its local anaesthetic effect it sometimes stops vomiting. Very large doses, by paralyzing the intestines, lead to constipation. Circulation. — Probably cocaine has little direct effect upon the circulation, but the vagus is somewhat depressed, and there- fore the pulse quickens ; larger doses slow it from stimulation of the vagus. Respiration. — It acts upon the respiratory center, first stimu- 27 3 1 4 ORGANIC MATERIA MEDICA. lating it, so that the rapidity and depth of respiration are in- creased ; but soon depression of the center follows, the respira- tory movements become feeble, and death takes place from asphyxia. Nervous System. — Cerebrum. — Moderate doses greatly in- crease the bodily and mental power, and give a sense of calm and happiness. This greater physical energy renders pos- sible the performance of long, exhausting muscular feats. For this, and for the extreme sense of peace produced, coca leaves mixed with clay or ashes are chewed by thousands of the inhab- itants of Peru and the neighboring countries. It is said that forty million pounds of the leaves are annually harvested. An excessive indulgence in the habit of coca chewing leads to indi- gestion, extreme emaciation, insomnia and enfeeblemeut of in- tellect. In animals coca causes cerebral convulsions. Spinal cord. — The effect of cocaine on this is obscure. Large doses are depressant. The action on nerves has been already mentioned. As a rule, muscles are unaffected. Eye. — When a solution of cocaine is dropped into the eye there is first a transitory contraction of the pupil. This is prob- ably due to reflex action, and soon it gives way to wide dilata- tion. The maximum is attained in an hour or two. The nor- mal state is regained in from twelve to twenty-four hours. The dilated pupil is feebly responsive to light, and the dilatation is rapidly overcome by physostigmine. The ocular tension is slightly lowered. Accommodation is partially, but never com- pletely, paralyzed. These effects are due to irritation of the sympathetic, and as they are quickly produced by dropping the drug in the eye they are probably local. Temperature. — This may rise in cocaine poisoning. Kidneys. — Cocaine is most likely excreted by these organs. Its influence on the quality and composition of the urine is not known. Therapeutics. External. — A 5 to 10 per cent, solution of the hydrochlo- rate may be injected subcutaneously as a local anaesthetic when PILOCARPUS. 315 any small operation has to be performed. Solutions, painted or dropped on, may be used for operations on the mouth, eye, ear, throat, teeth, vagina, urethra and rectum, and they may be ap- plied to any of these parts when they are very painful. Cocaine will relieve vaginal pruritus, and has been used locally applied in the nose in hay fever. Painful ulcers, fissures, &c, are beneficially treated with it. Ophthalmic surgeons employ it very largely to produce local anaesthesia of the eye for surgical operations. Internal. — Mouth. — A solution is useful for painting or spray- ing on to the throat previous to laryngeal examinations. Loz- enges of the hydrochlorate, containing 1-1 2 of a grain in each, are valuable for painful sore throat. Stomach. — Cocaine in some cases allays excessive vomiting, and has been said to cure sea-sickness. It is not often used in Europe as a medicine for its restorative effects; as already mentioned, it is not a food, and the good it does is only temporary. PILOCARPUS. Synonym. — Jaborandi. The leaflets of Pilocarpus pennatifolius (Nat. Ord. Rutacece). Brazil. Characters. — Leaflets very shortly stalked, about 4 in. long ; oval-oblong or oblong-lanceolate, unequal at base ; obtuse and emarginate ; slightly revolute and entire at the margins ; coriaceous. Upper surface glabrous, dull green ; under surface paler, often hairy, with prominent midrib and pellucid dots. Odor when bruised, aromatic. Taste on chewing, slightly bitter and aromatic at first, subsequently pungent, and increasing the flow of saliva. Impurities. — Leaves of species of Piper, not oval-oblong. Composition. — The chief constituents are — (1) A liquid, colorless, alka- loid, pilocarpine (C n H 16 N 2 2 ), ^ to I per cent. (2) Jaborine, an alkaloid resembling in its physiological action atropine, and therefore antagonistic to pilocarpine. (3) A volatile oil. (4) A peculiar acid. These active principles are soluble in alcohol, but only imperfectly so in water. Dose, 5 to 60 gr. Preparation. Extractum Pilocarpi Fluidum. — By maceration and percolation in diluted alcohol ; evaporation. Dose, 5 to 60 m. PILOCARPINE HYDROCHLORAS.— Hydrochlorate of Pilocar- pine. C n H 16 N 2 2 ,H CI. 31 6 ORGANIC MATERIA MEDICA. Source. — Obtained by shaking the extract of pilocarpus with chloroform and an alkali, evaporating, neutralizing with hydrochloric acid, and purifying by re -crystallization. Characters. — Minute white crystals, deliquescent, odorless, having a faintly bitter taste and neutral reaction. Solubility. — Very soluble in water and in alcohol. Dose, yi to % gr. Action. External. — None. Internal. — Gastrointestinal tract. — Pilocarpine is very quickly absorbed, and soon produces a great increase in the amount of salivary secretion. The mouth seems warm, and there may be a feeling of tenderness about the salivary glands. The saliva contains an abundance of salts and ptyalin, and can convert starch into sugar. Its increase is due to a direct stimulation of the filaments of the chorda tympani and other nerves which end in the cells of the salivary glands, so that stimu- lation of these nerves can add very little to the flow produced by the drug — in fact, not more than can be accounted for by vascular alterations. This action is antagonized immediately by belladonna, as that paralyzes the endings of these nerves. To a slight extent pilocarpine excites the secretion of the gastric juice and intestinal fluid. The unstriped muscle of the stomach and intestine is stimulated, and thus the drug may purge. The bile is unaffected. Large doses, especially of jaborandi, may produce vomiting. Circulation. — Pilocarpine has no effect on the blood, but it is a cardiac depressant. The pulse-rate, it is true, may be, and in the human being always is, a little accelerated at first, but soon both it and the blood-pressure fall. This slowing of the pulse is at once set aside by atropine, but is not prevented by sec- tion of the vagus, therefore pilocarpine acts on the heart itself, probably stimulating the terminations of the vagus. The blood- vessels are at first dilated. Respiration. — The drug has no effect on this. The amount of bronchial secretion is increased. Skin. — Jaborandi, through its alkaloid pilocarpine, produces PILOCARPUS 31 7 a very profuse secretion of sweat. It is the most powerful diaphoretic drug we have. A single dose may cause the flow of fifteen fluid ounces of sweat. It is said that the proportion of urea and chlorides in the sweat is greatly increased. This pro- fuse diaphoresis is due to the action of the pilocarpine on the cells of the sweat-glands, or the terminations of the nerves in them, and is stopped by atropine. The skin may flush, but this is not the cause of the diaphoresis. Under a course of jaborandi the hair grows more actively, but it becomes very coarse and dark. Kidneys. — If the sweating is profuse the secretion of urine is lessened, but repeated small doses of pilocarpine lead to slight diuresis. It is excreted unchanged in the urine. lemperature. — There may be a slight rise at first, but soon the temperature falls considerably. This is probably due in large part to the evaporation of the perspiration. Eye. — Whether applied locally to the eye or given internally, pilocarpine produces great contraction of the pupil, due to stimulation of the ends of the third nerve in the eye, and this is antagonized by atropine. It also causes increased tension of the eyeball, and an approximation of the near and far points of distinct vision. Other actions. — It stimulates the uterus, and has in very rare cases produced abortion. It increases the secretion of milk, of tears, of nasal mucus, and, according to some authors, that of cerumen. It causes the spleen and bladder to contract. It will be noticed that it has two main actions. (1) It stim- ulates the secretions, viz. those of the salivary glands, stomach, intestines, skin, kidney, bronchial mucous membrane, nose, lachrymal glands, and ear. In those that have been investigated, and probably in all, it acts locally. It has not been decided in every case, whether the cells of the glands or the nerve termina- tions in them are affected. (2) It stimulates the nerve termina- tions of involuntary muscles, viz. in the eye, the intestines, the stomach, the uterus, the spleen, the heart, the bladder, and it acts on the muscular coat of the vessels, although these, if 318 ORGANIC MATERIA MEDICA. affected, are usually dilated. The most important effects are the diaphoresis, the salivation, and the myosis. It is consequently antagonistic in its action to belladonna. Children bear large doses of it well. Pilocarpine is much more used than jaborandi, as it is more prompt and more certain in its action, and is less likely to cause indigestion. Jaborine has an action similar to that of atropine ; the amount of it in jaborandi varies, hence the varying effects of different specimens of the leaves, but there is never enough to totally counteract the pilocarpine. Therapeutics. Pilocarpine has been employed for many conditions, but its great use is as a diaphoretic in Bright's disease. For this purpose ^ of a grain or more of the hydrochlorate is injected subcu- taneously in the evening. The sweating is aided by wrapping the patient, who should be naked, in several warm blankets, and putting a hot water bottle to his feet. After the sweating has ceased, he should be dried and left in a dry blanket. As it is such a powerful cardiac depressant, it must be given with great caution when the heart is diseased. Occasionally it is employed locally in affections of the eye. Patients suffering from deafness due to disease of the auditory nerve or its terminations are some- times relieved by pilocarpine. Injected subcutaneously it has been given successfully as an antidote to belladonna poisoning. GROUP II. Vegetable Drugs, whose Main Action is on the Heart. Class I. — The digitalis group, decreasing the frequency and increasing the force of the beat of the heart : Digitalis. Squill. Class II. — The aconite group, decreasing the frequency and decreasing the force of the beat of the heart : Aconite. Veratrum Viride. DIGITALIS. 319 DIGITALIS. DIGITALIS. — Foxglove. The leaves of Digitalis purpurea (Nat. Ord. Scrophulariacece), the purple foxglove. Collected from wild British plants of the second year's growth when about two-thirds of the flowers are expanded, and carefully dried. Characters. — 4 — 12 in. long, up to 6 in. broad, with a winged petiole; ovate, subacute, crenate ; somewhat rugose ; hairy, dull green above, densely pubescent and paler beneath. Odor faint, agreeable, tea-like. Taste very bitter, unpleasant. Rese??ibling digitalis leaves. — -Matico leaves, which are more deeply reticulated. Composition. — The chief constituents are — (1) Digitoxin, a glucoside, the most active principle, very poisonous, cumulative. Insoluble in water, sparingly in alcohol and in ether. (2) Digitalin, a crystalline glucoside in- soluble in water. (3) Digitalein, an amorphous glucoside, soluble in water, and therefore suitable for hypodermic injections ; dose hypodermically T i^ gr., said to be non-cumulative. These three glucosides are said to represent the cardiac stimulating action of the drug. (4) Digitonin, a glucoside closely allied both chemically and physiologically to, and perhaps identical with, the saponin of senega (q. v.). This is a cardiac depressant, and is therefore antagonistic to the other three glucosides. (5) Digitin, a substance devoid of physiological action. All these five bodies are non- nitrogenous. (6) Two acids, digitalic and antirrhinic. (7) Other usual constituents of plants, as tannin, volatile oil, coloring matter, starch, sugar, gum, salts. It will be noticed that digitalis contains no alkaloids. The two following substances are met with in commerce : (A) Homolle's digitalin (same as Quevenne's digitalin), an amorphous yellowish-white powder or small scales, intensely bitter, inodorous, but irritating to the nostrils. Con- sists chiefly of digitalin with a little digitoxin. Possesses the action of the leaves. Granules of it are much used in France ; each usually contains -J3- of a grain, which is equal to 1)4 g r - °f tne powdered leaves. (B) Nativelle's digitalin : light white crystalline tufts of needles, very bitter. Soluble in chloroform and in alcohol, not in water or ether. It consists very largely of digitoxin, and is cumulative. Dose, g 1 ^ to -^ gr. in a pill. Incompatibles. — Per-salts of iron, acetate of lead, cinchona. Dose, )4 to 3 S T ' °f tne powdered leaves. Preparations. 1. Abstractum Digitalis. — By maceration and percolation with alcohol, evaporation with addition of sugar of milk. Dose, % to 1 gr. 320 ORGANIC MATERIA MEDICA. 2. Extractum Digitalis. — By maceration and percolation in alcohol and water, distil off the alcohol. Evaporation and addition of five per cent, of glycerine. Dose, )( to i gr. 3. Extractum Digitalis Fluidum. — By maceration and percola- tion in alcohol and water and evaporation. Dose, ]/ 2 to 3 m. 4. Infusum Digitalis.— Powder, 3 ; cinnamon, 3; boiling water, 185; alcohol, 15; to make 100 parts. Dose, 1 to 4 fl. dr. (note that it is drachms, not ounces). 5. Tinctura Digitalis. — Recently dried and in powder, 15 ; alcohol to 100. By maceration and percolation. Dose, 5 to 30 m. As the proportion of the many constituents varies in the preparations, some prefer always to give the powdered leaves. The infusion contains digitonin and not much digitoxin, the tincture contains both digitalin and digitoxin. Action. External. — The leaves are slightly irritating, but it is doubt- ful whether any of their constituents can be absorbed by the skin. Internal. — Gastro-intestinal tract. — Digitalis is a mild gastro-intestinal irritant, and even moderate doses cause vomiting and diarrhoea in some people. Blood. — It is rapidly absorbed; it is not known to affect the blood. Heart. — The first action of digitalis is to slow the beat of the heart, the diastole is prolonged, the duration of the systole is not altered, but its force is greatly increased, so much so that after large doses the heart may, in animals, be seen to become pale, because every drop of blood is squeezed out of it. The pulse is consequently increased in force, but retarded. If before the drug was given the heart was beating irregularly, it generally becomes regular. If a larger dose is given, it is observed that the intense systolic contraction is not uniform all over the organ. The auricles and ventricles do not beat synchronously; and even one portion — as the apex, for example — of the ventricle may remain spasmodically contracted DIGITALIS. 321 during the diastole of the rest of the ventricle. This causes the heart to assume hour-glass and other curious shapes. Finally it is arrested in systole, and is firmly contracted, quite pale, and unable to respond to any mechanical or electrical stimuli. This account is true for all animals, except that sometimes in dogs and men the heart finally stops in diastole. That these phenomena are chiefly due to the direct action of the drug on the cardiac muscles is shown by the fact that digitalis not only acts when applied locally to the heart, but will even increase the force of the contraction, when applied to the isolated apex in which it is believed no nerves exist. But the inhibitory activity of the cardiac peripheral end of the vagus is increased ; for a mild stimulation of the vagi, which, before the drug was given, had no effect, will after the drug is given stop the heart, and in warm-blooded animals digitalis does not very markedly retard the pulse, if the vagi have been cut, although it increases the force of the cardiac beat. Possibly to a slight extent the vagus centre in the medulla is stimulated, but the main action of digitalis is to excite the cardiac muscle itself and the cardiac inhibitory terminations of the vagus. Digitalis has been thought to affect the ganglia of the heart, but there is no satisfactory evidence of this. It has been proved that even small doses actually increase the amount of work done by the heart in a given time. Vessels. — Moderate doses of digitalis produce a great rise in the blood-pressure. This is partly due to the greater cardiac force, but not entirely, for in the web of the frog's foot and the rabbit's mesentery the arterioles have been observed to contract vigorously when digitalis has been given. As this still occurs in arterioles quite separated from the body, and through which an artificial circulation of blood containing digitalis is carried on, it is clear that the drug contracts the arterioles by direct action on their muscular coat. But as the con- traction is greater in an intact animal than in one whose spinal cord is destroyed, or in whom the nerves going to the part experimented upon are divided, it is clear that digitalis also 28 322 ORGANIC MATERIA MEDICA. stimulates the medullary and spinal vaso-motor centers. With toxic doses the irritation of the centers and of the muscular coat of the arterioles passes on to depression, and the blood- pressure falls. Kidney. — The effect of digitalis on the kidney is very uncer- tain. Most experimenters have found that in health it is diuretic, but some have not, and the same discrepancy in its action on the kidney exists in patients with heart disease, but generally in these cases it is a diuretic. The reasons for these discrepancies are that if the arterial vessels are, like the rest of the vessels in the body, tightly contracted by the drug, very little blood will come to the kidney, and very little urine will be secreted ; but if the digitalis does not constrict the renal vessels markedly, the in- creased cardiac force and the general rise of blood-pressure will send more blood through the kidney and more urine will be secreted. Some observers state that digitalin and digi toxin have a special effect in relaxing the vessels of the kidney. If this is so, the question is still more complicated, for then the diuretic influence of digitalis will depend largely upon the particular preparation which is given. The truth probably is, that with a small dose of digitalis or, in the first stage of a large one, the vessels of the kidney, like those of the rest of the body are con-" tracted, and the flow of urine is diminished ; but the renal arterioles, being the first in the body to suffer from the subse- quent arterial relaxation, dilate while the general blood-pressure is still high, and then digitalis acts as a powerful diuretic. We have no certain knowledge of the effect of digitalis on the constitution of the urine. Te?7iperatnre, — Moderate doses have no influence on the tem- perature, but toxic doses cause it to fall even in health. The reason of this is unknown. Respiration. — This is unaffected by digitalis unless poisonous doses have been given, when it begins to fail from the imperfect circulation through the respiratory mechanism. Nervous system and muscles. — Medicinal doses have no marked influence. Large doses will, because of the alterations DIGITALIS. 323 in the cerebral circulation, cause headache, giddiness, and dis- turbances of sight and hearing. In many cases of poisoning all objects have appeared blue. The reflex activity of the cord and motor nerves is depressed independently of the action on the circulation; sensory nerves are unaffected. Digitalis directly paralyzes muscles if given in toxic doses. Uterus. — This organ is said to be stimulated to contract by digitalis. Therapeutics. External. — Digitalis is sometimes used externally, in the form of a poultice made from the leaves, and placed over the loins in cases of renal congestion. Internal. — It is one of the most valuable drugs we have. It is chiefly given in cases of cardiac disorder. Mitral regurgitation. — If in any case of this variety of heart disease the organ is beating feebly, irregularly, and rapidly, digitalis in moderate doses will probably strengthen, regulate, and slow the beat. It will cause the left ventricle to contract more forcibly and to act synchronously in all its parts ; hence the mitral flaps will be better approximated, the regurgitation will be less, and more blood will be sent on into the arterial cir- culation. The prolonged diastole will also be of great advantage, for it will allow more time for the blood to flow from the dilated auricle, and from the right side of the heart and venous system generally, into the left ventricle. In mitral regurgitation, as is well known, venous engorgement and oedema of the lungs, of the right side of the heart, of the liver, the kidneys, and subcutaneous tissues is very common. Digitalis, by improving the venous flow towards the heart, will ameliorate all these symptoms. It might be supposed that by constricting all the peripheral arterioles it would impede the arterial flow, because the heart will have to contract against a greater peripheral resistance, but this disad- vantage is never enough to seriously hamper the increased cardiac power; and it must be remembered that it is a great advantage to the circulation to have a proper peripheral arterial resistance, 324 ORGANIC MATERIA MEDICA. for without that, the elastic coat of the arteries cannot aid the arterial flow. If, as it usually does in these cases, digitalis acts as a diuretic, this will be of great value in removing the oedema, and in causing the scanty high-colored urine to become pale and abundant. The improvement in the circulation relieves the cardiac pain and distress which so commonly accompany mitral regurgitation, the lividity passes off, the dyspnoea decreases, and usually in a day or two a wonderful improvement in the patient's condition takes place. The more any case of mitral regurgita- tion deviates from the above oedematous type, the less good, as a rule, will digitalis do. Thus cases, in which there is much pain and distress and but little regurgitation, are not so often benefited, although even of such cases, many are improved. Sometimes the vomiting caused by digitalis prohibits its use. Mitral constriction. — In this condition it is obvious that it will be a great advantage to lengthen the diastole, for then there will be a greater chance that the diastole will be long enough to allow the normal amount of blood to pass through the constricted orifice. In proportion as this end is attained, the oedema, lividity, and other signs of backward venous congestion will be relieved. The increased force of the auricular contraction caused by digi- talis will help in the same direction, and if it induces diuresis this is very valuable in aiding the reduction of the oedema. Disease of the tricuspid valve. — In both tricuspid constriction and tricuspid regurgitation, digitalis will be beneficial in the same way as in similar affections of the mitral valve. Aortic regurgitation. — As a rule digitalis is harmful, for by prolonging the diastole more time is allowed for the blood to flow back through the imperfectly closed aortic orifice, and hence there is great danger of fatal syncope. The drug should only be given in cases of aortic regurgitation when the heart is very rapid, or when there is evidence that not much blood regurgitates, or when there are reasons, such as the coincident presence of aortic obstruction, for wishing to strengthen and regulate the contrac- tion. The dose must be small and the effects must be carefully watched. DIGITALIS. 325 Aortic constriction. — This, unfortunately, is usually accom- panied by aortic regurgitation ; but sometimes when it is wished to increase the force of the beat, and so to drive more blood through the constricted aortic orifice, digitalis is useful, or when, as a result of the obstruction, mitral dilatation and consequent regurgitation, with much pulmonary and venous engorgement, have set in. Many cases of pure aortic obstruction do not re- quire drugs, for the heart hypertrophies sufficiently to overcome the obstruction. Bright 's disease. — In cases of contracted granular kidney in which the cardiac hypertrophy has been unable to overcome the peripheral resistance, and consequently the left ventricle and with it the auriculo-ventricular orifice has dilated, and mitral regurgi- tation has therefore ensued, digitalis may be of service for the reasons given on p. 323. A diuretic pill, often used for this con- dition, consists of calomel, digitalis leaves, and squill, a grain of each, made up with extract of henbane. Otherwise in chronic Bright' s disease digitalis is not a suitable diuretic, for it raises the tension of the pulse, which is already high. In the earlier stages of acute Bright' s disease it has been given as a diuretic, but it is questionable whether it is right to dilate the vessels of an acutely inflamed organ ; further, digitalis is always, unless the heart is diseased, an uncertain diuretic, and even in the early stage of acute Bright' s disease the arterial tension is somewhat raised. In chronic tubal nephritis uncomplicated by cardiac disease it is worse than useless, for it has no effect on the renal cells, and i^ raises the blood-pressure. Diseases of the cardiac muscle. — If the heart be fatty, digi- talis does no good ; it is indeed said that there is danger of rup- ture of some of the softened fatty fibres. The weakly acting heart that is met with after pericarditis, typhoid fever, scarlet fever, rheumatism, and other acute diseases, even if no valvular defects are present, is markedly strengthened by digitalis. Each contraction is more efficient, and the prolonged diastole allows more time for the muscle to rest. It is clear that in the course of twenty-four hours this additional repose, although but little in 326 ORGANIC MATERIA MEDICA. each cycle, will amount to a considerable time. Many men who have practised rowing or other hard exercise to excess, suffer from shortness of breath, and the apex of the heart is found to be a little outside the normal position, but there is no demonstrable valvular lesion. This condition, which also occurs in soldiers after a long campaign, is much benefited by digitalis. The dila- tation of the right side of the heart that so frequently accom- panies chronic disease of the lungs may be, but is not usually, improved by digitalis. Functional disease of the heart. — The irregular, palpitating beat, often seen apart from any organic disease, may be benefited markedly by digitalis ; but it must be remembered that this con- dition is commonly a result of indigestion, in which case the right treatment is, if possible, to cure the dyspepsia, and if digitalis is given at all, to do so cautiously, for it may excite in- digestion. The functional affections of the heart met with in highly neurotic subjects may be, but are not always benefited by digitalis. Exophthalmic goitre may improve under a long course of digi- talis, but generally this treatment fails. Hcemorrhage . — Although digitalis contracts the arterioles it is not often given as a haemostatic, for the increased blood-pressure may lead to greater haemorrhage, but it may be useful in the pul- monary haemorrhage, due to disease of the mitral valve. Alcoholism. — Moderate doses of digitalis have been said to be serviceable in chronic alcoholism on account of their stimulating effect on the circulation. Enormous doses have been given empi- rically in delirium tremens, but generally without any good result. Uterus. — Because of its power to contract the uterus, digitalis may be useful in menorrhagia. It is olten desirable to combine fluid preparations of digitalis with salts of iron, the resulting mixture, which is usually inky from the action of the iron on the tannin in the digitalis, can be clarified by the addition of a little dilute phosphoric acid. Be- cause of this difficulty the powdered digitalis leaves are often made into a pill with dried sulphate of iron. SQUILL. 327 Antagonisms. Antagonism between digitalis and aconite. — Aconite is a cardiac poison, weakening instead of strengthening the beat ; it dilates the peripheral vessels, it lowers the blood-pressure, and after death the heart is always found in a condition of diastole. In all these points it is antagonistic to digitalis. The action of aconite is very rapid, that of digitalis very slow. Therefore these drugs are not practical antidotes to each other in poisoning. Scoparin is also physiologically antagonistic to digitalis. Digitalis is cumulative. Patients who have taken it for a long while sometimes suddenly show symptoms of poisoning without any increase in the dose. This is because, as the drug is not excreted by the kidneys as fast as it is absorbed, it accumulates in the body. SCILLA. SCILLA.— Squill. The sliced bulb of the Urginea Scilla (Nat. Ord., LiliacecB). Mediterranean coast. Characters. — In narrow segments, about ten inches long, slightly trans- lucent, yellowish- white or reddish, brittle and pulverizable when dry, flexible after exposure to damp air, inodorous, mucilaginous, bitter and acrid. Composition. — The chief constituents are, — (i) Scillitoxin, the most active principle ; (2) Scillipiain, also active, and closely related to scillitoxin ; (3) Scillain or scittin, a bitter non-nitrogenous glucoside ; (4) Mucilage. Dose, 1 to 5 gr. Preparations. 1. Acetum Scillae. — Squill, 10. Dilute acetic acid, by percola- tion, to 100 parts. Dose, 10 to 45 m. 2. Extractum Scillae Fluidum. — Squill in powder, by macera- tion and percolation with alcohol, and evaporation. Dose, 1 to 5 m. 3. Syrupus Scillae. — Acetum Scillae, 40; sugar, 60; water to 100. Dose, yi, to 1 fl. dr. 4. Syrupus Scillae Compositus. Synonym. — Hive Syrup. (See Tartrate of Antimony and Potassium, p. 190.) 5. Tinctura Scillae. — Squill, 15. By maceration and percolation with diluted alcohol to 100. Dose, 5 to 30 m. Action. Squill so closely resembles digitalis in its action that the account of that drug will apply to squill with the following addi- 328 ORGANIC MATERIA MEDICA. tions. Squill is a much more powerful gastro-intestinal irritant; vomiting and purging result from even moderate doses, and after death, if animals are killed with it, much gastro- enteritis is found. In the second place, some constituent of squill is excreted by the bronchial mucous membrane, and in passing through it irritates it. The vascularity and the amount of secretion are thereby increased. Squill is, therefore, a power- ful expectorant. Thirdly, squill in the course of its excretion through the kidneys stimulates them; it is, therefore, a more energetic diuretic than digitalis, and it may irritate the kid- neys excessively. Therapeutics. Because of its irritating properties squill is not given alone, but it is frequently combined with digitalis when that drug is administered for heart diseases or as a diuretic. A very favorite diu- retic pill is composed of powdered squill, powdered digitalis leaves and calomel, 1 grain of each, made up with some simple vehicle. Squill is much used as an expectorant. Here also it is always prescribed in combination; it is too irritating to the bronchial mucous membrane for it to be advisable to give it in acute bron- chitis; nor should it be chosen in phthisis, lest it should cause dyspepsia ; but it is valuable in chronic bronchitis if the secretion is scanty. Squill should not be given in acute Bright' s disease, for it is too irritating to the kidneys. ACONITUM. ACONITE. — The tuberous root of Aconitum Napellus (Nat. Ord., Ranunculacece), collected, in the winter or early spring before the leaves have appeared, from plants cultivated in Britain, or imported in a dried state from Germany. Characters. — Usually 2 to 3 in. long. Upper extremity, crowned with base of stem, is y 2 to ^ in. in diameter; conical, shriveled, shows bases of broken rootlets; dark brown externally, whitish internally. Has a central axis with rays. Cautiously chewed, produces, after some minutes, tingling and numbness. Resembles horseradish (q. v.). Composition. — The active principle is the very poisonous alkaloid (aco- nitine (see below). Other principles are, perhaps, pseudo-aconitine, napellin, ACONITE. 329 nepallin, napallin, aconellin and others, combined with aconitic acid ; but our knowledge of them is unsatisfactory. Dose, y z to 2 gr. Preparations. 1. Abstractum Aconiti. — Powdered aconite, 200; tartaric acid, 2. By maceration in alcohol, percolation, evaporation, addition of sugar and milk to 100. Dose, ^toi gr. 2. Extractum Aconiti. — Powdered aconite, 100; tartaric acid, I. By maceration and percolation with alcohol, with evaporation to 100 ; addition of 5 per cent, of glycerine. Dose, T V to X S r - 3. Extractum Aconiti Fluidum. — Powdered aconite, 100; tar- taric acid, I. By maceration and percolation with alcohol, and evapora- tion to 100. Dose, J^ to 2 m. 4. Tinctura Aconiti. — Powdered aconite, 400; tartaric acid, 4. By maceration and percolation with alcohol to 1 000. Dose, J^ to 5 m. It should be remembered that Fleming's tinc- ture of aconite, which is found in the shops, is nearly twice as strong as this. Action. External. — Applied to the skin, to a mucous membrane, or to a raw surface, aconite or its alkaloid first stimulates and then paralyzes the nerves of touch and temperature; it therefore causes first tingling, then numbness and local anaesthesia, which last some time. Internal. — Gastro-intestinal tract. — Unless it is very dilute, mumbness and tingling are produced in the mouth. There are no other gastro-intestinal symptoms unless the dose is very large, when there may be vomiting. Heart. — The rate of the beat may be at first a little increased by aconite, but soon the pulse is very decidedly slowed, shortly after that, the force and tension become less. Finally the heart is arrested in diastole. It is certain that towards the end of its action aconite influences the heart itself, for it will retard the excised organ when applied directly to it. It is extremely 330 ORGANIC MATERIA MEDICA. probable that in the earlier stages the drug acts upon the cardiac nerves or their centers, but the details of such action are not known. The effect on the heart leads to a fall of blood- pressure, but whether this is partly due to an action on the vaso-motor system itself is undecided. Respiration, — The rate of respiration is slowed, expiration and the pause after it, are considerably prolonged. This is chiefly due to the action of aconite on the center in the medulla, but in part to the paralysis of the peripheral endings of the afferent vagal fibres. Nervous system. — The evidence is very conflicting, but it ap- pears clear that aconite, whether given internally or applied locally, depresses the activity of the peripheral terminations of the nerves; the nerves of common sensation and temperature are affected before the motor. Any pain that may be present is relieved. Later on, the paralysis of the motor nerves gives rise to muscular weakness. It is doubtful whether the cord is influenced. The brain is not. Te7nperature. — Aconite causes a febrile temperature to fall. The cause of this is not known. Skin. — Aconite is a mild diaphoretic ; in this case also we do not understand how it acts. Occasionally it produces an erythematous rash. Kidneys. — It is said to be a feeble diuretic, but its effect is very slight. We do not know the channel by which it is elimi- nated. Therapeutics. External. — As aconite produces local anaesthesia, it is ap- plied externally and often with great benefit in cases of neuralgia, especially facial neuralgia. Frequently it fails, and we cannot tell beforehand whether it will succeed. A small piece of the ointment (B. P., aconitine, 2; alcohol, 7; benzoinated lard, 100) maybe rubbed in till numbness is produced, but as this is a very expen- sive preparation it is usually better to paint on the liniment (which is in B. P. a 40 per cent, solution in alcohol, to which ACONITE. 33I 2 per cent of camphor is added), with a camel' s-hair brush. The pain of chronic rheumatism is sometimes relieved by aconite. Internal. — It may be given internally for neuralgia, but it does not succeed nearly so well as when applied externally. It is not used internally as much as formerly, when it was admin- istered in almost every febrile disease, with the object of decreas- ing the force and tension of the pulse. Certainly it does this very effectually, and the only reason why it is not so popular at the present time is, that it is not now thought desirable to reduce the force and frequency of the heart in these diseases. Perhaps it is used too little, for many believe that the milder febrile diseases, such as tonsillitis, laryngitis, or a common cold, are distinctly benefited by aconite. In addition to retarding the pulse it increases perspiration and lowers the temperature. As large doses diminish the force of the heart, it is usually given in doses of two or three minims of the tincture every hour or so till the pulse falls to nearly normal ; for the same reason it is not advisable to use it for prolonged fevers, as typhoid, nor when the heart is diseased, except in the few cases in which there is suffi- cient compensative cardiac hypertrophy. In such cardiac cases it is sometimes useful to slow the pulse, even when there is no fever. It will occasionally relieve the pain of aneurism. A common practice was to combine with it one or two drops of Vinum Antimonii, as that has much the same action on the heart. Formerly it was much used in surgery if it was feared that inflammation might set in after injuries. Toxicology. The symptoms come on quickly ; in a few minutes there is a severe burn- ing, tingling, sensation in the mouth, followed by numbness. Vomiting begins in an hour or so, and is very severe. There is an intense abdominal burning sensation. The skin is cold and clammy. Numbness and tingling with a sense of formication of the whole skin, trouble the patient very much. The pupils are dilated, the eyes fixed and staring. The muscles become very feeble, hence he staggers. The pulse is small, weak, and irregular. There is difficulty of respiration. Death takes place from asphyxia, or in some cases from syncope. He is often conscious to the last. Post 7nortem. — The usual signs of death from asphyxia are seen. $$2 ORGANIC MATERIA MEDIC A. Treatment. — Wash out the stomach promptly, give emetics (p. 76). In- ject stimulants, as ether or brandy, subcutaneously ; apply warmth. Atropine and the tincture of digitalis should be given subcutaneously. VERATRUM VIRIDE. VERATRUM VIRIDE.— American Hellebore. The rootlets and ihizome of Veratrum viride (Nat. Ord. Melanthacece), United States. Characters. — Entire or divided transversely or longitudinally, with or without attached rootlets. If entire, I, 2, or more in. long, ^ in. in diameter; erect, obconical, obtuse or truncated at the apex; dark brown externally, whitish within. Often has remains of leaves at upper end, and gives off on all sides numerous shrivelled yellowish-brown rootlets, several inches long, or the latter are detached and mixed with it ; the rhizome is then marked with scars. Odor none, but it excitts sneezing when powdered. Taste bitter, very acid. Resem- bling Veratrum. — Valerian, serpentary, arnica, but veratrum has thicker root- lets, and no odor. Composition. — The chief constituents are — (1) Jervine, an alkaloid. (2) Pseudo-jervine, an alkaloid. (3) Cevadine, an alkaloid. (4) Traces of three other alkaloids, viz., rubijervine, veratrine, and veratralline. (5) Resin. Dose, 1 to 5 gr. Preparations. 1. Extractum Veratri Viridis Fluidum. — Powdered veratrum viride macerated and percolated with alcohol, and evaporated. Dose, 1 to 5 m. 2. Tinctura Veratri Viridis. — Veratrum viride in powder, 50 ; by maceration and percolation in alcohol to 100. Dose, 2 to 10 m. This tincture must be distinguished from Norwood's Tincture of Veratrum Viride, of which the dose is 5 m., gradually increased. Action. The action of veratum viride is very complex, as it contains so many alkaloids, but experiments have only been made on two active principles. These are jervine, and a substance, vera- troidine, which further analysis shows to consist chiefly of rubi- jervine, resin, and, perhaps, some other bodies. Jervine, veratroidine, and veratrum viride will be considered separately. Jervine. — Gastro-intestinal tract. — When administered in- ternally this substance produces profuse salivation, but neither vomiting nor purging. VERATRUM VIRIDE. 333 Circulation. — The pulse is markedly lessened in frequency if the animal is quiet, but often the convulsions produced by the jervine cause a rapid pulse. The force of the cardiac beat is not at first altered. The blood-pressure falls at once, and con- tinues to fall till death. Experiments made by excluding dif- ferent parts show that these effects are produced by a powerful direct depressant effect on the cardiac muscle itself, and that the vaso-motor nerve-centers are powerfully paralyzed. Respiration. — This is profoundly depressed, and death takes place from asphyxia. Nervous System. — Early in the case there is muscular weakness, and this becomes more and more marked, so that the animal cannot stand, and reflex action is abolished. Yet, weak as these muscles are, they are soon violently convulsed, and it is found that jervine produces these apparently contrary effects by energetically stimulating the cerebral motor centers, but at the same time paralyzing the anterior cornual cells of the spinal cord, although not sufficiently to prevent the very strong impulses from the cerebral centers reaching the muscles and causing convulsions. The muscles themselves, and the motor and sensory nerves, are not affected ; or if they are, they are de- pressed a little, just before death. Consciousness and the pupils are uninfluenced. Veratroidine. — Gastro-intestinal tract. — This substance always produces vomiting and sometimes purging. Circulation. — At first it lessens the pulse-rate because it stimulates the pneumogastrics, consequently the blood-pressure falls, and if artificial respiration is kept up these effects continue till, if very large doses have been given, the stimulation of the vagi passes into paralysis and then the pulse rises in frequency. Veratroidine probably has no action on the vaso-motor centers. Its influence on the respiratory centers is so intense that if arti- ficial respiration is not maintained, the effects of the asphyxia so mask those of the drug on the vagi, that the blood-pressure rises, and the pulse becomes rapid. 334 ORGANIC MATERIA MEDICA. Respiration. — The function of respiratory centers is powerfully depressed, the animal soon becomes asphyxiated and dies. Nervous system. — The action is the same as that of jervine. Veratrum Viride. — The symptoms produced by this drug in man are as follows. They are easily explained by the com- bined actions of jervine and veratroidine :— The frequency and force of the pulse are profoundly depressed. There may be severe nausea and vomiting. After larger doses the pulse be- comes very feeble and uneasy, there is difficulty of respiration and intense muscular weakness. Convulsions are not common in man. The temperature may fall several degrees. Therapeutics. It is the opinion of most authorities that veratrum viride should be prescribed with great caution as it is such a powerful poison. It has been given as a cardiac depressant, but antimony and aconite are much safer. Some have, however, claimed that it is a better cardiac depressant than aconite, because the vomit- ing it induces quickly indicates that too large a dose has been administered ; but if the pulse is carefully watched too much aconite need not be given, and the vomiting itself is objectionable. VERATRINA. VERATRUM SABADILLA.— Cevadilla. Not officinal. The dried ripe seeds of Asagrcea officinalis (Nat. Ord. Mela?ttkacea) i sometimes mixed with their pericarps. Mexico. Characters. — % in., or less, long, narrow, fusiform, with a membranous wing above ; compressed, shining, wrinkled, blackish-brown. Odor none, but when powdered produces sneezing. Taste bitter, acrid. Composition. — The chief constituents are — (i) Veratrine, which is officinal (see below). (2) Cevadilline, an inactive alkaloid. (3) Cevadine, an inactive alkaloid. VERATRINA. — Veratrine, the active alkaloid or mixture of alkaloids of Asagrcea officinalis. It is usually not quite pure, because of slight admixtures of the other two alkaloids. Source. — (1) Macerate Asagrcea officinalis with boiling water for twenty- four hours. (2) Dry it and separate the seeds from the capsules, and grind them to powder. (3) Digest this with alcohol. (4) Pour the tincture thus produced into water to precipitate the resins. (5) Filter; from the filtrate pre* VERATRINA. 335 cipitate the veratrine with ammonia. (6) Purify by hydrochloric acid, charcoal, reprecipitation, filtration, &c. Pure veratrine crystallizes in rhombic prisms. The pharmacopceial veratrine is not pure [see above). Characters. — A pale, gray, amorphous powder. Odor none, but very irritating to the nostrils. Taste very bitter and acrid. Solubility. — 1 in 6 of ether, I in 3 of alcohol, readily in dilute acids, very feebly in water. Dose, 3L to T V gr. in pill. P?'eftarations. 1. Oleatum Veratrinae. — Veratrine, 2; oleic acid, 98. 2. Unguentum Veratrinae. — Veratrine, 4; alcohol, 6; benzoin- ated lard, 96. Action. External. — Veratrine has no effect when applied to the un- broken skin, but it is a powerful irritant when rubbed in ; it then causes a feeling of warmth, followed by prickling, severe pain, and finally numbness. There is at the same time considera- ble hyperaemia. Internal. — Gastro-intestinal tract. — Its irritant action is even more marked on mucous membranes than on the skin. In- halation of the minutest portion causes great irritation of the mucous membrane of the nose, violent sneezing, and a free discharge of mucus, which may be bloody. A speck on the tongue gives rise to burning pain and profuse salivation. On arriving at the stomach and intestine it produces great epigas- tric pain, vomiting and diarrhoea. Blood. — Veratrine is quickly absorbed. It is not known to affect the living blood, but it kills the white corpuscles in drawn blood. Heart. — It acts directly on the cardiac muscle as it does upon voluntary muscle : that is to say, the contractions of the heart become fewer, but each lasts a very long while until ultimately the heart stops in systole. It also acts on the vagus as on spinal nerves, the functional activity being first exalted, and this is partly the reason of the slowing of the heart ; after- wards the vagus is depressed, but this does not cause a quickening of the pulse because of the action of the veratrine on the cardiac 336 ORGANIC MATERIA MEDICA. muscle, but it may make the beat irregular. The blood -pressure at first rises from the increased force of the beat, but when the heart becomes very slow it falls. Possibly these effects are also, in part, owing to the action of the drug on the vaso-motor centers. Respiration — Small doses quicken respiration, large ones re- tard it, producing long pauses, and finally arresting it. These results are probably due at first to stimulation, and afterwards to paralysis, of the ends of the vagus in the lung, and to paralysis of the respiratory centers. The temperature is lowered. Nervous system. — The brain is unaffected, and probably veratrine has no influence on the spinal cord. Motor nerves are first excited and then paralyzed, and the same is true of sensory nerves and their endings, but here the primary stimulation is very marked, hence the pain produced by the local inunction of veratrine. Muscles. — The effect of veratrine is peculiar and characteris- tic. In animals to which it has been given, or in excised muscles to which it is applied, it is found that the period during which a single contraction lasts is enormously prolonged. If a tracing of the contraction be taken it will be seen that the latent period and the time of the ascent of the curve are unaltered, that the height is greatly increased and the descent is extraordinarily extended. This is a genuine lengthened contraction, which is neither rigor nor tetanus, but it almost exactly resembles the con- traction of the muscles met with in Thomsen's disease. This ef- fect of veratrine disappears if the muscle is cooled. Therapeutics. External. — Veratrine as an oleate or ointment has been much used as an inunction for neuralgia, and sometimes it suc- ceeds admirably, generally in the same class of cases as are benefited by the local application of aconite. Internal. — It is rarely given internally, as it has such a power- ful and peculiar action on the heart. SENEGA. 337 GROUP III. Vegetable Drugs employed for their Action on the Respiratory Organs, and not falling among Volatile Oils (q. v.). Senega, Sanguinaria, Pulsatilla, Ipecacuanha, Allium, Lobelia, Grindelia, Asclepias, Castanea, Inula. These are all gastro-intestinal irritants. Senega and ipecacuanha are both excreted by the bronchial mucuous membrane, which they irritate. Group II is connected with this group by senega, which acts on the heart like squill, and like it is excreted by the bronchial mucous membrane. SENEGA. SENEGA.— The root of Polygala Senega (Nat. Ord. Polygalacecz). From North America. Characters. — Upper end, an irregular knotty tuberosity with remains of small stems, tapering below into a tortuous keeled root, \ to % in. thick. Bark yellowish or brownish-gray, transversely cracked. Fracture short and brittle. Odor of bark peculiar and rancid, its taste at first sweetish, but afterwards acrid, and causing a flow of saliva. Central column woody, tasteless and inodorous. Resembling senega root. — Arnica, Valerian, Serpentary, and Green Hellebore, but none of these have a keel. Composition. — The active principle is saponin (C 32 H 54 18 ). So called because it is also found in saponaria (quillaia bark, q. v.) Saponin is sometimes termed senegin, or polygalic acid. It is a colorless amorphous glu- coside, decomposed by hydrochloric acid into sugar and sapogenin. It exists as a white powder, which forms a soapy emulsion when mixed with boiling water. It acts like digitonin, and is found in many plants. Impurities. — Other roots are mixed with it. Dose, 10 to 20 gr. Preparations. i. Abstractum Senegae. — Senega powdered, by maceration and percolation in alcohol, evaporated with addition of sugar of milk. Dose, 5 to io gr. 2. Extractum Senegae Fluidum. — Powdered senega, macerated and percolated in alcohol and evaporated with addition of sugar of milk ; 2 parts of ammonia are added. Dose, io to 30 m. 3. Syrupus Senegae. — Fluid extract of senega, 160; water of ammonia, 4; sugar, 600; water to 1000. Filter before adding the sugar. Dose, 1 to 2 fl. dr. 29 $$8 ORGANIC MATERIA MEDICA. 4. Syrupus Scillae Compositus. — See Tartrate of Antimony and Potassium, p. 190. Action. External. — Saponin (and hence senega) is an irritant to the skin. Internal. — Alimentary canal. — Senega in large doses is an irritant here also, producing salivation, vomiting, and diarrhoea. Even small doses often cause indigestion. It is absorbed with difficulty. Circulation. — Saponin circulates as such in the blood. It af- fects the heart like digitalis but not so certainly. It is ex- creted by the skin, the bronchial mucous membrane, and the kidneys. Respiration. When the powdered root is inhaled it acts as a violent irritant to the nose, causing much sneezing and cough, together with hyperaemia and increased secretion from the re- spiratory mucous membrane. If senega is taken internally, it al- so irritates the bronchial mucous membrane during its excretion through it, causing vascular dilatation, greater secretion, and, re- flexly, cough. It is, therefore, a stimulating expectorant. Kidney. — It is a diuretic and during its excretion through the kidney causes irritation of it. Therapeutics. Senega is only used as a stimulating expectorant. It is evi- dent that it will be useful in bronchitis, when the secretion is scanty, and when the power to cough is feeble. As it is an irri- tant to the bronchial mucous membrane, it must not be given in acute bronchitis, nor, on account of its gastrointestinal action, when there is indigestion. It has been employed as a diuretic, but it is not powerful, and is uncertain. SANGUINARIA. BLOOD ROOT. — The rhizome of Sanguinaria canadensis (Nat. Ord. Papaveracece). Collected in autumn. United States. Characters. — About 2 in. long and f in. thick, horizontal, cylindrical, somewhat branched, faintly annulate, wrinkled, reddish-brown ; fracture short IPECACUANHA. 339 somewhat waxy, whitish, with numerous small, red resin cells, or of a nearly uniform, brownish-red color; bark, thin; odor, slight; taste, persistently bitter and acrid. Composition.— (1) Sanguinarine. Symbol C 19 H 17 N0 4 . (2) Porphy- roxine. (3) Puccine. Preparations. 1. Acetum Sanguinariae. — Sanguinaria, 10; by percolation with diluted acetic acid to 100. Dose, 5 m. to 3 fl. dr. 2. Extractum Sanguinariae Fluidum.— By maceration and per- colation with alcohol and evaporation. Dose, 1 to 5 m. (expectorant), ^ to 1 fl. dr. (emetic). 3. Tinctura Sanguinariae. Sanguinaria, 15, by maceration in alcohol, and water, and percolation to 100. Dose, 5 m. to 4 fl. dr. Action and Uses. Sanguinaria is an acrid emetic with stimulant, narcotic powers ; it is also expectorant and said to be an emenagogue. It is chiefly used as a stimulating expectorant in chronic bronchitis or in ad- vanced stages of the acute disease. PULSATILLA. The herb of Anemone Pulsatilla and Anenome pratensis, and of Anemone patens var. Nuttalliana (Nat. Ord. Ranunculacece). Collected soon after flow- ering. United States. Characters. — Leaves radical, petiolate, si Iky- villous, twice or thrice deeply three-parted, or pinnately cleft, with linear, acute lobes, appearing after the large, purple flowers ; inodorous, very acrid. Composition. — The chief constituent is anemonin. Symbol, C 15 H 12 6 . Dose, 1 to 5 gr. Action and Uses. It is said to be very nearly the equivalent of senega, and also to paralyze the heart and respiratory centers. It has been used in asthma, convulsive coughs and in bronchitis. It has been highly recommended for orchitis and epididymitis. IPECACUANHA. IPECAC. — The root of Cephaelis Ipecacuanha (Nat. Ord. Rubiacece). Brazil. 340 ORGANIC MATERIA MEDICA. Characters. — Twisted pieces 2 to 4 in. long, J in. diameter. Cortical portion thick, brownish, annulated, with a resinous waxy fracture, active. Central portion, whitish, woody axis, inactive. Taste acrid, bitter. Odor slight, peculiar. Composition. — The chief constituents are — (1) Emetine, C 20 H 30 NO 5 . A crystalline alkaloid and the active principle. It is white (turns yellow on keep- ing), odorless, bitter, feebly soluble, but formes soluble unstable salts. (2) Ipecacuanhic or cephaelic acid. (3) A glucoside. (4) Tannin, volatile oil, starch, gum, etc. Impurities. — Hemidesmus, which is cracked, not annulated. Almond powder, occasionally found mixed with powdered ipecacuanha root, gives odor of prussic acid when moistened. Dose of powdered root, y^, to 2 gr. (expectorant), 15 to 30 gr. (emetic). Preparations. 1. Extractum Ipecacuanhae Fluidum. — By maceration and percolation with alcohol, distillation of alcohol, addition of water to resi- due, evaporation and addition of alcohol. Dose, 1 to 5 m. 2. Pulvis Ipecacuanhae et Opii. — Synonym, Dover's Powder. See Opium (p. 263). 3. Trochisci Ipecacuanhae — Powdered Ipecac, 25 gr., pow- dered tragacanth 25, powdered sugar 1000, syrup of orange, a sufficient quantity for 100 troches. Each troche contains % gr. ipecacuanha. Dose, 1 to 6. 4. Trochisci Morphinae et Ipecacuanhae.— See Morphine (p. 266). 5. Syrupus Ipecacuanhae. — Fluid extract of ipecac, 5 ; syrup, 95. Dose, 5 m. to 2 fl. dr. 6. Tinctura Ipecacuanhae et Opii. — See Opium (p. 264). 7. Vinum Ipecacuanhae. — Fluid extract of ipecac, 7; stronger white wine, 93. Filter. Dose 1 to 60 m. Action. External. — Ipecacuanha powder is a powerful irritant to the skin, producing redness, vesication, and pustulation. It has some antiseptic powers, for it can destroy anthrax bacilli, but it has no effect on the spores. This property is not due to its emetine, but to some other constituent. IPECACUANHA. 34I Internal. — Alimentary canal. — Here also the irritating action of ipecacuanha is seen. It increases the flow of saliva, dilates the gastric vessels, and stimulates the secretion of gastric juice. Therefore small doses are distinctly stomachic, and aid digestion. Large doses are, however, powerfully emetic. This is partly due to their irritant effect upon the stomach, but still more to the fact that emetine acts directly upon the vomiting center in the medulla, as can be proved by observing that, when the alkaloid is thrown directly into the circulation, vomiting fol- lows before there is time for it to have been excreted into the stomach. Ipecacuanha is, therefore, both a direct and indirect emetic. It produces a certain amount of depression, but not more than the mere act of vomiting will explain. It does not usually cause nausea. The irritant effect is continued in the in- testine, and hyperaemia, excessive secretion, and purging result. In dysentery there is a peculiar tolerance of ipecacuanha. Ipe- cacuanha increases the amount of bile secreted, and is therefore a direct cholagogue. Circulation. — No specific effect whatever is produced except by enormous doses which may arrest the beat of the heart, but the act of vomiting is somewhat depressing. Respiration. — This likewise is unaffected. Ipecacuanha pow- der when inhaled, or ipecacuanha taken internally, when it is excreted by the bronchial mucous membrane, causes hyperaemia of it, together with an increased secretion of bronchial mucus, and therefore, reflexly, coughing is stimulated. It is, conse- quently, an expectorant ; and because the nausea it induces depresses the circulation a little, it is called a depressant expecto- rant, but this is a misnomer, considering that the bronchial mucous membrane is stimulated. Animals to which large doses of ipecacuanha or of emetine have been given show, after death, considerable hyperaemia of the bronchial mucous membrane, of the lungs, and of the stomach and intestines, and the same con- dition of the respiratory passage is seen if ipecacuanha powder has been inhaled. Skin. — Ipecacuanha is a mild diaphoretic. 342 organic materia medica. Therapeutics. External. — Ipecacuanha is never at the present day em- ployed for its external irritant effect. It has been used with suc- cess, as an antiseptic, in cases of anthrax. It is directed that the wound should be dressed with the powder, and that 5 grains should be taken by the mouth, every four hours. Internal. — Stomach. — Occasionally in small doses, such as 4 or 5 minims of the wine or ^ gr. of the powder, it is em- ployed as a stomachic, and these quantities may even stop vomit- ing when other drugs have failed. A usual prescription to arrest the vomiting of pregnancy is a minim of ipecacuanha wine in water every half jhour. The powder of ipecac and opium has been praised in cases of gastric ulcer ; no doubt any good effect it may have is due to its stimulating power. Ipecacuanha is a very common emetic. It should not be given when it is desired, as in cases of poisoning, to empty the stomach quickly, for some time elapses before it is absorbed and influences the medulla; nor should it be given to the very feeble, for it has no action that will counteract the depression of the vomiting. But it is an excellent emetic when it is wished, by the act of vomiting, to empty the air-passages, as in bronchitis, the early stages of diphtheria, tracheitis, and laryngitis, for not only the vomiting but the effect of the ipecacuanha on the respiratory tract and the slight subse- quent depression will be beneficial. It is chiefly employed for this purpose in children, as they cannot cough well, and often it seems to act like a charm. It used to be given in the early stage of fevers, to empty the stomach of undigested food. A good emetic powder for an adult consists of 20 grains of powdered ipecacuanha with y 2 gr. of tartar emetic. Impecacuanha is said to be a specific for dysentery. How it acts is not known. Very large doses must be given — 60 to 90 grains in a single dose, or 20 grains every four hours. Half a grain to a grain or more is often combined in a pill with other cholagogues to relieve cases of hepatic dyspepsia, and sometimes with excellent results. Respiration. — Ipecacuanha is a very common expectorant. LOBELIA. 343 Lozenges may be sucked, or the syrup or wine may be given in- ternally. It is suitable in cases of bronchitis or phthisis in which the secretion is scanty, and therefore there is much purposeless cough ; and also when the disease is of long-standing, for then the stimulation of the chronically inflamed mucous membrane will aid the cure of it. Its power of exciting the act of coughing adds to its usefulness. The inhalation of ipecacuanha powder by means of an atomizer has been recommended in cases of asthma, and for the asthma- like paroxysms which often accompany chronic bronchitis. Some- times it does good, but it may make the trouble worse. Skin. — Dover's powder is very commonly used as a diaphoretic in mild feverish attacks. ALLIUM. GARLIC. — The bulb of Allium sativum (Nat. Ord. Liliacece). Sicily, Italy. Characters. — Bulb subglobular, compound, consisting of about eight compressed, wedge-shaped bulblets, which are arranged in a circle around the base of the stem, and covered by several dry, membranous scales. It has a pungent, disagreeable odor, and a warm acrid taste. Composition. — The chief constituents are: (i) An essential oil, which consists of a peculiar organic radical (ally I), combined with sulphur ; symbol (C 3 H 5 ) 2 S. (2) Mucilage. (3) Albumen. Preparation. Syrupus Allii. — Fresh garlic, 15 ; sugar, 60 ; diluted acetic acid, 40. Dose, 1 to 4 fl. dr. Action and Uses. The effects of garlic are those of a general stimulant, quickening the circulation, excititing the nervous system, and promoting expectoration. It is beneficial in impaired digestion, in chronic catarrhal and other pectoral affections in which symp- toms of inflammation have subsided and a relaxed state of the vessels remains. LOBELIA. LOBELIA. — The leaves and tops of Lobelia inflata (Nat. Ord. Lobe- liacece). Collected after a portion of the capsules have become inflated. North America. 344 ORGANIC MATERIA MEDICA. Characters. — Compressed, oblong, rectangular packages, ^ to I lb. each, and wrapped in sealed and labelled papers. The separate pieces are of varying lengths, yellowish-green, angular, and bearing sessile or stalked, hairy, oval, irregularly toothed leaves, together with some flowers and fruits. Odor slight, irritating. Taste first mild, then burning and acrid when chewed. Composition. — The chief constituents are — (i) Lobeline, a liquid, volatile, oily alkaloid, 30 per cent. Taste pungent. Odor like tobacco. It is combined with (2) lobelic acid, and forms crystallizable salts. (3) Lobelacine. Incompatibles. — Caustic alkalies, as they decompose lobeline. Preparations. 1. Acetum Lobeliae. — Powder, 10. By percolation with diluted acetic acid to 100. Dose, 10 to 60 m. 2. Extractum Lobeliae Fluidum. — Powder. By maceration and percolation in diluted alcohol, and evaporation. Dose, 1 to 10 m. 3. Tinctura Lobeliae. — Powder, 20. By percolation with diluted alcohol to 100. Dose, 5 to 30 m. Action. External. — Lobelia has no effect on the skin, but it is stated that poisonous symptoms may occur from absorption of it through the epidermis. Internal. — Gastro-intestinal tract. — Moderate or large doses are powerfully irritant, and thus they cause violent vomiting and purging. A peculiarity of the action of lobelia is that these re- sults are accompanied by very intense prostration, as shown by the feeble pulse, cold sweats, pale skin, and great muscular re- laxation. Circulation. — In the frog the heart is at first stimulated, but soon depressed, and it finally stops in diastole. The blood-pres- sure falls. This is due partly to the action on the heart, and partly to paralysis of the vaso-motor centers. Respiration. — Small doses slow respiration, large doses strong- ly depress the respiratory center, and death takes place from re- spiratory failure. The muscular coat of the bronchi is said to be relaxed. GRINDELIA. 345 Nervous system. — Toxic doses are required to affect the high- er cerebral centers, and then coma and convulsions are produced, but it is not clear how far these results are due to asphyxia. The respiratory and vaso-motor centers, and probably the cardiac, are, as already mentioned, depressed. Experiments seem to show that the motor centers of the cord are also depressed. Muscles and nerves are unaffected. Lobeline is probably excreted by the kidneys and skin, and is said to have diuretic and diaphoretic properties. Therapeutics. Lobelia has been recommmended as a purgative and as an emetic, but it should not be used for these purposes, because of its great liability to produce collapse. It is employed in asthma to relax the muscular coat of the bronchial tubes. A teaspoon- ful of the tincture should be given till nausea is experienced, but it should never be pushed beyond that point. It may also be prescribed for bronchitis accompanied by spasmodic dyspnoea. GRINDELIA. GRINDELIA. — The leaves and flowering tops of Grindelia robtista (Nat. Ord. Compositce). California. Characters. — Leaves about 2 in. or less long, varying from broadly spatulate or oblong, to lanceolate, sessile or clasping, obtuse, more or less sharply serrate, pale-green, smooth, finely dotted, brittle ; heads many-flowered ; the in- volucre hemispherical, about ^ in. broad, composed of numerous, imbricated, squamosely-tipped scales ; ray-florets yellow, regulate, pistillate ; disk-florets yellow, tubular, perfect ; pappus consisting of three arms of the length of the disk-florets ; odor balsamic ; taste pungently aromatic and bitter. Composition. — The chief constituents are — (1) A volatile oil. (2) A resin. (3) Probably an alkaloid Preparation. Extractum Grindeliae Fluidum. — By maceration and percolation with alcohol and water, and evaporation. Dose, % to 1 fl. dr. Action and Therapeutics. In small doses, grindelia is a mild stomachic and cardiac seda- tive, but its main action depends upon the fact that in its excretion 30 346 ORGANIC MATERIA MEDICA. by the bronchial mucous membrane it acts as an expectorant, and also relaxes the muscular coat of the bronchial tubes, and this explains its efficacy in asthma. Two or three doses of twenty minims of the fluid extract in milk, which prevents precipitation in the resin, given every twenty minutes will often allay the paroxysms of asthma. Between the attacks, this dose should be taken three times a day. The same quantity may with advantage be added to mixtures prescribed for chronic bronchitis, for not only is grindelia an ex- pectorant, but it relieves the asthmatic paroxysms which so frequently accompany bronchitis. It is very bitter ; its taste is best concealed byspirituschloroformi. Cloths soaked in a lotion of 1 fl. dr. of the fluid extract to 6 fl. oz. in water are applied to the skin for the dermatitis caused by Rhus toxicodendron, the poison ivy. The same lotion is used in burns, and as an injection in gleet and leucorrhoea. ASCLEPIAS. PLEURISY ROOT.— The root of Asdepias tuberosa (Nat. Ord. As- clepiadacece) . United States. Characters. — Large and fusiform, I to 6 in. long, and % in. or more in thickness ; externally orange-brown, internally whitish ; it is inodorous, and has a bitterish, somewhat acrid taste. Dose, J4 to 2 dr. Uses. Pleurisy root is used in the disease which gives its name, and in various pectoral affections. It possesses diaphoretic and ex- pectorant properties, without being stimulant. CASTANEA. CHESTNUT.— The leaves of Castanea vesca (Nat. Ord. Cupulifera), collected in September or October, while still green. United States. Characters. — Well known. Preparation. Extractum Castaneae Fluidum. — By maceration and percolation with alcohol and water, and evaporation. Dose, ]/ 2 to 2 fl. dr. cinchona. 347 Uses. Chestnut leaves are used only in whooping-cough, because they are supposed to possess antispasmodic and expectorant properties. INULA. ELECAMPANE. — The root of Inula Helenium (Nat. Ord. Composi- tes). Europe. Characters. — In transverse concave slices, with overlapping bark, ex- ternally wrinkled and brown ; internally grayish, fleshy, dotted with numerous shining, yellowish-brown resin-cells ; odor peculiar, aromatic ; taste bitter and pungent. Composition. — The chief constituents are — (i) Inulin, sometimes called alantin ; symbol C 6 H 10 O 5 , H 2 0, which is found in 19 to 44 per cent., accord- ing to the season; (2) alantic acid; (3) helenin ; symbol C 6 H g O. Dose, )l to 1 dr. Uses. It is chiefly used in diseases of the lungs, especially when complicated with general debility. Recently, some laboratory experiments have suggested that helenin may be of value in the treatment of tuberculosis, since it is a bactericide. GROUP IV. Vegetable Drugs having Antiperiodic, Antipyretic, and Antiseptic Properties. Cinchona, Quinine, Magnolia, Cornus, Salicin, Sali- cylic Acid, Gaultheria, Hydrastis. CINCHONA. CINCHONA. — Cinchona Bark. The dried bark of Cinchona Calisaya (yellow cinchona), C. officinalis (pale cinchona), C.succirubra (red cinchona) C. lancifolia (Columbian bark), and other species of Cinchona (Nat. Grd. Ru- biacece) from which at least 3 per cent, of the peculiar alkaloids of the bark may be obtained. South America, Jamaica, India, Ceylon. (Salts of quinine and cinchonine may be obtained from some species of Remijia.) Composition. — The chief constituents of cinchona bark are several alka- loids, acids, a glucoside, tannin, a coloring matter and a volatile oil. (1) Quinine. — An alkaloid. C 20 H 24 N 2 O 2 ,3H 2 O. Exists as the hydrate. White acicular crystals, inodorous, very bitter. Gives a green color with 348 ORGANIC MATERIA MEDICA.' chlorine water and ammonia ; turns the plane of polarization to the left ; solu- tions of its salts are fluorescent. Soluble in ether and in ammonia. Forms salts with acids. [See Sulphate and Hydrochlorate, p. 351. (2) Quinidine. — An alkaloid. C 20 H 24 N 2 O 2 . Isomeric with quinine, dif- fering from it only in crystallizing in prisms, turning the plane of polarization to the right, and not being soluble in ammonia except in excess. (3) Cinchonine. — An alkaloid. C 20 H 24 N 2 O 2 . Colorless prisms, inodor- ous, bitter. No green color with chlorine water and ammonia. Turns the plane of polarization to the right. Not fluorescent. Almost insoluble in ether and in ammonia. (4) Cinchonidine. — An alkaloid. C 20 H 24 N 2 O 2 . Isomeric with cinchonine, differing from it in turning the plane of polarization to the left, being sparingly soluble in ether, and being slightly fluorescent. Good red bark should yield 5 to 6 per cent, alkaloids, not less than 2 per cent, being quinine. Good yellow bark, at least 2 per cent, of quinine. Pale bark, very little quinine, but 0.7 to 1. 4 total a kaloids, chiefly cinchonine and quinidine. (5) Conquinamine . — An alkaloid. Not important. (6) Chinic or quinic acid. — C 7 H 12 6 Large colorless prisms. It and its salts are soluble in water, and thus quinine may be given subcutaneously as quinate of quinine. This acid is found in the coffee bean and other plants. It is allied to benzoic acid,. and appears in the urine as hippuric acid. (7) Chinovic acid. — A white amorphous substance related to chinovin. (8) Chinovin. — A glucoside, which easily decomposes into glucose and chinovic acid. (9) Cincho-tannic acid. — 1 to 3 per cent. It is the astringent principle of cinchona bark. It differs from tannic acid in becoming green with per-salts of iron. It is easily oxidized to cinchona red. (10) Cinchona red. — The coloring matter of the bark. It is almost insol- uble in water. (11) A volatile oil. — This exists in minute quantities. Cinchona bark owes its smell to it. Remijia bark yields in addition homoquinine, which produces quinine and another alkaloid, cupreine. Impurities. — Inferior barks. The total alkaloids are estimated as follows : (a) For Total Alkaloids. — Make a milk of lime 5 parts, and 50 parts of distilled water, thoroughly mix with 20 parts Cinchona, dry, digest with 200 parts of alcohol in a flask at near boiling for an hour. When cool pour upon a filter. Rinse the flask and wash the filter with 200 parts of alcohol. To the filtrate add sufficient diluted sulphuric acid to give acid reaction to test paper, CINCHONA FLAVA. 349 decant, distil or evaporate the alcohol, cool, filter and wash with distilled water slightly acidulated with diluted sulphuric acid, until the washings are not made turbid by solution of soda. Concentrate to 50 parts, and make it strongly al- kaline with solution of soda. Filter and wash precipitate with distilled water, until washings give but a slight turbidity with solution of chloride of barium- Drain the filter, detach the precipitate and transfer to a weighed capsule, dry the contents, cool and weigh. The number of parts multiplied by five (5) equals the percentage of total alkaloids in the Cinchona. b. For Quinine. — -To the total alkaloids from 20 parts of Cinchona, add distilled water acidulated with diluted sulphuric acid, until the mixture remains for ten minutes after digestion, just distinctly acid to test paper. Transfer to a weighed beaker, rinsing with distilled water, and adding enough of this to make the whole weigh 70 times the weight of the alkaloids. Neutralize with solution of soda. Digest and cool for half an hour. If crystals appear, filter, wash with distilled water, and dry. Add 11.5 per cent, (for water of crystallization) and 0.12 per cent of the weight of the entire filtered liquid (for solubility of crystals at 59 F.) This sum in parts, multiplied by five (5), equals the per- centage of crystallized sulphate of quinine, equivalent to the quinine in the Cinchona. CINCHONA FLAVA.— Yellow Cinchona, Calisaya Bark. The bark of the trunk of Cinchona Calisaya (Nat. Ord. Rubiacece), containing at least 2 per cent, of quinine. South America and India. Characters. — Flat pieces, varying in length and width, are from \ to f of an inch in thickness, almost entirely deprived of the brown, corky layer, compact, of a tawny-yellow color ; outer surface marked with shallow conchoidal depressions and intervening rather sharp edges ; inner surface cloudy and finely striate ; the transverse fracture showing numerous, very short and rigid, glisten- ing fibres, which are radially arranged, and rarely in small groups. The pow- der has a light, cinnamon -brown color, and a slightly aromatic but persistently bitter taste ; or in quills, either single or double, varying in length from ^ to 2 inches in diameter ; the bark is from -J-g- to y& of an inch in thickness ; it is covered with a grayish cork, marked by longitudinal and transverse fissures about one inch apart and forming irregular meshes with raised edges. The inner surface is cinnamon- brown, and finely striate from the bast fibres. The true yellow Cinchona bark must not be confounded with other Cin- chona barks of a similar color, but having the bast fibres in bundles or raised rows, and breaking with a splintery or coarsely fibrous fracture. Impurities. — Inferior barks, known by their not yielding the full strength of quinine and cinchonidine. Incompatibles. — Ammonia, lime water, metallic salts, and gelatine. 35 O ORGANIC MATERIA MEDICA. CINCHONA RUBRA.— Red Cinchona Bark. The dried bark of the trunks of cultivated plants of Cinchona succirubra (Nat. Ord. Rubiacece), con- taining at least two per cent of quinine. South America and India. Characters. — Quills or incurved pieces, a few inches to a foot long, y% to y 2 in. thick, coated with periderm. Outer surface rough from longitudinal furrows, ridges, transverse cracks, annular fissures, and warts, brownish or red- dish brown. Inner surface brick-red or deep reddish brown, irregularly and coarsely striated. Fracture nearly close in the smaller quills, finely fibrous in the larger. Powder brown or reddish -brown. No odor. Taste bitter and astringent. Preparations. From the bark of any species containing not less than 3 per cent, of its peculiar alkaloids. 1. Infusum Cinchonae. — Powdered Cinchona, 6; aromatic sul- phuric acid, 1 ; by percolation to 100. Yellow cinchona is ordinarily used. Dose, 1 to 2 fl. oz. 2. Tinctura Cinchonae Composita. — Powdered Red Cinchona, 10; bitter orange peel, 8 ; t serpentaria, 2 ; glycerin, 10. By maceration and percolation in alcohol and water, 100. Dose, 1 to 4 fl. dr. 3. Extractum Cinchonae. — Powdered Yellow Cinchona. By maceration and percolation in alcohol and water, distillation and evapor- ation, and addition of 5 per cent, of glycerin. Dose, 5 to 30 gr. 4. Extractum Cinchonae Fluidum. — Powdered Yellow Cin- chona, by maceration and percolation in alcohol and water, and evapo- ration, addition of alcohol and water. Dose, 10 to 60 m. 5. Tinctura Cinchonae. — Powdered Yellow Cinchona, 20; gly- cerin, 10. By maceration and percolation in alcohol and water to 100. Dose, y 2 to 2 fl. dr. QUININE. 1. QUININA.-C 20 H 24 N 2 O 2 ,3H 2 O. (Crystallized.) An alkaloid pre- pared from different species of cinchona. Characters. — A white, flaky, amorphous or minutely crystalline powder, permanent in the air, odorless, having a very bitter taste and an alkaline reac- tion. Soluble in 1600 parts of water, in 6 parts of alcohol, in 25 parts of ether, in about 5 parts of calomel, and in about 200 parts of glycerin. Dose, 1 to 20 gr. QUININE. 35I 2. QUININE BISULPHAS.— C 20 H 24 N 2 O 2 H 2 SO 4 ,7H 2 O. Characters. — Colorless, clear, orthorhombic crystals or small needles, efflorescing, odorless, having a very bitter taste and a strongly acid reaction. Soluble in about 10 parts of water, in 32 parts of alcohol. Dose, 1 to 20 gr. 3. QUININE HYDROBROMAS.— C 20 H 24 N 2 O 2 HBr,2H 2 O. Characters. - Colorless, lustrous needles, pungent, odorless, having a very bitter taste and a neutral or slightly alkaline reaction. Soluble in about 16 parts of water, in 3 parts of alcohol, in 6 parts of ether, in 12 parts of chlo- roform, and moderately soluble in glycerine. Dose, 1 to 20 gr. 4. QUININE VALERIANAS— C 20 H 24 N 2 O 2 C 5 H 10 O 2 ,H 2 O. Characters. — White or nearly white, pearly, lustrous, triclinic crystals, permanent, have a slight odor of valerianic acid, a bitter taste and a neutral reaction. Soluble in 100 parts of water and 5 parts of alcohol. Dose, 1 to 20 gr. From cinchona bark or remijia bark the following officinal salts are pre- pared : 5. QUININE SULPHAS.— (C 20 H 24 N 2 O 2 ) 2 H 2 SO 4 ,7H 2 O. Source. — Prepared from the powder of the various kinds of cinchona and remijia bark by extraction with alcohol after the addition of lime, or by the addi- tion of an alkali to an acidulated aqueous infusion, with subsequent neutraliza- tion by sulphuric acid, and purification of the resulting salt. Characters.— Filiform, silky, snow-white crystals, of a pure, intensely bitter taste and very light. Solubility. — I in 740 of water, and giving it a bluish tinge ; in 65 parts of alcohol ; easily in slightly acidulated water ( 1 'flX of a mineral acid in 2 fl. oz. of water will dissolve 1 gr. of sulphate of quinine), being reprecipitated by ammonia ; the precipitate is soluble in excess of am- monia and in ether. Impurities. — It should not contain more than 5 or 6 per cent, of cincho- nine, cinchonidine, quinidine and cupreine. Lime, chalk, magnesia, starch and other white powders. Salicin, detected by its giving a blood-red color with H 2 S0 4 . Incompatibles. — Alkalies and their carbonates, astringent infusions. Dose, 1 to 5 gr., or 5 to 20 gr. (antipyretic and antiperiodic) . 6. QUININE HYDROCHLORAS.— C 20 H 24 N 2 O 2 HCl,2H 2 O. Source. — Obtained from the same source and by the same process as sulphate of quinine, the separated alkaloid being neutralized by hydrochloric acid. Characters. — Crystals resembling those of the sulphate, but larger. 352 ORGANIC MATERIA MEDICA. Solubility. — I in 34 of cold water, 1 in 3 of alcohol. Very soluble in boiling water or boiling alcohol. Its solution gives a green color with chlorine water and ammonia. Dose, 1 to 20 gr. 7. QUINIDIN^ SULPHAS.— (C 20 H 24 N 2 O 2 ) 2 H 2 SO 4 2H 2 O. A neutral sulphate or an alkaloid, prepared from different species of Cin- chona, chiefly Cinchona pitayeitsis (Nat. Ord. Rubiacece). Characters. — White, silky needles. Permanent, odorless, having a very bitter taste, and a neutral or faintly alkaline reaction. Soluble in 100 parts of water, and in 8 parts of alcohol. Dose, 1 to 20 gr. 8. CINCHONINA.— C 20 H 24 N 2 O. An alkaloid prepared from different species of cinchona. Characters. — White, somewhat lustrous prisms or needles, permanent, •odorless, at first nearly tasteless, but developing a bitter after-taste, and having an alkaline reaction. Almost insoluble in cold or hot water, soluble in no parts of alcohol, in 371 parts of ether, and in 35 parts of chloroform. Dose, 1 to 30 gr. 9. CINCHONIDINiE SULPHAS.— (C 20 H 24 N 2 O) 2 , H 2 S0 4 ,3H 2 0. Source. — Obtained from the mother liquors of the crystallization of sul- phate of quinine by further concentration, purifying by crystallization from alcohol and finally from hot water. Characters. — Colorless, silky crystals, usually acicular. Solubility. — Easily in dilute acids, I in 100 of water, I in 71 of alcohol. Not in chloroform or ammonia. Solution bitter. Very slightly fluorescent. Turns the plane of polarized light to the left. Dose, 1 to 30 gr. 10. CINCHONIISUE SULPHAS.— (C 20 H 24 N 2 O) 2 H 2 SO 4 ,2H 2 O. Source. — Obtained from the mother liquors of the crystallization of the sulphates of quinine, quinidine, and cinchonidine by further concentration, pre- cipitating the alkaloids by caustic soda, washing with alcohol till free from other alkaloids, dissolving in sulphuric acid, purifying with animal charcoal, and crystallizing. Characters. — Hard, colorless, short, prismatic, vitreous crystals. Solu- bility. — I in 70 of water, I in 60 of chloroform, 1 in 6 of alcohol, freely in dilute acids, feebly in ether and ammonia. Aqueous solution bitter, neutral or faintly alkaline. Not fluorescent. Rotates the plane of polarization to the right. Dose, 1 to 20 gr. QUININE. 353 ii. CHINOIDINUM — Chinoidin. Synonym. — Quinoidin. A mixture of alkaloids, mostly amorphous, obtained as a by-product in the manufacture of the crystallizable alkaloids from cinchona. Characters. — A brownish-black, or almond-black solid, breaking when cold, with a resinous, shiny fracture, odorless, having a bitter taste and an alka- line reaction. Almost insoluble in water, freely soluble in alcohol, chloroform, diluted acids. Dose, 3 to 15 gr. Actions of Cinchona Bark and its Alkaloids. The action of cinchona bark is due almost entirely to the quinine in it ; the other alkaloids act in much the same way as this alkaloid, the sulphate and hydrochlorate of which produce the same effect as quinine itself. The following description will be that of the action of sulphate of quinine, which is often called quinine. Any difference between it and the bark or the other alkaloids will be mentioned in the course of this description. External. — Quinine is a very powerful antiseptic. A solu- tion of 1 in 500 destroys many forms of micro-organisms, and a solution of 1 in 250 prevents fermentation and putrefaction. Quinine is very fatal to all low forms of animal and vegetable life A solution of 1 in 1000 kills many infusoria. No effect is produced upon the sound skin by quinine, but it is irritant to a raw surface. Internal. — Ali?nentary canal. — Quinine acts like any other bitter, such as calumba. The bitter taste is very marked ; in the mouth the gustatory nerves, and in the stomach the gastric nerves, are stimulated. This leads reflexly to an increase of the salivary and gastric secretions, and to greater vascularity and peristalsis of the stomach, the appetite is sharpened and digestion is aided. Quinine is, therefore, a stomachic. These effects, of course, bring about a better absorption of food ; and hence, if digestion was previously feeble, the patient feels stronger after a course of quinine. In the stomach any salt of quinine is converted into a chloride, some of which is probably absorbed here ; for in the intestines it would be precipitated by the alkaline secretions. It is often excreted unchanged in the faeces. 354 ORGANIC MATERIA MEDICA. Blood. — Quinine, as the chloride, is readily absorbed into the blood ; and although this is alkaline, it is not precipitated, being probably held in solution by the gases of the blood. It is not known that it undergoes any alteration there, but it produces some remarkable changes. (a) White corpuscles. — If the movements of the white cor- puscles are being watched in a drop of blood on the warm stage of the microscope, and some quinine is added, they at once cease. Again, if the mesentery of a living frog be put under the micro- scope, and slightly irritated so as to set up inflammation, emigra- tion of the white corpuscles through the capillary walls, or diapedesis, as it is called, will be observed ; if now some quinine be injected into the circulation this ceases, but those white cor- puscles that have already passed out wander further from their capillary. If the quinine be applied locally to the mesentery, directly the white corpuscles have passed through their capillary their movement is stopped, and the motionless corpuscles collect in large numbers around the capillaries. It is clear, therefore, that quinine has the power of arresting the movements of white blood-corpuscles. In sufficient quantity it appears actually to destroy them, for in a cat killed by quinine they are much fewer in number than in a healthy cat. {b) Red corpuscles. — Quinine is said to cause a diminution in the size of these, but this is most likely not strictly correct. In fever if the temperature is high, the red corpuscles are probably a little smaller than natural. If the temperature be reduced by any means the corpuscles regain their normal size. Quinine will reduce the temperature, but it probably has no special action on the corpuscles. (c) Acidity of the blood. — Blood outside the body gradually becomes acid. Quinine prevents this. (d) Ozonizing power. — If ozonized oil of turpentine be mixed with a tincture of guaiacum, nothing occurs ; but if a drop of blood be added, that transfers the ozone to the guaiacum, oxidizes it, and turns it blue. This ozonizing power of blood is pre- vented by the addition of quinine. QUININE. 355 (e) The stability of oxyhemoglobin is strengthened by quin- ine, so that the blood does not yield up its oxygen as easily as normally, consequently it cannot absorb oxygen readily. This inability of haemoglobin to take up oxygen in the presence of quinine is parallel with its action on other varieties of protoplasm. For example, fungi absorb oxygen slowly if quinine be present, and thus fermentation may be prevented. Phosphorescent infu- soria (the phosphorescence is due to rapid oxidization) lose this property in the presence of quinine. The ozonizing power of fresh vegetable juices is retarded by it. Quinine is, therefore, very constant and very powerful in interfering with oxidation. Circulation. — Small doses of quinine probably increase the activity of the heart reflexly because they stimulate the stomach ; but large doses (larger than are given to man medicinally), either applied to the excised heart or circulating through it, directly paralyze the organ ; the pulse becomes slower and more feeble, and the heart is finally arrested in diastole. Whether it acts on the muscle or the ganglia is not known. Large doses lower the blood pressure considerably ; this is owing partly to the effect on the heart, but it is probable that this fall of arterial pressure is due in part also to the action of quinine on the blood-vessels. If the spleen is enlarged as a result of malarial fever, the administration of quinine, curing the fever, leads to a decrease in the size of the spleen, but it has no direct effect on this organ, as is often asserted. Respiration. — Although, as we have seen, quinine must, because of its retardation of oxidation, have a powerful influence on in- ternal respiration, diminishing the activity of metabolism, it has but a moderate effect on the respiratory movements. Small doses slightly increase, large doses depress them. Temperature. — Quinine has no power over the healthy tem- perature, but that of fever is markedly reduced ; it is therefore, an energetic antipyretic. Considering its direct capability of diminishing metabolism in the tissues, it seems fair to assume that the drug diminishes heat production, and that it does so by acting directly on the thermogenetic tissues ; but, as it acts on al 356 ORGANIC MATERIA MEDICA. protoplasm, it is quite likely that it may decrease heat production by also influencing the cerebral thermogenic centres. Cerebrum. — Small doses are believed to stimulate cerebral ac- tivity. The results of experiments upon the action of quinine on the brain are so discordant as to be at present valueless. The effects of a large dose in man will be described under Cin- chonism. Spinal cord and nerves. — In frogs, quinine causes a lessening of reflex excitability, which is removed by section below the me- dulla; but in large doses it produces a permanent diminution of reflex excitability. In these animals quinine also first excites and then paralyzes the sensory nerves or their peripheral endings. The muscles are uninfluenced. These effects are not seen in man. Uterus. — It has often been stated that quinine will lead to abortion, that it will, when labor has commenced, aid the expul- sion of the foetus, and that it will increase the menstrual flow if that is scanty. It appears that the first statement is certainly in- correct, and that the second and third are only correct for some women. Kidneys. — After a full dose of quinine it is found in the urine in half an hour, and is slowly excreted for several days, but by far the greater part is eliminated within the first forty-eight hours. The excretion of uric acid is greatly diminished, that of urea and other nitrogenous bodies in the urine is also consid- erably lessened. This confirms the statement already made that quinine retards considerably the metabolism of the body, but it should be stated that very little alteration is observed in the excretion of carbonic acid gas by the lungs. It is said that minute quantities of quinine are gotten rid of by all the secretions, as it may be detected in milk, saliva, bile, tears, etc. , and it may be found in dropsical fluids if the patient has been taking it. Cinchonism. — In many persons a dose of ten grains or more of quinine produces a train of physiological symptoms, chiefly from its influence on the nervous system. The patient soon complains of ringing in the ears, fulness in the head, and slight deafness. With larger doses these symptoms increase, dis- QUININE. 357 turbances of vision and giddiness are added, he may stagger when he walks, and the headache may be very intense. Quinine is hardly ever given as a poison, but if it should be, all these symptoms of cinchonism will be very severe ; the patient may be delirious and comatose, quite deaf and blind, and if he die it will be from collapse due to cardiac and respiratory failure. Great congestion of the middle ear and labyrinth is found in animals poisoned by quinine. The mild degrees of cinchonism pass off directly the drug is discontinued. Rarely quinine causes an erythematous rash, and it has been known to give rise to epistaxis. Those who work among cinchona barks may have a rash on their skin from the mechanical irritation of the powder. Relative Action of the Alkaloids. — The other alkaloids are quite similar in their action to quinine, but they are not so powerful. Their relative antipyretic effect is quinine ioo, quinidine 90, cinchonidine 70, cinchonine 40. Therapeutics. External. — Quinine is too expensive for use as an antiseptic. Internal. — Gastro-intestinal tract. — It is very largely used on account of its stomachic properties, chiefly for that variety of indigestion which is the outcome of general ill-health, want of fresh air, anemia, etc. , and not often when the stomach is the organ primarily at fault. The preparations of cinchona bark are very useful for this variety of dyspepsia ; they contain quite enough of the alkaloids. The compound tincture has the ad- vantage of containing other stomachics. Iron is very commonly given at the same time to correct the general condition. Quinine is frequently prescribed with the tincture of the chloride of iron, there is always enough free acid in this to dissolve any prepara- tion of quinine. The dose of the sulphate or hydrochlorate of quinine as a stomachic bitter is ^ to 2 gr. The hydrochlorate is often preferred, as it is the more soluble. Antipyretic effect. — Quinine was commonly used as an antipyretic, but it has now been replaced by more certain drugs, as phenacetine, acetanilide, and antipyrin. It is, however, a 358 ORGANIC MATERIA MEDICA. very fairly certain antipyretic. It is best given for this purpose in a single dose of 20 to 40 grains for an adult. Such large doses may be prescribed either as a solution of the hydrochlorate, or as the sulphate suspended in milk, and at the same time bromide of potassium or soda should be administered to avoid the disagree- able tinnitus which is set up. The diluted hydrobromic acid is an excellent solvent, and, at the same time, will relieve the ringing in the ears. About one or two hours elapse before the temperature begins to fall. Quinine is more efficacious in reduc- ing a temperature just beginning to fall than a rising one. Hence if possible it should be administered two or three hours before the time at which previous experience of the particular case shows the temperature will probably attain its maximum ; then the fall will be more marked and last longer than if the drug had not been given. Specific action, — Quinine, and to a less extent the other cinchona alkaloids, have the remarkable property of arresting the paroxysms of malarial fever. If 15 to 30 grains be taken about two to three hours before the attack is due, it will not take place, or it will be very mild. The same effect will be produced if smaller doses, about 5 grains, have been taken four or five times a day during the period between the attacks. Not only is it thus prophylactic, but the continued use of it is curative. It is also preventative, even if the persons to whom it has been given have never had ague. For this purpose it is administered to soldiers and sailors who have to enter malarious regions, and it is then found that few of them get ague. If the disease is very severe it is best to give single large doses. If a person has once had ague, illnesses that he subsequently suffers from are liable to assume a malarial type. This is espe- cially the case with neuralgia, which is then peculiarly paroxysmal. It is often on the forehead, when it is called brow ague. In such cases the effect of quinine is frequently very well marked, and a cure speedily takes place. Sometimes neuralgia which is not malarial is temporarily benefited. We do not know how quinine cures ague ; it is said to prevent the segmentation of the micro- cornus. 359 organism which is believed to exist in the blood in this malady. It has been given for a host of diseases, especially septicaemia, but there is not any evidence that it does good to any except those mentioned. The preparations of the bark contain so little quinine that they cannot be used as antipyretics or antiperiodics. Quinine should be avoided in (i) persons suffering from acute or subacute disease of the middle ear; (2) those suffering from gastro-intestinal irritation, which it may increase ; (3) those peo- ple, occasionally met with, in whom quite small doses produce very severe symptoms of cinchonism. Warburg's tincture is a medicine which has a very high reputation in India for malaria. It has been called Tinctura Antiperiodica. The published formula states that it is a proof spirit tincture, containing sulphate of quinine, I in 50; Socotrine aloes, I in 40; opium, 1 in 4000; rhubarb, I in 125; cam- phor, I in 500; with angelica seed, elecampane, saffron, fennel, gentian, zedo- ary, cubebs, myrrh, and white agaric as aromatics. Dose, I to 4 fl. dr. It is often prescribed to be made without the aloes. MAGNOLIA. MAGNOLIA. — The bark of Magnolia glauca, Magnolia acuminata, and Magnolia tripetala (Nat. Ord. Magnoliacece). United States. Characters.— The bark from young wood is quilled or curved, thin, ex- ternally orange-brown and glossy, or light gray, with scattered warts and some- what fissured; internally whitish or pale brownish and smooth; inodorous; taste somewhat astringent, pungent, and bitter. Dose, }( to 1 dr. Action and Uses. Magnolia bark is a gentle stimulant, aromatic tonic and dia- phoretic and is useful in chronic rheumatism, and is capable, if freely given, of arresting the paroxysms of intermittent fever. CORNUS. DOGWOOD. — The bark of Cornus jlorida (Nat. Ord. Comacece). United States. Characters. — In curved pieces, about y% in. thick ; outer and inner sur- face pale-reddish ; inodorous ; astringent and bitter. Preparation. Extractum Cornus Fluidum. — By maceration and percolation with glycerine and diluted alcohol, and evaporation. Dose, 10 to 60 m. 360 organic materia medica. Action and Uses. Cornus Florida taken internally, increases the force and fre- quency of the pulse. It is employed with success, at times, as a substitute for cinchona bark, by the physicians in the Southern States. SALIX. — Willow. The bark of the Salix alba and of other species of Salix (Nat. Ord., Salicacece). United States. Characters. In fragments or quills, from -£ z to t l of an inch thick, smooth; outer surface somewhat glossy, brownish or yellowish, more or less finely warty; under the corky layer, green; inner surface brownish white, smooth, the fibres separating in thin layers ; inodorous ; bitter, and astringent. SALICINUM. SALICIN. — C 13 H 18 7 . A neutral principle obtained from the bark of Salix Helix (Nat. Ord., Salicacece) , and other species of Salix. Britain and United States. Source. — (1) Make a strong decoction of willow bark. (2) Remove the tannin by warming and agitating the decoction with oxide of lead. (3) Eva- porate the solution. Salicin crystallizes out, and is purified by maceration with charcoal. Characters. — Colorless, shining, silky crystals of a bitter taste. Colored red with sulphuric acid. Solubility. — I in 28 of cold water, 1 in 7 of boiling water, I in 30 of alcohol. Not in ether. Dose, 5 to 30 gr. SALICYLIC ACID. ACIDUM SALICYLICUM.— Salicylic acid. HC 7 H 5 3 . Source. — Made by combining carbolic acid with carbonic acid gas. Thus dry carbonic anhydride is passed through carbolate of sodium heated to 400 F. C 6 H 5 ONa + C0 2 = NaC 7 H 5 3 (salicylate of sodium). This is treated with hydrochloric acid. NaC 7 H 5 3 + HC1 = NaCl + HC 7 H 5 3 (salicylic acid). Or salicylic acid may be obtained from natural salicylates, such as the oil of winter-green [Gaultheria procumbens, Nat. Ord., Ericacece), which contains methylsalicylate, or the oil of sweet birch, Betula lenta (Nat. Ord., Betulacece). Characters. — Fine white acicular crystals. The artificial are white and small. The natural are slightly yellowish and larger. Both have the following characters : — Inodorous. Taste first sweetish, then acid Light, easily diffused, irritating to the nostrils. Melt at 347 F. Resembling artificial salicylic acid. — Strychnine, but the crystals of strychnine are larger, colorless, non-irritating, less soluble, solution very bitter. Solubility. — 1 in 450 of water. Readily in alcohol, ether, hot water, solutions of ammonium citrate, ammonium acetate, SALICYLIC ACID. 36 1 sodium phosphate, or borax. The natural acid is not quite so soluble as the artificial. Aqueous solutions give a reddish violet color with perchloride of iron. Incompatible. Spirit of nitrous ether. Impurities. — Orthocreasotic and metacreasotic acids. These exist only in artificial salicylic acid. Dose, 5 to 60 gr. SODII SALICYLAS.— Salicylate of Sodium. (NaC 7 H 5 3 ) 2 H 2 0. Source. — Obtained by acting on carbonate of sodium or caustic soda with salicylic acid. Characters. — Small, white, crystalline plates. Odor none. Taste sweet- ish saline. Solubility. — 1 in 15 of water, I in 6 of alcohol. Impurities. — Orthocreasotic and metacreasotic acids. Dose, 5 to 60 gr. LITHII SALICYLAS.— Salicylate of Lithium. (LiC 7 H 5 3 ) 2 H 2 0. Source. — Obtained by heating salicylic acid, carbonate of lithium, and water, until effervescence ceases, filtering, and evaporating. Characters. — A white powder, deliquescent, odorless or nearly so, hav- ing a sweetish taste, and a faintly acid reaction. Solubility. Very soluble in water and in alcohol. Dose 1 to 15 gr. Action of Salicin, Salicylic Acid, and Salicylate of Sodium, and of Lithium. External. — Salicin and salicylic acid are antiseptics rather more powerful than carbolic acid. They are stimulant and mildly irritant to the skin. Locally applied, they check sweating. The salts of salicylic acid are not antiseptic. Internal. — Alimentary tract. — When inhaled or applied to the throat, salicylic acid is irritating, causing sneezing and cough. In the stomach also it is irritant, giving rise to pain, nausea, and vomiting unless well diluted. The sodium and lithium salts and salicin are much less irritating. The glucoside salicin is in the bowel converted into glucose and saligenin (C 7 H 8 2 ), and this is further decomposed into salicylic acid, salicyluric acid (HC 9 H 8 N0 4 ), and salicylous acid (HC 7 H 5 2 ). Blood. — Salicylic acid, whether taken directly or formed in the bowel from the decomposition of salicin, is rapidly absorbed in spite of its insolubility, and therefore it is probably taken up 3i 362 ORGANIC MATERIA MEDICA. as salicylate of sodium ; at least, this is the form in which it cir- culates in the blood, and consequently the following description will apply whether salicin, salicylic acid, or salicylate of sodium has been taken. It has been thought also to exist in the blood as an albuminate, but of this there is no evidence, nor for the theory that when the sodium salicylate meets with carbonic acid salicylic acid is set free. Some of the salicylic acid of the sodium salt unites with glycocoll, forming salicyluric acid, which appears in the urine. Thus: HC 7 H 5 3 +C 2 H 5 N0 2 (glycocoll)=:HC 9 H 8 N0 4 (salicyluric acid) + H 2 0. It will be noticed that this change is precisely analogous to the conversion of benzoic into hippuric acid by its union with glycocoll. Heart. — Salicin and salicylic acid are often stated to depress the force of the heart and cause a fall of blood-pressure. Careful comparison shows that salicin is not nearly so depressant as the acid — in fact it is probable that it has not this action at all, unless given in toxic doses. Further, natural salicylic acid is not so de- pressant as the artificial variety. For example, Charteris found that 30 grains of salicin, or 10 grains of natural salicylic acid, or 32 grains of natural salicylate of sodium had no injurious effect on a rabbit, but that much smaller doses than these of the artificial acid or its salt killed the animal. The artificial variety was found to contain orthocreasotic and metacreasotic acids, and these are powerful cardiac depresssants. Thus it seems probable that the depressing effects commonly ascribed to salicylic acid are really due to the impurities of the artificial form. Respiration. — Moderate doses have very little effect on respi- ration. Toxic doses strongly depress it. Temperature. — In medicinal doses salicin and salicylic acid have no influence on the temperature of man, in toxic doses they slightly lower it ; but they readily depress a ferbrile temperature, and are therefore called antipyretics. They cause a slight in- crease of perspiration but this is not sufficient to explain the fall. Salicylic acid and salicin are antiperiodic. Nervous system. — We know little of the effect of salicylic SALICYLIC ACID. 363 acid on the individual parts of the nervous system, The clinical symptoms known as salicylism will be described presently. Kidney. — Salicylic acid escapes chiefly through the kidneys. It has been stated also to leave the body by the sweat, the saliva, the bronchial secretions, and the faeces. It appears in the urine very soon after its ingestion (in from 10 to 30 minutes), but the elimination goes on slowly. It is excreted as salicyluric acid and sodium salicylate, which is split up by the phosphoric acid in the urine, yielding salicylic acid. The dark greenish color of the urine sometimes seen is due to small quantities of either indican or pyrocatechin. Occasionally salicylic acid causes haematuria, due to congestion of the kidneys. Probably it increases the nitro- genous elimination. It renders the urine antiseptic, and the salicy- luric acid in that fluid will reduce Fehling's solution. The urine of patients taking it gives a purple color with chloride of iron. Salicylism. — In about 60 percent, of the persons to whom salicylic acid or its salt is given a train of symptoms is produced to which the above name has been applied. They are very like those produced by quinine. It is probable that the cause of them is the impurities existing in artificial salicylic acid, but it is stated that the natural acid may give rise to them. The commonest is deafness, which is often accompanied by ringing in the ears; these symptoms may be relieved by the administration of a small amount of alcoholic stimulant fifteen minutes before each dose. Headache is also very frequent. The administration of the drug is usual y stopped when these symptoms show themselves, but if it is con- tinued the patient becomes violently delirious, there is nausea and vomiting, the face is flushed, and the other symptoms increase in severity. The pulse falls in both frequency and force, it be- comes irregular, epistaxis is common, and haemorrhages from other parts of the body have been recorded, such as haematuria and retinal haemorrhages. Albuminuria without haematuria has been observed. One of the rarest symptoms is erythema or urticaria. All this while the breathing has been becoming weaker, and death may take place either from cessation of the heart or the respira- tory movements. 364 organic materia medica. Therapeutics. External. — The ointment (officinal in B P., 1 part of the acid to 9 of hard and 18 of soft paraffin) may be used when an anti- septic stimulating ointment is required. A collodion composed of salicylic acid, a drachm ; collodium flexile, an ounce ; a glycerin containing 10 per cent, of salicylic acid; and a plaster, also 10 per cent., are good preparations. Strong applications of salicylic acid are very useful for removing excess of epidermis, warts, or corns. Powdered salicylic acid mixed with starch or chalk may be employed to check profuse perspiration of the feet and axillae. The German Pharmacopoeia has for this purpose a Pulvis Salicyli- cus cum Talco (salicylic acid, 3 ; wheaten starch, 10 ; talc, in powder, 87). The sweats of phthisis may be treated in the same way. A little salicylic acid is often added to Thompson's fluid (p. 223). Internal. — Salicylic acid is a specific for rheumatic fever ; it lowers the temperature, lessens the swelling, leads to a rapid ces- sation of pain, and may diminish the liability to pericarditis and other complications. It must be given well diluted to prevent dyspepsia. The sodium salt is often preferred as being the most soluble, but in order to diminish the risk of salicylism it should be prepared from natural salicylic acid. If the attack is severe, 20 grains every two or three hours should be given for the first twelve or twenty-four hours ; then, if the patient is doing well, the frequency of the dose may be gradually diminished, but it should be continued thrice daily for ten days after the tempera- ture is normal and the pain has ceased. Salicin is not so power- ful as salicylate of sodium, but it is said to be less depressant than the synthetic acid. These preparations are of no use for gout or osteo-arthritis. Salicylic acid or salicin may produce a fall of temperature in any fever, but, as we have more certain antipyretics, they are not used except for rheumatic fever. Some writers have found salicylic acid useful in migraine, sciatica, diabetes, and diphtheria, but it is probably of little value for these disorders. It has been given to render the urine acid in cases of alkaline urine and cystitis, but there are better remedies for this purpose. HYDRASTIS. 365 GAULTHERIA. WINTERGREEN.— The leaves of Gaultheria procumbens (Nat, Ord. Ericacea)* United States. Characters. — Well known. The medicinal properties reside exclusively in the volatile oil. OLEUM GAULTHERIA.— Oil of Wintergreen. Characters. — A colorless, yellow or reddish liquid, of a peculiar, strong, and aromatic odor, a sweetish, warm and aromatic taste, and a slightly acid reaction. Sp. gr. about 1. 1 80. It is soluble in alcohol. Dose, 1 to 5 m. Preparation. Spiritus Gaultherise. — Oil of gaultheria,' 3 ; . alcohol, 97. Dose, 1 to 2 fl. dr. Action and Uses. It is used as a more valuable substitute for salicylic acid. The oil obtained from the leaves should be used and not the artificial product which is now extensively manufactured. HYDRASTIS. HYDRASTIS. — The dried rhizome and rootlets of Hydrastis canaden- sisy the golden seal, yellow-root, or yellow puccoon (Nat. Ord. Ranunculacece). Grows in the Alleghenies, United States. Characters. — Rhizome is 1 to 2 in. long, y% to % m - thick; irregular twisted appearance, with thin rootlets 3 to 5 in. long. Scars of decayed stems on the upper surface. Yellowish brown with short fracture. Interior yellowish. Taste very bitter. Composition. — It contains — (1) Berberine, (C S6 H 42 N 2 6 ) is an alkaloid existing as yellow prismatic crystals, and is found in many plants (Berberis, Coptis, Columbo, Menispermum, Nectandra, Podophyllum, Xanthorrhiza, Xan- thoxylum, etc.), chiefly in the orders Berberidacece, Menispermacece, and Ranun culacecB. It is identical with buxine, the alkaloid of Buxus sempervirens, and pelasine, that of Cissampelos Pareira. (2) Hydrastin, a solid. It is an impure hydrochlorate of berberine. (3) A third alkaloid, xantho-puccine (unimportant). Preparations. 1. Extractum Hydrastis Fluidum. — Powdered hydrastis by maceration and percolation in alcohol and water, and evaporation. Dose, 5 to 60 m. 2. Tinctura Hydrastis. — Powdered hydrastis, 20; by maceration and percolation in alcohol to 100. Dose, V 2 to 2 fl. dr. 366 organic materia medica. Action. The chief alkaloid is berberine which in moderate doses acts as a gastric bitter, promoting the appetite, stimulating the gastric secretions, and peristalsis. Hydrastis increases the flow of bile and urine. It will contract the unstriped muscles of arteries and the uterus, and it is therefore haemostatic. It is mildly anti- periodic. In poisonous doses it stops the heart, causing a great fall of blood-pressure. Therapeutics. External. — Hydrastis is employed empirically as a local stimulating application in chronic inflammations, such as un- healthy ulcers. It is used also as a lotion in hyperidrosis, acne, and seborrhoea. Internal. — The chief use of hydrastis is that it is empirically administered for chronic inflammations of mucous membranes. It is said to be especially valuable for uterine affections, in the chronic gastritis of drunkards, and to a rather less degree in other forms of chronic gastro-intestinal catarrh. As an injection or lotion it is employed (either preparation diluted with an equal part of water) for chronic nasal catarrh, otorrhoea, leucorrhoea, gonorrhoea, and as a mouth wash in aphthous stomatitis, chronic pharyngitis, etc. It has been given to stop uterine haemorrhage, with great success. From hydrastin (hydrochlorate of berberine) an oxidiza- tion product has been made which is an excellent remedy for menorrhagia and metrorrhagia. Dose j^ to 1 grain either in pill or hypodermatically. As an antiperiodic, hydrastis is far inferior to quinine. GROUP V. Vegetable Purgatives. Class I. — Laxatives. Prune, Fig, Tamarind, Cassia Fistula, Manna, Viola, Phytolacca, Eupatorium. Castor oil (small doses). Class II. — Simple purgatives. Castor Oil, Rhubarb, Juglans, Senna, Frangula, Aloes. PRUNE, FIG, TAMARIND. 367 Class III. — Drastic purgatives. Scammony, Jalap, Bryonia, Croton Oil, Colocynth, Elaterium, Gamboge. Class IV.— Cholagogues. Podophyllum, Leptandra, Iris, Euonymin. PRUNUM. PRUNE. — The dried ripe drupe of Prunus domestica, the plum (Nat. Ord. Rosacea). South of France. Characters. — Ovoid-oblong, ij^ in. long, black, shrivelled; brownish pulp ; sweet mucilaginous taste. Composition. — The chief constituents are — (1) Sugar, (2) malic acid, and (3) a purgative principle. Prunes are contained in Confectio Sennae. Dose. They can be administered freely. Action and Therapeutics. Prunes are demulcent and slightly laxative. They may be eaten as articles of diet in cases of slight constipation. FICUS. FIG. — The dried fruit of Ficus carica (Nat. Ord. Urticacece). Smyrna. Characters.— Well known. Composition. — The chief constituents are — (1) Sugar, 62 per cent. (2) Gum. Figs are contained in Confectio Sennae, Dose. They can be administered freely. Action and Therapeutics. Figs are a pleasant food and mildly purgative, forming a con- venient remedy for slight constipation. TAMARINDUS. TAMARIND. — The preserved pulp of the fruit of the Tamarindus indica (Nat. Ord. Leguminosce). West Indies. Characters. — A reddish-brown, moist, sugary mass, inclosing strong- branched fibres, and brown, shining seeds, each enclosed in a tough membra- nous coat. Taste agreeable, refreshing, subacid. Impurity. — Copper. 368 ORGANIC MATERIA MEDICA. Composition. — The chief constituents are — (i) Tartaric acid and tar- trate of potassium. (2) Citric, acetic, and other acids. (3) Sugar. Tamarind is contained in Confectio Sennae. Dose. It can be administered freely. Action and Therapeutics. Tamarind is pleasant and acid to the taste, and a mild laxa- tive. It may be made into tamarind whey (1 part of tamarinds to 30 of milk) and given as an acid, cooling, slightly purgative drink in fevers. It is a good purgative for children, and may be spread on bread and butter. CASSIA FISTULA. CASSIA. — The fruit of purging cassia. The pulp obtained from the pods recently imported of Cassia Fistula, the purging cassia (Nat. Ord. Leguminosce). East or West Indies. Characters. — The pods are 1)4 to 2 feet long, 1 in. in diameter. Shortly stalked, pointed, blackish-brown, very hard, indehiscent ; divided inter- nally by their transverse partitions into numerous cells, each containing a soli- tary smooth, flat, oval, reddish-brown seed, surrounded by pulp. The pulp is viscid, blackish-brown, sweet in taste, sickly in odor. Composition. — The chief constituents are — (1) A purgative principle closely allied to cathartic acid. (See Senna, p. 375.) (2) Sugar, 60 per cent. Cassia is contained in Confectio Sennae. Dose, 1 to 8 gr. Action and Therapeutics. It is a laxative, only given in confection of senna. MANNA. MANNA. — A concrete saccharine exudation obtained by making trans- verse incisions into the stems of cultivated trees of Fraxinus Ornus (Nat. Ord. Oleacece). Calabria and Sicily. Characters. — Stalactite pieces, flat or concave on inner surface; pale yellowish-brown ; irregularly convex and white externally ; crisp, bitter, porous, crystalline, soluble in 6 parts of water. Odor, faint; taste, sweet and honey- like. Composition. — The chief constituents are — (1) Mannite, C 6 H 8 (OH) 6 , 70 per cent. (2) Cane sugar. Manna is contai?ied in Infusum sennae compositum. Dose, V 2 to 2 oz. poke root. 369 Action and Therapeutics. Manna is given as a mild laxative to children. It dissolves easily in milk, and is pleasant to the taste. VIOLA TRICOLOR. Synonym, — Pansy. The wild-grown, flowering herb of Viola tricolor (Nat. Ord. Violacece). Europe. Characters. — Stem angular and nearly smooth ; leaves alternate, petio- late, oval or oblong, crenate, with leaf-like, pinnatifid stipules ; flowers with an obtuse spur, and variegated petals, shorter or longer than the calyx ; inodorous ; taste, somewhat bitter and acrid. Dose, % to 1 dr. Action and Uses. Viola is an emollient, and slightly laxative, and has been used as a decoction in pectoral, nephritic, and cutaneous affections. PHYTOLACCA BACCA. POKE BERRY.— The fruit of the Phytolacca decandra (Nat. Ord. Phytolaccacece). United States. Characters. — A depressed globular, dark purple, compound berry, about )/$ in in diameter, composed of ten carpels, each containing a lenticular black seed; juice, purplish-red; inodorous; sweet, slightly acrid. Dose, 5 to 30 gr. PHYTOLACCA RADIX. POKE ROOT.— The root is the Phytolacca decandra. Characters. — Large conical, branched and fleshy; wrinkled, grayish- red ; inodorous ; sweetish, acrid. Dose, 5 to 30 gr. (emetic), 1 to 5 gr. (alterative). Uses. Phytolacca is used as an emetic and purgative, and it possesses also some narcotic properties. EUPATORIUM. THOROUGHWORT.-%^/w. -Boneset. The leaves and flower- ing tops of Eupatorium perfoliatum (Nat. Ord. Composites), United States. Characters. — Well known. Composition. — Its principal constituent appears to be a glucoside, Eupatorin. 32 370 ORGANIC MATERIA MEDICA. Preparation. Extractum Eupatorii Fluidum. — By water and percolation with diluted alcohol, and evaporation. Dose, }( to i fl. dr. Action and Uses. Thoroughwort is tonic, diaphoretic, and aperient. It is a domestic remedy for the commencement of a catarrh, influenza, or muscular rheumatism. OLEUM RICINL CASTOR OIL. — The oil expressed from the seeds of Ricinus com- munis (Nat. Ord. Euphorbiacece). India. Characters — Viscid, colorless or pale yellow. Odor faint, characteris- tic. Taste acrid, unpleasant. Solubility. — I in I of absolute alcohol, I in 2 of spirit. Sp. gr. 0.950 to 0.970. Composition. — The chief constituents are — (1) Ricinoleate of glyceryl, C 3 H 5 (C 18 H 33 3 )3. This constitutes the chief bulk. (2) Other fixed oils, as palmitin, stearin, etc. (3) Possibly an alkaloid, ricinine, not purgative. (4) According to some authorities an active principle which has not yet been isola- ted. Dose % to 2 fl. oz. Castor oil is contained in Collodium Flexile and Linimentum Sinapis Compositum. (Castor-oil seeds are not officinal, but it is important to recognize them. They are % in. long and y^ in. wide, ovoid, flattened. The seed is prolonged into a sharp beak. Epidermis shiny gray, marked by brownish bands and spots. Kernel white. They contain 50 per cent, of the oil, and an acrid substance which makes them poisonous. Three castor-oil seeds have been known to kill an adult man.) Action. External. — Castor oil is, like olive oil, protective and seda- tive, and may be used to drop into the eye when the conjunctiva is inflamed, and as a solvent for homatropine, but this solution is occasionally a little irritating. Internal. — Gastro-intestinal tract. — The so-called nasty taste of castor oil is mostly due to the smell, and is not noticed much if the nose is held when the oil is drunk. Medicinal doses produce no effect on the stomach. Reaching the intestine the oil is an ex- CASTOR OIL. 37I cellent simple laxative or mild purgative, acting in about five hours, and causing no griping nor subsequent constipation. The motion is soft but not liquid. Castor oil will purge even when rubbed into the skin. How it acts is unknown. It has been thought that the ricinoleate of glyceryl in the oil is decomposed in the duodenum, and the ricinoleic acid purges, but this is prob- ably incorrect. The most likely view is that the oil contains some purgative principle which has not yet been isolated. Prob- ably the seeds contain much more of this than the oil, for they are ten times more purgative, a fact which it is impossible to ex- plain if it is the ricinoleic acid which purges. Castor oil will purge when given per rectum. Mammary glands. — Applied locally to the breasts it is said to be galactagogue. Therapeutics. Castor oil is perhaps the best simple purgative we have, and is very useful in cases in which there is slight temporary consti- pation. Being mild in its action it is very suitable for getting rid of undigested food that is causing diarrhoea, and a dose of castor oil with a minute quantity of laudanum in it is a favorite remedy for certain forms of diarrhoea. It is also especially con- venient in pregnancy, after delivery, and when in any abdominal disease, as typhoid fever, peritonitis, or when, after abdominal operations, the irritation caused by the faeces makes it absolutely necessary to get the bowels open. Also it is very useful for chil- dren, or for very old or infirm persons, or for those suffering from piles or fissures. It is a good purgative to give before and after the use of anthelmintics. Its nauseous taste is the only objection to it. As already mentioned, this can largely be overcome by holding the nose, and there are many forms of castor oil in the market so prepared as to be almost colorless and odorless. It may be taken in cap- sules, but they are bulky. Lemon juice or coffee conceals the taste to some extent, or the oil may be added to a teaspoonful of peppermint water, and then a little brandy added till the oil neither sinks nor swims. If the inside and rim of the glass are 372 ORGANIC MATERIA MEDICA. moistened with the vehicle, the oil, which should, if possible, be between two layers of the vehicle, is hardly tasted. As an enema (castor oil i 3 , warm mucilage of starch 1 1 3 , mixed thoroughly) it is useful when a mild injection is required. Breasts. — The leaves of the castor-oil plant applied to the breasts will sometimes induce the secretion of milk. A fluid ex- tract of them may also be taken three or four times a day. RHEUM. RHUBARB. — The root, partly deprived of its bark, sliced, and dried, of Rheum officinale (Nat. Ord. Polygonacece), and other undetermined species. China and Thibet. Characters. — Cylindrical, conical, plano-convex, or irregular pieces. Outer surface covered with a bright yellowish powder, rounded or angular, smooth or a little wrinkled, showing beneath the powder reddish-brown lines mixed with a yellowish-brown substance, and often small star-shaped spots. The pieces are often bored with a hole, which contains the remains of the cord used to suspend them to dry. Internally hard, compact, fracture uneven, and with a marbled appearance. Odor peculiar, aromatic. Taste feebly astringent, bitter ; there is a gritty feeling between the teeth when chewed. Composition. — The chief constituents are— (i) Chrysarobin {synonyms, — rhein, chrysophan, see Chrysarobinum). (2) Chiysophanic acid. It is not known whether, when alive, rhubarb contains any chrysophanic acid, for when kept the chrysarobin quickly oxidizes to chrysophanic acid. The purgative properties are due to the chrysarobin, which also gives the yellow color. (3) Rheotannic acid, to which the astringency of rhubarb is due. (4) Oxalate of lime, 35 per cent., to which the grittiness is due. (5) Other bodies, about which little or nothing is known, viz. phaeorrhetin, emodin, erythrorrhetin, resins, aporrhetin, and rheumic acid. Impurities. — English rhubarb; different taste, smell, and excess of starch. Turmeric which is turned brown by boric acid. Dose, 1 to 5 gr. (stomachic), 10 to 20 gr. (purgative). Preparations. 1. Extractum Rhei. — By percolation with alcohol and water and evaporation. Dose, 3 to 15 gr. 2. Extractum Rhei Fluidum.— By maceration and percolation in alcohol and water, and evaporation, Dose, % to 1 fl. dr. RHUBARB. 373 3. Pilulse Rhei. — Powder, 300; powdered soap, 100 grs. Each pill contains 3 gr. of rhubarb. Dose, 1 to 5. 4. Pilulae Rhei Compositae. — Powdered Rhubarb, 200; purified aloes, 150 ; myrrh, 100; oil of peppermint, 10 grs. To make 100 pills, each pill contains 2 gr. of rhubarb. Dose, 1 to 3. 5. Pulvis Rhei Compositus. Synonym. — Gregory's powder. Rhubarb, 25 ; magnesia, 65 ; ginger, 10. Dose, ]/ 2 to 1 dr. 6. Syrupus Rhei. — Rhubarb sliced, 90 ; carbonate of potassium, 6; sugar, 600; cinnamon, 18; water to 1 000, by maceration and dilution. Dose 1 to 4 fl. dr. 7. Tinctura Rhei.— Rhubarb, 12; cardamom, 2; diluted alcohol to 100, by maceration and percolation. Dose, ^ to 1 fl. dr. (stomachic), 1 to 4 fl. dr. (purgative). 8. Tinctura Rhei Aromatica. — Rhubarb, 20; cinnamon, 4; cloves, 4; nutmeg, 2; diluted alcohol to 100. By maceration and per- colation. Dose, 1 to 3 fl. dr. 9. Tinctura Rhei Dulcis. — Rhubarb, 8 ; Glycyrrhiza, 4 ; Anise, 4; Cardamom, I ; diluted alcohol to 100. By maceration and percolation. Dose, yi, to 1 fl. oz. 10. Vinum Rhei. — Rhubarb, 10; calamus, 1; stronger white wine to 100, by percolation. Dose, 1 to 2 fl. dr. 11. Mistura Rhei et Sodse. — Bicarbonate of sodium, 30; fluid extract of rhubarb, 30 ; spirit of peppermint, 30 ; water to loco. By solu- tion. Dose, y 2 to 2 fl. oz. 12. Syrupus Rhei Aromaticus. — Aromatic tincture of rhubarb 10; syrup, 90. By mixture. Dose, 1 fl. dr. for child. Action. External. — Probably rhubarb would have, to a mild degree, the same action as Goa powder, but it is never applied ex- ternally. 374 ORGANIC MATERIA MEDICA. Internal. — Alimentary canal. — In the mouth, rhubarb in- creases the flow of saliva ; and in the stomach, in small doses, it, like any other bitter substance, stimulates the flow of gastric juice, and the vascularity and peristaltic movements of the stom- ach. It is, therefore, a stomachic, and will aid digestion. In large doses it causes purgation, producing in from four to eight hours a liquid motion, colored yellow by the chrysophan. The resinous constituents of rhubarb are said to increase the flow of bile, but certainly its cholagogue action is not sufficiently power- ful to completely explain its purgative properties. It is com- monly stated to very actively exaggerate intestinal peristalsis, but there is no adequate proof of this. It is liable to gripe. The purgation is followed by constipation ; this is ascribed to the rheo-tannic acid : if so, it is probably absorbed and subsequently re-excreted into the intestines, otherwise it would all be swept away in the purging. Kidneys. — The coloring matter is excreted in the urine and stains it yellow. The urinary flow is slightly increased. Therapeutics. Rhubarb is commonly given to children as a stomachic purga- tive in indigestion, especially when caused by errors of diet, for it clears away any undigested food, and its stomachic and after- astringent effects are valuable. In the same way it is useful in diarrhoea due to irritation caused by undigested food ; here the after-astringency is especially serviceable. A powder of pow- dered rhubarb and bicarbonate of sodium (which hides the taste) equal parts, with some powdered gentian, forms an excellent stomachic for young children. Rhubarb should never be given alone, because of the griping it causes. JUGLANS. BUTTERNUT. — The inner bark of the Juglans cinerea (Nat. Ord. Juglandacece) collected in Autumn. United States. Characters. — Thin flat or curved pieces, y% to ^ in. thick ; the outer surface nearly free from soft cork, deep brown ; the inner surface smooth and striate ; odor feeble, taste bitter and somewhat acrid. SENNA. 375 Preparation. Extractum Juglandis. — By maceration and percolation with alcohol, evaporation and addition of glycerine. Dose, 5 to 30 gr. Uses. Butternut is a mild cathartic, and resembling rhubarb, in the property of evacuating without debilitating the alimentary canal. It was much employed during the war of the Revolution. SENNA. SENNA ALEXANDRINA,— Alexandria Senna. The leaflets of Cassia acutifolia (Nat. Ord. Leguminosce). Alexandria. Characters. — ^ to ij( in. long, lanceolate or oval-lanceolate, acute, unequal at the base, entire, thin, brittle, pale yellowish green. Veined on the lower surface, nearly smooth. Odor peculiar, faint, tea-like. Taste mucila- ginous, sickly. Resembling senna. — Leaves of Solenostemma Argel, Uva Ursi, and Ba- rosma, all equal at the base. Impurities. — Any of the above. SENNA INDICA. — East Indian Senna. Synonym. — Tinnivelly senna. The dried leaflets of Cassia elongata (Nat. Ord. Leguminosce). Southern India. Characters. — 1 to 2 in. long, lanceolate, acute, unequal at the base, thin, entire, yellowish green and smooth above, duller beneath; glabrous or slightly pubescent. Odor and taste like Alexandrian senna. Composition of Both Kinds. — The chief constituents are— (1) Cathar- tic acid, an amorphous sulphurated glucoside. C 180 H 192 N 82 SO 2 . It exists as salts of earthy bases, such as calcium and magnesium. These salts are soluble in water. Cathartic acid is capable of decomposition into glucose and cathar- togenic acid. It is the chief purgative principle in senna and other purgatives. (2) Other glucosides, sennacrol and sennapicrin, which do not in most prepara- tions contribute to their action, as they are insoluble in water (3) Chrysophanic acid in small amounts as a coloring matter [see Rhubarb and Chrysarobinum). (4) A peculiar unfermentable sugar, catharto-mannite. Dose, 1 to 3 dr. Preparations of either kind. 1. Confectio Sennae. — Senna, 10; coriander, 6; fig, 12; tama- rind, 10; cassia fistula, 16; prune, 7; sugar, 50; water to make 100. By dividing, sifting and evaporating. Dose, 1 to 2 dr. 376 ORGANIC MATERIA MEDICA. 2. Extractum Sennae Fluidum. — Powder by maceration, perco- lation in alcohol and water, evaporation. Dose, i to 3 fl. dr. 3. Infusum Sennae Compositum. — Synonym. — Black Draught, Senna, 6; Manna, 12; Sulphate of Magnesia, 12; Fennel, 2; Boiling water to 100. Dose, 1 to 2 fl. oz. 4. Pulvis Glycyrrhizae Compositus. — Senna, 18; glycyrrhiza, 16; fennel, 8; washed sulphur, 8; sugar, 50. Dose, y 2 to 2 dr. 5. Syrupus Sarsaparillae Compositus. — q. v. 6. Syrupus Sennae. — Senna, 33; oil of coriander, I per cent, of the alcohol; sugar, 60; alcohol, 4; water to 100. By digestion, straining evaporation and filtration. Dose, X to 1 A- oz « Action. External. — None. Internal. — Senna, because of the cathartic acid in it, stimu- lates the muscular coat of the intestine, especially the colon, and produces some hypersemia. Consequently the fluid contents of the small intestine are hurried through the colon, and pale yellow- watery stools, containing some undigested food, are the result. Senna acts very feeble or not at all on the biliary secretion. Large doses open the bowels several times and produce griping, but not much hyperaemia. Probably there are other substances in senna, besides cathartic acid, having a purgative property, but it is by far the most important. Purgation by senna does not subsequently cause constipation. Some constituents of it are ab- sorbed, and may cause the urine to be red. It will purge if injected into the veins, and will impart its purgative properties to the milk of nursing women. Therapeutics. Senna is a safe, useful purgative for cases of simple constipa- tion. It is, because of its tendency to gripe and its nauseous taste, rarely given alone. The compound liquorice powder is to be preferred to the compound infusion of Senna ("black draught"), aloe. 377 as this is a nasty mixture. Senna is largely used to complete the effect of duodenal purgatives, as we seenn the old prescription of a blue pill at night and a black draught in the morning. Acting on the colon, it is valuable in slight cases of faecal collection. Compound liquorice pcwder is much used in habitual constipation and the constipation of pregnancy. Confection of senna, coated with chocolate, forms the well-known purgative Tamar Indien, and in this form can be taken by children. It is said that the infusion contains more of the active principles than other pre- parations; it soon decomposes, but i gr. of nitre to the fl. oz. will prevent this. FRANGULA. FRANGULA. — Frangula Bark. Synonym. — Buckthorn. The bark of Rhamnus Frangula (Nat. Ord. Rhamnacece). Collected from the young trunk and moderate sized branches, and kept at least one year before being used. Imported from Holland. Characters. — Small quills, bark only -^ in. thick, outer surface grayish or blackish brown; inner surface smooth, brownish-yellow. Fracture short and purplish externally, somewhat fibrous and yellowish within. No marked odor; taste sweetish and slightly bitter. Composition. — Fresh bark contains a glucoside, frangulin. This, in the old bark, has become converted into emodin (also found in rhubarb) to which the value of the bark is due. Preparation. Extractum Frangulae Liquidum. — Powder by maceration and percolation with alcohol and water, evaporation. Dose, ^ to 2 fl. dr. Action and Therapeutics. The fresh bark is a violent gastro-intestinal irritant, but that which has been kept a year is a mild laxative, acting like senna ; it is suitable for children and for use in chronic constipation. ALOE. ALOE SOCOTRINA.— Socotrine Aloes. The juice, when inspissated, which flows from the transversly cut bases of the leaves of Aloe socotrina f (Nat. Ord. Liliacece). Socotra. Resembling aloes. — Resins of jalap and guaiacum, which are not bitter. 37S ORGANIC MATERIA MEDICA. Characters. — In hard masses, occasionally soft in the interior, opaque, yellowish-brown or orange -hjown, not greenish, translucent on the edges ; fracture resinous, somewhat conchoidal : when breathed upon it emits a fragrant saffron like odor ; taste strongly bitter. It is almost entirely soluble in alcohol, and in four times its weight of boiling water. Mixed with alcohol, and examined under the microscope it exhibits numerous crystals. Socotrine aloes is less deep in color, less opaque, its powder is brighter and more reddish, and its odor is not nearly so disagreeable as that of Barbadoes aloes. Composition. — [i) Aloin, which is a little different from that of the Bar- badoes aloe, and is called Socoaloin, but the physiological properties of the two aloins, which are isomeric, are the same. (2) A resin. (3) A trace of gallic acid. (4) A trace of a volatile oil gives the odor. P? . >is. 1. Aloe Purificata. — Aloes, 100; alcohol, 15. Heat, strain, and evaporate. Characters. — In irregular brittle pieces, of a dull brown or red- dish-brown color, and having the peculiar, aromatic odor of socotrine aloes. It is almost entirely soluble in alcohol. Dose, y 2 to 10 gr. 2. Extractum Aloes Aquosum. — Aloes, 100; boiling distilled water, 1000. Disintegrate the aloes, let stand and filter, evaporate. Dose, y 2 to 3 gr. 3. Pilulae Aloes. — Purified aloes, 200; powdered soap, 200 grs. ; to make 100 pills. Each pill contains 2 gr. of aloes. Dose, 1 to 4 pills. 4. Pilulae Aloes et Asafcetidae. — Purified aloes, 400; asafoetida?, 4:0; soap, 400 grs.; to make 300 pills. Each pill contains 1*3 gr. of aloes. Dose, 1 to 5 pills. 5. Pilulae Aloes et Ferri. — Purified aloes, 100; dried sulphate of iron, 1 00 ; aromatic powder, 100 grs. ; confection of rose, a sufficient quantity to make 100 pills. Each pill contains 1 gr. of aloes. Dose, 1 to 4 pills. 6. Pilulae Aloes et Mastiches. — Purified aloes, 200; Mastic, 50; red rose, 50 grs. ; to make 100 pills. Each pill contains 2 gr. of aloes. Dose, 1 to 3 pills. ALOES. 575 7. Pilulse Aloes et Myrrhae — Purified aloes, 200; myrrh, 100 ; aromatic powder, 50 grs. ; syrup, a sufficient quantity to make 100 pills. Each pill contains 2 gr. of aloes. Dose, 2 to 10 pills. 8. Tinctura Aloes — Purified aloes, 10 ; extract of glycyrrhiza, 10. Macerate in diluted alcohol and filter to 100. Dose, % to 1 fl. dr. 9. Tinctura Aloes et Myrrhae. — Synonym. — Elixir Proprietatis Paracelsi. Purified aloes, 10; myrrh, 10. Macerate in alcohol and filter to 100. Dose, 1 to 2j< A- d r - 10. Vinum Aloes. — Purified aloes, 6; cardamom, 1 ; ginger, 1. Bv maceration in stronger white wine and filtration to 100. Dose, }^ to 1 fl. oz. Action of Aloes. External. — Aloes has no external action on the unbroken skin, but it can be absorbed from a raw surface, for aloes sprink- led on an ulcer, to which it is a slight stimulant, will lead to purging. Internal. — Gastrointestinal tract. — In the stomach the bitter principle of aloes causes it to act as a stomachic, like other bit- ters. In the intestine it increases the rate of the flow of bile, and probably the amount secreted. It produces little influence in the small intestine, but the muscular coat of the colon is powerfully stimulated, and the intestinal secretion from that part slightly accelerated. Aloes, therefore, purges, and naturally takes some time, usually fifteen to twenty hours, to act ; the motion is well formed, not very soft, as there is so little increased secretion of fluid, and dark colored from the bile in it. Some- times the drug gripes somewhat, because the muscular contrac- tion it produces is irregular. As it acts chiefly on the lower bowel the habitual use of it may lead to piles. Female genital organs. — Aloes will aggravate the menstrual flow : it is therefore an emmenagogue. It is excreted by the milk, for aloes given to the mother may purge the child. It is stated also to be excreted in the urine. 380 organic materia medica. Therapeutics. Aloes is an excellent purgative for cases of habitual constipa- tion, many of which are due to an imperfect contraction of the muscular coat of the large intestine. It is very commonly given as a dinner pill (1 gr. of watery extract of aloes and ^ gr. of ex- tract of nux vomica) to sufferers from chronic constipation, and in these cases its bitter principles acting as stomachics aid diges- tion. To avoid griping it is well to combine a little extract of hyoscyamus or a little extract of belladonna with it. One great advantage of aloes is that the dose need not be gradually in- creased. It is also very commonly given as a pill with nux vomica and a grain or two of the dried sulphate of iron to persons suffer- ing from chlorosis and other forms of anaemia. It overcomes the chronic constipation so common in these cases, and some regard this as very important for the cure of the disease. The amenor- rhcea so frequently associated with chlorosis is often benefited by aloes, and amenorrhoea due to other causes may also be relieved. Aloes is of great service in many cases of chronic constipation of children. A warm aqueous solution of aloin purges when in- jected subcutaneously. Aloes must not be given in pregnancy, haemorrhoids, or menorrhagia. The enema is anthelmintic. SCAMMONIUM. SCAMMONY. — A resinous exudation from root of Convolvulus Scam- monia (Nat. Ord. Convolvulacece). Syria and Asia Minor. Characters.- Flat, irregular cakes, ash-gray or blackish brown externally, sprinkled with gray powder. Very brittle. Fracture resinous, shining, porous, dark gray. Easily reduced to an ash-gray powder, forming a greenish emulsion with water. Odor peculiar, cheesy. When chewed gives a pricking sensation. Impurities. — Chalk and starch. Composition. — The chief constituents are — (1) The resin (q. v.), 75 to 80 per cent. (2) Gum, 10 to 20 per cent. (3) Starch. Dose, 5 to 15 gr. Preparation. Resina Scammonii. — Resin of Scammony. Source. — Digest scammony with successive portions of boiling al- cohol, precipitate the resin with water, wash it several times, and dry with gentle heat. JALAPA. 381 Characters. — Brownish, brittle, translucent pieces ; fracture resin- ous. Soluble in ether. Composition. — The chief constituent is jalapin (see p. 382). Impurities. — Guaiacum resin, which blues potato. Jalap resin, insoluble in ether. Dose, 2 to 8 gr. Resina Scammonii is contained in Extractum Colocynthidis Com- positum (see Colocynth). Action. Gastro-intestinal tract, — Scammony has no effect till it reaches the duodenum. With the bile it forms a strongly purgative compound, powerfully stimulating the intestinal glands and causing a profuse secretion of intestinal fluids. There is some exaggeration of vascularity, some irregular stimulation of the muscular coat, but these are comparatively slight, and there is little if any addition to the biliary flow. As a result of these actions, in about four hours there is a profuse watery evacua- tion of the bowels. The drug is, therefore, a powerful hydra- gogue cathartic, and in large doses a strong gastro-intestinal irritant. Its action is attended with some griping. It produces no effect if injected into the blood, and therefore acts only locally on the intestine. It is anthelmintic to both round-worms and tape worms. Therapeutics. Scammony being a prompt purgative, obstinate constipation in either children or adults may be treated with it. It may also be given as an anthelmintic. JALAPA'. JALAP. — The tuberous root of Exogonium, Purga (Nat. Ord. Con- volvulacece) . M exi co . Characters. — Napiform, pyriform or oblong, varying in size, the larger roots incised, more or less wrinkled, dark brown, with lighter colored spots, and short, transverse ridges ; hard, compact, internally pale, grayish -brown, with numerous, concentric circles composed of small resin cells ; fracture resinous, not fibrous ; odor slight, but peculiar ; taste sweetish and acrid. On exhaust- ing 100 parts of jalap by alcohol, concentrating the tincture, and pouring it into water, a precipitate of resin should be obtained, which, after washing with 382 ORGANIC MATERIA MEDICA. water and drying, should weigh not less than 12 parts, and of which not over 10 per cent, should be soluble in ether. Composition. — The chief constituent is the officinal resin, 15 to 18 per cent. (q. v.). Resembling jalap. — Aloes, which is- bitter. Dose, 5 to 20 gr. Preparations. 1. Abstractum Jalapae. — By maceration and percolation in alco- hol, evaporation with addition of sugar of milk. Dose, 2 to 10 gr. Abstractum Jalapae is contained in Pilulse Cathartica Composite . 2. Pulvis Jalapse Compositus. — Jalap, 35 ; bitartrate of potas- sium, 65. Dose, X to I °*r. 3. Resina Jalapae. — Source — Powdered Jalap ; by maceration with alcohol, percola- tion, distillation of alcohol, precipitation with water, and drying. Composition. — The chief constituents are — (1) Convolvulin, a glucosicle, 18 per cent., a hard substance insoluble in ether, more irritant than jalapin, and probably the most active ingredient of jalap. (2) Ja- lapin, a glucoside, 18 per cent. Dose, ]/ 2 gr. This is a soft resinous substance, soluble in ether. It is probably the active principle of scam- mony. It is found in jalap wood and jalap stalks. (3) Starch and gum. Dose, 1 to 5 gr. Action. The mode of action of jalap is precisely the same as that of scammony, with only two exceptions. It causes a greater secretion of intestinal juice, and is therefore more hydragogue ; it stimulates the vessels and muscular coat less, and therefore is less irritant and griping. Therapeutics. Jalap is very largely used as a hydragogue purgative when we want to draw off large quantities of fluid ; therefore it is especially suitable for patients with Bright' s disease, for those suffering from uraemia, and for those with dropsy from any cause. Large doses should not be given if the intestinal mucous membrane is liable to inflame easily. It is occasionally employed for severe consti- pation. CROTON OIL. 383 BRYONIA. BRYONY. — The root of Bryonia alba, and of Bryonia dioica (Nat. Ord. Cucurbitacece). Europe. Characters. — In transverse section about 2 in. in diameter ; inodorous, taste disagreeably bitter. Composition. — The chief constituents are — (1) a bitter principle, bryonin, symbol C^H^O^ ; (2) a resin; (3) a concrete oil. Preparation. Tinctura Bryoniae. — Bryonia, 10; by maceration and percolation with alcohol to 100. Dose, 1 to 5 fl. dr. Uses. Bryonia is an active hydragogue cathartic, but has been super- seded by jalap. OLEUM TIGLII. CROTON OIL. — The fixed oil expressed from the seeds of Croton Tig- Hum (Nat. Ord. Euphorbiacece). East Indies. Characters. — Brownish-yellow to dark reddish brown, fluorescent, with a viscid consistence, which is increased by age. Odor faint, peculiar, rancid. Taste oily, acrid. Sohibility. — I in 60 of alcohol ; freely in ether, chloroform, or olive oil. Sp. gr. 0.940 to 0.955. Composition. — The chief constituents are — (1) Several volatile acids (1 per cent, in all) ; these give the odor. Tiglic acid is the characteristic one. The others are acetic, butyric, valerianic. (2) Several fatty acids, both free and combined to form fats. (3) Crotonol, a substance which is non-purgative, but is capable of causing cutaneous irritation. Dose, y 2 to 2 m. on a lump of sugar, or mixed with butter or vaseline and placed at the back of the mouth. (Croton seeds are not officinal, but it is important to recognize them. They are ^ in. long, 1/3 in. broad, ovoid and bluntly oblong, covered with a brown shell, which on scraping becomes black. The kernel is white and oily. They yield 50 to 60 per cent, of croton oil. They are known from castor-oil seeds, which are like them, by the fact that the castor-oil seeds are bright, polished ? and mottled.) Action. External. — Croton oil is one of the most powerful irri- tants in the pharmacopoeia. A drop placed on the skin causes redness, burning pain, and quickly a crop of vesicles forms (vesi- 384 ORGANIC MATERIA MEDICA. cation); these rapidly become pustules (pustulation), and the surrounding subcutaneous tissue is red and oeiematous. The pustules may be umbilicated, but differ from variolous pustules in that they vary greatly in their size. Internal. — Gastro-intestinal tract. — Very soon after a drop has been taken, there is considerable griping and abdominal pain. In an hour or two, the bowels are opened, and this may subse- quently occur several times, the notions becoming more and more fluid. The croton oil greatly aggravates the vascularity of the stomach and intestines, the mucous membrane of which be- comes red, oedematous and angry-looking; there is a great in- crease of the intestinal secretion, but none of the bile. The drug produces, in fact, severe enteritis, and to a less extent gastritis. The motions may contain blood. These effects are all due to the local effect of the croton oil. It is probable that the peri- staltic movements are increased also ; whether this is a result of the irritation, or of some action of the drug exerted after absorp- tion, is not known. Croton oil applied to the skin may cause free purgation. Therapeutics. External. — Croton oil was formerly employed externally as an irritant and a counter-irritant for inflamed joints, pleurisy, bronchitis, phthisis, &c; but it is not often so used now, as the scars left after the suppuration are very unsightly, the application is too painful and the inflammation induced too severe. A little croton oil spread over an area not exceeding that of a dime may be applied to set up suppuration in the scalp, and so destroy an inveterate patch of ringworm if it is wished to cure it quickly. The croton oil will certainly do this, but the resulting suppuration is so severe that the remedy should be used with care, and only when all others have failed. The liniment, of the B. P. 15 per cent, in equal parts of oil of cajuput and alcohol, well diluted, is occasionally employed to stimulate the skin in alopecia. Internal. — Croton oil should only be given in very obstinate constipation not due to organic obstruction, and only one dose should be administered. Not more than one or two drops should COLOCYNTH. 385 be prescribed. Constipation due to lead poisoning and faecal im- pactions are sometimes suitable cases. Placed on the back of the tongue, it is, on account of its small bulk, a useful purgative for lunatics who refuse to take anything, and for unconscious patients, because in such cases it is quickly swallowed reflexly ; hence also it is commonly given to those who are unconscious from apoplexy. It must never be administered to children, to pregnant women, to feeble subjects, to those with haemorrhoids, nor to those suffer- ing from peritonitis, gastritis, or enteritis. COLOCYNTHIS. COLOCYNTH. — The fruit, freed from seeds, of Citrullus Colocynthis. Synonym. — Bitter calumba (Nat. Ord. Cucurbitacece). Imported from Smyrna, Trieste, France and Spain. Characters. — More or less broken, whitish, very light, spongy, tough balls, about 2 in. in diameter, consisting of the pulp in which the seeds are imbedded. The broken -up pulp without the seeds is alone officinal. This is light, spongy, whitish, odorless, with an intensely bitter taste. Impurities. — Seeds and cortex. Composition. — The chief constituents are — (1) Colocynthin, an amor- phous or crystalline, bitter, active glucoside, readily soluble in water and alco- hol. (2) Resinous matter having the names of citrullin, colocynthin and colocynthitin, insoluble in water. Dose, 2 to 8 gr. Preparations 1. Extractum Colocynthidis. — Colocynth. By maceration in diluted alcohol, expressed and straining. Percolate and evaporate. Dose, yi to 2 gr. 2. Extractum Colocynthidis Compositum. — Extract of Colo- cynth, 16; aloes, 50; cardamom, 6; resin of scammony, 14; soap, 14; alcohol, 10. By melting, straining and reducing to powder. Dose, 5 to 15 gr. 3. Pilulae Catharticae Compositse. — See Mercury, p. 175. Dose, 1 to 3 pills. Action. In small doses colocynth acts as a simple bitter, increasing the gastric and intestinal secretions and improving the appetite. In larger doses it augments the flow of bile and succus entericus 33 386 ORGANIC MATERIA MEDICA. considerably, stimulates the muscular coat, causes a little griping, and leads to the evacuation of a watery motion. In still larger doses the hypersecretion is excessive and the griping is severe be- cause the muscular coat is powerfully irritated, and several abun- dant watery motions result. The drug may therefore be called drastic, hydragogue, and cathartic. The depression pro- duced may be considerable. Therapeutics. Colocynth should never be given alone, because of the grip- ing it causes. In the colocynth and hyoscyamus pill, i part of colocynth 2 parts of hyoscyamus, which is often prescribed, the hyoscyamus prevents this painful result. Colocynth is an excel- lent purgative for producing a single abundant evacuation of the bowels in chronic constipation, such as that so often met with in persons suffering from hepatic disorder, and in those confined to bed. Because of the watery character of the motions it may be given in ascites or Bright' s disease, but jalap or scammony is usually preferred. It is too irritant for habitual use. It should never be administered if there is any suspicion of intestinal or gastric inflammation, nor in pregnancy. It is often combined with milder purgatives. A diuretic action has been claimed for it, but this is unimportant. ELATERINUM. ELATERINUM.— Elaterin. C 20 H 28 O 5 . A neutral principle, the active principle of elaterium, of which it contains 15 to 40 per cent. Extracted from elaterium, which is a substance deposited by the juice of the fruit of Ecballium Elaterium (Nat. Ord. Cucurbitacece). Europe. Source. — Exhaust elaterium with chloroform. Add ether, wash the re- sulting precipitate with ether ; purify by recrystallization with chloroform. Characters. — A neutral substance, in small, colorless, shiny, bitter, hex- agonal scales or prisms, having a bitter somewhat acrid taste (not to be tasted). Solubility. — Not in water, I in 125 of alcohol, easily in chloroform. Dose, 2V to L gr. Preparation. Trituritio Elaterini. — Elaterin, 10; sugar of milk, 90. Dose, ^ to 1 gr. GAMBOGE. 387 Action. Elaterin is violently purgative, producing profuse watery evacuations attended with griping and much prostration. It acts like colocynth, and except that it is much more energetic, the description of that drug will apply to it. It increases the salivary secretion. When injected- subcutaneously it purges. It is the most powerful hydragogue purgative in the pharmacopoeia. Therapeutics. Elaterin should not be given in ordinary constipation, as it is too violent in its effects, but on account of the large amount of fluid it brings away it is in suitable cases very useful in ascites and in Bright' s disease. The same cautions as were enumerated for colocynth are still more necessary here. It should not be given, or only with great care, in heart disease, on account of the depression produced. CAMBOGIA. CAMBOGIA. — Gamboge. A gum-resin obtained from Garcinia Han- burii (Nat. Ord. Guttiferce). Imported from Siam. Characters. — Cylindrical pieces, solid or hollow, longitudinally striated. Break with a smooth, conchoidal, glistening fracture. Tawny, changing to yellow when rubbed with water. Taste acrid. Powder bright yellow. Composition. — The chief constituents are — (1) A brilliant yellow resin, gambogic acid, 73 per cent. (2) Gum, 23 per cent. This is soluble, so that an emulsion of gambogic acid is formed with water. Impurities. — Starch, woody fibre. Dose, 1 to 5 gr. Gamboge is contained in Pilulae Cathartics Composite. Action. Gamboge is a drastic hydragogue purgative, causing much griping, and in large doses great irritation of the alimentary canal. Most of it passes in the faeces, but some is absorbed, causing the urine to be yellow. It is slightly diuretic. Therapeutics. It is not often prescribed, as it is uncertain, and gripes con- siderably. It should never be given alone. It has been used as an anthelmintic. 388 ORGANIC MATERIA MEDICA. PODOPHYLLUM. PODOPHYLLUM. — Synonym. — May apple. The dried rhizome and rootlets of Podophyllum peltatum (Nat. Ord. Berberidacece). North America. Characters. — Pieces of variable length and about \ to \ in. thick, flat- tened, cylindrical, with irregular tuberosities, which are marked above by a de- pressed circular scar, and give off below a number of very brittle brownish rootlets, or show, if these are broken off, a corresponding number of whitish scars ; dark reddish brown externally, smooth or wrinkled ; fracture short ; in- ternally whitish and mealy. Odor faintly narcotic. Taste bitterish, acid, nauseous. Composition. — The chief constituents are — (i) The alkaloid berberine (q. v.). (2) The officinal resin, which is the purgative principle. Preparations. 1. Abstractum Podophylli. — By maceration and percolation with alcohol, evaporation and addition of sugar of milk. Dose, 2 to 5 gr. 2. Extractum Podophylli. — By maceration and percolation with alcohol, distillation and evaporation of residue. Dose, 2 to 10 gr. 3. Extractum Podophylli Fluidum. — By maceration and perco- lation in alcohol and water, distillation and solution of residue. Dose, 5 to 20 m. 4. Resina Podophylli. — Synonym. — Podophyllin. Source. — By maceration and percolation in alcohol, distillation of alcohol, precipitation of resin in hydrochloric acid and water, wash and dry. Characters. — A pale-yellow to deep orange-brown amorphous powder, soluble in alcohol and ammonia. Composition. — Podophyllin resin contains at least two other resins, one soluble and the other insoluble in ether. These resins contain an active purgative crystalline body, podophylloxin. This, it is said, can be split up into picro-poiophyllic acid, which is inert, and picro-podo- phyllin, a crystalline neutral body, the active principle. Both these also exist free in the rhizome. Incompatibles. — Water precipitates it from alcohol, acids precipi- tate it from ammonia. Dose, ^toi gr. leptandra. 389 Action. External. — It has no external action unless applied to raw surfaces, from which it may be absorbed and then it will purge. Internal. — Gastro-intestinal tract. — Podophyllin has a bitter taste. It is in large doses a powerful gastro-intestinal irritant, and has caused death. In medicinal doses it gives rise to much griping pain, perhaps some nausea, and in about ten hours there is an evacuation of the bowels ; the motion which is liquid, is deeply stained with bile. The pain shows that the muscular coat is stimulated, the liquidity that probably more intestinal fluid is secreted, and the color that more bile is poured into the intestine. In small doses podophyllin decidedly increases the secretion of bile, in purgative doses it does not, although more bile is poured from the gall bladder into the intestine. It is thus a direct and indirect cholagogue. It probably acts after absorption, for all its effects can be produced if it is injected subcutaneously. Therapeutics. Podophyllin is only used for its cholagogue purgative action. It is especially suitable for constipation due to hepatic disorder, whether functional, as in the hepatic dyspepsia which commonly goes by the name of biliousness, or organic, as in hepatic cirrho- sis and cancer. It must be remembered that as it causes much griping, it should be combined with hyoscyamus or some other drug to overcome this ; that it takes a long while to act, and will therefore be swept away before it has produced any effect if given with quickly acting purgatives; and that it is better to begin with small doses, as people are very unequally affected by it. It may be advantageously combined with calomel in a pill. It is so dis- agreeable to the taste that it is better to dissolve the resin in aromatic spirits of ammonia (i gr. to 5J)- LEPTANDRA. CULVER'S ROOT. — The rhizome and rootlets of Leptandra virgin- ica (Nat. Ord. Scrophulariacece). United States. Characters. — Horizontal about 4 to 6 in. long, and about }£ in. thick, 390 ORGANIC MATERIA MEDICA. somewhat flattened, bent and branched, deep, blackish-brown, with cup-shaped scars on the upper side, with a thin, blackish bark ; rootlets thin, wrinkled, very fragile ; inodorous ; taste bitter and feebly acrid. Composition. — The chief constituents are — (i) Leptandrin, aglucoside; (2) a saccharine principle having the properties of mannit. Preparations. 1. Extractum Leptandrse. — By maceration and percolation with alcohol and water, evaporation and addition of glycerin. Dose, 1 to 3 gr. 2. Extractum Leptandrae Fluidum. — By maceration and perco- lation with glycerin and diluted alcohol, and evaporation. Dose, j^ to 1 fl. dr. Action and Uses. The recent leptandra root acts as a violent cathartic, and sometimes as an emetic. It is an excellent cholagogue and it ap- pears to have a special influence upon the muciparous follicles of the intestine and it acts very advantageously in cases of duode- nal indigestion and chronic constipation. IRIS. Synonym. — Blue Flag. The rhizome and rootlets of Iris versi- color (Nat. Ord. Iridacece'). United States. Characters. — Rhizome horizontal, consisting of joints, 2 or 4 in. long, cylindrical in the lower half, flattish near the upper extremity, and terminated by a circular scar, annulated from the leaf- sheaths, gray-brown ; rootlets long, simple, crowded near the broad end ; odor slight ; taste acrid, nauseous. Composition. — The chief constituents are — (1) starch; (2) gum; (3) tannin; (4) sugar; (5) an acid resin; (6) fixed oil; (7) probably an alkaloid. Preparations. 1. Extractum Iridis. — By maceration and percolation with alcohol and water, and evaporation. Dose, 1 to 3 gr. 2. Extractum Iridis Fluidum. — By maceration and percolation with alcohol and water, and evaporation. Dose, 10 to 30 m. IRIDIN. — Not officinal. Synonym. — Irisin. This is an oleoresin ob- tained by precipitation from the tincture by alcohol. Characters. — A dark brown, bitter, nauseous powder. Dose, 1 to 5 gr. volatile oils. 39 1 Action and Therapeutics. Iris is a cholagogue, and as it rarely gripes, it may be given when it is required to use a cholagogue purgative daily for some- time. It may be combined with euonymin, calomel, podophyllin and other cholagogue purgatives. EUONYMUS. EUONYMUS. — The dried bark of Euonymus atropurpureus (Nat. Ord. Celastracece). Synonyms. — Wahoo, spindle-tree, hominy bush. United States. Characters. — Incurved or quilled pieces, fragments, or shreds -^ t° X in. thick. Color light ash-gray, with blackish patches. Inner surface tawny, white and smooth, with pieces of pale yellow wood frequently adhering. Taste at first sweet, then bitter and acrid. Composition. — The chief constituents are — (1) Euonymin , a resin; (2) asparagin, and (3) euonic acid. Preparation. Extractum Euonymi (commonly called euonymin). — By macera- tion and percolation with diluted alcohol, distillation, evaporation of re- sidue, addition of glycerin. Dose, i to 5 gr. Action and Therapeutics. In small doses euonymin stimulates the appetite and flow of gastric juice, in larger, it is irritant to the intestine and is cathartic. It increases the amount of bile excreted into the intestine. It has slight diuretic and expectorant effects, but it is only used as a purgative for those cases of constipation in which the liver is disordered. GROUP VI. Volatile Oils. These, when applied externally, stimulate the skin, and thus cause redness, sometimes even vesication, tingling, and subsequent numbness. Taken inter- nally, they stimulate the gastro-intestinal tract,jincreasing its vascularity, the flow of saliva, of gastric juice, and of succus entericus ; and they excite its unstriped 392 ORGANIC MATERIA MEDICA. muscular fibres. Thus in moderate doses they are stomachics and carmina- tives ; in large doses they are gastro-intestinal irritants. Their irritation of the stomach reflexly stimulates the heart and the central nervous system. They are absorbed and excreted by the skin, which they may thus irritate, and by the bronchial mucous membrane, which they consequently stimulate, increasing the amount of secretion from it, its vascularity, the expulsive power of its unstriped muscle, and reflexly this irritation leads to coughing ; consequently they are expectorants. They are also largely excreted by the kidneys, which are stimulated even to inflammation, and hence these drugs are often diuretic ; and by the genito-urinary mucous membrane, which is also stimulated, often so energetically that it becomes inflamed. Some volatile oils act strongly in all these ways ; others act much more powerfully in some than in others. They will be classified according to the tissue on which they chiefly act, or for the action for which they are mostly used. Class I. — Volatile oils (or substances containing them), acting chiefly upon, or used chiefly for their stimulation of the skin. Terebinthina, Oil of Turpentine, Oil of Erigeron, Pix Liquida, Burgundy Pitch, Canada Pitch, Resin, Canada Balsam, Mustard, Oil of Cajuput, Eucalyptus, Rosemary, Arnica, Mezereum. Class II. — Volatile oils (or substances containing them) acting chiefly upon, or used chiefly for their stimulation of the gastro-intestinal tract. Pyrethrum, Cloves, Pimenta, Pepper, Nutmeg, Mace, Cinnamon, Capsicum, Ginger, Cardamom, Sumbul, Oil of Amber, Oil of Lav- ender, Oil of Bergamot, Peppermint, Spearmint, Anise, Illicium, Co- riander, Fennel, Caraway, Sambucus, Oil of Hedeoma, Absinthium. Class III. — Volatile oils (or substances containing them) acting chiefly upon the stomach, so as to reflexly stimulate the heart and central nervous systems, or chiefly used for this purpose. Valerian, Cypripedium, Asafcetida, Galbanum, Ammoniacum, Myrrh. Class IV. — Volatile oils (or substances containing them) acting chiefly upon, or used chiefly for their stimulation of the bronchial mucous mem- brane. Balsam of Peru, Balsam of Tolu, Storax, Canada Turpentine. Class V. — Volatile oils (or substances containing them) acting chiefly upon, or used chiefly for their stimulation of the kidneys and genito-urinary tract. Juniper, Buchu, Copaiba, Cubeb, Oil of Sandalwood, Matico. Class VI. — Volatile oils (or substances containing them) acting chiefly upon, or used chiefly for their stimulation of the female genital organs. Savine, Rue, Tanacetum. OIL OF TURPENTINE. * 393 Class I of Volatile Oils. Those used chiefly for their action on the skin. TEREBINTHINA. TURPENTINE. — A concrete oleo-resin obtained from Pinus australis and from other species of Pinus (Nat, Ord. Coniferce). Characters. — In yellowish, tough masses, brittle in the cold, crummy- crystalline in the interior, of a terebinthinate odor and taste. OLEUM TEREBINTHINA. OIL OF TURPENTINE.— The oil distilled, usually by the aid of steam, from the oleo-resin (common turpentine) exuding from Pinus australis and P. tada, America; P. pinaster, France; P. sylvestris, Russia; rectified if necessary. (Nat. Ord. Conifei' or as the French preparation eau de goudron. Tar water is made by stirring a pint of wood tar with half a gallon of water for fifteen minutes and decanting. The dose is a pint daily. It may be used externally as a wash. PIX BURGUNDICA. BURGUNDY PITCH. — The prepared resinous exudation from the stem of Abies excelsa, the spruce fir (Nat. Ord. Coniferce), melted and strained. Austria. Characters. — Hard and brittle, yet gradually adapting itself to the form of the vessel in which it is contained. Opaque, dull reddish or yellowish brown, fracture clear and conchoidal. Odor agreeable, aromatic, especially when heated. Taste sweet, aromatic. Readily soluble in glacial acetic acid. Impurities. — Palm oil, resin, and water, detected by not being soluble in glacial acetic acid. Composition. — Like ordinary resin [see p. 399), it contains resinous acids and a volatile oil. Burgundy pitch is contained in Emplastrum Ferri, Emplastrum Galbani, and Emplastrum Opii. Preparations. 1. Emplastrum Picis Burgundicae. — Burgundy pitch, 90; yel- low wax, 10. resin. 399 2. Emplastrum Picis cum Cantharide. Synonym— Warming Plaster. Burgundy pitch, 92 ; cerate of cantharides, 8. Heat the cerate and strain ; melt the pitch with the strained liquid. Action and Therapeutics. Pitch is used as a basis for plasters. It is mildly stimulant to the skin. PIX CANADENSIS. CANADA PITCH. Synonym. — Hemlock Pitch. The prepared resin- ous exudation of Abies canadensis (Nat. Ord. Coniferce). United States. Characters. — Hard, brittle, with shiny conchoidal fracture ; opaque or translucent, dark reddish-brown, having a weak, somewhat terebinthinate odor. Preparation. Emplastrum Picis Canadensis. — Hemlock Pitch Plaster. Canada pitch, 90; yellow wax, 10. Uses. Very like to those of Burgundy Pitch. It is however more readily softened by heat, and may be almost too soft for applica- tion at the temperature of the body. RESINA. RESIN. Synonyms. — Rosin, Colophony. The residue left after distilla- tion of oil of turpentine from the crude oleo-resin (turpentine) of various species of Pinus (Nat. Ord. Coniferce). United States. Characters. — Translucent, yellowish, brittle, pulverizable. Fracture shin- ing. Odor and taste like turpentine. Burns with a yellow flame and much smoke. Sp. gr. 1.070 to 1.080. Composition. — The chief constituents are (1) Three isomeric resinous acids, — pinic, sylvic, pimaric. (2) Traces of volatile oil of turpentine. Preparations . 1. Ceratum Resinae. Synonym. — Basilicon ointment; Resin, 35 ; yellow wax, 15 ; lard, 50. 2. Emplastrum Resinae. Synony?n. — Adhesive plaster. Resin, 14 ; lead plaster, 80 ; yellow wax, 6. Resin is contained in Emplastum Hydrargyri ; Resin Cerate in Linimen. turn Terebinthinae ; Resin Plaster in Emplastrum Arnicse, Emplastrum Bella- donnse, and Emplastrum Capsici. 400 organic materia medica. Action and Therapeutics. Resin is antiseptic and slighly stimulant, and is, therefore, an excellent application for indolent ulcers, sores, and wounds. Resin soap formed by boiling together in an evaporating dish for two hours 1800 gr. of resin, 300 gr. of caustic soda, and 1 pint of water, separating the soap by a strainer, and drying on a water- bath. It may be used as an emulsifying agent, but the taste is very disagreeable. TEREBINTHINA CANADENSIS. CANADA BALSAM.— Canada Turpentine, or Balsam of Fir. The liquid oleo-resin obtained by incising or puncturing the bark of the trunk and branches of Abies bahamea (Nat. Ord. Conifers). Canada. Characters. — It is pale yellow, faintly greenish, transparent, fluid, of the consistence of thin honey. Odor peculiar, agreeable. Taste slightly bitter. It slowly dries, forming a transparent mass. Readily soluble in ether, chloro- form, or alcohol. Composition. — It is an oleo-resin, and contains oils and resins isomeric with those of ordinary turpentine (see p. 393). Canada balsam is contained in Charta Cantharidis and Collodium Flexile. Action and Therapeutics. Canada balsam is rarely used exept for its physical property of drying to form an adhesive varnish. It has the same action as oil of turpentine. SINAPIS. 1. SINAPIS ALB A.— White Mustard. The seed of Sinapis alba (Nat. Ord. Cruciferce). From plants cultivated in the United States. Characters. — About T ^ in. in diameter, roundish, pale yellow, very finely pitted, hard; internally yellow, oily. Inodorous. Taste pungent. Composition. — The chief constituents are — (1) A bland fixed oil. (2) Sinalbin and myrosin ; the latter is a ferment, and in contact with water con- verts sinalbin, which is a glucoside, into a fixed pungent body called sulphocy- anate of acrinyl, glucose and sulphate of sinapin. 2. SINAPIS NIGRA.— Black Mustard. The seed of Sinapis nigra (Nat. Ord. Cruciferce). From plants cultivated in the United States. Characters — Scarcely half the size of white mustard seeds. Roundish, dark-reddish or grayish-brown, finely pitted, hard ; yellow internally. Inodor- ous when dry, even when powdered, but when rubbed with water yielding a MUSTARD. 40I strong pungent odor and irritating the eyes. Taste very pungent. Resembling black mustard seeds. — Colchicum seeds, which are larger, lighter and not quite globular. Composition. — The chief constituents are — (1) The same fixed oil as the white seeds, about 35 per cent. (2) Sinigrin (which is potassium myronate, a potassium salt of myronic acid, which is a glucoside) and myrosin, a ferment which on contact with water converts sinigrin into the officinal volatile oil of mustard (C 3 H 5 CNS, which is sulphocyanate of allyl), glucose and potassium sulphate. The volatile oil is very pungent, and its development on the addi- tion of water explains the pungency of ordinary mustard. 3. OLEUM SIN APIS VOLATILE.— Sulphocyanate of Allyl. (C 3 H 5 CNS. The volatile oil distilled with water from black mustard seeds after expression of the fixed oil. Characters. — Pale yellow, intensely pungent and irritant. Sp. gr. 1.017 to 1. 02 1. Solubility. — I in 50 of water, readily in alcohol and in ether. Preparations. 1. Charta Sinapis. — Black Mustard, Benzin, Solution of Gutta- percha. Percolate the mustard with benzin. Remove the powder and dry. Add the solution of gutta-percha, and with a brush apply to one side of a piece of rather stiff, well-sized paper. 2. Linimentum Sinapis Compositum. — Volatile oil of mus- tard, 3 ; extract of mezereum, 2 ; camphor, 6 ; castor oil, 1 5 ; alcohol, to 100 is by solution. Action of Mustard. External. — Mustard is a typical powerful local irritant. Thus it first produces dilatation of the vessels, which causes red- ness of the skin (rubefacient effect) and a sensation of warmth. Because of the irritant action of mustard on the sensory nerves, a severe burning pain is soon felt. The irritation of the nerves is followed by their paralysis, consequently there is a local loss of sensibility, and a diminution both of the pain produced by the mustard and of any that may have been present before its appli- cation. The irritation of the vessels leads to the transudation of plasma through them; this, collecting under the epidermis, raises it, and thus vesicles, blebs, or blisters are formed (vesicant effect). Mustard is also a counter-irritant (seep. 51); that is to say, the stimulation of the cutaneous nerves reflexly leads to 40 2 ORGANIC MATERIA MEDICA. a dilatation of the vessels of the viscera under the seat of appli- cation. This excitation of the sensory nerves is sufficiently powerful to reflexly stimulate the heart and respiration, and some- times to restore consciousness after fainting. Internal. — Gastro-intesiinal tract \ — Mustard also acts here as an irritant. Taken in the usual small quantities as a condi- ment, it causes a sense of warmth in the stomach, it moderately stimulates the secretion of gastric juice and the peristaltic movements, and therefore sharpens the appetite. A dose of one to four teaspoonfuls stirred up in a tumbler of water is sufficiently irritating to be a direct stomachic emetic, causing prompt vomit- ing without the depression which usually attends emetics, because the mustard reflexly stimulates the heart and respiration. Therapeutics. External. — A mustard poultice (equal parts of mustard and flaxseed meal) is a very common and efficacious application as an irritant and counter-irritant in rheumatism, pleurisy, pneumonia, bronchitis, pericarditis, and many inflammatory diseases. In the manner already explained, it will, when applied to the skin, soothe pain in gastralgia, colic, painful diseases of the chest, neuralgia, lumbago, &c. The paper or any of the mustard leaves that are sold, moistened in water, form an excellent application. Often the local application of mustard over the stomach relieves vomiting. A large mustard poultice applied to the legs was formerly used as a reflex stimulant in cases of syncope, asphyxia, and coma. Common colds and febrile conditions, especially in children, are often treated by placing the feet and legs or the whole body in mustard and warm water (10 to 15 ounces of mustard to every 15 gallons of water, as hot as can be borne), the object being by the cutaneous dilatation to withdraw blood from the inflamed part. A mustard sitz bath may be taken at the time of the ex- pected period, to induce menstruation. Internal. — Mustard is used as a condiment, and also as an OIL OF EUCALYPTUS. 403 emetic. It is especially valuable for poisoning by narcotics, be- cause of its reflex stimulant effects. OLEUM CAJUPUTI. — Cajuput Oil. The oil distilled from the leaves of Melaleuca Cajuputi (Nat. Ord. Myrtacece). Imported from Batavia and Singapore. Characters. — A transparent, very volatile, limpid, pale bluish-green liquid, with a strong, penetrating, camphoraceous odor. Taste, warm, bitter aromatic, camphoraceous, and succeeded by a sensation of coldness. Sp. gr. about 0.920. Readily soluble in alcohol. Composition. — The chief constituents are — (1) Hydrate of cajuputene, isomeric with Borneo camphor (q. v.), 75 per cent. (2) Another oil. Impurities. — Copper and other oils. Dose, 1 to 5 m. Action. The action of cajuput oil is exactly the same as that of the oils of cloves {see p. 409). Therapeutics External. — Cajuput oil is used as a stimulant, irritant, and counter-irritant — usually diluted with sweet oil— for all sorts of purposes when any of these effects are needed. Thus it is rubbed in for chilblains, myalgia, rheumatic pains, chronic inflammatory conditions of the joints or periosteum. It has also been em- ployed as a parasiticide for Tinea tonsurans. The only objection to its use is its strong smell. Internal. — It is occasionally given in dyspepsia, usually com- bined with other remedies, for the sake of its carminative, stomachic, and antispasmodic effects ; it may be taken on sugar. EUCALYPTUS. EUCALYPTUS. The leaves of Eucalyptus globulus (Nat. Ord. Myrtacece) collected from rather old trees. Australia. Characters. — Petiolate, lanceolately scythe-shaped, from 6 to 12 in. long, rounded below, tapering above entire, leathery, gray -green, glandular, feather- veined between the midrib and marginal veins ; odor strongly camphoraceous ; somewhat bitter and astringent. Preparation. Extractum Eucalypti Fluidum. — By maceration and perco- lation in alcohol and evaporation. Dose, l A to 2 fl. dr. 404 ORGANIC MATERIA MEDICA. OIL* OF EUCALYPTUS— The volatile oil distilled from the fresh leaves of Eucalyptus globulus ■, Eucalyptus amygdalina (Nat. Ord. Myrtacece), and probably other species of Eucalyptus, the blue gum tree. Characters. — Colorless or pale straw-colored, becoming darker and thicker by exposure. Odor aromatic. Taste spicy, pungent, leaving a sensation of coldness in the mouth. Neutral. Sp. gr. about 0.900. Solubility. — In an equal weight of alcohol. The oils from different species of Eucalyptus vary very much. Composition. — The chief constituents are — (1) A volatile oil, eucalyptol, about 70 per cent. It is that portion which in distillation passes over between 330 and 35 2° F. It is a mixtnre of {a) a terpene (C ]0 H 16 ) and (b) cymene (C 10 H U ). It is met with in commerce. (2) A crystallizable resin, probably derived from the oil, and yielding ozone. (3) Tannin. (4) An oil isomeric with hydrate of cajuputene. It is met with in commerce, and is called crystal- lizable eucalyptol, as it solidifies at 32 F. {see p. 403). Incompatible. — Alkalies, mineral acids, metallic salts. Dose, 5 to 30 m. Action. External. — Oil of eucalyptus is much less irritant when ap- plied externally than other volatile oils, but if its vapor is confined it will produce vesication and pustulation. It is powerfully anti- septic and disinfectant. Old oil is more antiseptic than new, probably from the greater amount of ozone it contains. Internal. — Gastro-intestinal tract. In medicinal doses oil of eucalyptus is stomachic, having the same actions as oil of cloves. In large doses it produces severe gastro-intestinal irritation, as shown by vomiting,, diarrhoea, and abdominal pain. Circulation. — It, like quinine, arrests the movements of the white blood-corpuscles ; and it likewise resembles this drug in its antipyretic and its anti-periodic actions, and also, it is said, in causing contraction of spleen ; but quinine is in all respects the more energetic. In medicinal doses the heart is stimulated by oil of eucalyptus, and the blood-pressure rises ; probably these effects are reflex from the stomach. After large quantities the action of the heart is enfeebled, and temperature falls. Respiration. — Small doses slightly accelerate, poisonous doses slow, respiration. Nervous system. — Large doses are powerfully depressant to the ROSEMARY. 405 brain, to the medulla, and to the spinal cord, abolishing reflex action. Death occurs from paralysis of respiration.' Mucous membranes, kidneys, and skin, — Like other volatile oils, eucalyptus is excreted by all these channels. It imparts its odor to and disinfects, the breath and the urine. It stimulates the organs by which it is excreted, consequently it is a diapho- retic, a stimulating expectorant, a diuretic, and a stimulant to the genito-urinary tract. Large doses cause renal congestion. Therapeutics. External. — It is used as an antiseptic for wounds, sores, and ulcers. It is three times as powerful as carbolic acid, and is there- fore preferred by some surgeons. A- eucalyptus gauze has been prepared as a dressing for wounds, which may be washed with a weak solution of the oil in alcohol. An ointment of eucalyptus oil 8 pts., iodoform i pt, paraffin and vaseline 40 pts. is applied to chancres. An emulsion of the oil is used as an urethral injection. It would probably be an efficient parasiticide. Internal. — A vapor of the spray of oil of eucalyptus has been recommended for diphtheria and .fetid bronchitis, and it is some- times given by the mouth to correct the fcetor of the expectora- tion. Occasionally it is used for its stomachic, carminative effects, especially if the faeces are very foul smelling, and some employ it in cystitis and pyelitis. It has been prescribed in septicaemia. As an antiperiodic for ague and an antipyretic it is far inferior to quinine. ROSMARINUS. ROSEMARY. The leaves of Rosmarinus officinalis (Nat. Ord. Labi- atce). Europe. Characters. — About I in. long, rigid, linear, entire, revolute, dark-green above, woolly and glandular beneath ; pungently aromatic, somewhat camphor - aceous. Preparation. Vinum Aromaticum. — Lavender, I ; origanum, 1; peppermint, I; rosemary, 1 ; sage, I ;- wormwood, I ; stronger white wine to 100. By percolation. 406 ORGANIC MATERIA MEDICA. 'OLEUM ROSMARINL— The oil distilled from the flowering tops of Rosmarinus officinalis. Characters. — A colorless or pale yellow volatile oil. Odor of rosemary. Taste w r arm, aromatic. Sp. gr. about 0.900. Soluble in alcohol. Composition. — The chief constituents are a terpene and a ^tearoptene. Dose, 1 to 5 m. Oil of rosemary is contained in Linimentum Saponis, Spiritis Odoratus, and Tinctura Lavandulae Composita. Action and Therapeutics. Oil of rosemary has an action similar to that of other aro- matic volatile oils. It is very commonly used to give a pleasant scent to lotions and other preparations which are used externally. ARNICA. ARNIC^E FLORES. — The flower head of Arnica montana (Nat. Ord. Compositce). United States. Characters. — About 1 in. broad, depressed-roundish, consisting of a scaly involucre in two rows, and a small, flat, hairy receptacle, bearing about 16 yellow, strap-shaped ray-florets, and numerous yellow, fine-toothed, tubular disk-florets, having slender, spinal shaped achenes, crowned by a hairy pappus. It has a feeble, aromatic odor, and a bitter, acrid taste. Preparation. Tinctura Arnicae Florum. — Arnica flowers, 20; by maceration and percolation in alcohol to 100. Dose, 15 to 45 m. ARNICA RADIX. — The dried rhizome and rootlets of Arnica mon- tana. Characters. — 1 to 2 in. long, ^ to ^ in. in diameter, cylindrical, dark brown, contorted, rough. Remains of leaves at upper end, wiry rootlets from the lower surface. Odor peculiar, aromatic. Taste acrid, bitter. Resembling arnica. — Valerian and Serpentary, each having characteristic odor; Veratrum Viride, having thicker rootlets. Composition. — The chief constituents are — (1) A volatile oil. (2) Tan- nic acid. (3) A volatile alkaloid, a bitter principle, and a resin. Preparations. 1. Extractum Arnicae Radicis. — By maceration and percolation in diluted alcohol, evaporation and addition of glycerin. Dose, 5 to 10 gr. MEZEREON. 407 2. Extractum Arnicae Radicis Fluidum. — By maceration and percolation in diluted alcohol and evaporation. Dose, 5 to 20 m. 3. Tinctura Arnicae Radicis. — Arnica root, 10 ; by maceration and percolation with diluted alcohol to 100. Dose, 5 to 10 m. 4. Emplastrum Arnicae. — Extract of Arnica root, 50; resin plaster, 100. Action and Therapeutics. The action of arnica is the same as that of volatile oils gen- erally. Externally the tincture is used as an application to bruises, but it is very doubtful how far its good effects are owing to the spirit, and how far to any increase of cutaneous vascularity due to the volatile oil of the arnica. It is rarely given internally, but in small doses it is a stom- achic, a carminative, and a reflex stimulant, and in larger doses causes vomiting and purging. It is excreted by the kidneys and mucous membranes, and it has been credited with obscure effects on the central nervous system. MEZEREUM. MEZEREON. — The dried bark of Daphne Mezereum or Daphne laureola (Nat. Ord. Thymelacece). Britain. Characters. — Long, thin, flattened strips, usually rolled into discs, or small quills. Externally covered by a brown corky layer. Internally whitish, silky, very tough. Odor none. Taste burning. Composition. — The chief constituents are — (1) A soft, brown resin, which is the anhydride of mezereinic acid. (2) An acrid, rubefacient, volatile oil. (3) Daphnin, a bitter, inert, glucoside in colorless crystals. (4) A fixed oil, inert. Preparations. 1, Extractum Mezerei. — By maceration and percolation with alcohol and evaporation. Used in Linimentum Sinapis Compositum. 2. Extractum Mezerei Fluidum. — By maceration and percola- tion with alcohol and evaporation. Dose, 5 to 15 m. 408 ORGANIC MATERIA MEDICA. 3. Unguentum Mezerei. — Fluid extract of mezereum, 25 ; lard, 80; yellow wax, 12. Mezereum is contained in Decoctum Sarsaparillse Compositum and Ex- tractum Sarsaparillae Compositum Fluidum. Action and Therapeutics. External. — Mezereon bark has the same actions as volatile oils generally. It is a powerful rubefacient and vesicant extern- ally, and is used chiefly in the compound mustard liniment, where it excites the same effects and is employed for the same purposes as the oil of mustard. Internal. — It is a gastric stimulant, producing, in large doses, vomiting and diarrhoea. Class II of Volatile Oils. Those used chiefly for their action on the gastro-intestinal tract. PYRETHRUM. PYRETHRUM. — Synonym. — Pellitory. The dried root of Anacyclus Pyrethrum (Nat. Ord. Composifce). Levant. Characters. — Unbranched pieces, 2 — 4 in. long, ^ — ^ in. in diameter. Bark thick, brown, shrivelled ; studded by dark-colored receptacles for the resin. Close fracture, showing radiate surface. Inodorous. Causes a pricking sensation in the mouth when chewed. Resembling pyrethrum. — Taraxacum, which is darker, and has not a burning taste. Composition. — The chief constituents are — (1) Volatile oils and resins. (2) Inulin, which in many plants replaces starch. Preparation. Tinctura Pyrethri. — Pyrethrum, 20; by maceration and percola- tion with alcohol to 100. Action and Therapeutics. Pyrethrum is a powerful sialogogue, and causes a burning sen- sation in thfc mouth, followed by numbness and tingling. Small quantities give a pleasant taste to tooth powders. CARYOPHYLLUS. CLOVES. — The unexpanded flowers of Eugenia caryophyllata (Nat. Ord. Myrtacetz). Penang, Bencoolen, and Amboyna. CLOVES. 409 Characters. — About l / 2 in. long, consisting of a dark brown, wrinkled, subcylindrical, and somewhat angular calyx tube, which tapers below and is sur- mounted by four teeth, between which the paler colored petals, enclosing the numerous stamens and style, are rolled up in the form of a ball. Odor strong, fragrant, and spicy. Taste very pungent and aromatic. It emits oil when indented. Composition. — The chief constituents are — (1) Oleum Caryophylli (q. v.). (2) Eugenin, a crystalline body. (3) Caryophyllin, a neutral body isomeric with camphor. Cloves are contained in Vinum opii. OLEUM CARYOPHYLLI.— Oil of Cloves. The oil distilled in United States. Characters. — Colorless when recent, becoming yellowish and then brownish. Taste and odor like cloves. Easily soluble in alcohol. Sp. gr. about 1.050. Composition. — The chief constituents are — (1) Eugenol (synonym. Eu- genic acid) , C 10 H 12 O 2 , which chemically resembles phenol, and forms permanent salts with alkalies. (2) A terpene. Dose, 1 to 5 m. Incompatibles. — Lime water, salts of iron, mineral acids and gelatine. Action of Cloves and Oil of Cloves. Oil of cloves is a typical example of a volatile oil the most important actions of which are exerted in the stomach. External. — When rubbed into the skin it is stimulant, rubefacient, irritant, and counter-irritant, and gives rise to considerable vascular dilatation. At first it causes a sensation of tingling and pain, which afterwards is replaced by local anaesthesia. It is a parasiticide and antiseptic. Internal. — Mouth.— -In the mouth, oil of cloves produces the same effects as on the skin ; there is a burning sensation accom- panied by vascular dilatation and an increased flow of saliva, and followed by local anaesthesia. Cloves stimulate the nerves of taste, and being volatile and aromatic, those of smell also ; by both these means taste is sharpened. Stomach — The stimulant effect of cloves is experienced here. The vessels are dilated, peristalsis is accelerated, the se- cretion of gastric juice is excited, and as cloves are pleasant 35 41 ORGANIC MATERIA MEDICA. and aromatic, they do not ordinarily produce nausea; conse- quently the appetite is increased. The combined effect of these actions is to aid digestive processes — therefore oil of cloves is stomachic ; and to facilitate the expulsion of gas — thus it is carminative. The stimulation of the gastric nerves to a slight extent reflexly affects the heart in the same way as alcohol ; there- fore the rate and force of the pulse are moderately in- creased. Intestines. — Here likewise oil of cloves dilates the vessels, and stimulates the secretion and the muscular coat of the intestine, consequently colicky pains due to irregular contraction of it are relieved, and flatus is expelled. Circulation. — Oil of cloves is readily absorbed from the intes- tine, circulates in the blood, and is said to increase the number of white corpuscles. It may to a slight extent stimulate the heart directly, but the greater part of the stimulation of the heart excited by it is reflex from the stomach. It is credited with the power of arresting painful spasmodic contractions in various parts of the body. It can, as we have seen, do this in the intestine, and possibly it may have to a slight extent the same action in the bronchial tubes, heart, etc. This causes it to be called anti- spasmodic. Mucous membranes. — Like other volatile oils it is excreted by the kidneys, skin, bronchi, and genito-urinary tract, and in pass- ing through these structures will act as a stimulating disin- fectant to their secretion ; but oil of cloves is never used for these purposes. Therapeutics of Cloves and Oil of Cloves. External. — Oil of cloves is too expensive for frequent ex- ternal application, but on account of its local anaesthetic effect it has been used for neuralgia. It is employed to give a pleasant scent to liniments. Internal. — The oil is sometimes dropped into decayed teeth to relieve pain. Cloves are freqently employed in cookery for their taste, and because they stimulate the appetite and aid diges- PIMENTA, 411 tion. The oil or the infusion (B. P., 1 in 40) may be used medic- inally as a stomachic, as a carminative, as an antispasmodic, or to relieve colicky pains in indigestion. It will be noticed that oil of cloves is sometimes combined with preparations of scammony, of castor oil, and of colocynth. This is to prevent the griping these purgatives might otherwise cause. PIMENTA. PIMENTA. — The dried, nearly ripe, full-grown fruit of Eugenia Pi- menta, the allspice tree (Nat. Ord. Myrtacece). West Indies. Characters. — Dry, light, roundish, % in. or more in diameter, crowned with the remains of the calyx in the form of a raised scar-like ring ; pericarp roughish, from the presence of oil-glands ; brittle, dark-brown, two-celled, each cell containing a brownish-black, somewhat compressed, reniform seed. Odor and taste like cloves. Resembling pimenta. — Pepper, which has no calyx ; cu- beb, which is stalked. Composition. — The chief ingredient is a volatile oil. It is chemically the same as that found in cloves. It is officinal (see below). Dose, 1 to 2 fl. oz. OLEUM PIMENTO.— The oil distilled in United States from the fruit of Eugenia Pimenta. Characters. — It is colorless, but becomes brown by keeping. Sp. gr. about 0.970. Solubility. — Readily in alcohol. Dose, 1 to 4 m. Oleum Pimentce is used in Spiritus Myrcise. Action and Therapeutics. The actions and uses of pimenta and its oils are precisely the same as those of cloves and oil of cloves. PIPER. PEPPER. — The dried unripe fruit of Piper nigrum (Nat. Ord. Pipera- cece). East Indies. Characters. — Globular, J/£ in. in diameter. Thin, blackish brown, peri- carp containing a hard, smooth, roundish, yellowish-brown or gray seed. Odor aromatic. Taste pungent. Resembling black pepper. — Pimenta, which has a calyx; cubeb, which is stalked. Composition. — The chief constituents are — (1) An oleo-resin. (2) Pi- perine. Dose, 5 to 20 gr. 412 ORGANIC MATERIA MEDICA. Preparations. 1. Oleoresina Piperis. — By percolation with stronger ether, dis- tillation and evaporation of the residue . Dose, % to i gr. 2. Piperina. — Piperine. C 17 H 19 N0 3 . A proximate principle of feebly alkaloidal power, prepared from pepper, and occurring also in other plants of the Nat. Ord. Piper acece. Characters. — Colorless, or pale yellowish, shiny, four-sided prisms, permanent, odorless and almost tasteless, when first put into the mouth, but, on prolonged contact, producing a sharp, biting sensation. Neural in reaction, almost insoluble in water, but soluble in 30 parts of alcohol. Isomeric with morphine, decomposes into piperic acid and a liquid alkaloid piperidine. Dose, 1 to 10 gr. Action. Pepper, because of its volatile oil, acts like other substances containing volatile oils ; thus externally it is at first rubefacient and counter-irritant, and subsequently it acts as an anodyne. In- ternally it increases the secretions of the mouth, and in the stomach it is stomachic and carminative. During its excretion it stimulates the mucous membrane of the genito-urinary tract. Piperine is believed to be a feeble antipyretic and antiperiodic. Therapeutics. Occasionally pepper is used externally as an irritant for the same class of cases as mustard. Internally it may be employed, in the form of a gargle, as a stimulant for relaxed conditions of the throat. It is taken in the form of a condiment for its stomachic properties. The confection or pepper lozenges are given empiri- cally to relieve haemorrhoids, ulcers of the rectum, and fissures of the anus. MYRISTICA. NUTMEG. — The dried seed of Myristica fragrans (Nat. Ord. Myristi- cacece) divested of its hard coat or shell. Malay Archipelago. Characters. — Ovoid, about 1 in. long. Externally grayish-brown, with reticulated furrows. Internally grayish- red, marbled with brownish-red veins. Odor aromatic. Taste warm, bitter, aromatic. OIL OF NUTMEG. 413 Composition. — The chief constituents are — (1) The concrete oil, 25 — 30 per cent. (2) The officinal volatile oil y 2 — 8 per cent, (see below). Nutmeg is contamed in Pulvis Aromaticus, and Tinctura Lavandulae Com- posita. MACIS. MACE. — The arillus of the fruit of Myristica fragrans (Nat. Ord. Myrts- ticacece) . Characters. — In narrow bands, 1 in. or more long, somewhat branched and laked above, united to broader bands below ; brownish-orange ; fatty when scratched or pressed ; odor fragrant, taste warm and aromatic. Composition. — The chief constituents are (1) a volatile oil, in from 7 to 9 per cent., a greater portion of which is macene, C 10 H 16 . (2) Two fixed oils. (3) A peculiar gummy matter similar to amidin. Dose, 5 to 20 gr. OLEUM MYRISTICA.— Volatile oil of nutmeg. The oil distilled in United States from nutmegs. Characters. — Colorless or pale yellow. Odor and taste of nutmeg. Sp. gr. about 0.930. Readily soluble in alcohol. Composition. — The chief constituents are — (1) Myristicen, a terpene. (2) Myristicol, a stearoptene. Dose, 1 to 3 m. Preparation. Spiritus Myristicae. Synonym. — Essence of Nutmeg. Oil of nutmeg, 3; alcohol, 97. Dose, 30 to 60 m. Action and Therapeutics. The action of oil of nutmeg is the same as that of other aromatic oils. Nutmegs are much employed in cookery for the sake of their volatile oil, which is an agreeable stomachic. CINNAMOMUM. CINNAMON. — The dried inner bark of shoots from the truncated stocks or stools of the cultivated cinnamon tree, Cinnamomum zeylanicum (Nat. Ord. Lauracece). Ceylon. Characters. — Closely rolled quills, ^g in. in diameter, and containing several smaller quills, thin, brittle, splintery. Externally dull, light, yellowish- brown, with little scars and faint wavy lines. Internally darker brown. Odor fragrant. Taste, warm, sweet, aromatic. 41 4 ORGANIC MATERIA MEDICA. Composition. — The chief constituents are — (i) The officinal volatile oil (q. v.) (2) Tannin. (3) Sugar and gum. Impurity. — Cassia bark. Preparations. 1. Pulvis Aromaticus. — Cinnamon, 35 ; cardamom, 15; ginger, 35; nutmeg, 15. Dose, 10 to 30 gr. 2. Extractum Aromaticum Fluidum. — Aromatic powder by- maceration and percolation with alcohol and evaporation. Dose, 10 to 30 m. 3. Tinctura Cinnamomi. — Cinnamon, 10 ; alcohol and water to 100. By percolation. Dose, 1 to 2 fl. dr. Cinnamon is contained in Infusum Digitalis, Tinctura Cardamomi Com- posita, Tinctura Lavandulae Composita, and Vinum Opii. OLEUM CINNAMOMI.— -The oil distilled from cinnamon. Characters. — Yellowish, becoming cherry-red on keeping. Sp. gr. about 1.040. Odor and taste like cinnamon. Composition. — The chief constituents are — (1) Cinnamomic aldehyde (C 6 H 5 C 2 H 2 COH), which makes up the greater part. (2) Cinnamicacid (C 6 H 5 C 2 H 2 C0 2 H). This exists also in styrax, and in balsams of Tolu and Peru. (3) Benzoates. Preparations. 1. Aqua Cinnamomi. — Oil of cinnamon, 2; by percolation with cotton and distilled water to 1 000. Dose, y 2 to 1 fl. oz. 2. Spiritus Cinnamomi. — Oil of cinnamon, 10 ; alcohol, 90. Dose, 10 to 30 m. Spirit of cinnamon is contained in Acidum Sulphuricum Aroma- ticum. Action and Therapeutics. . Oil of cinnamon has the same action as other aromatic vola- tile oils, and is therefore stomachic and carminative. Cinnamon bark in addition has, in virtue of its tannic acid, some astringent action, and is consequently a common flavoring stomachic vehicle for astringent powders and mixtures, except such as contain iron. CAPSICUM. CAPSICUM, 415 CAPSICI FRUCTUS. Synonym. — African pepper, Cayenne pepper. The dried ripe fruit of Capsictim fastigiatum (Nat. Ord., Solanacece). Zanzibar. Characters. — J^ to $£ in. long, j£ in. in diameter, shrivelled, conical. Consists of a dull red, shining, smooth, brittle, translucent pericarp, enclosing several small, roundish, flat seeds. Odor peculiar, pungent. Taste very bitter. Composition. — The chief constituents are — (1) Capsaicin, a crystallizable acid substance. (2) Capsicine, a volatile alkaloid smelling like coniine. (3) A volatile oil. (4) A resin. (5) Fatty matter. - Dried and powdered it constitutes red pepper. Impurities. — Various red substances, e. g. red-lead. Dose, 1 to 8 gr. Preparations. 1. Extractum Capsici Fluidum.— Capsicum. By maceration and percolation with alcohol, and evaporation. Dose, 1 to 8 m. 2. Oleoresina Capsici. — Capsicum. By percolation with stronger ether and distillation. Evaporate the residue. Dose, j^ to 1 m. 3. Tinctura Capsici. — Capsicum, 5. Alcohol and water, to 100. By percolation. Dose, 5 to 60 m. 4. Emplastrum Capsici. — Resin plaster and oleo-resin of capsi- cum. Cover muslin with the melted plaster, coat it when cool, by brush- ing on the oleo-resin. Action. The action of capsicum is like that of volatile oils generally. Thus externally it is a powerful rubefacient, irritant, and counter- irritant. Internally in small doses it stimulates the gastric se- cretions, causes dilatation of the gastric vessels, and excites the muscular coat. It is therefore stomachic and carminative. Therapeutics. It is used as a condiment. Medicinally it is given as a stomachic and carminative in dyspepsia, particularly that of drunk- ards when it is required either to excite the appetite and digestion, or to cause the evacuation of gas. 41 6 ORGANIC MATERIA MEDICA. ZINGIBER. GINGER. — The rhizome of Zingiber officinale (Nat. Ord. Zingibera- cece). East and West Indies. Characters. — Flattish, irregularly branched pieces, usually 3 to 4 in. long, each branch marked at its summit by a depressed scar. Externally pale buff, striated, fibrous. Fracture mealy, short, rather fibrous. Odor agreeable, aromatic. Taste strong, pungent. Resembling ginger. — Turmeric, which is yellow. Composition. — The chief constituents are — (1) An aromatic volatile oil, giving the flavor. (2) Several resins and allied bodies. Dose, 5 to 15 gr. Preparations. 1. Extractum Zingiberis Fluidum. — By maceration and perco- lation with alcohol, and evaporation. Dose, 5 to 15 m. 2. Oleoresina Zingiberis". — By percolation with stronger ether, distillation and evaporation of the residue. Dose, y 2 to 2 m. 3. Pulvis Aromaticus. — See Cinnamon, p. 414. 4. Tinctura Zingiberis. — Ginger, 20. By percolation with alco- hol to 100. Dose, X to * fl- ^ r * 5. Syrupus Zingiberis. — Fluid extract of ginger, 2; sugar, 65; water to 1 00. Dose, y 2 to 2 fl. dr. 6. Trochisci Zingiberis. — Tincture of ginger, 200; tragacanth, 50; sugar, 2000 grs. ; syrup of ginger in sufficient quantity, to make 100 troches. Each troche contains 2 gr. Dose. — Freely. Ginger is contained in the compound powder of rhubarb. Action and Therapeutics. Its action is the same as that of other substances containing aromatic volatile oils. It is chiefly used as a stomachic, carmina- tive, and flavoring agent. CARDAMOM. 4 1 7 CARDAMOMUM. CARDAMOM. — The fruit of the Malabar cardamom, Elettaria Carda- tnomum (Nat. Ord. Zingiberacece), Malabar. When the seeds are required for use the pericarps are rejected. Characters. — The pericarp is a three-sided capsule, ^ to 1 in. long, -J. to \ in. broad, of a tough, papery character, ovoid, obtusely triangular, shortly- beaked, rounded at the base, brownish yellow, longitudinally striated; no odor or taste. Seeds */£ in. long, irregularly angular, transversely wrinkled, reddish brown externally, whitish within. Odor aromatic. Taste warm, aromatic. Composition. — The chief constituents are — (1) A volatile oil, which is a terpene, C 10 H 16 . (2) A fixed oil. The pericarp is medically inactive. Preparations. 1. Tinctura Cardamomi. — -Cardamom, 15. By maceration and percolation with diluted alcohol to 100. Dose, 1 to 2 fl. dr. 2. Pulvis Aromaticus. — See Cinnamon, p. 414. 3. Tinctura Cardamomi Composita.— Cardamom, 20; cara- way, 10; cinnamon, 20; cochineal, 5; glycerine, 60. By percolation, with diluted alcohol to 1000. Dose, 2 to 4 fl. dr. Cardamoms are contained in Extractum Colocynthidis Compositum, Tinc- tura Gentianse Composita, Tinctura Rhei Dulcis. Action and Therapeutics. Cardamom, because of its volatile oil, acts like cloves or pep- per; therefore it is carminative and stomachic. As it has a pleasant taste, and the tincture is of a red color, it much used as a coloring and flavoring agent. A good flavoring carminative is the Tinctura Carminativa of the Brit. Pharm. Conference. It contains cardamom, 600 gr. ; strong tincture of ginger, iX g ; oil of cinnamon, oil of caraway, oil of cloves, each 100 tTL \ rectified spirit to 20 §. Dose, 2 to 10 Til. SUMBUL. SUMBUL. Synonym. — Musk Root. The dried transverse sections of the root of Ferula Sumbul (Nat. Ord. Umbelliferce). Russia and India. Characters. — Usually 1 to 3 in. in diameter, ^ to 1 in. thick. Outer surface covered with dusky brown, papery, transversely wrinkled bark, with 36 41 8 ORGANIC MATERIA MEDICA. short bristly fibres. Internally spongy, coarsely fibrous, dry, farinaceous, dirty yellowish brown, mottled with whitish patches and spots of exuded resin. Odor musk-like. Taste bitter, aromatic. Composition. — The chief constituents are — (i) A volatile oil. (2) Two resins. (3) Valerianic acid. (4) Angelic acid (g. v.) (5) Sumbulic acid. Preparation. Tinctura Sumbul. — Sumbul, 10; by maceration and percolation with alcohol to 1 00. This tincture is said to be useless, unless the fresh root is used. Dose, 1 to 4 fl. dr. Action and Therapeutics. The action of sumbul is the same as that of volatile oils in general. It is only used internally, and is given as a carminative in flatulence. It is also employed in much the same class of cases as valerian— that is to say, in neurotic conditions, hysteria, &c. In Russia it is given chiefly as a reflex stimulant in typhoid fever, dysentery, diarrhoea, &c, for the same purposes as musk is em- ployed in may other countries. OLEUM SUCCINI. OLEUM SUCCINI.— Oil of Amber. A volatile oil obtained by de- structive distillation of amber and purified by subsequent rectification. Characters. — A colorless or pale yellow, thin liquid, having an empy- reumetic, balsamic odor, a warm, acrid taste, and a neutral or faintly acid reac- tion. Sp. gr. about 0.920. It is readily soluble in alcohol. Dose, 5 to 20 m. Action and Uses. Oil of amber is stimulant and antispasmodic. It has been em- ployed with advantage in amenorrhea, hysteria, whooping-cough, and infantile convulsions of intestinal origin. LAVANDULA. LAVANDER.— The flowers of the Lavandula vera (Nat. Ord. Labiates). Southern Europe. CHARACTERS. — Calyx tubular, blue-gray, hairy, five-toothed, the upper tooth longer and roundish rhomboid ; corolla violet-blue, hairy and glandular OIL OF LAVENDER. 419 on the outside, tubular and two-lipped, the upper lip two-lobed, the lower lip three-lobed; stamens four, short in the corolla tube; odor, fragrant; taste* bitterish, aromatic, somewhat camphoraceous. Preparation. Vinum Aromaticum. — see Rosemary, p. 405. OLEUM LAVANDULA.— A volatile oil distilled from the flowering tops on the whole herb of the Lavandula vera. Characters. — A colorless or yellowish or greenish-yellow liquid having the aromatic odor of lavender, a pungent, bitter taste and a neutral reaction. Sp. gr. about 0.890 ; soluble in alcohol. Dose, 1 to 5 m. Preparation. Tinctura Lavandulae Composita. — Oil of lavender, 8; oil oi rosemary, 2; cinnamon, 18; cloves, 4; nutmeg, 10 ; red saunders, 8; alcohol, 680; water, 270; diluted alcohol to 1 000. By mixing and percolation. Dose, ^ to 1 fl. dr. OLEUM LAVANDULAE FLORUM. — The oil distilled from fresh Lavender. Characters. — A colorless or pale, yellow, volatile oil. Odor of lavender. Taste warm, bitter, aromatic. Sp. gr. about 0.890. Composition. — The chief constituents are a terpene and a stearoptene. Dose, 1 to 4 m. Preparations. 1. Spiritus Lavandulae. — Oil of lavender flowers, 3; alcohol, 97. Dose, y 2 to 1 fl. dr. 2. Spiritus Odoratus. Synonym. — Cologne water. Oil of ber- gamot, 16 ; oil of lemon, 8 ; oil of rosemary, 8 ; oil of lavender flowers, 4 ; oil of orange flowers, 4; acetic ether, 2; water, 158; alcohol, 800. By solution and filtration to 1 000. Compound tincture of lavender is contained in Liquor Potassium Arseni- calis. Action and Therapeutics. Oil of lavender has the same action as other aromatic volatile oils. It is used externally as a pleasant stimulating component of liniments, and most red lotions {see p. 150) are colored with it. Internally, especially in the form of the compound tincture, it 420 ORGANIC MATERIA MEDICA. makes a very agreeable gastric stimulant, carminative and color- ing agent. OLEUM BERGAMII. OIL OF BERGAMOT. — A volatile oil extracted by mechanical means from the rind of the fresh fruit of Citrus Bergamia var. vulgaris (Nat. Ord. Aurantiacece) . Characters. — A greenish-yellow, the liquid of a peculiar, very fragrant odor, an aromatic, bitter taste, and a slightly acid reaction, sp. gr. 0.850 to 0.890. It is soluble in alcohol and in glacial acetic acid. Oil of bergamot is contained in Spiritus Odoratus. MENTHA PIPERITA. PEPPERMINT. — The leaves and tops of Mentha piperita (Nat. Ord. Labiatce). United States. Characters. — Leaves about two inches long, petiolate, ovale-lanceolate, acute, sharply serrate, glandular, nearly smooth ; branches quadrangular, often purplish ; flowers in terminal, conical spikes, with a tubular, five-toothed, often purplish calyx, a purplish four-lobed corolla, and four short stamens ; odor, aromatic ; taste, pungent, cooling. Preparations. 1. Spiritus Menthae Piperitae. — Oil of peppermint, 10; pepper- mint, I. By maceration and percolation with alcohol to 100. Dose, 5 to 15 m. 2. Vinum Aromaticum. — see Rosemary, (p. 405). Spiritus Menthce Piperitce is contained in Mistura Rhei et Sodae. OLEUM MENTHA PIPERITA.— The volatile oil distilled from peppermint. Characters. — Colorless or greenish-yellow, thickening and becoming reddish with age. Odor like that of peppermint. Taste aromatic, followed by a sense of coldness. Sp. gr. about 0.900. Composition.— The chief constituents are — (1) Menthene (C 10 H 18 ), the liquid terpene. (2) Menthol \ the solid stearoptene (q. v.). Dose, 1 to 5 m. Preparations, 1. Aqua Menthae Piperitae. — Oil of peppermint, 2. By perco lation with cotton and distilled water to 1 000. Dose, y 2 to 2 fl. oz. 2. Spiritus Menthae Piperitae. — See above. Dose, 5 to 15 m. SPEARMINT. 421 "3. Trochisci Menthae Piperitee. — Oil of peppermint, 15; sugar, 1200 grs. ; mucilage of tragacanth to make 100 troches. Dose, Freely. Oil of peppermint is contained in Pilulae Rhei Compositse. Action and Therapeutics. The action of oil of peppermint is the same as that of volatile oils generally, but the cool, numb feeling often produced by vol- atile oils after the sensation has passed off is especially well marked with oil of peppermint ; and this effect, which is due to the men- thol in it, has caused it to be applied externally in neuralgia. Like many other volatile oils it is a powerful antiseptic. Internally it is a powerful stomachic and carminative, is often used as such, and also as a flavoring agent. MENTHA VIRIDIS. SPEARMINT. — The leaves and tops of Mentha viridis (Nat. Ord., Labiatce). United States. Characters. — Leaves about 2 inches long, sub-sessile, lance-ovate, acute serrate, glandular, nearly smooth ; branches quadrangular, mostly light green ; flowers in terminal, interrupted, narrow, acute spikes, with a tubular, sharply fine-toothed calyx, a light purplish, four-lobed corolla, and four rather long stamens ; aromatic and pungent. Preparation. Spiritus Menthae Viridis. — Oil of spearmint, 10 ; spearmint, 1. By maceration in alcohol and nitration to 1 00. Dose, 5 to 15 m. OLEUM MENTHA VIRIDIS.— The volatile oil distilled from Spearmint. Characters. — Very like oil of peppermint. Sp. gr. about 0.900. Composition. — The chief constituents are — (1) Menthene, the same ter- pene as in peppermint. (2) Caruol (C 10 H 14 O), a stearoptene isomeric with thymol (q. v.). Dose, 1 to 5 m. Preparations. 1. Aqua Menthae Viridis. — Oil of peppermint, 2. By percola- tion with cotton and distilled water to 1 000. Dose, yi to 2 fl. oz. 2. Spiritus Menthae Viridis. [See above). 42 2 organic materia medica. Action and Therapeutics. These are the same as those of oil of peppermint, but oil of spearmint is not so agreeable. ANISUM. ANISE. — The fruit of Pimpinella Anisum (Nat. Ord. Umbelliferce). Southern Europe. Characters. — Anise fruit, with exception of the Russian variety, which is shorter, is about ^ in. in length, oval-oblong, grayish-brown in color, and the whole surface is covered with short hairs. The two mericarps are united and attached to a common stalk ; each is traversed by five pale slender ridges, and its transverse section exhibits about fifteen vittse. Odor agreeable, aro- matic. Taste sweetish, spicy. Resembling anise. — Conium, which has single mericarps, smooth, grooved upon the face, and having crenate ribs and no vittae. Composi i ion. — The chief constituent is the officinal volatile oil (q. v). ILLICIUM. STAR- ANISE. — The fruit of Illicium anisatum. (Nat. Ord. Magno- liacece). Asia and America. Characters. — The fruit is pedunculate, and consists of eight stellately arranged carpels, about yi. m - l° n g» brown, dehiscent in the upper suture, inter- nally red-brown, glossy, and with a single, flattish, oval, glossy, brown-yellow seed; odor, anise-like; taste of the carpels sweet and aromatic, and of the seeds oily. Resembling star-anise. — Illicium religiosum, of which the carpels are more woody, shriveled, and have a thin curved beak, a faint clove like odor and an unpleasant taste. Dose, 5 to 30 gr. Oleum anisi may be distilled from this as well as from Pimpinella Anisum. OLEUM ANISI.— The volatile oil distilled in Europe from the anise. Characters. — Colorless or very pale yellow, with the odor of the fruit and an aromatic, sweetish taste. That from the Pimpinella Anisum solidifies between 50 and 6o° F. ; that from Illicium anisatum (star-anise) at about 34 F. Sp. gr. 0.976 to 0.990. Composition. — The chief constituents are — (1) A terpene, 20 per cent. (2) A stearoptene, anethol, 80 per cent. (C 10 H 12 O 4 ). Dose, 1 to 5 m. FENNEL. 423 Preparations. 1. Aqua Anisi. — Oil of anise, 2. By percolation with cotton and distilled water to 1 000. Dose, ^ to 1 fl. oz. 2. Spiritus Anisi. — Oil of anise, 10; alcohol, 90. Dose, 1 to 2 fl. dr. Oil of anise is contained in Tinctura Opii Camphorata and Trochisci Glycyrrhizse et Opii. Action and Therapeutics. The action of oil of anise is the same as that of aromatic oils generally. It is specially used to get rid of flatulence in children, and, on account of its slightly expectorant action, as a basis of cough mixtures. CORIANDRUM. CORIANDER. — The fruit of Coriandrum sativum (Nat. Ord. Umbelli- ferce). Europe. Characters. — Nearly globular, and consisting of two closely united hemispherical mericarps, crowned by the calyx teeth and stylopod, \ in. in diameter, brownish yellow, hard, faintly ribbed with both primary and second- ary ridges. The mericarps each enclose a lenticular cavity, and each is fur- nished on its commissural surface with two brown vittae. Taste agreeable, mild, aromatic. Odor pleasant when bruised. Composition. — The chief constituent is the officinal volatile oil (q v.). Coriander is contained in Confectio Sennae. OLEUM CORIANDRI. — A volatile oil distilled from Coriander. Characters. — Colorless or pale yellow, with the odor and taste of the fruit. It is isomeric with Borneo camphor (q. v.). Sp. gr. about 0.870. Dose, 1 to 5 m. Oil of coriander is contained in Syrupus Sennae. Action and Therapeutics. Oil of coriander has the same action as other volatile oils, It is chiefly used as a stomachic and carminative, and to disguise the taste of rhubarb and senna. FCENICULUM. FENNEL. — The fruit of Foeniculum vulgare (Nat. Ord. Umbelliferce) . Malta. Characters. — £ to f in. long, ovoid-oblong, curved, smooth, greenish 424 ORGANIC MATERIA MEDICA. brown or brown, capped by a conspicuous stylopod and two styles. Odor aromatic. Taste aromatic, sweet. Fruit readily separated into its two meri- carps, each of which has five ridges, of which the lateral are the broadest; four vittae in the grooves, and two on the commissure. Resembling fennel. — Conium fruit (fennel is larger and has prominent vittae), caraway and anise fruits. Composition. — The chief constituent is a volatile oil probably identical with oil of anise. Fennel is contained in Pulvis Glycyrrhizse Compositus. OLEUM FCENICULI.— A volatile oil distilled from Fennel. Characters. — A colorless, or yellowish liquid, having a characteristic odor, a sweetish, mildly warm taste, and a neutral reaction. Sp. gr. not less than 0.960. Preparation. Aqua Fceniculi. — Oil of Fennel, 2 ; By percolation with cot- ton and distilled water to 1000. Dose, % to 1 fl. dr. Oil of fennel is contained in Spiritus Juniperi Compositus. Action and Therapeutics. The same as those of oil of anise or of coriander. CARUM. CARAWAY.— The fruit of Carum Carvi (Nat. Ord. Umbellifera). England and Germany. Characters. — The fruit is usually separated into its two mericarps, each about \ in long, slightly curved, tapering at each end, brown, with five pale longitudinal ridges; in each of the intervening spaces is a large conspicuous vitta. Odor agreeable, aromatic. Taste pleasant, sweetish spicy. Resembling caraway. — Conium and fennel. Known by the small ridges and the spicy taste of caraway. Composition. — The chief constituent is the volatile oil (q. v.). Caraway is contained in Tinctura Cardamomi Composita. OLEUM CARL— The volatile oil distilled from Caraway. Characters. — Pale yellow, with odor and taste like the fruit. Sp. gr. about 0.920. Composition. — The chief constituents are — (1) Caruene, a terpene. (2) Caruol (C 10 H 14 O), isomeric with thymol (q. v.). Dose, 1 to 5 m. Oil of caraway is contained in Spiritus Juniperi Compositus. pennyroyal. 425 Action and Therapeutic-. The action and uses of oleum cari are the same as those of other aromatic volatile oils. It is employed as a carminative, stomachic and flavoring agent. SAMBUCUS. ELDER. — The flowers of Sambucus canadensis (Nat. Ord., Caprifoli- acece) United States. Characters. — The flowers are on level-topped, five-branched cyme?, have a superior, minutely five-toothed calyx and a cream-colored, wheel-shaped, five- lobed corolla, with five stamens on the short tube ; odor peculiar ; taste sweet- ' ish, aromatic, slightly bitter. Composition. — The chief constituents are — (1) A resin. (2) Valerianic acid. (3) A minute amount of a volatile oil. Dose, ]/ 2 to 1 fl. dr. Action and Therapeutics. Elder flowers are used to flavor medicines. HEDEOMA. PENNYROYAL. — The leaves and tops of Hedeoma pulegioides (Nat. Ord. Labiate). United Stav Characters. — Leaves opposite, short-petioled, about */ 2 in. long, oblong- oval, obscurely serrate, glandular beneath; branches roundish-quadrangular; flowers in small, axillary cymules, with a tubular-ovoid, two-lipped and five- toothed calyx, and a pale-blue, spotted, two-lipped corolla, containing two sterile and two fertile, exserted stamens; odor, strong, mint-like; taste, warm and pungent. OLEUM HEDEOMA.- A volatile oil distilled from Hedeoma. Characters. — A colorless or yellow liquid, of a pungent, mint-like odor and taste. Sp. gr. about 0.940. It is readily soluble in alcohol. Action and Uses. Pennyroyal is a gentle stimulant aromatic, and may be given in flatulent colic and sick stomach. ABSINTHIUM. WORMWOOD. — The leaves and tops of Artemisia Absinthium (Nat. Ord., Composites}, United States. Characters . — Leaves about 2 in. long, hoary, silky-pubescent, petiolate, 426 ORGANIC MATERIA MEDICA. roundish-triangular in outline, pinnately two or three cleft, with the segments lanceolate, the terminal ones spatulate, bracts three-cleft or entire ; heads nu- merous, subglobose, with numerous, small, pale yellow flowers, all tubular and without pappus ; odor, aromatic ; taste, persistently bitter. Composition. — The principal constituents are — (1) a volatile oil, (2) a bitter resin. Dose, io to 40 gr. Wormwood is used in Vinum Aromaticum. Class III of Volatile Oils. Those used chiefly for their action on the heart and central nervous system. VALERIANA. VALERIAN. — The rhizome and rootlets of Valeriana officinalis (Nat. Ord. Valerianacece). Collected in autumn from plants growing wild or culti- vated in Europe. Characters. — Short, erect rhizome, entire or sliced. Externally dark yellowish brown, giving off many slender, brittle, shrivelled rootlets, 3 to 4 in. long. Internally whitish. Odor developed in drying, strong, peculiar, disa- greeable. Taste unpleasant, camphoraceous, bitter. Resembling valei'ian. — Serpentary, arnica, green hellebore ; but valerian is known by its odor. Composition. — The chief constituents are — (1) A volatile oil, composed of a terpene, valerene (C 10 H 16 ), and valerol, which consists chiefly of valerian camphor (C 12 H 20 O), but contains a little resin. (2) Valerianic acid, HC 5 H 9 2 . It exists in many plants, and in cod-liver oil. The amount of it in valerian increases by keeping, while that of the oil decreases. It can be derived from amylic alcohol, C 5 H 11 OH(valeryl aldehyde). It is colorless, oily with the odor of valerian, and strongly acid, with a burning taste. Solubility. — 1 in 30 of water ; easily in alcohol and ether. Dose, 10 to 30 gr. of the root powdered. Preparations. 1. Abstractum Valerianae. — By maceration and percolation with alcohol and evaporation, addition of sugar of milk. Dose, 5 to 15 gr. 2. Extractum Valerianae Fluidum. — By maceration and perco- lation with alcohol and water, and evaporation. Dose, 10 to 30 m. 3. Tinctura Valerianae. — Valerian, 20; by maceration and per- colation with alcohol and water to 100. Dose, l A to 2 fl. dr. VALERIAN. 427 4. Tinctura Valerianae Ammoniata. — Valerian, 20 ; by macer- ation and percolation in aromatic spirit of ammonia to 100. Dose, ^ to 1 fl. dr. OLEUM VALERIAN^.— A volatile oil distilled from Valerian. Characters. — A greenish or yellowish, thin liquid, becoming darker and thicker by age and exp >sure to air, having the characteristic odor of valerian, an aromatic and somewhat camphoraceous taste, and a slightly acid reaction. Sp. gr. about 0.950. It is readily soluble in alcohol. Dose, 1 to 5 m. AMMONII VALERIAN AS.— NH 4 C 5 H 9 2 . Source. — By saturating valerianic acid by gaseous ammonia, obtained from a mixture of chloride of ammonia and lime, and crystallization. Characters. — Colorless or white quadrangular plates, deliquescent in moist air, having the odor of valerianic acid, a sharp, sweetish taste, and a neutral reaction. Very soluble in water and in alcohol. Dose, 2 to 8 gr. FERRI VALERIANAS.— Fe 2 (C 5 H 9 2 ) 6 . Source. — By precipitating a diluted solution of tersulphate of iron, with a solution of sodium valerianate and washing the precipitate. Characters. — A dark tile-red, amorphous powder, permanent in dry air, having a faint odor of valerianic acid, and a mild styptic taste. Insoluble in cold, but readily soluble in hot water. Dose, 1 to 3 gr. ZINCI VALERIANAS.— Zn(C 5 H 9 2 ) 2 . Source. — Mix hot solutions of sulphate of zinc and valerianate of sodium, evaporate and valerianate of zinc crystallizes out. Solubility. — 1 in 100 of water, I in 40 of alcohol. Characters. — Pearly scales with a feeble odor of valerian and a metallic taste, and an acid reaction. Incompatibles. — All acids, soluble carbonates, most metallic salts, vege- table astringents. Dose, y 2 to 3 gr. Action. Neither valerianic acid, valerianate of ammonium, valerianate of iron, nor valerianate of zinc is known to have any action. Valerian itself acts in virtue of its volatile oil, which has the same properties as other volatile oils. Valerian is therefore an irritant when applied externally; internally it stimulates the mouth, stomach, and intestines ; consequently it increases the ap- 428 ORGANIC MATERIA MEDICA. petite and the vascularity, the secretion, and the peristaltic action of the stomach and intestines ; and in its excretion, which takes place chiefly through the bronchial mucous membrane, kidneys and genito-urinary mucous membrane, it excites the flow of fluids excreted through these parts. Acting reflexly from the stomach, it stimulates the circulation rather more powerfully than most volatile oils. Therapeutics. Preparations of valerian, or still better the oil (2 to 51TL) sus- pended in mucilage with cinnamon water, are often given as carminatives in cases of flatulence, and as reflex stimulants in fainting, palpitation, &c. Valerian and valerianates sometimes relieve neuralgia, and they are often prescribed for hysteria and other neurotic conditions, but frequently without benefit CYPRIPEDIUM. Ladies' Slipper. — The rhizome and rootlets of Cypripedium pubescens and of Cypripedium parviflorum (Nat. Ord. Orchidacece). United States. Characters. — Horizontal, bent, 4 in. long; about y% in. thick; closely covered below with simple, wiry rootlets varying from 4 to 20 in. in length ; brittle, dark-brown or orange-brown; odor, faint but heavy; taste, sweetish, bit- ter and somewhat pungent. Composition. — It contains — (1) A volatile oil. (2) a volatile acid. (3) Two resins. (4) Tannic and gallic acids. Preparation. Extractum Cypripedii Fluidum. — By maceration and percolation with alcohol, and evaporation. Dose, 15 to 30 m. Action and Uses. Ladies' Slipper is a gentle, nervous stimulant, resembling Valerian in its action. It has been used for nervous diseases, epilepsy, hypochondriasis and neuralgia. ASAFCETIDA. ASAFETIDA.— A gum-resin obtained by incision into the living root of Ferula Narthex, of Ferula Scorodosma, and probably other species (Nat. Ord. Umbellifera). Afghanistan and the Punjaub. ASAFCETIDA. 429 Characters. — Usually in irregular masses, composed of tears agglutinated together by darker colored, softer material. When broken or cut, the exposed surface has an amygdaloid appearance ; the fractured tears are opaque, milk- white at first, but become first purplish pink and finally dull yellowish brown. Odor strong, alliaceous, persistent. Taste bitter, acrid, alliaceous. Asafetida forms a white emulsion with water. The fractured surface of a tear, on being touched with nitric acid, becomes a fine green. Resembling asafetida. — Gal- banum, ammoniacum, and benzoin, distinguished by their peculiar odors, which differ markedly from that of asafetida. Composition. — The chief constituents are — (1) A volatile oil, 5 per cent., the most important ingredient of which is the essential oil of garlic, persulphide of allyl (C 3 H 5 ) 2 S. This gives asafetida its very unpleasant odor. (2) Bassorin resin, 65 per cent. (3) Ferulic acid. (4) Gum, 25 per cent. Impurities. — Earthy matter. Preparations. 1. Emplastrum Asafcetidae. — Asafetida, 35; lead plaster, 35 ; galbanum, 15; yellow wax, 15; alcohol, 120. By digestion, straining, and evaporation. 2. Mistura Asafcetidae. — Asafetida, 4; water, 100. Dose, y 2 to 1 fl. oz. 3. Pilulae Aloes et Asafcetidae. See Aloes, p. 378. 4. Pilulae Asafcetidae. — Asafetida, 300 ; soap, 100 grs. ; to make 100 pills. Each pill contains 3 gr. Dose, 1 to 4 pills. 5. Pilulae Galbani Compositae. — Galbanum, 150; myrrh, 150; asafetida, 50 grs. ; syrup, a sufficient quantity ; to make 100 pills. Dose, 1 to 4 pills. 6. Tinctura Asafcetidae. — Asafetida, 20; By maceration with alcohol, and filtration to 100. Dose, y 2 to 1 fl. dr. 7. Mistura Magnesias et Asafcetidae. — Synonym. — Dewees' Carminative. See Magnesia, p. 136. Action. Both internally and externally, asafetida, in virtue of its vol- atile oil, acts like volatile oils generally. Its action as a stimulant to the intestinal muscle is especially well marked, hence it is com- 430 ORGANIC MATERIA MEDICA. bined with aloes in Pilulae Aloes et Asafoetidae ; and the enema, 30 gr. in 4 fl. oz. of water, will relieve flatus. Owing to its con- taining oil of garlic it is extremely nasty, and therefore it is not, like many volatile oils, available as a condiment. Its taste is credited with some mental effect in cases of hysteria. Therapeutics. Asafetida is not used externally. Internally it is prescribed to aid the action of other purgatives, and also to stimulate the muscular coat to expel flatus. It may be given by the mouth or as the enema. Partly on account of its reflex stimulating effect, but also on account of its very nasty taste, it is used to control hysterical, emotional, and other mental disturbances, but it often fails. For this purpose it may be combined with valerian. Cases of malingering may sometimes be cured by making the patient take, three times a day, an effervescing draught containing a few minims of each of the tinctures of valerian and asafetida. The effervescence makes the nasty taste of these medicines " repeat " in the mouth for some time after taking them. Asafetida oil would in the course of its excretion disinfect the urine and the expectoration, but its smell forbids its use for these purposes. GALBANUM. GALBANUM. — A gum-resin obtained from Ferula galbaniflua (Nat. Ord. Umbelliferce), and probably other species. India and the Levant. Characters. — Tears or masses of agglutinated tears. Tears roundish, about the size of a pea, yellowish brown or yellowish green. Translucent, rough, and dirty. Hard and brittle in the cold, softening with heat and becom- ing sticky. Masses contain pieces of root, stem, &c. They are hard, compact, yellowish brown. Odor peculiar, aromatic. Taste bitter, unpleasant. Resem- bling galbanum. — Ammoniacum, asafoetida, benzoin ; known by their different odors. Composition. — The chief constituents are — (1) Volatile oil, 6 to 9 per cent., isomeric with turpentine, C 10 H 16 . (2) A sulphurous resin, 60 to 67 per cent. (3) Gum, 19 to 22 per cent. ^4) Umbelliferone. Preparation. Emplastrum Galbani. — Galbanum, 16; turpentine, 2; Burgundy pitch, 6 : lead plaster, 76. AMMONIAC. 43I Galbanum is contained in Pilulge Galbani Composite, Emplastrum Asa- fcetidge ; see Asafoetida, p. 429. Action and Therapeutics. Galbanum acts like other substances containing volatile oils ; it is usually combined with ammoniacum or asafetida. It is used externally as a plaster for its irritant effect, to aid the absorption of old inflammatory products, and internally it is given with asafetida as a carminative. AMMONIACUM. AMMONIAC. — A gum-resin obtained from the stem (after being punctured by beetles) of Dorema Amt?toniacum (Nat. Ord. Umbelliferce), Persia and the Punjaub. Characters. — Small roundish tears, or masses of agglutinated tears ; pale brown externally, darkening on keeping, milky white and opaque inter- nally. Hard and brittle when cold, with a dull waxy fracture, but softening with heat. Odor faint, peculiar, non-alliaceous. Taste bitter, acrid. Forms a nearly white emulsion with water. Resembling ammoniacum. — Asafoetida, galbanum, benzoin, known by odor. Composition. — The chief ingredients are — (1) Volatile oil, 4 per cent. (2) Resin, 70 per cent. (3) Gum, 20 per cent. Dose, 5 to 30 gr. Preparations. 1. Emplastrum Ammoniaci. — Ammoniac, 100; diluted acetic acid, 140. By digestion, and evaporation. 2. Emplastrum Ammoniaci cum Hydrargyro. See Mercury, p. 73. 3. Mistura Ammoniaci. — Ammoniac, 4; water added gradually to 100. It forms a milk-like emulsion. Dose, ^ to 1 fl. oz. Action and Therapeutics. The actions of ammoniacum are precisely the same as those of volatile oils generally. It is employed externally to aid, by its mildly irritating effects, the absorption of chronic inflammatory products, and internally in chronic bronchitis with offensive ex- pectoration for the sake of the remote disinfectant expectorant effect that it has, in the course of its excretion through the bron- chial mucous membrane. 432 ORGANIC MATERIA MEDICA. MYRRHA, MYRRH. — A gum-resin obtained from the stem of Balsamodendron Myrrha (Nat. Ord. Burseracece). Collected in Arabia and Abyssinia. Characters. — Roundish or irregularly formed tears or masses of agglu- tinated tears, varying very much in size. Externally reddish-brown or reddish- yellow ; dry, covered with a fine powder; brittle. Their fractured surface is irregular, somewhat translucent, and oily. Odor agreeable, aromatic. Taste aromatic, acrid, bitter. Insoluble in water; when rubbed up with it, forms an emulsion. Composition. — The chief constituents are — (i) Myrrhin, a resin, 35 per cent. (2) Myrrhol (C 10 H u O), a volatile oil, 2 per cent. (3) Gum, 60 per cent. (4) A bitter principle. Impurities. — Many varieties of gum and gum-resins. Dose, 5 to 30 gr. Preparations. 1. Tinctura Myrrhae. — Myrrh, 20; by maceration with alcohol and filtration to 1 00. Dose, % to 1 fl. dr. 2. Pilulae Aloes et Myrrhae. See Aloes, p. 379. Myrrh is contained in Mistura Ferri Composita, Pilulae Rhei Com- positae, Pilulae Ferri Compositae, Pilulae Galbani Compositae, and Tinctura Aloes et Myrrhae. Action. External. — Both externally and internally, myrrh has the same action as other substances containing a volatile oil. It is a mild disinfectant, and a stimulant to sores and ulcers. Internal. — It has the same effects in the mouth. It is a stomachic carminative, exciting the appetite, the flow of gastric juice, and the vascularity and peristalsis of the stomach and intestines. The number of leucocytes in the blood is said to be increased by the administration of myrrh. It is excreted by mucous membranes, especially the genito-urinary and the bron- chial, and it stimulates and disinfects their secretions in its pass- age through them.. Thus it becomes an expectorant, a uterine stimulant, and an emmenagogue. balsam of peru. 433 Therapeutics. External. — Occasionally myrrh has been employed as a stimulant to sores and ulcers. Internal. — It is, in the form of ^ 3 °f tne tincture diffused through 5j of water, used as a mouth wash and gargle for sore spongy gums, relaxed throat, and other similar conditions, for which it is often combined with borax, as in the following formula : — Myrrh, 1 ; eau de Cologne, 16 ; borax, 1 ; water, 3 ; syrup, 3. It is frequently given with purgatives for the sake of its carminative and stomachic properties. It is also commonly combined with iron when this drug is given for anaemia, but the reason for this is not clear. It is prescribed for amenorrhoea, and has been given for cystitis, and as a disinfectant expectorant for chronic bronchitis. Class IV of Volatile Oils. Those used chiefly for their action on the bronchial mucous membrane. BALSAMUM PERUVIANUM. BALSAM OF PERU. — A balsam exuded from the trunk of Myroxy- lon Pereirce (Nat. Ord. Leguminosce), after the bark has been beaten, scorched, and removed. From Salvador in Central America. Characters. — A liquid about as viscid as treacle, nearly black in bulk ; in thin layers orange or reddish brown, and transparent. Odor balsamic. Taste disagreeable, burning. Insoluble in water, soluble in chloroform or spirit. Sp. gr. 1. 135 to 1.150. Composition. — The chief constituents are— (1) A volatile oil. This is present in large quantities; it consists of cinnamon (cinnamate of benzyl), styracin (cinnamate of cinnamyl), C 8 H 7 COOC 9 H 9 , peruvin (benzyl alcohol), styrone (cinnamic alcohol), and benzoate of benzyl. (2) Cinnamic acid, C 8 H 7 COOH (see p. 414). (3) Benzoic acid. (4) Resins. Dose, 10 to 30 m. or more, made into an emulsion with mucilage or yolk of egg. Action and Therapeutics. External. — Like most substances containing a volatile oil, balsam of Peru is a disinfectant, and also a stimulant when rubbed into the skin or applied to raw surfaces. Formerly it was much used for these purposes, chiefly as an application to indolent sores 37 434 ORGANIC MATERIA MEDICA. and chronic eczema. A mixture of balsam of Peru x part, lard 7 parts, is very useful for sore nipples and cracked lips. Now it is not often employed externally except as antiparasitic for pediculi, scabies, and ringworm. An ointment consisting of balsam of Peru 20, olive oil 50, petroleum 100 parts, may be used. For scabies it should be applied in the way already described for sulphur ointment ; it is a more agreeable preparation. Internal. — Like most volatile oils it is carminative and stom- achic, and after absorption is excreted by, and stimulates and dis- infects the mucous membranes. For this reason it is used as an expectorant in chronic bronchitis. It is also excreted by the skin and the kidneys. BALSAMUM TOLUTANUM. BALSAM OF TOLU. — A balm which exudes from the trunk of Myroxylon toluifera (Nat. Ord. Leguminosce) after incisions have been made into the bark. New Granada. Characters. — A reddish-yellow, soft, tenacious solid, becoming hard by keeping and brittle in the cold. A lens shows microscopic crystals of cinnamic acid. Very fragrant odor. Taste aromatic. Soluble in spirit, not in water, Composition. — The chief constituents are— (1) Toulene (C 10 H 16 ). (2) Benzoic acid. (3) Cinnamic acid. (4) Resins. Dose, 10 to 20 gr. as an emulsion with mucilage or yolk of egg. Preparations. 1. Syrupus Tolutanus. — Balsam of Tolu, 4; and sugar 65; dis- tilled water to 100. (Contains very little tolu, as that is almost insoluble in syrup) . Dose, ^ to 1 fl oz. 2. Tinctura Tolutana. — Balsam of Tolu, 10. By maceration with alcohol and filtration to 100. Dose, 1 to 2 fl. dr. The tolu is precipitated by adding water, therefore it should be suspended with mucilage. Balsam of Tolu is contained in Pilulae Phosphori and Tinctura Benzoini Composita. Action and Therapeutics. Although it has an action in all respects similar to that of balsam of Peru, it is only used as an expectorant in cough mix- tures. STORAX, JUNIPER. 435 STYRAX. STORAX. — A balsam prepared from the inner bark of Liquidambar orien talis (Nat. Ord. Hamamelacece). Asia Minor. Characters. — A brownish-yellow, semi-fluid balsam. Odor strong, agreeable. Taste balsamic. Composition. -The chief constituents are — (1) Styrol, a volatile oil (C 8 H 8 ). (2) Cinnamic acid (C 8 H 7 COOH), colorless, odorless, crystalline, can be oxidized to benzoic acid, is also found in cinnamon, and balsams of Tolu and Peru. (3) Styracin, which is cinnamate of cinnamyl (C 8 H 7 - COOC 9 H 9 ). (4) Two resins. Dose, 5 to 20 gr. Storax is contained in Tinctura Benzoini Composita. Action and Therapeutics. Storax has the same action as balsams of Tolu and Peru and benzoin, and may be employed for the same purposes. It is not often given internally except in the compound tincture of benzoin. Mixed with an equal part of olive oil it may be used to kill the Scabies hominis and pediculi. Class V. of Volatile Oils. Those used chiefly for their action on the kidneys and genito-urinary tract. JUNIPERUS. JUNIPER. — The fruit of Juniperus communis. (Nat. Ord., Coniferce). Characters. — Nearly globular, about \ of an inch in diameter, dark purplish, with a bluish-gray bloom, a three-rayed furrow at the apex, internally pulpy, greenish-brown, containing three ovate, somewhat triangular, bony, seeds, with several large oil-glands on the surface ; odor aromatic ; taste sweet, bitterish and slightly acid. North Europe. OLEUM JUNIPERI.— A volatile oil distilled from juniper. Characters. — Colorless or pale yellow. Odor characteristic. Taste warm, aromatic. Sp. gr. about 0.870. Soluble in 12 parts of alcohol. Composition. — Oil of juniper is a terpene isomeric with oil of turpentine, ^10^16* Dose, 2 to 10 m. Preparations. 1. Spiritus Juniperi. — Oil of juniper, 3; alcohol, 97. Dose, 30 to 60 m. 436 ORGANIC MATERIA MEDICA. 2. Spiritus Juniperi Compositus. — Oil of juniper, 10; oil of caraway, 1 ; oil of fennel, I ; alcohol, 3000 ; water to 5000. Dose, 1 to 4 fl. dr. Action. Oil of juniper has much the same action as oil of turpentine; but it is not so liable to upset the digestion ; and although it is a powerful renal stimulant and diuretic it does not easily cause haematuria and albuminuria. Therapeutics. It is not used externally. Occasionally it is given as a pleas- ant carminative and stomachic, but its main use is as a diuretic in heart disease, hepatic ascites, and chronic Bright' s disease. It certainly markedly increases the quantity of the urine, which it causes to smell like violets. As a constituent of Hollands and gin, these are good forms of alcohol for persons suffering from the above diseases. BUCHU. BUCHU. Synonym,. — Bucco. The leaves of — (1) Barosma betulina. (2) Barosma crenulata. (3) Barosma serratifolia (Nat. Ord. Rutacece). Cape of Good Hope. Characters. — Smooth, dull yellowish green, marked on the margins, especially the under surface, with oil-glands; peculiar strong odor; aromatic, mint-like taste. (1) The leaf of B. betulina is ^ in. long, cuneate or rhomboid-ovate, serrate-dentate, apex very blunt and usually recurved, texture more cartilaginous than the other species. (2) The leaf of B. crenulata is I in. long, oval-oblong, somewhat blunt at apex, narrowed at base into dis- tinct petiole, finely serrate or crenate-serrate. (3) The leaf of B. serratifolia is 1% in. long, linear-lanceolate, equally tapering at each end, apex truncate, sharply and closely serrate. Texture thin. Resembling buchu. — Senna and Uva Ursi, which have entire leaves. Impurity. — Leaves of Emplanum serrulatum (for B. serratifolia), which have no glands. Composition. — The chief constituents are — (1) A yellowish-brown volatile oil from the glands ; it consists of stearoptene (barosma camphor) in solution in a liquid hydrocarbon. The stearoptene is deposited on exposure to air. (2) A bitter principle. (3) Mucilage. Dose, 15 to 30 gr. copaiba. 437 Preparation. Extractum Buchu Fluidum. — Buchu by maceration and perco- lation in alcohol and water, evaporation. Dose, 15' to 30 m. Action and Therapeutics. A medicinal dose of buchu causes a slight feeling of warmth in the stomach, and a large one gives rise to vomiting. The vola- tile oil diffuses into the blood and is excreted by the bronchial mucous membrane, which it stimulates, and buchu is therefore occasionally given as an expectorant". Most of the oil is excreted by the kidney, which is also stimulated, and thus buchu is a mild diuretic. In the process of excretion it gives a peculiar odor to the urine, and acts as an astringent and disinfectant to the urinary tract, especially the bladder. It has consequently been administered for cystitis, irritable bladder, pyelitis, gonorrhoea, &c. Large doses continued for a long time are said to damage the kidney. The infusion contains very little of the oil. The fluid extract does not mix well with water on account of the oil in it. The action of the buchu is much the same as that of pareira, but it is pleasanter to take, and is a good vehicle for diuretics. COPAIBA. COPAIBA. — Copaiva. The oleo-resin obtained by deeply cutting or boring into the trunk of Copaifera Langsdorffii (Nat. Ord. Leguminosce), and other species of Copaifera. Valley of the Amazon, West and East Indies. Characters. — A more or less viscid liquid, generally transparent and not fluorescent, but some varieties are opalescent and slightly fluorescent; light yellow to pale golden brown. Odor peculiar, aromatic; taste acrid, bitter. Sp. gr. 0.940 to 0.993. Solubility. — Not at all in water, almost entirely in absolute alcohol, ether, fixed and volatile oils, benzol, and in four times its bulk of petroleum. Composition. — The chief constituents are — (1) The officinal volatile oil, 48 to 85 per cent, (see below). (2) The resin, 16 to 52 per cent. It exists dissolved in the oil. Dose, 10 to 20 gr. It is a brown resinous mass consist- ing of two resins: (a) copaivic acid (C 10 H 30 O 2 ),the chief constituent, a crystal- line resin, with a faint odor, a bitter taste, insoluble in water, easily soluble in absolute alcohol and ammonia; (6) a non-crystallizable viscid resin, \ l / 2 per cent. 438 ORGANIC MATERIA MEDICA. Impurities. — Turpentine, detected by the smell on heating. Fixed oils ; these leave a greasy ring round the resinous stain when heated on paper. Gur- jun balsam, which coagulates at 270 F.; copaiba does not. Dose, % to 1 fl. dr. in two and a half times as much mucilage of acacia. Preparation. Massa Copaibse. — Copaiba, 94; magnesia, 6. Dose, }( to 1 dr. OLEUM COPAIBA. Source. — The volatile oil distilled from Copaiba. Characters. — Colorless or pale yellow, with the taste and odor of copaiba. It is isomeric with turpentine, C 10 H 16 . Sp. gr. about 0.890. Dose, 5 to 20 m. suspended in mucilage of acacia (1^ fl. oz. for every fl. oz. of oil of copaiba) or yolk of egg. Cinnamon or peppermint water, with tincture of orange or ginger, covers the taste. It may be dissolved in alcohol and in water with the aid of Liquor Potassae, with which it forms a soap, or it may be given in capsules. RESINA COPAIBA.— The residue left after distilling off the volatile oil from Copaiba. Characters. — A yellowish or brownish-yellow, brittle resin, of a weak odor and taste of copaiba, and an acid reaction. Soluble in alcohol or amylic alcohol. Dose, 5 to 15 gr. Action. External. — Copaiba is a stimulant to the skin. Internal. — Gastro-intestinal tract. — It acts like other volatile oils. Small doses produce a feeling of warmth in the epigastrium, but with large doses its irritant effect leads to vomiting and diar- rhoea. Its taste is nasty, and the eructations it may cause are very disagreeable. Mucous membranes, — Here also it acts like other volatile oils. It is quickly absorbed, and then is excreted by all the mucous membranes, which it stimulates in its passage through them, in- creasing their vascularity and the amount of their secretion, which if foul is disinfected. Because of these actions it is a disinfectant expectorant, and a stimulating disinfectant to the whole of the genito-urinary tract. It imparts a powerful odor to the breath and mucous secretions. It is also excreted by the skin, and COPAIBA. 439 its irritant effect here is seen in the erythematous rash it often produces. Kidneys. — Copaiba has a more marked action on the kidneys than most substances containing volatile oils, and this is in great part due to the resin, which is particularly stimulating to the renal organs, and copaiba is therefore diuretic. Large doses of it greatly irritate the kidney, as is shown by pain in the loins and blood and albumen in the urine The resin itself is excreted in the urine, and can be thrown down from it by nitric acid ; but this precipitate is known not to be albumen by the fact that it is evenly distributed through the fluid and is dissolved by heat. If the renal congestion is severe, the urine may be very scanty. Therapeutics. Gent 'to-urinary tract. — Copaiba, or more usually its oil, is largely used to stimulate and disinfect this part of the body in cases of pyelitis, vaginitis, and gonorrhoea. It is often prescribed for this last disease, and is best given when the acute symptoms have subsided, otherwise it may increase them. Kidneys. — The resin which remains after distillation of the oil from copaiba is an admirable diuretic for hepatic and cardiac dropsy, but because of its liability to irritate the kidneys should not be given in Bright' s disease. After a time patients seem to become accustomed to it, for the diuresis is not so marked as at first. It is nasty and difficult to make palatable. Fifteen grains of the resin with 20 minims of alcohol, 15 grains of tragacanth powder to suspend it, and a fluid drachm of syrup of ginger in an ounce of water may be given for a dose. Bronchial mucous membrane. — Copaiba is occasionally used as a disinfectant expectorant when the secretion is very foul — as, for example, when the bronchial tubes are dilated. Skin. — Copaiba has been given in chronic skin diseases, as psoriasis, for the cutaneous stimulation caused by it, but it is now quite discarded. The reasons why it is rarely used except in gonorrhoea, for which it would not be employed if it had not such a strongly 440 ORGANIC MATERIA MEDICA. marked beneficial action, are that the smell of the breath of those taking it is very disagreeable, it is very nasty to the taste, and often causes indigestion. CUBEBA. CUB EB.— The unripe full-grown fruit of Cubeba officinalis (Nat. Ord. Piperacece). Java. Characters. — Globular, y^ in. in diameter, blackish or grayish-brown, wrinkled, tapering below into a rounded stalk, continuous with the pericarp. Beneath the skin is a hard, brown, smooth shell, in which in the mature fruit is the seed, but in commercial specimens this is so little developed that the peri- carp is almost empty. Odor aromatic. Taste warm, aromatic, bitter. Resem- bling cubeb. — Pepper and pimenta ; neither has a stalk. Composition. — The chief constituents are — (i) The officinal volatile oil y 6 to 15 per cent. (q. v.). (2) The officinal oleo-resin (q. v.), 6 per cent., which contains much cubebic acid and cubebin. (3) Cubebin, a tasteless, insoluble, odorless substance. (4) Cubebic acid. (5) A little piperine. Dose, 30 to 60 gr. Preparations. 1. Extractum Cubebae Fluidum. — Cubeb by maceration and percolation with alcohol and evaporation. Dose, y 2 to 1 fl. dr. 2. Oleoresina Cubebae. — A thick, viscid fluid. Source. — Percolate cubeb with stronger ether; evaporate the ether. Let the residue stand, and decant the oleo-resin off from the sediment. Dose, 5 to 30 m. 3. Tinctura Cubebae. — Cubeb, 10 ; by maceration and percola- tion with diluted alcohol to 100. Dose, y 2 to 3 fl. dr. 4. Trochisci Cubebae. — Oleoresin of cubeb, 50; oil of sassa- tras, 15; extract of glycyrrhiza, 400; acacia, 200; syrup of tolu, a sufficient quantity, to make 1 00 troches. Each troche contains y 2 mimim of the oleo-resin. Dose, 1 to 6. OLEUM CUBEBiE. Source. — The volatile oil distilled from cubeb. Characters — Colorless or greenish-yellow, with the odor and taste of cubeb. Sp. gr. about 0.920. Soluble in equal weight of alcohol. CUBEB. 44I Composition. — The chief constituents are — (1) Cubebene, a stereoptene like camphor. (2) Cubeben (C 15 H 24 ), a liquid oil. (3) A small amount of a terpene. Dose, 5 to 20 m. suspended in mucilage. Action. External. — Like other substances containing a volatile oil, cubeb is rubefacient when rubbed into the skin. Internal. — Small doses are stomachic and carminative, and improve digestion, but moderate doses are very liable to cause dyspepsia. Cubeb enters the blood, and, like many volatile oils, slightly stimulates the heart, and also excites the organs through which it is excreted. Occasionally, therefore, it causes an erythematous eruption on the skin; it increases and disinfects the bronchial secretion, and is consequently an expectorant ; but its main action is on the genito-urinary passages, the mucous membrane of which is powerfully stimulated, and the secretions of which are disinfected. The kidneys are also irritated, hence cubeb is a diuretic. It appears in the urine in a form (prob- ably as a salt of cubebic acid) which may be precipitated by nitric acid. Therapeutics. It is sometimes employed as lozenges, or as a powder, or as the smoke of cubeb cigarettes, to stimulate the mucous membrane in cases of slight bronchitis, chronic sore throat, or follicular pharyngitis. Chronic nasal catarrh and hay-fever have been treated by insufflations of the powder. Asthma is sometimes re- lieved by the cigarettes. Many popular bronchial troches contain cubeb; in them it exercises its expectorant action. Cubeb is rarely used as a stomachic or cardiac stimulant, because it is so liable to upset digestion ; but as it is less likely to do so than copaiba, is a little pleasanter to take, and is almost as powerful a stimulant to the genito-urinary mucous membrane, it is largely used in gleet, gonorrhoea, and chronic cystitis. OLEUM SANTALI. OIL OF SANDAL WOOD. Synonym.— Santal oil. The volatile oil distilled from wood of Santalum album (Nat. Ord. Santalacece) . India. 38 442 ORGANIC MATERIA MEDICA. Characters. — Thick, pale yellow. Odor strongly aromatic. Taste pungent, spicy. Readily soluble in alcohol, ether, or chloroform. Sp. gr. about 0.945. Composition. — Not known. Dose, 2 to 10 m. in capsules, or as an emulsion. Action and Therapeutics. The action of sandal-wood oil is the same as that of volatile oils in general, but, like that of the oils of copaiba and cubebs, it is especially manifested in the genito-urinary mucous membranes, which are stimulated and disinfected. The drug is used in gonorrhoea and gleet ; it is pleasanter than copaiba, but more expensive. It appears in the urine half an hour after administration. Some of it is excreted by the bronchial mucous membrane; it is, therefore, a stimulating disinfectant expecto- rant. Two or three drops on sugar will frequently relieve the hacking cough so often met with when but little sputum is ex- pectorated. MATICO. MATICO. — The leaves of Artanthe elongata (Nat. Ord. Piperacece). Peru. Characters. — A mass of broken, folded, compressed leaves, stems, flowers, and fruit. Leaves 4 to 6 in. long, short, petiolate, oblong-lanceolate, pointed, unequally heart-shaped, very finely crenulate, tesselated above. Veins prominent beneath, the depressions being clothed with hairs. Odor pleasant, feebly aromatic. Taste aromatic, bitter. Resembling Matico leaves. — Digitalis leaves (See p. 319). Composition. — The chief constituents are — (1) Volatile oil, i}i per cent. (2) A soft green resin. (3) Maticin, a bitter principle. (4) Artanthic acid. (5) Tannic acid. Preparations. 1. Extractum Matico Fluidum. — Matico, by maceration and percolation with glycerin, alcohol, and water, and evaporation. Dose, y z to 2 fl. dr. 2. Tinctura Matico. — Matico 10, by maceration and percolation with diluted alcohol to 100. Dose, V 2 to 1 fl. oz. savine. 443 Action. The volatile oil of matico probably has much the same action as that of cubeb, influencing chiefly the geni to -urinary passages. It has been given for the same cases, but is rarely used. The leaves are sometimes placed upon a bleeding surface. Their numerous hairs promote the clotting of the blood, and thus they are haemostatic. Class VI of Volatile Oils. Those used chiefly for their action on the female genital organs. SABINA. SAVINE. — The tops of Juniperus Sabina (Nat. Ord. Coniferce), col- lected in the spring. Britain. Characters. — Twigs densely covered with minute, imbricated, appressed, dark green leaves, with a large oval depressed central gland on their back. Odor, when bruised, strong and peculiar. Taste bitter, and disagreeable. Composition. — The chief constituent is the officinal volatile oil (see below). Dose, 5 to 15 gr. in powder. Preparations. 1. Extractum Sabinae Fluidum. — Savine, by maceration and percolation with alcohol and evaporation. Dose, 5 to 15 m. 2. Ceratum Sabinae. — Fluid extract of savine, 25 ; resin cerate, 90. OLEUM SABINAE. Source. — A volatile oil distilled from savine. Characters. — Colorless or pale yellow. Soluble in alcohol. Odor and taste as of savine. Sp. gr. about 0.910. Composition. — It contains several terpenes. Dose, 1 to 5 m. Action. Oil of savine has the same actions as oil of turpentine, but they are more marked. Thus externally it causes great redness, pain, vesication, and even pustulation. Internally it may pro- duce severe gastro -intestinal irritation, with vomiting, abdominal pain and purging. In its excretion through the kidneys and the mucous membranes of the genito-urinary tract it severely irritates 444 ORGANIC MATERIA MEDICA. them ; thus hematuria, scanty urine and pain on micturition may follow its use. The point in which the action of oil of savine differs from that of the oil of turpentine is that it powerfully irri- tates the ovaries and uterus, causing hyperaemia of them and accelerating menstruation. It also induces contractions of the pregnant uterus, and therefore it is an ecbolic. Therapeutics. The cerate has been used as a powerful irritant and counter- irritant, and internally savine may be given as an emmenagogue ; but, on the whole, its use is to be discouraged, as it is so liable to cause serious gastro-enteritis. It has often been administered as an ecbolic with criminal intent. OLEUM RUTiE. OLEUM RUT^E.— Oil of Rue. The volatile oil distilled from the fresh herb of Ruta graveolens (Nat. Ord. Rutacece). Britain. Characters. — A light yellow oil, becoming brown on keeping. Taste sharp, bitter. Odor aromatic, disagreeable. Soluble in equal weight of alco- hol. Sp. gr. about 0.880. Composition. — It is a mixture of several volatile oils. Dose, 1 to 3 m. Action and Therapeutics. External. — Oil of rue is irritant and vesicant. Internal. — In large doses it is a powerful gastro-intestinal irritant. It is hardly ever used for these purposes. It is elimi- nated in, and may be recognized by its odor in the urine, breath and perspiration. It is irritant to the kidneys, ovaries and uterus, and excites the menstrual flow; consequently it is given in amenorrhcea. From its stimulating action on the uterus rue has been used as an abortifacient, and fatal cases of poisoning from gastro-intestinal irritation have been recorded. It is very rarely given as a medicine. In all points its action resembles that of savine. TANACETUM. TANSY. — The leaves and tops of Tanacetum vulgare (Nat. Ord. Corn- positce), Europe, United States. CALUMBA. 445 Characters. — Leaves about 6 in. long; bipinnatifid, the segments ob- long, obtuse, serrate or incised, smooth, dark green and glandular; flower- heads corymbose, with an imbricated involucre, a convex, naked receptacle, and numerous yellow, tubular florets ; odor, strongly aromatic ; taste, pungent and bitter. Composition. — (i) Tanacetin. Symbol, C 11 H 16 4 . (2) Tannic acid. (3) Volatile oil. Dose, jl to 1 dr. Uses. Tansy possesses the properties of an aromatic bitter, and is an irritant narcotic. It has been used as an abortifacient, but is dangerous in large doses, several fatal cases having been recorded. GROUP VII. Vegetable Bitters. All these substances contain a bitter principle, which stimulates the functions of the stomach. Calumba, Calamus, Gentian, Quassia, Cascarilla, Chirata, Serpen- taria, Anthemis Matricaria, Cimicifuga, Taraxacum, Orange Peel, Orange Flowers. CALUMBA. COLUMBO. — The transversely cut disks of the root of Jateorhiza Calumba (Nat. Ord. Menispermacece). From the forests of Eastern Africa north of the Zambesi. Characters. — Flat, more or less circular disks about 2 in. in diameter, and *4 to yi, in. thick. Cortical part thick, with a wrinkled brownish-yellow coat. Center softer, concave and grayish yellow; there is a fine dark line between the two parts. Mealy fracture. Musty odor ; bitter taste. Composition. — The chief constituents are — (1) Calumbin (C 21 H 22 7 ), a neutral bitter principle crystallizing in white needles. (2) Berberine, an alka- loid (see p. 365), giving the yellow color. (3) Calumbic acid. (4) Starch, 33 per cent. No tannin is present, so calumba can be prescribed with salts of iron. Dose, 5 to 20 gr. Preparations. 1. Extractum Calumbae Fluidum. — Calumba. By maceration and percolation in diluted alcohol, and evaporation. Dose, 5 to 30 m. 446 ORGANIC MATERIA MEDICA. 2. Tinctura Calumbse. — Calumba, 10. By maceration and per- colation in alcohol and water, and evaporation. Dose, 1 to 4 fl. dr. Action. External. — Calumba is a mild antiseptic and disinfectant. Internal. — Mouth. — Calumba is a typical bitter ; the appe- tite is sharpened because the gustatory nerves are stimulated; this reflexly leads to dilatation of the gastric vessels and to an in- crease in the gastric and salivary secretions. Stomach. — The effects on the gastric mucous membrane which were brought about reflexly by the stimulation of the gustatory nerves are further exaggerated by the arrival of the saliva in the stomach, and by the direct action of the calumba on it. The result is to cause a feeling of hunger, an extra secretion of gastric juice and greater vascular dilatation, and all this helps the digestion of the food. Peristalsis in the stomach and intestine is made slightly more active, and thus calumba is carminative. Injected into the rectum it is anthelmintic, destroying the threadworm. Therapeutics. Calumba is only employed to stimulate the gastric functions and improve the appetite in cases of chronic indigestion due to a general weakness of action on the part of the stomach. It is thus a type of the large class of stomachics. It is especially valuable in that form of dyspepsia in which the stomach participates in a general feebleness of all the organs of the body, such as we see in anaemia, starvation, convalescence from acute diseases, tuber- culosis and general exhaustion. Bitters should never be used when there is acute or subacute gastritis, a gastric ulcer or pain. They will obviously make all these conditions worse. They must not be too concentrated, nor given for too long, lest they should over-irritate the stomach. They should always, as far as possible, be combined with modes of treatment designed to relieve the cause of the dyspepsia. Often they are called tonics ; all that is meant by this is that, as they render the digestion of food more GENTIAN. 447 easy, the general health will improve. Most bitters, when given as rectal injections, are anthelmintics for the Oxyuris ver?nicularis. Half a pint of the infusion of calumba may be thrown into the rectum of an adult. CALAMUS. SWEET FLAG. — The rhizome of Acorus Calamus (Nat. Ord. Ara- cea). United States. Characters. — Well known. Composition — The chief constituent is acorin, a glucoside. Symbol, Preparation. Extractum Calami Fluidum. — By maceration and percolation with alcohol, and evaporation. Dose, 15 to 60 m. Uses. Sweet flag is a simple bitter and feeble aromatic, and is used with advantage in pain or uneasiness in the stomach or bowels arising from flatulence or as an adjunct to purgative medicines. GENTIANA. GENTIAN. — The root of Gentiana lutea (Nat. Ord. Gentianacece), Central and Southern European mountains. Characters. — Cylindrical, tough, brittle pieces or longitudinal slices, a few inches to a foot or more long, ^ to I in. thick, with irregular longitudinal furrows ; pieces from the upper part of the root annularly wrinkled. Periphe- rally yellowish-brown ; centrally reddish-yellow. Bark thick, reddish. Wood spongy, separated from bark by dark zone. Odor heavy, peculiar. Taste first sweet, then bitter. Composition. — The chief constituents are — (1) Gentiopicrin, the active, very bitter glucoside, soluble in water and alcohol. Can be split up into glu- cose and gentiogenin. (2) Gentisic or gentianic acid united with gentio-pic- rin. (3) A trace of a volatile oil. (4) Gum and sugar. Gentian contains no tannin, but cannot be prescribed with iron, because that darkens the color- ing matter. Incompatibles. — Sulphate of iron, nitrate of silver, and lead salts. Preparations. 1. Extractum Gentianse. — By maceration and percolation with water and evaporation. Dose, 2 to 10 gr. 448 ORGANIC MATERIA MEDICA. 2. Extractum Gentianae Fluidum. — By maceration and perco- lation with diluted alcohol, and evaporation of residue. Dose, 5 to 30 m. 3. Tinctura Gentianae Composita. — Gentian, 8; bitter orange peel, 4; cardamom, 2. By maceration and percolation with diluted alcohol to 100. Dose, 1 to 4 fl. dr. Action and Therapeutics. Gentian has the same action as other bitters, such as calumba, and is employed for the same class of cases. It is more used than any other bitter, because its taste is pleasant and it is not astrin- gent. QUASSIA. QUASSIA. — The wood of Picrcena excelsa (Nat. Ord. Simarubacece). Jamaica. Characters. — In billets varying in size and covered with a dark gray bark. Wood dense, tough, porous, yellowish white. Generally seen as chips, shavings or raspings. Inodorous. Intensely bitter. Resembling quassia. — Sassafras, but this is aromatic and not bitter. Composition. — The chief constituents are — (1) Quassin, a bitter neutral principle occurring in crystalline needles. (2) A volatile oil. No tannin is present, and therefore quassia can be prescribed with salts of iron. Preparations. 1. Extractum Quassiae. — By percolation with water and evapo- ration, with addition of glycerin. Dose, y 2 to 3 gr. 2. Extractum Quassiae Fluidum. — By maceration and perco- lation with distilled alcohol and evaporate. Dose, % to I dr * Tinctura Quassiae. — Quassia, 10. By maceration and percola- tion with diluted alcohol to 100. Dose, yi to 2 dr. Action and Therapeutics. Quassia is an aromatic bitter stomachic, acting in the same way as calumba. As it contains no tannin it is often prescribed with iron. The only objection to it is that some persons find it CASCARILLA. 449 too bitter. Injected per rectum, it is an excellent anthelmintic for Oxyuris vermicularis ; half a pint of the infusion (i to 80 of cold water) may be given for this purpose. CASCARILLA. CASCARILLA. — The bark of Croton Eluteria (Nat. Ord. Euphor- biacece). Bahamas. Characters. — Quills of curved pieces, I to 3 or more in. long, \ to \ in. in diameter. Externally there is a silvery lichen, under that a dull brown, easily separable, corky layer. Fracture brown 7 short, resinous Odor agreeable, aromatic, especially when burned. Taste warm, bitter. Resembling cascarilla. — Pale cinchona, which is less white, smooth and small. Composition. — The chief constituents are — (1) Cascarillin, a bitter neutral crystalline substance. (2) Volatile oils. (3) Resins. (4) Tannin. Incompatibles. — Mineral acids. Lime water. Metallic salts. Action and Therapeutics. Because of its bitter principle cascarillin, cascarilla, like other vegetable bitters, improves the digestion, and this stomachic and carminative action is aided by the volatile oils in it. It is pleas- ant to take, and is suitable for the same cases as calumba. The infusion (1 to 10) will not keep good for more than a day unless the tincture (1 to 8) is added to it. Mineral acids precipitate the resin from the tincture ; therefore the infusion should be pre- scribed with them. CHIRATA. CHIRATA.— The plant Ophelia Chirata (Nat. Ord. Gentianacece), collected when the fruit begins to form. Northern India. Characters. — Root 2 to 3 in. long, generally unbranched. Stem 3 ft. or more long, rounded below, quadrangular above, branched dichotomously ; smooth, orange-brown or purplish ; consists of a thin, woody ring enclosing much yellow pith. Leaves ovate, 5-nerved. Flowers small, numerous, panicled. Odor none. Taste very bitter. Rese?tibling chiretta. — Lobelia, which is not bitter. Composition. — The chief constituents are — (1) Chiratin, an active bitter, amorphous principle. (2) Ophelic acid, with which it is combined. No tannin is present. Preparations. 1. Extractum Chiratae Fluidum. — By maceration and percola- tion with diluted alcohol and glycerin and evaporation. Dose, 45 O ORGANIC MATERIA MEDICA. 2. Tinctura Chiratae. Chirata, 10; by maceration and perco lation with diluted alcohol to loo. Dose, yi, to 2 fl. dr. Action and Therapeutics. Chirata has the same actions and uses as gentian, calumba, and other bitters. As it contains no tannin, it can be given with iron. It is more used in India than in England. SERPENTARIA. SERPENTARIA. Synonym.— Virginia Snakeroot. Source. — The rhizome and rootlets of Aristolochia Serpentaria and of Aristolochia reticulata. Nat. Ord., (Aristolochiacece). United States. Characters. — The rhizome is about I in. long, thin, bent ; on the upper side with approximate, short stem remnants ; on the lower side with numer- ous, thin, branching rootlets about 4 in. long ; dull yellowish-brown, internally- whitish ; the wood rays of the rhizome longer on the lower side ; odor aroma- tic, camphoraceous ; taste warm, bitterish and camphoraceous. The rootlets of Aristolochia reticulata are coarser, larger, and less interlaced than those of Aristolochia Serpentaria. Resembling Serpentaria. — Veratrum Viride, arnica, valerian, (q. v.). Composition. — The chief constituents are — (1) A bitter principle, aristol- ochin. (2) A volatile oil. (3) Resin. The rhizome deteriorates by keeping. Preparations. 1. Extractum Serpentariae Fluidum. — By maceration and percolation in alcohol and water, and evaporation. Dose, 10 to 30 m. 2. Tinctura Serpentariae. — Serpentaria, 10 ; by maceration and percolation with diluted alcohol to 1 00. Dose, y 2 to 2 fl. dr. Serpentaria is contained in Tinctura Cinchonae Composita. Action and Therapeutics. In the small doses in which serpentaria is given in medicine it is a bitter stomachic, acting just like calumba, and cascarilla, and it is used for the same class of cases. It is rarely pre- scribed alone. In large doses it produces vomiting and purging. Many virtues have been attributed to it which it does not possess. CIMICIFUGA. 45 1 ANTHEMIS. CHAMOMILE. — The flower-heads of Anthemis nobilis (Nat. Ord., Composite). Collected from cultivated plants. Europe. Character. — Subglobular, about ^ in. broad, consisting of an imbri- cated involucre and numerous white, strap-shaped, three-toothed florets, in- serted upon a chaffy, conical, solid receptacle ; a strong, agreeable odor ; and an aromatic, bitter taste. Dose, yi to 2 Uses. Chamomile is used as a mild stimulant for the languid appetite and general debility, which often attends convalescence from fevers. MATRICARIA. GERMAN CHAMOMILE. — The flower-heads of Matricaria Chamomilla (Nat. Ord., Composite). Europe. Characters. — About ^ in. broad, composed of a blackish, imbricate involucre, a conical, hollow, naked receptacle, about fifteen white, ligulate, reflexed ray-flowers, and numerous yellow, tubular, perfect flowers without pappus ; strongly aromatic and bitter. Resembling matricaria. — Anthemis arvensis and Maranta Cotula, but these have a conical, solid, and chalky receptacle. Dose, X I to ^ r - Uses. The properties and uses are identical with those of Cham- omile. CIMICIFUGA. CIMICIFUGA. — The rhizome and rootlets of Cimicifuga racemosa (also called Actea racemosa). The black snake-root or black cohosh (Nat. Ord. Ranunculaece). Northern United States. Characters. — Rhizome 2 to 6 in. long, ^ to 1 in. thick. Hard, brownish black, almost odorless ; bitter taste. On the upper surface remains of aerial stems; on the lower, wiry, brittle, branched rootlets, more or less broken off. It deteriorates by keeping. Composition. — The chief constituents are — (1) A volatile oil. (2) Tannic and gallic acids. (3) Two resins. Cimicifugin or macrotin is an impure resin deposited from the tincture on adding water. Preparations. 1. Extractum Cimicifugae Fluidum. — By maceration and per- colation with alcohol and evaporation. Dose, V2, to 3 fl. dr. 45 2 ORGANIC MATERIA MEDICA. 2. Tinctura Cimicifugse. — Cimicifuga, 20; by maceration and percolation with alcohol to 1 00. Dose, ]/ 2 to 2 fl. dr. Action. Cimicifuga has two chief actions. It influences the gastric secretion like any other bitter, and, to a slight extent, it depresses the rate but increases the force of the pulse, like digitalis. The arterial tension rises. It is said to cause contractions of the uterus and to increase the menstrual flow. Therapeutics. It has been used for chorea, dyspepsia, bronchitis, amenor- rhoea, rheumatism, neuralgia, and many other diseases. The evi- dence that it does any good is slight. TARAXACUM. TARAXACUM. Synonym. — Dandelion. The root of Taraxacum Dens-leonis (Nat. Ord. Compositce). Collected in the autumn from indigenous plants. United States. Characters. — About 12 in. long, y^ in. in diameter. Externally smooth, yellowish brown, Internally white. Short fracture. Milky juice. When dried is dark-brown, furrowed longitudinally, shrivelled. Fracture short, showing yellow, porous, woody axis, with irregular, concentric rings and a thick whitish bark. No odor. Taste bitter. Resembling taraxacum. — Pellitory, which is pungent when chewed. Impurity. — The root of the Ctchorium fntybus. Composition. — The chief constituents are — (1) Taraxacin, a neutral principle. (2) Taraxacerin. (3) Asparagin (found also in asparagus, marsh - mallow, liquorice, euonymus, &c.), of no therapeutical value. (4) Inulin, mannite, salts. (5) Resins (which give the juice its milky appearance). Preparations. 1. Extractum Taraxaci. — Fresh Taraxacum. By expression and straining and evaporation. Dose, 5 to 30 gr. 2. Extractum Taraxaci. — Taraxacum by maceration and per- colation in alcohol and water, and evaporation. Dose, 1 to 4 fl. dr. ORANGE. 453 Action and Therapeutics. Dandelion is a simple bitter, and acts as a stomachic, just like calumba. It is also slightly laxative. It was formerly much more used than at the present day. It has been said to stimulate the flow of bile, but this is incorrect. ORANGE PEEL. AURANTII AMARI CORTEX.— Bitter Orange Peel. The dried outer part of the rind or pericarp of Citrus vulgaris (Nat. Ord. Aurantiacece). Southern Europe. Characters. — Thin pieces or strips, dark brownish-green color, almost free from the white inner rind. Odor fragrant. Taste aromatic and bitter. AURANTII DULCIS CORTEX.— Sweet Orange Peel. The rind of the fruit of Citrus Aurantii (Nat. Ord. Aurantiacece). Characters. — Closely resembling bitter orange peel, but having an orange-yellow color. It has a sweetish, fragrant odor, and an aromatic, slightly bitter taste. Composition. — The chief constituents are — (i) A fixed oil, Oleum Corticis Aurantii, I to 2 per cent. It is isomeric with oil of turpentine. (2) A bitter crystalline principle, hesperidin. (3) Tannin, a small quantity. 1. Extractum Aurantii Amari Fluidum. — Bitter orange peel, by maceration and percolation with alcohol and water and evaporation. Dose, Yz to 1 fl. dr. 2. Tinctura Aurantii Amari. — Bitter orange peel, 20; by ma- ceration and percolation with diluted alcohol to 100. Dose, 1 to 2 fl. dr. 3. Syrupus Aurantii. — Sweet orange peel, 5 ; precipitated phos- phate of calcium, 1 ; alcohol, 5 ; sugar, 60. By maceration and addi- tion of water and filtration, to 100. Dose, as vehicle. 4. Tinctura Aurantii Dulcis. — Sweet orange peel, 20; by ma- ceration and percolation with alcohol to 100. Dose, 1 to 2 fl. dr. Bitter orange peel is contained in Tinctura Cinchonae Composita, Tinctura Gentianse Composita. AURANTII FLORES.— Orange Flowers. The partly expanded fresh flowers of Citrus vulgaris and Citrus Aurantium. 454 ORGANIC MATERIA MEDICA. Characters. — About y^ in. long; calyx small, cup-shaped, five-toothed, petals five, oblong, obtuse, rather fleshy, white and glandular-punctate ; sta- mens numerous, in about three sets ; wavy globular, upon a small disk, with a cylindrical style, and a globular stigma; odor very fragrant; taste aromatic and somewhat bitter. Preparations. i. Aqua Aurantii Florum. — Recent orange flowers, 40; by distillation with steam to 100. Dose, indeterminate. 2. Syrupus Aurantii Florum. — Orange flower water, 35; sugar, 65. Dose, indeterminate. OLEUM AURANTII CORTICIS.— A volatile oil extracted by mechanical means from fresh orange peel. Characters. — A pale, yellowish liquid, having the characteristic, aro- matic odor of orange, an aromatic, somewhat bitter taste, and a neutral reaction. Sp. gr. about 0.860. It is soluble in 2 parts of alcohol. Preparations. 1. Elixir Aurantii. — Oil of orange peel, 1 ; sugar, 100; by per- colation with cotton and alcohol and water, with solution of the sugar to 300. Dose, indeterminate. 2. Spiritus Aurantii. — Oil of orange peel, 6 ; alcohol, 94. Dose, indeterminate. Oil of Orange peel is contained in Spiritus Myrciae. OLEUM AURANTII FLORUM.— Oil of orange flowers. Synonym. — Oil of Neroli. A volatile oil distilled from fresh orange flowers. Characters. — A yellowish or brownish, thin liquid, having a very fragrant odor of orange flowers, an aromatic, somewhat bitterish taste, and a neutral reaction. Sp. gr. 0.850 to 0.890. Soluble in an equal weight of alcohol. // is contained in Spiritus Odoratus (q. v.). Action and Therapeutics. The various preparations of the orange are used largely as flavoring agents. They are slightly bitter and stomachic. GALL, TANNIC ACID. 455 GROUP VIII. Vegetable Drugs containing Tannic Acid. These are all astringent. Oak Bark, Nutgall, Catechu, Krameria, Kino, Haematoxylon, Ham- amelis, Rhus Glabra, Geranium, Rubus, Prinos, Rumex. QUERCUS ALBA.— White oak. The bark of the smaller branches and young stems of Quercus alba ( Nat. Ord. Cupuliferce) . Collected in spring from trees in United States. Characters. — In nearly flat pieces, deprived of the corky layer ; about % in. thick, pale brown ; inner surface with short, sharp, longitudinal ridges, tough; of a coarse, fibrous fracture, a faint, tan-like odor, and a strongly astringent taste. Composition. — The chief constituents are — (i) Querci-tannic acid, 4 to 20 per cent., a variety of tannic acid. (2) Quercin, a bitter principle. (3) Pectin, &c. Incompatibles. — See Tannic Acid. GALLA. — Nutgall. Excrescences on Quercus lusitanica (Nat. Ord. Cupuliferce), caused by the punctures and deposited ova of Cynips Gallce tinctoricB (Class, Insecta ; Order, Hymenopterd). Characters. — Hard, heavy, subglobular, ^ to ^ in. in diameter; tuberculated on surface ; the tubercles and the intervening spaces are smooth ; dark bluish green or dark olive-green externally ; yellowish or brownish white within, with small central cavity. Odor none. Taste first astringent, then sweetish. Composition. — The chief constituents are — (1) Tannic acid, 25 to 75 per cent. (2) Gallic acid, 2 to 5 per cent. Incompatibles. — See Tannic and Gallic Acids. Preparations, 1. Tinctura Gallae. — Nutgall, 20; by maceration with glycerine and diluted alcohol to 100. Dose, 1 to 2 fl. dr. 2. Unguentum Gallae. — Nutgall, 10; benzoinated lard, 90. ACIDUM TANNICUM.— Tannic acid. Synonym.— Tannin. C 14 H 10 O 9 . An acid extracted from galls. Source. — (1) Expose powdered galls to the damp for two or three days. 45 6 ORGANIC MATERIA MEDICA. (2) Add ether to form a paste, and let it stand. (3) Press this in linen, add more ether to the solid portion, and press again, (4) Mix the expressed liquids and slowly evaporate. Tannic acid remains. Characters. — Pale yellow vesicular masses or thin glistening scales. Taste strongly astringent. Reaction acid. Solubility. — Freely in water or alcohol; I in 3 of glycerine; I in 100 of ether. Gives a yellowish- white precipitate with gelatine (gallic acid does not). It is a first anhydride, formed from two molecules of gallic acid by the abstraction of water, 2C 7 H 6 5 — H 2 — C u H 10 O 9 , and is consequently digallic acid. Incompatibles. — Mineral acids, alkalies. Salts of antimony, lead, silver, per-salts of iron. Alkaloids, gelatine, emulsions. Dose, 1 to 2 gr. Preparations. 1. Collodium Stypticum. — Tannic acid, 20 ; alcohol, 5 ; stronger ether, 20; collodion, 55. By solution. 2. Trochisci Acidi Tannici. — Tannic acid, 100; sugar, looo; tragacanth, 25 grs. ; orange flower water, a 'sufficient quantity to make 100 troches. Each contains I gr. of tannic acid. Dose, 1 to 3. 3. Unguentum Acidi Tannici. — Tannic acid, 10 ; benzoinated lard, 90. Action. External. — Tannic acid is one of our most important drugs, because it coagulates albumen and gelatine with great readiness ; that is to say, it tans the tissues, for it is by coagulating the inter- stitial fluid in skins, that tannic acid converts them into leather. If an albuminous discharge is taking place from a sore or mucous surface and tannic acid is applied, the excreted fluid is coagu- lated, and the coagulum forms a solid protecting layer which pre- vents further discharge. As the tannic acid soaks into the tissues it coagulates the albuminous fluids there also, and this still further hinders the discharge of fluid, therefore it is an energetic as- tringent. If bleeding is taking place, tannic acid of course coagulates the blood as it flows and the clots plug the vessels ; at the same time the coagulum formed within the tissues, by its con- traction, constricts the blood-vessels, and thus tannic acid becomes a powerful haemostatic. Authorities differ as to whether it also contracts the blood-vessels by acting directly on them like lead, TANNIC ACID. 457 silver, ergot, etc., but probably it has no such action. Tannic acid is slightly antiseptic, and it is mildly depressant to sensory nerves. Like other acids it is irritant, but it is very feebly so, and consequently its action in this direction is more than count- erbalanced by its strongly astringent effects. Internal. — Gastro-intestinal tract. — Because tannic acid coagulates the mucous secretions and the fluids in mucous mem- branes, it makes the mouth dry when locally applied ; in the stomach and intestines it prevents the secretion of gastric and intestinal juices, and decreases the flow of mucus. For these reasons, and also because it precipitates pepsin, it interferes with digestion, In the intestine it is converted into gallic acid, but until this happens it can control gastric or intestinal bleeding. It is absorbed as gallic acid. Salts of tannic acid have no astrin- gent properties. Remote effects. — Gallic acid has no power to coagulate albumen, nor has it any astringent influence when locally applied, therefore it is difficult to believe that tannic acid has any remote astringent or haemostatic effects ; some claim that it has, but they have not proved their case. It is excreted in the urine as gallic and pyro- gallic acids. Many vegetable substances, as logwood, &c, depend, for their astringent properties, on the tannic acid they contain. Therapeutics. The therapeutical applications of tannic acid are very numer- ous. It is used as an astringent for ulcers, sores, various moist eruptions, tonsillitis, pharyngitis, nasal catarrh, otorrhcea, gastric catarrh, diarrhoea (large doses of 30 grains may be given, and catechu, logwood, &c, are favorite remedies), leucorrhoea, gonorrhoea, rectal ulcers, fissures, and prolapse, &c. It is employed as a haemostatic in bleeding from small wounds, ulcers, the gums, the pharynx, the nose, the stomach, the intestine, haemorrhoids, the bladder, &c. Whenever practicable a good method of application is to dust it on the part, especially for a haemorrhage; if this is gastric or intestinal, 30 grains or more should be frequently given by the mouth. For external use or 39 45 8 ORGANIC MATERIA MEDCIA. application to the throat the glycerine i in 5 is useful. A gargle of 3j of the glycerine to 5j of water may be made. The lozenges are convenient for pharyngitis. A spray (6 to 10 gr. in 5j of water) or an insufflation of tannic acid and starch maybe used for the mouth and larynx. The ointment of gall and opium, 1 to 14 of ointment of gall, is a favorite application for piles. The sup- positories (3 grains each) are useful for rectal discharges. Solutions of 10 gr. to 5j of water, may be injected into the urethra and bladder. The decotion of oak bark, employed as a rectal injec- tion, destroys the threadworm. ACIDUM GALLICUM.— Gallic Acid. HC 7 H 5 5 ,H 2 0. An acid prepared from gall [see Tannic Acid, p. 455). Source. — Boil one part of powdered gall with four parts of dilute sul- phuric acid, and strain. Gallic acid crystallizes out, and is purified with char- coal and recrystallization. Characters. — Pale triclinic prisms or silky needles. Taste slightly acid- ulous. Solubility. — I in 100 of cold water; I in 3 of boiling water; I in 4.5 of alcohol ; 1 in 5 of cold, I in 4 of hot glycerine. Incompatibles. — Per-salts of iron, and metallic salts generally ; Spiritus Athens Nitrosi. Dose, 5 to 20 gr. Preparation. Unguentum Acidi Gallici. — Gallic acid, to; benzoinated lard, 90. Action. Gallic acid has no power to coagulate albumen and therefore possesses none of the local properties of tannic acid. If it is wished to try to produce the supposed remote astringent effects of tannic acid, gallic acid may be administered, for tannic acid is in the intestine converted into it. CATECHU. CATECHU. — An extract prepared from the wood of Acacia Catechu (Nat. Ord. Leguminosce). Northern India. Characters. — In irregular masses, containing fragments of leaves, dark brown, brittle, somewhat porous and glassy, when freshly broken ; soluble in alcohol and partly soluble in water. It is nearly inodorous and has a strongly astringent and sweetish taste. CATECHU. 459 Composition — The chief constituents are — (i) Catechu-tannic acid (C 13 H 12 2 ), the active principle, isomeric with catechin, and converted into it by boiling or by the saliva, a red color being formed. (2) Catechin or catechuic acid, probably inactive. Both constituents give a green precipitate with per- salts of iron. Incompatibles. — Alkalies, metallic salts, and gelatine. Impurity. — Starch. Dose, 10 to 30 gr. Preparations. 1. Tinctura Catechu Composita. — Catechu, 12; cinnamon, 8; by maceration and percolation with diluted alcohol to 1 00. Dose, ^ to 2 fl. dr. 2. Trochisci Catechu. — Catechu, 100; sugar, 1000; tragacanth, 25 grains; orange flower water, a sufficient quantity to make 100 troches. Each troche contains 1 gr. Dose, 1 to 6. Action And Therapeutics. Catechu is a powerful astringent, acting in virtue of its tan- nic acid, and having a precisely similar action to it. It is used as a lozenge for sore throats, and the other preparation, the com- pound tincture is very efficacious for diarrhoea. KRAMERIA. KRAMERIA. Synonym. — Rhatany. The root of two officinal species ■ — (i)Peruvian rhatany, Krameria triandra ; (2) Savanilla rhatany, Krameria tormentosa (Nat. Ord. PolygalacecE). Peru and Brazil. Characters. — (1) Peruvian. — Branched or unbranched pieces of varying size. The bark separates easily ; it is 2V *° To m * thick, mostly rough and scaly ; dark reddish-brown externally, and bright brownish-red internally. Axis hard, brownish or reddish-yellow wood. (2) Savanilla. — Less irregular and not so long or thick ; bark smoother, thicker, more adherent and dark purplish or violet color. The bark of both kinds is strongly astringent, and tinges the saliva red. Composition. — The chief constituents are — (\)Rhatania-tannic acid (C 54 H 24 21 ) 20 to 45 per cent.; this is a kind of tannin. (2) Rhatannic red, the coloring matter. (3) Rhatannin, a neutral substance. Incompatibi.es. — Alkalies, lime water, salts of iron and lead, and gelatine. 460 ORGANIC MATERIA MEDICA. Preparations. 1. Extractum Krameriae. — By percolation with water and evaporation. Dose, 5 to 10 gr. 2. Extractum Krameriae Fluidum. — By maceration and perco- lation with glycerin, and diluted alcohol, and evaporation. Dose, 5 to 30 m. 3. Tinctura Krameriae. — Krameria, 20; by maceration and per- colation with diluted alcohol to 100. Dose, y 2 to 2 fl. dr. • 4. Trochisci Krameriae. — Extract of Krameria, 100 ; sugar, 1000; tragacanth, 25 grains ; orange-flower water, a sufficient quantity to make 100 troches. Each troche contains I gr. Dose, 1 to 6. 5. Syrupus Krameriae. — Fluid extract of Krameria, 35; syrup, 65. Dose, y 2 to 4 fl. dr. Action. The action of rhatany is due entirely to the tannic acid it contains. It is therefore a powerful astringent. Therapeutics. The powdered extract is the important ingredient of many tooth powders which are useful when the gums are liable to bleed. The infusion is an excellent gargle for a relaxed throat, and troches made of rhatany are also efficacious. Bleeding from the nose or the rectum may be stopped by applying powdered rhatany locally; the infusion (1 to 20) may be used as an injection in leucorrhoea or gonorrhoea. Any of the preparations, especially the fluid extract, are powerful astrigents for all varieties of diarrhoea, and may be taken to stop bleeding from the stomach and intes- tines. They are also given as remote haemostatics for haemop- tysis and haematuria, but they are not reliable for these purposes. KINO. KINO. — The juice obtained from incisions into the trunk of Pterocarpus Marsupium (Nat. Ord. Legziminosa?), inspissated without artificial heat. Malabar. LOGWOOD. 461 Characters. —Small, angular, glistening, reddish-black, brittle fragments- In thin pieces, and at the edges translucent and ruby-red. Inodorous. When chewed, sticks to the teeth and colors the saliva blood-red. Soluble in alcohol, partly in water. Composition. — The chief constituents are — (1) Kino-tannic acid, C 18 H 18 8 , 75 per cent. (2) Kinoin, a crystalline neutral substance. (3) Pyrocate- chin, C 6 H 4 (OH) 2 , a substance also found pathologically in the urine, and giving it a dark color. It reduces blue copper solutions. (4) Kino-red, formed from kino-tannic acid by oxidation. (5) Gum. Incompatibles. — Mineral acids, alkalies, all metallic salts, carbonates, gelatine. Dose, 5 to 30 gr. Preparation, Tinctura Kino. — Kino, 10; glycerin, 15. By maceration and nitration with water and diluted alcohol to 1 00. Dose, ^ to 2 fl. dr. Action and Therapeutics. Kino-tannic acid acts like tannic acid, and therefore kino is a powerful astringent. It is used in astringent gargles, and also in diarrhoea mixtures. H^MATOXYLON. LOGWOOD. — The sliced heart- wood of Hcematoxylon campechianum (Nat. Ord. Legttminosce). Campeachy, Honduras, and Jamaica. Characters. — The logs, in which form it is imported, are hard, heavy blackish-red externally, and internally reddish-brown. The chips are reddish- brown. Odor agreeable, peculiar. Taste sweetish, astringent. When chewed the saliva is colored reddish-pink. Resembling logwood. — Red. sandal-wood, which is more dense and less astringent. Composition. — The chief constituents are ( 1 ) Tannic acid. (2) Hema- toxylin (C 16 H 14 6 ), 12 per cent. Occurring in colorless crystals, which become dark-red on exposure to light. Solutions of it are used to stain histological specimens. Incompatibles. — Mineral acids, lime water, and tartar emetic ; metallic salts give a blue color. Preparation. Extractum Haematoxylon. — By maceration in water, boiling, straining, and evaporation. Dose, 5 to 15 gr. 462 organic materia medica. Action and Therapeutics. In virtue of its tannic acid logwood is a powerful astringent, and for this purpose is used to control diarrhoea of all sorts. It may be combined with other astringents, as chalk and opium. It does not easily produce constipation. It colors the urine and faeces dark red. One disadvantage of it is that it stains linen, if dropped on it. hamamelis. WITCHHAZEL.- The leaves of Hamamelis virginica (Nat. Ord. Hamamelacece). United States. Characters.— Short- petiolate, about 4 in. long, obovate or oval, slightly heart-shaped and oblique at the base, sinuate-toothed, nearly smooth ; inodor- ous; taste astringent and bitter. Composition. — The chief constituents are — (1) Tannin. (2) A volatile principle not yet isolated. (3) A little coloring matter. Preparation. Extractum Hamamelidis Fluidum. — By maceration and perco- lation with alcohol and water, and evaporation. Dose, y 2 to 2 fl. dr. Action and Therapeutics. Hamamelis, is, because of its tannic acid, astringent and haemostatic. The fluid extract is used for capillary haemor- rhage from wounds, for bleeding from the nose, the sockets of the teeth, the gums, or from piles, and it may be injected into the bladder in vesical haemorrhage. For all these purposes it is di- luted with water; the fluid may be any strength; 1 of the fluid extract to 10 or 20 of water is commonly employed. Locally ap- plied, hamamelis, either as the ointment (1 to 10) or a dilute fluid preparation, is used as an astringent in bruises, sprains, ■ pharyngitis, and nasal catarrh. The ointment is often used for piles. Given by the mouth, hamamelis may check diarrhoea, dysentery, etc. ; and it is reputed to be a remote haemostatic and astringent, but this is probably incorrect. RHUS GLABRA. SUMACH.— The fruit of Rhus glabra (Nat. Ord. Anacardiece). United States. CRANESBILL, BLACKBERRY. 463 Characters. — Sub-globular, about yfc in. in diameter, drupaceous, crim- son, densely hairy, containing a roundish-oblong, smooth putamen ; it is inodor- ous, and its taste acidulous. Composition. — The chief constituent is Tannin, which it contains from 6 to 27 per cent. Preparation. Extractum Rhois Glabrae Fluidum. — By maceration and perco- lation with glycerin and diluted alcohol, and evaporation. Dose, X to 1 fl. dr. Action and Uses. Sumac berries are astringent and refrigerant. The fluid ex- tract when diluted affords a very useful and effective gargle for inflammation and ulceration of the throat. GERANIUM. CRANESBILL. — The rhizome of Geranium maculatum (Nat. Ord. Geraniacece). United States. Characters. — Horizontal, cylindrical, 2 or 3 in. long, ^ in. thick, tu- berculated, longitudinally wrinkled, dark brown; bark thin; rootlets thin, fragile; inodorous; taste astringent. Preparation. Extractum Geranii Fluidum. — By maceration and percolation with glycerin, and diluted alcohol, and evaporation. Dose, ^ to 1 "fl. dr. Action and Uses. It is one of the best indigenous astringents, and is of great use in diarrhoeas and dysenteries, and in the various haemorrhages. RUBUS. BLACKBERRY. — The bark of the root of Rubus villosus, Rubus canadensis and Rubus trivia/is (Nat. Ord. Dryadece). United States. Characters. — In thin, tough, flexible bands, outer surface blackish or blackish -gray, inner surface pale brownish, sometimes with strips of whitish, tasteless wood adhering ; inodorous ; strongly astringent, somewhat bitter. Preparations. 1. Extractum Rubi Fluidum. — By maceration and percolation with glycerin, alcohol and water, and evaporation. Dose, V 2 to 2 fl. dr. 464 ORGANIC MATERIA MEDICA. 2. Syrupus Rubi. — Fluid extract of rubus, 20; syrup, 80. Dose, 1 to 2 fl. dr. Action and Uses. Dewberry and blackberry roots are tonic and slightly astrin- gent. They are used for diarrhoeas. PRINOS. BLACK ALDER. — The bark of Prinos verticillatus (Nat. Ord. Aqui- foliacece). United States. Characters. — Thin, slender fragments, about ^ in. thick, fragile ; outer surface brownish, ash-colored, with whitish patches and blackish dots and lines; the corky layer easily separating from the green tissue; inner surface pale greenish or yellowish ; fracture short, tangentially striate ; nearly inodor- ous, bitter, slightly astringent. Dose, ^ to 1 dr. Action and Uses. Black alder is considered tonic and astringent and has been proposed as a substitute for Peruvian Bark. It has been used in intermittent fever, diarrhoea and debility. RUMEX. YELLOW DOCK. — The root of Rumex crispus, and of other species of Rumex (Nat. Ord. Polygonacece). United States. . Characters. — From 8 to 12 in. long, about ^ in. thick, somewhat fusi- form, fleshy, nearly simple, annulate above, deeply wrinkled below ; externally rusty-brown, internally whitish, with fine, straight, interrupted medullary rays, and a rather thick bark; fracture short; odor slight, peculiar; taste bitter, astringent. Preparation. Extractum Rumicis Fluidum. — By maceration and percolation with diluted alcohol, and evaporation. Dose, % to 1 fl. dr. Action and Uses. Rumex is astringent, slightly tonic and alterative. It has been used in syphilis, scorbutic disorders, and cutaneous eruptions. SOAP. 465 GROUP IX. Vegetable Demulcent Substances. Olive oil, malt, chondrus, glycerin, oleic acid, althea, almond, tragacanth, acacia, cydonium, ulmus, liquorice, flaxseed, cetraria. OLEUM OL.IVJE. OLIVE OIL. — The fixed oil expressed from the ripe fruit of Olea eu- ropcsa (Nat. Ord. Oleacece). South Europe. Characters. — A pale yellow fluid. Odor faint. Taste oleaginous. Composition. — The two constituents are — (1) Olein, 72 per cent., a fluid oil, a compound of oleic acid and glyceryl, thus: C 3 H 5 (C 18 H 33 2 )3. (2) Pal- mitin, 28 per cent., a solid oil, a compound of palmitic acid, and glyceryl, C 3 H 5 (C 16 H 31 2 ^ 3 . The formula for oleic acid is C 18 H 34 2 ; and for palmitic, C 16 H 32 2 . Dose, ]A, to 1 fl. oz. Olive oil is contained in Emplastrum Plumbi and Unguentum Diachylon. SAPO. SOAP. — It is oleate of sodium, NaC 18 H 33 2 . Source. — Made by acting on olive oil with caustic soda, C 3 H 5 (C 18 H 33 2 ) 3 + 3 NaHO= 2 NaC 18 H 33 2 (hard soap)+C 3 H 5 (OH) 3 (glycerine). Preparations, 1. Emplastrum Saponis. — Soap, 10; lead plaster, 90; by solu- tion in water and evaporation. 2. Linimentum Saponis. Synonym. — Opodeldoc. Soap, 10; camphor, 5; oil of rosemary, I ; alcohol, 70; water to 100. SAPO VIRIDIS. GREEN SOAP. — A soap prepared from potassa and fixed oils, gener- ally from olive oil. It is an oleate of potassium. Preparation. Tinctura Saponis Viridis. — Green soap, 65; oil of lavender, 2; alcohol to 100, by filtration. Action and Therapeutics. External. — Olive oil is used to facilitate the rubbing of parts 5 for this purpose it is employed in massage. It is a com- 40 466 ORGANIC MATERIA MEDICA. mon soothing protective to burns and may be mixed with poultices to prevent their adhering to the skin. If rubbed in vigorously, it can be absorbed through the epidermis, and might be thus used as a food when nourishment cannot be given by the mouth. Internal. — For its soothing protective qualities it may be swallowed after corrosive poisons have been taken. It is an ex- cellent mild laxative, and can be given with food for this pur- pose. Some persons like it, with others it excites nausea and vomiting. An olive oil enema (olive oil, 4 5 ; warm mucilage of starch, 8 ^), or a soap enema (soap y 2 ^ ; warm water, 16 ^), is often used to open the bowels when a mild non-irritating in- jection is required. Large doses of olive oil are said to facilitate the expulsion of gall-stones, but this is very doubtful. Olive oil is a food, but it is not often used in this country as such. The history of fats and oils in the body is. discussed in works on physiology. MALTUM. MALT. — Synonym. — Byne. The seed of Hordeum distichum (Nat. Ord. Graminacea:), caused to enter the incipient state of germination by artifi- ficial means, and dried. It contains the ferment diastase, which can convert starch into dextrine and maltose. Thus io(C 6 H 10 O 5 )n-J-4nH 2 O==4nC 12 H 22 O n maltose +(C 12 H 20 O 10 )n, dextrine. Characters. — Is sweet, thick, brownish liquid, like honey. It forms an emulsion with oils. Composition. — This varies very much. The chief constituent is maltose (C 12 H 22 O n ) ; there is also some dextrine (C 12 H 20 O 10 ), some diastase (unless destroyed by boiling), albumens, the salts of barley, and sometimes alcohol. Preparation. Extractum Malti. — By maceration, dilution with water, straining and evaporation of the strained liquid. Dose, 1 to 4 fl. dr. Action and Therapeutics. Maltose is a very valuable food, especially for persons who are suffering from wasting diseases, and have a feeble digestion. It is easily retained by the stomach, even when, as often is the GLYCERIN. 467 case, in phthisis, other food, especially cod-liver oil, is rejected. In such a case a malt extract is an excellent substitute for cod- liver oil. Maltose as a food leads to the formation of fat. The diastase contained in malt extract, acting upon the starch in farinaceous food, converts it into dextrin and maltose, and thus if the secretion of saliva and pancreatic juice is feeble, the malt to some extent supplies their place. Like the ferments in pan- creatic juice and saliva, diastase can only act in an alkaline medium, and therefore should not be given until, at least, two hours after a meal. Emulsions of cod-liver oil in it are frequently useful. A mixture of extract of malt and iron is also valuable, (pyrophosphate of iron, 2 ; water, 3 ; dissolve and add extract of malt, 95. Dose, 1 to 4 fl. dr.). CHONDRUS. IRISH MOSS. — Chondrus crispus and Chondrus mammilosus (Nat. Ord. Algce). Ireland, United States. Characters. — Yellowish or white, hairy, translucent, many-forked; seg- ments flat, wedge-shaped or linear ; it has a slight seaweed odor, and a mucil- aginous, somewhat saline taste. Dose, 2 to 4 dr. Uses. Irish Moss is not only a demulcent but as well is a useful article of diet. GLYCERINUM. GLYCERIN.— C 8 H 6 (OH) 8 . Source. — It is a product of the manufacture of soap from fat (see p. 11), and should contain not less than 95 per cent, of absolute glycerin. Characters. — These are well known. It is soluble in water and alco- hol. Its sp. gr. is not less than 1.250. It is formed in the making of lead plaster (see p. 140). Dose, 5 to 60 m. Preparations. 1. Glyceritum Amyli.— Starch, 10 ; glycerin, 90. 2. Glyceritum Vitelli.— Fresh yolk of egg, 45; glycerin, 55. 3. Mucilago Tragacanthae. — Tragacanth, 6; glycerin, 18; by maceration with water and straining to 1 00. 468 ORGANIC MATERIA MEDICA. Glycerin is also contained in many extracts and fluid extracts, Massa Hydrargyri and Pilulae Phosphori. Action. External. — As glycerin is an excellent solvent for numer- ous bodies, such as iodine, bromine, alkalies, tannic acid, many neutral salts, alkaloids, salicin, &c, it is a good vehicle for ap- plying these substances to the skin and to sores. It does not evaporate nor turn rancid, and is powerfully hygroscopic. Internal. — In man the only visible effect produced by its administration is purging. This occurs with quite small doses if it is given by the rectum, but large doses are necessary if given by the mouth. It is absorbed from the alimentary canal, and is to a slight extent a food, for some of it is oxidized in the body. Sometimes its administration leads to the appearance in the urine of a body which reduces cupric oxide and gives the fermentation test for sugar. There has been much dispute as to whether glycerin can control nitrogenous metabolism, but it appears that it cannot in any way save the waste of nitrogenous tissues. It probably has some influence on the amount of glycogen in the liver. It has also been thought to prevent artificial glycosuria, but this is doubtful. Very large doses in animals cause the urine to be dark from the presence of the coloring matter of the blood, although there are no corpuscles in it \ they also lead to loss of muscular strength, lethargy, dryness of mucous membranes, collapse and death. Therapeutics. External. — Glycerin is much employed as a basis for appli- cations to the skin and the eye. . It is commonly used for chapped hands and slight excoriations. It is readily absorbed when rubbed into the skin, therefore it is a convenient vehicle for the absorption of substances by the skin. Belladonna mixed with glycerin is often rubbed in when we desire its local anodyne action {see p. 285). Internal. — As glycerin is sweet it is an excellent flavoring OLEIC ACID. 469 agent. It is demulcent, and is used as a vehicle for applying substances, such as tannic acid, to the throat. It is rarely given by the mouth for any medicinal virtue. It has been administered for dyspepsia, for diabetes, and as a nutritive agent, but in each case without any good result. One to two fluid drachms injected up the rectum, or a glycerin suppository, form an excellent means of opening the bowels in simple constipation, especially when the faeces are in the sigmoid flexure and rectum. The result is prompt, often occurring within less than half an hour. No pafn nor constitutional disturbance is produced. ACIDUM OLEICUM. OLEIC ACID.— HC 18 H 8S 2 . Source. — Made by saponifying oils and fats with superheated steam. The oleic acid is separated from the solid fats present by pressure. In the case of olive oil the reaction isC 3 H 5 (C 18 H 33 2 )3-|-3H 2 0:^3HC 18 H330 2 -|-C3H 5 (OH) 3 (glycerin). Characters. — A straw-colored liquid, nearly odorless and tasteless. very faintly acid. By exposure it darkens in color and becomes rancid. It becomes semi-solid at 40 F. Sp. gr. 0.800 to 0.810. Solubility. — Not in water. Easily in alcohol, chloroform, and ether. Impurities. — It is rarely pure, usually containing stearic and palmitic acids. Preparations. 1. Oleatum Hydrargyri.— (^ p. 174). 2. Oleatum Veratrinae. — (see -p. 375). Lead plaster contains oleate of lead. There is some doubt whether the pharmacopceial oleates are chemical combinations or simple solutions. Action and Therapeutics. Oleic acid is used as a solvent for remedies which it is desired to apply by means of cutaneous inunction, for it more readily penetrates the skin than fats and oils. ALTHAEA. MARSHMALLOW.- The root of Althcea officinalis (Nat. Ord. MalvacecB). United States. 470 ORGANIC MATERIA MEDICA. Characters. — In cylindrical pieces, from 3 to 6 in. long, about ^ in. in diameter, deeply wrinkled ; externally white, marked with a number of circular spots : internally whitish and fleshy. It has a faint aromatic odor and a sweetish, mucilaginous taste. Preparation. Syrupus Altheae. — Althea, 4; sugar, 60; water to 100. Dose, 1 to 4 fl. dr. Uses. Marshmallow is used as as a demulcent, and in irritation and inflammation of mucous membranes. ALMOND. AMYGDALA DULCIS. — Sweet Almond. Synonym. — Jordan almond. The ripe seed of the sweet almond tree, Amygdalus communis, var. dulcis (Nat. Ord. Rosacea). Malaga. Characters.— More than I in. long; oblong, acute at one end, rounded at the other, flattened ; brown, slightly rough exterior. Taste sweet and nutty. Composition. — The chief constituents are — (1) Oleum Amygdalce Ex- pressu7n (see p. 471), 50 per cent, a fixed oil. (2) Emulsin and other albu- minous bodies. Impurity. — The bitter almond, giving an odor of prussic acid when rubbed with water. Preparations. 1. Mistura Amygdalae.— Sweet almond, 6; acacia, 1 ; sugar, 3; distilled water, 100. Dose, 1 to 2 fl. oz. 2. Syrupus Amygdalae. — Sweet almond, 10 ; bitter almond, 3; sugar, 50; orange flower water, 5 ; water to 100. Dose, indeterminate. AMYGDALA AMARA.— Bitter Almond. The ripe seed of the bitter almond tree, Amygdalus communis, var. amara (Nat. Ord. Rosacea). Mogadore. Characters. — Like the sweet almond, but broader and shorter, with a bitter taste, and giving off an odor of ratafia when rubbed up with water. Composition. — The chief constituents are— (1) Oleum Amygdalce Ex- pressum (se. p. 471), 50 per cent., the same fixed oil as in the sweet variety. (2) Emulsin. (3) Amygdalin, which yields Oleum Amygdalce Amarcc (synonym. — Volatile oil of bitter almonds). Sp. gr. 1.060 to 1.070. This oil does not ALMOND. 471 exist in the bitter almonds, but it is obtained by distilling them with water. It is very important to distinguish it from the Oleum Amygdalae Expressum, which is harmless, but the oil of bitter almonds is usually very poisonous from admixture of prussic acid; for if moisture has had access to the glucoside amygdalin, C 20 H 27 NO 11 , on which, in the presence of water, the emulsin in the almonds acts as a ferment, the essential oil of bitter almonds, glucose, and prussic acid are formed, C 20 H 27 NO n +2H 2 O=C 6 H 5 COH (the volatile oil) -f- HCN-f-2C 6 H 12 6 . The oil when separated from the prussic acid is not poisonous, and is used to flavor sweets. An artificial oil of bitter almonds called nitro-benzol is often substituted, and has caused death. Dose, y> to l / 2 m. Preparation, Syrupus Amygdalae (See above). OLEUM AMYGDALA EXPRESSUM.— Expressed oil of al- mond. Source. — Obtained by expression from either sweet or bitter almond. Characters. — Pale yellow, nearly inodorous, with an oleaginous, nutty taste. Slightly soluble in spirit, easily in ether or chloroform. Sp. gr. 0.914 to 0.920. Dose, 1 to 4 fl. dr. OLEUM AMYGDALA AMAR^E. Source. — An oil obtained from bitter almond, by maceration with water and subsequent distillation. Characters. — A colorless thin liquid of a peculiar odor. Sp. gr. 1.060 to i .070. Soluble in 300 parts of water, and in alcohol. Dose, y$ to l / 2 m. Preparations. 1. Aqua Amygdalae Amarae. — Oil of bitter almond, 1 ; distilled water, 999. By filtration. Dose. 2 to 4 fl. dr. 2. Unguentum Aquae Rosae. — Synonym. — Cold Cream. Ex- pressed oil of almond, 50; spermaceti, 10; white wax, 10; rose water, 30. By melting. Action and Therapeutics. The sweet almond is demulcent. Its most important medi- cinal use is that it is made into flour to replace starchy food in cases of diabetes. Biscuits are made of the flour. These are very palatable, are a good nutritive food, and contain very little starch. 472 ORGANIC MATERIA MEDICA. The only objection to them is their price. With a little care they can be made at home The flour of other nuts, as Brazil nuts, has been used, but it is not nearly so palatable. The almond mixture is a very pleasant vehicle for the suspen- sion of insoluble substances, and the powder is a palatable basis for powders. Oleum Amygdalae Expressum might be used for the same pur- poses as olive oil. It is pleasanter but very expensive. TRAGACANTHA. TRAGACANTH. — A gummy exudation obtained from incision into the stem of Astragalus gummifer and other species (Nat. Ord. Leguminosce). From Asia Minor. Characters. — In white or yellowish, thin bands, of varying size or shape, marked with ridges, somewhat translucent, tough, but more pulverizable at a temperature of 120 F. Odorless and almost tasteless. Yen- sparingly soluble in cold water, but swells into a gelatinous mass, which is tinged violet (not so deep as the color given by starch) by tincture of iodine. Resembling tragacanth. — Scilla, which is thicker and opaque. Impurities. — Other gums. Composition. — The chief constituents are — (i) Bassorin, a gum (C 12 1^20^10) 9 33 F^ 1 * cent -5 on ly slightly soluble in water, unfermentable. (2) Arabin, another gum, 53 per cent., soluble in water, very like the arabin of acacia; but it is precipitated by acetate of lead. (3) A little starch. Preparatio?i. Mucilago Tragacanthae. — See Glycerin, p. 467. Tragacanth is contained in several troches. Action and Therapeutics. Tragacanth is a demulcent, and as such may be soothing when applied to a sore throat. Its chief use is to suspend in- soluble bodies as resins, oils, and insoluble powders. The muci- lage is better for this purpose because it is less liable to ferment. ACACIA. Synonym. — Gum arabic. A gummy exudation from Acacia Verek (Xat. Ord. Leguminosce), and from other species of Acacia. Kordofan. Characters. — Roundish or vermicular tears or masses. Colorless, or QUINCE SEED. 473 with a yellowish-brown tint. The tears are either opaque from numerous minute fissures and brittle, or they are glistening, transparent and difficult to break. No odor. Taste, bland, mucilaginous. Solubility. — Freely in water, not in alcohol. Composition. — The chief constituent is arabin, or arable acid, C 6 H 10 O ]5 ; most of it is combined with calcium, but some with magnesium and potassium. It is unaffected by acetate of lead. Impurities. — Starch, gum resins. Incompatibles. — Alcohol, sulphuric acid, borax, per-salts of iron, and subacetate of lead. Preparations. 1. Mucilago Acaciae. — Acacia, 34; water to 100. Dose, 1 to 4 fl. dr. 2. Syrupus Acaciae. — Mucilage of acacia, 25 ; syrup, 75. Dose, 1 to 4 fl. dr. Gum aeacia is contained in Mistura Amygdalae, Mistura Glycyrrhizse Composita, Pulvis Cretse Compositus, and in some Trochisci. Action and Therapeutics. Gum acacia is demulcent. It is used to suspend insoluble substances, as oils, resins, and insoluble powders. A fluid ounce of most oils or resinous tinctures requires 3 3 of mucilage of acacia for suspension, but copaiba requires 10 3. A disadvantage of it is that it is liable to ferment and decompose. It may give rise to indigestion and diarrhoea. CYDONIUM. QUINCE SEED.— The seed of Cydonia vulgaris (Nat. Ord. Rosacea). Austria, United States. Characters. — Well known. Composition. — The chief constituent is Cydonin. Symbol, C 18 H 28 O u . Preparation. Mucilago Cydonii. — Cydonium, 2 distilled water, 100. Dose, 1 to 4 fl. dr. Uses. Quince mucilage is used for the same purposes as the other mucilages. 474 ORGANIC MATERIA MEDICA. ULMUS. Synonym. — Slippery Elm. The inner bark of Ulmus fulva (Nat. Ord. Ulmece). United States. Characters. — In flat pieces, varying in length and width, about y% in. thick, tough, pale brownish- white, the inner surface finely ridged; fracture, fibrous and mealy ; the transverse section delicately checkered ; odor, slight, peculiar; taste, mucilaginous, insipid. Preparation. Mucilago Ulmi. — Elm, 6; boiling water, ioo. Dose, i to 4 fl. dr. Action and Uses. Slippery-elm bark, is an excellent demulcent. It is especially recommended in dysentery, diarrhoea and diseases of the urinary passages. GLYCYRRHIZA. LIQUORICE ROOT.— The root and subterranean stems or stolons, fresh and dried, of Glycyrrhiza glabra (Nat. Ord. Leguminosce). Cultivated in Britain. Characters. — Long cylindrical pieces, smooth when fresh, furrowed when dried; pliable; yellowish-brown or reddish externally, yellow and juicy internally; sickly earthy odor. When fresh, taste sweet and mucilaginous, slightly acid when dried. Resembling liquorice. — Pyrethrum and Taraxacum, which are not sweet. Composition. — The chief constituents are — (i) Glycyrrhizin, a yellow amorphous glucoside, C 24 H 36 9 , probably in combination with ammonia. With acids this yields a very bitter substance, glycyrrhetin and glucose. (2) Asparagin. (3) Grape sugar, resin, starch, gum, malic acid, etc. Preparations. 1. Extractum Glycyrrhizae. Synonyjn. — Commercial extract of liquorice. Characters. — In flattened cylindrical rolls, from 6 to 6^ in. long, and from ^ to i T J g in. thick ; of a glossy black color. It breaks with a sharp, conchoidal, shining fracture, and has a sweet peculiar taste. Not less than 60 per cent, of it should be soluble in cold water. 2. Extractum Glycyrrhizae Purum. — By maceration and per- colation with water of ammonia and distilled water. Evaporation. Dose, freely. FLAXSEED. 475 3. Extractum Glycyrrhizae Fluidum. — By maceration and per- colation with water of ammonia and diluted alcohol. Evaporation. Dose, 1 fl. dr. 4. Glycyrrhizinum Ammoniatum. — Glycyrrhiza, by maceration and percolation with water of ammonia and water ; precipitation with sulphuric acid, solution of water of ammonia, and drying. Dose, 5 to 15 gr. 5. Pulvis Glycyrrhizae Compositus. See Senna, p. 376. 6. Mistura Glycyrrhizae Compositus. Synonym. — Brown Mix- ture. Pure extract of glycyrrhiza, 3 ; sugar, 3 ; acacia, 3 ; camphorated tincture of opium, 1 2 ; wine of antimony, 6 ; spirit of nitrous ether, 3 ; water, 70. Dose, 1 to 4 fl. dr. 7. Trochisci Glycyrrhizae et Opii. [See Opium, p. 263.) Liquorice or its preparations are contained in many preparations, gener- ally to cover their nauseous taste. They hide very well that of aloes, cascara sagrada, chloride of ammonium, hyoscyamus, senega, senna, turpentine, and bitter sulphates, as sulphate of quinine. Action and Therapeutics. Liquorice is an excellent demulcent for sore throats. It is used to conceal the taste of nasty medicines, and as a basis for pills. The compound liquorice powder is laxative by virtue of its senna and sulphur. LINUM. FLAXSEED. Synonym. — Linseed. The ripe seeds of Linum usitatissimum, flax (Nat. Ord. Linacece). Cultivated in Britain. Characters. — Small, flat, oval, pointed, with acute edges; brown, smooth, shining externally, yellowish- white within; odorless; testa muci- laginous. Composition. — The covering contains much mucilage. The interior contains a fixed oil (30 per cent.), which is glyceryl united with linoleic acid. It is viscid and yellow, and is commonly called "drying oil" because it unites with oxygen and becomes resinoid on exposure. There is no starch nor sugar in linseed. OLEUM LINI. Synonym. — Linseed oil. A fixed oil expressed irom flaxseed, without heat. 476 ORGANIC MATERIA MEDICA. Characters. — A yellowish or yellow, oily liquid, having a slight, pe- culiar odor, a bland taste, and a neutral reaction. Sp. gr. about 0.936. Soluble in 5 parts of absolute alcohol and 1.5 parts of ether. Dose, y 2 to 2 fl. oz. Action and Therapeutics. Flaxseed tea (flaxseed, 150 gr. ; liquorice, 50 gr. ; boiling water, io5) is a common domestic demulcent ; the large quan- tity of mucilage it contains forms a coating for the pharynx and mouth, and thus relieves cough due to sore throat. It is said to be slightly diuretic. Action and Therapeutics. A flaxseed poultice (1 to 10 of boiling water) is a very com- mon means of applying warmth and moisture to a part. It is used to relieve pain, and as a mild irritant to accelerate inflam- mation and the bursting of an abscess, or as a counter-irritant in all sorts of deep-seated inflammations. The poultices should not be too thick, and should be smeared with oil to prevent their sticking to the skin. Flaxseed oil is applied to burns. Mixed with an equal quan- tity of lime water it forms carron oil, which is a substitute for Linimentum Calcis. CETRARIA. ICELAND MOSS. — The lichen Cetraria islandica (Nat. Ord. Lichenes). Iceland. Characters. — Foliaceous, branched, crisp, smooth, brown or grayish- white above, whitish beneath. Odor, none when dry, like seaweed when moist. Taste mucilaginous, and bitter. A strong decoction becomes gela- tinous on cooling. Composition. — The chief constituents are — (1) Lichenin, or lichen starch, 70 per cent. (2) Cetraric acid, a bitter principle, 2 per cent. (3) Lichesterinic acid. Preparations. Decoctum Cetrarise. — Cetraria, 5. By boiling in water and straining to 100. Dose, 1 to 4 fl. oz. aspidium. 477 Action and Therapeutics. The decoction is demulcent, and may be given in sore throat. The moss is a food, but it is very seldom used. GROUP X. Vegetable drugs which are used to kill parasites. A. Anthelmintics for the various species of Tapeworm. Aspidium, Pomegranate, Brayera, Koosso, Kamala, Pepo. B. Anthelmintics for the Roundworm (Ascaris lumbricoides). Santonica, Spigelia, Chenopodium, Azedarach. C. Anthelmintics for the Threadworm ( Oxyuris vermicularis). These are described under the head of astringents [see p. 458). D. Parasiticides used for pediculi. Stavesacre, Picrotoxin. ASPIDIUM. FILIX MAS. Synonym. — Male Fern. The rhizome with the per- sistent basis of the petioles of Aspidium Filix-mas and Aspidium marginale (Nat. Ord. Filices), collected late in autumn; divested of its scales, roots and all dead portions, and carefully dried at a gentle heat. Should not be used if more than a year old. Britain. Characters. — 3 to 6 or more in. long. The rhizome ^ to I in. in di- ameter, entirely covered by the curved, angular, dark brown bases of the petioles, and thus it seems larger than it is; brown externally, yellowish white or brownish within. Odor feeble, disagreeable. Taste sweetish and astringent at first, subsequently bitter and nauseous. Composition. — The chief constituents are — (I) Filicic acid, a colorless, crystalline body, said to be the active principle. (2) A fixed oil. (3) A vol- atile oil. (4) Tannic and gallic acids. (5) Resins. Dose, 30 to 90 gr. powdered. Preparation. Oleoresina Aspidii. — By percolation in stronger ether and evap- oration. Dose, X to 1 fl - dr - Action and Therapeutics Male fern is the most certain anthelmintic for the tape- worm we have. It may be flavored with ginger or peppermint. 478 ORGANIC MATERIA MEDICA. The intestine should first be emptied with a little castor oil to en- sure the worm not being protected by food. Then the male fern should be administered, and about twelve hours afterwards another dose of castor oil should be given to clear away the dead worm. Very little food should be taken during the treat- ment, and the head of the worm should be carefully searched for in the motion. Recently several cases of poisoning have been reported pre- sumably not due to an excessive dose, but to the oil administered at the same time with it. GRANATUM. POMEGRANATE. — The bark of the root of Punica Granatum (Nat. Ord. Granatacce). South of Europe. Characters. — Small quills or fragments, externally yellowish-gray, wrinkled or cracked, with faint longitudinal striae, or more or less furrowed with corky bands. Internally yellow, nearly smooth. Fracture short. Odor- less. Taste astringent. Composition. — The chief constituents are — (i) Tannin, 20 to 28 per cent. (2) Pelletierine, ]/% per cent., a colorless volatile oily alkaloid. (3) Isopelletierine, another liquid alkaloid. (3) A kind of mannite. Incompatibles. — Alkalies, lime water, metallic salts, gelatine. Dose, ^ to 1^ dr. Action and Therapeutics. The bark of the pomegranate root is a powerful astringent, and the decoction (1 to 10) may be used as a gargle for a sore throat. In large doses it is emetic and purgative. It is believed to be anthelmintic for the tapeworm. It is usually said that the pelletierine (dose of tannate, 3 to 6 gr.) is the active anthelmintic principle; but according to some the tapeworm is not killed, but is expelled by the purgative, by which a dose of the decoc- tion is usually followed. BRAYERA. CUSSO. Synonym. — Kousso. The dried panicles of the female flowers of Bray era anthelmintic a (Nat. Ord. Rosacea). Abyssinia. Characters. — In compact clusters or rolls about 10 in. long, or in small brownish or reddish fragments. Odor tea-like. - Taste bitter. Separate pan- KAMALA, PUMPKIN SEED. 479 icles, branched, zigzag, with hairs and glands on them, and a large bract at the base of each branch. Flowers numerous, small, shortly stalked, unisex- ual, male brownish, female reddish. Two bracts at the base of each flower. Calyx hairy, veiny ; ten segments on two alternating whorls. Composition. — The chief constituents are — (1) Koussin, a neutral active principle soluble in alkalies. (2) Oil, gum, tannic acid. Preparations. 1. Extractum Brayerae Fluidum. — By maceration and percola- tion with alcohol and evaporation. Dose, 1 to 4 fl. dr. 2. Infusum Brayerae. — Brayera, 6; boiling water to 100. Dose, 4 to 8 fl. oz. Action and Therapeutics. Kousso is rarely given in England, but it is used elsewhere as an anthelmintic for all species of tapeworm. KAMALA. KAMALA. Synonym. — Rottlera. — A powder which consists of the minute glands and hairs from the surface of Mallotus philippinensis (Nat. Ord. Euphorbiacece). India. Characters. — Fine, granular, mobile, brick-red. No odor. Nearly tasteless. Solubility. — Even boiling water takes up hardly anything. Alco- hol, ether, or chloroform forms deep red solutions. Composition. — The chief constituents are — (1) Rottlerin, a neutral prin- ciple. (2) A resin. (3) Tannin. (4) Red coloring matter. Dose, 60 to 120 gr. Usually given with tamarinds. Action and Therapeutics. Kamala is an anthelmintic. It will kill the Tcenia solium, and probably also the Oxyuris vermicularis and the Ascaris lumbricoides. It is a purgative. It is not much used in England. PEPO. PUMPKIN SEED.— The seed of Cucurbita Pepo (Nat. Ord. Cucur- bitacece). United States. Characters. — About ^ in. long, broadly ovate, flat, white, nearly smooth, with a shallow groove parallel to the edge ; containing a short, coni- cal radicle, and two flat cotyledons ; inodorous, bland and oily. Dose, 1 to 3 oz. 480 organic materia medica. Uses. Pepo administered as an emulsion, is one of the most efficient and harmless taeniafuges. SANTONICA. SANTONICA. Synonym. — Levant Wormseed. The unexpanded flower heads or capitula of Artemisia maritima, var. Stechmanniana (Nat. Ord. Compositce). Russia. Characters. — ^ in. long, oblong-ovoid, obtuse, pale greenish-brown, nearly smooth, resembling seeds in appearance, but consisting of from twelve to eighteen imbricated, involucral scales, with a broad, thick, yellowish-green midrib, enclosing three to five somewhat tubular florets. Odor, if rubbed, strong, peculiar, camphoraceous. Taste bitter, camphoraceous. Composition. — The chief constituents are — (i) Santonin (q. v.). (2) A volatile oil. Dose, 15 to 60 gr. SANTONINUM. — Santonin (C 15 H 18 3 ). A neutral crystalline princi- ple obtained from Santonica. Source. — Boil santonica with slaked lime and water. Strain, and from the hot fluid, precipitate the santonin with hydrochloric acid. Wash it with ammonia and water. Dry. Decolorize with alcohol and charcoal, and let it crystallize out from the alcohol. Characters. — Colorless, flat, glittering, prismatic crystals, turning yellow on exposure to light. Tasteless or feebly bitter. Solubility. — Not at all in mineral acids, feebly in cold water, easily in chloroform. It forms santonates with alkalies. Dose, ^ to 1 gr. (child), 2 to 10 gr. (adult). SODII SANTONINAS.— Symbol, 2NaC 15 H u 4 , 7H 2 0. Source. — By the action of sodium bicarbonate upon santonin. Characters. — Colorless, transparent, tubular, rhombic crystals, having a somewhat bitter taste. Soluble in 3 parts of water and in 12 parts of alcohol. Dose, 2 to 10 gr. Preparation, Trochisci Sodii Santoninatis. — Santoninate of sodium, 100; sugar, 2000; tragacanth, 50 grains; orange flower water, to make 1 00 troches. Dose, 1 to 5. Action. Santonin is anthelmintic, killing the roundworm, As- caris lumbricoides, and according to some authorities the Oxyuris SPIGELIA. 481 vermicularis, but this is doubtful. It has no action on tapeworms, as Santonin is absorbed as sodium santoninate. Medicinal doses will usually cause the urine, if it is acid, to be a greenish-yellow or saffron color, and if it is alkaline to be purplish red. This is due to the excretion in that fluid of some substance resulting from the changes undergone by santonin in the body. It is slightly diuretic. Often even small doses lead to xanthopsy — that is to say, everything the patient sees has a yellow tint ; probably this is the result of the staining of the tissues of the eye yellow. Several cases of fatal poisoning by santonin are on record. Cerebral symptoms are very prominent. Thus convulsions, accom- panied by unconsciousness, trismus, and dilated pupils, are gen- erally present. The surface becomes cold, there is sweating, there may be trembling, the pulse and respiration become weaker and weaker, and death takes place from cardiac and respiratory failure. The sodium salt is especially dangerous. Therapeutics. Santonin is used solely to kill intestinal worms. The dose of it should be given on an empty stomach, and should be followed in two hours by a purgative, such as calomel, which acts on the small intestine, for this is the part inhabited by the worms killed by santonin. It is certainly very efficacious for the Ascaris lumbricoides. As already mentioned, probably it has no effect on the Oxyuris vermicularis. SPIGELIA. PINK ROOT. — The rhizome and rootlets of Shigella marilandica (Nat. Ord. Loganiacece). United States. Characters. — Rhizome 2 in. or more long, about )/% in. thick, horizon- tal, bent, somewhat branched, on the upper side with cup-shaped scars ; on the lower side with numerous, thin, brittle rootlets about 4 in. long ; dark purplish-brown ; somewhat aromatic, sweetish and bitter. Resembling Spigelia root. — Phlox Carolina, but the rootlets are brownish-yellow, rather coarse, straight, and contain a straw-colored wood underneath a readily removable bark. 41 482 ORGANIC MATERIA MEDICA. Preparation. Extractum Spigelian Fluidum. — Spigelia. By maceration and percolation with diluted alcohol, and evaporation. Dose, % to 2 fl. dr. Uses. Spigelia is one of the most powerful anthelmintics. It may give rise to symptoms of narcotic poisoning, which, however, may be obviated by combination with a cathartic like senna. CHENOPODIUM. AMERICAN WORMSEED.— The fruit of Chenopodium ambrosio- ides, var. anthelminticu7?i (Nat. Ord. Chenopodiacece). United States. Characters. — Nearly y 1 ^ in. in diameter, depressed-globular, glandular, dull-greenish or brownish, the integuments friable, containing a lenticular, obtusely-edged, glossy, black seed. It has a peculiar, somewhat terebinthinate odor, and a bitterish, pungent taste. Dose, 15 to 30 gr. OLEUM CHENOPODII. — A volatile oil distilled from chenopodium. Characters. — A colorless liquid, of a peculiar odor and bitterish taste. Sp. gr. about 0.920. Dose, 2 to 10 m. Action and Uses. Wormseed is one of the most efficent anthelmintics, par- ticularly against Ascarides, but should be followed by a cathartic. AZEDARACH. AZEDARACH.— The bark of the root of Melia Azedarach (Nat. Ord. Meliacece). Southern United States. Characters. — Curved pieces or quills ; outer surface red-brown ; inner surface whitish or brownish ; almost inodorous, sweetish, afterwards bitter and nauseous. Dose, 2 to 8 dr. Uses. Azedarach is used in an infusion for the same purposes as pinkroot, as an anthelmintic, for which it enjoys a considerable reputation in the Southern States. STAPHISAGRIA. STAVESACRE.— The ripe seed of Delphinium Staphisagria (Nat. Ord. Ranunculacece). Europe. PICROTOXIN. 483 CHARACTERS. — Irregularly triangular or obscurely quadrangular, arched, blackish brown when fresh, but becoming dull grayish brown by keeping. Testa wrinkled and deeply pitted, nucleus soft, whitish and oily. No marked odor. Taste nauseous, bitter and acrid. Composition. — The chief constituents are — (1) A fluid oil. (2) A very poisonous alkaloid, delphine, acting like aconitine. (3) Other alkaloids. Action and Therapeutics. Stavesacre is only used as a parasiticide to kill pediculi. The affected part is rubbed with the ointment, 1 to 2 of ben- zoinated lard, which, in the case of pediculi vestimentorum is allowed to soak, day and night, into the garments next to the skin, for the parasite inhabits them. PICROTOXINUM. PICROTOXIN. — Picrotoxin (C 9 H 10 OJ. A neutral principle obtained from the seeds of Anamirta paniculata, Indian berry or fish-berry, the fruit of which is known as Cocculus indicus (Nat. Ord. Menispermacece). India. Source. — Obtained by exhaustion with alcohol, evaporation, and purifi- cation. Characters. — Colorless shining prisms with an intensely bitter taste. Solubility. — I in 150 of cold, 1 in 25 of boiling water. Freely in ether, not in oil. It does not form salts. Probably commercial picrotoxin is a mixture of several bodies. Dose, j^g to ^ gr. in a pill. Action. External. — Picrotoxin is very destructive to lower forms of life, and is therefore antiparasitic. Internal. — It is a powerful poison, causing convulsions, hyperpyrexia and stimulation of the respiratory center. Its mode of action is unknown. Therapeutics. External. — An ointment of 80 gr. of the seeds to 1 oz. of lard has been applied to the scalp to kill pediculi. It must be employed with caution, for this strong poison can be absorbed if the skin be broken. It is an expensive ointment. Internal. — Picrotoxin is used empirically, to check the night 484 ORGANIC MATERIA MEDICA. sweating of phthisis. A single dose should be given in the evening. Its action is uncertain, but sometimes it succeeds. Many other diseases have been treated with it, but there is no evidence that it has benefited them. Tablets, each containing 1-100 of a grain, are prepared for subcutaneous injection. One should be dissolved in a few minims of water immediately be- fore use. GROUP XI Vegetable drugs apparently having only a diuretic action. Uva Ursi, Scoparius, Apocynum, Triticum, Marrubium. UVA URSI. UVA URSI. Synonym. — Bearberry. The dried leaves of Arctosta- phylos Uva-ursi (Nat. Ord. Ericacece). Britain. Characters. — Very shortly stalked, obovate or oblong-spatulate, coria- ceous, y^ to ^ in. long. Upper surface smooth and shining ; under paler, minutely reticulated. Margin entire and slightly revolute. Odor hay-like when powdered. Taste very astringent. Resembling Uva Ursi. — Senna {see p. 375) and buchu [see p. 436). Composition. — The chief constituents are — (1) Arbutin (C 12 H 16 7 ), a bitter crystalline glucoside yielding glucose, hydrochinon, and methyl-hydro" chinon. (2) Ericolin, a bitter crystalline glucoside. (3) Urson, a tasteless neutral body. (4) Tannic and gallic acids, 33 per cent. Incompatibles. — Iron, lead and silver salts, alkaloids, and gelatine. Preparation. Extractum U vae Ursi Fluidum. — By maceration and percolation with glycerin and diluted alcohol, and evaporation. Dose, % to 1 fl. dr. Action. Uva Ursi is a well-marked diuretic, and is astringent and disinfectant to the urinary mucous membrane. Its dis- infectant action is probably due to the decomposition of the arbu- tin into glucose and hydrochinon, for after Uva Ursi is given hydrochinon is found in the urine, and it is a very energetic anti- UVA URSI, BROOM. 485 septic. This decomposition must take place in the kidneys, for hydrochinon is a powerful poison. Against this being the rea- son of the disinfectant action of Uva Ursi, it is urged that giving arbutin does not disinfect the urine; but others deny this, and the probability is that the first-mentioned view is correct. Arbu- tin is a powerful diuretic. The urine may be a pale greenish to dark greenish-brown color. Hydrochinon is also found in the urine in carbolic acid poisoning {see p. 252). The astringent action of Uva Ursi on the urinary tract is usually ascribed to the gallic and tannic acids, but as these are not remote astringents this is most likely wrong. Therapeutics. Uva Ursi is given to disinfect the urine in the same class of cases as buchu — that is to say, in pyelitis, cystitis and gonorrhoea. SCOPARIUS. BROOM. — The tops of Sarothamnus Scoparius (Nat. Ord. Leguminosce). Indigenous. Characters. — Branched, straight, dark-green, nearly smooth, tough twigs, with five wing-like angles. Occasionally with leaves attached. Taste bitter and nauseous. When bruised gives a peculiar odor. Composition. — The chief constituents are — (1) Scoparin (C 21 H 22 O 10 ), a yellow, crystalline, neutral principle, said to be diuretic. (2) Sparteine, an oily, liquid, volatile alkaloid. (See Appendix). Dose, % to 1 dr. Action. Broom has no external action, and very little beyond the fact that it is diuretic is known about its internal action. Therapeutics. Broom is a very useful diuretic. It is usually given in com- bination with other diuretics in cases of dropsy from heart dis- ease or interstitial nephritis. If there is acute renal inflammation it should not be prescribed. APOCYNUM. CANADIAN HEMP.— The root of Apocynum cannabinum (Nat. Ord. Apocynacece). 486 ORGANIC MATERIA MEDICA. Characters. — Long, cylindrical, % in. thick, pale brown, longitudinally wrinkled and transversely fissured ; inodorous, taste bitter, disagreeable. Composition. — The chief constituents are — (i) An amorphous, resinous substance, apocynin. (2) A glucoside, apocynein. Dose, 10 to 20 gr. Uses. Canadian Hemp has been found to be beneficial in dropsy, probably because of its diuretic action, when used as an infusion (1 to 16), of which the dose is one to two fluid ounces, twice or three times daily. TRITICUM. TRITICUM. Synonym. — Couch Grass. The rhizome of Triticum repens (Nat. Ord. Graminacece), gathered in the spring and deprived of the rootlets. United States. Characters. — Very long, about -^ in. thick ; creeping, smooth, hollow in the centre, straw-yellow ; inodorous and of a sweet taste. Preparation. Extractum Tritici Fluidum. — By percolation with boiling water, evaporation, addition of alcohol and filtration. Dose, 1 to 8 fl. dr. Action and Therapeutics. Triticum is a diuretic, and is used as a sedative in inflamma- tion of the genito-urinary membrane. MARRUBIUM. HOREHOUND. — The leaves and tops of Marrubium vulgar e (Nat. Ord. Labiatce). United States. Characters. — Leaves about I in. long, opposite petiolate, roundish ovate, obtuse, coarsely crenate, strongly rugose, downy above, white-hairy be- neath ; branches quadrangular, white, tormentose ; flower is dense, axillary, woolly whorls, with a stiffly, ten-toothed calyx, a whitish bi-labiate corolla and four included stamens, aromatic and bitter. Dose, 1 to 2 dr. Action and Uses. Horehound is largely a diuretic, in large doses laxative, and may be so given as to increase the action of the skin and kidneys, but its action is not marked. ERGOT. 487 GROUP XII. Vegetable drugs acting locally on unstriped muscle, especially that of the uterus. This group contains Ergot, Ustilago, Cotton Root Bark, Caulophyllum. ERGOTA. ERGOT OF RYE. — The sclerotium (compact mycelium), of Claviceps purpurea (Nat. Ord. Fungi), growing between the pales of and replacing the grain of Secale cereale, the common rye (Nat. Ord., Graminacece). Spain and Russia. Ergot is no part of the rye grain, which completely disappears as the ergot develops, Characters. — Subcylindrical, tapering at both ends, curved, y$ to 1^ in. long. Longitudinally furrowed on both sides, especially the concave, often cracked. Dark violet-purple without, pinkish-white within. Fracture short. Odor peculiar, disagreeable. Taste mawkish, rancid. Composition. — The chief constituents are — (1) Sphacelinic acid, a non- nitrogenous unstable body, insoluble in water, soluble in alcohol. Its alkaline salts are soluble in water, but readily decomposed. It is believed to be the active agent in contracting the blood-vessels. (2) Cornutine, an alkaloid be- lieved to be the agent which contracts the uterus. The so-called sclerotinic acid which can be extracted from ergot is really a mixture of sphacelinic acid and cornutine. (3) Ergotinic acid, a glucoside. (4) A fixed oil, 30 per cent. (5) Trymethylamine, to which the odor is due. (6) Tannin. Many other bodies have been found in ergot, but those given are believed to be the more important ; the composition of ergot is not yet certainly made out. Dose, 30 to 60 gr. Preparations. 1. Extractum Ergotae Fluidum.— By maceration and percola- tion with alcohol and water, evaporated with diluted hydrochloric acid. Dose, y z to 1 fl. dr. 2. Vinum Ergotae. — Ergot, 15. By percolation with stronger white wine to 100. Dose, 1 to 4 fl. dr. 3. Extractum Ergotae. Synonym. — Ergotin. Fluid extract of ergot, 500. By evaporation to 1 00. Dose, 5 to 15 gr. 488 ORGANIC MATERIA MEDICA. It is said that ammonia is the best solvent for the active principles of ergot. The Brit. Pharm. Conference gives the following : Tinctura Ergotce Ammoniata. — Ergot, io oz. ; aromatic spirit of ammonia, 20 oz. Dose, 10 to 6otn- Action. External. — None. Internal. — Gastro-intestinal tract. — The unstriped muscle of the intestine is stimulated by ergot, and this leads to greatly increased peristaltic movements, sometimes strong enough to cause relaxation of the bowels. The vessels of the intestine are constricted, in part because of the contraction of their own mus- cular fibers, and in part because of the contraction of those of the intestinal muscular coat. The result is that the intestine is blanched. Blood. — The active principles of ergot are readily absorbed, but they are not known to produce any effect on the blood. Heart. — The activity of the heart muscle is depressed by ergot ; therefore the rate of the pulse falls, and consequently at first the blood-pressure falls. Vessels.— But the fall of blood-pressure is soon followed by a great rise, and this is due to the general contraction of the arteries all over the body;, they can, in some parts, be seen to become smaller. The veins are contracted to a less extent. This vascular contraction does not take place if the spinal cord is de- stroyed, from which it is fair to infer that it is due to the action of ergot on the vaso-motor centers in the cord. Because it con- tracts the arterioles it is haemostatic. If the ergot be taken for a long time the contraction of the arteries leads to gangrene of various parts of the body, and this was a prominent symptom of the ergotinism (chronic poisoning by ergot) which used to be seen in the very poor who could get no better food than rye in- fested with Claviceps purpurea. Enormous single doses of ergot appear to paralyze the vaso-motor centers, and then the blood- pressure falls from vascular dilatation and cardiac depression. Nervous system. — Medicinal doses, or even an enormous single dose, very rarely affect the nervous system, but if ergot be taken for a long time a peculiar train of symptoms sets in; they con- ERGOT. 489 stituted the second variety of chronic ergotism in the days when diseased bread was eaten. The sufferer first complained of itch- ing and tingling, and a sensation of insects running over the skin; this was followed by numbness and local anaesthesia. These symptoms first appeared in the hands and feet, but spread over the whole body. They were followed by tonic contractions of various muscles, especially those of the extremities. The mus- cular power was lessened, and the gait was staggering. Later on there was diminution of sensation. Dimness of vision and loss of hearing were sometimes present. This variety of ergotism was usually accompanied by vomiting and diarrhoea. Death occurred from asphyxia, due to spasm and weakness of the respiratory muscles. Uterus. — Ergot powerfully excites the pregnant uterus of women and lower animals to contract and expel its contents. It is therefore called an ecbolic. It is not decided whether this effect is due to the action of the drug on the organ itself or on the spinal centres. Ergot has very little power to cause contrac- tion of the unimpregnated uterus. The flow of urine, of saliva, of sweat, and of milk is diminish- ed by ergot, probably because of the general vascular constriction. Therapeutics. The chief use of ergot is to cause efficient contraction of the uterus after labor, and so to diminish the risk of post-partum haemorrhage. If there is any likelihood of profuse bleeding it should be given subcutaneously, so that it may act rapidly. Ergot should be administered cautiously before the child is expelled, for the contractions produced by it not only gradually become more severe but more prolonged, so that ultimately the uterus remains tightly contracted for several minutes \ this is, of course, dangerous to the life of the child, and if the resistance be very great, may lead to rupture of the uterus. This drug has often been given as a haemostatic in haemoptysis and other haemorrhages from different parts of the body. Some authors claim great success. Frequently it fails, and unless it 42 490 ORGANIC MATERIA MEDICA. quite closes the bleeding vessel it is likely that it may, by the gen- eral rise of blood-pressure, do more harm than good. It is difficult to gauge its value, for so many haemorrhages will stop even if no drugs are given. It has been used to check the night-sweats of phthisis, and as an antigalactogogue. It is often desirable to combine the fluid extract of ergot with perchloride of iron. Because of the tannin in the ergot an inky mixture results, but this may be clarified by the addition of a little dilute phosphoric acid, and the taste may be covered with chloro- form water. USTILAGO. USTILAGO. Synonym. — Corn smut. Ustilago Maydis (Nat. Ord. Fungi), grown upon Zea Mays (Nat. Ord. Graminacece). United States. Characters. — Irregular, globular masses, sometimes 6 in. thick, con- sisting of a blackish membrane, inclosing innumerable, brownish-black, globu- lar and nodular spores ; odor and taste unpleasant. Composition. — The chief constituents are — (i) Ustilagin. (2) Propyl- amine. (3) Sclerotic acid. (4) A fixed oil. (5) Resin. Dose, y 2 to 1 dr. Action and Uses. Ustilago is believed to have the same action as ergot. It is supposed to increase the frequency, severity and duration of labor pains. GOSSYPII RADICIS CORTEX. COTTON ROOT BARK.— The bark of the root of Gossypium herbaceum and of other species of Gossypium (Nat. Ord. Malvacece). United States. Characters. — In thin flexible bands or quilled pieces ; outer surface brownish -yellow ; inner surface whitish, of a silky lustre ; inodorous ; taste very slightly acrid and faintly astringent. Preparation, Extractum Gossypii Radicis Fluidum. — By maceration and percolation with glycerin and alcohol, and evaporation. Dose X to 1 fl. dr. Action and Uses. Cotton Root Bark has the same action as Ergot, and is an emmenagogue and an abortifacient. It is used as an uterine COLCHICUM. 49I haemostatic in the treatment of menorrhagia and metrorrhagia from various causes and particularly for uterine fibroids. CAULOPHYLLUM. BLUE COHOSH. — The rhizome and rootlets of Caulophyllum thalic- troides (Nat. Ord. Berberidacece). IJnited States. Characters. — Rhizome about 4 in. long, and about % to f in. thick, bent ; externally gray-brown, internally whitish. Rootlets numerous, matted, about 4 in. long, and ■£$ in. thick, rather tough ; nearly inodorous ; taste sweet- ish, slightly bitter and somewhat acrid. Composition. — Its chief constituents are — (1) Leontin. (2) Two resins. (3) ^m. Dose, 5 to 30 gr. Uses. It is used to increase the force of uterine contractions, is sup- posed to be capable of arresting abortion, and to be useful in dysmenerrhoea. GROUP XIII. Colchicum. The sole value of this drug is that it is a specific for gout. COLCHICUM. COLCHICI RADIX. — The fresh corm of Colchicum autumnale (Nat. Ord. Melanthacece), collected about the end of June; and the same stripped of its coats, sliced transversely, and dried at a temperature not ex- ceeding 150 F. Britain. Characters. — Fresh corm about 1 in. long, I in. broad, conical, flat- tened on one side, rounded on the other ; outer coat thin, brown, membranous, inner coat reddish-yellow. Internally white, solid, yielding milky juice of bitter taste and disagreeable odor. Dried slices ^ to |- in. thick, yellowish at circumference, indented one side, convex the other, and thus reniform in outline. Surfaces firm, whitish, amylaceous. Fracture short. Odor none. Taste bitter. Composition. — The chief constituents are — (1) Colchicine, the active principle ; a bitter alkaloid in small crystals, soluble in water and alcohol, but changed by most acids into colchiceine, a neutral substance, and a resin. (2) Veratrine {see p. 334), in traces combined with gallic acid. (3) A fixed oil. (4) Starch, sugar, gum. 49 2 ORGANIC MATERIA MEDICA. Incompatibles. — All astringent preparations, tincture of iodine, and tincture of guaiacum. Dose 2 to 8 gr. in powder. Preparations. 1. Extractum Colchici Radicis. — Colchicum Root, by macera- tion and percolation in acetic acid and water, and evaporation. Dose, y 2 to 2 gr. 2. Extractum Colchici Radicis Fluidum. — Colchicum Root, by maceration and percolation in alcohol and water and evaporation. Dose, 2 to 8 m. 3. Vinum Colchicum Radicis. — Colchicum Root, 40; by per- colation with stronger white wine to 100. Dose, 5 to 15 m. COLCHICI SEMINA.— The seed of Colchicum autumnale, col- lected when fully ripe about the end of July, and carefully dried. Characters. — -^ in. in diameter, subglobular, pointed at hilum, red- dish-brown, rough, very hard and difficult to powder. Odor none. Taste bit- ter, acrid. Resembling colchicum seeds. — Black mustard seeds (see p. 401). Composition. — The chief constituents are — (1) The same as of the corm, but the proportion of the active alkaloid colchicine is larger. (2) A vol- atile oil in addition. Preparations. 1. Extracti Colchici Seminis Fluidum. — By maceration and percolation in alcohol and water, and evaporation. Dose, 1 to 5 m. 2. Tinctura Colchici. — Colchicum seed, 15 ; by maceration and percolation in diluted alcohol to 100. Dose, 10 to 30 m. 3. Vinum Colchici Seminis. — Colchicum seed, 15; by macera- tion with stronger white wine and filtration to 100. Dose, 10 to 30 m. Action. External. — When applied to the skin colchicum acts as an irritant, causing hyperaemia and smarting, and the dust inhaled gives rise to sneezing. Internal. — Gastro-intestinal tract. — In moderate medicinal doses colchicum produces no effect on most persons beyond colchicum. 493 slightly increasing the secretion of bile, but with others it causes loss of appetite, and a little purging, nausea, and colic. In larger doses it gives rise, in all persons, to great abdominal pain, vomiting, and profuse diarrhoea with the passage of blood. It is in fact a powerful gastro-intestinal irritant. There is also great prostration, the pulse becomes small, rapid, and thready, the skin cold and bedewed with sweat, and the respiration slow ; death is due to collapse. It is extremely probable that these re- sults are not owing to any action of colchicine on the heart or respiration, but that they are merely the consequence of the severe gastro enteritis, which, it is well known, will cause fatal collapse. These effects are produced if colchicine is injected subcutaneously, a circumstance which shows that this alkaloid is an active principle of the drug, and that it is excreted into the in- testine. It is a curious fact that after a certain point, increasing the quantity does not lead to an increase of the symptoms Nervous system. — Medicinal doses have no effect. Even a fatal dose does not impair consciousness. In frogs the reflex ex- citability of the cord is at first increased by large doses, and hence there may be convulsions. In mammals these do not take place, but in all animals ultimately the spinal motor centers are powerfully depressed, and the creature is paralyzed. Motor nerves and muscles are unaffected. Sensory nerves are somewhat depressed. Kidney, — The most discordant statements have been made about the action of colchicum on the urine, but it has not been definitely shown that either the quantity or composition is altered. After death by poisoning, the alkaloid is found in the blood and in most of the organs of the body. Therapeutics. Colchicum is hardly ever used except for gout. Given during the attack, it most markedly relieves the pain ; in smaller doses given between the attacks it diminishes their severity. It is often very useful for dyspepsia, eczema, headache, neuritis, conjunc- tivitis, bronchitis, and other conditions which, when occurring in 494 ORGANIC MATERIA MEDICA. those suffering from gout, are probably related to it. Occasion- ally it is combined with other cholagogues, especially if it is de- sired to give these remedies to a person who is the subject of gout. If any symptoms of gastric or intestinal irritation appear, its use must be discontinued for a time. The seeds are said to be more active than the corm. GROUP XIV. Two Stearoptenes. Both are antiseptic and are local anaesthetics. Camphor, Thymol. CAMPHORA. CAMPHOR. — C 10 H 16 O. A stearopten obtained from the wood of Cinnamomum Camphor a (Nat. Ord. Lauracece). Imported in the crude state and purified by sublimation. East Indies, China, and Japan. Source. — The wood of the tree is submitted to distillation, and the dis- tilled product on cooling deposits crystals of camphor, which are purified by pressure and sublimation. Characters. — Solid, colorless, translucent, crystalline masses ; if large they are fissured. Tough, but readily powdered if mixed with alcohol, ether, or chloroform. Odor powerful, characteristic. Taste pungent, bitter, followed by a sensation of cold. Sp. gr. 0.990 to 0.995. Burns readily with a bright smoky flame. Volatilizes slowly at ordinary temperatures. Sublimes entirely when heated. Solubility. — 1 in 700 of water, I in 2 of oil of turpentine, I in 4 of olive oil, readily in milk, ether, spirit, or chloroform. When triturated with either chloral hydrate, carbolic acid, or thymol it forms a thick liquid. Composition. — It is oxidized terebene, C 10 H 16 . It is often called laurel camphor. All camphors or stearoptens are oxidation products of hydrocarbons which contain 10 atoms of carbon (terpenes), and constitute the greater part of volatile oils, of which terebene or oil of turpentine (C 10 H 16 ) is best known. Isomeric with the terpene of oil of turpentine we have terpenes of oil of lavender, oil of peppermint, oil of chamomile, oil of caraway, oil of cloves, &c. Menthol (C 10 H 20 O) (q. v.) is a camphor or stearoptene derived from the terpene (C 10 H 20 ) called diamylene. Borneo camphor, which is often in com- merce substituted for the officinal camphor, is derived from Dryobalanops aromalica, and is known from the officinal variety by sinking in water — is C l0 H 18 O ; that is to say, an oxidized product of the terpene called camphene CAMPHOR. 495 or menthene, C 10 H 18 (existing in peppermint oil, see p. 420). Thymol and caruol {see pp. 421 and 497), C 10 H u O, are stearoptens or camphors, the result of oxidation of the terpene cymol, C 10 H U . Dose, 3 to 20 gr. CAMPHORA MONOBROMATA.— Monobromated Camphor. C 10 H 15 BrO. Source. — By heating bromine and camphor, solution in benzin, and recrystallization from hot alcohol. Characters. — Colorless, prismatic needles or scales, having a mild camphoraceous odor and taste, and a neutral reaction. Almost insoluble in water, it is freely soluble in alcohol, ether, chloroform and fixed oils ; slightly soluble in glycerin. Dose, 2 to 10 gr. Preparations. 1. Aqua Camphora. — Camphor, 8; solution in alcohol, 16; per- colation in alcohol with distilled water to 1 000. Dose, % to 2 fl. oz. 2. Linimentum Camphorae. — Camphor, 20; cottonseed oil, 80. 3. Linimentum Saponis. See Sapo, p. 465. 4. Spiritus Camphorae. — Camphor, 10; alcohol, 70; water, 20. Dose, 30 to 60 m. In milk or on sugar, as water precipitates the camphor. 5. Tinctura Opii Composita. See Opium, p. 264. 6. Ceratum Camphorae. — Camphor liniment, 3 ; olive oil, 3 ; cerate, 85. Camphor is contained in the following liniments : Belladonna, Soap, Compound Mustard. Action. External. — -Camphor, although not a volatile oil, acts very much like one. Thus it is a direct cutaneous stimulant, dilating the vessels of the skin, and at first causing a sensation of warmth, but subsequently a slight degree of local anaesthesia. It is a feeble antiseptic. Internal. — Gastro-intestinal tract. — In the stomach it is mildly Stimulant, dilating the vessels, increasing the flow of gastric juice and the peristalsis. Hence it is stomachic and carminative. It has a slight reflex stimulating effect on the heart. In medicinal doses it has little action on the intestines. 496 ORGANIC MATERIA MEDICA. Circulation. — It quickly enters the blood both from the skin and the intestine, and is said to increase the number of leuco- cytes in that fluid. To a slight extent the heart is excited directly by it in addition to the reflex stimulation just mentioned. Respiration — Probably some camphor is excreted by the bronchial mucous membrane, the vascularity and secretion of which it consequently stimulates. It has the reputation of being a feeble expectorant. Skin. — It is a mild diaphoretic. This effect is believed to be due to the action of the drug on the central nervous system. Probably some of the camphor is excreted by the skin, for the sweat may smell of it. Nervous system, — Different people are differently susceptible to the effects of camphor. Five to ten grains will in some per- sons produce a feeling of exhilaration, or in others a sense of comfort and quietness. Larger doses cause great excitement, giddiness, a slow pulse, and ultimately headache, burning pains in the stomach, faintness, confusion of ideas, delirium, violent convulsions, insensibility, a small feeble pulse, and finally death from collapse. It is a mild antipyretic. Sexual organs. — Camphor is reputed to be an aphrodisiac, but this is probably incorrect. Kidneys. — It is not excreted as camphor, but as complex sub- stances, one of which is campho-glycuric acid. Therapeutics. External. — Its stimulating effects make camphor a favorite ingredient of many liniments. It is constantly rubbed into the skin in some form or another as a mild irritant or counter-irritant in, for example, chronic rheumatism, chronic inflammatory in- durations, and the slighter chest complaints of children ; and al- so in myalgia, neuralgia, lumbago, and sciatica, in which cases, because of its property of causing local anaesthesia, it relieves pain. In addition to the pharmacopoeial preparations, a Chloro- formum Camphorae (camphor, 2 parts, dissolved in chloroform, 1 part) may be used. The liquid preparations with chloral, car- OIL OF THYME. 497 bolic acid, and thymol are excellent local anodynes for neuralgia, and may be dropped into a tooth to relieve toothache. Internal. — Camphor is used as a carminative, especially in neurotic subjects. It is a common remedy for a cold in the head, and is probably beneficial on account of its stimulation of the circulation and its slight antipyretic and diaphoretic effects. Many expectorant mixtures contain camphor. It has been given as an antispasmodic in hysteria and allied conditions, and some state that it is of use in cholera Monobromated Camphor re- sembles but is not identical with the bromides in its therapeutical action. OLEUM THYMI. OIL OF THYME.— A volatile oil distilled from Thymus vulgaris (Nat. Ord. Labiate.) Britain. Characters. — A colorless or pale yellow, the liquid, having a strong odor of thyme, a warm, pungent, and afterwards cooling taste. Sp. gr. about 0.880. It is readily soluble in alcohol. Dose, 1 to 5 m. THYMOL. THYMOL. — C 10 H 13 OH. A stearopten obtained from the volatile oils of Thxmus vulgaris (Nat. Ord. Labiate), Britain; Monarda punctata (Nat. Ord. Labiates), Britain; and Carum Ajowan (Nat. Ord. Umbelliferce), Asia. Source. — Saponify the oils with caustic soda, and treat the soap thus formed with hydrochloric acid ; or it is made by distillation of the oil and ex- posing the portion that first distils over to a low temperature. Characters. — Large, oblique, colorless crystals of the hexagonal stem. Odor of thyme. Taste pungent, aromatic. Solubility. — 1 in 1200 of cold water, 1 in 90 of glycerine, 1 in 2 of olive oil. Freely in alcohol, ether, or chloroform. Sp. gr. as a solid 1.028. Dose, 1 /l to 2 gr. as a pill Action and Therapeutics. Thymol is a more powerful antiseptic than carbolic acid. It has been used in antiseptic surgery for dressing wounds. A saturated solution of thymol gauze, and thymol ointment are employed. It is non-irritating. It has considerable antipar- asitic powers, and solutions in alcohol or ether (i in 15) have been used in ringworm. A solution in glycerine (1 in 200) has 498 ORGANIC MATERIA MEDICA. been recommended for sore throats. A little alcohol is very use- ful for facilitating the aqueous solution of thymol. The odor is likely to attract house flies. It is of no value for internal use. GROUP XV Vegetable drugs acting by virtue of important acids they contain. Lemon juice (citric acid), Prunus Virginiana (hydrocyanic acid), Benzoin (benzoic acid), Chrysarobinum (chrysophanic acid), Rhus Toxi- codendron (toxicodendric acid). LEMON. LIMONIS CORTEX. — Lemon peel. The outer part of the rind of the fresh fruit of Citrus Limonum (Nat. Or&.Aurantiacece). Southern Europe. Characters. — Thin, pale yellow pieces, rough on the outer surface from the presence of glands containing the oil ; inner surface has a little of the inner white rind attached. Fragrant odor ; bitter aromatic taste. Composition. — The chief constituents are — (1) The officinal Oleum Limonis (see below). (2) A bitter principle, hesperidin. Preparations. 1. Spiritus Limonis. — Essence of Lemon. — Oil of lemon, 6; lemon peel, 4 ; by maceration and percolation to 100. Dose, % to 2 fl. dr. 2. Syrupus Acidi Citrici (see citric acid, p. 215). Oleum Limonis. — The volatile oil (C 10 H 16 ) of Citrus Limonum. It is said to consist of two isomeric oils. Source. — Obtainable by expression. Characters — It is pale yellow, fragrant, warm, and bitter. Sp. gr. about 0.850. Soluble in alcohol. Oil of le??ion is contained in Spiritus Ammoniae Aromaticus. Dose, 1 to 4 m. Action and Therapeutics. The same as those of orange. The oil applied externally is rubefacient. LEMON. 499 LI M ON IS SUCCUS. — Lemon Juice. The freshly expressed juice of the ripe fruit of Citrus Limonum. Characters. — A pale yellow, slightly turbid liquid. Taste acid. Odor of lemons. Sp. gr. not less than 1.030. Composition. — Lemon juice contains about 7 per cent, of citric acid (H 3 C 8 H 5 7 ), free, and combined to form potassium and other salts. Also malic acid (H 3 C 4 H 3 5 ) and phosphoric acid. Dose, 1 to 2 fl. oz. Preparations. Syrupus Limonis. — Lemon juice, 40 ; fresh lemon peel, 2 ; sugar, 60; by solution in water and filtration to 100. Dose, yi to 2 fl. dr. 2. Acidum Citricum, see p. 215. Lemon juice is contained in Mistura Potassii Citratis. Action and Therapeutics. Lemon juice is used to relieve thirst, and to make effervescing mixtures and drinks. Its action in the body is the same as that of citric acid {see p. 215J. Three or four ounces of lemon juice daily is of great benefit in scurvy. Why this is we do not certain- ly know. Lemon juice is probably more efficacious than citric acid. PRUNUS VIRGINIANA. The bark of the Prunus serotina (Nat. Ord. Ai?iygdale tincture of benzoin, 1 3 \ spirit of chloroform, 43; oil of bitter almonds, 8 TTL; distilled water to 16 g. Dose, 2 to 8 3- It is frequently desirable to give cod-liver oil with iron. In that case the fol- lowing preparation, in which the oil is emulsified with an alkali, will be found useful: — Cod-liver oil, 4 5; citrate of iron and ammonium, 5 gr.; carbonate of potassium, 3 gr.; saccharin, % gr.; oil of caraway, 1 TT|; water to ^j. MEL. HONEY. — A saccharine secretion deposited in the honeycomb by the hive bee, Apis mellifica (Nat. Ord. Hymenoptera). Characters. — A syrupy liquid of a light yellowish or pale brownish- yellow color, translucent, gradually becoming crystalline and opaque, having a characteristic odor, and a sweet, faintly acrid taste. Preparation. Mel Despumatum. Synonym. — Clarified honey. Melt honey in a water-bath, and strain while hot. Clarified honey is contained in Confectio Rosas and Mel Rosae. Action and Therapeutics. Honey is demulcent, relieving dryness of the mouth and facil- itating swallowing. Oxymel, clarified honey 8, acetic acid 1, water 1, is a useful preparation. It is a common ingredient of cough mixtures. Honey is a mild laxative, and may be given to children for this purpose. CERA. CERA FLAVA. — Yellow Wax. Prepared from the honeycomb of the hive bee, Apis mellifica (Nat. Ord. Hymenoptera), 45 53° ORGANIC MATERIA MEDICA. Characteristics. — Firm, yellowish. Odor honey-like. Not unctuous. Soluble in oil of turpentine, not in alcohol. Composition. — It consists of melissic alcohol (C 30 H 61 OH) united with cerotic acid (C, f H 53 COOH). // is used in Ceratum resinae, (compound cerates), unguentum. CERA ALBA. — White wax. Made by bleaching yellow wax by ex- posure to moisture, air and light. Characters. — A yellowish- white solid, having a slightly rancid odor, and an aromatic taste. Sp. gr. 0.965 to 0.975. Uses. Yellow and white wax are only used as bases for many plas- ters and ointments, and for Charta Cantharidis. COCCUS. COCHINEAL.— The dried female insect Coccus cacti (Nat. Ord. Hem- iptera). Reared in Mexico and Teneriffe on Opuntia cochinillifera y and on other species of Opuntia. Characters. — Oval, flat or concave beneath, convex above, about i in. long, transversely wrinkled, purplish black or purplish gray, easily pulverized, the powder being dark red or puce-colored. Composition. — The chief constituent is carminic acid. Sulphuric acid and several other reagents precipitate from the decoction the well-known col- oring matter carmine. Cochineal is contained in the compound tincture of cardamom. Uses. Cochineal is only used as a coloring agent. CANTHARIS. CANTHARIDES. — The beetle Cantharis vesicatoria. Synonym. — Spanish flies. (Nat. Ord. Co/eoptera), dried. Collected chiefly in Hungary. Characters. — %{ to 1 in. long, ^ in. broad, with two long elytra or wing-sheaths of a shining coppery-green color, under which are two thin, brownish, transparent, membranous wings. Powder grayish-brown, containing shining, green particles. Odor strong, disagreeable. Composition. — The chief constituents are — (1) Cantharidin, the active principle, a fatty crystal lizable body forming shining colorless plates, soluble in alcohol, ether, acetic ether, glacial acetic acid, chloroform, and oils. It is CANTHARIDES. 53 1 found especially in the generative apparatus, the eggs, and the blood. (2) A volatile oil, giving the odor and said to have the same action as cantharidin. (3) A green oil, the coloring principle, closely allied to chlorophyll. Preparations. 1. Ceratum Cantharidis. — Cantharides, 3$; yellow wax, 20; resin, 20; lard, 25. 2. Ceratum Extracti Cantharidis. — Cantharides, 30; resin, 15; yellow wax, 35 ; lard, 35 ; alcohol in sufficient quantity. Cantharides, by percolation with alcohol, evaporation and mixture. 3. Charta Cantharidis. — Cantharides, 1 ; white wax, 8 ; olive oil, 4; spermaceti, 3 ; Canada turpentine, I; water, 10. Mixed and spread on paper. 4. Collodium cum Cantharide. — Cantharidal Collodion. — (See Flexible Collodion, p. 509). 5. Linimentum Cantharidis. — (See Turpentine, p. 393). 6. Tinctura Cantharidis. — Cantharides, 5 ; by percolation with alcohol to 100. Dose, 1 to 15 m. 7. Emplastrum Picis cum Cantharide. Synonym. — Warm- ing plaster. (See Burgundy pitch, p. 399). Action. External. — Cantharides is a powerful irritant, but it is slower in its action than most. If any of its preparations are applied to the skin, no effect is noticed for two or three hours; then a tingling, burning pain is perceived. Soon the part be- comes red from vascular dilatation, the drug now producing its rubefacient effect. The next stage is the formation of several vesicles. These soon run together to form one large bleb full of clear serum. Not only is cantharides an irritant and vesicant, but it is a powerful counter-irritant, probably dilating by re- flex action the vessels of the deep-seated organs under the point of application. Cantharidin can be absorbed by the skin in sufficient quantity to produce internal effects. 532 ORGANIC MATERIA MEDICA. Internal. — Cantharides is hardly used internally in medi- cine, as it is such a powerfal irritant. Gastro-intestinal tract. — It produces severe gastrointes- tinal irritation, the patient suffering from abdominal pain, diarrhoea and vomiting. There may be a burning pain in the throat; the motions and vomited matters may contain blood. These symptoms naturally cause much general depression. Genito -urinary tract. — The active principle is absorbed into the blood, and a kw hours after the gastro-intestinal symptoms have set in the patient complains of great pain in the loins and strangury — that is to say, there is an urgent desire to micturate ; the effort is very painful from vesical tenesmus, and the quantity of urine passed is very small ; it may contain albumen and blood. In severe cases of poisoning there may be greatly in- creased sexual desire, numerous seminal emissions, violent pria- pism, with swelling and heat of the genital organs. In women cantharides may cause abortion or induce menstruation. Post mortem. — Intense gastro-intestinal inflammation is present, consequently swelling, ecchymoses, and hyperaemia of the mucous membrane of the alimentary canal are observed. The kidneys are found to be very congested and in the early stage of acute nephritis. There is also much inflammation of the genito- urinary mucous membrane. Therapeutics. External. — Cantharides is very largely employed to raise a blister, and it is of all drugs the most commonly used counter- irritant. It is applied to the chest in pleurisy, over the pericar- dium in pericarditis, over the inflamed nerves in neuritis, over the mastoid process in disease of the ear, over joints with chronic effusion into them, over the stomach when there is gastric pain, vomiting, &c. A blister applied over the nerve will often relieve pain in neuralgia. It will be noticed that the collodion and the emplastrum are the strongest preparations, that the unguentum is strong, but the remaining preparations are weak. If a further counter-irritant effect is desired, the blister, which is usually CANTHARIDES. 533 pricked, may be irritated by the application of any irritating ointment; Unguentum Sabinae, (B. P., fresh savine tops, 8; yellow wax, 3; benzoinated lard, 16;) was formerly much used for this purpose. If the irritation produced by the canthar- ides itself is sufficient, a dressing of some simple ointment should be applied when vesication is complete. The cantharides prep- aration should not be left on after the development of the bleb, lest the cantharidin should be absorbed. Cantharides should not be applied to a part on which the patient lies, or a bedsore may form; nor must it be used in renal disease; and it should be care- fully employed in children or debilitated persons. It ought not to be applied to paralyzed limbs. Internal. — The drug is rarely given internally, but it has been used with success in small doses in cases of chronic gleet. Sometimes, but not often, it relieves chordee. APPENDIX, No. I. NON-PHARMACOPCEIAL REMEDIES. The following remedies are official in the British Pharmacopoeia. ACETANILIDE. ACETANILIDUM, B. P. Symbol.— C 6 H 6 .NH.C 2 H 8 0. Synonyms. — Antifebrin, — Phenylacetamide. Source. — Glacial acetic acid and aniline are heated together. C 6 H 5 N H 2 +HC 2 H 3 2 =C 6 H 5 NHC 2 H 3 0- r -H 2 0. Acetanilide is distilled over and purified by crystallization. Characters. — Colorless, scaly crystals, of a peculiar greasy feel and a pungent taste. Solubility, I in 194 of cold water, I in 50 of hot, I in 3^ of alcohol. Freely soluble in ether and chloroform. It melts at 235 F., forming a clear colorless liquid. Dose, 4 to 15 gr. in tablets, cachets, or suspended. Action and Uses. Acetanilide was introduced as an antipyretic but is used chiefly as an analgesic in neuralgic and rheumatic affections. It has been classed among the dangerous remedies, although some of the un- toward results may have been due to impurities. Although it has been employed internally as an antiseptic it can not be recom- mended. See also Phenacetine p. 554. Under the name of Antikamnia a substance has been intro- duced which is probably a mixture of 20 parts of bicarbonate of sodium, 70 of acetanilide and 10 of caffeine. Since acetanilide is a cardiac depressant, the addition of caffeine may be advanta- geous in some cases. ACIDUM MECONICUM. MECONIC ACID.— Symbol, H 3 C 7 H0 7 . Source. — The meconate of calcium, which is precipitated in the manufac- ture of hydrochlorate of morphine, is placed in hot water and treated with hydrochloric acid. On cooling, meconic acid crystallizes out. 534 APPENDIX. 535 Characters. — Almost colorless, micaceous crystals. Solubility, i in 150 of water, 1 in 45 of alcohol ; it is decomposed by boiling water. Preparation, B. P. Liquor Morphinae Bimeconatis. — Morphine is precipitated by ammonia from a solution of the hydrochlorate. It is dissolved in water, alcohol and meconic acid. Strength, I in 80. Dose, 5 to 40 m. ACONITINA. ACONITINE.— C^H^NO^. [?] Source. — It is precipitated from an aqueous solution of an alcoholic extract of the powdered root by ammonia, and then purified. Characters. — A white, amorphous or crystalline alkaloid. Causes tingling and numbness of the skin. An intense poison. Solubility. — I in 2600 of cold water, I in 40 of alcohol or ether, 1 in 1 of chloroform. Must be given internally with great caution. It is very difficult to obtain pure, and com- mercial preparations vary very much. Potash splits it up into benzoic acid, and aconine. Non-officinal species of aconitum yield different kinds of aconitine. Dose, 2^0 & T -> w * tn caut i° n - Preparation, B % P. Unguentum Aconitinae. — Strength, 8 grains in I ounce. ADEPS LANiE. WOOL FAT. — The purified cholesterin fat obtained as a bye-product in the dressing of sheep's wool. Source. — Sheep's wool, washed in cold water, then subjected to heat and pressure, yields a free wool fat. This is purified by melting, washing with an alkali, and then washed with an acid while it is heated. Characters. — Semi-transparent, pale yellow, tenacious body. Ignited, it burns with a sooty flame. Melts between ioo° and 112 F. ; odor like sheep's wool. Solubility. — Freely in chloroform and in ether, partially in alcohol. Insoluble in water, but on vigorous shaking takes up 1% times its own weight. ADEPS LANiE HYDROSUS. HYDROUS WOOL FAT.— Synonym.— Lanoline. Source. — Incorporate 3 oz. of water with 7 oz. of wool fat, and melt in a warm mortar. Characters. — Of a very pale-yellow, softer than wool fat. On heating it gives up its water. Glycerin also abstracts the water. 53^ appendix. Action and Therapeutics. Hydrous wool fat when gently rubbed in the skin is more quickly absorbed than most fats, hence it is a useful basis if we wish to administer substances — as, for example, mercury — by inunction. ALBUMEN. OVI ALBUMEN.— Egg albumen, B. P. The liquid white of egg of G alius Bankiva var, domesticus (Ord. Gallincs.) Action and Therapeutics. It is an antidote of poisoning by corrosives and irritants, es- pecially bichloride of mercury, sulphate of copper, lead salts and nitrate of silver. It is nutritive. ALCOHOL AMYLICUM. ALCOHOL AMYLICUM. Synonym— Fusel Oil. Symbol.— C 5 H n HO. Source. — Separated during the rectification of crude spirit and redistilled at from 25 3 to 260 F. Characters. — A colorless, very inflammable, oily liquid, with a peculiar odor. Sp. gr. 0.818. Used to make nitrite of amyl and valerianate of sodium. Uses. Fusel oil is a poison and is not used in medicine. The man- facturers of cinchona alkaloids use it as a solvent ; formerly it was wanted for the preparation of valerianic acid. ALOIN. ALOIN. Symbol. — C 16 H 18 7 . — A crystalline, neutral principle, ex- tracted from aloes by solvents and recrystallization. Characters. — Tufts of yellow, acicular crystals. Solubility. — Freely in hot fluids, sparingly in cold water or cold alcohol, not at all in ether. Rapidly altered by alkalies. The specimens of aloin are named according to the variety of aloes from which they are derived ; thus we have barbaloin, socoa- loin, nataloin (Natal), and zanaloin (Zanzibar). They differ very slightly from each other. They are isomeric, and their action is the same. Aloin is the active principle in aloes, but it does not gripe so much. Dose, ^ to 2 gr. APPENDIX. 537 ANETHUM. DILL. — The dried fruit of Peucedanum graveolens (Nat. Ord., Umbelliferce). Middle and Southern Europe. Characters. — Broadly oval, ^ in. long, brown, flat, with a pale, broad, membranous border. Mericarps distinct, odor and taste agreeable and aromatic. Resembling dill, conium, anise, fennel, caraway; but dill is winged. Composition. — The chief constituent is the officinal volatile oil (q. v.). Preparation, B. P. Aqua Anethi — Dill fruit I, water 10. Dose, i to 2 fl. oz. OLEUM ANETHI.— The oil distilled in Britain from the dill fruit. Characters. — Pale yellow, odor pungent, taste hot and sweetish. Composition. — The chief constituents are (i) Anethum, a terpene, (2) the oxidized oil identical with caruol. (See page 424.) Dose, 1 to 4 m. Action and Therapeutics. The same as those of anise and caraway. Dill water is a common carminative for children, and it covers very well the taste of sodium salts. ANTIPYRIN. PHENAZONUM, B. P. Synonym.— Phenyl— dimethyl— pyrazolone. Symbol.— C 6 H 5 (CH 3 ) 2 C 3 HN 2 0. Source. — Aceto-acetic ether is acted upon by phenyl-hydrazine, when phenyl-monomethyl-pyrazo'one, ethyl alcohol, and water are formed. CH 3 COCH 2 COOC 2 H 5 + H 2 NNHC 6 H 5 =C 6 H 5 (CH 3 )C 3 H 2 N 2 0+C 2 H 5 OH+ H 2 C The monomethyl compound is treated with methyl iodide and methyl alcohol. C 6 H 5 (CH 3 )C 3 H 2 N 2 0+CH3l=C 6 H 5 (CH 3 ) 2 C 3 HN 2 0-[-HL Characters. — Colorless, odorless, scaly crystals of a somewhat bitter taste, freely soluble in water, alcohol and chloroform. Incompatibles. — Sulphate, iodide, chloride of iron ; sulphate of copper ; iodine ; iodide of arsenic; carbolic, hydrocyanic, and nitric acids ; permanganate of potassium ; salicylates ; perchloride of mercury ; spirits of nitrous ether ; all preparations of tannin give a white precipitate ; calomel decomposes it. Dose, 3 to 20 gr. Action and Therapeutics. Antipyrin is given internally as a powerful antipyretic. It is also used as a haemostatic in haemorrhoids and epistaxis. It has been 46 53^ APPENDIX. used with some success in diabetes. It is largely employed as an anti-neuralgic and anti-rheumatic. Externally it is supposed to be an antiseptic, but local irritation has followed its hypodermic use, see also Phenacetine p. 553. Salipyrin is prepared by the action of antipyrin upon salicylic acid in substance. It is a white, coarsely-crystalline powder with a rather sweetish taste, readily soluble in alcohol, but slightly in water. The dose is twice that of antipyrin. In chronic articular rheumatism and rheumatic sciatica it has been successful, but it does not prevent relapses. lodopyrln, or iodontipyrin, is supposed to have a hydrogen atom in the phenyl group of antipyrin replaced by iodine. It is found in colorless, prismatic needles, which are tasteless. It is, with difficulty, soluble in cold water or alcohol but readily when hot. It causes a fall of temperature and perspiration but without collapse or shivering. It is doubtful if it has any advantage over antipyrin. The dose is from 8 to 24 grains. ARMORICA. HORSE RADISH.— The fresh root of the Cochlearia Armorica (Nat. Ord. Cruciferce). Cultivated in United States. It is most active in the autumn and early spring, before the leaves have appeared. Characters. — A long, cylindrical, fleshy root, enlarged at the upper end, where it is marked by the scars of fallen leaves, ]/ 2 to I inch in diameter, and usually a foot or more long. Pale yellowish or brownish-white externally ; whitish and fleshy within. Taste very pungent. Inodorous unless bruised or scraped. Resembling horseradish root. — Aconite root, which is shorter, conical, not cylindrical, darker, and causes tingling and numbness when chewed. Composition. — The chief constituent is a substance, which by the action of a ferment, yields a volatile oil identical with that of mustard. Preparation, B. P. Spiritus Armoricae Compositus. — Scraped horseradish root, 20 oz. ; bitter orange peel, 20 oz. ; nutmeg, y^ oz. ; alcohol, I gal. ; water, 3 pints. Dose, 1 to 2 fl. dr. Action and Uses. Horseradish is a condiment, having the same action as mustard. APPENDIX. 539 It has been used as a counter-irritant. The spirit is a pleasant flavoring and carminative agent. BARIUM. (Not officinal.) BARIUM. — Symbol, Ba. Combining weight, 137. Barii Chloridum, — Chloride of Barium, BaCl 2 2H 2 0. Characters. — Colorless, translucent tables. Dose, y 2 to 2 gr. Action. It causes the cardiac contractions to become slower and more forcible, acting like digitalis. The blood-vessels are constricted, and the blood-pressure rises. The plain muscular fibres of the intestine may be excited, and the peristalsis is increased. In these respects it resembles ergot as well as digitalis. It acts like veratrine when applied locally to voluntary muscles, prolonging the contraction \ but this effect is done away with by the applica- tion of potassium salts. Therapeutics. It is not often given, but it has been used for mitral insufficiency accompanied by irregularity of the heart, for haemorrhage, and as a stimulant in atony of the bladder or intestine. Formerly it was given in nervous diseases. Toxicology. Poisonous doses cause salivation, thirst, vomiting, purging, difficulty of breathing, and, from its action on the spinal cord, paralysis of the limbs. The heart is arrested in systole. BELA. BAEL FRUIT.— The dried half-ripe fruit of JEgle marmelos. (Nat. Ord. Rutacece.) From Malabar and Coromandel. Character. — Roundish fruit, the size of a large orange, usually im- ported in fragments of the hard, woody rind, with adherent dried pulp and seeds. Composition. — Not known. 54° APPENDIX. Preparation, B. P. Extractum Belae Liquidum. — Bsel fruit, I ; water, i t l. Dose, i to 2 fl. dr. Action and Therapeutics. The imported bael fruit is useless. In India the extract of the fresh fruit is used for the treatment of diarrhoea and dysentery ; but its mode of action is unknown. BUTYL-CHLORAL HYDRAS. HYDRATE OF BUTYL-CHLORAL.— C 4 H 5 C1 3 0,H 2 0. Synonym. — Croton chloral hydrate. (This is a misnomer). Source. — Dry chlorine gas is passed through aldehyde. Butyl-chloral (C 4 H 5 C1 3 0) is formed. It is separated by fractional distillation, and water added. Characters. — Pearly-white, crystalline scales, with a nauseous taste and a pungent odor like chloral. Solubility, I to 50 of water, freely in alcohol and glycerin. Incompatibles. — All alkalies. Dose, 5 to 20 gr. Action and Therapeutics. The action of this drug is exactly similar to that of chloral, but butyl-chloral hydrate is less certain in its effects. It is said to be less depressant to the heart, but this is doubtful. It has a specific action in relieving neuralgia of the fifth nerve. CAFFEINE CITRAS. CITRATE OF CAFFEINE. Symbol. — C 8 H 15 N 4 2 ,H 3 C 6 H 5 7 . This may not be a true chemical compound. Source. — Dissolve citric acid and caffeine in hot water; evaporate to dryness and pulverize. Characters. — A white, inodorous powder; is a feeble compound, easily splitting up. Taste and reaction acid. Solubility . — I in 32 of water, 1 in 22 of alcohol, I in 10 of a mixture of 2 of chloroform and I of alcohol. With 1 in 10 of water, it forms a clear, syrupy, supersaturated solution, but directly the mixture is stirred the citrate of caffeine is precipitated; then, if more water is added, the precipitate redissolves. This peculiarity in the solubility of citrate of caffeine often leads to mixtures being prescribed in which the citrate of caffeine is precipitated, and then it can be suspended in mucilage. Incompatibles. — Iodide of potassium, salts of mercury and tannic acid. APPENDIX. 541 CANELLA. CAN ELLA. — The bark of Canella alba (Nat. Ord. Canellacece) deprived of its corky layer and dried. From South Fiorida and the Bahamas. Characters. — Quills 3 to 8 in. long, or flattish pieces. Externally, orange, brown or buff, with sometimes remains of corky layer in gray patches ; whitish internally. Agreeable odor, like cloves and cinnamon ; bitter taste. Composition. The chief constituents are (i) a volatile oil (1 per cent.), consisting of several oils, one of which is identical with eugenic acid, from oil of cloves ; (2) a bitter principle, canellin. No tannin is present. Dose, 15 to 60 gr. Action and Uses. Canella bark is an aromatic bitter stomachic not often pre- scribed. CASCARA SAGRADA. Synonyms. — Sacred Bark, Chittem Bark. The dried bark of Rhamnus Purshianus, California buckthorn (Nat. Ord. Rhamnacece). From the North Pacific coast. Characters. — Quills or incurved pieces. The bark is only ^ to }/% in. thick. Externally grayish-white, smooth, marked with lichens ; internally brown, nearly smooth, and striated longitudinally. Fracture short externally, fibrous internally. No odor. Bitter taste. Composition. — The chief constituents are a bitter brown resin, a yellow resin, a red resin, a neutral substance, various acids, and a volatile oil. Preparations, B. P. 1. Extractum Cascarae Sagradae. — Alcoholic and aqueous. Dose, 2 to 8 gr. 2. Extractum Cascarae Sagradae Liquidum. — Alcoholic and aqueous. Dose, y 2 to 2 fl. dr. Action and Therapeutics. Cascara sagrada is a simple laxative and aperient, not causing much griping, and resembling in its action frangula bark, but it is more certain and more active. The bitter principle gives it stomachic properties. It is very serviceable for constipation, especially if chronic. A single pharmacopceial dose may either be taken in the even ng, or 10 to 15 Ttl of the liquid extract may 542 APPENDIX. be given three times a day before meals. One advantage of its use is that gradually increasing doses are not required. The liquid extract is very bitter ; this taste may be concealed by aromatics, liquorice or sal volatile, and it may be given in chloroform water. The Brit. Pharm. Conference advises the following syrup : — Liquid extract of cascara sagrada, 4?; liquid extract of liquorice, 3^; Tinctura Carminativa, 2 5 ( see Cardamom); syrup to 1 pt. Strength, 12 Tit of the liquid extract to 3j- Dose, 1 to 4 g. COCAINE HYDROCHLORAS. HYDROCHLORATE OF COCAINE. Symbol.— C 17 H 21 N0 4 ,HC1. Source — Agitate with ether, an aqueous solution of an acidulated alcoholic extract, made alkaline with carbonate of sodium ; separate and evaporate the ethereal liquid ; purify by repetition ; decolorize, neutralize with hydrochloric acid, and recrystallize. Characters. — Colorless, acicular crystals, or a colorless powder. Solu- bility. — 2 in 1 of water, 1 in 2^ of alcohol, I in 2^ of glycerin. The solution has a bitter taste, it produces in the mouth a slight tingling followed by prolonged numbness. Dose, ^ to 2 gr. For hypodermatic use, hydrochlorate of cocaine 100, salicylic acid 1.5, distilled water to 1000. Dose, 2 to 10 m. by the mouth, or 1 to 5 m. subcutaneously. Action and Therapeutics {see p. 313). CUSP-ARIA. CUSPARIA CORTEX. — Cusparia Bark. Synonym.— Angustura Bark. The bark of Galipea cusparia (Nat. Ord. Rutacece). From tropical South America. Characters. — Flat or curved pieces or quills, 6 inches or less long, l /(y inch thick, obliquely cut on inner edge. Externally a yellowish-gray, mottled, corky layer, which can be scraped off, and shows a dark brown resinous layer ; inner surface light brown, flaky. Fracture short, resinous, and showing under a lens, white points or lines. Taste bitter, aromatic. Odor musty, disagreeable. Resembling cusparia. — Canella Alba, but this is darker, and has pared edges. Impurity. — Bark of Strychnos nux-vo??iica (false Angustura bark) : its inner surface gives bright blood-red color with nitric acid, showing brucine ; cusparia does not. APPENDIX. 543 Composition. — The chief constituents are — (i) Cusparine, or angusturine, a crystalline bitter alkaloid. (2) An alkaloid, galipeine. (3) An aromatic oil. It is stated that no tannin is present, but iron salts are incompatible wilh cusparia. Incompatibles. — Mineral acids and metallic salts. Dose, 10 to 40 gr. Preparation, B. P. Infusum Cuspariae. — 1 in 20 of water at 120 F. (to avoid ex- traction of nauseous principles). Dose, 1 to 2 fl.'oz. Action and Therapeutics. Cusparia bark is an aromatic bitter, having a similar action to calumba. It is used to make Angustura Bitters. In South Amer- ica it is given as an antiperiodic. ELEMI. MANILA ELEMI. — A concrete resinous exudation probably from Canarium commune. (Nat. Ord. Burseracece.) From Manila. Characters. — A soft unctuous mass, becoming harder and yellowish by age. Strong fennel-like odor. Resembling Elemi. — Asafcetida, Galbanum, Ammoniacum, but Elemi is known by its smell. Composition. — The chief constituents are — (1) Resinous bodies, 80 per cent. (2) A terpene. Preparation, B. P. Unguenti Elemi.— Elemi, 1 ; simple ointment, 4. Action and Therapeutics. Elemi acts like oleo-resins generally, but is only used as a stimulant and disinfectant ointment. EUCALYPTUS. EUCALYPTUS GUM. Synonym. — Red Gum. A ruby-colored exu- dation from the bark of Eucalyptus Rostrata (Nat. Ord. Myrtacece) and from other species. Australia. Characters. — An inspissated secretion forming semi-translucent and garnet-colored granules. Tough and difficult to powder. Adheres to the teeth when chewed. Soluble in water. Resembling Eucalyptus Gum. — Kino, which is darker and feebly soluble in water. 544 APPENDIX. Composition. — The chief constituents are (i) Kino-tannic arid, (2) Catechin, (3) Pyrocatechin. Dose, 2 to 10 gr. in a powder, or in an aqueous solution or made into a pill with mucilage of acacia. Action and Therapeutics. Red gum is, in virtue of its tannic acid, powerfully astringent and is used in diarrhoea and dysentery. Lozenges, 1 grain in each, with fruit paste, or a decoction of 1 in 40, as a gargle, are em- ployed for relaxed throats. This decoction may also be given in 2 to 4 Z doses for diarrhoea. A fluid extract (red gum, 7 ; water, 21 ; alcohol, 1; dose, ^ to 1 fl. dr.) is a useful prepara- tion. Injected into the nose it stops epistaxis. Mixed with 1 to 10 of water it may be injected into the rectum or vagina, or may be used as a mouth wash. Suppositories, each containing 5 gr. of red gum, are prepared, and may be employed for piles. FARINA. FARINA TRITICI. — Wheaten Flour. The grain of wheat, Triticum sativum (Nat. Ord., Graminacece), ground and sifted. Composition. — The chief constituents are (1) starch, (2) gluten, (3) sugar ; (4) mucilage, (5) salt, (6) water. Action and Therapeutics. Flour is used in the form of Mica Panis (bread crumb) as a basis for pills, and in the making of cataplasmata. FERRUM. FERRI ARSENIAS. — Arseniate of iron. It consists of both ferrous and ferric arseniates, with some oxides. Source. — Mix hot solutions of arseniate of sodium and sulphate of iron, add bicarbonate of sodium to neutralize the free sulphuric acid that is formed. Arseniate of iron is precipitated. Characters. — A greenish, amorphous powder, insoluble in water. Impurities. — Sulphates. Dose, y 1 ^ to y z gr., as a pill. Uses. The arseniate of iron is used when a combination of these metals fs required. APPENDIX. 545 GELATINUM. GELATINE. — The air-dried product of the action of boiling water on gelatine tissue, as skin, tendons, ligaments, etc. Characters. — The translucent sheets or shreds. The solution in hot water is colorless and inodorous ; it solidifies to a jelly on cooling. It is insoluble in alcohol or ether. Its aqueous solution is precipitated by tannin. Action and Therapeutics. It is useful as a basis for suppositories, pessaries, bougies, cap- sules, lozenges, and as a coating for pills. HEMIDESMUS. HEMIDESMUS. — The dried root of Hemidesmus indicus (Nat. Ord. Asclepiadacece). Synonym. — Indian sarsaparilla. India. Characters. — Cylindrical, twisted, longitudinally, furrowed ; six inches long, their yellowish-brown corky layer easily separable from the rest of the bark, which is annularly cracked. Odor fragrant, taste sweetish. Resembling hemidesmus. Sarsaparilla, ipecacuanha, senega, but they have no cracks. Composition. — The chief constituents are (i) coumarin, (2) tannin (3) hemidesmic acid. Preparation, B. P. Syrupus Hemidesmi. — I in 10. Dose, 1 to 2 fl. dr. Action and Therapeutics. It is used chiefly in India, and for the same purposes as sarsa- parilla. HIRUDO. THE LEECH. — Two species are officinal, (1) Sanguisuga medicinalis, the speckled leech (belly greenish-yellow, spotted with black) ; (2) Sanguisuga officinalis, the green leech (belly olive-green, not spotted). (Nat. Ord. Anne- lida?) Characters of both species. — Body, soft, smooth, 2 or more inches long, tapering to each end, plano-convex, wrinkled transversely, back olive- green, with six rusty-red longitudinal stripes. Each leech has a muscular disc at each end. In the center of the anterior one is a triradiate mouth, provided with three saws and two rows of teeth. Action and Therapeutics. Leeches are used to remove blood. They are usually applied over deep-seated organs when they are congested, and great 546 APPENDIX. relief is often afforded. For example, three or four leeches near the liver, when that organ is enlarged in heart disease, or one or two behind the ear, when the tympanic cavity is inflamed, frequently do good. The leech being applied to the skin, the animal fixes itself by its sucker-like disc, makes a triradiate cut with its mouth, aud draws into its body, which consequently becomes swollen, about a drachm and a half of blood. If this is not sufficient, a hot fomentation put on, after the animal is removed, may in- crease the quantity to half a fluid ounce. The skin should be well washed with a little milk before the leech is applied. Oc- casionally the haemorrhage requires pressure, or some local styptic, as perchloride of iron, or better styptic collodion, to stop it. If leeches have to be applied to the mouth, rectum, or uterus, leech glasses, which only allow the head to protrude, should be used. HOMATROPINE HYDROBROMAS. HYDROBROMATE OF HOM ATROPINE. — Symbol, C 16 H 21 N0 3 HBr. The hydrobromate is an alkaloid prepared from tropine. Homa- tropine is really oxytoluyl-tropine. Source. — (i) Tropine (C 8 H 15 NO), a derivative of atropine is heated with oxytoluic acid in the presence of hydrochloric acid ; (2) ammonia is added, and pure homatropine shaken out with chloroform; (3) the chloroformic solution is evaporated; (4) the homatropine is neutralized with hydrobromic acid. Characters. — Small prismatic white crystals. Solubility. — I in 10 of water, 1 in 133 of alcohol. Dose, T ^Q to 2V S T - subcutaneously. Action and Therapeutics. Homatropine has an action exactly similar, so far as we know, to that of atropine. It is only used to dilate the pupil in oph- thalmic practice, the advantage over atropine being, that the dilatation produced by homatropine passes off in a quarter of the time. It maybe applied as a solution (4 gr. of the hydrobromate to §j, of distilled water). To dilate the pupil -^q-q of a grain is sufficient. Sometimes a solution in castor oil is used, for it is less likely to be washed out by the tears, but it may be rather irri- tating. APPENDIX. 547 HORDEUM. HORDEUM DECORTICATUM.— Pearl Barley. The dried seed of Hordeum distichon (Nat. Ord. Graminacece) divested of its integuments. Britain. Characters. — White, rounded, with a slight longitudinal furrow. Composition. — As of wheat. Preparation, B. P. Decoctum Hordei. Synonym. — Barley water. I to 15. Dose, freely. Action and Therapeutics Barley water forms a pleasant demulcent drink, especially if the throat be dry and sore. LAUROCERASUS. CHERRY LAUREL.— The fresh leaves of Prunus laurocerasus (Nat. Ord. Rosacea). Europe. Characters. — Thick coriaceous, in short strong petioles, oblong or ovate, 5 to 7 in. long, tapering towards each end, recurved at the apex, dis- tantly but sharply serrated, dark-green, smooth and shining above, pale be- neath. Prominent midrib with, on either side of it at the base, one or two glandular depressions. Inodorous, except on bruising, when they emit a ratafia-like odor. Composition. — The chief constituents are — (1) Laurocerasin, a gluco- side ; it is a compound of amygdalin and amygdalic acid. (2) Pmulsin. By the same changes as in the case with bitter almond {see p. 470), in the pres- ence of moisture or oil, prussic acid and glucose are formed. Preparation, B. P. Aqua Laurocerasi. — Made by distillation and standardized so that its strength is 0.1 per cent of absolute hydrocyanic acid. "Incompatibles. — Metallic salts. Dose, y 2 to 2 fl. dr. Action and Therapeutics. Aqua laurocerasi is not often employed ; owing to the volatiliz- ation of the prussic acid, its strength is not constant Its action is the same as that of dilute hydrocyanic acid, (see p 258). It is used as a flavoring agent. 54^ APPENDIX. MENTHOL. MENTHOL. — C 10 H 20 O. A stearopten obtained by cooling the oil dis- tilled from the fresh herb Mentha piperita (Britain) and Mentha arvensis vars. piperascens et glabrata (Nat. Ord. Labiates). Japan {see p. 420). Characters. — In fused crystalline masses or colorless, acicular crystals, moist from adhering oil, odor as of peppermint. Taste of peppermint ; the subsequent coldness in inhalation of air is well marked. Solubility. — Very sparingly in water or glycerin, 5 in 1 00 of alcohol, solution neutral, 4 in I in chloroform, I in 4 of olive oil. Impurities. — Glass and sulphate of magnesia. Dose, yi to 2 gr. Action and Therapeutics. Menthol is chiefly employed externally, for it produces local anaesthesia, a feeling of coldness and numbness, and thereby al- leviates the pain of neuralgia, especially if it involves a superficial nerve. It is very efficacious in some cases. The solid menthol in the form of a cone, may be drawn along the skin, or an al- coholic solution may be painted on, or a plaster (menthol, 2 ; yellow wax, 1 ; resin, 7 ; spread upon rubber cloth) may be ap- plied, a solution made by heat with oleic acid (1 to 2.4) is an ex- cellent preparation. The local application often relieves itching. It has been applied locally to carious teeth, and has been used with advantage in asthma. It is readily volatilized by the addition of hot wajter. Solutions of it have been painted upon the throat in diphtheria. Its internal administration has been abandoned as useless. It is a pure antiseptic. Menthol should be preserved in closed tin boxes. MORUS. MULBERRY JUICE.— The juice of the ripe fruit of Morus nigra (Nat. Ord. Urticacece). Britain. Characters.— Well known. Composition. — The chief constituents are — (1) Grape sugar. (2) Malic acid. Preparation, B. P. Syrupus Mori. — Mulberry juice, 1 pint ; sugar, 2% lbs.; alcohol* 2^ fl. oz. Dose, 1 to 2 fl. dr. appendix. 549 Action and Therapeutics. The juice of Mulberries is used as a coloring and flavoring agent. NECTANDRA. NECTANDRA.— Bebeeru Bark. The bark of Nectandra Rodicei, the greenheart tree (Nat. Ord. Laurinece). British Guiana. Characters. — Flat, heavy pieces, 1 to 2 feet long, 2 to 6 in. broad, ^ to )£ in. thick. Externally grayish -brown, internally dark cinnamon-brown, with longitudinal striae. Hard, brittle, coarse-grained fracture, no odor, taste bitter, astringent. Composition. — The chief constituents are — (1) Beberine, officinal B. P. as the sulphate. (2) Tannin. BEBERINE SULPHAS. SULPHATE OF BEBERINE. Symbol.— C 36 H 42 N 2 6 . Source. — (1) Exhaust bebeeru bark with dilute sulphuric acid, remove the excess of this by the addition of lime, precipitation of sulphate of lime, and nitration. (2) From the fluid, precipitate beberine with ammonia. (3) Dry it, dissolve in alcohol. (4) Distill off the alcohol, dissolve the residue in sulphuric acid, purify and dry at 140 F. Characters. — Dark, brown, translucent scales, yellow when powdered. Taste strong, bitter. Solubility. — 1 in 80 of water, sparingly in alcohol. As prepared it is a mixture of several alkaloids, chiefly sulphates of beberine and nectandrine. Incompatibles. — Alkalies and their carbonates, bromide of potassium, lime water, tartaric acid, tartrates, astringents, infusions and tinctures. Dose, 1 to 10 gr. Action. Bebeeru bark and beberine are bitter stomachics, having pre- cisely the same action upon the stomach as calumba. They were introduced because they are slightly antipyretic and antiperiodic. Beberine is a feeble antiseptic. Therapeutics. These substances are seldom used, as there are many other more convenient bitter stomachics, and their antipyretic and antiperiodic action is feeble. 55° APPENDIX. NITRO-GLYCERIN. TRINITRITE OF GLYCERIN. — Symbol, C 3 H 5 [(N0 2 )0]3. Synonym. — Trinitrin, Glonin. Source. — Glycerin is dropped into a mixture of sulphuric and nitric acids kept cool by ice. Characters. — A colorless oily liquid. Sp. gr. 1.6. Slightly soluble in water, easily in fats, oils, alcohol, and ether. Highly explosive. Mixed with silica, forms dynamite. Dose, 2 Jo to To & T * Never used undiluted. Is best administered in a I per cent, solution ot alcohol or in tablets of chocolates. Action and Therapeutics. Its action is the same as that of nitrite of amyl {see p. 244), ex- cept that the effects of nitro-glycerin are more persistent, and as it is only suitable for internal administration, they are slower in their onset. It is largely taken by persons liable to cardiac pains with the object of warding off the attack. Some authors regard it as a nitrate of glycerine, but certainly physiologically it be- longs to the class of nitrities. Those who look upon it as a nitrate, suppose that directly it gets into the body, a nitrite is formed. OLEUM ANTHEMIDIS. OIL OF CHAMOMILE.— The volatile oil distilled from chamomile flowers. Characters. — Pale blue or greenish-blue, becoming yellowish-brown. Odor and taste like chamomile. Composition. — The chief constituents are (1) a terpene (C 10 H l6 ), and (2) an oxidized portion which readily yields angelic and tiglinic acids. (3) A bitter principle. Dose, 1 to 4 m. Action and Therapeutics. Internally, like other volatile oils, oil of chamomile is a stom- achic and carminative. The infusion in large doses is a simple emetic. OLEUM CADINUM. OIL OF CADE. Synonyms.-—" Huile de Cade," Juniper Tar Oil. An empyreumatic oily liquid obtained by the destructive distillation of the woody APPENDIX. 551 portions of Juniperns oxycedrus (Nat. Ord. Coniferce) and other species. France. Characters. — An empyreumatic oily substance, odor smoky, tar-like, taste aromatic. Sp. gr. about 990. Solubility. — Freely in ether and chlor- oform, partly in alcohol, not in water. Mixes readily with fats and fixed oils. Composition. — Probably much the same as that of tar. Action and Therapeutics. Oil of cade has the same action on the skin as tar, but it is preferable as the odor is pleasanter. The diseases treated by the application of it are psoriasis, chronic eczema, and pruritus. A usual formula, is oil of cade, 1; soft soap, 4; alcohol, 4; or an ointment is used made by melting with it an equal part of yellow wax. OLEUM MYRISTICiE EXPRESSUM. OLEUM MYRISTICiE EXPRESSUM.— A concrete oil obtained by expression and heat from nutmegs. Characters. — Orange-brown, or orange-yellow, mottled, firm consis- tence, odor like nutmeg. Composition. — The chief constituents are (1) oleate of glyceryl C 3 H 5 (C ]8 H 33° 2 )3.(2) Butyrate of glyceryl, C 3 H 5 (C u H 7 2 ) 3. (3) Myristicate of glyceryl C 3 H 5 (C u H 27 2 ) 3. (4) a little volatile oil. (5) a little resin. Action and Therapeutics. Used in plasters as a sweet smelling stimulant. A liniment of Myristica, containing one part of the oil to three of olive oil, is an elegant antiparasitic for mild cases of ringworm. OPIUM. TINCTURA CHLOROFORMI ET MORPHINE B. P.— A close imitation of chlorodyne. (A) Dissolve hydrochlorate of morphine 8 gr. and oil of peppermint 4 HXj in rectified spirit 1 §; add chloroform I |j and ether 2 3 . (B) Mix liquid extract of liquorice, I § ; treacle I g ; and syrup, 3 g . Mix A and B and add dilute hydrocyanic acid )4 § an d increase the bulk to 8 § by adding syrup. Strength, — 10 m. contains chloroform l%m, ether ^m, morphine -£g gr. Dose, 5 to 10 m. 55 2 APPENDIX. PAPAVER. RHGEADOS PETALA.— Red poppy petals. The fresh petals of Papaver Rhozas (Nat. Ord. Papaveracece). Britain. Characters. — Scarlet, with a smell of opium and a bitter taste. Composition. — Red coloring matter 40 per cent. This consists of papa- veric and rhceadic acids. It is soluble in water. The petals contain no mor- phine, nor have they any narcotic properties. Preparation, B. P, Syrupus Rhoeados. — I in 3^. Dose, 1 fl. dr. Action and Uses. Poppy petals are only used as a coloring agent. PARAFFINUM DURUM, B. P. HARD PARAFFIN. Source. — Obtained by distillation from shale, separation of the liquid oils by cooling and pressure, and purification of the solid product. Characters. — A semi-transparent, colorless, crystalline, inodorous, taste- less solid, slightly greasy to the touch. Melts at HO° to 145 F., burns with a bright flame. Solubility. — Freely in ether and chloroform, slightly in alcohol, not at all in water. It is a mixture of several of the harder members of the paraffin series. PARAFFINUM MOLLE, B. P. SOFT PARAFFIN. Synonym.— Vaseline. Source. — Usually obtained by purifying the less volatile portions of petroleum. Characters. — White or yellowish, translucent, soft and greasy, free from acidity, alkalinity, or any unpleasant odor or flavor. Melts at 95 ° to 103 F. Insoluble in water. It is not saponified by caustic alkalies. Uses. As paraffin cannot become rancid, or irritate the skin, it is a very good basis for many ointments; but as it is absorbed with difficulty, it is not a suitable vehicle for the absorption of drugs by the skin. PARALDEHYDE. PARALDEHYDUM, B. P. Symbol, C 6 H 12 3 . Source. — A product of the polymerization of aldehyde by means of various APPENDIX. 553 acids or salts. For example, aldehyde may be acted on by hydrochloric acid, sulphuric acid, or zinc chloride; during the action the mixture becomes hot; on cooling to 32 F. paraldehyde crystallizes. 3C 2 H 4 0==C 6 H 12 3 . Characters. — A colorless liquid of ethereal odor and burning taste. It freezes at 50 F., boils at 250 F. Sp. gr. 0.998. Solubility. — I in 10 of water, freely in alcohol and ether. It should be kept preserved from light and air. Dose, X to 1 fl. dr. Action. External. — It is antiseptic. Internal. — Even large doses do not affect the gastrointes- tinal tract, heart or respiration; but enormous doses of paralde- hyde weaken the action of the heart, and kill by paralysis of the respiratory center. Nervous system. — It is a powerful hypnotic, without any unpleasant after effects. It acts quickly, and the sleep, which lasts several hours, is quiet, refreshing and dreamless. Paralde- hyde in toxic doses paralyzes the anterior cornua of the spinal cord ; thus it abolishes reflex action and causes paralysis. It does not affect nerves or muscles. Therapeutics. It is given solely as an hypnotic in the same class of cases as chloral, and as it does not act on the heart it may also be used for patients suffering from cardiac disease. It has been used largely in asylums to produce quiet in mania and sleep in melan- cholia. It may produce an erythematous rash. The great objec- tion to its use is its extremely nasty taste, which is best covered by prescribing it with syrup and tincture of orange peel in at least two fluid ounces of water to insure that a usual dose will be dissolved. It also gives an extremely offensive and persistent odor to the breath. PHENACETINE. PHENACETINUM, B. P. Symbol, C 10 H 13 XO 2 . Synonyms.— Para- acetphenetidin. C 6 H 4 OC 2 H-XHC 2 H 3 0. Source. — Glacial acetic acid is made to act upon paraphenetidin, a pro- duct of phenol. C 6 H 5 OC 2 H 5 XH 2 +HC,H 3 2 =C 6 H 4 OC 2 H 5 XHC 2 H 3 0-f-H 2 0. 47 554 APPENDIX. Characters. — Colorless scaly crystals, very sparingly (i in 1700) soluble in water. Soluble in 30 parts of alcohol, soluble in glycerin. Dose, 5 to 20 gr. (as an antipyretic), in cachets, capsules, or suspended. Action of Acetanilide, Antipyrin and Phenacetine. None of these has any action externally or on the gastrointes- tinal tract. Blood. — With ordinary doses of these drugs this fluid is un- affected, but in large doses the color is changed, from the forma- tion of methsemoglobin. The passage of this in the urine dis- colors it. Acetanilide causes the red corpuscles to break up, and arrests the movements of the white. We do not know for cer- tain whether the other two substances can produce this result. N Heart. — All these substances depress the heart. It is not known how they do this, but what little evidence there is appears to show that they have a directly paralyzing action on the cardiac muscle. This cardiac depression is much less marked with phenacetine than the- other two, and is perhaps less with acetan- ilide than antipyrin. Vessels — Acetanilide and antipyrin contract the smaller ves- sels from direct action on their muscular coat. The blood-pressure therefore rises. Both these substances are, owing to this prop- erty, local haemostatics. J? espir a tion.— This is not affected by ordinary doses. After toxic doses the force of the respiratory act progressively dimin- ishes. Kidneys. — These substances are all mild diuretics. The ex- cretion of urea is stated to be increased by them, but some say it is diminished. Large doses of any of them cause the urine to be dark from the passage of altered blood. Antipyrin is quickly excreted as such in the urine. Acetanilide is said to be excreted as aniline, but this requires confirmation. Skin. — Any of these three drugs may produce an erythema- tous rash, and they are occasionally mild diaphoretics. Temperature. — These three substances are all powerful anti- pyretics. They have a very slight action on the temperature of APPENDIX. 555 health, but they reduce it very markedly when it is raised from any cause. They were all introduced into medicine for this property. We have already seen {see p. 61) how numerous are the ways in which antipyretics may act. The fall of temperature produced by these drugs is not due to any action on the blood or the circulation, and it is too marked to be entirely owing to their slight diaphoretic action. They all decrease heat production, and it is most likely that they act directly upon that part of the central nervous system, probably the corpora striata, which presides over heat production. They all to a much less extent increase heat dissipation. The result of these two actions is that the temperature falls The proof of these statements is too long and complicated to give here, but we may mention that it is easy to show both by a calorimeter, and by the decrease of the pro- ducts of the febrile destruction of tissue, such as urea, that these drugs diminish heat production. The experiments which have been made to show that this is due to an action on the central nervous system are intricate and require confirmation. Nervous system. — These three drugs are powerful analgesics. Acetanilide and antipyrin in large doses are said to produce first convulsions, then coma and paralysis of motor nerves and mus- cles; but all these statements require further experiments. Therapeutics of Acetanilide, Antipvrin and Phenacetine. Pyrexia. — These three drugs have been very largely used to reduce the temperature in fever. All physicians are agreed that when this is over 105 or 106 F. it is desirable to bring it down. In most cases these drugs are the best means of doing this, but as they all take a little time to act, if the temperature is rising ex- tremely rapidly it is better to reduce it by means of a cold bath. Opinions are divided as to whether it is beneficial to reduce febrile temperatures of less than 105 . Probably if the fever lasts only a short time it is not necessary to reduce it, and therefore it is not usual to treat the short specific fevers as measles and scarlet fever with antipyretics. But if the fever last a long time, as in tuberculosis or typhoid fever, many hold that it is beneficial to 556 APPENDIX. give antipyretics to prevent the tissue waste entailed by the pyrexia. The practice is very common on the Continent, and fairly common in England. Some give the antipyretic if the tem- perature reaches 102. 2 F., but a commoner point to choose, in this country at least, is 103 F. Usually a single dose is given whenever the temperature, which is taken every two or three hours, reaches the point fixed. It usually falls to about 99 or ioo° F. soon after the administration of the drug. Phenacetine has the great advantage of depressing the heart very little, and rarely producing the alarming toxicological effects described below. It is, however, very insoluble, and slower and less power- ful in its action than the other two, but the effect lasts longer. Authorities differ as to whether antipyrin or acetanilide is to be preferred for general use. Antipyrin has the advantage of being soluble, but the balance of evidence is that toxicological symp- toms are less common after acetanilide, which, however, does not keep the temperature down quite so long as antipyrin. Both take about two hours to reduce the pyrexia to its minimum, the last named being rather the more rapid of the two. Antipyrin may be given subcutaneously, but this is not advisable, as absces- ses may be produced. Either may be given per rectum. Analgesic action. — All these drugs have the property of re- lieving pain. It is least marked with acetanilide, most with anti- pyrin ; but as phenacetine possesses it very strongly, it is, per- haps, on the whole, to be preferred as an analgesic, for toxic re- sults after it are very rare. These drugs are largely used to relieve the pains of neuralgia, sciatica, locomotor ataxia, migraine and various headaches. The dose of phenacetine for this purpose is 5 grains every hour for three or four hours; this generally gives relief. Doses of 10 grains of antipyrin may be used for the same purpose. This drug has occasionally done good in epilepsy. Toxicology. All of these drugs occasionally produce in man, collapse, cya- nosis, very slow respiration, a feeble and irregular pulse, vomiting, profuse sweating, and profound prostration. It is not known APPENDIX, 557 whether these symptoms are due to impurities in the drugs. Many deaths have been caused by them. It has been stated that during one epidemic of influenza in Vienna, seventeen persons were killed by antipyrin. Treatment. — Stimulation by alcohol and ether, subcutaneous- ly, and by the mouth. Strychnine subcutaneously to stimulate the heart. Warmth to the feet and body. PINUS LARIX. LARCH. — The bark of the Pinus Larix,th.e common larch (Nat. Ord. Coniferce), deprived of its outer rough portion and dried. Collected in the spring. Central Europe. Characters. — Flattish pieces or quills, external surface dark red, un- even ; inner, yellowish or pinkish, nearly smooth. Odor like turpentine. Taste astringent Resembling larch bark. — Red cinchona bark which is very bitter. Composition. — The chief constituents are — (r) Turpentiae. (2) Tannic acid. (3) Larixin, or larixinic acid, a crystalline bitter principle. Preparation B. P. Tinctura Laricis. —Larch bark, I ; alcohol, 8. Dose, 20 to 30 m. Action and Therapeutics. Larch bark is not often prescribed. Its action depends upon the oil of turpentine contained in the turpentine in it. PINUS SYLVESTRIS. OLEUM PINI SYLVESTRIS.— The oil dissolved from the fresh leaves of Pinus sylvestris (Nat. Ord. Coniferce). Russia. Characters. — Almost colorless. Odor aromatic. Taste pungent. Sp. gr. 0.870. Solubility. — 1 in 4 of alcohol. Composition. — The same as that of turpentine. Preparation, B. P. Vapor Olei Pini Sylvestris. — Fir- wood oil, 40 m.; rub with 20 gr. of light carbonate of magnesia ; add water, I ^ . Put 3 j of this in half a pint of cold and half a pint of boiling water, in a vessel so arranged that air, drawn through the liquid, can be inhaled. 55^ appendix. Action and Therapeutics. The action of fir-wood oil is the same as that of oil of turpen- tine (see p. 393). But it is pleasanter to inhale. ROSA. HIPS. — Rosae Caninae Fructus. — The ripe fruit of the Dog Rose, Rosa Canina and other species (Nat. Ord. Rosacea). Britain. Characters. — About 1 in. long, oval, scarlet, shining, smooth, no odor. Taste sweet, sub-acid. Composition. — The chief constituents are — (1) Malic acid. (2) Citric acid. (3) Tannic acid. (4) Sugar. (5) A volatile oil. Preparation, B. P. Confectio Rosae Caninae. — Hips, 1 ; sugar, 3. Action and Therapeutics. This confection is used as a basis for pills. SACCHARIN. GLUSIDUM, B. P. Symbol C 6 H 4 , CO, S0 2 NH. Synonyms.— Ben- zoyl -sulphonic-imide, glucusinide, gluside. - Source. — It is derived from toluene (C 6 H 5 , CH 3 ), a derivative of coal tar, by a complicated process. Characters. — A light, white, crystalline powder. In solution it has an intensely sweet taste; I of saccharin is equal to 300 of cane sugar. Solubility. — I in 400 of cold water ; I in 28 of boiling water ; I in 500 of chloroform ; 1 in 30 of alcohol ; I in 48 of glycerin. It unites with alkaline hydrates and carbonates, evolving from the latter carbonic acid gas, and yields soluble sac- charin, which has lost none of its sweetness, and is very soluble in water. Impurities. — Commercial saccharin is not a pure or uniform product; it often contains less than 50 per cent, of actual saccharin. Dose, y 2 to 2 gr. Action and Therapeutics. Saccharin is an antiseptic but is not used as such It is em- ployed as a sweetening agent, when from any cause, as diabetes, sugar can not be taken. It may be given in tablets, or with car- bonate of sodium, to form soluble solutions. An elixir is prepared, APPENDIX. 559 containing also, bicarbonate of sodium, alcohol and water. The strength is 3 gr. to the fl. dr., and the dose is 5 to 20 m. SAPO ANIMALIS. CURD SOAP. — Soap made with soda and a purified animal fat con- sisting principally of stearin. It is chiefly stearate of sodium. Action and Therapeutics. Curd soap is used as a basis for plasters, liniments, pills and suppositories. SODII ETHYLAS. ETHYLATE OF SODIUM.— Symbol NaC 2 H 6 0. Source. — By solution of metallic sodium in ethylic alcohol and crystalli- zation. Characters. — A deliquescent, caustic salt in white or whitish crystals. Preparation. Liquor Sodii Ethylatis, B. P. — Sodium, I ; ethylic alcohol, 20. This preparation has a sp. gr. of 0.567. Action and Therapeutics. Ethylate of Sodium is used locally as a mild caustic to remove naevi and other growths. SODII NITRIS. NITRITE OF SODIUM.— Symbol NaN0 2 . Source. — Made by heating nitrate of sodium with lead which becomes an oxide, taking oxygen from the nitrate. Characters. — A white, or yellowish, crystalline, deliquescent salt, very soluble in water. Dose, 2 to 5 gr. Action and Therapeutics. Its action is the same as that of nitrite of amyl and other nitrites. It is suitable for the same cases as nitroglycerin, as it is slower and gentler in its action than nitrite of amyl. SODII VALERIANS. VALERIANATE OF SODA.— Symbol NaC 5 H 9 2 Source. — Make valerianic acid by distilling a mixture of amylic alcohol, 560 APPENDIX. sulphuric acid, and bichromate of potassium. Saturate the distillate, which contains valerianic acid, with caustic soda, and evaporate. Characters. — White masses of a powerful valerian-like odor. Solubility. — Easily in both alcohol and ether. Dose, 1 to 5 gr. Action and Uses. The valerianate of soda has the same action and is used for the same purposes as the other valerianates. STROPHANTHUS. STROPHANTHUS. — The mature, ripe seeds of Strophanthus hispidus, var. Kombe (Nat. Ord. Apocynacece), freed from awns. Equatorial West Africa. Characters. — Oval acuminate, greenish-brown, covered with appressed silky hairs, f in. long, }/£ in. broad, base blunt, apex tapering, sides flattened, one side has a ridge from center to apex, dorsal surface convex. Kernel white and oily, consisting of a straight embryo with two thin cotyledons surrounded by their albumen. Odor characteristic. Taste very bitter. Composition. — The chief constituents are — (1) Strophanthin. This is in all probability the same as, or very closely allied to, the active principle oua- baine, which has been isolated from strophanthus. It exists in all parts of the plant, but mostly in the seeds (8 to 10 per cent.). It is a transparent, white, crystalline, bitter glucoside (being split up by acids into glucose and strophan- thidin). Insoluble in chloroform and ether, soluble in water. Ouabaine is said to be less soluble than strophanthin. (2) Kombic acid. (3) Inein, an active principle. Preparation, B. P. Tinctura Strophanthi. — Dried strophanthus seeds, 1 ; alcohol and ether, 20. Dose, 2 to 10 m. Strophanthin may be given hypodermically ; dose, jl^ to fa gr. Action. External. — None. Internal. — Gastro-intestinal tract. — Like digitalis, strophan- thus is liable to cause vomiting and diarrhoea, especially if the dose be large. In small doses its bitter action may come into play, and then it will aid digestion like any other bitter stom- achic. APPENDIX. 561 Heart. — Strophanthus acts on the heart exactly like digi- talis, for it strengthens the force without altering the duration of the systole, slows the rate of the beat, and consequently prolongs the diastole, and makes an irregular heart, regular. In fatal cases of poisoning by strophanthus the heart may be arrested either in diastole or systole. The details of its cardiac action are the same as those of digitalis. Vessels. — It does not constrict the peripheral ves- sels, or at any rate very slightly; therefore, the slow rise of blood pressure is almost entirely due to the action of the drug on the heart. This is the most important difference between it and digitalis, which contracts the vessels powerfully and consequently gives a greater rise of blood-pressure. Kidneys. — It is diuretic, but not nearly so powerful as digi- talis. Probably the diuresis is entirely due to the increased cardiac action No special alteration in the size of the renal vessels takes place under strophanthus. Nervous system. — This is not affected. In toxic doses it is a direct poison to the voluntary muscles. Both strophanthin and ouabai'ne are powerful local anaesthetics when dropped on the conjunctivae. Respiration — No particular effect is produced The African Kombe arrow poison is made from strophanthus. Therapeutics. Strophanthus is used in the same varieties of cardiac disease as digitalis ; that is to say when it is desirable to slow the heart, to increase its force, to make it regular, and to prolong the dias- tole. It is clear, therefore, that it will be chiefly valuable in cases of mitral disease. A priori, it might be thought that as strophanthus does not contract the peripheral vessels and so increase the cardiac resistance, consequently it would be the more useful drug, but experience has not confirmed this, and in the treatment of a case of heart disease, digitalis should be used first; but if the patient does not improve on this, then strophanthus may be tried. It will sometimes happen that strophanthus will not produce vomiting 48 562 APPENDIX. when digitalis does, but there are many individual differences. Digitalis should be given whenever a diuretic effect is desired ; but strophanthus, as it does not constrict the peripheral vessels, is preferable when it is wished to give one of these drugs to a patient suffering from chronic Bright' s disease. Strophanthus is not cumulative. It has been recommended in exophthalmic goitre. Ouabaine has been given in whooping-cough. SULPHONAL. SULPHONAL. — Symbol, C 7 H 16 S 2 4 . Synonyms. — Diethyl-sulphon- dimethyl-m ethane. (CH 3 ) 2 C( S0 2 C 2 H 5 )2. Source. — Mecaptan (ethyl hydrosulphide) is combined with acetone to form meacaptol, which by oxidation with permanganate of potassium yields sulphonal. Characters. — Colorless, tabular crystals, inodorous, almost tasteless. Solubility- I in 450 of cold, I in 15 of boiling water, 1 in 90 of alcohol or ether, 1 in 3 of chloroform. Dose, 5 to 30 gr. Action and Therapeutics. Sulphonal is an hypnotic. It does not depress the heart, but kills by paralysis of respiration. The drug is given for the same class of cases as chloral, but as it is so insoluble it is ab- sorbed with difficulty and very slowly ; hence it takes some hours to act, and its action may be prolonged into the next day. It produces its effect most rapidly if the fluid, in which it is sus- pended, is hot. It has been known to produce persistent erup- tions upon the skin. Several fatal cases of poisoning by this drug have been reported, and as well, severe general functional disturb- ances, have followed its use. THERIACA. TREACLE. — The uncrystallized residue in the refining of sugar. Action and Therapeutics. Treacle is used as a flavoring agent. It is slightly demulcent and laxative. APPENDIX. 563 THUS AMERICANUM. FRANKINCENSE. — The concrete turpentine scraped off the trunks of Pinus tceda, frankincense pine, and Pinus australis, the swamp pine, (Nat. Ord. Conifera). Southern United States. Characters. — When fresh it is a soft, yellow, opaque, tough solid, be- coming darker, dry, and brittle by keeping. Odor and taste as of other turpentines. Composition. — It is like other turpentines, an oleo-resin. Action and Therapeutics. Frankincense is used for the same purposes as resin (see p. 400). UVJE. RAISINS.— The ripe fruit of Vitis vinifera (Nat. Ord. Ampelidce), the grapevine, dried in the sun, or partly by artificial heat. Spain. Composition. — The chief constituents are — (1) Grape sugar, (2) Acid tartrate of potassium. (3) Other acids and salts. Action and Therapeutics. Raisins are used as sweetening agents, and are demulcent. YEAST. CEREVISI^ FERMENTUM.— Beer yeast. The ferment obtained in brewer's beer, and produced by Saccharomyces ( Torula) Cerevisi&y (Nat. Ord. Fungi). Characters. — Viscid, semi-fluid, frothy, exhibiting under the microscope numerous roundish or oval cells, or filaments composed of ceils. Odor peculiar. Taste bitter. Dose, ]/ 2 to 1 fl. oz. Action and Therapeutics. A yeast poultice (yeast 3, water at ioo° F. 3, flour 7,) has been applied to sloughing sores and ulcers, but it is rarely used. ZINCI SULPHOCARBOLAS. SULPHOCARBOLATE OF ZINC. Symbol.-Zn(C 6 H 5 S0 4 ) 2 H 2 0. Source. — Sulphocarbolic acid is formed by adding sulphuric acid to car- bolic acid. This is treated with oxide of zinc, the sulphocarbolate of zinc crys- tallizes on evaporation. 564 APPENDIX. Characters. — Colorless crystals, freely soluble in water. It is not given internally. ZINCI OLEATUM. OLEATE OF ZINC. Source. — By stirring oxide of zinc, 1 ; with oleic acid, 9 ; and heating until solution. Preparation, B. P. Unguentum Zinci Oleati. — Equal parts of oleate of zinc and soft paraffin. Uses. It is an excellent application when a less astringent prepara- tion than the sulphate is required. Equal parts of oleate of zinc, oleate of mercury and diachylon ointment, form an ointment which has the great advantage of be- ing transparent, and therefore the progress of the disease can be observed, without washing off the ointment. APPENDIX No. II. NON-PHARMACOPCEIAL REMEDIES The following drugs, although not in either of the Pharmacopoeias, are more or less often used. ACIDUM PYROGALLICUM. PYROGALLIC ACID. Symbol.— C 6 H s (OH) 3 . Synonym -Pyrogallol. Source. — Obtained by heat from gallic or tannic acid. Characters. — Light, small, white crystals. Odor none. Taste. — Very bitter, it produces a feeling of coldness on the tongue. Solubility.—! in 3^ of water, 1 in 10 of lard. Action and Therapeutics. It is used externally as an ointment (Jarisch's ointment is pyro- gallic acid, 60 gr.; lard, 1 oz.) for the treatment of chronic psoriasis. It is also an excellent parasiticide for ringworm. It must not be applied over too large a surface, as it may be ab- sorbed and produce toxic symptoms. Jarisch's ointment is very strong; a more usual strength is 10 or 20 gr to an ounce of lard. AMMONIO-MERCURIC CHLORIDE. SAL ALEMBROTH. —A double chloride of mercury and ammonium. Source. — Mix 271 parts of corrosive sublimate with 107 of chloride of ammonium, both in solution, and evaporate. Characters. — Flattened rhombic prisms, freely soluble in water or gly- cerin. It contains one molecule of corrosive sublimate combined with two of chloride of ammonium. Three grains of sal alembroth contain two grains of corrosive sublimate It is a very powerful antiseptic, but does not combine with albumen so readily as perchloride of mercury, and it is therefore less irri- tating. Action and Therapeutics. Sal alembroth gauze (containing 1 per cent.) and sal alem- broth wool (2 per cent.), both tinted with aniline blue, which is 565 566 APPENDIX. bleached by the discharge, so that it is easy to see if it has soaked through, are much used to dress wounds antiseptically. Sal alembroth injections (^ gr. in 10 tt[ of water) are a con- venient non irritating form in which to inject mercury subcuta- neously in syphilis. The precautions mentioned on p. 182 should be observed. AMYL COLLOID. — The composition of this is hydride of amyl, 1 ^; aconitine, I gr.; veratrine, 6 gr. ; collodion to 2 §. It is a fluid preparation. Action and Therapeutics. Amyl colloid is painted on the skin over painful areas in neu- ralgia, sciatica, &c. It is an elegant method of obtaining the local anaesthetic action of aconitine and veratrine, which is aided by the evaporation of the hydride of amyl. AMYLENE HYDRATE. Synonyms. — Dimethyl-ethyl- carbi nol ; Tertiary Amyl Alcohol. Symbol. — (CH 3 ) 2 C 2 H 5 COH. Source. — By the action of sulphuric acid on amylene, separation of the amylenesulphuric acid, dilution, filtration, neutralization and distillation. Characters. — A limpid, colorless liquid, of a peculiar odor. Sp. gr. 0.81. It is soluble in 8 parts of water, readily in alcohol, ether or chloroform. Dose, ]/ 2 to 1 fl. dr. Action and Uses. Amylene hydrate is a hypnotic, about midway in power be- tween chloral and peraldehyde, having a pleasanter taste than the latter. It is a safe hypnotic, having no action upon the heart or respiration, and it may have also anodyne properties. It can be administered in wine, raspberry syrup, or simply in water. After continued use it is apt to disagree with the stomach. ARISTOL. Di-thymol di-iodide. Symbol.—^ 7 t C 6 H 2 (OI)C — C(OI)H 2 cJ ^ 7 Source. — It is prepared by the decomposition of a solution of iodine in iodide of potassium, by an alcoholic solution of thymol. It contains about 46 per cent, of iodine. APPENDIX. 567 Characters. — An amorphous brownish-red, odorless, non-toxic powder, insoluble in water and glycerin, soluble in ether and alcohol, is readily taken up by fatty oils. Action and Uses. r It is used for the same purposes as is iodoform {see p. 256) in various skin diseases, as lupus, psoriasis and for tertiary syphilis, both in ointments, lanoline, flexible collodion and as a powder. It has the very great advantage of being free from odor. ASEPTOL. SOZOLIC ACID. — Ortho-phenol-sulphonic acid. Sulphocarbol. Sym- bol — (C 6 H 5 OS0 3 H = C 6 H 4 OHS0 2 H . ) Characters. — A brownish-red, syrupy liquid, formed by the union of car- bolic and sulphuric acids; sp.gr. 1.45. It generally contains one -third sozolic acid. It has a slight odor and is soluble in alcohol, water and glycerin. Uses. Aseptol is an antiseptic, less powerful than carbolic acid; used in aqueous solution, of the strength of five to ten per cent. It is not poisonous, nor has it irritating properties. BENZOSOL. BENZOYL-GUAIACOL.— Symbol.— C 6 H 4 OCH 2 OCOC 6 H 5 . Source. — By formation of a potassium salt from guaiacol, which is warmed with benzoyl-chloride, and recrystallized. Characters. — A colorless, crystalline powder, insoluble in water, readily soluble in hot alcohol, ether and in chloroform. It contains 54 per cent, of guaiacol. Dose, 4 to 12 gr. Action and Uses. Benzosol was introduced as a nearly tasteless combination for the administration of guaiacol, and which would not affect the alimentary tract. In the digestive tract it splits up into guaiacol and benzoic acid. BETAL. Naphthol ; naphthosalol ; Salicylic ether of Beta-naphthol ; Salinapthol. Symbol.— C 6 H 4 OHCOOC 10 H 7 . 568 APPENDIX. Source. — By heating together a mixture of Beta-naphtol-sodium, sodium salicylate in phosphoric chloride. Characters. — A colorless, tasteless, crystalline powder, insoluble in water or glycerin. Dose, 5 to 8 gr. Action and Uses. It was expected to prove as valuable as salol ; its chemical stability and lower degree of solubility were marked disadvantages. It is used to a limited extent for vesical catarrhs, gonorhcea and rheumatism. It decomposes, in the body, into /?-naphthol and salicylic acid. BISMUTHI SALICYLAS. SALICYLATE OF BISMUTH.— Symbol.— Bi(C 7 H 5 3 ) 3 .Bi 2 3 . Source. — Is prepared by diluting a glycerin solution of crystallized bismuthous nitrate with water, and decomposing this with a concentrated aqueous solution of sodium salicylate ; the precipitate is well washed with hot water and carefully dried. It contains about 76 per cent, of bismuth oxide and 23 per cent, of salicylic acid. Characters. — It is a soft, white powder, insoluble in water, glycerin and ether, but soluble in acids. Dose, 5 to 20 gr. Action and Uses. Salicylate of bismuth is an unirritating, intestinal antiseptic, and as such, is of great value as in the treatment 01 diarrhoea, typhoid fever, gastric and intestinal catarrh. BROMOFORM. TRIBROMOMETHANE.- Symbol.— CHBr 3 . Source. — By the action of bromine upon a solution of equal parts of Caustic potash and alcohol. Characters. — A clear, colorless liquid, of a not unpleasant odor, and a sweet taste. Sp. gr. 2.9. It is but slightly soluble in water but is readily sol- uble in alcohol. Dose, 5 to 20 m. Action and Uses. Bromoform is an anaesthetic. It has been used as a remedy of great value for whooping-cough, for which its pleasant taste and convenience of administration gave it great advantage. Cases of poisoning have been reported, so that it must be used with care. APPENDIX. 569 CACTUS. CEREUS GRANDIFLORUS. Synonym.— Night-blooming Cereus. The stems of Cactus Grandiflorus (Nat. Ord. Cactece). West Indian Islands. Characters. — Its branches, or stems are scandent, diffuse, radicant, slightly 5-7 angular; areolae, 5-1 2 spinulose ; spinules short, 2-3 lines long, nearly equalling the whorl ; flowers large, nocturnal, white, pleasantly and strongly fragrant ; the calyx is about 6 to 8 in. in diameter ; the inside being of a splendid yellow, the outside is of a dark brown; the petals of a pure white; and there is a vast number of recurved stamens in the centre. Preparation. Fluid Extract of the fleshy branches with flowers. Dose, 10 to 30 m. Action and Uses. The action of cactus is upon the intra-cardiac ganglia and accelerator nerves, through the cardiac plexus of the sympathetic, and there is not any interference with the inhibitory nerves, nor, indeed, does its administration produce any very marked vaso motor changes. It shortens the ventricular diastole, and in- creases the blood pressure. It is useful in cardiac weakness, that is, relative incompetency; in convalescence from typhoid fever; in simple eccentric cardiac dilatation ; in functional cardiac dis- eases, from tea, coffee, tobacco and alcohol, dyspepsia, neu- rasthenia of the climacteric, sexual exhaustion; in the "slow heart/ ' from overstimulation of the pneumogastric or degeneration of the muscular wall of the ventricles. It is of very great use in aortic regurgitation, but is absolutely contra-indicated in mitral stenosis, thus being of value in those cases where the use of digitalis is inadmissible. It has a sphere of action entirely of its own, not, however, replacing the digitalis or the aconite group, but it is useful in many cases, where these drugs are not only dangerous but absolutely contra-indicated. CHLORALAMIDE. CHLORAL, AM IDE. Synonym. — Chloral formamide. Symbol. — CCl 3 CH,OH,CONH 2 . Source. — rBy the combination of chloral and formamide. 5 70 APPENDIX. Characters. — Shining colorless crystals. Taste, slightly bitter. Solu- bility. — Slowly, in about I in 20 of water, 1 in 4 of alcohol, and in weak acid solutions. Should not be heated over 140 F., or mixed with alkalies, for, in either case, it decomposes. Dose, 15 to 50 gr. Action and Therapeutics. Chloralamide is an excellent hypnotic, producing calm, re- freshing sleep without any bad after-effects. Frequent use does not necessitate an increased dose, nor, as far as we know, is any chloralamide habit contracted. It does not relieve pain, but is equally serviceable for all varieties of insomnia, unless due to pain. If possible it should not be given as a powder, for it is then so very slowly absorbed, that probably some of it is decomposed in the intestines or stomach; occasionally, when powdered chlo- ralamide has been administered in the evening, the patient has not slept during the night, but has slept all the next day, because the drug has been so slowly absorbed. The best way to give it is to dissolve it in a little alcohol. The patient may be told to dis- solve 20 or more grains in sufficient brandy, to add water not above 130 F., and drink it before going to bed. Some speci- mens are very insoluble, and must be suspended. It is said that 10 minims of aromatic sulphuric acid added to gj of water will dissolve 30 gr. of chloralamide, but this is not always true. It acts if given as an enema. COCILLANA. — The bark of Sycocarpus Rusbyi (Nat.Ord. Meliacecz.) Bolivia. Characters. — The bark is thick, and ash-colored, becoming rough only with considerable age; inner surface is grayish -yellow; the odor is slight but peculiar; taste unpleasant (not bitter), slightly nauseous. Preparation. Fluid Extract. Dose, 10 to 30 m. Action and Uses. Cocillafia acts upon muciparous glands, increasing their ac- tivity ; on the bronchial mucous membrane, causing expectora- APPENDIX. 571 tion ; on the intestinal mucous membrane, producing a laxative effect; it also slightly increases the appetite; it slightly strengthens the heart beat, and the pulse, but does not stimulate the respira- tory centre. It is of very great value as an expectorant, prefer- able to ipecacuanha, in that it does not so readily cause nausea and a metallic taste in the mouth, and assists the regular move- ment of the bowels. If, however, nausea should be produced, it is very persistent. Its action is fully established three to six hours after administration, and persists at least for six hours. It can, in many cases, be substituted for apomorphine, carbonate of ammonia and for many other drugs, classed with more or less reason, as expectorants. CONVALLARIA MAJALIS.— The lily of the valley (Nat. Ord. Liliacece). The entire plant is used. Russia. Characters. — Leaves 4 to 6 in. long, radical, oblong, tapering. Flower stem leafless, radical, shorter than the leaves. Flowers white, bell shaped, drooping, forming a loose raceme. Composition. — The chief constituents are — (1) Convallamarin, C 23 H 44 12 a glucoside, the active principle. (2) Convallarin, a glucoside, said only to purge, in doses of 3 to 4 gr. Symbol C 34 H 62 O u . Preparations (Brit. Pharm. Conference). 1. Extractum Convallariae. — Aqueous, of the whole flowering plant. Dose, 2 to 8 gr. 2. Tinctura Convallariae. — The flowers, 1 ; proof spirit, 8. Dose, 5 to 20 m. Action and Therapeutics. The action of Convallaria Majalis is precisely that of digitalis, and it may be given in exactly the same varieties of heart disease. It is sometimes successful when digitalis has failed. It is not so powerful as digitalis, but some find it less likely to produce sick- ness. COTO. COTO. — The bark of an unknown tree, found in Bolivia. Characters. — In irregular pieces, outer surface irregular as well as the inner surface ; color, cinnamon-brown ; upon fresh cross-section the bark is seen 572 APPENDIX. to be filled with yellowish spots, except in the outer portions ; odor aromatic, especially if bruised ; the powder is very pungent ; Resembling Coto bark. — Para- coto bark, which has a less powerful odor and taste, and is marked with deep, whitish furrows upon its surface. Composition. — The chief constituents are — (i) A crystallizable body, Cotoin. (2) A volatile oil. (3) A resin. (4) Tannin. (5) Piperonylic acid. Symbol . — C 8 H 6 4 . Dose, 1 to 10 gr. Preparations. v 1. Abstract. Dose, yi to 5 gr. 2. Tincture. Dose, 1 to 10 m. 3. Liquid Extract B. P. Dose, 2 to 6 rri. COTOIN.— Symbol.— C 22 H 18 6 . Characters. — A pale yellow, amorphous powder, or in minute, curved, crystalline prisms, non- volatile, slightly soluble in water, soluble in alcohol, ether, and chloroform. It has a bitter taste and the dust is irritating to the nostrils. Dose, 1 to 3 gr. PARA-COTOIN.— Is extracted from Paracoto bark. Symbol.— C 19 rl 12 6 . Characters. — It is in minute laminar crystals, paler than cotoin, soluble in ether, chloroform, boiling alcohol, and somewhat in boiling water, but from this, it separates on cooling. Dose, 1 to 3 gr. Action and Uses. Coto is not astringent, but because it produces absorption, coto bark, cotoin and paracotoin (the last being weaker than cotoin) have established a reputation as remedies for diarrhoea, whether infantile, in phthisis or in typhoid fever. It also checks saliva- tion and night sweats. It should not be combined with Mistura Cretae. CREOLIN. Source. — Creolin is derived from coal tar and consists of a mixture of the sodium salts of some resinous acids with creolin oil and pyridines. Characters. — A dark brown, alkaline liquid containing in solution the higher homologues of phenol. It forms a turbid, milky mixture with water, APPENDIX. 573 which has the characteristic odor of the preparation. It is non-poisonous, it is not caustic, or even irritating, and has been largely adopted in place of carbolic acid. Dose, 5 m. Action and Uses. It is a harmless, cheap, non-irritating but powerful antiseptic. It is used pure, in solution (2 percent.), in ointment or as a soap, 10 per cent. It has been used internally in gastric fermen- tation, dysentery and typhoid fever. CURARE. WOORARA. Synonyms. — Ourari, Urari, Wourali. The South American arrow poison, prepared from species of Strychnos and other plants. Characters. — A blackish-brown dry extract with a bitter taste. Composition. — It contains an extremely active poison, curarine or cura- rina. Symbol. — C 18 H 35 N, a yellowish-brown powder, intensely bitter. Dose, J5 to % gr. Preparation (Brit. Pharm. Conference). Injectio Curarae Hypo dermic a. — Curare, 5 gr. ; add distilled water to form a thin paste. Put in a funnel plugged with absorbent wool, and gradually add more water till a drachm is obtained. Dose, 1 to 6 m. (subcutaneously). Lamellae or discs, each containing 2V °f a g ra i n > are a l so P re_ pared. They are dissolved in a few minims of water before injection subcutaneously. Action and Therapeutics. The physiological action of curare, by which it paralyzes the end plates of the motor nerves of voluntary muscle, is well known. It has been given successfully in tetanus, and is probably one of the most useful of all the drugs employed for this very fatal disease. DERMATOL. — This yellow, basic gallate of bismuth in fine powder, insoluble in most menstrua, and non-toxic, and non-irritant, is coming more in- to use. Used like iodoform, it has a drying and anti-bacterial effect on wounds. Excellent as a dusting powder, or as an ointment (1 in 10 of vaseline, etc.), it may be used in gauze, 10 per cent. It is non-stimulant, and therefore valueless in chronic or torpid ulcerations. 574 APPENDIX. DIURETIN.— (Sodio-Theobromine-Salicylate)C 7 H 7 NaN 4 2 ,C 6 H 4 OHC OON.A Source. — By the interaction of sodium theobromine and sodium salicylate. It corresponds to the caffeine-sodio salicylate, the salt of caffeine most used in Germany, and contains 44.5 per cent, of theobromine. Characters. — A white powder soluble in less than half its weight of warmed water, the solution remaining perfect when cooled. Dose, 60 to 120 gr. Action and Uses. It is a pure diuretic, without action upon the heart. It has been administered with benefit in cases of severe cardiac or hepatic dropsy. It is said that it does not produce depression, but it may occasionally give rise to severe symptoms, which may be due to impurities. DUBOISINE SULPHAS.— The sulphate of the alkaloid duboisine obtained from the leaves of Dubosia myoporoides. Duboisine is probably identical with hyoscine (see p. 289). Action and Therapeutics. The actions of duboisine are like those of atropine, and ophthalmic discs containing 1-5000 of a grain are used to dilate the pupil. ERYTHROPHLCEUM.- Casca Bark. Synonyms.— Sassy Bark, Or- deal Bark. The bark of Erythrophlceum Guineense (Nat. Ord. Leguininosa), Africa. Composition. — The active principle is erythrophlceine, an alkaloid. Preparation (Brit. Pharm. Conference). Tinctura Erythrophlcei. — Sassy bark, 1 ; rectified spirit, 10. Dose, 5 to 10 m. Action and Therapeutics. The action of erythrophlceum is the same as that of digitalis, and it may be used for the same class of cases. It is, however, more likely to cause vomiting. ETHYL BROMIDE. BROMIDE OF ETHYL. — Bromethyl, Ether Bromatus, Monobro- ethane. C 2 H 5 Br. APPENDIX. 575 Source. — From alcohol and sulphuric acid, with bromide of potassium and distillation. Characters. — A colorless, inflammable liquid, with a sweet odor and a burning taste. Sp. gr. 1.38. Not miscible with water. It must be used when quite fresh. Action and Uses. Bromide of ethyl is a rapid and transient anaesthetic, abol- ishing pain without, however, complete loss of consciousness. It is useful in minor and dental surgery. It is contraindicated in alcoholism, and bronchial, renal and cardiac disease. ETHYL CHLORINATED CHLORIDE. CHLORINATED CHLORIDE OF ETHYL.— Synonyms.— Bi- chloride of Ethidene, Monochlorethyl-chloride. Characters. — A colorless, volatile liquid possessing the odor and taste of chloroform. It is said to be identical with chloride of ethylidene. It has an sp. gr. about 1.2; isomeric with ethylene (Dutch liquid), but the boiling point and sp. gr. are higher. It is miscible in all proportions with pure ether, alcohol and chloroform, soluble about I in 300 in water. Uses. It is used as an anaesthetic, and is much safer than chloro- form, but is more costly. It is pleasanter, more rapid in action, causes no excitement during nor after its administration ; there is more rapid recovery from it. EUROPHEN ,— Isobutyl-orthocresol-iodide. f ^M C 6 H 3 JHI. It is prepared by the interchange of isobutyl alcohol and orthocresol in the presence of zinc chloride. This powder is an antiseptic. It is an amorphous, yellowish powder, and contains about 28 per cent, of iodine. Soluble in alco- hol, ether and in about 4 parts of olive oil ; insoluble in water or glycerin. A powerful germicide and bactericide ; used for wounds, like iodoform, and in similar quantities. EXALGINE. METHYL ACETANILIDE.— Symbol.— C 6 H 5 N(CH 3 )CH 3 CO. Source. — By warming together mono-methylaniline and acetyl chloride. Characters. — Colorless, acicular needles, with a slightly saline taste. Solubility, — I in 60 of water, freely in alcohol. Dose, 2 to 5 gr. 576 appendix. Action and Uses. Exalgine is a powerful analgesic, and has been used with success for neuralgia. Often it relieves when many other drugs have failed. Medicinal doses hardly ever cause depression. Large doses are antipyretic, but are not used for this purpose. It is used for sciatica, rheumatism, and of late for chorea. Several severe cases of poisoning having been reported, the usual dose should not be exceeded. EXTRACTUM CARNIS. EXTRACT OF MEAT.— This preparation has for its object the ob- taining the nutritive matters of the flesh of animals in a permanent, concen- trated state. Source. — Equal parts of meat and cold water. Straining, evaporation and straining. Characters. — Reddish-brown in color, of a slightly acrid taste, and of a disagreeable odor. Composition. — ioo parts of meal yield 25 of extract. It is rich in nitrogenous principles, but contains neither fat nor gelatin. The method of Liebig has been followed, with variations, by a large number of manufac- turers. The product, however, by no means represents the nutritive qualities of the meat itself, because the albumen and fibrine are largely wanting, be- sides an endeavor is put forth to get rid of the gelatin and fat. Of late the attempt has been made to retain these important nutritive principles. The beef meal which was used by Debove in his method of forced feeding (gavage) was practically desiccated beef; but it did not have its highest nutritive value because it was, to a considerable extent, composed of insoluble matters. The classical studies of Wurtz showed that in the juice of the Carica papaya (Nat. Ord. PassifiorcE) was a principle, called papain, capable of converting albuminoids into soluble albumoses and peptones. The fact that a similar vegetable digestive principle exists in the juice of the pine-apple and allied plants of the Nat. Ord. Bromeliacece, as was first shown by Marcafio, has been utilized in the manufacture of the Mosquera- Julia beef meal, where the pro- cess of digestion is carried on before desiccation, or it may be made as a jelly. The advantages of a vegetable over an animal pepsin, the greater acceptability to weak stomachs, the avoidance of the unpleasant taste and the disagreeable odor, and absence of bitterness, are very important. By this method the pre- paration contains only ten per cent, of water, has four times the amount ot albuminoid matter present in average lean beef, one-half of which is already APPENDIX. 577 in an assimilable form, and about three times as much fat, in addition. Be- sides, it is very convenient for administration. Action and Uses. It is useful as a nutrient and a stimulant in relieving prostration and fatigue. The broth seasoned with capsicum is valuable in alcoholic excess and delirium tremens. In the infantile bowel disturbances, when milk must be forbidden, it is often indicated. In phthisis it will frequently sustain the patient ; in the aged it will support life without taxing the digestive powers. The amount to be used should be regulated by the age and condition of the patient. FERRUM DIALYSATUM. DIALYZED IRON. Source. — By heating a solution of chloride of iron with ammonia, ferric hydrates being precipitated, this being redissolved by agitation, is placed in a dialyzer and suspended in water, which is renewed so long as it shows a trace of hydrochloric acid. Characters. — A reddish-brown liquid, free from astringent, styptic taste. Composition. — Its composition varies from Fe 2 Cl 6 , i2Fe 2 3 to Fe 2 Cl 6 , 95 Fe 2 O a and is a 10 per cent, solution of ferric oxychloride in water. Dose, 10 to 30 m. Uses. In arsenical poisoning a dose of common salt or bicarbonate of sodium, followed by 1 fl oz. of dialyzed iron diluted with water, is efficient. It is not considered an eligible iron preparation. GUAIACOL. METHYL PYROCATECHIN.— Symbol, C 6 H 4 OHOCH 8 . A liquid constituting from 60 to 90 per cent of creosote [See p. 254) which is mainly composed of this and creosol. Source. — From distillation of beech- wood tar. Characters. — A colorless liquid of a powerful aromatic odor. Sp. gr. I.I 17. Very slightly soluble in water. Dose, 1 to 15 m. Action and Uses. Guaiacol is used for the same purposes as creasote. It is, however less likely to irritate the intestinal canal and the kid- 49 578 APPENDIX. ' neys. The salicylate has also been introduced as a mild prep- aration. HYDROGEN PEROXIDE PEROXIDE OF HYDROGEN.— Symbol.— H 2 2 . Used in solu- tion, i to 10. Dose, i to 4 fl. dr. Therapeutics. It gives oxygen to the blood, improves digestion and relieves spasms of whooping-cough, and dyspepsia. It is also a non-poi- sonous antiseptic, destroying organized fermentations, as pus, and liberating oxygen. It is valuable in suppurating sores and for surgical dressings. ICHTHYOL. — Symbol, — C 28 H 36 S 3 6 (NH 4 ) 2 . Synonym. — Sulpho- ichthyolate of ammonium. Source. — A bituminous quartz containing the fossil remains of fish and other animals is distilled with sulphuric acid, and the distillate is neutralized with ammonia. Characters. — A viscous, brownish, almost black substance. Odor tarry. Soluble in water, glycerin, oils, fats, and vaseline. Dose, 10 to 30 gr. Sulphoichthyolates of lithium, sodium, and zinc are prepared. Action and Therapeutics. Ichthyol is chiefly used externally for chronic eczema and psoriasis. An ointment with lanoline and ichthyol 20 to 50 per cent, is easily made. Ichthyol has been given as a pill in 10 to 30 grain doses, thrice a day, for chronic rheumatism. IODOL. TETRA IODOPYRROL.— Symbol.— C 4 I 4 NH. Source. — From the interaction of iodine and pyrrol in alcoholic solutions. Characters. — A pale yellow, bulky powder, odorless and tasteless. It is insoluble in water. Dose, 8 to 15 gr. Action and Uses. It was introduced as an antiseptic iodine compound, and is used for the same purposes as iodoform. It has been administered internally as a substitute for iodide of potassium. APPENDIX. 579 THIOPHEN.— (C 4 H 4 S.) A body closely allied to pyrrol, has not been used in medicine. There are, however, two derivatives, (i) Sodium thiophen sulphonate (C 4 H 3 SNaS0 3 ), and (2) Thiophen di-iodide (C 4 H 2 L 2 S), which have attracted considerable attention. The former has been used as a substitute for /3-naphthol, and the latter in place of iodoform. It does not give rise to poisoning, nor eczema, and it apparently is a stimulant to granulation tissue. LYSOL. LYSOL. Source. — From tar-oil, by dissolving in fat and saponifying with alcohol. Characters. — A brown, oily-looking, clear liquid, with a slightly creasote- like odor, soluble in all proportions in water. Composition. — It contains about 50 per cent of cresols. Action and Uses. Lysol is an antiseptic, about one-eighth as poisonous as car- bolic acid, and one-half as poisonous as creolin, used in from one-half to two per cent, aqueous solution. The literature is voluminous and generally favorable. METHYLENE BLUE.— (Tetra Methylthionine Chloride.) Symbol. _NS(C 6 H 3 ) 2 , 2N(CH 3 ) 2 C1. Characters. — Small, indigo-colored scaly crystals, slightly soluble in water. Dose, 3 gr. Action and Uses. Methylene blue has been used for rheumatism of the joints and muscles. Lately it has been given for intermittent fevers, but the reports show that it possesses no advantages over quinine. It im- parts a blue color to nerve substances, and a like color to the urine. The Pyoctanins (blue and yellow) two other aniline dyes, have been introduced into medicine as antiseptics. They have also been used by injection into inoperable neoplasms, sar- comata, epitheliomata, but while it is believed that, by them, a cure is not impossible, no definite statements can be made. MILK. ARTIFICIAL HUMAN MILK. Preparation. — Take half a pint of skimmed milk, heat it to about 96 580 APPENDIX. F., and put into the warmed milk a piece of rennet an inch square or a tea- spoonful of essence of rennet. Put the milk in a fender, or over a lamp, until it is quite warm. As soon as it is set, remove the rennet, break up the curd into small pieces with a knife, and let it stand for ten or fifteen minutes ; the curd will then sink. Then pour the whey into a saucepan and boil quickly. Measure one-third of a pint of this whey, and dissolve in it, while it is hot, 110 grains of sugar of milk. When this third of a pint of whey is cold, add to it two-thirds of a pint of new milk and two teaspoonfuls of cream and stir- The food sliould be made fresh every twelve hours, and warmed as required. The piece of rennet, when taken out, can be kept in a cup and used for ten days or a fortnight. Care should be taken to select an essence of rennet, which does not make the milk taste. Action and Therapeutics. Artificial human milk is invaluable as a food for infants whose mothers cannot suckle them. Many cases of infantile diarrhoea, indigestion, and sickness can be cured by substituting this milk for the usual milk and water or infants' food. Some large dairy firms supply it, but it is cheaper to make it at home, and the above directions are easily carried out. MILK, PEPTONIZED. Preparation. — Mix a pint of milk with 5 fluid ounces of water. Heat to 140°, and add Liquor Pancreatus (Benger's), 2 fl. dr.; or Zymine, B. P., (Fairchild's Extractum Pancreatis), 5 gr.; and bicarbonate of sodium, 20 grs. Leave the mixture at the ordinary temperature of the room for three hours, or if kept at about 135 F. for about half an hour, then heat for a moment to boiling-point. This preparation should be kept on ice until required. Action and Therapeutics. Peptonized milk is used in many conditions in which it is thought that the gastric digestion is too feeble to digest ordinary milk, or in which it is desired to avoid the curdling of milk in the stomach. Milk should always be peptonized before being introduced into an enema. A usual nutrient enema consists of the yolk of an egg and milk up to four fluid ouuces. This mix- ture may be peptonized in just the same way and with the same quantity of peptonizing agents as the pint of milk. Thirty grains of common salt should be added to the enema before use. APPENDIX. 581 OPIUM. — The following non-officinal preparations are used: — Liquor Opii Sedativus (Battley's solution), about 50 per cent, stronger than laudanum. Acetum Opii Crocatum (black drop), four times as strong as laudanum. Syden- ha???s laudanum is a tincture of opium flavored with saifron. NAPHTHALINUM.— Naphthalin, naphthalene. Symbol.— C 10 H 8 . Source. — By subjecting coal tar to distillation, when it passes over after the coal naphtha. Characters. — It appears as a white, or shining, crystalline substance, fusi- ble at 176 F. Solubility. — It is soluble in alcohol, chloroform, ether, naph- tha, and the oils, bat insoluble in water, either acidulous or alkaline. Dose, 1 to 20 gr. Action and Uses. As naphthalin is not absorbed by the system, it acts only upon the mucous membrane of the bowels. It is a true intestinal an- tiseptic, and is of great value in dysentery, catarrhal, typhoid and phthisical diarrhoea, when it markedly lessens or entirely abolishes the fee tor of the movements. It has also been used as a vermifuge. Success in the treatment of dysentery usually requires a daily dose of 120 gr. best administered in starch wafers with oil of bergamot. NAPHTOL. (Iso- or 0-Naphtol). Symbol.— C 19 H 7 OH. Source. — By the action of fuming sulphuric acid upon naphthalin. Characters. — Colorless, scaly crystals, with a faint odor, and a transient, burning taste. Soluble in alcohol, ether, chloroform, oils and alkaline liquids. Dose, 5 to 10 gr. Action and Uses. Naphtol was introduced as an antiseptic, at first in dermato- logical practice as a 10 per cent, ointment, in scabies, ringworm and psoriasis. It is a remedy of great value in obtaining intestinal antisepsis, bacteriological investigations showing that it destroys certain micro-organisms in situ. If it is irritating to the bowels it can be administered in keratin-coated pills. OPIUM. The following alkaloids are sometimes used : THEBAINE— Para-morphine. Symbol. — C 19 H 21 N0 3 . It is con- tained in opium 0.15 to 0.30 per cent. 582 APPENDIX. Characters, — In long white, four-sided, rhombic prisms, odorless and having a bitterish taste. NARCEINE. Symbol. — C 23 H 29 N0 9 . It is contained in opium 0.02 per cent., and is in white, feathery crystals, and is very difficult to obtain pure. Dose, % to 1 gr. Action and Uses. Narceine closely resembles morphine in its action, but is prob- ably more hypnotic, and it is not followed by the disagreeable after effects. Thebaine is rarely used ; it resembles strychnine in its action. OREXIN HYDROCHLORIDE.— (Phenyldihydrochinazoline hydro- {NCH. chloride). Symbol.-C 6 H 4 { CHa NC e H 6 HCl. Characters. — Colorless, odorless, lanceolate crystals, efflorescent, of bit- ter and pungent taste, freely soluble in hot water. Dose, 5 to 8 gr. Action and Uses. Orexin has been recommended as a true stomachic, stimu- lating the appetite and increasing the functional activity of the digestive organs. It is useful in the anorexia of phthisis and of shock following operations, in anaemia, inanition and chronic gastric catarrh. It is not suitable for diseases of the stomach, such as acute catarrh or gastric ulcer. OXYCHINASEPTOL. Synonym.— Diaphtherin. Symbol.— HO, C 9 H 6 NH,0,S0 2 ,C 6 H 4 ,0,NHC 9 H 6 ,OH. Source. — A combination of oxychinolin with aseptol. Characters. — A sulphur-yellow powder, having an odor somewhat like phenol, soluble in both cold and warm water. Action and Uses. This is one of the very latest antiseptics of high power, as compared with lysol, carbolic acid and phenol. It tarnishes in- struments, and stains the hands yellow. It is apparently not irritant, and does not give rise to eczema. It is employed in aqueous solution of the strength of (generally), ^ to 2 per cent. It is relatively, not poisonous. APPENDIX. 583 PANCREATIN. — Zymine, B. P. — In the pancreatic juice of man, it is believed that four elements are contained : (1) Trypsin; (2) curdling ferment; (3) pancreatic diastase; (4) emulsin ferment. Pancreatin is a desiccated preparation of the pancreas, mixed with pow- dered malt, very hygroscopic. Dose, 5 to 15 gr. Action and Uses. Pancreatin is used as an artificial agent to assist the digestion of invalids and of old persons, or those prostrated by fever or ex- haustion. By means of this, food may be partially or wholly digested previous to administration. As it digests starches, fats and proteids, its field of usefulness is large. It should be used in combination with an alkali. PARISH'S FOOD.— A complicated preparation. The Syrupus Ferri Phosphatis Compositus of the Brit. Pharm. Conference corresponds to it. The ingredients of this are metallic iron, concentrated phosphoric acid, precipitated carbonate of calcium, bicarbonate of potassium, phosphate of sodium, cochi- neal, sugar, and distilled water. See p. 170. Dose, y 2 to 2 fl. dr. Action and Therapeutics. It is a pleasant preparation, given for the sake of the phos- phates and iron in it. Children take it easily. PENTAL.- (Tri-methyl-ethylene). Symbol.— C 5 H 10 . Source. — It is obtained by heating amylene hydrate in the presence of acids. Characters. — A colorless liquid, insoluble in water, but miscible in all proportions with alcohol, ether, and chloroform, highly inflammable. Sp. gr. 0.6783. Action and Uses. Pental is an anaesthetic, the equal of nitrous oxide in rapidity of action and safety, but superior to it, in its more prolonged action and in having no unpleasant after-effects. Even when in- sensibility to pain is reached, consciousness is retained sufficiently, to respond to commands. The stage of exhilaration is seldom present ; it does not lose its effect by repeated inhalations. It differs from chloroform in that it acts more promptly, and has no 584 APPENDIX. evil after-effects ; from bromide of ethyl, in that it is somewhat slower in its action, but is more lasting in its effects, and can be prolonged as may be necessary; from nitrous oxide, in that it can be continued for a longer time, and in its freedom from un- pleasant effects and in its safety. PHENOCOLL HYDROCHLORIDE. — Symbol.— C 6 H 4 .OC 2 H 5 . NHCO.CH 2 .NH 2 , HC1. Source. — By the intermixture of phenetidine and glycocoll or amido- acetic acid. Characters. — It is a white crystalline powder, soluble in about 16 parts of water. Dose, 5 to 15 gr. Action and Uses. Phenocoll hydrochloride is non-poisonous to animals, and it does not injuriously affect the blood. It is an antipyretic, not followed by collapse or cyanosis ; the perspiration is not stronger than after larger doses of antipyrin. It has also been used as an antineuralgic \ in severe acute articular rheumatism it has exer- cised a beneficial action upon the joints when all other remedies have failed. It is rapidly excreted by the urine, to which it gives a brownish color. The reports, of which there are now a con- siderable number, are favorable to this remedy. PICHI. — The leaves of the woody shrub, Fabiana Imbricata (Nat. Ord. Solanacece). Peru, Chili. Characteristics. — A woody shrub growing on rocky hill-tops, with plume-like sprays, the small densely crowded leaves much resembling those of a conifer. The branches and leafy branchlets are resinous, with an aromatic odor and taste. Composition. — It contains (1) an essential oil, (2) a resin, (3) a crystall- izing substance, (4) a bitter alkaloid, fabianine. Dose 10 to 40 m. of the fluid extract. Therapeutics. Pichi is a diuretic of great value in inflammation of blad- der and catarrh of the urinary tract. It is best prescribed with an alkali. APPENDIX. 585 PIPERAZINE. — Piperazidine ; Ethylenimine ; Diethylendiamine ; Dispermine. Symbol. — C 4 H 10 N 2 . Source. — Probably from hydrochlorate of ethylenediamine. Characters. — It occurs in colorless, well defined, acicular crystals, readily soluble in water. In cold aqueous solutions with uric acid, it will dis- solve twelve times as much, as will carbonate of lithium. Dose, 5 to 8 gr. Action and Uses. Piperazine increases the amount of urea, while the uric acid is diminished. It has been used in mental diseases and also in ead paralysis. There is opportunity for further investigation. PISCIDIA. JAMAICA DOGWOOD.— The bark of the root of Piscidia Eryth- rina (Nat. Ord. Leguminosce} West India Islands. Characters. — In pieces about yfc in. in thickness ; outer surface of a dark gray-brown ; inner surface is of a dark brown color, and very fibrous. It has a disagreeable odor of opium when broken ; taste acrid, and it produces a burning sensation in the mouth. Composition. — The chief constituents are a neutral principle, Piscidin, C 29 H 24 8 , which by recrystallization appears in colorless crystals, insoluble in water, soluble in chloroform and boiling alcohol. Preparation. Fluid extract, not miscible with water. Dose, ]/ z to 2 fl. dr. Action and Uses. Jamaica dogwood is a narcotic, which does not affect the irritability of motor, or peripheral ends of sensory nerves, reduces reflex action, dilates the pupil, reduces the frequency of the pulse. It is of value as an anodyne in neuralgia, and in nervous insomnia, and, when combined with viburnum, to relieve dysme- norrhea. Locally it has been applied with success for toothache. RESORCIN. — Meta-dihydroxyl-benzol. A derivative of benzol. Sym- bol,— C 6 H, (OH), Characters. — White crystals resembling, but larger than those of benzoic acid. Solubility. — 1 in 2 of water; 1 in 20 of olive oil. Dose, 5 to 30 gr. 5o 586 appendix. Action and Therapeutics. This substance, originally introduced as an antipyretic, is now rarely employed for this purpose, as it is too depressant to the heart. A solution of resorcin in glycerin, i in 4, is excellent for removing epidermic scales in chronic skin diseases, and also for getting rid of the scurf in seborrhoea sicca of the scalp, SALOL.— Phenyl ether of salicylic acid. Symbol.— C 6 H 4 (OH)COOC 6 H 5 . Characters. — Small white crystals of a pale yellow tint. Tasteless. Insoluble in water; soluble in alcohol, ether, fixed oils, and glycerin. Dose, 4 to 30 gr. in cachets or suspended in milk. Action and Therapeutics. In the body, presumably in the small intestine, salol splits up into carbolic and salicylic acids, and the former renders the urine dark. In rheumatic fever it is efficacious on account of the salicylic acid it contains, but it has no advantage over salicin or salicylic acid, and the carboluria may be troublesome. It is an antiseptic, and since this decomposition takes place in an alkaline fluid, it has been used as an intestinal antiseptic in acute diarrhoea, dysentery, cholera and other diseases, also in affections of the bladder and urethra. It is a remedy of very great value in the treatment of typhoid fever, for by the active disinfection of the contents of the intestine and of the ulcerations, it favors their healing and prevents reinfection, thus lowering temperature, diminishing the liability to relapses and to permanent damage to tissues. It is the logical treatment, because it destroys the cause of the symptoms, at the point of origin. SANITAS. — The oleo resin common turpentine {see p. 393), obtained from Pinus sylvestris, the common Scotch fir, is allowed to oxidize in the air. Sanitas is the aqueous solution of this oxidized turpentine. Its active anti- septic principle is peroxide of hydrogen. It also contains a little thymol and a camphor. Action and Therapeutics. It is a pleasant smelling, non-poisonous liquid, which may be used as a domestic antiseptic and disinfectant, but it is not so powerful as carbolic acid or as corrosive sublimate. APPENDIX. 587 SIMTJLO is the fruit of Capparis coriacea (Nat. Ord. Cappardacece). Peru. Action and Therapeutics. It is sometimes used for cases of epilepsy in which bromides disagree. A tincture (dose, 1 to 4 5) of it is prepared. SOMNAL.- Ethyl-chloral-urethrane. Symbol— CCLCH \ ^?* TT 3 3 2 |NHCOOC 2 H. A liquid preparation which is a combination of chloral, alcohol, and urethane. Characters. — A colorless liquid, soluble in hot water or alcohol, with a faint odor and a very pungent taste. Dose, 30 m. Uses. Somnal acts like chloral, but is more pleasant; its effect is quick, without depressing after-effects either in the head or stom- ach. It should be well diluted, and administered in an alcoholic mixture. SOJA BEANS.— The beans of Soya hispida. Composition. — Soluble casein, 30; albumen, 0.5; insoluble casein, 7; fat, 18; cholesterin, 2; water, 10; dextrin, 10; starch, 5 ; cellulose, 5 ; ash, 5 ; a powerful amylolytic ferment. These are powdered and made into a flour, from which bread and biscuits are prepared. The flour contains very little starch or sugar, sometimes not more than 2 or 4 per cent. Action and Therapeutics. Bread and biscuits made from the flour are used in the treat- ment of diabetes as a substitute for gluten bread ; they are quite as efficacious in reducing the sugar passed in the urine, and many patients prefer the taste. SPARTEINE. — An alkaloid from the flowers of Sarothamnus Scoparius (Broom) . Europe. Broom contains two principles, Scoparin, symbol, C 21 H 22 O 10 , and an alkaloid Sparteine, symbol, C 15 H 26 N 2 . Sparteine was obtained by distillation from the mother waters of the Scoparin. Characters. — It is a colorless liquid, having a peculiar bitter taste, and all the properties of a volatile alkaloid. It is heavier than water, dissolving only slightly in it, but takes up some of it itself, becoming opalescent. It 588 APPENDIX. readily neutralizes acids and forms crystallizable salts, which are extremely bitter. The sulphate occurs in greenish crystals, and is freely soluble in water. Dose, T ^ to 2 gr. Action and Uses. Poisonous doses of sparteine cause, in the lower animals, tremblings, incoordination, increase of reflexes, chronic and tonic convulsions, embarrassment of the respiration, acceleration of the pulse, and enfeeblement of the heart, followed by enfeeblement of all of the functions, convulsions, and death from asphxia. It paralyzes the respiratory centers, and the motor centers of the spinal cord, but has a very feeble influence upon the muscles, les- sening, though not destroying, their excitability. According to Laborde, under the influence of this alkaloid there is a very great increase in the size and height of the cardiac wave. If the dose has been a small one, the pulse is at first accelerated, after large doses there is a slowing. The arterial pressure is not materially changed except unless the dose is toxic, when it falls. Small doses weaken, and large ones paralyze the peripheral pneumogastric nerve \ upon the vasomotor system, it appears to have no influence, unless in very large toxic doses, when it, perhaps, acts as a paralyz- ant. It does not represent entirely the diuretic action of scopa- rius. According to See. sparteine is of very great value in pro- ducing regularity in cases of irregular cardiac action. It acceler- ates the beats when in a weak, atonic state and has the great advantage of acting quickly, is not cumulative, but on the whole is probably inferior to digitalis in power, but is useful in uncom- pensated heart disease. TEREBENE.- Symbol.— C 10 H 16 . An isomer of oil of turpentine. Source. — Produced by the action of sulphuric acid on oil of turpentine and distillation. Characters. — Colorless, and with a pleasant pine-wood odor. It does not mix with water, but can easily be emulsified with tragacanth, or it may be taken on sugar. Dose, 5 to 30 m. Action and Therapeutics. Terebene is an excellent stimulant, disinfectant expectorant for chronic bronchitis. It may be used as an inhalation thus : — APPENDIX. 589 Pure terebene, 40 TTU light carbonate of magnesium, 20 gr.; dis- tilled water, 1 5. Use a fluid drachm in a pint of water at 140 F. in an apparatus so arranged that air can be drawn through it and inhaled. Or it may be given with other expectorants in a mixture ; many patients find five drops a few times a day on sugar quite sufficient to cure a slight winter cough. TERPIN HYDRATE. TERPIN HYDRATE.— Symbol.— C 10 H 18 (OH) 2 ,H 2 O. Source. — By interaction of oil of turpentine, alcohol and nitric acid. Characters. — In large, colorless, odorless, rhombic crystals, with a faint aromatic taste. It is soluble in 250 parts of cold water, 10 parts of alcohol. Dose, 2 to 10 gr. Action and Uses. Terpin hydrate is an antiseptic, and will arrest the develop- ment of tubercular bacilli, increases the secretion of the mucous membrane, and the functional activity of the kidneys. It has been given as an expectorant in chronic and acute bronchitis, in whooping-cough, and rarely in the treatment of chronic nephritis. THALLIN. THALLIN. — Synonym. — Tetrahydroparachinanisol, C 9 H 10 N(OCH 3 ). Source. — By heating together para amidoanisol and acrolein in the pres- ence of an oxidizing agent. Characters. — It is an oily liquid which, when cooled, solidifies in yellow crystals. Action and Uses. It is used in medicine even in the form of a tartrate or sul- phate, which are rarely given internally, because they are poison- ous to the red blood corpuscles and to the nervous system. Their chief use is an injection for gonorrhoea in aqueous solution, 1 to 120 or 60., or they can be used in a 2 per cent, solution as gela- tin bougies. THIOCAMF is a disinfectant used for fumigation. It is a liquid formed by the action of sulphurous acid, on camphor, which on exposure evolves the sulphur dioxide in steady fumes, and is stable and permanent when contained in closed vessels, but rapidly evolves the S0 2 on exposure. 590 APPENDIX. TONGA. — A dark brown liquid obtained from the bark of several trees in Fiji, believed to be Premna taitensis and Raphidophora vitiensis Dose, i to 2 fl. dr. Action and Therapeutics. Tonga undoubtedly relieves some cases of intractable neural- gia, but unfortunately it is expensive. URETHANE. ETHYL-URETHANE.- Synonym. — Ethyl-carbamate. Symbol.— CO,NH 2 ,OC 2 H 5 . Source. — By the interaction of nitrate of urea and ethyl alcohol. Characters. — Colorless, columnar crystals, odorless and with a nitre-like look. Dose, 15 to 30 gr. Action and Uses. Urethane is used as a hypnotic, and is believed to provide a calm, natural sleep without disagreeable after effect. It was formerly more frequently employed. WOOD WOOL. — This is finely comminuted pine wood rendered antiseptic with corrosive sublimate. Action and Therapeutics. It is very absorbent, is used for dressing wounds, and is very popular in the form of diapers (sanitary towels) for use during menstruation or for uterine discharges, or after delivery. It is also used for infants' napkins. APPENDIX NO. III. THE PHARMACOPCEIAL VEGETABLE DRUGS ARRANGED ACCORDING TO THEIR NATURAL ORDERS. Nat. Order. Name of Plant. Part of Plant. Name of Drug. Algae . Chondrus crispus Apocynum cannabinum Plant Root Irish moss. Canadian hemp. Apocynaceae Asclepias tuberosa Root Pleurisy root. Aquifoliaceae Prinos verticillatus Bark Black alder. Aracese Acorus Calamus Aristolochia Serpentaria Rhizome Rhizome Sweet flag. Serpen tary. Aristolochiaceas... " reticulata u u Aurantiaceae Citrus vulgaris Rind of the fruit Bitter orange peel. " Aurantium ft u Sweet " " vulgaris and Aurantium Flowers Orange flowers. ** Limonum Rind and juice Lemon. ' ' Bergamia Oil from rind Bergamot. Berber idaceae Caulophylium thalictroides Rhizome and Blue Cohosh. rootlets May apple. Podophyllum peltatum Rhizome and rootlets (« Burseraceae Balsamodendron Myrrha Gum-resin from stem Myrrh. Caprifoliaceae Sambucus canadensis Flowers Elder. Viburnum prunifolium Bark Black haw. Celastrineae Euonymus atropurpureus Chenopodium ambrosioides Bark Euonymus American Worm- Chenopodiaceae.... Oil from fruit Var. anthelminticum seed. Compositae Anacyclus Pyrethrum Eupatorium perfoliatum Root Pellitory root. Thoroughwort. Leaves and tops Artemisia maritima Var. stech- Flower heads Santonica. maniana Calendula officinalis Herb Marigold. Anthemis nobilis Flowers Chamomile. Grindelia robusta Leaves and tops Grindelia Matricaria Chamomilla Flower-heads German Chamo- mile. Tanacetum vulgare Leaves and tops Tansy. Artemesia Absinthium W tt Wormwood. Taraxacum Dens-leonis Root Dandelion. Inula Helenium Root Elecampane. Arnica montana Flower heads, Arnica. rhizome, and rootlets Lactuca virosa Milk juice Lettuce. Erigeron canadense Oil from herb Fleabane Lappa officinalis Root Burdock. Coniferae Pinus australis Oil from exuded oleo-resin (tur- Oil of turpentine and resin. pentine), the residue is resin Pinus pinaster Abies balsamea i < n Oleo resin exud- Canada balsam. ing from bark " australis tt << Abies excelsa Resin from stem Burgundy pitch. 591 592 APPENDIX. Nat. Order. Name of Plant. Part of Plant. Name of Drug. Coniferae Abies canadensis Resin from stem Canada pitch. Pinus palustris Distillate from wood Tar. a tt Distillate from Oleum pini syl- leaves vestris, Thuja occidentalis Tops Arbor vitae. Juniperus communis Fruit Oil of juniper. " sabina Tops Savine Con volvulaceae. ... Convolvulus Scammonii Root Scammony. Exogonium Purga Tuberous root Jalap. Cornaceae Cornus florida Bark of root Dogwood. Cruciferae Sinapis alba Seed White mustard. " nigra " Black mustard. Cucurbitaceas Citrullus Colocynthis Fruit Colocynth. Bryonia alba Root Bryonia. " dioica " Cucurbita Pepo Seed Pumpkin seed. Ecballium Elaterium Fruit Elaterium. Cupuliferae Quercus alba Bark White oak. " lusitanica Parasitic excres- cences Nutgall. Castanea vesca Leaves Chestnut. Ericaceae Arctostaphylos Uva-ursi Leaves Uva ursi. Chimaphila umliellata Leaves Pipsissewa. Gaultheria procumbens Oil Salicylic acid. Erythroxylaceae.. Erythroxylon coca Leaves Coca. Euphorbiaceae Croton Eleuteria Bark Cascarilla. ** Tiglium Oil of seed. Croton oil. Ricinus communis " Castor oil. Stilhngia sylvatica Root Queen's root. Mallotus philippinensis Glands and hairs Kamala. Filices Aspidum Filix-mas Rhizome Male fern. Fungi Claviceps purpurea Sclerotium Ergot Ustilago Maydis Smut Ustilago. Gentianaceae Gentiana lutea Root Gentian. Ophelia Chirata Plant Chirata. Geraniaceae Geranium maculatum Triticum vulgare Rhizome Seed Cranesbill. Starch. Graminaceae " repens Rhizome Couchgrass — Hordeum distichum Seed Pearl barley. Saccharum officinarum Cane Sugar and treacle. Granataceae Punica Granatum Bark of root Pomegranate. Guttiferae Garcinia Hanburii Gum resin Gamboge Hamamlaceae Liquidambar orientalis Balsam of bark Storax. Hamamelis virginica Leaves Hamamelis. Iridaceae Crocus sativus Iris versicolor Stigma Rhizome and Saffron. Blueflag. rootlet Juglandaceae Juglans cinerea Bark of root Butternut Labiatae Rosmarinus officinalis Origanum vulgare Oil of leaves Plant Oil of rosemary. Wild marjoram. Salvia officinalis Leaves Sage. Rubus villosus Bark of root Blackberry. " canadensis U <( it " trivialis I. K it *' idseus Fruit Raspberry. Scutellaria lateriflora Plant Scullcap. Lavandula vera Oil of flowers Oil of lavender. Hedeoma pulegoides Leaves and tops Pennyroyal. Herb Peppermint. " viridis Herb Spearmint. Melissa officinalis Leaves and tops Balm. Thymus vulgaris Stearopten from oil Leaves and tops Thymol. Marrubium vulgare Horehound. APPENDIX. 593 Nat. Order. Name of Plant. Part of Plant. Name of Drug. Lauraceae Cinnamomum zeylanicum " Camphora Bark of shoots Stearopten of Cinnamon. Camphor. wood Sassafras officinalis Root and pith Sassafras. Leguminosae Astragalus gummifer Gum from stem Tragacanth. Acacia Verek Gum from stem Gum arabic. Glycyrrhiza glabra Root Liquorice. Sarothamnus Scoparius Tops Broom. Pterocarpus santalinus Wood Red saunders. " Marsupium Juice from trunk Balsam from do. Kino. Myroxylon Pereirae Balsam of Peru. " toluifera IC Balsam of Tolu. Physostigma venenosum Seed Calabar bean. Andira Araroba Exudation of stem Goa powder. Cassia acutifolia Leaflets Senna. " elongata t< a Fistula Fruit Cassia. Haematoxylon campechianum Wood Logwood. Tamarindus indica Pulp of fruit Tamarind. Acacia Catechu Wood Catechu. Copaifera Langsdorffi Oleo-resin from trunk Copaiba. Lichenes Cetraria islandica Allium sativum Urginea Sciila Thallus Bulb Bulb Iceland Moss. Garlic. Squill. Liliaceae Aloe socotrina Juice of leaves Aloes. Linaceae Linum usitatissimum Lobelia inflata Strychnos nux-vomica Seeds and oil Leaves and tops Seed Linseed. Lobelia. Nux vomica. Lobeliaceae Loganiaceae Strychnos Ignatia Seed Ignatia. Spigelia marilandica Rhizome and rootlets Pink root. Gelsemium sempervireus Rhizome Gelsemium. Lycopodiaceae Lycopodium clavatum Sporules Lycopodium. Magnoliaceae JUicium anisatum Fruit Star-anise. Magnolia glauca Bark Magnolia. acuminata ' •f tripetala (< ti Malvaceae Gossypium herbaceum Hairs of seeds and Cotton. bark of root Althaea officinalis Root Marshmallow. Melanthaceae Colchicum autumnale Seed and corm Colchicum. Veratrum viride Rhizome and root- lets. Veratrum viride. Asagraea officinalis Seed Veratrine. Meliaceae Melia Azedarach Jateorrhiza Calumba Bark of the root Root Azedarach. Columbo. Menispermaceae .. Chondrodendron tomentosum " Pareira. Menispermum canadense Rhizome and root- Canadian Moon lets seed Anamirta paniculata Glucoside from seeds Picrotoxin. Myristiceae Myristica fragrans Seed and fruit Nutmeg. Myrtaceae Eugenia caryophyllata Myrcia acris Flower bud Cloves. Oil from leaves Bay. Eugenia Pimenta Fruit Pimento. Melaleuca cajuputi Oil from leaves Cajuput oil. Eucalyptus globulus Leaves Eucalyptus. '• amygdalina <« « Oleaceae Olea europaea Oil from fruit Olive oil. Fraxinus Ornus Exudation of stem Manna. Orchidaceae Cypripedium pubescens Rhizome and rootlets Ladies' slipper. Vanilla planifolia Fruit Vanilla. 594 APPENDIX. Nat. Order. Name of Plant. Part of Plant. Name of Drug. Papaveraceae Papaver somniferum Juice from cap- sules Plant Opium. Chelidonium majus Celandine. Sanguinaria canadensis Rhizome Bloodroot. Pedalacese Sesamum indicum Oil of seed Benne oil. Piperaceae Piper nigrum Cubeba officinalis Fruit Black pepper. Cubeb. ti Artanthe elongata Leaves Matico. Phytolaccaceae.... Phytolaceae decandra Root and fruit. Poke. Polygalaeae Polygala Senega Rumex crispus Root Senega. Yellow Dock. Root Krameria triandra n Rhatany. " tormentosa u u Rheum, officinale it Rhubarb. Ranunculaceae Aconitum napellus Anemone Pulsatilla Root Aconite Herb Pulsatilla pratensis " ti patens it tt ; Delphinium Staphisagria Seed Stavesacre. Cimicifuga racemosa Rhizome and root- lets Rhizome Cimicifuga i Hydrastis canadensis Rhamnus frangula Hydrastis. Rhamnaceae Bark Frangula. Rosaceae Rosa gallica " centifolia Petals Red rose petals. Cabbage rose pe- ** ■ tals. 7 " damascena Flowers *■ Rose. Cydonia vulgaris Seed Quince seed. ' Amygdalus communis var. Seed Sweet almond. : dulcis var. <( Bitter almond. ■ amara Brayera anthelmintica Female inflores- Kooso. cence Prunus domestica Fruit Prune. serotina Bark Wild cherry. Quillaia saponaria Coffea arabica Bark Soap bark. Caffeine. Rubiaceae Alkaloid from beans : Cinchona succirubra Bark Cinchona bark. " Calisaya tt Calisaya bark. Cephaelis Ipecacuanha Root Ipecacuanha. Rutaceae Xantholylum fraxineum Barosma betulina Bark Prickly ash. Buchu. Leaves crenata (> u " serratifolia ft iC Ruta graveolens Oil from plant. Oil of rue. Pilocarpus pennatifolius Leaflets Jaborandi. Salicin. Salicaceae Salix Helix Glucoside of bark Alba Bark Willow. Santalaceae Santalum album Paullinia sorbilis Oil of wood Seed Sandalwood. Guarana. Sapindaceae Sapotaceae Isonandra Gutta Concrete juice Gutta percha. Digitalis. Culver's physic. Scrophulariaceae.. Digitalis purpurea Leaves Leptandra Virginica Rhizome and rootlets Simarubaceae Picraena excelsa Wood Quassia. Smilaceae Smilax officinalis Root Sarsaparilla. 11 medica « « Solanaceae Capsicum fastigiatum Atropa Belladonna Fruit Capsicum. Belladonna. Root and leaves Datura Stramonium Seed and leaves Stramonium. Hyoscyamus niger Leaves Henbane. Solanum Dulcamara Branches Bitterweed. Nicotina Tabacum Leaves Tobacco. APPENDIX. 595 Nat. Order. Name of Plant. Part of Plant. Name of Drug. Sterculiaceae Theobroma Cacao Oil from seed Oil of theobroma. Styraceae Styrax Benzoin Resin from bark Benzoin. Terebinthacese Pistacia Lentiscus Resinous exuda- tion Mastic. Rhus glabra Fruit Rhus glabra. Rhus Toxicodendron Fresh leaves Rhus Toxicoden- dron. Ternstraemiacese. . Camellia Thea Alkaloid from leaves Caffeine. Thymelaceae Daphne Mezereum Bark Mezereon. Umbelliferae Conium maculatum Fruit Hemlock. Pimpinella Anisum (i Anise. Ferula Narthex Gum resin from Asafetida. root " scorodosma (< u . " galbaniflua Gum resin Galbanum Ferula sumbul Root Sumbul. Dorema Ammoniacum Gum - resin from stem. Ammoniac. Coriander sa ivum «( Coriander. Foeniculum vulgare t< Fennel. Carum Carvi u Caraway. Urticaceae .~ Humulus lupulus Strobiles Hops. Ficus Carica Fruit Fig. Ulmus fulva Inner bark Slippery elm. Cannabis sativa Plant American canna- bis. Cannabis indica. Cannabis sativa Tops Valerianaceae Valeriana officinalis Rhizome and rootlet. Valerian. Violaceae Viola tricolor Herb Pansy Zingiberaceae Eletaria cardamomum Fruit Cardamom. Zingiber officinale Rhizome Ginger. Zygophy lleae Guaiacum officinale Wood Guaiacum. " sanctum M u APPENDIX No. IV. A LIST OF LATIN PHRASES COMMONLY USED IN THE WRITING OF PRESCRIPTIONS. aa. Ad. Ad lib. Ad us. JEq. Alt. hor. Ampul. Aq. Aq. bull. Aq. dest. Aq ferv. Aq. fluv. Aq. font. Aq. pluv. Bib. Bis ind. Bis in 7 d. Bol. C. Cap. Cap. Chart. Chartul. Col. C. m. C. m. s. C. n. Cochl. Cochl. ampl. Cochl. infant. Cochl. mag. Cochl. mod. Cochl. parv. Contin. Cuj. C. v. Cyath. Cyath. vinos. D. d. D. d. in d. Det. Dieb. alt. Dim. Div. D. in p. ae. Exhib. F. or ft. F. h. F. m. F. pil. Form. F. s. a. Gtt Habt. Ana Adde _ Ad libitum Ad usum ^Equates Alternis noris Ampulla Aqua Aqua bulliens Aqua destillata Aqua fervens Aqua fluviatilis Aqua fontalis Aqua pluvialis Bibe Bis indies Bis in septem diebus Bolus Cum Capiat Capsula Charta Chartula Cola Cras mane Cras mane sumendus Cras nocte Cochleare Cochleare amplum Cochleare infantis Cochleare magnum Cochleare modicum Cochleare parvum Continueter Cuj us Cras vespere Cyathus Cyathus vinosus Dosis Da De die in diem Detur. Diebus alternis Dimidius Divide Divide in partes aequales Exhibiatur Fiat Fiat haustus Fiat mistura Fiat pilula Formula Fac secundem artem Gutta or guttse Habeat of each. add. to the desired amount. according to custom. equal. every other hour. a large bottle. water. boiling water. distilled water. hot water. river water. spring water. rain water. drink. twice a day. twice a week. a large pill. with. let him take. a capsule. a paper. a small paper. strain. to-morrow morning. to be taken to-morrow morning. to morrow night. spoonful. a table-spoonful. a teaspoonful. a table-spoonful. a dessert-spoonful. a teaspoonful. let it be continued. of which. to-morrow evening. a glassful. a wine glassful. a dose. give. from day to day. let it be given. on alternate days. one half. divide. divide into equal parts. let it be given let it be made. make a draught. make a mixture. make a pill. a prescription. make according to art. drop or drops. let him have. 597 59« 8 APPENDIX. Hor. intermed. Horis intermediis at intermediate hours. H. s. Hora somni at bedtime. Ind. Indies daily. Lat. Dol. Lateri dolenti to the painful' side. Mic. pan. Mica panis bread crumb. Mit. Mitte send. Mod. prsescript. Modo praescripto in the manner directed. Non repetat. Non repetatur let it not be repeated. O. m. Omni mane every morning. Omn. bih. Omni bihora every two hours. Omn. hor. Omni hora every hour. O. n. Omni nocte every night. P. or pt. Perstetur continue. Part. aeq. Partes aequales equal parts. Penecil cam. Penicillum camelinum a camel's-hair pencil. Pil. Pilula. a pill. P. r. n. Pro re natS. when required. at Quantum libet as much as is requisite. Quantum sufficit a sufficient quantity. Q.v. Quantum volueris at will. R. Recipe take. Rep. Repetatur let it be repeated. Sing. Singulorum of each. Si op. sit. Si opus sit if necessary. Sum. Sumat or sumendum let him take or let it be taken T. d. Ter in die three times a day. Ter. Tere Rub. INDEX. Abbreviations, 37. Absinthium, 423. Abstracta, 17. Acacia, 472. Accelerator nerve, action on, 49 Accommodation, 100. Aceta, 17. Acetanilide, 534. Acetic ether, 243. Acids, 213. Acidum aceticum, 214. — arseniosum, 184. — benzoicum, 500. — boricum, 222. — carbolicum, 250. — chromicum, 193. — chrysophanicum, 372. — citricum, 214. — gallicum, 458. — hydrobromicum, 209. — hydrochloricum, 214. — hydrocyanicum, 258. — lacticum, 216. — meconicum, 534. — nitricum, 214. — oleicum, 469. — phosphoricum, 194. — pyrogallicum, 565. — salicylicum, 360. — sulphuricum, 213. — sulphurosum, 220. — tannicum, 455. — tartaricum, 215. — valerianicum, 426. Aconite, 328. Aconitina, 535. Adeps, 525. — benzoinatus, 500. — lanae, 535. hydrosus, 535. Adjuvans, 33. Administration of drugs, 30. iEsculap, 82. iEther, 240. — aceticus, 243. Air, 64. Albumen, 536. Alcohol, 225. — amylicum, 536. — tertiary Amyl, 566. Alkaline earths, 131. — metals, 108. Alkaloids, 11. Allium, 343. Allyl 343- Almond, 470. Aloe, 377. Aloin, 536. Alterative, 103. Althaea, 469. Alum, 138. Aluminium, 138. Ammoniacum, 431. Ammonii benzoas, 500. — bromidum, 205, — valerianas, 427. Ammonio-mercuric chloride, 565. Ammonium, 125. Amygdala, 470. Amyl colloid, 566. Amyl nitrite, 244. Amylene hydrate, 566. Amylic alcohol, 536. Amylum, 512. Anaesthetics, general, 95. — local, 89. Anaphrodisiacs, 101. Anemonin, 336. Anethum, 537. Angustura Bark, 542. Anhidrotics, 55. Anise, 422. Anodynes, local, 89. Anthelmintics, 41. Anthemis, 451. Anticholagogues, 86. Antiemetics, 78. Antifebrin, 534. Antigalactagogues, 102. Antihydrotics, 55. Antimony, 189. Antiparasitics, 41. Antiperiodics, 42. Antipyretics, 61. Antipyrin, 537. Antiseptics, 39. Antisialogogues, 70. Antispasmodics, 67. Antizymotics, 40. Aphrodisiacs, 101. Apocynum, 485. Apomorphinas hydrochloras, 275. Aqua, 104. — destillata, 104. Aquae, 17. Arabin, 13. Arbor Vitae, 520. Argentum, 144. Aristol, 566. Aonorica, 538. Arnica, 406. Arsenic, 184. Asafoetida, 428. Asclepias, 346. Aseptol, 567. Aspidium, 477. m Astringents, 53. — intestinal, 83. Atropa belladonna, 278. Atropina, 279. 599 6oo INDEX. Atropinse sulphas, 280. Aurantii cortex, 453. — florum, 453. — fructus, 453. Aurum, 172. Azedarach, 482. Bael fruit, 539. Balm, 505. Balsam of Peru, 433. — of Tolu, 434. Balsams, 13. Barium, 539. — chloride of, 539. Basic gallate of bismuth, 573. Basis, 33. Bassorin, 13. Baths, 105. ■ Battley's solution, 581. Bebeeru bark, 549 Beberine sulphate, 549. Bela, 539. Belladonna, 278. Benne oil, 508. Benzin, 511. Benzosol, 567. Benzoyl-guaiacol, 567. Benzoyl-sulphonic-imide, 558. Benzoin, 500. Berberine, 365. Betol, 567. Bile, action on, 84. Bismuth, 152. — basic gallate of, 573. — salicylate of, 568. Bisulphide of carbon, 512. Bitters, 445. Bitter sweet, 520. Black alder, 464. —berry, 463. — draught, 376. —drop, 581. —haw, 521. — wash, 180. Bladder, action of drugs on, 60. Bleaching powder, 198. Blue flag, 390. Blue ointment, 173. —pill, 173. Boluses, 18. Boneset, 369. Borax, 222. Boro-glyceride, 222. Bougies, 28. Brain, action on, 92. Brandy, 225. Brayera, 478. Bromides, 205. Bromide of ethyl, 574. Bromine, 204. Bromoform, 568. Bronchial secretion, 66. — spasm, 67. Broom, 485. Brucine, 296. Bryonia, 383. Buchu, 436. Buckthorn, 377. Burdock, 518. Burgundy pitch, 398. Burnett's fluid, 147. Butternut, 374. Butyl-chloral hydras, 540 Byne, 466. Cacao butter, 510 Cactus, 569. Cachets, 28. Caffeinae citras, 540. Caffeine, 293. Cajuput oil, 403. Calabar bean, 302. Calamus, 447. Calcium, 131. — hypophosphite, 196. Calomel, 174. Calumba, 445. Calx, 133. — chlorata, 198. — sulphurata, 134. Cambogia, 387. Camphor, 494. — monobromata, 495. Canada balsam, 400. —pitch, 399. Canella, 541. Cannabis indica, 291. — Americana, 292. Cantharides, 530. Capsicum, 415. Capsules, 28. Caraway, 424. Caraway, oil of, 424. Carbolic acid, 250. Carbon, 223. Carbonei bisulphidum, 512. Cardamom, 417. Carlsbad water, 122. Carminative tincture, 417. Carminatives, 75. Carron oil. 133. Carum, 424. Caruol, 421. Caryophyllus, 408. Casca Bark, 574. Cascara Sagrada, 541. Cascarilla, 449. Cassia Fistula, 416. Castanea, 346. Castor oil, 370. Cataplasmata, 29. Catechu, 458. Cathartic acid, 375. Cathartics, 81. Caulophyllum, 491. Caustics, 51. Calendula, 519. Celandine, 519. Cera alba, 530. — flava, 529. Cerasin, 13. Cerata, 18. Cerebral depressants, 94. — stimulants, 95. Cereus grandiflorus, 569. Cerevisiae fermentum, 563. Cerium, 138. Cetaceum, 526. Cetraria, 476. Cevadilla, 334. Chalk, prepared, 131. Chamomile, 451. — German, 451. — oil of, 550. Charcoal, 223. Charta, 18. Chelidonium. 519 Chemical constitution, 38. Chenopodium, 482. Cherry laurel, 547. Chestnut, 346. Chimaphila, 521. Chinoidinum, 353. Chirata, 449. INDEX. 60 1 Chittem bark, 541. Chloral, 247. Chloralamide, 569. Chloralformamide, 569. Chloric ether, 235. Chlorinated Chloride of Ethyl 575.. — lime, 198. — soda, 199. Chlorine, 195. Chlorodyne, 551. Chloroform, 254. Cholagogues, 85. Chondrus, 467. Chromium, 193. Chrysarobin, 372, 502. Churrus, 292. Cigarettes, 29. Ciliary muscle, 100. Cimicifuga, 451. Cinchona, 347. — flava, 349. — rubra, 350. Cinchonidine, 352. Cinchonine, 352. Cinchonism, 356. Cinnamon, 413. Citrine ointment, 176. Cloves, 408. Clysters, 29. Coca, 312. Cocoa, Brazilian, 296. Cocainse hydrochloras, 542. Cocillana, 570. Coccus, 550. Cochineal, 530. Codeina, 274. Cod-liver oil, 527. Coffee, 293. Colchicum, 441. Cold pack, 105. Collodia, 18. Collodium, 509. Collunaria, 29. Colly ria, 29. Colocynth, 385. Colophony, 399. Condal, 122. Condy's fluid, 172. Confectiones, 18. Conium, 307. Conine, 308. 51 Conserves, 18. Constitu.ns, 33. Convallaria majalis, 571. Copaiba, 437. Copper, 151. Coriander, 423. Cornus, 359. Corrigens, 33. Corrosive sublimate, 174. Coster's paste, 201. Coto, 571. Cotton, 509. — seed oil, 5 to. Couch grass, 486. Counter-irritant, 51. Cranesbill, 463. Cream of tartar, 113. Creasote, 254. Cremora, 29. Creolin, 572. Creta prseparata, 13 . Crocus, 508. Croton chloral hydrate, 540. Croton oil, 383. Cubeba, 440. Cuca, 312. Culver's root, 389. Cumulative action, 33. Cuprum, 151. Curare, 573. Curd soap, 559. Cusparia, 542. Cusso, 478. Cydonium, 473. Cypripedium, 428. Damask rose, 504. Dandelion root, 452. Daturine, 288. Decocta, 18 Deliriants, 93. Delphine, 483. Dermatol, 573. Demulcents, 54. Deodorants, 40. Diachylon ointment, 140. Dialysed iron, 577. Dialysis, 14. Diaphoretics, 54. Diaphtherin, 582. Diethyl-sulphon-dimethyl- methane, 562. Digestion, action on, 68. Digitalin, 319. Digitalis, 365. Di^itoxin, 319. Dill, 557. Di methy 1-ethyl-carbi nol,s66. Direct action, 38. Disinfectants, 39. Dispermine, 585. Dissolution, law of, 92. Di-thymol-di-iodide, 566. Diuretics, 57. Diuretin, 574. Dogwood, 359. Domestic measures, 16. Donovan's solution, 173. Doses, 31. Dover's powder, 261. Drastics, 81. Drops, 15. Drugs, administration of, 30. Duboisinse sulphas, 574. Dulcamara, 530. Dusart's syrup, 170. Dynamite, 550. Ears, action on, 100 Easton's syrup, 170. Ecballii fructus, 386. Ecbolics, 101. Egg albumen, 536. Elaeoptenes, 12. Elaterinum, 386. Elaterium, 386. Elder, 425. Elecampane, 347. Electuaries, 18. Elemi, 543. Elixirs, 19. Elutriation, 13. Emetics, 76. Emetine, 340. Emmenagogues, 102. Emollients, 53, Empirical therapeutics, 10. Emplastra, 19. Emulsiones, 29. Emulsions, 13. Enemata, 29, 82. Epsom salts, 135. Ergot, 487. Erythrophloeum, 574. 60 2 INDEX. Erythroxyion, 312. Galactagogubs, 102. Haemostatics, 53. Escharotics, 51. Galbanum, 430. Hamamelis, 462. Eserine, 302. Gall, 455. Hard soap, 465. Essentia, 29. Gamboge, 387. Haschisch, 292. Essential oils, 12. Gargarismata, 29. Haustus, 29 Ether, 240. Garlic, 343. Heart, action on, 46. — acetic, 243. Gastric antiseptics, 73. Hedeoma, 425. — Bromatus, 271. — juice, action on, 71. Helenin, 347. Ethyl Bromide, 574. — sedatives, 75 Hellebore, American, 332. — carbamate, 590. Gastro-intestinal irritants, 74. Hemidesmus. 545. — chlorinated chloride, 575. Gaultheria, 365. Hemlock pitch, 399. Ethylenimine, 585. Gelatine, 543. Hemp, Indian, 291. Eucalyptol, 404. Gelsemium, 306. — Canadian, 485. Eucalyptus, 403. General therapeutics, 10. Henbane, 289. —gum, 543. Generation, action on, 101. Hips, 558. Eugenol, 506. Gentian, 447. Hirudo, 545. Euonymus, 391. Geranium, 463. Hoffman's anodyne, 241. Euonymin, 391. Ginger, 416. Homatropine, hydrobrom- Eupatorium, 369. Glonoin, 550. ate 546. Europhen, 575. Glucosides, n. Honey, 529. Exalgine, 575. Glucusimide, 558. Hops, 276. Expectorants, 67. Glusidum, 558. Hordeum, decorticatum, 547. Extracta, 19. Glycerita, 22, 524. Horehound, 486. — fluida, 20. Glycerin, 467. Horseradish, 538. Extractum carnis, 576. Glycerine, constitution, 11. Hot pack, 107. Eye, action on, 98. Glycogenic function, 86. Huile de Cade, 550. Glycyrrhiza, 474. Humulus, 276. Farina lini, 532. Goa powder, 502. Hunyadi Janos, 82, 122. — tritici, 544. Gold, 172. Hydragogues, 82. Fats, definition of, 12. Gossypium, 509. Hydrargyrum, 173. Fel bovis, 523. — radicis cortex, 490. Hydrastis, 365. Fennel, 423. Granatum, 478. Hydrocyanic acid, 258. Ferri arsenias, 544. Granules, 29. Hydrogen peroxide, 478. — valerianas, 427. Gray powder, 173. Hyoscine, 289. Ferrum, 154. Gregory's powder, 373. Hyoscyamine, 289. — dialysatum, 577. Griffith's mixture, 155. — sulphate, 290. Ficus, 367. Grindelia, 345 Hyoscyamus, 289. Fig, 367. Guaiacol, 577. Hypnotics, 94, 272. Filix mas, 477. Guaiacum, 513. Hypodermic injections, 29. Fir-wool oil, 557. —resin, 514. Hypophosphites, 196. Fixed oils, 11. Guarana, 296. Flax seed, 475. Gum acacia, 472. Ice-bags, 106 Flour, S44- Gum resins, 13. Ice poultices, 106. Fceniculum, 423. Gums, 13. Iceland moss, 476. Fomenta, 29. Gun cotton, 509. Ichthyocolla, 524. Fox glove, 319. Gunjah, 292. Ichthyol, 578. Fowler's solution, 184. Guttae, 29. Ignatia, 302. Frangula, 377. Gutta-percha, 511. Illicium, 422. Frankincense, 563. Incompatibility, chemical, Franz, Joseph, 122. H^matinics, 43. 33- Fredrichshall, 82, 122. — indirect, 44. — physical, 35. Fusil oil, 536. Hasmatoxylon, 460. Indian sarsaparilla, 545. INDEX. 603 Indirect action, 38. Infusa, 22. Inhalations, 31, 64. Injectiones, 29. lnsufflationes, 29. Intestinal antiseptics, 83. — astringents, 83. Intestines, action on, 79. Intra-ocular tension, 100. Inula, 347. Iodides, 202. Iodine, 199. Iodoform, 256. Iodol, 578. Ipecacuanha, 339. Iris, 390. Irish Moss, 467. Iridin, 390. Iron, 154. Irritants, 50. Isinglass, 524. Isobutyl-ortho-cresol-iodide, 575- Jaborandi, 315. Jalap, 381. Jamaica dogwood, 585. James's powder, 189. Jarish's ointment, 565. Jasmine, 306. Jervine, 334. Juglans, 374. Juices, 33. Juniperus, 435. Juniper tar oil, 550. Kamala., 479. Kino, 460. Kissingen, 122. Kola nut, 293. Kombe poison, 560. Kousso, 478. Krameria, 459. Labarraque's solution, 199. Lac, 579. Lactucarium, 277. Ladies' slipper, 428. Lamellae, 29. Lanoline, 535. Lanolinum, 29. Lapis divinus, 152. Lappa, 518. Larch bark, 537. Lard, 525. — oil, 526. Latin phrases, 596. Laudanum, 264. Laurocerasus, 547. Lavender, 418. Laxatives, 80. Lead, 140 Leech, 545. Leiter's coils, 106. Lemon, 498. Leptandra, 389. Lettuce, 277. Levigation, 13. Lignum vitae, 513. Lily of the Valley, 571. Lime, 131. Limonis cortex, 498. — succus, 499. Linctus, 29. Linum, 475. Linimenta, 21. Linseed, 475. Liqueurs, 226. Liquor carbonis detergens, 398. Liquores, 22 Liquorice, 474 Lithontriptics, 58. Lithia water, Londonderry, *3*. Lithium, 130. Li thii Salicylate, 361. Liver, action on, 84. Lixiviation, 14. Lobelia, 343. Lobeline, 343. Local action, 38. Logwood, 460. Londonderry Lithia Water, *3i- Lotiones, 29. Lozenges, 28. Lupulinu 111,276. Lupulus, 276. Lycopodium, 513. Lye, 14. Lysol, 579. Mace, 413. Maceration, 14. Magnesium, 135. Magnolia, 359. Male fern, 477. Malt, 466. Manganese, 170. Manganum, 170. Manila elemi, 543. Manna, 368. Marienbad, 122. Marigold, 519. Marjoram, 507. Marrubium, 86. Marshmaliow, 469. Massae, 22. Mastiche, 510. Mate, 293. Materia medica, 9. Matico, 442. Matricaria, 451. Measures, 15. — domestic, 16. Mel, 529. Mella, 22. Melissa, 505. Menispermum, 517. Mentha piperita, 420. — viridis, 421. Menthol, 548. Mercury, 173. — administration of, 182. Metabolism, action on, 103. Meta - dihydroxyl - benzol, 585. Methyl acetanilide, 575. — pyrocatechin, 577. Methylene blue, 579. Metrical system, 15. Mezereum, 407. Milk, 579. •*— action on, 102. — • artificial human, 579. — drugs excreted in, 102. — peptonized, 580. Mindererus' spirit, 129. Misturae, 22. Mollinum, 30. Monk's-hood, 328. Monobromethane, 574. Monsel's solution, 158. Morus, 548. 6 04 INDEX. Morphinae acetas, 265. — hydrochloras, 265. — sulphas, 265. Moschus, 522. Motor centers, 93. — nerves, 88. Mucilagines, 22. Mulberry juice, 548. Muscles, action on, 87. Musk, 522. Mustard, 400. Mydriatics, 99. Myotics, 100 Myristica, 412. Myrrh, 432. Naphthaline, 581. Naphthol, 567, 581. Naphthosalol, 567. Narceine, 582 Narcotics, 95. Natural orders, 591. Nebulae, 30. Nectandra, 549. Nerves, action on, 88. Neuritis, drugs causing, 90. Neutral principles, (gluco- sides), 11. Nicotine, 311. Night blooming cereus, 569. Nitrite of amyl, 244. Nitrites, 243. Nitro-glycerin, 550. Nutgall, 455. Nutmeg, 442. Nux vomica, 296. Oil of allspice, 411. — almonds, 471. — amber, 418. — anise, 422. — bay, 507. — bergamot, 420. —cade, 550. — cajuput, 403. — cloves, 409. — copaiba, 438. — coriander, 423. — cubeb, 446. — diH, 537- — erigeron, 396. — juniper, 435. Oil lavender, 419. flowers 419. — lemon, 498. — mustard, 401. — peppermint, 420. — rosemary, 406. — rue, 441. — sandal-wood, 441. — sassafras, 519. — savine, 443. — spearmint 421. — tar, 397. — theobroma, 510. — thyme, 497. — turpentine, 393. Oils, fixed, 11. — volatile, 12. Ointments, 28. Olea, 22. Oleata, 22. Oleic acid, 469. Oleo-resina cubebae, 440. Oleo-resins, 13. Oleum aethereum, 241. — amygdalae expressum, 471. — anethi, 537. — anisi, 422. — anthemidis, 550. — bergamii, 420. — cadinum, 550. — cajuputi, 403. — carui, 424. — caryophylli, 407. — chenopodii, 482. — cinnamomi, 434. — copaibae, 438. — coriandri, 423. — cubebae, 440. — erigerontis, 396. — eucalypti, 404. — foeniculi, 424. — gaultheriae, 365. — gossypii seminis, 510. — hedeomae, 425. — juniperi, 435. — lavandulae, 419. — limonis, 498. — lini, 475. — menthae piperitae, 420. Oleum menthae viridis, 421. — morrhuae, 527. Oleum myricae, 507. — myristicae, 413. expressum, 551. — olivae, 465. — picis liquidae, 397. — pimentse, 411. — pini sylvestris, 557. — ricini, 370. — rosae, 505. — rosmarini, 406. — rutae, 444. — sabinae, 443. — santali, 441. — sassafras, 519. — sesami, 508. — sinapis volatile, 401. — succini, 418. — terebinthmae, 393. — theobromae, 510. — thy mi, 497. — tiglii, 383. — Valerianae, 427. Olive oil, 465. Opium, 261. Orange flowers, 453. — fruit, 453. — peel, 453. Ordeal bark, 574. Origanum, 507. Ortho-phenol-sulphonic acid, 567. Orexine hydrochloride, 582. Ouabaine, 560. Ovi albumen, 536. — vitellus, 526 Ox-gall, 523 Oxymella, 30. Oxychinaseptol, 582. Oxytoxics, 101. Pack, cold, 106. — hot, 107. Paint, 30. Pancreatin, 583. Papaver 552. Paraffin, 552. Para acetphenetilin, 553. Paracotoin, 572. Paramorphine, 581. Paraguay tea, 294. Paraldehydum, 552. INDEX. 66 Parasiticides, 41. Paregoric, 264. Pareira, 516. Parish's food, 170, 583. Paste, 30. Pastillus, 30. Pearl barley, 547. Pennyroyal, 425. Pental, 583. Pepo, 479. Pepper, 411. Peppermint, 420. Pepsinum saccharatum, 524. Percolation, 14. Pedes, 30. Peroxide of hydrogen, 578. Pessus, 30. Petrolatum, 512. Petroleum benzin, 511. Pharmaceutical processes, 13- Pharmacognosy, definition, 9 Pharmacology, 30. — definition, 9. Pharmacopoeia, definition 10. — preparations of the, 17. Pharmacy, 10. — definition, 9. Phenacetine, 553. Phenazonum, 537. Phenocoll hydrochloride, 584 Phenol, 250. Phenylacetamide, 534. Phenyl-dimethyl-pyrazolone 537- Phosphorus, 194. Physostigma, 302. Physostigmine salicylate, 303. Phytolacca, 369. Pichi, 584. Picrotoxin, 483. Pig men turn, 30. Pilocarpine hydrochloras, 3i5. Pilocarpus, 315. Pilulae, 22. Pimenta, 411. Pink Root, 481. Pnus larix, 557. — sylvestris, 557. Piscidia, 585. Piper, 411. Piperine, 412. Piperazine, 585. Pipsissewa, 521. Pix Burgundica, 398. — liquida, 396. Plasma, action on, 42. Plasters, 19. Pleurisy root, 346. Plumbum, 140. Plummer's pill, 175. Pneumogastric, action on, 48. Podophyllin, 38 . Podophyllum, 387. j Poison ivy, 503. — nut, 296. Pomegranate, 478. Poppy petals, 552. Porphyroxine, 339. Posology, 31. Potassa Sulphurata, 212. Potassii bromidum, 205. — iodidum, 202. Potassium, 108. Powders, 25. Preparations standardized, 14. Prescribing, 33. Prescription, 36. Prickly ash, 515. Primary action, 38. Prinos, 464. Prune, 367. Prunus virginiana, 499. Prussic acid, 258. Pterocarpi lignum, 568. Puccine, 339. Pullna, 82. Pulsatilla, 339. Pulveres, 22. Pumpkin, 479. Pupil, action on, 98. Purgatives, 80, 414. Pustulants, 51. Pyrethrum, 408. Pyrogallic acid, 565. Pyroxylin, 509. Quassia., 448. Querelas alba, 512. Quillaia, 513. Queen's root, 571. Quince seed, 473. Quinine, 350. Raisins, 563. Rash, drugs producing a, 56. Raspberry, 506. Rational therapeutics, 9. Red corpuscles, action on, 43- Red gum, 543. — lotion, 150. — precipitate, 173. — saunders, 568. Refrigerants, 71. Remote action, 38. Resin, 399. Resins, 12. Resorcin, 585. Respiration, action, 63. Respiratory centre, 65. Rhamni frangulae cortex, 377- — purshianse cortex, 541. Rhatany, 459. Rheum, 372. Rhoeados petala, 552. Rhubarb, 372. Rhus Glabra, 462 . — toxicodendron, 503. Roborans plaster, 159. Rosa gallica, 504. — centifolia, 504, Rosae caninae fructus, 558. Rosemary, 405. Rose petals, 504. Rosin, 399. Rottlera, 479. Rubefacients, 50. Rubinat, 82. Rubus, 463. — idseus, 506. Rue, 444. Rumex, 464. Sabadilla, 334. Sabina, 443. Saccharated pepsin, 524. Saccharin, 558. Saccharum, 505. - — lactis, 523. 6o6 INDEX. Sacred bark, 541. Saffron, 508. Sage, 507. St. Ignatius bean, 296. Sal alembroth, 565. — ammoniac, 128. Salinaphthol, 567. Sal volatile, 128. Salicin, 360. Saline Purgatives, 82. Salivary glands, action on* 69. Salix, 360. Salol, 586. Salt, 122. Salvia, 507 Sambucus, 425. Sanguinaria, 338. Sanguinarine, 339. Santal oil, 441. Santalum rubrum, 508. Sanitas, 586. Santonica, 480. Santoninum, 480. Sapo, 465. — animalis, 559. — viridis, 465; Saponin, 337. Sarsaparilla, 516. Sassafras, 518. — medulla, 518. Sassy bark, 574. Savine, 443. Scaling, 14. Scammony, 380. Scilla, 327. Scillitoxin, 327. Scoparin, 587. Scoparius, 485. Scull cap, 520. Scutellaria, 520. Secondary action, 38. Seidlitz powder, 121. Senega, 337. Senna, 375. Sensory, nerves acting on, 89. Serpentaria, 450. Sevum, 523. Sherry, 226. Sialogogues, 69. Silver, 144. Simulo, 587. Sinapis, 400. — alba, 400. — nigra, 400. Soap, 465, 559. Soap, constitution of, 11. Soda waters, 122. Sodii benzoas, 500. — bromidum, 205. — ethylas, 559. — hypophosphis, 196. — hyposulphis, 124. — iodidum, 202. — nitris, 559. — salicylas, 361. — santoninas, 480. — sulphocarbolas, 254. — valerianas, 559 Sodio-theobromine-salicyl- ate, 574. Sodium, 117. Soft soap, 465. Somnal, 587. Soporifics, 94 Soja beans, 587. Sozolic acid, 567. Sparteine, 587. Spermaceti, 526. Spigelia, 481. Spinal cord, action on, 90. Spirit of nitrous ether, 243. Spirits, 225. Spiritus, 22. — frumenti, 225. — vini gallici, 225. Sponging, cold, 106. — hot, 107. Squill, 327. Standardizing, 4. Staphisagria, 482. Starch, 512. Stavesacre, 482. Stearoptens, 12, 494. Stillingia, 517. Stomach, action on, 71. Stomachics, 72. Storax, 435. Stramonium 288. Strophanthus, 560. Strychnine, 296. — sulphate, 297. Styptics, 53. Styrax, 435. Succi, 30. Sudorifics, 54. Suet, 523. Sugar, 505 — drugs causing it, 86. — of milk, 523. Sulphocarbol, 567. Sulphocarbolate of soda, 254. Sulphoicthyolate of ammoni- um, 578. Sulphonal, 562. Sulphur, 209. Sulphuris iodidum, 212. Sumach, 462. Sumbul, 417. Suppositoria, 26. Suspensions, 13. Sweet Flag, 447. Sweet spirits of nitre, 243. Sydenham's laudanum, 581 Symbols, 15. Sympathetic system, 100. Syrupi, 26, Tabacum, 311. Tabellse, 30. Tamar indien, 377. Tamarind, 367. Tanacetum, 444. Tannin, 455. Tar, 367. Tarasp, 122. Taraxacum, 452. Tartar emetic, 189. Tea, 293. Teeth, action on, 68. Terebene, 588. Terebinthina canadensis, 400. Terpin hydrate, 589. Tertiary Amyl alcohol, 566. Tetraiodopyrrol, 578. Tetramethylthionine chlo- ride, 579. Thallin, 589. Thebaine, 581. Theine, 293. Therapeutics, 30. — definition, 9. Theriaca, 562. INDEX. 607 Thiocamf, 589, Thiophen, 579. Thiophen diiodide, 579. Thuja, 520. Thus Americanum, 563. Thymol, 497. Tinctura chloroformi et mor- phinae, 551. Tincturae, 26. Tobacco, 311. Tonga, 590. Tonic, 103. Toxicology, definition, 6. Tragacanth, 442. Treacle, 562. Tribromomethane, 568. Trimethylethylene, 583. Trinitrin, 550 Triticum, 486. Triturationes, 27. Trochisci, 28. Tropine, 546. Turpentine, 393. Ulmus, 474. Unguenta, 28. Urari, 573. Urea, action on, 87. Urethane, 590. Urethra, drugs acting on, 60. Urinary System, drugs act- ing on, 56. I Urine, composition altered, 59- j — rendered acid, 58. i alkaline, 58. I aseptic, 59. ! Utilago, 490. Uterus, action on, 102. Uvae, 563. Uva ursi, 484. Vagus, action on, 48. Valerian, 426. Vanilla, 506. Vapores, 30. Vaselinum, 30. Vaso-motor centre, action on, 52. Vegetable drugs, 261. Veratrine, 334. Veratroidine, 333. Veratrum viride, 332. — sabadilla, 334. Vermicides, 41. Vermifuges, 41. Vesicants, 50. Vessels, action on, 49. Viburnum, 521. Villacabras, 82. Vina, 28, Viola tricolor, 369. Vinum, 247. Virginia prune, 499. Virginia snake root, 450. Vitellus, 526. Volatile oils, 12, 442. Wahoo, 391. Warburg's Tincture, 359. Water, 104. — distilled, 104. Wax, 529. Weights, 13. White corpuscles, action on, 44. Willow, 360. Witchhazel, 462. Wines, 28, 247. Wood wool, 590. Wormwood, 425. Wourali, 593 Xanthothylon, 515. Yeast, 563. Yellow wash, 174. — dock, 464. Yolk of egg, 526. Zinci Oleatum, 564. — sulphocarbolas, 563. — valerianas, 427. Zincum, 147. Zingiber, 416. Zymine, 583- CATALOGUE No. 7. ' JULY, 1892. A CATALOGUE OF Books for Students. INCLUDING THE ? QUIZ-COMPENDS ? CONTENTS. PAGE PAGE New Series of Manuals, 2,3,4,5 Obstetrics 10 Anatomy, . 6 Pathology, Histology, . .11 Biology, . II Pharmacy, . . . .12 Chemistry, . . 6 Physical Diagnosis, . .11 Children's Diseases, . • 7 Physiology, . . . . n Dentistry, , 8 Practice of Medicine, . n, 12 Dictionaries, 8, 16 Prescription Books, . . 12 Eye Diseases, . 8 ?Quiz-Compends ? . 14,15 Electricity, . • 9 Skin Diseases, . . .12 Gynaecology, . 10 Surgery and Bandaging, . 13 Hygiene, • 9 Therapeutics, . . ,9 Materia Medica, . • 9 Urine and Urinary Organs, 13 Medical Jurisprudence, • 9 Venereal Diseases, . . 13 Nervous Diseases, . 10 PUBLISI IED BY P. BLAKISTON, SON & CO., Medical Booksellers, Importers and Publishers. LARGE STOCK OF ALL STUDENTS' BOOKS, AT THE LOWEST PRICES. 1012 Walnut Street, Philadelphia. *** For sale by all Booksellers, or any book will be sent by mail, postpaid, upon receipt of price. Catalogues of books on all branches of Medicine, Dentistry, Pharmacy, etc. , supplied upon application. Just Ready Price 10 cents V 3000 Questions on Medical Subjects. THE NEW SERIES OF MANUALS. No. 5. DISEASES OP CHILDREN. SECOND EDITION. A Manual. By J. F. Goodhart, m.d,, Phys. to the Evelina Hospital for Children ; Asst. Phys. to Guy's Hospital, London. Second American Edition. Edited and Rearranged by Louis Starr, m.d., Clinical Prof, of Dis. of Children in the Hospital of the Univ. of Pennsylvania, and Physician to the Children's Hos- pital, Phila. Containing many new Prescriptions, a list of over 50 Formulae, conforming to the U. S. Pharma- copoeia, and Directions for making Artificial Human Milk, for the Artificial Digestion of Milk, etc. Illus. '* The merits of the book are many. Aside from the praiseworthy work of the printer and binder, which gives us a print and page that delights the eye, there is the added charm of a style of writ- ing that is not wearisome, that makes its statements clearly and forcibly, and that knows when to stop when it has said enough. The insertion of typical temperature charts certainly enhances the value of the book. It is rare, too, to find in any text-book so many topics treated of. All the rarer and out-of-the-way diseases are given consideration. This we commend. It makes the work valuable." — Archives of Pedriatics , July , i8go. 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In our estimation, it is the best book of the kind ever written." — N. Y. Medical Journal. " Dr. Waring's Therapeutics has long been known as one of the most thorough and valuable of medical works. The amount of actual intellectual labor it represents is immense. . . . An in- dex of diseases, with the remedies appropriate for their treatment, closes the volume." — Boston Medical and Surgical Reporter. " The plan of this work is an admirable one, and one well calcu- lated to meet the wants of busy practitioners. ^ There is a remark- able amount of information, accompanied with judicious comments, imparted in a concise yet agreeable style." — Medical Record. No. 7. MEDICAL JURISPRUDENCE AND TOXICOLOGY. THIRD REVISED EDITION. By John J. Reese, m.d., Professor of Medical Jurispru- dence and Toxicology in the University of Pennsyl- vania ; President of the Medical Jurisprudence Society* of Phila. ; Third Edition, Revised and Enlarged. " This admirable text-book." — Amer.Jour. of Med. Sciences. " We lay this volume aside, after a careful perusal of its pages, with the profound impression that it should be in the hands of every doctor and lawyer. It fully meets the wants of all students He has succeeded in admirably condensing into a handy volume all the essential points." — Cincinnati Lancet and Clinic, " The book before us will, we think, be found to answer the ex- pectations of the student or practitioner seeking a manual of juris- prudence, and the call for a second edition is a flattering testimony to the value of the author's present effort. The medical portion of this volume seems to be uniformly excellent, leaving little for adverse criticism. The information on the subject matter treated has been carefully compiled, in accordance with recent knowledge. The toxicological portion appears specially excellent. Of that por- tion of the work treating of the legal relations of the practitioner and medical witness, we can express a generally favorable ver- dict." — Physician and Surgeon, Ann Arbor, Mich. Price of each Book, Cloth, $3,00 ; Leather, $3.50. 6 STUDENTS' TEXT-BOOKS AND MANUALS. ANATOMY. Macalister's Human Anatomy. 816 Illustrations. A new Text-book for Students and Practitioners, Systematic and Topo- graphical, including the Embryology, Histology and Morphology of Man. With special reference to the requirements of Practical Surgery and Medicine. With 816 Illustrations, 400 of which are original. Octavo. Cloth, 7.50; Leather, 8.50 Ballou's Veterinary Anatomy and Physiology. Illustrated. By Wm. R. Ballou, m.d., Professor of Equine Anatomy at New York College of Veterinary Surgeons. 29 graphic Illustrations. i2mo. Cloth, 1. 00; Interleaved for notes, 1.25 Hold en's Anatomy. A manual of Dissection of the Human Body. Fifth Edition. Enlarged, with Marginal References and over 200 Illustrations. Octavo. Bound in Oilcloth, for the Dissecting Room, $4.50. " No student of Anatomy can take up this book without being pleased and instructed. Its Diagrams are original, striking and suggestive, giving more at a glance than pages of text description. * * * The text matches the illustrations in directness of prac- tical application and clearness of detail." — New York Medical Record. Holden's Human Osteology. Comprising a Description of the Bones, with Colored Delineations of the Attachments of the Muscles. The General and Microscopical Structure of Bone and its Development. With Lithographic Plates and Numerous Illus- trations. Seventh Edition. 8vo. Cloth, 6.00 Holden's Landmarks, Medical and Surgical. 4th ed. Clo., 1.25 Heath's Practical Anatomy. Sixth London Edition. 24 Col- ored Plates, and nearly 300 other Illustrations. Cloth, 5.00 Potter's Compend of Anatomy. Fifth Edition. Enlarged. 16 Lithographic Plates. 117 Illustrations. See Page 14. Cloth, 1.00; Interleaved for Notes, 1.25 CHEMISTRY. Bartley's Medical Chemistry. Second Edition. A text-book prepared specially for Medical, Pharmaceutical and Dental Stu- dents. With 50 Illustrations, Plate of Absorption Spectra and Glossary of Chemical Terms. Revised and Enlarged. Cloth, 2.50 Trimble. Practical and Analytical Chemistry. A Course in Chemical Analysis, by Henry Trimble, Prof, of Analytical Chem- istry in the Phila. College of Pharmacy. Illustrated. Fourth Edition, Enlarged. 8vo. Cloth, 1.50 MBf" See pages 2 to 5 for list 0/ Students' Manuals . STUDENTS' TEXT-BOOKS AND MANUALS. 7 Chemistry : — Continued. Bloxam's Chemistry, Inorganic and Organic, with Experiments. Seventh Edition. Enlarged and Rewritten. 281 Illustrations. Cloth, 4.50; Leather, 5.50 Richter's Inorganic Chemistry. A text-book for Students. Third American, from Fifth German Edition. Translated by Prof. Edgar F. Smith, ph.d. 89 Wood Engravings and Colored Plate of Spectra. Cloth, 2.00 Richter's Organic Chemistry, or Chemistry of the Carbon Compounds. Illustrated. Second Edition. Cloth, 4.50 Symonds. Manual of Chemistry, for the special use of Medi- cal Students. By Brandreth Symonds, a.m., m.d., Asst. Physician Roosevelt Hospital, Out- Patient Department; Attend- ing Physician Northwestern Dispensary, New York. i2mo. Cloth, 2.00 Leffmann's Compend of Chemistry. Inorganic and Organic. Including Urinary Analysis. Third Edition. Revised. Cloth, 1.00; Interleaved for Notes, 1.25 Leffmann and Beam. Progressive Exercises in Practical Chemistry. 121110. Illustrated. Cloth, 1.00 Muter. Practical and Analytical Chemistry. Fourth Edi- tion. Revised, to meet the requirements of American Medical Colleges, by Prof. C. C. Hamilton. Illustrated. Cloth, 2.00 Holland. The Urine, Common Poisons, and Milk Analysis, Chemical and Microscopical. For Laboratory Use. Fourth Edition, Enlarged. Illustrated. Cloth, 1.00 Van Niiys. Urine Analysis. Illus. Cloth, 2.00 Wolff's Applied Medical Chemistry. By Lawrence Wolff, m.d., Dem. of Chemistry in Jefferson Medical College. Clo. f 1.00 CHILDREN. Qoodhart and Starr. The Diseases of Children. Second Edition. By J. F. Goodhart, m.d., Physician to the Evelina Hospital for Children ; Assistant Physician to Guy's Hospital, London. Revised and Edited by Louis Starr, m.d., Clinical Professor of Diseases of Children in the Hospital of the Univer- sity of Pennsylvania; Physician to the Children's Hospital, Philadelphia. Containing many Prescriptions and Formulae, conforming to the U. S. Pharmacopoeia, Directions for making Artificial Human Milk, for the Artificial Digestion of Milk, etc. Illustrated. Cloth, 3.00; Leather, 3.50 Hatfield. Diseases of Children. By M. P. Hatfield, m.d., Professor of Diseases of Children, Chicago Medical College. Colored Plate. i2mo. Cloth, 1. 00; Interleaved, 1.25 4^* See pages 14 and 15 for list of f Quiz- Comp ends? 8 STUDENTS' TEXT-BOOKS AND MANUALS. Children: — Continued. Starr. Diseases of the Digestive Organs in Infancy and Childhood. With chapters on the Investigation of Disease, and on the General Management of Children. By Louis Starr, m.d., Clinical Professor of Diseases of Children in the Univer- sity of Pennsylvania. Ulus. Second Edition. Cloth, 2.25 DENTISTRY. Fillebrown. Operative Dentistry. 330 Illus. Cloth, 2.50 Flagg's Plastics and Plastic Filling. 4th Ed. Cloth, 4.00 Gorgas. Dental Medicine. Fourth Edition. Cloth, 3.50 Harris. Principles and Practice of Dentistry. Including Anatomy, Physiology, Pathology, Therapeutics, Dental Surgery and Mechanism. Twelfth Edition. Revised and enlarged by Professor Gorgas. 1028 Illustrations. Cloth, 7.00 ; Leather, 8.00 Richardson's Mechanical Dentistry. Fifth Edition. 569 Illustrations. 8vo. Cloth, 4.50; Leather, 5.50 Sewill. Dental Surgery. 200 Illustrations. 3d Ed. Clo., 3.00 Taft's Operative Dentistry. Dental Students and Practitioners. Fourth Edition. 100 Illustrations. Cloth, 4.25 ; Leather, 5.00 Talbot. Irregularities of the Teeth, and their Treatment. Illustrated. 8vo. Second Edition. Cloth, 3.00 Tomes' Dental Anatomy. Third Ed. 191 Illus. Cloth, 4.00 Tomes' Dental Surgery. 3d Edition. 292 Illus. Cloth, 5.00 Warren. Compend of Dental Pathology and Dental Medi- cine. Illustrated. Cloth, 1. 00; Interleaved, 1.25 DICTIONARIES. Gould's New Medical Dictionary. Containing the Definition and Pronunciation of all words in Medicine, with many useful Tables etc. y 2 Dark Leather, 3.25 ; y 2 Mor., Thumb Index, 4.25 Harris' Dictionary of Dentistry. Fifth Edition. Completely revised by Prof. Gorgas. Cloth, 5.00; Leather, 6.00 Cleaveland's Pronouncing Pocket Medical Lexicon. Small pocket size. Cloth, red edges .75 ; pocket-book style, 1.00 Longley's Pocket Dictionary. The Student's Medical Lexicon, giving Definition and Pronunciation , with an Appendix giving Abbreviations used in Prescriptions, Metric Scale of Doses, etc. 24mo. Cloth, 1. 00; pocket-book style, 1.25 EYE. Hartridge on Refraction. 5th Edition. Illus. Cloth, 2.00 Swanzy. Diseases of the Eye and their Treatment. 158 Illustrations. Fourth Edition. Cloth, 3 00 Fox and Gould. Compend of Diseases of the Eye and Refraction. 2d Ed. Enlarged. 71 Illus. 39 Formulae. Cloth, 1. 00 ; Interleaved for Notes, 1.25 See pages 2 to 5 for list 0/ Students* Manuals. STUDENTS' TEXT-BOOKS AND MANUALS. 9 ELECTRICITY. Bigelow. Plain Talks on Medical Electricity. Cloth, i.oo Mason's Compend of Medical Electricity. Cloth, i.oo Steavenson and Jones. Medical Electricity. A Practical Handbook. Just Ready. Illustrated. i2mo. Cloth, 2.50 HYGIENE. Coplin's Practical Hygiene. By W. M. L. Coplin, Adjunct Professor of Hygiene, Jefferson Medical College, Philadelphia. Illustrated. In Press. Parkes' (Ed. A.) Practical Hygiene. Seventh Edition, en- larged. Illustrated. 8vo. Cloth, 4.50 Parkes' (L. C.) Manual of Hygiene and Public Health. Second Edition. i2mo. Cloth, 2.50 Wilson's Handbook of Hygiene and Sanitary Science. Seventh Edition. Revised and Illustrated. Cloth, 3.25 MATERIA MEDICA AND THERAPEUTICS. Potter's Compend of Materia Medica, Therapeutics and Prescription Writing. Fifth Edition, revised and improved. See Page if. Cloth, 1.00; Interleaved for Notes, 1.25 Biddle's Materia Medica. Eleventh Edition. By the late John B. Biddle, m.d. Revised by Clement Biddle, m.d., 8vo, illustrated. Cloth, 4.25; Leather, 5.00 Potter. Handbook of Materia Medica, Pharmacy and Therapeutics. Including Action of Medicines, Special Thera- peutics, Pharmacology, etc. By Saml. O. L. Potter, m.d., m.r.c.p. (Lond.), Professor of the Practice of Medicine in Cooper Medical College, San Francisco. Third Revised and Enlarged Edition. 8vo. Cloth, 4.00; Leather, 5.00 White and Wilcox. Materia Medica, Pharmacy, Phar- macology, and Therapeutics. A Handbook for Students. By Win. Hale White, m.d., f.r.c.p., etc., Physician to and Lecturer on Materia Medica, Guy's Hospital. Revised by Reynold W. Wilcox, m.d., Professor of Clinical Medicine at the New York Post Graduate Medical School, Assistant Physician Bellevue Hospital, etc. American Edition. In Press. MEDICAL JURISPRUDENCE. Reese. A Text-book of Medical Jurisprudence and Toxi- cology. By John J. Reese, m.d., Professor of Medical Juris- prudence and Toxicology in the Medical Department of the University of Pennsylvania ; President of the Medical Juris- prudence Society of Philadelphia; Physician to St. Joseph's Hospital ; Corresponding Member of The New York Medico- legal Society. Third Edition. Cloth, 3.00; Leather, 3.50 $&- See pages 14 and ij for list 0/ f Quiz- Compends ? 10 STUDENTS' TEXT-BOOKS AND MANUALS. NERVOUS DISEASES. Gowers. Manual of Diseases of the Nervous System. A Complete Text-book. By William R. Gowers, m.d., Prof. Clinical Medicine, University College, London. Physician to National Hospital for the Paralyzed and Epileptic. Second Edition. Revised, Enlarged, and in many parts Rewritten. With many new Illustrations. Octavo. Vol. I. Diseases of the Nerves and Spinal Cord. 616 pages. Cloth, 3.50 Vol. II. Diseases of the Brain and Cranial Nerves. General and Functional Diseases. Nearly Ready. Ormerod. Diseases of Nervous System, Student's Guide to. By J. A. Ormerod, m.d. , Oxon.,F.R.c.P. (London), Member Path- ological, Clinical, Ophthamological, and Neurological Societies, Physician to National Hospital for Paralyzed and Epileptic and to City of London Hospital for Diseases of the Chest, Demon- strator of Morbid Anatomy, St. Bartholomew's Hospital, etc. With 75 Wood Engravings. Cloth, 2.00 OBSTETRICS AND GYNECOLOGY. Davis. A Manual of Obstetrics. By Edw. P. Davis, Dem- onstrator of Obstetrics, Jefferson Medical College, Philadelphia. Colored Plates, and 130 other Illustrations. i2mo. Cloth, 2.00 Byford. Diseases of Women. The Practice of Medicine and Surgery, as applied to the Diseases and Accidents Incident to Women. By W. H. Byford, a.m., m.d., Professor of Gynaecology in Rush Medical College and of Obstetrics in the Woman's Med : ical College, etc., and Henry T. Byford, m.d., Surgeon to the Woman's Hospital of Chicago. Fourth Edition. Revised and Enlarged. 306 Illustrations, over 100 of which are original. Octavo. 832 pages. Cloth, 5.00 ; Leather, 6.00 Lewers' Diseases of Women. A Practical Text-book. 139 Illustrations. Second Edition. Cloth, 2.50 Parvin's Winckel's Diseases of Women. Second Edition. Including a Section on Diseases of the Bladder and Urethra. 150 Illus. Revised. Seepages. Cloth, 3.00; Leather, 3.50 Morris. Compend of Gynaecology. Illustrated. Cloth, 1.00 Winckel's Obstetrics. A Text-book on Midwifery, includ- ing the Diseases of Childbed. By Dr. F. Winckel, Professor of Gynaecology, and Director of the Royal University Clinic for Women, in Munich. Authorized Translation, by J. Clifton Edgar, m.d., Lecturer on Obstetrics, University Medical Col- lege, New York, with nearly 200 handsome Illustrations, the majority of which are original. 8vo. Cloth, 6.00; Leather, 7.00 Landis' Compend of Obstetrics. Illustrated. 4th edition, enlarged. Cloth, 1.00; Interleaved for Notes, 1.25 Galabin's Midwifery. By A. Lewis Galabin, m.d., f.r.c.p. 227 Illustrations. See Page 3. Cloth, 3.00; Leather, 3.50 4SF" See Pages 2 to 5 for Kst of New Manuals. STUDENTS' TEXT-BOOKS AND MANUALS. 11 PATHOLOGY. HISTOLOGY. BIOLOGY. Bowlby. Surgical Pathology and Morbid Anatomy, for Students. 135 Illustrations. i2mo. Cloth, 2.00 Davis' Elementary Biology. Illustrated. Cloth, 4.00 Gilliam's Essentials of Pathology. A Handbook for Students. 47 Illustrations. i2mo. Cloth, 2.00 *** The object of this book is to unfold to the beginner the funda- mentals of pathology in a plain, practical way, and by bringing them within easy comprehension to increase his interest in the study of the subject. Gibbes* Practical Histology and Pathology. Third Edition. Enlarged. i2mo. Cloth, 1.75 Virchow's Post-Mortem Examinations. 3d Ed. Cloth, 1.00 PHYSICAL DIAGNOSIS. Fenwick. Student's Guide to Physical Diagnosis. 7th Edition. 117 Illustrations. i2mo. Cloth, 2.25 Tyson's Student's Handbook of Physical Diagnosis. Illus- trated. i2mo. Cloth, 1.25 PHYSIOLOGY. Yeo's Physiology. Fifth Edition. The most Popular Stu- dents' Book. By Gerald F. Yeo, m.d., f.r.c.s., Professor of Physiology in King's College, London. Small Octavo. 758 pages. 321 carefully printed Illustrations. With a Full Glossary and Index. See Page 3. Cloth, 3.00; Leather, 3.50 Brubaker's Compend of Physiology. Illustrated. Sixth Edition. Cloth, 1. 00; Interleaved for Notes, 1.25 Stirling. Practical Physiology, including Chemical and Ex- perimental Physiology. 142 Illustrations. Cloth, 2.25 Kirke's Physiology. New 12th Ed. Thoroughly Revised and Enlarged. 502 Illustrations. Cloth, 4.00; Leather, 5.00 Landois' Human Physiology. Including Histology and Micro- scopical Anatomy, and with special reference to Practical Medi- cine. Fourth Edition. Translated and Edited by Prof. Stirling. 845 Illustrations. Cloth, 7.00; Leather, 8.00 " With this Text-book at his command, no student could fail in his examination." — Lancet. Sanderson's Physiological Laboratory. Being Practical Ex- ercises for the Student. 350 Illustrations. 8vo. Cloth, 5.00 PRACTICE. Taylor. Practice of Medicine. A Manual. By Frederick Taylor, m.d., Physician to, and Lecturer on Medicine at, Guy's Hospital, London ; Physician to Evelina Hospital for Sick Chil- dren, and Examiner in Materia Medica and Pharmaceutical Chemistry, University of London. Cloth, 4.00; Leather, 5.00 4®* See pages 14 and 15 for list of ? Quiz-Compends t 12 STUDENTS' TEXT-BOOKS AND MANUALS. Practice : — Continued. Roberts' Practice. New Revised Edition. A Handbook of the Theory and Practice of Medicine. By Frederick T. Roberts, m.d., m.r.c.p., Professor of Clinical Medicine and Therapeutics in University College Hospital, London. Seventh Edition. Octavo. • Cloth, 5.50 ; Sheep, 6.50 Hughes. Compend of the Practice of Medicine. 4th Edi- tion. Two parts, each, Cloth, 1.00; Interleaved for Notes, 1.25 Part i. — Continued, Eruptive and Periodical Fevers, Diseases of the Stomach, Intestines, Peritoneum, Biliary Passages, Liver, Kidneys, etc., and General Diseases, etc. Part ii. — Diseases of the Respiratory System, Circulatory System and Nervous System ; Diseases of the Blood, etc. Physicians* Edition. Fourth Edition. Including a Section on Skin Diseases. With Index. 1 vol. Full Morocco, Gilt, 2.50 From John A. Robinson, M.D., Assistant to Chair 0/ Clinical Medicine, now Lecturer on Materia Medica, Rush Medical Col- lege, Chicago. " Meets with my hearty approbation as a substitute for the ordinary note books almost universally used by medical students. It is concise, accurate, well arranged and lucid, . . . just the thing for students to use while studying physical diagnosis and the more practical departments of medicine." PRESCRIPTION BOOKS. Wythe's Dose and Symptom Book. Containing the Doses and Uses of all the principal Articles of the Materia Medica, etc. Seventeenth Edition. Completely Revised and Rewritten. Just Ready. 32mo. Cloth, 1.00; Pocket-book style, 1.25 Pereira's Physician's Prescription Book. Containing Lists of Terms, Phrases, Contractions and Abbreviations used in Prescriptions Explanatory Notes, Grammatical Construction ot Prescriptions, etc., etc. By Professor Jonathan Pereira, m.d. Sixteenth Edition. 32mo. Cloth, 1. 00; Pocket-book style, 1.25 PHARMACY. Stewart's Compend of Pharmacy. Based upon Remington's Text-book of Pharmacy. Third Edition, Revised. With new Tables, Index, Etc. Cloth, 1.00 ; Interleaved for Notes, 1.25 Robinson. Latin Grammar of Pharmacy and Medicine. By H. D. Robinson, ph.d., Professor of Latin Language and Literature, University of Kansas, Lawrence. With an Intro- duction by L. E. Sayre, ph.g., Professor of Pharmacy in, and Dean of, the Dept. of Pharmacy, University of Kansas. i2mo. Cloth, 2.00 SKIN DISEASES. Anderson, (McCall) Skin Diseases. A complete Text-book, with Colored Plates and numerous Wood Engravings. 8vo. Cloth, 4.50; Leather, 5.50 Van Harlingen on Skin Diseases. A Handbook of the Dis- eases of the Skin, their Diagnosis and Treatment (arranged alpha- betically). By Arthur Van Harlingen, m.d., Clinical Lecturer on Dermatology, Jefferson Medical College; Prof, of Diseases of the Skin in the Philadelphia Polyclinic. 2d Edition. Enlarged. With colored and other plates and illustrations. i2mo. Cloth, 2.50 &&- See pages 2 to 5 for list 0/ New Manuals. STUDENTS' TEXT-BOOKS AND MANUALS. 13 SURGERY AND BANDAGING. Moullin's Surgery. 500 Illustrations (some colored), 200 of which are original. Cloth, net 7.00; Leather, net 8.00 Jacobson. Operations in Surgery. A Systematic Handbook for Physicians, Students and Hospital Surgeons. By W. H. A. Jacobson, b.a. Oxon., f.r.c.s. Eng. ; Ass't Surgeon Guy's Hos- pital ; Surgeon at Royal Hospital for Children and Women, etc. 199 Illustrations. 1006 pages. 8vo. Cloth. 5.00; Leather, 6.00 Heath's Minor Surgery, and Bandaging. Ninth Edition. 142 Illustrations. 60 Formulae and Diet Lists. Cloth, 2.00 Horwitz's Compend of Surgery, Minor Surgery and Bandaging, Amputations, Fractures, Dislocations, Surgical Diseases, and the Latest Antiseptic Rules, etc., with Differential Diagnosis and Treatment. By Orville Hokwitz, b.s., m.d., Demonstrator of Surgery, Jefferson Medical College. 4th edition. Enlarged and Rearranged. 136 Illustrations and 84 Formulae. i2mo. Cloth, 1. 00 ; Interleaved for the addition of Notes, 1.25 ***The new Section on Bandaging and Surgical Dressings, con- sists of 32 Pages and 41 Illustrations. Every Bandage of any importance is figured. This, with the Section on Ligation of Arteries, forms an ample Text-book for the Surgical Laboratory. Walsham. Manual of Practical Surgery. Third Edition. By Wm. J. Walsham, m.d., f.r c.s., Asst. Surg, to, and Denis of Practical Surg, in, St. Bartholomew's Hospital; Surgeon to Metropolitan Free Hospital, London. With 318 Engravings. See Page 2. Cloth, 3.00; Leather, 3.50 URINE, URINARY ORGANS, ETC. Holland. The Urine, and Common Poisons and The Milk. Chemical and Microscopical, for Laboratory Use. Illus- trated. Fourth Edition. i2mo. Interleaved. Cloth, 1.00 Ralfe. Kidney Diseases and Urinary Derangements. 42 Illus- trations. i2mo. 572 pages. Cloth, 2.75 Marshall and Smith. On the Urine. The Chemical Analysis of the Urine. By John Marshall, m.d., Chemical Laboratory, Univ. of Penna; and Prof. E. F. Smith, ph. d. Col. Plates. Cloth, 1. 00 Memminger. Diagnosis by the Urine. Illustrated. Cloth, 1. 00 Tyson. On the Urine. A Practical Guide to the Examination of Urine. With Colored Plates and Wood Engravings. 7th Ed. Enlarged. 121110. Cloth, 1.50 Van Niiys, Urine Analysis. Ulus. Cloth, 2.00 VENEREAL DISEASES. Hill and Cooper. Student's Manual of Venereal Diseases, with Formulae. Fourth Edition. i2mo. Cloth, 1.00 4^* See pages 14 and ij for list of ? Quiz-Compends ? NEW AND REVISED EDITIONS. PQUIZ-COMPENDS? The Best Compends for Students' Use in the Quiz Class, and when Pre- paring for Examinations. Compiled in accordance with the latest teachings of promi- nent lecturers and the most popular Text-books. They form a most complete, practical and exhaustive set of manuals, containing information nowhere else col- lected in such a condensed, practical shape. Thoroughly up to the times in every respect, containing many new prescriptions and formulae, and over two hundred and fifty illustrations, many of which have been drawn and engraved specially for this series. The authors have had large experience as quiz-masters and attaches of colleges, with exceptional opportunities for noting the most recent advances and methods. Cloth, each $1.00. Interleaved for Notes, $1.25. No. 1. HUMAN ANATOMY, " Based upon Gray." Fifth Enlarged Edition, including Visceral Anatomy, formerly published separately. 16 Lithograph Plates, New Tables and 117 other Illustrations. By Samuel O. L. Potter, m.a., m.d., m.r.c.p. (Lond.), late A. A. Surgeon TJ. S. Army, Professor of Practice, Cooper Medical College, San Fran- cisco. Nos. 2 and 3. PRACTICE OF MEDICINE. Fourth Edi* tion. By Daniel E. Hughes, m.d., Demonstrator of Clinical Medicine in Jefferson Medical College, Philadelphia. In two parts. Part I. — Continued, Eruptive and Periodical Fevers, Diseases of the Stomach, Intestines, Peritoneum, Biliary Passages, Liver, Kidneys, etc. (including Tests for Urine), General Diseases, etc. Part II. — Diseases of the Respiratory System (including Phy- sical Diagnosis), Circulatory System and Nervous System; Dis- eases of the Blood, etc. *#* These little books can be regarded as a full set of notes upon the Practice of Medicine, containing the Synonyms, Definitions, Causes, Symptoms, Prognosis, Diagnosis, Treatment, etc., of each disease, and including a number of prescriptions hitherto unpub- lished. No. 4. PHYSIOLOGY, including Embryology. Sixth Edition. By Albert P. Brubaker, m.d., Prof, of Physiology, Penn'a College of Dental Surgery ; Demonstrator of Physiology in Jefferson Medical College, Philadelphia. Revised, Enlarged, with new Illustrations. No. 5. OBSTETRICS. Illustrated. Fourth Edition. By Henry G. Landis, m.d., Prof, of Obstetrics and Diseases of Women, in Starling Medical College, Columbus, O. Revised Edition. New Illustrations. BLAKISTON'S ? QUIZ-COMPENDS ? No. 6. MATERIA MEDICA, THERAPEUTICS AND PRESCRIPTION WRITING. Fifth Revised Edition. With especial Reference to the Physiological Action of Drugs, and a complete article on Prescription Writing. Based on the Last Revision of the U. S. Pharmacopoeia, and including many unofficinal remedies. By Samuel O. L. Potter, m.a., m.d., m.r.c.p. (Lond.), late A. A. Surg. U. S. Army ; Prof, of Practice, Cooper Medical College, San Francisco. Improved and Enlarged, with Index. No. 7. GYNAECOLOGY. A Compend of Diseases of Women. By Henry Morris, m.d., Demonstrator of Obstetrics, Jefferson Medical College, Philadelphia. 45 Illustrations. No. 8. DISEASES OF THE EYE AND REFRACTION, including Treatment and Surgery. By L. Webster Fox, m.d., Chief Clinical Assistant Ophthalmological Dept., Jefferson Med- ical College, etc., and Geo. M. Gould, m.d. 71 Illustrations, 39 Formulae. Second Enlarged and Improved Edition. Index. No. 9. SURGERY, Minor Surgery and Bandaging. Illus- trated. Fourth Edition. Including Fractures, Wounds, Dislocations, Sprains, Amputations and other operations ; Inflam- mation, Suppuration, Ulcers, Syphilis, Tumors, Shock, etc. Diseases of the Spine, Ear, Bladder, Testicles, Anus, and other Surgical Diseases. By Orville Horwitz, a.m., m.d., Demonstrator of Surgery, Jefferson Medical College. Revised and Enlarged. 84 Formulae and 136 Illustrations. No. 10. CHEMISTRY. Inorganic and Organic. For Medical and Dental Students. Including Urinary Analysis and Medical Chemistry. By Henry Leffmann, m.d., Prof, of Chemistry in Penn'a College of Dental Surgery, Phila. Third Edition, Revised and Rewritten, with Index. No. 11. PHARMACY. Based upon " Remington's Text-book of Pharmacy." By F. E. Stewart, m.d., ph. g., Quiz-Master at Philadelphia College of Pharmacy. Third Edition, Revised. No. 12. VETERINARY ANATOMY AND PHYSIOL- OGY. 29 Illustrations. By Wm. R. Ballou, m.d., Prof, of Equine Anatomy at N. Y. College of Veterinary Surgeons. No. 13. DENTAL PATHOLOGY AND DENTAL MEDI- CINE. Containing all the most noteworthy points of interest to the Dental student. By Geo. W. Warren, d.d.s., Clinical Chief, Penn'a College of Dental Surgery, Philadelphia. Illus. No. 14. DISEASES OF CHILDREN. By Dr. Marcus P. Hatfield, Prof, of Diseases of Children, Chicago Medical College. Colored Plate. Bound in Cloth, $1. Interleaved, for the Addition of Notes, $1.25. These books are constantly revised to keep up with the latest teachings and discoveries, so that they contain all the new methods and principles. No series of books are so complete in detail, concise in language, or so well printed and bound. Each one forms a complete set of notes upon the subject under consideration. Illustrated Descriptive Circular Free. JUST PUBLISHED. GOULD'S NEW Medical Dictionary GOMPAGT. CONCISE. PRACTICAL. ACCURATE. COMPREHENSIVE UP TO DATE. It contains Tables of the Arteries, Bacilli, Gan- glia, Leucomaines, Micrococci, Muscles, Nerves, Plexuses, Ptomaines, etc., etc., that will be found of great use to the student. Small octavo, 520 pages, Half-Dark Leather, . $3.25 With Thumb Index, Half Morocco, marbled edges, 4.25 From J. M. DaCOSTA, M. D., Professor of Practice and Clinical Medicine, Jefferson Medical College, Philadelphia. "I find it an excellent work, doing credit to the learning and discrimination of the author*' *** Sample Pages free. Warn SBBB9&V' *■«•■ pb^BSK? ■ H 1 ■ 1 : H '01 K ■ Pi ■ £ n ilb 1 R"iSrv i>«-*/ wiC-.v, 1 >■-■ ■ Ik*- V^ »i^'. » ^C*' ' l i ^ ■ l ■ ^^H - f : ■ : I 1 1 3&*d«>?r 1 *»&/£ ■ n**X- 1 -^-•VC"''' 1 ■ ^H ■ • - ■ ■ fefc _ ^Bk 4^ H 1 fflK l&^HR? ji*i>. ^fl * 1 |»nl ■ ■ Hre^*^ ,f-x. vBE&l; m* ' ■ ■ H ■ . • 1