SNe + as i tes i) assent a oe = es wie ieee pe Senge weer : _ Ee ee a ne ae eR . PHYSICIAN'S DOSE AND SYMPTOM BOOK, CONTAINING THE DOSES AND USES — : és OF yer P ‘ \ THE PRINCIPAL ARTICLES OF THE MATERIA MEDICA AND OFFICINAL PREPARATIONS; ALSO, Table of Weights and Measures. , Classification of the Materia Rules to Proportion the Doses Medica. of Medicines. Pharmaceutical Arrangement. Common Abbreviations used in | Table of Symptomatology. Writing Prescriptions. Oullines of General Pathology Table of Poisons and Antidotes. and Therapeutics. BY JOSEPH H. WYTHES, A.M., M.D., AUTHOR OF ‘‘THE MICROSCOPIST,’’ “ CURIOSITIES OF THE MICROSCOPE,” ETC., ETC. Seventh Gihition. PHILADELPHIA : DPINDSAY ‘AND*BEARISTON. 1866, Entered, according to Act of Congress, in the year 1864, BY LINDSAY & BLAKISTON, Th the Clerk’s Office of the District Court for the Eastern District of Pennsylvania. HENRY B. ASHMEAD, PRINTER, Nos. 1102 and 1104 Sansom St. co 7 a E ane PREFACE TO THE FOURTH EDITION. Tue favor with which this little manual has been received, and the number of copies sold, is proof of its utility. It was compiled for the assistance of students, and to furnish. a vade mecum for the general practitioner which would _ save the trouble of reference to larger and more elaborate works. ; During the author’s connection with army hospitals at Washington and on the Potomac, he noticed with pleasure that it was in frequent use by the attending surgeons, and he trusts that the present improved edition will prove even more useful] than the past. The Pharma- ceutical arrangement of the Materia Medica (Chapter VII), added to this edition, will com- mend itself to all. PREFACE TO THE THIRD EDITION. THE necessity of another edition of this little work, has afforded the compiler an opportunity of such condensation in the part devoted to medicinal substances, that room has been fur- nished for a large number of articles previously omitted. The list now embraces every officinal * remedy and preparation; nearly every useful native medicinal plant, and a variety of remedies recently introduced to the profession. The part devoted to symptoms of disease, and the outline of General Pathology and Therapeu- tics, will commend themselves to the student on examination, and assist him to avoid becoming a mere routinist in the treatment of disease. The classification of the Materia Medica, the table of poisons and antidotes, the rules for pro- portioning doses, and the table of weights and measures, add to the value of the work, and render it a vade mecum, in which the most useful information is compressed into the small- est possible compass. DOSE AND SYMPTOM BOOK. I. TABLE OF WEIGHTS AND MEASURES. APOTHECARIES’ WEIGHT. i Pound. Ounces. Drachms. Scruples. Grains. tbl — 12 => = 288 = 5760 ES 1 = 8 = 24 = £480 om see 3 = 60 3) l= 20 APOTHECARIES’ OR WINE MEASURE. Gallon. Pints. Fluidounces. Fluidrachms. Minims. Cong. 1 = 8 = 128 = 1024. = 61440 Ol = 16 = 4128 = 1680 fZ1l = 8 = 480 fZ 1 =< m, 60 The drop of water is about equal to a minim, 60 drops being equal to a fluidrachm. It is important, however, to bear in mind, that this is by no means - a6 TABLE OF WEIGHTS AND MEASURES. the case with other fluids; for example, a minim of the tinctures being about equal to two drops, or 120 drops to the fluidrachm. DOMESTIC MEASURES. A teacup is considered equal to 4 fluidounces. A wineglass * “ 2 ¢ A tablespoon ‘¢ cc 4 ce A teaspoon os “6 1 fluidrachm II. RULES TO PROPORTION THE DOSES OF MEDICINE. In prescribing, the following circumstances should always be kept in view :—Age, Sex, Temperament, Habit, Climate, the condition of the stomach, and Idiosyncrasy. Agr.—For an adult, suppose the dose to be ONE, or 1 drachm. Under 1 year will require only 1- 12th, or 5 grains. Under 2 years will require only 1-8th, or 74 grains. Under 3 years will require only 1-6th, or 10 grains. Under 4 years will require only 1-4th, or 15 grains. Under 7 years will require only 1-3d, or 1 scruple. Under 14 years will require only 3, or 4 drachm. Under 20 years will require only 2-3ds, or 2 scruples. Above 21 years the full dose, 1 drachm. Above 65 the inverse gradation of the above. Opiates affect children more powerfully than adults, but children bear larger doses of calomel than adults. Sux.—Women require smaller doses than men; they are more rapidly affected by purgatives than men, and the condition of the uterine system must never be overlooked. 8 RULES TO PROPORTION DOSES. TEMPBRAMENT.—Stimulants and purgatives more rea- dily affect the sanguine than the phlegmatic, and consequently the former require smaller doses. Hazits.—The knowledge of habits is essential; for persons in the habitual use of stimulants and nar- cotics, require larger doses to affect them when laboring under disease, while those who have habit- uated themselves to the use of saline purgatives, are more easily affected by these remedies. Persons, however, who have habituated themselves to the use of opium, do not require larger doses than usual of other narcotics. CiimatEe.—Medicines act differently on the same indi- vidual in summer and in winter, and in different climates. Narcotics act more powerfully in hot than in cold climates, hence smaller doses are re- quired in the former; but the reverse is the case with regard to calomel. CoNDITION OF THE STOMACH, AND JDIOSyNCRASY.—The least active remedies operate very violently on some individuals, owing to a peculiarity of stomach, or rather disposition of body, unconnected with tem- perament. This state can be discovered only by accident or time; but when it is known, it should always be attended to. In prescribing, the practitioner should always so regu- late the intervals between the doses, that the next dose may be taken before the effect produced by the first is altogether effaced ; for, by not attending to this circumstance, the cure is always commenc- ing, but never proceeding. It should, however, also be kept in mind, that some medicines, such as the mercurial salts, arsenic, &c., are apt to accumulate in the system; and danger may thence arise, if the doses too rapidly succeed one another. The action also of some remedies, elaterium and digitalis, for RULES TO PROPORTION DOSES. 9 example, continue long after the remedy is left off ; and therefore much caution is requisite in avoiding too powerful an effect, by a repetition of them even in diminished‘ doses. Aloes and castor oil acquire activity by continued use, so that the dose requires to be diminished. The following simple rule, given by Dr. Young, will be found very useful as a guide in prescribing for children. For children under 12 years of age, the doses of most medicines must be diminished in the proportion of the age to the age increased by 12: thus at 2 years 2 1—Viz. ==}: or, in other words, add the age to ee 12, and divide the sum by the age, and the product will be the proportion of the dose to that of an adult. At 21, the full dose may be given. 10 III. COMMON ABBREVIATIONS USED IN WRIT- Abbreviation. aa Ad lib. Ad saturand. Aq. ferv. Aq. tepid. Chart. Coch. mag. Coch. parv. Colent. Collyr. Contts. F. vel ft. Fol. Garg. Gtt. Haust. Infus. M. Mass. Mist. Pils Puly.. Q. s. R. Rad. Ss. Ss. Tinct. Latin. Ana. Ad libitum. Ad saturandum. Aqua fervens. Aqua tepida. Chartula. Cochlear magnum. Cochlear parvum. Colentur. Collyrium. Contusus, Fiat vel fiant. Folium vel folia. Gargarisma. Gutta vel guttee. Haustus. Infusis. Misce. ° Massa. Mistura. Pilula vel pilule. Pulvis vel pulveres. Quantum sufficit. Recipe. Radix. Signa. Semis. Tinctura. ING PRESCRIPTIONS. English. Of each. At pleasure. Until saturated. Hot water. Warm water. A small paper. A tablespoonful. A teaspoonful. Letthem bestrained An eyewater. Bruised. Let them be made. A leaf or leaves. A gargle. A drop or drops. A draught. An infusion. Mix. A mass. A mixture. A pill or pills. A powder or pow- ders. A snfficient quan- tity. Take. A root. Write. The half. A tincture. 11 Be TABLE OF POISONS AND ANTIDOTES. In all cases of poisoning, the first step is to evacu- ate the stomach, which should be effected by one of those emetics which is most powerful and speedy in its operation, as sulphate of zinc, or sulphate of cop- per. When vomiting has already taken place, copious draughts of warm water or mucilaginous drinks should be given, to keep up the effect till the poisoning sub- stance has been evacuated. If vomiting cannot be produced, the stomach-pump must be used. Inflammation of the stomach, congestion of the brain, and other symptoms, are to be treated on gen- eral principles, viz.: by blood-letting, cold applica- tions, revulsives, cool mucilaginous drinks, milk, lime- water, &c. When prostration exists, stimulants should be resorted to, as in other cases. The following is a list of the usual poisoning sub- stances, with the appropriate remedies : POISONS. ANTIDOTES, Acids. The Alkalies. Common soap (soft or hard) in solution is an efficient remedy, and has the advantage of being always at hand. It should be followed by copious draughts of tepid water or flax- seed tea. For nitric and oxalic 12 POISONS AND ANTIDOTES. acids, the carbonates of magnesia and lime (chalk and water) are the best antidotes. When sul- phuric acid has been taken, the use of much water will be im- proper. Alkalies and their The Vegetable Acids. Common salts. Earths. Baryta and its salts. Lime. ~ Todine. Iodide of Potas- sium. vinegar being always at hand, is most frequently used. The fixed oils, as castor, flax-seed, almond and olive oils, form soaps with the alkalies, and thus, also, de- stroy their caustic effect. They should be given in large quanti- ties. Epsom or Glauber’s Salts, in solu- tion, or diluted sulphuric acid. The fixed oils also have the same effect as with the alkalies proper when not in a compound state. Starch, or wheat flour, in large quantities, well mixed with wa- ter. For Iodide of potassium, there being no antidote, vomiting must be promoted by copious draughts of warm water. Uichidony and its Astringent Infusions, as of galls, salts. Arsenic and its compounds. oak bark, Peruvian bark, or green tea, very strong. Hydrated Peroxide of Iron, in ta- blespoonful doses every 5 or 10 minutes. See Ferri Oxydum Hy- dratum. POISONS AND ANTIDOTES. 13 Bismuth and its compounds. Copper and its compounds. Gold, salts of. Iron, salts of. Lead, salts of. Mercury, salts of. Silver, salts of. Tin, salts of. Zinc, salts of. Phosphorus. Gases. Albumen. Copious draughts of milk, combined with sweet mu- cilaginous drinks. Albumen, as milk or whites of eggs in solution, should be freely ad- ministered. Vinegar must be avoided. Sulphate of Iron, with a free use of mucilaginous drinks. Carbonate of Soda, with mucilagi- nous drinks. Sulphate of magnesia (Epsom salts) or diluted sulphuric acid. Albumen, as whites ofeggs, milk, or wheat flour beaten up with wa- ter. ° Common salt (chloride of sodium), largely given. Albumen. Whites of eggs, milk or flour. Albumen, or carbonate of soda, with copious draughts of warm water, and especially milk. Magnesia with water, and copious draughts of mucilaginous drinks. Ammonia cautiously inhaled is re- commended for chlorine. As- phyxia produced by carbonic acid or carbonic oxide gases or sulphuretted hydrogen, must be © treated by copious affusions of - cold water, especially to the head, 14 POISONS AND ANTIDOTES. blood-letting, artificial respira- tion, stimulants carefully admin- istered, &c. Creosote. Albumen, or whites of eggs, milk, or wheat flour. : Alcthol or spirit- A powerful emetic should be given, uous liquors. followed by copious draughts of warm water. Congestion of the brain and other symptoms, to be treated on general principles. Opium and other The chief reliance is to be placed narcotics. on the most active emetics (as tartar emetic, sulphate of copper, or sulphate of zinc), and the stomach-pump. Emetics are pre- ferable to the stomach-pump when the narcotic has been taken in substance. The patient should be kept in motion, and cold wa- ' ter dashed on the head and shoulders. Blood-letting may be- come necessary to relieve con- gestion. After other remedies fail, artificial respiration should be resorted to. CLASSIFICATION OF THE MATERIA MEDICA. A convenient arrangement of medicinal agents is a necessity felt by every student and practitioner. The most philosophical arrangement known to the com- piler of this work, is that of Headland, in his Prize Essay, of which the following is a brief synopsis : I. Counter-Irritants, — Frictions. Sinapisms.— Blisters. Issues. II. Medicines acting locally on the mucous surface. A. Irritant Emetics,—Sulphates of Zine and Copper, Common Salt, Mustard, Horse- radish. B. Stomach Anzsthetics—Hydrocyanic Acid. Creosote. Nitrate of Bismuth. C. Irritant Cathartics, — Cathartic Vermifu- ges, and Resinous Cathartics in part. III. Hematics,—Medicines acting in and upon the blood. A. Restoratives,—Restoring deficient. mate- rials. . 1. Aliments. 2. Acids, — Mineral. Sulphuric. Hydro- chloric. Nitric. Phosphoric. Vegetadle. Acetic. Citric. Tartaric. _Malic.— Super-Salts of the Alkalies. 3. Alkalies,— Potash. Soda. Ammonia. Lime. Magnesia.—Their Carbonates and neutral Acetates, Citrates, and Tartrates. 16 THE MATERIA MEDICA. 4. Tonics, — Bitter. principles of Vegeta- bles. 5. Chalybeates,—Iron and its salts. 6. Solvents (urinary solvents). a. Antilithics, — Mineral. Alkalies, their Carbonates and neutral salts with Vegetable Acids.—Bi- borate and Phosphate of Soda. Benzoic and Cinnamic acids. b. Antiphosphatics,—Mineral and Ve- getable Acids. Sour fruits. B. Catalytics—Destroying or counteracting morbid agencies in the blood. 1. Antiphlogistics,;—Antimonials. Mercu- rials. Alkalies. Salines. 2. Antisyphilitics,—Mercurials. Gold. Io- dide of Potassium. Sarsaparilla. (7) 3. Antiscrofulitics, — Iodine. Bromine. Chlorine. lIodides and Bromides. Potash. 4, Antiarthritics,—Colchicum. Nitro-hy- drochloric Acid. Lemon juice. 5. » latina, and other exanthematous diseases, to pro- mote the eruption. Dose. Of an infusion of 5ij to a pint of boiling water, given without restriction as to quantity. CARUM. Caraway Seeds. (C. carui.) Carminative. Use. In flatulent colic, and to give warmth to pur- gatives. Dose. Gr. x to 3j, swallowed whole, or in powder. CARYOPHYLLUS. The Clove. fe aromaticus.) Stimulant, aromatic. Use. As a corrigent to other remedies, and a con- diment. Dose. Gr. v to x, in powder. CASCARILLA. Cascarilla Bark. (Croton Eleuteria.) Tonic, stomachic. Use. As an adjunct to cinchona in ague; in ob- stinate diarrhoea, and after dysentery; a good vehi- cle for powdered Peruvian bark, and small doses sulphate magnesia, and sulphuric acid in debility of stomach attended with constipation ; in dyspep- sia, and flatulent colic. Dose. Gr. x to 3j in powder. The infusion is the best form. CASSIA. Cassia Pulp. (C. fistula.) Laxative. Use. Where a gentle medicine is required in cos- . tive habits, combined with aromatics. Dose. Ziv to 3j. CASTANEA. Chinquapin. (C pumilla.) Tonic and astringent. Use. In intermittents. CASTOREUM. Castor. CER 45 Antispasmodic, emmenagogue. Use. In typhus, hysteria, epilepsy, amenorrhea. Dose Gr. x to }j in a bolus; 3j, or more, in clysters ; of little value as a remedy. CATALPA CORDIFOLIA. Catawba tree. Reputed poisonous, but has been used in asthma, 3iij or Ziv of seeds in Zxii water, boiled to Zvi, given morning and night. CATARIA. Catnip. Leaves of Nepeta Cataria. Tonic and excitant. Use. In domestic practice in amenorrhea, colic, &ec. Dose. %ij in infusion. CATECHU. Catechu. (Acacia catechu.) Astringent, tonic. Use. In diarrhoea, from a relaxed state of the bowels, and in intestine and uterine hemorrhages ; locally in aphthee, ulceration of the gums, and in coughs and hoarseness from the relaxation of the uvula, and epistaxis. | Dose. Gr. x to 3j in powder; in the latter case, a piece is allowed to dissolve slowly in the mouth; but is best given with sugar, gum Arabic and water. ~~ CEANOTHUS AMERICANUS. New Jersey tea. Astringent. Used in syphilis in decoction (Zij to Oj). A strong infusion used in aphthz and dysen- tery. CELASTRUS SCANDENS. Climbing Staff-tree. Emetic, diaphoretic, narcotic. CENTAUREA BENEDIOTA. Blessed Thistle. May be used as tonic in cold infusion (38s of leaves to Oj). A stronger infusion taken warm in bed pro- motes diaphoresis. A still stronger infusion is emetic. CERA FLAVA ET CERA ALBA. Yellow Wax and White. 46 CER Demulcent, emollient. Use. In diarrhoea and dysentery; but principally used in the formation of cerates and ointments. - Dose. Jj to Zss twice or thrice a day, in form of emulsion; melt the wax with a little oil, then tri- turate it with yolk of egg, and groat gruel f3ij. CERATUM CALAMINA. Calamine Cerate. Tur- ner’s Cerate. (Prepared Calamine, Yellow eee Aa Ziij, Lard, 1bj.) A mild ‘astringent, CERATUM CANTHARIDIS. Blistering plaster. (Can- tharides in penne lbj. Yellow Wax, Resin, 44 Zvii, Lard, CERATUM CHT ACEI. Spermaceti Cerate. (Cetacei Zij, Ceree Alb. 3ij, Olive Ol. fZiv. The wax and oil being melted together, add the spermaceti, and stirantil the whole is cold.) Emollient, cooling. CERATUM PLUMBI ACETATIS. Cerate of Acetate of Lead. (Plumbi Acetas cont. Zij, Ceres Alb. Zij, Olive Ol. fZviij. Melt the wax in seven fluid- ounces of the oil, then add the acetate rubbed down with the remainder; and stir with a wooden spatula until the whole be united.) Cooling, astringent, resolvent. Use. In inflamed sores, excoriations, and burns. CERATUM PLUMBI SUBACETATIS. Cerate of Subacetate of Lead. (Goulard’s Cerate.) Com- pound Lead Cerate. (Liq. Plumbi diaceiatis f3Z iij, Cere Ziv, Olive Ol. Oss, Camphore Zss. Melt the wax in fZvij of the oil, then remove the mixture from the fire, and when it begins to thicken add gradually the solution of diacetate of lead, and as- siduously stir the whole with a wooden spatula until it is cold; lastly, add the camphor dissolved in what remained of the oil, and mix.) CER 47 Use. The same as the former. CERATUM RESIN. Resin Cerate. (Resine Cere aa lbj, Olive Ol. fZxvj. Melt the resin and wax over a slow fire, then add the oil, and strain while hot.) Yellow Basilicon. Digestive, cleansing. Use. To foul, indolent ulcers. CERATUM RESINA’ COMPOSITUM. Compound Resin Cerate. (Take of resin, suet, yellow wax, aa lbj, turpentine lbss, flaxseed oil Oss. Melt to- gether, strain through linen, and stir till cool.) CERATUM SABINA. Savine Cerate. (Zij powdered savine mixed with lbj melted resin cerate.) Irritative, drawing. Use. To keep a discharge from a blistered surface. It is much preferable to the Ceratum Cantharidis, occasioning less pain, and preserving a sufficient discharge. CERATUM SAPONIS. Soap Cerate. (Oij solution of subacetate of lead, Zvj soap, 3x white wax, Oj olive oil; boil the solution of subacetate of lead with the soap, over a slow fire, to the consistence of ho- ney, then evaporate over a water-bath till the water is all dissipated, and lastly mix in the oil and wax.) Desiccative, resolvent. Use. Applied, spread on linen, round fractured limbs, after all inflammation is abated and the bones are united; and to strumous swellings. CERATUM ADIPIS. Simple cerate. (Take of lard Zviij, white wax Ziv. Melt them together, and stir them constantly till cool.) CERATUM ZINCI CARBONATIS. Cerate of Carbo- nate of Zinc. (Turner’s Cerate.) (Take of prepared Carbonate of Zinc, Yellow Wax, each half a pound. Lard two pounds. Melt the wax and lard together, and when upon cooling they begin to thicken, add the carbonate of zinc, and stir till cool.) / 48 CHI CEREVISILA FERMENTUM. Yeast. Tonic, laxative. Use. In typhoid fever, externally to fetid ulcers. Dose. f3ss to £3). CETACEUM. Sperinaceti. Demulcent, emollient. Use. In coughs and dysentery; and in the com- position of ointments. Dose. 38s to Zjss, rubbed up with sugar, or with an egg, in emulsion. CETRARIA. Iceland Moss. (C. islandica.) Tonic, demulcent, nutrient. See Decoct. Cetrar. CHELIDONIUM MAJUS. Celandine. Acrid, purgative, diuretic, diaphoretic. Weed in jaundice. Dose. Gr. xxx, dried herb or root. CHELONE GLABRA. Balmony. Tonic, cathartic, anthelmintic. Dose. 3j fluid extract. CHENOPODIUM. Worm Seed. (C. anthelminticum.) Anthelmintic. Use. To destroy lumbrici in children, for which it is given morning and evening for three or four days; then followed by calomel, or some brisk ca- thartic. Dose. Of the powdered seeds, from jj to Hij to a child two or three years old, in syrup; of the oil, which is more frequently given, from five to ten drops, mixed with sugar or in emulsion; of the de- coction, made by boiling 3j of the fresh plant in Oj of milk with the addition of orange peel, or some other aromatic, a wineglassful, or a tablespoonful of the expressed juice of the leaves. CHIMAPHILA. Pipsissewa. Leaves of Chimaphila Umbellata. Diuretic, tonic, astringent. CIN 49 Use. In urinary affecticns, scrofula, and rheuma- tism. Dose. Oj of decoction in 24 hours. CHLOROFORM. Anesthetic. From the accidents which have occurred from its use pure Sulphuric Ether, or one part chloroform, two parts ether, is preferable for the purpose of procuring insensibility to the pain of surgical operations. Dose. For internal use nx to f3). CHONDRUS. Irish Moss, Carrageen. A good sub- stitute for the Iceland Moss, which it closely re- sembles. (Macerate Zss of the moss ten minutes in cold water, turn it off, add Ojss boiling water; boil to a pint, strain, and add sugar and lemon juice to improve the flavor. Milk may be substituted for water, if a more nutritious preparation be required.) CICHORIUM INTYBUS. Chicory. Tonic, aperient, deobstruent. Used in jaundice and phthisis, in decoction (2j or Zij to Oj). CIMICIFUGA. Black Snake Root. Cohosh. (C. racemosa.) , Tonic, diuretic, diaphoretic, expectorant, emmena- gogue. Use. Employed extensively in the United States, as a domestic remedy, in rheumatism, dropsy, chorea, hysteria, and especially in pulmonary affec- tions, for which it has been regarded by some as a specific. Dose. Of the powder, gr. x to 3j; of the decoction, made by boiling 3ui of the bruised root in Oj of water, from f3j to fZij may be given several times a day. CINCHONA. Peruvian Bark. (C. flava-pallida-rubra.) Strongly and permanently tonic and antiperiodic, slightly astringent, stomachic, and febrifuge. Use. Inintermittents, after evacuating the stomach 5 50 COL and bowels; in continued fevers ; keeping the bowels clear; confluent smali-pox ; erysipelas; acute rheu- ma‘ism; cynanche maligna; scarlatina; passive hemorrhages ; and in every disease attended with deficient action. Externally in clysters, gargles, and lotions, in gangrenous ulcerations, &. To check the nausea excited by it, wine, aromatics, and car- bonic acid are added; to prevent purging, opium; costiveness, rhubarb. Dose. Given in infusion, decoction, and extract. The latter is a good form, if well prepared ; of this ' gr. iij to gr. x in pill, or dissolved in infusion of roses, or syrup of orange peel, three times a day. Of the powder, Dj to Ziij in infusion of liquorice, or water. CINNAMOMUM. Ciaskenon Bark. Cassia. Stimulant, astringent, carminative, tonic. Use. As a grateful aromatic in dyspepsia and diarrhoea; to cover the taste of nauseous remedies, and with cathartics to prevent griping. The infusion checks vomiting. Chewed in palsy of the tongue. Dose.. Gr. v to Dj in powder. COBWEB. Spider’s web. Antiperiodic and antispasmodic. Dose. Gr. v or vi. Used as a styptic. COCCUS. The Cochineal insect. The dried female. Use. Chiefly for giving a red color to tinctures, &c. COCHLEARIA OFFICINALIS. Scurvy-grass. Stimulant, aperient, diuretic. COFFEE. (C. Arabica.) Medically is excitant to the nerves, and resists the intoxicating effects of alcohol and opium. COLCHICI RADIX ET SEMEN. The Bulb and Seeds of the Meadow Saffron. (Colchicum autumnale.) Narcotic, diuretic, cathartic. Use. In dropsies, gout, rheumatism, neuralgia, CON 5] bronchitis, and scarlet fever. Colchicum is rather palliative than curative in gout and rheumatism. It is a useful addition to saline medicines in fevers and all inflammations. It should be given in small doses combined with magnesia, and, if necessary, often repeated. Dose. Gr.j to gr. v of the recent bulb in pill. COLLINSONIA CANADENSIS. Horse-weed. Heal- all. A decoction of fresh root used in catarrh of the bladder, leucorrheea, dropsy, &c.; and a poultice of leaves to bruises and the like. COLOCYNTHIS. Bitter Cucumber Pulp. (Cucumis colocynthis.) Strongly cathartic, drastic, hydragogue. Use. Too violent to be used alone. When com- bined with calomel, extract of jalap, and gamboge, colocynth forms a highly efficient and safe cathartic, especially adapted to congestion of the liver and portal circle, and torpidity of this organ. In dropsy, and affections of the head, also, highly useful. Dose... Gr.,j to gr..v. COLOMBO. Calumba Root. (Cocculus palmatus.) Tonic, antiseptic. Use. In bilious vomitings, and those attendant on pregnancy, dyspepsia, and cholera. Dose. Gyr. x to )j twice or thrice a day. Incomp. Acetate and diacetate of lead; infusion of galls. COLLODIUM. Oollodion (a solution of gun cotton in ether) an artificial epidermis. COMPTONIA ASPLENIFOLIA. Sweet Fern. Tonic, astringent. A decoction used in diarrhea. CONFECTIO AROMATICA. Aromatic Confection. (Cinnamomi, Mpyristice, sing. Zij, Caryoph. 3, Cardam. 3ss, Croci Zij, Cretee Prep. Zxvi, Sacch. Pur. lbij. Rub the dry substance to a fine powder 52 CON and keep it in astoppered vessel. When it is to be used, add water gradually till the whole be incor- porated.) Stimulant, cordial. Use. In the low stage of typhoid fevers, atonic gout; hysteria; nervous languors. Dose. Gr. x to 3j in bolus or mixtures. Incomp, Acids of any kind; metallic salts. CONFECTIO AURANTII. Confection of Orange. (Aur. Cort. exter. recent. radula separ. lbj, Sacch. pur. lbiij. Beat the rindin a stone mortar with a wooden pestle, gradually adding the sugar.) Stomachic. Use. In dyspepsia of children; and as a vehicle for other remedies. Dose. 3j to 3j. CONFECTIO CASSIA. Cassia Confection. (Cassiz -pulpe lbss, Manne Zij, Tamarindi pulpe 3j, Syr. Rose £Zviij. Bruise the manna; then dissolve it by heat, and having mixed in the pulp, evaporate to a proper consistence.) Gently laxative. Use. For habitual costiveness ; and as a purge for children. Dose. 3j to 3j. CONFECTIO OPII. Opium Confection. (Opii duri Zvi, Piper Long. 3j. Zingib. rad. Zij, Carui Sem. Ziij, Tragacanthe contrite 3ij, Syrupi Z3xvj. Rnb the opium with the syrup made hot; then add the other articles in the state of powder, and mix.) Gr. j of Opium in gr. xxxvj. Narcotic and stimulant. Use. Atonic gout, flatulent colic, colliquative diarrhoea, in the chalk mixture. Dose. Gr. x to 38s in a bolus or mixture. CONFECTIO ROSAi GALLICA. Confection of the CON 53 Red Rose. (Rose Gal. Petal. nondum explic. ab- ject ung. lbj, Sacch. pur. lbiij. Beat the petals in a stone mortar, then add the sugar, and beat into a uniform mass. ) Astringent, tonic. Use. In diarrhoea. Rubbed up with new milk it is useful in early convalescence from acute dis- eases. A good vehicle. Dose. 3j to 3). CONFECTIO SENN AU. Confection of Senna. (Senne Fol. Zviij, Ficorum lbj, Tamarindi, Cassiz Pruno- rum Gall, Pulpee, sing. lbss, Coriand. Ziv, Glycyr- rhize Ziij. Sacch. pur. lbijss, Aque Oiij. Rub the Senna leaves and Coriander seeds to powder and sift; boil the residue with the figs, liquorice root, and the water to one-half, then press and strain. Evaporate the strained liquor to f3Zxxiv, then add the sugar. Finally rub the syrup with the pulp, and, adding the sifted powder, mix the whole.) Laxative. Use. In habitual costiveness, and that attending pregnancy. Dose. 3] to Ziv. CONIT FOLIA, SEMEN. Hemlock Leaves and Seeds. (C. Maculatum.) Narcotic, poisonous in an overdose; resolvent. Use. As a palliative in cancer and scirrhous, scrofulous, and syphilitic ulcerations and swellings ; pertussis; chronic enlargements of the liver and other abdominal organs; cutaneous affections ; asthma; chronic pulmonary diseases, and neuralgic affections. Externally Ziij of the dried herb boiled in Oj of water as a fomentation to open scrofulous and cancerous ulcers; or as a cataplasm, by adding linseed meai and oatmeal. Dose. Gr. ij to gr.iv of the powder, or from gtt. ij 5* 54 COP of the expressed juice, very gradually increased to 3j. Of the extract, gr.j to gr. iv to be reduced if it causes vertigo. The extract is the best form of administering it; it may be usefully combined with ipecacuanha in pulmonary affections, where we wish to quiet cough and relieve bronchial irri- tation. CONTRAYERVA. Contrajerva Root. (Dorstenia con- traverva.) Tonic, stimulant, sudorific. Use. In typhus, nervous fever; the fever of denti- tion in weak infants; and dysentery. Dose. Gr. x to 3ss. CONVALLARIA MULTIFLORA. Solomon’s Seal. Tonic, mucilaginous, mildly astringent. Used in leucorrheea, &c. Dose. Fluid extract 3ij to 3v. CONVOLVULUS PANDURATUS. Wild Potato. Feebly cathartic, diuretic. Dose. 40 grs. of dried root. COPAIBA. Copaiba balsam. (C. officinalis.) Stimulant, diuretic, purgative in large doses ; acts on the urethra. Use. In gonorrhea, gleet, leucorrhea, dysentery, and all affections of mucous membranes; hemor- rhoidal affections. Dose. ™xx to fZj in emulsion with gum or yolk of egg; in pills by mixing the copaiba with magne- sia and exposing the mixture to the air. Incomp. Sulphuric acid, nitric acid. COPTIS. Goldthread. (C. trifolia.) Tonic. Use. In all cases where a simple tonic is required. In aphthous affections of the mouth and throat. Dose. Of the powder from gr, x to gr. xxx. Of the tinct. 3j, 3j root, Oj alcohol. CRE 55 CORIANDRUM. Coriander Seed. (C. sativum.) Carminative. Use. In flatulencies ; but chiefly to cover the taste of other medicines. Dose. ‘Aj to 3j entire, or in powder. CORYDALIS FORMOSA. Turkey Corn. Alterative, tonic. Used in syphilis, scrofula, &. Dose. Of fluid extract 10 to 40 drops. CORNUS FLORIDA. Dogwood. Tonic, astringent. Use. In all cases to which Peruvian Bark is adapted, which it closely resembles, especially intermittents. Dose. May be given in powder, decoction, or ex- tract of the powder, from )j to 3j. Infusion most employed. CORYLUS ROSTRATA. Beaked Hazel. Anthelmintic. Used the same way as cowhage. COTULA. Mayweed. Wild chamomile. Herb of Anthemis Cotula. Antispasmodic, vesicant externally. Best given in infusion. - CREASOTUM. Creasote. Use. Externally applied in rheumatism and neu- ralgia. Given in some stomachic affections, as dyspepsia, and anorexia, and to allay nausea and vomiting ; used externally in porrigo scutulata, and to relieve toothache, also to foul ulcers and cancer- ous sores. Dose. From mj to mij. CRETA PRAJPARATA. Prepared Chalk. Take of chalk a convenient quantity ; add a little water to it, and rub it into fine powder; throw this into a large vessel nearly full of water, stir briskly, and after a short interval pour the supernatant liquor, while yet turbid, into another vessel. Repeat the 56 CUN process with the chalk remaining in the first vessel, and set the turbid liquor by, that the powder may subside. Lastly, pour off the water, and dry the powder. ' Internally antacid; externally absorbent. Use. In diarrhoea from acidity; externally when sprinkled over burns, after the inflammation has subsided, and a poultice applied, the skinning over the sore is much hastened. Dose. Gr. x to 3j or more. CROCUS. Saffron. (C-. sativa.) Stimulant, exhilarating; diaphoretic, emmena- gogue. Use. In hysteria and other nervous affections ; chiefly to impart color to officinal tinctures. ose. Gr. v to Zss. : CUBEBA. Cubebs. (Piper Cubebe.) Stimulant, purgative, diuretic. Use. In gonorrhea, gleet, leucorrhoea. Also as a grateful stomachic, and carminative in disorders of the digestive organs. Cubebs have been recom- mended in every stage of gonorrhea, but they are most safe and effectual in chronic diseases, and where the inflammation is confined to the mucous membrane of the urethra. If not speedily useful, they should be discontinued. Dose. From gr. x to 38s of the powder, every six hours. The volatile.oil is sometimes substituted in ‘the dose of ten or twelve drops, suspended in muci- lage, or sugar and water. CUCURBITA CITRULLUS. Watermelon. Seeds used in strangury, and as a diuretic. In- fusion 3j or 3ij to Oj, ad lib. CUNILLA MARIANA. American Dittany. Used in warm infusions to promote perspiration, relieve colic, dysmenorrhea, CYN 57 CUPRI ACETAS. Acetate of copper. Tonic, stimulant, escharotic. Use. In epilepsy, chorea, and other spasmodic affections. Dose. Gr. + gradually increased to gr. ij. Incomp. Alkalies, chalk mixture, sulphuric acid. CUPRI SULPHAS. Sulphate of Copper. Tonic, emetic, astringent, escharotic, alterative, styptic, antispasmodic. Use. In epilepsy, hysteria, and intermittent fever ; and to produce vomiting in incipient phthisis, in croup, and in poisoning; externally as a stimulant to ulcers and to take down fungus. 116 OLE OLEUM ATHEREUM. Ethereal Oil. Heavy Oil of Wine. An ingredient of Hoffman’s anodyne. . OLEUM CAJUPUTI. Oil of Cajuput. Powerfully stimulant. Use. In epilepsy, palsy, chronic rheumatism, spasmodic affections of the stomach and bowels, cholera. Mixed with Olive oil, itis used externally in gout and rheumatism ; also for toothache. Dose. One to five drops in emulsion or on sugar. OLEUM CARUI. Oil of Caraway. Stimulant, carminative. Use. In flatulent colic, and as an adjunct to pur- gative pills. Dose. Hj. to mx. OLEUM CARYOPHYLLI. Oil of Cloves. Use. The same as cloves. Dose. WH j.to Niv. OLEUM CHENOPODII. Oil of Wormseed. Anthelmintic. Dose. Four to eight drops for a child, repeated morning and evening for three or four days, and then followed by a brisk cathartic. OLEUM CINNAMOMI. Oil of Cinnamon. Powerfully stimulant, stomachic. Dose. mj to mMiij on sugar. OLEUM COPAIBA. Dose. Ten or fifteen drops in emulsion. OLEUM CUBEBA. Oil of Cubebs. Stimulant, diuretic. Use. The same as the cubebs; but less efficacious in gonorrhea, OLEUM FCNICULI. Oil of Fennel Seeds. Use. The same as of the seeds. Dose. Mr ij to Mxx. OLE 117 OLEUM GAULTHERLA. Oil of Partridge Berry. Use. To cover the taste of other medicines. OLEUM HEDEOMA. Oil of Pennyroyal. Use. As a@ stimulant in flatulent colic and sick stomach, and to impart flavor to mixtures. Dose. Two to ten drops. OLEUM JUNIPERI. Oil of Juniper. Stimulant, carminative, diaphoretic, diuretic. Use. In dropsies ; advantageously added to digi- talis when it is given in the form of pills. Dose. ij to Wx or more, rubbed up with sugar or mucilage and water. OLEUM LAVANDULZA. Oil of Lavender. Stimulant. Use. In hysteria and nervous headache. Dose. ™,j to mv on a lump of sugar. OLEUM LINI. Linseed Oil. Demulcent, emollient, laxative. Use. It has been given with advantage in ileus, when purgatives have failed; but it is chiefly used in the form of clyster, in flatulent colic attended with costiveness; and in abrasions of the rectum ; externally in burns and wounds. Dose. fZss to f3j; in clysters, fZiij to fZ vj. OLEUM MENTHA’ PIPERITZ. Oil of Peppermint. Stimulant, antispasmodic, carminative. Use. In cramp of the stomach and flatulent colic. Dose. Wj to miij rubbed up with sugar or mucilage. OLEUM MENTH 4 VIRIDIS. Oil of Spearmint. Stimulant, carminative. Use. In flatulence and anorexia. Dose. ™,j to nv, on a lump of sugar. OLEUM MONARDA. Oil of Horsemint. Use. A powerfulrubefacient; also a stimulant and ’ carminative. 118 OLE OLEUM MORRHU®. Cod-liver Oil. (A fish oil obtained from several fishes belonging to the genus Gadus, by exposing to the sun the livers, cut in slices, and collecting the oil that runs out. That which runs out first resembles olive oil, and is called yellow cod-liver oil. If the livers are in a state of putrefaction, the oil becomes of a chestnut-brown color.) Diuretic, alterative, slightly diaphoretic. Use. Used extensively in scrofula, rickets, rheu- matism, chronic cutaneous diseases, chorea, tuber- cles, atrophy. A fashionable remedy of late in in- cipient phthisis. Its chief virtue is probably owing to its nutritive properties. Dose. Zij to Ziv two or three times a day; to children 3j, with lemon syrup, coffee or sugar and water. Externally in cases of ulcer, fistula, &c. OLEUM MYRISTICA. Oil of Nutmeg. OLEUM OLIVA. Olive Oil. Demulcent, emollient, gently laxative. Use. In catarrhs and pulmonary complaints; in emulsion with mucilage; in a simple state when acrid matters are taken into the stomach; exter- nally it has been advantageously used as a friction in plague; as an injection in gonorrhea; an adjunct to clysters in dysentery and abrasions; and in the formation of ointments and plasters. Dose. £3} to f3j triturated with mucilage or mixed with water by means of a few drops of liquor potassee or liquor ammonize. OLEUM ORIGANI. Oil of Origanum. Stimulant, narcotic. Use. Scarcely ever given internally ; a drop of it put into a carious tooth relieves the pain of tooth- ache. OLEUM PIMENTA. Oil of Pimento. OLE 119 Stimulant. Use. In debilities of the stomach, colic, and tympanitis. Dose. MH iij to mv, rubbed with sugar. OLEUM RICINI, Castor Oil. (Bruise the castor seeds, previously decorticated; then express the oil without the application of heat.) Zxiv of the seeds yield about f Ziij of oil. Purgative. Use. In all cases where stimulant purgatives would be hurtful; particularly in dysentery, col- ica pictonum; calculous complaints and ileus; and as it operates very quickly, in spasmodic. affections. It is an excellent purge at all times for children, women in child-bed, and after surgical operations in which the viscera are at all concerned. It is also a good adjunct to clysters. Dose. f3ss to fZiss, either floated on a little water,and covered with a small quantity of brandy, or in the following draught: RK. Olei Ricini f Zss, Mucilaginis q. s. tere optime, et paullatim adde, Aquee Destillate f3j, Spir. Lavandule Comp. nxx, Syr. Tolutani fZss. Misce. OLEUM ROSMARINA. Oil of Rosemary. Stimulant. Use. In nervous complaints. Dose. Mi ij to mLvj rubbed up with sugar. OLEUM SABINA. Oil of Savine. Stimulant, emmenagogue; externally vesicant. Use. In the same cases for which the plant is em- ployed. Dose. ij to mvj. OLEUM SASSAFRAS. Oil of Sassafras. Stimulant, sudorific, diuretic. Use. In scorbutus, chronic rheumatism, cutane- ous diseases. An external application (3j to 3j Ol. 120 OLE Oliv.), useful in indurated mamme of parturient women. Dose. tr ij to m.x rubbed with sugar. OLEUM SUCCINI. Oil of Amber. Stimulant, antispasmodic, diuretic, rubefacient. Use. In hysteria, epilepsy, and deficient menstrua- tion; externally in paralysis, and chronic rheuma- tism of the joints. The following is reccommended as a friction in tic douloureux: R. Ol. Succini f3j, Tinct. Opii fZss. Misce. Dose. WV to MW xij rubbed up with mucilage. OLEUM SUCCINI OXIDATUM. Oxidated Oil of Amber. ._(Olei Succini fZj, Acidi Nitrici fZiijss. Put the oil of amber in a glass vessel, and gradu- ally drop the acid into it, at the same time stirring the mixture with a glassrod. Let it stand for thirty- six hours, then separate the supernatant resinous matter from the acid fiuid beneath, and wash it re- peatedly, first with cold, and lastly with hot water, till the acid taste be removed.) Use. Recommended as a substitute for musk, to which it is analogous in its properties. OLEUM TEREBINTHINA. Oil of Turpentine. Stimulant, diuretic, sudorific, anthelmintic, rube- facient. Use. In chronic rheumatism, lumbago, and sci- atica; and in passive uterine hemorrhages ; dropped into the ear in deafness from defect of wax ; applied to indolent tumors ; and in embrocation in rheuma- tism and bruises. It is given in very large doses, alone, or united with honey, against the teenia so- lium, which it brings away entire, dead, after two or three doses. Dose. 1.x to fZj in the first cases; but for the expulsion of tenia f3ss to f Zij. OLEUM TIGLII. Croton Oil. OPT 121 A powerful hydragogue purgative, acting gener- ally in moderate doses without pain, but-in large _ doses excites vomiting and severe griping pain. A drop placed on the tongue, in a comatose state, will usually operate. Use. In constipation and torpor of the intestines —in dropsy, apoplexy, mania, coma, inflammation of the brain, hydrocephalus, and whenever power- ful revulsion from the head is indicated. Exter- nally, as a revellent, or counter-irritant, producing a pustular eruption in twelve hours after the first friction—in rheumatism and gout, phthisical affec- tions, incipient phthisis, and in the neuroses, as palsy, hooping-cough, spasmodic. asthma. Dose. to } and } drop every two or three hours, in emulsion or pill. Externally, four to six drops may be rubbed in twice a day.. If the skin be very sensitive, mix it with an equal portion of some fixed or volatile oil. OLEUM VALERIAN A. Oil of Valerian. Dose. Four or five drops. ONION. Garden Onion. (Allium Cepa.) Stimulant, diuretic, expectorant, rubefacient. Dose. A teaspoonful of juice, with sugar, in non- inflammatory catarrhs of children. OPIUM. Opium. Stimulant in small doses, but in larger narcotic, antispasmodic, diaphoretic, sedative, anodyne; ex- ternally, its stimulant effects are considerable, but soon followed by its narcotic. Use. In all painful affections, where the inflam- matory diathesis is not very considerable; in diar- rhoea and dysentery; intermittents; in typhus, in smaller doses as a cordial, in larger to allay irrita- tion and produce sleep ; cholera and pyrosis ; in rheu- matism when inflammatory fever is not present ; re- 11 122 - OPI trocedent gout; and in convulsive and spasmodic diseases. When combined with calomel, in inflam- mation, after blood-letting, and in syphilis, as well as to arrest the progress of gangrene. It is employed in a watery solution, containing gr. ij in f3j of water, as an injection in gonorrhcea and spasmodic stricture, as an adjunct to clysters in diarrhoea; and by friction, united with oil in tetanus and other spasms. Dose. Gr. } to gr. ss, to produce its stimulant ef- fects; gr. j to grs. ij, is narcotic; but in spasmodic complaints it has been given to a very great extent. “Incomp. Lime-water, alkaline carbonates, bichlo- ride of mercury, nitrate of silver, sulphates of zinc, copper, and iron, infusion of yellow bark, astringent infusions and decoctions, solutions of catechu and of kino; acetates of lead. *.* When opium has been taken as a poison, the stomach should be first evacuated by the stomach- pump, worked with infusion of yellow bark, or by emetics containing very little water, and, after the whole of the opium has been evacuated, aromatic stimulants given, and mustard cataplasms applied externally. As the dose of opium varies much, according to circumstances, and as the quantities vary in phar- maceutical preparations, we have thought it advisa- ble to insert the following table of proportions for reference : Opium. Dose. + of a grain to 2 grs. or more. Acetum Opti (Black drop) contains 1 gr. Opium to NVil. Confectio Opii contains 1 gr. Opium in grs. xxxvi. Morphia. 1-6th of a gr. equivalent to gr. j} Opium. Morphia Acetas. 1-6th of a grain equivalent to gr. j Opium. PAN 123 Liquor Morphie Acetatis. 1-6th gr. Morphia in mv. Morphic: Murias. Same as Morphia. Morphie Sulphas. Same as Morphia. Pilule Calomelanos et Opii. 1 gr. Opium to iij grs. Calomel. Pilule Opi. 1 gr. Opium in each pill. Pilule Plumbi Opiate. One-half gr. Opium in each. Pilule Saponis Composite. 1 gr. Opium in grs. v. Pulvis Ipecacuanhe et Opti. 1 gr. Opium in grs. x. Tinctura Opti (Laudanum). 1 gr. Opium in Mm xix. Tinctura Opti Camphorata (Paregoric). 1 gr. Opi- um in fZss. Tinctura Opti Acetata. 1 gr. Opium in Mxx. Trochisci Glycyrrhiza et Opi. One-tenth gr. in each. Vinum Opti. Same as Tincture. ORIGANUM. Common Marjoram. (0. vulgare.) Tonic, stomachic, emmenagogue ? Use. In debilities of the stomach: scarcely ever used. Dose. Grs. x to 9j in powder. OROBANCHE VIRGINIANA. Beech drops. Cancer- root. A parasite on the root of the beech. Astringent. OXYMEL SCILLA. Oxymel of Squill. (Melis lbiij, Aceti Scillz Oij. Evaporate in a glass vessel, over a sand-bath, to a proper consistence.) The boiling is hurtful, destroying the acrimony on which the virtue of the squill depends. Expectorant, diuretic, aperient; in large doses emetic. Use. In humoral asthma, chronic coughs, dropsy ; to excite vomiting in pertussis. Dose. fZss to fZij in cinnamon water, or any other aromatic water. PANAX. Ginseng. Root of P. quinquefolium. - Demulcent. The Chinese panacea. 124 Pay PAPAVER. White Poppy Capsules. (P. somnife- rum.) Relaxant, anodyne. Use. Externally as a fomentation (Ziv of the dried heads being bruised and boiled in Oiv of water to Oij), to inflamed or ulcerated parts. The addition of a little distilled vinegar aids the narcotic power of the decoction. PAREIRA. (Pareira brava.) Tonic, aperient, diuretic. Use. In irritable bladder. Dosé. Grs. xxx to 3j. Tincture (one part to five of alcohol) f3). PETROSELINUM. Parsley Root. (P. satwum.) Aperient, diuretic. Use. In nephritic and dropsical affections—given in infusion. - PHOSPHAS SODA. Phosphate of Soda. Purgative. Use. In all cases where the bowels require to be opened. When dissolved in broth made without salt, the taste of the phosphate is not perceived. Dose. 3} to Zij. -Incomp. Alum, chalk, and all salts with an earthy base. PHYTOLACCA BACCH ET RADIX. Poke Ber- ries. Poke Root. (P. decandra.) Emetic, purgative, alterative, and narcotic. A narcotico-acrid poison. Use. The juice, evaporated to an extract, is em- ployed as an escharotic by cancer doctors. As an alterative in small doses in chronic rheumatism. As an ointment in psora, tinea capitis, and other cutaneous diseases. Dose. As an emetic, from grs. x to grs. xxx. As an alterative, from gr. i to grs. Vv. PTL 125 PILULA ALOES. Aloetic Pills. (Aloes Socotrine, Saponis sing. partes zequales, q. s.) PILULA ALOES COMPOSITA. Compound Aloetic Pills. (Aloes contrite lbj, Ext. Gentianz Zss, Olei Carui mxl, Syr. q. s.) Dose. Grs. v to xx. PILULA ALOES CUM ZINGIBERE. Pills of Aloes and Ginger. (Aloes Hepat. 3j, Rad. Zingib. in Pulv. trite 3j, Saponis Hispanici 4ss, Ol. Essent. Menthe Pip. 3ss.) In their operation these three are alike, warm, stomachic, purgative. Use. In habitual costiveness. Dose. Grs. x to 5j made into pills. PILULZ ALOES ET MYRRHA. Aloetic Pills with Myrrh. (Aloes 3ij, Croci Stigmatum, Myrrhe sing. 3j, Syr. q. s.) Cathartic, emmenagogue. : Use. In chlorotic, hypochondriacal, and cachectic habits, to stimulate and open the bowels. Dose. Grs. x to hj made into pills. PILULA ALOES ET ASSAFC@TIDA. Aloetic and Assafoetida Pills. (Aloes Socotr., Conf. Rosx, As- safcetidee, Saponis, sing partes equales, q. s.) Purgative, stomachic, anodyne. Use. In dyspepsia attended with flatulence and costiveness; hysteria; amenorrhea. Dose. Grs. x in pills twice’a day, or at bedtime. PILUL# ALOES ET FERRI. Pills of Aloes and Iron. (Sulph. Ferri grs. xxxvj, Aloes Barb. grs. xxiv; Pulv. Aromat. grs. lxx, Conf. Rose q.s. Ft. Pilule xlviij.) ' Use. An excellent combination of a tonic and purgative. 1-3 pills. PILULA ASSAF@TIDA. Compound Pills of Assa- 11* 126 PIL foetida. (Assafcetida, Galbani, Myrrhe, sing. Ziij, Conf. Rose, q. 8.) Use. In hysteria and other nervous affections. Dose. Grs. Vv to grs. xX. PILULA CALOMELANOS ET OPII. Pills of Calo- mel and Opium. (Calomel grs. xxiv, Opium grs. viij, Conserve of Roses, a quantity sufficient to make a mass to be divided into twelve pills.) Use. For rapidly bringing the habit under mer- curial influence. PILULH CATHARTICA COMPOSITA. Compound Cathartic Pills. (Take of Comp. Extract of Colo- cynth Zss, Ext. Jalap. Calomel, a4 Ziij, eee ij. M., ft. pil. No. 180.) Use. In constipation and hepatic conpesian A most useful pill. Dose. 3 pills. PILULA COPAIBA. Pills of Copaiba. (R. Copaiba 3ij, Magnesia 3j. Mix, and set aside till it con- cretes into a mass, which is to be divided into 200 pills.) Use. In 2 aps ate and affections of the mucous membrane. 6 pills. PILULZ DIGITALIS ET SCILLA. Pills of Fox- glove and Squill. (Digitalis, Squill, of each )j. Aromatic Electuary Rij. Make into xx pills.) Diuretic. Use. In dropsy. 1 or 2 pills. PILULA FERRI CARBONATIS. Vallet’s Iron Pills. Use. In chlorosis, &c. Dose. 10 to 30 grs. in 24 hours. PILUL FERRI COMPOSITA. Compound Pills of Iron. (Myrrhe"cont. 3ij, Sode Carbon. Ferri Sul- phatis, Sacch. sing. 3.) Tonic, emmenagogue. Use. In dyspepsia and chlorosis. ; PIL 127 Dose. Gr. x to 5j in pills, twice or thrice a day. PILUL FERRI IODIDI. Pills of Iodide of Iron. (Sulphate of Iron 3j, Iodid. Potas. Hiv, Tragacanth 10 gr., Sugar 3ss. Mix with Syrup. Form 40 pills.) Hach pill contains about 4 gr. iodide of iron. PILULZ HYDRARGYRI CHLORIDI MITIS. Calo- mel Pills. (Calomel Zss, Gum Arabic 3j, Syrup. q. 8. Make 240 pills.) 1 gr. Calomel in each pill. PILULA OPII. Opium Pills. (Opium powder 3), Soap 12 gr. Make sixty pills.) Hach contains 1 gr. Opium. PILULZ FERRI SULPHATIS. Pills of Sulphate of Iron. (Sulph. of Iron gr. xxiv, Ext. of Taraxacum 3j, Cons. of Roses grs. xxiv. Make into xxiv pills.) Use. As a tonic, in dyspepsia connected with a torpid state of the liver. PILULAH GALBANI COMPOSITA. Compound Gal- banum Pills. (Galbani 3j, Myrrhe, Sagapenii, sing. Ziss, Assafoetida Ziv, Syrupi q. s.) Both these forms of pills operate as antispasmodic and emmenagogues. Use. In chlorosis, hysteria, and hypochondriasis. Dose. Gr. x to hj made into pills, every night at bedtime. PILUL# HYDRARGYRI. Mercurial Pills. (Hy- drarg. Pur. 3ij, Confect. Rose Gallice Ziij, Glycyr- rhizee Rad. cont. 3j. Rub the quicksilver with the confection until the globules disappear; then add the liquorice-root powder, and beat the whole into a uniform mass.) Antisyphilitic, alterative; in large doses purga- tive. Use. In syphilis, perhaps the best form of the remedy; in some cutaneous diseases and intermit- tents, attended with visceral and lymphatic obstruc- tions; to purge in jaundice, dropsies, and ileus. 128 PiY Dose. For the former objects, gr. v to gr. x twice a day, united with opium, if the bowels are easily affected; for the latter, gr. xij to Aj every three or four hours. PILULA QUINILA SULPHATIS. (Pills of Sul- phate of Quinine. R. Sulph. Quin. 3j, Gum Arabic 3ij, Syrup q.s. M., ft. 480 pills.) PILULA RHEI. Rhubarb Pills. (Rhubarb in pow- - der 3ij, Acetate of Potassa 3j, Cons. of Roses Jss. Make into xliv pills.) Use. A moderate purgative. PILULA RHEI COMPOSITA. Compound Rhubarb Pills. (Rhei in puly. trite 3j, Aloes Zvj, Myrrhe Ziv, Saponis 3j, Ol. Carui 3ss, Syrupi q.s. Beat them into a mass.) Laxative, stomachic. Use. In dyspepsia attended with costivéness. Dose. Gr. x to Hj twice a day. PILULA SAPONIS COMPOSITA. Compound Pills of Soap. (Opii duri contriti Ziv, Saponis Ziij.) Gr. v contain gr. j of opium. PILULA SCILLA COMPOSITA. Compound Squill Pills. (Scillz Recent. exsiccate et cont. 3j, Zin- giberis contrite 3ij, Saponis Ziij, Ammoniaci con- triti Zij, Syr. q. s. Form a mass.) Expectorant, diuretic. Use. In asthma and chronic catarrh; as an ad- junct to digitalis in hydrothorax and other dropsies. Dose. Gr. x to Rj twice or thrice a day. PIMENTA. Pimenta Berries. (Myrtus Pimenta.) Stimulant, carminative. _ Use. Chiefly as a condiment, and as an adjunct to other medicines. Dose. Gr. v to Rij. PIPER LONGUM. Long Pepper. Similar to Black Pepper. BU. 129 PIPER NIGRUM. Black Pepper. Tonic, antiperiodic, stimulant, carminative. Use. To check nausea in gouty habits; remove hiccough; and increase excitement in palsy. Steep- ed in rum it cures ague. | Balsam.” {| Aloes. Group 3.—Simple Solutions in Alcohol. Camphore Zij to Oj. Dose gtt. 20. Stimu- lant. Ol. Menth. Pip. fZij to Oj. Dose gtt. 20. Car- minative. Ol. Menth. Satives fZij to Oj. Dose gtt. 30. Carminative. PHARMACEUTICAL PREPARATIONS. 201 Tinct. Iodinii Zj. Dose gtt. 15. Alterative. Iodine 3ss, as ett. Iodide Potass 3). ert ‘¢ Todinii Comp. Soap, Use ex- «¢ Saponis Camphorata. { Camphor, tern- Oil Rosemary.) ally. 3d Class.—Made with Aromatic Spirits of Ammonia. Tinct. Guaiaci Ammoniata Ziv to Ojss. Dose f3j. Stimulant, diaphoretic. “ Valerianze Ammoniata Zij to Oj. Dose f3j. Antispasmodic. | MEDICATED WINES. White or Sherry wines used in making them. Vinum Aloes 3j+Cardamom, pes J: eel Gingero) aperient. « Rhei Ziij+Canella 3j, | tal Oe ieee 5), t0 Diluted Alcohol £3 ij peace sama “¢ Colchici Rad. Zvi to Oj. Dose gtt. 10 to fz). Diuretic, nervous sedative. ‘¢ Colchici Sem. Zij to Oj. Dose fzj to fzZij. Diuretic and nervous sedative. ‘ Ergote Zij to Oj. Dose fzj. Excito-motor stimulant. “¢ Jpecacuanhe 3j to Oj. Dose fzj to fZss. Expectorant. ‘¢ Tabaci Zj to Oj. Dose gtt. 20. Diuretic. ¢ -Veratri Albi Ziv to Oj. « Antimonii, 2 grains Tartar Emetic to fZj. Dose fj to fZss. Expectorant, emetic. 202 PHARMACEUTICAL PREPARATIONS. VINEGARS. With 1 part Acetic Acid to 7 of water. Acetum Colchici 3j to Oj, Alcohol fZss. Dose gtt. 30 to fZij. Diuretic, sedative. Acetum Scille Zij to Oj. Dose gtt. 30 to fZj. Diu- retic, sedative. “| Opii Zijss to Oj) "Dose git. 5 to 10. See below. PREPARATIONS OF OPIUM. ( Opium Zss, aired Tinct. Opii Cam- | Camphor )j, to 8 ee: phorata4 Benzoic Acid Zss, te co- hol. Dose (Paregoric) | Oil Anise fZss, | H oney 33, £3] to fZss. rs Opik (Landainuin) Opium 51 to Zij to Oj. Dose gtt. 25. Opium 3j, ‘« Opii Acetata~ Alcohol fZiv, } Dose gtt. 20. Vinegar f3 vi. Py Opium 3ij : « Opii (Syden- Gi ? {to Sherry Oj. me innamon ham’s Laud.) Cloroahel 33 Dose gtt. 20. ( Opium Z viii, Acetum Opii pe utmeg 3ss, | to OiijfZiv when fluid. (Black drop) } Saffron Zss, Dose gtt. 5 to 10. Sugar 3 xii Liquor Morphia Sulphatis, 4 grain Morphia to f3j. (Magendie’s Solution, used in New York and Boston, has 16 grains to fZj.) Dose f3j. DECOCTIONS. Decoctum Chimaphile 3j to Ojss; boil to Oj. Dose Oj per diem. Alterative. J PHARMACEUTICAL PREPARATIONS. 203 Decoctum Uve Ursi Zj to fZxx; boil to Oj. Dose fZij. Astringent, diuretic. re Dulcamaree 3j to Ojss; boil to Oj. Dose fZij. Alterative, narcotic. Hematoxyli 3j to Oj; boil to Oj. Dose fZij. Astringent. ae Quercus Alb. 3j to Ojss ; boil to Oj. Dose fZij. Astringent. ¢ Cinch. flav. 4j to Oj; boil ten minutes. Dose fZij. Tonic. “ Cinch. rub. 2j to Oj; boil ten minutes. Dose f3ij. Tonic. Cornus Floridz 4j to Oj; boil ten minutes. Dose fZij. Tonic. ts Senega 3j to Ojss; boil to Oj. Dose fZij. Stimulant, expectorant. ¥e Hordei 3ij to Oivss ; boil to Oij. Ad libitum. Demulcent. . Cetrarie Zss to Ojss; boil to Oj. Dose Oj per diem. Tonic, demulcent. ee Taraxi. Zij to Oij; boil ten minutes. Dose fZij. - Diuretic. M: Sarsap. Comp.: Pheenagnt | to Oiv ; boil fifteen Goatie minutes. D ose Liquorice aa 3), pink Se Mezereon Jiij Reape EXTRACTS. lst Class.—Narcotic inspissated juices. Extractum Aconiti. Dose 1 to 2 grs. a Belladonnee. Dose 1 to 2 grs. “ Stramonii fol. Dose 1 to 2 grs. e Conii. Dose 2 to 3 grs. fe Hyoscyami. Dose 2 to 3 grs. 204 PHARMACEUTICAL PREPARATIONS. 2d Class.—Hydro-Alcoholic and Alcoholic Extracts. Extract. Aconiti Alcoholicum. 3 gr.tolgr. Narcotic. te Belladonni Alcoholicum. Dose $ gr. to 1] gr. Narcotic. Stramonium Seminis. Dose 3 gr. to 1 gr. Narcotic. Conii Alcoholicum. Dose 1 to 2 grs. Nar- cotic. Hyoscyami Alcoholicum. Dose 1 to 2 grs. Narcotic. Nucis Vomice. Nervous stimulant. Hellebori. Dose 10 to 15 grs. Cathartic. Jalape. Dose 10to 15 grs. Cathartic. Rhei. Dose 10 to 15 grs. Cathartic. Podophylli. Dose 5 to 10 grs. Cathartic. Cinchon. Flav. Dose 10 to 15 grs. Tonic, alterative. Cinchon. rub. Dose 10 to 15 grs. Tonic, alterative. Sarsaparille. Dose 10 to 15 grs. Tonic, alterative. Colocynthidis Comp. (Colocynth made into tincture, and evaporated, aloes, scammony, soap, and cardamom added.) Cathartic. 3d Class.—By displacement with cold water and evap- oration. Extract. Gentiane. Dose 10 to 20 grs. Tonic. (¢ Quassiz. Dose 3 to 6 grs. Tonic. Dulcamare. Dose 3 to 6 grs. Alterative, narcotic. Krameriz. Dose 10 to 20 grs. Astringent. Juglandis. Dose 10 to 20 grains. Cathartic. Opii. Dose 1 gr. Narcotic. PHARMACEUTICAL PREPARATIONS. 205 Extract. (79 ée Jalapin. 4th Class. Hematoxyli. Dose 10 to 20 grs. Astringent. (By decoction in water, straining and evap- orating.) Taraxaci. Dose )j to 3j. Diuretic, &c. (Expressing milky juice, and evaporating.) Colchici Aceticum. Dose 1 to 3 grs. Diu- retic. (Evaporating a medicated vinegar.) UNOFFICINAL AND PSEUDO-EXTRACTS. Digitalis Ale. Dose 4 gr. Sedative, diuretic. Ignatia Amara. Dose 3? gr. Tonic, excito- motor. Lupulin. Dose 3 to 5 grs. Narcotic. Cimicifuga. Dose 3 to 10 grs. Sedative tonic. Valerian. Dose 3 to 10 grs. Antispasmodic. Calisayicum. Dose 2 to 5 grs. Tonic, antiperiodic. Ergota (aqueous). Dose 2 to 5 grs. Excito- motor. Pareira (aqueous). Dose 10 to 30 grs. Tonic, diuretic. Uva Ursi (aqueous). Dose 10 to 30 grs. Tonic, diuretic. Lobeliz Aceticum. Dose 2 to3grs. Nar- cotic sedative. Cannabis Sativa. Dose 1 gr. Narcotic stimulant. Glycyrrhize (Liquorice). Demulcent. CONCENTRATED OR RESINOID EXTRACTS. Dose 3 to 8 grs. Cathartic. Podophyllin. Dose 1 to 3 grs. Cathartic. 18 206 PHARMACEUTICAL PREPARATIONS. Macrotin (impure resin of Cimicifuga). Dose 1 to 6 grs. Sedative, tonic. Stillingin. Dose 2 to 4 grs. Leptandrin. Dose 2 to 4 grains. Hydrastin. Dose 1 to 2 grains. Tonic. FLUID EXTRACTS. 1. Concentrated Syrups. ACh Senne fluidum. Dose fZss. Cathartic. Rhei fluidum. Dose fZj. Cathartic. 66 Spigelize et Senne fluidum. Dose fZj. An- thelmintic. - i Sarsaparille fluidum. Dose 13): Diaphoretic, alterative. 2. Alcoholic. cs Valeriane fluidum. Dose f3j. Antispas- modic. 3. Oleo-resina, prepared with Ether. Cubeba fluidum. Dose 5 to 30 drops. Stimu- lant. a Piperis fluidum. Dose 1 to 5 drops. Stimu- lant. UNOFFICINAL FLUID EXTRACTS. lst Class.—Syrups. = Cinchona fluidum. Dose £3). ut Buchu fluidum. Dose f3j. “ Hydrangea fluidum. Dose fZss. «Rhubarb and Senna fluidum. Dose f3ss. ue Ergot fluidum. * Dose f3). i Serpentaria fluidum. Dose fZss. 2d Class.— Alcoholic. “ Buchu fluidum. Dose fj. PHARMACEUTICAL PREPARATIONS. 207 a Serpentaria fluidum. Dose m,20 to 30. Taraxacum fluidum. Dose fj. ‘ Gentian fluidum. Dose fj. ‘(Lobelia fluidum. Dose m5 to 20. “ Cimicifuga fluidum. Dose m30. 3d Class.—Oleo-resins, with Ether. Piperoid of Ginger. Used in confectionery. Oleo-resin Capsicum. Used in confectionery. Oil of Male Fern. Oil of Ergot. Dose 1,20. In parturition. SYRUPS. Syrupus Simplex.—Sugar 2 lbs., water 1 pint. Dis- solve by heat. lst Class.—Infusions or Decoctions mdde permanent by Sugar. Syrup Aurantii Corticis. By maceration with boiling water. An adjuvant. Syr. Senna (with Fennel). Digest with hot water. Laxative. Dose f3j to fZij. Syr. Krameria. Displacement with cold water. As- tringent. Dose fZss. Syr. Pruni Virginiane. Displacement with cold water. Sedative, tonic, and expectorant. Dose fZss. Syr. Senege. Decoction. Stimulant, expectorant. Dose f3j to fZij. Syr. Scille Comp. Decoction. Stimulant, expector- ant. Dose 120 to f3j. ; 2d Class.—By evaporation from a diluted Alcoholic Extract, and Sugar added. Syr. Ipecacuanhe Zss in Oj Syrup. Expectorant. Dose f3j to fZss. 208 PHARMACEUTICAL PREPARATIONS. Syr. Scilla Comp. Squill and Seneka, Expectorant. +Tart. Em. gr.j tofZj. Dose gtt. 20 to fz). Syr. Rhei 3j in Oj Syrup. Laxative. Dose fZss to f Ziv. 5 Sarsaparilla Guaiacum, ) Alter’e. Syr. Sarsaparilla. Roses, Senne igsore, | Dose and essential oils. fZ ss. 3d Class.—Containing Acetic Acid. Syr. Allii. Macerate Garlic in dil. acet. acid and add sugar. Antispasmodic. Dose fzj. Syr. Scille. Acet. Scille Oj-Sugar lbij. Expector- ant. Dose f3j. 4th Class.—Simple Syrup as a base. ® Syr. Acidi Citrici 3j to Oj Oil of Lemon mj. Ve- hicle. Syr. Krameriz (2d process). Ext. 3j to Oj. Astrin- gent. Dose f3ss. Syr. Tolutanus. Tinct. 3v to Oj. Adjuvant. Syr. Zingiberis. Tinct. fZss to Oj. Adjuvant. { Rhubarb 3’; 7 Car- Cloves, mina- Cinnamon 4a Jj, tive, Syr. Rhei Aromaticus. J Nutmeg 33s, |. laxa- | Dil. Alcohol q. s. [ tive. Displace Oss Tinct. | Dose Rvaporate to Ziv; | fZijto | Add Ojss Syrup. J f3j. Syr. Amygdalis. 1 pt. bitter almonds, 3 pts. sweet almonds. Demulcent. Syr. Limonis. Lemon-juice Oj, Sugar Ibij. Vehicle. Syr. Acacie. Gum 3j, Sugar 3 vii, Water fZiv. Ex- cipient for pills. PHARMACEUTICAL PREPARATIONS. 209 CONFECTIONS. Confectio Rose. Powd. Rose 2 pts., Sugar 15 pts., Honey 3 pts., Rose-water 4 pts. # Aromatice. Arom. Powd. 54, Saffron, 3, Syr. Aurant. 6, Honey 2. Sy Opii (1 gr.in 36). Opium Powd. 44, Arom. Powd. 48, Honey 112. re Senne. P. Senna and Ooriander, with Figs, Prunes, Cassia, &c. SPIRITS, OR ESSENCES. Spiritus Myristica. Nutmeg Zij to Dil. Alcohol 1 gal. Distillation. 4 Juniperi Comp. Oils of Juniper, Caraway, and Fennel. Solution. a Pimenta. Oil of Pimenta in Dil. Alcohol. Solution. ““ Rosmarini. Oil fgiv to 1 gal Alcohol. So- lution. * Lavandule. Flowers lbij to 1 gal. Alcohol. Distillation. a Layandule Comp. Cinnamon, Cloves, { to Sp. Davelde: Maceration, Nutmeg, Saunders, & Sp. Rosemary. displacement. POWDERS. Medicines adapted to the form of powders are in- soluble mineral substances, vegetable products, and some soluble substances. Insoluble—too large doses for pills.—Carbo-ligni, Mag- nesia, Calcis Phosph., Pot. Bitrart., Sulphur Sub., Creta Ppt., Ferri Subcarb., Calomel, &. Vegetable powders, as Powd. Cinchona, Colomba, Gentian, Rhubarb, Jalap, Cubebs, &c. In certain combinations, and when pills are objected to.— Powd. pil. Hydrarg., Ext. Colocy., Opium, Digitalis, 18* 210 PHARMACEUTICAL PREPARATIONS. Nux Vom., Kino, Tannic Acid, Gallic Acid, Potas. Nit., Opium Alkaloids, Cinchona Alkaloids, Sub- nit. Bismuth, &c. Diluents for powders.—Sugar, Lactin, Powd. Acacia, Cinnamon, Arom. Powd., Ext. Liquorice, Gum Tra- gacanth, Elm Bark, &c. PILLS. Medicines adapted to the pilular form are, powders in léss than 15 grain doses, gum-resins, extracts, and oleo-resins and oils in small proportions. Unadhesive materials—Calomel, Dover’s Powders, Sub- nit. Bismuth, Morphia Acetas, &c., Strychnia, Pulv. Digitalis, Pulv. Ipecac., Plumbi Acetas, Ant. et Pot. Tartrate, Ant. Sulph., Argenti Nitras, Argenti Oxi- dum, Ferri Pulvis, Ferri Subcarbonas, &c., Potass. Iodid., Camphor, &c. Medicinal excipients.—Extracts, Pil. Hydrarg., Pil. Co- paibe, Pil. Ferri Carb., Terebinthina. -With moisture.—Powd. Aloes, Rheum, Kino, Tan- nin, Opium, Scilla, Ferri Citras, Assafoetida, &c. With alcohol.—Guaiacum, &c. With dilute SO,.—Quinie Sulph., Cinchoniz Sulph., Quinidize Sulph., Quinoidine. Inert excipients.—Powd. Acacia, Tragacanth, Soap, Bread crumbs, Confections, Syrup of Gum, Honey, Molasses, Syrups. LIQUIDS. Suitable medicines are most soluble salts, light in- soluble powders, extracts, gum-resins, oils, &c. Forming eligible solutions with water.—Alumen, Ammon. Murias., Ant. et Pot. Tart., Barii Chloridum, Calcii Chloridum, Ferri Sulph., Ferri et Pot. Tart., Man- ganesii Sulph., Magnesiee Sulphas, Potassz Acetas, Pot. Bicarb., Pot. Carb., Pot. Citras, Pot. Chloras, PHARMACEUTICAL PREPARATIONS. 211 Pot. Tartras, Potassii Bromid., Pot. Iodid., Morphia Acetas, Morphia Sulphas, Morphia Murias, Sod Bicarb., Sod. Boras, Sod. Carbonas, Sod. Sulph., Sod. et Pot. Tart., Sod. Chlorid., Sod. Phosph., Acid Citric, Acid Tartaric, Acid Tannic. Mixing, but not forming clear solutions in water diffused by agitation —Magnesia, Potas. Bitart., Sulph. Prae- cip., Pulv. Cinchone, Pulvy. Ipecac., Quinizs Sulph. Miscible by trituration alone.—Ext. Aconiti, Ext. Bellad., Ext. Conii, Ext. Hyoscyami, Ext. Stramon., Ext. Taraxaci, Ext. Kramer., Ext. Glycyrrh., Confections, Assafoetida, Ammoniac, Guaiacum, Myrrha, Scam- mony. Suspended by viscid excipients. —Copaiba, Ol. Amygdala, Ol. Ricini, Ol. Terebinth., Olea Essentia, Ferri Pro- tocarb. Requiring additions to form solutions.—Quin. Sulph., Cinchon. Sulph., Quinid. Sulph., Chinoidine, Jodine, Hydrarg. Iodid. Rub. Requiring viscid substances—Ammon. Carb., Hyd. Chlorid. Corros., Pot. Cyanuret, Potassa. Vehicles or correctives (especially of salines).—Aq. Medicate, Syrups, Tinct. Cinnamomi, Tinct. Cin- nam. Comp., Tinct. Cardam. ° Tinct. Card. Comp., Infus. Rosa Comp., Saccha- rum, Olea destillata, Tinct. Tolutana, Tinct. Zingiberis. \ CERATES AND OINTMENTS. 1st Class.—Simple, much used as Vehicles. Ceratum Simplex. 1 pt. White Wax, 2 Lard. Firmest healing dressing. ak Cetacei. 1 Sp. Cet., 3 White Wax, 6 Olive Oil. Firm healing dressing. Unguentum Simplex. 1 White Wax, 4 Lard. Softer healing dressing. 212 PHARMACEUTICAL PREPARATIONS. Ung. Aquz f Almond Oil, Sp. Ceti, Softest heal- Rosee. White Wax, Rose Water. f ing dressing. Ceratum / 5 Resin, 8 Lard, ) Stimulant healing dress- Resine. | 2 Yellow Wax. ing. (Basilicon.) 2d Class.—Mechanical mixture of Medicinal Substance with unctuous ingredient. Group 1.—By fusion. Cerat. Resin, Suet, Yellow Wax,) Stimu- Resinze Comp. | Turpentine, Flaxseed Oil. f lating. Ung. Picis Liq. Tar and Suet, equal parts. Stimu- lant, antiseptic. Cerat. Canth. 12 pts., Lard 10, ) Epispastic, Cantharidis. | Yel. Wax, Resin 4a 7 pts. f blist. cerat. Group 2.—By trituration. Cerat. Sabine. 1 pt. Savin, 6 Resin Cerate. Stimu- lant dressing. Ung. Galle. 1 pt. Galls, 7 Lard. Astringent. Ung. Veratri alb. 1 pt. Root, 4 Lard and Oil Lemon. In itch. Cerat. 3iij Calamine, Zxii Lard, ) Mild ast. and . hae Ziij Wax. desiccant. Cerat. 1 pt. ZnO0,CO,, Zinci Carb. | 5 Simple Ointment. le aa : pt Sa \ id astringent. Ung. Cuprif 1 pt. 2Cu0,Ac,6HO, Mild Subacet. { 15 pts. Simple Ointment. { escharotic. Ung. - f1 pt. KO,SbO,,T, Antimonii. | 4 pts. Lard. Ung. Hydrargyri. Equal parts Hg and Lard. Al- \ Mild astringent. \ Vesiccant. terative. Ung. Hydrargyri {.1 pt. Hg,01,NH,, Desiccant, Ammon. 12 Simple Ointment, { alterative. Ung. Hydrargyri f 1 pt. HgO, Stimulant Oxid. Rub. 8 Simple Ointment, f alterative. PHARMACEUTICAL PREPARATIONS. 213 Ung. f1 ptI, one-fifth pt. KI, ) Discutient, altera- Todinii. | 24 Lard. tive. Ung. Iodinii f 1 pt. I, 2 pts. KI, ) Discutient, altera- Comp. 32 Lard. * tive. Ung. Potassii { 1 pt. KI+-1 pt. Ag., ) Discutient, al- Todid. 8 Lard. terative. Ung. Plumbi f 1 pt. PbO,CO,, ) Astringent, desic- Carb. 6 Ung. Simp. cant. Ung. Sulphuris. 1 pt. S, 2 pts. Lard. In Itch. Sulph. 3j, Ammon. Merc. 3}, } | Beng. Acid 3), Ol. Berg. £3), In Sulph. Acid f3j, Nit. Potas.-{ Itch. 3ij, Lard Zvi. Ung. Belladonne. 1 pt. Ext., 8 Lard. Anodyne. Ung. Stramonii. 1 pt. Ext.,8 Lard. Anodyne. Ung. Creasoti. Creasote fzss, Lard 3j. Antiseptic, stimulant. Ung. Sulphuris Comp. 3d Class.—By digesting the ingredient in Lard. Ung. Tabaci. 3j Leaves to lbj lard. Narcotic. Ung. Mezerei. Ziv Bark to Zxiv Lard, Zij Wax. Stimulant. Ung. Cantharidis (with boiling water), Zij to 3viij Resin Cerate. Stimulant. 4th Class.—The unctuous ingredient is decomposed. Ung. Hydrarg. Nit. (Citrine Ointment). Powerful stimulant and alterative. Cerat. Saponis. Soothing dressing. Cerate PlumbiS. Acet. (Goulard’s Cerate.) Cooling. 214 VIII. TABLE OF SYMPTOMATOLOGY. A. TOPOGRAPHICAL. 1. General Aspect of Patient. I, ATTITUDE. Unusual languor—invasion of acute disease—course of chronic ones. Unnatural boldness—insanity—delirium. General immobility—catalepsy. Irregular and perpetual movement—chorea. Distorted features, altered position, and impaired mo- tion of limbs—hemiplegia. Tonic spasm of trunk—tetanus. II. DECUBITUS. Constantly dorsal—cerebral apoplexy, organic disease of brain and spinal marrow, acute ee gen- eral articular rheumatism. Prone—generally in gastric, intestinal, hepatic, and renal colic. Lateral—some stages of pleurisy or pneumonia (not general) ; in consumption, when one lung is affected, the diseased side is usually lain on. Sitting—diseases of heart and lungs, which interfere with respiration. Head thrown back—laryngeal and tracheal disease. SYMPTOMATOLOGY. 215 Restlessness, jactitation, &¢.—the invasion of acute inflammation, idiopathic fevers, many affections of children, delirium and acute mania. III. VOLUME OF BODY. ‘General enlargement—anasarca, or emphysema from a wound of the chest. 2. Signs furnished by Head, Face, and Neck. Head bent to one side—convulsions, hemiplegia, tor- ticollis, dislocation of cervical vertebra, cervical glandular swellings, cicatrices of neck, after: burns. Head bent forward—vertebral malformation. Head bent back—diseases with dyspnoea, as croup, laryngismus stridulus, suffocative catarrh, &c. Te- tanus, spinal meningitis of neck. Cranium increased in size—chronic hydrocephalus— hypertrophied brain. (Edematous scalp—erysipelas, smallpox. Facies stupida (dull expression)—typhoid fever. Facies vultuosa (full, red face, injected eyes)—cardiac hypertrophy, cerebral congestion. Pinched countenance (opposite of last)—acute peri- tonitis, in health, from exposure to severe cold. Facies hippocratica—in chronic disease just before death, in unusually prolonged acute disease. 3. Physiognomical Ruge. Rugee transverse (in forehead)—excessive pain rising externally. R. oculo-frontales (from forehead vertically to root of nose)—distress, anxiety, anguish, and severe in- ternal pain. In acute disease, an imperfect or false crisis, impending efflorescence, and often fatal ter- mination. Linea oculo-zygomatica (from inner angle of the eye below the cheek-bone)—in chil- 216 SYMPTOMATOLOGY. dren, a cerebral or nervous affection; in adults, disorder or abuse of the generative organs. Linea nasalis (from upper border of ala nasi, curved to outer margin of the orbicularis oris)—strongly marked in phthisis and atrophy, inferior part indi- cates gastric disease, upper part affection of the upper part of intestine. Conjointly with retraction of the cheek, and with the L. oculo-zygomatica, the eyes being fixed and complexion wan, an indication of worms. L. labialis (from angle of mouth to lower part of face)—in children, a thoracic affection with dys- pneea. L. collateralis nasi (in a semicircular direction toward the chin, external to last two)—chronic and obsti- | nate disease of thoracic or abdominal viscera. (Edema of face and See Dua ae ss sometimes in anemia. Transient redness or flushing of face—women suffer- ing from menstrual irregularity, and at the critical period. Hectic flush—phthisis, wasting, chronic affections. Paleness of face—cold stage of fever, and acute in- flammation, chronic diseases, especially Bright’s disease, in convalescence. Dingy white or greenish face—aneemia. Yellow tint—jaundice. Yellow at labial commissures and ale nasi—slight hepatic derangement. Citron tint—in cancerous affections. Bluish hue—impeded venous circulation, as in as- phyxia, Asiatic cholera, typhus fever, cyanosis. Slate color—from the use of Nit. Silver. Perpetual motion of eyelids—some cases of mania and idiocy. Forcible closure of eyelids—photophobia. SYMPTOMATOLOGY. 217 Eyelids open—injury of portio-dura from paralysis of the orbicularis. Paralysis of upper lid—lesion of third pair of nerves. Ephiphora (flowing of tears over the cheek)—obstruc- tion of lachrymal duct, in initial stage of ophthal- mia, and in some neuralgic affections of the eye, presence of a foreign body. Nostrils dilating forcibly and rapidly—difficult respi- ration. Itching nostrils—in children a sign of intestinal worms. 4. Region of the Throat. Enlarged—some anginose affections, in the first months of pregnancy, and at the approach of puberty in females. : Violent pulsation of carotid arteries—acute mania, cerebral inflammation, hypertrophy of heart with dilatation of right ventricle, anemia, sometimes in typhoid fever. Pulsation of arteria innominata (above the sternum, in front and to the right of the trachea)—aortic regurgitation. Circumscribed swellings—glandular enlargements. 5. Region of the Chest. General expansion of one side—large pleuritic effusion. Bulging at base of lung—gravitating pleuritic effusion. Bulging at anterior superior parts of chest—emphy- sema. Bulging in right hypochondrium—enlargement of liver. Bulging in precordial region—effusion into pericar- dium, or hypertrophy of heart. Tumor about the junction of third rib, with right side of sternum—aneurism of ascending aorta. 19 218 SYMPTOMATOLOGY. Tumor between the base of scapula and the spine— aneurism of descending aorta. Retraction of one side (usually the left)—after absorp- tion of pleuritic effusion. Depression or local retraction—absorption of circum- scribed effusion, phthisis. Respiration increased (healthy ,standard about 20 a minute)—dyspnoea, as in spasmodic asthma. Respiration diminished—pleurisy and pleurodynia, paralysis of respiratory muscles, pneumonia, em- physema, pneumothorax, phthisis, &c. Respiration jerking—spasmodic asthma, obstruction of larynx and trachea, pleurodynia. Respiration costal—abdominal inflammation and dia- phragmatic pleurisy. 6. Abdominal Region. General increase of volume—ascites, meteorism, tym- panites (these latter known by resonance, and occur in adynamic diseases, peritonitis, intestinal obstruc- tion, hysteria, &c.). Enlargement of hypochondria—diseases of liver or spleen. Enlargement in epigastrium—hysteria and cancer of stomach. Enlargement in hypogastrium—distention of bladder, ovarian tumors, fecal accumulation, &c. Diminished size—in most chronic diseases, as chronic dysentery, in lead colic (with hard muscles). 7. Genital Organs. Enlarged penis in children—vesical calculus, mastur- bation. Cartilaginous hardness of corpora cavernosa—from onanism. Retraction of testicles—renal calculus. Distended scrotum—hydrocele, hematocele, sarcocele. SYMPTOMATOLOGY. 219 Enlarged labia majora—general dropsy, local affec- tions. 8. Hxtremities. Immovable—paralysis. Contracted and rigid—softening of brain, &c. (Edematous—from embarrassed circulation. Articulations swollen—rheumatism, hydrarthrosis, _ white swelling, &c. Diminished in size—-paralysis. B. PHYSIOLOGICAL. 1. Functions of the Nervous System. I. SENSATION. Morbidly augmented—acute inflammatory affections of brain and spinal marrow, idiopathic fevers, hys- teria. Tensile pain—phlegmonous inflammation. Dull, heavy pain—enlarged viscera, internal tumor, effusion in serous cavities, in the loins previous to menstrual and hemorrhoidal discharges. Smarting pain—skin deprived of cuticle, or under in- fluence of irritants. Lancinating pain—cancer and neuralgia. Boring pain—constitutional syphilis, rheumatism, gout, inflammation of periosteum, &c. Contusive pain—from bruises, in acute diseases. Itching and formication—cutaneous disorder. Exaltation of vision—ophthalmia, inflammation of brain and meninges, some nervous affections. Musce volitantes—affections of brain and optic nerve, dyspepsia. Hearing painfully acute—cerebral inflammation, hys- teria. Hearing obtuse—in typhus fever. 220 SYMPTOMATOLOGY. II. VOLUNTARY MOTION. Increase of strength—acute disorder, with delirium, cerebral infammation, mania. Debility—in most diseases. Paralysis—indicative of lesion of brain or spinal mar- row, as apoplexy, spinal softening, &c., or of injury to a nervous trunk, or it may be functional, as in some cases of hysteria. Trembling—cold stage of fever, nervous affections, ataxic fevers, in old persons, action on the system of lead, mercury, strong coffee, alcoholic liquor, tobacco, and opium. Rigidity of limbs—in upper, extremities, a symptom of softening of the brain, cerebral extravasation, hysteria. Ill. REFLEX OR EXCITO-MOTORY SYSTEM. Cramp—pregnant women, hysteria, painter’s colic, &:, Gee Tetanus (another form of tonic spasm)—may be tris- mus when the muscles of mastication are affected, emprosthotonos, with the body bent forward, opis- thotonos, if bent backward, and pleurosthotonos, with lateral curvature. Clonic or temporary spasm—seen in convulsions of children, in hysteria, and some affections of the brain, in subsultus tendinum taking place in acute, ataxic diseases, in hiccough, &c. Morbid rhythmical movements—disease of cerebellum or its commissures. Reflected or sympathetic sensations, as pain at ex- tremity of penis from calculus of bladder, pain in right shoulder from congested liver, in left shoulder from disordered stomach, &c., are numerous. SYMPTOMATOLOGY. 221 IV. INTELLECT. Exaltation of affections—hypochondriasis. Abolition of moral sensibility—mania, typhus fever. Illusion and hallucination —insanity. Exaltation of intellect—melancholia, sometimes at close of life. Enfeebled intellect—typhus fever. Delirium—diseases of brain and its meninges, typhus fever, the exanthemata; diseases of chest and -ab- domen. Insomnia—mania, &c. Drowsiness—typhoid fever, some affections of the brain, &c. 2. Function of Respiration. I. DYSPN@A. 1. From the access of pure air impeded. a. Mechanical. Rigidity of parts—cartilages ossified, pleura indurated, rickety distortion. Pressure of parts—tumors or dropsies of abdomen. Obstructiofis of air-tubes—effusions, swellings, or tumors pressing on them, spasm of glottis or bronchi. Compression of lungs—effusions or tumors in pleural sac, in pleurisy, hydrothorax, pneumothorax, aneu- rism, &c. Alteration in tissue of lungs—enlargement of the ves- sels, effusions, as cedema, hepatization, tubercle, &c., altered structure, or emphysema, dilated bronchi, vomica, &c. b. Chemical. Deficiency of oxygen in the air—mephitic gas, rarified air, 19* 222 SYMPTOMATOLOGY. c. Vital. Pain of parts moved in respiration—pleurodynia, pleuritis, peritonitis, &c. Paralysis of muscles—injury of spinal marrow. Weakness of muscles—prostration in ataxic fever, &c. Spasm of muscles—tetanus, spasmodic asthma. 2. From the state of the blood. a. Mechanical. Obstruction to the passage of blood—diseases of heart and great vessels, tumors pressing on them. b. Chemical. An excessively venous state—violent exertion. Deficiency of red particles—anzmia, chlorosis. 3. From the nervous relation of parts. Excessive sensibility of par vagum—hysteric dyspnea, cerebral fevers. Defective sensibility of par vagum—coma, narcotism, &e. II. COUGH. Hollow or barking—in last stage of consumption, chronic bronchitis, in some nervous affections. Sharp or ringing—in croup. Hoarse—incipient catarrh, chronic laryngitis, angin- ous affections. W heezing—asthma. Belching—some disease of larynx. Paroxysmal—hooping-cough, hysteria. On auscultation, bronchial (harsh, rapidly evolved, concentrated)—phthisis, pneumonia, pleurisy, dila- tation of bronchi. On auscultation, cavernous (hollow)—tubercular ex- cavation, dilated bronchi. On auscultation, amphoric (metallic or ringing)— SYMPTOMATOLOGY. 223 broncho-pleural fistula, large, tubercular excava- tion. Ill. EXPECTORATION. Scanty—first stage of acute affections of lungs. Copious—decline of acute disease of air-passages or lungs, in chronic affections. Serous or watery—forming stage of bronchitis, pul- monary congestion, and vesicular emphysema. Mucous—bronchitis, and pneumonia. Purulent—phthisis, third stage of pneumonia. Nummular (like coin)—tubercular phthisis, bronchitis of measles, occasionally in chronic bronchitis. Flocculent, muco-purulent—advanced phthisis. Tubular—plastic bronchitis, pneumonia. Whitish—beginning of acute affections of the lungs. Yellowish or greenish—acute bronchitis. Rusty—pneumonia. Putrid smell—gangrene of lungs. Faint and sweetish smell—bronchitis, and first stage of phthisis. Alliaceous odor—broncho-pleural fistula. IV. PAIN. Dull, heavy, aching, round the base of the chest— acute bronchitis. Soreness in sternal region, and between the shoul- ders—acute bronchitis. Sharp, lancinating, sudden, usually below the nipple— pleuritic. Darting from anterior part of chest to interscapular region—in phthisis. Constant pain between the shoulders—in phthisis, chlorosis, other chronic diseases. Vv. EFFECTS OF PERCUSSION. Increased clearness of sound—in pneumothorax and emphysema. 224 SYMPTOMATOLOGY. Dullness of sound—pneumonia, pleurisy, phthisis, hy- drothorax, &c. Wooden sound—chronic pleurisy, with dense mem- branes. Tympanitic—pneumothorax and emphysema. Tubular—pleuritic effusion, tubercular excavation. Amphoric (imitated by filliping the inflated cheek)— tubercular cavities. Cracked metal sound—cavities near the surface. VI. EFFECTS OF AUSCULTATION. Exaggerated respiration—in portion of lungs adjoining those unfit for respiration. Weak respiration—from obstruction to entrance of air to the part. Suppressed respiration—when mucus clogs up a large bronchus. Jerking respiration—incipient pleurisy, spasmodic asthma, tuberculous infiltration. Incomplete respiration (inspiratory murmur defi- cient)—spasmodic asthma. Bronchial respiration (like the top of sternum and root of lung naturally)—in pneumonia, tubercles, &c. Cavernous and amphoric—tuberculous excavation. Dry Rhonchi. Sibilant—in bronchitis, from modified caliber of air- cells. Sonorous—in bronchitis, from modified caliber of air- cells. Dry, crackling (few in number, coexisting with inspi- ration)—first stage of phthisis. Humid Rhonchi. Crepitation (imitated by rubbing a lock of hair be- tween the fingers near the ear)—pneumonia in stage of engorgement and of resolution. SYMPTOMATOLOGY. 225 Subcrepitant (more moist than last)—in capillary bronchitis, pneumonia at resolution, pulmonary apoplexy, codema of lung. Mucous—bubbling through liquid in bronchi of large size. Cavernous or gurgling—same as last, but in the pul- monary excavation, Friction sound—from diseased pleura. Diminished vocal resonance—in vesicular emphy- sema, pneumothorax. Exaggerated vocal resonance, or bronchophony—tu- bercle, pneumonia in stage of hepatization. Aigophony (nasal tone like a bleat of a goat)—pleu- ritic effusion. Pectoriloquy (resonance, as in a hollow, and trans- mitted in articulate words)—tubercular caverns, and dilated bronchi. Metallic, tinkling sound (imitated by striking gently a hollow glass vessel with a pin)—in pneumo-hy- drothorax, with bronchial fistula, in some excava- tions of the lungs. ; ° 3. Circulatory Functions. I. AUSCULTATION OF THE HART. a. Its Impulse. (Is correspondent with the pulse at the wrist, unless mechanical impediments exist.) Strong—in fevers and inflammations. Small vibratile—after hemorrhage, in anzmia, &c. Full, strong, heaving, and somewhat diffused—hyper- trophy. Still more powerful, felt over the whole precordial region—hypertrophy with dilatation. Feeble and diffused—ventricular dilatation. 226 SYMPTOMATOLOGY. Sharp, concentrated—in anzmic or nervous persons, atrophy of the muscular walls of the heart with fatty degeneration. Visible at scrobiculus cordis—obstruction anterior to tricuspid valve. Visible at scrobiculus cordis, as well as between the ribs of left side—disease of mitral valve. b. Its Rhythm. (The natural rhythm is a long sound, a short sound, and an interval.) Altered rhythm—most frequent cause is valvular change, dilatation of heart and atrophy of walls of ventricles, effusions into the pericardium. c. Its Sound. (Natural sound represented by lub-tub-lub-tub.) Louder and clearer—dilatation of the cavities, with thinning of the walls, without valvular disease. Clearer, but not louder—muscular atrophy of the parietes. Decreased sounds—impeded action, hypertrophy. (Unnatural sounds, or murmurs.) Endo-cardial, (or blowing murmurs, bellows murmur, rasping murmur, filing murmur, musical murmur)— indicative of valvular lesions, of diseased blood, as anemia, of nervous disease of heart. Exocardial (rubbing murmur and its varieties)—peri-° carditis, from the attrition of roughened surfaces. II. CHARACTER OF THE PULSE. a. As to its Force and Intensity. Strong resists compression by the finger. In inflam- matory affections, especially of the parenchyma of the solid viscera, as lungs and liver, in the active SYMPTOMATOLOGY. 227 hemorrhages. In plethoric and strong individuals, any derangement of circulation will cause it. Weak (easily compressible)—disease with prostration, nervous and chronic affections, especially when caused by perverted nutrition, produced by fear, diseases of old men, women, and children. Full, volume of artery seems increased—natural pulse of plethoric and tall persons, diseases with strong pulse, cerebral congestion and apoplexy, cardiac disease. Small, opposite of full—often from narrowing of aortic orifice, in the serous phlegmasiz, as_ peritonitis, pericarditis, inflammations of stomach, intestines, bladder, &c., in hysteria, hypochondriasis, and other nervous affections, in chlorosis, in cold stage of fevers, diseases with violent paroxysms of pain, a symptom of adynamic and ataxic diseases, and of purulent resorption. Corded (hard, sharp, or contracted, giving a vibra- tory sensation to the fingers)—in the membranous phlegmasie, sanguine congestions, active hemor- thages, neurosis, lead colic, &c. Soft (compressible or liquid, yields readily to pres- sure)—in adynamic affections. b. As to its Rhythm. Frequent—febrile and inflammatory disease, hemor- rhages, &c. Slow or infrequent—apoplexy, acute tubercular men- ingitis, some adynamic affections, sometimes in dis- eases of heart. Unequal (dicrotous or double in beat)—convalescence. 4. Function of Digestion. Tongue diminished in size (generally also trembling and dry)—typhus and other low fevers. 228 SYMPTOMATOLOGY. ‘Tongue coated, &c.—Dr. Louis’ observations indicate that the tongue does not show the true state of the stomach. This is a subject worthy of further in- vestigation. Appetite voracious—pregnancy, hysteria, and insanity. Appetite diminished—most acute diseases. Thirst increased—acute affections, especially of stom- ach and bowels—after hemorrhage, in diabetes. Thirst abolished—some cerebral diseases with coma. Vomiting—beginning of acute inflammatory and fe- brile affections, early pregnancy, in colic, cerebral diseases, hernia. Pain aggravated by pressure—inflammation of vis- cera, peritonitis. Pain relieved by pressure—overdistention, neuralgia, colic. Tormina—acute colic. Tenesmus—in‘dysentery. Feeces watery—serous diarrhea, Asiatic cholera. Feces mucous (like white of egg)—-chronic inflam- mation of the colon. Feces hard and scybalous—constipation, colic, cancer of stomach, &c. Feces clay color—deficiency of bile. Feces yellow or dark brown—excess of bile. Feces dark green——from bile, after calomel in children. Feeces red or streaked with blood—dysentery, when the blood is dark, and, mixed with the feces, it is ‘ usually from the upper part of intestinal canal. Feces pitchy black—-melena. Feces pure blood, unattended with colic-—-hemor- rhoids. Feces semi-transparent and colorless, with whitish clots (like rice-water or turbid whey)—Asiatic cholera. Feeces black—from iron as medicine. SYMPTOMATOLOGY. 229 Feces with shreds of false membrane—dysentery and diarrhcea, biliary or intestinal calculi, worms, &c. Feces with fat—diabetes, phthisis. Feces fetid—adynamic diseases. 5. Urinary Secretion. Suppression or diminution—most inflammatory and febrile diseases, dropsy. Retention in the bladder—from paralysis, typhoid fever, hysteria, &c. Increased amount—diabetes, cold stage of fevers, hys- teria, from various passions of the mind. - Urine darker than usual in inflammatory affections ; if much blood is abstracted during their progress, it becomes clearer; at the height of the inflamma- tion it is clear and deeply colored; when it sub- sides, there is a yellow or reddish sediment of uric acid and urates. Deposits of uric acid (red or yellow sand sediments)— fever, acute inflammation, rheumatism, phthisis, all the grades of dyspepsia, diseases attended with arrest of perspiration, diseases of genital apparatus, from blows and strains of the loins, excessive in- dulgence in animal food, too little exercise. Deposits of earthy phosphates (white sediment)—in- dicate a depressed state of the nervous energy of serious importance. Deposits of oxalate of lime—digestive derangement. Urine containing blood—hemorrhage of kidneys or urinary tract. Albuminous urine—Bright’s disease, dropsy after scar- latina, &c. Mucous urine—irritated or inflamed state of genito- urinary mucous membrane. Sugar in urine—dyspepsia; when excessive, diabetes mellitus. 20 230 SYMPTOMATOLOGY. 6. Perspiration. Profuse—acute rheumatism, decline of acute inflam- mations and fevers (the latter often critical). Diminished—early stage of acute disease, dropsy, dia- betes. Night sweats—phthisis (profuse, debilitating). Excessive acid odor—(rheumatism, gout). Odor fetid—some adynamic fevers. Odor mouldy—measles, scarlet fever. Odor ammoniacal—sometimes in typhoid fever. Odor peculiar in insanity. Odor of chlorine or rotten-stone—miliary. 7. Animal Heat. General heat of surface—in fevers. External local heat—in inflammation. Forehead hot—cephalalgia, Scalp hot—cerebral disease. Integument of chest hot—thoracic inflammation. Hands and feet hot—pbhthisis. Peculiar acrid heat (burning the applied hand)—in typhus fever. Chill—initial of fever, and of the phlegmasiz, particu- larly pneumonia. Temperature generally low—from languid circulation. Coldness of hands and feet—in nervous and anzmic persons. 231 IX. OUTLINES OF GENERAL PATHOLOGY AND THERAPEUTICS. A. PRIMARY ELEMENTS OF DISEASE. I. Properties of Contractile arse Fiber. 1 ad. IRRITABILITY. Excessive. Seen in excessive strength, as in deli- rium; or in quickness, as in convulsions or clonic spasm; or in unusual duration, in tonic spasm (cramp, catalepsy, and tetanus). Aemedies.—If from flow of blood, antiphlogistic ; firm pressure on mus- _ cles in cramp (masseter muscle in trismus). If from — b nervous irritation, narcotics and antispasmodics, especially stramonium, belladonna, sulphuric ether, and Indian hemp. . Defective. In force (weakness and paralysis) or in readiness to contract (as from opium, digitalis, &c., and some cerebral diseases). Remedies.—Repose, if from exhaustion; stimulants, as ammonia, bran- dy, &c., (often large quantities), electricity, cold water dash; strychnia and cantharides in paralysis (endermic application best). b. TONICITY. (Cold increases tonicity and impairs irritability. ) . Excessive. Remedies.—Antimony, &c., to relax the fiber. . Defective. Remedies.—Tonics, especially cold, Pe- ruvian bark, iron, the mineral acids, and generous living. >» . 232 PATHOLOGY AND THERAPEUTICS. LI. Properties of Nerves. ad. SENSIBILITY (GENERAL). 1. Hxcess. Narcotics mostly required, as opium, hen- bane, hemlock, &c. If vascular excitement, anti- phlogistic treatment; with weakness, slow pulse, and absence of fever, tonics and stimulants as well as narcotics required. (Inhalation of ether the most powerful anodyne.) 2. Defective (as in coma, &c.). Sometimes depletion ; if no disease, mental excitement, bodily exertion, the cold dash, and friction; from narcotics and re- tained excrement: use purgatives, diuretics, emetics, &c. If anemia, stimulants. 3. Perverted Sensibility (illusory or depraved sensa- tions). Chalybeates, &c.; narcotics, &., as palli- atives. 5. LOCAL SENSIBILITY. 1. Excessive (from disease, &c., as the pain of pleurisy, &c.). If from inflammation, antiphlogistics; if re- maining after inflammation, anodynes (endermic application of morphia often useful; remove the cuticle by a blister, and apply one or two grains of a soluble salt of morphia; as the acetate or hydro- chlorate ; repeat once or twice daily, and keep the surface moist); counter-irritation and warmth (as gastrodynia relieved by a sinapism at the pit of the stomach). In a weak circulation, especially if the pain be intermittent, tonics are useful (as neuralgia treated with quinine, and iron; hemicrania with quinine, or liquor arsenicalis). C. VOLUNTARY MOTION. 1. Excessive. Depletion, antimonials, cold to the head, PATHOLOGY AND THERAPEUTICS, 233 if determination of blood. If more nervous, nar- cotics. 2. Defective. Excite the nervous centers through the circulation, as by stimulants, &c. (Hysterical coma often removed by a turpentine injection, or croton oil purge, which acts both as a revulsive to the vessels, and a stimulant to the nerves.) 3. Perverted Volition. Treatment various; in delir- ium tremens by narcotics, as opium; in chorea, by nervous tonics, especially iron and zinc. d. REFLEX ACTION. Connected with organic life. The contractions of all the sphincters, and the regular action of the muscles of respiration depend on it. (A nervous influence, independent of the will conveyed by af- ferent nerves from the surface to the spinal marrow, and reflected from it through efferent nerves to the muscles of the parts.) 1. Hxcess. Seen in spasm of throat in hydropho- bia, tetanus, hysteria, &c.; in convulsive motions of lower limbs when tickled, &c., in paraplegia, &c. Also in epileptic and apoplectic convulsions, which are centric when resulting from diseases in the head or loss of blood; or eccentric when from irri- tation of the extremities of afferent nerves; as from teething, intestinal, uterine, and renal irritation, passing a bougie, sometimes, &c.; also in partial spasms and sympathetic irritation of distant parts. If these inordinate reflex actions are general or extensive, as convulsions, tetanus, and paraplegia, we refer them to undue excitement, or erethism of the spinal marrow; the more partial examples (sym- pathetic irritation, &c.) may arise from a small por- tion of it only, or of the afferent or efferent nerve of the part. Increased flow of blood to the medulla, 20* 234. PATHOLOGY AND THERAPEUTICS. or its nerves, or the branches of the sympathetic nerve; the direct action of poisons, as strychnia ; mechanical irritation on the spinal marrow, or its nerves (as in tetanus, tumors, and spicula of bone in spinal canal, &c.), may cause this excitement. The involuntary excito-motory property is also ac- cumulated by rest and sleep. Hence narcotism, in- jury of the spine, sedentary habits, too much sleep, &c., by suspending volition, may cause a morbid excess of involuntary nervous power and develop convulsive and spasmodic symptoms, which are the result of its overflow. Remedies.—Often antiphlogistic, because often de- pendent on determination of blood. If more purely nervous, as tetanus, &c., a narcotic used (hydrocy- anic acid, woorara, resin of Indian hemp, conium, &c., reduce the power of the spinal system, and cause general relaxation of muscles, but they may destroy life by arresting respiration; useful, however, in small doses in slighter irritations, as vomiting, nerv- ous palpitation, and hiccough.) Extract of bella- donna and stramonium, useful in convulsive cough and spasmodic asthma, and combined with opium in the spasms of colic, dysentery, and dysuria. In weak subjects, without inflammation, medi- cines which act as stimulants to the heart, and ves- sels, and cerebral functions, and also as sedatives to the medullary system (the stimulant antispas- modics, as ether, ammonia, musk, essential oils, ex- ternal heat and counter-irritation, &c.). Tonics also reduce the excitability of the spinal excito-motory system, especially metallic tonics, as iron, nitrate of . silver, sulphate and oxide of zinc, and sulphate of copper, cold baths, change of air, and exercise useful. »,” Defective reflex actions ; seen in paralysis of sphinc- ‘ PATHOLOGY AND THERAPEUTICS. 235 ters, eyelids, and muscles of respiration; and ex- treme debility from fatigue, excitement, or directly depressing influences. Remedies.—Stimulants, narcotics, tonics (indis- criminate use of narcotics, hazardous in extreme weakness) ; should be preceded or combined with stimulants; those least depressing to be preferred, as opium; give suitable nourishment also in liquid form. é. REFLECTED (OR SYMPATHETIC) SENSATION. Reflex action referred to motion, but the impressions which cause sensation may be reflected in a similar manner: thus, ascarides in the rectum cause itching of the anus, congestion of the liver, often a pain in the right shoulder-blade, and the pains of angina and gastrodynia often extend to the whole chest; the former especially radiates to the left arm. Remedies.—1st. Those that remove the irritating cause. 2. Anodynes, by deadening sensibility (the efficacy of trisnitrate of bismuth and hydrocyanic acid in gastrodynia, and some kinds of angina, not referable to a narcotic property). Tonics are often useful, as morbid sympathies, like other nervous disorders, are exalted by weakness or irregularity of the circulation. III. Properties of Secretion. Excessive Secretion weakens, from the drain it causes from the blood. Its effects may be forward on the parts to which the secretion goes, or backward on the organ which secretes it and the blood from which it is formed. (Forward effects of excessive secretion of bile seen in bilious diarrhoea or cholera; of profuse mu- 236 PATHOLOGY AND THERAPEUTICS. cous secretion in the intestines in simple diarrhea ; in the bronchi in dyspncea and cough; in the stom- ach, seen in pyrosis or water-brash, &c. Backward effects seen in torpid bowels after diarrhcea. ) Remedies.—If dependent on the quantity and qual- ity of the blood, depletion, derivation, and evacu- ants. (The excessive secretion then a means of relief, and arrested by increasing it, as a purge of calomel will stop a bilious diarrhcea, from an en- gorged liver.) If from nervous or other irritation, causing weakness and disturbance of the functions, it may be checked by tonics and astringents (as cold to the part, alum, superacetate of lead, sul- phates of zinc and copper, gallic acid and tannin, vegetables which contain tannin, &c., mineral acids, &c. These act by direct application, as in diarrhea or leucorrheea, or through the circulation. Some agents, without a general astringent effect, diminish the secretion of particular organs, as opium, which remarkably lessens the secretion of the liver, and sometimes that of the kidneys). If excessive secretion have caused febrile disturb- ance, means to increase other secretions may restore a proper balance. Thus, in bilious cholera, saline diuretics and diaphoretics are serviceable; in renal irritation, with copious secretion of lithic acid, blue pill to augment the bile is often beneficial (combi- nations of medicines more useful in any disturbance of secretion, especially if long continued, as mercu- rials with diuretics, antimonials with salines, &c.). 2. Defective. May cause general plethora, or local congestions, leading to dropsical effusions, fluxes, hemorrhages, or inflammations. Forward effects instanced in disorder in the latter stages of diges- < tion, from deficiency of bile. Backward effects often ». ada in congestion of the organ; and very remarka- PATHOLOGY AND THERAPEUTICS. 237 bly in the case of the excretions, as urine and bile, which poison the blood when retained, causing ty- phoid symptoms, extreme depression, coma, and death. Ifthe suppression be incomplete in the lat- ter instances, the poisoning process is more tardy, producing various functional and visceral derange- ment, as delirium, or lethargy, dyspnoea, palpitation, vomiting, diarrhoea, &c. (The excrementitious mat- ters may then be detected in the blood, and other parts of the body; as the color of bile in the text- ures in jaundice; urea in the blood, &c., in gland- ular degeneration of the kidneys, &c. Gout, rheu- matism, degeneration, dropsies, &c., are often caused by various degrees of defective excretion.) Remedies —If from defective supply of blood, stimulants, &c.; if from inflammation or conges- | tion, depletion or derivation. Often the first dis- order is in the secreting structure itself, and the remedy must be those agents which increase the respective secretions; as mercury for the liver; col- chicum, niter, &c., for the kidneys; croton oil, jalap, sulphate of magnesia, &c., for the intestines, &c. (These specific stimuli in excess, or too long con- tinued, may cause not only general weakness, but also an exhaustion of the vital properties which they excite; as long or excessive use of mercury causes torpidity of the liver; of purgatives, imper- fect action of bowels; of diuretics, scanty, albu- minous, or watery urine;—hence they should be intermitted and alternated with tonics, as bitters with mercurials; chalybeates with saline aperients and diuretics.) In chronic cases, medicines which are inferior in efficacy to be preferred, because less exhausting—(examples: taraxacum, iodine, sarsa- parilla, nitric and nitro-muriatic acids). Where defective secretions are not readily restored, they 238 PATHOLOGY AND THERAPEUTICS. may sometimes be compensated for by artificial substitutes. Thus ox-gall, aloes, and soap, or toasted bacon at breakfast promotes the action of the intestines, in defective secretion of bile; and defective secretion of mucus may be remedied by mucilage, &c. 3. Perverted Secretion often accompanies excess and defect. In febrile diseases, the secretions of the kidneys and the alimentary canal are altered as well as diminished; inflammation and determina- tion of blood change as well as increase the secre- tion from mucous membranes, rendering it more saline and sometimes albuminous, &c. Altered se- cretion may be unfit for use; as a thin, acrid mucus irritates instead of protecting the membrane, as in coryza and mucous diarrhoea; viscid, dry mucus obstructs the tubes; altered gastric juice causes in- digestion; sebaceous matter accumulating in the follicles of the skin causes irritation, inflamma- tion, &c. Remedies.—Usually those which increase secre- tion. In some cases tonics may be advantageously combined with them. Such a combination is pre- sented in most of those remedies called alteratives. IV. Constituents of the Blood. The principal constituents of the blood, necessary to be mentioned here, are the red particles, fibrin, and albumen, either in excess, defect, or alteration. The other constituents of the blood are oil, salts, and water. In malignant cholera, the defect of saline matter and water, owing to the excessive evacua- tions, seems to be the cause of the obstructed cir- culation, lividity, and collapse, and hence the tem- porary efficacy of injection, of saline solutions into \. the veins of such patients. PATHOLOGY AND THERAPUETICS. 239 a. RED PARTICLES. The red particles of the blood are distinct structures— living cells, floating in the liquor sanguinis; they have a tendency to cohere in piles or roleaus in fresh-drawn blood, and this tendency is strongest in blood taken from a person affected with inflam- mation. . 1. Hxcess. Seen in sanguineous plethora. A slight increase has been detected in the early stage of in- flammations and fevers, especially eruptive fevers, as measles and scarlatina. Remedies.—Blood-letting the speediest agent. Low or vegetable diet and the antiphlogistic regimen generally : saline medicines, much diluted and taken copiously, have a remarkable effect. © 2. Defect. Seen in the lymphatic temperament, also after a great loss of blood, in chlorosis and other ansemic states, in scrofulous and tubercular dis- eases, in the latter periods of fevers, and after severe inflammations, in granular degeneration of the kidney, &c., &. Known by paleness of parts natu- rally red, pallid or sallow complexion, a weak state of the functions generally. Remedies.— Air; light nourishing food, especially brown meats; tonics, particularly iron (Quevenne’s metallic iron, Merrum per Hydrogen). 3. Alteration. Of the red particles is evinced by change of color in the blood, and change of form in the in- dividual corpuscles, as seen by the microscope. Seen in scurvy; in the Walcheren and other malignant fevers, in cachemia, from malarious in- fluence, generally in connection with a diseased spleen ; in congestive typhoid fevers, &c. Remedies.—Saline medicines have been recom- mended in typhoid and malignant fevers; but reme- dies to increase the excretions in connection with 240 PATHOLOGY AND THERAPEUTICS. those mentioned under the last head, are less questionable; in malarious and anemic cachzemia ; the use of purgatives and diuretics, combined with chalybeate tonics, has produced the best effects. b. FIBRIN. But little difference between fibrin and albumen, in chemical composition, yet fibrin is distinguished by its being organizable or susceptible of life. It causes the coagulation of the blood; it constitutes the buffy coat and coagulable lymph } and is prob- ably the material by which chiefly the textures are nourished and repaired. 1, Hxcess. In all true inflammatory diseases, especiaily those of a sthenic character, and in acute rheuma- tism. There is a relative excess also in diseases connected with a deficiency of red particles. Remedies.—Blood-letting and low diet; yet fibrin is less reduced by them than excess of red particles. Remedies which increase the more solid secretions probably diminish the fibrin. 2. Defect. Seen in fluidity, or but slight coagulation of blood when drawn, or in asthenic tendency to hemorrhage, and unmanageable oozing of blood from an accidental wound, &c., in cases of poisoning with hydrocyanic acid, &c., in adynamic fevers, &c., in cases of asphyxia, cyanosis, &c. Remedies.— Assist the functions on which the sup- ply of fibrin depends. If the digestive organs will bear them, meat, eggs, bread and other articles abounding in protein: assist digestion and assimi- lation by stimulants, bitters, quinine, and the min- eral acids; help respiration by the access of pure, cool air; avoid fatigue; secure sleep, if necessary, by narcotics; toxicological means, of course, if called for. PATHOLOGY AND THERAPEUTICS. 241 3. Alterations. Seen in the varieties presented by the buffy coat, and contractions of the clot of blood. Also in the varieties of the reparative process. False membrane, deposits, &c., in a healthy subject, may be euplastic, or in a high degree organized and healthy. But in many instances the nutritive ma- terial is caco-plastic, or susceptible of only a low degree of organization, as in induration, from chro- nic inflammation, in fibro-cartilage, cirrhosis, gray tubercle, &c. It may also be aplastic, or not or- ganizable at all, as in pus, curdy matter, yellow tubercle, &c. Remedies.—The increased properties of separation and contraction manifested by blood in inflamma- tion, are reduced by blood-letting, &c. Yet if anti- phlogistic remedies do not remove localinflammation, they may render its product more injurious by lowering its plasticity. Hence the necessity of en- deavoring to remove inflammation before they be- come chronic, and when there is risk of such event, improving the condition of the blood by a tonic and nutritive plan, conjoined with local antiphlogistic measures. A similar tonic treatment is indicated in scrofulous, chlorotic, and other cachectic states, where the fibrin is relatively copious with a ten- dency to aplastic deposits. In addition, remedies likely to keep the fibrin dissolved, as alkalies, and iodide of potassium, are advisable, although the efficacy of these means has not been fully proved. c. ALBUMEN. 1. Excess. Exists in most cases of inflammations, and fevers, especially during their more active stages. Its increase is not, however, in proportion to that of fibrin. Its_excess in cholera is due to the removal 21 242 PATHOLOGY AND THERAPEUTICS. of the water of the blood. Very poor living, exten- sive hemorrhage, and other drains will reduce it. 2. Defect. Met with in cases of albuminuria, and in diabetes: it seems to be a chief constituent of the dropsical diathesis. Remedies—Those which restrain wasting dis- charges and improve general nutrition. Cod-liver oil recommended for the last purpose. V. Changes in the Blood by Respiration. The change of venous into arterial blood is never in excess, for the activity of the respiration is adapted to the rapidity of the circulation, and the correspond- ing need of change. Defect of the change is the essence of asphyxia or apnoea. ; Remedies.—Rest, fresh air and sedative medicines (as digitalis, hyoscyamus, &c.), or antispasmodics. Sometimes an enfeebled circulation may require stimulants, or an engorged venous system calls for depletion. In suspended animation from drowning, &c., artificial respiration, frictions, the warm bath, stimulants, &c. VI. Changes in the Blood by Excretion. See Sect. III. Property of Secretion. Other changes may be produced in the blood from the transformation of the chyle and or the textures, in- cluding the processes of nutrition and reparation (probably the cause of gout, diabetes, and obesity). The presence of foreign matters in the blood, also, may excite various contagious epidemic or endemic diseases ; but too little is yet ascertained to supply any certain knowledge. PATHOLOGY AND THERAPEUTICS. 243 b, PROXIMATE OR SECONDARY ELEMENTS OF DISEASE, I, Anemia. The exciting causes of anemia are circumstances which injure or withdraw the blood; profuse dis- charges of other fluids; scanty or poor food; im- pure air; chronic diseases, and uterine irregularity, as chlorosis. The general symptoms are weakness, both muscular and organic; defective nutrition; and imperfect sanguification; the nervous system is also fre- quently excited. ftemedies.—(See A, Section IV.) Those which in- crease the constituents of the blood. II. Hyperemia, or Excess of Blood. This may be general (plethora), with increased motion (sthenic), or with diminished motion (asthenic) ; or it may be local, with diminished motion (conges- tion), or with increased motion (determination of blood). The results of these may be hemorrhage, flux, dropsy, &c. Another variety of hyperemia may be distinguished by an altered or perverted action of the vessels. This is chiefly local, and in- cludes inflammation. Remedies.—For plethora, blood-letting and other evacuants. In the sthenic kind, sedative and relax- ing remedies are also indicated, but in the asthenic, tonics, and even stimulants; or alterative aperients as mild mercurials, with rhubarb, aloes, or senna, salines, and taraxacum, iodide of potassium, &c., may prepare the way for various tonics. For congestion, the most important means are those which contribute to a removal of its cause, as the loosening of a ligature, reduction of a compressing tumor, moderating the action of a diseased heart, or restoring the secretion of the liver, &. In con- 244 PATHOLOGY AND THERAPEUTICS. gestion from atony of the vessels, a change of pos- ture sometimes gives relief, as in congestive fevers, when the head is affected, it should be elevated ; congested uterine, or hemorrhoidal, vessels, and varicose limbs, are assisted by the recumbent pos- ture. Pressure, as by bandages, &c., is also useful at times. Astringents are sometimes useful by in- creasing the contractility of the vessels. Stimulants also are often very effective, as diluted spirit lotion to a congested conjunctiva, capsicum gargle to a congested throat, or a stimulant wash to a purple sore, &c. For determination of blood, the removal of stimuli or irritants from the part, or the reduction of their ac- tion by soothing or diluent remedies, is the first in- dication. The atonic distention of the arteries sup- plying the part may be relieved by cold, astringents, and derivants; as cold lotions to the head, and the hot foot-bath in determination to the head. Evacu- ants, also, and frequently blood-letting, are indi- cated as derivants. Inflammation.—In incipient inflammation, for the con- gestion, aStringents, stimulants, or evacuants may be useful. For the irritation of the nerves and vessels, sedatives, derivatives, and evacuants. In local inflammation, the remedies for congestion and determination are applicable. For impeded circu- lation in a part, moist heat, and other stimulants; but, for increased circulation, the remedies for de- termination. In inflammation with fever, general blood-letting and other evacuants are called for; relaxants, as antimony, &c.; low diet, &c. (A remarkable fact has been discovered by Dr. Mar- shall Hall, viz., that in inflammatory diseases a much larger quantity of blood may be drawn without producing syncope, than can be taken in health, or PATHOLOGY AND THERAPEUTICS. 245 in other diseases.) He says: “In cases in which it is doubtful whether the pain or other local affection be the effect of inflammation or of irritation, the question is immediately determined by placing the patient upright, and looking upward, and bleeding to incipient syncope. In inflammation much blood flows ; in irritation very little.” This he considers a rule for blood-letting, a guard against undue and inefficient blood-letting, and a “ source of diagnosis, in the fullest sense of the word.” The following table shows the results of his investi- gations, as to the tolerance of blood-letting in differ- ent diseases, before incipient syncope. I, AUGMENTED TOLERANCE. 1. Congestion of the brain, 3 xI-l. 2. Inflammation of serous, synovial, and fibrous mem- branes, 3xxx-xl. 3. Inflammation of the parenchyma of organs (brain, lung, liver, mamma, &c.), Zxxx. 4. Inflammation of the skin and mucous membranes (erysipelas, bronchitis, dysentery), 3xvj. II. HEALTHY TOLERANCE. This depends on the age, sex, strength, &c., and on the thickness of the parietes of the heart; and is about Zxv. III. DIMINISHED TOLERANCE. . Fevers and eruptive fevers, 3 xj-xiv. . Delirium tremens and puerperal delirium, 3 x—xij. . Laceration or concussion of the brain. Accidents before the establishment of inflammation. Intestinal irritation, 3 viij—x. . Dyspepsia, chlorosis, 3 viij. . Cholera, Z vj. Soi wet Ot 21* 246 PATHOLOGY AND THERAPEUTICS. The exhaustion from long-continued inflammation often renders stimulants and tonics necessary; as also the depression arising from the influence of purulent or gangrenous matter. The effused pro- ducts of inflammation require evacuants, attenuants, alteratives, stimulants, friction, &c. Varieties of Inflammation.—The sthenic form requires of course all the antiphlogistic measures, but in the asthenic form, local blood-letting is better than general, which is illy borne. Antimony or mercury, and blisters, form the chief treatment. The diet, though light, should not be too spare. Erysipelatous inflammation is generally asthenic, and often requires stimulant and tonicagents. The local treatment consists of punctures and incisions; cauterization by nitrate of silver; and mercurial ointment, which is supposed to modify the character of the poison. A solution of sulphate of iron in water, one ounce to a pint of: water, applied to the part by moistened rags, acts like a charm. The aphthous inflammation of children is to be treated by aperients, with a local application of borax, ora weak solution of sulphate of zinc. Scrofulous inflammation owes its peculiarity to a de- graded condition of the plasma, or nutritive material of the blood; and hence it is most benefited by tonics, nourishing diet, &c. Cod-liver oil, iodide of potassium, &c., are medicines in repute. Rheumatic and gouty inflammation require means to eliminate the morbid matter from the system, as mercury and colchicum. Active antiphlogistic mea- sures are often necessary, however, before these medicines will act. Gonorrhceal inflammation requires mild antiphlogistic and demulcent measures at first, and astringent in- jections and terebinthinate remedies afterward. Mercury is the chief specific in syphilis. PATHOLOGY AND THERAPEUTICS. 247 c. STRUCTURAL DISEASE. Ineluding increased nutrition (hypertrophy), dimin- ished nutrition (atrophy), and perverted nutrition, would open a field too extensive for a table like the present. It pertains, too, rather to the department of morbid anatomy than to pathology proper. (See A, Section IV.) MODES OF DEATH. I. Beginning at the heart. 1. Suddenly (syncope). This is instantaneous; the subject suddenly turning pale, falling back, or dropping down, and expiring with one gasp. 2. Gradually (asthenia). The symptoms are,—in- creasing weakness of, body and mind, with perhaps no marked derangement in any particular function ; increased frequency, and diminishing strength of the pulse; the face, lips, &c., becoming paler and paler, or of a peculiar sallowness; extremities be- come cold and cedematous; tongue often dry and brown, or furred, and the mouth aphthous; excre- tions imperfectly voided at first, then the sphincters lose their power, and the discharges are involun- tary ; general sinking. II. Beginning at the breathing apparatus (asphyxia or apnoea). Symptoms: increased feeling of suffocation ; face, neck, &c., congested, and changing from red to purple, and from purple to livid; stupor; reduc- tion of temperature; weak and irregular pulse ; rapid reduction of muscular strength. III. Beginning at the brain (coma). Its symptoms are those of interrupted function of the brain, in- sensibility, and suspension of voluntary motion, the heart’s action not being materially impaired. The excito-motory system of the medulla is often affected, as well as the sensorial and voluntary 248. PATHOLOGY AND THERAPEUTICS. functions: hence respiration is interrupted, convul- sions sometimes. ensue, and the sphincters are re- laxed. IV. Beginning at the medulla (paralysis). This mode, - like that of the last, is really by apnoea, but the ex- cito-motory function is the first to fail.. Of course there can be no respiration when. this ceases. V. Beginning with the blood (necremia). The symp- toms are typhoid, putrid, or malignant ; a congested surface, the color being dusky or livid; exanthe- matous patches on the skin, or petechie ; ecchymo- ses, or oozing of thin, bloody fluid from the gums, nostrils, &c.; extreme prostration; obtuse senses and mental faculties; sometimes with delirium and twitching of the limbs; half-closed eyes and dilated pupils; frequent and unequal respiration; no ap- petite; intense thirst; a dry, brown tongue with dark sordes on the lips and teeth; progressive fall of temperature ; cold, clammy, and fetid perspiration ; hiccough; subsultus tendinum; scanty, offensive urine; involuntary discharges. INDEX. A. Abbreviations .....0...+6. Abdominal symptoms..... Absinthium ......... ARBOR IN CHELU Os alee aiacs Bialels Chioridl. Gi ...0 cweacen 741 Calcis carbonas precipi- CAEUS 1c a a ctcracioia cer ctaye eas Calendula officinalis...... 41 Calomel....... ete algal 83 Calx ehlorinath.. ys cies: 41 CaMpnor iin Succes cece ca ek ~ WAteL,.cccccccvescene 35 Gam plore sc sice cost seere cay aL Geno las asic’ erence ous 0 cre crew eees WANtNAPIS 2. psisccoseasvaae anes CADSICUIN 5). Soaaseee aoe COcHINGAL:. cescs s ..s cicokinels 50 Cochlearia officinalis... Ai ae) Co Hee ee Ce tistec a os sl Oe COnGSIe ovee co ans bc asee se hee Colehieuin ccs cessacren, OU COLIMSOMT OS clas epee sO Conodhim esas ce Cake ee) DE Colocynthisise esol seca. = OL Colombo n eS ses wees es crete Ok Colishhot cee bs oc cre ae cee 172 Columbine ............0-. 35 COMITGY. <6 cae ca secede soe bom Compound lead cerate..... 46 TEsiN’ CEPAte [0's eee se), 40 spirit of ether........ 147 Common mallow ......... 108 Comptonia asplenifolia.... 61 Concentrated or resinoid bxtracts 0s... eas 208 Confectio aromatica....... 61 MOVANT Le ee cate ies MO GABBI iis c's oie cle tiaisie cicte emcee Of Orange...c..sceeee-. 92 OL LOSES... a Ncie Bin-cbleis ei Om OPW cow cacccs cece emae rose gallicze.......... 62 GTITEC toate sed as cant hone COMICOLION wo vc ces we cee pec nOo OMIM hc wee ae case cee PROD Contrayerva.......0...... 54 _ Convallaria multifiora..... 54 Convolvulus panduratus.. 654 Copaiba.. ci. cvevvecsseee 54 INDEX. Copper’ cess reapers veces +) la (SOPUIB . chess semieeicee Riewes 2-04: WOTIANIOL. . semaleecaneesioe U0 COriandf aM. 2... .telewesds. US Cornus Florida ....... We 23) Corrosive sublimate..;.... 83 Corydalis formosa........ 55 Corylus rostrata .......... 55 MOTTON cis bso 's = xo ware eeeels 80 WOU ce dices secies e's 2 a eeKtOD AUC EATS SE ae PDs 222 Counter-irritants.......... 15 GOWDARE.. 60 seeasccle SEARS 114 rane se bills Peo c sic ce < sje 79 CTERSOG sce tccceecees cas lds OD Creasotum........- Facials si eo Creta preparata.......... 55 GCTOCUB.., coils aus arate ee a00 CHDEDR ois oats eidolere etalon EO: Cucurbitay citrullus........ 56 Culver’s physic........... 98 Cunilla mariana... «see. OO CUPTHACGtas... sacs. cniseiese pad, BUIPHAG.L San cee ne Fee RO Cuprum ammoniatum..... 57 CUTLcuimt. ce eeaiedee se OL CUBDATIA RR ontecsn ase hee nLoo Cyano-hydric acid........ 24 Cyanuret of silver........ 36 CYAOdININ ence cqeesin eas aa 01. Cypripedium,............. 58 D. DanGOMOUs selecsse esc see shod PPO TGHS. watuenerste.a/eiiieta ais = 0's 57 Deadly nightshade. cecoers 40 Decoctionaloescompositum 58 calumbs compositum. 658 Decoctions......... Pole e Wetepeu Decoctum cetrariz........ 59 chimaphile..... woeeee , 09 cinichons........ Mest ae cornus Floride....... 59 POLCHMATB Ties eee 60 RLANAL Ge wale dys os alcles San UU, hmatoxyli.s.. 2.” 60 HOLA on be eee cecae Gis INDEX. Decoctum quercus........ 61 sarzx compositum.... 61 SCUCL RH Joatalcielsias os telus, GF SCI 235. eam sina es. OC TATaAX 2Cl aera wie- eels « s WV USL. eee sce siete « ~ 62 Decubitus of patient...... Defect of albumen........ TOV oe nates a ore le statis of red particles. ...... Defective irritability...... 23 Telex ACHON. . ss eae soe SECEOUMOWea'aiee a 2 0 vcincie,s BETMSDOLLLL Vin ois wisisieieie’ ass GOULCULY,'c.40\<14:4 siane'vie' azis voluntary motion..... Doliriantsy shisie «es 90 nates Derangement of sensation. voluntary motion..... Derangements of animal HOAts Aeiee'c area tres diag 200 digestion.......... Ae, intellect. eee. 5 a perspiration .....,..0. reflex system... respiration..,......0.. 221 urinary secretion ..... eee eereees Dewberry root..........+- 138 Diaphoretics ..... S wapaier eo Digitalis... .<- sek esa na dete Oe ITU cle brershale e.g b 6 cise si siniaie einer Dilute acetic acid......... 23 hydrochloric acid,.... 24 hydrocyanic acid...... 24 WICLIC ACA Sew a's ea os 5 ol a Sulphuric acids:.225.. | 27 ILOSCOLES... acescee ee Tele ta eh Oe DIOSUA./. « sinaseoesen'ees pear a DTOSPYFOHs. © cle 0.5.01 waseiae lt AO Distilled vinegar.......... 21 DDG at o/rg aecigietomssmae STOO Diuretics...... 51+) Ca EEL 19 AUC TOOUsasmeete vines ese. LAO DOGWOOG sencicedesiocesis sas 54 Dog’s bane...... Reis aisle een one Dog’s tooth violet......... 68 Domestic measures......-. 6 DTACOMINUIL. s seinrince cas ge, OS rare) DYAGON TOOt.'s se aia)s os00 0 40 DWICHIMETH sacle s't'0is 5 susissrn as LEY OR SISAULON dais s.51n acho Gece DYSPNWMA. ...cevcccesscees Kk. APUG ee tiara loe se Sun cate si HLaGeriOls yielded sss 0\4'0/8+ + BLY MSlOMloee a eta eck dass «ers Ery throm cece 4 ebisais' «1s Ethiops mineral........0. PTI OMY TAG Seale cium # bec eicrea:e PUPAtOVIUIM ea» op oicis acess se BL PHGL DIG sas muelhls cote oe acl Excessive irritability...... reflex action.......... SOL LAMOM tels's's'b cc's 'a,04,¢ sensibility. .......... COMIC dss veces cs S voluntary motion..... Excess of albumen........ DRUEY Scare lets se stereos. c+ red particles.........- Expectorants.........+..-- Expectoration ...eseese.-- 2 DXUPAetShawales ain sicdavislatei<:s Extractum aconiti,........ 254 Extractum aconiti aleoholi- CUTIE ec ic ale, Siete aemrerane belladonne.:.......0. 69 cannabis indies ...... 69 CONG RON 2. Bo oa eu a nm 69 colchici aceticum...... 70 colocynthidis composi- CULE tre icon ee Sania naaa WOW ce tse awe oh sie Ale cubebee fluidum. ba RE 1) MON ANT Foe e's scsi p mel ae SIYCVITHIZ . . co euieiee HeMaAloxyll 5 som deme oe hyggcyami .. snsceweec el JAAD Rss selec snes seam . 1 JUSIANGIS Foo ocalciseny 7k RPAIDOT COs soc ic «one td nucis vomic#®......... 72 piperis fluidum........ 72 podophylli............ 72 CQUASEIEC ce stelle aig's asin io ip 72 THGRGG selewiste cisitigieweie Ne rhei fiuidum Bis Week aie 8 wie 72 sarsaparille fluidum,.. 72 SATZ® .esecsececeoneee 72 BULA TOs orn x icin ata ita senné fluidum........ 73 spigelice et senn fluid- RDU tle pin retateur nts eile ae PAPO b:6 he eaten cis pees ie valerian fluidum.... 73 F. False sarsaparilla. a fecleieuk atk 15) MHICOLA, Dante cr on0.000.. 81 Farinaceous medicines.... 190 HalHOOV IMUM. «04 6 ache cece vis HUGTVROL 0 9 6's ecscm'p oie eee eats Rota k MOUENCITASs sess 2c oe aetacame de: et potassee tartras..... 76 et QUINIZ CitTas. 6... ee 040 ferrocyanuretum...... 74 TOMPOUIN cps mccain oe) ee iodidi solution..... we eee ACTER eva vies preveie ating nh’ 153 ‘oxidum hydratum. 65) PROSPRAS 50 nnscencigne $0 PUMA OIESE 2. (esas 'o 03, ¢ 0's) 08 4 76 INDEX. Ferri subcarbonas......... 76 sulphas ...+.++ Ames 76 POEUN oso ewes Bisse: axe ammoniatum: re pit ove 74 Fever bush...... Ne vetare dase te 40 HOOG et siee to ese. 9's.4.0;910 170 J ETO LESS oa Aa es APSR hy MOSM lave (a's 6s c-0ii miele aibly 77 HGWWOEE | s 0'ce woccceccesiems 240 AGEN fess oc oie a.c0 bees pa 4 Fixed oils and fats....... . 191 MARCO tclec s ccies cecenes LOL SDUIE ATIC cleccrereise ewe asia ovis! LOM HlNid: CXtPAClSs os. cena eee LUG MABIMCTIMM © stele aeceesec seal CT Foxglove..... 2859) Sree epee AIRE oh WUGABSET thastaics oeteinae te sire Fepeny )4 G. Gelpanum . coh os cele cinenss Dei (ah tea Reo ae okie dethen. ite Gallictine: ] Sol tees axe ee GaINGACHts oh cae oe peeks BLO GaALises cess petites! seene StS Gamibosia es cee stoeiectecs 270 Garden lettuce....... Seti ue (ZATIIC Mic 4) cdo te aie ls aie wets eure). LO Gases ares caneWin te cum eae onal. kod LAA UITHSL aac eas Oem sss’ Wecw est Gelsémintiiciscase-cccea 15 GentidMie si sssriedcepecee TO GerAniUMMy vip ciate sajecesnep 00 German chamomile....... PRO ee ac coe aimethetdoam nD GIITCNIAS c.g. nis nips aene aes GUND EPA Cont vicina a eait see nia nl IENSGH Gy Joc nle tia e aie Seni a. 0 02. LOO Glauber’s salts............ 145 Glyeerina oo... web smn ses OUT GY CYTTHIZA oo see ener eee, SO Gnaphalium...... ale ciace! aia 80 GOL OES spate 4yzib ore ¢,'< SE ee) Goldthredd ic .< isn nekas (De GOlGEN POG 5 sys ciesias.cins sisi, LO GOOS8C-ZTASS......ccancercne. 7S Gossypium..... set ahisibioce ace: 5 EO Goulard’s cerate...-...... 46 INDEX. GLANCE 50:0 05550 2's’ ed 80 GUAIACI S00 tne a etal aie on tse 80 Gum ammoniac........... 3l Gain arabic cores seine. 20 H, Hamamelis..’. 627 aeeeeels oy OL Hamatics! ccs cane wees? ec B YS Hematoxylum........ gem OL | Hardnachss cacy cre eas 4 ove SLT Head symptoms ...... sraresng ED Heal-anie. oc 2: sie\eueleseespicnd € Hedeoma..... Se alaiesasase a alee Oe HIGLEBOLUS fe can dcemmatieten Oe FVOLOUTUSs she ke deicle eetasinicieg Oe FLOND AN Os alae cca mee ave cue et) OO IPS DEUCA se eines ate sais sea oi Heracleum 13... ce acemese ) Oe Hen CHeLAl vise. sre ois wma. die aoc Hoffman’s anodyne........ 147 HIONGCY>)- «piss ategiacise seiees sa 109 TODS, satan poe, MN tA esp ecndiiat o Horse-ta.dist vs cae camencck OF HLOPSO WECCic ash nalowie a oreinne O10 LOPSE Mb e a coir anree acccecee Lobes RUINS. = cateeen temas. woe HY ATanS68 soo. wo eumecse, OL Hydrargyri chloridum cor-. TOSLV UIA; 2s chotswne cick chloridum mite....... 83 FOAIGUM, <2 2 ccce 6 serene jodidumrubrum,..... 84 oxydum nigrum..... . 84 sulphuretum nigrum... 84 sulphuretum rubrum... 85 sulphas flayus....... - 89 Hydrargyrum ammonia- LT a in\eler's o s/bie 6 oisieiaties OO CUM CTClA.....esee-ee 85 cum magnesia ....... «. 9O nitrico oxydum....... 85 oxydum rubrum...... 86 PVAPasIS.cases co tees os s6 7 (OR Hydrochlorate of ammonia 3 HYOStyamus .......22.00. 86 Hyperemesis eeesaee 240 Hypericum... .....°. sonar. OG 255, 1. Tceland mOss,.......%. PRS ak ic: Tehthyceblla esc... 5. CO Tae aie atte tans a's. c\o) S.e:s 5 spans 87 Imfatiens....... salad eae at Indian hemp... 3.25 dala, ues PHYSIC Uaciecle's cae aeeal™ bo VIER Drs ie av ei tial sole ea: dcie Thebriantsics senele esse cedce Infusions...... Balls indoor we Infusum angusture....... 87 ANCMEMIGIS,.. 00 cccasee Ot AYMOTACIB. <<. cesececes OO DUCD ee eRe ose BO caryophylli.......s00. 89 CASCATILA (sv os) malar ers catechu compositam,.. 89 cinchonz cum limonum CINCH OWE soa blox adesie. . OO COLUM ivtescccice. tree” SO Cigitalisee ccs « cosarawie, OO CUPAlOFil. G2 eda ceaen OU gentiane compositum. 91 HUMIRA Sie cep ean KraMerid™. vii vice'ee's 08 Hint se he Vets eette aufese-e pruni Virginiane..... 91 CQURSSICARS Seuss e's «0 THOM As eece pie ceaces Oe rose gallicum.s....... 93 SareapaPrilie .cFsc.ece, 95 BON ese eee eekaiemas. Oo serpentaria......2.... 94 SPIGelinc sess gevescecs I TAWACI cicaeetaewes ac. OF TMi tsscsteewterpes Oe valerian2 ..... Mutane OF Inorganic products........ 182 Dae ett ets Gin voles. OE JOdIdGS Of WOM esse tcc ede, C4 MOLCULY sits cea eee beka OF potassuimesty2e27). 12° 135 SVG coticge cats ansc e's 36 BULPMUtoceeees fs egsiae LOL WMG este newacvecsaccees LOO Jodo-hydrargyrate of potas- MLUiiee she ence tse es 256 Todine...... Miele etepladin eae oD Ipecacuanha.......eese0-. 95 NYUS Ic a's ieee cietec owls oe ieee OO Teiah WOR Pees so se eae Sets 49 Tron HUN OB: oe o/s tile es were 76 ron Seaethes ees a aee (6) USM IAB SES h.6 cals 0'c stem 6 ole 86 J. LAD ja e's po, 2 in! com beans eiite OD JTUSTAHS eins soe s bain 'sientnie tO JUNIPETUS ...... eee eeeae OO K. Kalniialatitona, >... cease Or ECO. Uiid's sce eua len oedema KOQO808 Pisce sehen aa ceees 0 OS KTAMOMAGs vceesreeabe se.) OF L. Lac sulphuris rae all A Cia ag 151 actate OF 1rOMis. cas wes ac Viale Pactuca Sativa. « oe tia casecec valeriana........ AAA -valerianze ammoniati.. -wingiberis.... ...-seece SPEMGIMVGS, Gdns G-cliesels ceases « PCM Risso, sik ath ay, s, cies INDEX, 161 161 161 161 162 162 162 162 162 162 163 163 Tonics and astringents..... TOUT CS.:s essing a eee eats s\n: 6 ase PODICIEYs', ba eiaeitle | eile anisole) or. "ROOtHACHE LTC, «+0 os ce cess OO TOTMENIINA ... a, «0 oe aeeie mL Oo Touch-me-not...... 3 eietniateis Hubows TEOMIGOUCNATON.,..oocsevcee AIO TeAPACA DLE... 20 cecsecieas ) LEO Trailing arbutus..... seemed BERT ON LACT; eins w= =), 0.0.4 ese aseteeae) BE ULLTTL TY ce lone yb eco ioiaie waiensieelicl RPIOSLOUTI o's sos. 6104.0 sie bee sone HAD Trisnitrate of bismuth .... 40 Prochise] ACACIR. ccccseees L110 VOTES occ eraniaiisi els eleaimcy) WAKE glycyrrhize et opii.123,'171 ipecacuanhée ......... ‘171 WIBSUCEL vie are opis cinid o eal menthe piperitz ..... 171 morphize et ipecacu- AND. seccane pee Myer ly af Tulip tree bark... sscceasiss) LOU Turkey corn........ ao sippied 0 Purmerics..,«cisesseeuep aie AG OE sy Turner’s Cerate.....-seceee 46 Turpeth mineral..... I as" TU SS11B20, as oie aunselermnsietereieaw es U. TRONUS iss aces sees 6 a5 Apeegean lp? Unguentum antimonii..... 172 aque TOS2....... ce ae org Pelladonns Viesecan Lio GADENATIGIB Jc scncse0 Lis iy CLEABOEL fee see bie S Saanich TO cupri subacetis........ 1735 PITS cit et cee Scene Ape DYVOrALL YT. . a. 5.5 io hydrargyri nitratis. .. 173 hydrargyri oxidi rubri 173 TOUU oy 5 sees git acn ea teel POUT Len ta nue Siavelgielsieeas se 173 iodinii compositum.. . 173. mezerel co. pasts 174 picis Hamid. Me... 174 INDEX, 263 Unguentum plumbi carbo- Water pepper.....--.ss.e- 130 DACIS Tee ree c-6! 41 wala, TSF Watermelon vsindescic se 6 sn 00 RIN PIOX eevee ce aie Tat WV Ve cate ous acterals tee 6 cate 45 stramonii............. J)74 | Weights and measures.... 5 sulphuris..... aiete iss: © 174 | White horehound......... 109 sulphuris compositum. 175 HeNehorGs sees he slesdae LO VOETAtri'. ss ss cates mae LTO POP Deere’ oaitictec nies ss sp 124 ZUM GI catsiate 5225 eee 175 PPECIPITATC Le sea! os sais 85 Unoflicinal and pseudo-ex- Wild chamomile....... ees OD TVACUS Seo Saverls oe « Sees fluid) 6xbraciss ic cs's.'3 206 UW eal PASSA ee ara cp ne sisle als 175 UTSH ess se A eel alstate ntera’s 17a igs WAlOPIANA) sac aiecepoe cere Pies 7d) Valerian ruot....... ea ee 176 Valerianate of bismuth.... 40 Vegetable alkaloids....... 194 ACIGE: wa:e a's batelaig omernne oe VORALLIA,. 4 elcte ce are Da eltgeher reel nO Veratrum album...... eee LEG viride..... Dicale nietecwa ee OOO Verbascum thapsus....... 176 Verbena officinalis........ 177 VOT VAT OS sce ia's eratelae SE MUS IAL WENO QUY e's ccs esti estas eo of meadow saffron. . 21 of opium..... latina cipere 21 VAN ‘al Oesie se ececteees cain bee antimonii...... acest wiped Wi: colchici radicis........ 177 ergote...... sesagesanerl Te ipecacuanhe.......... 178 ODE vars 6 ogi aera sin 123, 178 PEL. 6 o's 3c. ly Een ya go) SMORICU HA 1c ai ctiere a snie ash 2 178 VAG re aici orate eee adios s aie 177 IFOLOtH He seater ere dalite «82.6 177 Volatile or essential oils .. 191 Volume of body.......... 215 WwW. CUCU POE sates casey 3205 PINSET i eis ce shiacwe away oO INGISO aah e esis wsicieu hoo DOU TOs acarteeins|s9.s\8 asc 54 yam....... ASE Sie 62 Wine of Ay aie Sei, tn CWZOLS. deinvslewos 5.6 temay lee TP GCAO Voie ieta a sais sine a dS OPLUMUMTA csr s caieiats aie sae ogi CS Winterascngepenseeseascate chro Winter’s Oapkis ss ue ctw caro Witch: hazel. vc << cee caleba or “WoOrmseed sec ccadede ge alae W OFMWO0Gi. Sc cin'e cceateate yo) Woody nightshade........ 63 xX. ManthorrNizay so csc0e oes bse 19 CANEROM YIN, Wecisci cle o> 179 Mg Varrows.steivias Sve sisi ae WiGaStsc ee cwlsleve asses cee sal aol Yellow jasmine........... 785 « LOObe a dese vee pace) ses Oy Lao Z. ANG. .Pulesters arte eereioeiaeeres rake Zinc! ACCtas.<.sce ss seis la.0: Oi 179 carbonas precipitatus. 186 chloridimrija nae. ae 180 iodidum..... wetaimald bie 5p OO ORY OUM sis's cis, oie ¢ wisibinins§ 180 BUDO MASS eisantee vvelsieate ve 180 AUTO DOR nS oi sele.o ec crere.d tcvehe oe 181 eas ha ae af an Soot ie Fe en