[Entered, according to the Act of Congress, in the year 1877, by 
WILLIAM R. WARNER & CO. 
in the office of the Librarian of Congress at Washington.] PHOSPHORUS 
IN 
FUNCTIONAL DISORDERS 
OF THE 
NERVOUS SYSTEM, 
INDUCED BY 
OVER-WORK 
AND OTHER INFLUENCES INCIDENTAL TO 
im: ole n life. 
With Formulae and Treatment. 
Compiled from Monograph by E. A. Kirby, M. D., Member of the 
Royal College of Surgeonsj Prof. f. A. Thompson, Physician 
to the City Dispensary, London, 
AND FROM OTHER 
PUBLISHED BY 
WILLIAM R. WARNER & CO. 
CHEMISTS, 
PHILADELPHIA, PENNA. 
1S77. CONTENTS. 
Introduction, 3 
Phosphorus, its Physiological and Pathological Relations, 5 
Therapeutic Uses, 10 
Pharmaceutical Preparations, Old and New, 13 
Phosphorus in Pill Form, 15 
A Course of Phosphorus, 18 
Dose of Phosphorus, 19 
Contra-indications, 20 
Special Diseases in which Phosphorus is Employed, 21 
Functional Disorders of the Nervous System, 21 
Overwork, 22 
Loss of Nerve-Power 22 
Impotence, 25 
Nervous Indigestion, 27 
Gout and Gouty Affections, 27 
Melancholia, 28 
Neuralgia, 29 
Temporary Nervous Exhaustion, 31 
Nervous Prostration, 32 
Hysteria, 32 
Epilepsy and Epileptic Vertigo, 33 
Cerebral Softening, 34 
Skin Diseases, 35 
Regimen, Diet, &c., in Nervous Disorders, 36 
Constipation 36 
Wet 37 
Sleep, 3<? 
Gouty and Rheumatic Affections, Syphilis, &c 38 
Physiological Rest, 39 
Summary of General Principles of Use of Phosphorus, 40 
Formulae for Administration of Phosphorus, 41-48 INTRODUCTION. 
The following pages consist, for the most part, of contributions on 
the use of Phosphorus in its elementary state by various prominent 
authors. Their experience in the employment of this potent agent 
has been of so gratifying a character, as to confirm the general impres- 
sion of the profession that in certain affections,—those of the nervous 
system especially—it is one of the most valuable remedies which modern 
therapeutics has developed and perfected. Until a comparatively 
recent date, Phosphorus was but little prescribed by the practitioner, 
and even so distinguished a writer as Pereira declared, not many years 
since, that in England it was but rarely employed, and that it would 
be unnecessary, therefore, to enter minutely into an account of its uses. 
The physician, even though anxious to prescribe it in cases in which it 
would seem to be indicated, was timid, lest from its faulty or imperfect 
pharmaceutical preparation, it might, by its dangerous chemical char- 
acteristics, produce violent irritation or inflammation. It remained 
for the skillful pharmacist to place it in such a palatable and innocuous 
shape for administration, that in medicinal doses it could be prescribed 
with perfect safety and with undoubted assurance that its full therapeu- 
tic value might be realized. Such a desirable consummation was 
effected in 1870 by the introduction to the profession of the pilular 
form by Wm. R. Warner & Co., as the most reliable and convenient 
method of administering it. It may be unhesitatingly asserted that 
such a discovery has been the means of gaining for this remedy a very 
conspicuous position in the materia medica of the present day, inspir- 
ing confidence in the place of distrust, and offering the long coveted 
opportunity of testing to the full extent its efficacy in some of those 
painful and other diseases, in which the nervous system plays so im- 
portant a part. The experience of private and hospital practice has 
confirmed the general verdict of the profession in favor of this form of 
administration of Phosphorus, and the columns of the medical journals. 
3 4 
INTR OD UCTION. 
of this and other countries contain numerous recent contributions to 
the same purport. When thus administered, properly protected from 
all deleterious chemical changes, it is as safe a remedy as any other 
that may be prescribed by the physician, whilst it exhibits specific 
therapeutic qualities which belong to no other agent. Not a single 
case has been reported in which injurious effects have resulted from the 
use of Phosphorus pills, made by the perfected method discovered and 
applied by Wm. R. Warner & Co. It is very generally acknowledged 
that sugar, from its preservative qualities, especially as a preventive of 
oxidation, is the best coating material for this substance. It would be 
safe, perhaps, to assert that the poisonous qualities which were formerly 
ascribed to this article were almost wholly due to the imperfection of 
its method of preparation. It is for the physician, after choosing judi- 
ciously the cases in which its use would appear to be indicated, to ad- 
minister it in that form in which its potency may be most usefully 
developed, without attendant disturbance or irritation, of the digestive 
organs more particularly. This pilular form fulfils all these conditions 
perfectly, and should, therefore, supersede all others for administer- 
ing it. 
The practical value of Phosphorus as a therapeutic agent will be con- 
sidered in the following pages as it exists normally in the human sub- 
ject, in its applicability to the cure of disease, and especially in those 
various disordered conditions consequent upon overwork, which are 
characteristic of modern civilization. Indeed it is to this great bane 
of modern life, which exhausts the vital energies of thousands of useful 
and valuable citizens, that Phosphorus is called upon to display its 
almost antidotal power in renovating nerve-tissue or giving tone to the 
shattered system. Its proper mode of administration and dose will 
also be discussed, and illustrative cases cited to substantiate its claims 
upon the attention of the practitioner. PHOSPHORUS. 
ITS PHYSIOLOGICAL AND PATHOLOGICAL PPL A- 
TLONS, PE MEDIAL VALUE, MEDICINAL PPOPER- 
TLES, AND THEPAPEUTIC USES. 
Physiology furnishes us with a rational explanation of the remedial 
value of Phosphorus ; and it further explains the pathological condi- 
tions or morbid states of the system under which it may be administer- 
ed with advantage. But to many the testimony of clinical experience 
and the deductions of carefully-conducted experiments are more satis- 
factory than any theory based upon physiological data, however 
reasonable it may appear. Many persons think, with Professor Stille, 
that “ simple experience forms the only crucible in which a therapeu- 
tical fact or doctrine can be fairly tried; and whatever sustains this 
test may be accepted as a real and permanent addition to our thera- 
peutical resources.” While thoroughly endorsing this opinion, a brief 
resume of the physiological chemistry of Phosphorus will assist us in 
estimating its value in medicine. 
Phosphorus,-it is well known, is a normal constituent of the blood, 
and a never-failing ingredient in all the more important tissues and 
fluids of the body. It is a very important constituent of nerve tissue, 
and is found especially abundant (nearly two per cent.) in the great 
nerve centres.* 
* The following, according to L’Heritier, is the chemical constitution of the ner- 
vous matter, and the relative proportion of its different constituents in individuals of 
different classes:— 
Infants. 
Youths. 
Adults. 
Aged Persons. 
Idiots. 
Water 
8279 
74-26 
72-51 
73^5 
70'93 
Albumen 
7-00 
10*20 
9-40 
8-65 
8-40 
Fat 
3'45 
5-30 
6-10 
4-32 
5.00 
Osmazome and Salts . 
5-96 
8-59 
10-19 
I 2" 18 
I4-42 
Phosphorus . . . . 
o-8o 
1-65 
1-So 
i-oo 
C85 
It is a significant fact that it is found in all animal and vegetable juices, and occurs 
as phosphates in the mineral kingdom, in which form it is used to increase the fer- 
tility of the soil. 
It will be remarked that the amount of Phosphorus is the greatest at the period of 
greatest mental vigor; and that in infancy, old age, and idiocy the proportion is 
not above half that which is jiresent during the adolescent and adult periods. 
According to Professor Borsarelli (Medical Times and Gazette, Aug. 31, 1861, 
p. 229.) the quantity of Phosphorus in the brain of man varies from 1-352 to 1-790, 
the medium being triple the amount assigned to this organ by Persoz and Opermann. 6 
PHYSIOLOGICAL AND PATHOLOGICAL 
In common with iron, sulphur, and lime, and other inorganic ele- 
ments, Phosphorus is a very important alimentary principle, and when- 
ever its supply is not in proportion to the needs of the economy, 
deterioration of nervous tissue and nervous force is an inevitable con- 
sequence. 
These inorganic elements enter into the composition of the organs 
by which the conversion of latent into active force is effected. The 
cerebro-spinal system,—the brain and spinal cord and the nerves 
directly connected with these centres;—and the nerves of organic life, 
(the ganglionic system), which preside over, regulates, and controls 
the functions relating to nutrition and secretion,—are consequently 
structurally enfeebled whenever their supply is abnormally defective. 
Our knowledge of the chemical constitution of the nervous system 
is confessedly unsatisfactory ; it is known however that nerve substance 
proper contains the following proximate principles, viz., protagon, 
neurine, fatty matters combined with phosphorus, and bases combined 
with peculiar fatty acids. 
Protagon Cn6 H241 N4 P was discovered and described by Lieb- 
reich in 1865, and it is to this principle that the solidity of the brain 
is thought to be due. It is interesting to know that quite recently 
three classes of phosphorized bodies have been discovered in the brain, 
viz., kephalius, myelius, and lecithius, containing glycero-phosphoric 
acid as a proximate nucleus. 
It would appear, therefore, that the presence of Phosphorus in its 
normal proportion is necessary to the structural integrity of these im- 
portant nervous centres,—to their growtii and development in the 
young, as well as to their maintenance and perfection in adolescence ; 
and it follows that the evolution of nervous force is mainly dependent 
upon nutrition, and that it is liable to be exalted or diminished in 
proportion as this process is perfectly or imperfectly performed. 
Dr. Flint observes: “When new organic matter is appropriated by 
the tissues to supply the place of that which has become effete, the 
mineral substances are deposited with them ; and the organic princi- 
ples, as they become effete or are transformed into excrementitious 
substances and discharged from the body, are always thrown off in 
connection with the mineral substances which enter into their compo- 
sition. This constant discharge of inorganic principles, forming as 
they do an essential part of the organism, ?iecessitates their introduc- 
tion with the food in order to maintain the normal constitution of the 
parts. As these principles are as necessary to the proper constitution 
of the body as any other, they must be considered as belonging to the 
class of alimentary substances. This conclusion is inevitable if alimen- DELATIONS OF FREE PHOSPHORUS. 
7 
tation be regarded as the supply of material for the regeneration of 
the organism.” 
We know that every part of the organism is constantly undergoing 
physiological decay and repair, and this molecular change is a neces- 
sary and inevitable condition of life. When, therefore, the balance is 
lost, and the destructive process from any cause (defective supply of 
new material, or over exercise of functions) is in excess of that of re- 
pair, the organism falls into decay. 
It is essential to the condition which we call health that waste of 
tissue be duly compensated by the appropriation of new material; and 
if this process fail, we have, as an inevitable consequence, not only 
structural deterioration of the organs themselves, but their functions 
become first weakened, then perverted, or imperfectly performed, and 
finally completely arrested. 
In precisely the same sense that common salt is an alimentary sub- 
stance, Phosphorus also is food ; and it is a notable physiological fact, 
that those animal and vegetable substances which are richest in this 
element best sustain brain work, renovate nerve tissue, and restore 
nervous energy when enfeebled by disease or temporarily depressed by 
excessive activity. 
We have seen that functional activity of the nervous system produces 
disintegration, and waste of nervous matter; and it does appear that 
there is an especial relation between the quantity of Phosphorus oxi- 
dized and the amount of force expended and nerve tissue destroyed. 
Stepping from physiology into the domain of pathology, we find 
that disease destroys life by using up too rapidly the supply of nerve 
force. We discover evidence of the fact that excessive activity of the 
nervous system increases the waste of Phosphorus; and whenever the 
elimination is increased, nervous force is always reducednutrition im- 
paired, the nerve centres are damaged, functional disease induced, and 
life prematurely destroyed. 
In inflammatory diseases of the brain there is reason to believe that 
an unusually rapid disintegration of tissue takes place, a marked in- 
crease of the alkaline phosphates in the urine being always present. It 
is also a fact, and one well known to brain-workers, as well as to phy- 
sicians, that laborious mental work, especially if coupled with worry 
and anxiety, is constantly accompanied with an increased excretion of 
the Phosphorus compounds. 
This devitalization and unusual waste takes place at the expense of the 
element, and unless it be compensated as sometimes it is, instinctively as 
it were, by an increased consumption of phosphorized food, the nervous 
centres, temporarily lose power, and a state of lowered vitality (nervous 8 
PHYSIOLOGICAL AND PATHOLOGICAL 
exhaustion), so frequently experienced by hard-working professional 
and literary men, is induced. This condition is only relieved by a 
lengthened period of rest from mental labor, sleep, and nutritious 
food. 
“ Additional evidence,” says Dr. Carpenter, “for the belief that 
the functional activity of the nervous tissue involves disintegration of 
its tissue by the agency of oxygen is found in the increase of alkaline 
phosphates in the urine when there has been any unusual demand upon 
the nervous power. 
“ No others of the soft tissues contain any large amount of Phos- 
phorus ; and the marked increase in these deposits, which has been 
continually observed to accompany long-continued wear of mind 
(whether by intellectual exertion or by the excitement of the feelings), 
and which follows any temporary strain upon its powers, may fairly be 
attributed to this cause. 
“ The most satisfactory proof is to be found in cases in which there 
is a periodical demand upon the mental power, as, for example, among 
clergymen, in the preparation for an'd discharge of their Sunday duties. 
This, when the demand for mental exertion is severe, and especially 
when there is that state of excitability of the nervous system which is 
frequently co-existent with a diminution of its vigor, is found to be 
very commonly followed by the appearance of a large quantity of the 
alkaline phosphates in the urine. And in cases in which constant and 
severe intellectual exertion has impaired the nutrition of the brain, and 
has consequently weakened the mental power, it is found that any pre- 
mature attempt to renew the activity of its exercise causes the reappear- 
ance of the excessive phosphatic discharge, indicative of an undue 
waste of nervous matter.”* 
Take again the disease known as spermatorrhoea (by this term I in- 
clude all those disorders which are primarily dependent on an abnor- 
mal loss of semen); it furnishes us with additional evidence that ex- 
cessive waste of Phosphorus is inimical to physical and mental vigor. 
The spermatic fluid is rich in Phosphorus, and its emission from the 
system, in whatever manner produced, is, when excessive, highly inju- 
rious. The nervous centres being deprived of their proper pabulum, 
fall into a state of exhaustion, and the effects ultimately produced in 
the economy are the same as those that we see resulting from over- 
work and excessive mental strain. A morbid condition is set up in 
which a general loss of nerve-power is manifested. Definite forms of 
functional disorders, such as cerebral and spinal paresis, neuralgia, epi- 
* Principles of Human Physiology. RELATIONS OF FREE PHOSPHORUS. 
9 
lepsy, melancholia, etc., are induced, and if these are neglected, struc- 
tural changes are soon developed, leading to softening, paralysis and 
death. It is very remarkable that the phenomena of disease present in 
these cases of seminal waste should so closely resemble those induced 
by mental strain, although in the former they are usually more pro- 
nounced, more exhausting, and more serious. Premature failure of 
mental power, loss of memory, irritability, nervousness, and extreme 
depression, are common to both. We conclude, therefore, that de- 
phosphorized blood is incapable of supporting the nutrition of the cere- 
bro-spinal centres, and that functional disorders frequently result. 
In relation to this subject, it may be mentioned that it is a well- 
known pathological fact that sexual excesses (in which nervous excite- 
ment and overwrought emotions are added to the material loss) are, 
for the same reason, productive of a general loss of mental and physi- 
cal power, as well as of diseases affecting the organs of respiration and 
circulation. 
“ I am convinced,” says Mr. Acton (whose opinion on this subject 
maybe taken to be of some weight), “ that many of the most obstinate 
as well as obscure diseases which the medical man meets with, arise 
from repeated loss; and I am no less certain that hypochondriasis, 
various forms of indigestion, debility, and nervous affections, arise from 
the same cause.” 
“ Any warning against sexual dangers would be very incomplete if 
it did not extend to the excesses too often committed by married per- 
sons, in ignorance of their ill effects. Too frequent emissions of the 
life-giving fluid, and too frequent sexual excitement of the nervous 
system are in themselves most destructive.” 
The practice is certainly often continued until health is seriously im- 
paired ; and when the patient is at length compelled to seek advice, he 
is shocked to learn that his sufferings arise from excesses unwittingly 
committed. 
Dr. Cotton says : “Of all vices, however, none are more apt to lead 
on to consumption than the unnatural or unrestrained indulgence of 
the sensual passions. To this cause alone the germs of tubercle are 
very frequently traceable; and I am convinced that the many bearings 
of this subject upon physical and mental energies have a much closer 
and more frequent relationship to phthisical affections than we can ever 
expect, from their peculiar nature, to see fully demonstrated.” 
11 Menorrhagia, diarrhoea, leucorrhoea, and other hcemorrhages and 
fluxes, if excessive, reduce the powers of life and the capacity to resist 
disease. No loss of the kind, however, does so much harm, and is of 
so irreparable a nature, as that of the semen. In many of the lower 10 
THERAPEUTIC USES OE PHOSPHORUS. 
tribes of animals the males live till they copulate, and then die : the 
reproduction of the species is at the expense of the life of the individual. 
That our own species is not wholly exempt from this law, is apparent 
from the fact that immoderate venery produces extreme debility and 
premature decay, and predisposes body and mind to various dis- 
eases.” 
In 1862 Dr. Smith read a paper before the Medico-Chirurgical So- 
ciety, entitled “ A Statistical Inquiry into the prevalence of numerous 
conditions affecting the constitution in one thousand phthisical persons 
when in health.” It is here stated that “ n-6 per cent, of the males 
had committed sexual excesses; i8’2 per cent, had been addicted to 
masturbation; and 22 per cent, had suffered from involuntary emis- 
sions.” 
It is unnecessary to pursue the subject further. Enough has been 
said to show that, as a pathological fact, excessive elimination of Phos- 
phorus is highly detrimental to the physical stamina and mental power 
of the adult; that it is also inimical to growth and development in the 
young, and a frequent cause of disease of the vital organs and nervous 
system. 
The Therapeutic Uses of Phosphorus may be fairly gathered 
from what has already been stated; nevertheless, it will be well, by 
way of a resuvii, to state more definitely the several morbid conditions 
for which Phosphorus is known to possess remedial power. 
The subjects, therefore, who benefit most from Phosphorus are those 
whose nervous power has been injuriously affected by: (1) Early 
indiscretions, vicious and irregular habits ; (2) Intemperance ; 
(3) Worry and overwork ; (4) Failure in business or reverse of 
fortune; (5) Mental strain and prolonged anxiety; (6) Exces- 
sive grief, etc. 
From the testimony of the authorities cited below, it will be seen 
that Phosphorus has a very wide application in medicine. Its thera- 
peutic effects are mainly due to its alimentary properties, and that 
when employed as medicine it is appropriated as food in building up 
and renovating nerve tissue. In administering Phosphorus we are not 
introducing into the blood a substance foreign to its constitution, but 
are simply supplying one of its normal constituents, which, owing to 
some morbific influence, has become deficient,—it may be from exces- 
sive dis-assimilation of tissue, or an insufficient supply of the element 
in the animal and vegetable substances taken as food. Its physiologi- 
cal action in the economy then being that of renewing and strengthen- 
ing brain and nerve tissue, it follows that it may be administered in THERAPEUTIC USES OF PHOSPHORUS. 
11 
every case of nervous disorder in which we have reason to believe that 
the process of dis-assimilation has been unusually destructive. 
Many well-known authorities agree in these views: 
Dr. Radcliffe says: “ For the last seven years, also, I have used 
Phosphorus in the majority of cases of chorea in which I have used cod- 
liver oil, and for the same reason. I asked myself whether the fact 
that Phosphorus is present in large quantities in the great nerve-centres, 
and that the amount of this ingredient seems to have some direct relation 
to the activity of the nervous functions,—being as much as two per 
cent, in adult life, and below one percent, in infants and idiots,—might 
not show that Phosphorus is specially indicated as food for a weak, ner- 
vous system, as much indicated, perhaps, as Iron in cases where there 
is a deficiency of red corpuscles in the blood; and this question once 
put seemed to require an answer in the affirmative.”* 
“ In proper doses,” Dr. Radcliffe continues, “ Phosphorus produces 
the very changes which are desired in cases of chorea, and analogous 
forms of convulsive disorder. Properly watched, it is quite innocent 
in its action, and may be most beneficial. Of this I am most confi- 
dent.”"}* 
“ The chief use of Phosphorus in medicine,' ’ says Dr. Wood, “ is as 
a nutrient tonic to the nervous system. In all cases of nervous exhaustion, 
whether involving the cerebral or spinal centres, it is of great value. I 
have seen marked benefit from its use when the symptoms were not 
severe enough to indicate organic lesion, but the tnost remarkable results 
have been in the cases in which the structure of the centres was appar- 
ently deeply implicated. In threatening cerebral softening, in myelitic 
paraplegia from excessive venery, it is the only drug which appears 
really to affect the nerve-centres. In neuralgia, attention has recently 
been drawn by several writers to its virtues; and as neuralgia is often 
simply an expression of exhausted nerve-power, the use of Phosphorus 
is commended by reason as well as by experience. It is probable that it 
may be of some value in cases of impaired vitality, although the ner- 
vous system be not obviously implicated.”! 
Burgess and Mavor, in a work “On the Therapeutic value of 
Drugs, as deduced from Experiments on Man and Animals,” say:— 
“ Phosphorus is indicated in the diarrhoea of phthisis, pneumonia, 
in malignant jaundice, fatty heart, atheroma of the arteries, mollities 
*Reynolds, System of Medicine, p. 220, art. Chorea. 
f Reynolds, System of Medicine. 
H. C. Wood, Clinical Lecturer on Diseases of the Nervous System in 
the University of Pennsylvania, etc. 12 
THERAPEUTIC USES OF PHOSPHORUS. 
ossium, softening of the brain and spinal cord, nephritis, in atonic 
conditions of the cerebro-spinal system and muscular weakness in chil- 
dren, irritable weakness of the sexual organs induced by excessive 
venery, incipient caries, purpura, functional paralysis, adynamic fevers 
with prostration and emaciation, hectic fever,'progressive spinal paraly- 
sis, marasmus, general debility, chronic catarrh, arthritic hemicrania, 
broncho-pneumonia, phthisis pulmonalis in the early stage, gastro- 
enteritis with emaciation, ulceration, and fistulous ulcers.” 
Professor Percy (S. R.) has employed it with great advantage in 
cases of furuncular eruptions. 
“ In medicinal doses,” Dr. Harley says, “Phosphorus is a stimu- 
lant to the nervous system, and may be given when there is a tendency 
to nervous prostration and general enfeeblement, as in the early stages 
of the palsy of the insane, and cases of cerebral or spinal atrophy.” 
“In small doses,” says Dr. Pereira, “Phosphorus excites the ner- 
vous, vascular, and excretory organs. It creates an agreeable feeling 
of warmth in the epigastrium, increases the fulness and frequency of 
the pulse, augments the heat of the skin, heightens the mental activity 
and the muscular power, and operates as a powerful sudorific and diu- 
retic.” 
It has been sagely remarked that the effects of Phosphorus differ 
almost entirely as the dose is therapeutic or toxic. With this proposi- 
tion we will not quarrel; but it may be more useful to know that, even 
when administered in strictly therapeutic doses, its effects vary entirely 
according to the amount given. The action of Phosphorus is in fact 
threefold: i. Nutritive; 2. Tonic; 3. Stimulative. Its nutritive 
and tonic action is best secured in doses of from a fiftieth to a twenty- 
fifth of a grain ; while as a stimulus to the nervous centres the dose 
should not be less than a twenty-fifth, and not more than a twelfth. PHARMACEUTICAL PREPARATIONS, 
OLD AND NEW. 
MODE OF ADMINISTRATION. 
We now come to consider the best mode of administering this re- 
markable medicine. Although Phosphorus was discovered by Brandt 
in 1669, no formula for its internal administration appeared in the 
Pharmacopoeia until May, 1874. It is true that several formulae for 
the preparation o£ Phosphorus—pills and solutions—were to be found 
scattered about in works of Materia Medica; but these were all more 
or less defective and practically of no value, a few were peculiarly dan- 
gerous, as will be seen on reference to recipes given further on. The 
only formulae bearing impress of authority were those of the Prussian 
Pharmacopoeia (Phosphated Oil) and of the French Codex (Phosphor- 
ated Ether). Both preparations are known to be unstable, and there- 
fore uncertain and dangerous. For other reasons they are practically 
objectionable, and exceedingly unpleasant to take. Moreover, it is 
never necessary to exhibit Phosphorus in a fluid form. All Solutions 
should be avoided. In Ether or Alcohol [tinctures] they are subject 
to constant variations in strength, owing to evaporation in the one 
case and to the absorption of water and partial precipitation in the 
other; while in Oil (especially in Cod Liver Oil) the Phosphorus is 
liable to oxidation, and the mixture is so exceedingly nauseous that 
patients are with difficulty persuaded to take a second dose. 
Phosphites and Hypophosphites of Soda, Potash and Lime have been 
largely employed as a means of introducing Phosphorus into the sys- 
tem; but the results obtained by equally competent observers are very 
contradictory. By some they are said to be highly beneficial, by others 
to be almost inert. It is certain that no reliance can be placed upon 
the various salts. It may be asked, why should we employ feeble and 
uncertain compounds, when free Phosphorus is required, and can be 
now easily procured and safely administered ? 
Phosphide of Zinc has been very recently tried, and, it is said, suc- 
cessfully. It is thought by some practitioners to be an effective mode 
of administering the element. It is, however, slow in its action, and 
often gives rise to violent local disturbance, causing nausea and vomit- 
ing. To set the Phosphorus free, this compound must undergo decom- 
13 14 
PREPARATIONS OF PHOSPHORUS. 
position ; and since it occasions quite as much digestive disturbance as 
solutions of Phosphorus, and possesses no advantage over them, while 
in point of therapeutic value it is very inferior to the pure metalloid, 
there can be no reason to retain it amongst our preparations. 
Red Amorphous Phosphorus.—This is an allotropic variety of the ele- 
ment. When pure, it contains no free Phosphorus. Any remedial 
value it may possess is due to imperfect isolation, and as this is always 
more or less incomplete, it should not be prescribed. If pure, its thera- 
peutic value is nil; if impure, the amount of Phosphorus is uncertain, 
and may be dangerous. 
It is interesting to note that the dose of this substance, as given by 
different therapeutists, is found to vary from one-sixth of a grain to ten 
grains. 
Oleum Phosphoratum, B. P., 1874. A solution of Phosphorus in 
Almond Oil, 10 minims=a fifteenth of a grain of Phosphorus. Of the 
several fluid preparations hitherto devised, this is undoubtedly the least 
objectionable. It is a matter of daily experience that patients will not 
be persuaded to take more than a dose or two of any medicine that 
causes a sense of discomfort; and for this reason tinctures of Phospho- 
rus are practically useless. Nausea, flatulence, eructations, and loss of 
appetite are symptoms always interpreted by patients, and no doubt 
correctly so, to indicate that the medicine taken is indigestible—“dis- 
agrees with the stomach.” Useful remedies in this manner are often 
abandoned before it is possible to perfectly affect the system. When 
Phosphorus excites any local irritation, it is invariably due to the "im- 
perfect preparation or to a badly chosen mode of administration, and 
not to the metalloid itself; where failure occurs it is- to be ascribed 
solely to this cause. It is encouraging to know that when it is rightly 
prepared Phosphorus provokes no disagreeable symptoms whatever, and 
is incapable of producing corrosion or irritation of the mucous mem- 
brane of the stomach. 
Dr. Hammond, of New York, gives the following formula for admin- 
istering Phosphorized Oil: 
]£ Olei Phosphorat. . . | ss. 
Mucil. Acaciae. . . . J j. 
01. Bergamii. . . . gtt. xv. 
M .ft. emulsio. Dose : gtt. xv. ter die. 
Dr. Routh, who has prescribed it under the name of Sol. Phosphori 
Medicati, says :—“This is not a preparation which everybody can take. 
It sometimes operates very energetically as a poison, producing, even 
in doses of ten drops, intense sickness, temporary loss of power in the PREPARATIONS OF PHOSPHORUS. 
15 
extremities, and a deadly pallor—in fact, it cannot be tolerated in 
these doses by some persons. It is more prudent to begin with five 
drops, gradually increasing the dose one drop daily, and in this way it 
can be brought up often to thirty or forty minims for a dose 
The effect of long-continued employment of this remedy is somewhat 
remarkable. It seems occasionally to produce an intense burning along 
the intestinal tract. Patients describe it as a coal of fire within them. 
I have usually considered i-3oth of a grain of Phosphorus 
quite a large enough dose to begin with, i.e., about ten drops of this 
solution. But we should be prepared for sudden occurrence of the 
poisonous symptoms,—’.sickness, vomiting, faintness, palpitation, and 
temporary loss of motor power [!] This Solutio Phosphori Medicati, 
is, of all the preparations I have used, that by which these poisonous 
symptoms may be most readily induced.” [! !] 
This account certainly offers no encouragement for a further trial 
of Sol. Phosphori, and could the effects here described be traceable to 
the action of Phosphorus, after its assimilation, we should not be justi- 
fied in using it at all; but as they are due to the partially oxidized 
Phosphorus acting locally upon the tissues, it is simply the method 
of administration and not the remedy that should be abandoned. 
This remark applies with equal force to all preparations of Phosphorus 
the administration of which is followed by any similarly distinct evi- 
dences of poisoning. 
Phosphorus “ Pcrles." [Phosphorized oil in capsules.]—If phos- 
phorized oil is to be administered, this preparation is the best means 
of doing it, but the capsule does not remove the objection to it. 
The capsule dissolves directly it reaches the stomach, the oil is 
at once set at liberty, and the membrane exposed to the partially 
oxidized Phosphorus, giving rise to that most disagreeable effect, the 
eructation of phosphorated hydrogen. 
Phosphorus in Pill Form.—Ashburton Thompson tells us that Kunkel 
gave free Phosphorus in the form of “ luminous pills” before 1721, but 
his process for making them was not published, and died with him. 
Leroy, in 1798, believed that he had re-discovered Kunkel’s method, 
and he entrusted their manufacture according to it to Charles le Pel- 
letier, a brother of the celebrated Bertrand le Pelletier. But Leroy 
was so impressed with the danger of giving unequally divided Phospho- 
rus, and the mode of preparation in question was so difficult to carry 
out, that he declined to confide it to any other person. 
Many attempts have been made to make pills from a solution of 
Phosphorus. Mandl has given an example; other persons have also 
furnished formulae from time to time, and all have signally failed. 16 
PHOSPHORUS IN PILULAR FORM. 
In a recent article on the value of Phosphorus in Medicine, which 
appeared in “ The Doctor,” the following reference is made to formulae 
for the preparation of Phosphorus pills, still to be found in text- 
books. 
“ Before closing, we are bound to advert to some published formulae 
worthy to be spoken of as curiosities of pharmacy, except for the fact 
that some are dangerous. They pass from one book to another un- 
challenged and without comment, and authors who we should have 
thought better informed on the pharmacy of Phosphorus have quoted 
them, though with what purpose, as they are practically useless, it is 
difficult to divine. Why perpetuate obsolete prescriptions which are 
likely to do harm? We have met with some of these in which direc- 
tions impossible to follow are given. Thus as late as 1873 we actually 
find this credited to Burgess, in a work on skin diseases :— 
Phosphorus, g. iij. to xx. 
Almond oil, gtt. x. to lx. 
Powdered acacia, q. s. 
Make twelve pills. 
Dose: one twice a day. Use in lupus and syphilitic tubercular disease. 
“ How many persons have been poisoned by this it may be difficult 
to say. Perhaps the difficulty of dispensing the prescription may have 
saved some lives, but we are astonished beyond measure to find a care- 
ful teacher admitting into his work a formula which is too defective to 
attempt to prepare. If by some means ten or twenty grains of it was 
got into twelve pills, most assuredly the person who took them would 
be poisoned. Twenty grains of phosphorus in twelve pills ! ! 
“A very similar formula was for many years a standing dish in 
Hooper’s ‘ Physician’s Vade Mecum.’* In the last edition we are glad 
to see it omitted. With such formulae floating about, we cannot be 
surprised that phosphorus acquired the reputation of being a violent 
irritant poison ; but during the last few years it has been given right 
and left, and is taken just like any other tonic, and we hear nothing of 
poisoning except in a few solitary cases in which it has been clearly 
proved that the dose was excessive or its preparation defective. 
*IJ. Phosphori gr. iij. 
Ol: caryophylli, np. xij. 
Pulv. glycyrrhizre q. s. 
Divide into twelve pills, and give one, twice a day, cautiously increasing the 
number. 
This pill is recommended “ in lupus, obstinate scaly diseases, and syphilitic 
tubercles.” PHOSPHORUS IN PILULAR FORM. 
17 
“Nothing can be easier than to make powdered phosphorus into pills, 
and it is to be feared that most of the pills in the market are of this sort. 
Hence they are uncertain, and consequently dangerous. Other speci- 
mens are so hard and insoluble, that as in those of the Pharmacopoeia, 
the absorption of the dose is altogether conjectural.” 
It can answer no useful purpose to discuss further these defective, and 
let us hope now obsolete, formulae. 
The profession and the public, however, cannot be too careful in 
avoiding these dangerous compounds. 
None of the preparations referred to (and they are the only ones 
which have any claim to remedial utility) answer the end in view satis- 
factorily ; some of them are uncertain in their action, while others are 
most objectionable because they invariably give rise to local disturb- 
ance, and disorder of the digestive functions. What is really wanted 
is a preparation which shall hold the Phosphorus in the finest state 
OF SUBDIVISION, HIGHLY DILUTED and CHEMICALLY UNCHANGED ; the ob- 
ject of primary importance being to convey the Phosphorus into the blood 
unoxidized, without irritating the tissues with which it must necessarily 
be brought into contact. It is a clinical fact, based upon large experi- 
ence, that the remedial value of Phosphorus depends wholly upon its 
assimilation before, a?ui 7iot after, its conversion into Phosphoric Acid 
or other Phosphorus compound.* 
The advantages of administering Phosphorus in this form are suffi- 
ciently obvious, and may be thus summarized :—i. The Phosphorus 
is virtually retained in a state of solution. 2. It is so 
treated that it excites no local irritation. 3. As the disin- 
tegration of the pill necessarily occurs gradually, the Phos- 
phorus becomes incorporated with the food; and is conveyed 
slowly into the circulation by assimilative process. 
*Note—The Phosphorus pills of WM. R. WARNER & CO. meet this want 
and give complete and satisfactory results. The ELEMENT IS IN A PERFECT 
STATE OF SUBDIVISION; IT IS THOROUGHLY INCORPORATED WITH 
THE EXCIPIENTS WHILE IN SOLUTION, AND IS SUGAR-COATED 
WHILE IN A SOFT MASS, thus instcring ACCURACY, RELIABILITY and 
PROTECTION from the OXIDATION, which occurs in other preparations of 
this material. The pills have been in constant use for nearly eight years; they 
have been subjected to every test—chemical as well as therapeutical—that could be 
applied to them; and have proved, not only to be thoroughly effective, but free 
from all toxic properties. It is therefore not too much to say that all the diff- 
iculties which so long beset the administration of Phosphorus are entirely re- 
moved by this process. 18 
ADVANTAGES OP TIIE PILULAR FORM. 
It is quite possible that solution of the pill is not completed before 
it reaches the duodenum, or it may be on its passage through the small 
intestines. The pills, in fact, may be regarded simply as convenient 
carriers of free Phosphorus (in a highly diluted state) to the absorb- 
ents, where it is rapidly taken up and becomes a constituent of the 
living body without disturbing any of its functions. It is in this way 
alone that Phosphorus exhibits its full remedial power, and it is satis- 
factory to know that it is easily effected, without even incurring the 
risk of inducing those symptoms of poisoning which are of so frequent 
occurrence when Phosphorus is administered dissolved in oil or 
alcohol. 
For its preparation Pil. Phosphori requires skilled and very careful 
manipulation ; the process employed is too complex and far too diffi- 
cult to be undertaken without practical instruction and a properly con- 
structed apparatus which it necessitates. It cannot, therefore, be 
prepared extemporaneously by the chemist, as other pill masses com- 
monly are. 
The success which has attended its administration, we believe to be 
due not only to the peculiarly attenuated form in which the Phospho- 
rus is held and the readiness with which it is assimilated, but also to 
the unremitting care taken to prevent failures by reason of unskilful 
manipulation. Had these precautions not been taken, not only failure 
but accidents would have undoubtedly occurred, and the reputation of 
the drug would have suffered much, but most unfairly ; doubt and sus- 
picion would have still surrounded the therapeutic value of an exceed- 
ingly useful remedy, which has no substitute in medicine. 
The physician may therefore have no hesitancy in prescribing this 
pill. In the Formulary will be found several useful combinations 
which may be obtained. already prepared. Most of these have been 
very largely used, and found exceedingly useful for the treatment of 
the diseases for which they are recommended. 
A COURSE OF PHOSPHORUS. 
It is now known that it is not only safe to continue Phosphorus for 
many months, but that in chronic cases it is necessary to do so in 
order to produce its full remedial effect. Relief may and frequently 
is very speedily obtained; but in cases of long-standing disease, de- 
pending upon structural change, and exhibiting a material loss of 
power, permanent benefit cannot be expected from a few doses. The 
cure will depend upon the persistent use of the remedy in small doses ADMINISTRA TION AND D OSE OF PHOSPHOR US. 
19 
until its physiological action is well secured. To this end the dose 
should be taken not less than three times a day (always with a meal), 
for a period of six or eight weeks, or until about four or six grains 
have been administered : then it may be suspended for a few days, and 
again resumed for another six weeks, and with a like intermission con- 
tinued for six or eight months, the patient of course being under pro- 
fessional observation. In locomotor ataxy, Pil. Phosphori 1-50 gr., 
and Pil. Phosphori et Nuc. Vomicae have been resorted to continuously 
for twelve months with excellent results, and without giving rise to a 
single unpleasant symptom. 
The dose of Phosphorus is variously stated by different authorities. 
As its therapeutic action, and therefore its efficacy greatly depends 
upon the amount given, it is a matter of considerable importance, and 
should in every case be carefully determined. The dose given by Prof. 
Stille is one-twentieth to one-fourth of a grain; by Dr. Garrod one-for- 
tieth to one-twentieth of a grain. The twenty-fifth grain, we believe, is the 
maximum dose, and one that cannot be increased without some risk of 
incurring disagreeable consequences. Dr. J. C. Wood, who has had 
large experience in the use of Phosphorus, thinks that in therapeutic 
doses its physiological action is entirely different from that which it 
exerts when given in larger quantities. He says : “ Like Iron, Cod- 
Liver Oil, etc., it appears to act, when given in minute doses, as a 
stimulant to the nutrition of the tissues into whose composition it, en- 
ters as this is precisely the manner in which we desire it to act, large 
doses should not be given, and no attempt should be made to impress 
the system suddenly. In exceptional cases it may be desirable to ad- 
minister full doses as a stimulant to the nervous system. 
Experience enables me to say confidently, that for all purposes it 
will be found safer and more efficacious to give small doses repeatedly 
(every four or five hours, and in exceptional cases every two) than to 
surprise, as it were, the system by large doses. The fiftieth of a grain 
is a medium and perfectly safe dose, and one that is most generally 
prescribed ; a twenty-fifth of a grain is a safe dose, but being of course 
proportionately more active, the effect of such doses is Stimulation, 
and requires watching; they are only necessary in cases where the stimu- 
lant action of the element is indicated. In Neuralgia, Phosphorus 
is almost a specific ; full doses are necessary and generally well borne. 
The Pil. Phosphori, gr. 1-50, one or two maybe taken an hour before 
an expected paroxysm, and be repeated three or four times a day. It 
DOSE OF PHOSPHORUS. 20 
CONTRA -INDICA TIONS. 
is a wise rule, however, not to exceed an eighth of a grain of Phospho- 
rus in the twenty-four hours. 
CONTRA-INDICATIONS. 
Phosphorus is contra-indicated in active congestion of the brain, and 
generally in plethoric states of the system, and it should not be given 
to persons inclined to haemorrhage. The fact cannot be too often 
repeated, that the drug in moderate doses acts as a nutrient when it 
cannot be borne as a stimulant, and may exert some devitalizing 
action; and in doubtful cases small doses only should be given; in 
anaemia always with iron. PHOSPHORUS 
IN 
FUNCTIONAL DISORDERS 
OF THE 
1TEE/VOTTS SYSTEM. 
(LOSS OF NERVE-POWER; OVERWORK.) 
In these high-pressure times prostration from loss of nerve-power is 
a very common disease; it is, in fact, the “complaint” of modern life. 
It prevails more or less in all classes of the community; but it is most 
frequently found among those engaged in professional, scientific, and 
literary pursuits, and those engrossed in commerce or by mercantile or 
financial speculations. It is constantly met with also in what is called 
fashionable life, and amongst those having nothing to do, as well as 
those who live in an atmosphere of perpetual nervous excitement and 
pleasure-seeking, involving incessant activity of heart and brain. 
Growing boys and girls, students and scholars, whose mental powers 
are unduly stimulated and spurred into action by keen competitive 
struggles, are also frequent subjects of this complaint. 
“Of all the parts which go to make up the wonderful whole of the 
human body,” says Dr. Hadfield Jones, “there is none to which a 
deeper and more mysterious interest is attached than to the nervous 
system. By this we think and move and have our conscious being ; 
in this, if anywhere, inhabits our ‘ divince particula auras f by this we 
are linked with the outer world, and are capable of affecting and being 
again affected by the persons and things around us. By this our im- 
material acts upon, and sways, our material part; and by the higher 
development of this, and its capability for higher actions, man is espe- 
cially distinguished from the lower creation. All the passions and 
emotions, all the intellectual efforts, all the perceptions and recollec- 
tions operate through and on this system. If this be so, is it any 
wonder that exhaustion should frequently befall this delicate and com- 
plex machinery, or that its disorders should be among the most fre- 
quent that our fallen nature is doomed to bear ? Even under favorable 
circumstances the nervous system must often be severely taxed; how 
much more then will this be the case when sorrow, toil, and anxiety 
predominate in the lot assigned 
21 22 
LOSS OF NERVE-POWER 
Overwork and Fast Living are the principal factors inducing Loss 
of Nerve-Power (we do not mean living fast in the sense it is commonly 
employed, although dissipation and excesses of all kinds are, without 
doubt, a frequent cause of diminished power), and we refer particularly 
to the now universal custom of living in a hurry, amongst scenes of 
constant and multifarious excitement, and which are the salient charac- 
teristics of the age. 
The destructive tendencies of life at high pressure, and the manner 
in which it induces disease is graphically described in the following 
passages of Mr. W. R. Greg’s lecture on “ Life at High Pressure 
“ The physical consequences of this needless hurry are grave enough; 
the moral consequences are, possibly, graver still; though both sets of 
effects are as yet only in their infancy, and will take a generation or 
two fully to develop. 
“ The rapidity of railway travelling produces a chronic disturbance 
in the nervous system; and the anxiety to be in time, the hurrying pace, 
cause a daily wear and tear, as well as accelerated action of the heart, 
which kills or injures thousands. The constitutions which are thus 
enfeebled and impaired we transmit damaged to our children, who add 
to and pass on the sad inheritance. Heart disease, too common 
already, may be expected to be more common still. We are, perhaps, 
most of us, conscious at some time of the need to be quiet and alone, 
but few of us have estimated adequately the degree in which an atmos- 
phere of excitement, especially when we enter it young and continue 
in it habitually, is fatal to the higher and deeper life; the subtle poi- 
son which it disseminates throughout the whole character; how it saps 
solidity and strength of mind ; how it daily becomes more necessary 
and in increasing measure; how it enfeebles and renders abnormally 
sensitive the subtle organization of the brain ; and how far, by slow 
and sure gradations, it carries us on towards a mental and moral con- 
dition which may justly be pronounced unsound. But ‘ high pressure’ 
is shown even more in our style of work than in our rate of movement. 
The world is more' exacting in its demands from all laborers, except 
merely manual ones. Success in professional, public, and commercial 
life demands more strenuous and exhausting toil, sterner concentra- 
tion, and a more harsh and rigid sacrifice of the amenities which time 
offers the easy-going than was formerly the case. The eminent lawyer, 
the physician in full practice, the minister and the politician who 
aspires to be a minister, even the literary workman and eager man of 
science, are now condemned to an amount and severity of exertion, 
which forces one after another to break off (or to break down) in mid- 
shattered, paralysed, reduced to premature inaction or senility. AND OVERWORK. 
23 
What work does for the learned professions, anxiety does for the mer- 
chant and the manufacturer. The barrister must make hay while the 
sun shines, for it shines so late; the physician cannot, in middle life, 
select among the patients whom he has longed for through the years 
of youth ; while the statesman has to undergo a prolonged pressure to 
attain what Macaulay calls ‘ that closely-watched slavery which is dig- 
nified with the name of power.’ Men who have given up their entire 
being to this business-labor often lose all capability of a better life, all 
relish for recreation or contemplation, all true appreciation of leisure 
when it comes at last; for the faculties of enjoyment, like all others, 
are apt to grow atrophied with disuse. The successful man too often, 
with much to retire upon, has nothing to retire to; for literature, 
science, domestic ties, public and philanthropic interests, nature itself, 
have been lost sight of during the mad struggle, and these are treasures 
the key to which soon grows rusty. This ceaselessness and severity cf 
toil gives the prizes of life to men of exceptional physique.” 
This to many may appear a startling and overdrawn picture of the 
battle of human life; but truth and experience compel us to admit it 
to be a faithful one. 
Physicians know full well the sacrifices that are made at the shrine 
of mammon, and of the many who are compelled to retire from the 
struggle physically, and too often morally, ruined before middle age is 
attained. 
“ Much to retire upon, nothing to retire to /” What a biting satire. 
When the goal is reached, is it worth the cost ? 
Yet this unnatural life of struggle, unrest, and of perpetual excite- 
ment and effort, with all its perils and forfeitures, has become, either 
from choice or necessity, the normal state in which we live; for by an 
irresistible force of circumstances it is thrust, nolens volens, even upon 
those who would if they could escape it. 
Under these unwholesome conditions, is it a matter of surprise that 
the most prevalent diseases are those which are directly induced by 
mental and physical overstrain ; that brain and heart disease, and loss 
of nervous power, are the common complaints of modern life ? 
Besides the two great factors mentioned,—overwork and fast living,. 
—there are other causes which tend towards nervous depression or loss 
of nerve-force; the most detrimental is probably defective hygiene, 
living in low and damp situations, in close and confined neighborhoods, 
in houses ill-constructed affording but a scanty supply of fresh air and 
sunlight, to which perhaps are added bad drainage and defective ven- 
tilation. Unwholesome conditions of the kind exist in all large and 
crowded cities, and then the very atmosphere is more or less devital - 24 
LOSS OF NERVE-POWER 
ized. The blood of human beings surrounded by these influences be- 
comes impoverished and imperfectly decarbonized, the nutritive pro- 
cesses are imperfectly performed, secretion and excretion interfered 
with, and vitality is at its lowest It must be manifest that should de- 
fective sanitary arrangements be superadded to overwork, as in many 
cases they will be, the nervous system is more rapidly lowered in tone. 
It is under these circumstances that overwork provokes intemperance, 
that recourse is so frequently had to alcoholic stimulants to spur the 
flagging energies of failing heart and nerve,—alas ! a practice far too 
common, and one of the worst features of “life at high pressure,” sus- 
tained under the conditions which we have described. A man may be 
perfectly sure that if his work cannot be done without a constant re- 
course to alcoholic stimulants in any form, he will not be able to go on 
long and accomplish more with its aid; artificial stimulants do but 
hasten and render more inevitable the final collapse. Even constitu- 
tions commonly called “ fine” cannot long resist the additional evils 
engendered by “ taking to drink.” 
A well-known fact may here be mentioned, since it is an example of 
the potency of these influences, viz., that acute diseases, fevers and in- 
flammation (especially when these occur in large and crowded neigh- 
borhoods)—which were formerly treated successfully by the lancet and 
other depletory measures, now assume a low adynamic type, and yield 
only to an opposite plan of treatment—tonics, support, and stimula- 
tion. 
Moreover, it would not be difficult to show that many functional 
derangements with which the physician has to deal,—affecting the 
action of heart, liver, and stomach,—and which bear a variety of 
?iames, are almost wholly due to a deficiency of power in the organic 
nervous system. 
. “ It is difficult to form a decided opinion on the matter; but there 
seems, I think, reason to entertain the belief that failure of nervous power 
is much more characteristic of disease of the present day, than of that 
which prevailed forty years ago. For this there may be various causes: 
the greater confinement of large numbers of the population within doors, 
and often in unhealthy rooms or workshops; the harder struggle to be 
maintained in the battle of life, the greater amount of the commoda 
vitce—may all tend to increase the susceptibility of the nervous system, 
and to impair its resisting power. However the exact truth may be, 
whether the type of disease is altered or not, I hold it to be abun- 
dantly clear that the great majority of disorders we have to treat at the 
present time show more or less marked indications of failure of nervous AND OVERWORK. 
25 
power; and I believe it to be a matter of great practical moment to 
keep this steadily in view.” 
How, it may be asked, is a man to know when he is living too fast ? 
When his work, be it mental or physical, or both, is injurious? How 
is he to ascertain that he is overworked ? The answer we think is, when 
the daily routine of duty is followed by fatigue which is not removed 
by repose; by errors and omissions creeping into his work; when for- 
getfulness becomes frequent, and the affairs of the day pursue him at 
night; when the mind is busied and his rest disturbed by the occupa- 
tions and the cares of business; and when, after restless sleep, he 
awakes to resume the duties of the day unrefreshed. Wakefulness is 
always a suspicious symptom; a man who works hard should sleep 
soundly, and if sleep is absent it is highly probable that the circulation 
through the brain is abnormally active. 
Constitution (Diathesis) sex, age and idiosyncrasy, exercise control- 
ing influences in determining the form in which loss of power is ex- 
pressed. These various conditions also increase or lessen the gravity 
of its consequence, but they have all, therefore, to be taken into ac- 
count in making a prognosis and in deciding upon treatment. The 
following symptoms, or some of them, are always present:— 
Wakefulness, and a sense of depressio7i in the chest, “ a sinking, 
empty feeling," amounting sometimes to physical pain; this is usually 
the first to attract the notice of the patient. Mental power is impaired 
and less retentive. The mind is spiritless and depressed with gloomy 
forebodings of evil; success in life earnestly sought after, and hardly 
worked for, is now despaired of. Habitually taciturn and irritable, the 
patient seeks to be alone and shuns all society. The heart acts irregu- 
larly, the pulses beat feebly, and too rapidly, the digestive process is 
imperfectly performed ; nutrition is arrested, the muscles waste, color 
fades, and a condition of nervous inervation, technically known as 
paresis, is established, sometimes involving the cerebral hemispheres, 
sometimes the upper portion of the spinal column, but not unfrequently 
involving all the nervous centres. 
Impotence.—“This is a term,” says-Mr. Acton, “given to al 
those morbid conditions which are opposed to the physiological union 
of the two sexes.” The subject cannot, therefore, be discussed at 
length here, nor indeed, would it be alluded to, except that it is often 
symptomatic of a grave, “morbid condition” of the nervous centres, 
and we take cognizance of it only because it is intimately associated 
with our subject. 
In estimating the significance of Impotence as a symptom, it is 26 
PHOSPHORUS IN IMPOTENCE. 
necessary to bear in mind that the sexual instinct is not physiologically 
developed in all men and women alike, but rather in an unequal de- 
gree,—in some it is strongly developed, and in others feebly so. 
Great natural differences exist in this respect, and are quite consistent 
with perfect hcdlth. But extremes of both kinds are abnormal, and 
result from nervous derangement. They frequently lead to disease, 
and for that reason demand medical treatment. 
The sexual instinct is under the control of the nervous system, and 
it is observed that indifference, and it may be entire absence of desire, 
and sexual incapacity, or perversity of sexual feeling, are, each and all, 
the concomitants of certain depressed or morbidly excited conditions 
of the nerve centres, which have already been fully discussed. But 
persistent impotence is not in any case to be assumed. This fact should 
be more generally known, because it is a state which may alarm and 
depress some minds exceedingly. Nervous persons are often tormented 
by fears of sexual incapacity; in some cases this fear may amount to a 
monomania. 
Temporary incapacity yields usually to appropriate treatment directed 
to exalt the tone of the nervous system, and requires nothing special. 
Phosrphorus, Nux Vomica, and Strychnia are the most useful reme- 
dies. Electricity—Faradisation and the continuous current—is also a 
useful agent. But neither the one nor the other, without judicious 
general treatment, can be relied upon. 
Dp. Wm. Mason Turner reports the following cases: 
Impotence.—Mr. O. II., of Arkansas, aged forty-five, hale, married, likewise con- 
sulted me by letter, giving a full history of his ailment. Much disturbed con- 
cerning his condition. Put him on Phosphorus and Nux Vomica, with custom- 
ary directions concerning exercise, diet and animal indulgences. Some two 
months or more elapsed, when I heard a favorable report from him. Heard 
from him again; he frankly admitted that, in the meantime, he had been indulg- 
ing too freely in strong drink. 
Impotence and Spermatorrhcea.—Was written to by Mr. , then living in 
Illinois, now in Denver, Colorado—evidently a young man of refinement and 
culture. Had been in London for several years, where he indulged to excess in 
sexual pleasures. The result was that his virility was soon so much impaired 
that he could never consummate coitus. He had spermatorrhoea also, due, 
doubtless, to an enlarged and irritable prostate. As he contemplated marriage, 
he was naturally solicitous about his case. I put him on the treatment similar 
to that given in the above case; only I alternated the phosphorus and nux 
vomica pill, with the simple phosphorus pill (i-ioo gr.) He was loth to admit 
any improvement whatsoever, but finally did so, and to a sufficient extent to en- 
courage me in the continued use of phosphorus. NERVOUS INDIGESTION 
27 
Nervous Indigestion.—Described under various appellations— 
atonic dyzpepsia, neuroses of the stomach, etc., is one of the commonest 
manifestations of loss of nerve-power,—and if the acute forms of indi- 
gestion arising from improper food and the abuse of alcohol be ex- 
cluded,—it is perhaps the commonest of all forms of dyspepsia. 
The processes of digestion and of assimilation are almost wholly un- 
der the influence of the nerves of organic life, and when from any 
cause these centres of nervous force are enfeebled, want of tone is at 
once manifested by all the important functions involved. It is within 
the experience not only of doctors, but of all classes of brain-workers, 
as well as those actively engaged in business and exposed to the wor- 
ries and anxieties thereby entailed, that the digestion is greatly influ- 
enced by the state of the mind at the time when food is taken. That 
digestive power is liable to be lowered by sudden emotions and pas- 
sions there can be no doubt. The natural secretions are sometimes 
suddenly interrupted and digestion delayed or wholly arrested, leading 
to nausea and the rejection of the food taken. Habitual overwork 
and anxiety exercise a continuously depressing influence on the nervous 
centres; hence it is that indigestion, expressive of a want of nervous 
power, is the bane of professional life. The treatment necessitates,— 
ist. The removal of the cause, when that be practicable. The his- 
tory of the case generally discloses some errors in the mode of life 
which may be corrected. 
2ndly. The discontinuance of injurious habits and all practices that 
tend to depress nervous force. Laborious or excessive mental work 
should be lightened and relieved as far as possible from difficulties and 
anxieties. Wholesome open-air physical exercise should be increased. 
Long railway journeys to and from business discontinued. The per- 
petual hurrying to and from the stations, and the constantly recurring 
anxiety to catch the train, are self-imposed injuries. These may cer- 
tainly be removed for a time at least. The increasing prevalence of 
heart disease is, I believe, attributable very much to these causes. 
3rdly. The diet should be carefully regulated, but in this matter the 
experience of the patient should always be consulted. 
Simple Phosphorus, Phosphorus and Nux Vomica, with and without 
Aloes, are the most useful medicines. 
Gout and Gouty Affections.—It is beyond doubt that excessive 
mental labor and, ccetcrisparibus, when this is conjoined with a seden- 
tary life, favors the development of gout. In like manner sudden 
grief, fear, fits of anger, and other depressing passions, frequently ex- 
cite attacks in those predisposed to it. Venereal excesses sometimes 
operate in the same manner, and favor the production of the disease. 28 
PHOSPHORUS IN MELANCHOLIA. 
It is important to bear this in mind, because from a gouty condition 
of blood—a uric acid diathesis—many troubles arise. Dyspepsia, gra- 
vel, calculus ; affections of the skin, psoriasis, eczema, as well as head- 
ache, neuralgia, sciatica, epilepsy; these, and other affections closely 
associated with the gouty diathesis, are, in many cases, primarily de- 
veloped by a lowered tone of the nervous system, which is induced by 
overwork and high pressure. 
A very interesting clinical fact may here be mentioned which has an 
important bearing in the treatment of these affections, it is this—that 
Phosphorus acts as a solvent for uric acid. It has been observed that 
patients who habitually pass uric acid (in its crystallized form) get rid 
of the gravel; whilst taking Phosphorus “the gravel” in all cases dis- 
appears. To this fact is probably due the alleviation of the rheumatic 
and neuralgic pains which follow its employment; and, at the same time, 
the disappearance of dyspeptic symptoms, induced by the presence of 
uric acid. Whether this is accomplished by the diuretic effect of the 
Phosphorus increasing the quantity of water, or by any special solvent 
action of its own, I am not prepared to say; but, from personal obser- 
vation, I can speak positively as to the fact. 
Dr. Buckler, of Baltimore, was the first to recommend Phosphate of 
Ammonia as a remedy for gout, and Dr. Garrod and others have used 
it with success. It is considered to possess great solvent power for the 
urate of soda. It is probable that free Phosphorus possesses a like 
power. 
Melancholia, or Emotional Insanity.—This form of dementia is 
without doubt one that may be properly classed among induced dis- 
eases incidental to modern life. It is often caused by over brain ac- 
tion, and a combination of the very causes which we have already 
seen produces the milder forms of loss of nerve-power and physical 
debility. 
Dr. S. W. D. Williams, Medical Superintendent of the Sussex Lu- 
natic Asylum, publishes the following cases treated in the asylum; and 
as they are illustrative cases and offer invaluable testimony to the reme- 
dial action of Phosphorus, his report is appended verbatim : 
Case I.—J. F., male, cet. 51 years, married, agricultural laborer. Admitted 6th 
September, 1S73. No hereditary taint, but father given to drinking; first attack; 
has been gradually coming on for twelve months; supposed to be caused by 
dismissal from employ by a master with whom he had worked for many 
years. On admission, he was in a state of pure melancholia, apparently un- 
complicated with delusion. His state of wretchedness and misery, was pitia- 
ble in the extreme, and he was constantly on the look-out for some means PHOSPHORUS IN NEURALGIA. 
29 
of destroying himself. His bodlily health was fairly good. His nights were 
almost entirely sleepless, and he was treated after admission with chloral. 
This gave him temporary relief, but he became worse again, and on the 27th 
September the chloral was changed for opium and chloric ether; after which 
he began to refuse his food; and on November 12th, being no better, he 
was ordered 1-30 gr. Phosphorus, night and morning. Within a few days 
the depression became much less, and by December 12th had quite left him. 
Result—Recovery. 
Case 2.—J. B., female, set. 30 years, single. Admitted 6th June, 1873, when 
she is described as having a restless manner, and constantly wandering about 
day and night; as having great lowness of spirits without any apparent cause; 
and as expressing herself as being fearful she shall destroy herself to escape 
from her miseiy, although she is unable to assign any cause for her dejec- 
tion. Menstruation regular; bodily health fairly good. Was treated chloric 
ether and opium, and with chloral. The attack lasted seventy days, and on 
August 17th she was reported as recovered. On August 28th, she relapsed, 
and remained ill nearly as long, but by November 27th was considered well 
enough to be brought before the committee for discharge. The excitement 
attendant on the prospect of regaining her liberty was too much for her, and 
she relapsed before she could be removed from the asylum. She was now 
put on Phosphorus, and the attack lasted only twenty-seven days, since when 
(two months) she has remained cheerful and well. 
Result—Recovery. 
Case 3.—M. O., female, set. 27 years. Admitted February 7th, 1874. This is the 
first attack, and has lasted only ten days, and is stated to be due to excessive at- 
tention to her religious duties. On admission she was in a state of religious ex- 
altation, and had delusions on religious subjects, but in the course of a day or 
two she became very depressed, and slept but little at night. Chloral gave her 
rest for a night or two, but soon lost its effect, and opium was tried without 
benefit; indeed, she seemed to be lapsing into a state of melancholia atonita. 
On the 17th, Phosphorus was ordered; on the 22d, she was much improved, and 
the tongue had the silvery white appearance already described as due to this 
medicine. This case is still under treatment, and there is every prospect of re- 
covery. 
Result—Probable Recovery. 
Neuralgia.—This affection, when not directly the result of some 
physical cause interfering with the integrity of the nerve in which the 
pain is situated, is almost invariably due to a depressed state of the 
nervous system. Its very existence must be received as an evidence of 
deficient physical stamina, and that the nervous system is not duly 
nourished. The remote factor may be malaria, syphilis, rheumatism, 
gout, or some other cause capable of devitalizing the organism, and as 
a consequence that of the nerves (Hammond).* 
* Diseases of the Nervous System, page 833. 30 
PHOSPHORUS IN NEURALGIA. 
This being so, it follows that our remedial measures should be di- 
rected principally to improving the nutrition of the affected nerve, and 
to the removal of any constitutional taint that may be present. 
The first indication is best fulfilled by simple Phosphorus in large 
doses, or Phosphorized Iron. In facial Neuralgia and brow ague 
it should be combined with Quinine, and if malarial influence be sus 
pected, full doses of Quinine are desirable. The treatment of Sciatic 
Neuralgia (Sciatica) will mainly depend upon the cause. Local irri 
tation, when detected, must be, if practicable, carefully treated. The 
constitutional measures employed are, however, of the utmost import 
ance, and must be conducted on the principles already described. 
Phosphorized Iron, with Nux Vomica, acts most beneficially. If syphi- 
litic taint be suspected, Iodide of Potash must on no account be 
omitted 
The following table is taken from a valuable paper contributed to 
the “■London Practitioner," by Prof. J. Ashburton Thompson, on 
the use of Phosphorus for the above-named complaint, larger doses 
being employed by him (the 1-25 gr.), and with marvelous success. 
He records 18 cases, as will be seen by table below, and arranges them 
in three classes—Acute Primary Attacks, Acute Recurrent Attacks, 
and Chronic cases. Six cases occur in each class. In the first class 
the ages ranged between 25 and 46; in the second, between 30 and 40 ; 
in the third, between 24 and 40. 
Some of the patients suffered from Trigeminal, some from Cervico- 
Occipital, some from Cervico-Brachial Neuralgia, and one in the second 
class from Sciatica. All the cases in the first classes were cured ; of 
the third class three were cured, one of the patients having been 
afflicted 16 years, without a week’s freedom from pain. 
Sex. 
Age. 
Nerves Affected. 
Duration 
of 
Extreme 
Duration 
of 
Treatment. 
Complication. 
Result. 
Attack. 
PRIMARY ACUTE CASES. 
M 
40 
R Trigeminal. 
4 days. 
4 days. 
Catarrh. 
Recovery. 
F 
26 
L. Trigeminal. 
14 days. 
10 days. 
Anmmia. 
F 
25 
21 days. 
24 hours. 
None. 
M 
46 
Cervico-Occipital. 
12 hours. 
12 hours. 
General Derangement. 
F 
28 
L. Trigeminal. 
14 days. 
48 hours. 
Lactation. 
1-' 
26 
<< «< 
6 days. 
12 days. 
Catarrh. 
“ 
RECURRENT ACUTE CASES. 
F 
60 
R. Sciatic. 
is davs. 
36 hours. 
Decay of Nature. 
Recovery. 
F 
33 
L. Trigeminal. 
5 days. 
6 days. 
None. 
F 
32 
“ “ 
21 days. 
24 hours. 
“ 
F 
33 
R. Trigeminal. 
io days. 
4 days. 
Lactation. 
“ 
F 
30 
14 days. 
5 days. 
Phthisis. 
“ 
F 
30 
7 days. 
48 hours. 
Debility. 
“ 
CHRONIC 
CASES. 
F 
28 
( R. & L. Trigeminal. 1 
j Cervico-Brachial. J 
18 mos. 
5 weeks. 
Phthisis. 
Relief. 
F 
24 
R. & L. Trigeminal. 
4 weeks. 
9 days. 
“ 
M 
35 
f Occipital, R. & L. ) 
( Trigeminal J 
Cervi co-Brachial. 
12 mos. 
13 days. 
Nervous Debility. 
Cure. 
F 
36 
2 mos. 
14 days. 
Pregnancy. 
F 
26 
R. & L. Trigeminal. 
16 years. 
18 days. 
None. 
*4 
F 
4 3 
R. Trigeminal 
4 mos. 
15 days. 
“ (Decayed Teeth.) 
None TEMP ORAR Y NER VO US EX HA USTIOJY. 
31 
Neuralgia in men is frequently simply an expression of loss of nerve- 
power ; it may be the consequence of dissipation and excesses of 
various kinds,—but overwork and intense intellectual exertion also 
produce the disease. It is of little moment where the pain is located, 
the treatment must be general. Phosphorus and Nux Vomica, with or 
without Quinine, are remedies which seldom fail to give relief. 
Women suffer more frequently and intensely from neuralgia than men 
do; and it is usually associated with diseases of menstruation,— 
menorrhagia, especially. Hyperfecundation, rapid child-bearing, 
frequent miscarriage, haemorrhage, prolonged lactation, and changes 
occurring at the climateric period of life, induce a neuralgic condition 
of the nerves. In all cases the general treatment should be directed 
to the removal of the cause, whenever this is possible. Local treatment 
should not be neglected. Opium and Aconite are powerful palliatives. 
The best form of applying the former is by hypodermic injection • 
the sixth of a grain of the Sulphate of Morphia will usually succeed in 
arresting very speedily a severe paroxysm of pain : the latter by means 
of the liniment or strong tincture applied externally. 
A full, nutritious diet, with a fair allowance of wine, is a necessary 
part of the treatment in almost all forms of Neuralgia. 
Temporary Nervous Exhaustion.—Whenever the system is tem- 
porarily jaded by overwork, wearied by unusual or excessive mental 
effort, or suffering under exceptional nervous exhaustion from any 
cause, Phosphorus will be found a useful remedy. In such cases 
its exhilarating and restorative effect is very marked. The one-twen- 
tieth or one-sixteenth of a grain may be given either alone or, combined 
with Nux Vomica or Quinine, with meals. It quickly produces a 
remarkable sensation of bien-etre, of comfort and exhilaration, and a 
manifest increase of power. It gives to the weary and languid brain 
not merely a fillip, but material support, with increased capacity for 
renewed exertion, while it restores the animal spirits. The specific 
effect of Phosphorus is far less evanescent than wine and alcoholic 
stimulants, and it is not followed by depression common to them. It 
is well to remember that the employment of the remedy is open to 
abuse. The prescriber should be careful to see that this is guarded 
against. 
Dr. Janney reports as follows :—My nephew, a young man aged 
nineteen years, native of Bucks County, Pennsylvania, and a student 
at Swarthmore College, up to October, 1874, was very robust and 
healthy. Presented himself with the following symptoms : Emaciated, 
terrible headache, loss of memory, languor and low spirits. Treated 
him at once with Warner & Co’s Compound Phosphorus Pills. On 32 
NERVOUS PROSTRATION AND HYSTERIA. 
the 15th of November, after four weeks treatment, his mother reported 
him well, memory restored, and he once more at his studies. 
Nervous Prostration occurs in the later stages of typhus and 
typhoid fevers,'pneumonia, and other asthenic conditions. Phosphorus 
may thus be prescribed as a special nerve stimulant, as well es a reno- 
vator of nerve tissue, with successful results. Full doses are 
always necessary, Pil. Phosphori, 1-50 gr., should be ordered every 
three or four hours, of course watching closely its effect. In these 
cases it must be given boldly, and must not be delayed until it is too 
late to save the patient from his impending fate. The Ethereal Tinc- 
tures are recommended by some practitioners, but it is preferable, in 
all cases, to effect the gradual and certain absorption of the element, 
and this is best secured by the administration of the Pil. Phosphori, 
rather than by depressing the patient with nauseating doses of solutions 
of Phosphorus. 
When it is wished to obtain the stimulating effect of the remedy, and 
that quickly, the pill should be dissolved in a little warm water (a wine- 
glassful) before it is taken. No better mode can be adopted, when- 
ever it is thought desirable or necessary to give Phosphorus in a fluid 
form. 
Hysteria.—“The hysteric state,” says Dr. Russell Reynolds, “is 
essentially one of mental perturbation, and it is brought into existence, 
if not inherited, by those conditions which are most active in produ- 
cing disorder of the mind : in the male sex by worry, anxiety, over- 
work, late hours, accidental injuries, and dissipation \ in the female 
sex by vexatious emotions, want of sympathy or success, disappointed 
or concealed affection, want of occupation, fear, and morbid condi- 
tions or supposed morbid conditions of the reproductive system.* 
It would appear that the 
nutrition of the whole nervous system is changed, but that change is of 
such a kind that it passes beyond our power of recognition, except in 
its physiological or pathological effects. We cannot see degeneration 
of tissue here or too rapid metamorphosis there, but we can witness the 
effects of such morbid processes in movement in secretion and nutri- 
tion, and we observe some of the ultimate results of such changes in 
emotion and sensation.” 
Inasmuch, therefore, that, in its multiform manifestations, hysteria 
is a direct expression of exhausted vital power, Phosphorus may usually 
be employed with much advantage. It is best administered in combi- 
* System of Medicine, vol. ii.. p. 98. T PILE PS Y AND EPILEPTIC VERTIGO. 
33 
nation with Zinc and Aloes; or if there be ancemia, with Iron and 
Quinine. 
The moral treatment of hysteria is obviously of great importance. 
The form that it should take will depend entirely upon the causes to' 
which the affection may be due, a remark that applies to all cases 
associated with loss of self-control, as well as defective nervous power. 
Epilepsy and Epileptic Vertigo.—“ There are two distinct ele- 
ments to be regarded in the therapeutics of epilepsy. The one is the 
diminution or removal if the condition which is the essential element of 
the disease; and the other is the mitigation of the paroxysmal symp- 
toms (Reynolds).* The treatment of this, like other affections of 
the cerebro-spinal system, chiefly depends upon the origin and cause 
of the seizure. 
In one hundred and two cases treated by Dr. Hammond/)* in which 
evidence was received, the epilepsy originated from the following 
causes :— 
Over mental exertion 17 
Venereal excesses ...... ' . . 15 
Menstrual derangement IO 
Anxiety and grief IO 
Indigestion ....................... 11 
Dentition 11 
The remaining twenty-eight originated in frights, blows, sunstrokes, 
fever, etc. 
It will be observed that a very large proportion of the ascertained 
causes were precisely those which lead to deterioration of nervous 
tissues, and in these cases Phosphorus will be found extremely useful 
by diminishing or removing “ the essential elements” of the disease. 
In the treatment of epilepsy, is usually employed Phosphorus in 
combination with Zinc; the attacks-become less frequent and less 
severe as the patient comes fully under the influence of the medicine. 
In chronic cases even small signs of improvement should encourage us 
to persevere with the remedy for six or eight months at least. 
Vertigo and Headache are symptoms of cerebral ancemia as well 
as hyperancemia, and when so caused they are relieved by Phosphorus 
and Iron. 
Giddiness and persistent headache should never be neglected ; they 
* System of Medicine, vol. ii. 
f Diseases of the Nervous .System, p. 575. 34 
CEREBRAL SOETENING. 
are often the earliest symptoms of an impending epileptic or paralytic 
seizure, which by proper treatment may be averted. 
Cerebral Softening.—In softening of the brain, Dr. Hammond 
has found Phosphorus of distinct and great advantage; but, as it is 
reasonable to expect, its effects are more marked in those cases in 
which the softening is insidious and gradual in its attack, than in those 
in which it results from thrombus, embolism, or hemorrhage. The 
author gives two examples in which the illness supervened on much 
excessive mental application, and in which perfect recovery was noted. 
Convenience, as well as other reasons, would lead to the substitution 
of a pill. 
. Pie presents one case of brain softening which occurred in a clerk 
aged fifty, who had rheumatic fever at the age of twenty-five, but, he 
alleges, without any cardiac complication. 
Since then he has been subject to attacks, sometimes of gout and 
sometimes of muscular rheumatism, recurring two or three times a 
year. 
The heart sounds are normal, and the health in other respects good. 
After the attack of acute rheumatism his hair fell off; and what re- 
mained of it, or grew subsequently, is quite white. 
The illness began with a little difficulty in writing, which seemed to 
consist in loss of free movement of the fingers simply. On the second 
day this symptom had increased, and was accompanied by tingling, 
which affected the whole of the lower half of the right hand, but was 
more intense in the ring and little fingers, and the ulnar side of it. 
On the third day there was numbness of the same parts, and the 
tingling was also felt in the right side of the trunk. Neither the leg 
nor the arm suffered, nor was any other symptom of illness detected. 
On the fifth day, the other symptoms remaining in statu quo, a dis- 
tinct loss of directing power was observed in the right extremity, but 
indefinite movements of the limb were performed readily. 
There was also loss of muscular power, as indicated by the grasp. 
After five weeks of treatment with alterative and tonic medicines, all 
the symptoms related were present, as at first. There was no improve- 
ment. During that time there had been a little depression of spirits, 
but no other symptom. He was then placed under Phosphorus treat- 
ment. Improvement was at once observed; in a week the tingling 
disappeared from the sides, and then it began to leave the fingers; at 
the same time the power of direction was recovered. 
The numbness next left, so that he was able to pick a pin off a hard 
table ; and at the end of a month he was again able to write, not with SKIN DISEASES. 
35 
his usual freedom, nor without effort, but fairly well. The muscular 
power had increased, and there was still further improvement distinctly 
traced to the remedy employed. 
Skin Diseases.—A large class of cutaneous diseases arise from de- 
fective nutrition, and are directly traceable to debility, break down of 
the periphral, together with the central nerve-power, resulting from 
overwork and intense anxiety of mind ; others are diathetic and some 
are purely neurotic. In skin diseases arising in this way Phosphorus is 
exceedingly useful, particularly in psoriasis, chronic eczema, pruritus, 
and those forms of strumous and cachectic affections of the skin usually 
treated with arsenic, cod-liver oil, and other nervine tonics. It is to 
be always remembered, that in the treatment of these affections local 
treatment must not be neglected. 
In a paper contributed to the Dublin Journal of Medical Science, Dr. 
Eames speaks of Phosphorus as being more than a substitute for 
arsenic; that he has succeeded in curing cases with it where arsenic 
entirely failed. DIRECTIONS FOR REGIMEN, DIET, ETC., 
IN THE TREATMENT 
OF 
FUNCTIONAL DISORDERS OF THE NERVOUS SYSTEM. 
The recognition of the disturbing cause is the key to the suc- 
cessful treatment of loss of nerve-power and all its various manifesta- 
tions. It is advisable, therefore, to get from the patient a faithful 
history of his or her case. It is in vain to enforce rules, fix diet, 
limiting supplies and forbidding luxuries, in vain to harass the patient 
with all kinds of directions and prohibitions if, in ignorance of the one 
essential element of the disease we leave it uninfluenced. 
As already stated, the remedies which act most beneficially 
are: i. Phosphorus; 2. Quinine; 3. Nux Vomica or Strychnia; 
4. Digitalis; 5. Iron. 
Regimen and the regulation of diet are subjects of the utmost im- 
portance in the treatment of all disease. They are especially so in 
disorders affecting nutrition of the nervous system. A single error in 
diet or regimen may delay or hinder the success of any plan of treat- 
ment however well devised, and therefore the few practical suggestions 
which it is ventured to offer under this head will not be considered 
superfluous in a treatise on the employment of a new, to many an un- 
tried, remedy. It will be understood that they are only intended to 
indicate general principles of management, while very many cases will 
require particular directions. 
Before commencing, as well as during the Phosphorus treatment, 
attention must be paid to what is understood as the “general health,’’ 
—the condition of the digestive organs, the biliary and renal secre- 
tions, the action of the bowels, etc., and suitable remedies must also 
be prescribed for functional disorders. 
Constipation is a very constant concomitant of nervous disorders, 
and a cause of much mischief as well as discomfort if not removed. 
Not uncommonly it is due simply to want of tone (nerve-power) in the 
muscular coat of the bowels, and is then best treated by adding Nux 
Vomica to the Phosphorus. When it occurs from diminished secretion 
of bile, mild mercurials may be given ; if these be objected to, Podo- 
phyllin will be found an excellent substitute for Mercury; it may be 
36 REGIMEN AND DIET. 
37 
given from time to time in small doses as an alterative as well as an 
aperient. 
Portal Congestion should be relieved by Active Aperients. In 
most cases the bowels should be acted upon once a day. An occasional 
dose of simple aperient medicine will effectually prevent “clogging of 
the liver,” which some writers affirm occurs during a course of Phos- 
phorus. 
Diet.—Patients should be satisfied with simple but good nutritious 
food; it should consist of a moderate amount of fresh meat, mutton, or 
beef, well but not over dressed, game or poultry, fresh vegetables,* 
and a liberal supply of cream, butter, and other animal fats. Eggs, 
when fresh and uncooked, are very digestible and highly nutritious. 
In cases of extreme debility, as many as half a dozen may be taken 
daily. Fresh fish of all kinds are generally admissible. For breakfast, 
coffee is a good beverage; it is an agreeable stimulant, and if not too 
exciting is more refreshing than cocoa or tea, the latter (not green tea) 
may be taken, however, if preferred, once or twice a day, but not oftener. 
The quantity as well as the kind of food must, however, in a great 
measure be determined by the digestive power of the patient, but over 
feeding is to be especially guarded against. Nervous patients, as a 
rule, are dyspeptics, and their digestive power is much impaired. Milk 
and farinaceous substances, such as lentilmeal (rcvalenta), corn-flour, 
macaroni, and other Italian pastes, with a little fresh fish or meat 
broth once a day, will be found better borne by most invalids than 
solid animal food. The extract of meat (Liebig) has very little 
nutritive value, but nevertheless it is useful; a cup of strong broth 
made with it may be ordered to be taken once or twice during 
the night with a dose of Phosphorus, when nervous exhaustion 
is very marked. In treating nervous debility it is a common practice 
to recommend animal food two or three times a day. “ Heavy meals” 
are great evils, they embarrass digestion, and arrest rather than favor 
nutrition, and in my experience are highly injurious. Nitrogenous 
food, taken in excess, loads the blood with the products of disassimila- 
tion, embarrasses the circulation, and unnecessarily taxes the excretory 
organs. The quantity of animal food should, as far as possible, be 
regulated by the power to assimilate, which, in some cases, owing to 
lowered nervous power, is, as already observed, in a very languid con- 
dition. 
The moderate use of wine and spirits, rather than total abstinence, 
* Not always admissible in acute dyspepsia. 38 
DIET, REST, ETC. 
is, in most cases desirable. It is a common practice, but a fatal error, 
to seek relief from nervous depression in an excessive use of alcoholic 
drinks. Beer of all kinds, as a rule, is not well borne, it is apt to im- 
pair and delay digestion and to charge the urine with lithates. There 
are, however, some exceptions to the rule ; in cerebral paresis, for in- 
stance, patients are much benefited by a judicious use of both wine and 
beer. The habitual use of alcohol, if excessive, we have already shown, 
is a destroyer of nerve-power, and its moderate use is only to be per- 
mitted as a medicine, and the quantity allowed should be definitely 
defined. Tobacco operates as a powerful sedative and depressor of 
nerve-force, and for this reason should be used with great moderation 
or abandoned. The influence of habit in the use of this narcotic must 
be taken into account. 
From w'hat has been said it will be inferred that matters of this kind 
are of practical importance in the treatment of the several diseases un- 
der consideration, and patients should be made to understand that they 
must strictly conform to the prescribed regimen. I usually make it the 
subject of a separate prescription, and state definitely, for the guidance 
of the patient, what may and what may not be taken. 
Sleep.—Want of sleep, we have already seen, is one of the earliest 
symptoms of loss of nerve-power, of an over-fatigued, over-worked 
brain, and one of the first that will be relieved by Phosphorus, a very 
significant fact indeed. The importance of sleep will be at once ap- 
parent when we call to mind its physiology. “ Simple repose suffices 
to relieve fatigue of the muscles; but sound sleep, and sound sleep 
alone, relieves fatigue of the brain ; without it there can be no rest for 
the organ, and no repair of its tissue.” When, therefore, this is want- 
ing, imperfect, or broken, little progress towards regaining power can 
be made ; and if, therefore, wakefulness be not speedily relieved by 
Phosphorus, as it very generally is, affording the most satisfactory evi- 
dence of its beneficial operation, a dose of Chloral, or a combination of 
it with Indian Hemp and Morphia at bedtime, may be ordered, espe- 
cially if much nervous excitement co-exists. The Bromide of Ammo- 
nium, in from 15 to 30 grain doses, is very useful in these cases, and 
seldom fails to produce refreshing sleep when Opium or Chloral is not 
admissible. 
Gouty and Rheumatic Affections, Albuminuria, Secondary Syphilis, 
and other diathetic conditions, it is known, operate as powerful de- 
pressants, and add to our difficulties in the treatment of functional dis- 
orders of the nervous system. These affections are prevalent among 
the over-worked and under-fed, as well as the over-fed and, it may be, FFIYSIOLOGICAL REST. 
39 
under-worked as well as over-worked. In such complications, but in 
the acid diathesis especially, it is necessary to regulate the diet with 
great care. The alkaline mineral waters are useful; seltzer or potash 
may be taken during meals.* Early hours, and the daily use of the 
bath, cold or tepid, according to the constitution and habits of the 
patient; cold, either plunge, douche, or sponge, should be preferred. 
The Turkish Bath is also exceedingly useful in many disorders of the 
nervous system. In cases complicated with Gout or Rheumatism it 
must on no account be omitted ; indeed, it may always be safely pre- 
scribed when there is no heart disease. Late hours, involving loss of 
rest and excessive nervous excitement, and dissipation of all kinds, 
tending directly or indirectly to fatigue or exhaust nervous force, must 
of course be abandoned. Regular exercise in the open air should be 
recommended as a necessary part of the treatment. Some men 
whose busy brains, during long business hours, have been closely 
engaged in financial or commercial schemes, unwisely seek relief, or as 
they call it change, in card-playing, and in the excitement of gaming; 
this is a very bad practice. It adds fuel to the fire by increasing wear 
and tear, and by curtailing the period of necessary repose. The repair 
of nervous tissue is retarded, and the reaction of depression which 
always follows every kind of abnormal and excessive nervous excite- 
ment is prolonged. 
Physiological Rest.—This subject remains to be noticed ; and it 
is not an unimportant one. I have already said that absolute repose 
is necessary to the nutrition of the brain ; this is only secured by 
natural sleep. But repose should be secured by day as well as by 
night, and this is best done by an entire abstention from the occupa- 
tions which have overtaxed the mind, and by mental distractions of a 
pleasurable kind. Change of air and scene assist this ; in some cases 
are essential to recovery. In softening of the brain in particular, no 
treatment will avail unless supplemented by a complete cessation from 
work, and by change of air and scene. 
In the treatment of the condition described as below par, complete 
rest is a sine qua non, and whenever practicable this must be associated 
with change of some sort. 
In cerebral paresis supervening on excessive mental application, mere 
cessation from the routine of daily duties is insufficient: the brain 
needs wholesome exercise as well as repose, and this is best attained by 
* Vichy, Pullnaand Friedrichshall are useful as aperients. They should be taken 
before breakfast. The addition of a little hot water is found to increase their aperient 
action. 40 
GENERAL PRINCIPLES FOR USE OF PHOSPHORUS. 
new and pleasurable occupations, providing they be quite differ- 
ent in character. In most cases travel is found an efficacious and 
powerful restorer of nerve-power and energy. It calls into play 
faculties and emotions of the mind which may long have lain dor- 
mant, and reposes others that have been overstrained and weakened. 
New occupations, providing they be quite different in character from 
what has gone before, afford rest to a mind that has been overworked 
on one subject. The symptoms and history of every case will indicate 
where the strain has been most severe, and what functions have been 
most overtaxed, and help us to advise specifically on this subject. 
It is, however, with no small difficulty that patients are prevailed 
upon to give up or curtail work which has long engrossed the energies 
of both heart and brain ; they will often persistently refuse to accede 
to the advice of the physician or to the entreaty of friends until it is 
too late to avail It is only by a dearly bought experience they learn 
how vain it is for the will to persist when the body refuses to follow. 
To sum up the general principles of the employment of Phosphorus 
as a nerve tonic, for which it is recommended by no less authority than 
Prof. Delpech, Prof. Fisher of Berlin, Dr. Eames (.Dublin Journal), 
Dr. Burgess, and Dr. Hammond of New York, the special treatment 
indicated in these cases is: 
ist. Complete rest of mind, especially abstention from all occupa- 
tions resembling that upon which the mind has been overworked. 
2d. The encouragement of any new hobby or study not in itself 
painful, which the patient might select. 
3d. Tranquility to the senses, which expressly give in these cases 
incorrect impressions, putting only those objects before them calculated 
to soothe the mind. 
4th. A very nourishing diet, especially of shell fish. 
5th. The internal administration of Phosphorus in pilular form, pre- 
pared by Wm. R. Warner & Co. FORMULA* 
FOR THE ADMINISTRATION OF FREE rilOSPHORUS 
IN COMBINATION WITH 
Iron, Quinine, Zinc, Nux Vomica, Strychnia, Morphia, Indian Hemp, 
Cantharides, Digitalis, Aloes, etc. 
A TABLE OF COMBINATIONS. 
1—PIL. PHOSPHORI 1-100 grain, 1-50 grain, 1-25 grain, in each. 
2—PIL. PHOSPHORI COMP. 
Phosphori 1-100 grain. 
Ext. Nuc. Vom. Y grain. 
3—PIL. PHOSPHORI CUM NUC. VOM. 
Phosphori 1-50 grain. 
Ferri Red. 1 grain. 
Phosphori 1-50 grain. 
Ext. Nuc. Vom. grain. 
4—PIL. PHOSPHORI CUM FERRO, 
5—PIL. PHOSPHORI CUM FERRO ET NUC. VOM. 
Phosphori 1-100 g.-ain. 
Ferri Carb. 1 grain. 
Ext. Nuc.Vom. Y grain. 
6—PIL. PHOSPHORI CUM FERRO ET QUINIA, 
Posphori 1-100 grain. 
Ferri Carb. 1 grain. 
Sul. 1 grain. 
Phosphori 1-100 gr. 
Ferri Carb. 1 gr. 
Quini® Sul. 1 gr. 
Ext. Nuc. Vom. Y gr- 
7—PIL. PHOSPHORI CUM FERRO ET QUINIA ET 
NUC. VOM. 
8—PIL. PHOSPHORI CUM QUINIA, 
Phosphori 1-50 grain. 
Quini® Sul. 1 grain. 
Phosphori 1-50 grain. 
Ferri Red. 1 grain. 
Quini® Sul. J4 grain. 
Strychniae 1-60 grain. 
9—PIL. PHOSPHORI CUM QUINIA CO., 
10—PIL. PHOSPHORI CUM QUINIA ET NUC. VOM., 
Phosphori 1-50 grain. 
Quini® Sul. 1 grain. 
Ext. Nuc. Vom. Y Er- 
Phosphori 1-50 grain. 
Quini® Sul. l/2 grain. 
Pv. Digitalis % gr. 
Pv. Opii Y grain. 
Pv. Ipecac. Y grain. 
11—PIL. PHOSPHORI CUM QUINIA ET DIGITALE CO, 
12—PIL. PHOSPHORI CUM DIGITALE CO., 
Phosphori 1-50 grain. 
Pv. Digitalis 1 grain. 
Ext. Hyoscy. 1 grain. 
13—PIL. PHOSPHORI CUM DIGITALE ET FERRO, 
Phosphori 1-50 grain. 
Pv. Digitalis 1 grain. 
Ferri Red. 1 grain. 
14—PIL. PHOSPHORI CUM CANNABE INDICA, 
Phosphoii 1-50 grain. 
Ext. Cannab, Ind. Y grain. 
15—PIL. PHOSPHORI CUM MORPHIA 
ET ZINCI VALER- 
Phosphori 1-50 grain. 
Morphias Sul. 1-12 grain. 
Zinci Valer. 1 grain. 
16—PIL. PHOSPHORI CUM ALOE ET NUCE VOMICA, 
Phosphori 1-50 grain. 
Ext. Aloes Aq. gr. 
Ext. Nuc.Vom. Y gr. 
17-PIE. PHOSPHORI CUM ZINCO CO. 
Phosphori 1-50 grain. 
Zinci Sul. 1 grain. 
Lupulin® i grain. 
Phosphori 1-50 grain. 
Pv. Digitalis J4 grain. 
Pv. Ipecac- 54 grain. 
Pv. Opii Y grain. 
18—PIL. PHOSPHORI CUM OPIO ET DIGITALE, 
19-PIL. PHOSPHORI CUM STRYCHNIA, 
Phosphori 1-50 grain. 
Strychniae 1-60 grain. 
Phosphori 1-50 grain. 
Pv. Nuc. Vom. 1 grain. 
Sol Cantharidis Con. 1 )t\. 
20-PIL. PHOSPHORI CUM CANTHARIDE CO., 
41 
* Prepared by WM, R. WARNER & CO. FORMULAE. 
[!■] 
PIL. PHOSPHORI MOO gr., 1-50 gr., or 1-25 gr. 
Dose—One pill, twice or three times a day, at meals. 
The Remedial Uses of Phosphorus have already been fully dis- 
cussed. When the indications can be filled by Phosphorus alone, these 
pills which contain the usual dose of free Phosphorus, will be found, 
not only convenient, but thoroughly reliable and tsafe. 
b-] 
PIL. PHOSPHORI COMP. 
R Phosphori, 1-100 gr.; Ext. Nucis Vomicae, gr. 
Dose—One or two pills three times a day, after meals. 
Therapeutics.—Phosphorus and Nux Vomica, in the proportions 
above indicated, form a mild but valuable remedy. As a nutritive 
tonic and stimulant to the nervous system, especially the spinal cord, 
this pill is admirably adapted for the treatment of a large number of 
nervous disorders dependent on defective nutrition and debility of the 
spinal column. It increases appetite and promotes digestion. In this 
dose Phosphorus maybe safely given even to children in those diseases 
in which the hypophosphites are employed with advantage. 
[3-] 
PIL. PHOSPHORI CUM NUCE VOMICA. 
R Phosphori, 1-50 gr.; Ext. Nucis Vom., j/fa gr. 
Dose—One or two three times a day with food. 
Therapeutics.—This combination is especially indicated in atonic 
dyspepsia, lowness of spirits, and in that condition of general depression 
and loss of power popularly known as “ below par," and in break-down 
from overwork or mental fatigue. Phosphorus and Nux Vomica are 
probably the only medicines which can be relied upon as sexual stimu- 
lants, and possesses real aphrodisiac power. Their administration, 
however, with this view requires circumspection : large doses are not 
42 FORMUFF. 
43 
necessary nor desirable, neither should they be long-continued without 
cessation; one or two pills twice or three times a day, according to 
the circumstances of the case, may safely be prescribed for two or three 
weeks in succession with advantage. 
[4-] 
PIL. PHOSPHORI CUM FERRO. 
R Phosphori, 1-50 gr.; Ferri Redacti, 1 gr. 
Dose for Adults—Two, twice or three times a day, with food. 
For Children between 7 and 12 years of ape—One, twice or thrice 
daily, with food. 
Therapeutics.—Phosphorus and Iron, as it has already been said, 
is a powerful nervine tonic and blood restorer. It is especially valu- 
able in tubercular diseases, co7isumption, tabes mesentcrica, scrofula, 
and the strumous diseases and cachectic conditions of children. It is 
given with great advantage in anosmia, chlorosis, in sciatica, and other 
neuralgic affections; also in furuncular inflammations, carbuncles, 
boils, etc., etc. This pill is very suitable for anaemic children. An 
admirable adjuvant to a course of cod liver oil. 
[5-] 
PIL. PHOSPHORI CUM FERRO ET NUCE VOMICA. 
R Phosphori, i-ioo gr.; Ferri Carb., i gr.; Ext. Nucis Vom., 
V\ sr- 
Dose—One or two pills three times a day, with food. 
Therapeutics.—See Pil. Phosphori cum Ferro. Mr. Jabez Hogg 
believes this formula will be found extremely valuable in atrophy of 
the optic nerve. 
It is especially beneficial in anaemic conditions and sexual debility, 
and in neuralgia occurring in persons who have exhausted the vital 
powers by dissipation or excesses. 
[6.] 
PIL. PHOSPHOR! CUM FERRO ET QUINIA. 
R Phosphori, i-ioo gr.; Ferri Carb., i gr.; Quiniae Sulph., i gr. 
Dose—One pill three times a day, with food. 
Therapkutics.—The uses of Iron and Quinine in combination are 
too well known to need any remark. Phosphorus intensifies their 
action, while it imparts additional power by stimulating the nutrition 
of the nervous system. This is an excellent tonic in general de- 
bility, and a valuable combination in cerebral anaemia and spinal 
irritation. 44 
FORMULAE. 
(70 
PIL. PHOSPHORI CUM FERRO ET QUINIA ET NUCE VOMICA. 
R Phosphori, 1-100 gr. ; Ferri Carb., 1 gr.; Ext. Nuc. Vom., 
Y\ gr-i Quinae Sul., 1 gr. 
Dose—One pill three times a day, with food. 
Therapeutics.—The action of Iron, Quinia and Nuc Vomica, 
intensified by Phosphorus, imparting additional power by stimulat- 
ing the nutrition of the nervous system. 
[8.] 
PIL. PHOSPHORI CUM QUIHIA. 
R Phosphori, 1-50 gr.; Quiniae Sulph., 1 gr. 
Dose for Children from 7 to 10years—One pill three times a day. 
For Adults—Two twice or three times a day, at meals. 
Therapeutics.—Phqsphorised Quinine is a valuable combination 
of two powerful restoratives. Acting as a nutrient tonic to the entire 
nervous system, it gives power to the brain and spinal cord, and to the 
functions presided over by the organic nervous centres. Imparting 
tone to the digestive organs, it gives strength to, and improves the 
condition of the whole system. As a nutritive tonic, this pill is one 
of the best that can be devised. In most cases where Quinine is indi- 
cated, it may be prescribed with great advantage, it being more active 
given in this form than when administered alone. 
[9-] 
PIL. PHOSPHOR! CUM QUINIA COMP. 
R Phosphori, 1-50 gr.; Ferri Redacti, 1 gr.; Quiniae Sulph., gr.; 
Strychniae, 1 60 gr. 
Dose—One pill three times a day, with food. 
Therapeutics.—This is a valuable and highly efficient combination 
of nerve tonics. It will be found exceedingly efficacious in that nu- 
merous class of disorders which is characterized by impoverished blood 
and diminished nerve-power, and which is often induced by overwork, 
by dissipation, and by excesses of various kinds, a condition in which 
Iron and Phosphorus are strongly indicated. It must be obvious that 
this preparation is admirably adapted to effect the purposes for which 
these powerful therapeutic agents are usually prescribed. It will be 
found more effectual than the Hypophosphites and other feeble modes 
of exhibiting Phosphorus. FORMULA. 
45 
[10.] 
PIL. PHOSPHORI CUM QUINIA ET NUCE VOMICA. 
R Phosphori, 1-50 gr.; Quiniae Sulph., 1 gr.; Ext. Nucis Vom., 
,r4 er- 
Dose for Adults—One or two twice or three times a day, with food. 
For Children—One pill twice or three times a day. 
For the use of this valuable combination, see Pil. Phosphori cum 
Quinia, formula No. 8. 
[”•] 
PIL. PHOSPHORI CUM OUINIA ET DIGITALE COMP. 
R Phosphori, 1-50 gr.; Quiniae Sulph. y2 gr.; Pulv. Digitalis, 
>2 gr.; Pulv. Opii, ]/x gr.; Pulv. Ipecac. % gr. 
Dose—One or two pills every six or eight hours, with food. 
Therapeutics.—Formula No. 18. 
Dr. Niemeyer, in his “Practical Medicine,” highly commends these 
combinations in the treatment of consumption ; he recommends them as 
antipyretics. Digitalis and Quinine have a well-merited reputation 
as a means of arresting abnormal calorification and reducing animal 
heat. This preparation is especially appropriate in cases of phthisis, 
when fever of a periodic type, marked by chills and evening exacerba- 
tions, is present. 
The addition of Phosphorus in small doses, operating as a nutritive 
tonic, cannot fail to give additional value to these medicines. 
[12.] 
PIL. PHOSPHORI CUM DIGITALE COMP. 
R Phosphori, 1-50 gr. ; Pulv. Digitalis, 1 gr. ; Ext. Hyoscyami, 
1 gr. 
Dose—The administration of Digitalis always requires caution. One 
pill may be taken thrice or four times in twenty-four hours. It is 
well to allow an interval of six or eight hours between each dose. And 
when it is long continued it is necessary to examine the pulse (in the 
sitting and erect posture) every few days. This combination should 
only be given when medical supervision is practicable. 
Therapeutics.—The action of Digitalis on the involuntary muscu-* 
lar fibre is analogous to that of Strychnia and Nux Vomica on the vol- 
untary muscular system, viz., it increases contractile force. “We 
must be guided,” says Dr. John Harley, “by this fundamental fact, that 46 
FORMULA?.. 
it directly promotes constriction of the involuntary muscular fibre." 
The combination of Phosphorus with Digitalis is a very happy one, 
the effect being to promote increase of nerve and muscular power. As 
a Heart Tonic it is a valuable medicine in those conditions of debility 
of the muscular fibre which are so commonly induced by persistent 
mental and physical over-work, and of which irregular or intermittent 
action is often the indication. It is useful also as a sedative, to con- 
trol undue action from general nervous irritability, and in the palpita- 
tion attending debility, exophthalmic goitre, valvular disease, and aneu- 
rism. On account of its power to increase the contractile force of the 
muscle, Digitalis has been called the “ quinine of the heart.” 
As a diuretic, the combination operates actively ; it is indicated in 
cardiac and renal dropsy, and in Bright’s disease. Digitalis acts di- 
rectly on the kidneys as well as through its effects on the heart, and 
the flow of urine is often copious, and the relief afforded very striking. 
[IS-] 
PIL. PHOSPHORI CUM DIGITALE ET EERRO. 
R Phosphori, 1-50 gr.; Pulv. Digitalis, 1 gr.; Ferri Redacti, 1 gr. 
Dose—One pill three or four times a day, with food. 
Therapeutics.—Of the remedial value of Phosphorus and Iron 
enough has been said. In its combination with Digitalis we have an 
admirable tonic which cannot fail to be useful in the treatment of many 
forms of heart disease. It is administered as a tonic to the heart with 
great advantage in all ancemic conditions associated with feeble and 
irregular action, palpitation, etc. 
[14.] 
PIL. PHOSPHORI CUM CANNAEE IffDICA. 
R Phosphori, 1-50 gr.; Ext. Cannabis Ind., gr. 
Dose—One or two twice or three times a day, with food. 
When Morphia is contra-indicated, and sleep is to be produced, 
this combination may be employed in place of formula 15, Pil. Phos- 
phori cum Morphia Comp. 
A good aphrodisiac in some cases, where the combination with Nux 
Vomica fails, or is contra-indicated. 
L15-] 
PIL. PHOSPHORI CUM MORPHIA ET ZIHCT VALER. 
R Phosphori, 1-50 gr.; Morphiae Sulph., 1-12 gr.; Zinc. Valer., 
1 gr- 
Dose—One twice or thrice daily, or two at bedtime. FORMULAE. 
47 
Therapeutics.—In phthisis when accompanied with hysterical irri- 
tability and troublesome cough, and with but little febrile disturbance, 
it both soothes and supports. Nervous Cough—one of the innumer- 
able manifestations of hysteria—is relieved by this combination. It 
may be advantageously administered with co ' liver oil. I have seen 
cases in which marked improvement has resulted from a course of this 
treatment. In the early stages of Phthisis, Phosphorus should be taken 
in small doses. 
Free Phosphorus is a more efficient and reliable remedy for the treat- 
ment of consumption than the Hypophosphites, recommended by Dr. 
Churchill.* In some forms of neuralgia this formula may be substitu- 
ted for that containing Quinine. 
In severe cases two pills may be given as a dose. 
[l6-] 
PIL. PHOSPHORI CUM ALOE ET NUCE VOMICA. 
R Phosphori, 1-50 gr.; Ext. Aloes Aquosse, gr.; Ext. Nucis 
Vomicae, gr. 
Dose—One every day with or immediately after luncheon or dinner. 
As a dinner pill it fills many indications. 
Therapeutics.—It is useful especially in the atonic form of dyspepsia 
and neuroses of the stomach, hypochondria, and other nervous affections 
associated with habitual constipation. It is also advantageously em- 
ployed as an occasional substitute for combinations with iron, which 
sometimes induce constipation. 
[*7-3 
PIL. PHOSPHORI CUM ZINCO COMP. 
R Phosphori, 1-50 gr.; Zinci Sulphatis, I gr.; Lupulinae, 1 gr. 
Dose, for Adults—One or two, three times a day. For Children— 
One, two or three times a day. 
Therapeutics.—This combination has been found exceedingly use- 
ful in the treatment of the diseases peculiar to women, uterine disturb- 
ances, torpidity of function, with leucorrhoea, dysmenorrhcea, and hyste- 
ria; also in melancholia, and other mental derangements, occurring 
on the appearance and cessation of the menses 
[i8.] ‘ 
PIL. PHOSPHORI CUM OPIO ET DXGITALE. 
R Phosphori, 1-50 gr.; Pulv. Digitalis, gr.; Pulv. Ipecac. 
gr.J Pulv. Opii, % gr. 
*See Ranking's Abstract, vol. xxvi., page 41. 48 
FORMULA?. 
Dose—-One or two pills every six or eight hours. 
Therapeutics.—The same as Pil. Phosphori cum Quinia ct Digi- 
tale, formula n, in cases in which Quinine is inadmissible. 
(19.) 
PIL. PHOSPHORI CUM STRYCHNIA. 
R. Phosphori, 1-50 gr.; Strychnite, 1-60 gr. 
Dose—One tAvice or thrice a day. 
Therapeutics.—Precisely that of Phosphorus and Nux Vomica, 
formula 3. This combination will be employed when a stronger dose 
of Phosphorus is indicated, or Strychnia preferred to Nux Vomica. 
[20.] 
PIL. PHOSPHORI CUM CANTHARIDE COMP. 
R Phosphori, 1-50 gr.; Sol. Cantharidis, concentrated, 1 q 
Pulv. Nucis Vom., 1 gr. 
Dose—One or two pills, twice or three times a day, with food. 
Therapeutics.—The employment of Cantharides, internally, has 
been much overlooked. It is highly spoken of by all modern writers 
on Therapeutics, and in certain cases I have found it to possess very 
remarkable remedial power. When administered in this form it does 
not produce any irritation of the gastro-intestinal mucous membrane, 
but operates as a gentle stimulant to the genito-urinal organs. In 
Bright’s disease, after the acute symptoms have subsided, this prepara- 
tion with the Perchloride of Iron operates very beneficially. It is use- 
ful also in chronic urethral discharges, obstinate gleet, etc. It is espe- 
cially useful in atony or paralysis of the bladder, producing inconti- 
nence or retention of urine, and in the dysuria of old men. It has 
been employed with much success in premature failure of sexual power 
resulting from excesses or self-abuse in early life, and in impotence in- 
duced by passive seminal discharges. 
As a stimulating emmenagogue and diuretic, it is useful in obstinate 
cases of amenorrhcea, and also in atony of the uterus and leucorrhceal 
discharges. 
In some forms of chronic skin diseases, eczema and psoriasis, this 
combination promises to be very useful. 
Middle-aged women frequently suffer much from weakness of the 
sphincter of the bladder—are unable to “hold their water,” and are 
troubled by a constant desire to pass it. These cases are much relieved 
by small doses of Cantharides and Phosphorus, the latter increas- 
ing nerve-power. ADVERTISEMENT. 
W-A-IR/IISriEIR, <3c CO’S 
PHOSPHORUS PILLS. 
The method of preparing Phosphorus in pilular 
form has been discovered and brought to perfection by 
us. The element is in a perfect state of subdivision and 
incorporated with the excipient while in solution. The 
non-porous coating of sugar protects it thoroughly from 
oxidation, so that the pill is not impaired by age. See 
our complete list of Pil: Phosphori with combinations. 
Specify WARNER & CO. when prescribing, and 
order in bottles of one hundred each when practicable, 
to avoid the substitution of cheaper and inferior brands. 
The following letter, in addition to our Centennial 
award, is but a portion of the testimony as to the perfect 
preparation of our Pil: Phosphori. 
WM. R. WARNER & CO. 
Philadelphia. 
NEW YORK, November nth, 1877. 
Messrs. Wm. R. Warner & Co., 
Manufacturing Chemists, <5rv., Philadelphia, Pa. 
Gentlemen:— 
The Phosphorus Pills submitted to me for chemical 
analysis and microscopic examination, afford only traces of Phos- 
phoric Acid, and contain the one-twenty-fifth of a grain (gr. 1-25) of 
the element in each Pill, as expressed upon the label; they do not 
exhibit particles of undivided Phosphorus, the mass being perfectly 
homogeneous in composition, soft in consistence, and thoroughly pro- 
tected by the non-porous coating of sugar from the oxidizing influence 
of the air. Each Pill is an example of what skill, care and elegant 
Pharmacy can do,—I regard them as a marvel of perfection. 
Very respectfully, 
A. E. McLEAN, 
Analytical Chemist and Microscopist, 
40 and 42 Broadway, N. Y. 
Late of Gardner cN Ainstie’s Laboratory, Edinburgh, Scotland.