maaMtm T» 7 ■ Lf ??*v7h.ej> £>.,%,. A, •( v. L--W mU'^-'^JOT '-- I I Surgeon General's Offica to* SP (M M} /c r, . .; V' ■* i A ri //,?)U. w pharmacopoeia Ctnrorgtca: OR, A MANUAL OF CHIRURGICAL PHARMACY, COMPRISING ALL THE VALUABLE FORMULA! OF THE NEW LONDON PHARMA- COPOEIA, AND OF THE SEVERAL PHARMACOPEIAS APPERTAINING TO THIS BRANCH OF SCIENCE, WITH NOTES AND OBSERVATIONS, AS WELL ON THE METHOD OF COMPOUNDING, AS LIKEWISE ON THE PROPERTIES AND USE OF EACH. Bv J. WILSON, Surgeon, HUNTINGDON. Honorary Member of the Medical Society of Guy's Hospital, and several years Assistant Apothecary to that Institution. WITH A TRANSLATION OF THE WHOLE OF THE FORMULA, AND ADDITIONAL NOTES AND ILLUSTRATIONS; By WILLIAM MEADE, M. D. Member of the American Philosophical Society of Philadelphia; Honorary Member of the Royal Physical Society of Edinburgh, Sec. &c. &c. FIRST AMERICAN, FROM THE THIRD XOSTJOX EDITION. PHILADELPHIA: PUBLISHED BY THOMAS DOBSON AND SON, AT THE STONE HOUSE, Nq. 41, SOUTH SECOND STREET. William Fry, Printer. 1818. District of Pennsylvania, to wit: ***#f#»* Be JT REMEMBERED, that on the ninth * SEAL. * day of January, in the forty-third year of the * * independence of the United States of America, ******** A. D. 1818, Thomas Dobson and Son, of the said district, have deposited in this office the title of a book, the right whereof they claim as proprietors, in the words following, to wit: " Pharmacopoeia Chirurgica: or, a Manual of Chirurgical Pharmacy, comprising all the valuable Formula: of the new London Pharmacopoeia, and of the several Pharmacopoeias appertaining to this branch of science, with Notes and Ob- servutions, as well on the method of compounding, as like- wise on the properties and use of each. By J. Wilson, Sur- geon, Huntingdon. Honorary Member of the Medical So- ciety ofGi.'i' Hospital, and several years Assistant Apothe- cary to-that Institution. With a translation of the whole of the Formulae, and ^daiivonal Notes and Illustrations; by Wil- liam Meade, M. D. Member of the American Philosophical Society of Philadelphia; Honorary Member of the Royal Physical Society of Edinburgh, &c. 8cc. &c. First American from the third London edition." In conformity to the act of the Congress of the United States, entituled," An act for the encouragement of learning, by secu- ring the copies of maps, charts, and books, to the authors and proprietors of such copies, during the times therein mentioned." And also to the act, entitled, " An act supplementary to an act, entitled, " An act for the encouragement of learning, by secur- ing the copies of maps, charts, and books, to the authors and proprietors of such copies during the times therein mentioned," and extending the benefits thereof to the arts of designing, en- graving, and etching historical and other prints." D.CALDWELL, Clerk of the District of Pennsylvania. T6 ASTLEY COOPER, Esq. F.R. S. SURGEON OF GUY'S HOSPITAL, &c. &c. 8to DEAR SIR, PERMIT me to return you my most grateful ac- knowledgments for the honour you have done me, by allowing so humble a work, as a Manual of Chirurgical Pharmacy, to be presented to the public under your auspices. Your kind and disinterested manner in receiving and patronizing this attempt, whilst yet in its infancy, is only an additional proof of those liberal and enlarged prmciples which, upon all occasions, you so nobly manifest in the advance- ment of that science you pre-eminently adorn. The satisfaction arising from the termination of a work, which is favoured by your kind partiality, is greatly increased by the opportunity afforded me of expressing my obligations to you, as a Patron and a Friend.—Nor is it less pleasing to me to acknow- iv DEDICATION. ledge the grateful sense I feel, of having been honour- ed with the confidence and good opinion of those, who so ably support you in administering relief to the indigent and afflicted, in an establishment which combines the improvements of science with the be- neficence of charity, and wherein the views of each are promoted by characters equally conspicuous for their humanity and their skill. If, in bringing together the more common and improved Formulae of Medical Surgery, I have been fortunate enough to render their composition less precarious, or their application less uncertain, I shall consider myself amply recompensed by the under- taking. With sentiments of unfeigned gratitude and re« spect, allow me, DEAR SIR, TO SUBSCRIBE MYSELF, YOUR OBLIGED HUMBLE SERVANT, J. WILSON. PREFACE. My official situation, for some years, in one of our great Public Hospitals, (Guy's) having enabled me to pay particular attention to the medical depart- ment of Surgery, as conducted by some of our first Surgeons and Physicians, I was induced, at the so- licitation of my Bookseller, to attempt a Manual of Chirurgical Pharmacy, and to comprise in it such select formulae as I had seen more immediately em- ployed, or which I conceived more essentially ne- cessary with the object of my undertaking. These Formulae I have given under the title of Pharma- copoeia Chirurgica; not with any idea of superseding a work of the same title and character; but as being a term familiar to the medical world at large, and very expressive of my purpose. In selecting my materials I have not scrupled to consult all our best Pharmacopoeias; as well those of our London and Edinburgh Colleges; as likewise such as have been edited for the particular use of our chief hospitals. a 2 vi PREFACE. I believe I may venture to affirm, that I have only given such Formulae as I have seen repeatedly com- pounded and employed, unless otherwise expressed. I have endeavoured to render each formula as con- cise and clear as possible, both as to the mode of preparing it, and the intention of employing it, by short practical notes and illustrations, afforded as well by my own observations as by the practice and experience of others. If it be objected to me, that I have neglected to no- tice several modern applications for the cure of many important diseases in Surgery, applications by some considered almost as specifics, it is from my aver- sion to this very term in the cure of all disease, and from my disappointment in experiencing their fail- ure, when brought into practice under my own cog- nizance, that I have omitted them; for, I believe no well informed Surgeon or Physician will now scarce- ly venture to talk about specifics; and the influence which many, or all such new applications, excite over the human frame, may be readily understood upon some general principle. Under this head I might notice Galvanism, Elec- tricity; several of the vegetabilia, denominated Nar- cotics; many of the saline mineral substances; with a number of others which have been internally administered, or externally employed. Under the head of Bougies I have omitted to notice the gold and silver probes for ascertaining PREFACE. vu the nature and character of Stricture in the Urethra, as recommended by Mr. Charles Bell. I, however, think them an ingenious contrivance, with which every Surgeon should be furnished. In consequence of my distance from the press, several errors and omissions will Ik- found in the course of the Work; these I have endeavoured to correct and supply by an exact list of Errata, and by a short Appendix, which I trust will, in some measure, excuse for such deficiency and neglect. From the circumstance that much of my Work was struck off previous to the London College having announced their intention of re-publishing their Pharmacopoeia, I have been necessarily obliged to retain the names and appellations of their former one—where any individual article, however, occur- ring in the Materia Medica, is offered as serving any general surgical intention, I have given it from the first, under the character both of the Edinburgh and London Pharmacopoeia, in order to render the difference of names as familiar as possi- ble. I have likewise added an Index of the old and new names; also a general Index of the several for- mulae adopted by our London College, as well to meet the wishes and intentions of that learned body, as to promote any general improvements connected with Medical and Chirurgical Science. PREFACE TO THE SECOND EDITION. 1 HE first impression of this Manual of Chirurgical Pharmacy being sold off, it became necessary, from my engagements with my Bookseller, and from the favourable reception which the Work experienced from the Public, that I should prepare a new Edi- tion. The circumstance, likewise, of the London Pharmacopoeia being re-edited some few weeks after the principal part of the first Edition was struck off, impressed me still further with the necessity of the undertaking, as well on account of giving to Chirur- gical Pharmacy the improvements of the College both in composition and nomenclature, as also of facilita- ting the business of the Surgeon in the way of gene- ral prescription. The New Nomenclature throughout the whole of the Work I have minutely followed; and such formula as are to be found in the London Pharmacopoeia I have carefully noted. PREFACE. IX In revising the Work several errors and irregu- larities which had, from a variety of causes unneces- sary to be noticed, unavoidably been overlooked, I have corrected or expunged. Some new formulae I have added, and some few I have erased. I there- fore offer this as an improved Edition; humbly trusting that it will be found acceptable as a book both of reference and practice in one of the great de- partments of modern Surgery. PREFACE TO THE AMERICAN EDITION. IN presenting this first American edition of the Pharmacopoeia Chirurgica, the editor assures him- self, that he offers an useful and acceptable work to the profession in general. This Manual of Chirur- gical Pharmacy has been stamped, by the faculty in Europe, with general approbation; it is the pro- duction of a gentleman, whose opportunities for obtaining a correct knowledge of Pharmacy, and ap- plying that knowledge to practice, were of no ordi- nary character. Among the various attempts which have been made, to compile a useful and practical collection of Formulae, the editor has as yet met with none in any degree to be compared with this, which he now offers to the public, comprising more valuable and useful prescriptions than are to be found in any other work of the same nature. PREFACE. xi In the notes and illustrations which are annexed to each article, the author has given us the result of much observation and practice, expressed in such terms as are best adapted to the present states of the science. The editor has not the vanity to imagine, that he can add much, to so valuable and useful a Phar- macopoeia; by giving a translation of the whole of the Formulae, he has adopted the wishes of those upon whose judgment he relied, and who conceived it would not be unacceptable. On looking over a work, which contains so much that is useful, the editor confesses, that he could find little to disap- prove, and but few of the most essential formulae omitted; he therefore has had but seldom, any reasoa to differ from the author, and but little to substitute for what he has omitted; nor has he thought fit to alter, in any degree, the original text of the author, under a full persuasion that such a liberty was neither correct nor allowable. In the present state of the science of Medicine and of Surgery, daily improving by experience, and adding rapidly to the number of valuable remedies derived from the discoveries of modern Chemistry, the most experienced practitioner frequently feels himself without a guide in his practice to keep pace with these improvements. To such persons, the editor cannot but think that a work of this nature may be occasionally useful; but to the student«whose *ii PREFACE. theoretical knowledge of his profession, has only prepared him to commence the arduous duties of the practice of it, he may, without hesitation, re- commend the study of this Manual of Pharmacy. It is in the hospital or sick chamber, that such a work becomes valuable to him; teaching him the familiar and extemporaneous application of medi- cines to every variety of disease, and rendering his practice as free from error as the state of our know- ledge in such cases will admit. If it is objected that in a work stiled a Phar- macopoeia Chirurgica, the editor has exceeded the strict bounds of his duty, by inserting such formulae as are considered within the province of the Phy- sician, it should be recollected how difficult it is to draw the line of distinction; surgery and physic are, particularly in this country, so closely connected, that an attendance on the lectures of the professor of Surgery, is very properly a prerequisite for a degree in Medicine. -No apology therefore seems necessary for introducing into this Manual of Chi- rurgical Pharmacy, most of those valuable prescrip- tions, which are necessary for enabling the surgeon to co-operate with the physician, and to practice his profession, with credit to himself, and with ad- vantage to the public. W. M. ^atmacopoeta Cinrutgfca* ACIDUM ACETICUM. (P. L.) VINEGAR. Vinegar possesses both stimulating and discutient properties as an external application; and is usually applied in fomentations and baths; or in the form of a cataplasm, mixed with some farinaceous substance, such as soft bread, oatmeal, or linseed powder. See Cataplasma Acidi Acetici. Vinegar has long been held in repute by some of our best surgeons, as an excellent application in the cure of sprains and bruises. Previous, however, to the use of vinegar, whether it be in the form of fomentation, poultice, or as a cold lotion, to parts where much injury has been inflicted, so as to have produced considerable extravasation of blood into the cellular substance, local blood-letting should always be premised; but if the injury be not very considerable, vinegar may be had recourse to immediately after the accident. It is a frequent practice with some of our best surgeons to use vinegar mixed with linseed meal, in the form of a cold cataplasm, in cases of sprains A 3 PHARMACOPOEIA and bruises accompanied with considerable inflam- mation and heat, directing the poultice to be renew- ed as often as it becomes dry; but as in this case the intention is to diminish the great heat of the part, and consequently the tension and pain, by the constant evaporation of moisture from the surface, cloths dipped in a solution of vinegar and water, (see Lotio Acidi Acetici Comp.) would appear a more preferable application; for, besides that the meal, when mixed in this way, is very apt to become soon stiff and hard, it is in itself a bad conductor of caloric, and as such wet cloths are less objectionable; but then it must be recollected, that they should be kept constantly moist. In chronic inflammations of the eyes and eyelids, vinegar has lately been brought into considerable repute, also where the eyes are weak and watery; likewise in the more acute forms of ophthalmia, after topical and general blood-letting have been used freely. See Collyrium Acidi Acetici. The acid of vinegar, obtained by repeatedly freez- ing the water in which it is diffused, has often been usefully employed as a styptic, in relieving haemor- rhages from the nose. As an external application the Acidum Aceticum Impurum, or common vine- gar, may in general be employed. CHIRURGICA. -3 ACIDUM NITRICUM. (L.) NITRIC ACID. The acid of nitre is obtained in various degrees of oxygenation. When the proportion of oxygen to that of azot is less than three of the former to one of the latter, it has hitherto been termed nitrous acid; and in this state it freely emits fumes of a red colour when exposed to the atmosphere. If the oxygen be to the azot as that of four to one, the acid in this state is colourless, or nearlv so, emits no vapour, and takes the appellation of nitric acid. The difference then, as will be already perceived, in the nitrous and nitric acids, consists in a greater or less quantity of oxygen, or rather in a variable proportion of nitric oxyd, with which the acid is combined. By expo- sing nitrous acid in a retort to a gentle heat, the nitric oxyd is vaporized, and pure colourless nitric acid remains in the retort; this may again be rendered nitrous acid, by impregnating it with the red nitrous fumes, which are nothing more than nitric oxyd combined with a portion of acid. Nitric acid is a very powerful styptic and escharo- tic, and stains the skin of a yellow colour wherever it comes into contact with it. It is a powerful caus- tic in the hands of the surgeon, and forms probably one of the readiest and safest means of preventing the evil consequences arising from the bite of rabid animals, and of destroying the poison; as it not only 4 PHARMACOPOEIA acts upon the parts contiguous to the bite, but decom- poses any saliva which may have been infused into the wound. It is, however, apt to spread itself too far over the sorrounding surface, unless cautiously used: this is best prevented by dipping a small glass tube into the acid, and fixing it upon the injured parts. Nitric acid, sufficiently diluted with water, forms an excellent lotion for old indolent ulcers, or where the granulations are soft and spongy, or the edges of the wound are hard and callous. For these purposes the Lotio Acidi Nitrici will generally an- swer the intention; a greater or less quantity of the acid being added, according as the nature of the sore shall require, or the judgment of the surgeon shall deem fit. Within»these few years nitric acid gained such considerable repute in the cure of sy- philis, that with some surgeons it was thought suf- ficient to supersede the necessity of giving mercury for the removal of that complaint. Experience, however, soon rejected what enthu- siasm, in its eagerness for innovation, had too has- tily adopted, and practitioners, we believe, now, one and all, make use of mercury, as the only safe and certain means of curing lues. But it cannot be de- nied that nitric acid, when judiciously administered, possesses very considerable effects over some forms of this complaint, independently of its efficacy in cer- tain other disorders; previous to the notice of which, we shall first brieflv detail what has been said bv CHIRURGICA. 5 the able and scientific Pearson, on the use of acids in general in the cure of lues, more particularly the nitric acid. 'Since the time when the science of Chemistry first began to be cultivated with success- ful diligence, and an enlarged and more correct knowledge of bodies has been acquired by experi- ments, wisely imagined, and skilfully conducted, frequent attempts have been made, though with un- equal success, to apply the principles of that useful science to the phenomena of disease, and the opera- tion of remedies. When a great number of hypothe- tical notions are successively proposed upon subjects, at the best but imperfectly understood; when sys- tems are constructed upon scanty and fallacious ob- servations, and are chiefly supported by doubtful ana- logies; it may be naturally expected, that such pro- ductions of the fancy will partake of absurdity and error: or, at the most, will present nothing to the mind but undiluted obscurity.' Of the vegetable acid, he observes^ ' that it was the only medicine of that class which had been employed as a specific against lues venerea till towards the close of the last century; but to what extent it was introduced into practice cannot now be ascertained.' The test of his experi- ence proved vegetable acid to be an agreeable tonic to the stomach, and, in some few solitary cases, to meliorate the general health; but never in a single instance did he find it, * competent to the removal of any one venereal symptom.' On the efficacy or A 2 6 PHARMACOPOEIA inefficiency of nitric acid in this complaint, he thinks ' that the power of this medicine has not yet been ascertained in so satisfactory a manner as to pre- clude all difference of opinion upon the subject.' However, in the cases which he details the number of cures bears no adequate ratio to the quantity of unsuccessful failures, wherein an attempt was made to relieve this complaint by the nitric acid. During several years attendance at one of the first hospitals in town, I may safely aver, that in no one case were the symptoms of confirmed lues removed by the exhibition of nitric acid; neither as instanced by the practice of the different surgeons, nor coming under my own immediate observation. Nitric acid was, however, used both liberally and successfully for removing the debilitating effects of mercury, for giving tone to the stomach, improving the appetite, and imparting a granulating and healthy aspect to certain ulcers remaining after a due course of mer- cury had been persevered in, and which were ag- gravated and increased by a further continuance in its use. In some eruptive complaints, particularly of the lower extremities, and evidently connected with he- patic affection, accompanied with great heat and itching, I have seen the nitric acid more beneficial than any other form of medicine, given in doses from eight to ten, or fifteen drops, twice or three times in the day, sufficiently diluted with water, and sweet- CHIRURGICA. 7 ened with sugar. The usual commencing dose'of this acid is from halfadramto a dram by weight, mixed with a pint of distilled water, and properly sweetened, to be drank through a glass tube within the twenty- four hours. It is recommended to be taken through a tube as it is highly injurious to the teeth. ACIDUM SULPHURICUM. (Z.) SULPHURIC ACID, FORMERLY OIL OF VI- TRIOL. Sulphuric Acid is powerfully corrosive and as- tringent, and highly destructive of all animal matter. If made into an ointment with axunge, it may be conveniently employed in the cure of psora. See Ung. Acidi Sulphurici. It has lately been used with con- siderable success by one of our first surgeons, in the form of a collyrium, sufficiently diluted with water, in the atonic stages of ophthalmia: but here its efficacy is attributable to its astringency alone,and not to any peculiar specific effects.* * The author in treating of the virtues of sulphuric acid, has scarcely done justice to its medical qualities. As a general tonic, it is used with good effect; particularly in loss of appetite, weakness and relaxation of the stomach. In a dilute state it is also employed externally with success, as a lotion in cutaneous eruptions, as well as a gargle in putrid sore throat. The Infusum Rosa: of the London Pharmacopoeia, so generally esteemed, de- rives its principal virtues from the sulphuric acid which it con- tains. Under the term acids it will be also perceived, that the author has taken no notice of several other very powerful acids; few of PHARMACOPOEIA jERUGO. (£.) CUPRI SUB-ACETAS IMPURA. (..V. C. R.) CUPRI SUB-ACETAS. (£.) SUB-ACETATE OF COPPER, FORMERLY VER. DIGRIS. Sub-acetate of Copper, or Verdigris, is deter- gent, and mildly escharotic. It was formerly much used to take down fungous excrescences, and to des- troy the hardened edges of old and indolent ulcers; but it is now neglected for more effectual and spee- dier remedies. It enters in a powder, called pulv. sabinae c. aerugine of St. Bartholomew's Hospital, (see Pulvis Sabinae Compositus) which is much recommended by some surgeons for the removal of venereal warts. The linimentum aeruginis of the London College is said to be an excellent gargle for ulcers of the mouth and throat; but it requires to be used with some degree of caution. See Garga- risma jEruginis.* them being employed in surgery, except in a combined state; and wherever any such are recommended, they will be found under some officinal form; such as, the Gargarisma acidi muria- tici. * Copper in a variety of forms, lias been used both externally and internally; as an external application, both the acetate and sulphate have been principally employed; the sulphate very generally as an escharotic. The author very properly observes that some degree of caution should be used with respect to the internal administration of it, but the deleterious effect arising from the use of Metallic poisons, cannot be too strongly incul- CHIRURGICA. 9 J1RUGO CUM HYDRARGYRI SUBMURIATE. VERDIGRIS WITH SUBMURIATE OF MERCU- RY. R. JEruginis praeparatx Hydrargyri submuriatis sing, drach. j. misce. Take of Verdigris, Submuriate of mercury; of each one drachm. This is a useful powder as an application to chan- cres and ill-conditioned sores, putting a stop in some measure to the phagaedenic nature of the former, and correcting the thin gleety discharge of the lat- ter. Its action may be considerably quickened by the addition of a scruple, or half a dram, of the hydrar- gyri nitrico-oxidum to the quantity of the articles a- bove prescribed; but preparations of this kind are in general much inferior in merit to the nitrate of silver, or nitric acid. ALUMEN. (L.) ALUMINA ET POTASSiE SUPERSULPHAS. (N. C. R.) ALUM, OR SUPERSULP HATE OF ALU MINE AND POTASH. ALUMINJE SULPHAS. (£.) SULPHATE OF ALU MINE. Alum has long held a place in the Pharmacopoeias both of this country and of the continent. If it be cated on the minds of young practitioners. It does not appear as yet that the advantages arising from the internal exhibition of any of the preparations either of Lead or Copper can over- balance the certain injury which the constitution may receive from the use of them, while we have other remedies which are equally safe and more effectual. 10 PHARMACOPOEIA exposed to a pretty considerable heat for some time its water of crystallization is driven off, and it is denominated alumen ustum, or alumen exsiccatum. This is however, for the most part, a very unneces- sary process, unless the alum be used as an escharo- tic, or for sprinkling upon wounds, for it again takes up its water of crystallization when united with fluids. As an external remedy alum is not at present much used. It has been celebrated by the older physicians and surgeons as a most powerful styptic, and formed the principal ingredient in all their styptic powders. As a laxative in colic, more particularly when arising from the noxious effects of lead, alum has been much recommended; but at present it is laid aside for more certain remedies. It may be usefully enough employed as an injection, dissolved in a decoction of oak bark, against the fluor .albus, and other increased discharges from the vagina in women. See Decoctum Corticis Quercus. ANTHEMIDIS FLORES. (X.) ANTHEMIS NOBILIS. (£.) CHAMOMILE, the Floivera. Chamomile flowers are used externally in baths and fomentations, as a discutient and anti-septic ap- plication, and often with good effect. See Decoc- tum Anthemidis Florum and Decoctum Malvae Compositum. CHIRURGICA. H ANTIMONII ARSENIAS. ARSENIATE OF ANTIMONY. R. Antimonii in pulv. triti unc. ij. Arsenici albi in pulv. triti unc.j. Take of Antimony, powdered, unc. ij. White arsenic, powdered, unc. j. These are to be melted together in a crucible, with a heat not too powerful, otherwise the arsenic will be volatilized, and prove highly noxious to the operator. After they have been fluxed together, and have become cold, they are to be reduced to powder. This caustic, under the title of Arsenical Caustic, was much used by the late Mr. Justamond in the cure of cancers. It is, perhaps, one of the best forms of caustics composed of arsenic. When united with powdered opium its effect is equally certain, and it is said to be much less painful. ANTIMONII MURIAS. (E.) MURIATE OF ANTIMONY. Muriate of Antimony, better known by the name of Butter of Antimony, is a powerful caustic, and much used by farriers, and others of that description, for the purpose of destroying fungous excrescences or fistulous openings in the feet of cattle. It is used by some surgeons for destroying warts and excres- cences, and for removing opacities of the cornea; but it is seldom had recourse to. 12 PHARMACOPOEIA ARGENTII NITRAS. (Z..) N1TRAS ARGENTI. (E.) NITRATE OF SILVER, FORMERLY LUNAR CAUSTIC. Nitrate of silver is the most manageable caustic we possess, at the same time the most generally useful; and in the greater number of cases its action is sufficiently powerful to answer the full intention of the surgeon. For surgical purposes it is formed into small cylindrical sticks, by pouring the fused nitrate of silver into proper moulds. These sticks should always be kept in close stopper vials, and co- vered with soft dry paper, both to preserve them against the action of the air, as also to prevent their corroding or discolouring the fingers in handling. Every surgeon of experience is acquainted with the utility of nitrate of silver on a great number of occasions: as a caustic in removing fungous excres- cences; in taking off the callous euges of long-con- tinued ulcers; as likewise for keeping the edges of such sores in a proper, healthy, granulating state. For these intentions the stick is generally employed, the surface of the nitras argenti being previouslyjust moistened; or it is used in the form of a solution, in the proportion of a drachm to an ounce of distilled water, bv means of a camel's hair brush. It may be worth while to remark, that the vial containing this solution should be covered with dark coloured paper, CHIRURGICA. 13 that it should be close stopped immediately after using it, and kept in a dry place. The nitras argenti is eminently useful in a great number of venereal ulcers, in eradicating venereal warts, after they have been removed by the scissars or the knife, and in the permanent cure of strictures in the urethra. It has been recommended as an application to certain species of ulcers, said to be cancerous, or partaking of the nature of the Noli me tangere, both upon the nose, and in the neighbourhood of the face; and, lastly, it has been recommended by some as a spe- cific for destroying the venereal virus of chancres before it has acted too generally on the surrounding surface, so as to have become absorbed into the sys- tem. When used for the purpose of destroying the virus of an incipient chancre, the caustic should be scraped to a point, a practice recommended by the ingenious Mr. Hunter, by which means the whole surface of the chancre may be brought into contact with the caustic. He likewise directs a renewal of this practice till the slough thrown off leave the ulcer florid and healthy, like the surface of a granulating simple sore. A caution has been set up against this mode of practice, and that very justly, that the glans penis of some patients partakes of deep and extensive slough- ing upon the application even of the slightest caustic; and that very generally in constitutions of a scrofulous cast such consequences are apt to supervene. But here B U PHARMACOPOEIA other considerations are to be taken into the account independent of scrophula, which very materially in- fluence the propriety of using caustic for destroying chancre on its first appearance. It too frequently happens that a chancre is not discovered till some abrasion of the surface has taken place, or till it has so far developed itself that the contiguous surface has become contaminated; and where such is the case we only increase the extent of a venereal sore, by removing, through the means of any corroding ap- plication, that which is only supposed to be the in- fected part. Very generally, too, such patients, imme- diately on the discovery of a chancre, at the same time that they destroy it by caustic, begin with a very liberal use of mercury, or are put upon it by their surgeons, under the influence of which, in some con- stitutions, every description of ulcer or wound will become highly irritable, painful, and spreading; aotwithstanding, in many forms of ulcer or open sore, though perfectly unconnected with syphilis, mercury exhibited internally is one of the best pos- sible remedits we can have recourse to in order to induce a proper and healthy action; but we believe in such cases that the untoward nature of the sore proceeds from a disordered state of the functions of digestion and of excretion through the intestinal canal, and not from any peculiar character of the ulcer itself. If then the constitution be unfavourable to the internal use of mercury, or if the spreading ma- CHIRURGICA. 15 lignity of a chancre be accompanied with any degree of ambiguity or doubt, the propriety of using lunar caustic, on the first appearance of the chancre, to de-- stroy the further progress of the venereal poison, is in one case highly questionable, and in the other dan- gerous and absurd; for we cannot use it safely in the latter instance without the internal aid of mercury at the same time, which alone is to destroy the virus, and bring about a cure; and in the other instance should the constitution be such that when influenced by mercury any open sore becomes irritable, unheal- thy and spreading, our practice and intention are cer- tainly at issue, since by using caustic, and giving mercury at the same time, we are adopting two con- tradictory means of cure, which have a directly op- posite tendency. Besides, if mercury be necessary, and alone to be depended upon, we are not in want of surgical applications less painful and more proper than caustic ones. The use of lunar caustic, however^ in the hands of an experienced practitioner, for the entire removal of chancre in its early state, without the exhibition of mercury, may by some be thought perfectly justifiable, cince it is experience alone which can dictate the propriety of adopting any means of cure at all hazardous or uncertain in its effects; while the reputation of a younger surgeon would be materially injured should any thing like error, or want of skill, become manifest in his practice, though 16 PHARMACOPOEIA his intention be equally proper and well found- ed.* We shall speak on the propriety of using lunar caustic for the permanent cure of strictures, under the head of Medicated Bougies. Lunar caustic has often been administered inter- nally to an extent scarcely credible. Latterly it has been highly recommended in some inveterate ulcers, given in the form of pills, united with crumbs of bread; but we fear its efficacy will often prove very uncertain. See Pilulae Argenti Nitratis. * From the undecided manner in which the author speaks here of the application of Lunar Caustic in cases of chancre, its good effects may appear problematical, but it appears to me that almost under every circumstance the application of it will be of decided advantage, whether in the early stage or not. If applied on the first appearance of the chancre it will in most cases so effectually prevent the venereal action from going on, that mercury will be unnecessary; but even should it be still thought prudent to have recourse to mercury, the application of Lunar Caustic to the part can be attended with no injury, on the contrary it will generally induce a healthy action in the sore. With respect to the internal exhibition of Lunar Caustic, not- withstanding the few cases which are recorded of its virtues, I should still hesitate before I recommended the use of so violent and dangerous a remedy. A rage prevails at present for exhibiting as medicines the most violent metallic preparations, which may lead inexperienced practitioners to venture too frequently on the use of them. Nitrate of silver is a most corrosive substance, and so soluble a salt that its action on the coats of the stomach must be very powerful and dangerous. Muriate of silver on the contrary is nearly insoluble, and of course would be less injurious; a trial of this preparation has, therefore, been very judiciously suggested by Dr. Coxe in his edition of the New Dispensatory. CHIRURGICA. 17 BALSAMUM PERUVIANUM CUM FELLE. PERUVIAN BALSAM WITH OX'S GALL. R. Fellis bovini drach. iij. Balsami Peruviani drach. j. misce. Take of Ox's gall, drach. iij. Peruvian balsam, drach. j. Mix. Dr. Hugh Smith directs thi6 as a remedy to be occasionally dropped into the ear, in cases where a constant fetid discharge indicates a diseased state of its secretions. Together with this practice, however, it will be requisite to syringe the ear every day with a weak solution of soap and water, which in gene- ral will effect more than any other application; more especially if the morbid state of the secretion be ac- companied or connected with a deficiency of wax, or should the latter have become hard and concreted. See Saunders on the Ear. CATAPLASMA ACIDJ ACETICI. CATAPLASM OF VINEGAR. This cataplasm may be formed by mixing vine- gar in sufficient quantity with either oatmeal, lin- seed meal, or crumb of bread. If linseed meal be used alone, it is apt, from its tenacity, to become hard and dry, thus occasioning a degree of incon- venience to the part upon which it is applied. Lin- seed meal is, however, very useful for giving this B2 18 PHARMACOPOEIA tenacity in a proper degree to the poultice when mix- ed with either of the other articles. This poultice is generally directed to be applied cold, and is of ser- vice against sprains and bruises, for which intention it is much in use in the several hospitals. When used for a length of time it has occasionally been found highly serviceable for removing scrofulous enlarge- ments of the joints; this it is supposed to effect by keeping up a constant and equable stimulus upon the part, sufficient in some cases to produce a degree of redness upon the surface. See remarks under Acidum Aceticum. CATAPLASMA ALUMINIS. CATAPLASM OF ALUM. This cataplasm, better known by the name of Alum Curd, is made by briskly agitating the whites of two eggs with a lump of alum till a coagulum is formed. It is useful in some cases of ophthalmia, both of the purulent kind and of the chronic, when attended with a watery excretion, if applied to the eye between two pieces of thin linen rag. The alum curd has been found an efficacious remedy applied to chilblains, previous to the skin cracking and be- coming sore, and hence it is a practice in some schools to wash the children's feet repeatedly with a strong solution of alum, which is said to keep off those troublesome companions. See Liquor Aluminis Compositus. CHIRURGICA. 19 CATAPLASMA BYNES. CATAPLASM OF MALT. R. Bynes farinx Cerevisix spumx q. s. ut fiat cataplasma. Take of Meal of malt Fresh yest sufficient to make a poultice. This cataplasm,taken from the Pharmacopoei aof Guy's Hospital, is chiefly of use in foul spreading ulcers, or in spreading gangrenous wounds, as a means of gently stimulating the parts, and of taking off the disagreeable odour, by evolving a considera- ble quantity of carbonic acid gas; for these inten- tions it sometimes will succeed very well. The poul- tice answers much better when both the ingredients arefresh, as the fermentation is more considerable; it should likewise be applied warm. See Cataplasma Fermenti. CATAPLASMA CARBONIS. CHARCOAL POULTICE. To a sufficient quantity of the common linseed meal poultice, stir in as much charcoal in fine pow- der as it will bear,and let the whole be well mixed. This cataplasm is often used to sweeten foul offen- sive ulcers and venereal sores, and for this purpose it is of great service; it will likewise often dispose them to assume a more favourable and healthy 0 aspect. 20 PHARMACOPOEIA CATAPLASMA CEREVISI^E. CATAPLASM OF ALE OR STRONG-BEER GROUNDS. This is made by stirring into ale or strong-beer grounds a sufficient quantity of oatmeal or linseed powder. This cataplasm may safely be recommend- ed to general notice as an excellent stimulant and antiseptic in cases of large sloughing ulcers and mortified parts. It ought to be renewed at least twice in twelve hours, and applied as warm as the parts will bear. CATAPLASMA CONII. CATAPLASM OF HEMLOCK. To the fomentum conii add as much oatmeal or linseed flour as will form a cataplasm. This poul- tice is applied to cancerous and scrofulous sores of a highly irritable and painful nature, to diminish their sensibility, and to correct the acrid discharge. For these purposes Mr. Justamond preferred the fresh herb bruised. See Cataplasma Digitalis. CATAPLASMA CUMINI. CUMMIN CATAPLASM. R Cumini seminum lib, j. Lauri baccarum Scordii foliorum exsiccatorum Serpentaris radicis singulorum unc. iij. Caryophyllorum unc j. CHIRURGICA. 21 Take of Cummin seeds, lb. j. Sweet-bay berries, Leaves of scordium, Virginia snake root, of each, unc. iij. Cloves, unc. j. These ingredients being reduced to powder, are to be mixed with thrice their weight of honey, so as to form a cataplasm. The cataplasma Cumini is a warm stimulating application, and may often be used with great advantage to ulcers and wounds where there is great languor of the circulation, or an evident disposition to gangrene, or when the parts have taken on wide and extensive sloughing: it must be recollected, however, that in several cases the Cummin cataplasm, when used alone, will be found to excite the parts too much, and to produce a degree of erysipelatous inflammation, which is too liable to run into the original disposition; a portion of it there- fore is generally mixed with some milder form of ingredients, as oatmeal or linseed flour, previously formed, by means of boiling water, to the consistence of a cataplasm. I have repeatedly seen the aspect of sloughing venereal ulcers greatly meliorated by an application of one part Cummin cataplasm with two parts of the common linseed meal poultice; and where the edges of the ulcer have been highly irritable and painful this inconvenience has frequently been re- moved by covering them with the ceratum opii spread upon lint, previous to the application of the poultice. 28 PHARMACOPOEIA The Cataplasma Cumini is one of the Formula expunged by the London College in the new edition of their Pharmacopoeia.* CATAPLASM A DIGITALIS. CATAPLASM OF DIGITALIS. Boil three ounces of the dried leaves of the Fox- glove, or four ounces of the fresh plant, in two pints of distilled water to one. A sufficient quantity of this liquor, mixed with a portion of linseed meal, so as to form a poultice of proper consistency, may be used in all those cases, where the cataplasma conii is indicated, and not unfrequently with greater advantage. It will be found to allay pain, remove irritation, and greatly diminish the increased sensi- bility of the part to which it is applied. CATAPLASMA DAUCI. CARROT CATAPLASM. Boil any quantity of fresh carrots till they are sufficiently soft to be beat into a smctoth even pulp, which is to be applied as a poultice. This has been found very effectual for sweetening cancerous sores and foul ulcers, thereby rendering the condition of • The above complicated and troublesome cataplasm is now •carcely ever used by modern surgeons, it being entirely super- seded by others more simple and yet equally efficacious. I have not however, taken the liberty to expunge it, as the author speaks of its virtues from extensive experience. CHIRURGICA. 53 the patient much more comfortable. In a trial made with turnips, used in the same way as carrots, atone of the first medical institutions.of the metropolis, the same effects were produced, and apparently in a greater degree than with carrots. In -some cases these effects may be further promoted by sprinkling into the pulp some finely-powdered charcoal pre- vious to applying it. CATAPLASMA FARINACEUM. COMMON BREAD CATAPLASM. This poultice, which is very generally in use, is commonlv made by soaking slices of bread in milk, and simmering them together over a gentle fire till they are reduced to the proper consistence of a poul- tice. The whole is then to be beat smooth with a spoon, and applied as warm as the patient's feelings will readily admit. As milk is very liable to turn sour, and is said to possess no greater relaxing pow- er than water, it has been objected to as being always improper in poultices. This objection will certainly hold good whenever stale milk is made use of, or if the same poultice be kept too long applied; but if the milk be fresh, and the poultice renewed night and morning, we do not know any thing that occa- sionally gives such ease and comfort to the patient as this form of cataplasm. Indeed it generally agrees better for a time with open abscesses, pre- viously brought to a fit state of maturation either 24, PHARMACOPOEIA by fomentations, or the linseed meal poultice, than any other form of application with which I am ac- quainted, particularly if the skin be irritable and in- flamed, or the patient's constitution very delicate. If water be substituted for milk the poultice is sel- dom of sufficient tenacity. It is true this inconve- nience may be remedied by the addition of a little linseed meal, but in some instances the meal appears to irritate and fret the skin so much, that some pa- tients undergo much uneasiness from this cause; an objection which the cataplasm of bread and milk is seldom subject to, especially if it be not applied too hot. To milk abscesses, where the discharge is pro- fuse, this form of poultice is often extremely proper. CATAPLASMA FERMENTI. (Z.) CATAPLASM OF YEST. R Far in x. lib. j. Cerevisis Fermenti O. ss. Take of Meal, lb. j. Yest, O. ss. This formula is recommended by the London College; it is similar to, and used with the same in- tentions as, the Cataplasma Bynes. The yest and meal should be mixed together, and exposed to a gentle heat, till a degree of fermenta- tion take place. O. in the formula: denotes octant, a pint. CHIRURGICA. 25 " CATAPLASMA L1NI PULVERIS. LINSEED MEAL CATAPLASM. R. Faiinx lini lib. ss. Aq. ferventis O. iss. lake of Linseed meal, lib. ss. Boiling water, O. iss. Or this poultice maybe formed by stirring linseed powder into boiling water, in quantity sufficient to form it of a proper consistency. It is usual to cover the surface of the cataplasm with a small portion of olive oil before it is applied. This is the poultice in general use at the different hospitals. It is a very good emollient, and will for the most part answer every intention that is expected from warmth and moisture applied at the same time to an inflamed part. To parts which are highly irritable, accompanied with great tension and pain, the virtues of this poul- tice may often be considerably improved by substitu- ting the poppy fomentation, (fomentum papaveris) instead of water. It will likewise be proper to fo- ment the parts with the same at the different inter- vals that the poultice is renewed. By substituting the fomentum papaveris this poultice acquires no inconsiderable anodyne property: and as the reliev- ing of pain is always a very material consideration, the surgeon will do right to prescribe its use when- ever the inflammation is situated in the neighbour' C 2* PHARMACOPOEIA hood of tendinous or ligamentous parts, as in deep- seated paronychia of the fingers, in collections of matter about the wrist or ancle, or whenever there is a strong fascial covering to the imposthume, the pain in all these cases being generally very acute. I have lately seen this form of poultice applied in the active state of gouty inflammation very successfully, affording very considerable relief both in assuaging the pain, and lessening the excessive sensibility of the affected part; Mr. Birch, surgeon of St. Thomas's Hospital, di- rects equal parts of crumb of bread and linseed pow- der to be formed into a poultice with boiling milk. In the formula of the Pharmacopoeia of Guy's Hos- pital the linseed meal poultice is introduced under the head of Cataplasma Commune, and is directed to be formed of a pound of the pulv. pro cataplas- mate mixed with a sufficient quantity of boiling water, and to be covered with oil previous to ap- plying it. This pulvis pro cataplasmate is formed by adding two pounds of finely powdered bran to one pound of linseed meal, forming as cheap, at the same time as good an application as can be used in the greater number of cases where poultices are re- quisite. CHIRURGICA. 54/ CATAPLASMA PAPAVERIS ALBI. See CATAPLASMA LINI. CATAPLASMA PLUMBI ACETATIS. CATAPLASM OF ACETAT OF LEAD. R. Liquoris plumbi acetatis drach. j. Aquse distillate O. j. Micae panis q. s. Take of Liquor of acetate of lead, drach. j. Distilled water, O. j. Crumbs of bread; sufficient. Slices of bread are to be soaked in the water mixed with the water of acetate of litharge, in the way recommended for forming the bread and milk poultice, which are afterwards to be simmered to- gether in an earthen vessel, over a gentle fire, to a due consistence. To superficial inflammations and where the external use of lead is deemed requisite, this form of cataplasm is probably as good as any for applying it. It should be recollected, however, that this poultice is better suited in the commence- ment of inflammation, where our intention is to pro- duce simple resolution, rather than where our ob- ject is to hasten and promote maturation, unless the skin be very irritable and tender during this latter process; in which case it will sometimes be found requisite to continue the use of the lead till the ab- scess burst, or is opened by the surgeon, and when 28 PHARMACOPOEIA this is effected, it will probably be safer practice to abstain altogether from its use; for I am decidedly averse to the application of lead in any form to re- cent wounds, and that more especially where the surrounding parts have become loose and flaccid, from the great tension being removed by an eva- cuation of confined matter. Again, if the previous inflammation have been very considerable, or there be deep and extensive sloughing, or if the vitality •f the parts have been greatly destroyed, and there exist the least disposition to gangrene, in all these eases the cataplasma plumbi acetatis will certainly do harm.* CATAPLASMA ROS.E. CATAPLASM OF THE CONFECTION OF ROSES. Confection of roses has sometimes been recom- mended as a useful and convenient application to * It may be observed here, that with respect to the external application of solutions of lead, they are seldom admissible or useful, except with an intention of allaying irritation and pro- ducing a resolution of the tumor; and that in order to promote their object in the commencement of inflammation, the solution should in general be applied cold, and renewed when the heat becomes troublesome. In order to insure this, linen cloths, repeat- edly wetted with a cold solution, are more convenient than poul- tices and should always be preferred, except when it is intended to promote and expedite suppuration; in which case, warm poul« tices should be had recourse to, but these should never be com- posed of preparations of lead. CHIRURGICA. 29 weak watery eyes, and as a useful remedy in chronic inflammation of the edges of the eye-lids, also in the ophthalmia tarsi. It is said to be mildly astrin- gent, which property may be considerably increased by the addition of a small quantity of powdered alum, in the proportion of one or two grains to half a dram of the conserve. Such applications are, how- ever, held in trifling repute. CATAPLASMA SOD.E MURIATIS. CATAPLASM OF COMMON SALT. R. Pulveris lini Micse panis singulorum partes xquales Aqust, sodse muriate saturate, q. s. Take of Linseed meal, Crumbs of bread; equal parts, ' Saturated solution of muriate of soda, sufficient to make a poultice. This form of poultice has lately been brought into considerable repute for the reduction of indo- lent strumous swellings and enlargements of the glands. After being some time used it generally oc- casions very considerable redness upon the surface, and excites, not unfrequently, so much inflammation upon the part to which it is applied, that it becomes necessary to abstain from its use, and substitute the common white bread and milk poultice in its stead; as soon, however, as the inflammation sub- sides, the saline poultice should again be employed; C2 so PHARMACOPOEIA and by alternating this mode of practice, strumous swellings, and scrophulous enlargments of a chronic obstinate nature, have very frequently been totally dispersed.* CATAPLASMA SINAPIS. MUSTARD CATAPLASM. R. Seminum sinapis in pulverem contritorum. Medullas panis sing. lib. ss. Acidi acetici q s. Take of Mustard seed powdered, Crumbs of bread; equal parts, Vinegar, sufficient to make a poultice. These ingredients should be well beat together, so as to form a cataplasm. The mustard poultice is a very powerful stimu- lant, generally inflaming the surface where 'tf is ap- plied so much as to raise blisters. As a surgical application it is very seldom used. We do not see, however, why it should not prove beneficial if ap- plied to the soles of the feet in certain comatose af- fections and lethargic stupors, arising from violent concussion or injuries of the head, more especially when free evacuations, both by the lancet and pur- gative remedies, have been premised. * This form of poultice has been brought into use, in conse- quence of the benefit which persons affected with scrophulous tumors have received from the Cataplasma Quercus Marina, or the Marine Plant called Sea-tang; and where this cannot be ob- tained in afresh state, the above poultice may be substituted with advantage. CHIRURGICA. 31 It will be seen, that in our list of cataplasms we have expunged many extemporaneous prescriptions collected by others, and which appear to have been held in very high repute by surgeons with whom they had their origin, or by whom they were chiefly recommended and employed. This rejection has not arisen from any hasty refusal of credit due to the praise which they have obtained, nor from any disbelief in the utility and service they have af- forded; but from a persuasion that the advantage gained from all poultices may be reduced to two or three general intentions, and that such may be effected by means much more simple and easy than have been generally supposed. We have, therefore, endeavoured to render the formulae under this head as concise and simple as possible; not venturing how- ever to reject any formula which may have been highly recommended, unless we have seen equal benefit afforded by others less operose, and less compounded. CAUSTICUM COMMUNE CUM OPIO. COMMON CAUSTIC WITH OPIUM. R. Potassze cum calce drach. ij. Opii in pulv. triti. drach. ss. Saponis mollis q. s- misce. Take of Potass with lime, drach. ij. Opium powdered, drach. ss. Soft soap, sufficient. Mix. This caustic will answer, in general, sufficiently well for most purposes where a caustic is indicated. 32 PHARMACOPOEIA For the mode of applying it, see observations under the article Potassa cum cake. CERATUM CALAMINE. (L.) CALAMINE CERATE. R. Calamine pracparata Cera flavx sing. lib. ss. Olivx olei O. j. Take of Calamine, prepared, Yellow wax; .of each, lib. ss. Olive oil. O. j. The wax being cut into small pieces, and mixed with the oil, they are to be melted together over a slow fire, and when sufficiently cooled the calamine is to be stirred in, being previously reduced to a very fine powder. Notwithstanding the modus ope- randi of this cerate might give rise to some hypothe- tical, and perhaps unsatisfactory discussion, it cer- tainly is entitled to very considerable merit in cer- tain cases, where the surface has been some time excoriated, the surrounding skin irritable, and the dicharge thin, and in considerable quantity; more especially if the part so affected be immediately con- tiguous to bone, or there be little or no interposing muscular substance. As a proof of which I have frequently seen the cerate of calamine agree better with ulcers or abrasions situated upon the fore part of the tibia than any other application. As an exter- nal remedy to burns and scalds, after the pain and CHIRURGICA. 33 violence of the inflammation have been removed by suitable means, this cerate will often be exceedingly proper. It has sometimes proved serviceable in the ophthalmia tarsi, placed upon the edges of the eye- lids every night at bedtime by means of a camel's hair brush, in cases where more stimulating applica- tions could not be borne: its efficacy, in this latter affection, may sometimes be increased by the addi- tion of a little soft extract of opium, in the propor- tion of half a drachm, or even a drachm, of the opi- um to an ounce of the cerate. CERATUM CALAMINE CUM PLUMBI ACETA- TIS L1QUORE. CALAMINE CERATE WITH LIQUOR OF ACE- TATE OF LEAD. R. Cerati calaminae lib. j. Plumbi acetatis liquoris unc. ij. Misce. Take of Calamine cerate, lib. j. Liquor of acetate of lead, unc. iij. In forming a small quantity of this composition the ingredients may be pretty well blended together by simply triturating them on a marble slab; if the proportions be in the quantity prescribed the cerate will be better made by observing the directions giyen by the College for the formation of the Ceratiyn Calaminae, adding the liquor of acetate of lead mixed with the calamine: It will be requisite in this case to 34 PHARMACOPOEIA keep the mixture stirring till perfectly cold. This application is a favourite remedy with some expe- rienced surgeons to burns and scalds, and often de- servedly so.* CERATUM CALAMINE CUM HYDRARGYRI N1TR1CO-OXYDO. CALAMINE CERATE WITH NITRIC-OXYD OF MERCURY. R. Cerati calamine unc. ij. Hydrargyri nitrico-oxydi (in pulverem tenuissimum redacti) drach. iiss. Misce. Take of Calamine cerate, unc. ij. Nitric oxyd of mercury, minutely powdered, drach. iiss. Mix The cerate and nitric-oxyd of mercury should be very intimately united by trituration. This is a very common, and at the same time a very useful for- mula; and to indolent and ill-conditioned ulcers much recommended, as a very proper stimulant for indu- cing an action conducive to the restoration of the parts. * This mode of forming a cerate by attempting to combine a Liquid with an ointment, originated with Goulard, since .which it has become a favourite remedy; however it does not very ob- viously appear that any advantage can be obtained from it, that may not more effectually be promoted by substituting the oxydum plumbi semivitreum or litharge, for the liquor plumbi acetatis, as in the emplastrum plumbi. CHIRURGICA. 35 CERATUM CETACEI. (L.) CERATE OF SPERMACETI. R. Cetaceiunc. ss. Cerae alba unc. jj. Olivx olei unc. vr. Take of Spermaceti, unc. ss. White wax, unc. ij. Olive oil, unc. iv. Mix. These ingredients should be slowly melted together, and when removed from the fire they should be stirred till cold. The use of this applica- tion is sufficiently obvious. CERATUM CETACEI CUM HYDRARGYRO PR^CIPITATO ALBO. CERATE OF SPERMACETI WITH WHITE PRECIPITATED MERCURY. R. Cerati Cetacei unc. ij. Hydrargyri prsecipitati albi drach. iiss. Misce. Take of Cerate of spermaceti, unc. ij. White precipitate of mercury, drach. iiss. Mix. This application may be usefully employed against herpetic and tettery eruptions. It will often succeed in Psora. CERATUM CONII. CERATE OF HEMLOCK. R. tftiguenti conii lib. j. Cetaoei unc. ij. Cerae albs unc. iij. Misce. 36 PHARMACOPOEIA Take of Hemlock ointment, lib. j. Spermaceti ointment, unc. ij. White wax, unc. iij. Mix. This cerate is of firmer consistency than the ointment under the same name, and as such, in some cases, where hemlock as an application is indicated, it is preferable; inasmuch as it requires to be re- newed much less seldom; a circumstance in sores or ulcers very necessary to be attended to. It is one ©f the select formulae of St. Bartholomew's Hospital. CERATUM CRETE ACETATIS COMPOSITUM. COMPOUND CERATE OF ACETATE OF CHALK. R. Emplastri plumbi unc. viij. Olei Olivac Crets pp. Acidi acetici singulor unc. iv. Plumbi superacetatis in pulv. trits drach. iij. Take of Plaster of lead, unc. viij. Olive oil, Prepared chalk, Vinegar; of each unc. iv. Superacetate of lead, finely levigated, drach. iij. The oil and lead plaster are first to be melted together over a gentle fire; the prepared chalk is then to be added, and the whole is^to be well incorporated together by brisk stirring. When the CHIRURGICA. 37 mixture is sufficiently cooled, the vinegar and super- acetate of lead are to be added, and the stirring is to be continued till the composition is nearly cold. Dr. Kirkland, in his Medical Surgery, distin- guishes this cerate by the appellation of neutral cerate: it is a good application in many cases where the surface is abraded and irritable, and in the latter stages of burns and scalds. Dr. K.'s recommendation sufficiently warrants its introduction to general use. See Kirkland's Medical Surgery. CERATUM HYDRARGYRI SUBMURIATIS. CERATE OF SUBMURIATE OF MERCURY. R. Hydrargyri submuriatis drach. j. Cerati cetacei drach. vj. Misce. Take of Submuriate of mercury, drach. j. Spermaceti ointment, drach. vj. Mix. These should be rubbed together, so that the sub- muriate of mercury be equally distributed through the whole of the cerate. This is a good stimulating application to ulcers of an indolent nature, more especially such as are venereal; and with this inten- tion it is much used and recommended by Mr. Lucas, surgeon of Guy's Hospital. CERATUM LYTT.E. (L.) CERATE OF CANTHARIDES. R. Cerati cetacei igne emolhti, drach. vj. Lyttarum in pulverem tritarum drach. j. Misce D 38 PHARMACOPOEIA Take of Spermaceti cerate softened by heat, drach. vj. Blistering fly minutely powdered, drach. ij. Mix. This is a common form of cerate for keeping up a discharge from blisters, and rendering them what is called perpetual. It is requisite that the cantharides be very minutely divided, previous to their being blended with the cerate of spermaceti, which is di- rected to be first softened by the fire. CERATUM MELLIS. CERATE OF HONEY. R. Olivs olei oss. Mellts dispumati lib. ss. Cerx flavse Emplastri plumbi sing. unc. ir. Take of Olive oil, O. ss. Clarified honey, lib. ss. Yellow wax, Plaster of lead, of each unc. iv. To the wax, oil, and plaster of the oxyd of lead, melted together, the honey is to be added, and the mixture should be stirred till cold. This cerate is made use of in St. Bartholomew's Hospital. It is gently stimulating, and somewhat de- siccative. CERATUM MELLIS CUM TEREBINTHINA. CERATE OF HONEY WITH TURPENTINE. R. Mellts dispumati Terebinthinac vulg. sing, lib, i. Pollinis tritici q. s. CHIRURGICA. 3* Take of Clarified honey, Common turpentine, of each lib. j. Fine flour, sufficient to make a cerate. The honey and turpentine being liquified together, :i sufficient quantity of fine wheat flour is to be stirred in, to give it the consistency of a cerate. The author has seen this application made use of to chilblains, in a state of ulceration, on the feet and hands of children, with the best possible effects. They should be kept constantly covered with it, and dressed night and morning. , CERATUM PLUMBI. CERATE OF OXYD OF LEAD. R. Emplastri plumbi unc. vj. Adipis pr separate unc. viij. Olivx olei unc. iv. Misce. Take of Plaster of lead, unc. vj. Lard, prepared, unc. viij. Olive oil, unc. iv. Mix. These ingredients are to be melted together over a gentle fire. This is a mild application; and well adapted for superficial sores and abrasions of the skin, especially if accompanied with a considerable discharge. Its efficacy may in some cases be pro- moted by stirring into the melted mixture liquor of acetate of lead, in the proportion of one drachm to an ounce of the cerate. 40 PHARMACOPOEIA CERATUM PLUMBI COMPOSITUM. (Z.) COMPOUND CERATE OF ACETATE OF LEAD, R. Plumbi acetatis unc. ijss. Cera: flavse unc. iv. Olivae olei tine. ix. Camphorx drach. ss. Take of Acetate of lead, unc. ijss. Yellow wax, unc. iv. Olive oil, unc. ix. Camphor, drach. ss. The camphor should be rubbed down with a small portion of the oil, and the remaining oil and wax being melted together, over a gentle fire, the liquor plumbi acetatis is to be stirred in; and when the mixture is nearly cold the dissolved camphor is to be added: the whole should then be briskly agitated till perfectly cold. This is rather a complicated composition; but being given by the royal College we must not doubt its efficacy as a fit application in some peculiar affec- tions. It may be employed as a gentle stimulant and desiccative; as such it may be used with advantage in some cases of burns and scalds; in chronic oph- thalmia of the tarsus; and for the increased secretion of tears, which so frequently affects the eyes of elderly people. CHIRURGICA. 41 CERATUM RESINjE. (L.) CERATE OF ROSIN R. Resinse flavae Cerae flavae sing. lib. ss. Olivaeolei O. j. Take of Yellow rosin, Yellow wax, of each lib. ss. Olive oil, O. j. These should be slowly melted together, the wax being previously cut into small pieces. CERATUM SAPONIS. (L.) SOAP CERATE. R. Saponis unc. viij. Cerae flavae unc x. Plumbi oxydi semivitrei contriti lib. j. OlivaeoleiO.j. Acidi acetici cong. j. Take of Soap, unc. viij. Yellow wax, unc. x. Semivitrified oxyd of lead, lib. j. Olive oil, O. j. Vinegar, one gallon. The London College directs this cerate, originally taken from the practice of St. Bartholomew's Hos- pital, and much used and recommended by the late celebrated Mr. Pott, to be prepared in the following way: Boil the vinegar with the oxyd of lead over a slow fire, constantly stirring them till they become D2 42 PHARMACOPOEIA united and glutinous; then add the wax, oil, and soap, previously melted together; observing that the temperature of the two compounds be nearly at the same degree when they are blended with each other. The whole should again be effectually and constantly stirred till the cerate is nearly cold. In making this preparation the greatest possible caution is required, the fire should never be too rapidly ap- plied, the stirring should be uniform and incessant, and the heat should only be sufficient to keep the two compositions liquid at the time when they are united. The original intention in using this cerate was that of its being a very useful application, when spread upon linen, to fractured limbs, for the obvious purpose of acting as a proper stay to the part, and tending to keep the points of the bone in due apposition, possessing at the same time the pro- perty of a saturnine application. As a remedy to open sores we much doubt whether it be ever judi- cious to apply it. As a means of support to fractured bones, for we can consider it in no other light, it may prove a very effectual, and at the same time a very dangerous one. When spread on linen, and ap- plied in one piece firmly round the limb, in such a way that the two ends overlap each other, the worst possible effects may ensue; for should much tume- faction come on, the inflamed vessels will be com- pletely strangulated, and high erysipelatous inflam- mation, and a rapid state of gangrene may be* the CHIRURGICA. 43 result. The author recollects an instance of this sort, which had nearly proved fatal. A boy having broken his thigh, the limb was immediately enveloped by the surgeon in attendance with a circular bandage of soap cerate, and the patient for some hours left to his fate; a rapid state of swelling ensued; the lad became tortured with pain, from which he was only released by his mother judiciously cutting the band- age of soap cerate, and removing it altogether; but not before high inflammation had been excited, and dark-coloured vesicles raised in different parts conti- guous to the injury. The limb was ordered to be laid upon a soft pillow, and linen rags wetted with a lotion, consisting of three parts liquor ammonise acetatis, and one of spirit of wine, were kept con- stantly applied, by which means the tumefaction and inflammation gradually subsided, and the boy, after a severe and protracted confinement, ultimately got well. We believe it is now a universal maxim with surgeons of eminence never to recommend the soap cerate to fractured limbs till all inflammation and swelling have entirely disappeared, nor till a union in some degree has been effected. It is some- times recommended as a constant covering to stru- mous enlargement of the glands, as also to scrophu- lous swellings, and in some cases with seemingly good effect. 44 PHARMACOPOEIA CERATUM SEVI COMPOSITUM. COMPOUND CERATE OF PREPARED SUET. R. Adipis praeparatae unc. viij. Sevi praeparati pp. unc. iv. Olivae olei unc. ij. Misce. Take of Lard prepared, unc. viij. Mutton suet, pp. unc. iv. Olive oil, unc. ij. Mix. The prepared mutton suet and hog's lard are to be melted together over a gentle fire, the oil should then be added, and the whole stirred till cold. This is a cheap and mild application, and where a co- vering simply to an abraded surface is required, it will be found to answer the purpose as well as many others which are more compounded, and far more expensive. CEREOLUS CHIRURGORUM. A BOUGIE. The term, Bougie, is given by surgeons to a long, slender, flexible instrument, which is formed for the purpose of being introduced along the urethra into the bladder. Since the commencement of adopting this form of instrument into the practice of surgery, for the relief of certain maladies incident to the urethra, various opinions have, occasionally, pre- vailed as to the probability that the cure of such ma- ladies might be accelerated by peculiar remedies CHIRURGICA. 4 5 employed in the composition of the instrument; and that it might be so contrived, as to remove every variety of complaint, or even disposition to com- plaint, in the urethra, from that of spasm, arising without any obvious cause, and being only transi- tory in its nature, but producing in some degree Suppressio urinse, to that of confirmed stricture, depending on a morbid alteration of the internal membrane of the urethra, and giving rise to an utter impossibility, almost, of passing a drop of urine. In consequence of such opinions being entertain- ed; opinions suggested by the phantoms of hypothe- sis, and maintained through an ignorance of the com- mon principles of the animal economy, and a gross deficiency of knowledge of the modus operandi of medicine; or hatched by the knavery of empiricism, and propagated by her abettors at the expense of truth; a variety of heterogeneous and inappropriate articles have been introduced into the composition of bougies; and in order to attach to them the ne- cessary degree of credit, they have been designa- ted with the title of Medicated Bougies, (Cerei Medicati) and offered to the public as constructed to meet every urgent emergency, and every possible variety of disease, which should occur in the ure- thra: containing in their composition something relaxant, something antispasmodic, something seda- tive to relieve irritation, something corrosive to des- troy, and something corroborating to bind up and 46 PHARMACOPOEIA tighten the parts; thus obviating any preternatural irregularity and deformity, whether from laxity, debility, spasm, or total obliteration in the urinary canal. From a conviction that bougies, if simple, act only by their mechanical pressure and distension; and if medicated, as it is called, that this can only be done with any effect by communicating to them a corrosive quality, as by arming them, either with the common lunar caustic, or kali purum; our for- mulae for the composition of bougies are compara- tively very few. We, likewise, deem it fit, further to observe, that, however well proportioned or ap- propriate may be the articles intended for their composition, bougies will seldom or never be well formed, but by those who are constantly employed in making them; and that the surgeon may always purchase them much cheaper and better thm he can make them himself. The following appear to us the most proper formulae for introduction. CEREOLI SIMPLICES. SIMPLE BOUGIES. R. Cerae albae unc. xvi. Terebinthinae venetae unc. iss. Olivae olei unc. j. Take of White wax, unc. xvj. Venetian turpentine, unc. iss. Olive oil, unc. j. The wax and turpentine are to be melted together »ver a slow fire, and the oil is then to be added. CHIRURGICA. . *7 R. Olivae olei O. iiss Cerae flavae lib. j. Minii lib. iss. Take of Olive oil O ijss. Yellow wax lib. j. Red lead, lib. iss. Boil together over a slow fire till the minium is perfectly dissolved, which it will be in about four or six hours. DR. SWEDIAUR'S BOUGIE. R. Cerae flavae lib. j. Cetacei ceti drach.iij. Plumbi acetatis drach. v. Take of Yellow wax, lib. j. Spermaceti, drach. iij. Acetate of lead, drach. v. These ingredients, like the former, are to be boiled together, till the composition is judged to be Of a proper consistence for forming bougies. MR. B. BELL'S BOUGIE. R. Emplastri plumbi unc. iv. Cerae flavae unc. iss. Olivae olei drach. iij. Take of Plaster of lead, unc. iv. Yellow wax, unc. iss. Olive oil, drach. iij. 48 PHARMACOPOEIA The wax and oil are to be melted in one vessel, and the lead plaster in another, previous to mixing. See precautions under the formula, Ceratum Saponis. In order to form a bougie, a slip of linen, in width from a quarter to two thirds of an inch, or an inch at the one end, and from two thirds of an inch to one inch and a quarter at the other end, and in length from ten to twelve inches, must be dipped in the melted composition, taking care that it be evenly applied; it is then to be carefully folded up into the proper longitudinal shape, and rolled firmly between two marble slabs till perfectly smooth and even. Bougies thus formed are somewhat tapering, but very trifling so. Before introducing them they should always be drawn once or twice through be- tween the thumb and finger, and then covered with sweet oil. They should always be pliant and flexible, yet sufficiently firm to resist the necessary degree of force employed by the surgeon for their introduc- tion into the bladder. They should be kept in a cool place, or one that is somewhat damp, and constantly enveloped with soft paper. The preceding compositions are suited for form- ing bougies, which are sufficiently firm, yet some- what soft and yielding; so that by introducing one of proper size along the course of the urethra, we shall generally be able to ascertain the seat and na- ture of the disease: if spasmodic, by the continued or lengthened indentitions along the course of the CHIRURGICA. 49 bougie, or by its being flattened or compressed so much that its roundness, previous to its introduc- tion, is much altered upon its being withdrawn; and if arising from permanent stricture, by the twisted, corkscrew, or spiral shape the instrument generally receives; presenting us, in some degree, with a mould of the thickened walls of the urinary canal, and showing us to what extent the stricture has advanced, and in a great measure what form it has assumed; thus guiding our conduct in attempting a radical cure by caustic. Bougies of these compositions may, likewise, be of great utility in pointing out to us what advantages we are gaining during the cure by caustic, and proving the good effects d:. rived by each introduction of the caustic bougie; for, previous to using the latter, the simple bougie should always be passed down to, or even, if possible, beyond the seat of disease, and suffered to remain in the urethra for half a minute or a minute, after which the caus- tic one should be immediately employed. THE CATGUT BOUGIE. There are few, if any, cases of stricture occurring in the urethra, wherein the catgut bougie is to be preferred; and in the treatment of no small number of strictures in the urinary canal, which have come under our observation, though they were of every description, we do not recollect one instance where it was necessary to employ this form of instrument. E 30 PHARMACOPOEIA Indeed, in the hands of a young practitioner, we are fearful the catgut bougie might sometimes prove highly injurious, both from its smallness and hard- ness; and if pressed forward with too much force in the first instance, in a case of permanent stricture, or where there is an indurated cicatrix, nearly ob- literating the passage, it is very liable to rupture the urethra, unless coming in direct apposition with the aperture of the stricture. The catgut bougie, however, has lately been made the means of forming a bougie, in our opinion, infinitely superior to any other for the treatment of spasmodic strictures. This is called the Caoutchouc Bougie, and is made by covering the catgut bougie with a solution of Indian rubber or gum, in sufficient quantity to form it of a proper size and shape. The precise method of forming these bougies is confined to one or two persons; and though great secrecy is observed, both as to the composition, and the way in which the instrument is formed, yet we believe the secret consists in finding a suitable solvent for the Indian gum. This solution being of a proper consistency, is put into a deep vessel, and the catgut is carefully and repeatedly immersed into it, till a sufficiency of the gum has adhered, so as to form it of the proper size for a bougie. It is probable, that some time is allowed to intervene between each dipping, in order that the solution on the catgut may contract a suf- ficient firmness, so as readily to admit of a second CHIRURGICA. 51 layer of coating by dipping. Now the chemical properties of caoutchouc, froma knowledge of which this excellent form of bougie has been produced, are thai following:l It is softened by heat, and at length melts, swelling up and emitting an unpleasant odour; on cooling again it remains adhesive, acquires the consistence of tar, and never recovers .its former elasticity. It may be dissolved by heat in fat oils, and will combine also with heated wax. It is soluble in cajeput oil, and completely so in aether, if the sether be previously washed with water. If dissolved in aether the gum, upon the evaporation of the cethert completely recovers its former elasticity.1 From this account it would seem, that aether was the proper menstruum for dissolving caoutchouc, when in- tended to be used for purposes wherein it is re- quired that its elasticity should not be diminished. It must, however, be found a very extravagant way of preparing these bougies, and probably some other cheaper solvent may have been discovered. For re- lieving spasmodic affections of the urethra, produ- cing suppression of urine, whether arising from a peculiar morbid irritability of the part, or originat- ing from some remains of a permanent stricture imperfectly cured, we are acquainted with no form of instrument that will in general effect relief more easily and safely to the patient than the caoutchouc bougie; as being sufficiently firm, elastic, and pliant, and which may always be introduced without dan- 52 PHARMACOPOEIA ger of breaking; an accident the metallic bougies, which we shall next speak of, are not totally free from; nor does the caoutchouc bougie ever assume the corkscrew shape by meeting with even a trifling degree of resistance in the urethra, like the common wax or plaster bougies. THE METALLIC BOUGIE. Bougies are likewise formed by the combination of different metals, which, when melted together, form a substance almost as flexible as softened wax. These bougies are of a beautiful silvery white, as it has been called, which they never lose by keeping, and are sufficiently pliant for all purposes; but they are altogether inelastic, and remain in whatever shape they may be placed in, whether by the opera- tor, or from meeting with some foreign and opposing body, till a greater force be applied to alter that shape, which alteration is easily effected'owing to their extreme flexibility. If, then, one of these me- tallic bougies be introduced into the urethra, whether for the purpose of relieving some spasmodic affec- tion, or to break down any stricture which may exist, it will be found occasionally to meet with more resistanc , and to occasion more pain, than even the catheter in one case, or common caout- chouc bougie in the other. The cause of this resis- t£iite to the metallic bougie, we attribute to its par- taking of a curve, or rather an angle, more readily CHIRURGICA. 53 at about an inch, or an inch and a half, from its point, than at any other part; and that in proportion as it meets with more or less resistance in the pas- sage will this angle be more or less acute. Having assumed this angle, the remaining distance to the point is much less flexible, from its shortened di- mension, and will often, especially to a young opera- tor, occasion considerable difficulty before he can pass it easily under the arch of the pubis, so as to follow the proper curve of the urethra; an objection the caoutchouc bougie is totally free from, owing both to its equable flexibility and uniform elasticity throughout. Indeed it is not beyond our recollection that the metallic bougie more than once has broken when within the bladder, to remove which, the pa- tient was compelled to undergo the same operation as if he had been labouring under the stone; and notwithstanding some allowance may probably be made for the awkwardness of the surgeon, yet we think an occurrence of this nature a decided objec- tion to the general use and adoption of metallic bougies. THE CAUSTIC BOUGIE. This bougie is formed by arming the common wax bougie with the caustic potash, (potassa fusa,) or nitrate of silver (argenti nitras,") the latter of which is certainly preferable, both from its being less deliquescent, and from its action being much E2 54 PHARMACOPOEIA more confined to the part to which it is applied. At the end of the bougie, a small slender roll of lunar caustic, from one fifth to one third of an inch in length, is closely confined within its centre; and as the plaster bougies should always be made of rolls of new cloth, the caustic is rendered sufficiently firm and permanent, as the whole length is included except the very point intended to act. Whenever a stricture proceeds from an indurated cicatrix, whe- ther broad or narrow, which has arisen from a slow and gradual alteration in the internal membrane of the urethra, or immediately from the influence of some venereal affection, the surest and most effectual mode of relief is by the caustic bougie. Much skill and dexterity are, however, required on the part of the surgeon, who undertakes to cure permanent stricture by caustic applications. In the first place he should be well acquainted with the anatomical structure of the urethra, from the very extremity of the penis to the neck of the bladder; and he should be well versed in the mode, both of passing the ca- theter and common bougie. He should, likewise, be conversant with the resistance which is frequently experienced from the violent spasmodic action of the urethra, taking place upon its being distended by the introduction of any instrument along its canal; for, without this knowledge, he may be very liable to mistake a common case of spasm for permanent Stricture; and by adopting the caustic as a means of GHIRURGICA. 55 cure, may do almost irretrievable mischief. In our observations on common bougies, we have offered some remarks whereby to distinguish these two dif- ferent causes of interruption to the free flow of urine from the bladder. In order to ascertain the exact place of the stricture, a common bougie should be passed down to it; and the distance of the stricture from the extremity of the penis, should be marked upon the caustic bougie by the previous measure- ment made with the common one. In conducting the cure of permanent strictures by caustic bougies, it is always requisite, previous to using the caustic, to pass as full a sized common bougie (it being first covered with some mild unctuous substance) as the patient can well bear, down to the seat of stricture, and to keep the parts for half a minute, or a minute, upon the stretch, by drawing the penis well up upon the bougie; recollecting, however, to use no violence. After withdrawing the common bougie, a caustic one of the same diameter, or nearly so, should be immediately passed down to the stricture, previously made ready by exposing the very end of the caustic, and just moistening it; taking care, however, to smear the circumference of the bougie with lard, oil, or spermaceti ointment. When the extremity of the bougie is found to have come into contact with the stricture, it should be gently pressed forward, or worked backwards and forwards for half a minute or a minute, till it is judged that it has made some 56 PHARMACOPOEIA impression upon the stricture by the pain expressed by the patient; it is then to be immediately with- drawn, and if the patient complain of great pain, he should be ordered to lie upon a bed for some time, and twenty or thirty drops of the tincture of opium should be exhibited in a wine-glass of some aromatic water. This process may be repeated every second or third day, according to the progress made in the cure of the complaint, and the pain and inconve- nience complained of by the patient. It will, some- times, greatly expedite the cure, to pass a common bougie down to, or even through the stricture on the intermediate days of using the armed bougie. Delicate as is this operation, and requisite as is the caution in conducting it, we may venture to affirm that there are few permanent strictures which do not admit of a radical relief by a just and proper adoption of it. Much has been said about the violent haemorrhages which sometimes ensue after the use of the caustic, but we believe nine times in ten they will be found to depend on a too frequent use of the caustic, or from continuing it too great a length of time in the canal so as to destroy the urethra. As an additional means of ascertaining the seat and form of strictures in the urethra, see Charles Bell's Operative Surgery, on the use of the gold and silver headed wires. CHIRURGICA 57 CONIUM. (L.) CONIUM MACULATUM. HEMLOCK: The Leaf, Flower, and Seed. There is not, perhaps, among the whole number of articles contained in the materia medica, one which has experienced greater reverses in the opi- nions, both of physicians and surgeons, than hem- lock; being at one time held forth to notice almost as a general panacea, and at another decried as pos- sessed of no merit whatever, whether employed as an external application, or given as an internal re- medy. Indurations, scirrhosities, cancers, in what- ever part they might chance to be situated, ophthal- mia of every kind, and ulcers of every description, have been represented as safely and readily reme- diable by the exhibition of hemlock: on the other hand its efficacy in such affections has been totally denied. From our own experience of this plant, given for such complaints, and which has been suf- ficiently ample to warrant an opinion upon the sub- ject, we think that it will generally prove very in- adequate in the greater number of these complaints. It certainly, however, possesses the power of better- ing certain ulcers very materially, and disposing them to heal; and that when no other medicine can be administered with equal safety, or with equal success. Scrofulous ulcers, accompanied with pain and irritability, attended with a glassy aspect, and. 58 PHARMACOPOEIA oftentimes a surrounding erysipelatous blush, espe- cially if the pulse be quick and hard, are very gene- rally greatly meliorated by taking the conium. Mr. Pearson, surgeon of the Lock Hospital, than whom no one appears to have examined certain articles in the materia medica, as to their virtues in venereal affections, more accurately, or to have detailed his experience of them more faithfully and clearly, in his book on that subject, and which ought to be in the hands of every surgeon of the United Kingdom, says, " The extract and powder of hemlock may be sometimes given with evidently good effect in spreading irritable sores; whether they are connec- ted with the active state of the venereal virus, or when they remain after the completion of the vene- real course; and it would seem that the benefit con- ferred by this drug ought not to be ascribed solely to its anodyne qualities, since the same advantages cannot always be obtained by the liberal exhibition of opium, even where it does not disagree with the stomach.' He further says, that it is almost a spe- cific in the venereal ulcer which attacks the toes at their line of junction with the foot, and which often becomes gangrenous; and that in any spreading gangrenous sore, where there exists great pain, and no appearance of any remarkable debility, hemlock will frequently effect more than bark, vitriol, or cordials. It has appeared to me that, whenever hemlock is likely to do good, the patient either ex- CHIRURGICA. 59 periences some benefit soon after commencing with its use, or that he is affected with but a compara- tively small dose. The preferable mode of exhibit- ing it is in pills, formed of the expressed juice and the fresh powder of the leaves. The dose to begin with is generally one of these pills twice in the day, gradually increasing them till they produce a sensible effect on the stomach, or some degree of giddiness. As many as twenty of these pills may sometimes be given in the day. I recollect, in a case of carcino- matous sore, where one hundred and twenty of these pills, consisting of five grains each, were exhibited in twenty-four hours, and continued for some time without the least benefit or inconvenience to the pa- tient. See Fomentum Conii, and Pil. Conii Compos. CINCHONA CORDIFOLIjE CORTEX. (Z,.) CINCHONA OFFICINALIS. (E.) CINCHONA, the Bark; commonly called PERUVIAN BARK. Of the three varieties enumerated by botanists, and noticed in some of our Pharmacopoeias, the yellow Peruvian bark is the only one essentially ne- cessary in surgical practice, being much more pow- erful than either of the other species. The Cinchona has now become so much in use with the surgeon, and is universally deemed of such importance in sevral cases which come exclusively under his cognizance, that no apology is required for offering 6© PHARMACOPOEIA it to his observation. It is, however, a medicine by no means to be administered indiscriminately, un- der a supposition the most unworthy possible a man of science or judgment, [that if it do no good it never does harm; for we have repeatedly seen cases, purely surgical, very materially aggravated by an incautious and improper exhibition of this remedy, owing to its impeding the functions of some one or more important organ, the due and healthy perfor- mance of which is so requisite to good healti, that the regular and orderly action of the animal eco- nomy is incompatible with their disturbance. In constitutions phthisically inclined, and where the pulse is generally quicker than natural, more espe- cially if there be any dyspmea, or any disposition to active haemorrhagv from the lungs, the surgeon ought to weigh well the propriety of giving the cin- chona, whatever may be the case under his care. If there exist any preternatural determination of blood to the head, we should be very cautious how we ad- minister cinchona, or if under its administration any marks of congestion in the chest take place, or the pulse become quickened, it is for the most impro- per. In many cases of ulcers, particularly of the lower extremities, evidently connected with a de- ranged state of the functions of the chylopoietic viscera, and more particularly those of the liver, the free and liberal use of the bark is generally pre- scribed; and we may venture to affirm, in the great- CHIRURGICA. 61 ter number of instances, very improperly. In gan- grene, accompanied with turgescency of the blood- vessels, immediately supervening upon high and active inflammation, whether of the phlegmonous or erysipelatous kind, much harm has often been occasioned by the too early employment of the bark. In most ulcers, however, connected with great irri- tability or laxity of fibre; in wounds where there is any tendency to passive hsemorrhagy, or where the surface is pale and glassy, or where there is an evi- dent indolence in the granulating process, or where the discharge is too profuse and unhealthy, or where the wound shows a disposition to slough or enlarge itself, in all these cases the use of the bark is most unequivocally called for. It is recommended, on the first authority, in incipient venereal buboes; in ulcers of the tonsils and gangrenous ulcers from a venereal cause; as likewise in chancres of the penis, immediately on their first appearance, if at all dis- posed to slough. Cinchona, too, hastens the exfolia- ting process, and for the most part is proper when- ever the vis vita? is languid and deficient. It is best given in substance where the stomach will bear it, in doses of twenty-five or thirty grains, three times in the day, or oftener; and in some cases in doses of one or two drams, every four hours. It is often ren- dered much more agreeable by the addition of some aromatic, and much more palatable by being given in liquorice infusion, in milk, or in a weak decoction F PHARMACOPOEIA of malt. If the cinchona run off by stool, this effect may be corrected by the addition of a few drops of the tincture of opium, and often by combining it with some grateful stimulant. COLLYRIUM ACIDI ACETICI. COLLYRIUM OF VINEGAR. R. Acidi acetici unc. j. Spiritus tenuiorjs unc. ss. Aq. rosae unc. viij. misce. Take of Distilled Vinegar, unc. j. Weak spirits, unc. ss. Rose water, unc. viij. Mix. These proportions will in general be found ap- plicable in most cases. The strength, however, may be diminished or increased, by a diminution or increase of the vinegar. This collyrium is often usefully applied to weak watery eyes, or to remove the pain and sense of pricking, experienced in the globes of the eyes, after they have been fatigued by close attention to some one object. It is of use in chronic scrofulous oph- thalmia; as likewise in the more acute forms of oph- thalmia, after free evacuations. See the article Aci- dum Aceticum. CHIRURGICA. 63 COLLYRIUM AMMONIA ACETATIS CAM- PHORATUM. COLLYRIUM OF ACETATE OF AMMONIA WITH CAMPHOR. R. Liquoris ammoniac acetatis unc. ij. Misturae camphorae unc. vj. misce. Take of Liquor of acetate of ammonia, unc. ij. Camphorated mixture, unc. vj. Mix. This mixture forms a very elegant, and, in general, a very effectual collyrium in cases where mild as- tringent and stimulating remedies are indicated. COLLYRIUM AMMONIA ACETATIS CUM OPIO. COLLYRIUM OF ACETATE OF AMMONIM WITH OPIUM. R. Liquoris ammoniae acetatis unc. i j. Aq. distitJatae ferventis unc. vj. Extracti opii mollis gr. x. Take of Liquor of acetate of ammonia, unc. ij. Boiling water, unc. vj. Extract of opium, soft, grs. x. Dissolve the soft extract of opium in the boiling water; strain through fine linen, and add the liquor of acetate of ammonia. This application will often be found to afford considerable relief in cases of acute ophthalmia, more especially in the early stages, and where the pain is very considerable. 64 PHARMACOPOEIA COLLYRIUM CUPRI AMMONIATI. COLLYRIUM OF AMMO NIATED COPPER. R. iEruginis preparatae gr. iv. Ammoniaemuriatis scrup. ij. Liquoris calcis recentis unc. viij. Take of Verdigrise prepared, grs, iv. Muriate of ammonia, scrup. ij. Fresh lime water, unc. viij. This collyrium, the Liquor Cupri Ammoniati of the Dublin College, is similar to the Liquor Cupri Ammoniati of the London. It is the aqua sapphirina of former writers, and intended to be used as an application for the removal of specks situated upon the transparent cornea of the eye, whether arising from previous inflammation or any other cause. It is, however, a doubtful remedy, and I believe seldom resorted to. * * Different preparations of copper have been recommended in the composition of collyriums. It does not appear to the editor that the collyrium cupri ammoniati is one of the best or the safest; as here introduced it is much too strong to be used with safety without being diluted, besides its being a very unchemical com- position, from the different compounds which enter into it. A much more elegant and effectual collyrium, where solutions of copper are perferred may be made in the following manner. R. Sulph. Cupri gr. vj. Aq. Camphorat. unc. viij. Misce. Take of Sulphate of copper, gr. vj. Camphorated water, unc. viij. Mix. This form of collyrium, the strength of which can always be correctly regulated, is nearly the same as has been recommended CH1RURGICA. 65 COLLYRIUM HYDRARGYRI MURIATIS. COLLYRIUM OF MURIATE OF QUICKSILVER. R. Hydrargyri nuiriatis gr. ij. ad iv. Aquae distillatae unc. viij. Misce. Take of Muriate of mercury, gr. ij. to iv. Distilled water, unc. viij. Mix. This solution of muriate of quicksilver may be used, in general, with great advantage in the oph- thalmia syphylitica, especially if conjoined with the internal exhibition of mercury. I have likewise often prescribed this collyrium with very good effect in cases of scrofulous ophthalmia in children, where the eye-lids and the tarsus itself have been long af- fected with chronic inflammation, or where little troublesome ulcers are situated on its margin. It is likewise very beneficial in that state of ophthalmia, denominated, Psorophthalmia. by Mr. Ware, and used with success In the cure of that affection of the eyes which he denominates Purulent Opthalmy, and which so frequently succeeds active inflammation of that organ. This remedy, he recommends, should always be applied by means of a small syringe, which must be introduced between the edges of the eyelids, in such a manner that the liquor may be carried over the whole surface of the eye; by this means, the whole purulent matter will be washed away, and sufficient of the styptic liquor will remain to act as an astringent and to diminish the discharge. F2 66 PHARMACOPOEIA COLLYRIUM OPII. COLLYRIUM OF OPIUM. R. Opii extract! mollis gr. x. Camphorae gr. vj. Aquae distillatae ferventis unc. xij. Take of Soft extract of opium, gt\ x. Camphor, gr. v. Boiling water, unc. xij. Rub the camphor and opium in a mortar till they are well blended together, and add the boiling dis- tilled water; or, R. Fomenti papaveris, unc. iv. Aquae rosae, Misturse camphorae aa. unc. ij. Take of Fomentation of poppies, unc. iv. Rose water, Camphorated mixture, each, unc. ij. Either of these collyria may be used with pro- priety and advantage in the early stages of ophthal- mia, when accompanied with much pain and tume- faction; and the latter one at the commencement of the purulent ophthalmia of infants. COLLYRIUM LIQUORIS PLUMBI ACETATIS. COLLYRIUM OF ACETATE OF LEAD. R Aq. distillatae unc. vii. Liquoris Plumbi Acetatisj gtt. xv. ad gtt. xxs. Misce. * CHIRURGICA. 6r Take of Distilled water, vij. Liquor of acetate of lead, gutt. xv. to xxx. Mix. The strength of this application must be modified according to the irritability of the inflamed eye. It forms a very common, and in general, a very good cooling astringent collyrium. COLLYRIUM PLUMBI ACETATIS. COLLYRIUM OF ACETATE OF LEAD. R Aquae rosae, unc vj. Plumbi acetatis, drach. ss. Misce. Take of Rose water, unc. vj. Acetate of lead, drach. iss. Mix. This is a cooling and mild astringent application. COLLYRIUM ZINCI ACETATIS. CO LLYRIUM OF ACETATE OF ZINC. R. Zinci acetatis, drach. ss. Aquae distillatae unc. xij. Misce. Take of Acetate, of zinc, drach. ss. Distilled water, unc. xij. Mix. COLLYRIUM ZINCI SULPHATIS. COLLYRIUM OF SULPHATE OF ZINC. R. Zinci sulphatis drach. ss. Aquae distillatae, O. i. Misce. Take of Sulphate of zinc, drach. ss. Distilled water, O.j. Mix. 63 PHARMACOPOEIA These are very common and suitable applications to weak inflamed eyes, or where there exists a ten- dency to a preternatural secretion of tears. We may form a substitute for the former collyrium, by adding to the latter one, thirty or forty drops of the liquor plumbi acetatis, suffering the sediment to subside, and straining off the clear liquor.* COLLYRIUM ZINCI SULPHATIS CUM CAMPHORA. COLLYRIUM OF SULPHATE OF ZINC WITH CAMPHOR. R. Zinci sulphatis, drach. ij. Spiritus camphorae, drach. iij. Aquae distillatae fervent is, unc. iv. Aquae rosae, unc. viii. Take of Sulphate of zinc, drach. ij. Camphorated spirit, drach. iij. Boiling water, unc. iv. Rose water, unc. viij. * Solutions of sulphate of zinc, according to the above formulae, constitute by themselves very useful astringent collyriums, but attempting to combine with them a solution of acetate of lead as above suggested, appears to the editor perfectly useless and inconsistent with chemical affinity, as on adding the lead a de- composition immediately takes place, the lead combining with the sulphuric acid of the zinc and forming an insoluble compound, while the zinc then only remains in solution combined with the acetous acid; .nothing therefore is obtained by this combination, which is frequently made use of, that cannot more correctly be prescribed by a simple solution of acetate of zinc, which of itself is a useful collyrium. CHIRURGICA. 69 Pour the boiling water upon the zinc and cam- phorated spirit in a closed vessel, and when cold, strain through linen or fine tow; then add the rose water. This collyrium is chiefly used with the same intention as the two preceding ones; it is, however, more stimulating, and better adapted for relieving the pain and weakness incident to the eyes of elderly people, when depending on debility of the optic nerves. CONFECTIO CINCHONA. CONFECTION OFCINCHONA. R. Cinchonae pulveris unc. j. Conservae rosae unc. ss. Syr. aurantii corticis q. s. ut fiat confectio. Take of Powder of cinchona, unc. j. Conserve of roses, unc. ss. Syrup of orange peel, sufficient to make a confection. The dose is a drachm, three or four times a day. This is a convenient, and to some patients, an agree- able mode of administering the chiehona. Either the Carbonate of Soda, or the Carbonate of Iron, in the quantity of two or three drachms, or the di- luted vitriolic acid, in quantity sufficient to produce an agreeable acidity, may be added to this confec- tion, according as the indicatio medendi shall point out the utility of conjoining one or other of these articles. * * This form of giving the cinchona, will not answer in every case: it is greatly improved by combining it with an aromatic, 7Q PHARMACOPOEIA CONFECTIO SENNA COMPOSITUM. COMPOUND CONFECTION OF SENNA, R. Confectionis Sennae unc. ij. Jalapae pulveris drach. ij. Potassae tartratis unc. ss. Syr. zingiberis q. s. ut fiat confection. without which it will frequently not sit easy on the stomach, when given in substance; it may also be combined with bitters, such as columba or gentian root, which in many cases of debi- lity of the stomach, will be attended with great advantage. But perhaps there is no method of administering preparations of iron with so much benefit, as in the form of electuary or confection, combining it as above suggested with the cinchona. It cannot however be given in sufficient quantity, nor long continued, without adding a proportion of some warm aromatic, by which means it becomes one of the most valuable tonic remedies in all cases of great relaxation and debility. The addition of sulphuric acid to an electuary as here' prepared, does not appear to the editor as judicious, though as a tonic and stomachic, it is a va- luable medicine, and may be taken after each dose of the elec- tuary to the quantity of fifteen or twenty drops in a small glass of water. As no form of giving either the bark or steel in this manner has been noticed, the editor thinks it may be useful to add the following as one of those forms which experience has taught him the utility of. R. Pulv. cinchona unc. j. Ferri carbonat. O. ij. Pulv. rad columb. drach. iss. "■ Pulv. aromat. O. j. Syr. cort aurant. q. s. ft. electuarium cujus sumat cochl. parv. ter in die. Take CHIRURGICA. 71 Take of Confection of senna, unc. ij. Powder of jalap, drach. ij. Tartrate of potash, unc. ss. Syr. of ginger, sufficient to make an electuary. Tins is a very convenient and effectual r medy for keeping the bowels in a free soluble state. The dose is a drachm once in the day, or oftener. CONFECTIO SINAPEOS. MUSTARD CONFECTION. R. Sinapis seminum leviter contusorum unc. j. Confectionis aurantii unc. jss. velq. s. Ut fiat confectio. Take of Mustard seed bruised, unc. j. Confection of orange peel, sufficient to make aeon- fectiou. The dose is two drachms, three or four times in the day. This electuary, taken from the pharmaco- poeia of Guv's Hospital, is as agreeable a mode of exhibiting the; ntustard as any we are acquainted with. It is a r^rm stimulating, and slightly tonic, medicine; and c^e which we thmk might often be prescribed vvith advantage for indolent strumous Take of Powder of cinchona, unc. j. Carbonat of iron, drach. ij. Col'.iml-o root powdered, drach. iss. Av .in lie j.owdtr, drach ij. Svrup of« at g'- neel sufficient to make an electuary, of whicfe a small tea-spoonful may be taken three times a day. 72 PHARMACOPOEIA enlargements of the glands, and for recent, or chronic ulcers of a similar character. CONFECTIO SULPHURIS. CONFECTION OF SULPHUR. R. Sulphuris loti unc. iss. Confectionis sennae unc. ij. Potassae nitratis drach. iij. Syr. aurantii q. s. ut fiat confectio. Take of Sulphur washed, unc. iss. Confection of senna, unc.ij. Nitrate of potass, drach. iij. Syrup of orange peel, sufficient to form a confection. The dose is from one to two drachms, once or twice in the day, taken so as to keep the bowels in a free state. In haemorrhoidal affections, and previous to and consequent upon, the operation of fistula in ano, this electuary will be found to afford considerable benefit, by keeping up a proper action through the intestinal canal, and by preventing any undue accumulation of feculant matter in the lower bowels. CONFECTIO TEREBINTHIN^. TURPENTINE CONFECTION. R. Terebinthinae olei rectificati drach. j. Mellis depurati unc. ss. Misce. Take of Rectified oil of turpentine, drach. ,i Clarified honey, unc. ss. Mix. CHIRURGICA. 7S This electuary is often prescribed with advantage as a stimulating diuretic, in the quantity of a drachm to two drachms, in cases of protracted gleets or seminal weaknesses; in continued pains of the lum- bar region, imitative of nephritic affections, and in sciatica, it is likewise often given as a warm diapho- retic medicine.* DECOCTUM ANTHEMIDIS FLORUM. (Z.) DECOCTUM ANTHEMIDIS NOBILIS. (E.) Vulg. DECOCTUM CHAMCEMELI. DECOCTION OF CHAMOMILE FLOWERS. R. Chamcemeli florum unc. j. Carui seminum unc. ss. Aquae distillatae O. v. * The author might have added a much greater number of useful confections or electuaries, as many medicines can be ad- ministered in this form with more advantage than in any other, particularly where it is necessary to prescribe them in sub- stance. For instance, in obstinate chronic diarrhoeas and dysen- tery, as well as in passive haemorrhagies, either from the intes- tines or uterus, where the use of powerful astringents are indicated, they may be prescribed with great benefit, in the form of an electuary, as follows: R. Gum kino drach. ij. Aluminis drach. iss. terantur bene simul, adde Confect. opii drach. iij. Conserv. rosae q. s. fiat electuarium. Take of Gum kino, drach. ij. Alum, drach. iss. powdered together, and add Confection of opium, drach. iij. Conserve of roses, sufficient to make an electuary. G 74 PHARMACOPOEIA Take of Chamomile flowers, unc. j. Caraway seeds, unc. ss. Water, O. v. Boil for fifteen minutes, and strain. DECOCTUM CHAMOZMELI, Or, DECOCTUM PRO ENEMATE. {Dub.) DECOCTION OF CHAMOMILE FLOWERS, OR DECOCTION FOR CLYSTERS. R. Chamcemeli florum unc. ss. Fceniculi dulcis seminum drach. ij. Aquae distillate O. j. Take of Chamomile flowers, unc. ss. Seeds of sweet fennel, drach. ij. Water, O.j. Boil for ten minutes, and strain. Or, DECOCTUM PRO FOMENTO. DECOCTION FOR FOMENTATIONS. R. Abrotoni exsiccati, Absinthii maritimi exsiccati, Anthemidis florum singul. unc. j. Lauri foliorum unc. ss. Aquae distillatae O. vj. Take of Leaves of southernwood, dried, Wormwood, Chamomile flowers, of each, unc. j. Bay leaves, unc. iss. Water, O. vj. Boil a little time, and strain. CHIRURGICA. 73 These decoctions may be used indiscriminately for fomentations; being sufficiently simple to be had recourse to where such applications are preferred. The two former are said to be emollient and discu- tient; and the last one, which was one of the formula of the late London Pharmacopoeia and which we have retained under its primitive title, possesses anodyne and gently stimulating properties. DECOCTUM DULCAMARA. DECOCTION OF DULCAMARA, OR BITTER- SWEET. R. Dulcamarae stipitum exsiccatorum unc. s». Aquae ferventis O. j. Take of Twigs of dulcamara, dried, unc. ss. Boiling water, O. j. Boil the twigs of the Dulcamara, or Bitter-sweet, in the boiling water, for a quarter of an hour, and strain. This decoction is greatly recommended by some practitioners as an efficacious remedy against cuta- neous affections, whether arising from scrofula, lepra, or lues; also, in very many anomalous cases proceed- ing from one or other of these causes: but it is by no means equal to the commendations which have been bestowed upon it. In one or two cases I have seen it highly serviceable, and that after other remedies had proved ineffectual. The dose is from 76 PHARMACOPOEIA one to two ounces, mixed with an equal portion of milk, three or four times in the day. DECOCTUM GUAIACI. DECOCTION OF GUAIACUM WOOD. R. Guaiaci ligni rasi unc. iv. Glycyrrhizae radicis contusae unc. j. Coriandri seminum contusorum une. ss. Aquae distillatae O. viij. Take of Guaiacum wood, rasped, unc. iv. Liquorice root, bruised, unc. j. Coriander seeds bruised, unc. ss. Water, O. viij. Boil the guaiacum raspings in the water till the fluid is reduced to one half, and towards the end of the boiling, add the liquorice root and coriander seeds. The dose is from four, to six or eight ounces, three or four times in the day. This decoction is a stimulating, diaphoretic medicine; acting in some cases very powerfully both upon the kidnies and skin; and generally proving serviceable in cutaneous affections depending on a debilitated, or-atonic, state of the secerning vessels of the surface. In indolent strumous abscesses, where the discharge is gleety, and the aspect of the wound livid or unhealthy, the decoction of guaiacum is not unfrequently one of the best means we can employ for meliorating the discharge, and inducing an healthy action in the granulating process. It has been greatly recom. CHIRURGICA. 77 mended in syphilis, for restoring the strength and vigour, when the system has been much reduced from mercury and confinement; as also for remov- ing a thickened state of the ligaments and perios- teum; and for curing foul indolent ulcers, whether resulting from scrofula or lues, particularly in the latter case, if a due course of mercury have been persisted in for a proper length of time. DECOCTUM HORDEl. (Z.) DECOCTION OF BARLEY. Barley Water. R. Hordei seminum unc. ij. Aquae distillatae O. ivss. Take of Barley seeds, unc. ij. Water, O. ivss. Wash off the mealy matter adhering to the barley with cold water; and extract the colouring matter by boiling it a little in half a pint of water. Throw this decoction away, and put the barley, thus purified, into four pints and a half of boiling water, and boil to one half. Decoction of barley, taken freely for common drink, is a useful diluent in strangury, dysury, and painful micturition, whether depending on irrita- bility of the bladder, recent gonorrhoea, or the ab- sorption of cantharides from an abraded surface. Its utility may often be further promoted by the addition of gum arabic, nitre, or crystals of tartar, G2 78 PHARMACOPOEIA in the proportion of half an ounce of the former, and a drachm of each of the latter, to each pint of the decoction. Sweetened vvith manna or sugar, as the state of the patient's bowels may require, with the addition of the nitre, it proves a very useful diluent after the operation of lithotomy. DECOCTUM MALVM COMPOSITUM. COMPOUND DECOCTION OF THE MALLOW. R. Malvx exsiccatae unc. j. Anthemidis florum exsiccatorum unc. ss. Aquae distillatae O. j. Take of Leaves of mallow, dried, unc. j. Chamomile flowers, dried, unc. ss. Water, O.j. Boil for fifteen minutes, and strain. See remarks under Decoctum Pro Fomento. DECOCTUM MEZEREI. DECOCTION OF MEZEREON. R. Mezerei corticis radicis recentis drach. ij. Radicis glycyrrhizae contusae unc. j. Aquae distillatae O. iij. Take of Bark of mezereon root, drach. ij. Liquorice root bruised, unc. j. Water, O. iij. Boil the mezereon in the water till the liquid is reduced to two pints, and towards the end of the boiling add the liquorice root. CHIRURGICA. 79 The dose of the Mezereon decoction is from four to eight ounces, three or four times a day. It has been much recommended as an antivenereal remedy, especially for curing membranous nodes, and affections of the bones; and for alleviating noc- turnal or continued pains accompanying such affec- tions; but we believe, it in general falls short of such efficacy, and like many others of the same class, possesses very little, if any, antisyphilitic powers, and often excites nausea and inconvenience in the primse vice. DECOCTUM QUERCUS CORTICIS. R. Quercus corticis contusi unc. ij. Aquae distillatae O. iij. Take of Oak bark, bruised, unc. ij. Water, O. iij. Boil to two pints, and strain. This is a good as- tringent injection for gleety discharges from the vagina continuing after the exhibition of mercury; as likewise for prolapsus ani. It may be further im- proved by the addition of a drachm, or two drachms of powdered alum, mixed with each pint of the decoc- tion. DECOCTUM SARSAPARILLiE. (L.) DECOCTION OF SARSAPARILLA. R, Sarsaparillae radicis incisae unc. viij. Aquae distillatae O. viij. 80 PHARMACOPOEIA Take of Sarsaparilla root, sliced, unc. ij. Water, O. viij. These are directed by the college to be macerated in a gentle heat for four hours; after which the sar- saparilla is to be taken out and bruised, and mace- rated for two hours longer. It is then to be boiled to two quarts, and the liquor is to be strained. DECOCTUM SARSAPARILLA COMPO- SITUM. {L.) COMPO UND DE CO CTION OF SARSAPARILLA. R. Decocti sarsaparillae ferventis O. iv. Guaiaci ligni rasi, Sassafras radicis concisae, Glycyrrhizae radicis contusae sing. unc. j. Mezerei radicis corticis drach. iij. Take of Decoction of sarsaparilla, O. iv. Guaiacum wood, rasped, Sassafras root, sliced, Liquorice root, sliced, of each, unc. j. Bark of mezereon root, drach. iij. Boil for fifteen minutes and strain. The mezereoa should be added towards the end of the boiling. The dose of these decoctions is from four to eight ounces, three or four times in the day. Both have been much extolled for venereal nodes, ulcers, and nocturnal pains; but we cannot, with some practi- tioners, concede to them the celebrity they have ob- tained. The former, combined with an equal portion CHIRURGICA. 81 of milk, is not unfrequently useful for restoring the constitution after along continued course of mercury; as also when exhibited alone, for relieving the dys- peptic symptoms supervening upon the same cause. Probably the sarsaparilla powder, given in milk, in doses of one or two drachms, three or four times a day, is equal if not superior to either of them. DECOCTUM VERATRI ALBI. (L.) DECOCTION OF WHITE HELLEBORE. R. Veratri radicis contritae unc. j. Aquae distillatae O. ij. Spiritus rectificati unc. ij. Take of Root of white hellebore, powdered, unc. j. Water, O. ij. Rectified spirits, unc. ij. The hellebore powder is to be boiled in the water till only one half of the fluid remain; to which, when cold, add the rectified spirit. This decoction is principally of use for curing psora: it is, however, less effectual than the unguent, but more elegant and cleanly. DECOCTUM ULMI. (L.) DECOCTION OF ELM BARK. R. Ulmi corticis recentis contusi unc iv. Aquae distillatae O. iv. Take of Elm bark, bruised, unc. iv. Water, O. iv. 82 PHARMACOPOEIA Boil to a quart. The dose is from four to eight ounces, three or four times a day. The decoction of elm bark has occasionally been of service in cuta- neous affections of the herpetic kind; as likewise for assisting the action of mercury in affections of a similar character, when depending on a syphilitic taint. EMBROCATIO ACIDI ACETICI SPIRITUOSA. SPIRITUOUS EMBROCATION OF VINEGAR. R. Acidi acetiai Q. j. Spiritus tenuioris O. ss. Misce. Take of . Vinegar, O.j. Weak spirits of wine, O. ss. Mix. This is a stimulating astringent application; it is often of great use in spreading phlegmonic inflam- mations of the skin; in incipient scirrhi; in hernia humoralis, after topical bleeding; in bruises and ec- chymosis; and as a lotion to some species of old offensive ulcers. With the addition of two drachms of powdered alum it has been much extolled as an effectual remedy to recent chilblains. The mode of applying it is by covering the part or parts affected with cloths dipped in the embrocation, and keeping them pretty constantly moist. CHIRURGICA. 83 EMBROCATIO ACIDI ACETICI SP1RITUOSA CUM CAMPHORA. SPIRITUOUS EMBROCATION OF VINEGAR WITH CAMPHOR. R. Acidi O. ij. Spiritus rectificati O. iij. Aquae distillatae O.j. Camphorae unc. iij. Take of Vinegar, O. ij. Rectified spirit, O. iij. Distilled water, O. j. Camphor, unc. iij. Dissolve the Camphor in the Spirit of Wine, and add the vinegar and water, previously mixed. This forms a good embrocation for painful rheuma- tic swelling of the joints. It is likewise a very bene- ficial stimulant 'for relieving sprains and bruises; also for exciting the absorbents in cases of extra- vasation of blood from local injuries, particularly after the symptoms of high excitement have been removed by topical or general bleeding and by other suitable means. EMBROCATIO AMMONLE. RMBROCA TION OF AMMONIA. R. Liquoris ammoniae unc. j. Spiritus aetheris sulphurici unc. ss. Spiritus lavandulae compositi unc. ij. 84 PHARMACOPOEIA Take of Liquor of ammonia, unc. j. Sulphuric ether, unc. ss. Compound spirit of lavender, unc. ij. This embrocation is often very efficacious as a stimulant and rubefacient, for relieving painful af- fections of the face and other parts; as likewise for removing thickenings and enlargements of the joints, consequent upon gouty and other inflammations. EMBROCATIO AMMONIA ACETATIS. EMBROCATION OF ACETATE OF AMMONIA. R. Ammoniac praeparatae unc. iv. Acidi acetici O. viss. vel q. s. ad saturationem. Spiritus tenuioris O. iij. Take of Ammonia prepared, unc. iv. Vinegar, O. viss. or sufficient to saturate the amrnt- nia, Weak spirit of wine, O. iij. Mix the ammonia with the vinegar, and after the effervescence ceases, add the spirit. This embrocation, the Embrocatio Communis of the Pharmacopoeia of Guy's Hospital, is in common use for the relief of sprains and bruises, and as a general application to injured parts where the skin remains entire. Mixed with linseed meal, and ap- plied warm, in the form of a cataplasm (renewing it once or twice in the day), it is often of great utility in slow chronic inflammations of the joints; as like- CHIRURGICA. 85 wise in incipient diseases of the hip joint; more particularly if conjoined with local blood-letting.* EMBROCATIO OPII COMPOSITA. COMPOUND EMBROCATION OF OPIUM. R. Tincturae opii Spiritus aetheris sulphurici sing, unc ij. Spiritus camphorae unc. ij. Misce. Take of Tincture of opium, Sulphuric aether, of each unc. ij. Camphorated spirit, unc. ij. This embrocation is used with the same inten- tions as the Embrocatio Ammonise and Embrocatio Saponis cum camphora. In some painful affections of the muscles, it some- times acts as an immediate specific; in odontalgia, it will often give instant ease; in sciatica, it is fre- quently of great benefit; and in deep-seated pain in the neighbourhood of the ear, it generally relieves sooner than any other application. * This is nothing more than the Aqua ammoniac acetatae of the London Pharmacopoeia, combined with spirit of wine. It is a most excellent application, and particularly useful in dispers- ing glandular tumors of the breasts: but as it is one of the for- mulas of the Dispensatory, and always to be found in the shops, it is unnecessary to prescribe it extemporaneously. H 36 PHARMACOPOEIA EMBROCATIO SAPONIS CUM AMMONIA. EMBROCATION OF SOAP WITH AMM ONIA. R. Saponis duri albi unc. xv. Camphorae unc. v. Spiritus rectificati O. iv. Eiquoris ammoniae O. j. Take of White soap, unc. xv. Camphor, unc. v. Rectified spirit, O. iv. Liquor of ammonia, O. j. Digest the soap in the spirit of wine and liquor of ammonia, previously mixed, till it is perfectly dissolved; then add the camphor. This embrocation, selected from the valuable formulae of Guy's Hospi- tal, is a useful and elegant external stimulant. EMBROCATIO SAPONIS CUM CAMPHORA. EMBROCATION OF SOAP WITH CAMPHOR. R. Linimenti saponis unc. ij. Spiritus camphorae unc. j. Olei origani draeh. ij. Tincturae opii unc. ss. Misce. Take of Soap liniment, unc. ij. Camphorated spirit, unc. j. Oil of Origanum, drach. ij. Tincture of opium, unc. ss. Mix. This embrocation is similar to the celebrated anodyne liniment of Bates. It is one which the au- CHIRURGICA. 87 thor has repeatedly seen prescribed with considera- ble benefit to the patient, in painful rheumatic swell- ing of the joints; in arthritic pains; in sciatica, lumbago, and chronic rheumatism. It is often an immediate remedy to the tooth-ach, when proceed- ing from a caries of the tooth, if lint be dipped in the embrocation and placed in the decayed part. EMPLASTRUM AMMONIACI. PLASTER OF AMMONIACUM. R. Ammoniaci gummi resinae pulveris unc. ij. Aceti scillae q. s. Take of Gum ammoniac powdered, unc. ij. Vinegar of squills, sufficient. It will be requisite that the vinegar of squills and ammoniacum be intimately incorporated by beating them together in a marble or Wedgewood's mortar. This plaster possesses very considerable stimu- lating powers; generally exciting the skin so much, where it is applied, as to occasion a considerable de- gree of redness, and not unfrequently innumerable papillary vesications. EMPLASTRUM AMMONIACI CUM HYDRAR- GYRO. PLASTER OF AMMONIACUM WITH QUICK- SILVER. R. Ammoniaci purificati lib. ss, Hydrargyri purificati unc. iij. Olei sulphurati drach. j. vel q. s. 88 PHARMACOPOEIA Take of Ammoniacum, strained, lib. ss. Quicksilver, purified, unc. iij. Sulphureted oil, drach. j. or as much as is sufficient. The quicksilver is to be triturated with the sul- phurated oil till the globules perfectly disappear; the strained ammoniacum is then to-be added, being previously liquefied; and the whole is to be well blended together so as to form a plaster. The intention of combining the ammoniacum with the quicksilver, is that of increasing its stimu- lating and discutient properties; at the same time that it forms a plaster very powerfully adhesive. It is much used for dispersing venereal nodes and tophi; for removing thickenings of the ligaments and enlargements and indurations of the periosteum, remaining after a course of mercury; and as a con- tinued application to indurated scrofulous glands, in order to produce a resolution of their substance, by keeping up a uniform stimulus upon their ves- sels. For the above intentions it is superior to the Emplastrum Hydrargyri, yet too frequently insuf- ficient for the purposes for which it is designed. EMPLASTRUM AMMONIA MURIATIS. PLASTER OF MURIATE OF AMMONIA. R. Ammonite muriatis unc. ss. Saponis unc. j. Emplastri plumbi unc. ij. CHIRURGICA. 89 Take of Muriate of ammonia, unc. ss. Soap, unc. j. Plaster of lead, unc. ij. The lead plaster and soap being liquefied togeth- er, the muriate of ammonia, previously powdered, is to be added. This plaster should be applied im- mediately after it is formed, to the part which it is intended to cover, otherwise the intention is lost; for, the alkali in the soap entering into combination with the muriatic acid of the muriate of ammonia, forms thereby muriate of potash or soda, and am- moniacal gas (on which the virtue of the plaster de- pends) is slowly but abundantly liberated, acting as a powerful stimulant and rubefacient. It should be renewed once every four and twenty hours. EMPLASTRUM CER^l. (Z,.) WAX PLASTER. R. Cerae flavae, Sevi preparati sing. lib. iij. Resinae flavae lib. j. Take of Yellow wax, Suet, prepared, of each, lib. iij. Yellow rosin, lib. j. Melt these together, and strain while the mixture is fluid. This plaster, the emplastrum attrahens of former dispensatories, is chiefly used to keep up a discharge from a part which has been blistered, and hence its H 2 90 PHARMACOPOEIA former name. What Dr. Duncan observes upon this head, however, we think very pertinent and proper; " that this plaster irritates too much, on account of the resin; and hence, when designed only for dress- ing blisters, the resin ought to be entirely omitted, unless where a continuance of pain and irritation, excited by the vesicatory, is intended." That " all plasters are improper dressings for blisters; their consistence making them sit uneasy; and their ad- hesiveness rendering the taking them off painful:" and that u cerates, which are softer and less adhe- sive, appear much more eligible." EMPLASTRUM CUMINI. (£.) CUMMIN PLASTER. R. Cumini seminum Carui seminum Lauri baccarum sing. unc. iij. Picis aridae lib. iij. Cerae flavae unc. iij. Take of Cummin seeds, Caraway seeds, Bay berries, of each, unc. iij. Burgundy pitch, lib. iij. Yellow wax, unc. iij. The three former ingredients, in a state of fine powder, are to be added to the pitch and wax, pre- viously melted together, and the whole is to be well mixed. This is a warm stimulating plaster: I have in some few cases lately added to it'the antimonium CHIRURGICA. 91 tartarizatum, in the proportion of a drachm to an ounce of the plaster, and find the effect produced similar to what is occasioned by the liniment of an- timony, but in a superior degree. EMPLASTRUM CUMINI CUM OPIO. CUMMIN PLASTER WITH OPIUM. R. Emplastri plumbi lib. j. Emplastri cumini lib. ss. Camphorae (pauxillo alcoholis in pulverem tritae) unc q. Opii pulveris.uno. j. Take of Plaster of lead, lib. j. Plaster of cummin, lib. ss. Camphor, ground fine, with a little alcohol, unc. ij. Opium powdered, unc. j. To the melted lead and cummin plaster, add the camphor and opium. We must confess we do not place so much re- liance on the utility of opium in the composition of plasters as is generally done. The above formula, however, appears as good as any which we have seen, where this intention is held in view. See £m- plastrum Opii. EMPLASTRUM EUPHORBII. EUPHORBIUM PLASTER. R. Emplastri picis compositi unc.iv. Euphorbii pulverizfti drach. ss. 32 PHARMACOPOEIA Take of Pitch plaster, unc. iv. Euphorbium powder, drach. ss. The compound pitch plaster being melted, the euphorbium, in fine powder, is to be added, and the mixture kept stirring till nearly cold. This plaster is a powerful stimulant and rubefacient, and is much recommended by some surgeons in chronic affec- tions of the knee and hip joints, and for removing deep-seated indolent pains. In scrofulous affections of the knee and hip, con- stituting what is called hip disease and spina ventosa, I think much good is to be effected, particularly in the early stage, by either the Emp. Cumini or Emp. Euphorbii with the addition of the tartarised anti- mony. EMPLASTRUM GALBANII COMPOSITUM. (Z.) COMPOUND GALBANUM PLASTER. R. Galbani gummi-resinae purificatae unc. viij. Emplastri plumbi lib. iij. Terebinthinae vulgaris drach. x. Abietis resinae contritae unc. iij. Take of Gum galbanum, unc. iij. Plaster of lead, lib. iij. Common turpentine, drach. x. Powdered rosin, unc. ij. To the galbanum and turpentine, melted together, add the powdered frankincense; and lastly, the lead plaster in a state of liquefaction. CHIRURGICA. 93 The practice of applying this plaster, which pos- sesses a stimulating or heating power, derived from the gums and resin, to hasten suppuration in boils and small imposthumes, is at present much neglect- ed for the milder, safer, and more proper one, of prescribing emollient and discutient cataplasms. The compound galbanum plaster is, however, not without its merit in other cases, where these cata- plasms might be very injudicious. In indolent glan- dular enlargements of a strumous character, in fixed and long continued pains in the neighbourhood of the joints, or in anomalous or arthritic pains of the ligaments, by covering the part or parts so affected with this plaster, and renewing it every eight or ten days, we shall often afford considerable benefit. It would appear, from some cases which have fallen under my observation, to be a good remedy applied over the whole lumbar region of children, in rickety affections accompanied with great weakness in the lower extremities; likewise as a covering to their en- larged joints; but this, more properly, falls under the province of the physician. EMPLASTRUM HYDRARGYRI. (Z.) MERCURIAL PLASTER. R. Emplastri plumbi lib. j. Hydrargyri purificati unc. iij. Oleisulphurati drach. j. Take of Plaster of lead, lib. j. Purified quicksilver, unc. iij. Sulphureted oil, drach. j. 94 PHARMACOPOEIA This plaster is made in a way similar to the em- plastrum ammoniaci cum hydrargyro. It is, however, a very inferior application. EMPLASTRUM LYTTiE. PLASTER OF CANTHARIDES, OR BLISTER. ING PLASTER. R. Lyttarum in pulverem subtilissimum tritarum lib. j. Emplastri cerae lib. iss. Adipis praeparatae lib. i. Take of Cantharides, minutely powdered, lib. j. Plaster of wax, lib. iss. Suet, prepared, lib. j. The wax plaster and prepared lard being melted together, and suffered to become nearly cold, the cantharides, in a state of fine powder, are to be sprinkled in, and the whole mass well blended to- gether. It may not be improper to observe, that the em- plastrum lyttae very frequently fails in producing vesication, the specific object for which it is pre- scribed; this failure is too of ten attributable to some inattention or want of caution on the part of the person who prepares it for immediate application, or to some degree of awkwardness on the part of the nurse. In spreading this plaster upon strong linen or leather, the spatula should never be heated be- yond the degree of boiling water, and in general a CHIRURGICA. 95 much lower degree of heat will be sufficient; the plaster should likewise be spread sufficiently thick; and in order further to insure its success, it will be proper either to dip the plaster previously in vine- gar, or to wash the part, to which it is to be applied, with the same, or to cover it for an hour with a common poultice. This plaster too should be proper- ly secured, but should never be bound on too tight. In some surgical cases, where blisters are called for, as in cases of spina ventosa, in diseases of the hip, in some glandular tumors, in thickenings of the ligaments, and in enlarged bursse, two different modes of using them have been adopted, and it is still a question which is to be preferred, that of keeping up a discharge from the vesicated part, by some suitable means, or of renewing the vesica- tion at short intervals by repeated blisters, and suf- fering the part thus acted upon to heal as soon as possible, after the blister is removed, by covering it with some mild unctuous substance. In the more obstinate cases which have come under my observa- tion, it would appear that the latter mode was pre- ferable, as being more effectual and less trouble- some to the patient. By the repeated application of blisters, the influence excited appears to extend much deeper, so as to derive a greater quantity of blood from the immediate neighbourhood of the vessels, or from the vessels themselves which are in a state of disease, than the influence excited by 96 PHARMACOPOEIA an application less stimulating, upon the surface of a part already abraded. The character of the dis- charge would likewise appear essentially different; in the latter case being a purulent secretion from the superficial exhulents of the surface only; in the other a copious effusion of serum, mixed with a large portion of lymph, produced from a deeper order of vessels. Whether, however, the more beneficial consequences resulting from the repeated application of blisters, be owing to the causes here assigned, or be depending upon some other which I do not understand, still the preference will equally hold good, provided the majority of cases be favourable to the practice; which, from what I have seen, as well from my own experience as from the very ex- tended practice of others which I have had an op- portunity of observing, I think I can most unequi- vocally assert. During the action of the Emp. Lyttse, and for some hours after its removal, the patient should uniformly drink freely of the decoct, hordei, with the addition of the gum arabic (acacia? gummi.) EMPLASTRUM OPII. (Z.) PLASTER OF OPIUM. R. Opii duri contriti unc. ss. Abietis resinae contritae unc. iij. Emplastri plumbi lib. j. CHIRURGICA. 97 Take of Opium, powdered, unc. ss. Resin, powdered, unc. iij. Plaster of lead, lib. j. To the melted plaster add the melted frankincense and opium, and well mix. In the former edition of this Pharmacopoeia we gave a formula, Emplastrum- Opiatum, very similar to the above; this we have retained under the head of Emp. Cumini cum Opio, in order to give place to the Emp. Opii of the College. EMPLASTRUM PLUMBI. PLASTER OF THE OXYD OF LEAD. R. Plumbi oxydi semivitrei in pulverem subtilissimum triti lib. v. Olei olivx cong. j. Aquae O. ij. Take of Litharge, powdered, lib. v. Olive oil, cong. j. Water, O. ij. These are to be boiled together over a gentle fire, till the oil and litharge are well incorporated. During the boiling, it will be necessary to keep the mixture constantly stirring with a long wooden spatula, and to add, occasionally, a little boiling water, to supply the place of that which evaporates, and to prevent the mixture from burning and growing black. Not- withstanding the water which is added be boiling, the composition is very apt to explode, and to be I 9* PHARMACOPOEIA thrown about with violence; as such it should be re- moved from the fire before each addition of the water. This plaster forms the basis for several others. It is of great use for covering some slight excoriations of the skin, and for retaining the edges of fresh cut wounds in a state of apposition. EMPLASTRUM RESINS. (Z.) RESIN PLASTER. R. Emplastri plumbi lib. iij. Resinae flavae unc. vi. Take of Plaster of lead, lib. iij. Yellow rosin, unc. vi. To the melted lead plaster add the resin, previously pulverized. The quantity of resin to be employed in the com- position of this plaster, must, in some degree, depend on the temperature of the atmosphere. This plaster is the common strapping, as it is called, of the different hospitals, the utility of which is now very generally known. For a particular ac- count of its superior excellence in promoting the cure of old ulcers, by producing an approximation of their sides, and by giving a due and necessary degree of support to the new vessels constituting the granulations, see Bayntun, on treating old ulcers, published at Bristol, 1799; a book which every surgeon ought to have in his possession. CHIRURGICA. 99 EMPLASTRUM SAPONIS. (Z.) SOAP PLASTER. R. Saponis lib. ss. Emplastri lithargyri lib. iij. Take of Soap, lib. ss. Plaster of lead, lib. iij. Melt the plaster, and "add the soap, previously cut into thin slices. This plaster is said to be a mild discutient appli- cation. ENEMA AMYLI CUM OPIO. INJECTION OF STARCH WITH OPIUM. R. Amyli drach. j. ad ij. Aquae frigidae unc. ij. Aquae ferventis unc. iv. ad vj. Opii pulveris gr. ij. ad gr. iv. Take of Starch, drach.j. to ij. Cold water, unc. ij. Boiling water, unc. iv. to vj. Opium, powdered, gr. ij. to iv. Rub the powdered opium and starch together till they are minutely divided; then add, by degrees, the cold water, and lastly the boiling water. The starch renders the retention of the injection more certain, by which means the full action of the opium is better secured. 100 PHARMACOPOEIA This enema is often of considerable service in re- lieving painful affections of the rectum, whether ari- sing from a stricture or cancer of this part, from fis- tula in ano, or from haemorrhoids. It will very generally relieve suppression of urine, depending on spasmodic stricture of the urethra; or indeed take off any preternatural spasm about the neck of the bladder. It is of great utility for relieving the strangury that takes place during the active stage of gonorrhoea; as likewise for removing the distress- ing sensation of weight and uneasiness in the regio pubis and in the perinaeum, owing to the prostate gland and neck of the bladder being affected from the same cause. ENEMA CINCHONjE. INJECTION OF CINCHONA. R. Cinchonas pulveris unc.j. Florum anthemidis drach. ij. Aquae distillatae O. j. Take of Powder of cinchona, unc.j. Chamomile flowers, drach. ij. Water, O j. Boil to ten ounces and strain, and add vini rubri unc. iij. This is an excellent tonic injection. It may be recommended in prolapsus recti; in fistula in ano, where the discharge is profuse and the habit delicate; and in some cases, as a general tonic, where the bark cannot be administered in any other way. CHIRURGICA. 101 ENEMA COMMUNE. COMMON INJECTION R. Decocti hordei O. j. ad ij. Olivae olei unc. ij. ad iij. Magnesiae sulphatis unc.j. Misce. Or, R. Decocti hordei, O. j. adij. Olivae olei unc. ij. ad iij. Misce. Or, R. Decocti anthemidis florum unc. viij. ad xij. Fomenti papaveris unc. xij. Misce. Take of Barley decoction, O. j. to ij. Olive oil, unc. ij. to iij. Sulphate of magnesia, unc.j. Mix. Or, Take of Barley decoction, O. j. to ij. Olive oil, unc. ij. to iij. Mix. Or, Take of Decoction of chamomile flowers, unc. viij. to xij. Poppy fomentation, uno» xij. Mix. The former of these injections is well calculated for emptying the lower bowels, without stimulating them too forcibly. The two latter are frequently found to afford considerable relief in peritoneal in- flammations, whether arising from any injury com- municated to the abdomen, or taking place after an operation, wherein the viscera of the abdomen have been immediately or relatively concerned. As in these cases, it is intended the injection should act as a fomentation to the part or parts already in a state I 2 102 PHARMACOPOEIA of inflammation, it will be requisite to administer it as slowly as possible, in order not only to its being retained some time, but that the whole of the quantity, here prescribed, may be thrown up. If the injection be administered very gradually, there will seldom be any re-action of the intestines to ex- pel it immediately; and by being retained for some time, it not only acts as a fomentation, but generally brings away, when it is returned, any feculent mat- ter which may be lying in the lower bowels. The pain, tumefaction, and tenderness sometimes taking place over the whole of the abdomen, supervening upon lithotomy, and that even when the intestinal canal has been freely evacuated, would seem to de- pend, in certain instances, upon the bowels becoming preternaturally distended with flatus, from losing as it were their proper tone and support; in cases of this kind the last of these formulas for clysters will be preferable, not only as possessing an anodyne property but likewise as being well adapted for communicating a gentle degree of tone to the re- laxed intestines, thereby relieving those unpleasant symptoms which might otherwise end in peritoneal inflammation, or induce so much weakness as to destroy the patient. It should be particularly re- collected, that when prescribed in such cases, it be not only administered very slowly, as has already been directed, but that it be repeated once or twice every twenty-four hours, till the violence of the symptoms be removed. CHIRURGICA. 103 When the decoct, hordei is used for injections, it should be much thinner than as directed in the com- mon formulas; if diluted with an equal portion of boiling water, it answers very well. ENEMA COLOCYNTHIDIS. INJECTION OF COLOCYNTH OR BITTER APPLE. R. Colocynthidis medullae minutim inclsae drach. j. Aquae ferventis unc. x. Sodae muriatis Syrupus spinae cervine sing. unc. ss. Take of Colocynth, sliced, drach. j. Boiling water, unc. X. Muriate of soda, Syrup of buckthorn, of each, unc, ss. Boil the colocynth in the water for ten or fifteen minutes, and strain; to the strained liquor add the muriate of soda and syrup of buckthorn. This is a good stimulating purgative clyster, and generally effectual for evacuating the lower bowels: it will often be of considerable efficacy, if adminis- tered in coma, stupor, and other affections of the brain occurring from local injuries. ENEMA GALL.E. INJECTION OF THE GALL-NUT. R. Gallae pulveris unc.j. Aquae distillatae O. iss. 104 PHARMACOPOEIA Take of Powder of galls, unc.j. Water, O. iss. Boil to a pint and strain. This injection, if exhibited once or twice a day, will very frequently be found to afford considerable relief in some affections of the rectum where there exists a frequent tendency to prolapsus ani connect- ed with an increased secretion of mucus, or accom- panied with great pain; in the bleeding piles, as they are called, it is often very proper: In some cases the addition of two or three grains of powder- ed opium will give increased effect to this injection. ENEMA OPII. OPIATE INJECTION R. Infusi lini unc. viij. Tinct. opii drach. j. ad ij. Misce. Or, R. Infusi lini unc. viij. Opii pulveris gr. ij. ad iij. Take of Infusion of linseed, anc. viij. Tincture of opium, drach. j. or ij. Mix. or, Take of Infusion of linseed, unc. viij. Opium, powdered, gr. ij. or iij. Let the powdered opium be first well mixed with a small portion of the linseed infusion, then add the remainder. Either of these injections may be used where opium is indicated as a clyster—See Enema Amyli cum Opio. CHIRURGICA. 105 ENEMA RICINI OLEI. INJECTION OF CASTOR OIL. R. Ricini olei Mellis, singulorum unc.j. js Infusi lini unc. x. Take of Castor oil, Honey, of each, unc. j. Infusion of linseed, unc. x. Rub the castor oil with the honey till they are in- timately united, and gradually add the linseed infu- sion. Where an injection is intended, to act quickly as an evacuant of the lower bowels, this of castor oil will be found, in general, safe and effectual. ENEMA TABACI. INJECTION OF TOBACCO LEAF. R. Tabaci foliorum scrup. ij. Aquae ferventis unc. xij. Take of Tobacco leaves, scrup. ij. Boiling water, unc. xij. Macerate till cold, and strain. The specific intention of the tobacco clyster is, to relieve constipation of a peculiar kind: such as arises from a portion of intestine being confined or strangulated, in the disease called hernia, whereby the peristaltic motion is interrupted or entirely stopped. For a full account of hernia, and its dif- 106 PHARMACOPOEIA ferent varieties, di-e Mr. Cooper's publications or inguinal, femoral, and umbilical hernia: also a treatise on the same subject by Mr. Lawrence. The modus operandi of the above injection, is supposed to be that of pr^ ducing such a sedative effect upon the whole nervous power, that a degree of general re taxation takes place; the spastic state of the fibres constringing the intestine, is taken off, and the bowels restjrcd to their proper action. But the effect of tobacco, administered in this way, is very variable, and in sonu cases so great as to endanger the vital powers, or even to produce death. From this circumstance it would appear to be of the greatest moment to determine the relative de- grees of power between the system and the remedy, previous to our employing it; or to know to what extent the powers of the remedy are likely to extend, compatible with the powers of life to resist it. This would seem only to be accomplished by taking into full consideration the violence of the effects produ- ced, whether by incarceration or strangulation, de- terminable by the length of time which may have supervened after such an occurrence, and by the precise nature of the hernia. The state of the pa- tient as to how far he is capable of bearing further depression must likewise be well weighed, for we should consider that the medicine may have great influence upon the result of the operation, if it be deemed necessary to be performed; for, the shock CHIRURGICA. 107 given to the nervous power by an injury inflicted upon the stomach and the bowels, is comparatively greater th«.n what would take place from the same extent of injury communicated to any other part. This pathological fact is in some instances exempli- fied to a great degree, by nausea, vomiting, sudden and great prostration of strength taking place from an apparent trivial cause. Cold suddenly applied to the abdomen; a diminution of the ordinary quantity of clothing; an attack of colic; or an irregular dis- tention of an intestine from flatus, will sometimes produce sudden and alarming effects. With facts of this kind before us, we ought to weigh well the pro- priety of ordering the tobacco injection (which very probably is soon to be followed by one of the nicest and greatest operations in surgery), when the sys- tem is already much reduced by the previous dis- ease of hernia, and especially if the intestine have been long confined. If there have been great and long continued sickness and vomiting, if the tumour be extremely tense and tender, the patient much exhausted, and all our attempts to reduce the rup- ture have failed, in such cases the tobacco injection has never appeared to afford the least profit; and such a remedy without profit can seldom fail to pro- duce mischief. If in endeavouring to reduce hernia soon after the bowel may have become confined, we should be unsuccessful, the tobacco injection may beemployed, and after half an hour a second endea- 108 PHARMACOPOEIA vour may be attempted; or half the injection may be. thrown up, and after half an hour the remaining half; after which, the patient being placed in such a situ- ation as to favour the particular relaxation of the parts connected with the disease, the reduction of the hernia may again be carefully tried. To affix any precise limit of time, however, within which this means to relieve incarcerated or strangulated hernia should be had recourse to, might to a young surgeon be a most desirable acquisition; but every man cf experience knows the impracticability of such a law, and he is only guided by his former knowledge and practice. After twelve hours suffer- ing and pain, I would much rather prefer attempt- ing the operation without the previous exhibition of the tobacco enema, than after it had been employed; particularly in a weak or delicate person, in a pa- tient of advanced age, or in infancy. i ENEMA TEREBINTHINjE. TURPENTINE INJECTION. R. Terebinthinae unc ss. Ovi unius vitellum, Infusi lini unc. x. Take of Turpentine, unc. ss. The yolk of an egg, Infusion of Jinseed unc. x. Rub the turpentin. with the egg till they are per- fectly incorporated, and add the linseed infusion. CHIRURGICA. 109 The turpentine injection has frequently been of service in violent attacks from a stone in the bladder; in suppression of urine from the same cause; and in painful micturition arising from irritability of the bladder. It is one of the Formula of Guy's Hospital. EPITHEMA PLUMBI ACETATIS. EPITHEM OF ACETATE OF LEAD. R. Confectionis rosae, unc.j. Mellis rosae, Liquoris plumbi acetatis, Tincturae opii, singulorum drach. ij. Misce\ Take of Confection of roses, unc.j. Honey of roses, Liquor of acetate of lead, Tincture of opium, of each, drach. ij. Mix. This epithem is much in use at Guy's Hospital as a useful application to painful, irritable, venereal ulcers: it will likewise be found very serviceable, if applied to chancres after the use of the lunar caustic or nitrate of silver, particularly when the sore ap- pears fretted and irritable. If the parts are disposed to slough, it should be abstained from. See Ung. Plumbi Acetatis cum* Opio. EPITHEMA TEREBINTHINjE CUM CAM- PHORA. TURPENTINE EPITHEM WITH CAMPHOR. R. Ung lenti resinae unc. iij. Camphorae, pauxillo spiritus rectificati in pulverem tritae, unc. ss. Terebinthinae olei rectificati q. s. ut fiat epithema. K 110 ' PHARMACOPOEIA Take of Ointment of resin, unc. iij. Camphor triturated with a little spirit of wine, unc. ss. Rectified oil of turpentine, sufficient to make an epithem. This epithem, spread upon leather, and renewed daily, is a good application for relieving some painful chronic affections of the joints, whether of a rheu- matic or arthritic nature; it may likewise be employ- ed in indurations, and in enlargements of the liga- ments arising from the same cause. FOMENTUM CHAMCEMELI. See DECOCTUM ANTHEMIDIS NOBILIS. FOMENTUM CONII. CICUTA FOMENTATION. Boil half a pound of the fresh leaves of hemlock or three ounces of the dried herb, in a quart of water, for half an hour, and strain. See Cataplasma Conii. FOMENTUM DIGITALIS. FOMENTATION OF THE FOX-GLOVE. Boil three ounces of the dried leaves of digitalis, or four ounces of the fresh plant, in two pints of water to ODe, and strain. See Cataplasma Digitalis. The fomentations of hemlock and fox-glove may be used indiscriminately: it will also be proper to lament the parts with them during the renewal of CHIRURGICA. Ill the poultices. With some surgeons they are recom- mended to be frequently applied, being used instead of the poultices. FOMENTUM GALL^E. FOMENTATION OF THE GALL-NUT. R. Gallx contusae unc. ss. Aquae ferventis O. ij. Take of Galls, pounded, unc. ss. Boiling water, O. ij. Macerate for one hour and strain. This fomentation is used for the same purposes as the Enema Gallse, being o«ly a weaker prepara- tion of the gall. . FOMENTUM PAPAVERIS. FOMENTATION OF THE POPPY. R. Papaveris somniferi (capsulae et seminum) unc. ij. Aquae distillatae O. iij. Take of Poppy, (the seed and capsule,) unc. ij. Water, O. iij. Cut the capsule of the poppy into thin slices, and bruise both these and the seeds; afterwards boil in the water to one pint and strain. The anodyne pro- perty of the poppy is contained in the capsule; the seeds, however, contain a large portion of mucilage and oil, and as such are emollient, and may improve the fomentation. See Cataplasma Lini, and Colly- rium Opii. 112 PHARMACOPOEIA GARGARISMA ACIDI MURIATICL GARGLE OF MURIATIC ACID. R. Acidi muriatici gtt. xx. Mellis rosae unc. j. Becocti hordei"! vel >Unc. iv. Misce. Infusi lini j Take of Muriatic acid, gutt. xx. Honey of roses, unc.j. Decoction of barley, or linseed, unc. iv. Mix. The muriatic acid gargle is much used as a means of removing inflammation of the throat, more par- ticularly such as is accompanied with ulceration. It is oftentimes of great benefit in aphthous affections; but it should be recollected that, from its injurious effects to the teeth, the mouth and fauces# should be well washed with either barley water, or water luke- warm, b$th before and after using it. GARGARISMA ^RUGINIS. GARGLE OF VERDIGRIS. R. Linimenti aeruginis drach. ij. Mellis rosae unc. j. Infusi lini unc. vj. Take of Liniment of verdigrise, drach. ij. Honey of roses, unc.j. Infusion of linseed, unc. vj. This gargle has been recommended for deterging foul ulcers of the throat and tonsils; and for these CHIRURGICA. 113 purposes it is extensively employed. I would, how- ever, in no wise recommend it to general use, as I do not think it quite free from danger. GARGARISMA ALUMINIS. ALUM GARGLE. R. Aluminis drach. j. Decocti cinchonae unc. xij. Mellis rosae unc. iss. Misce Take of Alum, drach. j. Decoction of cinchona, unc. xij. Honey of roses, unc. iss. Mix. This is a good astringent gargle, and in a relax- ed state of the uvula and contiguous parts after a course of mercury, in bleedings and sponginess of the gums from the same or any other cause, and in chronic or frequent inflammations of the tonsils, it will be found exceedingly proper and beneficial. GARGARISMA LINI. LINSEED GARGLE. R. Infusi lini unc. xiv. Mellis rosae unc. ij. Acidi sulphurici diluti drach. iss. Misce. Take of Infusion of Unseed, unc. xiv. Honey of roses, unc. ij. Diluted sulphuric acid, drach. iss. Mix. This is the common gargle of Guy's Hospital. K2 114 PHARMACOPOEIA In many cases where mild astringents are indicated, it will be found to answer very well. GARGARISMA MYRRHS. MYRRH GARGLE. R. Infusi rosae unc viiss.* Tinct. myrrhae unc. ss. Misce. Take of Infusion of roses, unc. viiss. Tincture of myrrh, unc. ss. Mix. Mildly astringent and detergent. GARGARISMA POTASSiL NITRATIS. GARGLE OF NITRE, OR NITRATE OF PO. TASH. R. Decocti hordei lib. j. Potassae nitratis drach. vj. Oxymellis unc. ij. Misce. Take of Decoction of barley, lib. j. Nitrate of potass, drach. vj. Oxymel, unc. ij. This is the gargarisma refrigerens of some of the older dispensatories. It is a mild, cooling ap- plication, and often more serviceable at the com- mencement of inflammatory affections of the ton- sils and fauces than those which contain any of the mineral acids as their most active ingredient. CHIRURGICA. 115 GARGARISMA ROS£. ROSE GARGLE. R. Infusi rosae unc. iv. Mellis rosae vel Syrupus mori unc.j. Misce. Take of Infusion of roses, unc. iv. Honey of roses, or Syrup of mulberry, unc.j. Mix. This is a simple and elegant gargle for common purposes. GARGARISMA SODjE BORACIS. GARGLE OF BORAX. R. Sodae boracis drach. ij. Aquae rosae unc. vij. Mellis rosae unc. j. Misce. Take of Borate of soda, drach. ij. Rose water, unc. vij. Honey of roses, unc. j. Mix. The borax gargle is very much in use as a mild detergent in aphthous affections in children, and for removing superficial inflammatory ulcerations of the gums; especially if attended with a copious secretion of saliva. It occasionally may be rendered more pleasant, without any diminution of its effects, by substituting the syrupus mori for the mel rosae, or a thin mucilage of the quince seed for the rose wa- ter. 116 PHARMACOPOEIA Among the several formulae for gargles which we have collected and offered to general notice, it will be seen that several of them possess the same pro- perties; differing so slightly in degree as to subject us to the charge of unnecessary prolixity, where the intention is so simple and self-evident, that the same end might be accomplished by any one of them; requiring only some general observation as to the necessity of occasionally increasing or diminishing the acidity or astringency of the gargle. By giving, however, several distinct formulae, the surgeon who has not had the advantages of extensive practice or experience, will be less liable to incur the dissatis- faction of his patient, or to hazard his displeasure, by any unequal or improper strength of the medicine which he may prescribe.* • The different formulae which the author has here inserted for gargles, are so judiciously selected, that there are few, of any consequence, which have escaped his notice. It often happens, however, that in certain cases of syphilis of long standing, the tonsils and uvula or part of the fauces are found in a state of ulceration; in which case, besides the inter- nal administration of mercury, the parts should be frequently washed with some proper gargle: much advantage, therefore, will be found from the use of such a formula as the following; which, besides other active ingredients, is combined with a small quantity of mercury. R. Hydrarg. oxymuriat. gr. iij. solv. in sp. vini rect. unc. ss. et adde, Decoct, cinchon. unc. vj. Tinct. myrrh Mel rosae aa unc ss. Misce, fiat gargarism. Take of CHIRURGICA. 117 HAUSTUS AMMONIA ACETATIS. DRAUGHT OF ACETATE OF AMMONIA. R. Liquoris ammoniae acetatis, Aquae menthae singul. unc. j. Syrupus papaveris drach. j. Misce. Take of Liquor of acetate of ammonia, Mint water, of each, unc.j. Syrup of poppies, drach. j. Mix. The intention of this draught is to determine to, and keep up action upon the skin, so as to promote a gentle diaphoresis: an object, oftentimes, of the greatest moment to the surgeon, not only in cases where there exists a preternatural fulness, or inflam- matory diathesis in the vessels of a particular part, as after a recent wound or injur}'; but likewise af- ter some of the more important operations, acting as a means of keeping under general inflammation, or preventing too great excitement of the sangui- ferous system. It may be exhibited every four or five hours.* * It frequently happens, that much more powerful sudorifics are required, than that which the author has given in the Take of Oxymuriate of mercury, gr. iij. dissolved in spi- rit of wine, unc. ss. add Decoction of cinchona, unc. vj. Tincture of myrrh, Honey of roses, of each, unc. ss. Mix, and make a gargle. 118 PHARMACOPOEIA HAUSTUS MAGNESIA SULPHATIS. DRAUGHT OF SULPHATE OF MAGNESIA. R. Magnesia sulphatis drach. iij. ad ij. Aquae menthae unc. ij. Tinct. jalapae drach. j. Acidi nitrici diluti gtt. xx. Misce. above formula. The aqua ammoniae acetatae will generally have some effect in determining to the skin; but its action is greatly increased, by combining it with an antimonial, or some other more powerful diaphoretic; in which case it can be prescribed with great convenience, in the following forms: R. Liquor ammon. acetat. Aq. cinam. aa unc. ss. Aq. fontis drach. vj. Vini antimonialis gutt. xxx. Tinct. opii gutt. xx. Misce, fiat haust. Take of Water of acetate of ammonia, Cinnamon water, of each, unc. ss. Distilled water, drach. vj. Antimonial wine, gutt. xxx. Tincture of opium, gutt. xx. Mix, and make a draught; or R. Mistur. camphorat. unc. ss. Liquor ammon. acetat. drach. iij. Antimon. tartarizat. gr. j. Tinct. opii gutt. xx. Syr. althaea, unc. ij. Misce, fiat haust. Take-of Camphorated mixture, unc. ss. Liquor of acetate of ammonia, drach. iij. Tartar of antimony, gr. j. Tincture of opium, gutt. xx. Syrup of marshmullows, unc. ij. Mix, and make a draught. CHIRURGICA. 115 Take of Sulphate of magnesia, drach. iij. to. i. Mint water, unc. ij. Tincture of jalap, drach. j. Dilute nitric acid, gutt. xx. Mix. This is a good saline purge. The nitrous acid takes off the unpleasant bitterness of the sulphate of magnesia. HAUSTUS EMETICUS. EMETIC DRAUGHT. R. Vini ipecacuanhae unc. j. Vini antimonii drach. ij. Misce. Or, R. Vini antimonii unc. ss. Aqua distillate drach. vj. Misce. Or, R. Antimonii tartarizati gr. iij. Aquae distillatae ferventis unc. jss. Misce. Or, R. Pulveris ipecacuanhae scrup. j. Aquae menthae. Aquae purae aa. drach. vj. Misce. Take of Wine of ipecacuanha, unc.j. Wine of antimony, drach. ij. Mix; or, Take of Wine of antimony, unc. ss. Distilled water, drach. vj. Mix; or, These two forms of combining the aqua ammonia acetas are considered by the editor as eminently useful, in a variety of cases, where diaphoretics are indicated; such as, in inflamma- tion of a phlegmonous nature, or in erysipelatous fever. During the use of mercury, it is also often of advantage to make use of such medicines as will determine to the skin, in which case, a draught as above suggested, may be administered at bed time, and occasionally repeated. 120 PHARMACOPOEIA Take of Tartrate of antimony, gr. iij Distilled water, boiling, unc. iss. Mix; or, Take of Powder of ipecacuanha, scrup. j. Mint water, Pure water, of each, drach. vj. Mix. These draughts all possess pretty strong emetic properties, but any one of them may be safely ex- hibited when medicines of this class are called for. HAUSTUS RICINI OLEI. DRAUGHT OF CASTOR OIL. R. Ricini olei unc. ss. Tincturae sennae unc. ss. Take of Castor oil, unc. ss. Tincture of senna, unc. ss. This is a warm soluble draught, operating with little or no inconvenience: in nephritic affections; during the cure of stricture by caustic; and in most affections of the bladder, it is very serviceable; as it relieves the lower bowels without much pain or inconvenience to the patient. When the tincture is objectionable, the oleum ricini may be mixed into a draught with a little of the yolk of egg, or with ho- ney. CHIRURGICA. 121 HAUSTUS TEREBINTHINjE. TURPENTINE DRAUGHT. R. Terebinthinae chiae, vitello ovi solutae, scrup. j. ad drach. ss. Aquae cinnamomi, Aquae distillatae sing, drach. vj. Misce. Take of Chian turpentine, mixed with the yolk of an egg, scrup. j. to drach. ss. Cinnamon water, Distilled water, of each, drach. vj. Mix. In irritability of the bladder, unaccompanied with inflammation; in gonorrhoea after the active stage is removed; and in painful chronic affections in the re- gion of the kidnies, the turpentine draught exhibited twice or three times a day, will very often afford con- siderable benefit. * * The author appears to have selected fewer formulae for draughts than are generally made use of, as it is not only a very convenient method of administering medicine, but in some in- stances, the only way in which particular medicines can be pre- scribed with propriety; such for instance, as when it becomes necessary to order remedies, which are either so extremely vo- latile as to require being administered quickly, or so extremely active, as to require to be minutely divided and given in small quantity. In illustration of the first, the editor may mention every variety of ether; and of the second, perhaps arsenic and digitalis are good examples; either of which, when given in a liquid state, are best administered in the form of a draught L 122 PHARMACOPOEIA HIRUDO. THE LEECH. The freedom with which topical blood-letting is now employed, may safely be enumerated among the modern improvements of surgery; and in many cases one of the most effectual and least objectionable me- thods is, by means of the leech. These animals, how- ever, are become so extravagantly dear, either from the exactions of those people who employ themselves in gathering them, or by the monopoly of some of our drug merchants, that the patient is very frequently under the necessity of enduring his pain and suffer- ings, from an utter impossibility to procure what his surgeon has prescribed. To remedy this evil, every surgeon ought, so far as he has the means in his power, to procure a quantity of leeches at the time the leech-catchers gather them, when they are in general much cheaper; or indeed, with a little eare and trouble he might breed a sufficient number every year to answer all his purposes. In order to breed them, a large stone reservoir or wooden cis- tern nearly filled with soft water, and provided with a shelving, covered with moss and sods, should be placed in such a situation that nearlv the whole of it is exposed to the rays of the sun; the bottom should be furnished with a cock, with a strainer answering to it in the inside, to allow the water, which should always be brook or river water, to be occasionally CHIRURGICA. 123 drawn off; but this should not be done more than once in three weeks or twice a month in winter, and once a week in summer. If a little muddy water is first poured into the reservoir or cistern, the leeches will, in general, thrive better. The greater number of the full sized leeches after the breeding season, which is during the latter summer months, should be removed into large open mouthed bottles, which should occasionally be exposed, or half exposed, to the sun; taking care that they are never more than half full of water, as the leeches are extremely fond of creeping up the dry part of the bottle in order to drain themselves: during the cold weather the cistern or reservoir should be surrounded with warm ma- nure. The young leeches are some years before they arrive at full growth, during which time they should not he removed from the cistern. When a leech is to be applied, it should be remo- ved from the water some short time previously, and placed on a dry towel or napkin; by this method it will generally fix its hold the moment it is applied to the skin. Some surgeons direct them to be placed in glasses, to be inverted over the part from whence the leeches are intended to draw blood: a piece of writing paper folded into a conical shape, and cut smooth at the open end, is neater and answers equal- ly well. The part or parts to which they are to be applied, should be first well sponged with warm wa- ter and soap, and carefully dried. If the leeches will 124 . PHARMACOPOEIA not fix, the parts may be moistened with a little warm milk, sweetened with sugar; or with a little cream; or, what sometimes will make them fix in- stantly, the parts may be smeared with a little raw meat: and if the weather be extremely cold, it will be of advantage to swim them a little time in luke- warm water. After they have filled themselves with blood, and loose their hold, they should be placed upon a plate or saucer, and have their heads cover- ed with salt, which occasions them to vomit up the blood with which they have gorged themselves. This is called by the people who keep them, purging the leech, which should be done sufficiently to make them eject all the blood they have swallowed; after this they should be put into water just warmed. Some recommend taking the leech by the tail and squeez- ing it through the fingers and thumb, so as to force from it all its blood; but this is a cruel practice, and will for the most part destroy it. The parts to which they have been applied, should be covered with cloths wrung out of hot water, or with warm napkins, according as the surgeon shall deem fit. If the bleed- ing be troublesome, a little fine flour will in gene- ral put a stop to it; or a fold or two of dry linen, applied so as to make a little pressure; covering the part with a little tartar emetic has sometimes in- stantly succeeded, when other means have failed. In all local phlegmonous inflammations, whether aris- ing from injury or any other cause, leeches afford CHIRURGICA. 125 us one of the readiest and most effectual modes of relief; in slow chronic inflammations, taking place in the neighbourhood of the large joints,—in ecchy- mosis from a blow or bruise,—in furunculus or boil, —in whitlow,—in scirrhus when the pain is violent, or when the vessels appear much distended or en- larged, leeches will for the most part afford consi- derable relief. At the commencement of an abscess leeches will in general give considerable alleviation, if they do not put a stop to the progress of the in- flammation; and in an abscess of the breast they are peculiarly proper. In erysipelatous inflammation, hawever, leeches will not unfrequently aggravate the disease.* In carbuncle they are often improper, or in atonic inflammation which is likely to terminate in sphacelus. I have seen leeches, when applied to the neighbourhood of the eye, produce great and ex- tensive erysipelatous inflammation, with considera- ble oedema and swelling. These observations have been drawn from actual experience; but after all much must be left to the direction and judgment of the surgeon, and the peculiar idiosyncrasy of the patient. * In erysipelas, however, I have witnessed much benefit from the free use of leeches in the first instance, and warm fomen- tations afterwards; but then it has only been when situated in the extremities, or in cases connected with phlegmonous inflam- mation, or where the erysipelas has arisen from injury. L 2 12$ PHARMACOPOEIA HYDRARGYRUS. QUICKSILVER, OR RUNNING MERCURY. For a very ample, elaborate, and excellent account of mercury, see Dr. Cullen's Materia Medica, Vol. II. p. 442; and for a particular consideration of its various preparations, see Dr. Swediaur's Pharmacopoeia Syphilitica, at the end of his book on the venereal disease. We are led to give the fol- lowing account of mercury, from Dr. Duncan's Dispensatory, as appearing to us more practical than any other which we have seen. " The mercury employed in England is princi- pally from the mines of Hungary. When taken into the stomach, in its metallic state, it has no action on the body, except what arises from its weight or bulk. It is not poisonous, as was vulgarly supposed, but perfectly inert. But in various states of combi- nation, it produces certain sensible effects. It quick- ens the circulation, and increases all the secretions and excretions. According to circumstances, the habit of the body of the patient, the temperature in which he is kept, the nature of the preparation, and the quantity in which it is exhibited, its effects are indeed various: it sometimes increases one secre- tion more particularly, sometimes another, but its most characteristic effect is the increased flow of saliva, which it generally causes, if given in suffi- cient quantity. Mercury in medical surgery is ex- CHIRURGICA. 127 tensively employed; it is exhibited as an errhine, as a sialagogue, as a cathartic, as a diuretic, as a sodo- rific, as an astringent, as a stimulant. And with some of these views it is administered in indolent and chronic inflammations, especially of the glan- dular system. In exanthematous disorders. In spasmodic diseases; tetanus, trismus, hydrophobia, &c. In impetigines, scrofula, syphilis, elephantiasis, lepra, icterus, &c. &c. In local diseases; in caligo cornea, amaurosis; gonorrhoea; obstipatio; tumors of various kinds; herpes, tinea, psora," &c. " Mercury occasionally attacks the bowels, and causes violent purging, even of blood. This effect is remedied by intermitting the use of the medicine, and by exhibiting opium. " At other times mercury is suddenly determined to the mouth, and produces inflammation, ulcera- tion, and an excessive flow of saliva. In this case the use of the mercury must be discontinued for a time; while according to Mr. Pearson's advice, the patient should be freely exposed to a dry cold air, with the occasional use of cathartics, Peruvian bark, and mineral acids, and the assiduous application of astringent gargles. On the other hand, the sudden suppression of ptyalism is not without danger. It is most frequently caused by cold liquids being taken into the stomach, or exposure to cold and moisture, while under the influence of mercury; the danger is to be obviated by the quick introduction of mercu- 123 PHARMACOPOEIA ry, so as to affect the gums, and by the warm bath occasionally." " Sometimes also a morbid condition of the sys- tem occurs during a mercurial course, and which tends to a fatal issue. Mr. Pearson has termed it erithismus. It is characterised by great depression of strength; a sense of anxiety about the prsecordia; frequent sighing; trembling, partial or universal; a small, quick pulse; sometimes vomiting; a pale con- tracted contenance; a sense of coldness, while the tongue is seldom furred, or the vital or natural functions much disordered. In this state a sudden or violent exertion of muscular power will some- times prove fatal. To prevent dangerous conse- quences, the mercury must be discontinued, what- ever may be the stage, extent, or violence of the disease for which it has been exhibited, and the pa- tient must expose himself freely to a dry and cold air, in such a manner as shall be attended with the least fatigue; and in the course of ten or fourteen days he will sometimes be so far recovered as to resume the use of mercury." This account comprises what is almost necessary to be known in regard to a general knowledge of mercury, when exhibited under circumstances which fall within the province of the surgeon. I have, under the article Hydrargyri Submurias, noticed some of its peculiar and specific effects; which I intend further to accomplish, under the different CHIRURGICA. 129 formulae in which mercury, or rather some one of its preparations, forms the principal ingredient. HYDRARGYRI ACETIS. (E.) ACETITE OF QUICKSILVER. This is a mild preparation of mercury, but sel- dom employed. It was the principal ingredient in Keyser's celebrated pills. Dissolved in rose water, in the proportion of two grains of mercury to an ounce of the water, it will occasionally be found useful against cutaneous eruptions. It may be safely administered, formed into pills with crumb of bread, in the quantity of a grain to five grains, night and morning, as a gentle mercurial. HYDRARGYRYRUS CUM CRETA. (£.) CHALK WITH QUICKSILVER. This is one of the mildest preparations of mercu- ry. The chalk merely promotes the mechanical di- vision of the quicksilver, thus affording a larger surface to the atmosphere, the oxygen of which it readily absorbs. Dr. George Fordyce, in his Lectures on the Ma- teria Medica, denies to this preparation any mercu- rial effect. I have, however, seen its efficacy suffi- ciently to convince me the doctor had formed a premature opinion on this subject. As an antisy- philitic it is much slower in its operation than the 130 PHARMACOPOEIA pilula hydrargyri, and should only be employed in cases where the pill is inclined to run off by the bowels, or as a substitute for it to children. The dose to an adult is from five grains to a scruple, or half a drachm, twice in the day, exhibited in any- viscid substance, as honey, treacle, jelly, or barley water made thick. HYDRARGYRI NITRICO-OXYDUM. (L.) OXYDUM HYDRAGYRI RUBRUM. (E.) NITRIC-OXYD OF MERCURY. (L.) RED OXYD OF MERCURY. {£.) The nitric oxyd of mercury should never be em- ployed but in a state of levigation, or after it has been minutely triturated. It is a useful stimulant, and escharotic; and formed into an ointment often- times has excellent effects upon old or ill-conditioned ulcers. See Unguentum Hydrargyri Nitrico-Oxy- dum. Half a grain, or even a grain, united with three or four grains of fine sugar, and blown into the eye, has sometimes removed ulcerous affections of the cornea, or a thickening from exuded lymph. See Benj. Bell's System of Surgery. HYDRARGYRI OXYMURIAS. (L.) MURIAS HYDRARGYRI. (£.) OXYMURIATE OF QUICKSILVER. This preparation of mercury is very generally employed as a cure for syphilis, supported by the CHIRURGICA. 131 authorities of Van Swieten and Boerhaave. Mr. Peaiscn, however, only allows to it the power of re- moving the'primary symptoms, or of aiding the com- mon effects oi mercury. He tells us that it will often fail in removing chancre, and that the patient is not secure against a constitutional affection, even under the most steady perseverance in its use. It is, how- ever, not unfrequently a very useful auxiliary to mer- curial frictions, in doses of an eighth, or a sixth of a grain, administered in the form of a pill, or dis- solved in any aqueous menstruum, exhibited twice or even three times in the day. If given to the quan- tity of a grain, it has been said to bring on most ac- tive and sudden ptyalism; and to be an immediate and effectual remedy in the first stage of virulent gonorrhoea: few, however, I believe, would reccom- mend this practice. As an external application it is violently escharotic, and acts powerfully as a caustic. In solution (see Lotio Hydrargyri Oxymuriatis) it is useful for destroying fungous flesh, and for remo- ving herpes. I have seen it likewise employed with benefit as a wash, in some ulcerations of the fingers and other parts when connected with diseased bones or periosteal inflammation. In relieving ulcerous af- fections of the throat, nocturnal pains, and desquama- tions of the skin from a syphilitic cause, it is often essentially beneficial when given as an internal reme- dy. The muriate of quicksilver is said to form the principal ingredient in all the quack syrups. 132 PHARMACOPOEIA HYDRARGYRI SUBMURIAS. (L.) SUBMURIAS HYDRARGYRI. (£.) SUBMURIATE OF QUICKSILVER. Formerly Calomel. This preparation of mercury is more extensively, and perhaps more usefully, employed by the sur- geon than that of any other article in the Materia Medica. Internally employed it is eminently ser- viceable, whether administered as a purgative, or given as an alterative, in a variety of cases which require surgical aid.—It is, perhaps, capable of cu- ring syphilis in every form. In small doses, or in larger ones combined with opium, it excites ptya- lism, and acts powerfully upon the glandular system throughout.—It obviates the pain and constipation of the bowels, arising from the incautious and inju- dicious use of lead; and administered as an altera- tive in doses of a grain or two grains, once or twice in the day, it has repeatedly relieved paralytic affections of the extremities, arising from the same cause, and which had resisted all other means. Ul- cers of an indolent inactive nature, attended with a thin ichorous discharge, will not unfrequently as- sume an healthy aspect, and eventually heal by the use of calomel, whether exhibited as a brisk pur- gative or given as an alterative; nor can we, in gene- ral, cure ulcers of an equivocal character, by any other means. With children of a strumous habit, CHIRURGICA. 1-33 and where there exists ulcerous affections upon the surface, or when we have to do with glandular en- largem-nL's, caljmel is the best purgative we pos- sess. As an external application, it is equally advanta- geous when judiciously employed. SUB-SULPHAS HYDRARGYRI FLAVUS. (E.) Olim, Turpethum Minerale. SUB-SULPHATE OF QUICKSILVER. Formerly, Turpeth Mineral. The sub-sulphate of mercury is a very powerful medicine when used internally, acting as a strong emetic in doses of two or three grains. Given in this way it has sometimes cured hernia humoralis very quickly. I have seen it repeatedly used as an errhine in the quantity of an eighth, or a quarter of a grain, mixed with a little liquorice powder or the compound powder of asarabacca, once or twice in the day, in cases of amaurosis, when the disease was supposed to depend upon a debilitated state of the optic nerve; but I cannot say I have ever seen it decidedly advantageous in this complaint. HYDRARGYRI SULPHURETUM RUBRUM. (L.) RED SUPHURET OF QUICKSILVER. This is principally employed in fumigations against venereal ulcers in the mouth, throat, and nose. M 134 PHARMACOPOEIA Mr. Pearson, from his experiments, concludes that where it is an object to put a stop to the progress of the disease suddenly, the sulphuret of mercury if thrown upon a red hot iron and the fumes be in- haled, will often answer better than any other means. It is liable, however, sometimes to induce violent salivation, and that rapidly; and, consequently, great debility. Mercury must likewise be introduced into the constitution by inunction, as if no fumigations had been made use of. INFUSUM ARMORACLE COMPOSITUM. COMPOUND INFUSION OF HORSE RADISH. It. Armoraciae radicis recentis concisae Sinapis seminum contusorum singulorum unc. j. Aquae ferventis O. j. Take of Fresh horse radish, sliced, Mustard seed, bruised, of each, unc.j. Boiling water, Q. j. Macerate for an hour in a close vessel, and strain off the clear liquor. The dose of this infusion is from an ounce and a half to two ounces, three or four times a day. It may occasionally be rendered more agreeable by the addition of a little spirituous water. See Confectio Sinapeos. CHIRURGICA. 135 INFUSUM CAPSICI. INFUSION OF CAPSICUM, OR INDIAN PEP- PER. R. Capsici bac'carum capsulae gr. iv. Aquae distillatae unc. vj. Take of Capsule of Indian pepper, gr. iv. Distilled water, unc. vj. Infuse for two hours, in a close vessel, and strain off the clear liquor. It is necessary to remark, that the capsule of the capsicum only should be used, and not the red powder, as the latter contains com- mon salt, and for the most part, the red oxyd of lead. This infusion is a powerful stimulus when applied externally to a sensible part, and as such it has been strongly recommended in ophthalmia from relaxa- tion, and in amaurosis from the same cause: it should be applied to the edge of the tarsus by means of a camel's hair brush in the former case, and dropped into the eye in the latter, to the quan- tity of two, three, or four drops; in both cases the pain it occasions is exceedingly great, and it requires great firmness on the part of the patient to bear a continuance of its use. In gutta serena, where the pupil has appeared in- capable of being influenced by a strong light, or when the disease has been preceded by great and 136 PHARMACOPOEIA continued pain in the forehead, I have never seen the capsicum do the least good. INFUSUM CINCHONA CUM CALCE. INFUSION OF BARK, WITH LIME. R. Cinchonae pulveris unc. ij. Liquoris calcis O. ij. Take of Powder of cinchona, unc. ij. Lime water, O. ij. First rub the bark with a small quantity of the lime water in a marble mortar, pouring on the re- mainder gradually; afterwards infuse them together twenty-four hours in a close vessel, and when the faeces have subsided, strain off the clear liquor. This is an elegant form for administering the bark. The lime is said to increase the strength of this in- fusion, by rendering a greater portion of the cincho- nin of the bark soluble in the water. See the article Cinchona. INFUSUM LINI. (L.) INFUSION OF LINSEED. R. Lini usitatissimi seminum contusorum unc.j. Glycyrrhizae radicis concisx unc. ss. Aquae ferventis O. ij. Take of Common linseed, bruised, unc. ij. Liquorice root, sliced, unc. ss. Boiling water, O. ij. Digest in a close vessel placed near the fire, for four hours, and straijs. CHIRURGICA. 137 This is intended as a beverage in strangury and gonorrhoea, to be drank to the quantity of a quart during the day. It is a useful drink likewise after lithotomy, or after any of the eperations where the bladder or urethra have been immediately concern- ed. If the bowels be torpid or confined, two or three ounces of fresh figs and half an ounce of gum arabic, (gummi acacise,) may be added to each quart of the infusion; and it should then be made into a decoction, by being boiled fifteen or twenty mi- nutes.* * The author has here given fewer formulae for exhibiting medicines in the state of infusion than are generally to be found in works of this nature. This is the more to be regretted, as the medicinal qualities of many articles of the materia medica are best extracted by infusion. To remedy this omission, the editor has taken the liberty to add here a few very useful formulae, for exhibiting medicines of very powerful qualities, in this manner. For others of a more complicated nature, and more in the depart- ment of medicine than of surgery, the editor must refer to Dr, Coxe's last edition of the American Dispensatory. INFUSUM GENTIANA COMPOSITUM. Compound Infusion of Gentian. R. Gentian rad. concis. Cort. aurant. siccat. aa drach. j. Cardamom, seminae contus. drach. ss. Aq. fervent. O. j. Take of Gentian root, sliced, Orange peel, dried, of each, drach. j. Cardamom seeds, bruised, drach. ss. Boiling water, O. j. M 2 Mace- 131 PHARMACOPOEIA INJECTIO COPAIBA. INJECTION OF COPAIBA. R. Copaibae drach. j. Mucilaginis acacia; unc. ss. Aquae rosae unc. vj. Take of Balsam of copaiba, drach. ji Mucilage of gum arabic, unc. ss. Rose water, unc. vj. Rub the copaiba and mucilage well together and add the rose water. Macerate for an hour or two in a covered vessel, and strain. This is an extremely useful bitter, and may be exhibited in all c&see, where there is great loss of appetite and debility of the stomach. INFUSUM CINCHONA. Infusion of Cinchona Bark. R. Cinchonaepulv. unc.j. Cort. cinnam. Coit. aurant. siccat. aa drach. iss. Aq. ferventis O. j. Take of Cinchona bark, in powder, unc. j. Cinnamon bark, Orange peel, dried, of each, drach. iss. Boiling water, O. j. Macerate for twenty-four hours, then strain off the liquor. This is a very elegant preparation of bark, and may be admi- nistered to the quantity of a small wine glass, twice or thrice a day. Its tonic qualities may be sometimes improved, by adding fifteen or twenty drops of diluted sulphuric acid to each dose of the infusion; in this form it will frequently set easy on weak sto- machs, when it cannot be administered in substance. IN- CHIRURGICA. 139 INJECTIO CUPRI SULPHATIS. INJECTION OF SULPHATE OF COPPER. R. Cupri sulphatis gr. vj. Aquae distillatae unc. vj. Tincturae opii drach. j. Misce. INFUSUM SENNjE CUM TAMARINDIS. Infusion of Senna -with Tamarinds. R. Tamarind, fruct. unc.j. Sennae fol. drach. ij. Semin. coriand. drach. j. Sacchare commun. unc. Aq. ferventis unc. xij. Take of Pulp of tamarinds, unc.j. Senna leaves, drach. ij. Coriander seeds, drach. j. Brown sugar, unc. j. Boiling water, unc. xij. Macerate the whole for four hours, then strain the liquid. This is a mild and useful purgative. It sets easy on the sto- mach, and is well calculated to be administered in inflammatory diseases, where a cooling aperient is necessary. It may be given to the quantity of four ounces, and repeated every second hour, till it operates. INFUSUM JAPONICUM. Japonic Infusion. R. Extract, mimosa catechu drach. ij- Cort. cinnamomi drach. j. Semin coriand. drach. ss. Aq. ferventis unc. viij. Infunde in aq. ferventis, unc. viij. adde, Syr. zingib. unc.j. et cola. Take UO PHARMACOPOEIA Take of Sulphate of copper, gr. vj. Distilled water, unc. vj. Tincture of opium, drach. j. Mix. INJECTIO HYDRARGYRI. INJECTION OF QUICKSILVER. R. Unguenti hydrargyri drach. j. Olei olivae unc.j. Misce. Take of Mercurial ointment, drach. j. Olive oil,unc. j. Mix. This injection should be warmed previous to using. INJECTIO HYDRARGYRI SUBMURIATIS. INJECTION OF SUBMURIATE OF MERCURY. R. Hydrargyri submuriatis drach. ij. Mucilaginis acacix unc. ss. Liquoris calcis O. j. '■''■■■'■ ■ ■ ■ ■ ' .11. Take of Extract of catechu, drach. ij. Cinnamon bark, drach. j. Coriander seeds, drach. ss. Infuse in barley water, unc. viij. add, Syrup of ginger, unc. j. and strain. This is a very agreeable way of administering so powerful an astringent as the extract of catechu; and where the bowels are extremely relaxed, it will frequently be found a very useful medicine. It may be taken to the quantity of a table spoonful, repeated, if necessary, every two hours. CHIRURGICA. 141 Take of Submuriate of mercury, drach. ij. Mucilage of gum arable, unc. ss. Lime water, Q,j. Rub the submuriate and mucilage well together, and add, gradually, the lime water. See remarks un- der Injectio Zinci Sulphatis. INJECTIO PLUMBI CARBONATIS. INJECTION OF CARBONATE OF LEAD. R. Plumbi carbonatis drach. j. Tragacanthae pulveris compositi drach. ij. Opii pulveris scrup. j. Aquae ferventis O.j. Take of Carbonate of lead, drach. j. Compound powder of tragacanth, drach. ij. Opium powdered, scrup. j. Boiling water, O.j. INJECTIO THEjE. INJECTION OF TEA. R. Theae viridis foliorum drach. j. Aquae ferventis unc. vj. Take of Leaves of green tea, drach. j. < . Boiling water, unc. vj. Macerate in a close vessel till cold, and strain. INJECTIO ZINCI SULPHATIS. INJECTION OF SULPHATE OF ZINC. R. Zinci sulphatis drach. ss. Aquae distillate O. j. Misce. H2 PHARMACOPOEIA Take of Sulphate of 2inc, drach. ss. Distilled water, O.j. Mix. Among the whole class of remedies employed for surgical purposes, there is scarcely one which has occasioned a greater diversity of opinion, than injections in the cure of gonorrhoea. Opinions diametrically opposite, supported by names alike conspicuous and eminent, we have neither the judgment nor temerity to reconcile; and shall con- tent ourselves with observing, when injections have appeared serviceable and when otherwise, so far as we have had an opportunity of observing. At the commencement of gonorrhoea, the irritation and ardor urinae is often so great as to occasion the greatest possible distress; the urethra then being so exquisitely sensible that the slightest distention of its orifice or canal, even by fluids of the blandest nature, gives the most exquisite pain. The inflam- mation in this stage is evidently of the tonic kind, with an accumulated quantity of nervous sensibility, incompatible with the mere stimulus of distention or even contact with a foreign body: there is a co- pious secretion of the mucus which lubricates the canal, which at first is thin and acrid from contain- ing a greater quantity of the salts of the blood; there is a degree of irritative fever excited;—the urine is oftentimes scanty and high coloured, and whenever it is passed aggravates all the symptoms, leaving an CHIRURGICA. 143 increased desire to pass more urine, attended with a burning smarting pain. The intention of cure, then, would here appear to be that of lessening the inflammation of the parts by removing the disten- tion, and of diminishing the stimulating properties of the urine.—We should also endeavour, as much as possible, to take off the accumulated sensibility of the urethra, so as to render it less susceptible both of the stimulating properties of the urine and of the gonorrhceal discharge. To answer these views, leeches applied to the under part of the ure- thra along its whole course would appear a means likely to be useful, together with the free use of cold saturnine applications externally applied to the penis. The bowels should be freely evacuated, and determination induced both to the kidnies and skin, so as to excite a free diaphoresis and a copious flow of urine; by which means we take off the heat and inflammation of the urethra, remove the irritative fever, and greatly diminish the stimulating proper- ties of the urine. Opium may likewise be had re- course to, either alone or combined with camphor, or with antimony and hemlock: hyoscyamus and bel- ladonna may likewise be tried. Do injections, used at first, tend to produce these effects, or do they not rather retard them? When the violence of the symp- toms are abated, and the increased secretion and discharge are kept up by an atonic state of the parts, injections, by corrugating, stimulating, or strength- 144 PHARMACOPOEIA ening the relaxed internal surface of the urethra, would certainly seem more eligible and proper; but here again objections present themselves, which though, perhaps, not founded on any true patholo- gical reasoning, would still appear valid by conse- quences which too frequently supervene. There is an uncertainty in applying the injection equally and regularly, by which means its astringent or stimula- ting properties may bring on sudden or increased action in some of the relaxed vessels, so that they shall either become thickened or enlarged, or pour out a considerable quantity of inflamed lymph, which may afterwards become the ground work of adhesions; or induce an irregular puckering of the internal membrane; either of which effects may give rise to stricture. Of the injections enumerated, those containing mercury are most extensively em- ployed. The Injectio Hydrargyri Submuriatis is very commonly resorted to. The Injectio Hydrar- gyri is a milder form, and in one instance where gonorrhoea had continued beyond six weeks, it was almost instantly put a stop to by once using it. The Injectio Copaibae is more stimulating, and is perhaps better fitted for females, when a discharge is kept up from a relaxed state of the rugae or folds of the vagina, whether arising from gonorrhoea, from too frequent coition, or from the fluor albus or whites. The Injectio Plumbi Carbonatis, Zinci Sulphatis, and Cupri Sulphatis, are all of them CHIRURGICA. 145 astringent; their astringency increasing in the order they are here arranged. The Injectio Zinci Sul- phatis made double the strength prescribed, is one which Mr. Astley Cooper very generally employs for the radical cure of hydrocele, and that almost with uniform good effect. It may be worth while here to remark that, in a conversation I once had with Mr. George Babington, late Surgeon in the Guards, he observed to me that he was in the habit of curing all the obstinate gonorrhoeas which came under his care, and which were very consider- able, by large and frequent doses of the copaiba; and that even in the active stage of gonorrhoea he employed it with success; but he never had recourse to injections. LINIMENTUM J1RUGINIS. LINIMENT OF VERDIGRIS. R. JEruginis praeparatae unc.j. Acidi acetici unc.vj. Mellis depurati unc. xiv. Take of Verdigris prepared, unc.j. Vinegar, unc. vj. Honey, strained, unc. xiv. Dissolve the verdigris in the vinegar, and strain through linen; afterwards add the honey, and boil the whole over a slow fire to the consistence of a thick syrup. This preparation, after standing some time, de- N 146 PHARMACOPOEIA posits its thicker parts, which in the older Pharma- copoeias, was denominated the Unguentum ^Egypti- acum, the thinner parts going by the name of the Mel ^Egyptiacum. Both under verdigris, and the formula gargarisma seruginis, we have taken an opportunity of express- ing our opinion on the propriety of using this com- position to affections of the mouth and fauces: that it is possible for a portion of it to be conveyed into the stomach, from which circumstance much incon- venience might be occasioned; and that the same intention intended to be answered by it may be ef- fected by means less hazardous. It must be confessed, however, that aphthae and ulcers of the mouth and tongue, particularly where there exists a disposition for them to run into a sloughing state, or when they are connected with a syphilitic cause, and the system is under the action of mercury, are often very suddenly and happily meliorated and healed by using the linimentum aeru- ginis; but it must be recollected that a small portion only should be applied, and that by means of a probe armed with lint; likewise that the mouth should be well gargled or cleaned afterwards, either with the common gargle or gargle of myrrh. LINIMENTUM AMMONIA. LINIMENT OF AMMONIA. R. Ammonia liquoris subcarbonatis unc. ss. Olei olivae unc. iss. Misce. CHIRURGICA. 147 Take of Liquor of subcarbonate of ammonia, unc. ss. Olive oil, unc. iss. Mix. This is a strongly stimulating application. To each ounce of the liniment a drachm of cam- phor, rubbed down with a little spirit of wine, may be added; or the liniment may be made with the li- quor ammoniae,—this is left, however, to the option of the surgeon. LINIMENTUM AMMONIA CUM ANTIMONIO TARTARIZATO. LINIMENT OF AMMONIA WITH TARTARISED ANTIMONY. R. Linimenti ammoniae unc.j. Antimonii tartarizati drach .j. Misce. Take of Liniment of ammonia, unc.j. Tart sate of antimony, drach. j. Mix. See Unguentum Antimonii. LINIMENTUM AMMONLE CUM OLEO TE- REBINTHIN.fi. LINIMENT OF AMMONIA WITH OIL OF TUR- PENTINE. R. Linimenti ammoniae unc. jss. Olei terebinthinx rectificati unc. ss. Misce. Take of Liniment of ammonia, unc. ss. Rectified oil of turpentine, unc. ss. Mix. 148 PHARMACOPOEIA This liniment will not unfrequently afford very sudden and permanent relief in chronic rheumatism, in lumbago, sciatica, and affections of the knee and ancle joints, depending on a gouty or rheumatic cause. LINIMENTUM BITUMINIS COMPOSITUM. COMPOUND LINIMENT OF TAR. R. Petrolei barbadensis unc.j. Camphorae pauxillo spiritus rectificati in pulverem redactae unc- ss. Misce. Take of Barbadoes tar, unc.j. Camphor rubbed up with a little spirit of wine, unc. ss. Mix. This liniment is not unfrequently recommended by Mr. Forster, Senior Surgeon of Guy's Hospital, in affections of long standing, whether of the knee or ancle joints, where he suspects any degree of thickening about the ligaments, or an effusion of lymph. It should be spread upon leather and applied round the part or parts, with direction to renew its use every fourth or fifth day. LINIMENTUM CAMPHORS. CAMPHOR LINIMENT. R. Camphorae Liquoris potassae subcarbonatis singulorum unc.j Olei olivae unc. iv. CHIRURGICA. 149 Take of Camphor, Liquor of subcarbonate of potash, of each, unc.j. Olive oil, unc. iv. This liniment possesses similar properties to, and may be used with equal advantage as, the liniment of Mr. Ware, with which he recommends the out- side and edges of the eyes to be moistened, by means of the finger, night and morning, when vision is rendered imperfect from a supposed deficiency of power in the optic nerves, or from an incipient amaurosis. It is a pretty strong stimulant, but acts more gradually than the compound camphor lini- ment. The camphor should first be dissolved in the liquor of potash, and the oil should be added. LINIMENTUM CAMPHORS COMPOSI- TUM. (£) COMPOUND CAMPHOR LINIMENT. R. Camphorae unc. ij. Liquoris ammoniae unc. vj. Spiritus lavandulae O. j. Take of Camphor, unc. ij. Liquor of ammonia, unc. vj. Spirit of lavender, O. j. Let the water of ammonia be mixed with the spirit of lavender; and distil from a glass retort, with a slow fire, sixteen ounces. In this dissolve the camphor. In order to save the trouble of distilling, rectified spirit of wine may be employed; but it is N2 15» PHARMACOPOEIA more expensive. This is a powerfully stimulating and penetrating liniment.* LINIMENTUM ELEMI. LINIMENT OF GUM ELEMI. \\. Unguenti elemi compositi unc. vj. Olivae olei unc. xij. Misce. Take of Compound ointment of gum elemi, unc. vj. Olive ail, unc. xij. Mix. This is a stimulating digestive liniment. It may often be used with advantage for promoting the dis- charge from blisters, setons, and issues. It will like- wise often be useful if applied to the edges of the eye-lids, in the ophthalmia incident to old age. LINIMENTUM HYDRARGYRI. (Z..) LINIMENT OF QUICKSILVER. R. Unguenti hydrargyri fortioris Adipis suillae singulorum unc.j. Camphorae drach. ij. Spiritus rectificati gtt. v. Liquoris ammoniae unc. j. * Thereseems to "be no necessity for so troublesome a process as is here directed, nor does the editor perceive that any advan- tage can arise from the use of spirit of lavender, in preference to spirit of wine; as it can possess no particular virtue by sub- mitting it to distillation with the ammonia. A much more expe- ditious, and equally useful liniment may be made extemporane- ously, by first dissolving the camphor in spirit of wine, and then adding the liquor of ammonia. CHIRURGICA. 151, Take of Strong mercurial ointment, Hogs laid, of each, unc.j. Camphor, drach. ij. Rectified spirit of wine, gtt. v. Liquor of ammonia, unc. j. To the camphor, dissolved in the spirit of wine, add the water of ammonia, together with the oint- ment of quicksilver previously mixed with the lard. This and the preceding liniment are both, of them taken from the Pharmacopoeia of St. Bartholomew's Hospital, similar ones to each of which I have fre- quently seen employed. The addition of the liquor ammoniae in the latter one, renders it more stimu- lating, and, probably, enables the absorbents to take in a greater share of the mercury. This liniment would appear admirably calculated as a remedy for external chronic venereal pains, for removing nodes, tophi, &c. remaining after a mercurial course, and for some indolent rheumatic pains of the muscles and ligaments. It should be well rubbed into the parts affected night and morning by the patient; if by an assistant, it will be requisite to have the hand covered with bladder or oil-skin; a caution requisite whenever mercurial frictions are conducted by an assistant. See remarks under Ung. Hydrargyri. 152 PHARMACOPOEIA LINIMENTUM PLUMBI ACETATIS COM- POSITUM. COMPOUND LIMMENT OF ACETATE OF LEAD. R. Liquoris plumbi acetatis unc.j. Olivae olei unc. ij. Tinct. opii drach. ij. Misce. Take of Liquor of acetate of lead, unc.j. Olive oil, unc. ij. Tincture of opium, drach. ij Mix. See remarks under Liquor Plumbi Acetatis. LINIMENTUM OLEI CUM CALCE. LINIMENT OF OIL WITH LIME. R. Olei lini unc. xij. Liquoris calcis unc. vj. Take of Linseed oil, unc. xij. Lime water, unc. vj. Agitate the oil and lime water briskly together till they are well incorporated. In cases of burns and scalds, where the cuticle has been destroyed, I have seen this liniment pretty extensively employed, particularly after the violence of the inflammation in the first instance had been got under by other means. The part, or parts, should be kept covered with this liniment, spread upon fine old linen; taking care that the rags covering the sores are always in a state of moisture. CHIRURGICA. 15S LINIMENTUM OPII. LINIMENT OF OPIUM. R. Linimenti saponiscompositi unc. iss. Tinct. opii unc. ss. Misce. Take of Compound soap liniment, unc. iss. Tincture of opium, unc. ss. Mix. This liniment is very similar to the anodyne bal- sam of Bates. It is greatly recommended for sprains, bruises, and chronic rheumatic pains. Where, how- ever, there is considerable inflammation from the injury communicated, or a considerable degree of ecchymosis with great tension and pain, I should feel inclined to discourage the adoption of so active a stimulant, and defer its use till the urgency of the first symptoms have been removed by local blood- letting, and by discutient or emollient applications. LINIMENTUM SAPONIS COMPOSITUM. COMPOUND SOAP LINIMEAT. R. Saponis albi duri unc. iij. Camphorae unc.j. Spiritus rosmarini O. j. Take of Hard white soap, unc. iij. Camphor, unc. j. ' Spirit of rosemary, O.j. Digest the soap in the spirit. 154 PHARMACOPOEIA LIQUOR ALUMIN1S COMPOSITUS. (L.) COMPOUND LIQUOR OF ALUM. R. AUiminis Acidi acetici Zinci sulj>hatis singulorum unc. ss. Aquae ferventis O. ij. Take of Alum, Vinegar, Sulphate of zinc, of each, unc. ss. Boiling water, O. ij. Dissolve the alum and zinc in the boiling water; then strain through paper. This is a useful astringent application. It will of- ten answer in removing chilblains; in curing slight excoriations of the cutis; in taking down superficial excrescences; and in correcting the ichorous dis- charge or hsemorrhagic tendency in some old ulcers* -—It may be employed as a good collyrium in the ophthalmia senilis. LIQUOR ARSENICALIS. (L.) ARSENICAL LIQUOR. R. Arsenici oxydi praeparati, in puiverem subtilissi- mum triti, Potassae subcarbonatis ex tartaro, singulorum gr. 64. Aquae distillatae O. j. Take of Oxyd of arsenic prepared, and in fine powder, Subcarbonate of potash, of each, gr. 64. Distilled water, O. j. CHIRURGICA. 155 Boil the arsenic and subcarbonate of potash till the arsenic is completely dissolved; then strain through fine linen, when cold. This preparation differs in strength from the Aquae Arsenicalis.—The College direct half an ounce of the spirit of lavender to be added, and the waste occasioned by the boiling to be made good with distilled water. The dose is from eight to twenty drops twice in the day. It would almost however appear desirable, from the uncertain quantity contained in a drop as being subject to the' influence of various causes, that this liquor be mere diluted, in order to its being exhibit- ed in a larger and more certain dose. If instead of the sixty-four grains, two grains only be dissolved in the pint of water, the dose may with safety be half an ounce. LIQUOR HYDRARGYRI OXYMURIATIS. (L.) LIQUOR OF OXYMURIATE OF MERCURY. R. Hydrargyri oxymuriatis gr. viij. Aquae distillatae unc. xv. Spiritus rectificati unc. j. Take of Oxymuriate of mercury, gr. viij. Distilled water, unc. xv. Rectified spirit, unc. j. Mix. Dissolve the oxymuriate in the distilled water, and add the spirit. This is a cheap and convenient form for adminis- tering this muriate. The dose is two drachms twice 156 PHARMACOPOEIA in the day. It should be recollected that all these solu- tions, when administered internally, be given in glass or wooden vessels; as metallic substances are, more or less, subject to decompose them. Other menstruuins have occasionally been em- ployed by different practitioners, as more effectual vehicles for exhibiting the oxymuriate of mercury. R. Hydrargyri oxymuriatis gr. ij. Tincturae cinchona: unc. ij. Take of Oxymuriate of mercury, gr. ij. Tincture of cinchona, unc. ij. Triturate the muriate with the tincture till it is perfectly dissolved. This medicine was first introduced to notice by Mr. Astley Cooper, as an excellent tonic and mer- curial alterative in strumous enlargements and scro- fulous ulcerations;—in some of the secondary symp- toms of lues;—in sloughing buboes, where the other forms of mercury were found to disagree; in exos- toses and periosteal inflammations from a scrofulous taint; and in those mixed cases of scrofula and lues which are now become so very common and difficult of cure. The dose to an adult is from a drachm to two drachms twice in the day. It may be given either in the decoction of bark or guaiacum, or in the decoctions of sarsaparilla, conjoined as useful auxiliaries; or it may be exhibited as an auxiliary CHIRURGICA. 157 » itself in some cases of confirmed lues, conjoined with mercurial frictions, or even with the internal use of calomel, or the pilula hydrargyri. R. Hydraigyri oxymuriatis gr. j. Syrupus papaveris unc. iv. Take of Oxymuriate of mercury, gr. j. Syrup of poppies, unc. iv. The oxymuriate of mercury should be intimately triturated with a small portion of the syrup, and the remainder should be gradually added; taking care that the solution be complete. This was first administered at Guy's Hospital, by- Mr. Stocker, apothecary of that institution, to a pa- tient labouring under an inveterate venereal sore throat, where the ulceration and sloughing were considerable, and after all the common means had failed. The dose recommended was a table spoonful twice a day, or oftener, according as the stomach and bowels might be influenced by its use. After a short period of strict adherence to this medicine, the greatest possible alteration, both in the appearance of the ulcer, and in the patient's health, took place; and in a few weeks the man was discharged from the hospital quite well. I have seen the same solution made use of in two similar affections, and with the same beneficial result. O 158 PHARMACOPOEIA LIQUOR ACIDI NITRICI- NITRIC ACID LIQUOR. R. Acidi nitrici gtt. xxx. Aquae distillatae O. j. Sacchari albi unc. ss. Misce. Take of Nitric acid, gtt. xxx. Distilled water, O. j. White sugar, unc. ss. Mix. The above quantity may be drank, in divided doses, during the day. See Acidum Nitricum. The sulphuric acid may be administered in the same way as a useful tonic and astringent. LIQUOR CALCIS. LIME WATER. Formula are given both in the London and Edin- burgh Pharmacopoeias, for making this preparation. Lime water forms a highly useful and efficacious menstruum, for rendering some of the preparations of mercury most effectual as external applications. See Lotio Hydrargyri Submuriatis, and Lotio Hy- drargyri Oxymuriatis: lime water has been used in psora and tinea capitis, but with little or no benefit* LIQUOR PLUMBI ACETATIS. (L.) LIQUOR OF ACETATE OF LEAD. R. Plumbi oxydi semivitrei O. ij. unc. iv. Acidi acetici cong. vj. CHIRURGICA. 159 Take of Semivitrified oxyd of lead, O. Ij. unc. iv. Vinegar, cong. vj. Mix and boil over a gentle fire to six pints, dur- ing which the mixture should be constantly stirred. After the liquor has stood some time, so that the feces have subsided, strain. This preparation, the acetate of lead, better known by the old name of Extractum Saturni, or Goulard's Extract, is a remedy much used by surgeons, when properly diluted, as an external application in super- ficial and phlegmonic inflammations of the skin; in slight inflammatory affections of the eyes; and in some kinds of herpetic eruptions; likewise as a general remedy to burns and scalds where the cuticle re- mains entire. It is usually employed as recommend- ed by the London College under the form of liquor plumbi acetatis dilutus, which consists of a drachm, by weight, of the liquor plumbi acetatis, mixed with a pint of distilled water, together with a drachm, by measure, of proof spirit of wine. This liquor, for the generality of purposes wherein it is employed, will be found to answer very well; but when used as a collyrium, in some cases it will be found much too strong, and the patient will not be able to bear it above half the strength. The late Mr. Justamond, as also Dr. Cheston, of Gloucester, were in the ha- bit of applving the liquor plumbi acetatis, combined with an equal portion of a spirit resembling the tine- ?6© PHARMACOPOEIA tura ferri muriatis, to the edges of cancerous sores; but we must confess we do not see very clearly with what intention the lead was employed. We should suppose that the tinctura ferri, or what was tanta- mount to the same, was applied for the purpose of putting a stop to the frequent haemorrhages, so com- mon in such kind of sores: and indeed we know that Mr. Justamond used it for this express intention, the good effect of which every surgeon of experi- ence must have witnessed; but then, if the lead were conjoined in order to remove the irritation, or accord- ing to some, to paralyse the extremities of the bleed- ing vessels, opium, not only as most effectually allay- ing pain and taking off irritation, but likewise as being free from the pernicious consequences some- times supervening from the use of lead to a large abra- ded surface, would be preferable. Indeed it is a ques- tion with some whether lead in any form should ever be applied to an open and irritable wound, or to an abraded surface.* * This preparation of lead, as the editor has before observed, is on many accounts very objectionable; it is scarcely possible to make it at all times of uniform strength, as this depends so much on the quality of the vinegar, and the heat, or length of of time which is employed in the digestion. For which reason this preparation of lead, which was introduced into practice by Goulard, is now very generally superseded by the use of the plumbum acetatum, or the crystallized acetate of lead, the strength of which is uniformly the same when properly prepared j it is true that it is asuperacetate, but this is rather an advantage? it is perfectly soluble in distilled water, and in this state posses- CHIRURGICA. 161 > LIQUOR POTASS^. (L.) LIQUOR OF POTASH. AQUA POTASS^. (£.) WATER OF POTASH. Formula are given both in the London and Edin- burgh Pharmacopoeias, for making the liquor and aqua potassse, either of which may be adopted. As a remedy we have noticed its use under the fol- lowing article. It may be given in doses of ten, fifteen, or twenty drops, in linseed or liquorice tea, twice in the day. In the Pharmacopoeia of St. Thomas's Hospital a formulae is given for the more accurate exhibition of this remedy. It is the following: y AQUA KALI PURI DILUTA. R. Aquae kali puri unc. j. Aquae distillatae unc. ij. Misce; dosis, drachma una bis die ex unciis quatuor infusi lini. ses all the qualities of the extractum saturni, which is a sub- acetate, and which is not perfectly soluble without an additional quantity of the acid. The strength of the solution of acetate of lead, can be always most conveniently regulated according to the nature of the part to which it is to be applied; thus if to a limb affected with phleginonic inflammation, a solution of two drachms of the acetate of lead in one pint of water will be suffi- cient; but if necessary to apply it to a more tender organ, suck s the eye, a solution of less than half that quantity will b* sufficient Oa 162 PHARMACOPOEIA Take of Water of pure potash, unc.j. Distilled water, unc. ij. The dose of this may be two drachms taken twice a a day in four ounces of infusion of linseed. N. B. The old names are here retained, conform- able to the original prescription. LIQUOR POTASSjE SUBCARBONATIS. (/..) LIQUOR OF SUB-CARBONATE OF POTASH. AQUA CARBONATIS POTASSiE. (E.) WATER OF CARBONATE OF POTASH. We do not notice the liquor subcarbonatis potassse from any supposed merit it may possess as an external application, but from the frequency with which some surgeons have administered it in cases of gravel and stone. Previous to the accurate analysis of human calculi, by Fourcroy and others, every species of stone was thought to give way to the ac- tion of alkaline medicines, and under this impres- sion they were almost universally had recourse to, without discrimination or judgment, in such com- plaints. At present little is expected from alkalies, except in casts where the stone is known to consist almost entirely of uric acid; and in such instances the liquor subcarbonatis potassse is given in doses from twenty to forty drops, or even to a drachm, in a bason of thin gruel, linseed or liquorice tea. In cases of gravel, where a quantity of red sabulous CHIRURGICA. ' 163 matter is frequently discovered at the bottom of the chamber-pot, the liquor subcarbonatis potassae may prove eminently serviceable, such matter being found to consist principally of uric acid; but probably under such circumstances the liquor potassae is to be pre- ferred. For, notwithstanding the weak affinity which exists between potash and carbonic acid, so slight indeed, that it really acts as an alkali when admi- nistered internally, yet the liquor of pure potash, besides that the quantity given is not only much less bulkv, and to the generality of stomachs much less nauseous, is equally, or more certain in its effect; and if we wish to exhibit the greatest possible quan- tity of alkali, we can safely, and for the most part agreeably, recommend the soda water, as an auxi- liary, to be taken in the way of common drink. The liquor potassae has been found to relieve some of those stomach affections which are not unfrequently connected with nephritic complaints, more effectually than the liquor subcarbonatis potassae; but, after all, the exhibition of these remedies ought not to be persevered in for too great a length of time, since such a practice has sometimes been attended with disadvantageous consequences to the system; and it is the opinion of some of our best surgeons, that the operation which too frequently we are obliged to have recourse to, is rendered more hazard- ous by the previous free use of alkalies, in whatever form they may have been employed. 164 PHARMACOPOEIA LOTIO ACIDI NITRICI. NITRIC ACID LOTION. R. Acidi nitrici drach. j. Aquae distillatae O. j. Misce. Take of Nitric acid, drach. j. Distilled water, O. j* Mix. The nitrous acid lotion is much used as an appli- cation to spongy granulations, and to old foetid ulcers attended with a thin ichorous discharge. It is often too, one of the best means we can employ for correcting the fetor, and for promoting the exfolia- tion of diseased bone. LOTIO AMMONIA ACETATIS. LOTION OF ACETATE OF AMMONIA. R. Liquoris ammoniae acetatis unc. vj. Spiritus rectificati unc. ij. Misce. Take of Liquor of acetate of ammonia, unc. vi Rectified spirit, unc. ij. Mix. This lotion will be found very generally service- able in mammary inflammations, previous to sup- puration, and at the commencement of all external glandular swellings, more particularly after local blood-letting. I have frequently seen it extremely useful in discussing paronychia, or whitlow of the fingers, after the application of leeches. It should be applied by means of three or four folds of old linen, which are to be kept constantly wet* CHIRURGICA. 165 LOTIO AMMONLE MURIATIS. LOTION OF MURIATE OF AMMONIA. R. Ammoniae muriatis unc.j. Acidi acetici impuri O. ss. Aquae distillatae O. j. Misce. Take of Muriate of ammonia, unc.j. Vinegar, O. ss. Distilled water, O. j. Mix. This lotion contains discutient properties in a very powerful degree. It will probably prove more efficacious if a smaller quantity of the ingredients, but in the same relative proportions as above men- tioned, be mixed together at a time and made use of as soon as they are united. LOTIO AMMONITE MURIATIS SPIRITUOSA. SPIRITUOUS LOTION OF MURIATE OF AMMONIA. R. Ammoniae muriatis unc. j. Spiritus rectificati unc. iv. Acidi acetici impuri O.ss. Misce. Take of Muriate of ammonia, unc. j. Rectified spirit, unc. iv. Vinegar, O. ss. Mix. The lotio ammoniae muriatis, and the lotio ammo- niae muriatis spirituosa, are both from the Pharma- copoeia of Guy's Hospital. For discussing some kinds of slow chronic inflammations about the liga- 166 PHARMACOPOEIA ments of the joints, or for removing any thickening or indurations, consequent upon an injury to such parts, it will not unfrequently be found to afford more essential service than any other form of lotion we can employ. LOTIO CALCIS. LOTION OF LIME. R. Liquoris calcis unc. vj. Spiritus tenuioris unc. iij. Misce. Take of Lime water, unc. vj. Weak spirit of wine, unc. iij. Mix. This lotion is held in high repute by some practi- tioners, as an excellent application, in the first in- stance, to burns and scalds were the cuticle remains entire.—It should be used cold and the parts kept constantly covered with it by means of fine linen cloths. LOTIO HYDRARGYRI OXY-MURIATIS. LOTION OF OXY-MURIATE OF QUICK. SILVER. R. Hydrargyri oxymuriatis gr. iv. Aquae distillatae O. j. Misce. Take of Oxymuriate of mercury, gr. iv. Distilled water, O. j. Mix. A few drops of rectified spirit of wine, or one or two drops of the marine acid, will greatly expedite CHIRURGICA. 167 the solution of the muriate of quicksilver in the wa- ter. This lotion will be found essentially useful in many affections of the cuticle of an herpetic nature; in psora it will often succeed without the least dan- ger or inconvenience, used as a wash to the eruption night and morning. In psorophthalmia it is almost an infallible specific. LOTIO HYDRARGYRI OXY-MURIATIS FLAVA. YELLOW LOTION OF OXY-MURIATE OF QUICKSILVER. R. Hydrargyri oxymuriatis scrup. ij. Liquoris calcis O. ij. Take of Oxymuriate of mercury, scrup. ij. Lime water, O. ij. Rub the muriate of quicksilver with the lime wa- ter till it become a yellow oxyd of mercury. This lotion is extensively employed against external sy- philitic eruptions, as also in scabies, and desquama- tions of the cuticle; and sometimes with good effect to those destructive ulcers of the nose and face deno- minated Noli me Tangere. LOTIO HYDRARGYRI SUBMURIATIS NIGRA. BLACK LOTION OF QUICKSILVER. R. Hydrargyri submuriatis drach. ij. Liquoris calcis O. j. 168 PHARMACOPOEIA Take of Submuriate of mercury, drach. ij. Lime water, O.j. Rub the calomel with the lime water till it be- come a black oxyd of mercury, which will be sus- pended in the fluid by brisk agitation. The black wash of mercury is very extensively employed in most of the venereal wards of the dif- ferent hospitals in London, as one of the best ap- plications to syphilitic sores. To chancres, when not disposed to slough, this wash will oftentimes act like a charm, inducing them to heal almost in a few hours, and even when they are in a sloughing state, if it be applied warm in the form of pouluce with linseed meal, it will, very generally, produce the same good effect. Ulcers too of the extremities, at- tended with a sloughing cellular membrane, often succeed better under the use of this poultice, than by any other means. In removing fungous ex- crescences situated about the roots of the nails, the lotio hydrargyri nigra is often very beneficial. Pre- vious to the use of this wash, the phials containing it should be well agitated, when a portion of it should be poured into a shallow vessel, on the bottom of which is placed one or more pieces of lint, as circumstances may require; the clear liquor should then be gradually poured away, v/hich leaves the black oxyd of mercury upon the lint, in which way it should be applied. CHIRURGICA. 169 LOTIO MYRRH.fi. LOTION OF MYRRH. R. Tincturae myrrhae Liquoris calcis sing, unc.j. Misce. Take of Tincture of myrrh, Lime water, of each, unc.j. Mix. This lotion is given us by Dr. Kirkland, in his Medical Surgery, as a good application for taking down fungous flesh. In a case of fungus of the brain, he found it extremely proper and serviceable, by dipping into it dossils of lint, and applying them to the excrescence. LOTIO OPII. LOTION OF OPIUM. R. Opii extracti mollis drach. ij. Aquae distillatae O.j. Take of Soft extract of opium, drach. ij. Distilled water, O.j. Dissolve the opium by trituration, adding the water gradually; to facilitate the solution, the water may be used in a state of boiling. Where opium is indicated as an external applica- tion, this lotion will be found a convenient form for applying it. P 170 PHARMACOPOEIA LOTIO PICIS. LOTION OF PITCH. R. Acidi picis rectificati unc.j. Aquae distillatae O. j. Misce. Take of Rectified acid of pitch, unc.j. Distilled water, O. j. This lotion is useful for curing certain eruptions about the heads and necks of children, attended with desquamation of the cuticle and not unfre- quently accompanied with an ichorous discharge, yet very different from tinea capitis. It has been recommended for removing freckles.* LOTIO PLUMBI ACETATIS. LOTION OF ACETATE OF LEAD. R. Liquoris plumbi acetatis drach. j. Spiritus tenuioris unc.j. Aquae distillatae O. j. Misce. Take of Liquor of acetate of lead, drach. j. Weak spirit, unc. j. Distilled water, O. j. Mix. This lotion is very extensively employed in cases * The editor confesses himself at a loss to understand, what the author means by rectified acid of pitch; he has searched in vain in modern chemical works for any such acid. The author may here have alluded to the aqua picis liquida, or the tar wa- ter of the Dublin Pliarmacopocia, but this cannot be called an acid ofpitch.it being only a solution of theempyreumatic oil, effected by means of acetous acid, and possessing, as an external applica- tion at leas,t very trifling properties. CHIRURGICA. 171 where a preparation of lead is indicated. See Liquor Plumbi Acetatis. LOTIO PLUMBI ACETATIS COMPOSITA. COMPOUND LOTION OF ACETATE OF LEAD. R. Liquoris plumbi acetatis drach. i . Acidi acetici unc. iv. Spiritus tenuioris unc. j. Aquae distillatae O. j. Take of Liquor of acetate of lead, drach. ij. Acetic acid, unc. iv. Weak spirits, unc.j . Distilled water, O.j. The proportion of lead in this lotion is greater than in the preceding one, but it is in a state of more complete solution by the addition of the distilled vinegar. It is very discutient and sedative. LOTIO POTASS^ SULPHURETI COMPOSITA. COMPOUND LOTION OF SULPHURET OF POTASH. R. Potassae sulphured unc. ss.. Saponis Venetae unc. j. Spiritus rectificati unc. iv, Tinct. myrrhx unc. ss. Liquoris calcis O. j. Take of Sulphuret of potash, unc. ss. Venetian 9oap, unc. j. Rectified spirit, unc. iv. Tincture of myrrh, unc ss* Lime water, O.j. !72 PHARMACOPOEIA The soap and sulphuret of potash are to be well triturated together, after which the lime water is to be gradually added, and lastly the spirit of wine and tincture of myrrh. This lotion has been greatly recommended in tinea capitis, upon the authority, we believe, of Mr. Barlow, an eminent surgeon in Lincolnshire. In the cases, however, in which we have seen it employed, it certainly did not afford that benefit which was an- ticipated from its adoption. Before using it, it is re- quisite to shave the head clean, first cautiously sepa- rating and cleaning with warm soap and water all the matted hair. The head should then be well washed with this lotion night and morning, and in order to retain it to the part as long as possible, slips Of lint should be dipped in the lotion, with which the whole head should be covered, and which should be confined on by means of an oil-skin cap. LOTIO SULPHURIS. LOTION OF SULPHUR. R. Sulphuris praecipiiati drach. ij. Plumbi acetatis scrup. j. Aquae rosae unc. viij. Misce. Take of Precipitated sulphur, drach. ij. Acetate of lead, scrup. j. Rose water, unc. vj. Mix. This lotion is mentioned by Dr. Graves, in his valuable Conspectus, upon the authoritv of the late CHIRURGICA. 173 Mr. B. Bell, as being an effectual remedy against herpetic eruptions in the face of females, used night and morning. LOTIO ZINCI ACETATIS. LOTION OF ACETATE. OF ZINC. R. Zinci acetatis drach. j. Aquae distillatae O.j. Misce. Or, R. Zinci sulphatis drach. ss. Aquae distillatae O. j. Take of Acetate of zinc, drach. j. Distilled water, O. j. Mix. Or, Take of Sulphate of zinc, drach. iss. Distilled water, O. j. Either of these lotions will frequently be found extremely serviceable in slight excoriations of the cuticle, in chronic ophthalmia, and in general for removing any small fungous excrescence, or for checking such a disposition. MEL HYDRARGYRI. HONEY OF QUICKSILVER. R. Hydrargyri cum creta unc ss. Mellis depurati unc. j. Take of Mercury with chalk, unc. ss. Clarified honey, unc.j. Rub these together till they are minutely incor- porated. Lint smeared with this composition and P 2 174 PHARMACOPOEIA applied to irritable venereal sores will in some cases be found an easy suitable application* Ulcers of the mouth or fauces, of a venereal character, may be covered by/ means of a camel's hair brush, with this preparation, with perfect safety, and not unfrequently with benefit. I have once known the sloughing state of a chancre corrected by the mel hydrargyri, after many other applications had been used without effect. Perhaps the following may be offered as a more certain preparation of mercury. R. Hydrargyri oxydi cinerei drach. j. Cretae przeparatx drach. iij. Mellis depurati unc. j. Take of Ash coloured oxyd of quicksilver, drach- j. Prepared chalk, drach. iij. Clarified honey, unc. j. MEL ROSiE. (L.) HONEY OF ROSES. The honey of roses is often used to slight ulcer- ous excoriations about the mouth and lips: if the sub-borate of soda, (borax), be mixed wiih the mel rosae, in the proportion of two scruples or a drachm of the former to an ounce of the latter, a very useful application is formed for aphthous affections incident *,o children. CHIRURGICA. 175 MISTURA COPAIBjE. MIXTURE OF BALSAM OF COPAIBA. R. Copaibae unc. ss. Mucilaginis acacix gummi unc.j. Mellis dispumati unc.j. Aquae distillatae unc xij. Take of Copaiba, unc. ss. Mucilage of gum arabic, unc.j. Strained honey, unc.j. Distilled water, unc. xij. The copaiba being well triturated and intimately- blended with the honey and mucilage, the water is to be gradually added, so as to form a mixture. Co- paiba is a heating, irritating, stimulant; at the same time, however, it is highly beneficial in certain affec- tions of the urinary organs. In gleets it is often of immediate benefit, and in the atonic stage of gonor- rhoea, or in blennorrhcea urethrae as it is denominat- ed, I have known three or four doses put a stop to the discharge. Taken so as to prove laxative, as in doses of half a drachm or a drachm, twice or three times a day, it is recommended as an effectual reme- dy in cases of piles; if, however, the haemorrhoidal vessels be in a state of great tension; or if there be much external tumefaction, accompanied with gene- ral fever, these symptoms should first be removed previous to the use of the copaiba. In the case of an elderly lady whom I had the honour of attending, in conjunction with Doctor Babington, and whose 176 PHARMACOPOEIA complaint was judged to be an ulcer of the bladder, from the nature of the symptoms, (a copious puru- lent sediment in the urine after standing a little time,—great pain previous to, and after making wa- ter,—constant pain in the lumbar region shooting down the left thigh,—tenesmus,—together with fre- quent lancinating pains in the rectum and regio pu- bis), the balsamum canadense was directed to be taken in a decoction of leek beards; but this medi- cine heating, Dr. B. prescribed the copaiba in the form of an emulsion, with mucilage, honey, and the mistura amygdalae: of this the lady was not able to take more for a dose than what contained ten or twelve drops of the copaiba. After the first week or ten days some alleviation of her symptoms was ef- fected, and the quantity of copaiba was increased to thirty drops for a dose. In a short time she took half an ounce in the day, with a gradual amendment of her complaint, and persevering in the use of the copaiba for three months, she was entirely relieved, though she had not been able to leave her room for near a twelvemonth previous to seeing Doctor Ba- bington. The dose is from an ounce to two ounces, three times a day. MISTURA BALSAMI PERUVIANI. MIXTURE OF PERUVIAN BALSAM. R. Balsami Peruviani drach. ij. Mellis depurati unc.j. Aquae distillatae unc. vij. CHIRURGICA. 177 Take of Peruvian balsam, drach. ij. Strained honey, unc. j. Distilled water, unc. vij. This mixture is prepared in the same method as the preceding one. It is a warm, aromatic, stimulat- ing medicine; and for promoting the granulating pro- cess in indolent ulcers of the lower extremities, par- ticularly in females were the habit isleucophlegma- tic or dropsical, the balsamum Peruvianum has been used both externally and internally with considera- ble benefit. In paralytic numbness, or in chronic rheumatic pains, the balsamum Peruvianum will sometimes be found an efficacious remedy. In a case of paralysis of the wrist, accompanied with general tremor, arising from the noxious effects of lead, the mistura balsami Peruviani, with the con- junction of calomel every night at bed-time, soon effected a permanent cure. The dose is from an ounce to two ounces, three times a day. MISTURA CATHARTICA. CATHARTIC MIXTURE. R. Menthae sativae exsiccatx unc- j. Aquae ferventis unc. xv. Sodae sulphati s unc. iij. Potassae super-tartrajis draeti. j. Antimonii tartarizati gr. ss 178 PHARMACOPOEIA Take of Dried mint, unc. j. Boiling water, unc. xv. Sulphate of soda, unc. iij. Super tartrate of potass, drach. j. Tartrate of antimony, gr. ss. Macerate the dried mint in the boiling water for a quarter of an hour, and in the strained liquor dissolve the crystals of tartar, sulphate of soda, and tartarised antimony. This is the common house physic of Guy's Hospital. The dose is from two to six ounces in the morning. MISTURA GUAIACI. (£.) G UAIACUM MIXTURE. K. Guaiaci gummi-resime drach. iss. Sacchari purificati drach. ij. Mucilaginis acaciae gummi drach. ij. Aquae cinnamoni unc. viij. Take of Gum guaiacum, drach'. iss. White sugar, drach. ij. Mucilage of gum arabic, drach. ij. Cinnamon water, unc. viij. Rub the gum resin with the sugar and mucilage, and gradually add the cinnamon water. This medi- cine possesses similar properties to, and, in general, may be used with equal advantage as the mistura balsami Peruviana^ CHIRURGICA. i7# MISTURA MOSCHI. R, Moschi scrup. ij. Sacchari albi drach. iss. Ammoniae carbonatis drach.ss. Spiritus lavandulae compositi drach. j. Spiritus juniperi unc.j. Aqua: cinnamoni unc. v. Take of Musk, scrup. ij. White sugar, drach. iss. Carbonate of ammonia, drach. ss. Compound spirit of lavender, drach. j. Spirit of juniper, unc. j. Cinnamon water, unc. v. Rub the musk and sugar together till they are in- timately incorporated, after which add the ammonia dissolved in the cinnamon water, together with the other spirits. We are induced to offer this medicine to public notice, under the form recommended by the late in- genious Mr. White, of Manchester, from the great benefit it has afforded in some cases of sloughing phagedenic ulcers, both venereal and strumo-syphi- litic, in Guy's Hospital. It is found generally in the course of a few hours to raise the pulse, to lessen the irritability of the ulcer, to put a stop to the sloughing, and to promote a healthy appearance: this I have seen it effect in the most desperate cases. From the expense of the musk it is often adultera- ted with blood, dried and coarsely powdered; and sometimes with asphaltum; also with a gritty resi- 180 PHARMACOPOEIA nous substance like the gum kind: for a means of detecting these abuses, see Duncan's Pharmacopoeia, page 288. After the bad condition of these ulcers has been changed by the musk, the ammonia may be continued alone with advantage; but it is often requisite to have recourse again to the musk. In sphacelus and mortification I have seen it do great service, particularly in elderly people. See an ingeni- ous account of the powers of Musk in Gangrene and Mortification, by the late Mr. White, of Manches- ter, in which several cases are clearly and amply detailed. MOXA. MUG WORT. In the Pharmacopoeia Chirurgica, published by the Philanthropic Society of St. George's Fields, and which has become a very popular work, the moxa is spoken of and recommended as pre/erable to the actual cautery, and a translation given from the Ap- paratus Medinicaminum of Murray, both as to the mode of preparing and applying it. This soft lanu- ginous substance, says Murray, is prepared by the inhabitants of Japan and China, from the tops of the dried plant and from the leaves, by first bruising them with an iron*pestle, and afterwards rubbing them between the hands, so as to separate all the downy parts. Of this a little cone is prepar- ed, nearly an inch long, which being moistened with CHIRURGICA. 1*1 saliva and affixed to the part in pain, is set fire to. On account of its soft downy nature, it gradually consumes away till it reaches the surface, .first with a sense of glowing heat to the patient, but after- wards with intolerable pain. The part thus burnt soon passes into a state of suppuration, which is sometimes promoted or hastened by means of bruis- - ed onion or garlic. A similar down may be collected from different plants; from the globe thistle, from the leaves of centaury, from the torch-weed, or from flax. The effect produced is the same as from applying the actual cautery, or caustic potash; but it is a harsh empirical kind of practice, and which, we believe, no surgeon of eminence would now think of adopt- ing. MUCILAGO ACACIiE GUMMI. MUCILAGE OF GUM ARABIC. Put half an ounce of the clear picked gum into two ounces of cold distilled wat«r, and suffer it to remain till dissolved. MUCILAGO CYDON1.E SEMINUM. MUCILAGE OF QUINCE SEEDS. R. Cydoniae seminum drach. j. Aquae distillatae O. ss. Take of Quince seeds, drach. j. Distilled water, O. ss. 182 PHARMACOPOEIA Boil over a slow fire till the liquor become thick and viscid. MUCILAGO TRAGACANTHjE GUMMI. MUCILAGE OF GUM TRAGACANTH. R. Tragacanthae gummi elccti unc. j. Aquae ferventis O. j. Take of Gumtragacanth, unc.j. Boiling water, O. j. Macerate in a close vessel for twenty-four hours, afterwards let the mucilage be beat smooth and even with a wooden spatula. OLEUM CAMPHORS. CAMPHORATED OIL. R. Camphorae unc. j. Olivae olei unc. iv. Olei terebinthinae rectificati unc. iss. Take of Camphor, unc.j. Olive oil, unc. iv. Rectified oil of turpentine, unc. iss. Rub the camphor with the olive oil till it is dis- solved, and add the rectified oil of turpentine. This application is powerfully stimulating, and by some said to be powerfully antispasmodic. It is recom- mended in deep-seated rheumatic affections attend- ed with much pain, to be rubbed freely upon the part or parts affected, which are afterwards to be covered with new flannel. I have known it some- CHIRURGICA. 183 times suddenly relieve lumbago and sciatica; and often afford great benefit in indolent chronic pains about the ligaments and joints. It is said to have re- moved suppressio urinae, by being rubbed over the regio pubis. It is likewise one of those forms on which much reliance has been placed as a rubefaci- ent at the commencement of spina ventosa and hip disease; but in these affections it requires to be used with great circumspection, and probably never before local bleeding. It may not be improper here to ob- serve, that all applications containing camphor as their chief ingredient, are to be recommended with necessary caution to incipient swellings of the joints; more particularly where there exists any appearance of a gouty diathesis, or where this disease has pre- vailed previously; for it is the opinion of some ex- perienced practitioners that retrocedent gout has been occasioned by camphor rubbed upon a gouty extremity. The camphorated oil is sometimes pre- scribed with good effect as a liniment to the whole abdomen, in cases of ascites, after the operation of "paracentesis. OLEUM USITATISSIMI LINI. (L.) OLEUM LINI USITATISSIMI. (E.) OIL OF LINSEED. Linseed oil has sometimes been used as an exter- nal covering to recent wounds, and cancerous sores; *84 PHARMACOPOEIA but we believe with no other effect than that of be- ing a soft easy covering. OLEUM OLIVtE CARYOPHYLLATUM. OLIVE OIL UNITED WITH OIL OF CLOVES. R. Olivae olei unc.j. Olei caryophylli unc. ss. Misce. Take of Olive oil, unc j. Oil of cloves, unc. ss. Mix. This combination appears to be very similar to the celebrated embrocation of Roche, so strongly-recom- mended for whooping cough; and probably will be found equally advantageous if a small quantity of it be rubbed upon the stomach, with a warm hand, night and morning, for fifteen or twenty minutes. OLEUM SUCCINI CUM OPIO. OIL OF AMBER WITH OPIUM. R. Succini olei unc.j. Tine, opii unc. ss. Misce. Take of Oil of amber, unc.j. Tincture of opium, unc. ss. Min. This is an application which we should venture to employ externally to that painful affection of the face, denominated Tic douloureux; it is, however, like all other remedies in this affection, uncertain in its effects. It should be rubbed upon the part in pain CHIRURGICA. 185 by means of flannel, and if the complaint be connect- ed with caries of the teeth, a small quantity of the oil may be applied to the part diseased. OPIUM PURIFICATUM. (Z.) PURIFIED OPIUM. The effects of opium are so well understood that the surgeon employs it in certain affections with an almost perfect assurance of success. Its modus ope- randi has been the subject of so much controversy, that it would be only to rouse the keenness of criti- cism were we to venture an opinion favourable to either party. Its powers of excitement, however, for it is in general thought to be a most diffusible stimu- lus, are by no means equal to produce those sedative effects which always ensue from its use; and proba- bly the precise nature of its action upon the common sensorium, or upon the living solid, remains yet to be explained. It is a medicine which possesses the power of allaying all painful irritation in a most re- markable degree, and obviating the power of impres- sions both upon the body and mind. Hence it is essentially beneficial in most spasmodic affections; in all inflammations from local causes; in burns and scalds; in violent contusions on the extremities; in all lacerated wounds; in fractures; in all irritable ul- cers; and particularly in that species of inflammation and sphacelus, which so commonly attacks the toes and margin of the feet in elderly people, and for Q2 i8» PHARMACOPOEIA which it received the greatest recommendation to general notice from Mr. Pott. Here, however, I am persuaded, it only acts by diminishing the general ir- ritability of the system, and by removing the disposi- tion in the contiguous parts to participate so readily of the previous disease; for medicines possessing similar powers upon the system, possess the same ^)ower, more or less, in relieving this complaint. PILULE ALOES CUM FERRO. ALOETIC PILLS WITH IRON. R. Aloes spicatac extracti drach. iss. Myrrhae gummi-resinae drach. ij. Ferri sulphatis drach. j. Extracti gentianae q. s. Take of Extract of aloes, drach. iss. Gum myrrh, drach. ij. Sulphate of iron, drach. j. Extract of gentian, sufficient- The myrrh, aloes, and iron, being reduced into fine powder, are to be formed into a mass proper for making pills, by beating them up with a suf- ficient quantity of the extract of gentian. This composition was the pulvis aloes cum ferro of the London College; but it is here directed to be formed into pills, instead of employing it as a powder, by substituting the soft extract of gentian for the dry. The quantity here prescribed will be sufficient t© CHIRURGICA. 187 form 120 pills, of which two, three, or four may be taken once or twice a day. In some ulcers of the lower extremities, particularly in females of a leu- cophlegmatic or strumous habit, more especially if there be a vicarious discharge from them with much oedema of the leg and foot, the alvine excretion at the same time being indolent and irregular, these pills will not unfrequently be found a very useful auxiliary to the external applications. The dose is from two to four once or twice in the day. PILULiE ANTIMONII CUM OPIO. PILLS OF ANTIMONY WITH OPIUM. R. Pulveris antimonialis gr. viij. Opii ; urificati duri gr. ij. Confectionis cynosbati q. s. ut pilulae quatuor for- mentur. Take of Antimonial powder, gr. viij. Purified opium, gr. ij. Confection of hips, sufficient to form four pills. The hard purified opium being rubbed into fine powder, and the pulvis antimonialis added, they are to be beat into a mass proper for forming into pills, with the confection of hips. This quantity being divided into four pills, one or two of them may be administered every three or four hours, in those lo- cal inflammations and ulcerations, which are accom- panied with great heat and pain, and which so 188 PHARMACOPOEIA commonly attack the feet of elderly people. I have likewise seen them afford great relief in gonorrhoea during its active stage, when the patient has been distressed occasionally in the night with priapisms and chordee. They may likewise, for the most part, be exhibited where opiates are indicated, unless there exist any affection of the stomach, which might be increased by the antimony. PILULE ARGENTI NITRATIS. PILLS OF NITRATE OF SILVER, R. Argenti nitratis gr. vj. Micx panis drach ij. Aquae distillatae q. s. ' Take of Nitrate of silver, gr. vj. Crumb of bread, drach. ij. Distilled water, sufficient. The nitrate of silver being reduced into fine pow- der in a glass mortar, the crumb of bread must be added, and by means of a few drops of distilled water a mass must be formed of uniform consistence, to be divided into twenty-four pills. This is a convenient form for administering the nitrate of silver, as being less likely to disorder the stomach than in any other way. In several cases of noli me tangere which have come under my care, the argenti nitras has certainly produced more good than any other medicine, with which I am acquainted. In a case of this kind, CHIRURGICA. 189 where both the nostrils and the left under eye-lid had suffered materially, the ulcers going on to spread, the cheeks being thickly incrusted with honey-comb like scabs, from whence an acrid ichorous discharge was poured forth, fretting and inflaming the cuticle of the whole face, and after a number of different remedies had been employed to no purpose, these pills were prescribed; and awash consisting of eight grains of the same metallic salt, with eight ounces of elder flower water, was recommended twice or three times a day externally. A pill was directed to be taken night and morning, gradually increasing one daily, till the patient took twelve in the day, six night and morning. Before a week had elapsed some amendment was perceptible, >the patient observing that " her face felt more dry than ever she had experienced it before, and drying things were always good for it."—After the expira- tion of two months under this plan, six pills being taken night and morning, which to the patient pro- duced a sensible glow in the stomach, and tended to keep the bowels in a soluble state, the disease had entirely given way, the nostrils and eye-lid being perfectly cicatrized over, and the incrustations of the cheeks all removed, the cuticle looking clear and healthy.* • The editor has already given his opinion on the danger at- tending the internal exhibition of nitrate of silver; if however it "thought proper to prescribe it, the dircct.ons wh.ch are above 190 PHARMACOPOEIA PILULE ARSENICI. ARSENIC PILLS. R. Oxydiarsenici albi recenter parati scrup. j. Fructus piperis nigri selecti drach. ij. Mucilaginis gummi acaciae drach. iij. Take of W!ute oxyd of arsenic, recently prepared, scrup. j. Black pepper, drach. ij. Mucilage of gum arabic, drach. iij. This is the famous Asiatic pill, which was pur- chased and made public by the English Literary Society at Calcutta. The oxyd of arsenic and black pepper are direct- ed to be beat at successive intervals in an iron mortar for four days; after which they are to be levigated on a marble slab into an impalpable powder, and then formed into a mass with the mucilage, to he divided into J 70 pills, of which the dose is one pill, night and morning, for fifteen or twenty days. The following formula would appear to us much less operose and equally advantageous. R. Oxydi arsenici albi, Potassae sub-caibonatis singulor. gr. x. Aquae distillatae drach. viij. given for forming those pills, are not the most judicious; it would be much safer to dissolve the nitrate of silver in a small quantity of distilled water, previous to adding the bread, in the same manner as is directed in forming the pills of oxymuriate of mercury; by this means the nitrate of silver is more equally proportioned to the number of pills, a circumstance, of some con- sequence in the use of so dangerous a medicine* CHIRURGICA. 191 Take of White oxyd of arsenic, Subcarbonate of potass, of each, gr. x. Distilled water, drach. viij. These being put into a Florence flask and placed over a gentle fire, the water is to be suffered to boil gently, till it is reduced to three drachms, after which, let it be filtered into a glass mortar, and by means of crumb of bread form a mass to be divi- ded into eighty-five pills. The arsenic pill is much celebrated in India and China, as a specific for ele- phantiasis, even of the most inveterate kind; for ob- stinate syphilitic eruptions; for diseases arising from the continued and injudicious use of mercury; for leprosy and cancer; and for all glandular enlarge- ments in strumous and cachectic habits. On the internal use of arsenic we have only to observe, that to us it has always appeared a most formidable and unmanageable remedy; and particu- larly when exhibited in any thing like a solid form, even in the most divided doses. PILULA COLOCYNTHIDIS. COLOCYNTH PILL. R. Colocynthidis extracti compositi dfacb. j. Saponis drach. ss. Take of Compound extract of colocynth, drach. j. Soap, drach.ss. Beat into a mass to be divided into twenty pills. 192 PHARMACOPOEIA PILULA COLOCYNTHIDIS COMPOSITA. COMPOUND COLOCYNTH PILL. R. Extracti colocynthidis compositi, ' Pilulae aloes cum myrrha singul. drach. ss. Take of Compound extract of colocynth, Aloetic pill with myrrh, of each, drach. ss. Beat into a mass to be divided into twelve pills. PILULA COLOCYNTHIDIS CUM HYDRAR- GYRI SUBMURIATE. COLOCYNTH PILL WITH SUB MURIATE OF MERCURY. R. Extracti colocynthidis compositi gr. xlviij. Hydrargyri submuriatis gr. xij. Take of Compound extract ofcolocynth.gr. xlviij. Submuriate of mercury, gr. xij. Beat into a mass to be divided into twelve pills. The intention of these three several formulae is sufficiently obvious; they are all more or less purga- tive, and must be resorted to as the surgeon may determine. PILULE CONII COMPOSITA. COMPOUND HEMLOCK PILL. R- Hydrargyri submuriatis gr. ix. Extracti conii drach. j. Camphorae drach. ss. Spiritus rectificati, gtt. v CHIRURGICA. 193 Take of Submuriate of mercury, gr. ix. Extract of hemlock, drach. j. Camphor, drach. ss. Rectified spirit of wine, gtt. v. Rub the camphor with the spirit till it be dissolv- ed, after which add the submuriate of mercury and extract of hemlock; let the whole be then beat into a mass, to be divided into twenty-four pills. The above pills have been much,celebrated in re- lieving spasmodic stricture; they are given in the same way, and frequently in the same disorders, as the Pilulse Hydrargyri submuriatis cum Conii ex- tract, from which they only differ, virtually, in the addition of the camphor. PILULA DULCAMARA. PILL OF BITTER-SWEET. R. Sulphureti antimonii drach. iss. Extracti stipitum dulcamaras unc. ss. Pulveris stipitum dulcamaras q. s. Take of Sulphuret of antimony, drach. iss. Extract of the twigs of dulcamara, unc. ss. Powder of the twigs of dulcamara, sufficient to forna amass. Beat the precipitated sulphuret of antimony and extraet of bitter-sweet till they are intimately incor- porated; after which, by the addition of the powder, make a mass of proper consistency to be divided into ninety pills. R 194 PHARMACOPOEIA The dose of these pills is one, two, or three, twice or thrice in the day, in cutaneous affections, where the dulcamara has been recommended and found serviceable. They may be made a very useful aux- iliary to the decoction. See Decoctum Dulcamara?. PILULA GUAIACI. PILL OF GUAIACUM. R. Guaiaci gummi-resinae drach. iij. Balsami Peruviani q. s. Take of Gum guaiacum, drach. iij. Peruvian balsam, sufficient to form a mass. Baet the guaiacum powder with the balsam till a proper mass is made; which is to be divided into forty-eight pills. Dose ij. ad iv. with each dose of the decoction if requisite; or, alone, thrice in the day, in cases where this remedy is indicated. See Decoctum Guaiaci. PILULA GUAIACI COMPOSITA. COMPOUND PILL OF GUAIACUM. R. Gummi resinae guaiaci drach. ij. Extracti opii gr. vj. Hydrargyri submuriatis gr. xij. Antimonii tartarizati gr. iv. Tincturae myrrhae q. s. Take of Gum guaiacum, drach. ij. Extract of opium, gr. vj. Submuriate of mercury, gr. xij. Tartarite of antimony, gr. iv. Tincture of myrrh, sufficient to form a mass. CHIRURGICA. 195 The gum resin of guaiacum being well triturated with the hard extract of opium, add the submuriate of mercury and tartarized antimony, and with a sufficient quantity of the tincture of myrrh, form a mass to be divided into thirty-six pills. I have known all the secondary symptoms of syphilis yield to these pills, after a month or six weeks continuance of them, when the more usual means had proved ineffectual. The dose, two, or three, night and morning. PILULA HYDRARGYRI. MERCURIAL PILL. {L.) R. Hydrargyri purificati drach. ij. Confectionis rosae drach. iij. Glycyrrhriae pulveris drach. j. Take of Purified quicksilver, drach. ij. Confection of roses, drach. iij. Powder of liquorice, drach. j. Triturate the mercury with the confection of roses till the globules perfectly disappear; after which add the liquorice powder, and beat the whole into an uniform mass. Or, R. Hydrargyri purificati Confectionis rosae singulor. unc.j. Amyli pulveris unc. ij. (D.) Or, R. Hydrargyri purificati Extracti glycyrrhizae, singulor. drach. iij. Pulveris glycyrrhizae drach. iss. 196 PHARMACOPOEIA Take of Purified quicksilver, Confection of roses, of each, unc. j. Powder of starch, unc. ij. Take of Purified quicksilver, Extract of liquorice, of each, drach. iij. Powder of liquorice, drach. iss. The mode of forming the mercurial pill, as pre- scribed by the Edinburgh and Dublin Colleges, must be the same as that directed by the London College. The Edinburgh College directs the mer- cury to be triturated with the confection of roses, till the globules perfectly disappear, after which the starch is to be added and the mass formed; the Dublin College directs the mercury to be triturated with the extract of liquorice root softened with warm water to the consistence of honey, till the same effect is produced; the liquorice root in fine powder is then to be added, and the whole beat into a uni- form mass. The division of the mercury by the confection of roses is effected more readily and more permanently than by the extract of liquorice, and as such would appear to be a more certain remedy; the addition, however, of the liquorice powder, by the London College, is objected to by Dr. Duncan, on account of its extreme aptness to become mouldy; but this is not the case provided the liquorice powder be not adulterated with some improper and spurious sub- CHIRURGICA. 19? stance. The substituting of the powdered starch for the liquorice powder, as directed by the Edin- burgh College, gives the pill a much firmer con- sistency; but we should suppose that it renders it by keeping, hard and brittle, by which it is not im- probable that the mercury may again run into its metallic state, as is notoriously the case when it has been triturated and divided by a solution of the gums; more especially after keeping a long time. The mercurial pill, in a medicinal point of view, is, perhaps, one of the most effectual mercurial pre- parations for curing lues. It is, however, occasionally subject to run off by the bowels, an effect which diminishes the certainty of the remedy, and weakens the patient. To obviate this inconvenience opium is generally added, from the quantity of a fourth of a grain to a grain. Two or three grains of rhubarb powder exhibited every morning for a week will not unfrequently answer the same end; or five, ten, or fifteen grains of the compound powder of ipeca- cuanha may be given every night at bed-time: this will in general correct the inconvenience, and re- move any griping pains in the bowels. PILULA HYDRARGYRI OXYMURIATIS. PILL OF OXY-MURIATE OF MERCURY. R. Hydrargyri oxymuriatis gr. xv. Ammonix muriatis gr. xx. Aquae distillatae ferventis unc ss. Mies panis q. s. R2 198 PHARMACOPOEIA Take of Oxymuriate of mercury, gr. xv. Muriate of ammonia, gr. xx. Distilled water, boiled, unc. ss. Crumbs of bread, sufficient to form a mass. The muriate of mercury being well rubbed in a glass mortar with the muriate of ammonia, pour on the boiling water gradually, and a complete solution will be effected; afterwards add a sufficient quanti- ty of the crumb of bread to absorb all the fluid, which is to be well beat into a mass, to be divided into 120 pills. In forming these pills, and all others wherein any ■metallic oxyd or salt is employed, a wooden spatu- t la should be employed instead of a metal one. The pills should likewise be kept in liquorice, or fine hair-powder, in preference to chalk or magnesia. The dose of these pills is one, night and morning: the stomach will, however, not unfrequently bear two of them at night; and in some aggravated cases one may be administered in the middle of the day with additional benefit. The above formula was first presented to me by Dr. Curry, of Guy's Hospital; and recommended with great advantage in those cases wherein the liquor hydrargyri muriatis is generally employed. The solution however is often found to nauseate, or produce some inconvenience in the stomach and bowels; an objection the pills are less liable to, as well on account of their gradual solubility in the CHIRURGICA. 199 stomach, as that the corrosive state of the metallic salt is much corrected by the mucilaginous quality of the bread. PILULA HYDRARGYRI SUBMURIATIS. PILL OF THE SUBMURIATE OF MERCURY. R. Hydrargyri submuriatis, pp. gr. xij Confectionis cynosbati, q. s. ut fiant pilulae xij. Take of Submuriate of mercury, gr. xij. Confection of hips, sufficient to form twelve pills. The dose of these pills is one, two, or more, night and morning, as the nature of the case may r. quire, or as the patient's constitution is able to bear. In syphilitic affections, however, the submuriate of mer- cury is best combined with opium in the generality of cases. See Hydrargyri Submurias. Or, PILULA HYDRARGYRI SUBMURIATIS. (L.) PILL OF SUBMURIATE OF MERCURY; anciently PLUMMER'S PILL. R. Hydrargyri submuriatis, Antimonii sulphureti singulor. drach. j. Guaiaci gummi-resinae pulveris drach. ij. Copaibae q. s. ut fiant pilulae 60. Take of Submuriate of mercury, Sulphuret of antimony, of each, drach. j. Gum guaiacum, powder, drach. ij. Balsam of copaiba, sufficient to make sixty pftls- 200 PHARMACOPOEIA This we believe to be the original recipe of Dr. Plummer, Professor of Medicine in Edinburgh. It is given in the new Pharmacopoeia of Dr. Duncan, under the form of compound antimonial pill, and instead of the gum resin of guaiacum and copaiba, the extract of gentian and Spanish soap have been substituted; and so far as regards the composition of the pill, this alteration is certainly for the better, but in a medical point of view, the formula as we have given it appears preferable. In the Pharmacopoeia of Guy's Hospital three of these pills are directed to be taken night and morn- ing, drinking after each dose a pint of the decoction of guaiacum. These pills have been long celebrated in leprosy, and in most cutaneous eruptions. I have repeatedly seen their great good effect in many cases of seconda- ry syphilitic symptoms, particularly when affecting the skin. They have been greatly recommended in sloughing venereal buboes; in gleets remaining after the cure of gonorrhoea; in pimply affections of the face; in old ulcers of the legs, attended with a thin ichorous discharge, and accompanied with great pain and swelling; in sciatica; and in all stages of syphilis. Whey, Bristol water, and decoction of the woods have been generally recommended at the same time, to be taken pretty copiously. Under the action of such remedies, and indeed under all mer- curials, it is particularly requisite to be careful against taking cold. CHIRURGICA. 201 PILULA HYDRARGYRI SUBMURIATIS CUM CONII EXTRACTO. PILL OF THE SUBMURIATE OF MERCURY WITH HEMLOCK. R. Hydrargyri submuriatis gr. vj. Conii extracti drach, j. Misce—fiant pilulae xij. Take of Submuriate of mercury, gr. vj. Extract of hemlock, drach. j. Mix, and form twelve pills. In some indolent scrofulous ulcers, in buboes of an equivocal character, and in incipient glandular swellings, this pill will be found highly advantage- ous. See John Pearson on the Venereal Disease; Kirkland's Medical Surgery; and Justamond's Sur- gical Tracts, by Houlston. The dose is from one to two, once, twice, or three .times a day. PILULA SOD.E CUM SAPONE. SODA PILL WITH SOAP. R. Sodae carbonatis drach. ij. Saponis draeh. j. Syrupus zingiberis q. s. Take of Carbonate of soda, drach. ij. Soap, drach. j. Syrup of ginger, sufficient. Beat the soda, being first finely pulverized, with 202 PHARMACOPOEIA the soap, and with the syrup of ginger form amass, to be divided into forty-eight pills. Three or four of these pills may be taken twice or three times in the clay in calculous and nephritic complaints, where alkalies are indicated or found to afford relief. In irritability of the bladder, accompa- nied with painful micturition, or a desire to pass the urine frequently, and which upon standing depo- sits a ropy puriform sediment, these pills will often be found very beneficial: as a useful auxiliary, a strong infusion of the uva ursi may be advantage- ously recommended after each dose of the pills. PILULA TEREBINTHIN^. TURPENTINE PILL. R. Terebinthinae chiae drach. ij. Pulveris rhabarbari drach. j. Balsami copaibae q. s. Take of Chian turpentine, drach. ij. ^fc Powder of rhubarb, drach. j. Balsam of copaiba, sufficient. The turpentine being liquified in a water bath, stir into it the powder of rhubarb; and when cold, beat up the mass with a sufficient quantity of the balsam of copaiba, so as to render it of a proper consistency for forming into pills of five grains each. This is one of the many select formulae taken from the Pharmacopoeia of Guy's Hospital. The dose of these pills is from three to six, once CHIRURGICA. 203 or twice a day, in gleets and other affections of the urinary organs remaining after gonorrhoea. PILULA TEREBINTHINLE COMPOSITA. COMPOUND PILL OF TURPENTINE. R. Terebinthinae chiae Gum mi olibani sing, drach- j. Ferri sulphatis scrup. j. Bals. Peruviani q. s. Take of Chian turpentine, Gum ohbanum, of each, drach. j. Sulphate of iron, scrup. j. Balsam of Peru, sufficient. The gum olibanum and sulphate of iron being reduced into fine powder, add the turpentine, and beat them into a mass, with a sufficiency of the balsam of Peru, to be divided into twenty pills. The dose of these pills is the same as the preceding: they have frequently been found highly serviceable in the same affections, more especially in females, PLUMBI SUPERACETAS. (Z..) ACETIS PLUMBI. (E.) ACETATE OF LEAD. Formerly, Sugar of Lead. The superacetate of lead dissolved in distilled water, in the proportion of a drachm to a pint of fluid, is a good external application in some cases of superficial inflammations, especially of the phleg- 204 PHARMACOPOEIA monic kind; also against slight bruises of the skin, and inflammatory affections of the eyes. It may be applied, in general, by means of cloths soaked in the solution; or the solution may be mixed with crumb of bread, (which has been previously soaked in boiling water, and afterwards squeezed as dry as possible) and applied in the form of a cold cataplasm. If an ounce of the Acidum Aceticum be added to each pint of this solution, it will, in some instances, be found a superior application. POTASSA FUSA. FUSED POTASH. Formerly Pure Kali. The potassa fusa is one of the most violent caustics, next to the actual cautery, that we possess; acting on the living substance immediately on its coming into contact with it, and entirely destroying it to some extent; leaving a deep black eschar or dead discoloured part, which after a time is sepa- rated from the surrounding living substance, and a deep abraded secreting surface remains, forming what is called a drain or deep issue. Both the cause and consequence have very generally, in surgical language, been comprehended under the term caustic. Caustics are chiefly called for in deep-seated chronic or strumous inflammations, for the purpose of inducing a counter action by means of the inflam- mation and loss of substance they produce, and the consequent secretion of pus which takes place; thus CHIRURGICA. 205 effecting a resolution of the injury which is going on within.—In diseases of the hip joint, in spina ventosa, in incurvations of the spine, and in com- plaints of a similar character, issues and drains (whether excited by the caustic or other means,) are chiefly called for, and as a preference is usually given to the caustic in order to produce them, the following is the usual mode generally practised: A circular piece of adhesive plaster being pro- vided, sufficiently large to cover the whole of the abscess intended to be opened, upon the middle of it a number of narrow oblong pieces of the same adhesive are placed, (the adhesive being outward,) at parallel distances, and crossing each other at right angles, so as to form a sort of square with a hollow centre, in which the caustic is placed. This square being raised high enough to contain the caustic, the whole must be covered with another circular por- tion of adhesive, nearly the size of the original one, having a hole cut in the centre, corresponding to the hollow containing the caustic, and through which the caustic is intended to act upon the part to which it is applied. By this contrivance the danger of the caustic spreading and destroying too great an extent of surface is in a great measure obviated. After the removal of the caustic, the common white bread and milk or linseed-meal cataplasm should be applied, and renewed twice a day, till the eschar separate. 206 PHARMACOPOEIA pulvis hydrargyri subsulphatis compositus. COMPOUND POWDER OF SUBSULPHATE OF MERCURY. R. Hydrargyri subsulphatis gr.j. Pulveris asari drach. iss. Misce. Take of Subsulphate of mercury, gr.j. Asarabacca powder, drach. iss. Mix. Divide the above quantity of sub-sulphate of •mercury and powder of asarabacca, being first inti- mately united, into eight parts, one of which may be used as an errhine once or twice in the day in cases of gutta serena; in ozsena; and not unfre- quently with advantage after the removal of polypi. PULVIS IPECACUANHA COMPOSITUS. (L.) COMPOUND POWDER OF IPECACUANHA. R. Ipecacuanhae radicis pulveris Opii purificati, in pulverem triti, singulor. drach. j. Potassae sulphatis unc.j. Take of Ipecacuanha powder, Purified opium, ground to powder, of each, drach j. Sulphate of potass, unc.j. Rub the purified opium into an impalpable pow- der with a small quantity of the potash, and gradu- ally throw in the remainder together with the powder of ipecacuan; taking care that the mixture CHIRURGICA. 207 be complete. The dose of this powder is from eight to twenty grains. It is an admirable remedy for quieting the bowels when affected by mercurial inunctions, or by the internal exhibition of that metal. It will be proper, not unfrequently, to direct small doses of this remedy at the time you may be employing mercury in any shape; particularly if the patient's bowels be troubled with tormina or twitch- ings. In exanthema mercuriale it is often ex- ceedingly proper, after evacuations, by its gently determining to the skin and by procuring rest. Given to the quantity of ten or fifteen grains, at the commencement of gonorrhoea, every night when the patient is going to rest, it will be found to prevent priapisms and chordee, or to lessen the pain arising from them. PULVIS MYRRHjE. POWDER OF GUM MYRRH. I have seen the fine powder of gum myrrh of great service as a gentle stimulant to fistulous openings, and other ulcers about the verge of the anus; and, indeed, to almost all ulcers which re- quired gently stimulating; more particularly in parts where there exists much cellular substance, or where pressure is inadmissible. A powder consisting of three parts of cinchona^ and one part myrrh, was very generally and in- deed very usefully employed by the older surgeons? 208 PHARMACOPOEIA for correcting an unhealthy discharge from a large open surface; for giving tone and action to indolent or ill conditioned sores; and not unfrequently, for taking off any hsemorrhagic tendency, whether in old or recent ulcers or wounds, arising from atony or debility.—It has likewise an excellent effect in removing the unpleasant odour so frequently con- nected with such a state of parts. PULVIS RHABARBARI. POWDER OF RHUBARB. The powder of rhubarb has been much recom- mended by Mr. Holme, and others, as an external application to ulcers of a spongy nature; more par- ticularly if attended with an exuberancy of granula- tions, or when bearing a glassy aspect: the effect is that of a mild tonic astringent. We believe, however, that the nitric acid or the argenti nitras, are in gene- ral preferable and more effectual; especially if pres- sure, as recommended by the practice of Mr. Bayn- ton, be had recourse to, which of itself will often answer every intention. PULVIS RHABARBARI COMPOSITUS. COMPOUND POWDER OF RHUBARB. R. Rhabarbari pulveris Sodae carbonatis singulor. unc. j. Columbae pulveris unc. ij Misce. CHIRURGICA. 209 Take of Powder of rhubarb, Carbonate of soda, of each, unc. j. Pcwder of columba, unc. ij. Mix. This powder is much recommended in scrofulous enlargements of the glands, and in many eruptive complaints of an anomalous character. The dose is from a scruple to a drachm twice in the day, ad- ministered in any convenient liquid: it should be given, however, in such quantity as gently to act upon the bowels, and the practice should be follow- ed up for some weeks. PULVIS RHABARBARI CUM HYDRARGYRI SUBMURIATE. POWDER OF RHUBARB WITH SUBMURIATE OF MERCURY. R. Pulveris rhabarbari unc. j. Hydrargyri submuriatis Zingiberis radicis pulveris sing, drach. ij. Misce. Take of Powder of rhubarb, unc. j. Submuriate of mercury, Powder of ginger, of each, drach. ij. Mix. The dose from twelve to fifteen or twenty grains, administered as a brisk purge. In some cases jalap may be advantageously sub- stituted for the rhubarb. S 2. 210 PHARMACOPOEIA PULVIS RHABARBARI CUM JALAPA. POWDER OF RHUBARB WITH JALAP. R. Rhabarbari pulveris drach. vj. Jalapae pulveris unc. ss. Zingiberis pulveris drach. iss. Misce. Take of Powder of rhubarb, drach. vj. Powder of jalap, unc. ss. Powiler of ginger, drach. iss. This is in general a mild and effectual purgative. The dose is from fifteen grains to half-a drachm or a drachm, as occasion may point out. PULVIS SABIISLE COMPOSITUS. COMPOUND POWDER OF SAVIN. R Foliorum sabinae pulveris unc. ij. Acetatis cupri Hydrargyri nitrico-oxydi singulor. unc. ss. Take of Leaves of savin, powdered, unc. ij. Acetate of copper, Nitric oxyd of mercury, of each, unc. ss The nitric-oxyd of mercury and verdigris being reduced to fine powder, add the savin, and let the whole be well mixed. This powder has been greatly celebrated for de- stroying venereal warts: they will however frequently require extirpation with the scissars, after which this powder sprinkled on them, will very generally pre- vent their return. CHIRURGICA. 211 PULVIS SOD^ SULPHATIS COMPOSITUS. COMPOUND POWDER OF SULPHATE OF SODA. R. Sodz sulphatis unc. j. Potassae nitratis drach. ij. Misce. Take oT Sulphate of soda, unc. j. Nitrate of potass, drach. ij. Mix. The above quantity being pulverised and well Aixed, may be divided into nine powders, of which one may be exhibited three or four times a day in common gruel, barley water, or linseed infusion; some prefer as a vehicle for administering this pow- der, a solution of gum acacise. Notwithstanding we have no specific remedy for the cure of gonorrhoea, yet the nitre and soda in the above proportions, and given in such quantity as to determine to the kid- aies rather than the bowels, appear to produce more relief by lessening the irritability of the urethra, and diminishing the stimulating properties of the urine, than most other remedies: indeed I have often seen gonorrhoeas which had continued for a length of time, giving great distress and uneasiness to the pa- tient, completely cured by the above means in a few days. 212 PHARMACOPOEIA PULVIS UVM URSI COMPOSITUS. COMPOUND POWDER OF UVA URSI. R. Pulveris uvx ursi unc. j. Sodae carbonatis unc. ss. Misce. Take of Uva ursi, powdered, unc. j. Carbonate of soda, unc. ss. Mix. The dose is from fifteen grains to a drachm, twice or three times in the day. It is greatly recom- mended in nephritic and other affections of the bladder. TEREBINTHINJE OLEUM. OIL OF TURPENTINE. The oil of turpentine is a strong stimulant. It is sometimes used as a styptic to stop bleeding, particu- larly where the hsemorrhagy proceeds from an atonic state of the vessels: as from loose spongy granula- tions, from varicose veins, or cancerous sores. Within these late years, it has obtained great celebrity, as one of the most effectual remedies in the cure of burns and scalds. TINCTURA BENZOINI COMPOSITA. (L.) COMPOUND TINCTURE OF GUM BENJAMIN. R. Benzoini unc. iij. Styracis balsami colati unc. ij. Balsami tolutani unc. j. Aloes spicsttae extracti unc. ss. Spiritus rectificati O. ij. CHIRURGICA 213 Take of Benzoin, unc. iij. Balsam of storax, unc. ij. Balsam of Tolu, unc. j. Extract of aloes, unc. ss. Rectified spirit of wine, O. ij. Macerate for fourteen days, and strain. This tincture was held in high repute as an inter- nal remedy, with some of our former surgeons; being considered an excellent vulnerary and corrector of acrimony, both in internal and external wounds and bruises. This practice, however, has fallen to the ground, with the ideas that gave rise to it; and the tincture of Benjamin is now only employed as an external cover- ing to superficial cuts, or slight lacerated wounds, at least by surgeons. TINCTURA ClNCHONiE. (£.) TINCTURE OF CINCHONA. R. Cinchonae lanc'tfoliae corticis contriti, unc. vij. Spiritus tenuioris O. ij. Take of Cinchona bark, powdered, unc. vij. Weak spirit of wine, O. ij. Macerate for fourteen days, and strain. The college have here considerably increased the quantity of the cinchona bark to the proportion of spirit. It is, however, only to be considered as an auxiliary to the bark in substance. The dose is from a drachm to half an ounce. 2U PHARMACOPOEIA TINCTURA FERRI AMMONIATI. (L.) AMMONIACAL TINCTURE OF IRON. R. Ferri ammoniati unc. iv. Spiritus tenuioris O.j. Macera et cola. Take of Ammoniated iron, unc. iv. Weak spirit of wine, O. ij. Macerate and strain. This preparation, as Dr. Duncan observes, is merely a solution of the ammoniated iron in proof spirit. I have often seen this tincture administered in strumous and rickety affections with much bene- fit to the patient, more particularly to children. The usual dose to an adult, is from ten drops to the quan- tity of a drachm, to be taken in warm water twice or three times in the day. Probably the best rule of regulating the exhibition of this remedy, like all others which are apt to nau- seate or disorder the stomach, is to begin with small doses, and gradually to increase the dose as far as is admissible without exciting much inconvenience to the patient. The late Mr. Justamond very strenuously advo- cated the use of the ammoniacal iron in scirrhus and cancer, and in most other glandular affections, administering it to an extent scarcely credible with those who have not gone far out of the usual rou- tine of exhibiting several of the metallic preparations, CHIRURGICA. 215 or with such as feel alarmed at deviating from the practice of giving minute and divided doses of any active remedy. Mr. Justamond, however, much as he excelled in the treatment of such disorders, ap- pears to have gone too far into the praise of this preparation; especially when he gave it in confirmed scirrhus or open cancer, under an impression that he was in possession of a remedy somewhat deserv- ing the appellation of a specific against these most formidable of all human ills in the shape of disease. So far as I have had an opportunity of witnessing the influence which this, or any other metallic or vegetable preparation possesses over true scirrhus or cancer, at least in a curative -point of view, I am sorry to observe, that I believe no benefit whatever is, or ever will be, obtained from medicine inter- nally exhibited: that is, benefit effectual and perma- nent. Such is the opinion of some of our first surgeons and physiologists, which I fear will be more strength- ened in proportion as the nature and constitution of the parts so diseased are examined into by minute dissection, after extirpation or removal from the sound parts. If we are to consider scirrhus as a dis- ease of disorganized structure, often beginning in a part over which the living principle has compara- tively little influence, unconnected with any specific poison in the habit acting on this particular part, and against which the animal solid is incapable of defending itself, either in preventing a further in- 216 PHARMACOPOEIA crease, or in throwing off the disease through the means of any remedy; which scirrhus, without re- moval, will soon run into an open sore, generating a discharge in some instances as dangerous as the poison of the rattle-snake, which, after destroying the diseased parts, goes on to act vvith equal vio- lence on the adjoining substance, or into which state the adjoining substance immediately falls, whether it be gland, cellular substance, muscle, blood-ves- sel, or nerve; it would seem inconsistent with the laws of pathology and therapeutics, that any inter- nal remedy should be capable of acting upon such a disease: for no medicine can produce resolution in an enlarged disorganized substance, but through the medium of the absorbents, and here is a complaint in which not only the functions of the absorbents are obliterated, but the vessels themselves entirely diseased, and in such a state as not to be influenced by any power which the system can exercise over them. How far the disposition to the complaint may be put a stop to before it has produced an alteration in the functions incompatible with restoration, is what we have seldom the means of judging of; for the dis- ease is not often discovered till this opportunity is gone by. How far a recurrence is to be prevented, after the diseased part has been removed bv the surgeon, is at the present d:y a matter of speculative hypothesis, and mere opinion, and must for ever CHIRURGICA. 217 remain so, till pathology has discovered to us the true nature of the malady, or at least so far illustrated its character that we are no longer in doubt as to its constitution and cause. In glandular enlargements, however, whether re- sulting from mere debility or depending upon some strumous affection; whether as a consequence of previous inflammation or originating out of slow and gradual obstruction; the ammoniacal iron, and several of the other preparations of iron, acting as remedies which quicken the circulation, and impart a degree of tone to the living fibre, will not unfre- quently be found highly beneficial, often p. oducing a complete resolution of the enlargement. We see the same results daily from the judicious exhibition of mercury in such complaints; sometimes by giving the alkalies; often by cinchona; by a change of air and diet; or in short by whatever accelerates the circulation and imparts strength to the constitution. True scirrhus may, sometimes, be kept under by a vigorous adoption of such suitable means as have been recommended and proved by men of the first eminence. Cancer may be meliorated by proper ex- ternal dressings, and by mild and easy applications. The constitution may, for a longer or shorter time, be assisted and supported, so as to bear up, in a degree, against the encroachments of the one, or the destructive ravages of the other; but I believe the only probable relief for an advancing scirrhus ie 218 PHARMACOPOEIA the knife; and the best possible treatment for a cancer, after it has got to that state as to forbid removal, is to endeavour to give the patient as much ease and support as may be, by a proper and discretional use of those remedies, both external and internal, which are found most to relieve and assuage bodily pain, and to quiet mental suffering.* TINCTURA FERRI MURIATIS. (/,.) MURIATED TINCTURE OF IRON. R. Ferri carbonatis O. ss. Acidi muriatici O.j. Spiritus rectificati O. iij. Take of Carbonate of iron, O. ss. Muriatic, acid, O. j. Rectified spirit, O. iij. Pour the muriatic acid upon the carbonate of iron in a glass vessel, and allow the mixture to stand * "Benign Scirrhus," (says the scientific Pearson, in his Principles of Surgery, a book which I hope every surgeon in the kingdom is in possession of,) "is to be preserved from as- suming a malignant form by, 1st, low and vegetable diet-" 2dly, By saline purgatives, at due intervals—3dly, By the appli- cation of leeches, under proper regulations—4thly, By avoiding all violent emotions of the mind—5thly, by supporting, or de- fending the part from injury and irritation, by means properly adapted to the situation of the disease—6thly, By solutions of lead, combined with alcohol, which have been found bene- ficial in alleviating pain. But we would protest against the man, who by trusting to, or trifling with any remedies, in an external scinhus, where all appearances favour the expectation of per- manent advantage from the removal of it, makes his patient lose an opportunity thr.t can never be recalled." CHIRURGICA. 219 three or four days, occasionally agitating the liquor with a wooden spatula; after which it must be care- fully poured off from the faeces, and the spirit added. As an external application the muriated tincture of iron is a very strong styptic, possessing both sti- mulating and escharotic properties in a powerful de- gree. Applied to the extremities of bleeding vessels both in cancerous sores and loose spongy fungi and excrescences, it will often succeed in stopping the hse- morrhagy. I have seen it of use in removing some of those marks upon the skin, denominated Navi: also in destroying the roots of such excrescences as frequently proceed from the gums and alveolar pro- cesses, the greater part of their substance having been first removed by ligature. As an internal remedy, in a surgical point of view, the tinctura ferri muriatis has obtained great cele- brity with some, for the removal of spasmodic stricture in the urethra, and for relieving retention of urine from the same cause. We believe Mr. Cline was the first who employed it with this inten- tion, giving ten drops in a glass of warm water every ten minutes, till a resolution of the spasm took place* It certainly may, occasionally, be found a very powerful antispasmodic, by the influence which it exercises over the stomach; and more particularly, perhaps, in affections of the urinary organs. Might it not be found serviceable in some cases of gravel and stone, when the concretion has been 220 PHARMACOPOEIA found to consist principally of phosphate of lime, as is not unfrequently the case? The usual dose to an adult is from fifteen to forty drops in a glass of warm water, twice or oftener in the day. TINCTURA GUAIACI AMMONIATI. (L.) AMMONIATED TINCTURE OF GUAIACUM. R. Guaiaci gummi-resinae contritae unc. iv. Spiritus ammoniae aromatici O. iss. Take of Gum guaiacum, bruised, unc. iv. Aromatic spirit of ammonia, O. iss. Macerate for fourteen days and strain. The guaiacum tincture is a heating stimulating medicine. It is often serviceable in the cure of old indolent ulcers, where the habit requires energy and vigour. The dose is from a drachm to half an ounce, in warm water, gruel, or barley water, twice a day, or oftener. TINCTURA LYTT.fi. (L.) TINCTURE OF LYTTA. R. Lyttarum contusarum drach. iij. Spiritus tenuioris O. ij. Take of Blistering.fly, powdered, drach. iij. Weak spirits, O. ij. Macerate for fourteen days, and strain. CHIRURGICA. 221 The tincture of the blistering-fly possesses all the irritating and medicinal properties of the insect, and as such is not unfrequently made use of in conjunction with other stimulants of a milder cha- racter, as a rubefacient and stimulant. It is likewise conjoined with unguents, for the purpose of keeping up a discharge from a part already abraded. As an internal remedy, great caution is requisite in the exhibition of it. It has been found, however, to carry off the remains of a gleet both safely and effectually, after other remedies had proved ineffec- tual; as likewise to cure fluor albus, and to put a stop to increased discharge from the vagina. It has been given with effect in diabetes; also in partial and general paralytic debility. See Vol. I. of the Edinburgh Medical Journal. The usual dose is from ten to thirty drops, twice or three times a day, in any convenient vehicle; but it has latterly been given in much greater quantity. TINCTURA MYRRH.fi. (L) TINCTURE OF MYRRH R. Myrrh* contusxunc. iij. Spiritus rectificati unc. xxij, Aqu* distillatae O. iss. Tak« of Myrrh, powdered, unc. iij.. Rectified spirits, xxij. Distilled water, O. iss. Macerate for fourteen days, and strain.. T 2 232 PHARMACOPOEIA The tincture of myrrh is a heating stimulant. It is often found a very useful application to sordid ulcers, and to caries of the bones, either alone or diluted with water: used with any of the calcareous tooth-powders, by dropping a few drops upon the tooth brush, it is thought by some of our best dentists to preserve the teeth, by giving tone and firmness to the gums. TINCTURA OPII. (L.) TINCTURE OF OPIUM. R. Opii duri contriti unc. iiss. Spiritus'tenuioris O. ij. Take of Hard opium, ground, unc. iiss. Weak spirits, O. ij. Macerate for fourteen days, and strain. The strength of this solution is here reduced to a less degree of certainty by using the unpurified opium. The dose is from fifteen to fifty drops, as often as occasion may require. See the article opium. A vinous solution of opium has been much re- commended in some chronic and strumous ophthal- mias: one or two drops to be instilled into each in- flamed eye. UNGUENTUM ANTIMONII TARTARIZATI. OINTMENT OF TARTARIZED ANTIMONY. R. Antimonii tartarizati drach. iss. Cerati cetacei unc.j. Misce. CHIRURGICA. 223 Take of Tartrite of antimony, drach. iss. Spermaceti ointment, unc. j Mix. This ointment is much celebrated for the relief of deep-seated chronic pains and inflammations in the neighbourhood of the joints. Its operation after a time is very peculiar, producing small distinct pus- tular inflammations, which soon terminate in ma- turation. After the full effect of the ointment has been produced, a common bread and milk poultice should be applied, and as soon as the parts are heal- ed the ointment should again be had recourse to. It is often necessary to continue this alternate plan for a very long period, but it is generally with a happy result. UNGUENTUM ARSENICI. OINTMENT OF ARSENIC. R. Oxydi arsenici pulveris drach. j. Adipis suill* Cerati cetacei singulor. drach. vj. Take of Oxyd of arsenic, powdered, drach. j. Hogs lard, Spermaceti ointment, of each, drach. vj. Melt the hog's lard and cerate of spermaceti over a slow fire; after which pour the melted fluid upon the oxyd of arsenic in a glass mortar, and tritu- rate till the whole is intimately united. This is a powerful stimulant and corrosive. It is sometimes used to destroy the surface of cancerous 22* PHARMACOPOEIA sores, or that species of ulcer denominated Lupus. I have known it applied to an incipient chancre with good effect; it requires, however, great caution when used. UNGUENTUM fiRUGINIS. OINTMENT OF VERDIGRIS. R. JE.uginis prxparatx pulveris Hydrargyri submuriatis singulor. drach. j. Cerati resin* unc. j. Terebinthin* Venetse unc.ss. Take of Verdigris, powdered, Submuriate of mercury, of each, drach. j Cerate of resin, unc.j. Venice turpentine, unc. ss. Melt the cerate of resin, and add the turpentine; after which stir in the verdigris and calomel in a state of previous commixture and levigation. This ointment is recommended to general notice as a cure for the tetter or ring worm, which latterly has shown itself in several families and schools, both in the metropolis and in different parts of the coun- try. It is said to have been imported into this island from the East Indies. Its seat is the hairy scalp, and the objects of its attack are children from in- fancy to the age of puberty. It would seem, from the opportunity afforded me of judging, to present itself under several forms; but whether arising out of some difference of its CHIRURGICA. 225 infectious principle, or from constitutional pecu- liarity to be variously affected, I cannot determine. These different species appear remediable by means more or less mild and disagreeable: the aggravated kind of tetter, however, has hitherto resisted, under my care, all attempts at cure, except when treated with Unguentum iEruginis, which I have not yet seen fail. Jn one species of the complaint, the first sign which presents itself is a discoloration of the hair; it loses its brightness, assumes a dingy yel- lowish hue, and falls off. The scalp soon becomes rough and puffy, and somewhat elevated, with desquamation of the cuticle. This species, beginning first at a point, spreads rapidly, takes on a circular form, and leaves an unhealthy bald blotch. In ano- ther species, the tetter creeps along the scalp in irregular lines, destroying the hair in its progress. In some cases the hair appears to fall off without any affection of the scalp; but upon examination it will be found much whiter than natural, with a de- gree of transparent glossiness. To these several forms I have generally seen one or other of the following formulae succeed: the Lotio Potasase Sulphureti, the Lotio Ficis, the Lotio Sulphuris, the Lotio Hydrargyri Oxymuriatis. Under all cir- cumstances the head should be kept quite close -shaved; and the application which may be employed should be used night and morning. In some in- stances a solution of lunar caustic has cured the 226 PHARMACOPOEIA disease very readily, used in the proportion of a drachm to an ounce of water. After the letter has been covered a few times with the solution, at in- tervals of one or two days, and the eschars separated, the scalp beneath will, if a cure be effected, appear sound and healthy: indeed it would almost seem desirable to the species of ringworm above described, to make use of the caustic wash as a preliminary means. The aggravated kind of tetter is very dif- ferent from any of the preceding: very difficult of cure, and most distressing to the patient. Even with the use of the Unguentum iEruginis, the greatest possible care and attention are requisite; and that for a continuance with some patients almost impos- sible to be complied with. If, however, the remedy prove certain in its effects, neither the length of time necessary to complete a cure, nor the unplea- santness of it, can be thought any consideration; especially if placed in comparison with so loathsome a disease. In the greater number of cases where the oint- ment has been tried (and in all it has succeeded,) the disease had previously advanced to a formidable state. I have, however, had opportunities of observ- ing this kind of tetter from its first commencement. A small speck of crustaceous matter is observed adhering to some part of the scalp, generally, I think, on that part which covers the occipital bone. In this crustaceous coat, which appears to form an CHIRURGICA. 227 eschar in the scalp, one or more hairs are enveloped, which are so closely united to it as to appear almost inseparable. Indeed there can be no doubt but that the matter is secreted by the hair or hairs so en- circled; for, if eradicated, they will be found in a state of disease^-their base being thickened, semi- transparent, and connected with a small globular speck of black shining matter, which in some cases appears adhering by a peduncle, and in others en- circled as it were, in part, by the extremity of the hair. If this coating of crustaceous matter be re- moved with the point of a probe, and the diseased hairs eradicated, the tetter, too frequently, soon re- appears; and that occasionally with more virulence. Removing the incrusted matter, and completely ■ destroying the abraded surface of the scalp, whether with a solution of nitrate of silver, or by any other escharotic, has hitherto disappointed my expecta- tions of permanent relief. In conducting the cure of this species of tetter by the preceding preparation of verdigris, it is necessary that the scalp be kept close shaved, and that the head be washed clean every night with warm soap and water, and after- wards with bran and water, and then rubbed per- fectly dry. The ointment may be applied either on lint, thinly spread, or it may be rubbed on with the finger: an oil-skin cap should likewise be worn during the whole time the ointment is used. It is further necessary to observe, that the use of 22S PHARMACOPOEIA this ointment in some cases is apt to fret and irritate the skin: often producing an erysipelatous affection, and exciting small pustular eruptions: should this circumstance occur it will be proper to discontinue the preparation, and to make use of some slight as- tringent wash, once or twice in the day, v ith a little mild ointment at bedtime: very frcqucr'lv these latter means having carried off the ti iipehis and eruption, the original complaint will be found to have been cured. UNGUENTUM CER.E. WAX OINTMENT. R. Cer* flavae unc. vj. Olei olivae O. j. Take of Yellow wax, unc. vj. Olive oil, O. j. Mf.lt over a slow fire, and agitate briskly till cold. This is a mild unctuous covering. UNGUENTUM CONII. OINTMENT OF HEMLOCK. R. Conii f'oliorum contusorum lib. j. Adipis praeparat* lib. iss. Take of Bruised leaves of hemlock, lib. j. Lard, lib. iss. Melt the hog's lard over a slow fire and throw in the bruised hemlock; after which boil gradually CHIRURGICA. 229 till the leaves become friable, when the melted fluid must be strained and expressed. This ointment is often found an excellent covering for irritable, scro- phulous, and painful sores. It may be found a useful auxiliary to the internal use of hemlock, in that species of ulcer which attacks the toes and fingers at their line of junction with the foot and hand; likewise in spreading irritable sores of whatever character. UNGUENTUM ELEMI COMPOSITUM. (L.) COMPOUND OINTMENT OF GUM ELEMI. R. Elemi lib. j. Terebinthins vulgaris unc. x. Sevi pr*parati lib. ij. Olei oliv* unc. ij. Take of Gum elemi, lib. j. Common turpentine, unc. x. Mutton suet, prepared, lib. ij. Olive oil, unc. ij. Melt the elemi and mutton suet over a gentle fire; after which stir in the turpentine and oil, and strain through linen. This is a stimulating digestive ointment. It may be usefully employed for promoting a discharge from issues and setons. U 230 PHARMACOPOEIA UNGUENTUM GALLjE COMPOSITUM. COMPOUND OINTMENT OF GALLS. R. Gallarum pulveris drach. ij. Opii purificati duri pulveris drach. j. Liquoris plumbi acetatis drach. ij. Adipis pr*parat_...] Hard pitch, Yellow wax, Yellow resin, of each, unc. ix. Olive oil, lib. j. Liqjjift together over a gentle fire, and strain through linen. This ointment is a powerful digestive and strong stimulant. UNGUENTUM PICIS LIQUIDS. (/-.) OINTMENT OF TAR. R. Picis liquidae Sevi praeparati singulor. lib. j. Take of Liquid pitch, Mutton suet, of each, lib. j. Melt together and strain through linen. This ointment has been much extolled for re- moving tettery eruptions, and for curing some 238 PHARMACOPOEIA species of breakings out of the hairy scalp greatly resembling tinea. Both the above ointments, as likewise the cerate of yellow rosin, have been much used and recom- mended as good digestives—-the practice, however, of employing these forms of ointment is now nearly exploded. UNGUENTUM PLUMBI ACETATIS COM- POSITUM. COMPOUND OINTMENT OF ACETATE OF LEAD. R. Unguenti cerae unc. j. Hydrargyri nitrico oxydi drach. j. Liquoris plumbi acetatis drach. j. Extracti opii mollis drach. ij. Take of ' Wax ointment, unc. j. Nitric oxyd of mercury, drach. j. Liquor cf acetate of lead, d:\ich.j. Soft extract of opium, drach. ij. Triturate the soft extract of opium with the nitric oxyd of mercury and liquor of acetate of lead; after which mix in the ointm^ut of wax, and let the whole be well blended together. This is an admira- ble form of ointment for cleaning some kinds of sloughing ulcers and ch.mcres. I have seen chancres h- .ij under its use which had resisted all other ap- plications. CHIRURGICA. 239 UNGUENTUM RESINjE FLAVJE CUM OLEO TEREBINTHIN.E. OINTMENT OF YELLOW RESIN WITH OIL OF TURPENTINE. This ointment, or rather epithem, is made by blending as much oil of turpentine, by trituration, with the cerate of resin as it will take up. On the authority of Mr. Kentish, the oil of tur- pentine, which is a very strong stimulant, has of late been very ingeniously and very strenuously re- commended to general notice, for its specific in- fluence in the relief and cure of burns and scalds. The intention is that of keeping up, in a minor degree, the stimulating influence of caloric; so as to enable the vessels of the inflamed surface to get rid of their contents,by a recovery of their former tone and power, without falling into that atonic state of inflammation, which is generally followed by the death and destruction of their substance, in conse- quence of the powerful effects of the exciting cause being too rapidly withdrawn. This theory is ex- tremely ingenious, but savours strongly of the Brunonian principles. 1 he rapid evaporation of the oil suddenly con- vevi. - off a considerable portion of the accumulated quan ity of heat evolved by the injury, and which in itself becomes an exciting cause of inflammation, 240 PHARMACOPOEIA may perhaps, be considered one, if not the principal means of effecting the benefit accruing from its use. Perhaps the whole of its action is explicable upon this principle of evaporation, and upon the stimulus which, at the same time, it imparts:—removing by the one effect, inflammation and heat, and by the other, giving power to the vessels; thus establishing, as it were, the relative bearing between action and power. Mr. Kentish, in his treatment of burns and scalds, directs the oil of turpentine to be previously made warm; and afterwards cloths to be dipped into it, with which the injured parts are to be entirely covered, and the oil is to be renewed as often as the cloths become dry, till the pain has abated, and the inflammation is relieved; after which, if there be any suppuration, the parts are to be dressed with the above ointment. I am not, by my own experience, enabled to speak as to the decided superiority of the above practice; neither have I the wish to depreciate its merits, or dissuade its adoption—by some of my friends I have heard it very warmly recommended; but, in the trials made with it in one of our large public hospitals, wherein Mr. Kentish's rules were strictly followed, and which I had an opportunity of closely observing, it was very unsuccessful. In one instance, the hands, arms, and face being much burnt by an explosion from gunpowder, the CHIRURGICA. 241 liquor plumbi acetatis compositus and the oleum terebinthinae were conjointly made use of to dif- ferent parts, in which there did not exist any perceptible difference, in the extent of the injury, either by the feelings of the patient, or to the eye of a by-stander. In the parts to which the liquor was applied, the inflammation subsided much sooner; and the suppurative process which took place after- wards was much milder and more healthy under the unguentum plumbi acetatis and unguentum zinci, than was that treated with the oleum terebin- thinae. Five other cases were all unfavourable under Mr. Kentish's plan of cure. UNGUENTUM SABINAE. OINTMENT OF SAVIN. R. Foliorum sabinae recentium, contritorura unc. iv. Cerae flavae unc. iij. Adipis prxparatae lib. j. Take of Fresh leaves of savin, unc. iv. Yellow wax, unc. iij. Hogs lard, lib- j. In forming this ointment much care and attention are requisite. The hog's-lard being first slowly melted, the savin leaves should be added, when the lard should be heated to the boiling point, in which state it should be kept till the leaves are friable; the wax should then be added in a state of liquefaction, and X 242 PHARMACOPOEIA the ointment should be briskly agitated till it is cold. The savin ointment is intended for keeping up a discharge from a part already vesicated or abraded. UNGUENTUM SAMBUCI. OINTMENT OF ELDER. R. Sambuci florum lib. ij. Adipis prieparatx lib. ij. Take of Elder flowers, lib. ij. Hogs lard, lib. ij. Boil the elder flowers in the lard till they be- come crisp and friable, after which strain through linen. This is a mild unctuous covering. UNGUFNTUM SULPHURIS. (L.) OINTMENT OF SULPHUR. R. Sulphuris sublimati unc. iij. Adipis praeparatae unc. viij. Misce. Take of Sulphur, sublimed, unc. iij. Hogs lard, unc. viij. Mix. This ointment possesses all the specific properties of the sulphur for the cure of psora. It may be ren- dered much more agreeable by the addition of a small quantity of oil of lemon. As a more effectual cure for psora, pruritus, and other mixed cuticular CHIRURGICA. 243 affections bearing the character of one or other of these diseases, the London College have given us the following formula: UNGUENTUM SULPHURIS COMPOSI- TUM. (L.) COMPOUND OINTMENT OF SULPHUR. R. Sulphuric sublimati lib. ss. Verai i i'acii< is contritae unc. ij. Potassae nitratis drach. j. Saponis mollis lib. ss. Adipis praeparatae lib. iss. Take of Sulphur, sublimed, lib. ss. Hellebore root, powdered, unc. ij. Nitrate of potass, drach. j. Soft soap, lib. ss. Hogs lard, lib. iss. Mix. Mix the whole well together. This ointment, however, will be found much too powerful for irritable and delicate people; and espe- cially as an application to children. UNGUENTUM SULPHURICI ACIDI. OINTMENT OF SULPHURIC ACID. R. Adipis praeparatae unc. ij. Acidi sulphurici drach. ij. Misce. Take of Hogs lard, unc. ij. Sulphuric acid, drach. ij. This ointment should be formed in a Wedgewood's mortar. It is said to cure psora. 244 PHARMACOPOEIA. UNGUENTUM VERATRI. (L.) 6INTMENT OF WHITE HELLEBORE. R. Veratri pulveris unc. j. Adipis praeparatae unc. viij. Olei limonis drach. j. Take of Powder of white hellebore, unc. j. Hogs lard, unc. viij. Essential oil of lemons, drach. j. The hog's lard being melted over a slow fire, stir in the hellebore powder and oil of lemon, and briskly agitate the mixture till it is cold. This ointment is much used and recommended for psora and pruritus. It should be used every night. UNGUENTUM ZINCI. (Z.) OINTMENT OF ZINC. R. Zinci oxydi unc. j. Adipis praeparatae unc. vj. Misce. Take of Oxyd of zinc, unc. j. Hogs lard, unc. vj. Mix. This ointment will be found useful in some species ef ophthalmia, smeared upon the tarsi every night at bed-time. It may likewise be applied with advantage to a part nearlv cicatrized over, as a gentle stimulant and astringent. LATIN INDEX. A Page ACIDUM aceticum 1 nitricum 3 sulphuricum 7 JErugo 8 cum hydrar. submuriate 9 Alumen 9 Anthemidis flores 10 Antimonii arsenias 11 murias 11 Argenti nitras 12 B Balsamum Peruv. cum felle 17 Cataplasma acidi acetici aluminis bynes carbonis cerevisiae conii cumini digitalis dauci farinaceum fermenti lini pulveris papaveris albi plumbi acetatis rosae sodx muriatis sinapis Causticum commune cum opio Ceratum calaminae calaminae cum plumbi acetatis hquore 17 18 19 19 20 20 20 22 22 23 24 25 27 27 28 29 30 31 32 33 X Page Ceratuin calaminae cum hy- drar. nitrico-oxydo cetacei cum hydrar. prae cipitato albo conii cretae acetatis comp. hydrargyri submuriatis 37 lyttae 37 mellis 38 mellis cumterebinthina38 plumbi 39 pluinbi compositum 40 resin as saponis sevi compositum Cereolus chirurgorum Cercoli simplices Swediaur Bell catgut metallici caustici Conium Cinchonae cordifoliae cortex 59 Collyrium acidi acetici 62 ammoniae acetatis cam- phoratum ammoniae acetatis cum opio cupri ammoniati hydrargyri muriatis opii liquoris plumbi acetatis 66 plumbi acetatis 67 zinci acetatis 67 zinci sulphatis 67 34 35 35 35 36 246 LATIN INDEX. Page Collyrium zinci sulphatis cumcamphora 68 Confectio cinchonae 69 sennae compositum 70 sinapeos 71 sulphuris 72 terebinthinx 72 D Decoct, anthemidis florum 73 chamaemeli 74 pro fomento 74 dulcamarx 75 guaiaci 76 hordei 77 malvae compositum 78 mezerei 78 quercus corticis 79 sarsaparilla: 79 compositum 80 veratri albi 81 ulmi 81 Bmbrocatio acidi acetici spi- rituosa 82 acidi cum camphora 83 ammoniae 83 acetatis 84 opii composita 85 saponis cum ammonia 86 cum c«mphora 86 Emplastrum ammoniaci 87 ammoniaci cum hydrar. 87 ammoniae muriatis 88 cerae 89 cumini 90 oum opio 91 e\iphorbii 91 galbanii compositum 92 hydrargyri 93 lyttae 94 opii 96 plumbi 97 resin ae 98 Page Emplastrum saponis 99 Enema amyli cum opio 09 cinchonx 100 commune 101 colocynthidis 103 gallx 103 opii 104 ricini olei 105 tabaci 105 terebinthinx 108 Epithema plumbi acetatis 109 terebinthinx cum cam- phora 109 Fomentum chamcemeli 110 digitalis 110 gallx 111 papaveris 111 Gargarisma acidi muriatici 112 xruginis 112 aluminis 113 lini 113 myrrh x 114 potassx nitratis 114 rosx 115 sodx boracis 1L5 H Haustus ammonix acetatis 117 magnesix sulphatis 118 emeticus 119 ricini olei 120 terebinthinx 121 Hirudo 122 Hydrargyria 12S Hydrargyri acetis 129 Hydrargyrus cum creta 129 Hydrargyri nitrico oxyd. 130 oxymurias 130 submurias 132 sub-sulphas 133 sulphureturo 135 LATIN INDEX. 247 Page Infusum armoracix com- positum 134 capsici 134 cinchonx cum calce- 186 lini 136 gentian sc comp. 137 cinchonx 138 sennx cum tamarindis 139 japonicum 139 Injectio copaibx 138 cupri sulphatis 139 hydrargyri 140 submuriatis 140 plumbi carbonatis 141 thex 141 zinci sulphatis 141 Linimentum xruginis ammonix ammon ix cum anti- monii tartarizato ammonix cum oleo terebinthinx bituminis compositum camphorx compositum elemi hydrargyri plumbi acetatis com- positum olei cum calce opii saponis compositum Liquor aluminis comp. arsenicalis hydrargyri oxymuriat. acidi nitrici calcis plumbi acetatis potassx suhcarbonatis Lotio acidi nitrici ammonix acetatis muriatis 145 146 147 147 147 148 149 150 150 152 152 153 153 154 154 155 158 158 171 161 162 164 164 165 Page Lotio ammon. spirituosa 165 calcis 166 hydrar. oxymuriatis 165 flava 167 hydrargyri submuria- tis nigra 167 myrrh x 169 opii 169 picis 170 plumbi acetatis 170 composita 171 potassx sulphureti composita 171 sulphuris 172 zinci acetatis 172 M Mel hydrargyri 173 rosx 174 Mistura copaiba 175 balsami Peruviani 176 cathartica 177 guaiaci 178 moschi 179 Moxa m 180 Mucilago acacix gummi 181 cydonix seminum 181 tragacanthx gum- mi 182 Oleum camphorx lini olivx caryophyllatum succini cum opio Opium P Pilulx aloes cum ferro antimonii cum opio argenti nitratis arsenici colocynth idis composita Pilula colocynthidis cum hydrargyri submuriate 182 183 184 184 185 186 187 188 190 191 192 192 248 LATIN INDEX. Page Pilulx conii composita 192 dulcamarx 193 guaiaci 194 composita 194 hydrar. 195 oxymuriatis 197 submuriatis 199 cum conii ex- tracto 201 sodx cum sapone 201 terebinthinx 202 composita 203 Plumbi super-acetas 203 Potassa fusa 204 Pulvis hydrargyri subsul- phatis compositus 206 ipccacuanhx composi- tus 206 myrrhx 207 rhabarbari 208 compositus 208 cum hydrar. submur. 209 rhabarbari cum jalapa 210 sabina compositus 210 sodx sulphatis compo- situs 211 uvx ursi compositus 212 T Terebinthinx oleum 212 Tincturabenzoinicomp. 212 cinchonx 213 Page Tinctura myrrhx 221 opii 222 ferri ammoniati 214 ferri muriatis 218 guaiaci ammoniati 22f) lyttx 220 U Unguentum antimonii tar- tarizati 222 arsenici 223 xruginis 224 cerae 228 conii 228 elemi compositum 229 gallx compositum 23U hydrargyri fortius 230 nitratis 233 nitrico oxj di 234 oxydi rubri 234 hydrar. submuriatis 236 picis aridx 237 liquidx 237 plumbi acetatis comp. 238 resinx flavx 239 sabinx 241 sumbuci 242 sulphuris 242 acidi 243 compositum 243 veratri 244 zinci 244 ENGLISH INDEX. A Page ACID acetic, or vinega*r 1 nitric 3 sulphuric 7 Alum 9 Antimony, arseniate of 11 muriate of H Balsam of peru with ox's gall 17 Bougies, varieties of 44 to 56 Cataplasm of ale-grounds 20 of alum 18 of bread 23 of carrot 22 of charcoal 19 of cummin 20 of digitalis 22 of hemlock 20 of lead, acetate of 27 of linseed 25 of malt 19 of mustard 30 of roses 28 of salt 29 of vinegar 17 ofyest 24 Caustic with opium 31 Cerate of the blistering fly 37 calamine 32 with lead 33 mercury 34 chalk 36 hemlock 35 honey 38 with turpentine 38 Page Cerate of lead 39 acetate of 40 mercury 3f rosin 41 spermaceti 35 with mercury 35 soap 41 suet 44 Chamomile, the flowers 10 Cinchona 59 Collyrium of ammonia, ace- tate of, with camphor 63 of ammonia, acetate of, with opium 63 ammoniated copper 64 of lead, acetate of 69* mercury 65 opium 66 vinegar 62 zinc 67 sulphate of 67 Confection of cinchonx 69 mustard 71 senna 70 sulphur 72 turpentine 72 D Decoction of barley 77 bitter-sweet 75 chamomile 73,74 elm bark, 81 for fomentations 74 of guaiacum wood 76 hellebore 81 mallows 78 mezereon 78 250 ENGLISH INDEX. Page Decoction of oak bark 79 sarsaparilla 79,80 Draught of ammonia, ace- tate of 117 castor-oil 120 emetic 119 magnesia, sulphate of 118 turpentine 121 Embrocation of ammonia 83 acetate of 84 opium, compound 85 soap, with ammonia 86 with camphor 86 vinegar with camphor 83 spirit- ous 82 Epithem of lead, acetate of 109 turpentine 109 Fomentation of cicuta 110 foxglove 110 gall-nut 111 poppy 111 G Gargle of alum 113 borax 115 linseed 113 magnesia, sul- phate of 112 muriatic acid 112 myrrh 114 nitre 114 roses 115 verdigris 112 Giyster, see injection H Hemlock 57 Honey of mercury 173 roses 174 Page I Infusion of bark with lime 136 capsicum 135 horse -radish 134 linseed 136 gentian comp. 137 cinchona bark 138 senna with ta- marinds 139 japonic 139 Injection of copaiba 138 copper, sulphate of 139 lead, carbonate of 141 zinc, sulphate of 141 merciuy 140 of mercury, sub- mu.iateof 140 tea • 141 or g'.ysters of castoroil 105 cinchona 100 colocynth 103 common 101 of the gall-nut 103 lead acetate of 109 opium 104 starch with opium 99 tobacco 105 turpentine 108 Leech, efficacy of and mode of breeding 122 Liniment of ammonia 146 with tartarized antimony 147 ammonia with turpentine 147 camphor 148 compound 149 elemi 150 lead, acetate of compound 1.V3 ENGLISH INDEX. 251 Page Liniment of mercury 150 oil with lime 152 opium 153 soap, com- pound 153 tar, compound 148 verdigris 145 Liquor of alum, compound 154 arsenical 154 lead, acetate of 184 lime > 158 of mercury, oxymu- riate of 155 nitric acid 158 potash 161 subcarbonate of 162 Lotion of ammonia, acetate of 164 muriate of 165 muriate of, spirituous 165 lead, acetate of 170 comp. 171 lime 166 zinc, acetate of 173 mercury, oxymu- riate of 166 yellow 167 black 167 myrrh nitric acid opium pitch potash, sulphu- ret of, comp. sulphur Page Mercury, submuriate of 132 subsulphate of, yellow 133 sulphuret of, red 133 Mixture, cathartic 177 of copaiba 175 of guaiacum 178 ofm.isk 179 of Peru, balsam 176 Mucilage of acacia 181 linseed 181 tragacanth 182 gum Arabic 181 quince seeds 181 Mugwort 180 Mercury acetite of with chalk nitrie oxyd of oxymuriate of Oil of amber with opium 184 camphorated 182 of Unseed 183 olives, with oil of cloves 184 Ointment of antimony tar- tarized 222 arsenic 223 elder 242 elemi, compound 229 galls, compound 230 hemlock 228 hellebore 244 lead, acetate of, comp. 238 mercury, nitrate of 233 nitric, oxyd of 234 red oxyd of 234 stronger 230 submuriate of 236 pitch 237 savin 241 sulphur 242 acid of 243 compound 243 126 tar 237 129 verdigris 224 129 wax 228 130 zinc 244 130 Opium 185 169 164 169 170 171 172 <252 ENGLISH INDEX. Page P Pills, aloe tic with iron 186 of nitrate of silver 188 antimony with opium 187 arsenic 190 colocynth 191 compound 192 with mercury 192 dulcamara 193 guaiacum 194 compound 194 hemlock comp. 192 mercury 195 oxymuriate of 197 submuriate of 199 with hemlock 201 soda with soap 201 turpentine 202 compound 203 Plaster of ammonia, mu- riate of 88 ammoniacum 87 with mercury 87 the blistering fly 94 cummin 90 with opium 91 euphorbium 91 galbanum 92 lead 97 mercurial 93 opium 96 Page Plaster of reein 98 soap 99 wax 89 Potash—fused 204 Powder of ipecacuan. com- pound 206 mercury, subsulphate of, compound 206 myrrh 207 rhubarb 208 compound 208 with jalap 210 with mercury 209 savin, compound 210 soda, sulphate of, com- pound 211 uva ursi, or bear berry 212 Silver, nitrate of 12 Tincture of Benjamin, the gum 212 cinchona 213 guaiacum, ammoniated 220 iron, ammoniacal 214 muriate of 218 of the blistering fly 220 myrrh 221 opium 223 « M#, >¥• ■ v«Jc" # Mei/- Hist, W7fiP •^rfv A r&C. 1 "TV- ' :"^*