Gen. Leonard Wood's Notebook of Harvard Medical School. Dec. 1881-June 1882. Leonard Wood Harvard Medical School 13 Allen St Oct 1887  Materia Med, Dec 15, 1881 Rec. In [cross out] Phospharated oils the oil is heated to remove any air or water which may be in the oil. [cross out] Sulphur and sulphuroric acid may be used for parecticul troubles itch and ring worm. Sulphur may be given bulk a dose from a teaspoonfull to a table spoonfull Sulfuric acid dilute may be given in doses from 10 to 30 drops in a tumbler of water. Strong 1-3 drops to the same amt of H2O For painting the tincture in better than the compound tinc The latter is better than the pure tinc for atemization The tinc is visil in water The compound tinc in vol or water since the iodine in vol in a solution of pottassic hydrate Iodine is given internaly in the form of a tincture very dilute but even then it is very irritating and is given in does of 2C gm It is also given mixed with starch which makes it much less irritating and may be given in larger doses 4-6 C gm Iodide of potass may be administered in sal in which it keeps very well It is given with compound syrup of sasaphrilla which hides its taste completly Potassic hydrate. It is a caustic and acts in a soap, and is given internaly as an anti acid 1 Substances to read up Dec 13 81 Aqua carni 214. 4.gm Spiritus aromaticus amoniae 13.42. 2-4 3 Glycerites of Co3. tannin. gallic acid 605. Oleate of Hg 973 Troches 1474 Confections 450 Extracts 565 Porvelus 1181 Pills 1888 Emplastium 524 Suppositores 1380 Tinctures 1430 Unguenta 1482 Limimentum 825 Cerata 377 Lotions 878 Syrupus 1389 Spiritus 1337 Vina 1521 Oleum phosphatum 1008 .3 (.4) Palula phosphori 1100 .2-.4 (3) Syrupus ferri phosphatis 1393 4. (4.) [illegible] dilutium phosphoricums 69 -1-4 (2.) [illegible] 214 .3-.5 (.4) Page dose Liquor sodii 866 .6-4. gm (2) Unguentum sulphatis (178-278) 1496 H2So4 80 (.6) Tincturum iodidi 1448 " Comparndium 1449 .6-2. (1) Bromidum potassii 1137. .2-2. (1) Iodidum " 1156 .2-2. (1) " Sodic 1321 .1-2. (1) [illegible] 1310 .1-2. (1) [illegible] 1264 [illegible] calci 317 .1-2. (1) Iodidum 324 .86-.2 (.1) [illegible] cylate of sodium 74 Liquor Pottassii 863 .6-6 (2) Pulveres effervesentes aperientes 1184 Linamentum saphonis 830 Liquor calcio 842 32-192 (.75) " Mg citratis 856 128-192 150) Liquor ferri sulphatis 850 .3-1 (.5) Syrupus iodidi ferri 1391 .6-2.6 (1) Pilluae iodidi ferri 1098 .2-.5 Tincture ferri chloridi 1444 .6- Ferrum reductum 65 .06- Tincture ferri chloria 1444 .6-2 Ferrum reductum 637 .06- Pilluae ferri carbonate 1096 .05- Ferri et potassii tartras H2O 627 Ferri citias H20 624 3-1.3 Terum dialystum 649 .3-2. Ferri et quinae citron H20 628 .3 Materia Medica Dec 22 1881 Antimony. a metal allied to Bi prep from the sulphide it is very likely to be mixed with Ag or Ni or even Ar Sulphurate of Antimony this of the U.S. found in all parts of the world. seperated from its infus by fusion.- Sulphurated antimony this is a mix of several varieties of Antimony Sometimes called the golden sulphur of antimony Dose 3 dec grm. Plummer pill these are made of Sulphuretted antimony and Calomel molasses and [cross out]. Oxy sulphurette of antimony. Oxide of Antimony official insol in H2O Jame's powder. dose-1 grm Tarter emetic this is a whitish powder sal- water [cross out] sal about 1-10 This may be given as [cross out] a [cross out] tea to & reduce the hearts action and the bodily temperature As one emetic dose 1/2-1 die grm Antimony plaster 1 part of tarter emetic. 4 parts of burgundy pitch almost absolet at present This usual produce pustules. Wine of Amt. Tarter emetic Sherry wine and distilled water has no taste except the taste of the wine This is often used in cough mixtures. Compound mix of licorice this contains liccorice antimoni sweet spirit of [cross out] water, antimny Syrup of squills antimny in the form of tarter emetic and various other drugs- Bi: found in Texas Saxony. distribed as a sulphide or oxide or in combination with other metals Has to be purified on it in often to contain Ac or Lb 4 Officinal prep- [cross out] Sub carbonate B in NH3HO and NiCO3 + H2O. A creamy white tastless and odourless invol- H2O. 5-3 grm Sub Nitrate. made like the carbonate and then dissolved in nitric acid, Earthy taste insol in H2O, and the gastric and intestinal juice. given in ulceration of the stomach intestine and in digestive troubles-it prob acts as a moderate astringent and by its mechanical presence. Tannate of Bi. This is used in many enemata in powders. Usefull in decanter Hg made usual from the seprerate metal. Mettalic this is so used in the fluids of the body and may be given in large doses on an active cathartic Not to be given in this way Hg concreurm 5 parts of Ag + 3 parts of chalk This is given where the continuous effect of mettalic Hg is wanted, dose 2-5 gms Mercurial plaster Hg + oilve oil + resin. [cross out] Mercurial oint 24 parts & 2 (of suitg cord). This in a resonably active way of giving Hg. Mercurial pill Hg 3 part & confec of dose 5 or 6 parts & a certain amt of Acorice Given for contained uses where a systemic effect is desired. 2 dse grm. And in every dose where a cathartic Plaster of amoniac amtt g Yellow sulphate of Hg dose 2-3d grm Vermillion Oxide of Nitrate of Hg-sometime called citrate ctim ointment Beniodide & [cross out] sulphide, White ppt all varieties of Hg. Silver. is used almost entirely in the form of nitrate, occur- large plater. kept in the form of sticks or plates used mixed with Ag Cl. making luna Caustic white solid must be kept from the light. It destroy the skin superficial if coagulates the products of its decomposition. When it was more used than at present it was apt to stain the tissue or the conjuncture in conjunctivitis Zn, given as an emetic as the Sulphide is in daily use Oxide used on an [illegible] dressing for ulcers- Or given as arscenic acid Can in the form of the Sulphate or an emetic Q Antimony 190 Sulphurete of antimony " Sulphuretted 191 Plummer pill 109 4 [cross out] Oxide of antimony 186 James powders 1186 Tarter Emetic 183 Emplastium antimonic 528 Vinum antimonic 1522 Misture Compemda licoricae 925 Syrop of squill 1901 Bi Sub carbonate of Bi 288 " Nitrate " 292 Tannate of Bi 293 Hg 735 Concretum Hg 742 Mercurial pill Plaster of antimony and Hg Yellow sulphate of Hg 733 Vermillim 734 Oint of nitrate of Hg Benzodide and Br sulphide of Hg Ag Nitrate Z- Z- sulphate Cu Cu S4 Materia Med Jan 5 1882 Prescrip are usualy written in Latin In using the Metric system the Roman or Arabic numerals are used Prescrip consists of two independent sentences. let that of which Recipe in the predecent drugs to be taken in the pred 2 that of which Sugar is the predicate Acrid all aberrations Cleanse of construction Every drug should have a line and no more It is a good idea to give the name of the patient It should sometime be written under the 2 gnd. especx when two or more Prescrip are going to the same house Age of the patients partic when children should be set down Name of the prescutor should be put in the [cross out] presciption Then the dose is of great size something should be used to indicate that it is not a mistake and that has attracted the attention of the [cross out] doctor In Germany the ! is used here the word are used but it is best & write out the direction in full Materia Medica, Jan 16, 1882. [illustration] Rules for doses. They should be proportioned to the wt of the patient This is Clarks way. Another way is to divide the age of the patient by 12 plus the age of the patient (age/age + 12) In very old persons so know to diminished. Amt of the prescription so should bear in mind the amt of the ant in proportin to its dose and the length of time it is to be taken Water Alcohol. fixed its glyc syrup. These are the best & excipient All of the decoc and infusion will spoil in a warm room & in 3 days to a week Instances keep under. syrups also keep well - a month or so in warm weather Materia Med Jan 26, 1882 Starch this is found in almost all plants, in a partialy easy product and is used in a pot for the plant and its progeny Usual formed on the pitch and is found in tubers and seeds In the fruits in the process of ripening it dissapates. As long as starch is pure and good there seems to be very little little difference of what nature it is Potato are large oval granuler and the small ones not more than one fifth and very few intermedi forms. Their size is 1/500 of an inch in all well organized grain you have a black spot in each and Rice. starch angular. Starch is very slightly sol in cold H2O. in fact it is a question wheather they are affec at all it in partialy sal in boiling H2O bursting at 280 deg. [cross out] Amylum or starch several compounds of starch are used in med. and pharmacy Glyceritum amigli. 1 part starch 8 of glyc. used dil for eye wash and used to hold ether sol Iodids of starch. is a mix of starch and I the I being in small amt Good as an antidote in cases of I poisoning. Arrow root. this is quite an important prep used to be used quite extensively on a food for chil cancer from a root grain in trop countries. Corse grain powder squeaking seen between the fin Common starch another variety of arrow root This root is used in trachea of Ipecehcach Gume 2 var. 1 called arabin Sol in H2O & vasolin Icacia reid is one of the more hilrye found in Trop countries this exudes are fewer and less and is plucked in this form Tacking gum then is the best called cordifan Gum Arabic is Composed of arabic & calcium & magnesium- Arabic acid readily obtained from Gum Arabic-The former Arabic is used in trochers and pills-but always mixed with Glycerine and water owing to its hardness. Mucilage used as a vehicle- Frapeau-from the seed in the wild of Europe and Asia-A fam 24 Sol Page Dose Antimony 190 gm Piluae amtimonii compositae or Plummers pill=Sb.S+ H5Cl+ Guiac + molasses 1094 1-22Pill Pulvis antimonalis or guiac powder .2-1. = Oxide of An. + Phosphate of Wine 1186 [cross out] Antimonii et potassi tartar or tartar emetic =SbO. + B. tartrate of K + H2O. (H2O). 183 106-.03 Syrupus scillae compositus= Tartar emetic + squill + seneka + Sugar + dilute alcohol 1401 [cross out] .6-2. Mistura glycyerhi 2 ae composita. compound mixture of licorice = Licorice + sugar. + acacia + camphorated tinct opium + venum antimonii + Spr of nitrous ether + H2O 925 16. Bismuth 294 Bismuthi subcarbonac = Bi + HN0 + NH3HO + NaCo3 + H2O (HNO3) 288 .6-4. Bismuth tannac = BiNO3 + HNW3 + NaHo + tannic (HNO3) Hgdraygyri Piluae = Hg 384gr + confec of roses 576 gr licorice root 192 gr make 384 pills. 1199 .2-.4 Hgdrargyrum cum creta [cross out] = Hg + chalk rub until globules [cross out] cease to be visable 742 0.2-.6 Sal Page dose Hydrargyri sulphuretum rubrum, or vermilion = Hg + Smeted Sal in Aqua regia. used as a fumigant and disinfectant 734 Hg2Cl = Hg + HS04 + NaCl [cross out] Sol- 2 part boiling 16 of cold H20 719 .004 Hg2Cl2 Hydrargyri cl mite = Hg + HgCO4 + NuCl Sal in the mineral acid. [cross out]. usual given in a syrup or in wafers. 722. .06-.1 Hydrargryri rodidum rubium Hg2Cl + IK + H2O. Sol in Hot alchol in a bit powder. 720 .004 This Cotten is called the Bimiodide & Hg Hg iodidum vende = Hg + I + stronger alcohol insol in water and alcohol 730 .05-.06 Hg sulphur & lava = Hg + H2SO4 > 33/550 1-2 Zinc Zinici sulphur = Zn + ZnCO3 + Cl + H2SO4 + H2O. Sol in a large excess of H2O 1547. As an emetic it is given dissolved in tepid H2O in a dose of .6-4. Regular dose for continued treatment .06-.1 in pill form Cu Cupri sulphas = Sulphide oxidized in the sulphate Sol in H2O 482 As an emetic dose is .1-.6 mixed with pul sugar; Continued treatment is free form .01-.1 Amylum 10 of 3 to 1 of 1 171 Iodidum amyli 10 of 3 to 1 of 9 776 Glyceutum amyli 1 of 3 to 8 of 9 686 Tragacantha secretion from the tree astragalus verus. formed in trunk 1 wide and 4 or 5 inches long. of a white color 1465 Acacia 3 Ipecacuanhu. opium. 4 grm 60 gr each. KSO4 [cross out] gum. 32 rub together into fine powder = Comp Ipecacpau 1188. (1.) Pulvis glycynhiza compositus.= Powdered senna. powdered. licorice coat. each 60 gram Refined sugar 180 grm. make powder 1188 (3.) Pulvis jalapae compositus. = Jalap in powder 30 grm. bitart of potassum 60 grm. 1189 (1.) Pulvis opii compositur = 1 1/2 oz. of opium, black pepper 2 oz. of ginger 5 oz. [cross out] caraway & first 6 oz. tragacanth 1/2 oz 1190 (.2) Pulvis rhei compositur = R Rhubarb 4 oz. Mg 12 oz. gange 2oz. 1190 (2.)  Materia Med. Feb 2 1882 Licorrice. Manna. Glyceryzin in the sugar which is the important portion of the licorrice Stick licorrice this is make by boiling the root down to a thick syrup and filtering and [cross out] cooling into stick. the syrup of lic is very useful as a [cross out] vehicle: as in the powder Manna comes from the trunk of an ash tree grown from in [cross out] and earthern [cross out] Cellulose is used in med in the form of [cross out] gun cotton. this is heavier and darker than normal cotton. it will dissolve Ether and alcohol forming colloidian Used to cover little cuts and so forth Also used in holding wounds together As it gives it contracks strongly Wood exposed to a hight temp it decomposes into [illegible]. sub one of the most usefull in tar. pearl in odor. a cool reac. sol in ether alcohol or chloroform usualy gives a form of an infusion made by maserating 1 of ten in 4 of water stram Glyc of tar, oint of tar Infusion or given internaly as may the glyc but not as much Oil of cade. another form used by dermatologists. supp to be made from cedar. This looks like tar and its prop but the odor is more aggreable. Creosote made by disstil of tar, and sep by alk. in of a yellowish or reddish color which it got upon standing. Sal in 80 parts of H2O. Sal in ether alchol good anticeptic, used like Carbolic acid. Made as a water and as an ointment 1 to 80 in the lowest amt of Hcc which can be used Charcoal. Cabo ligni. or tar is made in this country in a very crude way. It is used as a deodorizer and is applied to sloughing sores is given internaly or ceases where diges. is poor and the food putrifies in the stomach Parafinic made from wooden or coal tar; comp of several sol Insol in H2O. slight so in alcohol used as a mix in the powder [cross out] cerates Carbolic acid made in the chestnut dis of wood and coal. rarely comes pure in [crystal??????] at ordinary temp when pure crys are seperate and distinct and of a white color Melts comp at 90 deg. absorbs H2O on exp to atmosphere. [cross out] Glycerate. 1-4. Suppose Oint. Sol or water. These are the forms which are used Salycilic acid is made from Carbolic acid, and is much cheaper than the old form which was made from winter green Cosmoline vaseline Page Liquorice = 5.8.0. Collodium 443 Tar 1109 Oint of tar 1493 Glycerite of tar 687 Charcoal 349 Creasote 471 Carbolic acid 31 [cross out] Salicylic acid 73 Materia Medica Feb 9. 1882 [cross out] Salicylic acid given [illegible] and in cases of rheumatism given in powde and in solution. dec 25th 1 grm. taken in powders with a little something to disguise its taste. When given in H2O you should give it in an little water. salicylate of NA is a little more oil than the common variety Carbolic C6H6O. Usually comes in liquid form. when pure it crystalizes in the form of pure salt. salt [illegible] crystals which melt at 90 deg. when mixed with glycerine in water it is much more convenient A teaspoonful to 1/2 pint or a good proportion. 1-20 in to strongest that can be made. 1-4 5 or 6oz in olio as strong or need in an grs cl. In oint 1-16 in night. Petroleum in the crude state has been used externaly and inter but 2 not of much use Cosmoline & vasoline. Cosmoline in the sol left on the sill after the distill of the more sol sub. Ergoline is a sol which comes off during the first portion of the distillation is used as a means of local anethesia Northern Lengene. vaseline are the sol which come over after ergoline Next come the parafines which are waxy solids insol in H20 and sol in Hot alcohol If the distill is not carried far enough to carry over the parafine you get a dark sub with a tiny odour. and when this is passed through animal charcoal and you get the clear cosmoline and vasoline The charcoal is heated just enough to cause the oils to come come through in a liquid state Cosmolines never crystalize and have this advantage over parafine All these sal never became carried and are those better than the animal fats. and they do not decompose the drugs with which they are mixed Sub-made by fermentation 1st alcohol = wines beers etc they all depend upon the fermentation of sugar. in presence of a little albuminous sal. [cross out] with the presence of heat There are also a certain number of subtle odours sal called ether which give a certain flavor to the liquors. One medicine is made from malt extracts. not officinal = malt [cross out] treated with H2O to remove all sugar. and then evaporated in a syrupy consistency contain grape sugar dissolved in H2O and a little amt of diastase not very valuable Other products made from malt are the beers. [cross out] as wheat 4-5. Ales-6-8. porter and stout 6-8. [cross out] porter and ale clored by addit of caramel Wines are made from such fruits as do not need the addition of yeast but have a [illegible] in which the sugar fungus takes root Wet and dry refer to amt of sugar. White and red refer to the color of the fruit Sparkling wines are those [cross out] bottled before fermentation stops and so you get a little CO2 Officinal wine are port and sherry Port is a red wine with a large amt of tannin and comes from Portugal 89 & ought to have 20 or 22% Sherry wine is lighter and does not contain so much tannin Usual has from 16-20% Rome wines are prob more pure as are the lighter French and German wines generaly. They usual have a good deal of free [cross out] Br tartrate of K. Alcohol distilled from wine make brandy That distilled from grain [illegible] as [cross out] Whiskey, Molasses makes rum 3 grades of alcohol on the Pharstinger alcohol=82%. Proof spirit=92% of alcohol ordinar alcohol=82% Proof spirit=50% of alcohol Alcohol is used in the fluid extract tinctures resins and others From this comes ether by distilling alcohol with H2HO4 that which comes over between given temperature. it is a clear volatile inflam sil sol in H2O or proper of 1-14. or if a little alcohol is added it in more sol Mixes with alcohol sol to any extent fats volatile oils are all sol in it as are the greater part of the alkcloride [cross out] Used for complete and local anethesia but for the case is not good. Internaly dose is a tea to a tablespoonfull best was in to enclose in a cup sale. By the rectum there is good for colic. should be mixed with starch or some sach sub Prep are the compound spirit of ether. and spirit of nitrous ether Subjects for [cross out] recitation Maranta 8.9.9 Acacia Leg. 3 Tragicantha Leg 1465 Glycyrrhiza Leg 688 Manna Oleaceae 897 Saccharum lactis (Sol in H20) 1246 Collodium (cross out) 443 .05-.1 Creosotum (Sol in H2O Ether, alcohol) 471 .15-.1 Acidum carbolicum " 31 Cosmoline (Sal in sol and fixed oils) 1058 Paraffinum " 1057 Whiskey 122, 1345 Wine 1521 Rum 122 Brandy 122, 1350 Beer 7, 618 Alcohol 121 Amyl Nitrac (Sal in rect Spirit) 168 .1-.3 Ether 105 Spiritus aetherius compositus 1338 .2-.4 1. Nitrici aetherius 1339 1-2 Iodoformum Sal in (C2H8O) 780 .06-.2 Chloroformum 401 1-4 sub cut Chloralam hydratum 393 .6-2. Also read up the proofs gums and starches LLLL 4 Materia [cross out] Medica Feb 16. 1882 Recitation Best tragicantha is called fluke tragicanth Subjects for recitation Mar 9.1882 Oleum aetherium 977 Spiritus aetherius compositus. ( ) 1338 2.-4.(3) " " Nitrioci 1339 1. 2.(1) Linimentum chloroformi 828 Mistura " 922 16. 32. (20) Spiritus " 1344 1.-4. (2) Amyl nitrici 168 .1-.3 (2) Buchu Lutaceae 305 4-16. (10) Oleum menthae pepeutae 998 .06-.2 (.1) Spiritus " " 1348 .3-1. (.5) Aqua " " 218 16. (16) Oleum amnamonic 990 .06-.1 (.1) Matera Medica Feb 23. 1882 Internal use of Chloroform It is used as a solvent for may sol only one officinal. Chloroform guttae pertchae Drop on a lump as sugar is a good way to take it dose 10 drops It also comes in capsules of gelatine Extemporary it may be mixed with any of the viscid fluids. There is a dilute sol of chloroform in H2O 1-1000. Ether is used in various forms [cross out] Nitrite of amyl in another prep of the dose usual given by inhalation and it causes flushing of face and rapid breathing. and causes a elevation of [??striped] muscules. After 3 inhalations are enough to start with. It is a good plan to tell the patient what the effect of the med will be. given internaly- doses of 3 drops Chlorine in presence of the air in slightly delinquent It is given dose in H2O or which it is a sol to any extent frequently given in syrup Has a flavor like rancid english walnuts should be largely diluted with H2O given subcut but then is painfull. best way is to give it internaly dose is 1 grm gt is somewhat dangerous. medicine and should alway administered with caution. Good way to give this is to put each [cross out] dose in a seperate bottle and sealed up and thus it keeps good [cross out] Iodiformum most of H2O sol in Ether alcohol chloriform. Used externaly as a stimulating oint. and also given internaly it is unirritating. best given in the form of a pill. Dose for internal admin in a diagram Essential and volatile acids champhors resins, gum resins amd balsims Essential oils are usual already formed vegetable products and are insol in the process of plant, and occur as separate and distinct masses [illustration] Appearance of ginger under the microscope showing the starch granular and in every few cells we see the refractive manner of the essential oil Long [illegible] show the cells of sweet flag and here the oil globules are found at the junction of several cells [illustrations] Charring the pouder of oil globules in the sage. In some plants the cells of essential oils are in a [illegible] with a long [illegible] In [cross out] Birches and orange [cross out] leaves you sees the cells of the essential oil with the naked eye Cell on the outer rind of orange [illustration] appearing on the outer [illustration] layer of the rind the [illustration] inner cut thirds being of fine connective tissue [illustration] cut through a piece of pine wood. showing oil cells. In the parsnip fruit the oil cells are found. [illustration] Cut showing the latter In some of the fruits the oils are found in the form of emlulsions Such as gamboge [cross out] tree. Prop of these oils. These are not usualy found single but you [cross out] have several mixed varying only in their densities and boiling point and these varieties with polarized light This is the case with the oil of turpentine and are seperated by carefull fractional distillates Then again they are associated with oxigenated oils. These are seperated by the action of deoxidating agents. The are thought to be formed by decom of essential oils-resins are associated with these due to above mentioned degen. Essential oils are pure white motile oils and the longer they have been distilled the darker they are. Some oils have a greenish hue when first distilled such as oil of cammomile In some cases they are of a bright blue color. These [illegible] by firmly umbillicae Sp gr raises from 900 to 1050 more than 9/10 are below the density of H2O When oils are of diff density in the same plant the best odor in [illegible] from the lighter All of the oils are sal in H2O to extent of 1/1000. All sol in Ether alcohol and chloroform. They can be distilled and restilled without change. They are usualy seperated from the drugs containing then the by distillation.- In orange peel by pressing the rind upon sponge. In the the prep of perfumes they are obtained by packing in fat. The oils preparred by pressure are above the most fragrant Orange family oils are found Citris aurantium = oil of orange peel rind. essential oil for leaf used in perfumes. an oil prepared from the flower Lemon is the same for yields the same. Bergamot = oil from rind Citron also gives an oil Mint family gives an series of volatile oils. Lavender. peppermint spearmint, rosmary sage, are on this list Bucher pilocarpus, Umbrillafarae = caraway, anois coriander 5 NO Subjects for rec. Mu 7. 82. cinnamon 431 Laniace [cross out] 1441 Tintura cinnamoni (4.) Aqua Labiatae 217 Lavender " 134 7 (.3) Spiritus Lavandulae 1347 (3.) " " Comp 1347 (3.) Thymol Laniaceae camphor lamel 1023 (.2) Spirtus camphorae 1344 (1.) Agua camphorae 214 (16.) Linamentum " 827 " saponis 830 Opium 1030 Tinctura opii camphorata 1454 (.5) Cabeba 477 Oleoresina cubebae [cross out] 975 (1.) Tincturae cubebae 1442 (4.) [cross out] Copaiba Leg 459 (.5) Copabic acid 460 5 Oleum Copaibae 991 (.5) Materia Medica Mar 2. 1882 Camphor is an oil solid at the ordinary temperature of the body. another is tymol and methol is another these melt readily and then have the appearance of the ordinary essential oils. Steauptine is the name applied to these. They are associated with a hydro carbon and have the formular of the hydrocarbon. These have great anticeptic prop. They are sal in low parts of H2O Sal in all prop of alcohol- 1-1000 is right for an anticeptic Resins are decomposed of essential oils and are very abundant. [cross out] They are insol in H2O. has an odor of the oil usualy are transparent. may be amorp or crystalline. Sol in either alcohol and ether some are sol in one of these and some in both. [cross out] Some are sol in alk forming soapes. Gum resin = small sol of vol oil large amt in resin. usualy more of one half and they also have a gum sol in H2O. When found in the plants they are in the form of an emulsion usualy white or yellow color. The resin is not solution but in a state of fine solution in the fluide of the plant Balsams there may then beyond or solid. all have essential oil and a complicated cut of resin sal come by of crystiline and camphore. sal many which in benzoic [cross out] acid Myrtile family gives oil of [illegible]. has a green color. this is quite distinctive Eucalyptus globulus [cross out] This is an Australian tree and gives two kinds of essential oils. and the lighter of these is a pure hydrocarbon Leaves have a cured edge resem a cythe, [cross out] [cross out] Mycer acris give the oil of bay and you also get the pure bay resin Cloves. these are turgid flower buds and are native or are found in southern Asia Brazil found of size of an ordinary pear tree The tree is beaten and these little buds drop of and are gathered and dried and sent into comerce. On section the great size of the oil cavity is remarkable and this has the largest % of oil of any crude drug in the world. It gives a pure colorless oil heavier than [cross out] water and upon distill it gives vegemic oil. Allspice or pimentia this is a West Indian drug given an oil called oil of allspice and is a little colored. This finishes the myrtle family. Nutmeg tree. this is a family by its self. Native of India has a fleshy anterior layer out of which drops the nutmeg of comerce The [cross out] seed of the fruit produce mace. This mace producing matter surrounds the seed or nutmeg and comes out with the nut and is separated afterward Oil of nutmeg is obtained by pressure and has a large amt of solid fat, composed of palatine and other fats. It also has an essential oil which has the characteristic odor This solid fat is known as oil of mace. though mace has some of it Laurel = [cross out] acacia champhor. sasafrass. cinnamon. Camphor is prepared by putting pieces of the wood in a sill and steaming and the camphor comes out in little drops. at this time an oil also exude called the oil of champhor. it is an essential oil Cinnamon bark of cinnamomum cilaricum. commences from Ceylon, There is a Tree growing in the south of Asia which is not cinnamon and is curled or follows and is thick. [illustration] True cinnamon is thin and curled not both under and is composed of various layers. [illustration] it is an almost solid stick Sasafrass. this is found above the northern and middle state and northern. The bark of the wood is the part used Essential oil come from [illegible] of the whole tree. Pepper family. Peper and cubebs one most import, Both are the fruits of the plant and are pure green because then have more oil and resin. pepper is black color. Cubeb are of same size and have a long stem and this long stem assists in recognition of the fruit. The stem is a prolongation of the cells. White pepper is got from the same plant and same from the ripe fruit and the center layer are removed and the center is used. Where as the black pepper in got from green fruit. now the other part of the fruit has the sharp stringy resin, and hence characteristics of black pepper. the middle from the fragrant hence the more aggreable taste and odor and of white pepper Ginger family = ginger curcumin cardamom, grains of powders, galina In ginger and curcumin the resine is taken. Vale as med is due to essential oils and resins. oil is a simple hydrocarbon. resin is very composited. Sweet flag. has essential oil and resin. or resembles the ginger family. Pine family = turpentine which gives oil of turpentine and rosent Can turpentine, Burgundy pitch Oils of jupiter and cider. oils of cade and tar. These two arter are get by distillation Oils have several sub resins are rather complicated White sandal wood = oil of sandal wood. [cross out] Cyean turpentine Busticara lenticurs [cross out] Copabia formed in a South American tree found in countries in the trunk resin in the most important part and is much more agreable than the oil itself Copabi acid is amphis and came from the resin there is also a crystaline Balsam of tolu. and peru Balsam of tolu got by heat and The perm also comes out with this and is separated by disc. Benzoin similar. wood is tolu and perm. and furnishes Langeric acid 2/2/9 23 5/9 115 118 3 Materia Medica Mar. 16. 1882 Tannic acid group. This corresponds to the vegetable astringents All veg astringent are then astringent prop to come for of tannic acid or decomp. and all the tannic acids are astringents Leps and smyrna smyrna galls These trees resemble the scrub oak of this country and grows along the eastern ends of Med sea and the gall is drawn out by the irritation caused by the sting of a fly who makes a wound in limb and deposits her egg. this cause an irritation and you get a hary nodulated growth covered with bark and as it ripening the maggot ate out and eases an opening Other oak are troubled by these in similar insects even in our own forests [cross out] When their gall is compl formed you have a little glove of a dull greenish color. In the best galls you see no hole. in the older ones you see the hold Taste is strongly astringent and puckering and sweetishy Alepo galls are the best. other are lighter in color and have a large hole Blue galls have twice the amt of tannic acid 80% Also have some gallic acid abt 3%. You also sometimes get long narrow galls of the same structure Janponica and true Chinese galls are caused by a different insect and in a different tree. They have all the same prp of tannic acid and gallic acid as the blue gall but there are not efficient Gallic and tannic acid ointment of gall tincture of gall. These two cartarise seldom used Tannic in the broadest sense it relives a grasp of sal which have abt the same prop. they are all acid in sal from inks with salts of iron. ppt gilden and albumen, and are oil astringents They are supposed to be a decom product [cross out] of essential veg sub Galls tannic acid blue black with salts of iron. Prob every plant has some peculiarity on the tannic acid which it produces Galls tannic acid is the one commonly used and is made by depositing the powdered galls with very little H2O or exposing to the dew on a dam night and then moistened with ether and stand 4 hours and expressed - again- moistened and exposed and the two fluids distilled Prob it is never pure. is never pure or crystalline It is of a buff color sal is ether in which H-c has been added It ppt all alklies most not salts. Slightly decom by ht and yet pryre gallic acid and mets collic acid or left Glycente of tannic 1 of tannic & 2 of gly supposition. torches and ointment. When it it is given it is not worth while to give it with any other sal. as it will prob ppt it. Gallic acid galls mac with H2O of mouth. liquid thins any and they are boiled with hot H20 and distilled. Then is abt in the form of crystals. [cross out] In an alcohol ether Only offic prep is the glyc and oint For local application is best For maternal gallic acid because tannin is decomp into then in stomach dose -.2-1. gm catataput and creminic [cross out] kino, catachu, gummuim, rubris spirea, pomgrente, red rose, hoemic tuloline. Materia Med. Mar 23. 1882. Bitter tonic. No medicine or nearly none have only one action but have more than one [cross out] Drugs have an action of their own. Bitter tonics are widely distrib through out the vegetable kingdom. they are not numerating and are followed by increased appetite. They are disordered into mineral and vegetable. Vegetable act through the stomach. Bitterness exists in all parts of the stomach drug. Nux vomica's active principles are- strychnia and buscia. [cross out] In many cases the latter principles have never been extracted as such most of them are soluable in H20 and in the fluids of the mouth Gentian family a particularly bitter This family [cross out] in [cross out] poisonous there are no alkeloids in [cross out] these and the bitter principles are neutral. Cinchona. have a bitterness tast alkeloids quinic oil Magnolia have bitter principals Dog wood and burberry family all have active bitter principals (Barbarima an active principle of bitter) All these increase digestion and promote assimilation and to increase the appetite If these resultsare not obtained stop them- they are given before eating, if it is dose before eating take it after All bitter tonics are sol in H2O on at least to a certain extent, Gentian is most violent of all the bitter tonics- except prehaps the alkeloids, Have a milky juice bitter are all herbs no shoots on trees. The roots are very fleshy and devoid of woody tissue found in Europe and america, they are 4-5 feet high. root one or two feet long. the root is the important part. It grows on the high lands. not on our lands once marshy districts came far from Switzerland and Spain [cross out] Genteana leutea. this is the principal kind and is the officinal American gentian has small fibrous Gentin pieum is the active and peculia principal of the gentian powder It is a glucoside. It should never be given with a free mineral oxalic as the tanic effect is destroyed. There is no tannic in that drug: Should not be given with the tincture of chloride of iron May give one before and the other after meals. [cross out] Sabacia. quascia. part used in the wood. and a yellowish color It has no tannic acid Columbia order many [illegible] Columbic [cross out] is one of the acetic principals. columbic acid. terelyn [cross out] These enable the important. gold thread is at common domestic bitter cinic Commonule is also one of the important bitter tonics Magnolid [cross out] is used as tonic. (active prin = magnolium) Leucodendron = (Leucodendini.) [cross out] Galls. [cross out] 799 [cross out] Geranium [cross out] Rubris Gentian [cross out] Sub for recitation Mar 28 N.O 6 Page Dose in gm Galls. [cross out] 667 Tannic Acid Cupuliferol 86 5 Gallic " 45 1. Catechu Leg- 370 [cross out] Tinct of " 1439 4. Kino Leguminosia 799 [cross out] 1. Tinct " 1449 6. Kramenia Polygtolaceal 800 .5 Tinct " 1450 6. Geranium Geraniaceae 679 2. Spiraea Roeaceae 1337 .3 tld ex Rubris " 1235 [cross out] Gentian Gentianaceae 677 1. tld ex Ex " 579 .3 Tinct " 1446 6. Colombo 326 1 Tinct " 1436 6. tl Ex 597 4. Quassia Simarubaceae 1194 1. Ext " 590 .2 Tinct " 1456 4. Chammomile Anthemideae 470 .3 Anthemic " 181 .3 Oil 984 Infusa catechu 763 50. " comp 763 [cross out] Anthemedic infusa 760 64. Infusa. columabae 761 64. " gentianae 765 32. " quassiae 768 64. Suppositories of tannic acid 1382 Syrupm rubi 1400 6. " [cross out] kramerial 1395 3. T Acid extract of blackberry 609 6. " Calumbo 597 4. " gentian 683 2. " geranium 604 4. " rhotany 686 2. Glycerinum gallici 685 " tannici 686 2. Trocher of catechu 1474 " tannic acid 1473 Unguenta " 1483 Unguentum gallae 1486 Astringents all you need rember one 9. in number Galls Catechu Butter tinct are 3. import Kino Columbo amt nex Kramina Qussia Geranium [cross out] [cross out] gallic & tannic acid Gentian Rubus Haematoxalyne Spirea Tannic acid is sol in 6 parts of glycerine Tannic acid should not be prescribed with any other active [cross out] chemical principal Nearly all the astringents come under this head. De gallic acid is the latest chemical name for [cross out] tannic acid Usual strength of ointments is one to sixteen. (1-16) Neither tannic or gallic acid should be given with the salts of iron Gallic acid does not ppt the alkaloids Tannic does Tannic given into with ac and are salts of iton Gallic with forms mix with one not with ic Materia Med. Apr 13, 82 Alkeloids These one of varying comp and prop. Taste and solubility But they are alk in sol. unite with acids to form salts sol in alcohol and ether insol in H2O apt to be crystalline and a pretty def chem comp. They were discovered in 1616 by a Dutch apothecary They are found in both hemispheres and as a rule in warm regions. As a rule the classes of drugs have alkeloids of a more or less similar character There is no part of the plant which may be said to yield the alkeloid exclusively but some parts are more adapted for allarming it In the [cross out] cinchonas may be said to come from the bark. Nux vomica comes from the seed of a plant Pilocarpin comes from the leaves and in all plants the alk are prop in solution in the Juice of the plant In the case of the poppy the juice is taken and dried and you get opium. As a rule the older the plant the more the quant of the Alkeloid. Beyond a certain age however the diminish. In temp parts of plants (leaves) it is greatest at maturity thin in time of fruit. but it should be taken just before it ripens and after it has attained its full size They seem to degenerative products of the plant. mute products so to speak They have no particular oder as a rule The effect of cultivation on the alk varies particulary opiums and cinchona. These are much [cross out] increased greatly by cultivation Some of these are very perishabe where are very liable to decomp- but as a rule they may be said to be permanent They are usualy combined with some vegetable acid forming a salt Morphic with mecomic acid quinca with a tannic acid Rarely they are free as narcotics Nux vomica contain strychnia an brucine They are extracted by replacing the natural acid by a mineral acid is then currently H2SO4 is used it in when extracted by maceration of percolation. this sub is neat by a mineral [cross out] alkelie and is then purified in various ways- Some are sol in water then the process of acidulation cct is not needed. Some are sol in C4H2O All the alkeloids have two terminations inc. ia Americans use the termination ia Morphia They all have carbon hydrogen nitrogen oxygen C.H.N2O. Coelia may be made artificialy a may others by the decomp of some of the unnatural alkeloids In general they are solids They may be crystalline or amorphous. white or colored usualy they are usualy more or less colored Rarely they are liquid only 4 or 5 of these are from these one all soluble (fluid) There also usualy have some solid salts In color they should be white when not so here purity is doubtfull all sol in alcohol most of them are sol in ether or chloroform. usualy most in H2O [cross out] But are a little more sol in acid sol. There propotions vary [cross out] in plants from 1/1000-1/10 Administration The permanent ones may be given in powder. a pill form ground up with ease in of milk [cross out] in some case they may be made with pill as is the case with quinnia If sol in water may be given then. or if so in acid sol may be given in this manner (in sol) Read up. Nux vomica, strychnia Brucia, iguatia gelsem [cross out] gelsemium Materia Medica April.20. 1882 [cross out] Poppy family. they have large cherry flower and secrete a milky fluid. The fruit is in a capsule and has numerious small seed and on bruising yield a nauseous and dull oder. The juice is sometimes irritating to the skin. The plants are not tropical as a rule. but is found in temperate regions The leaves do not appear as curly as the blossoms. The leaves are wider than long and have one or two lobes on the sides. Sanguinarina in the alk of blood cort or sanguinarina. This contains several coloring matter dose of drug 1-4 gram Tincture=1-8. dose of = 60-80 drops. Neither are much used. Syrup of sanguinaria dose 2-8 gram This is neither usefull in cough mix Poppy pareas an animal growing as a weed in smaller than the regular poppy has red petals from which is made a bright red tincture Poppoa somnifera-or the opium poppy this the are cultivated in our gardens There are thee kinds of them one found along the Mediterranean and two other kinds. Poppora albumn this is found in England and is cultivated in Persia and is used for production of persian opium The capsules are used as an article of med separate from opium. Narcotine papaverine have been found in the capsules of the white poppy. Opium is the dried juice of these plants and is obtained from the capsule For the purpose of getting opium the poppys are cultivated as hay produced larger amts of the sub It comes to in of a rather dark color soft and comes mostly from Acid Munor-when the cultivation is extensive. Sol in H2O the extent 51-55% and yield 55 or 60% or mineral matter as an ash. Egyptian opium. brittle yellow flower Persian. in hard round balls. European opium seldom found in East Indian opium given by Chino and are used at home. Read up opium eau germania Materia Med April 27. 1882 Turkey opium is the one used in the drugs of medicine. and come from Asia Minor Opium has 18 alkeloids. Morphia cadina Narcine. Narcotine. This the order of the from most important ones. Morphia is found to the extent of 10% in the Asia Opium 22% has been found in French opium this is the highest on record. Egyptian 4-8% Persian opium 4-8% from 10%. Chinese has 2-3% if morphia. Morphia is sol in H2O and and produce large white crystalis. This may given in sol. but the most common was in a form of one of the salts. 9 times out of 10. The sulphate are used. Acetate. Meconote. hydoclorote. one three other salts in common use. There is an effund sol of morphia Liquor Morphiae sulphates Codina is given in some causes Narcine is not in this and like codina should be given in powder a full dose of morphia & 1 cent gram codina and Narcine 3-8 c gm Tincture of opium (laudanum) 1-12 of dilute alcohol. dose 20-40 drops for an adult. it uses 25 to 28 drops to the gram and dose is from 6-8 gram Drained tincture from the narcotine and some other dose sub removed. dose 15-20 drops 6-9 gram. Camphorated tinct of opium dose 16 gram Acetated tinct not much used pill of opium 1-4 of drop dose in/gr or one pill = 1 gram Comp pill of opium 4-1 Ag extract of opium. dose is one half as great as that of opium .3 C gram 1 opium. 1 ipecacuhana + 8 pints of HgS Tulligi powder is Red comp dul camaici capsicum- belladina hyacinaus stramonium dubrysin tobaco Dul comp = sugar and solanin and dulcamain. Ex fld ex. decoction are the prep. Capsicum. this has no alk as do all the rest of the family. it is the common red pepper Belladonna this is a weed found in the southern part of Europe and America varied parts in Germany Alk in atrophide root and leaves are both officinal. [cross out] Atrophia and hyacyanine are the two alk atrophia is given usualy on a sulphate There is an green extract for leaves and root and solid extract from the root. hyocyanius niger. the alk are the same as those well. but the amt. amt is reversed. this having less atrophia and for a 3d hyacine Stramonium [cross out] All the group [cross out] have the same alk for this active [cross out] Tobaco Tinct of hy fld ex of hy. fld x of Bell ext The four drugs marked are the ones which have the same active principal Subject for recitation May 4, 1882 Page Nux Vomica 960 Strychnia 1354 Brueia Loganiaceae 961 Igasima 961 Ignatia 754 Gelsemium 674 Opium (Pepaver 1056) 1030 Sanguinania Papaveraceae 1253 Dulcamara 518 Capsicum Solanaceae 347 Belladonna 274 Hyoscyamia 747 Stramonium 1356 Duboisia 517 Tobacco 1404 Prep of opium Acet tincture of opium 1454 .5 Extract " 587 .03 Tincture " 1453 1. Deodorized tinct " 1455 1. Camphorated " 1454 1. Opium pill 1118 .06 Compound evap pill 1110 1.3 " opium pill Tinct opii acetat Ex of opium Tinct " Deodorized Tinct " Camphorated " Opium pill Compound " Extract of belladonna for oils and leaves Tincture " Extract of hyoscyamus Tincture " Compound ipecac - powder 1. Extract of belladonna 571 .01 " Fl. 597 [cross out] .3 Tincture " 1434 1. Tincture of capsicum 1438 6. Extract of hyoscyamus 583 .3 Fl " 605 .5 Tinct " 1448 4. Extract of Nux Vomica 586 .1-.2 Fl " Tincture. " 1452 1. Morphia sulpher 937 .01 Percolation. 593 Repercolation 595. Materia Med 82. May 11. Cinchona (Rubiacae) This includes some very usefull drugs of ipecacuhanah-coffee and Cinchona are the 3 principal drugs- Some alkeloids are also produced It is confined to the Andes Mt in So America. The tempratue of the region is temperate and sometimes get freezing and there is much sunshine and fog. They grow on the the eastern slopes. The best kinds grow abt. 6000 ft above the sea They are either shrubs or trees and the trees are from 30-80 ft. They are evergreen. leaves are opposite and oblong and rather narrow The genus has from 34-40 kinds of [cross out] The cinchona these are becoming more and more scarce. The bark of the roots and of the whole tree are good. Flat and dull. bark. the flat bark comes from the roots and large branches and trunk the quilled come from the small branches. Color of it bark varies from a horn to a dark red = and it is very brittle The efficient kind of bark and the yellow bark cinchona flava from cinchona [cross out] This comes from the southern districts. This is the best of the barks. And it has little depression which we called digital depressions Cinchona pallida this is entirely not of the market. Cinchona ruba. these are the thre kinds 1852 was then plant was introduced into good: These barks have form alkeloids quina & quinidia. cinchonia and cinchonidia quina quinnidria. cinchonidia and cinchonia There are also two others out of any great value. which has just been discovered in Jaundice. [cross out] quinnic and cincho [cross out] tannic acid are the are the acids with which these alk in comp with Materia Medica May. 18. 1882 Cinchonidia yield crystallyzable salts when dried Quinia. Quinidia. Cinchonia yield the same. All of these are caprobe of decomp. with certain acid yielding an other class of comp [cross out] The effects of these 4 alk are abt the same. Qunia is most import next quinidia. This last has been change to be even more active. The [cross out] cinchona cinchinodia. The dose of these is abt twice as large as that of quinia. They are less soluabe then quinia. Kinic acid is the acid with which there are usual described. The colony matter of the bark in cinchona bark. tincture Decretum Cinchonic floral comp tinct (Qunia Decoct cinch. rubae- infusion and comp. tincture) 1st list are the import [cross out] compounds under from the yellow bark. 2d from the red bark. The yellow is supposed to contain the most quinia. Extracts and Fld extracts of cinchona. Sulphates of these comp are used more in this country Acetates and muriates are used abroad. When ordering a solution of these salts add to the mixture a much dil H2SO4 an you have grams of the cinchona. Thus if you order 4 grams to 1 oz of fluid you would add to it 4 grams of H2SO4 this amt will always dist the cinchona. Citrate of iron and quinia. Pill of quinia. valenate of quinia there are these soluabe officinal comp of quinia. Syrup of licorice root in a soluable vechicle [cross out] to give quinia in [cross out[ Ipecacuanha - this is a soluabe plant of this same order [cross out] rubiaciae and they gum in clumps like hucelebery branches The bark is rough and tough and quite ridgely There is one alkaloid is of a light brown color. forming salts with the acids. Called Amicia Wine. Syrup, fld Extract. powder This bitter is the best for an emetic Dose of powder 1 grm. fld ex. 1-1.5 grm Syrup 30 grm as an expectorant syrup and wine 4 grm Coffee. This is a tree found in [cross out] Africa and East India- and has been collected in Arabia Mocha. Java. Rio This is the order of these berries in order of their value. Caffaine is the alkeloid Tea. active principle or caffeine Paulinia sobulis Erythoxylon [cross out] Crea. Flex [cross out] Paraguay Jaborandi alk-pils caipsin Kino comp powder 1189 Comp uses pill 1097 Myrr 36. Carb of Nu. 18. FeSo4 18 Syrup a sufficient quantity Materia Medica May 25 82 [cross out] Physostygma. Calabar bean. Lobelia The Seeds of thus are very small. The plant grows commonly in North America Is not much used except as an expectorant and no cough mixtures. It is a very dangerous drug as it may not cause vomiting and etc as a person has no alk. urine is best prep. Maculatum conium. leaves and fruit are used no good Conia in the alk in a burnout liquid Fld extract of the fruit is the only thing worth using except the alk which is hard to get Ergot. There is a fungus growing on the head of many grasses and is taken in a certain stage the Chemical name is claviceps. Found around the seed and orange. it is usualy taken from rye. It has none of the rye in it but is a seperate growth. it is propagated in two ways. by budding and by true punctuation. It sprots very quickly and should not be used when over a year old. Extract of Ergot called ergotine [cross out] These in ales an alk is ergotic 2d alk ergotamine. has been found to found to have active principle. 2 Clerotic acid is obt from the drug Tld Extact is the best prep in the market at present. Remite nature of Southern Europe There are several kinds. The roots looks much like horseradish root. Active principle or aconitia European yieled most aconitia. Japanese yield most [cross out] pressd aconitia. both yielding the two but in reverse proportion Recitation [cross out] June 1st 1882 Cinchona 414 " rubae 415 " flora 414 " pallida 414 Rubiaceae Quinia 424 Quinndia 424 Cinchonia 424 Cinchonidia 424 Tinct cinchonae. flavae 1440 Decoction " 498 Comp tinct "" 1440 Tinct " rubae Comp " Decoction " 498 Extract of flld extract & rubae 575 " florae Citrate of quinia " andxion 628 Pull " 1101 Valenate " 1212 Ipecacuannaha 783 Alk. [cross out] Emetic Wine 1524 Syrup 1395 Fld extract 605 Powder 1187 Coffee 310 Tea Rubiaceae Jaborandi Rubiaceae 1084 Alk pilocarpin 1084 Flex Aquifoliaceae 754 Physostigma Leguminosae 1078 Alk Physostigmia Ergot Fungi 441 Alk ergotine 543 Extract of Ergot 601 Powder Aconite Ranunculaceae 93 Alk aconitia 98 Conia Lobelia Materia Medica May June 1.82. Recitation ꝶ Hydrarg. Biminidid gr 11/11 Potass Iodid ʒ 1/vi Syrup durantic Aquae āā ℥ 11/11 ♏︎ ʒ 1/1 ʒ J.D. ꝶ Hydrargi Bineodidi gr iJ Potassic Iodide ʒ iiss Syrup durantin- ℥ iv Signa one teaspoonfull in water morning and evening ꝶ Hyd-Ratiod grs XXX Pulv opii 1. V Ext gentian M Signa one pill morning and evening after meals. Materia. Med. June 8. 1882 Veratrum viride This a native of So America alk in veratria Veratrum album is another kind The caustic are the same- but their action is very diff. They both are depressants and purgatives but the album is much more active Veridia ventidia vertiodia are the the other alk. [cross out] Colchicum the corn is the part used. Cochichin is the alk. Digitalis (fox glove) Biennial stem comes the 2d year long narrow leaves The leaf is used [illustration] and contain the active principle. Alk is digitalis digitaline in a glucoside. Tinct solid & powder. fld & root are the parts used. Tincture is the best prep Squill. This is the size of a large Bermuda onion and has the general appearance of the onion except that the leaves are flat instead of round When have a good deal of gum in resin. Vinegar and syrup of squill are two very fine prep Sarsaparilla. It had a great up at first as a cure for syphilis known on the green leaves and have long roots. and are a little dark [cross out] at the ends than in the middle. and are quite long 4-12 ft Mealy and non mealy these mearly indicate the amt of starch Decoction. tinct. camp syrup. this last is good for a flavoring mix White sandal wood produces oil of sandal wood. Cuso. alk cusine. 1℥ plus 1 pt of hot H2O drink good curing for the worm Pomgranite alk:- Conelinia Pumpkin seed- are all good for tape worm Santorini [cross out] Male fern Carthardi of active pini is cantharidine. times good for stram liniment. used aloe for blisters. Ceratin cantharades Carthartics Senna carthartic acid Leg 1287 Colycinth Colacynthin 446 Eleterium eleterini Cucurbitaceae 520 Jalap convolvulin (resin) 796 morning glory formely a dose scammony) 275 Scammony Jalapin aonvolvulaceae / 275 Mandrake- Podophylinum resin 296, 1123 Gamboge gum resin 669 Alter olein 135 Rhubarb rhubarbic acid 1225 Berberidaceae Guttiferae [cross out] Lulraceae Polygonaceae Causes Sayre running jumping over exertion. Skating sitting down on a cold stone a cold place or any other extraneous accident which may produce inflam of hip joint These are the causes mentioned by Sayre. or giving use to inflam of the joint. He first says that if this occur in a person who posed a strainin constitution [cross out] it will go on unless arrested. Will go on to produce deformity. anchylosis and shortening and any terminate in death He qualifyer his remarks by saying that. then- The opinion [cross out] of surgeons for the last 75 years and has been generally taught and recurred and that age and authority have rendered a sort of surgeons gospel to rebell against which would be heresy and blasphemy & from to rather sarcastic time of these remarks it is quite certain that Dr Sugre does not agree with the doctrine which has been taught and seemed for so long a time. He [cross out] also makes the statement those most practitioners agree that it cannot be cured by an antiscufilosis method of treatment A statement which is not worth much is as much a the writen dose not mention the stage of the disease. It is quite evident that no system of treatment will restore destroyed bone: By restore I mean restore it to its former condition of course. [cross out] an irregular out growth of osseous tissue may take place. Not until we payed more attention to last treatment-did we meet with much Due cause in the treatment of this affection and argues that this fact alone proves that the disease cannot be constitutional for here cured local treatment. influence a constitutional disease and moreover he says that he has been able to trace the majority of his cases to a direct traumatic organ and that most of her patients are of a robust and vigorous constitution presence is then attack and that the constitutional disturbance came afterward and was entirely dependent upon the hip trouble. instead of the opposite state possesses a most medium outer state and that the common error is that the affects of the disease have been mistaken for the consequence [cross out] for there are no [cross out] troubles which are capable of producing more sever constitutional trouble than disease of the joints and we often see cases of phthis [cross out] upon such disease. Dr Sayre gives a list of 143 Cases in which 131 were clearly traced to treaments injury directly are to joint. and that in only 3 cured the disease be troubled to no definite cause unless we consider a constitutional cause a direct one. [cross out] He later makes a remark which seems a little like a leaf hole.- in be used in care of need - when he says that in many of the cases it requires the very closest Examination to find out the cause for the decrease does not usually follow directly the injury but that it sometime does not appear for months after the accident so that the patient and his friends have naturally forgotten all about the accident and its connection with the disease- until especially recommended of it by the investigation Lurking at the matter is a perfectly unprejudiced manner & seems to one a thorough Sayre by this last remark had so to speak cut the bridge behind him. for it seem to me that in any person suffering for one matter what we could get a hurting of a full in jar or present of some kind within a space of matter and since it is a well known fact that people are perfectly willing to weigh a [cross out] [cross out] jump bruise or fall [cross out] the cause of every joint trouble. it seems a though it would be a pretty easy matter to get such a history partic if the surgeon be looking for such. Moreover the surgr with above the family history of his so called white patients A person [cross out] born of a phthisical family may present all the appearance of white health and often are until they are stricken down with the disease Sayre. Syrup- He describes the disease with these diff stage. 1st characterized by inflamation 2d. by Effusion. abduction and apparent elongation 3d by rupture of capsular ligament medium adduction and apparent shorting 1st Stage detail In cases where the inflamation is of a case grade such as we usually find in those of a stramonium diathesis the symp are obscure and diff of diagnosis. and are often opened to the knee instead of the hip then peculiarity often leaves artery be careless in ignorant observes and many a child is treated for trouble in the knee when it is really-the hip joint The child walks with a limp which when once seen will not be forgotten or mistake for any thing else. The child stands upon the well leg and throws the bone or forward The flexor if the disease limb or also very imperfect-The knee on the affected side not being capable of being flexed sufficiently to burn it against the chin where the other readily is-, Pressure upon the soft parts over the joints. a direct pressure over the joints as a shot may form of pressure which tends to face the head of the bone into the joint produces pain Rolling the limb slightly so as to be here pressure. at once relieves pain and if carefull examination with pressure-an extension no differently will be found as a rule- diagnosis- You also get in most cases an atrophy of the muscles of the affected thigh. which in many cases is very slight [cross out] indeed usually is the first stage This is one set of symp however which a very characteristic even in the very early stage of the disease. If we look at the muscles of the thigh we shall find many if then quite strangly can [illegible]. and after seeing strength and on attempting 1 flex of leg we shall get more or less resistance accompanied by a tweaking a spasmodic action as he flex. which is a very important and characteristic syrup. 2d Stage Here we have stage of effusion which if much a amt will produce a peculiar deformity An apparent elongation of the limb fluttering of the nates on the effected side of the inner being lower on the side than on the sound side, You also get at this stage or apparant anchyloses which is produced by muscular contraction, and the thigh is slightly flexed [cross out] pelvis and leg on thigh. Then if own due be reflex action and serves the purpose of keeping the joint still and gives us an indication of the treatment to be followed The flexor. The Tenno vaginis femoris pectineus. rectus femoris are so firmly contracted that the whole pelvis moves in the effusive acetabulum That this does not depend on a long anchyloses [cross out] at this time is forced by puncturing the joint. when from the nates in obtained a it is by cutting the muscles. Thus the power of liquid released in a joint being able to produce false anchyloses is shown And experiments have been made by injecting the hip joint through the pulse line by which procedure. Erosion. abduction and sensibility of joint here produced. 3d stage The disease if not arrested is given use to cure and perforate of the acetabulum or ulceration and rupture if the capsule of the joint which causes an effusion of of fluid which [cross out] might be either synovina or pus into the surrounding tissue which eventually produces an opening somewhere in the thigh is many metanes at some distance from the joint Their rupture often gives here to the [cross out] the colon That dislocation has taken place for the suddenness of the occurrence When the capsule ruptures and no adhesions here takes place the limb seem shorten and is adducted and inverted. and is aliment affronts to that of the 2d stage This adduction is spoken of by Sir Charles Bell and swell test gives relief by running to acertain extent the head of the bone the inflamed cavity but the result is active dislocation is many cases. Sayre says he in no case has true luxation been found in thigh. in some argue apparently the same Theory due to the crown of the head of femur is on its bearing seperated from the bone and being left in the joint This allusion, the upper joint of bone to slip upward and formulate the true luxation In making a diagnosis hip disease must not be confused with Sacro illiac disease. In the latter we get the elongation of the limb which we get in 1-2d stage of hip but in hip elongation-due to effusion into hip joint and is detached by measurement of sub. ant spine to the pustules. where as Sacro illac there is no elongation here these joints. The seat of pain is also diff- In sacro iliac is tender who press every point of sacrum and ileum. In hip you also get a immobility of [cross out] joint and the movement spine as seen by putting hard under patient and lifting by the spine which before diminshed a curve will come down hard against the table- treatment of first stage All authors whose opinion are worth anything other than the treatment [cross out] should be perfected and mobility of the joint and relief of the synovial membrane for all irritating pressure from Together Sayre Says with constitutional remedies. and general stimulation as may be seen. in each case, The occasional application of Iodine or some other caustic irritant at this stage may give some relief. Now when the joint is left to itself we get a constant and irritating pressure due to the reflex contraction of the muscle which irritating pressure not only tends to irritate the joints of pressure but of the pain caused [cross out] tends to extract the strength [cross out] of child and near out so to speak the newer resistance Causing spasms during which there is much suffering acct. by the constant pressure of the two inflamed surfaces there is more or less also of the head of the bone and of the acetabulum. Here we have to apply some method of extension in course the constant and depressing cause of suffering. We at this stage not only wish to relive pressure to a great extent but also to keep the joint quiet to do the time on many kinds of apparatus. But at the stage when we have a chance of getting a cure without loss of motion it is imperative that the splint be removed at short intervals- and passive motion of be mild and gentle character give care being taken to make gentle extension to remove the inflamed surface from contact is such a pain- and lest we start off the irritation anew. If the passive motion is not given Sayre says, loss of motion is the joint results. 2d Stage here over- treatment is smaller to put it in certain extent. He keep up the [cross out] extension constantly and in order to get rid of the effusion we may apply certain irritants - leeches on joint. But best of all- to better of condition if patient and if suff well to be able to to move but put a give kind of effect and with high shoe and crutches get him out in open air. If pressure from effusion becomes very great and there is danger if rupture of capsule Sayre recommends pucture by hard great trochanter and evacuation of fluid, But in many cases the inflam is of severe a character that the patient cannot stand the slightest move and has to be kept absolutely at rest We have in the stage according to Sayre a rupture of the [cross out] capsules. a perforation of the acetabulum Rupture being the more common and the fluid within pus or lymp Toxicology Prof Wood Mar 31. 1882. Tar H Tartaric acid this resembles that of oxolic acid in nearly all its symptoms but the blood in the stomach is fluid and vermillion in color. chemical analysis is very diff because it is used so commonly in perishable food. it is converted into carbonic by digestion and hence cannot be detected after absorp- Evap to dry-extract with alcohol. drive off alchol. adding a little H2O on the divide into 2 parts. 1st neut with pottasic carb and then add the other half and you get the acid tartrate of K. or cream of Tarter which occurs as prismatic crystals of acid tartrate of K. The tart is good for ammonic salts-[cross out] of caustic potass pottasic carb: see special taste In trying the charring test do not use platinum foil Treatment is to give dilute alk. Alk. [cross out] These are similar to the corrosive acidic reaction of vomitus. has [cross out] alk reaction. The destruction of time in more extensive parts caustic pottass Because the acids from camp with all which one insol Alk carb. & hydrate and ammonia camp are the principal ones. [cross out] NH4HO affects the air passage particularly. Treatment should be acids vinegar. The pain is greater than that of the fixed alkelies. The organic should be sealed up at once-as carbonates are formed by absorp of carbonic acid from the air Sodic hydrate evap to a white powder Test for pottasic hydrate in the reverse of the tartaric test Recovery is very sure in alk poisoning Phosphorous. This is a very mediocre poison. and is very common one the sym do not come on very quickly. And is apt to be overlooked Vermin pastes and maches are the principal sources of [cross out] accidental poisoning Stick phos this is poisonous- the Red is not and is amorph [cross out] where on the stick is not Red phos in [cross out] matches is not poison. When used chemicaly the ends are soaked in coffee or tea. If these are soaked to long the phos is oxidized into hamamelis phos acid or not long enough as he may not stir it up. A good may hours elapse before sym come on. gas comes of the stomach tracks like garlic and if seen in dark has a phosphorescent glow. Give 5-10 hours Common for Nervous for Hamerhages from those may be sizy or combined Common for time 5-6 hours pain in throat swollen tongue diff in deg. vomiting not bloody or dark in phosphorent has a slight grody oder. Colic. dranken tender abdomen best for 24-36 hours then they stop but the pulse is still feeble and the patient collapsed. Best in for 2-4 days- sudden death may take place- often between the 2-4 day. jaundice appears- Same is time of NH3 in regard to jaundice (Ac, Sb, Ba, PHO, NH3 all these act much alike and produce fatty degen) When the jaundice appears you get headach. fatty matter (most def) in one- delirium coma and death is for 6-12 days. 2d from Nervous. Sym depend on active or nervous system from membrane. cramp [illegible]. Jaundice in case-. the delerium coma & death 6-12 days 3d- death is not so early. vomitus bloody. stools bloody. life may be preserved untill the enlarged liver may be diseased. Colic at time an [cross out] in 3-4 week. death from hemorrhage. which come from all the mucous mem. and then are hemorhages- spots under the skin. Recovery from phos. is rare and the prognosis is alway very doubtfull unfavorable. Phys-action of phos. 1 That it is oxidyed at expense of O2 the tissue and blood 2d that it is absorbed in each and acts after absorp 3 That phosphuretted hydrogen is produced and cause death The 1st [cross out] is true to an certain extent. as is the second. If it be injected far into the blood you get an entre diff set of symptoms In regard to the 3d many say that it is imposs. [cross out] And that the gas is at once oxidized and become harmless but this depends on the way in which it is prepared. if prepared with nascent hydrogen. you get the regular eyes and port mortem appearance. and blood clots that then last in his [cross out] vein. Shorter period of death in 3 hours fatal dose for 1-3 gram but a much smaller dose is often fatal in children. Two maches in a child- 2 [cross out] months old. 3rd maches have proved fatal- one if a adult. Match=[cross out] .01 g gram if taken but great irritation- put in alimentary canal- if take-fine ports or after soaking you get no irritation Usualy you get cochainores in the mucus membrane Fatty dege of liver kid heart and muscular tissue give the powerful sym [cross out] the gastric and intest gland are fatty degenerated liver may be large or small. accending to the time the disease has lasted. Inflamatory lesions are rare more common with ar- kid- have the look of the arge white kid if has Bright. Free phos must be detected as an analgous- because there is so much in the tissue of the body. in fact in all fluids and tissue it is found. Autopsy. Have iron dark and look for phos. in mouth and throat then shake up the contents of stomach and you will get the luminosity which shows free phosphorus. It is oxidized very soon to phosphorus. and then it be phosphoric acid Odor luminosity and reduct test which reduces Ag Ma to mettalic ag Then is also applicable to phosphoretted hydrogen. This lummonsity is prevented by temperature. NH3 fumes. This latter import an NH3 in pul. for times Dose. is the way gr do the analysis with vaps. passes through the condense at the point where the vapors condense. there you get the luminosity. This is very delicate. 1 match will give the lumen for 1/2 hour. or 500 cc of H2O s a rule abt 3/6 of the phosposses over from the reduct. Treatment. All fatty food must be stopped Castor oil must not be used for the reason that phos mixes not as more easily absorbed. Turpentine old (new of no good) which has been exposed to air and has ozone. and is supposed to act by oxidation of the phos it could be given in large doses. Medical Chem April 13. 82 Recitation Mental symp. actions of the attendant & Take a note of all [cross out] who are present. What a compound poisoning & Where a person has been given and a drug has been given to cover the symptoms. This is compound posoning. Instance strychnia. then give morphia. Intoxication may hinder the absorp of a poison Morphia and strychnia are antagonistic The chemist should be given a hint as to what the poison is as it saves time and material this latter is a very important thing as the amt of material is always limited He should make the ordinary preliminary test of the sub and by so doing he may get an important hint. But if care important thing to do is to make a microscopic & diminution of the intestinal Tract to discover traces of the poison either emptily or leaves. Digitalis has on it two kinds of hair one jointed and the other not jointed and very bright [cross out] very few other leaves have this appearance. The color of the contents are important or giving a hint the oder. in case of the volatile poisons. Fatty degeneration of liver & heart indicates phos are antimony Corrosive sub may also cause the appearance in a less degree Organs should be divided into more than two parts [illustrations] Begin carefull examination of the food you can tell what was last eaten and abt how long subjected been going on. and these get an idea of when the food was taken. Organs should always be opened by the [cross out] medical examiner and not left for the chemist Doctor should always be on the look out for pretended poisoning. they may simulate the most of the symp but not all of them Lead is the only metal which comes under the stupefactants Opium makes a class by itself the narcotics Corrosives have purely a local action [cross out] Take chap XI. XII. [cross out] Toxicology April 14. 1882 Wood wants to see me. Monday in his labratory [cross out] Toxicology April. 14. 1882 Arsenic poisoning. In getting the sublimate of ar. heat the tube where you think the sol is to form and you get large crystals. Sources of ar-poisoning are numerous (Arsenious oxide) white ar is the most common. A perfect pure- [cross out] sulphide is not poisonous for it is insol in the juices of alimentary canal but by exposure to moisture a part is conveted into the white arsenious oxide and in poison. Mettalic ar (pure) is not poisonous. this by exposure undergoes a similar change to the above and forms arsenious oxide This metal mixed with white make the fly powder of the stones) Arsenic oxide (pentoxide) has not given any cases of poison This readily takes up moisture and becomes [cross out] converted into a moist mass White ar = 2 kinds Transparent and opaque. The opaque is [cross out] more sol in H2O than the other in [cross out] crystal Colors are very common source of poison. Arsenite of copper Shields green parse green are the same thing and are [cross out] poisonous Foulers sal is a poisonous sal Donivans sal in [cross out] made of as and also has Hg in sal. As dist in soft soap in a common source of poisoning and is used as an anti paricitic Arseniuretted hydrogen this is formed in Marshes test for ar and is extremely poisonous Salts of arsenious air is acids are poison but they have give few cases of poisoning [cross out] Yellow sulphide as a color has given rise to cases of poisoning, partic in childrens toys. Where it has been used as a coloring matter Symp. often [illegible] of white ar. and the sal of ar vary very much We may have 2 varieties of acute. Acute = rapidity of symp violence and rapid death This is not so common in the sal acute = death in two week In cases of acute sym appear in 1 hour after injection of poison which is almost clear white as at Paris- green-white gives no tast except a sort of burning sensation Paris gives a coppery taste. [cross out] Sensation of heat great there great pains on the epigastrium a little later a dysenteric pain in the rectum Vomiting and purging may cease as rapidly. Very great prostration fainting cold extremities & deat in for 6 to 8 hours & Now there is another kind of poisoning where the purging pain with vomiting may be absent but you have a great deal of narcotism and the patient dies in 6-8 hours. The common for in the sal acute sign comes in for 1-10 hours- these may be destroyed by various causes and states of the system. opium- may delay the syrup- intoxication. One case a man took 120 grams and sym did not come on for 3 days- death in 6. When the sym do commence by have abt vomiting and purging and prostration and great old pain then comes after a day or so a let up if there symptoms. Thirst weakness irregular heart cold extremities. painfulll deglutes (pass) remain this last for 20-48 hours then comes a reaction and we have the result of inflam Old tender symptomatic resonance tenderness sleeplessness action of heart is affected face is swollen an cyanotic sometime for 2d-5th day you get an [cross out] erruption due to action on [cross out] the sweat glands & then effort to eliminate Rarely you have jaundice (and after death you get fatty degen). Intellect remains intact untill a few hours before death then convulsions- and death death in such a case is in for 2 days-2 weeks. We may have both in the acute and subacute bloody vomitus and blood stools. Death may not take place untill after all ar has been eliminated death being due to secondary condition due to inflammation but this is rare- Chronic form of poisoning Usualy due to administration of Fowlers-sal-in two large dose-The poison (Ar) is not an accumulative [cross out] but is [cross out] one which is eliminated and in chronic cases it is taken a little faster the eliminated Here you get alum the eruption vomiting. Blood is there and rarely and here hemorrhages from nose uterus throat &cl- face looks prematurely old hyperaesthaesia of skin-trembling of the limbs-(palsy) death in for a [cross out] month to three years. Poisoning due to external application. such as caustic here are aliment always have an eurption at the point of application. Ordinarily in case [cross out] acute [cross out] as an average death cause in [cross out] 1 day Shortes period in 20 minutes longest 2 years in a case of chemi 2 or 3 grain of white or in an fatal dose 1/8 of a gram has produce serious results 2 grams given divided denser [cross out] scattering through 5 days has proved fatal. (1/2 of Fowler = 2 grams of as.) We find no acute great inflam of mucus mem of stomach & intestine. In the chemi and sal acute you see no sighn of acute inflamation. The only thing in a full swelling of the gastric glands [cross out] color due to fatty deg. same is true of glands in intes partic solitary glands Fatty degeneration comes on in some cases. with remark the rapidity beginning in 3-4 hour. complet in 10. at times preservation of the tissue is- a thing to be observed in this is quite characteristic of ar. Prof Wood mentions a case where the body was preserved for 26 years. Purpuric spots may be found beneath the skin. There are no lesions of skin mouth or esophagus. In the stomach you get ulceration at times. great redness and at times perforation but this is not common. This redness may cover the whole surface or may be confined to spots or may only effect the fold of the tongue Upon carefull ex we can usual find traces of it on little white or yellow patches. white in death has come a quick yellow (sulphide of O2) if death has been delayed We find the same look in the upper part of small intestine and in the [cross out] rectum. The solid [cross out] organs not affected heart kid liver and muscular tissues are as a rule fatty degen. As may remain in the tissues for a long time Case all on [cross out] record where it was clean in 16 days in part when given in larger doses. it is not in copiously eliminated In a case of chronic ar was detected 6 1/2 [cross out] weeks after the last dose. Medical Chem. recitation. April 20. 82 What are the common symp of irritant persons. [cross out] vomitus blood- pain in stomach. In corrosives you often get periton How frequent are cases of H2SO4 poisoning. Give syrup of H2SO4 poisoning. Pain in old men. browning of mucus mem of oesophagus coffee ground vomitus acid reaction constipation [cross out] suppression of urine. bladder empty or filled with bloddy fluid Dilute H2SO4 will brown H2O when exposed to the air until you get a given sp gr and the red stain becomes brown What sub is often mixed with H2SO4 Ans Indigo. This is often mixed with H2SO4 and its marked blue color readily leads to its detection Dilute H2SO4 does not cause such violent symp and you do not get peritonitis so often and rarely have perforation Total dose in 2 grams. Antidotes are chalk. lime. MgCO3. Mg is preferable to the others as it acts also as a carthartic and then assists in its removal Give tests for H2SO4 BACl does not distinguish between free and combined H2SO4 Diff [cross out] between H2SO4 & HNO3. Color of vomitus in yellow pain more diff and it also attacks the air passages. Spots on clothing are [cross out] yellow as they are on the mucus mem. the yellow color is due to formation of nitrate of [cross out] albumen Nitric acid also gives out an oder due to nitrous fumes- H2SO4 is oder-less Tests for nitric acid = FESO4 + H2SO4 Symp of HCL resemble those of Nitric most as this solubility is abt the same. both affect the air passages Detection is very hard- M. If free HCL is present you need not add nitric acid for a crystal of nitre will do. the same is true in the reverse. where you may add a gram of common salt. AgCL is sol in NH4OH and sodic hyposulphate, this test alone does not distinguish it for all of the hylogen acids are kept. by their (hydy iodie. hydobromic. hydo [cross out] cyanic) Principal sources of oxalic poisoning Salts of Cinm. these may consist of two ingredients. [cross out] [cross out] The crystals of oxalic acid and MgSO4 cannot be distinguished. as far as look goes. Oxalic doses not charr. Epsom salt [cross out] insol in alcohol. sol in H2O. Oxalic sol in H2O sol in alcohol. In a tube you can by gentle heating sublime oxalic Oxalic acid is very sour and on nacent of its extreme solubility it is almost impos. to give it cunningly. Syp Burning pain in stomach vomiting if patient lives several hours you get purging vomitus. may be bloody is not but if strong usualy get. blood after absorp you get a weak pulse collapse and prostration putre when given in dilute form. Shortest fatal period in 3 minutes. Calk is best in this case because it is much less sol. than Mg. Next in time H2O If acid is strong you use not the stomach pump if weak do other cure [cross out] Begin with post mortem look (oxalic and go to ar poisoning Toxicology April. 21. 1882 The elimination of ar is usualy complete in 3 weeks. One case is on record when found after 6 weeks. The as is not distil uniformly through the body sometimes asking more partic the liver which has more than any other tissue. here the max amt is greatest in about 15 hours providing that absorp commenced at once we may have an amt if ar = to 6 pains of white as. At this time fatty degeneration has commenced. The time at which it commences is important it may commence in 7 hours. In once case it was much advanced in ten hours in one case it had started well in 7 hours. Some claim that the greatest amt [cross out] so stored up in the brain and nervous tissue But they performed the test by marshes test. and as some sulpher and organic matter may be deposited the weight of the tule may be increased and hence an ounce. Liver and kid have abt the same amt in proportion to their weight. The amt in the stomach and intestines depends upon the amt of absorption Treatment of acute ar poisoning The great thing is to get rid of the poisonous matter. Large amts of ar may adhere to walls of stomach. Use stomach pump if you can get one if not use greasy H2O mustard and water or dry thing which will dissolve the ar and cure vomiting at same time. freshly prep ferric hydrate. is the very best antidote. Ingestion of alk camp are very impressive because the ar camp are so soluble. When the pump is used stream should be passed for an hour or so Magnesia is the next best thing In order to remove that which has been thrown into the intestine give castor oil to carry it through quickly. In case which go as favorably the urine should be tested daily for the pressure of Ar- Prep and tests for ar. Two forms trans and opaque. 1st in large masses and in such case sol [cross out] in H2O acid is not common. 2d in the form which is often met find in octahedral and 12 sided crystals in [cross out] caustic sal in boiling H2O slightly in cold. Weight of ar- A heaping-[cross out] teaspoonful weight 150 grains tablespoonful 520 grains Sp gr of white or in much greater than that of H2O. but it floats on water to a great extent this dir it from other powders And this should always be done at once at be used as should the test for volatility or not very are volatile. put a little on a knife blade and at dips opens or does HgCl. HgCl2 & [cross out] [cross out] sal-ammoniac. Metallic as in also vol or well as The whole oxide, Another very ready test which can be applied to all the compounds of ar. Heat with a strong reducing agent (best sodic black flux.) This is better than the pottasic because the latter takes up H2O. which rather hinders the test. This tube gives off an oder as garlic. and you get a deposit of white ar. corresponding to the amt of air in the tube. this is very valuable in all. legal cases Arsenite is yellow. arsenate CuSO4 + arsenionic acid= let green arsenitie of CU. CUSO4 + arsenic acid = blue green [cross out] arseniate. both the cu & Ag sal are sal in mineral are in and NH4OH The sulphuretted by hydrogen test in one of the most usefull tests for it can be applied to powder as well as sal. Common ar As2O3 may be converted into As2O5 by boiling with [cross out] NHO3 or with free cl. Formation of tupple arsenate of these crystals are similar to those of tupple phosphate. The atom of phosphorous being replaced by an atom of As (MgNH4PO0) (MGNH4AsO4) [cross out] (Arsenic acid test for any form in oxidzed with cl of HNO3. amt is acidulated with HCL and N sol of uranium added and the test is just the same as that for the phosphate. This is a test he must to need before) If you destroy the organic matter and pass [cross out] Sulphurated hydrogen you get a ppt even though you have not metals there This is due to organic sulphides No [cross out] dependence should be placed upon the color of the ppt [cross out] obtaned by passing H2S. With the sal of the white fused nose in water all the tests for arsenic acid may be obtained) Reinches test. acidulate the sal with HCl and boil the copper remove a pail of ar from the sal. and it is deposited on the copper Wash and dry between filter paper and this gives a sublimate of copper. The best kind of a tube is one with a lath and a slim neck Marshes Test. Methods of analysing Medical chem. April 27. 1882. What are the post mortem appearance of H2SO4 poisoning. PhH2 is usefull in the test for oxalic acid for it eliminates the a large amt of organic matter. Essential diff between acid and alk. poison. reaction of vomitus differs. Taste is sour alk. nauseous and burning. and gives a soapy feel. Vinegar or nitric acid or lemon juice. one the most ready remedies for the alk. Better than either of these in milk or olive oil. [cross out] In any case of poisoning never use any preservative fluid. Most of the salts of the alk acts both localy and generaly 1 pound of phos will make denser mache Never give any oily mixture of oils or oily camp in a case of phos poisoning but give saline carthartic [illustration] Some pill Phos is absorbed as such as is proved by an examination of the urine. How do we know that phosphoretted hydrogen absorbed [cross out] as is proved by breathing through a sal of nitrate of silver which is reduced and as the breath is not Cummous gen I know that there is no free phosphorous Turpentine should be given in large doses for if given in small doses it is absorbed and acts as a poison but given in large doses it passes rapidly through the intestine and does no great harm. Large dose is about a teasponfull - take spoonful. If the patient has been treated with turpentine the phosphorescence is obscured. NH4HO. sulphuretted hydrogen also does this Ar and Sb for the next recitation Toxicology April 28, 1882. Test for as in wall paper. Marshes test is the only reliable one for paperer of all the colors and for cloths. Cut the paper into small pieces moisten with conc. H2SO4 and char on a H2O both be sure that they are all moistened with HeSO4. 2d (Mosten with NH3 and you get an azure blue due to copper then add a drop of ag NO3 and you get a cannary yellow doe to resenite of silver sal in excess of NH3 and the mineral acids) Moisten the charred paper with H2O & filter or rather wash with water and filter. In performing Marshes test care must be taken to add neither to much or to little & always test your reagents is doing the test as the ordinary. 2 or 8 H2SO4 is apt to contain As. and this is done by testing the flame with a porcelain plate before the mixture has been added in common cases gm should also beat the delivery tube for 15 minutes to be shure that no nerve is formed in the tube. Haematuria is a common syrup associated with arsenuretted hydrogen poisoning and gin also have nausea. In a moist atmosphere the ar in wall paper ashes a little sulphuretted hydrogen then in inhaled acid the dust dewed from the paper. But when the paper is of a bright color you can sometimes get a green dust above. the doors and windows where dusting is not common. here we get 2 ounces gas and dust And the fact that dust is in the air has been founded by filling water with [cross out] a cotten and passing a current of air through bringing it mite contact nitrate of silver and for this it has been obtained After the gas has been tested then introduce to sal and wait for a minute or two. Sources of chronic poisoning most common in wall paper. paste green all of the aniline pigments are apt to contain ar. Shield green arsenite of copper has 60% of copper and in the olden times was a most common source of farming [cross out] Orpiments & reoba are sour of poisoning and as they are applied to large they give use to many cases of poisoning Another course in the use in the ants or fly paper for instance. which is very poisonous. Coloring of clothing is also apt to contain ar and gives use to many cases of poisoning. If fabric has wool you must destroy the organic matter with HCL. [cross out] KCLO. filter and work with extract with H2O and nitro dose wt fork Artificial flowers give use to many cases of poisoning, partic green and red Water color paints partc light green have ar. the dark green is also poison although not due to ar. Candy is often colored with Ar partic the red and green. Paris green is colored with paris green Chrome yellow in [cross out] used as a coloring matter Aniline pig used in confec are sometimes poisonous. Wine claret is often colored with a pig containing Ar. Arsenical syrups raspberry blackberry jelly jams Fonstein in wine is detected very easily as follows add to 30 cc of wine + 10 cc of sub acetate of Ph han and fiter cool + 10 drops of Ha + 10 cc of angl alcohol and shake and often then has seperatia the alcohol is colorless if pure but if not it is rose or cherry red if it certain rosac acid alohol will be yellow. if colored with Alum get violet or red. In test color put some in a test tube of a little NH3 and if it becomes colorless it must be fontrein Wall paper. He cannot say from to look if a paper wheather it has ar or not. We may even have the same pattern and color one has ar. other not. (False shield green = chrome yellow + prussian blue) Paper used for wrapping candy often has a large amt of ar. Glazed paper often have an minimal amt of ar. in them and are very dangerous and are used by young children in toys. Playing chidr often have a large amt of ar. Toxicology May 5. 1882. Symp of chronic as passing. Most of these symp are due to the dust set free from the paper. Which comes in contact with the mucus mem of the throat and lunge. There is catarrh cough and the patient has apparently a bad cold there is also conjunctivitis. And ar a small amt is swallowed ar get dyspepsia and if the inflam gets into the intestine we get a little diarreah Lately we have symp due to the action of the ar on the nervous system and you get what is known as nervous prostration. And all the symp of these obscure diseases [cross out] may be caused by ar. (Carpets often have a large amt. of ar.) Women are much more frequently affected than the men because they are in the corner more - Gradudual [cross out] peculiarity has much to do with this Death is often caused by the form of poisoning Epleptic convulsion may be caused by the form of ar poisoning Antimony poisoning Sources are Tar tarter emetic & the Tar chloride. The pure metal and the sulphides are not poison. Tarter emetic is a double tartrate of antimony and potassium. KSbOT. This has abt 44% of antimony This has caused many deaths both from chronic and acute poisoning When taken in large doses it acts as a violent emetic and thus you get rid of it- Here if antimony has 32 gr to pint of sherry wine. Ointment 120 gr to the ounce. When a large dose is taken you get an acrid tart. (which ar has not but as a whole it useable as poisoning) Then vomiting and purging much may be absent - sore mouth and throat and the mucus green is covered with an apthous crust. solution is also seen (as it is sometime in ar) Vomitus often bloody as are the stools, cramps in the abdomen, sometimes spasms The symp strongly resemble those of acute dysentary Antimony in fatal cases progresses rapidly and fatally toward death When the dose is small it goes on untill recovery commences which is also regular and progressive In ar there are intermissions and let up, which differ from the symp of [cross out] antimony which is progressive and regular. [cross out] over The prostration is in propotion to the amt given In cases of chronic posioning there is an increase in the amt of urine, and the urine has large amts. In ar the urine is diminished Intestinal symp resemble those of chronic dysentary External application of antimony pastes the chloride which is found in most cancer pastes causes cases of poisoning. When this is applied you often get a pustulous eruption on the surface of the body. Post mortem. examination. Of those crust fatty degeneration inflamatory process which may be confined to duodenary cecum [cross out] ileum. The greater part of the small intestine being skipped. Fatal dose is hard to determine. 1/16 of a grain have given severe syrups. But this is exceptional. The smallest fatal dose was 3/4 gr in child 2 gr for an adult, death ordinarily takes place in from 2-6 days Treatment. Is to force the vomiting. Give Tannic or gallic acid These are drugs at hand and are very valuable remedies Gallic completely precipates the antimony forming. The Tr gallate This drug (tarter emetic) is very sol in water. KSbOT in ppt from sal by nitric acid care must be taken not to add to much acid as it is sol in excess-if nitric a. in an excess of HT. this last dection gushes it from the similar B1 compound By this depletion the oxy salt is formed Leneker test gives a blacker deposit on the copper in Sb then is ar and the subliment is nearer the flame and the crystals are vesiculate rather then tetrahedral Mauher Test is of great value And if the delivery tube is heated the Sb is deposited on both sides. And if heated in a close current of H2S you get a yellow sulphide of ar and an orange sulphide of Sb. If put in pased through Sal of AgNo3. is in you get ppt of more Ag. in case of Sb. you get a mixture = Sb ag As sal in soda hypochlorate Sb in ammonia sulphide In cases of Sb poisoning all the urine which can be obtained should be. For after you can detect the Sb by concentrating and preforming Denmcher Test Sb can often be detected in the body long after death and it preserves the tissue The case of poison from the tea chloride are very few and its action is that of a corrosive and in the cases which have been seen the intestines have been very much impared Medical Chem. Toxicology-May 11. 82 What is the treatment in a case of acute Ac poison? Ans Give emetics and then give a sal of fresh ferrio hydate which is made by ppt ferric cl. with NH4HO and wash the filtrate trouorghly, until all NH4HO is removed. because any free NH3 will for arcenite of NH3 which is very sol and is readily absorbed. a mix of Mg with this is still better- Have test white Ar powder? Ans. It floats on water-and is a heavy white powder-volatilizes on heating and gives of white fumes-which may be condensed on a slide. Gives a bluish tint in the lower part of the flame Sulphuretted hydrogen added to the sub gives a yellow color. Deincher test and the reduction test with [cross out] [cross out] blood flux which is made by igniting sodic carbonate. Liquids. tests ar those with Agnitate and with Sulphate of copper and with uranium. the last is used to get the quantative test. the proportion of which are the same as the test for phosphates. In the analysis the phorphosic acid is seperated by the sulphuretted hydogen and thus all poor of this reaction being due to phosphoric acid is removed Means of distinguishing ft Ar and Sb by marcher test?. [cross out] Ans Diff in color and solubility and in volatility In the nervous with nitric acid and crop: and test with nitrate of Ag- from if ar grey in Sb. Has test a green powder quickly of Ac? Ans [cross out] is reduction test NH3HO + AgNO3 This is done by adding the NH3 to the powder get a blue dust by Cu-then add the Ag and you get an dicenite of Ag which is a canary color In testing paper you moisten the paper with the H2SO4 and char. filter and add to acid in the H generator All the test mentioned on the paper are watch glow tests-only a grain of the poison being used-with one dose of the reagent What are the principal sources of KSbOt poison? Ans the tarter emetic and the tar chloride and the prep wine of antimony-and the ointiment of antimony Sb cu very much most sal has ar. And the taste is acrid and the crystals are tetrahedral and large. these points distinguish it from ar-What are the symptoms of Sb poison-? What is the progress in Sb? In chronic poisoning the syrup resembles those of chronic dysentary for which it is distinguished only by the examination of the urine. This is the only way you can distinguish it from dysentery. The amt of the urine is increased in chronic due by stimulation of the kidney What are the part mortem appearance ? Ans-There is inflam of the digestive track-[cross out] with exception of small intestine which is mostly skipped-fatty degen is also seen partic in the eyes What would you expect in case of chronic poison? Ans fatty degen and no sensation Mucus mem of air passages is more apt to be inflamed in antimony than in ar What do we see when Sb has been applied externaly and it is also seen at time when taken internaly. What is the antidote? Ans any sal containing gallic and tannic acid Gallic acid can only be used as a reagent [cross out] for quantitive work When the Sb is in form of terchebudi What are some of the ready test for ASb OT.? One Reineher test Marsher test. Bedside test in sal ability taste charring and gives oder of sugar. dipped into flam get. mix of simple and blue. Which are color of Sb and K. Sulphuretted by doses to powder = orange color added to sal-plus HCl also gives orange color. Orange sulphate of Sb in sal in HCl and in this sal. if dropped into H2O get a white ppt of oxg. chloride sal in HCl and HNO3 Take next two chapters. Hg. cu. Toxicology May. 12. 1882 Hg. Hg and all its comp which are sol in gastric juice and poison. The principal sources are HgCl2. HgCl & Hg. Calomel prob gives use to the most cases of poisoning because it is impure and has some of the soluble-cl-or it contains some-which is sal in the gastric juices. If you treat HgCl-with HCl + H2O and you get no mercury-but if you add to it gastric juice you do get it. hence never give calomal during digestion. Hg is the principal source of chronic poisoning due to the fact that Hg is vol at any temp above 40 deg F. And in the mints and Cabrotarge where it is used you get many cases. HgCl2 gives many cases of poison from its extensive uses as are anti parasitic. And is the taking sal which were intended as external lotions. All the sal ferrus of Hg may be absorbed from any surface. Hg as absorbed through the skin as surely and is not changed of [cross out] and has been found as such. Symp of Hg Cl2 are local and general. The local are corrosive almost as much as acids and alk. have inflam of the whole alamentary canal. Mouth and osephagous are often covered with a white coat due to an abluminate of Hg After exposure to air for long time becomes harm. Vomiting in rapid first contents of stomach then becomes often bloody more so than As in Sb due to its greater corrosive action The diarrhea is more apt to be bloody the old pain is intense. Vomiting comes quicker than in As Dejecturs are frequent are bloody urine is almost suppressed and very scanty and you have in all cases symp of acute nephritic This is due to effort of kid to eliminate the poison. Breath is fetid and has peculiar odor and in some cases we get salvation but not comming Usualy toward end patient seems a little better but the heart goes slower and weaker-respiration diff and death is from a few hours to a day or two Nervous sym. Loss of sensation in lower part of body upper part is normal. An depletion is also common much resembling erysipelas but last only 4 days. Chronic poisoning commonly called professional poisoning from the frequency [cross out] with which mercury colour are effected This may be caused by frequent doses of Hg in medicines The first symp is that the gums are a little swollen and tender This tenderness is procured by tying the gums together. Next is the diarrhea. If the [cross out] Hg has been given a long time we get a purple line due to the decomp of food in that place forming. H2S which unites with Hg and gives sulphide of Hg. same things cause the rings in lead and copper poison. In long cases jaw and cheek may become ulcerated and these may be mistaken for syphilis pain in the bones also comes which closely resemble those of syphlis Patient is pale and aenemic for action of Hg on the blood Trembling and epileptic convulsion Tenderness of gums follow weakness and diarrhea are the warning symptoms. The production of sal irration varies much with the acids by dust effected time of its appearance varies much has been known to come in 1 hour. It may reappear after having ceased. [cross out] The Hg being given in the mean time Salvation may be produced by many sal digestives. Ar EL. Iodide of A False teeth. B. compound. and all irritating compounds applied to ant will produce this. Mercurial palsy and salvation are very rarely seen together. Symp of Hg applied external are abt the same. salvation and eruption are more common. Post mortem. Evidences of inflam and irritation. The white coat. which goes down on for a part of small intestine. When exposed to air stomach looks black. The tongue is swollen and the papillae much enlarge. Kidneys are acutely inflamed. (Acute parenchy nep) In chronic you have (Chronic inter stit). Fatal dose-3gr of corrosive sal in the fatal dose on an average time 1-5 days. In chronic duration of life is uncertain. Treatment fever vomiting Give all the albumen as either is the best antidote forming an almost insol abluminate of Hg. Eggs. milk are the two best Flour may be used. The starch may be removed by washing the flour with water and straining through a cloth. But it may be used [cross out] mixed Use of stomach pump is doubtfull. For syrup or chronic Chlorate of potassum should be used. Test volatility, This is true unless in combination with fixed acid. There is no charring H2S gives black color with HgCL2 in HgCl HgCl2 if warmed in a tube gives long vesiculate crystals. If a little soda be mixed with the comp and you get a sublimate of that Hg. Which may be condensed into a large one by rubbing together with a glass rod or tube. Toxicology May 18. 1882 What are the principle sources of Hg poisoning. Corrosive sal furnishes the cases of acute poison. Hg and calomel the cases of chronic. What employments give cause of chronic poison. What is the best preventative against Hg from a factures. Ans sprinkle the floor with NH4HO This has been forced to do a good deal to prevent this. HgCl2 = IC HgCl ous HgCl is a heavy crystalline sub very sol in H2O. Alcohol. ether and [cross out] Calomel is often contain united with corrosive sub. How are HgCl. and HgCl2 made? What are the symp of a large dose of HgCl2. Ans, Urine sunken from blood. vomiting violent and [cross out] bloody nauseous taste. White coat. More apt to get blood because it is more corrosive Can we have acute poison from the extend application of the poison ? Lead and [cross out] cu give a line around the gums. as do all mineral poison which give it black sulphate-PbgHg gives blue line Cu more if a purple. What is the time of death. Ans usualy in twenty four days What is the antidote Ans. obl matter. Eggs. milk. flour. These form an [cross out] obl of Hg. which is sal in an excess of the alb so to much should not be given PM appearances. Mouth and oesophagus have a white color due to alb if Hg turns brown or exposure to air stomach and all parts of the track touched by the poison. Perforation some times takes place: Kidney-in acute gives acute parenchymatous crephuts chronic produce chronic and interstitial What are the symp of chronic poison? Ans tenderness of gums and teeth. diarrhea in one of the first symp. What is solution? Ans Increased [cross out] secretion of saliva. There may come on quite rapidly. quickest time on record in 1 1/2 hours is the quickest time on record-some persons are much more easily sal seated than [cross out] others. children are not so easily [cross out] salivated but are easily affected by the poison Has detect Hg comp by ready test? Crystaline form in case of HgCl2. Calomel-amorphas. HgCl2 fuses and get white fumes-and condence a piece of [cross out]-cold glass and are useable shape [cross out] & Hood [cross out] Sulphide of Hg in sal only. aqua regia [cross out] Pb. Cu next time Toxicology May. 19. 1882 Hg is usually gotten rid of in a week or so. When a person has been treated by munctin it may be found for a long time a year even. Hg has been found in the lunge due to inhalations of Hg fumes. Lead poisoning This is often met with partic in the chronic form. Most frequent form is the poisoning of water through lead pipes. Soft H2O attacks a lead pipe. much more than hard water. & water containing an excess of alk carbonate attack it much more vigorously. Oxygen dissolved in the water under with lead to form ox of Pb or common litharge. this meets the oxy carbonate of lead which is not very soluble. If the H2O which has stood over night is drawn off there is little danger of Pb poisoning. Acids or preserved fruits attacks the lead in the tin or silver and you get poisoning in this way. The so called tin foil usualy contains a large amt of lead some specimens have as much as 90% Painters are very liable to lead poson. due to use of white lead (carbonate of lead) Plumbers type setters are prone to this trouble Lead is a cumulative poison and is absorbed as such. and it may not appear in the urine untill after treatment Inhalation of lead dust in the urine causes many cases of poison Granden of colors are very liable to this trouble Red and yellow led are used often as a pigment and this cause poison Use of lead in enamel of cooking utensils causes many cases of poison. Ordinary porcelain lined dishes may have lead in composition Cleaning bottle with shot is apt to cause poison. due to the formation of a slight amt of PbCo3 on the wall of the bottle Cleaning champain bottles with spot a fine spot reoccurring in the bottom of the bottle and their giving use to poisoning Ordinary red wafers sometimes contain lead. Coloring of food and confections with chrome yellow often causes acute poisoning due a much to chronic acid a to lead. Many hair dyes have a large amt of Pb. Acute poison is caused usualy by ingestion of sugar of lead. Use of neither in lighting a pipe with the ordinary matches which are colored with red lead. In acute poison We get first symp of ordinary irritant poison and a sweet tast. colic and constipatin. This last is characterit of lead ar is tart Colic is sever and is epgastric and is relieved by deep pressure a abdomen is dry other irritant pressure increases it Lead is a stupefacient and the stupor comes as either late and lat of 2 or 3 days before death. Recovery from Pb is very rare and is incured in by an acute febril attack and recovery is slow- Chronic poisoning Mal-nutrition pale anemic Urine is less. yellowish hue to the skin. blue line at junct of teeth and gums Emaciation takes place and often a tone according to strength of patient Colic, paralysis artralgia Colic been relieved by ferriac and old in retracted so you can see shape of spinal column and is thought to be neuralgia if in brachial plexus and arrested with convuls and pulse 30 or 40, Releized by Arthralgia always free movement of bones and found near the joint and resembls herniation and is destroyed by the fact there is no inflamation- and is found mostly in bones extremetie Next comes the paralysis which affect preferably the upper-extrem and affect first the extensore and the wrist drops and is most common in the hand most used. This may come on very rapidly though as a rule a long time lapses. Cerebral limbs is next Epileptic convulsions comes- due part to hair dye- and face powder- violent head ache [cross out] No danger comes from sleeping in a fresh painted room or for a lead in concerned but the colics are due to turpentine and the volatile oils. In cases of chronic poison if of long standing we get interstit Bright. Tretment in acute the best antidote is epsom salt. this forms the med [cross out] sulphate and acts as an [cross out] carthartic If any other sulphate is used it should be followed by a carthartic because the sulphate after a time is attacked by the intestinal juices. Lead in case of chronic poison is in the form of an atheminitc of Pb- This in doses by K9-to a slight extent hence the value of the drug for of at dose all at once we should get acute poisoning If with K9 produces colic you must give it very slowly or if not able to stand it at all use hot sulphur baths and after a time the patient will be able to stand the K9 Electricity is good for the paralysis Peculiar pain of lead colic is distinctive, it location in epigastrium and diss on pressure. We do not find many PM symp-sometimes a white coat if fresh. black if death has taken place sometimes before If lead has much acetic acid in comp you may get symp of irritation Tox. recitation May 25. 1882 What are the symp of acute copper poison? What is the color of the stool How distin. between chronic copper and lead poisoning. Pb is constipated Cu loose. pain in epigastrium is releived in Pb by pressure. in cu is not Pb is circumscribed. Cu diff use. Pb old is contracted. Cu swollen and tense. [illustration] What is the action of H2O or Cu Sulphurettic hydrogen produces the Heat sulphide of Cu and is sol in dilute. [cross out] Ha Cu is not a constit of the animal economy only to a very limited extent. Is is an accumulative poson as much so as lead [illustration] What kind of food are most apt to remove lead? Ans. any kind for acid fruit. and many of the vegetables partic tomatoes. many of the alk veg also remove the lead. Acid drinks. Cider. beer. shiny wine Mix of Acetate of lead and sol plum make the most of the hair dyer and oils and give use to most of the cerebral symp. [illustration] [cross out] -Pb. Toxicology. Rec-June 1st 82- -HgCl2 -Hg Cl2 distinguish betwe the two -Cu -Ac -Sb Paris green. Paris contain both Ar and Cu green must be force to Strychnine Morphia Either strychnia or morphia will be mixed with one of the metals there will be only one metal in the mix are here you have paris green. then you will have two metals Oxolic acid KCh [cross out] In Sick acts as a strong irritant. In Cl acts also as an irritant and has also a corrosive action Cases of Bi poisoning are on record they resemble ar quite strongly and they were due to impurity in the Bi and in fact all these Bi comp have ar- due to the fact that the Bi axe is also an arcenical one Prof Hood says that he never examined [cross out] a specimen of Bi without detecting the presence of as- Tellurium is often in comp with the Bi- and in fact a strong odor of garlic to the hearth which is very dist. Sub nitrate and sal combined or an acid may produce symp of irritant poison. Cranium. this gives symp as an irritant. When insol cronate is taken the HCl of the gastric juice forms [cross out] a sal comp and you get symp of poison Candy colored with chrome yellow coloring of gums; yellow layer surrounding hams- have given cases and were prohib by European countries coloring clothing with this has given use to cases of poisoning Digitalis and helebore are both cumulativ poisons- Poisoning by Carbolic acid this is a decidely a corrosive poison. The urine become dark and smokey and a diminution of alk sulphates Then we have gastric symp slight fever. in severe cases are finely get cerebral symp and convulsions People inflicted with any septic disease are more apt to be affected partic young person. When introduced sub cut as by spray produce it quite rapidily Test for Carbolic 1st purple color-due to sal+Fe2Cl. 2d Se+NH4HO-calcic hypo clorate is ordinary calcic clorate Dark color of urine is not in proportion to amt taken but the amt may be approximately estimate by examining the sulphates. The amt carbolic absorbed Morphine C17H19NO3 (6-15%) use 6 are the Codiene C18H21NO3 (-1)% most import Thebaine C19H21NO3 Pepoveuine 620H21NO4 Narcotine C22H23NO7 (6-8%) Narceine C23H29NO9 Meconic C10H10O8 Opiamine C21H21NO7 Meconic Acid H3C7HO7 (6-0%) Suporific Convulsive Toxicological Narceine Thebaine Thebanie 1 Morphine Pepovensive Codeine 2 Codeine Nicotine popoveine 3 Codeine Narceine 4 Morphia Narcotine 6 Narceine Morphine 5 These are given in the order of there power in the diff classes- Tox June 2. 1882. Blue color with Fe2Cl6 Throden-reagent orange [cross out] HNO3 In a legal case do the test with Fe2Cl6-and in this same sol you can do the HNO3 test and get the deep orange. Trohdeir reagent gives the most delicate tests for morphine Morphia heated with H2SO4 then add crystal of KNO3 and get a flaw of color- Principal test for mecornic acid in the fine Cl test = Blood red. color which is not bleached by corrosive sub in HCl Acetate of lead. pptr the meconic acid from orange mix Sublimation two for morphia is very delicate. take a piece of Cu put on it some morphia then put in a Cu washer- and over the top part a glass-shade you get the crystals deposited on glass slide. this test is good for strychnia. This test is only applicable to pure alk not to the sulphates H2So8 and K2CU2O7. test are the principal test for strychinia A very large amt of Morphia will disguise the test- as will a large amt of KSbo T Strychnia in sol is 1000 parts cold 2500 of hot. This is the most bitter sub known 1 gr in 10000 parts of H2O gives a very bitter taste Comp sal of I2 = a very good ppting reagent for the various kinds of alk. First thing you do in a case of suspected alk poisoning with convulsion and see if you get the bitter taste morphia does not give convulsions in adult but does in children Strychnia should give us color with [cross out] HNO3 if trucia is present you get a slight colorless. If you have strychnia mixed with tarter emetic you will have to separate strychnia by washing a little of the powder with chloroform acate the fluid erup- and then do the tests with the residue- If Morphia is present use in the same way. alcohol. alcohol also takes up oxolic acid and HgCl2 but there do not interfere with the tests for either morphia and strychnia The chemistry of the alk is very diff due to large amt of organic matter and the quant used is so small that you do not find dig undis in the stomach In Drug. the drug H2SO4 removes all the alk and sal organic matter Opium poisoning This is very common. due to care with which it is obtained. Prussic strychnia Ar. Hg. Cl2 are the only 4 poisons in sub which are recognized a poison by US laws. Laudaum resembles much tart of hubarb Powdered opium given for case- Laudanum and sal of morphia are the principal source of pain Parggani is a frequent source in children Action of opium is a compound one Sleep is produced by only 3 (see but gives two pages back.) Narceine is more poisonous. the morphic and does not relieve pain Wine of opium if old has not much evacuation. Tannic prep of opium may be absorbed from any surface If opium is absorbed closely we get a stimulant effect if rapidly more. Tox. June 8. 1882. Opium. In poisonous doses-the acts of M and opium is similar. Acute. Due to rapid absorp of large doses, almost immediate, coma and in course of 1 hr to 30 min get death in this case pupil is dilated Rarely get convulsions this form is rare Common forms- sym come in 1 hr have 1st stimulant actions. if absorp is delayed, increased pulses excitable dry skin and throat nausea vomiting itching, may be ruptured if gives an an empty stomach all the stage may be wanting. 2d stage anesthesion deep sleep. relax of muscles pupil much contrived. not react to light comp in sensibility last for several hour. 6-8. 3d coma deep tortuous respiration. pupil dilated take place first before death. death is for 5-15 hrs In children often get convulsions and in adults lower in animal seat the more fre. the convulsion. Recovery is common as increases and Two kinds of opium true sweating during the first stage. exudation of serum during the 2d. Chronic (opium habit) There is nothing marked abt this stage only that a person get into a habit so that an eminence amt may be taken in some case. 9℥ have been taken per day. This usualy results in suicide This habit is often induced by neither giving this to children. They rarely live to be more than two years old. On the averge death takes place in 12-15 hrs in opium poisoning if he has lived over 12 hrs and have & covered from stops. prognosis is favorable Total dose in adult has been 1 gr of M. 4 of 10. 1ds of laud Children and old people are very susceptible Peope suffering from B without dropsy are very easily affected All cases when in much pain large doses may be taken; PM. conyer of brain and some afflicts hemorrhages. Apoplexy and intoxication are the appearances most often taken for opium. You can get either the odor of [cross out] [cross out] camphorated tinct. pepele are diff in apoplexy and only one side paralyzed opium both in opium and still you can usualy partly arouse the patient in apoplexy you can not do so. Stomach pump is the best they emetics so good to cause the stomach is paralysed Pain and an electric battery no good incites atropa not belladonna are good to counteract the action. Action of atropia last for 24 opuim for 12 and if you give to much atropa you may get death from this After exactly with acid and alcohol-shake with bergon and get meconic than with alcohol and the morphia may be take for the alcohol by shaking with H2O + [cross out] few drop of H2SO and evap [cross out] Morphine resists decay for a very long time and has been detected [cross out] after 10 mo. Strychnia last for the same time Cases of several years. Strychnia in cases detected for death takes place so quick that it has not been eliminated Strychinine Strychnine or vox vomica are the princple sources of the poison Symp usualy case in for 10-20 MM due to great sol of strychnia- the gastric juice 1st feeling of anxiety and terror and anguish and by some little jar-the patient is thrown into convulsion is ever that of patient may seat apex- Lead and heels the face is separate due to interference with it the comes a lot up and the face may become pale- intermission last for 5-15 Min. and then another convulsion- which if the case is to be fatal is longer than the 1st This goes on and in [cross out] adult death takes place The 4 or 5 convulsion if death to a convulsion it is due to obstructed use if during internal due to it have in death usual takes place- abt one hr-Consqent time as usual in 6 1/2 hrs-All sub which produc a slightly sal can hinder the absorp and the symp- All tannic acid comp for tannate of strychnine opium has dmeds. 1/2 gr has produced death in 25 min 1/16 gr has killed children. Treatment is to remove- strychnia and the very to do it is to chloroform the patient Ether and chloroform are the remedies Tox June 9 1882. Tannic acid is good to give in cases of strychnine then give chloroform chloral also gives releif, and should be injected subcut. [cross out] Surface of body is [cross out] Acid if death takes place during convulsion Fingers and toes are very strongly flexed. The post mortem acidity is very marked and last a very long time All organs are congested veins are full partic in uper part or cord and brain and may be of aflicted hemorrhages if the autopsy is made soon after death the heart is empty and contracted digestive organs show nothing In children death may come before the 4 or 5 convulsions and in animals with only one. Epilepsy. here previous history is taken into account. We have only one convulsion at a time Intellect is lost during the fit In strychnia the mind is clear. Tetanus then varies from strychnia by the duration and progress. In tetanus first the jaw is effected in strychnia it is not first and is but the convulsions are much larger and death is from 6-10 days. Puerperal convulsions here the patient is absol unconscious and the interval may be long or short and as a rule the patient does not talk inteligenty during the intermission. death rarely takes place before but if child in strychnia it does- the bitter taste also is noticed. In puerperal convul- the symp of nephritic is usualy present but [cross out] the urine is passed invol and the convulsions are larger Strychnine occurs in the crystalline form. ambere in rapidy crystalize neede if slow sol in sour parts of cold. 2500 of boiling H2O taste in most bitter sub known Readily sol in acids and in ppt by alk. The salts are very sol in H2O [cross out] 1 part of strych gives a very bitter taste with 40000 of H2O and can be tasted in 420,000 Insol in ether slightly sol in chlorform slightly sal in amyls alcohol H2SO4+K4CU2O7 detects [cross out] 10000 1 gr Best test is the fray Test Brucine not as bitter as strychnia and acts similary, but is not so strong The may be changed into brucine by reducing agent- brucine to strychnia by oxidation Brucine + cane. H2SO4 + well H2O give an orange colored juice at junction of the water and acid (test for nitrate) Shaken with benzoes removed shakes again and allowed to crop. and give get a pretty clear- comp or strychnia Belladonna dartura stram- 1 hyoscy amus niger Most cases are accidental due to taking sal intended for external use Alk are strophine and hyoscy aminic. these alk are common to all this. the all parts of plant are poison Signs are rapid 1st dry throat 2d dilated pupil. If gives several days or max dose it acts as an accumulative poison. after a time get dizziness and nausea- locomotion is not normal patient walk. as though drunk. have a [cross out] eruption similar to scarlet fever-. bladder and rectum are fairly red. This is import for the poison may be accumlates in this place and be reabsorbed. The urine is not dims but if any thing a little increased- Sometime get convulsion after a time have a gay and lively delirium freely erupts coma-convulsions and death after a few days although may come often after hours using. cinnamon-and is often unused in S. fever. after 24 hrs you can give a favorable prognosis. because this is the limit of its action. 600 gr of leaves = 1 gr of diaphus Renys of bell are blue and give strong blue color 360 gr of coat = 1 gr 1/10 gr is proved fatal Sub cut. or 3 -.005 In grm have proved fatal Stomach pump suction purges are all of value, tannic delays the absorp and is only of use to dely the effect. cold application to head and spine Morphia has been used to counteract the effects and is quite good. [illustration] Color is increased in atrophia. dr- O and if color 2 is livid both dose form M.O = sleep A = no sleep Tox June 12 1882. Morphine does not act well after a large dose of apophine and indeed a worse than nothing- Octuphine after- large doses of Morphia acts by contracting the blood vessels and preventing cerebral congestion. PM. are not charcoal in atrophine or belladonna We sometimes get congestion and if the lungs of bell have been taken get a blue color. Best test for atrophine the phys. test sol in alcohol and the acids Dilation of pupil come in-10-20 mins if taken into stomach. 5-10 subcut 2-3 under eyelid. Chemical test are not of much account Stramonium seed are the same shape but large and blacker than hyoscyami or belladonna: Atrophine is quite useful Each of these drugs have two alk Bell has tar the light and the heavy Indian poke- veratrum viride This is a very common source of poison poisoning has united active vomiting purging [cross out] a heart pulse 30. Vomiting is abt. almost immediate stomach and inter congestion and in the climates by the kid. hyperemia is carried. and as it may be diluted in the urine it should be saved except in the case of morphia which cannot be- Give emetics and stimulents to hurry up action of the heart Buysle anyl- alchol- chlorof all remove this from an acid solution A little piece of this + H2SO4 = find a yellow finds a red piece + HCl4 + heat = amythestic blue Alk & sugar + HCl = 1st green then purple and frosty blue. Phys test = staring of heat sal in oil acids and ppt by irregen agent Digitalis Acute and chronic the last or due to the cumulative effect of the drug Acute symp commence usual from 1-3 hrs 1st a feeling then we have violent vomiting. fear and vomitus [cross out] are green in alle prep except the alk. this eye is protruded and diluted and vision impared. lights look blue + dizzy. usualy in case. protruded, pulse 40-50 and irregular, (in terotrine the pulse is not to apt to be irregular). force of heart in increased. vomiting due to irritation last a long time. solution may arise finely more or less delirum nervous and def convulsions and death chronic. A sort of chronic inflam of the stomach in febrile headache for uses. Then when the accumulative effect take place get above symp Heart is not always contracted 1/16 gr of alk is very dangerous. Treatment vomits. purge. and give stimulants. Tannin is not of much good for it is sol. Taste of the drug is bitter [cross out] Digitaline + H2SO + Bromine fume gives a purple color. It is very sol in chlorform or chlorhydate Principal test is physiological test. When the leaves are given you can seen under the microscope two kinds of. has a long refactive have one seen and short reginated ones HA is bitter the H2SO4 in dryag test Aconite. both leaf flow and root are poison and there are many accidental cases of poisoning by this it is one of the more fatal drugs known. Symp rapid for a few min- 1 hr even when appled xternaly always have a single uses time in the part to which it has been applied Intense headach- numbly a case- loss of vision- nausea rarely vomiting. skin feels cold, speech and vison sometimes cut pupil at first dilated then contracted drum in heart at 1st which this slow 40-50 death 1-8 hrs [cross out] 31℥ of root is false 2℥ of leaf prep of aconite vary much in strength 1/10 gr proved fatal of the alk. Emetic, pump stram are all that can be done. active from sal alcohol benzol chloroform ether Best test is the physiological one 1. of gr applied to tongue gives tingling sensation. H2SO4 gives yellow then red after 24 hrs = colorless Phos acid gives the same Amt of urine a swell and here painfull bladder nearly empty and contracted Toxicology June 13 1882. Prussic acid This is classed among the neurasthenics Very active and fatal Ordinary prep is a 2% sal Chiefly suicidal and accidental Death comes almost before glass leaves the lips. Key is much used in the arts and give many cases partic in the silver shape. absorp cherry & the tissues. It is made firm bitter almonds 25 or parts of almonds = 6 pars of anhydrous KCN Bitter almond H2O = 1/2-1% of the acid Cherry Camel Water has abt the same All parts of cherry camel are poison Leaves of peach several almond. Aloe and cherry mounting ash. apricot apple and pear-seeds. All alk sals of prussic acid are- poison. fine ferri and sulph cyanides are not poison unless com Camel with an acid HgCg2 very poisonous The bitter almond itself has given no cases of poison Large dose-1-2 min sign can patient falls at once. eyes fixed prominent glistening pupils dil and unseen to light. Combi flexed jaw set foaming at mouth. repentation and limbs convulsive odor is usualy precipitabe death very sureth in a few min usualy person is not seen before death If a small dose Symp comes in few min not pain and dizzyness in head. Nausea at times. Loss of muscular forms inside of two minutes. Frothing at mouth eyes from fixed and from pupils dilated. Later tetanic spasms. Cases of seven people time of death occured from 20 min to 45. Small dose 1st stage dizzy convulsive impart costive and chest 2. Loss of consciousness. convulsive invol dependence- 3-Conv-relax of muscles paralysis The odor of prussic acid is import and should always be sought after Tobacco may disguise the smell. The loss of mus power is very import usual come inside of 2 min usualy one. Opium alcohol prussic acid may all produce coma prussic come very quick opium never made of 13 mins cerebral condit is O mg let up. P never O pupils dil P contracted. A=odor. P-death a few mmin. O-6-12. A-recovery No chronic P poisoning. External surface is somewhat livid with are blue-finger & toes clenched-join ret eyes from pupils dil On opening the body find intense [cross out] venous congest Liquid blood is cherry red I3 nitric benzoic the liquid blood is brown. the odor of the two is much alike Smallest dose 9/10 gr Odor is often absent. The limit betwt the therapeutic dose and the futil one is very narrow Fatal dose 1 gr-oil of bitter almonds 17 m. 2 1/2 gr of KCN is fatal Death is from a few mins to 1 hr- Cold apperatus to hard emetic stomach pump dil sal of own ferric and ferrous salts. these for Prussian blue In doing the two for RCN the fluid should always be a little old for a free acid hinder the action then add a little HCL and gr grt The test [cross out] 2 hours-1/25,000 gr Sulphur 1/50000 " Silver 1/100,000 " Contents of stomach must be disc and fumes caught in sal of AgNo3 28 days is the longest time that prussic acid has been detected Pand Nete tongue-diff. Nete benzic has a latent fever-which may last for several days due to delay in absorp. because it is slowly absorbed. if followed up with a dose of alcohol it is rapidly absorbed But still P is much more rapid Both produce the same symp. in character but not is rapidly with excpt of blood and odor of nitro benzen last longer Tobacco and poisoning is a mild form this is not uncommon to nausea vomiting Mertine and leaves produce diff symp Mertine produces immediate unconsciousness and death and it be so rapidly absorbed that it does not reach the stomach it is strong alk and corrodes the tissue and can often be detected in them. this [cross out] sub is very sol. The Sources of severe cases are usualy accidental. due to surface absorp of the alk through the skin Hupping tobacco around the skin has caused fotic cases-symp comes 5-6 min dizzy acute pain in stomach vomiting partial convulsions slow respiration death is from 10-15 min rarely purging Some symp are produced by absorp through skin, diff prep of tobacco have from 2-8% of tb 12gr of leaves has proved fatal 1gr of alk is fatal Emetics stomach pump Stimulants artificial up is good Odor is noticeable after death and this is the prin test. Myers regent ppts it Hemlock poison is usualy accidental This [cross out] should closely resembles ordinary caraway The prep of this vary in strength Sup is less than 1 hr dizz paralysis then heart and supinating muscles are affected and artificial us is most beneficial other muscles are affected patent walks through during eye lids tend to close convulsions may occur at times comes death from 1-3 hrs. artifical useful and stimulents burdy if the body and conjest of ham and curd Exuding into the surrounding tumor if purulent is [cross out] a chance which fever at some point if symp it may become [cross out] absorbed Here also we keep up an plan of extension If sooner open which discharge purulent mature we put here to be with a case of cancer and such a case only we may get an arrest of dream and a even growth of time should bring anchylosis as we may get a destruction of head of lice and perforation of acetabulum which may cause dangerous pelvic abscess.- In such a case the treatment recommended by Sayre- Excision which should be done as soon a the [cross out] causes has been diagnosticated and if performed early the trunk that it gives the chance of success. The one thing which does more then anything and with great success in hip joint disease-a fever recovery to reduce suffering and remove irritation-extension-This [cross out] over separates the inflamed surface and also gives fixation of the joint Dr Bradford gives these uses to which it put 1st as a means of overcoming the muscles. which are spasmodicaly contracted about the diseased joint. 2d as a means of fixation of the joint 3d To seperate the liner forming the joint. What extension whereas form-many cases it resembles but that it fails at many more is equally true. Which first is Explained-it thinks by Dr Bradford when he says that we get the relief from pain-]. these cases where we have inflamed liver to deal with and we do not get in those cases where the pain comes from an inflamed and distended capsule. A very common method of extension is that known as the weight and pully method and it is not only well known but quite popular. Indeed in many cases is has been given to much credit Dr Bradford says = regard to the means of extension that if are visit the wards of a hospital at midnight he will find the patients giving us all sorts of positions some burned over on the fires- and then legs being exposed= such a manner that the extensor is removed from the hip to the knee: [cross out] [cross out] It has when afflicted in this manner one virtue. it confines the patient to the bed and in those cases where it pain is so severe as to prevent all movement. not severe- its purpose quite well-Yet taken a a [cross out] while incoherent any regulating afection is as a means of extension imperfect cure-[cross out] it is incapable of previewing the parallelism of the limbs and you patient may receive with a deformity which is as bad as an amputation. But combined with thorough means of prussic it is a most excellent agent What has been good of this is also true of the phy enlarged method of Hutchinson [cross out] In which the extension is furnished by the set of the leg The patient being put in crutches and a high shoe. Here in young children we have a chance of all sorts of accidents which may resemble the old or keep up the present inflamation They will often step-the foot pains-the inflam be of a sal acute from and [cross out] the act does not produce much pain or the will flex to knee and have in the affected part.-Here being the wt-the diseased joint in these very ad-[cross out] the afflict to patient who have awaked the year of diseases.-Walking but the limb then causing water of the joint-[cross out] short they are liable to see ruts of accidents and when setting the extension to a great extent removed and you get in almost every act a slight movement in the joint Thomas of Leavesport mentions a splint which gives the perfect fixation and at the same time permits of locomotion It consists of an L shaped splint. The care free being so bent or to Enclose the chest and as it is usually made there are two cases follow-The upper coming just below the amyles of scapulae and the lower is put above out of ileum. These are covered-with a strong covering which extends for one to the other and either lower around the chest a-found while the long arm is fitted to the curves of the leg to which it is firmly bandaged Tayloring long extension often is much used and is of great service particularly as a increase of Extension and protecting the joint for [cross out] concussion and keeping the inflamed surfaces apart. It is also to a great extent is very good means of fixation of the joint but in the formation it holds only as 2 day powers It does not prevent turning in sleep or the rotation of the limb and it also has the [cross out] inconvenience of being put in with a plaster and is some about leaves But it does preserve the portions of the limbs and although it does permit if very slight motion. The joint since is constantly is extending the limb- it tends to keep the inflamed surface opate and according to some certain [cross out] good mention under the circumstance is not partic impervious. After all painful cases absolute fixation-lead and with either-will breeches or as a splint similar to the one inserted by Dr Haton of this city-a Treatment use are forced to relapse and-are which-some claimed by good authorities Under this treatment fever will diminish-and the child often gains in flesh and strength that we should always get them out into it on a same a paralle In it the treatmet of all cases use here to excuse much judgement and no definite rule can be consider for the treatment of the disease. but it must be dictated by the experience and judgement of the surgeon Dr Bradford sums the matter up as follow-       Lotic hydrogyn flava = 1 of Hg2Cl2 to 300 of CaHO " " mgrs 1 of HgCL " 60 " "