' .".'it' .;-..,vv.j..-, r,;,.-.- -\ «■ ,«•/-*!•(* -jTr/.'f r'/v-.'i'.■-■•.■-'>. ■ , '.:^'/^^>'('^u/:.',-.,^;,>' • UNITED STATES OF AMERICA WASHINGTON, D. C. GPO 16—67244-1 $ * NEW REMEDIES: THE METHOD OF PREPARING AND ADMINISTERING THEM; THEIR EFFEC TS ON THE HEALTHY AND DISEASED ECONOMY, &c. PRODESSE QUAM CONSPICI. THIRD EDITION, WITH NUMEROUS MODIFICATIONS AND ADDITIONS. BY ROBLEY DITNGLISON, M. D., Sec. A. P. S., Professor of the Institutes of Medicine, and Materia Medica in Jefferson Medical College of Philadelphia; Attending physician to the Philadelphia Hospital, &c. &c. w ^____-----------"rr "■ -°- L • -j PHILADELPHIA: LEA & BLANCHARD. 1841. 184-1 c~ l Entered according to Act of Congress, by Robley Dunglison, M. D., in the Clerk's Office of the District Court of the Eastern district of Pennsylvania. Griggs &. Co., Printers. PREFACE TO THE THIRD EDITION. The favourable reception, which the first* and second editions of the New Remedies have experienced, and the necessity for a third edition in so short a period, have sufficiently shown, that the work has been found useful. Grateful for this result, the Author has endeavoured to render the present edition still more acceptable to the Profession. He has subjected it to an entire revision, has modified in certain respects the arrangement, and altered the nomenclature so as to cause it to correspond more nearly to that adopted in the Pharmacopoeia of the United States. In the space of time that has elapsed since the appearance of the last edition, opportunities have occurred for testing farther the value and the method of preparing many of the articles. The results of these observations have been added, and especial care has been taken to insert every novelty of practical interest to the Physician and the Pharmaceutist. Fresh articles have likewise been introduced into notice, some of which constitute useful additions to the Materia Medica. These have been incorporated * The first edition appeared in the American Medical Library for 1839, of which the Author is Editor. IV PREFACE. in their proper places, with other therapeutical agents that were omitted in the preceding edition; for example,—Iodide of Am- monium, Iodide of Arsenic and Mercury, Cimicifuga, Lactate of Iron, Protocarbonate of Iron, and Monesia. Some other new remedies, which have been recently brought forward, the Author has not admitted, inasmuch as their qualities have either not been sufficiently tested, or their superior efficacy may be questioned: amongst these may be enumerated Anihrako- kali,* Sulphate of Cadmium,-f Gentiana Chirayita,^ and Paulli- * Anthrakokali, from «v6/>*£ coal, and Kali, potassa. This article was first pro- posed by Dr. Polya, of Pesth, in the year 1837, as a remedy in chronic cutaneous diseases. Two forms are employed, the simple and the sulphuretted. The former is prepared by dissolving carbonate of potassa in 10 or 12 parts of boiling water, and adding as much slacked lime as will separate the potassa. The solution thus obtained contains only caustic potassa. The filtered liquor is placed on the fire in an iron vessel, and suffered to evaporate until neither froth nor effervescence occurs, and the liquid presents a smooth surface like oil. To this is added the levigated coal, in the proportion of 160 grammes to 192 grammes of potassa. The mixture is stirred and removed from the fire, and the stirring is continued until a black homo- geneous powder results. This powder is kept in a dry place. To obtain the sulphuretted anthrakokali, 16 grammes of sulphur must be mixed accurately with the coal, and the mixture be dissolved in the potassa as directed above. M. Polya affirms, that the Anthrakakoli exerts its influence on the skin gene- rally, and especially on chronic cutaneous affections. It has also been given bene- ficially in scrofula and chronic rheumatism. The dose of the simple and sulphuretted preparations is 10 centigrammes three times a day.—See M.M. Jacobovics, in Gazette Medicale de Paris, Nos. 9 & 12, and Riecke, Die neuern Arzneimittel, u.s. w. 2te Auflage, S. 37. Stuttgart, 1840. t Sulphate of Cadmium, Cadmii seu Melini seu Klaprothii Sulphas, Sulphas Cadmicus, Cadmium Sulphuricum, Klaprothium Sulphuricum, Melinum Sul- phuricum; Germ. Schwefelsaures Cadmium, Schwefelsaures Klaprothium. Used in spots on the cornea, by Rosenbaum, Helling, Kopp, and Guillie: in chronic tor- pid inflammation of the conjunctiva, by Grafe, Daynac,and Giardano, in the quan- tity of half a grain to a grain to the ounce of water.—Riecke, op. cit. S. 133. t The Gentiana Chirayita, Henricea Pharmacearcha, Swertia Chirayita, is a native of India, and is employed in that country in dyspepsia, and as an antipe- riodic in intermittens. It has been highly extolled by Drs. Currie, Sigmond and others. These gentlemen, consider that the secretion from the liver improves under its use; and the latter advises it not only in torpor of the digestive PREFACE. V nia,* the main properties of which are given in the subjoined notes. Hereafter, these may be esteemed worthy of a place in the body of the work. Even now, indeed, the testimony in their favour is as strong as that adduced in support of some of the articles which are already there. ROBLEY DUNGLISON. Philad. No. 9, Girard Street, Dec. 1840. function, but he prefers it to sarsaparilla where the latter is considered to be indi- cated, as after large quantities of mercury have been taken, or where profuse sali- vation has been induced. It has also "been advised in atonic leucorrhoea. It yields its virtues to alcohol and water. (Gent, chirayit. gss, Aq. fervent. Oss.) The tincture is made by macerating five ounces of the Chirayita for 14 days in two pints of proof spirit. Dose, a tea-spoonful. The dose of the powder is one scruple. The Chirayita is imported into England, tied up in bundles.—See "Note upon Gentiana Chirayita," by Dr. Carson, in American Journal of Pharmacy, new series, Vol. vi. No. 1, April, 1840, p. 20. * The Paullinia is an extract from a plant of the same name, a native of Brazil. It is prepared by the Indians, and seems to possess considerable excitant powers. M. Gavrelle recently presented a specimen of it to the Societe de Medecine of Paris, as well as a new alkali, which had been separated from it by two chemists of Paris. Both the extract and the alkali are very bitter, and somewhat resemble Cafeine. M. Gavrelle states, that the Paullinia is obtained from the Paullinia sor- bilis; Family, Sapindaceae. M. de Chastetus found it to be composed of gum, starch, a resinous matter of a reddish brown colour, a fat oil, tannin, and a crystallizable substance, possessing the chemical properties of cafeine. In Brazil, and the neighbouring countries, it is given in the form of Tisane— the powder being mixed with cocoa—in diarrhoea and dysentery. Asa tonic, M. Gavrelle has employed it successfully in chlorosis, tedious convalescence, paralysis, the colliquative diarrhoea of phthisis, and hemicrania. According to Von Martius, an extract is prepared in Brazil from the Paullinia sorbins, which is known there under the name ofGuarana, and is administered in similar pathological cases.—(See Art. Guarana, in Diet. Univers. de Mat. Med. par Merat et De Lens, Tom. ii. p. 365, Bruxelles, 1838.) The Hydro-alcoholic extract of Paullinia is considered to represent the plant most accurately in its chemical properties. Of this, M. Gavrelle has given formu- la for Lozenges, Syrup, Pills, Powder, Tincture, and Ointment—Journal de Chimie Med., and Encyclographie des Sciences Medicates, Juillet, 1840, p. 230. See, also, American Journal of Pharmacy, Oct. 1840, p. 286. 1* PREFACE TO THE FIRST AND SECOND EDITIONS. The information, concerning the remedies of more recent intro- duction, lies scattered in so many works, that it cannot be ac- cessible to the mass of physicians. The author has, consequently, believed, that he would be rendering a service to the profession by concentrating the results of experience within reasonable limits, so that they may be readily available to all. The majority of the new agents—it will be found—have been furnished by modern chemistry; and their employment has been attended with this ad- vantage, that—when properly prepared—they are not liable to uncertainty in their operation; whilst the various plants from which the strychnine, emetine, quinine, &c. are obtained, are liable to irregularity of action, owing to faults in desiccation, to the season in which they are culled, &c. &c.—objections which cannot apply to the active principles when separated from them. Owing to the difficulty of sifting the results of true from those of false observation, the author has esteemed it proper to give, as far as he was able, the recorded experience of all who have employed the remedies in question. It need scarcely be said, that to make a correct observer and a good therapeutist, a knowledge of every department of medical science is demanded. Anatomy, physiology, pathology, and ma- teria medica are, indeed, but introductory to the great object which the practitioner has in view—the alleviation and removal of suffering. Were it otherwise, it would be but necessary to in- stitute empirical trials, in every case of disease, with various articles in and out of the received lists of the materia medica, and from such vap-ue trials to endeavour to deduce what is termed " experience." The erroneous idea prevails too extensively, that every one is capable of profiting by observation, and that, therefore, all who viii PREFACE. have had the same amount of experience, must be equally capable of treating disease. Setting aside, however, the consideration of the differences that must necessarily result from the varied powers of individuals, it can scarcely be maintained, that he, whose at- tention has not been properly directed to the study of the prelimi- nary branches, which have been enumerated, and whose mind has not been trained in tracing the relation between cause and effect, can ever duly profit by mere experience in that which has been properly termed "the most inductive of all sciences."* To treat disease methodically and effectively, the nature of the actions of the living tissues, in both the healthy and morbid con- ditions, must be correctly appreciated; the effects, which the articles of the materia medica are capable of exerting under both those conditions, must be known from accurate observation, and not until then can the practitioner prescribe with any well-founded prospect of success. Numerous errors would be perpetrated, were we to profess, and to carry out such profession, that we are guided by experience only, unless that experience had been gained by a due consideration of all the physiological, pathological, and therapeutical bearings of the subject. In illustration of this, the well-known case, cited by Dr. Paris, in his Life of Sir Humphry Davy, may be adduced. The enthusiastic Beddoes, having hypo- thetically inferred, that the inhalation of the nitrous oxide might be a specific for palsy, a patient was selected for trial, and placed under the care of Davy—at the time assistant to Beddoes. Be- fore administering the gas, Davy thought of ascertaining the temperature of the body by the thermometer placed under the tongue. The paralytic, deeply impressed by Dr. Beddoes with the certainty of the success of the remedy, of which he knew nothing—soon after the thermometer was placed in his mouth. believing this to be the great curative agent—declared that he felt somewhat better. Nothing more was, therefore, done; and he was requested to return on the following day. The same form was then gone through, with the same results; and, at the end of a fortnight, the sick man was dismissed cured, no agent of any kind having been employed, except the thermometer. Now, if the reasoning powers were not duly exerted, experi- ence would obviously teach, as the result of this case, that the thermometer is an antiparalytic. The rational therapeutist is not, however, satisfied with this knowledge of the fact, for "fact it is." He enquires into the mode in which the effect was induced, and he is not long in referring it to the influence exerted by the mwal * Propterea sola experientia absque doctrina et ratione incerta est, et con- jecturalis. Qui enim novit rhubarbarum pargare bilem, nescit tarnen quando, quibus, et cui morbo prosit, nisi sit medicus doctus et peritus. Priraros. De vulgi erroribus in medicina, lib. i. cap. xl. Amstelod. 1639. PREFACE. IX over the physique; and he classes the thermometer with Perkin- ism, animal magnetism, and their congenerous arts,—amongst articles that act chiefly through the new impressions, which they make on the senses. It might seem to those who are unacquainted with medical history, that in periods approaching our own, no such illogical inferences could be deduced, and that it has been the custom with the profession for ages, to bestow all due caution, and the most rational enquiry in the collection of facts. Such, however, is far from being the case. It is, indeed, humiliating to reflect on the credulity or faulty observation that has existed among na- tions, who have successfully cultivated many of the other branches of natural science. It ought scarcely to be credited, and yet it is nevertheless true, that the aqua spermatis ranarum, or " water of frog's spawn," was to be found not very long ago in the Pharma- copoeia of Sardinia; and the aqua hirundinum cum castoreo, or " water of swallows with castor," in those of Manheim and Wirt- emberg. The latter preparation is directed to be made as follows: __Take of young swallows bruised in a mortar, forty; rue, two handfuls ; castor one ounce; white wine three pints. This dis- gusting preparation was given in hysteria and epilepsy. Again; the bufones exsiccati, or, " dried toads," were in the Pharmaco- poeias of Spain and Wirtemberg—having been formerly admi- nistered in powder, as a diuretic, in dropsy. In another work,* the author has cited many examples as strange as those in- stanced, and it would be easy to enumerate still more. In a recent French journal, and in an article by M. Ricord— the distinguished physician to the Venereal Hospital of Paris—we have an example of the pertinacity with which ancient prepos- sessions and inculcations adhere to us, and how difficult it is to think and to act according to the unbiased suggestions of our own observation and reflection. In the treatment of blennorrha- o-ic epididymitis, or swelled testicle from gonorrhoea, M. Ricord recommends compression to be made by means of the " spara- drap " or plaster of Vigo with mercury. The history of this plas- ter is singular. Although still in the Pharmacopoeia of Pans, it resembles its prototypes but in name. In the pharmacopoeia of Wirtemberg, it is directed to be formed of living frogs and living earthworms, boiled with various inert and by us rejected herbs in white wine and vinegar—the decoction being strained, and added to olive oil, litharge, oil of baybernes, turpentine, yel- low wax, olibanum, euphorbium, and liquid storax, all melted to- gether. . , r , Yet, it is scarcely possible to conceive, that the frog s spawn could have been supposed to yield a product, on distillation, dif- * General Therapeutics, p. 55. Philad. 1836. X PREFACE. fering from that of other animal substances, when subjected to the same process; that the swallows—in the preparation cited—added any thing to the antispasmodic virtues of the castor, or that the li- ving frogs and earth worms exerted any efficacy in the spara- drap de Vigo—a plaster, employed for compressing tumours, and for which purpose we use one of simple adhesive constituents. They have all been properly rejected from the lists of our medi- cinal agents, and are looked upon as irrational; yet we are com- pelled to infer from the fact of their having been received, in some countries, into officinal publications, into the pharmacopoeias, which emanate from congregations of those of our profession, who are esteemed learned by education and by practice—that they were originally admitted under the sanction of fancied ex- perience. In the darker periods of medical history, monstrous and revolt- ing polypharmacal preparations were introduced, and nothing but the blindest devotion to authority or to established custom could have occasioned their retention. It is not long since the Theriac of Andromachus—itself but a modification of the anti- dotum Mithridatum—was dismissed from the British Pharmaco- poeias. It consisted of seventy-two articles, and was a farrago— as Dr. Heberden observed—that had "no better title to the name of Mithridates than—as it so well resembles—the numerous undisciplined forces of a barbarous king, made up of a dissonant crowd collected from different countries, mighty in appearance, but in reality an ineffective multitude, that only hinder each other." The electuarium opiatum polypharmacum, of the Pari- sian codex—the descendant of the old theriac, with even an additional number of ingredients—contains acrid substances, 5; astringent, 5; bitter, 22; indigenous aromatics, 10; umbelliferous aromatics, 7; balsams and resinous substances, 8; fetid ingredi- ents, 6; narcotics, 1; earthy substances, 1; gummy or amylace- ous, 4; saccharine, 3. Total, 72—and one of these the flesh of the viper; a little more than a grain of opium—which may be regarded as a principal effective ingredient—being contained in a dram of the compound. Yet, when the question arose in the London College of Physicians, as to what should be the fate of this " many headed monster," and when it was proposed by Dr Heberden, that it should be ejected from the Pharmacopoeia,— on a division, it was found, that there were thirteen votes for 're- taining and fourteen for rejecting it. Its ostracism was deter- mined by a majority of one only, in a learned body twenty-seven of whose members were present. Such was the fate of a "heterogeneous farrago," which, as Dr. Paris has remarked, "can be vindicated upon no principle of combination," and yet enjoyed the confidence of physicians for PREFACE. XI ages—a confidence unquestionably founded, in their belief, on experience, but experience based upon defective observation, and, consequently, on erroneous inferences—the results being consecu- tive rather than consequent, and bearing no relation whatever to the assigned cause. Happily, more correct ideas are beginning to be entertained on the subject of true experience. It is now felt—to employ the language of a distinguished surgeon—Professor Liston—that the greatest number of well assorted facts on a particular subject constitutes experience, whether these facts have been culled in five years or in fifty. A better system, too, of observation generally prevails, so that we have discarded the absurd and revolting agents, that are still retained in the books of authority of some European countries. Much, however, remains to be done. The catalogue of the Materia Medica is yet overstocked, and the pruning knife has still to be applied to lop off many of the redun- dancies, which have been proved to be such, by the more accu- rate attention, that is daily paid to tracing the due relation be- tween cause and effect. " To purchase a clear and warrantable body of truth," as Sir Thomas Brown has well observed, " we must forget and part with much we know." Every one will be compelled to admit, that it is the duty of the correct therapeutist to doubt the existence of qualities in any arti- cle until they have been adequately proved. When such is the case, no reasoning can set aside facts; but unless the evidence be overpowering, it is equally his duty to remain in doubt, espe- cially should reflection suggest to him strong grounds for believing, that the number of observations has been insufficient, that they have not been properly made, or are inconsequential. To enable the profession to form an accurate estimate of the value of remedies of more recent introduction, or of the older remedies whose use has been revived under novel applications, the present volume was undertaken by the author. In Germany, several works exist on this subject, and that of Riecke—to which the author has repeatedly referred—served as a basis for many of the articles; his observations, however, do, not come down farther than the year 1836. Some of the state- ments—especially in relation to the observations of certain of the German physicians—are given on Riecke's authority, for he has rarely appended references, by which the correctness of his as- sertions could be tested.* * Recently, a second and enlarged edition of Riecke's work has appeared ; but the therapeutical additions to it are by no means as numerous as the author had expected to find them. He has, consequently, made but few extracts from it in the present edition. It is entitled, "Die neuern Arzneimittel, ihre physischen und chemischen Eigenschaften, Bereitungsweisen, Wirkungen Xll PREFACE. It has been a great object with the author to furnish exact re- ferences to works in which farther information may be obtained, and the number of these will show, that he has devoted no small amount of time and attention to the subject. He has likewise added the results of his own experience in public and in private. Uhe motto which he has selected—prodesse quam conspici—con- veys, in epitome, his feelings. His sole object has been, " to be useful"—and if he has succeeded, the reward is ample. ROBLEY DUNGLISON. Philadelphia, No. 9 Girard Street, October 15, 1839. auf den gesunden und kranken organismus, und therapeutische Beniitzung. Von Victor Adolf Riecke. Dr. Med., Mitglied des Vereins fur Heilkunde in Preussen, u. s. w.; zweite, vollig umgearbeitete Auflage. Stuttgart, 1840." NEW REMEDIES. ACIDUM ACETICUM EMPYREUMATICUM. Synonymes. Acidum Pyro-aceticum, A. Ligni pyro-oleosum, A. pyrolignosum Acetum ligneum, Pyroligneous, and Pyrolignic acid. French. Acide pyro-acetique, A. pyfolignique, A. pyroligneux, Vinaigre de bois. German. Brenzlrche oder brandige Holssaure ; Holzsaure; Holzessig. The pyroligneous acid, although brought much into notice— revived as it were—in recent times, is by no means the product of those times exclusively. The cedria, with which the Egyptians embalmed the bodies of the dead, it is presumed, was identical with it. Pliny recommends cedria, or the oil of tar, got from the cedar, in toothach,* and Galen unites with him.f The virtues of the pyroligneous acid are often also referred to by Boerhaave.J METHOD OF PREPARING. The pyroligneous acid is prepared in chemical laboratories by the dry distillation of wood, especially of hard wood, which is placed in an iron retort heated to redness. First of all, there passes over a light brown or greenish fluid, which contains some empy- reumatic oil; to this succeeds the pyroligneous acid, which is formed during distillation. If the distillation be continued, more empyreumatic oil passes over., and lastly tar. The chief constituent of the pyroligneous acid is vinegar, which can be deprived of its empyreumatic constituents by rectification with fine porous animal charcoal. Besides the vinegar, it con- * Hist. Nat. xxxiv. 11. f De Simpl. Medic. Facult. lib. vii. See Cormack oh Creosote, p. 59. Edinb. 1836; or the American edit, in Dunglison's American Medical Library. J Riecke, Die neuern Arzneiniittel. u. s. w. S. 6. Stuttgart, 1837. 2 10 ACIDUM ACETICUM EMPYREUMATICTTM. tains empyreumatic oil, (pyrelain;) empyreumatic resin, (pyrretin,) a peculiar matter containing azote, and similar to an extract, (an empyreumatic extract,) and spirit of tar, (spiritus pyrolignicus.) Of late years, Reichenbach has discovered in it a new substance, creasote;* which seems to be the most important ingredient, its medicinal efficacy appearing to be dependent upon that substance. Impure pyroligneous acid is of a brownish colour, and of an acid smoky smell and taste. This is the preparation which is generally used externally; but, by chemical means, the acid may be purified so as to furnish the acidum pyrolignosum rectificatum. This differs from the impure pyroligneous acid in containing less empyreumatic resin and extract, and creasote. The London Col- lege again prepare from it a stronger acid, the acidum aceticum fortius, which is extremely volatile and pungent, and is used as a revellent. EFFECTS ON THE ECONOMY IN HEALTH. From experiments instituted on animals, it would appear, that the administration of the pyroligneous acid in large doses, occa^ sions vomiting of a considerable quantity of a frothy fluid, smelling strongly of the acid; tremors of the limbs, convulsions, tetanus, protrusion of the eyes, insensibility, paralysis of the limbs, dyspnoea* croupy cough, hoarseness, &c. The death of the animal supervenes with symptoms of suffocation, and the fatal termination is often rapidly induced. Inspection after death exhibits manifest venous congestion in the brain, spinal marrow, lungs, liver, and spleen, and in the right side of the heart, with, at times, inflammation of the stomach. According to Berres, it occasions markedly narcotic effects. In by no means considerable doses, he found it to cause violent pain in the stomach and bowels, nausea and vomiting, general weakness, heaviness, vertigo, convulsions, and even death, without exhibiting any marked effect upon the vascular system. In smaller doses, it is said to produce a sensation of burning in the stomach, and after a time to quicken the pulse, and augment the cutaneous and renal depurations. Others—and the best observers, we think—deny it any narcotic properties.! As an antiseptic, its efficacy is undoubted, and this has been long known. The creasote is, doubtless, the main agent in producing this result, and wherever the administration of creasote is indicated, the use of the pyroligneous acid may be proper. * See the article Creasote. f Richter's Specielle Therapie. S. 255, Berlin, 1828. ACIDUM ACETICUM EMPYREUMATICUM. u EFFECTS ON THE ECONOMY IN DISEASE. Possessed of the properties described above, the pyroligneous acid was at once suggested in cases of gangrene and sphacelus, in which it was successfully used, as well as in cachectic conditions brought on by the misuse of mercury, and in herpetic, flabby. fungous, and sloughing ulcers; in porrigo, and in toothach produced "by caries, the acid being dropped upon cotton and applied to the hollow tooth. In most of these cases, it was generally exhibited both internally and externally. Numerous experiments have been made with it in various affections by different observers; but its use has been more especially extolled in cases of gangrene, in which it corrects fcetor, and promotes the separation of the dead parts.* The physicians of the Berlin Charite experimented with it in cases of sloughing gangrenous sores with such success, that they pronounced it an antiseptic of the highest order.f _ Besides the cases mentioned, it has been advised in excoriated nipples, mixed with white of egg,J in cancerous and scrophulous affections, in cancrum oris, in caries of the bones, and as a gargle in scarlet fever. It has, moreover, been recommended by Buchanan§ in deafness caused by deficient secretion of the cerumen of the ear, and in discharges of an offensive character from the meatus auditorius, as well as from other outlets; in chronic inflammation of the tarsal edges of the eyelids, and in scabies. In gastromalacia it has been recommended by Pitschaft|| and Teufel;! in phthisis by Harless, and in dropsy, diarrhoza, putrid nervous fevers, &c. by Ampach;** yet, as was before remarked, it is rarely employed internally; indeed, both externally and internally, it has been greatly sup- planted by creasote. MODE OF ADMINISTRATION. The inequality in the strength of the preparation renders it difficult to fix upon any precise dose. Of the impure pyroligneous acid, Sachs administered from five to thirty drops three or four times a day, in simple or aromatic water. * Dr. T. Y. Simons, in American journal of the Medical Sciences, vol. v. t Riecke, Op. cit. S. 9. j; Dr. Bursharat, in Gazette Medicale, and Amer. Journ. ot the Medical Sciences, Feb. 1833, p. 503. § Illustrations of Acoustic Surgery, Lond. 1825. || Med. Chirurg. Zeitung, No. 7, 1625. IT Annal. fur die gesammte Heilkund. unter der Redact, d. Mitghed. der Badenseh. Sanitatsk. 2ter Jahrg. 1825. ** Rust's Magazin, B. xvi, H. 2. S. 353, and Richter, Op. cit. B. x. S. 25/, Berlin, 1628. 12 ACIDUM ACETICUM EMPYREUMATICOTT. Externally, it is applied both in a pure and dilute state; frs the former case to ulcers, by means of a pencil, several times in the day. It is generally diluted with simple water; but in cases of cancrum oris, sugared water has commonly formed the diluent. It is also applied at times in the way of cataplasm. As a wash in porrigo, and as an injection, it may be diluted with six or eight parts of -water; as a collyrium, the proportion may be one part of the acid to twelve of water, and it may be employed, of about the same strength, as a gargle. Heim has recommended the following application in cancrum oris. Mel acidi acetici empyreumatici* Honey of pyroligneous acid. R. Acid. acet. empyreum. crud. $iss. Mellis rosati, |j. M. To be applied by means of a pencil. Buchanan advises the following form of injection in cases os purulent discharges from the meatus auditorius. Injectio acidi acetici empyreumatici* Injection of pyroligneous acid. R. Acid, acetic, empyreum. 3y- Aquae destillatee, 5vj. M. Fiat injectio bis die utenda. The following drops he recommends in cases where the eeru- men is deficient in quantity. Guttce acidi acetici empyreumatici. Drops of pyroligneous acid. R. Acidi acet. empyreum. crud. Olei. terebinth, rectif. Sp. aetheris sulphur, comp. aa. partes aequales. M. Two drops of this compound are to be dropped every ni^ht into the meatus auditorius. J & ACIDUM HYDROCYANICUM. 13 Cataplasma acidi acetici empyreumatici. Cataplasm of pyroligneous acid. R. Furfur, ffcss. Pulv. sem. lin. ?j. M. bene et adde Acid, acetic, empyreum crud. q. s. ut fiat cataplasma. To be applied in cases of foul ulcers. Linimentum acidi acetici empyreumatici. Liniment of pyroligneous acid. R. Acid. acet. empyreum. 5ss. Balsam, peruv. 31J. Vitell. ovi, q. s. ut fiat linimentum. To be applied on lint three times a day to sloughs and ulcers. Collutorium acidi acetici empyreumatici. Mouth-wash of pyroligneous acid. R. Acid. acet. empyreum. rectif. ^ss. Aquae cinnamomi simpl. 5iv. Syrup, moror. 5ij. M. Dr. Phobus advises this as a wash for the mouth in cases of cancrum oris. It should be kept in a glass vessel covered with black paper to prevent decomposition. ACIDUM HYDROCYANICUM. Svnosymes. Acidum Pnissicum, Acidum Borussicum, A. Zooticum, A. Zootinicum, Hydrocyanic, or Prussic Acid. French. Acide Hydrocyanique, Acide Prussique. German. Blausaure, VVasserstoffblausaure, Hydrocyansiiure, Cyanwasser- stoffsaure. This acid can scarcely be looked upon as new: yet it is only in recent times that its application to pathological conditions has been well aopreciated. It was discovered by Scheele, in 1780; but its ir 2* 14 ACIDUM HYDROCYANICUM. preparation in a state of purity, and its exact chemical constitution, were not understood until Gay-Lussac published the results of his investigations on the subject in the year 1815.* METHOD OF PREPARING. The three chief modes of preparing the hydrocyanic acid, at present received into the pharmacopoeias, are those of Scheele, Gay-Lussac, and Vauquelin; the first of which was adopted by the framers of the United States' Pharmacopoeia of 1820, and by those of Belgium, Paris, and Ferrara; the second,by the Pharma- copoeias of Paris and Ferrara; and the third by those of Belgium, Paris, and the United States.—(Edition of 1830.) 1. Scheele's Method. Take of Prussian blue, 128 parts. Red oxide of Mercury, 64 parts. Distilled water, 105 parts. Boil for a quarter of an hour, constantly shaking; strain, filter, and wash the residuum with Boiling water, 128 parts. Mix the two liquids together; introduce them into a flask, and add, Porphyrised iron filings, 96 parts. Sulphuric acid, (66°) 24 parts. Diluted with Distilled water, 24 parts. Shake the mixture, and keep the flask for an hour in cold water- pour the decanted liquid into a tubulated retort placed in a sand bath to the neck of which is attached an adapter that passes into a tubulated :receiver, whence a curved tube issues that passes into a flask filled with water; lute the apparatus; cover the receiver with wet rags; raise the heat until the liquid boils, and until there have passed into the receiver—192 parts. Add to this liquid, of Carbonate of lime, 8 parts * Annales de Chimie, torn, lxvii. p. 128, and torn. ACIDUM HYDROCYANICUM. m This process of Scheele always affords an acid mixed with a variable quantity of water. 2. Gay-Lussac''s Method. Take cyanide of Mercury, at pleasure. Introduce it into a tubulated retort, the neck of which is fur- nished with a wide tube of glass filled with broken marble and. chloride of calcium, which tube communicates, through a smaller one, with a bell glass surrounded by a freezing mixture. Pour on muriatic acid sufficient to rise above the cyanide to the Height of a finger; heat gradually and moderately, and receive the condensed product into the bell glass. The acid, obtained in this way, is anhydrous, and of ther specific gravity .700.. 3. Vauquelin's Method. Take of Cyanide of Mercury, 1 part. Distilled water, 8 parts. Pass a current of hydro-sulphuric acid gas into the solution,' until the gas is in excess; pour into the liquid pulverised sub- carbonate of lead in sufficient quantity to remove the excess of hydro-sulphuric acid: shake the mixture constantly, and when it has no longer the smell of putrid eggs, and ceases to blacken paper impregnated with acetate of lead, filter and preserve it carefully. The product of this operation has been considered to approxi- mate to the average density of the acid of Scheele.* The variable density of the acid prepared after Scheele's method has prevented it from being generally used in medicine. The acid of Gay-Lussac is most commonly employed; but as its degree of concentration renders it dangerous, it is diluted with distilled water. Robiquet has proposed to bring its density to .900, by adding two parts of water to it. Thus reduced, it resembles the acid of Scheele, with the advantage, that there is a constant and known ratio between the pure or anhydrous acid, and the quan- tity of water united with it. Magendie adds to it six times its bulk, or eight and a half times its weight of distilled water, and calls the * See Notes on Hydrocyanic acid, by Dr. R. E. Griffith, in Philad. Journ. of Pharmacy, iv. 17. Philad. 1833; also, Pereira, Elements of Materia Medica, part i. p. 236. London 1839. The dispensatory of the United States of America, by Drs. Wood and Bache, 4th edit. p. 748. Philad. 1839, and Mr. David Stewart, Maryland Medical and Surgical Journal, April, 1840. p. 264, 16 ACIDUM HYDROCYANICUM. mixture acide prussique medicinal,* medicinal prussic or kydro> cyanic acid. Others have advised the employment of a mixture of three parts of water, and one part of acid, under the name of acide hydrocyanique au quart, or " hydrocyanic acid of quar- ter strength."! Dr. Bache asserts, that he has had the process of the United States' Pharmacopoeia (Proust's or Vauquelin's) repeated, when he found the acid obtained to have the specific gravity .998. EFFECTS ON THE ECONOMY IN HEALTH. Hydrocyanic acid is usually classed amongst the narcotic poisons,J yet there is reason for believing, that its ordinary effects are purely sedative. Whilst the agents belonging to the class of narcotics produce, first of all, excitation in the organic actions, followed sooner or later, when the agent is in sufficient dose, by signs of sedation, this acid occasions the latter results only. It is the most powerful of our poisons, producing, in an adequate dose, the fatal result so suddenly, that the animal experimented upon can scarcely be removed from the lap of the experimenter before all signs of life are extinct. This rapidity of action nega- tives the idea, that the acid acts through the mass of blood, and favours the view of those who believe, that the impression is made immediately on the nerves of the part with which it is placed in contact, or on the nerves that are distributed to the lining mem- brane of the blood vessels, as suggested by Messrs. Addison and Morgan.§ It seems to us, however, that the same objection applies to the explanation of these gentlemen as to that which ascribes the effects to the poison being taken into the blood—that the fatal result is often too sudden for us to presume that it has entered the blood vessels; unless we esteem it an agent possessed of powerfully penetrating properties. In very large doses, the sensibility of the whole nervous system becomes annihilated almost with the rapidity of lightning. A female, who was deceived by the odour of a solution of hydrocyanic acid in alcohol, drank a small vialful and died in two minutes, as if struck with apoplexy. A strong healthy man, thirty-six years of age, being detected in thieving, swallowed a small vialful of the acid, staggered a few steps, and fell dead. Four or five minutes afterwards, the physician who was called, found him lifeless, without the slightest trace of pulse or respira- * Formulaire pour la preparation etc. de plusieurs nouveaux medicamens. f Pharmacop£e Universelle, par Jourdan, i. 31. Paris, 1828. X Christison's Treatise on Poisons, 3d edit. Edinb. 1836. \ An Essay on the operation of poisonous agents upon the living' bodv Lond. 1829. s *' ACIDUM HYDROCYANICUM.. n tion.. In a few minutes, convulsive expirations were observed^ but no indications of returning life: the face was sunken and livid; the hands and feet deadly cold; the forehead and face cold and dry; and the eyes half open and glassy.* Dr. Damasonf relates the case of a druggist, who had some hydrocyanic acid in a vial with a ground stopper, and as it had been prepared almost three months, thinking that it was decom- posed, he opened the vial, and applied it to his nose to ascertain whether the acid retained any smell: he instantly fell down, and remained for half an hour without giving the slightest signs of life; but finally recovered after an illness of several days. Many experiments have been made on animals with this acid, A drop, introduced into the bill or anus of a sparrow, induced death in from one to two minutes, preceded by convulsions. Even holding the bill over a vial filled with the acid proved fatal. A duck was destroyed by fourteen drops. Twenty drops introduced into the stomach of a rabbit killed it in three minutes. When a few drops were injected into the jugular vein, death supervened still sooner. A small dog, to which two drops had been given, experienced shortness of breath; staggered, fell, passed its urine repeatedly; vomited twice, and afterwards seemed quite well. The same animal took, five hours later, eight drops, and fell into a tetanic, comatose condition, but recovered in half an hour. More severe but not fatal effects resulted from sixteen drops. Thirty to forty drops administered to dogs and cats, produced violent convulsions and death, in from six to fifteen minutes. The experiments of Emmert and Coullon seem to have shown that the action of hydrocyanic acid is more violent when it is injected into the jugular vein, or inhaled in a concentrated form; less so when injected into the rectum. In the case of a horse, into whose jugular it was injected, death occurred in twenty-one minutes. When placed in contact with the dura mater, or with nerves, no striking phenomena were perceptible. [?] This fact was confirmed by Viborg.J On the other hand, when received into a wound in its concentrated state, it acts most violently. Scharring, who broke a glass containing the acid, and received some of it into the wound produced thereby, died in an hour after the accident. It is not easy to deduce comparative results from the statements of different experimenters, inasmuch as we are ignorant of the * Hufeland, Journal der practisch. Heilkund. Band. xl. St. 1, S. 85 to 92, and Osann, in Art. Blausaure, in Encyc. Worterb. der Medicinischen Wis- eenschaft. Band. v. S. 528. Berlin, 1830. f Journal de Chimie M^dicale. Juin 1831., \ Osann, loc. cit. S. 580. 18 ACIDUM HYDROCYANICUM. precise strength of the acid employed. A French physiciaij made some experiments on the uncertainty of the strength ot the medicinal acid; and he found, that he could swallow a whole ounce of one sample, and a drachm of a stronger sample, with- out sustaining any injury; but on trying some, which had been recently prepared by Vauquelin, he was immediately taken ill, and narrowly escaped with his life.* Mr. Pereirat once caused the instantaneous death of a rabbit by applying its nose to a receiver filled with the vapour of the pure acid: the animal died without a struggle. A drop of the pure acid of Gay-Lussac, placed in the throat of the most vigorous dog, caused it to fall dead after two or three hurried respirations.J We have already alluded to the effect of the acid when dropped upon the conjunctiva—a mucous surface, and therefore possessed of highly absorbing powers: but it cannot be placed with im- punity in contact with surfaces, which, owing to their being covered with cuticle, do not readily absorb.. Orfila§ states, that a professor of Vienna, having prepared a pure and concentrated acid, spread a certain quantity of it on his naked arm, and died a short time afterwards. Dr. Christison,j| however, says this was probably a mistake. On repeating some of the experiments, hel found, that a single drop, weighing scarcely a third of a grain, dropped into the mouth of a rabbit, killed it in eighty- three seconds, and began to act in sixty-three seconds; that three drops, weighing four-fifths of a grain, in like manner killed a strong cat in thirty seconds, and began to act in ten; that another was affected by the same dose in five, and died in forty seconds; that four drops, weighing a grain and a fifth, did not affect a rabbit for twenty seconds, but killed it in ten seconds more; and that twenty-five grains, corresponding with an ounce and a half of medicinal acid, began to act on a rabbit, as soon as it was poured into its mouth, and killed it outright in ten seconds at farthest. Three drops, projected" into the eye, acted on a cat in twenty seconds, and killed it in twenty more; and the same quantity, dropped on a fresh wound in the loins, acted in forty- five, and proved fatal in one hundred and five, seconds. When given in rather too strong a dose, or—if in proper doses •^•at too short intervals, it produces headach, and vertigo, which go off, however, in a few minutes: when inhaled, even if diluted * Revue Medicale, xvii. 265, and Christison on Poisons, 3d edit. p. 690. Edinb. 1836. f Op. citat. p. 242. j Mageudie, in Annales de Chimie et de Physique, vi. 347, and Formu- lary. 5 Toxicologie. I! Op. cit. p. 707. IT Op. cit. p. 694. See also, Dr. Geoghegan, in Dublin Medical Journal, for 1835, and Pereira, Op. cit. p. 242. ACIDUM HYDROCYANICUM. 19 with atmosplieric air, it causes vomiting, prostration, pains in the back part of the head, and great diminution of the arterial pulsa- tions. In a more concentrated state, the effects are more rapidly fatal than in any other form of administration. M. Robert found that when a bird, a rabbit, a cat, and two dogs, were made to breathe air saturated with its vapour, the first and second died in one second; the cat in two seconds; one dog in five, and the other in ten seconds.* With regard to the parts of the economy that are primarily acted upon by the hydrocyanic acid, there can be but little doubt in designating the nervous system.f In no other way can we readily explain the extreme rapidity of its action in fatal cases. When once mixed with the blood, however, out of the body, it altogether changes the character of that fluid, and opposes its coagulation.^ Some of the German writers^ have endeavoured to indicate three grades of its action on the economy. First. In moderate doses, long continued, it occasions a marked diminution in the action of the nervous and vascular systems; vertigo; dispo- sition to syncope: epistaxis as a consequence of thinness of the blood, and a disposition to putrid diseases.|| Secondly. In larger doses, the sedative effect of the acid on the spinal marrow, and the abdominal ganglia, is indicated by feelings of weakness, numb- ness, tremors, and other involuntary motions of the extremities, involuntary discharge of the urine and fasces, augmentation of the cutaneous and urinary depurations; palpitations, anxiety at the prascordia, weak pulse, and> according to some, headach, espe- cially in the back part of the head; excoriation of the tongue and inner parts of the cheeks,TI and salivation. This last symptom is dven by Dr. Christison** on the authority of Drs. Macleod and Granville.-ff It has been suspected, however, that salivation, in these cases, was brought about by the use of an impure acid, con- taining probably a small quantity of the deuto-chloride of mercury, particularly if the acid had been prepared—according to the pro- cess of the" Dublin College—with bicyanide of mercury, muriatic acid and water. Mercury is, indeed, asserted to have been * Annales de Chimie, xcii. 59. f Dr. Lonsdale, Ed in. Med. and Surg. Journ. Jan., 1839, and Lond. Lan. June 15, 1839, p. 440. , T ne1Mn I Magendie, Lectures on the Blood. Lect. xvu. in Lancet, for Jan. 2b, lb.^y, p. 636. On its Action when injected into the Vessels; see Mr. Blake, in Edin. Med. and Surg. Journ. April, 1839, p. 339. 5 Richter, Specielle Therapie, Band, x, S. 280. Berlin, 1828; and Osann, 3oc. cit. S. 527. || Encyc. Worterb. B. ii. S. 315. IT Born, in Rust's Magazin, B. xiii. S. 282. ** Op. citat. p. 701. ft Lond. Med. and Phys. Journ. xlvi. 359 and 36a 20 ACIDUM HYDROCYANICUM. actually discovered in the acid by Sylvester's test. Thirdly. Iti still larger doses, violent affections of the spinal marrow, con- vulsions, trismus, opisthotonos, emprosthotonos, fainting, &c. are induced. From the results of all his observations, Osann* infers, that the hydrocyanic acid acts dynamically on the nervous system, by tiiminishing, depressing, and annihilating its life, and, through the nervous system, affecting the organs of vegetation or nutrition, and of hasmatosis;—that it incontestably has a specific relation to the spinal marrow, the ganglions of the abdomen, and the dependent organs; and hence it is, that, in comparison with other narcotic agents, it is less stupifying, whilst it influences more deeply the phenomena of vegetative or organic life. He properly remarks, however, that the inferences of Jdrg,f from his experiments, are apparently opposed to this view. Jorg considered its effects upon the brain to be excitant, and that it occasioned turgescence of that organ. EFFECTS ON THE ECONOMY IN DISEASE. From the effects produced by the hydrocyanic acid on the healthy body, we may infer the cases of disease in which it may be indicated. It is decidedly sedative, allaying nervous irritability and vascular action, and therefore adapted for all cases in which these are inordinately excited. Yet its power, as a medicinal agent, is not as great as was at one time presumed, and as is still presumed by many. In some countries, too, it has found more favour than in others. In Italy, France and England, it has been more extensively used than in Germany; yet in many of the Phar- macopoeias of the last country it has been admitted into the list of officinal agents. The great objections that have been urged against it are—its danger, even in a small dose, if not carefully adminis^ tered; the difficulty of having it always of the same strength; the impossibility of administering it undiluted, and the danger of givino- too strong a dose in consequence of its rising to the surface of" water. More than once the difference in the strength of the acid prepared by different methods, would seem to have o-iven rise to unfortunate results. OrfilaJ mentions the case of a Sick person who had used for a length of time the hydrocyanic acid, in increasing doses, with advantage; when, being compelled to send her prescription to another apothecary, the acid he employed was so strong as to produce death, with all the symptoms of poisoning * Loc. citat. S. 526. t Materialien zu einer kiinftigen Heilmittellehre. B. i S 53 117 I Toxicologic ACIDUM HYDROCYANICUM. 21 by hydrocyanic acid. For these and other reasons, Riecke, L. W. Sachs, and Osann greatly prefer the Aqua laurocerasi and the Aqua amygdalarum amarum, which, although in other respects not less objectionable, are far less dangerous.* Possessed of the powerful sedative agency, which has been described, it is not to be wondered at, that the hydrocyanic acid should have been prescribed in a multitude of cases, and, as con- stantly happens, that unsuccessful trials, suggested by the merest empiricism, should have been made with it. In inflammations, especially when accompanied with marked erethism of the nervous system, it has been greatly extolled, and, next to blood-letting, has been regarded by many as one of our most valuable antiphlogistics. The followers of the contro-stimu- lant school esteem it as one of their most efficacious contro- stimulants. In the acute inflammations of internal organs it has been highly recommended by the Italian physicians, Borda 'and Brera, in thoracic inflammation, after blood-letting, in conjunction with tar- tarised^ antimony and similar sedative agents; and by others in enteritis, metritis and nephritis, and in active hemorrhages. In chronic inflammations it has been advised by Granville, Magendie, Heller, Elwert, Behr, Roch, &c, especially in chronic catarrh, bronchitis, and hooping cough. In the last affection it is conceived by Dr. Roef to possess a " specific " (?) power. In warm weather he thinks that it will cure almost any case of simple hooping cough in a short time; that in all seasons it will abridge its dura- tion, and in almost every instance, where it does not cure, that it will, at least, materially relieve the severity of the cough. In pulmonary consumption it has been recommended by Gran- ville, Magendie, S. G. Morton, Fantonetti,J and others, particu- larly where there is any inflammatory or spasmodic complication; but others, as Neumann, Weitsch, Sir James Clark, Andral,§ Forget,|| and, we may add, ourselves, have given it in these very cases without any success. By some, indeed, it has been affirmed, that its administration in phthisis is to be adopted with caution, as in many cases instead of allaying, it appears to have increased, * Die neuern Arzneimittel, ihre physischen und chemischenEigensclmften, Bereitungsweise, Wirkung auf den gesunden und kranken Organisrnus, u. s. w. von V. A. Riecke, S. 5. Stuttgart, 1837; Osann, loc. citat. and Encyclop. Wort. ii. 315. f A Treatise on the Nature and Treatment of Hooping Cough, &c, p. 10. London, 1838. \ Gazette des Hopitaux, Fev. 19, 1839. \ Bulletin General de Therapeutique, Mars. 1840. || L'Experience, Nov. 14., 1839; and Atner. Med. Intel., Sept. 1., 1840, p. 170. 3 22 ACIDUM HYDROCYANICUM. the cough and fever, diminished the expectoration, and occasioned a sense of suffocation:* it has been, moreover, asserted, that its depressing and destructive agency has acted injuriously on the organism of the consumptive.! In chronic nervous diseases, especially when of a spasmodic character—as in spasmodic affections of the heart—even when organic, the hydrocyanic acid has been advised as a soothing agent, as well as in spasmodic asthma; in the sense of suffocation that accompanies hydrothorax and other affections; and in spas- modic dysphagia. Its efficacy, too, has been marked, according to Elliotson,J in various neuropathic disorders of the stomach, especially in those in which pain at the epigastrium was the leading symptom,—in every form, indeed, of gastrodynia; and in painful affections of the boicels, of a similar character, it has been found useful by Mr. Pereira.§ In enlargement of the heart it was found by Heller to diminish the force and frequency of the pulsations, and in this way to afford essential relief. In an old person, labouring under anasarca ac- companied by great pain in the breast, Rees observed, after the administration of Vauquelin's acid, great diuresis, with the removal of the dropsy and its concomitant symptoms.|| In the asthma pulverulentum of the Germans, (Staubasthma,) that is, in the variety to which millers, bakers, grinders and others are liable, Creutswicher is said to have found it highly serviceable.*!! Its efficacy has not been so marked in epilepsy, chorea and kindred affections; yet it has been strongly recommended in tetanus. Trevezant ordered it in a case of traumatic tetanus, after opium had been given in vain, in the dose of from two to twelve drops with favourable results.** On the other hand, Klein gave it in a similar case, with no other apparent effect than that of rendering death more easy .-ft It has likewise been advised in spasmodic^ pains of the uterus. Yet, although it would seem to be soothing and antispasmodic * Schneider, Med. PraktAdversarien am Krankenbette,Erste Lie Decoct, malvae. tijj. M. The bottle should be shaken before each application. All these formulae are objectionable for the reasons before as- signed, and it is consequently better to drop the acid at the time of using it, taking care that it has not lost its properties. ACIDUM LACTIS. Synonvmes. Acidum Lacteum, Lactic Acid, Acid of Milk. French. Acide Lactique. German. Milchsaure. This acid is recommended as a therapeutical agent by Magendie in the last edition of his Formulaire.f METHOD OF PREPARING. Lactic acid may be obtained either from milk or from the juice of the red beet. In the latter case, the juice is put in a situation the temperature of which is between 77° and 86° Fah. After the lapse of a few days, a commotion is observed in the mass, which is known under the name "viscous fermentation," {fermentation visqueuse,) and hydrogen and carburetted hydrogen are evolved in considerable quantity. When the mass has become fluid again, and the fermentation has ended, which generally requires about two months, it is evaporated to the consistence of syrup; the whole then becomes traversed by a multitude of mannitic crystals, which, when washed with a small quantity of water and dried, are en- tirely pure. The mass,moreover, contains a saccharine matter, which affords all the ,signs of the sugar of the grape. The product of the evaporation is next treated with alcohol; this dissolves the lactic acid, and precipitates several substances, * Tweedie's Libr. of Med., v. 288, Lond. 1840. t Formulaire pour la preparation et l'emploi de plusieura nouveaux medi- caraens, &c. Edit. 9eme. Paris, 1836. 28 ACIDUM LACTIS- which have not yet been examined. The alcoholic extract is then dissolved in water, which occasions a fresh precipitation. The liquid is now saturated with carbonate of zinc, and by this means a fresh precipitation is effected, more copious than the preceding, By concentration, the lactate of zinc shoots into crystals, which are collected and heated in water, to which animal charcoal, pre- viously washed in muriatic acid, has been added: the fluid is then filtered, and the lactate of zinc is deposited in perfectly white crystals: these are washed in boiling alcohol, in which they are insoluble; afterwards they are treated with baryta, and then with sulphuric acid, which separates the lactic acid, which is finally concentrated in vacuo.* Mitscherlichf gives the following process for preparing it pure, Lactate of lead, formed in the usual way, is decomposed by sul- phate of zinc, the sulphate of lead is separated, and the lactate of zinc crystallised by evaporation; this is at first yellow, but by re- peated crystallisations, it is obtained of a pure white. The solution of this lactate is decomposed by pure baryta; the oxide of zinc separated, and the lactate of baryta, which is in solution, is de- composed by sulphuric acid, and the fluid evaporated; this yields a clear, colourless, syrupy, not volatile acid, which is decomposed and leaves a residue of charcoal, when heated at a sufficiently high temperature. Milk, which has been suffered to ferment for a long while, and is treated in the same way, affords lactic acid. Corriol has like- wise detected it in an aqueous infusion of the nux vomica, When concentrated in vacuo, until it parts with no more water, lactic acid is a colourless liquid, of syrupy consistence; its specific gravity being about 1.215. It is inodorous, but of a very sour taste, similar to that of the strongest vegetable acids. When exposed to the air, it attracts moisture. Water and alcohol dis- solve it in all proportions. One of its most striking properties, which is of especial interest to the physician, is, that it quicklv dissolves phosphate of lime, especially that which is contained in bones. EFFECTS ON THE ECONOMY. As lactic acid seems to play a part amongst the juices which effect the solution of the food in the stomach, Magendie thinks it may be given with advantage in cases of dyspepsia produced by simple debility of the digestive apparatus; and his experiments afforded him very encouraging results. In consequence too of the facility with which is dissolves the phosphate of lime, it has been suggested, whether it might not be administered with advantage in * Gay Lussac & Pelouze, Annales de Chimie et de Phvsique. Avril 1833 (Tom. lii. 410.) y 4 '^VIU' ±00° t Report to British Association, 2d meeting, and Philad. Journ. of Phar- macy, vi. 83. Philad. 1834-5. ACONITINA. 29 cases of white gravel, or, in other words, of phosphatic depositions from the urine. Magendie has not yet been able to institute ex- periments on this matter. At the time when the edition of his Formulary, to which wre have referred, was published, he had com- menced some clinical experiments with the lactate of potassa, and the lactate of soda, but without any results worthy of being com- municated to the profession. He recommends these salts, how- ever, to the attention of physicians. MODE OF ADMINISTRATION. Magendie gives the lactic acid either in the form of lemonade OX of lozenges. Potus Acidi Lactis. Lemonade of lactic acid. &. Acid. lact. liquid. 3j. ad 3iv, Aqua3,fbij. Syrupi, 5ij. M. Pastilli Acidi Lactis. Lozenges of lactic acid. R. Acid. lact. pur. 3ij« Sacch. pulv. 5j. Gum. tragac. q. s. 01. aether, vanigl. gtt. iv. M. Make into Lozenges weighing half a dram each. Let the Lozenges be kept in a well closed vessel. Of these,, from two to six may be taken in the 24 hours without any evil consequences. ACONITINA. Synonymes. Aconitia, Aconitium, Aconitine. German. Akonitin. This active principle, which was discovered by Peschier.* and by Brandes, has been recommended of late by Turnbull,f whose * Tromrasdorf's Journal der Pharmacie, v. 84. f On the medical properties of the natural order Ranunculacese, and more particularly on the uses of sabadilla seeds, delphinium staphysagna and aconitum napellus, and their alcaloids, veratria, sabadilline, delphjnia and aconitine, chap. iii. Lond. 1835. 30 ACONITINA. eulogies on the medical virtues of the natural order Ranunculaceoa are evidently overstrained. MODE OF PREPARING. Turnbull gives two processes; the former being the more easy of manipulation; the latter yielding a purer result, and on the whole being preferable. A quantity of the fresh root of the aconitum napellus, being very carefully and cautiously dried and reduced to powder,—one part of it by weight, and two parts by measure, of strong alcohol, are to be digested together at a gentle heat for seven days, and the tincture, whilst warm, is to be filtered. It must then be reduced to the consistence of an extract, by careful evaporation, at a low and well regulated temperature; the object of this being to prevent the destruction or expulsion of the active principle, which would very probably ensue, if' the temperature employed were higher than barely sufficient to carry off the alcohol. To the extract, thus prepared, liquid ammonia is to be added, drop by drop, and mixed well with it, to precipitate the alcaloid; in this part of the process care must be taken that too much be not added, as in some instances the product appears to have been decomposed by inattention to this circumstance. It is not easy to give a precise rule as to the quantity; but enough will have been added, if the extract exhales the odour of ammonia when stirred. The mass now consists of impure aconitine, mixed with a quantity of extractive, and other matters soluble in water, and it may be taken up either by boiling alcohol, or by sulphuric ether; or the soluble matter may be removed by repeated washings with small quantities of cold water, which will leave the aconitine. This latter process, Turnbull says, is the one he has generally employed, and it is performed by pouring a little water on the extract, and mixing them carefully together; then allowing the undissolved part to subside, pouring oft" the fluid, and repeating the operation as long as any soluble matter is taken up: a quantity of light brown or gray powder is left, which may be purified by subsequent solution in alcohol. This powder contains the active properties of the aconite, in a high degree of concentration. The second process consists in dissolving the alcoholic extract, prepared as above, without the addition of the ammonia, in as much cold water as will take it up, and carefully decantino- the solution from the insoluble part, and filtering it. To the filtered solution liquid ammonia is to be added, drop by drop, as long as any precipitation is occasioned. When the precipitate has subsided, the supernatant fluid must be carefully poured off, or drawn off by means of a syphon; and after the precipitate has been deprived of as much of the fluid as possible, it should be purified by a sufi> ACONITINA. 31 cient number of washings with small quantities of cold water, or, what is better, it may be dissolved in as much alcohol as will take it up, and the solution be thrown into cold water; the precipitate thus formed is to be carefully dried. The product obtained by this process is white. The London college, in their Pharmacopoeia, of 1836, give 'he following form.—Take of aconite root, dried and bruised, two pounds; rectified spirit, three gallons; dilute sulphuric acid, solution of ammonia, and purified animal charcoal, of each a sufficient quantity. Boil the aconite with a gallon of the spirit for an hour, in a retort with a receiver fitted to it. Pour off the liquor, and again boil the residue with ano- ther gallon of the spirit, and with the spirit recently distilled, and pour off the liquor also. Let the same be done a third time. Then press the aconite, and having mixed all the liquors and filtered them, distil the spirit. Evaporate the remainder to the proper consistence of an extract. Dissolve this in water and filter. Evaporate the solution with a gentle heat, so that it may thicken like syrup. To this add dilute sulphuric acid, mixed with distilled water sufficient to dissolve the aconitine. Next drop in solution of ammonia, and dissolve the aconitine which is thrown down in dilute sulphuric acid, mixed as before with water; then mix in the animal charcoal, occasionally shaking for a quarter of an hour. Lastly, filter; and having again dropped in solution of ammonia so as to precipitate the aconitine, wash and dry it.* Well prepared aconitine, according to Geiger, is a firm, colourless, and translucent mass; of a shining appearance, friable and inodorous: the taste is disagreeably bitter, leaving behind it an acrid sensation in the throat, but not corrosive or burning. The aconitine does not dissolve readily in water; at the ordinary temperature it requires one hundred and fifty parts thereof, but only fifty parts of boiling water. Tincture of iodine occasions in the solution a reddish brown precipitate; the tincture of galls a white one. It forms, With the acids, for the most part, salts that are not crystallisable, which readily dissolve both in water and spirit of wine. EFFECTS ON THE ECONOMY. The effects of aconitine appear to be essentially analogous to those of delphinine. A grain of the first of the two preparations described by Turnbull was dissolved in a dram of alcohol: twenty drops of the solution put into the mouth of a guinea pig occasioned death in a few minutes. Other experiments, too, have been performed, all of which demonstrate the extreme activity of the substance. If a grain or two of aconitine or veratrine or * See, also, the Dispensatory of the United States of America, by Drs. Wood and Bache, 4th edit. p. 761, Philad. 1839. 32 ACONITINA. delphinine be mixed up with a little lard, or dissolved in a dram of alcohol, and a small quantity be rubbed on the skin, a sensation of heat and tingling is experienced after the friction has been persevered in for a minute or two. There is a slight difference, however, in the effects produced, and the resemblance is greatest between those of the delphinine and the aconitine. When a small quantity of aconitine, says Turnbull, either made into an ointment, or dissolved in alcohol, is rubbed for a minute or two upon the skin, a sensation of heat and prickling is experienced; to this succeeds a feeling of numbness and con- striction in the part, as if a heavy weight were laid upon it, or as if the skin were drawn together, by the powerful and involuntary contraction of the muscles beneath. This effect lasts from two or three to twelve or more hours, according to the quantity rub- bed in. So small a portion as the one hundredth part of a grain has produced a sensation that has continued a whole day. Whilst employing the aconite itself in his clinical practice, Dr< Lombard,* of Geneva, tried its effects on animals, and chiefly in reference to its action on the heart. , The experiments were made on frogs, whose hearts beat with great regularity, and for a consi- derable time after the animal has been mutilated. The medicine was introduced into the stomach or applied locally to the heart, which was laid bare after the animal had been stupified by blows on the head. He found, that the aconite employed internally rendered the pulsations less frequent, without irregularity, and consequently that it exerted a decidedly sedative effect on the heart; whence he infers, that it is a proper remedy in active diseases of the heart, and indeed in inflammatory affections in general, in which he exhibited it with success. In cases of poi- soning by it, the contractions of the heart have been found diminished, and almost suspended,! and tne hornceopathists regard it to be an energetic antiphlogistic. The diseases, in which Turnbull chiefly employed aconitine externally, were of the neuralgic kind; but he used it as well in gouty and rheumatic cases, and its success, he remarks, fully answered his anticipations. He employs it either in the form of solution in alcohol, in the proportion of one or more grains to the dram,—or of ointment, made according to the following formula: R. Aconitin. gr. ij. Alcohol, gtt. vj. Tere optime et adde adipis, Jj. ut fiat unguentum. The alcohol is added to prevent the aconitine from forming a thick compound with part of the lard, so as to render it difficult to * Gazette Medicale de Paris, Oct. 10,1835. | Orfila, Toxicologic, ii. 221. ACONITINA. 33 make a proper ointment. In one case of tic douloureux, of extreme severity, as much as eight grains was prescribed in the ointment with the most marked benefit. The best mode of applying it is simply to rub a small portion of it over the whole seat of the affection, until the pain is either for the time removed, or until the full effect described above, is induced on the cutaneous nerves, and the friction should be repeated three or four times, or more frequently, during the day, according to the effect on the disease; the proportion of the aconitine being increased at every second or third rubbing. Turnbull found, in the case of the aconitine—as well as in that of the veratrine, and the delphinine—that unless the friction occasioned a full development of the peculiar impressions caused by the aconitine, when rubbed on the skin, no benefit whatever was to be looked for from its employment; and he observes, that if there be the slightest abrasion of the skin, an application of such activity should riot be resorted to; and that it should be carefully kept from coming in contact with any of the mucous membranes. Mr. F. C. Skey* details two cases which were cured by it. It was rubbed down into an ointment with lard, in the proportion of one grain of the former to one dram of the latter, and applied in a small quantity by the forefinger over the track of the painful nerve, and was gently rubbed or rather smeared over the surface for half a minute or longer, once or twice a day, according to the degree of pain. Turnbull likewise advises the external application of an ammo- niated extract of aconite, which is made by evaporating very carefully, and at a low temperature, the tincture of the dried root of the plant, prepared as directed in the process for obtaining aconitine, to the consistence of an extract. To every dram of this, eight or ten drops of liquor ammonias should be added, and after the mixture has stood a short time in a very gentle heat, to drive off the excess of ammonia, it may be used in the form of an ointment, according to the following prescription: R. Ext. aconit. ammon. 3j Adipis. 3iij« Misce ut fiat unguentum. When this ointment is rubbed upon the skin, it occasions sensa- tions in the part similar to those produced by the aconitine oint- ment ; they are, however, rather more pungent. In less severe cases, Turnbull advises the simple saturated tincture of the dried roots, with or without the addition of a little ammonia. The alcoholic extract of aconite has likewise been advised by * London Med. Gaz. Nov. 5.1836. 4 34 *'•*»* ^ t Lancet, Aujj. 25, 1838, p. 770. j Journal de Pharmacie, xx, 399. Paris, 1833. § Fonnulaire—-derniere edition. .ETHER. HYDKOCYANICUS. 43 cyanic acid, without being so violent a poison, and, consequently, he esteems it worthy of regard as an addition to the materia medica. MODE OF PREPARING. Equal parts of sulpho-vinate of baryta and cyanide of potassium are mixed intimately together, put into a glass retort, to which a tubulated receiver is adapted, and exposed to a moderate tempera- ture. By distillation, a colourless, or slightly yellowish fluid is obtained, which separates into two distinct strata. The lighter consists chiefly of hydrocyanic ether, which is not pure however, but mixed with water, alcohol, sulphuric ether, and hydrocyanic acid. In order to purify it, it must be strongly shaken, and, with four or five times its bulk of water, must be exposed for some time to a temperature of 60° or 70° centigrade j it must be again agitated with a little water, decanted, suffered to remain in con- tact with chloride of lime for twenty-four hours, and then dis- tilled. The ether thus obtained is pure. It is a colourless fluid, of a penetrating, disagreeable garlicky odour. Specific gravity 0.78. It boils at 82° centigrade; is very slightly soluble in water, but soluble in every proportion in alcohol and sulphuric ether. In its pure state it does not disturb a solution of nitrate of silver. It inflames very readily, and burns with a blue light. Caustic po- tassa decomposes it with difficulty, and only when highly con- centrated. EFFECTS ON THE ECONOMY. Six drops of this ether placed in the throat of a dog, occasioned, in a short time, deep respiratory efforts: the dog fell on its side and convulsions succeeded, with considerable motion of the paws. This condition continued for four minutes, after which the effects gradually disappeared, and in the course of half an hour passed away. Six drops injected into the jugular vein rapidly caused death, with symptoms similar to those induced by the hydrocyanic acid. According to Magendie, these experiments were frequently repeated by him with different modifications, after which he ven- tured upon its administration in disease. He added six drops of the ether to a mucilaginous linctus, and prescribed it to a patient labouring under hooping-cough, who, in the course of a few days, derived signal benefit from it, and without complaining of its pene- trating, disagreeable odour. The same good effects happened to several patients to whom he gave it in the Hotel Dieu. But although the results were favourable in cases in which the hydro- cyanic acid was indicated, he found it necessary to discontinue its use, on account of the invincible nausea which its smell induced. Magendie advises it in those diseases in which mixtures of the hydrocyanic acid have been found of service. 44 AQUA AMYGDALARUM. AQUA AMYCxDALARUM, (CONCENTRATA.) Synonymes. Water of Bitter Almonds. French. Eau d'Amandes Ameres. German. Bittermandelwasser. The water of bitter almonds has been received into many of the modern Pharmacopoeias;—into those of Bavaria, Pans, Ferrara, Hanover, Hesse, and Prussia, for example. METHOD OF PREPARING. The Pharmacopoeia of Prussia directs it to be prepared in the following manner:—Take two pounds of bitter almonds, bruise well, and add—whilst triturating them—ten pounds of spring water, and four ounces of highly rectified spirit of wine. Let the mixture rest for twenty-four hours in a well closed vessel, and then distil two pounds. The product must be kept in a well stopped bottle. The inequality in the strength of the aqua lauro-cerasi and of the medicinal hydrocyanic acid suggested this preparation, which was extolled by Hufeland for its uniformity. Its effect is entirely like that of the aqua lauro-cerasi, but its greater regularity in strength and action has not been confirmed. i Giese found the quantity of hydrocyanic acid contained in the product of the above formula half less than that in the cherry laurel water; and Jorg, from his experiments upon himself and others, proved it to be much weaker and more uncertain. Neither this preparation, nor the distilled aqua lauro-cerasi, is employed in this country, or in Great Britain. Every objec- tion made to the hydrocyanic acid seems to be equally applicable to them. AQUA BINELLI. 45 AQUA BINELLI. Synonymes. Aqua Balsamica Arterialis. German. Binellisches Wasser. Not many years ago, this Italian nostrum was vaunted through- out Europe, as a styptic in every kind of hemorrhage—both when internally and externally administered. By several enlightened Italian physicians—Cotugno, Antonucci, Santoro, and others, it was found highly serviceable, and Von Grafe* thought, at first, that he had observed good effects from it. This opinion was confirmed by the observations of Kosch, Vrolick, Metzger, &c.f Subsequently, however, not only he but Simon,J Dieffenbach,§ and Dr. John Davy,|| found that it was not possessed of more effi- cacy than simple cold water.Tf The new haemostatic received its name, Acqua BineUi, from Dr. Fidele Binelli, the inventer. It was a perfectly transparent fluid, almost tasteless, having a slightly empyreumatic odour; but neither the presence of salt, alkali, earth, nor acid, could be de- tected by the senses. The first public trials, to test the efficacy of the liquid in arrest- ing hemorrhage, were instituted at Turin, in 1797, by order of the government, the results of which were esteemed favourable. Soon after this Binelli died, and the secret for making the preparation is said to have died with him; but in the years 1829 and 1830, the successors of Binelli affirmed, that they had discovered the secret, and fresh experiments were instituted and repeated in Ger- many. Various blood-vessels were divided on animals,—the femoral and carotid arteries, and the internal jugular veins;—and the cuts were made in every direction; some longitudinally, some obliquely, others completely across, and, in all cases, the hemor- rhage yielded as soon as charpie, or lint, steeped in the acqua * Griife's Journal, Bd. xvii. p. 650. t Ibid. Bd. xxvi. X Horn's. Archiv. 1833, Sept. und Oct., s. 926. \ Hecker's Literarische Annalen, 1833, s. 486. || Edinburgh Medical and Surgical Journal, July, 1833, and Researches physiological and anatomical, by John Davy, M. D., F.R.S.,&c, &c i, 344 Lond. 1839; or Dunglison's American Medical Library edition. Phila., 1840. IT E. Qrafe, Art. Kreosot. in Encyclopadisches Worterbuch der medici- nischen wissenschaften, Bd. xx. S. 536. Berlin, 1839. 5 46 AQUA BINELLI. binelli, was applied and pressed gently against the wound for five or ten minutes. Encouraged by the results of these experiments, the liquid was tried on man and with advantage; but it was soon found, that the results were not owing to any properties of the liquid, but to the cold, moisture, and appropriate pressure. The author has given the results of the experiments and observations of Dr. John Davy in another work.* They convey interesting information as regards the physiology, pathology, and therapeutics of wounded vessels, and impart a useful lesson to the inquirer—not to deduce inferences from inadequate data, without having investigated eiTery collateral circumstance that may bear upon a question. The results of Dr. Davy's experiments show how hemorrhage from wounding a large artery, which would be speedily fatal, may be readily arrested by moderate compression with several folds of linen or cotton moistened with water; and they farther show how, under this moderate com- pression, the wound in the artery may heal, and the vessel remain pervious, without the supervention of aneurism. Dr. Davy lays stress on moderate pressure, such as may still allow the blood to pass through the canal of the artery. At the meeting of the British Association in 1839,f Dr. Ma- cartney, of Dublin, in alluding to the powers which nature pos- sesses to repress hemorrhage provided the cut surfaces be treated as an open wound with cold applications, related a case in which, after amputation of the hand of a child, the stump was dressed with lint kept wet with cold water, and in which no ligature was applied or required. This Dr. Macartney deemed to be the first case on record, in which amputation was performed without the application of a ligature. It has been suggested, that the acqua binelli may be indebted for its fancied haemostatic property to creasote in some form, but Dr. Davy's explanation appears all sufficient to account for the phenomena. Under these circumstances we may follow the ex- ample of Riecke,J and pass it by with this cursory notice. * General Therapeutics, p. 198. Philad. 1836. oL^V^ln^ AUg' 81, 1839' and AmeriCan Medical Intel%encer, * Die neuern Arzneimittel. S. 28. Stuttgart, 1837. AQUA PICIS LIQUIDS. 47 A. PICIS LIQUIDS. Synonymes. Aqua Picis, Aqua Picea^ Infusum Ficis Liquids seu Picis Empyreumaticse Liquids, Potio Picca, Tar Water. French. Eau de Goudron. German. Theerwasser. This preparation, at one time so much extolled, and recom- mended on the authority of the celebrated Bishop Berkeley, but which had almost fallen into total disuse, has been recently revived, more especially since it has been found to contain crea- sote. It was first employed extensively in England about the middle of the last century, and was drunk not simply as a thera- peutical but as a prophylactic agent, so that, Riecke facetiously remarks, almost as much tar-water was consumed by the inhabi- tants of London, as beer and other drinks !* As commonly happens in such cases, practitioners passed from one extreme to the other, and as they gradually found the tar water was not capable of accomplishing all that had been ascribed to it, they ultimately neglected it altogether. Still, for- mulas for its preparation exist in many Pharmacopoeias—in those of Dublin, Bavaria, Brunswick, Paris, Russia, Saxony, Sweden, and Wirtemberg, for example. The water takes up from the tar a small portion of acetic acid, creasote, and resinous matter; and it was formerly much praised as a remedy in pulmonary consumption, and as a diuretic; its virtues, however, appear to rest almost wholly on the con- tained creasote. Some years ago, Arnheimer, of Duisburg, recalled the attention of practitioners to it as a remedy in many chronic cutaneous affec- tions, especially of the herpetic kind; and he asserted, that he found no remedial agent more valuable when its use was perse- vered in for one or two months to the extent of a pint or two daily. Arnheimer directed patients to prepare it for themselves in the following manner. A pound of tar was put into a deep porcelain dish, and a quart of water poured upon it; for half an hour it was stirred with a spoon; the mixture was then allowed to stand for twenty-four hours; the tar remaining on the surface * Die neuern Arzneimittel. S. 38. Stuttgart. 1837. 48 AQUA PICIS LIQUID^. of the water was skimmed off, and the clear fluid put into well stopped bottles. He advises, that a large quantity should not be prepared at once, as the water in time becomes ropy and its golden yellow colour is changed to a darker hue. It is generally taken without any repugnance. Since the discovery of creasote, tar wrater has received fresh consideration, and it is not improbable that it may come again into more general use, as it appears, from recent experiments, that there are cases where it would seem to merit a preference over creasote. M. Petrequin has lately made some trials with both in chronic catarrh, and in different stages of phthisis.* The number of cases communicated by him is twenty-three; of these seven were cases of chronic catarrh, in which creasote was given; generally the cough was mitigated by it, but in two cases no effect was produced on that symptom. The expectora- tion was usually diminished or facilitated: in two cases, how- ever, no advantage was derived from it, and in one case the sputa were bloody. In the majority of the cases, the dyspnoea ceased; in others, it continued; and in the same number of cases the pain in the breast was relieved by its use. As to its effects on the digestive organs, it several times excited thirst; but the most marked result was the sensation of burning, which it caused, in the majority of cases, in the digestive tube or in the breast. In two cases it exhibited no influence on an existing diarrhoea, whilst in two others it appeared to diminish the number of the evacuations. Iii two cases it excited vomit- ing, and commonly produced nausea. On the whole, in the greater number of cases it appeared to render good service, but in one it was of no avail, and in another it seemed to aggravate the affection. In four cases of incipient phthisis, treated with creasote, M. Petrequin obtained the following results. Although in one in- stance, the cough was aggravated; in the majority of cases the opposite was the fact. The expectoration was facilitated but diminished in quantity; the dyspnoea was more or less improved, and in two cases the pain in the chest was relieved. In this dis- ease, also, the creasote excited burning in the epigastrium or chest, and in one instance fugitive sensations of heat and creep- ing in the limbs. In one case the benefit was striking, in two the improvement was to a less extent, and in one the disease was augmented. Four other cases were of advanced phthisis. In most of them the cough was more or less improved,—never increased; the * Gazette Medicale de Paris, No. 45. Nov. 5,1836. AQUA PICIS LIQUIDS. 49 oppression remained much the same, but in one case it became more severe. As regards the effects upon the digestive organs, they were much the same as in the first class of cases. The improvement in one case was insignificant; in two others but slight, and in the fourth case the affection was aggravated. M. Petrequin directs tar water to be prepared by digesting an ounce of tar in a quart {pinte) of water for eight days, and then filtering. It is taken mixed with milk, and to the extent of from eight to twelve ounces in the day. With this preparation, he treated three cases of chronic catarrh. The cough was always improved by it, the expectoration diminished or facili- tated; the dyspnoea alleviated or removed, and the pains in the chest improved or dissipated. In two cases, it appeared to act beneficially on vomiting which accompanied the cough. The appetite was improved, and in one case diarrhoea appeared to be diminished, whilst in two others, existing constipation yielded during its use. In all the cases, sleep was restored. On the urinary secretion it exerted no in- fluence, and it neither excited thirst nor nausea like creasote. In three cases of incipient phthisis, its action was more bene- ficial than that of creasote. The cough was always ameliorated, the expectoration facilitated or diminished, and the dyspnoea and thoracic pain relieved. In one case, it seemed to act favourably on accompanying emesis, and in another to quench the thirst. It excited or improved the appetite, and aided digestion. In one case of advanced phthisis, the alleviation produced by the tar water was beyond all expectation, but in another the disease had proceeded so far that it was wholly unsuccessful. So far, then, as M. Petrequin's experiments go, they would seem to show that advantage may be derived, in the cases in question, from the administration of creasote and tar water; and that the latter is perhaps possessed of properties which the other has not —to the same degree at least. The cases are, however, too few to enable us to deduce any thing entirely satisfactory. Fresh experiments will doubtless be instituted, which may ena- ble us to infer positively on matters that must as yet be considered involved in doubt.* We have administered it freely in phthisis, as well as in chronic bronchitis. In the latter affection, it has relieved cases, in which the accustomed excitant expectorants are found to be serviceable. The same has been the fact in the former disease; but farther than this no advantage has accrued from its administration. * Deslande?, Diet, de Medec. et de Chirurgie prat, xi, 233. 5* 50 ARGENTI PR^PARATA. In a late French periodical,* some cases are published from the records of the hospitals for 1829 and 1830, during the attendance of the late Professor Dupuytren, in which injections of tar water were successfully administered in catarrhus vesica;, along with the use of pills of turpentine. - The tar water was made by infusing in the cold, for a night, a pound of tar in ten pounds of spring water, filtering and warming the solution before using it. Large quantities of this were in- jected through an elastic gum catheter, which was forthwith withdrawn and the patient directed to retain the injection as long as possible. The injection was repeated daily, and Venice tur- pentine was administered internally in the form of pills. ARGENTI PR^PARATA. Synonymes. Preparations of Silver. German- Silberpraparate. Of the preparations of silver, the nitrate is the only one that has been much used, and this chiefly as an external application. Re- cently, however, the attention of physicians has been directed to the internal use of many of those preparations, and especially by M. Serre,f- professor of surgical clinics at Montpellier. This gentleman commenced his first trials in May, 1835, in the civil and military hospital of St. Eloi. At this time there was an un- usual number of syphilitic patients in the wards, of which the most severe and appropriate cases were selected for treatment by the preparations of silver, the chloride, cyanide, and iodide. Trials were also made with the divided metallic silver, the oxide of sil- ver, and the chloride of ammonia and silver. At first these pre- parations were administered iatraleiptically; the chloride, the cyanide, and the iodide in the quantity of one twelfth of a grain; the chloride of silver and ammonia in the quantity of one four- teenth of a grain; and the oxide of silver and the divided silver in the dose of one eighth, and one quarter of a grain, respectively. * La Lancette Franchise, Avril 8, 1837. t Bulletin General de Therapeutique, 1836. ARGENTI PR^PARATA. 51 M. Serre soon found that these doses were generally too small: he therefore raised that of the chloride and the iodide to one tenth and one eighth of a grain, without the slightest inconvenience re- sulting. The other preparations were also increased in the same proportion, with the exception of the chloride of silver and am- monia, which requires more precaution than any of the other preparations. M. Serre did not restrict himself to the iatraleiptic administra- tion of these substances, but employed them internally in the form of pill, and externally as local applications. The formulae pre- ferred by him were the following:— Pulvis Argenti Chloridi. Powder of chloride of silver. R. Argent, chlorid. gr.j. % Pulv. irid. florent. gr. ij. Reduce to a fine powder, and divide into eight or ten portions; to be rubbed on the tongue. Pilulce Argenti et Ammonice Chloridi. Pills of chloride of silver and ammonia. R. Argent, et amnion, chlorid. gr. j. Pulv. irid. florent. gr. ij. Conservas flor. tilise q. s. ut fiat massa in pilulas xiv dividenda. For internal use, Unguentum Oxidi Argenti. Ointment of oxide of silver. R. Oxid. argent, gr. xx. Adipis. 5j- Misce, ut fiat unguentum. When the iodide or cyanide is substituted for the oxide of sil- ver, ten or twelve grains of these may be added to the ounce of lard. 52 ARGENTI PR^PARATA. M. Serre describes several cases of syphilis in which the pre- parations of silver were administered according to the above forms. The first patient was a soldier, 26 years old, of athletic constitution, who, at the time of his admission into the hospital, had several large chancres on the prepuce, so-close to each other as to seem to form one large circular ulceration, five or six lines in diameter. After a few days' rest, and the use of baths, M. Serre ordered the chloride of silver in friction on the tongue in the quantity of one twelfth of a grain. The ulcers were treated with simple cerate {ceratum galeni) spread on lint. After the second rubbing, the patient experienced violent colicky pains, which were not severe enough, however, to induce a discontinu- ance of the remedy. Scarcely had a grain of the chloride been employed, when the secretion from the ulcerated parts became less: the surface of the chancres lost the kind of grayish border which they possessed, and the cicatrisation proceeded rapidly. The frictions were continued, and the condition of the patient went on improving. At the end of two months he left the hos- pital. In the five subsequent cases the same plan of treatment was pursued. The chloride was used exclusively according to the iatraleiptic method. The symptoms were various; in addition to chancres, there was in one case a suppurating bubo; in another, syphilitic vegetations at the margin of the anus; and in a thirdj fissures in the same part. In the seventh case, in which there were chancres, gonorrhoea, and extensive rugous blotches on the nates, the chloride of silver was rubbed on the tongue, and applied topically in the form of ointment. The eighth patient, who suf- fered with large condylomata, as well as with ulcers in the neck, took the chloride in pills to the extent of nine grains in the course of the treatment; frictions with the ointment of silver were also applied to the affected parts. M. Serre deduces from all his experiments the following amongst other conclusions. First. The preparations of silver have this great advantage over those of mercury, that they never oc- casion salivation, nor do they induce in the intestinal canal or in the respiratory organs, the disagreeable effects that are too often caused by 'mercury.. Secondly. That should their therapeutical agency be confirmed by experience, and they be introduced into hospital practice, great advantage will be derived as respects the purity of the wards, and the cleanness of the bedclothes &c. Thirdly. That patients can be treated by them in secret as well as when travelling, without fear of detection. Fourthly. That the preparations of gold are to be preferred in these respects, but that gold has the disadvantage of exciting too much, and cannot, therefore, be exhibited to those of a nervous and excitable temperament, or who have weak and delicate chests. In such ARGENTI CHLORIDUM. 53 cases the preparations of silver merit the preference. Fifthly. The preparations of silver are much cheaper than those of gold, and are, therefore, more available in practice amongst the poor and in large hospitals; and, moreover, they are more easily pre- pared, which is a consideration of some moment, as regards the pharmaciens of small towns. Sixthly and lastly. There are cases in which mercurial and gold preparations fail, and where the preparations of silver might be of great advantage. The observation of others has not confirmed the assertions of M. Serre. M. Ricord* employed the various preparations, made after the formulas given by M. Serre, in the same doses; but not being able to observe any effect that could be fairly ascribed to the agents, he ventured upon considerably larger doses, as much, for example, as twelve grains a day of the iodide and cyanide, but without any marked results. In this country, the preparations of silver have been but little, if at all, used in syphilis, nor do they appear to merit special favour/j- I. ARGENTI CHLORIDUM. Synonymes. Argentum Muriaticum, A. Salitum, Chloruretum Argenti, Argentum Chloratum, Chloride, Chloruret or Muriate of Silver. French. Chlorure d'Argent. German. Salzsaures silber, Chlorsilber. The chloride of silver is prepared by the decomposition of a solution of nitrate of silver, by an excess of a solution of chloride of sodium. The resulting product, or the chloride of silver, appears under the form of a flaky, clotted, very thick precipitate: it must now be washed repeatedly with boiling water, and be exposed to the heat of a sand-bath, so that it may dry as speedily as possible. Chloride of silver, prepared in this way, is of a white colour, devoid of taste, and not soluble in water, but soluble in ammonia. In the light it speedily changes, especially when much divided, or when moist, and assumes a somewhat dark violet hue, as the chlorine is given off. The chloride of silver suffers no decomposition when united * J. J. L. Rattier, La Lancette Franchise, No. 122, Oct. 13, 1836. f Dr. W. P. Johnson, Medical Examiner, Nov. 23,1839, p. 743. 54 ARGENTI ET AMMONITE CHLORIDUM. with vegetable matters. It must be dried and kept protected from the light.* Its uses have been referred to under the head of the prepara- tions of silver, (p. 50.) II. ARGENTI ET AMMONLE CHLORIDUM. Synonymes. Argentum Muriaticum Ammoniatum, Chloruretum Argenti et Ammonise, Chloride or Chloruret of Silver and Ammonia. French. Chlorure d'Argent et d'Ammoniaque. German. Silbersalmiak, Salzsaures Silberammonium. This preparation is obtained, when we saturate, by the aid of heat, liquid ammonia with fresh precipitated and carefully washed chloride of silver. The operation must be accomplished at such a degree of heat, that the fluid shall boil once; for if the boiling be continued a few moments and in the open air, no crystals will be deposited on cooling. If the fluid, whilst in full ebullition and preserved from the light, be filtered, very regular crystals will be deposited on cooling, which may be dried between blotting paper, and should be kept in a well stopped bottle. The chloride of silver and ammonia has a bluish white colour, the peculiar smell of ammonia, and a burning, almost caustic, taste. In the air, it gradually exhales ammonia, and acquires all the properties of simple chloride of silver, without, however, losing the form of the original composition. If the crystals be kept in the ammonia in which they were formed, they do not experience the slightest change in their colour from the influence of light. When treated with distilled water, the chloride of silver and ammonia is decomposed. A portion saturated with ammonia is again dissolved; yet a much greater portion remains undissolved; this contains only a small quantity .Ji of ammonia. The chloride of silver and ammonia experiences the *$ same decomposition through the influence of heat, as when it is exposed to the open air, except that the decomposition takes place more rapidly. It displays nothing extraordinary, when rubbed with organic matters. This remedy, as was before remarked, has also been used with advantage by Serre in cases of syphilis. Another preparation, the Liquor argenti muriatico-ammo- niati, has been long recommended by Kopp, in cases of chronic ■ *T,9,n the mode of forminS the various preparations of silver, see Chamou, m Bulletin General de Therapeutique, No. xvi. Aug. 30, 1836. ARGENTI PRiEPARATA. 55 nervous affections. It is prepared^ according to the following formula:— R. Argent, nitric, fus. gr. x. Aquae distillat. 5ij. Soluto filtrato instilla liquoris natri muriatici, (Sodse Muriatis,) q. s. ad praecipitandum. Prsecipitatum sedulo ablutum solve in liquoris am- nion, caust. ^iss: adde acidi muriatici 3iij. vel q. s. ut praecipitatio evitetur et argentum muriaticum in statu solutionis permaneat. Pondus fluidi filtrati sequale sit unciis duabus cum dimidia.* This preparation is transparent, but under the effect of light suffers black flakes to be deposited. It is therefore necessary to preserve it in small bottles, painted black, in a dark place. In using it, acid substances should be avoided. Kopp found this liquor argenti muriatico-ammoniati of great efficacy in St. Vitus's dance. It may be given to children of about ten years of age, morning, noon, and night, in doses of three drops, gradually raised to six, in a spoonful of distilled water. (See page 50.) III. ARGENTI CYANIDUM. Synonymes.—Argentum Cyanogenatum, Cyanuretum Argenti, Cyanide or Cyanuret of Silver. French.—Cyanure d'Argent. German.—Blaustoffsilber, Cyansilber. This is obtained by permitting a weak solution of hydrocyanic acid to act on a solution of nitrate of silver. The very light white precipitate, formed thereby, must be repeatedly washed with dis- tilled water, and be reduced to dryness in a moderately heated oven. In the preparation of the cyanide of silver, as of the iodide, it is essential to pour on only so much of the fluid in the formation of the precipitate as may be required for the complete decomposi- * "Take of fused nitrate of silver, ten grains; distilled water, two ounces: Into the filtered solution drop enough of a solution of chloride of sodium to precipitate. Dissolve the carefully washed precipitate in an ounce and a half of caustic liquid ammonia; add three drams of muriatic acid, or enough to avoid precipitation, and the muriate of silver may remain in a state of solu- tion. The weight of the filtered fluid should be equal to two ounces and a half." 56 ARGENTUM DIVISUM. tion of the nitrate of silver. If too much hydrocyanic acid be used, a part of the precipitate will be separated in the form of the hydrocyanate of silver. If, instead of the hydrocyanic acid, the hydrocyanate of potassa be used, the latter, if added in too great proportion, will unite with the cyanide of silver, and form a solu- ble double salt. Cyanide of silver is of a white colour, devoid of taste, not solu- ble in water, but soluble in ammonia. In the air, the surface very soon becomes of a dark violet hue, similar to that of the chloride of silver under like circumstances. The cyanide of silver is dry, and should be kept preserved from the light. It experiences no decomposition when mixed with neutral vegetable matters. Its use in disease has been referred to under the preparations of silver. IV. ARGENTUM DIVISUM. Synonymes.—Metallic Silver in a state of division. German.—Zertheiltes Silber. Pure oxide of silver is placed in a porcelain crucible, and the fire is increased to dull redness. The product is then allowed to cool, rubbed in an agate mortar, and sifted through a close sieve or bolting cloth. In this condition, divided silver forms a very fine powder, of a dullish white colour; the air has no influence upon it, unless when impregnated with sulphureous vapours. Besides the use of this preparation in syphilis, already referred to, it may be remarked, that the filings of silver, argentum lima- turn, which agree with it in chemical relations, had been adminis- tered ten years before in cases of intermittent fever, by Dr. Meyer, of Buckeburg.* Notwithstanding the testimony adduced in its favour, it is pro- bably wholly inert, or exerts but a mechanical agency. * Riecke, Op. cit. S. 436. ARGENTI PR^EPARATA. 57 V. ARGENTI IODIDUM. Synonymes. Argentum lodatum, loduretum Argenti; Iodide or loduret of Silver. French.—Iodure d'Argent. German.—Iodsilber. Iodide of silver is obtained by mixing a solution of the nitrate of silver with one of the iodide of potassium. The yellowish flakes, produced by the admixture of the two fluids, are then washed several times with distilled water, and dried in an oven. In this preparation, also, it is important, that only so much of the reagent should be added as is necessary for the complete de- composition of the salt of silver. A surplus of the iodide of potas- sium would form with the already precipitated iodide of silver a soluble and crystallisable double salt of iodine, whereby the quan- tity of the product, which it might be desirable to obtain, would be diminished. Iodide of silver is of a very pale yellow colour, but becomes, under the action of light and air, of a deeper yellow. It has no taste, and is neither soluble in water nor in ammonia. The latter property serves to distinguish it from the chloride and the cyanide of the same metal. Like the chloride, the iodide must be kept in a dry dark place. Neutral vegetable substances appear to exert no action upon it. Its properties have been enumerated under the head of the pre- parations of silver, (p. 50.) VI. ARGENTI OXIDUM. Synonymes. Argentum Oxydatum, Oxydum Argenti. French.—Oxide d'Argent. German.—Silberoxyd, Oxydirtes Silber. This oxide is obtained by the reaction of caustic potassa on a solution of nitrate of silver. The alkaline fluid must be added in excess, and the oxide, which is the product of the decomposition, must be washed several times in a considerable quantity of water, and be dried by moderate heat, and preserved from the light. In the state of hydrate, the oxide is black; when anhydrous, it 6 58 ARGILLA PURA. appears as an olive greenish brown powder; it is tasteless, and capable of absorbing carbonic acid from the air. Under the long continued influence of light it is blackened; and at a heat below the obscure red, it is reduced to the metallic condition. To be kept for a long time in the pure state, it must be protected from the light, in a well stopped bottle. This prepartion, which was also recommended by Serre, has- been used by Van Mons in syphilis.* (See page 50.) ARGILLA PURA. Synonymes. Alumina pura, Terra aluminosa pura, Terra Aluminis, Terra bolaris seu Argillacea pura; Pure Argil or Alumina. French.—Alumine factice. German.—Reine Tbonerde; reine Alaunerde. This substance was known in olden times by the names Arme- nian Bole, Terra sigillata, &c, in which forms it was always, however, mixed with lime and iron. It was highly extolled as an absorbent, demulcent, diaphoretic and astringent; was em- ployed in hemorrhage, diarrhoea and dysentery, phthisis, poisoned wounds, &c, and was also applied externally in cases of erysi- pelas. It had almost fallen into complete oblivion, when its use was resumed by some of the German practitioners. With us, it is scarcely ever, if ever, prescribed. METHOD OF PREPARING. The purest argil is prepared by drying the sulphate of alumina and ammonia, and exposing it for 20 or 25 minutes to a red heat, in a crucible: the sulphuric acid and ammonia are driven off; and the argil remains behind in the form of a white powder. For- merly, it was prepared by dissolving alum in water, and preci- pitating the argil from the solution by means of carbonate of potassa or soda, or of caustic potassa. It is affirmed, however that generally more or less sulphuric acid remained with the earth, so that it required to be purified by repeated washing until there was no longer any acid reaction. If a still higher degree * Riecke, Op. cit. S. 440. ARGILLA PURA. 59 of purity be needed, the precipitate is dissolved in muriatic acid, and the argil precipitated by caustic ammonia. The powder, prepared by these methods, is of a white colour and devoid of smell or taste; but it communicates to the tongue a feeling of astringency. When breathed upon, it yields a pecu- liar earthy smell. It is insoluble in water, but attracts moisture greedily from the air, and forms with it a gelatiniform mass. EFFECTS ON THE ECONOMY IN DISEASE. Pure argil was highly recommended by Percival in indigestion attended with predominance of acidity; and it was in such cases extolled by the Dresden physicians, Ficinus and Seiler.-* Ac- cording to the former, it merits a preference over all other absor- bents, inasmuch as it forms astringent salts with acids. He found it especially useful in diarrhoea and dysentery, particularly in children. Seiler recommended it in the vomiting of infants, which is usually accompanied by acidity, and in the diarrhoea of older children. Neumannf found it successful in checking diarrhoea, which nei- ther starch glyster, nor opium, nor any other therapeutical agents had succeeded in diminishing. He made a mixture of two drams of argil, and four ounces of a decoction of logwood, and adminis- tered it to children by the teaspoonful. Weese,J also employed it successfully in several cases of infantile diarrhoea, where there was evidently a predominance of acid. The latest encomiast of the argilla depurata is Diirr, who, for several years, has admi- nistered it in the diarrhoea and cholera of infants, and has found it highly efficacious. The chemical reasons, urged by Ficinus and others, merit attention. The article is worthy of employment in affections of the intestinal tube, in which astringents are indicated. The muriatic, and the acetic or lactic acid are always in the stomach when any alimentary or other matter is present there; these acids cannot fail, consequently, to unite with the argil, and the resulting compound must possess astringent properties. MODE OF ADMINISTERING. The dose in the 24 hours, for a very young child, is from 5ss * Zeitschrift fur Natur. und Heilkunde der Dresdner Professoren, B. I. H. 1, S. 82. f Bemerkungen iiber die gebrauchlichsten Arzneimittel, von Dr. Karl Georer Neumann, S. 55, Berlin, 1840. X Rust's Magazin, B. xii. H. 2, S. 247. 00 ARGILLA PURA. to 3j; for older children, from 3j to 3ij. Smaller doses are of little or no avail. The vehicle is commonly an emulsion. The following forms are given by Riecke.* Mistura Argillce. Mixture of Argil. R. Emuls. sem. papav. (ex ±ss. parat.) ^iiiss. Argillae purae, 9ij. Syrup, altha^se, 5ss. M. Dose—A teaspoonful to a child two years old affected with diarrhoea. R. Argill. pur. Jss. Gum. Arab. Jj. Sacch. alb. 3ij- Aq. foenicul. 5iij. M. Dose—The same as the last to a child one year old.. R. Emuls. oleos. cum vitell. ovor. parat. 5j. Syrup, alth. 5j. Argill. depurat. 3ss. Aq. cinnam. simpl. Jj. Extract, cicut. gr. ij. M. Dose—The same as the two last to a child three months old, affected with cholera infantum. DuRR. X Die neuern Arzneimittel. S. 41. Stuttgart, 1837. ARNICA. 61 ARNICA. Synonymes. Arnica Montana, A. Plauensis, Doronicum Germanicum, Panacea Lapsorum, Ptarmica Montana, Caltha Alpina, Calendula Alpina, Narda Cel- tica altera, Doronicum plantajjinis folio, Leopard's Bane. French.—Arnique, Tabac ou B^toine des Savoyards, Tabac de Montagne, Doronic d'Allemagne, Tabac des Vosges. German.—Wohlverlei, Fall kraut. This plant, which belongs, in the sexual system, to the Synge- nesia polygamia superflua and to the natural order Synantherece, is in the secondary list of the Pharmacopoeia of the United States, but it is not much used in this country; nor does there appear to be any clear appreciation of the cases for which it is adapted.* Such, too, appears to be the sentiment of the French practitioners " It may be concluded,"-say MM. Merat and De Lens,f " that we have as yet insufficient data to pronounce positively on the affec- tions in which the arnica can be unequivocally efficacious; we must, consequently, always bear in mind its heating and active qualities when we prescribe it." In Germany, the flowers and root are much employed in para- lysis, as an excitant to the nervous system; and it is chiefly to introduce the volatile oil—the oleum cethereum florum arnica, {Germ. Wohlverleiol)—to the attention of the profession, that we refer to the arnica at all. This oil is obtained from the flowers, and has been much recommended by Schneider in old cases of paralysis, which are the result of the apoplectic condition. He bimself often administered it with evident success; the paralytic limbs becoming warmer, more active, and more serviceable under its use. Schneider mixes four drops of arnica oil with halfan ounce of the liquor anodynus Hoffmanni, or spiritus nitri dulcis, and of this he gives, for a dose, from four to twelve drops several times a day. The mixture has an agreeable smell and taste. Four drops of the oil to four ounces of sugar form a good elaosaccharum.% * Dr. Wood, in Dispensatory of the United States, by Drs. Wood and Bache, Art. Arnica. f Dictionnaire Universel de Matiere Medicale, &c. i. 423. Paris, 1829. X Riecke, Die neuern Arzneimittel, u. s. w. S. 337. Stuttgart, 1837. 6* 02 ARSENIAS AMMONITE. ARSENIAS AMMONIA. Synonymes. Ammonium Arsenicum, Arseniate of Ammonia. French. Arseniate d'Ammoniaque. German. Arseniksaures Ammonium. This preparation of arsenic has been highly recommended, since the year 1818, by Biett, in several cutaneous diseases, and especially in psoriasis inveterata.* METHOD OF PREPARING. It may be prepared by taking arsenic acid one part, dissolving it in water, and adding pure or carbonated ammonia sufficient to saturate the acid;—or, as follows:—Take of white arsenic one part; nitric acid four parts, and muriatic acid half a part; saturate the solution with carbonate of ammonia, and let the arsenical salt crystallise. EFFECTS ON THE ECONOMY IN DISEASE. A grain of this salt may be dissolved in an ounce of distilled water; and of the solution from twenty to twenty-five drops be begun with daily, gradually increasing the dose until it reaches a dram or more in the twenty-four hours. There does not seem to be much difference between the effects of this preparation and those of the other forms of arsenic, that have been received into the Pharmacopoeias. The arsenious acid itself, as well as the arsenite of potassa and the arseniate of soda— the officinal solution of the former well known every where under the name of "Fowler's Solution;" that of the latter known, in continental Europe especially, under the name " Aqua Arsenicalis Pearsonii'' or Solution de Pearson, are possessed of precisely the * Cazenave, in Diet, de Medec. 2d edit. iv. 30; and Cazenave's and Schadel's Practical Synopsis of Cutaneous Diseases, translated by R. G. Griffith M D Philadelphia, 1829. ARSENIAS AMMONIA. 63 same properties as the arseniate of ammonia, and like it have been found equally efficacious in obstinate diseases of the skin. Nor is the knowledge of the agency of arsenical preparations in cutaneous affections new. In India, the efficacy of arsenic in those diseases has been long known: and, in Europe, attention was attracted to it by Fowler,* and Girdlestone/f and subsequently by Willan,J by Pearson,§ and others; but no one has administered the arsenical preparations more extensively in these diseases than M. Biett, of Paris, whose situation afforded him ample oppor- tunities for testing the virtues of the different articles of the Ma- teria Medica in skin complaints. He has succeeded, by means of the arsenical preparations, and especially of the one we are now considering, in removing several inveterate affections of the skin, that had resisted every other remedy. The author has found equally beneficial results from this practice in his own experience. All chronic cutaneous diseases are dependent upon an alteration in the functions of the capillary vessels or vessels of nutrition of the part affected, and there appear to be but two ways in which those vessels can be reached, so that a new action may be im- pressed upon them;—in the one case, through the medium of the general circulation; and, in the other, through the agency of topi- cal applications, made to come in contact with the diseased sur- face. Arsenic, like iodine,mercury in small doses, and certain other alteratives, acts in the former way—modifying, after a protracted exhibition, the fluid of the circulation in such manner, that it makes an altered impression on the morbid capillaries, and breaks in upon the diseased catenation. In no case, however, have we observed these salutary effects, until the use of the arsenical pre- paration had been persevered in for several weeks. These dis- eases are chronic in their nature, and they require a chronic medication. Time is, indeed, in every case, an element in the cure. * Medical Reports. London, 1786. f Essays on the Hepatitis, &c. of India. London, 1787. 1 Description and Treatment of Cutaneous Diseases. London, 1798. § Observations on the effects of various articles of the Materia Medica in the Venereal Disease, 2d edit. London, 1807. 64 ARSENICI IODIDUM. ARSENICI IODIDUM. Synonymes. loduretum Arsenici, Arsenicum lodatum, Iodide of Arseni German. Iodarsenik, Arsenikiodtire, Iodarsen. Of late this preparation has been highly extolled by Biett, in same class of affections as the last;—applied externally. METHOD OF PREPARING. The iodide is prepared, according to Magendie,* in two ways: 1. By heating in a glass alembic, a mixture of sixteen parts of arsenic and one hundred parts of iodine. The combination sub- limes in the form of orange coloured needles. 2. Thirty parts of pulverised arsenic, and one hundred parts of iodine are boiled in one thousand parts of water. As soon as the liquid becomes colourless, it is filtered, and the filtered solution is evaporated to dryness. If it be thought advisable, this can be sublimed. EFFECTS ON THE ECONOMY. When iodide of arsenic is injected into the veins it does not exert so strong an action on the heart as might be expected from so poisonous a substance. Mr. Blakef twice injected solutions, containing each six grains of this substance, into the jugular vein of a dog, without producing the slightest appreciable effect on the heart. On injecting a solution, containing fifteen grains, the action of the heart was immediately arrested. MODE OF ADMINISTERING. Biett has frequently applied the following ointment in cases of phagedenic tuberculous herpes. * Formulaire, edit. cit. f Edinburgh Medical and Surgical Journal, April, 1839, p. 336. ARTEMISIA VULGARIS. 65 R. Arsenic, iodid. gr. iij. Adipis. ?j. M. exacte, ut fiat unguentum. Cazenave gives, as the usual proportion for an ointment, one part of the iodide to eighteen of lard. Professor A. T. Thomson has employed the iodide in several cases of lepra and impetigo, with very great success.* He begins with tenth of a grain doses three times a day, and increases them to a quarter of a grain. In some cases, he had not been able to exceed two-thirds of a grain, as symptoms of poisoning came on, and the medicine had to be given in diminished doses. Recently, the iodide has been given with success in a case of cancerous disease of the breast, by Dr. F. C. Crane.f The dose was an eighth of a grain, which was reduced to one-twelfth, and gradually increased to a third of a grain, beyond which it could not be borne In a case of inveterate lepra vulgaris, however, it was carried to the extent of one grain the dose, with the_ most decided curative effects. ARTEMISIA VULGARIS (RADIX.) Synonymes.—Mugwort. French. Armoise Commune. German. Beifusswurzel, Gemeiner Beifusswurzel. Almost all the species belonging to the genus artemisia are possessed of bitter and aromatic properties, and several afford the " wormseed." The artemisia vulgaris was employed by many of the older physicians, but it had fallen into oblivion, when its use was revived in Germany, by Burdach, a physician at Triebel, near Sorace,J who recommended it strongly as a preventive of epilepsy. Since that time, it has been much prescribed in that * Lancet, Jan. 19, 1839, p. 621. t Lancet, Aug. 31,1839. X Hufeland's Journal, B. lviii. St. 4 und 5. 66 ARTEMISIA VULGARIS. country, but its employment has not extended much to other countries of Europe, or to this side of the Atlantic. The root is the part preferred;—formerly the herb and the tops were solely used. The root was employed in epilepsy, centuries ago, but it had been neglected, or was only exhibited as a nostrum, when Burdach entered upon his investigations, of which the following is a summary. The root of the artemisia should be dug up in autumn, after the stalk has become dry, or in the spring before the stalk has shot up; but perhaps the latter half of November is as good a period as any. It must be freed from the adherent earth by shaking. Burdach regards washing to be objectionable, as the root may lose some portion of its efficacy thereby. The old, ligneous, mouldy, and damaged parts of each root must be care- fully removed, and the fresh young side roots (fibrillse,) which are distinguished by their smell, clear colour, and greater juici- ness, must be spread on paper, and dried in the shade, and as soon as they become brittle they must be carefully preserved. Besides the fibrillar, the soft, sound, and juicy parts of the root, especially the fleshy rind of the thicker roots, must be used. The period required for drying them varies; in moist weather it may require two months; but late in the year the desiccation may be aided by the gentle warmth of the sun, or of a stove; the latter must never, however, rise higher than from sixty-four to sixty-eight degrees of Fahrenheit. If put away too early the root becomes spoiled; if, too late, it loses many of its volatile parts. When powdered, it ought not to be kept too long, as the volatile portions escape and it soon becomes devoid of smell. Even during the process of pulverising loss is sustained, and the fresh powder has a much feebler odour than the entire root, so that Burdach advises for distant patients, that the root in substance should be sent to them, and that they should be recommended to pound it for use in a well covered mortar. By pulverising, the inner, hard, woody parts are separated from the smaller roots; they must be removed and thrown away, as the powder of the cortical sub- stance of the small radicles has alone been found efficacious. The smell of the well dried root is very strong, pungent and pe- culiar, especially when we open a vessel in which it has been stored away in quantity. The taste is sweetish, sharp and nau- seous. EFFECTS ON THE ECONOMY IN DISEASE. It has been already remarked, that Burdach* recommends the artemisia especially in epilepsy; and he affirms that it requires no preparation or special attention. * Casper's Wochenschrift, Oct. 22,1836, S. 675. ARTEMISIA VULGARIS. 67 It is most efficacious when given about half an hour before the attack, which it usually prevents; but if this be impracticable, it may be given as soon as the patient comes to. The dose is a heaped up tea-spoonful, (from fifty to seventy grains,) which may be administered in warm beer; the patient should be put to bed immediately, covered up warm, and allowed warm small beer to drink, so as to occasion diaphoresis—care being taken that he does not expose himself to cold. This course is to be repeated so long as there are any traces of mischief. When the remedy, how- ever, acts favourably, Burdach asserts, that frequent repetition is not often necessary. At times, it happens, that when the dose has been raised to a dram and a half, and thrice repeated, no cri- tical sweat follows; Burdach then aids the operation by giving the liquor cornu cervi succinatus, {spiritus ammonice succinatus,) in an infusion of serpentaria, valerian root and arnica flowers; but the effect, he says, was always better when the diaphoresis was produced by the artemisia alone. One important advantage in the use of this agent is, that a judgment can be speedily formed of its utility; when much may be expected from it, a marked im- provement usually occurs after the first doses. In those cases of epilepsy which recur every day, and sometimes even from three to fifteen times a day, and especially where the paroxysms are so violent and frequent, as to leave little interval for the patient to be restored to consciousness, the artemisia has proved more cer- tain in its operation, either by removing or mitigating the disease. In such cases, two doses were given on the first day, and after- wards one tolerably strong dose daily till the third day. In those forms of epilepsy, whose attacks recurred twice daily, morning and evening, the artemisia acted very beneficially; the paroxysms soon became somewhat weaker, shorter, and were postponed a day or two. In such cases it is advisable to continue the remedy for some weeks. Infants at the breast bear the artemisia espe- cially well. It is equally efficacious in the epileptic attacks of young females from twelve to fifteen years of age, and prior to the establishment of menstruation. Under its use, the catamenia have generally taken place, and the epilepsy has disappeared. On the other hand, the artemisia was found to aggravate cases of epi- lepsy occurring as a disease of growth, (Entwickelungskrank- heit,) in young persons from seventeen to twenty-two years old, and as a consequence of great corporeal development. It was equally unfortunate in cases of epilepsia nocturna, where the paroxysms came on irregularly at an interval of about five, ten, or fifteen days, and generally about midnight; as well as in that form in which, after the patient had suffered for six, seven, or eight weeks, under violent symptomatic sweats, a morbid condi- tion ensued from two to three times every twenty-four hours, con- 68 ARTEMISIA VULGARIS. sisting of repeated epileptic attacks, with great prostration in the intervals. . These are the main results of the communications of burdach on this subject.* The number of his experiments and observa- tions was considerable, and the results appear to have been fre- quently most happy, especially in the case of females, who seem to have exhibited themselves more beneficially impressed by the remedy than males; the proportion of cures being as three to two. Tosettrf gives the proportion of cases in women and chil- dren to that of men, as eight to six. In the Berlin Charite, the artemisia is said to have been used with equal success. The German journals contain numerous cases, on the authority of E. Grafe,J Wagner,§ Van Maanen,|| Wolf,! Osann, Bonorden,** Schluter, Bird,ff Lowenhard,}} Geis,§§ and others.|||| But few physicians, according to Riecke, have been disappointed in it, and where they have been, he ascribes the failure to its having been given in cases for which it was inappropriate, or to the preparation of the artemisia not having been properly attended to.!! In consequence of a German physician having recommended the Artemisia absinthium to Professor A. T. Thomson, Professor Elliotson*** was induced to try it in epilepsy. The patient to whom he gave the medicine was a girl, seventeen years of age, who had been affected with epileptic fits for four months—three or four occurring daily. A dram of the powder of the artemisia was given three times a day. This was on the 30th of March. On the 9th of April, the dose was increased to two drams, when the fits became less frequent, but not less severe. On the 16th, the dose was repeated every four hours. She had only one slight fit in the course of twelve days; and on her dismissal, on the 24th of May, she had had no fit for twenty-six days. Dr. Elliotson was of opinion, that the strong infusion would be less offensive to the patient, and quite as effective as the powder. * Riecke, Die nenern Arzneimittel, u. s. w. S. 49. Stuttgart, 1837. f Diss, inaug. de Radice Artemis, vulg. remed. antiepilept. Berolin, 1827: and Osann in Art. Artemisia, Encyc. Worterb. iii. 313. Berlin, 1829. X Grafe und Walther's Journal, B. vi. H. 2. § Hufeland's Journal, lix. S- 6. || Ibid. lxi. 5. IT Ibid. Ixti. 3. ** Ibid. lx. 1. ft Ibid. Ixv. 3. XX Ibid. Ixv. 3. \\ Ibid. Ixv. 3. |||| Richter's Specielle Therapie. B. x. S. 377. Berlin, 1828. ITU Op. cit. S. 49. V Lancet, July 9,1836. ARTEMISIA VULGARIS. 69 Besides epilepsy, the artemisia has been used with advantage in other diseases, as in St. Vitus's dance.* Wutzer employed it successfully in the convulsive diseases of childhood, and it is recommended by Biermannf in eclampsia infantum, occurring during the period of dentition. He recommends it to be given to children in gradually increasing doses, commencing with half a grain; and, an hour afterwards, giving a grain, and in two hours, two grains, which is usuajjy the last dose required. The gradual augmentation of the dose he considers advisable, "to prevent the crisis which the artemisia induces, from being too turbulent," (sturmisch.) Kolreuter, of Carlsruhe, administered the artemisia in different diseases with great success. He prefers the extractum resinosum radicis artemisioe, vulgaris to the root in substance. This is prepared in the following manner. A quantity of the dried and powdered root is covered with highly rectified spirit of wine, and permitted to digest for some time: the filtered liquor is then evaporated in an earthenware vessel, until it has attained the consistence of an extract. Kolreuter employed this advantageously in the eclampsia of children, (in certain cases after the application of leeches;) in tormina unaccompanied by inflammation; in the diarrhoea of children and adults; in sporadic cases of cholera morbus, and in dysentery, after the bloody evacuations had ceased; in gastric fevers, on their assuming a nervous character, and in dysphagia, cardialgia, chronic vomiting, scirrhus of the stomach, chronic cephalalgia and neuralgia of the face; in chlorosis, and in obstruc- tion of the catamenia, as well as in epilepsy. The dose in the twenty-four hours, from 5ss. to 5j.; to small children, a few grains. Such is the chief testimony adduced in favour of the artemisia by the German writers mainly. It is to be feared, that the advantages to be derived from it in epilepsy have been exagge- rated. Where there is no organic disease of the encephalon, substances, which, like the artemisia, are nauseous, bitter and aromatic, may be productive of advantage in the way of tonics and revellents. In one case of this nature it was employed by the author, but the results were not striking. When aided by other means and appliances, it appears likewise to be powerfullv diaphoretic, and doubtless, therefore, in appropriate cases—espe- cially where there is much nervous impressibility—it may be productive of the good effects ascribed to it by Burdach, Kolreu- ter, and others. Yet—as Osann has remarkedj—it must be * Gittermann, in Hufeland's Journal, lxii. 1. Bonorden, Op. cit. f Riecke, Op. cit. S. 50. \ Art. Artemisia, in Encyc. Wtfrterb. iii. 313. Berlin, 1829. 70 ARTEMISIA VULGARIS. improper where polysomia, or a tendency to active congestion or hyperemia, is present. The analysis of Hergt, Hummel, and Janike afforded, along with traces of volatile oil, some balsamic resin, both of which are excitants to the living economy. MODE OF ADMINISTERING. The following forms for its administration have been adopted by some of the German authorities. Decoctum Artemisia, Decoction of Mugwort. R. Rad. artemis. vulg. concis. ^j. Coque cum aquae fontanae q. s. per semihoram ad. colat. Jbj. Half a tea-cupful of this may be taken every two hours in cases of epilepsy. HlLDENBRAND. Pulvis Artemisice. Powder of Mugwort. R. Rad. artemis. vulg. in pulvere, 3j. Sacch. alb. 9j. M. et fiat pulvis. The powder to be administered daily in the evening, in warm beer, in cases of epilepsy. Loewenstein. Mistura Artemisice. Mixture of Mugwort. R. Ext. resin, artemis. vulg. gr. iv. Gum. arab. 9j. Sacch. alb. 3iij« Emuls. amygd. 5iij. M. ASPARAGUS OFFICINALIS. 71 A coffee-spoonful* to be given every half hour in eclampsia in- fantum. The dose may be gradually raised to two COffee-SpOOn- fuJg^ KoELREUTER. ASPARAGUS OFFICINALIS (TURIONES.) Synonymes. Asparagus Shoots. German.—Spargelnsprossen. The diuretic effect of the common asparagus is well known, and has given occasion to its admission into many of the pharmaco- poeias of continental Europe—into those of Amsterdam, Anvers, Brunswick, Spain, Paris, Ferrara, Geneva, and Wirtemberg, for example. Within the last few years, the young shoots have been introduced by the French practitioners, and hitherto they have been mainly administered in one form only—that of syrup. The Syrup of asparagus, (syrupus asparagi. French—Syrop des Pointes d'Asperge. German—Spargelsyrup,) is commonly prepared according to the following formula. A quantity of fresh asparagus is taken—Chevallier says only the upper green* heads or tops of the young shoots—these are bruised in a marble mortar, after which the juice is expressed and heated in a water bath, until the albumen is coagulated: it is then filtered through paper, and to every pound of the juice thirty ounces of white sugar are added. It is then passed through flannel.f This syrup has been recently recommended as a sedative in palpitation of the heart, and as an agent that might be advan- tageously substituted for digitalis. According to Richard and Soubeiran, however, the syrup never diminishes the number of pulsations as the digitalis commonly does. Other French physi- ciansj regard it as a general sedative agent, and affirm, that they * About two ordinary tea-spoonfuls. f See on the preparation of this syrup, MM. Latour de Trie, and Roziers, in Journal de Pharmacie, Dec. 1833, and Philad. Journal of Pharmacy, vi. 122. J Eusebe de' Salle, in Gazette Medicale, Mai 28, 1831, and Gendrin, in Gazette Medicale de Paris, Juin, 1833. 72 AURI PRjEPARATA. have employed it advantageously for the relief of neuralgia, and even of such pains as are caused by organic disease, as well as in violent coughs, &c. Some have esteemed it an antidote to coffee, in preventing the sleeplessness which it occasions.* The common dose of the syrup is two, four to six spoonfuls in the course of the day. Rieckef says, the Medicinalrath Heyfelder informed Jiim, that he had employed the syrup of asparagus with "good" effect in diseases of the heart, according to Gendrin's method, and especially in hypertrophy of that organ. He found it, more- over, worthy of recommendation in dropsy, crusta lactea, and in other cutaneous affections, when mixed with the ordinary drink; but it is probable that the good effect in these skin diseases was owing to the sugar—little, if any, perhaps, being ascribable to the asparagus. An extract of asparagus has been recommended recently. It is made by macerating the inner, white, strongly odorous portion of the sound, not ligneous, two to three years old, roots in cold water: like the syrupus asparagi it is said to retard the circulation of the blood, and to dispose to sleep. On account of its disagreeable taste, it is given in the form of pill. The dose is from 5ss. to 3ij. in the 24 hours. AURI PR^PARATA. Synonvmes. Preparations of Gold. French.—Les preparations d'Or. German.—Goldpraparate. The administration of gold in medicine is not modern In the times of alchemy, it was frequently used in nervous diseases, con- vulsions, hypochondriasis, mental affections, profuse salivation. e Art. Gold, in Encycl. Worterb. der medicinisch. Wissenschart. B. xv. S. 77. Berlin, 1837. 7# 74 AURI PRjEPARATA. have been investigated by many observers. Experiments on ani- mals had already exhibited the powerful influence, which they are capable of exerting on the organs and functions of organic life. One of the most prominent effects appears to be, an increase of the various secretions; commonly, the urinary secretion is largely augmented, as well as the transpiration, and the intestinal and salivary secretions. Not unfrequently, under the continued ad- ministration of the gold, actual salivation ensues, which differs, however, from that induced by mercury. It is always slow in appearing, and is by no means so exhausting as that caused by mercury; nor do troublesome ulcers occur; whilst the saliva is thinner, and not so tenacious. Like mercury, the preparations of gold occasion excitement in the organism, which often ends in a true febrile condition: after they have been taken for some time in moderate doses, there is generally a feeling of increased warmth in the stomach, and an augmentation of the appetite. The pulse is rendered fuller and more active, and the animal heat and vital activity are augmented, so that in such as are predisposed to the affection, hemorrhage is apt to take place. The catamenia recur sooner than usual under their influence, and the quantity lost may be greater.* Sooner or later, a regular attack of fever not un- frequently supervenes,—as indicated by shivering, pains in the limbs, back, and stomach,—which may continue for a few hours, but sometimes lasts for days, and at length ends by sweating, deposit tions in the urine, and occasionally by salivation. In very large doses, the preparations of gold are corrosive poi- sons. The symptoms, caused by their use, when they act as such, are—oppression in the region of the stomach, nausea, vo- miting, pains in the abdomen and diaphragm, a metallic taste in the mouth, augmented secretion of saliva, without the teeth or gums being affected, pulse excited and breathing oppressed.f As a general rule, they are not esteemed proper for impressible individuals; on the other hand, in persons of torpid constitutions they would appear to have exerted an excitant influence even on the generative system. Certain persons, according to Chrestien and Niel, are not susceptible of this action; and again there are some, according to Cullerier, junr., who cannot tolerate them in any form. When too large a dose has been given, the remedy should be entirely discontinued for some time, or the dose be diminished; the effects will soon disappear. One of the greatest recommen- dations of gold over mercury, in the eyes of many, is, that it * Riecke, Op. cit. S. 55. j GrOtzner, in Rust's Magazin, xxi. 3. AURI PR2EPARATA. 75 does not act so destructively on the organism, and never induces such a cachectic condition as the latter occasionally does.* EFFECTS ON THE ECONOMY IN DISEASE. The diseases, in which the preparations of gold have been administered, in modern times, are chiefly the following. 1. Syphilis.—They have been occasionally used in primary sores, but have been mainly employed in secondary syphilis, especially in old cases, where a doubt often exists, whether there is more of mercurial cachexia or of syphilis in the case. They are given, also, where there is a scrofulous complication, and where it is desirable to exhibit some other remedy than mer- cury; and lastly, their use is indicated where mercury has failed in removing syphilis.f Many practitioners doubt whether the preparations of gold should be esteemed much inferior to those of mercury. Numerous experiments, instituted, amongst others, by Chrestien,J Cullerier, junr.,§ S. L. Mitchill,|| Niel, Biett, Lalle- riandll Wendt,** and Legrand,ff have shown, that their em- ployment has been most advantageous in the different forms of syphilis, and that they have rarely disappointed expectation. Alibert found them especially useful in syphilitic eruptions. It must be borne in mind, however, that when they are given in syphilis, their operation is slow, and that, in the first instance, the symptoms may appear aggravated; they are not, therefore, adapted for cases in which it is important to act speedily, so as to arrest the disease at once, and prevent its farther development. 2. Gonorrhoea. In protracted cases of gonorrhoea, several physiciansJJ have extolled the preparations of gold; others, as Wendt and Ritter, have advised them for the sequelae of gonor- rhoea (Trippernachkrankheiten:) it is not probable, however, that they could be of much use in gonorrheal affections, which, as is well known, are curable without any mercurial preparations. 3. Scrofula. The efficacy of the preparations of gold in scrofula, was deposed to by Chrestien, Eberle, Niel, Legrand,§§ Herrmann, and Kopp.|||| According to observation, it would * Riecke, Op. cit. S. 56. t Eberle, Treatise on the Mat. Medica, 2d edit, i, 247. X Op. Citat. p. 6.; see, also, Lettre a M. Magendie sur les preparations d'Or, &c. Paris, 1828. \ Diet, des Sciences Medicales, Art. Or. Tom. xxxvii. || Dyckman's Dispensatory, p. 201, and Eberle, Op. cit. IT Journal Universel des Sciences Medicales, t. xxvii. ** Rust's Magazin, Bd. xvi, St. 1. ff Gazette Medicale de Paris, Oct. 30, 1837. XX Grfitzner, Op. cit. 55 Bulletin Generate de Therapeutique, No. xv. Aout. 15, 1837. UII DenkvvQrdigk. in der arztl. Praxis, iii. 351. 76 AURI PR^EPARATA. appear that it effects improvement in the mildest cases, and is beneficial where there is much torpor, but that it ought to be avoided in irritable subjects. In scrofulous ophthalmia, and in scrofulous porrigo, it would seem to have been most efficacious. Recently, the preparations of gold have been employed by M. Baudelocque at the Hopital des Enfans Malades, and by M. Velpeau at La Charite.* At the former institution, they were given in enormous doses. M. Baudelocque gave the hydro- chlorate and the stannate in doses of from ten to twelve grains, without producing any effect on the disease, and without any apparent injury to me constitution of the children subjected to the experiment. The oxide of gold prepared by potassa was carried as high as twenty grains during the day. At La Charite, Velpeau gave fifteen, eighteen, and twenty grains of the hydro- chlorate and oxide of gold during the day, and higher doses were not tried, solely on account of the expense of the medicine. These results are strongly discordant from those of Orfila and Devergie, the former of whom affirms that the hydrochlorate of gold is more active than the corrosive sublimate, and the latter states, that in the dose of one tenth to one twentieth of a grain, it produces more or less inflammation of the lining membrane of the stomach and intestines. 4. Scirrhus and cancer. The utility of the preparations of gold appears to have been most decided in scirrhous induration of the tongue, according to the observation of Wendt, Helm, and others; in such case, they are rubbed on the tongue; this, indeed, is the most common form of administration. H. Hoffmann relates a case of scirrhus of the pylorus, in which the muriate of gold was entirely successful; and frictions with the muriate, or the oxide of gold on the labia pudendi have been recommended by Hufeland, Herr- mann, Meissner, Grbtzner, Gozzi,f and others, in cases of scirrhus and cancer of the uterus. In the same affections, Krimer has advised them to be applied to the os uteri. Scirrhosities, it is affirmed, have been dispersed through their agency; and even in open cancer marked improvement has been perceptible. 5. In tumours of the bones, and in like affections, the prepara- tions of gold have been employed successfully by some practi- tioners, and especially when the cases originated in syphilis. 7. Several forms of lepra have been treated with them by Ali- bert, and A. T. Chrestien, and with the best effects. 8. In Amenorrhaea, Carron du Villards employed the cyanide suc- cessfully, beginning before the expected menstrual period. Lastly.—Wendt, Delafield, and Grotzner have administered * L'Experience, No. lxxxvii.; and Lancet, March 23, 1339, p. 31. t Sopra 1'uso di alcuni remedii aurifici nelle malattie venere. Bologn. 1817; and Ornodei, Annal. Univers. di Medicin. vol. v. AURI CHLORIDUM. 77 them with benefit as diuretics in dropsy. With others, however, they have failed. According to Riecke,* the results of experience would seem to show, that they are especially adapted for dropsy, dependent upon organic disease of some viscus. None of the preparations of gold are much employed at the present day. Their expense is, indeed, a weighty objection— unless there were striking advantages in adopting them in special cases of disease in preference to other articles of the Materia Medica. I. AURI CHLORIDUM. Synonymes. Aururri Chloratum, A. rnuriaticum, Chloretum Auri, Murias Auri, Aurum Oxydulatum Muriaticum, Aurtim Salitum, Chloruretum Auri, Auri Terchloridum, Muriate of Gold, Chloride of Gold, &c. French. Chlorure d'Or, Muriate d'Or. German. Salzsaures Gold, Chlorgold, Goldchlorid, Salzsaure Goldoxydul. This preparation is received into several of the European Phar- macopoeias, and is usually formed by digesting one part of gold leaf in three parts of the nitro-muriatic acid in a sand bath, and evaporating gently to dryness. Magendie,f however, recom- mends the following method. Take one part of fine leaf gold, divide it into small portions, (and put it into a vial of white glass; pour upon it three parts of aqua Tegia—formed of one part of nitric acid—and two parts of muriatic acid, and heat the whole in a small sand bath, so arranged, that in case the retort breaks the fluid may be recovered without loss. The solution of the gold will soon take place. The fluid must then be evaporated until the smell of chlorine is perceptible. This point can be readily determined, as after the decomposition of the aqua regia there is a period during which the nitrous acid is alone given off. The disengagement of the chlorine indicates the commence- ment of the decomposition of the chloride formed. The vessel must now be removed from the fire and suffered to cool. The chloride appears immediately as a crystalline mass, in the form of a mul- titude of beautiful yellow needles. In this condition, the chloride of gold is as pure as it need be: it contains no excess of muriatic acid, and is not deliquescent. It can be preserved in the same vessel in which it has been pre- pared—by merely stopping it with paper—without any danger of its undergoing decomposition. Wendt directs it to be formed in the following manner: * Op. cit. S. 58. t Formulaire. 78 AURI CHLORIDUM. R. Auri puri quantum placet, Solve in Acid, nitric, part, j, ----muriat. pur. part, iij, Deinde leni calore evapora ad siccum in vase vitreo. Massam reman- entem saturatam dissolve in aq. distill.; solutam filtra et ad crystallisan- dum sepone. Crystallos collectos tere in mortario porcellaneo supra arenam calidam ad siccum. Sal concretum statim, ne humidi quid attrahat, in vitro obturato serva.* Muriate of gold, prepared according to Magendie's formula, is very acid, but this property is not owing to its containing any free acid. The taste is also styptic and disagreeable. It only attracts moisture from the air when it contains an excess of muriatic acid, as is the case in Wendt's preparation. It is readily soluble in water with which it forms a solution of a beautiful yellow colour. Many animal and vegetable substances, and especially the epi- dermis, are coloured by it of a purple violet when it is placed in contact with them. Exposed to a moderate heat, it passes to the state of protochloride. When heated to a greater degree, in close vessels, chlorine is disengaged and metallic gold left behind. Wendt's preparation, when dissolved, is very easily decom- posed, and it has therefore to be kept from the influence of light and air. The chloride is one of the most active of the preparations of gold. It belongs to the class of corrosive poisons,f and greatly resembles corrosive sublimate in its operation on the economy. It must consequently be administered with caution—even a tenth of a grain has been known to induce unpleasant irritation of the stomach.J It has been given both internally and externally in syphilis, dropsy,^ and glandular affections. The dose is from one sixteenth to one twelfth of a grain once or twice a day, being gradually but slowly increased. In the like quantity it has been rubbed upon the tongue and gums. Exter- * Take of pure gold at pleasure, Dissolve in Nitric acid, one part, Muriatic acid, three parts, Then evaporate with a gentle heat to dryness in a glass vessel. Dissolve the saturated remaining mass in distilled water, filter the solution and set it aside to crystallise. Rub the collected crystals in a porcelain mortar over warm sand to dryness. Keep the concrete salt in a well stopped glass vessel to pre- vent it from attracting moisture. t Orfila, Toxicolog. i, 593. X Magendie, Formulaire. j Wendt, in Rust's Magazin, B. xxv. AURI CLORIDUM. 79 nally, it has been applied in the form of ointment or watery solu- tion—the last more particularly in ophthalmia, especially of the scrofulous kind, in which Jahn found it very efficacious. The following are some of the forms in which it has been pre- scribed. Boli Auri Chloridi. {Boli Antisyphilitici, Pharmacopoeia Batava.) Antisyphilitic Boluses. R. Auri chlorid. gr. ss ad gr. ij. Extract, aconit. gr. vj ad gr. xij. Fiant boli sex. Two of these to be taken for a dose, and repeated three times a day. Pilulce Auri Chloridi. {Pilulce Chlorureti Auri, Ph. Amstelodamensis nova.) Pills of Chloride of Gold. R. Auri chlorid. gr. x. Pulv. rad. glycyrrhiz. Jiij. Syrup, q. s. ut fiant pilulse cl. |}ose.—One daily, gradually augmenting the quantity. R. Auri chlorid. gr. i. Pulv. lycopod. gr. xv. M. fiat pulv. in part, xvi dividend. One of the powders to be rubbed upon the tongue and gums daily. Chrestien. Gradually, the same quantity of the muriate may be divided into twelve and ten parts, and used in the same way. Unguentum Auri Chloridi. Ointment of Chloride of Gold. R. Auri chlorid. gr. iv. Misce intime cum Ung. rosat. ^j. Wendt. 80 AURI ET SODII CHLORIDUM. Collyrium Auri Chloridi. Collyrium of Chloride of Gold. R. Auri chlorid. gr. ij. Solve in aquae distill. ±vj. F. collyrium. To be applied by means of linen compresses, or dropped into the eye. Jahn. II. AURI ET SODII CHLORIDUM. Synonymes.—Aurum Muriaticum (Pharmac. Borussic.) Aurum Muriaticum Natronatum, Aurum Chloratum Natronatum, Sodii Auro-Terchloridum, Perchloruretum Auri et Sodii, Chloretum Auri cum Chloreto Natrii, Muriaa Aurico-natricum, Chloruretum Auri et Sodii, Chloride of Gold and Sodium, Hydrochlorate or Muriate of Gold and Sodium, Auro-terchloride of So- dium. French.—Hydrochlorate ou Muriate d'Or et de Soude. German.—Salzsaures Goldnatrum, Chlorgoidnatronium, Goldnatriumchlorid. This preparation is in the Pharmacopoeias of Prussia, Ferrara, Sweden, &c. Figuier directs it to be prepared in the following manner.* Dissolve four parts of gold in aqua regia, and evaporate the solu- tion to dryness; add thirty-two parts of water, and one part of chloride of sodium, and evaporate to one half. On cooling, cry- stals will form, which consist of 69.3 parts of chloride of gold; 14.1 parts of chloride of sodium, and 16.6 of water. The formula of the Prussian Pharmacopoeia is as follows;— R. Auri, partes vj. Solve in Acidi muriatici, q. s. Acidi nitrici quantum ad auri solutionem requiritur, guttatim addendo. Tunc admisc. Natri muriatici sice. part. x. Et post solutionem leni igne evaporando in pulverem flavum redige.t * Annales de Chimie, Fcvrier, 1822, and Riecke, Die neuern Arzneimittel, S. 63, Stuttgart, 1837. f Take of gold, six parts: Dissolve in a sufficient quantity of Muriatic acid, adding as much nitric acid as is required to dissolve the AURI ET SODII CHLORIDUM. 81 This preparation has a beautiful yellow colour, and appears under the form of four-sided prisms. It attracts moisture from the air, but to a less degree than the chloride of gold with excess of sulphuric acid. The Aurum Muriaticum Natronatum of the Germans is milder than the preceding preparation, and is more frequently adminis- tered, especially in Germany, than any of the preparations of gold. It is used both internally and externally. The dose is about the same as that of the last preparation, but it may be carried higher. Kopp affirms,* that he has frequently employed this prepara- tion with advantage in scrofulous tumefaction of the upper lip, when given in small doses. He prescribed daily, and once or twice a day, from one thirtieth to one twenty-fourth of a grain of the aurum muriaticum natronatum, reduced to powder, with two grains of sugar, and by means of the finger rubbed on the inner side of the affected lip. In adults with scrofulous, thick, sensible, and slightly inflamed nose, Rieckef recommends the ointment, given below, to be applied to the nasal fossas, and three times a day a powder composed of from one sixteenth to one twelfth of a grain of the salt of gold to two grains of sugar (Milchzucker,) to be rubbed on the gums with the moistened finger. The salts of gold, according to Riecke, appear to have a specific action on the organs in the mouth, on the gums and the nose! Pulvis Auri et Sodii Chloridi. Powder of Chloride of Gold and Sodium. R. Auri et sodii chlorid. part. iij. Irid. florent. in pulv. subtil, part. ix. Three grains of this represent three quarters of a grain of the salt of gold. These three grains are divided into thirty frictions for the weakest doses, and into three for the strongest. Starch may be substituted for the powdered orris root. Legrand. Solutio Auri et Sodii Chloridi. Solution of Chloride of Gold and Sodium. R. Auri et Sodii Chlorid. gr, ij. Aquae destillat. 5j. M. gold. Then mix ten parts of dry muriatic of soda; and after evaporating the solution over a slow fire reduce it to a yellow powder. * Op. cit. B. iii, S. 351. f Die neuern Arzneimittel, u. s. w. S. 442. 8 82 AURI ET SODII CHLORIDUM. Ten drops to be given every two or three hours, in cases o; i r Grotzner. dropsy. Pilulce Auri et Sodii Chloridi. Pills of Chloride of Gold and Sodium. R. Auri et sodii Chlorid. in aquae destillat. q. s. solut. gr. iv. Extract, aconiti, 9ss. ------stipit. dulcam. 3J- Pulv. rad. althaeae, q. s. ut fiant pilulae Nro. lxxx. Three pills to be taken three times a day. Grotzner. Pastilli Auri et Sodii Chloridi. Lozenges of Chloride of Gold and Sodium. R. Auri et Sodii Chlorid. gr. v. Pulv. sacchar. alb. |j. Misce exacte in mortar, vitreo. Mucilag. gum. arabic. q. s. ut fiant pastilli lx. Each of these will contain about one twelfth of a grain of the jt A. T. Chrestien. Pilulce Auri et Sodii Chloridi. Pills of Chloride of Gold and Sodium. R. Amyli. solan, tuberos. gr. iv. Gum. arab. 3j. In mort vitr. exacte mistis adde terendo Aur. et sod. chlorid.—in 3j aq. destillat. solut.—gr. x. Fiant pilulae cxx. Each of these contains about one twelfth of a grain. A. T. Chrestien. Unguentum Auri et Sodii Chloridi. Ointment of Chloride of Gold and Sodium. R. Aur. et sod. chlorid. gr. iij—iv. Adipis. 5ss. Misce exacte. Fiat unguentum. Used in friction. Grotzner. R. Aur. et sod. chlorid. gr. iiss. Adipis. 3iss. M. The size of a bean to be placed in the nasal fossae in scrofu- lous cases* along with the iatraleiptic use of the powder before described. Riecke. * See page 81. AURI CYAN1DUM. 83 III. AURI CYANIDUM. Synonymes. A. Cyanuretum, Cyanuret, Cyanide or Tercyanide of Gold. French. Cyanure d'Or. The mode of preparing this combination, recommended by M. O. Figuier,* of Montpelher, is as follows. He decomposes the chloride of gold by the cyanide of potassium, but he states that many precautions are necessary to procure it in a pure state. The chloride must be as neutral as possible, which can only be done by recrystallising the salt several times. The cyanide must not be alkaline, or contain any formiate or carbonate of potassa. This salt is to be added to the solution of the chloride of gold very cautiously as long as there is any precipitate, taking care that there is not the slightest excess of the cyanide, as this would cause ,i solution of part of the product, and the formation of soluble double cyanides. The cyanide, thus made, is to be well washed with pure water, and dried in a dark place. In some recent experiments, Magendief found that the cyanide is one of the substances that promote the coagulation of the blood. Where, consequently, it is desirable to impress a modification on that fluid in chronic cutaneous and other affections, its adminis- tration might perhaps be found useful. M. Pourche,J who has used it successfully in syphilis and scro- fula, recommends its administration—in the form of frictions on the tongue—mixed with powdered orris root, well washed in al- cohol, and dried. Pulvis Auri Cyanidi. Powder of Cyanide of Gold. R. Auri cyanid. gr. j. Pulv. irid. florent. gr. iij. M. In pills he prescribes it as follows:— * Journal de Pharmacie, xx, S. 99. and Amer. Journ. of Pharm. vi. 82 Philad. 1833-4. See, for another mode of preparing it, Deferre, in Bulletin General de Th6rapeutique, Fevrier, 1838. f Legons sur le Sang, &c,; and Translation, in Lancet, January 20, 1839, p. 636. | Journal de Pharmacie, xx, 599 & 649. 84 AURI CYANIDUM. Pilulce Auri Cyanidi. Pills of Cyanide of Gold. R. Auri cyanid. gr. j. Ext. mezereon. gr. iij. Pulv. althaeas q. s. ut fiat massa. Each pill to weigh five grains. The children, the dose at first should never exceed one fifteenth of a grain. Mistura seu Liquor Auri Cyanidi. Mixture or Solution of Cyanide of Gold. R. Auri cyanid. gr. iij. Aquae alcoholisat. 5viij. M. Dose—A tea-spoonful twice a day, gradually increasing the dose. IV. AURI IODIDUM. Synonymes.' A. loduretum, Iodide or loduret of Gold. French. Proto-Iodure d'Or. According to the French Codex, this is made by adding a solu- tion of pure cyanide of potassium to a solution of chloride of gold, collecting the iodide of gold, which falls down, on a filter, and washing it with alcohol to remove the excess of iodine, which precipitates with it. This has been used in the same cases as the other preparations of gold, in the dose of one fifteenth to one tenth of a grain. V. AURI NITROMURIAS. Synonymes. Aurum Nitrico-Muriaticum. German.—Saltpetersalzsaures Gold. The nitromuriate of gold has been recommended of late years by Recamier, whose attention was directed to it by accident. AURI OXYDUM. 85 A worker in gold had a cancerous tumour on the back, which, as it incommoded him, he touched frequently with the hand; this occurred whilst he was dissolving gold in aqua regia; after this the tumour soon presented another appearance, and disappeared in a short time. Recamier thought it probable, that the work- man had received some of the solution upon his fingers, which had thus been applied to the tumour. Under such impressions, he employed it in the case of a female, who was affected with an extensive cancer; the disorganized parts resumed their natural texture, and completely healed, although the cancerous dyscrasy ultimately proved fatal. In the case of a female, with fungus of the neck of the uterus, a complete cure was effected by it; and in cancer of the uterus he found it very advantageous. Recamier prepares it by dissolving six grains of pure muriate of gold in an ounce of aqua regia: and he applies it like other corrosive agents, taking care to confine it to the parts to be acted upon. When the object is to cauterise, it must be applied to the affected parts, until a whitish scab or crust is formed, which falls off in three or four days; after which the application may be repeated as often as may be necessary. The pain, caused by the operation, is generally insignificant, and in cases where it is violent it can be allayed by pledgets.dipped in laudanum. VI. AURI OXYDUM. Synonymes. Auri Teroxidum, Aurum Oxydatum, Oxide of Gold, Peroxide of Gold, Auric Acid. French.—Oxide d'Or. German.—Goldoxyd, Oxydirtes Gold. The oxide of gold prepared by calcination is the crocus solis of the Wirtemberg Pharmacopoeia. The oxide is received also into the Pharmacopoeias of Ferrara, and Hannover. Magendie* recommends the following as one of the modes of preparation. Take any quantity of chloride of gold, put it into a flask of white glass and pour upon it six or seven times its weight of boiling water, to dissolve the chloride; then add crystallised baryta gra- dually, until the liquid is no longer acid, as shown by a strip of litmus paper. The liquid is then boiled, permitted to cool, and filtered. The precipitate is washed several times with warm * Formulaire, &c. 8* 86 AURI CYANIDUM. water; the water of the various washings is brought together and evaporated nearly to dryness; the saline mass when cool is then dissolved in water, and in this way more and more oxide of gold is obtained, which may be added to the other. The oxide of gold is now washed with boiling water, until the water no longer affords a precipitate on the addition of nitrate of silver. It is then washed once or twice with water acidulated with nitric acid, to remove the small quantity of carbonate of baryta formed during the operation, and which may remain mixed with the oxide. These washings are-repeated with cold water, until the instillation of sulphuric acid occasions no longer any white pre- cipitate, which indicates that it is free from baryta. The oxide is then dried at a heat of from 167° to 190° of Fah- renheit, after which it is kept in a cool and dark place in a well- stopped bottle. The process recommended by M. Cottereau is the following.— An excess of magnesia must be boiled with a dilute solution of muriate of gold, till the solution loses its colour; the whole is then to be filtered, and the precipitate well washed; the result, which is aurate of magnesia, is to be treated with an excess of diluted nitric acid, which removes all the magnesia, and leaves the oxide in a pure state. This is to be again well washed and dried be- tween sheets of bibulous paper, but without compression or expo- sure to light or heat.* In the French Codex it is directed to be prepared by boiling four parts of calcined magnesia with one part of terchloride of gold and forty parts of water. Then wash, first with water to remove the chloride of magnesium, and afterwards with dilute nitric acid to dissolve the excess of magnesia.-j- In the condition of a hydrate, the oxide of gold is of a yellow colour, but when dried of a blackish violet. It is never entirely soluble in muriatic acid, always leaving behind a small portion, which is reduced to the metallic state during desiccation. Neither sulphuric nor nitric acid has an action upon it. The oxide of gold has been administered by manv physicians, and especially by Westring, Neil, Chrestien, and Lcgrand,J in the same diseases as the other preparations. * Amer. Journ. of Pharm. 2d series, ii, 110. Philad. 1837. f Pereira, Elements of Materia Medica, Pt. i, p. 424. Lond. 1639. X Op. citat. AURUM METALLICUM. 87 VII. AURUM METALLICUM. Synonymes. Metallic Gold. French. Or M£tallique. German. Metallisches Gold. Metallic gold is either administered in the form of the aurum limatum, or gold filings—formed by filing the finest gold with a fine toothed file—or in that of the pulvis ailri, (Fr. Or divise— Germ. Goldpulver,) wrhich is obtained by amalgamating gold with quicksilver, and driving off" the quicksilver by heat.* Accoi> ding to Trommsdorf, a very fine gold powder may likewise be obtained by precipitating the gold from a dilute solution of the metal in nitro-muriatic acid, by means of green sulphate of iron. The precipitate, thus formed, when washed and dried, is of a brownish colour, but when polished exhibits the most beautiful golden splendour.f Chrestien and Niel have exhibited metallic gold largely, and they affirm successfully; but, according to Wendt, it has no action on the economy. It is not easy, indeed, for us to con- ceive, that a substance so difficult of oxidation can have much, if any, effect. The former gentleman and Gozzi regard it as the mildest of the preparations of gold, but as equally efficacious with the others, although more tardy in producing its effects. Metallic gold has been administered in the dose of from a quarter of a grain to a grain, three or four times a day, in the form of powder or pill; the dose being gradually increased: or it has been rubbed daily upon the tongue, in the quantity of from one to three grains mixed with starch powder, or the powder of the. lycopodium. Where the condition of the tongue and of the interior of the mouth does not admit of this, Niel advises that a blister should be applied on the side of the neck, and that the denuded surface should be dressed with a mixture of a grain of gold amalgamated with mercury, and half a dram of lard; gra- dually augmenting the quantity of gold to two grains. In syphi- litic ulcers and excoriations, metallic gold is applied externally, amalgamated with the proper quantity of mercury, and united writh unsalted butter, lard, or cerate, in the proportion of twelve grains to one ounce. In syphilitic excrescences, frictions with gold powder, mixed with the saliva, are said to have been ser- viceable. * Jourdan's Pharmacopee Universelle, ii. 215. Paris, 1828. f Riecke, Die neuern Arzneimit. S. 56. Stuttgart, 1*37. 88 BALLOTA LANATA. The following formulas are given by Riecke.* R. Pulver. anri, gr. vj. Amyli. gr. lxyj. M. F. pulv. in part, xij aequales divid. A powder to be given four times a day. R. Pulver. auri. , Sem. lycopod. aa. gr. ij. M. F. pulvis. A powder to be rubbed once a day upon the tongue. BALLOTA LANATA. Synonymes. Leonurus Lanata. German.—Wolliger Wolfstrapp. This plant belongs to the natural family Labiatee, and to the class Didynamia, order Gymnospermia. It grows exclusively and commonly in Siberia, in dry mountainous regions. In its native country it has been long administered as a power - ful diuretic, especially in dropsy. Both Gmelin and Pallas refer to it in this respect in their travels in Siberia. Within the last few years, its use has extended elsewhere; and it is now frequently employed in Russia, Germany, and Italy, It is said to be often adulterated with the leonurus cardiaca, ballota nigra and marru- bium;f and it is important, that the genuine Siberian plant should be used, as the observations of Brera have shown the cultivated plant to be very powerless. For medicinal purposes, the whole plant has been employed, with the exception of the root. The diseases, in which the ballota lanata has been adminis- * Riecke, Die neuern Arzneimit. S. 59, Stuttgart, 1837. t Schmidt's Jahrbuch der in- und auslandisch. gesammt. Medicin. B. iv, S 275, and Riecke, Op. cit. S. 68. BALLOTA LANATA. 89 tered abroad—for it has not been employed in this country—are the following:— 1. Dropsy.—Rehmann prescribed it several times with decided advantage; and where organic disease prevented the cure, the urinary secretion was always largely augmented by it. The che- mical condition of the urine was likewise strikingly changed during its use; at first, it was whitish, afterwards darker, and ultimately almost black or of a deep brown, like the darkest beer. At times, according to Rehmann, when the accumulation of fluid was pretty well removed, a pain would occur in the hypochondres, indicating that the use of the ballota should be laid aside. Schilling, in Werchny-Udinsk, asserts, that he cured several cases of dropsy by it. Rupprecht and Muhrbeck admin- istered it with the best effects, and Brera* found it extremely serviceable in hydropic conditions, especially where they had been preceded by, or were complicated with, rheumatic or gouty affections. Luzzato prescribed it with equal success; and Hey- felder who gave it according to the prescription of the Russian physicians, observed the urine to be of a blackish yellow hue at the commencement, and afterwards of a very dark colour. He found, however, that to keep up the diuresis it was requisite to combine it with other diuretics, or to change it for other agents. 2. Rheumatism and Gout.—In these diseases, the ballota is administered in Siberia. Brera, as well as his compatriots, Ghi- della, Fontebuoni and Luzzato, have tested its efficacy by repeated trials. The pains generally soon disappeared under its use, and a cure took place without a relapse. 3. Adiposis.—In a case of tbis kind, it was exhibited in St. Petersburg by Dr. Weisse. The fatness wTas inordinate, and the remedy acted most favourably. It did not, however, occasion diuresis, but under its use an hemorrhoidal flux returned, which had previously been arrested. MODE OF ADMINISTERING. Decoction is the best form for administering the plant; from ^ss to |j to iviij of water;—this portion to be divided into two halves, and to be taken in the course of the day. Rehmann boils ^iss to ^ij of the coarse powdered plant in ffjij of water down to half; to which he adds, according to circumstances, some diffusi- ble excitant or a few drops of laudanum. Of this mixture he directs a cupful to be taken morning and evening, gradually increasing the dose. * Antologia Medica, No. 2. Febbrajo, 1835. 90 BARYI IODIDUM. BARYI IODIDUM Synonymes. Baryum lodatum, Iodide of Baryum. German.—Iod baryum. In solution, Baryta? Hydriodas, Hydras Baryi Iodati, Baryta Hydriodica, Hydriodate of Baryta. German. IodwasserstofFsaure Schwererde; Hydriodsaurer Baryt. This preparation has been introduced quite recently. MODE OF PREPARING. According to Tunnermann, the iodide of Baryum is prepared by heating the hydriodate of baryta for a sufficient length of time, excluding the light: by the admission of air, the iodide is converted into baryum and free iodine. As the iodine of bary- um, when it comes in contact with water,—as is commonly the case in prescriptions,—is immediately converted into hydriodate of baryta, it is simpler to employ the latter altogether. The hydriodate of baryta is obtained by boiling baryta earth in a solution of iodide of iron in water (made by taking one part of pure iron filings, and four parts of iodine, pouring upon them from six to eight parts of water, agitating frequently and apply- ing warmth gently until the fluid appears clear and almost colour- less,) or, what is cheaper, by boiling the solution of iodide of iron with carbonate of baryta, which must be added in small portions so long as there is any effervescence. The fluid obtained by either process, after filtering, must be clear and neutral, and yield no bluish or blue precipitate with the ferrocyanate of potassa; should it yield a precipitate, the decomposition of the salt of iron is incomplete. Should the solu- tion, formed in the first manner, have an alkaline reaction, the excess of baryta must be removed by exposing the mixture to the air, whereby it becomes converted into a carbonate, and falls to the bottom. The solution is then evaporated until a pellicle forms, the heat being gentle; the crystals are placed quickly between printing paper (Druckpapier) and kept in a wTell stopped glass vessel. They form white radiated plates, which easily deliquesce in the air, and on that account cannot be prescribed in the form of powder, but may be dissolved in some aromatic water. BERBERINA. 91 EFFECTS ON THE ECONOMY. Jahn instituted several experiments with the iodide of baryum and the hydriodate of baryta, both on plants, on animals, and on man in a state of health and disease. In considerable doses, it acts as a poison on the organism, and as one of the acrid class. Administered in very small doses, and with great circumspection, he found it to be serviceable in scrofulous and similar morbid con- ditions, and as an alterative in morbid growths, hypertrophy, chronic inflammation, &c, in which conditions it proved equally useful with the muriate of baryta, mercury, or iodine.* Jahn's ob- servations did not, however, lead him to speak positively regarding its advantages or defects; and he adds the caution—" Caute, per Deos, incede, latet ignis sub cinere doloso." Jahn's observations were published in 1830, and, according to Riecke, he has been since silent on the subject. Rothamel administered the hydriodate in a desperate case of scrofula, occurring in a patient twenty-one years of age, with great success. He began with one eighth of a grain three times a day, and increased the dose gradually during a protracted administration of the article, until three grains were taken four times daily. Biett has administered it frequently in cases of scrofulous swell- ings, and at times externally, according to the following form:— R. Baryi iodid. gr. iv. Adipis, 5j. M. fiat unguentum. BERBERINA. Synonymes. Berberinum, Berberine. German. Berberin. The inner bark of the Berberis vulgaris is of a yellow colour, and a bitterish, somewhat astringent, taste. It is cathartic, and was formerly used in jaundice; originally, perhaps, in consequence * Riecke, Op. cit. S. 71. 92 BERBERINA. of the " signature " of the yellow colour.* In more modern times,, it has been again recommended in the same disease on the faith of experiments.f The bitter principle of the root was discovered a few years ago by Buchner and Herberger, and its properties have been investi- gated by Brandes.J' Buchner first recommended, at a meeting of the German Association of Naturalists and Physicians in the year 1834, that it should be received into the Materia Medica; but hitherto few experiments have been made with it. METHOD OF PREPARING. An alcoholic extract of the root of the berberis vulgaris is pre- pared, to which water is added. This throws down a pulveru- lent brown substance; the fluid is then poured off; and the sub- stance dried; it is then treated with alcohol, which takes up the berberine, leaving a small portion undissolved. By evaporating the alcohol, the berberine remains.§ Thus prepared, berberine resembles an extract; it is of a brownish yellow colour, translucent, and smells like the root; its taste is a pure bitter, and it becomes soft in the air. Buchner|| succeeded in obtaining the bitter principle pure, and in a crystal- line form. Its reaction is neither alkaline nor acid; it is soluble in alcohol and water, but not so readily in the latter as in the former. When crystallised, it requires 600 parts of water for its solution; whilst in alcohol, at a medium temperature, it is soluble in 100 parts. It approximates the alcaloids in its nature, as with certain acids it forms crystallisable compounds. It is not soluble in ether. The brownish yellow solution formed by it is turned of a reddish brown by alkalies, like the infusion of rhubarb, and acids restore the colour. EFFECTS ON THE ECONOMY. According to Buchner, no injurious consequences are to be ap- prehended from the administration of berberine as a therapeutical agent: of this he had an opportunity of satisfying himself both on his own person and on others. When labouring under indigestion, * Ray's Historia Plant, ii, 605. f Lond. Med. Repos., new series, i, 38. X Archiv. der Apotheker Vereins, ii, 29. I Riecke, Op. cit. S. 442. || Journal de Pharmacie, xxi, 309. and Philadelphia Journal of Pharmacy, vii, 328. Philadelphia, 1835. 3 BIGNONIA CATALPA. 93 he took it with the best effects; not only was the dyspepsia re- moved, but also a yellow hue of the skin which had previously existed. He recommends it, therefore, as an excellent stomachic, especially when there is disturbance of the functions of the liver. In doses of two, five or ten grains, it only aids the appetite, but in larger doses—fifteen to twenty grains—it acts upon the bowels without inducing tormina, and therefore not as a drastic. Within the last few years Koch has published some observa- tions on the use of the berberine. He treated several cases with it as prepared by Buchner himself, when he found all his results confirmed, and that it merited a high rank amongst bitter agents. He gives two cases of marked disturbance of the digestive func- tion, in which the berberine afforded essential service. BIGNONIA CATALPA (SILIQU^E.) Synonymbs. Catalpa, Catalpa Cordifolia, C. Arborescens, C. Arborea, Catalpa or Catawba Tree. The Bignonia Catalpa belongs to the natural family Bignonia- ceas; class Didynamia; order Angiospermia. It is a tree well known in this country, but is not applied to any medicinal use. According to Kampfer and Thunberg, the Japanese physicians consider the pods of the Bignonia Catalpa to be a powerful remedy in different asthmatic affections. This gave occasion to several Neapolitan physicians—and especially to Professor Antonucci— to institute experiments in reference to its virtues, and their report was decidedly favourable. Brera also extols it in asthma. As to the precise mode in which it acts, we have no exact in- formation. Dierbach and Richter, according to Riecke,* place it amongst the Acria; whilst, according to the analysis of Grosso,f it seems more probable that its active principle is of a fatty nature, resembling the butter of the cacao. We think it extremely pro- bable, that it possesses no other virtues than those of a simple demulcent, and that the properties ascribed to it have been mainly, * Op. cit. S. 72. f Gazette Medicale de Paris, 1834, p. 8. 9 94 BOLETUS LARICIS. if not wholly, derived from the substances associated with it. Brera, for example, administered it with thejfollowing additions;* R. Siliquar. catalp. ^ss. Aquae fontan. q. s. ad colatur. ^viij. Adde Oxymel. scillae, ^ss. Or R. Siliquar. catalp. 5ss. Senegae rad. 3ij- Aquae fontan. q. s. ad colatur. ^viij. Adde Oxymel. scillae, ^i. To be taken by little and little. BOLETUS LARICIS. Synonymes. Boletus purgans, B. albus, Agaricus albus, Fungus Laricis, Po- lyporus officinalis, Fungus of the Larch. French. Agaric blanc. German. Lerschenschwamm, This fungus grows on the stem and larger branches of the larch. Formerly it was administered as a cathartic, but in this respect it has become obsolete. Still it is retained in many phar- macopoeias ; for example, in those of Amsterdam, Bavaria, Bruns- wick, Paris, Ferrara, Geneva, Hamburg, Hanover, Oldenburg, Poland, Prussia, Saxony, Sweden, Wirtemberg, and Wurzburg. Recently, it has been administered frequently in the colliquative sweats of phthisis. Barbut of Nismes made many trials with it,f which were favourable; and the experience of Andral was * Ricettario Clinico, Pad. 1825. t Burdach, in Journal der praktisch. Heilkund. von Hufeland, Mar. 1830. BKAYERA ANTHELMINTICA. 95 similar.* More recently, however, he has expressed the opi- nion, that no great advantage has been derived from it.f By several of the German physicians equally advantageous results have been obtained—as by Toel and Trautzsch—so that, as RieckeJ suggests, it deserves, perhaps, to be better known and investigated. Recently, Kopp has added his testimony in its favour.§ Formerly, as a cathartic, half a dram to a dram of the pow- dered boletus was given. In profuse diaphoresis it is adminis- tered in doses of from two to six grains. This dose, repeated for a few evenings, according to Barbut, arrests the sweating;— Riecke thinks, through its revellent excitation of the abdominal nerves; for which reasons he suggests, that the propriety of the union of opiates with it, to prevent its purgative effect, may be questionable. Kopp gives it in the dose of three grains', morning, noon, and night. If it acts upon the bowels, which is rarely the case, the dose must be diminished. i BRAYERA ANTHELMINTICA. This plant is a native of Abyssinia, and belongs to the family Rosaceoe Sanguisorbeae of Decandolle, Icosandria Digynia of Linnseus. It was first taken from Abyssinia to Europe by Dr. Brayer, from whom it received its name. The flowers are the parts used in»medicine, and they yield, on examination, an extractive matter, containing tannin, which is most readily taken up by hot water, and consequently, the decoction is the best pre- paration. In Abyssinia,*the flowers of the brayera are said to have been employed with the greatest success in tapeworm, but in Europe, * Journal de Pharmacie, vol. xx. f Cours de Pathologie interne, &c. recueilli et redige par A. Latour, p. 157. Edit, de Bruxelles, 1837. X Op. cit. S. 73. \ Denkwardigk. in der arztlich. Praxis. Frankf. 1836, S. 344, cited by Riecke. 96 BRAYERA ANTHELMINTICA. no experiments had been made with them until Dr. Plieninger, having become acquainted with a missionary from Abyssinia, and heard his description of their wonderful effects, obtained some of the flowers from him,* which he subjected to his friend, Dr. Kurr, who descried on examination the principles above mentioned. . With the rest of the flowers Dr. Plieninger made trial in two cases. He took a handful of the blossoms, about |j or §iss and boiled them in Jxvi of water down to one half, adding to the strained liquor as much honey as counteracted, in some measure, the objectionable taste. This decoction was taken by a delicate woman about 30 years of age, who had previously taken the ex- tractum filicis maris in pilular form, according to Peschier's plan, without success. In the course of the day she passed numerous fragments of taenia, mixed with mucous discharges, without ex- periencing any striking inconvenience from the remedy. From this time, she remained free from the parasite. A robust man, 38 years of age, who had taken large quantities of tartar emetic in consequence of violent inflammation of the lungs,—whilst he lay sick of this disease, discharged a great many portions of taenia, without having previously exptrienced any inconvenience from the presence of the entozoon. In July, 1834, he took the same decoction. Since then he has had no appearance of the taenia in his evacuations. Although but few cases have occurred in which ffie brayera has been administered in European practice, Dr. Plieninger con- siders that it is a valuable addition to the materia medica, inas- much as it can be administered to delicate persons and children, without violence being done to the whole organism, as is the case with many of the true authelmintics. The article has not been imported in sufficient quantities into Europe to admit of the necessary trials for fully testing its efficacy. In this country—so far as we know—it has not yet been seen. BROMINUM. Synonymes. Bromium, Brominium, Muride, Bromine. French. Brome. German. Brom. This elementary substance was discovered in 1826, by Balard, of Montpellier. In its chemical properties it is allied to chlorine * Riecke, Op. cit. S. 73. BROMINUM. 97 and iodine. Balard detected it whilst occupied in some investi- gations on the water of saltponds, and gave it the name bromine —from P^u/ms, "a stench or smell"—on account of its disagree- able odour. It is met with chiefly in sea water, and in certain animal and vegetable substances that live therein. It has like- wise been found in many mineral waters, of this and other countries, and especially in the salt springs—as of Salina, by Professor Silliman, and of Kenawha, by Professor Emmet. METHOD OF PREPARING. Balard's mode of preparing bromine consists in passing a cur- rent of chlorine through bittern, after which ether is added, and the two liquids are strongly agitated. The chlorine decomposes the hydrobromate of magnesia—the form in which the bromine ex- ists in the bittern—and converts the hydrobromate into a muriate of magnesia, setting the bromine free. The ether dissolves the evolved bromine, the mixture assuming a hyacinth red colour. The ethereal solution is agitated with caustic potassa, by which hydrobromate of potassa is generated; the ether becoming co- lourless and pure, and fit to be used for dissolving fresh portions of bromine. When a sufficient quantity of the hydrobromate has been obtained, it is mixed in a retort with peroxide of manganese, and acted on by dilute sulphuric acid, by which the bromine is given off. The sulphuric acid sets free the hydrobromic acid, which, at the moment of its disengagement, is deprived of its hydrogen, by the oxygen of the peroxide of manganese, and is thereby converted into bromine. The bromine passes over in reddish vapours, and is made to condense under water, contained in an appropriate receiver. M. Bussy* prefers the following form.. The mother waters of kelp {Soude de Varecq,) after iodine has been precipitated from them by means of chlorine, contain bromine in the state of a metallic bromide, when care is taken to add no more chlorine than is required to precipitate all the iodine. To 1250 parts of these mother waters, 32 parts of peroxide of manganese in powder,. and 24 of common sulphuric acid at 66° are added. The mixture is then put into a tubulated glass retort, to which a tubulated re- ceiver is adapted, and to the latter a tube, which dips into a flask. The retort and receiver as well as the tube must be ground so as to fit accurately without lutes or corks, which would be destroyed by the chloride. * Journal de Pharmacie, Janvier, 1837. 9* 98 BROMINUM. Every thing being arranged, the retort is heated until the liquid is made to boil, when the bromine condenses in the receiver under the form of red oily striae, with a small quantity of water. The operation must be arrested when the red vapours cease to be produced. . By slightly heating the receiver, without dismounting the appa- ratus, the bromine may be made to pass over into the flask, in which it will condense on cooling. The mother waters used in this preparation should not be re- jected, until it is evident on the addition of a fresh quantity of sul- phuric acid and oxide of manganese, that they contain no. more bromine. Bromine, at the ordinary temperature, is a fluid of a blackish red colour, when regarded in quantities,—but of a hyacinth red when placed in a thin layer between the eye and the light. Its smell is strong and disagreeable, resembling that of chlorine. Its taste is strong. It colours the skin yellow—the colour gradually disappearing of itself. Its specific gravity is 2.966. It is readily set free; and, when volatilised, assumes the form of dark red vapours. It boils at 117°; is soluble in water, and the solution is of a yellow colour. In its chemical relations with other bodies, bromine, as before observed, resembles chlorine and iodine; but the chlorine appears to have more power, and the iodine less, than the bromine, as the bromine is separated from all its combi- nations by the chlorine, whilst it decomposes the compounds of iodine, and assumes the place of the latter. It forms acids both with oxygen and hydrogen.. EFFECTS ON THE ECONOMY IN HEALTH. Experiments have been instituted to discover the influence of bromine on the animal economy, and especially by Barthez.* In this respect, also, bromine resembles iodine, and like it belongs to the class of irritant poisons. Twelve grains of bromine, dissolved in water, and injected into the jugular vein of a dog, destroyed it almost instantaneously. Cc-ugh occurred; the respiration and circulation were accelerated; the pupils dilated; the male organ was erect; and these signs were followed by involuntary dis- charge of the excrement, and at times stiffness of the upper and lower extremities. On dissection, Barthez found the cavities of the heart full of coagulated blood, and the lungs gorged with the same * De 1'Action du Brome, &c. (These) Paris, 1828. See, also, Fournet, in Bulletin General de Th£rapeutique, Fevrier, 1838. BR0MINUM. 99 fluid; in the venae cavae there were dark coagula; and, in the stomach and intestines, small, bloody, blackish cylinders, similar to cylinders of lunar caustic. The same quantity introduced into the stomach caused death in three or four days, when the oesophagus was tied; when, however, the animal was able to vomit, fifty to sixty drops were requisite. The poison acts less intensely when it is given in conjunction with aliment; it produces coughing, excitement, nausea and vomiting: constant sucking of the tongue was noticed, with frequently extraordinary restlessness and anxiety, and debility gradually aug- menting until death. On opening the body the stomach has been found contracted; the mucous membrane wrinkled, at times soft- ened, and frequently the seat of roundish ulcerations of an ashy green colour. Near the pylorus, Barthez found black spots, which could be readily scraped off with the back of the scalpel, and left gangrenous ulcers exposed. Barthez recommends magnesia as an antidote to bromine, but he rests his recommendation on a single observation only. Butzke obtained similar results from his experi- ments. In one case, only, in which a dog died a few hours after a dose of three drams of bromine, he found the intestines unchanged, and death could only be ascribed to the paralysing influence of the poison on the nervous system.* EFFECTS ON THE ECONOMY IN DISEASE. Pourche first used both the pure bromine and the hydro-bromate of potassa for therapeutical purposes. He found it very effica- cious in scrofula, especially in dispersing strumous swellings, both when given internally and applied externally.f In a case of very large goitre it was highly serviceable. Ac- cording to Pourche's observation, it excited heat in the face, headach, dryness of the throat, &c, which, however, soon disap- peared. Pourche gave the bromine internally, diluted with forty parts of distilled water, beginning with five or six drops of this mixture, and gradually raising the dose. It has also been added in a dilute state to lotions and cataplasms. The remedy is not, however, much used. Magendie frequently administered the bromine, but more com- monly some of its preparations. He prescribed it in cases in which the iodine did not appear to exert the proper efficacy, or where * Christison on Poisons, 3d edit. p. 186. f Bulletin General de Therapeutique, No. 14. Juillet 30,1837. 100 BRUCINA. the patient had become accustomed to its use. The diseases in which he used it were chiefly scrofula, amenorrhea, and hypertro- phy of the ventricles of the heart. More recently, it has been administered by M. Fournet,* in cases of chronic arthritis, both internally and externally; but his facts, as he himself remarks, were too few to enable him to de- duce any general conclusions as to the therapeutical value of the remedy in those affections. He always gave it in a pure state, in the form of mixture, with a solution of gum: externally, it was applied in the form of alcoholic mixture to the affected joints. The dose was at first two drops in four ounces of the vehicle; and it was gradually increased by two drops at a time, until as much as sixty drops were given in the twenty-four hours. The alcoholic mixture, used by M. Fournet as an external ap- plication, consisted, at the commencement, of ten drops of the bromine to an ounce of alcohol: this was augmented daily by five drops until it reached one hundred and twenty drops. The preparations of bromine are described in other parts of this volume. BRUCINA. Synonymes. Brucinum, Brucia, Brucium, Brucine. This alkaloid was discovered by Pelletier and Caventou in 1819, in the bark of the false angustura {brucea antidysenterica.) It is found also in small quantities in the nux vomica, and in St. Ignatius's bean. METHOD OF PREPARING. An alcoholic extract of the false angustura bark is prepared, which is dissolved in a large quantity of cold water, and filtered, in order to separate the fatty matter. The colouring matter is precipitated by acetate of lead, the excess of this is thrown down by sulphuretted hydrogen gas, * Bulletin G^n^ral de Therapeutique, F^vrier, 1838. BRUCINA. 101 and the brucine by an alkaline base, for which purpose mag- nesia may be employed. The precipitate from the magnesia is then washed, dried, and treated with alcohol, which lays hold of the brucine: this is obtained by evaporation. As the brucine is somewhat soluble, the precipitate of the magnesia ought not to be washed too much. The brucine thus obtained is coloured, but it may be procured colourless by forming an oxalate of brucine, and treating it with a mixture of equal parts of alcohol and ether. The oxalate is thus deprived of its colouring matter; after which it is decomposed by magnesia, and the brucine is thus obtained wholly pure and devoid of colour. Pure brucine is of a white colour, and forms regular crystals in the form of oblique prisms, having a base representing a parallelo- gram; it has a pearly lustre, tastes very bitter, and is soluble in 500 parts of boiling water, and in 850 parts of cold. In alcohol , it dissolves readily, from which solution it is obtained in the cry- stalline form. When exposed to the influence of heat, it melts at a temperature very little above that of boiling water. At a higher temperature it is decomposed, and affords the same products as vegetable substances that do not contain azote. With the acids, brucine forms neutral salts, which differ from the salts of strych- nine. The sulphate of brucine crystallises in very fine needles, and resembles the sulphate of morphine, but has a much more bitter taste. The nitrate of brucine does not crystallise, which con- stitutes an essential difference between brucine and strychnine. With an excess of nitric acid, the salt has a beautiful pearly {nacre) colour. EFFECTS ON THE ECONOMY. Brucine acts energetically on the animal economy in the same manner as the false angustura, but much more strongly. It is similar, in its operation, to strychnine, but is considered to be weaker in the proportion of one to ten, according to Pelletier; one to twelve, according to Magendie;* and one to twenty-four, ac- cording to Andral.f It. requires four grains of brucine to kill a rabbit, whilst half a grain of strychnine is sufficient. A tolerably strong dog, to which three grains of brucine had been given, was affected with symptoms resembling tetanus, but did not succumb. Pelletier is of opinion that brucine, or rather the alcoholic ex- tract of the false angustura, might be substituted in practice for' * Formulaire, &c. des Nouveaux Medicamcns, &c. f Journal de Physiologie de Magendie, iii, 267, Juillet, 1823. 102 BRUCINA. the extract of nux vomica; its operation is nearly the same, whilst there is no danger of its acting too violently. Andral has frequently prescribed brucine, and his deductions are, that we have it far more under our control than strychnine. Like strychnine, it has been given in cases of paralysis with vary- ing success. It would appear to have acted most beneficially in paralysis resulting from lead poisoning. Magendie administered it in two cases of atrophy, one of the leg, and the other of the arm, w7ith success. MODE OF ADMINISTERING. Brucine, according to Magendie, may be given either in pills or tincture; gradually augmenting the dose. Andral raised it from' half a grain to five grains. Magendie recommends, that the alkaloid should always be that obtained from the false angustura; the brucine of the nux vomica being mixed with a portion of strychnine, which adds to its activity, and renders it difficult to determine the dose. The following formulae are recommended by him:— Pilules Brucince. Pills of Brucine. R. Brucin. pur. gr. xij. Conserv. rosar. Jss. M. exactiss. et fiant pilulae xxiv. One pill to be begun with—twice a day. Tinctura Brucince. {French, Alcool de Brucine.) Tincture of Brucine. R. Alcohol (36° Areom.) 5j. Brucin. gr. xviij. M. Of this tincture, from six to twenty-four drops may be gi in the form of mixture, in any vehicle. CAINCiE RADIX. 103 Mistura Brucince. Mixture of Brucine. {Potio Stimulans.) R. Brucin. gr. vi. Aqua? destillat. 5iv. Sacchar, alb. 5y. M. Dose.—A table-spoonful night and morning. Magendie. CAINCiE RADIX. Synonymes.—Rad. Chiococcffi, R. Cainante, R. Caninanae, R. Cahincse, R. Kahincse, R. Serpentarise Braziliensis; Cainca Root. Portuguese.—Raiz Crusadinha, R. Preta. German.—Caincawurzel. The plant, which furnishes the root introduced into Europe of late years, and which has since become known as a remedial agent, is the Chiococca anguifuga, of the family Rubiaceae, sexual sys- tem, Pentandria Monogynia.* The shrub grows wild in the forest of Brazil, especially in the province of Minas Geraes, and the root is used there against the bites of serpents. This root is of the thickness of the finger, round, and knotty; the surface smooth or irregularly wrinkled; the wood tough and of a whitish colour; the smell disagreeable, especially that of the fresh root; and the taste at first like that of coffee, but afterwards nauseous and pungent. The bark of the root alone possesses efficacy, the woody portion having no action. The bark separates readily from the wood; it is thicker on the root itself than on its branches: and on the outside, is of an amber, or brownish yellow green colour; yellower and brighter on the youngest parts: the epider- mis is not easily separated. According to the chemical investi- * Art. Chiococca, in Encyclopad. Wflrterb. vii, 521. Berl. 1831, and Von Martius, Spec. Mat. Med. Brasil, i, 18. 104 CAINCE RADIX. nations of Pelletier and Caventou,* the following are found to be fhe constituents of the bark:-l. A bitter principle, crystalhsable n small, white, silky, shining needles; inodorous, and very solu- HeTn hot alcohol, which communicates to the whole plant a degree of astringent bitterness, and at the same time has an acu? reaction on litmus paper. In order to separate to acid, which has been termed by those chemists the Acidum Cahincxcum, in a pure state, the alcoholic extract of the root must be dissolved in water, filtered, and precipitated by lime, until the fluid loses all bitterness; the precipitate is then decomposed by oxalic acid and boiling alcohol; or the acetic or muriatic acid may be dropped into L aqueous decoction of the bark of the root, and, in the course of a few days, the acidum cahincicum will separate in the form of small crystals. With the cahincic acid, prepared m this. way, however, some colouring matter is still united. 2. A fatty, sreen, nauseous smelling substance, which communicates to the plant its smell. 3. Yellow colouring matter, and 4. A viscid colouring matter.f EFFECTS ON THE ECONOMY. The effect of the cainca root seems to be especially exerted on the digestive and urinary organs. It occasions watery evacua- tions and diuresis. From the experiments, however, of Albers,J made on a great number of dropsical patients, in the Charite at Berlin, he was induced to deny its diuretic powers, and to place it amongst the drastic purgatives, by the side of the helleborus niger. Wolff was of the same opinion. According to Von Langsdorf,§ it is a highly efficacious emmenagogue, possessing als0__to use his own language—considerable resolvent virtues, and hence employed in dropsies, that are connected with obstruc- tions in the abdomen. Riecke,|J asserts, that he had occasion to employ it in two cases of ascites complicated with induration of the liver. He had no expection of effecting a radical cure, but it afforded no palliation; diuresis was not excited, whilst nausea, colic, and diarrhoea supervened, so that he discontinued it: he gave it in decoction. Others have observed the same inconve- nience from its use, or have found it wholly ineffectual; for exam-; ^Journal General de Medecine, Mai, 1830, and Phil. Journ. of Pharmacy, iii. 165. Philad. 1831. f Journal de Pharmacie, xvi, 465. X Medicin. Zeitung. No. iv. Sept. 1832. \ Hecker's Litter. Annal. B. iv. S. 395, and Rust's Repertorium, B. xiv. S.458. || Die neuern Arzneimittel, u. s. w. S. 84. Stuttgart, 1837. CAINCE RADIX. 105 pie, B. Heyfelder, Reinhardt, Bartels,* and others. Riecke suggests the possibility, in these cases, of adulteration of the drug. On the other hand, the cainca has been highly extolled by Francois, Ribes, Wagner, Solieer, L6wenstein,f &c, but particu- larly by Von Langsdorf. The main diseases in which the cainca is recommended, are, First. Dropsies, in which many favourable trials have been made by Von Langsdorf, Spitta,J Guddoy, Engler, Francois, Wagner, Solieer, Robredo,§ &c. Secondly. Intestinal worms, against which it appears to act like other drastics. Thirdly. In ob structed menstruation; on this subject, however, farther trials are needed. When it operates as an emmenagogue it is probably altogether like cathartics that act more especially on the lower part of the bowels, that is, by contiguous sympathy. Fourthly. M. Frangois has recommended it highly in catarrhus vesica, but the experience of others has not confirmed this.|| It may be men- tioned, that in its native country, it is used for rheumatic pains; in a peculiar kind of pica experienced by the negroes of South America; and, as already remarked, against the bites of serpents. MODE OF ADMINISTERING. The cainca is given in various forms—powder, infusion, and decoction; and, besides these, a tincture and an extract have been made of it. A syrup and a wine have also been recommended. To form the latter, one ounce of the powdered root is infused in a pint of wine; the tincture is made with one part of the root and eight parts of alcohol at 20°. The alcoholic extract is considered to be the most uniform in strength, and has therefore been preferred by many. The syrup is formed by dissolving 3iiss of the extract in a little alcohol, mixing this with a pint of hot simple syrup, and allowing it to boil for some time, in order that the alcohol may evaporate. The dose of the powder is from di to 5ss in the twenty- four hours. It appears, however, to be the most objectionable form, and to give rise to unfavourable symptoms more frequently than the others. Opinions vary as to whether the infusion or the decoc - tion should be preferred. According to Caventou and Pelletier, * Grafe und Walther's Journal der Chirurgie, u. s. w. xxiv, S. 470. Ber- lin, 1836. f De radice Caincte ejusque in morbis hydropicis virtute. Berol. 1828. \ Hecker's Litterar. Annal. iv. 396. § Journal de la Academia de Medicina de Megico. Oct. 1836, and Brit. and For. Med. Review, p. 562, Apl. 1838. j| Bulletin General de Therapeutique, No. 13, Juillet, 1837. 10 106 CAINOE RADIX. boiling extracts very well the efficacious parts of .the root, and there are cases in which the decoction has rendered essential ser- vice after the infusion had been administered without success. Of the decoction, from 3j to 3iij are given in the day. Of the ex- tract, the dose, in the"twenty-four hours, is twenty to thirty grains; of the tincture 3j to 31J * The decoction, used by Spitta and others, was made as follows: Decoctum Radicis Caincce. Decoction of Cainca Root. R. Rad. caincse, 3U- Coque cum aquae commun. ffciss ad dimidiam partem, et cola, Dose.—A table-spoonful three times a day. Von Langsdorf.j By others, the following form has been employed, R. Rad. cainc. ^j. Aquae commun. fhij. Coque ad dimidiam partem et cola. D0Se.—Two table-spoonfuls three or four times a day. Engler. Dr. John H. Griscom4 of New York, considers there is a re- markable analogy between the cainca and the apocynum canna- dinum. . The Acidum Cahincicum, described above, is said to possess tonic, cathartic and diuretic powers, and has been used success- fully in some cases by Francois, in the dose of six grains gradu- ally increased to fifteen. * Journal de Chimie Medicale, Mai, 239-242. Paris, 1827. f Hufeland und Osann'6 Journ. B. lxii, St. 2. X Amer. Journal of the Medical Sciences, for May, 1833, p. 55. CALCIS CHLORIDUM. 107 CALCIS CHLORIDUM. Synonymes. Calcis Hypochloris, Oxychloruretum Calcii, Protochloruretum Calcii; Chloruretum Oxydi Calcii, Bichloruretum Calcis, Oxymurias Calcis, Calx Oxymuriatica, C. Chlorinata, Calcaria Chlorata, Chlorum Calcariae, Chloretum Calcarise, Calcaria Chlorica, Chloride or Chloruret of Lime, Ten- nant's Bleaching Powder. French. Protoxichlorure de Calcium, Oxichlorure de Chaux, Chlorure d'Oxide de Calcium, Bichlorure de Chaux, Oximuriate de Chaux, Muriate Suroxio-ene ou Oxigene de Chaux, Chlorate ou Souschlorate de Chaux, Poudre'de Blanchement, Poudre de Tennant. German. Kalkchlorid, Chlorkalk. Chloride of lime is a compound of chlorine and oxide of cal- cium. METHOD OF EREPARING. It may be prepared either in the dry or moist way. In the for- mer case, the chloride is made to act on the hydrate of lime in a pulverulent form; in the latter, the chlorine, in a gaseous state, is passed into lime water. For technical purposes, the latter is most used; for pharmaceutical, the former. In the London pharmaco- poeia, it is directed to be prepared as follows:—Take of hydrate of lime a pound, chlorine as much as may suffice; send in the chlorine to the lime in a proper vessel, till it is saturated. Chlorine is very easily evolved from binoxide of manganese, mixed with muriatic acid, by a gentle heat."* The chloride is generally however obtained from large chemi- cal establishments. Chloride of lime has the appearance of a white, loose powder, of a sour, bitterish and somewhat biting taste, exhaling a marked smell of chlorine, and dissolving with tolerable facility in water, at the same time giving off much chlorine gas.f * Brande's Dictionary of Materia Medica, p. 135. Lond. 1839; and Wood & Bache's Dispensatory, 4th edit. p. 829. Phila. 1839. t Link, Art. Chlor, in Encycl. Worterb. der Medicin. Wissenschaft. va. 579. Berlin, 1831. 108 CALCIS CHLORIDUM. EFFECTS ON THE ECONOMY. The action of the chloride of lime is generally esteemed to be analogous to that of the liquid chlorine; Hufeland, however, as- similates it to that of the muriate of lime. The data have been considered as scarcely, perhaps, sufficient to determine its precise operation. It appears to us, however, to act mainly by means of its chlorine, which, being loosely combined, is readily disengaged; —all acids, even the carbonic, occasioning its separation. It is not much employed internally, but according to Cima, who gave it in scrofulous affections, it occasions slight pains in the abdo- men, burning in the stomach, and at times diarrhoea. As to its internal administration Cima, it has been observed, gave it in cases of scrofulous swellings. By Cloquet it was used both internally and externally, in gangrenous ulcers; and by Grafe, Deschamps, and Graves,* in cases offactor oris. In a case of pectoral disease, with great faztor of the breath and expectoration, it was administered by Drs. Graves and Stokes with remarkable benefit. A pill of three grains of the chloride with one of opium being given three times a day, and the quantity being increased to twelve grains a day: the bed was also sprinkled with a solution of the chloride. By Reidf it was administered in dysentery, and in a bilious typhus occurring in summer: by Dr. CoplandJ in the last stage of typhus fever, when the evacuations were highly offensive, given in draughts of aromatic water with mucilage ; by Groh, Cohen, and Schlesier§ in phthisis, and by Grafe in gonorrhoea. In none of these cases is it presumable, that the chloride of lime pos- sesses virtues not contained in liquid chlorine. For external use it has been adopted in various cases, and espe- cially in ulcers. According to Trusen, an aqueous solution Of the chloride is proper for torpid ulcers of almost all kinds—the pha- gedenic, the scrofulous, &c. In syphilitic ulcers it appears to be of use when the chancre is sloughing, and eats deep into the flesh. || Trusen employed the solution formed by rubbing from 3iij to * Dublin Hospital reports, vol. v. •j- Transactions of the Association of Fellows and Licentiates of the College of Physicians in Ireland, vol. v. 1838. t Houlton's Appendix to translation of Magendie's Formulary, p. 163. § Casper's Wochenschrift fur die {resammte Hoilkunde, No. 37, 1838. || Dr. Mene, in Gazette Medicale, Feb. 11, 1832. CALCIS CHLORIDUM. 109 3iv. of chloride of lime with a pint of water, pouring off the su- pernatant fluid after it had stood a quarter of an hour, and apply- ing it by means of pledgets of lint to the ulcer, renewing the ap- plication whenever the lint became dry. In this way he found the profuse ichorous secretion from old ulcers diminish, the offen- sive odour abate, and fresh and healthy granulations spring up. By the same kind of treatment, phagedenic, herpetic, and scrofu- lous ulcers generally cicatrised speedily and permanently.* Trusen employed, at the same time, the antimonium crudum with cathartics; and in all cases he directed strict repose and re- gulated diet. Trusen's observations have been confirmed by many modern physicians, amongst whom may be mentioned Labarraque, Lis- franc, Ekl, Lemaire, Heiberg, and Kopp. In ozcena good effects were observed from it by Horner,f Awl,J Heron,§ and Strathing: and a solution of it, in the form of injection, was found serviceable in fistula, by Trusen and Ricord. Even in cancerous ulcers, recourse has been had to it by Heiberg, Labarraque, Duparcque, Martinet, &c: and in all cases it corrected the offensive odour, and, at times, the ulcer itself assumed a more favourable appear- ance. Dr. Frohlich|| used it with advantage in a cancerous affection of the face, in the strength of one part of the chloride to sixteen parts of water. In such cases it has been recommended, in order to have the concentrated action of the chloride, that it should be formed into a paste by admixture with water, and be applied in this manner. It has been used also, in cases of ulceration of the mouth, by Kopp, Angelot, Heiberg, &c, applied either in the form of solution or of a soft paste. In cases of ivounds the application of a solution of the chloride has been recommended by many, as by Trusen, Ekl, Lisfranc,U to promote cicatrisation after the inflammation has subsided. In a case of punctured wound, received in dissecting, and when the inflammation was proceeding up the arm with alarming rapidity, and the pain and tension were extreme, the patient experienced immediate relief from a solution of the chloride used as a lotion, combined with the free use of leeches.** * See, also, Houlton's Appendix to Magendie's Formulary, p. 162. f Amer. Jour, of the Medical Sciences, No. xi. X Ibid, No. xxii. for Feb 1833, p. 543. J Ibid. Nov. 1836, p. 271. || Medicin. Jahrbiicher des k. k. osterreich. Staates. B. xvii. S. 168. Wien, 1834. IT Bulletin General de Therapeutique, Juillet, 1838, ** Alcock, Essay en the use of the Chlorurets, &c. London, 1827. 10* 110 CALCIS CHLORIDUM. Gubian* has proposed to apply a solution of it to prevent the pitting from small-pox. The maturated pustules are to be opened and washed with a weak solution; desiccation takes place very promptly, and, it is said, no marks or pits are left. On account of its antiseptic properties, the chloride has been applied in cancrum oris by Labarraque, Richter, Berndt, and numerous others, and in the sloughing affections of the female organs of generation of an analogous nature, by Labarraque and Ekl; in hospital gangrene by Percy, Labarraque, Siedmogrodzki, Delpech, and Renard; in gangrene of the scrotum, as well as in ordinary gangrene, by Heiberg and Trusen, in all of which cases it has been of decided efficacy.f In such cases it may be applied either in the form of the paste above mentioned, or in strong solution—^ij. to ffej. of water. In burns of the second and third degree, when they are not spread over too great a surface of the body, a solution of the chloride of lime, according to Trusen, markedly diminishes the pain, moderates the too great suppuration, and excites, especially in the second degree, sound granulations, and in the third, speedy separation of the dead portions, and in both cases a smooth and firm cicatrix. Either a solution of the chloride united with muci- laginous substances, or a liniment prepared of the chloride may be applied. Lisfranc's observations^ entirely accord with those of Trusen. Lisfranc applies compresses spread with cerate over the burnt parts; the compresses having holes in them so that the burnt places are exposed; they are then covered with lint soaked in a solution of chloride of lime, which is kept in situ and moistened as it becomes dry. A solution of the chloride of lime, as well as of the chloride of soda, may be applied, indeed, with advantage in the first stage of a burn or scald; and Mr. Holt§ affirms that he knows nothing so efficacious.in a "black eye." Dr. Chopin,|| too, affirms, that in wounds produced by contu- sion, laceration, or by the explosion of gunpowder, where there is much pain, speedy and certain relief is produced by the chloride of lime, the dressings being kept constantly wet with a solution of it; he found it, as well as the chloride of soda, very serviceable also in cases of sore nipples. In chilblains the chloride has been used, both in the form of solution and of liniment with advantage; and not only in ulce rated pernio, but where the skin was unbroken, by Trusen, Lis- * Journal de Chimie Medicale, vi. 315. f Riecke, Die neuern Arzneimittel, u. s. w. Stuttgart, 1837. X Gazette Medicale, Mars 21, 1835. See also Bulletin General de The- rapeutique, Juillet, 1838. § Lancet, April 6th, 18133. il Gazette Medicale, Oct. 31, 1835. CALCIS CHLORIDUM. Ill franc, Grafe and others. In many cases, however, it has been found advantageous to diminish the inflammation by the applica- tion of leeches before it was employed. In cases of deeper frost bites than those which produced pernio, the chloride has likewise proved beneficial. In salivation, caused by mercury, this agent has been found valuable,* especially when administered at the beginning of the increased secretion. When the ptyalism has proceeded to a greater extent, Trusen uses, at the same time, sulphureous baths. A collutory of the chloride of lime not only diminishes the exces- sive secretion from the salivary glands, but speedily mitigates the sense of burning in the mouth; induces the healing of the erosions of the mucous membrane, and corrects the mercurial fcetor. In such cases, we have frequently employed it and with advantage, although the affection is not much under the control of medicine. In offensive odours from the mouth, arising from carious teeth, Regnard employed a solution of the chloride, but it excited the salivary glands in a disagreeable manner. On the other hand, E. Grafe recommends it strongly in this very case, and even in caries itself, both inwardly and externally as a collutory and tooth powder. In the latter form it is said to" remove speedily the tartar and yellow depositions on the teeth. By Chevallier and Kluge the chloride is strongly recommended for cleansing the mouth. The latter gives a formula for a collutory, which will be found amongst the prescriptions at the end of this article. It effectually cleanses the mouth, whilst it does no injury to the enamel. In scarlatina, a solution of the chloride may be employed most advantageously as a gargle, and in the form of ablution to the surface.f In scrofulous swellings of the glands, the chloride of lime, ac- cording to Cima, may be applied with advantage in the form of ointment, and by Grafe it is recommended in swellings of the joints. It has likewise been used successfully by Werneck in goitre. In several chronic eruptions, it has been much extolled—as in herpes, by Kopp; in the itch, by Heiberg, Derheims,J Ouzel, Fantonetti,§ Hospital,|| and WittzackTI; in pruritus pudendimulie- * Elliotson, in Mr. Houlton's Appendix to translation of Magendie's Formuiiiry. Amer. edit. p. 162. Philad. 1834. f Dr. Copland, in the Appendix to Houlton's edition of Magendie's Form- ulary, p. 163. Dr. S. Jackson, of Northumberland, (now of Philadelphia,),in Amer. Journal of Med. Sciences, xii. 261 and 550, and Ibid, for May, 1838, p. 56. (Dr. J. uses the chloride of soda.) X Journal de Chirnie Medicale, ii. 575. § Bulletin de Therapeutiqne, 1833; and American Journal of the Medical Sciences, August, 1833, p. 533. || Amer. Journal of the Medical Sciences, Nov. 1834, p. 240, (extracted.) f Caspar's VVochenschrift, Feb. 4, 1837, S. 79. 112 CALCIS CHLORIDUM. bris, by Darling; and in tinea, by Trusen, Roche, Cottereau, Kopp and Ebermeier. In the last disease, it is applied in the form of liniment; in the others, in solution, but in the itch often also in the form of ointment. Michaelsen recommends the following method of treating the itch. Take of the chloride of lime from two to four ounces, according to the degree in which the disease exists, and the length of time it has been in the system; put this in a common flask or bottle full of rain or river water, so that as much as possible may be dissolved. In using it, the patient must shake the bottle well, in order that some of the undissolved lime may be taken up. With this, he washes the parts affected with the itch three or four times a day. Every third or fourth day, when the skin becomes somewhat rough or irritated, the patient is made to take a tepid bath, or to wash himself with warm soap and water, and this until the cure is accomplished. The internal management is the same as in other plans of treatment. In the case of young children, the mixture must of course be weaker, about one ounce to a pound of water. By this plan, the patient, it is said, is entirely cured, without any unpleasant concomitants, in from seven to ten days. The chloride of lime has likewise been applied in purulent ophthalmia. Varlez* cured contagious blennorrhcea of the eye, by dropping upon it a solution of the chloride. Colson, Delatte, and Reynaud,-j- also saw good effects from it, both in acute purulent ophthalmia, and in chronic ophthalmia with granulations, obscurity of the cornea, and especially in copious secretion from the meibo- mian glands. GutfirieJ applied a solution of the chloride suc- cessfully in three cases of ophthalmia neonatorum; and Pereira§ advises a weak solution in the same cases. Farvagnie used it beneficially in scrophulous and catarrhal ophthalmia.^ The chloride has likewise been employed advantageously in other blennorrheas besides the one mentioned, and especially in the gonorrhceal.^ Grafe, of Berlin,**, affirms that he succeeded with it when copaiba and cubebs had failed. He used it both in the form of pill, made as described hereafter, and of injection— the injection being made by dissolving gr. xxiv. in 5vj. of water, and adding 5ss. of wine of opium. But one of the most important of the applications of the chloride * American Journal of Med. Sciences, i. 459. f Journal fur Chirurgie, u. s. \v. B. xiv. II. 4. I Medical and Physical Journal, Nov. 1827. ] Elements of the Mat. Med. pt. i. p. 354. London, 1839. || Verhandlunsr der vereinigt. arztlich. Gesellschaft. der Schweiz. Jahr 1829. Zurich, 1830. IT Alcock, Essay on the use of Chlorurets, &c. London, 1827. ** Amer. Journal of Medical Sciences, and Amer. Journal of Pharmacy, 2d series, vol. ii. 86. Philadelphia, 1838. CALCIS CHLORIDUM. 113 is as an antiseptic and disinfecting agent.* It is admirably adapted for preventing and checking putrefaction, and for correcting the offensive odour of parts already putrefied :f and hence its applica- tion is most useful in anatomical investigations.! Some time before dissection, the body may be enveloped in a cloth wetted with a solution of the chloride, which must be kept wet by sprin- kling it from time to time with a solution made of |j. of the chloride to a pint of water; in this manner the offensive odour is speedily corrected. The chloride is equally well adapted for purefying the air of the wards of hospitals, jails, or ships; a little of the solution being sprinkled from time to time on the floors; or shallow ves- sels, containing the chloride, being placed in different parts of the room. It is used, moreover, for neutralising contagious miasmata dispersed in the air or contained in clothing, furniture, &c. care being taken in all these cases that due ventilation be practised. It has been doubted, however,§ and even denied, that its use is productive of any advantage in preventing the spread of infectious, contagious, or epidemic diseases. Nay, it has been affirmed to be positively injurious, by deteriorating the atmosphere, and in this there may be truth, unless the precautions we have mentioned be taken. In various cases, in which such diseases have prevailed, it has destroyed all offensive odour, but the extension of the malady has not been prevented. MODE OF ADMINISTERING. The chloride of lime has been given internally both in the form of solution and of troches, the dose being from gr. j. to grs. vj. four to six times a day. Externally, it is generally applied in solution of different strengths, (from 5J-to 3iv. to eight ounces of water)— the solution being decanted to remove the particles of lime from it, unless where it is considered advisable to employ the turbid solution. In cases of very offensive evacuations from the bowels, ten or fifteen grains may be added to a common enema. It is likewise * Labarraque, on the use of the Chlorides of Soda and Lime, translated by Jacob Porter. New Haven, 1829. f Alcock, Op. cit. X Magendie, Forrnulaire, &c. j Observation on the chlorides and chlorine as " disinfecting agents,'' and as preventives of cholera. By H. Bronson. M.D. Boston, 1832. See, also, American Journal of the Medical Sciences, for Feb. 1833, p. 481; Dr. Albers, in London Med. Gaz. viii. 410, (as to its inefficacy in cholera;) and Pereira, Op. cit. p. 352. London, 1839. 114 CALCIS CHLORIDUM. applied in the form of ointment and liniment, and also of a paste made by admixture with water. The following forms have been given for its administration.* Trochisci Calcis Chloridi. Lozenges of Chloride of Lime. R Calcis Chlorid. 3ij. Sacchar. alb. Iviij. Amyl. §j. Gum. tragac. 3j- Carmin. grs. iij. M. Fiant trochisci. pond, gr, iij. One of these to be taken three or four times a day, and allowed to dissolve in the mouth, in cases of fcetor oris. Deschamps. Mistura Calcis Chloridi. Mixture of Chloride of Lime. R Calcis chlorid. 3J- Emuls. amygd. 5vij. Syrup, gummos. 5j. M. A table-spoonful every three hours in gonorrhoea. E. GRAEFE.f Pilulce Calcis Chloridi. Pills of Chloride of Lime. R Calcis chlorid. Jj. Ext. opii. gr. ix. Mucilag. gum. arab. q. s. Divide in pilulas liv. * Riecke, Op. cit. S. 94. t Journal far Chirurgie, u. s. w. B. xiv. St. 2. CALCIS CHLORIDUM. H5 Dose.—One every two or three hours in gonorrhoea, gradually increasing the dose until eight, ten, or twelve are taken every hour. Graefe. Collutorium Calcis Chloridi. Collutory of Chloride of Lime. R Calcis chlorid. grs. xv. ad 3ss. Mucil. gum. arab. ?j. Syrup, cort. aurant. 5ss. M. A little of this solution to be applied by means of a mop of charpie to ulcers in the mouth. Angelot. R. Calcis chlorid. 3 iij. Aquae destillat. Alcohol, aa. 5ij 01. rosar. gtt. iv. Solve et filtra. Chevallier. A tea-spoonful of this solution is mixed with a glass of water, and used in fcetor oris. According to Riecke,* an analogous nos- trum has been sold at a high price under the name—Pneumoka- tharterion. R. Calcis chlorid. 3j. Solve leniter terendo in Aquae distillat. ffevi. Tunc adde Alcohol, puriss. (.830) pond. spec. Sviij. Mist, reponatur in loco frigido per horas xxiv; tunc filtretur et reserv. in lagena bene obturata. (" Let the mixture be put aside in a cold place for twenty-four hours; then let it be filtered and kept in a well stopped vessel.") It has been recommended that the mouth should be rinsed with this after the teeth have been brushed. Freybero von Kluge. * Op. cit. S. 94. 116 CALCIS CHLORIDUM. The Pharmacopoeia of Sweden has an antiscorbutic collutory, called Linctus ad stomacacen seu oxymuriatis calcici, which is formed as follows: R. Solut. calcis chlorid. 3ss. Aqua? fontan. Mellis, aa. 3vj. M. R. Calcis chlorid. 5ss. Solve exactiss. trituratione in Aq. fontan. ±ij. Et post limpid, clarificat. admisce Alcoholis, 5ij. 01. rosar. gtt. iv. M. The mouth is rinsed in cases of salivation with a mixture made by adding a tea-spoonful of the solution to a glass of water. Trusen. Dentifricium Calcis Chloridi. Dentifrice of Chloride of 'Lime. R. Calcis chlorid. in pulv. gr. iv. Corallinae rubra?. 3ij. M. A new tooth-brush should be slightly wetted and dipped in this powder, and rubbed over the teeth. Employed to give their natural colour to teeth. Magendie. Solutio Calcis Chloridi. Solution of Chloride of Lime. R. Calcis chlorid. 3hj. Solve in Aquae distill, fly. Adde Tinct. opii crocat. vel Vini opii, Jj ad 3ij. M. Applied to frost-bites. Trusen. CALCIS CHLORIDUM. 117 R. Calcis chlorid. 5ss. Tere invicem et sensimaffunde Aq. font, (seu rosar.) ffoj. Et post clarificat limpid, admisce Mucil. gum. arab. (seu sem. cydon.) ?ij. Trusen. Applied by means of linen rags in cases of burns. R. Calcis chlorid. 3ij- ad Jiij. Aquae, ffoi. Solve. To be applied by means of rags kept constantly wet, in cases of hospital gangrene; the mixture being shaken. Rust and Kluge. R. Calcis chloridi, 2iij. Aquae destillat. Jfoj. Solve et cola. Used as a lotion in cases of Itch, on the thighs, legs, and arms, twice or thrice daily. In general, six or eight days are sufficient to effect a cure. Magendie. The disinfecting liquor of Labarraque, Liqueur desinfectante de Labarraque, is made by adding ten parts of water, to one part of the chloride of lime divided in a mortar; suffering the solution to settle, and then filtering. Collyrium Calcis Chloridi. Collyrium of Chloride of Lime. R. Calcis chlorid. gr. iv. ad vj. Laudan. liquid. Sydenham. 9ss. Mucilag. gum. arab. 3iss. Aq. rosar. iij. M. et filtra. To be dropped in the eye in cases of catarrhal and scrofulous ophthalmia. Farvagnie. 11 118 CALCIS CHLORIDUM. Cataplasma Calcis Chloridi. Cataplasm of Chloride of Lime. R. Calcis chlorid. Sodas muriat. aa. ±ss. Aquae destill. fhss. Farinae sera. lin. q. s. utfiat cataplasma. Used in cases of scrofulous swelling of the joints. Graefe. Unguentum Calcis Chloridi. Ointment of Chloride of Lime. R. Calcis chlorid. 5J- Adipis, ±j. M. fiat unguentum. To be rubbed in, in cases of scrofulous swellings. Cima. R. Calcis chlorid. 3ss. Adipis, ij. M. F. unguent. Used in goitre. Werneck. R. Adipis, gj. Boracis venet. Calcis chlorid. aa. 3j. M. exactissime. In cases of chilblains. R. Flor. sulphuris, iiss. Calcis chlorid. bene, tritur. iij. Adipis, gx. M. Trusen. Hospital. In itch, morning and evening. Linimentum Calcis Chloridum. Liniment of Chloride of Lime. R. Calcis chlorid. 3ss. Tere in mortario vitreo et sensim affunde Aq. rosar. (seu fontanae,) ij. Et post, limpid, clarificat admisce 01. amygd. dulc. ij. To be applied by means of a pencil in cases of tinea capitis. Trusen. CALENDULA OFFICINALIS. 119 CALENDULA OFFICINALIS. Synonymes. Calendula Sativa, Caltha Sativa, Verrucaria, Chrysanthemum, Sponsa Solis, Single Marigold, Garden Marigold. French. Souci, S. Ordinaire. German. Ringelblume. This plant belongs to the family Synantherese, and in the Lin- neean system to Syngenesia necessaria. It is much cultivated in the gardens of southern Europe more especially, and grows wild there. The whole plant has a feeble aromatic smell, which is not, however, unpleasant. The taste is bitter and somewhat pungent. It was examined chemically by Geiger and Stoltze,* who found in it a peculiar glutinous matter, readily soluble in spirit of wine; insoluble in ether, and in ethereal or volatile oils, and but little soluble in water; to this they gave the name calenduline. EFFECTS ON THE ECONOMY. The term officinalis indicates, that the calendula was formerly received into the lists of the Materia Medica as an " officinal;" but it had become entirely obsolete when Westring,f a Swedish physician, in 1817, recalled attention to it. He recommended it particularly in cases of cancer of the breast and uterus having no- ticed its good effects by accident. Visiting an aged female, who had suffered, for a long time, under an extremely painful indura- tion of one mamma, he found she was able to allay the burning pain by the application of the fresh plant. This induced him to try it in several cases of cancer, and from the results he was led to infer, that it is perhaps the best agent that can be employed in that frightful malady. He never, how- ever, employed the calendula alone, but associated with it other active remedies, so that but little attention was paid to his recom- mendation;—a great portion of the efficacy of the agents em- ployed, being—it was thought probable—ascribable to the asso- ciated articles. Some time after Westring's publication, the remedy was used * Berlin. Jahrb. d. Pharmac. B. xxi. S. 282. f Erfahrung uber die Heilung der Krebsgeschwiire, u. s. w. Translated from the Swedish into German by K. Sprengel. Hal. 1817. 120 CALENDULA OFFICINALIS. by others, and his observations were confirmed. Rudolph* em- ployed it with advantage internally, in a case of induration of the mammce in a young female; but the acetate of iron was at the same time applied externally in solution. Fehrf found it highly useful not only in incipient, but in advanced scirrhus. Stein praises it in cancer of the integuments (hautkrebs.) He forms the expressed juice of the young plant and flowers into an oint- ment with fresh butter, and applies it once or twice a day by- means of lint, having previously washed the ulcers with a decoc- tion of the plant. Internally, the calendula is prescribed in the form of decoction, made with milk or water, or of a mellago pre- pared from the fresh juice, dissolved in an aromatic water; or made into pills. When the salve is applied, a sense of burn- ing arises, which speedily becomes absolute pain. This soon, however, abates; and almost wholly disappears:—if too violent, more butter may be added; the ichorous discharge becomes im- proved; the offensive odour corrected, and in from fourteen to twenty-one days, the ulcer is converted into one of a benign and readily cicatrisable character. Rust also frequently administered the extractum calendula? in cancerous ulcers and as a discutient in chronic indurations, in combination, however, with other efficacious agents. Schneider affirms, that he prescribed the extract of calendula with the best effects in induration of the stomach, and in tumefaction and decided induration of the glands and uterus. A decoction of the flowers and plant, he employed in cancer of the uterus, and found it an excellent soothing, and discutient agent. Muhrbecki used the extract with eminent success in chronic vomiting; Car- ter§ in extremely obstinate vomiting; and De Camp in a case of cardialgia, where the excitability of the stomach was so great, that every remedial agent was rejected before it had opportunity to act. Fehr also extols it as an emmenagogue, for which pro- perty it was celebrated with the older physicians. As Riecke|| has remarked, the amount of experience with the calendula is yet small—too small for us to pronounce whether it merits a fixed place in the lists of the materia medica. * Hufeland und Osann's Jour, der prakt. Heilk. B. Iviii. St. 1. S. 119. f Verhandlungen der verein. arztlich. Gesellschaft. der Schweiz. Jahrg. 1831, and Dierbach, in Heidelberger Annalen, B. x. H. 4. S. 501 Heidel- berg, 1834. X Huf'eland's Journal der prakt. Heilk. B. lxii. St. 5, S. 123. .Rust's Magazin. der gesammt. Heilk. B. xi. S. 350. § London Med. Rep. April, 1826, p. 347. See, also, Link and Osann, in art. Calendula in Encyc. Worterb. u. s. w. B. vi. S. 520 Berl 1831 || Op. cit. S. 101. CALENDULA OFFICINALIS. 121 METHOD OF ADMINISTERING. The extractum calendulas is contained in the Hannoverian and Saxon Pharmacopoeias; in the latter it is directed to be pre- pared in the following manner: Take of the calendula officinalis, 1 part. Water, 8 parts. Macerate for twenty-four hours; then boil for a quarter of an hour, and strain forcibly; boil the remainder with four parts of water; mix the two liquors, and, after twenty-four hours' rest, evaporate to the proper consistence.* The dose of the extract is different according to different obser- vers. Muhrbeck gave four grains, five times a day. Fehr allows, jij. to 5vj* Phobus directs the dose of the extract, prepared according to the Prussian Pharmacopoeia, to be eight to sixteen grains, gradually increasing it to 3ss. and more, from two to four times a day. It may be given either in the form of pill or mix- ture. Externally, the extract is used in solution, to moisten the dressings of ulcers, and to form ointments. The dose of the decoction of the fresh plant is jg. to ^ij. The Sardinian Pharmacopoeia has a conserva florum calen- dula, made by beating together- one part of the flowers and two parts of powdered sugar. It has, also, an acetum florum calen- dula, made of one part of the petals digested in four parts of vinegar; and the Wirtemberg Pbarmacopoeia has an unguentum florum calendula, made of four ounces of the petals boiled in a pound of fresh butter, until the mixture is entirely evaporated. This is used as an emollient and resolvent. Pilula Calendula. Pills of Calendula. R. Ferri oxydat. fuse. Herb, calend. pulv. Extract, calend. aa. 5j- Mucilag. gum. arab. q. s. ut fiant pilulae xc. Dose.—Five to eight, three times a day, as a soothing agent in cancerous ulcers. Rust. * Pharmacopee Universelle, &c. par Jourdan, ii. 536. 11* 122 CARBO ANIMALIS. EL Hydrarg. submuriat. 9ss. Sulphur, aur. antim. 9j. Extr. calendul. ----conii macul. aa. 9ij. M. f. pil. pond. gr. ij. Dose._Five pills, three times a day, as a discutient in chronic indurations. Rust. Lotio Extracti Calendula. Lotion of the Extract of Calendula. R. Extract, calend. ■------cham. vulg. aa. 3ij< Solve in Aq. lauroceras. gij« Adde Tinct. opii simpl. 3j • As a wash (Verbandwasser) in cancerous ulcerations. Rust. It is obvious that the precise agency of the calendula cannot be tested in any of these formulas, the substances associated with it being themselves active agents. In this country, we do not believe it is ever used. CARBO ANIMALIS. Synonymes.—Carbo Carnis, Animal Charcoal. French.—Charbon animal. German.—Thierische Kohle; Fleischkohle, Thierkohle. Animal charcoal is an ancient remedy, which has been revived amongst us. The older physicians used several kinds, and re- commended them in various diseases, but without having any fixed principle; the circumstances, indeed, that suggested their exhibition in many cases, are entirely unintelligible to us of the present day. In the old Wirtemberg' Pharmacopoeia, we find the Erinaceus combustus, or "burnt hedgehog," as an antihydropic; the Sericum tostum, or " burnt silk," and the Hirundines com- busta, or " burnt swallows," as antiepileptics; the Lepus. combus- tus, or "burnt hare," as an antilithic; the Reguli usti, or " burnt CARBO ANIMALIS. 123 wrens," advised in nephritis and in calculous affections; and the Talpa combusta, or " burnt moles," at one time much extolled in erratic gout, lepra, scrofula, ulcers and fistulas! All have pro- perly fallen, however, into oblivion with the profession, although there may yet be some, who cling with pertinacity to these relics of ancient ignorance and superstition. The cancer remedy of Cosme, into the composition of which burnt shoe soles entered, appears to have kept up the employment of animal charcoal; as well as the " burnt sponge," Spongia usta, in which, however, the charcoal is of but little efficacy compared with the iodine it contains. These were perhaps the only forms in which animal charcoal was used at the time when Weise, a German physician, revived its employment; and many physicians soon came for- ward to attest favourably in regard to it. METHOD OF PREPARING. Weise gives the following method of preparing it. Cut ribs of veal, with the flesh attached, into small pieces, and put them in a drum for roasting coffee,—turning the drum constantly whilst it is placed over the fire. When inflammable air begins to pass off, which is distinguished by the flame playing around the drum, the combustion must still be kept up a quarter of an hour longer. If it be continued so long as any inflammable air is disengaged, the preparation is inefficacious. The substance, most commonly met with under the name of animal charcoal, is obtained by burning bones. The residue, when reduced to powder, is the well known substance bone black or ivory black.* This generally contains more or less phosphate of lime according to the kind of bone from which it has been procured. This is directed in the London Phar- macopoeia to be purified by digestion in dilute hydrochloric acid as follows: " Take of animal charcoal, a pound; hydrochloric acid and water, each twelve fluid ounces. Mix the hydrochloric acid with the water, and gradually pour it upon the charcoal; then di- gest for two days in a gentle heat, occasionally agitating. Set aside, and pour off the supernatant liquor; then wash the char- coal with repeated portions of water, till no traces of acid are perceptible; lastly, dry it."f Charcoal, prepared in this way, should be a combination of carbon, carbonate and phosphate of lime, hydrogen, and azote. From an analysis, which Meurer made of animal charcoal, prepared according to Weise's for- mula, it contains also muriate and a little carbonate of soda, as well as a portion of iron. * See Art. Carbo Animal is, by Dr. F. Bache, in Wood and Bache's Dispen- atory, 4th edit. p. 165. Philad. 1839. f Brande, Dictionary of Materia Medica, p. 151. London, 1839. 124 CARBO ANIMALIS. EFFECTS ON THE ECONOMY. In the case of a young man of scrofulous diathesis, Weise saw a tumour, of the size of a hazelnut, and very painful, situate under the nipple, disappear under the use of animal charcoal. According to him, its efficacy is strongly exerted on the uterus and mammas. Rothamel and Hohnbaum extol it in dyspepsia and gastricism, as well as in cases of diarrhaa. In obstinate chronic glandular indurations, especially of the mammary glands, Weise affirms it to be a certain remedy; he, at the same time, however, considers a regulated diet to be indispensable. Scirrhus of the lips, he says, also disappears under its use, and even scirrhous goitre when the charcoal is associated with burnt sponge. On cartilaginous polypi, it is said to have exerted a beneficial agency, and to have diminished the tendency of mucous polypi to return after operation. Even open cancer, it is asserted, has been healed by it.* On these recommendations of Weise, animal charcoal has been used by several German physicians, especially by Wagner, Kopp, Pitschaft, Radius, Rothamel, Hesselbach, Gumper, Hohnbaum, Fricke, Michaelsen, and Siebenhaar; and as a general result of their observations it would seem not to be devoid of therapeutical agency; all hough many of the experi- menters failed in noticing any sanative effect from it. Fricke, for example, did not observe the least benefit in the very cases mentioned by Weise. He gave it also in the way of experiment, in several other cases, but without detecting the slightest influence on the organism. Other physicians saw advantages from its use in open cancer, but these were only transient. On the other hand, the experience of Wagner, Kopp, Michaelsen, and Rotha- mel would seem to show, that it was effectual in removing; inci- pient scirrhus of the mamma. Kopp employed it successfully in scirrhous goitre, and Pitschaft in a case of what he terms struma varicosa. Radius dispersed under its use a considerable swelling of the submaxillary glands. In scrofulous affections, especially in scrofulous indurations of the glands, it proved useful in the hands of Kopp, Rothamel and Speranza. Pitschaft, in a delicate, stru- mous woman, who was suffering constantly under ozana, found it of eminent service after other remedies had failed. Radius thought it aided the absorption of a disintegrated cataract, and Siebenhaar saw good effects from it in induration of the pan- creas. Rieckef suggests, that farther trials might show that it might be used in the place of iodine, which it appears to resemble in its action on the economy, whilst it affects the organism less in- juriously. It is extremely doubtful, however, whether the proper- *" Riecke, Die neuern Arzneimittel, u. s. w. S. 104. t Op. cit. CARBO ANAMALIS. 125 ties of the two substances can be regarded as at all analogous, and whether the animal charcoal is possessed of any other properties than those usually ascribed to the prepared charcoal. MODE OF ADMINISTERING. The carbo anamalis is given in doses of from half a grain to three grains twice a day, commonly in the form of powder with sugar, or with powdered liquorice root. Weise advises it to be sprinkled on the hard edges of cancerous ulcers, and Speranza extols an ointment made of charcoal and oil or simple cerate as a discutient in scrofulous swellings. Pulvis Carbonis Animalis. Powder of Animal Charcoal. R. Carbon, animal, gr. ij. Pulv. rad. glycyrr. gr. v. F. pulvis. A powder to be given morning and evening. R.~ Carbon, animal, gr. vi. Spong. marin. ust. gr. xij. Pulv. rad. glycyrrhiz. 3ss. M. F. pulv. in partes vi aequales dividendus. A powder to be taken night and morning in scirrhous goitre. Riecke. R. Pulv. carbonis animal, gr. iv. Pulv. rad. glycyrrh. 9iv. M. et divide in part. viij. One of these to be taken dry, morning and evening, a little water being drunk afterwards, in cases of scirrhous indurations of the mamma3. After the eight powders have been taken, the dose may be increased gradually by half a grain, until it ulti- mately attains four grains. At the same time, abirritating and spare diet should be inculcated. Boli Carbonis Animalis. Boluses of Animal Charcoal. R. Pulv. carbon, animal, gr. iij. Ammon. muriat. pulv. 9j. Ext. conii macul. gr. ij. ----glycyrrhiz. q. s. ut fiat bolus. One of these to be given three times a day;—in cases of swell- ing and scirrhus of the prostate, and of the mucous membrane of the urethra. Magendie. 126 CARBONIS SESQUI-IODIDUM. CARBONIS SESQUI-IODIDUM. Synonymes. Carbonis Sesqui-ioduretum, Sesqui-iodide or Sesqui-ioduret of Carbon. This preparation is made by mixing concentrated alcoholic so- lutions of iodine and potassa until the former loses its colour. A solution is obtained, from which the addition of water will throw down a yellow precipitate—the sesqui-iodide of carbon. This substance is soluble in alcohol and ether, but insoluble in water. The ethereal solution yields large yellow crystals by slow evaporation. It has a sweet taste, and a strong saffron-like odour. Mitscherlich* considers the taste very disagreeable. Fifty grains given by Dr. Cogswell^ to a strongly made terrier dog, proved fatal; and, on dissection, the large vessels were found congested; the inner membrane was closely corrugated, and the apices of the rugge were of a rose red colour. EFFECTS ON THE ECONOMY IN DISEASE. Dr. LitchfieldJ used it with advantage in five cases of enlarged glands; in two of lepra, and three of porrigo, in the form of oint- ment composed of 5ss of the powder to 3yj of simple cerate. CETRARINA. Synonymes. Cetrarine, Cetrarin. French.—Cetrarin. This substance has been extracted, of late, from the lichen islandicus or cetraria islandica, by M. Herberger, a pharmacien at Kaiserslautern.§ * Traite de Chimie, traduit par Valerius. t Essay on Iodine, p. 122. Edinb. 1837. X Lond. Med. Gaz. Aug. 1836. j Buchner's Repertorium, B. viii. H. 1. 1837. CETRARINA. 127 METHOD OF PREPARING. The coarse powder of the lichen is boiled for half an hour in four times its weight of alcohol at .883; it is left at rest until va- pours cease to be given off, to avoid the loss of the alcohol; it is then strained and pressed. Three drams of hydrochloric acid pre- viously diluted with water are now added to each pound of the lichen; this is mixed with from four times and a quarter to four times and a half its bulk of water, and the mixture is left at rest for a night in a closed flask. The next day, the deep yellow fluid, which swims above the copious deposite obtained, is poured off: this deposite is the impure cetrarin, the colour of which is more or less greenish. It is now collected on a filter {chausse,) left to drain as little as possible and subjected to pressure. To purify it, it must be divided into small fragments, and washed whilst still moist with alcohol or ether, which deprives it of colour; it is then treated with two hundred times its weight of boiling alcohol, in that the inorganic matter, which has hitherto accompanied it, is scarcely soluble. The greater part of the cetrarin is gradually precipitated on the cooling of the alcoholic solution. The portion which still remains in solution, may be separated by the evapora- tion of the alcohol. Pure cetrarin is at times in the state of a white powder, resem- bling magnesia; at others in small globules united in the form of arborisations, which do not present—even under the microscope —any crystalline texture. When gently compressed, it has a slight silky splendour. It is light, unalterable in the air, inodorous, and has a very intense bitter taste, especially in the alcoholic so- lution. Its best solvent is absolute alcohol, one hundred parts dis- solving 1.70 of it at the boiling temperature, but only 0.28 at 14° centig. (58° Fahr.) Alcohol, at 0.830 dissolves 0.44 when boiling, 0.28 at 25° cent. (77° Fahr.) and only 0.04 at 14° cent. (58° Fahr.) It is still less soluble in boiling and in cold water, the essential oils, creasote, &c. It is somewhat more soluble in ether, but insoluble in the fixed oils.* EFFECTS ON THE ECONOMY IN DISEASE. Miiller, a physician of Kaiserslautern,f details two cases in which he has administered the cetrarin. One of these was a quartan, the other a tertian intermittent. The effects appeared * Journal de Pharmacie, xxiii, 505, Paris, 1837, and Bulletin G£n£ral de Th£rapeutique, No. 18, Sep. 30,1837. t H. Bruck, in Bulletin G£n£ral de Th^rapeutique, No. 17, Sep. 15,1837. 128 CHIMAPHILA. to be exerted more slowly than those of quinine, but it seemed to him not to affect the stomach as much.[?] Its price must be considerably less, as M Herberger succeeded in obtaining from a pound of lichen 135 grains of very pure cetrarin. It has not been given, so far as we know, in this country. METHOD OF ADMINISTERING. Muller gave it in the form of powder according to the follow- ing prescription:— R. Cetrarin. Gummi arabic. aa. gr. ij. Sacchar. alb. 9ss. M. et fiat pulvis. Dose.—One of these every two hours during the apyrexia. H. Bruck,* suggests, that if dissolved in spirit of wine, its action may be incomparably more potent, and that it may more speedily arrest the paroxysms of an intermittent than when given in powder. CHIMAPHILA (FOLIA.) Synonymes. Chimaphilse vel Chimophilse Umbellatse Folia; Pyrolse Urn- bellaUe Folia, Winter Green, Pipsissewa. French.—Herbe a pisser, Pyrole en Ombelle. German.—Die Blatter des holdenbliihtigen Wintergruns. This plant is not new to us; but numerous trials have been made with it recently in Europe. It is admitted into the Pharma- copoeia of the United States, is a beautiful evergreen, and is indi- genous in the northern parts of Europe, Asia, and America. It belongs to the natural family of heaths, Ericese; and in the Lin- naean System, to Decandria Monogynia. A good description of it is given by Barton.f * Op. cit. t Medical Botany, i, 17; see, also, Art. Chimaphila, in Wood & Bache'a Dispensatory, 4th edit. p. 197. Phila. 1839. CHIMAPHILA. 129 The leaves have a bitter sweetish taste, with some degree of astringency. The taste of the stems and roots is, in addition, con- siderably pungent. Boiling water and alcohol extract the virtues of the plant. The constituents, so far as ascertained, are bitter extractive, tannin, resin, gum, lignin and saline matters. EFFECTS ON THE ECONOMY IN DISEASE. The leaves of the Chimaphila were long used by the Indians of this continent, and from them the American physician wasinduced to employ them. The first regular treatise respecting the plant is said to have been a thesis of Dr. Mitchell, published in the year 1803.* In Canada it is said to have been long used in diseases of the urinary passages, especially in calculous dropsy, and in chronic gout and rheumatism; its effects appearing to resemble—but not to exceed—those of the uva ursi. Somervillef and Barton extol it as an excellent diuretic in different forms of dysuria, and in dropsies, especially such as succeed to acute diseases; in nephral- gia as a palliative, especially when the paroxysms are occasioned by gravel which has accumulated in the kidney; and even in cesical calculus. During its use the appetite improved, and the digestive powers augmented; the patients often experiencing— immediately after it was taken—an agreeable sensation in the stomach, and in the region of the kidneys. RadiusJ found it especially serviceable in dropsy,gout and rheu- matism; and in inordinate activity of the secretory function of the mucous membranes—chronic catarrh, phthisispituitosa, &c. Ac- cording to him, it is contraindicated where there is much fever, disposition to diarrhoea, gastricism, and great debility of the sto- mach. Heyfelder affirms, that the chimaphila appears to be ad- vantageous in the debility of the digestive organs attendant upon dropsy, but its diuretic effect is not considerable or enduring, so that it requires to be associated with other more powerful agents. Experiments, which have been made recently in the Biirgerhos- pital at Pesth, and which have been collected by St. Rochus and published by Windisch, the director of the hospital, are extremely favourable to the chimaphila. Within two years, nearly two hun- dred dropsical cases are said to have been radically cured by it. Windisch recommends it most strongly to the attention of his col- leagues; he asserts it to be one of the best diuretics we possess; that it does not impair digestion; moderately accelerates the circu- lation; gently encourages the action of the bowels, and powerfully * Barton's Collection, ii, 2. f Medico-chirurgical Transactions, v, 340. X Auserlesene Heilfbrmeln zum Gebrauche far praktische Aerzte und Wun- darztc, u. s. w. Leipz. ISoG. 12 130 CHIMAPHILA. augments the urinary secretion; that the patients willingly take it, and that it induces no nausea. It was administered with advan- tage in dropsies unaccompanied by fever, and not dependent upon organic mischief, upon " corruption of the humours or paralysis of "the lymphatic textures." In febrile conditions and inflamma- tory diatheses, it is said to have been always injurious, as well as when it was administered prior to the resolution of obstructions remaining after long protracted intermittents; but when these are removed, and no excitement exists, more, according to Windisch, is to be expected from it than from any other agent, and he strongly advises, that careful trials should be made with it in the proper cases. He advises, also, that its use should be persevered in, in order that, good effects may be derived from it. We have frequently administered the chimaphila in public and private practice, and have found it serviceable, where a tonico- diuretic was indicated. MODE OF ADMINISTERING. The chimaphila is given either in infusion, or, what is prefera- ble, in decoction; the dose in the day being from half an ounce to an ounce. Where it does not act sufficiently on the bowels, Radius advises, that a few senna leaves should be added. In af- fections of the chest, he found the addition of the sweet spirit of nitre advantageous. Generally, however he gave the chimaphila alone. Windisch found a combination of it with tartar emetic, liver of sulphur, sal ammoniac, squill, and, in very great weak- ness, cinchona and preparations of iron, serviceable. Radius often administered also the aqueous or spirituous extract. Decoctum Chimaphila. Decoction of Chimaphila. R. Chimaphil. umbellat. ta. Macera per horas xij. in aquae font, ffjij. (fijiss Ph. Lond.) Coque ad colatur. fj^j. To be used daily in dropsy. Somerville. Dr. Joy* adds to this two drams of the Liquor Potassae car- bonatis, and directs four table-spoonfuls of the mixture to be taken three times a day. He recommends it " in dropsy and chronic affections of the urinary organs," as if all these affections were identical pathological conditions! * Twecdie's Library of Medicine, v. 312. London, 1840. chlorinum. 131 R. Chimaphil. umbellat. ^ss ad ^j. Coque cum aquae font, ^xij, ad reman. |vj. Coctione finita. adde Spiritus frumenti. (gin, malt spirit or whisky) gij. Digere frigide per horas vj, et cola. Dose—Two spoonfuls to be taken four times a day in dropsy and gout. Radius. R. Chimaphil. umbellat. 5vj- Coque cum aq. font, ^xij ad reman, ^vj. Sub finem coctionis adde Fol. sennae 3ij» et cola. Dose—A spoonful to be taken every two hours. Radius. CHLORINUM. Synonymes. Chlorinium, Chlorum, Chlorine, Murigene, Acidum Muriati- cum Oxygenatum, Acidum Marinum Dephlogisticatum, Spiritus Salis Marini Dephlogisticatus. French.—Chlore. German.—Chlor, Chlorgas. Uncombined chlorine is employed medicinally not only in the gaseous but liquid state. Of each of these we shall treat in suc- cession. The forms for evolving it in the gaseous state, as well as the gaseous chlorine itself, have had various names assigned them ex- pressive of their chemical or medical properties. They have been termed, respectively, Acidum muriaticum oxygenatum ad con- tagia; Fumigatio muriatico-oxygenata; Pulvis ad fumigationes muriaticus; Species pro vaporibus superoxydi muriatici; Suf fitus oxymuriaticus; S. chlorini; Alexiterium Chloricum, Fumi- gation de Chlor, F. de Guyton, F. Guytonienne, F. Hygieni- que, &c. mode of preparing. Chlorine is obtained from muriatic or hydrochloric acid. For this purpose, one part of well pulverised peroxide of manganese with five or six parts of concentrated muriatic acid is put into a retort, to which heat is applied and the gas received over water. 132 CHLORINUM. Or, it may be obtained from a mixture of one part of manganese, four parts of kitchen salt, two parts of concentrated sulphuric acid, and four parts of water. Chlorine is a greenish yellow gas; of a peculiar, strong, disa- greeable, stifling odour. The flame of a lighted taper introduced into it becomes at first pale, afterwards red, and is ultimately ex- tinguished. It remains unchanged in the highest temperatures. It has a great affinity for hydrogen, so that it abstracts this gas from every substance that contains it, and forms with it muriatic acid. Hence it decomposes all the gases that contain hydrogen, and all organic colouring matters, as well as—it is conceived by many—miasmata and contagious matters. EFFECTS ON THE ECONOMY. Chlorine, when diluted, and received into the lungs, occasions coughing, and symptoms of suffocation, to which a protracted catarrh often succeeds; not unfrequently, too, we observe in those, who are compelled to be exposed to the gas, bronchitis, and pneumonia. Animals soon die when they are immersed in it.* In Mr. Broughton's experiments, mice exposed to it fell dead in less than' thirty seconds. On opening them, the heart was found palpitating; the peristaltic motion of the intestinal canal continued, and could be- kept up by irritating it with a probe. The vessels of the brain were collapsed. The lungs were tinged with the yellow colour of the gas, and the peculiar odour of chlo- rine was perceptible throughout their structure. Coagulation of the blood took place as under ordinary circumstances. A rabbit, two or three weeks old, was immersed in chlorine, and died in less than half a minute. On opening the thorax, the heart was found acting freely, and on puncturing the aorta, the blood jetted out forcibly to a considerable distance. The peristaltic motion of the bowels was also going on. The vessels of the brain were in a collapsed state. The lungs were very much distended, tinged yellow, and when removed from the chest to a distance, emitted the odour of chlorine. The right ventricle of the heart was distended with dark blood. The eyes were much glazed in each experiment. " It has been generally thought," adds Mr. Broughton, " that chlorine is incapable of passing the epiglottis " (the glottis,) " but from the above observations it is evident that this gas enters the bronchial tubes in the act of inspiration. A portion of it probably circulates through the brain, suspending the * See Christison on Poisons, 3d edit. p. 736. Edinb. 1836. CHLORINUM. 133 cerebral functions without directly destroying the action of the involuntary organs,—contractility remaining long after the de- struction of animal life, as is evinced by the activity of the heart and of the intestinal canal."* These very facts, however, seem to show, that but little of the gas enters the lungs; probably no more than what passes imme- diately preceding the closure of the glottis by the forcible con- traction of the arytenoidei muscles. When inhaled in a dilute state, it is absorbed, and, according to Mr. Wallace, the urine acquires bleaching properties. It would appear, also, that, in manufactories, the chief consequences, resulting from exposure to an atmosphere of chlorine, are acidity and other stomach com- plaints, which the men generally remove by taking chalk :f this fact is confirmatory of the view, that acidity of the stomach is usually, if not always, dependent upon excess in the secretion of the gastric acids, the most important of which is the hydrochloric. Where chlorine is inhaled, it is reasonable to suppose that more of the hydrochloric acid may be secreted in the stomach. METHOD OF EMPLOYING. 1. By inhalation.—In the way of inhalation, chlorine gas is never administered in a state of purity, but always diluted with atmospheric air; often, too, it is united with watery vapour. Gannal affirms that the workmen in a bleaching establishment; who suffered under diseases of the chest, were visibly improved, and ascribed the amelioration to the inhalation of air containing chlorine. Pie, therefore, instituted various experiments on con- sumptive individuals, from which good results, he conceived, fol- lowed. Sir James MurrayJ also mentions that a friend of his had observed similar effects among his workmen exposed to the inhalation of watery vapour strongly impregnated with chlorine. The experiments, however, which were instituted at La Charite, in Paris, on this mode of treating phthisis, were by no means en- couraging; and the same may be said of those at the Hotel Dieu of that citv, instituted by Rullier.§ In many cases, indeed, the disease appeared to be aggravated. Bayle likewise thought the inhalation of chlorine generally un- * Journal of the Royal Institution, from Jan. to Juno, 1830. f Percira, Elements of Materia Medica, pt. i. p. 107. Lond. 1839. X A Dissertation on the Influence of Heat, &c, Lond. 1829; cited in the Dublin Journal of Medical Science, for March 1839, p. 96. \ See, also, Pereira, Op. cit. pt. i. p. 108. Lond. 1839. 12* 134 CHLORINUM. favourable, although he asserts that he cured a case of tubercular phthisis thereby. Recently, it has been again recommended by Cottereau. Professor Albers,* of Bonn, who administered it repeatedly, and carefully watched its effects, conceives that it acts as a stim- ulant when applied to the membrane, but that, when it gets into the blood, its effects are antiphlogistic; and he is of opinion that, when there is no haemoptysis, or violent local irritation present, chlorine inhalations may be used in diseases of the lungs and air passages. Its stimulant effect gradually diminishes, and, after a time, the mucous surfaces of the lung become less sensible to its exciting influence. In tubercles of the lung, in chronic catarrh, in chronic inflammation and ulceration of the bronchial mucous membrane, and in dilatation of the bronchi, he found it of no ser- vice, and, in most cases, it could not be borne, in consequence of the irritation it induced; but its operation was very salutary in pure ulceration of the lungs or vomica. It had always, however, to be administered cautiously and experimentally. Dr. Stokes always found chlorine inhalations prejudicial in phthisis, producing, in every case, increase of bronchial irritation, dyspepsia, and arrest of the pulmonary secretion. In his trials of the remedy in gangrene of the lungs,-\ he found it decidedly bene- ficial, correcting the foetor of the breath and expectoration, and, therefore, calculated to obviate not only the local but the consti- tutional symptoms. Sir James Clark J is of opinion that the inhalation of chlorine has only produced relief in persons whose lungs have been dis- eased to a very limited extent. Dr. Pancoast informs the author, that a case of aphonia, occurring in a young lady, in which there was but little volun- tary power over the diaphragm, was cured by the inhalation of chlorine, after the galvanic plates and the electro-magnetic appa- ratus had been used in vain. The chlorine may be inhaled from a common dish or inhaling apparatus, by dropping any of the acids on a mixture of chloride of lime, so that the acid may be disengaged slowly, but the best method of inhaling it, as well as iodine, is that recently recom- mended by Dr. Corrigan.§ He properly remarks that,' in order that inhalation may have a fair trial, it is requisite, first, That the apparatus should be simple in its construction, and'easily kept in order. Secondly, That it should be capable of keeping up a * Hannoversche Annalen, 1S33, and Br. and For. Rev. fur July, 1837, p. f Dublin Hospital Reports, vol. v. X Treatise on Tubercular Phthisis, p. 84, Lond. 1834: also, Amer. edit. Philad. 1835. § Dublin Journal of Medical Science, March, 1839, p. 94. 4 CHLOR1NUM. 135 supply of vapor for any length of time, and that the evolution of the vapour should be steady and easily regulated. Thirdly, That it should also furnish a sufficient supply of aqueous vapour to prevent any irritation of the larynx, or lining membrane of the air tubes; and, fourthly, and most important of all, that its em- ployment should entail neither trouble nor fatigue on the invalid. To fulfil these objects, Dr. Corrigan advises the apparatus represented in the figure beneath. It consists of a light open iron-wire frame, about eighteen inches high, at the bottom of which is a spirit lamp, A: at the proper height above it is an evaporating porcelain dish, about six inches in diameter, B: above this is a glass globe, C, with its neck downwards. In the neck of the globe is a cork, D, bored, and through the opening is drawn, moderately tight, a short plug of cotton wick, such as is used in a spirit lamp: in the glass globe at E, opposite the neck, is drilled a pin-hole, to allow air to pass in, according as the fluid within drops out through the neck. To use it, the porcelain dish is filled with hot water, the spirit lamp is lighted, and as soon as the water in the dish has begun to boil, the glass globe containing the chlorine, (if this be the substance used,) is placed as shown in the illustration below. The rate, at which the fluid in the globe shall percolate the cotton wick and drop into the hot water beneath, is easily regulated. If it does not drop with sufficient rapidity, one or two of the threads of the cotton may be removed. If it drops too rapidly, this is corrected by pressing in the cork more tightly, or introducing one or two addi- tional threads of wick. 136 CHLORINUM. In employing the chlorine, eight ounces of saturated solution of chloride of lime may be poured into the glass globe; and into the water of the porcelain dish, two ounces of the dilute sulphuric acid of the pharmacopoeia. As the solution of the chloride drops, the acid seizes on the lime, and the chlorine is evolved in con- nexion with aqueous vapour.* Chlorine is but little used in this form, and can only be adapted for cases in which the pathological condition of tbe bronchial mucous membrane, or neighbouring parts, requires the exhibition of an excitant.f In this way, it may be occasionally serviceable in chronic bronchitis; but its administration requires great cau- tion.;}; In cases of poisoning by the hydrocyanic acid, as well as by sulphuretted hydrogen, chlorine is a most efficacious agent. The chloride of lime may be used for this purpose. 2. By Fumigation.—Fumigations of chlorine have been parti- cularly recommended by Wallace, of Dublin.§ They appear to resemble, in their action, the nitrous and nitro-muriatic acid baths,|| and have been especially employed in liver diseases, unaccom- panied by inflammation, but in which there is a disturbance of the biliary secretion. According to Wallace, fumigations of chlorine are more certain than ablutions and baths of nitro-muriatic acid, and they have the advantage, that their application subjects the patient to less inconvenience. The good effects of chlorine, in such cases, have likewise been tested by Zeise,*^| in his bathing establishment at Altona. When the chlorine is, in this way, brought into contact with the skin, it soon occasions a pricking sensation; increase of transpiration; great afflux of fluids to the surface of the body, and sometimes a pustular eruption; increased secretion of saliva, urine, and bile; slight inflammation of the mouth and fauces, and impeded respiration and circulation. Wallace found chlorine fumigations serviceable not only in hepatic diseases with disordered secretion of the liver, but in several * Lond. Med. Gazette, April 6, 1839, p. 49. f Toulmouche, in Revue Medicale, Avril, 1834. See, on the various modes of inhalation, Sir C. Scudamore, in Lond. Med. Gaz. Feb. 7, 1840, and Dun- glison's Amer. Med. Intel. April 15, 1840, p. 25. X Archives Generates, Avril, 1834; and a communication on the ex- cellent effects of chlorine vapour in catarrh, in Gazette Medicale de Paris, June, 1838. \ Researches respecting the Medical Powers of Chlorine, &c. Lond. 1822. || See, on the Nitro-Muriatic Mixture, as a remedial agent, Dr. J. P. Met- tauer, Amer. Journ. Med. Sciences, Feb. 1840, p. 291. Dr. Mettauer is dis- posed to refer the action of the compound, in every case, to the presence of chlorine, and to believe with Dr. Scott, of India, who first introduced the nitro-muriatic acid to notice, about twenty-three years ago (1817,) that a solu- tion of chlorine in water will answer, in all cases, as well as the acid. IF Nye Hygea udgived af C. Otto, 1825, and Hufeland und Osann's Journ. der prakt. Heilkund. B. lxiii. St. 1. CHLORINUM. 137 other morbid conditions, as hypochondriasis, cachexia, and in all affections in which a prolonged excitation of the skin, and a resto- ration of its suppressed or impaired functions could be esteemed serviceable,—hence, in old cases of syphilis, scrofula, chronic ca- tarrh, and rheumatism: generally, cathartics were combined with the fumigations, and the evacuations were constantly observed to present a highly bilious character. In chronic cutaneous affections, as in lepra, psoriasis, and sca- bies, these fumigations have been found useful; but, generally, fu- migations of sulphurous acid are employed by preference, in con- sequence of the greater facility with which they can be prepared.* Injections of chlorine gas have been employed for the radical cure of hydrocele by M. Deblois, of Tournay, and M. Deconde.-j- The chlorine gas is contained in a bladder, to which is attached a pipe and stopcock adapted to the canula of the trocar, into which it is fixed after the fluid is evacuated: the stopcock is then turned, and the bladder pressed so as to force the gas into the tunica vagi- nalis. When this is distended, the pipe and bladder are removed, and the thumb is placed over the mouth of the trocar, so as to prevent the issue of the gas for the space of two minutes; it is then ajlowed to escape, and two or three repetitions of the injection are made, which are sufficient for the cure. It would appear, that risk must be incurred from the injection of such an acrid substance, but M. Deconde says not. Fumigations of chlorine, with the view of destroying the mat- ter of contagion, and of preventing the spread of contagious dis- eases, have long been used. J As long ago as the year 1773, they were proposed by Guyton de Morveau, and hence they have been called the " Guytonian, or the " Guyton Morveau fumigations." They are the best agents for the purpose that we possess. In fumigating the extensive general penitentiary at Milbank, Westminster, Dr. Faraday adopted the following method. One part of common salt was intimately mixed with one part of the black oxide of manganese; the mixture was placed in a shallow earthen pan, and two parts of oil of vitriol, previously diluted with two parts by measure of water, were poured upon it,—the whole being stirred with a stick. Chlorine was liberated for four days. The quantities of the ingredients employed were 700 pounds of common salt, the same quantity of the oxide of manganese, and 1400 pounds of sulphuric acid.§ When chlorine is evolved in the manner described, it is liable, * Green on Diseases of the skin. Dunglison's American Library edit., Philad. 1838. f Bulletin Medical Belsre, Janvier. 1836. X Link, Art. Chlor, in Encyclopad. WOrterb. der medicin. Wissenschaft B. vii. S. 575. Berlin, 1831. § Pereira, Op. cit. p. 107. 138 CHLORINI AQUA. like all the acid gases, to the objection, that it is extremely irritating when respired. It cannot, therefore, be used in the sleeping apart- ments of the sick, although it maybe employed beneficially after they have been withdrawn, and the object is to disinfect the cham- ber. It ruins all polished surfaces, but this can be effectually ob- viated by painting them over with a compost of starch. The chlorides are not liable to the same amount of objection, as they exhale the chlorine slowly.* CHLORINI AQUA. Synonymes. Aqua Chlorinii, Liquor Chlori, Aqua Chlori, Aqua Oxymu- riatica, Liquor Acidi Muriatici Oxygenati, Aqua Oxygenata Muriatica, Aqua Oxygeno-Muriatica, Liquor Alexitereus Oxygenatus, Solutio Alexi- teria Oxygenata, Solution of Chlorine, Liquid Oxymuriatic Acid. French.—Chlore Liquide, Eau de Chlore. German.—Chlorwasser. This preparation is contained in many of the pharmacopoeias. It is in those of Austria and Anvers; and in the Batavian, Bava- rian, Belgian, Danish, Dublin, Parisian, Finnish, Hannoverian, Polish, Prussian, and Swedish.f It has been more extensively administered on the continent of Europe than in this country, or in Great Britain. METHOD OF PREPARING. The Prussian Pharmacopoeia directs chlorine gas, made after the manner before described, to be passed into the bottles of a Woulfe's apparatus filled with distilled water, until two-thirds of the water are displaced; the bottles are corked under water, and the water is agitated until it takes up the gas. The liquid is then drawn off into small bottles, which are well filled, and kept in a dark place. In this way, liquid chlorine may be kept for a long time undecomposed. In its preparation, some little muriatic acid is formed, so that it has at times to be purified by treating it with a solution of nitrate of silver. EFFECTS ON THE ECONOMY IN HEALTH. From experiments made by OrfilaJ on dogs, it appears that * See the author's General Therapeutics, p. 509. Philad. 1836. f Pharmacop£e Universelle, i. 405. Paris, 1828. X Toxicologic Gen6rale, i. 141. CHLORINI AQUA. 139 considerable doses of a moderately concentrated solution of chlo- rine prove fatal, by exciting sooner or later inflammation of the stomach, accompanied with great languor; and when death takes place very rapidly, signs of organic alteration are met with in the stomach. In its action on the economy, chlorine is closely allied to the acids, and especially to the muriatic. Introduced into the stomach in moderate doses, the solution of chlorine excites an agreeable feeling of warmth, which soon spreads over the whole of the body: in strong doses, according to L. W. Sachs, a kind of intoxicating stupor is induced by it, soon succeeded by prostra- tion. It has been conceived to act equably as a moderate excitant on the nervous system, and thereby to moderate inordinate action in any part, and is, to a certain extent, antiphlogistic, without pos- sessing any of the debilitating qualities of the antiphlogistics pro- per. In the opinion of some of the German pathologists, it exerts a powerful stimulation on the organic actions, especially on the lymphatic and glandular systems, moderating inordinate secre- tion. Its antiseptic properties are likewise considerable. It would appear, however, that the number of observations has not been sufficiently great—although they have been by no means few— to allow of any comprehensive appreciation of its exact modus operandi on the human organism.* EFFECTS ON THE ECONOMY IN DISEASE. Although the solution of chlorine is properly no new remedy, it is only of late years that it has been frequently administered. At the present day,'in some countries, it is in common use. It is not long since Meurer maintained, that it is impossible to administer chlorine internally, and. that in every case in which it was believed to have been given, the article really taken was the hydrochloric or muriatic acid; for, owing to the affinity of chlo- rine for hvdrogen, whenever any union takes place between it and organic matters, the chlorine, he affirmed, disappears, and muriatic acid alone exists, as he had proved by repeated experi- ments. In this assertion, however, he was opposed by many observers. Herzog and Barmann came forward with experi- ments to show that Meurer had gone too far in his deductions; and from all the experiments, it would appear, that in prescribing the aqua chlorini many mistakes had been, and—we may add— still are committed. From Barwald's experiments it would ap- pear, that if water which has rested on aromatic or other vege- table substances be chosen for the dilution of the aqua chlorini instead of distilled water, a difference is produced in the rapidity * Riecke, Die neuern Arzneimittel, u. s. w. S. 30. Stuttgart, 1837. 140 CHLORINI AQUA. of the decomposition. In a mixture of aqua chlorini, distilled water, and simple syrup, the decomposition takes place tardily; but if, in place of the syrup, a mucilaginous juice be substituted —for example, the syrupus althseae—acids are speedily formed; as well as when a decoction of althasa is substituted for distilled water; whereas a mixture of the decoction of salep, (gr. v to water ^j,) syrup, and the aqua chlorini in well stopped bottles remained undecomposed above twenty-four hours. In these experiments, however, the persistence of the smell and taste of the chlorine exhibited, that the whole of the chlorine had not been converted into muriatic acid. In the same manner as in the case of the decoction of marshmallows, the addition of the infusum sennae and infusum Valerianae, as well as of the solutions of ex- tracts, and especially of liquorice, destroyed the smell of the aqua chlorini instantaneously, even when the taste of chlorine could still be detected. When the solution was combined with reme- dial agents, that contained much colouring matter, the decomposi- tion took place with great rapidity. From the results of these experiments, Barwald advises the aqua chlorini to be given in admixture with distilled water and simple syrup, as in this way only can we be sure, that the patient has taken the chlorine undecomposed. Herzog' lays it down as a rule, that the solution of chlorine should only be mixed with colourless transparent sub- stances—water, simple syrup, gum arabic or the decoction of salep. In respect to its administration in disease, we shall speak first of its internal use, which in several morbid conditions seems to have rendered good, and in some cases eminent, service. The following are the diseases in which it has been chiefly recom- mended. 1. Irritative fever, as in the violent irritative fever that occurs during the period of dentition; in which it has been administered with great success by Kopp, Mehlhausen, Goden, Trusen, and Riecke.* Dangerous determinations to the head have been, in this way, obviated, along with the unpleasant complications which are apt to_ be occasioned thereby. Toelf exhibited it in convul- sions, during dentition, which were accompanied by too great activity of vessels, and he affirms, that he has prescribed no remedy, which, in all respects, answered so wrell. 2. Nervous fever, especially when tending to the putrid cha- racter. In the plague, according to Wagner, it is of no avail; but in putrid fever, according to Kopp, it is highly useful. Span- genberg observed good effects from it in an epidemic typhus with hepatic derangement. It is likewise extolled in typhus by Wolf, * Op. cit. S. 30. t Archiv. d. med Erfahrung, Marz und April, 1825. CHLORINI AQUA. 141 Braun, Hufeland, and others; and by Sacco in the fever called petechial,—itself a typhus. Of late, it has been much used in Germany in the typhus abdominalis, which corresponds to our typhoid fever, to oppose the origin and development of the intes- tinal ulcerations; but when the disease is farther advanced it has been found useless. It is especially recommended in this disease by Clemens, but he commonly premises the use of an emetic. Trusen considers the emetic unnecessary. He first applies leeches to the epigastrium, and then prescribes immediately the aqua oxymuriatica in considerable doses;—in lighter cases, a dram every two hours; and if the disorder of the head be already great, the tongue chapped (rissig,) and the peculiar expression of coun- tenance present, he gives two drams every two hours. Bartels is less satisfied with the action of chlorine in abdominal typhus. It raises, he says, the sinking powers very speedily, but often excites the sanguiferous system, and not unfrequently increases the abdominal symptoms so palpably, that the physician is com- pelled to have recourse to other agents. Riecke* thinks, how- ever, that it may be of essential service in this disease, which so frequently mocks, the best directed efforts of the practitioner ; and he suggests, that farther experiments are highly desirable, espe- cially as those instituted by Trusen and others are not free from objections, by reason of their having combined with the chlorine substances tbat quickly decompose it. 3. Carbunculus malignus (Milzbrandkarbunkel.)—In the va- riety of malignant anthrax caused by handling the skins of cat- tle, the internal and external use of chlorine has been found of essential service by Ettmuller, Herbst, Stumpf, and Hoffmann. 4. Scarlatina.—Pfeufer, Wendt, Kopp, and Trusen extol it highly in this disease, for which, on theoretical grounds, it would seem to be appropriate, by reason of the great turmoil in the san- guiferous system, as indicated by rapidity of pulse and inordinate secretion of heat, bearing but little direct ratio to the degree of vital energy. Braithwaite, who, it is asserted, was one of the earliest, if not the earliest, who advised chlorine in scarlatina, supposed that it acted as specifically as the bark in intermittent^ or mercury in syphilis; and Trusen asserts that it maybe advan- tageously used in cases where other remedies have been found ineffectual. It is especially recommended by Braun and Spiritus in malignant scarlatina. 5. In other febrile exanthemata, small-pox, measles, rubeola, &c, it has been prescribed with advantage. In putrid dysentery, (faulige Ruhr,) it is extolled by Nysten and Kopp; and in inter mittent, by Kopp and Kretschmar. Trusen recommends it in the irregular, and especially in the anticipating forms, where 13 * Op. cit. S. 33. 142 CHLORINI AQUA. there is danger of their becoming continued. Under its use he found the paroxysms became regular, with perfect apyrexia, so that the ordinary febrifuges could be advantageously given. In gastric fever, Trusen trusted to it solely for the removal of the disease: he found that it corrected the morbid secretions from the mucous membrane of the digestive tube. Other physicians have also derived equally favourable results from its administration in flint ni sG3,^*G« 6. In gastromalacia, it has been prescribed by Rhades, Blasius, and Winter, but as Riecke,* from whom this detail of the expe- rience of the German practitioners has been chiefly taken, pro- perly observes, farther observation is necessary before we can decide as to its efficacy in such cases. 7. In erysipelas, especially of children, it has been recom- mended by Kopp. . ' 8. In inflammation of the liver, favourable results were obtained from it in the Children's Hospital of St. Petersburg; and it exhi- bited, in these cases, the analogy to calomel in its action, which has been pointed out by many observers. 9. In hydrophobia, it has been used both internally and exter- nally as a preventive, especially by the Italian physicians Brera, Previtali,f Ghisaldoni, Agliati, Arrigoni, Narcisi, and Anelli, whose experience is in its favour. Wendelstadt and Ruppius have likewise published favourably regarding it. It is obvious, however, that much fallacy may arise as to the precise agency of reputed preventives. Every one, for example, who may be bitten by a mad dog is not attacked with hydrophobia; and, un- less great caution be used, any article may be regarded as a preventive. This is the main reason why we have so many preventives of hydrophobia and other diseases. 10. Again:—the solution of chlorine has been advised by Rup- pius and Mertzdorf in dropsy, especially such as supervenes on the acute exanthemata. 11. In the diathesis phfliisica, it has been recommended by Gdden, and has been affirmed to moderate the hectic in phthisis, and to make the remissions more marked. In these cases, it re- quires to be given in large doses, and to be exhibited for a con- siderable time. 12. In many cases of chronic cutaneous affections, with dimi- nished plastic energy, it has been used with success by Kopp. 13. Lastly: in noma or cancrum oris, and in faetor of the mouth, it has been recommended internally as well as topically; and, according to the experiments of Persoz, Nonat, and others, it renders eminent service in cases of poisoning by the hydrocyanic acid. * Op. cit. S. 34. t Pratiche Osservazioni sulP Idrofobia, &c. Milan, 1820. CHLORINI AQUA. 143 Externally, it is used either pure, diluted with water, or in com- bination with oil. Godier affirms that he cured strumous swell- ings of the glands by a cerate of chlorine. Eisenmann, Cullerier, and Blache recommend it at times pure, at others diluted, in the way of injection, in gonorrhoea and leucorrhaea. It is employed, also, in flabby, putrid, and offensive ulcers, in the carbunculus malignus, in chronic cutaneous affections, as tinea capitis, itch, (Deimann,) herpes, (Alibert,) cancrum oris, asthenic aphtha, &c. Lastly: ablution with a solution of chlorine, or of the chlorides, has been advised as a preventive of venereal infection. In can- cerous ulcers, it corrects the unpleasant odour, and excites a new action in the part; causing the secretion of a better pus: farther than this, we cannot expect much from it. Baths of chlorine are recommended by Wagner as an excellent means for preventing the plague. Schonlein advises that, in scarlatina, the whole sur- face of the body should be washed with a mixture of aqua chlorini and water, which he prefers to ablution with cold water. Finally:—the aqua chlorini is occasionally sprinkled in the sick chamber to purify the atmosphere during the prevalency of con- tagious or other diseases. MODE OF ADMINISTERING. As already remarked, whenever the aqua chlorini is prescribed, its facility of decomposition must be borne in mind. It is, for this reason, best to prescribe it with water only, or at most with the addition of simple syrup, for internal administration. For external use, water alone should be associated with it. As to the precise mode in which chlorine is affected by fatty substances, we have as yet no accurate knowledge; it may be calculated, however, that a part undergoes decomposition. Such combinations have, notwithstanding, been found very useful. The solution should never be prescribed in quantity larger than is necessary for twenty-four hours, as by frequently opening the vessel in which it is contained, decomposition readily ensues. The vessel should be put into a dark place, and be surrounded by- black paper. The average dose for an adult, in the twenty-four hours, may be fixed at an ounce, although much larger doses may be given without inconvenience. It is scarcely necessary to say that the precise dose must vary with the degree of concentration. Unguentum Oxygenatum ex tempore parandum. Ointment of Chlorine. R. Aquae cblorin. p. j. Adipis, p. viij. M. 144 CIMICIFUGA. Used in the itch. Pharmacopoeia of Austria. Linimentum Aqua Chlorini. Liniment of Chlorine. R. Aquae chlorin. 5J- Olei olivar. Jj. M. Externally^ in obstinate itch, tinea capitis, and herpes. Deimann. R. Cerae albae, 5y. Leni calor. liquef. adde 01. amygdal. q. s. Ot fiat linimentum cui refrig. adde Aq. chlorin. 3iss. M. Used externally in cases of ulcers. Ludwig. Gargarisma Aqua Chlorini. Gargle of Chlorine. R. Pulv. tragac. gr. xij. Aquas, 5iv, Aquae chlorin. Syrup, aa. rss. M. To be used as a gargle in ulceration and chronic inflammation of the mouth and fauces. Ratier.* CIMICIFUGA. Synonymes. Cimicifuga Racemosa, C. Serpentaria, Acteea Racemosa, Ma- crotrys Racemosa, Black Snakeroot, Cohosh, Bugbane, Cohort. French.—Act.£e, Herbe Saint Christophe. German.—Traubenformiges Christophskraut. This plant is a native of the United States, growing in shady and rocky woods from Canada to Florida. Sexual System — Polyandria Di-Pentagynia; natural order, Ranunculacege. The root is the part used in medicine. It yields its virtues to boiling Formulaire pratique des h6pitaux civils de Paris, 3me edition. Paris, CIMICIFUGA. 145 water, and was found by Mr. Tilghman, of Philadelphia, to con- tain gum, starch, sugar, resin, wax, fatty matter, tannin, and gal- lic acid, a black colouring matter, a green colouring matter, lignin, and salts of potossa, lime, magnesia, and iron.* EFFECTS ON THE ECONOMY IN DISEASE. The Cimicifuga belongs to the class of Acro-narcotics. Until recently, it is said to have been employed chiefly in domestic prac- tice, as a remedy in rheumatism, dropsy, hysteria, and in various affections of the lungs, especially such as resemble consumption. It is noticed here, however, chiefly in consequence of the encomiums, that have been passed upon it, of late, as a remedy in chorea. Several cases of this disease, reported; by Dr. Jesse Young to have been cured, were published some years ago; and at the same time it was stated, that Dr. Physick had known it prove successful in several instances-! Dr. WoodJ also states, that he administered it in a case of chorea, which rapidly reco- vered under its use, after the failure of purgatives and metallic tonics. He also remarks, that he had derived the happiest effects from it in a case of convulsions, occurring periodically, and con- nected with uterine disorder. Very recently, Dr. T. S. Kirk- bride,§ of this city, has published some cases of success, obtained in the same disease, from its administration; after free purging had been employed. In one successful case, in a girl, nine years old, whose mental faculties were much disordered; and who had lost nearly all power over both her left extremities; there being at the same time,, irregularity of the bowels, headach, and pain frequently shooting down the left arm, cups were applied to the back of the head and neck once; stimulating pediluvia were pre- scribed, with friction, with salt, over the surface of the body, and she was moderately purged every day for a week before the- Cimicifuga was begun with. Dr. Kirkbride refers to a very in- tractable case that fell under the care of Dr. Otto, and which yielded ultimately to the Cimicifuga. He always purges before he has recourse to it, and general frictions with salt or the flesh brush, and pustulation with Croton oil over the spine, he believes to be of much value in the chronic cases. Dr. Beadle|| of New York treated a case successfully in a girl eighteen years of age. There was considerable gastric derange- ment, with suppression of the catamenia for nearly five months, * Journal of Philadelphia College of Pharmacy, vi. 20; and Dr. Wood, in Dispensatory of the United States, by Drs. Wood and Bache, Art. Cimicifuga. f American Journal of the Med. Sciences, ix. 310. \ Op. citat. \ American Journal of the Medical Sciences, February, 1840, p. 289. y New York Journal of Medicine and Surgery, July, 1840, p. 191. 13* 146 CIMICIFUGA. from pregnancy. She was put upon the use of the Cimicifuga, five grains of the powder being given every three hours, and no other remedy except an occasional dose of sulphate of magnesia. There was little improvement in her condition, during the day, for nearly a week, after which she improved rapidly and was well in three weeks. The medicine produced no sensible effect. Allusion has been made to the employment of the Cimicifuga in popular practice in cases of rheumatism. Like other narcotico- acrids, when pushed, so as to produce catharsis and even slight narcosis, it may unquestionably be of service in acute forms of the disease.* In some parts of the country, it has become a very popular remedy in coughs; and Dr. E. G. Wheelerf affirms, that he has found it useful in several cases of severe and protracted cough; and especially so in the chronic cough or bronchitis of old people. Dr. Wheeler states farther, that by some eminent physicians, it has been thought to be a good substitute for the secale cornutum in parturition, being dissimilar, however, in its mode of action,— relaxing the parts and thereby rendering labour short and easy. MODE OF ADMINISTERING. The dried root of the Cimicifuga may be given in powder. Dr. Kirkbride administered it in the dose of a tea-spoonful; and Dr. Wheeler in the dose of 3j from three to five times a day. It is most commonly, however, given in the form of the Decoctum Cimicifuga. Decoction of Black Snake Root. R. Rad. Cimicifugse contus. %']. Coque paulisper in Aqua? Oj. Dose—One or two fluid ounces—two to four table-spoonfuls— several times a day. Tinctura Cimicifuga. Tincture of Black Snake Root. R. Rad. Cimicifug. contus. 5iv. Alcohol (.835) Oj. * Drs. E. A. Anderson, and Alexander Vedder, in Dunglison's American Me- dical Intelligencer, Vol. 2, p. 296. Philadelphia, 1839. ^Ako, Boston Medical and Surgical Journal, Oct. 2, 1839, p. 126. f Boston Med. and Surg. Journal, Sept. 4,1839, p. 65. CINCHONINA. 147 Dose.—Twenty drops three or four times a day. An idea pre- vails that the stronger the alcohol the better is the preparation, but this may be questioned. CINCHONINA. Synonymes. Cinchonia, Cinchoninum, Cinchonin, Cinchonine. Although Duncan of Edinburgh, Reuss, of Moscow, and Gomez,* of Liston, had endeavoured to separate the active prin- ciple of the cinchonas, and had given the term cinchonine to a resinous extract obtained in their investigations; the honour of discovering both cinchonine and quinine and of applying them to practical purposes belongs to the French chemists—Pelletier and Caventou.f Cinchonine is commonly obtained from the gray or pale varie- ties of cinchona; the yellow furnishing the quinine, and the red both cinchonine and quinine. It is an alkaloid strikingly anala- gous to the quinine in its chemical and medical relations, but is not as much used. METHOD OF PREPARING. Cinchonine is obtained by boiling the bark in alcohol, until it loses all its bitterness; the' alcoholic solution is then evaporated to dryness in a water bath; the extract, thus obtained, is dissolved in boiling water, strongly acidulated with muriatic acid; an excess of calcined magnesia is added, which, after a few minutes' boil- ing, will fix all the red colouring matter, and render the liquid clear. When cold, the liquid is filtered, and the magnesian pre- cipitate washed with cold water; it is then dried in a stove; and all the bitterness separated by repeated digestions in boiling alco- hol ; the alcoholic liquors are mixed, and the cinchonine crystal- lises as the fluid cools. The cinchonine, thus obtained, still con- tains a green fatty matter, which may be separated by solution in a very weak acid. If the acid be too strong, it will dissolve a part of the fatty matter, and the intended object will be thus de- feated.J * Richter's Specielle Therapie, B. x. S. 325. Berlin, 1828, and Magendie's Formulaire. f Annalesde Chimie et de Physique, xv. 289 and 337. X Magendie, Formulaire, &c. " 148 CINCHONINA. Cinchonine may also be obtained by treating pulverised pale cinchona by weak sulphuric acid, precipitating the solution by means of lime in excess; collecting the precipitate on a filter, washing, and treating it, after drying, with boiling alcohol.* Cinchonine is white, translucent, crystallising in needles; re- quiring, for its solution, 700 parts of cold water, according to Magendie; according to others, 2500 parts of boiling water. On account of its very sparing solubility in water it has but a slightly bitter taste. In alcohol, it is readily soluble, and the solution is extremely bitter, as well as the salts formed by its union with acids, which resemble the salts of quinine. It does not dissolve readily in fixed or volatile oils, or in ether. At a certain tem- perature, it volatilises; -a great part, indeed, is destroyed by the operation, yet a sensible portion escapes the decomposing power of the caloric. In medicine, pure cinchonine, as well as the sulphate and ace- tate, is prescribed. The sulphate is soluble in 54 parts of water, and in 6.5 parts of alcohol, (s. g. 0.815;) it is not soluble in ether. It forms crystals and tastes bitter. The acetate, on the other hand, does not crystallise; and is less soluble in water than the sulphate; but an excess of acid facilitates the solution. EFFECTS ON THE ECONOMY. It is not necessary to say much on the application of cinchonine and its preparations to disease, as they have been almost wholly superseded by the quinine and its salts. It is a weaker article, and therefore requires to be given in larger doses; Magendie and Gittermann assert, that it has been found ineffective as a febrifuge. Baly,f Chomel,J Mariani,§ Wutzer,|| and others, however, have exhibited it successfully.! Dufresne** frequently prescribed it, and he assigns it this claim to preference, that it is almost tasteless, or at least that the bitter taste is but tardily developed; and that it needs not to be given in combination with acids, as the acid con- tained in the gastric secretions will render it soluble.+t He gave it in intermittents during the apyrexia in the quantity of from six * Pharmacopee Universelle, i. 414. Paris 1828 f Nouv. Biblioth. Medicale, ix. 189. X Nouv. Journ. de Mddecine, Mars, 1821. j Osservaz.sulla Pratica del Solfato de Cinconina, &c SeptR1827U.nd CaSPer'S Kdt" Rep6rt' B" XXi' and Bulletin des ^iences M^dic. l4ru,CiuCh0ninTT' ?" M^''at and De Lens> Dict- de Mat. MeU ** Bibliotheque Universelle, Mai, 1831, p. 89 * Ste«StalTl8G36,2p.im.U"eli"°de"e SC'e"2e Med'Che " a*** ^ CINCHONINA, ' 149 to twenty grains, and he found it, moreover, of marked use in the cases of gastralgia with formation of acid, which are so often met with in young females, and are not unfrequently associated with leucorrhoea, hypochondriasis, melancholy, &c. MODE OF ADMINISTERING The following formulae have been recommended, but, as was before remarked, they are rarely used, the preparations of qui- nine being now almost universally prescribed. Syrupus Cinchonina. Syrup of Cinchonine. R. Sulphat. cinchonin. gr. xlviii. Syrup, simpl. ftjj. Used in the same cases as the syrupus quininse; a tablespoon* ful for a dose. Magendie. Vinum Cinchonina. Wine of Cinchonine. R. Sulphat. cinchonin. gr. xviij. Vini Maderens. f^ip Tinctura Cinchonina. R. Sulphat. cinchoninse, gr. ix. Alcohol (34° or s. g. .847.) 5j. M. Magendie Ma Magendie recommends that this tincture should be used for preparing, extemporaneously, the wine of cinchonine, by adding two ounces of the tincture to a pint of Madeira wine. Boli Antifebriles.* Febrifuge Boluses. R. Sulphat. cinchonin. gr. iij. Micae panis, Mellis, Glycyrrhiz. aa. q. s. ut fiat bolus. Dose,—one of these to be repeated every two hours. Brera. * Ricettario Clinico di Brera. Padov. 1825. 150 CODEINA. Mistura Cinchonince. Mixture of Cinchonine. R. Sulphat. cinchonin. gr. vi ad xlviij. Potassae acetat. Sacchar. alb. aa. ?ss. Solve in Aquae chamaem. 5vj. Dose—A table-spoonful every two hours, in intermittents. Sundelin. CODEINA. Synonymes. Codeinum, Codeia, Codeine. German.—Kodein. Although opium had been repeatedly examined by the che- mists, and certain of its active constituents separated from it, it was not until within the last few years, that the article, whose name is at the head of this paragraph, had been obtained from it. It was discovered by Robiquet in 1832,* and as it has been exhibited as a therapeutical agent, it requires notice. METHOD OF PREPARING. According to Winkler,f this new alkaloid may be prepared in the following manner. The morphine is first thrown down from a solution of opium made in the cold by means of ammonia; the meconic acid is precipitated by the muriate of lime; for the removal of the colouring matter, the fluid is then treated with the extract or subacetate of lead; and the extract of lead, contained m the fluid poured off from the precipitates, is afterwards decom- posed by sulphuric acid; the fluid, separated from the sulphate of lead, is now treated with an excess of caustic alkali; the mixture is exposed to the air until the excess of free alkali has attracted carbonic acid from it; it is then agitated and digested with ether, and left to evaporate spontaneously, after which a yellowish, * Journal de Pharmacie, xix. 91 and 162. Paris, 1833. f Buchner's Report, xlv. p. 459, cited in Journal de Pharmacie, xxi. 251. Fans, 1835. CODEINA. 151 highly transparent, but not crystalline compound remains, which forms with muriatic acid a crystalline salt, and resembles exactly the codeine of Robiquet. Merck* procures the codeine in a very simple manner. He treats morphine precipitated by soda with cold alcohol; the spirit- uous tincture is carefully saturated with sulphuric acid; the alco- hol drawn off, and the residue treated with cold water as long as it is turbid; it is then filtered, and the filtered liquid evaporated until it has the consistence of syrup: on cooling, ether is poured over it in a large flask; caustic alkali is added in excess, and the whole strongly agitated, The ethereal mixture is then so satu- rated that the codeine crystallises from it in a few hours. By evaporating the ether, and treating the residue with alcohol, the codeine is obtained by degrees wholly pure, and separated from an oily matter, which is a great object to crystallisation. Codeine, according to Pelletier consists of 31 parts of carbon; 40 parts of hydrogen; 5 parts of oxygen, and 2 of azote. It is an alkaloid, soluble in water, alcohol and ether; but not so in alkaline solutions. It unites readily with acids, and, with the muriatic acid especially, forms a salt, which crystallises with great facility. When the crystals of codeine are heated on a plate of platina, they burn with a flame without leaving any residue. Heated in a tube, they melt at about 150° centigrade; and, if allowed to cool immediately, they form a crystilline mass; if, how- ever, the heat be continued, the oleaginous fluid rises along the sides of the tube, appearing to shun the heat; but it does not vola- tilise. When dissolved in water, codeine communicates to it deci- dedly alkaline properties. 1000 parts of water at 60° Fahrenheit, dissolve 12.6 parts of codeine; the same quantity at 100°, 37 parts, and at 212°, 58.8 parts. If more codeine be added to boiling water than can be taken up, the surplus melts, and forms, like the meco- nine, an oleaginous layer on the bottom of the vessel. This aqueous solution, by careful refrigeration, affords a translucent and uncom- monly well defined metal. The tincture of galls forms a copious precipitate with a solution or codeine, in which respect, the latter differs essentially from morphine, as it does in many other of its properties. EFFECTS ON THE ECONOMY. As morphine does not represent the whole of the activity of opium, Robiquet concluded, that other substances might concur thereto, and he conjectured that codeine might be one of those. * Journal de Pharmacie, cited in Amer. Journal of Pharmacy, new series, i. 171. Philad. 1835. 152 CODEINA. Under this idea, Kunkel* instituted experiments with it on rabbits and dogs, from which he obtained the following results. First. Codeine differs from morphine in this, that it does not, like the latter, paralyse the lower extremities. Secondly, Codeine appears to exert a powerfully excitant action. It occasions con- vulsions of the limbs, and of the muscles of the neck, and when it produces death, this seems to be owing to its action on the cere- bellum and medulla oblongata; twice he noticed symptoms of backward progression under its use, and those parts after death were found turgid with blood. To judge from the condition of the heart and lungs it affects likewise the circulatory organs. It occasions inflammation of the tissues, with which it comes into immediate contact. Its action is more energetic, when introduced into the cellular membrane, than into the stomach. It seems, also, to exhibit a special action on the urinary organs, for animals to which it is given never evacuate their bladder as long as they are under its influence. Thirdly. The action of codeine differs from that of the watery extract of opium, in not paralysing the hinder extremities; but it approximates it in this, that it acts, as has been said, more powerfully when introduced into the cellular membrane than into the stomach, and accelerates the respiration and circulation. Kunkel, however, remarks upon the results of his experiments, that they demand repeated trials for confirmation, as he was only able to experiment with a very small quantity of the substance. Robiquet observes that Kunkel's experiments have led to the in- ference, that when codeine is combined with acids, it loses much of its efficacy—the very opposite, by the way, to the inferences of Magendie. Barbierf has taken considerable pains to fix the value of code- ine as a remedial agent. He prescribed it in the dose of one or two grains in a syrup, prepared with the aqueous solution of the alkaloid, of such strength, that a table-spoonful or half an ounce contained one grain of codeine. In his opinion, it exerts a pecu- liar agency on the nerves of the ganglionic system, whilst it ap- pears to possess but little influence on the hemispheres of the brain, and to make no impression upon the spinal marrow. In the epi- gastric region, he remarks, the agency of codeine is powerfully manifested; and here in the centre of the ganglionic system, its effects may be investigated, and their extent and magnitude ap- preciated. If a spoonful, or, at an interval of from °one to two hours, two spoonfuls of the syrup of codeine be administered to one affected with the symptoms to be described immediately, * Journal de Chimie Medicale, ix. 223. t Gazette Medicale, Mars 8, 1834. CODEINA. 153 we shall find, that it exhibits a considerable and remarkable effect upon the economy. If the person complains of pain in the epigastric region, beneath the lower extremity of the sternum, and stretching to the sides and back; and if, with these symptoms, there is combined a feeling of heat, indescribable anxiety, marked debility, paleness, decided alteration of the features; a sense of painful traction sometimes on one side, at others in the other side of the epigastric region, with tendency to syncope, frequent sighing, despondency, and more or less sensibility to pressure in the epigastric region, &c, Barbier considers the seat of the dis- ease to be the epigastric nervous plexus; and in such cases, he says, he has found no remedy superior to the syrup of codeine. He has observed it afford decided relief where the coats of the stomach were manifestly in a state of degeneration. A common effect of the codeine is sleep; which is never accompanied by heaviness of the head, or by determination of blood to the brain. When the persons awake from the sleep produced by codeine, the countenance is bright and lively, and there is a tendency to laughter. Barbier was led to believe, that it does not affect the nervous cords connected with the vertebral portions of the cen- tre of the nervous system. In his observations at the hospital of Amiens, he often noticed the neuralgic affection of the abdomen above mentioned to be accompanied by pains in the head, loins, and limbs, and whilst the codeine relieved the abdominal unea- siness, it left the others untouched,—a singular circumstance if true, but requiring fresh observation before we can esteem it to be established. He remarks farther, that almost all the patients that were benefited by the codeine had used laudanum unsuccess- fully. Codeine, he adds, occasions no manifest change in the circulation and respiration; it does not disturb the digestive func- tion; seems merely to diminish the feeling of hunger, and occa- sions no constipation. During its use, itching of the surface is frequently experienced. When applied to the skin, it induces no striking phenomena. When applied, in the dose of two grains, to a surface abraded by a blister, it excites a painful sensation of burning, without any other change appearing to supervene; the neuralgic pains, for the removal of wbich it may have been thus employed, not appearing to be modified by* it. Mr. Gregory made experiments upon himself and some of his pupils with the nitrate of codeine. None of them experienced any effect from a dose of three grains and under; from four to six grains, however, occasioned striking symptoms—quickness of the pulse, sense of heat in the head and face, remarkable ex- citement, like that following the use of intoxicating liquors; agree- able, and apparently permanent, stimulation, accompanied by considerable itching, which began at the head and extended over the whole body. To this succeeded, in the course of a few hours, 14 154 CODEINA. a disagreeable sense of relaxation, with nausea, and often vomit- ing. None of the experimenters felt the slightest inclination to sleep, until after the supervention of the feeling of relaxation. Riecke* thinks, that these experiments confirm Kunkel's ob- servations, that the codeine loses its efficacy when combined with acids. In the year 1834, M. Martin Solon, at one of the sittings of the Academie Royale de Medecine, when the experiments of Barbier with codeine were the subject of discussion, confirmed his views regarding its soporific property. It appeared to him to allay the cough of the consumptive. He remarked, however, that he had not observed the effects on the ganglionic nervous system, which Barbier had witnessed. Magendief took a grain of codeine, dissolved it in a little water, and injected it into the jugular vein of a middle sized dog, which was immediately thrown into a profound sleep—readily broken, however, by any strong noise made in the vicinity of the animal; but the interruption was of brief duration,—sleep soon recurring. This condition persisted for several hours without being accom- panied by any unpleasant symptoms. The effect was not the same with the muriate of codeine; a single grain of this salt in- troduced in the same manner into the organism suddenly in- duced deep sleep, but after the animal had slept five or six hours, it died. Several similar experiments afforded a like result. Magendie administered the codeine in the Hotel Dieu to different patients. He found that one grain, given once or twice, suc- ceeded, in many cases, in inducing a quiet and soft sleep, to which no confusion succeeded the next day, as is commonly the case with morphine. As respects intensity of action, he com- pares one grain of codeine to half a grain of morphine. Two grains often excited nausea, and even vomiting. Magendie found the muriate to be decidedly stronger than the pure codeine. Two grains commonly induced, besides sleep, vertigo, nausea and even vomiting; but this dose succeeded like a charm, in cases of neuralgia faciei and in sciatica, which had resisted the most valued agents.J Dr. Miranda, of the Havana, has published^ the results of his experience with codeine in what he calls powerful nervous irrita- tions of the mucous membrane of the stomach, and he affirms, that he cured eleven cases by the syrup of codeine alone. He began with a dram of the syrup night and morning, and * Die neuern Arzneimittel, u. e. w. S. 140. Stuttgart, 1837. f Formulaire pour la preparation et l'emploi de plusieurs nouveaux rn^dica- mens. Edit. 9me. Paris, 1836. X Gully's Translation of the 8th edit, of Magendie's Formulaire. Lond. 1835. § Journal de Pharmacie, xxiv. 145. Paris, 1838. COLCHICUM AUTUMNALE. 155 gradually increased the quantity to an ounce in the twenty-four hours. His success was so striking that he is induced to " re- gard the discovery of codeine as fortunate for humanity, especially for climates like that of the Havana, in which gastrites are so multiplied." The syrup of codeine, syrupus codeina, is directed by M. Cap^ to be prepared in the following manner:— R. Codein. gr. xxiv. Aqua? destillat. ^iv. Sacchar. purificat. 3vnj- Reduce the codeine to an impalpable powder in a glass or porcelain mortar. Triturate with one-third of the water, allow it to settle and decant. Treat the residuum with another third of the water, and again with the remainder. Put the whole into a small mattrass, covering the opening with a piece of moistened parchment perforated with a pinhole. Heat in a water bath until the codeine has entirely disappeared. Remove the mattrass from the fire to add the sugar; cover the opening again; agitate, and put the vessel again in the bath, until the sugar is completely dis- solved. Each ounce of the syrup contains two grains of codeine. The muriate has been used in this city, but it has not been found to possess any virtues which the salts of morphine do not; whilst its price is enormous—as much, we are informed, as four dollars the dram. COLCHICUM AUTUMNALE. Synonymes.—Colchicum, Meadow Saffron. French.—Colchique, Tue-Chien, Mort aux Chiens, Safran des Pres, Safran Batard, Vieillotte. German.—Herbstzeitlose, Zeitlose, Wiesensafran, Herhstblume. The meadow saffron is a well-known plant in the temperate parts of Europe, where it grows wild in moist meadows. It be- longs to the family Colchicaceae; and, in the Linnean system, to the class Hexandria, order Trigynia. The plant is avoided by cattle; and its active poisonous properties have been long known; fatal cases, indeed, still occur every now and then from its em- * Ibid, xxiii. 418. Paris, 1837. 156 COLCHICUM AUTUMNALE. ployment, not only in animals, but in consequence of its too free use in the treatment of gout. Reynolds, the inventor of the wine of Colchicum, commonly called Reynolds's Specific, is said to have killed himself by an overdose of it. A case is given of a man who took, by mistake, an ounce and a half of the tincture, and died in forty-eight hours, after much suffering from vomiting, acute pain in the stomach, colic, purging, and delirium.* The cases pf two children are also on record, who were poisoned by a handful of the seeds, and who died in the course of the day, death being preceded by violent vomiting and purging. In the bodies of these children, considerable redness of the mucous coat of the stomach and small intestines was found; in other cases, no morbid appearance has been detected.f Recently, a fatal case has been published by Dr. Blumhardt, from the papers of Dr. Neubrandt. The patient, a man, aged thirty-two, took by mistake, a decoction made of a large table- spoonful of the seeds of Colchicum to three pints of water. He was soon afterwards attacked by vomiting, purging, and died two days afterwards under symptoms of narcosis and endo-enteritis. Another fatal case is referred to, in the same journal,J which was caused by the leaves of the Colchicum.§ Colchicum is not of modern introduction. It is, indeed, the Hermodactyl of the ancients. It had, however, almost wholly fallen into neglect, when its use was revived in Great Britain, in the first quarter of the present century, as an excellent agent in rheumatic and gouty affections. That it is highly esteemed as a therapeutical agent is shown by the number of officinal works into which it has been admitted. Amongst others, it is in the phar- macopoeias of Austria, the United States, Amsterdam, and Anvers, and in the Batavian, Belgic, Brunswick, Danish, Dublin, Spanish, Edinburgh, Paris, Ferrara, Geneva, Hamburg, Hannoverian, London, Lisbon, Russian, Saxon, Swedish, and Wirtemberg. Several chemists have investigated the composition of the plant. Pelletier and Caventou believed that they had found veratrine in it; but, from the examination of Geiger and Hesse, it appears that the alkaloid, discovered by those gentlemen, was not veratrine, but a peculiar principle, colchicine, which is found in every part of the plant; crystallises in slender needles, is inodorous, and of a very bitter, and afterwards biting taste. Introduced into the nose, it does not occasion sneezing like veratrine. It has but a feeble alkaline reaction; but neutralises acids completely, and forms * Edin. Med. and Surg. Journal, xiv. 262. f Christison on Poisons, 3d edit. p. 791. Edinb. 1836. X Medicinisches Correspondenzblatt, 1840, and Encyclographie des Sciences Medicales, Mai, 1840, p. 492. § See a case of overdose of Colchicum, by Mr. T. A. Henderson, in Lond. Med. Gaz. Aug. 17, 1839, p. 763. COLCHICUM AUTUMNALE. 157 with them crystallisable salts, which have also a bitter pungent taste. It dissolves with tolerable facility in water. For therapeutical purposes, the root or bulb, (cormus,) as well as the flowers and seeds of the colchicum have been administered. The fresh root has a somewhat disagreeable smell, and a bitterish acrid taste. When chewed for any length of time, it excites the secretion of saliva and thirst; destroys the feeling of the tongue; causes a sense of burning in the mouth and lips ; constriction of the fauces, hiccup, violent pains in the abdomen, vomiting, diar- rhoea, and discharge of blood upwards and downwards. By drying, the bulbs lose somewhat of their efficacy. The seeds have of late come much into use. They are inodorous, but of a very acrid taste. Their agency is like that of the bulb, and —some think—they are more equable in their effects. To ensure this, however, they must be gathered wholly ripe, when they first become entirely black. They have been highly recommended by Dr. Williams and others. The flowers are the mildest part of the plant. They have like- wise been successfully administered by several English physicians. EFFECTS ON. THE ECONOMY IN HEALTH., In its effects, colchicum resembles digitalis in one. thing, that it renders the pulse less frequent,* according to Thomson and Wallis; but in other respects, Osann and Rieckef think it agrees more with the squill. In moderate- doses, the different parts of the plant that have been mentioned act as diaphoretics, diuretics, and car thartics. On the digestive organs, they are conceived to produce less debilitating effects than the squill. Sir Everard Home ascribes much of the griping and' nauseat- ing effect, that sometimes follows the use of the vinous and other tincture of colchicum, which have not been carefully filtered, to thersediment which forms in them, and which may be removed without injury to the desired effect of the medicine.J Several experiments were made with the colchicum on healthy individuals. In the first case, 160 drops of the vinous tincture of the seeds were taken in 24 hours by a young man, aged 18: the first dose being 50 drops, the last 60. Seven copious evacuations were produced, with loss of appetite and debility, for 24 hours. In the second case, a youth, 17 years old, took 170 drops in 9 hours, in doses of 70, 30, and 40 drops; nausea and vomiting, and six copious evacuations followed. Third case; a youth, aged 15, * Art. Colchicum, Encyc.Worterb. der med. Wissensch. viii. 136. Berlin, 1832. t Op. cit. S. 142. , t Brande's Dictionary of Mat. Med. p. 189. Lond. 1839. 14* 158 COLCHICUM AUTUMNALE. took 130 drops in 10 hours, and in four doses; the first of 40 drops, and the last three of 30: vomiting and only one stool were the result. Fourth case; a youth, aged 12, took 60 drops in two doses, after an interval of eight hours: nine copious watery eva- cuations were produced. Fifth case; a youth, aged 17, took 40 drops at bed-time, 30 drops next morning, and 30 drops seven hours after—in all, 100 drops in 19 hours: vomiting and faint- ness, and five copious evacuations were the result. The same boy afterwards took 70 drops at one dose, which were followed by vomiting and headach, but not by purging. Sixth case; a boy, aged 10, took 80 drops in 24J hours, in four doses, of 20, 15, 25, and 20 drops: great sickness and vomiting, and nine eva- cuations resulted. EFFECTS ON THE ECONOMY IN DISEASE. The diseases in which colchicum is recommended, are as fol- lows : In gouty and rheumatic cases, it has been supposed to be almost a specific. Numerous practitioners have testified to its valuable agency in such affections; among these may be named Mr. Want, Dr. Johnson, Dr. Williams, Mr. Battley, Dr. Armstrong, Sir Eve- rard Home, Sir C. Scudamore, Mr. Haden, Dr. Copland, Dr. Graves, Sir Henry Halford, Dr. Wallis, Dr. Barlow,* and Mr. Wigan,f in England; and Locher-Balber, Kahleis, Gumpert, Plasse, Weber, Klokow, Biermann, &c. in Germany .J Colchicum is presumed to be the active ingredient of the cele- brated gout remedy—the Eau medicinale d'Husson—which has been considered to be formed of two ounces of the colchicum root, macerated in eight ounces of Sherry wine; the dose being from twenty to eighty drops. In acute rheumatism, as well as in various inflammatory affec- tions, colchicum was proposed by the author's friend, Mr. Charles T. Haden,§ as an excellent sedative to reduce excited organic action, which he conceived it capable of effecting to such an ex- tent, that blood-letting might generally be rendered unnecessary * Art. Gout, in Cyclopaedia of Practical Medicine. f Lancet, and Med. Gaz. June 30, 1838. In rheumatic gout, Mr. Wigan gives it in the dose of eight grains every hour, until " active vomiting, pro- fuse purging, or abundant perspiration takes place, or at least until the sto- mach can bear no more." Thus administered, he pronounces it to be "the most easily managed, the most universally applicable, the safest, and the most certain specific (?) in the whole compass of our opulent Pharmaco- poeia. X Riecke, Op. cit., and Richter's Specielle Therapie, x. 180. Berlin 1828 \ Practical Observations on Colchicum Autumnale in Inflammatory Dis- eases. Lond. 1320. ' COLCHICUM AUTUMNALE. 159 in febrile and inflammatory disorders ;* yet, in the very cases in which it was esteemed so appropriate by Mr. Haden and by Car- minati,-j- it is regarded unadvisable by others. Thus, Riecke,J speaking of its use in acute rheumatism, says, that it was at one time given in that disease under the most opposite circumstances, buf that it was soon found necessary to restrict its employment within narrower limits, and to pretermit it when any considerable febrile condition existed. We have often exhibited the different preparations of colchi- cum in gout, and frequently with decided advantage; but very often it has failed altogether. In our own person, it has never appeared to prevent or to modify the paroxysm. In acute, and the same may be said of chronic rheumatism, its advantages have not been by any means clearly marked in our experience: many physicians, however, testify most strongly in its favour. Like other acronarcotics, as the cimicifuga, when pushed to the ex- tent of slightly affecting the system, as shown by nausea, with some cerebral confusion, it has at times effected a revulsion, which has broken in upon the morbid chain in cases of acute rheumatism. In chronic rheumatism it has exhibited less marked results: yet there is no agent, perhaps, which is so much em- ployed in rheumatic cases in general. In none of these cases, according to most observers, need any sensible evacuation be produced by it, although some, we have seen, have affirmed—and such is the result of our observation— that it is more efficient when it evinces its influence upon the skin or alimentary canal.§ The vinous tincture of the seeds has been extolled in the tetanus of warm climates, by Dr. W. G. Smith,|| of Port-au-Prince. He begins with 3ss and increases the dose every half hour, repeating it until emesis or catharsis has been produced. The remedy is then discontinued. In dropsy, colchicum was used of old with good results; and it has been employed in modern times. Carminati gives the de- tails of a case of dropsy supervening on scarlatina, and Plasse, one of hydrothorax, in which it was advantageously prescribed. In such cases, it may be well to push the remedy until it affects the bowels. In chronic bronchitis it has been given by many physicians, * See, also, Dr. Lewins, in Edinb. Med. and Surg-. Journal for April, 1837, and in Brit, and For. Medical Review, for Oct. 1837, p. 565. f Mernor. dell' Instituto del Regno Lombardo-Venet. 1819. \ Op. cit. S. 143. § See Wood and Bache's Dispensatory, Art. Colchicum; and Lewins, Op. citat. || Amer. Jour, of the Med. Sciences, for Nov. 1835, p. 66. 160 COLCHICUM AUTUMNALE. and especially by Drs. Armstrong* and Hastings,! with advan- tage. By RittonJ it has been advised as an extremely efficacious remedy in leucorrhaea, in the dose of five grains of* the powder three times a day; and in several spasmodic diseases it has been extolled by Raven. Mr. Tait§ speaks in exalted terms of it in scarlatina—the dose, to children from four to six years of age, being three or four drops of the vinum colchici every three or four hours. Mr. Fosbroke advises it in ischuria; Elliotson saw favourable effects from it in obstinate prurigo; Bullock gave it in erysipelas; and by Chisholm and Baumbach|| it was exhibited successfully against tapeicorm. The colchicum is sometimes applied externally as a liniment to rheumatic joints, in the form of the tincture of the seeds or bulb.1I Of late, it has been recommended by Mr. Wansborough in gout;** two drams of the tincture of the seeds being added to jiv of a spirit lotion. It is affirmed, however, that the local use of mor- phine had the same effect,ff—the part being bathed in hot water for a minute, and then lint being applied, spread with simple ce rate, on which about three grains of acetate of morphine were distributed. Still more recently, Mr. LaycockJJ has advised the tincture of the root as an external application in rheumatism, alone or com- bined with the tinctura camphorae. It has been used in the au- thor's Clinique at the Philadelphia Hospital, and often with ad- vantage ; but whether much or any of the benefit was produced by the colchicum, the author was unable to decide. MODE OF ADMINISTERING. Colchicum is not so frequently given in substance, although we often prescribe it in this form. The dose of the powdered root is from three grains to ten, given several times in the day. The offi- cinal preparations of this country and Great Britain are;—the acetum colchici (United States and London;) the oxymel colchici (Dublin;) the syrupus colchici (United States and'Edinburgh;) the vinum colchici radicis (United States and London;) and the * Pathology of Consumptive Diseases. Lond. 1822. t Inflammation of the Mucous Membrane of the Luno-s. Lond 1821 X Lancet, August 2, 1834. j American Journal of the Medical Sciences, May, 1838, p. 205. || Rust's Maoazin, B. xxi. S. 270; and Osann, in art. Colchicum, in Encyclopad. Worterb. der medicin. Wissenschaft. B. viii. S. 136. Berlin, 1832. IF Dictionnaire de Matiere Medic, par. MM. Merat & De Lens, ii. 361 ** Lancet, July 29, 1837. ft Ibid, August 5, 1837. XX Lon. Med. Gaz. March 16,1839, and June 8. 1839, p. 388. COLCHICUM AUTUMNALE. 161 extractum colchici aceticum (London.) These are made from the bulb. The officinal preparations from the seeds are the tinctura semi- num colchici (Dublin;) and vinum colchici seminis (United States.)* The London Pharmacopoeia has likewise, a spiritus seminis colchici ammoniatus or tinctura colchici composita, which is much used by the English physicians; and is formed by macerating two ounces and a half of bruised colchicum seeds in a pint of aromatic spirit of ammonia. Battley recommends an Extractum colchici e succo bulborum recenter expresso, and such a preparation is in the Pharmacopoeia of Austria.f The dose is two grains every two hours. Dr. A. T. Thomson recommends a saturated vinous tincture, made by macerating an ounce and a half of the dried bulb in twelve ounces of white wine. From thirty to sixty minims to be given to gouty patients when in pain. The dose of the powdered root or seed is, as we have said, from three to ten grains; of the acetum colchici, from thirty minims to one fluid dram; of the syrupus colchici, from one fluid dram to half a fluid ounce; of the vinum colchici radis, from fifteen mi- nims to one and a half fluid dram; and of the vinum colchici se- minis, from one to two fluid drams. Dr. Copland^ suggested the use of the fresh flowers in the form of vinegar, tincture, &c, as milder than the seeds or bulbs, and yet equally efficacious in rheumatic and other affections; but they are not employed. Mistura Colchici. Mixture of Colchicum. R. Magnes. sulphat. ^j ad gij. Solve in Aquae menth. crisp, ^x. Adde Acet. colchic. ^j. ad ^iss. Syrup, croc. ^j. Magnes. 9viij. M. To be well shaken. Three table-spoonfuls to be administered, so that from four to six evacuations maybe produced in twenty- four hours. Given in paroxysms of gout. Sir C. Scudamore. * Dunsrlison's General Therapeutics, Philad. 1836; and Dispensatory of Messrs. Wood and Bache. f Jourdan's Pharmacopee Universelle, i. 436. Paris, 1828. X Lond. Med. Repos. 1823. 162 CORTEX ADSTRINGENS BRASILIENSIS. Gutta Colchici Composita. Compound Drops of Colchicum. R. Extract, aconit. J}i to Jss. Solve in Vin. sem. colchic. ?ss. M. Fifteen, twenty, thirty, or forty drops to be given three times a day. Weber. R. Tinctur. sem. colchic. ------guaiac. simpl. aa. 3iij. M. Dose—Thirty or forty drops three times a day, in chronic rheu- matism. Blasius. R. Tinct. sem. colchic. ------digit, aa. Jij. Sp. aether, nitric. 9j. M. Dose—Twenty drops on sugar. Hildenbrand. Pilula Colchici. Pills of Colchicum. R. Pulv. colchic. gr. iij. Saponis medic, q. s. ut fiat pilula. Dose—Three daily, increasing the quantity to five or six. Ritton. Linimentum Colchici et Camphora. Liniment of Colchicum and Camphor. R. Tinctur. rad. colchic. Camphorae, aa. partes aequales. M. Laycock. CORTEX ADSTRINGENS BRASILIENSIS. Synonymes.—Astringent Bark of Brazil. This bark was introduced into Germany, in the year 1818, by Schimmelbusch, a merchant, who carried it from Brazil, where CORTEX ADSTRINGENS BRASILIENSIS. 163 it had long been used internally as well as externally, as an ex- cellent astringent.* According to Von Martius,f it is the bark of the acacia jurema, but this is not certainly determined.J Merrem§ affirms, that the genuine bark is in more or less flat pieces, at times in half, or complete rolls, from four to twelve inches long; from an inch to two inches and a half broad, and from one to four lines thick: these are more frequently straight than crooked. The bark may be separated into two parts, an outer, which is rough, and an inner rind of a smooth fibrous character: the two are but loosely connected together. The outer bark is of a grayish brown colour, traversed by longitudi- nal and transverse furrows, having here and there, white and grayish white crusty growths, covered with a foliated lichen. The inner bark is of a dark red brown on its outer surface, and after the outer bark has been separated, is somewhat smooth: on the inner side, it is of a brighter reddish brown, and, probably owing to the laceration of the woody splinters, somewhat fibrous. The younger bark is smooth in the fracture, and of a dull splen- dour. The older bark, which is thicker, is unequal, and may often be separated into fibrous layers, which are readily lacera- ble. When chewed, it has a tolerably strong astringent, some- what bitter and disagreeable taste, but it does not excite nausea, or leave any arriere-gout. It has scarcely any smell. In its chemical relations, it resembles the ratanhy.|[ EFFECTS ON THE ECONOMY. Merrem, who made numerous experiments with this bark, affirms, that whilst it possesses the properties of astringents in general, and to a high degree, it is -rather sedative than exciting, agrees with the digestive organs, and aids the peristaltic action. He employed it, first, with more or less success, in hemorrhage —in epistaxis, hamoptysis, and metrorrhagia; and Giintherll found it very efficacious in profuse menstruation arising from atony of the uterus. Secondly; in mucous discharges, as leucor- rhcea, blennorrhea, &c. Thirdly; in inflammatory and exanthe- * Von Schlectendal, in Encyclop. Worterb. der medicin. Wissenschaft. B. viii. S. 538. Berlin, 1832. f Reise, ii. 788. X Riecke, Die neuern Arzneimittel, S. 146. S Ueber den Cortex adstringens Brasiliensis. Koln, 1828. || See the analysis by Hofrath Trommsdorf, in Brandes' Archiv. B. xxxui. S.260; and Dierbach in Heidelberg. Annalen, B. x. H. 3. S. 357. Heidelb. 1'in Harless Rhein-Westphal. Jahrbuchern, B. viii. St. 1, S. 72; and Brande's Archiv. Band xi. S. 200. 164 CORTEX ADSTRINGENS BRASILIENSIS. matous affections—as cynanche, urticaria, and in periodical ery- sipelas of the face. Fourthly; in nervous diseases, especially when combined with disturbances of the menstrual function, and leucorrhaa: and, fifthly; in iveakness and catarrhs of the genital organs, bladder, and rectum. The Indians consider, that the bark affects especially the generative apparatus, and, from the experiments of Merrem, it would seem, that its agency is more particularly exerted in cases of leucorrhaa; and in many, after the cinchona had been administered without effect.* MODE OF ADMINISTERING. Merrem prescribed it in various forms. He gave the powder in doses of from 9j to 3ss, three or four times a day, mixed with water. It appeared to him to act most beneficially in cases of mucous discharges unaccompanied by disorder of the digestive functions; and he found that the powder was better borne by some than the decoction, which is somewhat singular, as the woody matter is more apt, in such cases, to disagree. He rareiv gave it combined with aromatics, and never found the combination of use. To form the decoction, an ounce of the coarsely powdered bark was boiled with sixteen ounces of water, down to Sviij; and to this an ounce of syrup was added. The dose was from one to two spoonfuls every two hours. Merrem also prepared an extract, and a tincture, in the same manner as these preparations are made of the cinchona; of the former he took from one to two drams, dissolved it in six ounces of an aromatic water, and added |ss of syrup. Of the mixture, a spoonful was given every hour. Externally, the decoction was injected three times a day in leucorrhcea, and in blennorrhcea; or, in the former disease, a sponge imbued with the decoction, was introduced, and kept there for some time. It has been applied, also, as an astringent to ulcers. Mistura Corticis Brasiliensis Adstringentis. Mixture of the Astringent Bark of Brazil. R. Decoct, cort. adstring. Brazil, £vij. Copaib. cum vitelli ovi q. s. subact. Tinct. ferri pomati aa. 3ij. Syrup, balsam, ^j. M. Dose.—A spoonful every two hours, in obstinate gonorrhoea and leucorrhcea. Merrem. * Osann, in Encyc. Warterbuch der median. Wissensch. viii. 541. CREASOTON. 165 R. Cort. adstring. Brasil. 5ss. Coque cum aquae fontan. q. s. Sub fin. coction. adde Herb, sabin. 5ss. Colaturae, 5viij. adde Syrup, cort. aurant. 2j. Dose.—A spoonful every hour, in cancer of the uterus, and in the hemorrhage thence arising. Merrem. CREASOTON. Synonymes.—Creosoton, Creosotum, Kreosoton, Kreosotum, Creosote, Cre- asote, Kreosote, Kreasote. German.—Kreosot, This substance was first discovered, a few years ago, by Rei- chenbach, of Blansko, and is extensively employed as a therapeu- tical agent. Its marked chemical properties suggested, that it might be possessed of a decided influence on the economy, and numerous experiments were immediately instituted to test the ac- curacy of the notion. These were of the most opposite charac- ter, and it is not. surprising, as in every similar case, that there should have been great discrepancy in the results* and in the opi- nions deduced therefrom. There can be no doubt, however, that the creasote forms a valuable addition to the list of our remedia1 agents. MODE OF PREPARING. The process given by Koene,* is esteemed one of the best for preparing it on a large scale;—almost the only way in which it is formed: we consequently meet with it only in commerce;—being rarely made in the shops. Tar, derived from pit-coal, is distilled in a retort provided with a long tube, having a large mouth. Under this is placed a re- ceiver. The oil, which comes over first, swims on water; and it is necessary to remove, from time to time, the products of the dis- tillation, until an oil is obtained, which sinks in water. When this * Annates de Chimie et de Physique. Juillet, 1835. See Cormack on Creosote, p. 36. Lond. 1836; or the Amer. edit, in Dunglison'e American Medi- cal Library; also, Turner's Chemistry, 5th edit. p. 872. 15 166 CREASOTON. is the case, the product is collected. The heavy oil, obtained during the distillation, condenses not only in the receiver, but in the tube of the retort, where it unites with the naphthaline, form- ing a butyraceous substance. By applying a gentle heat, the mass will drop into the receiver. The product is now allowed to remain in a cool place for some hours, after which it is pressed. The expressed naphthaline still contains oil, which is separated by heating it with its own weight of acetic acid, until it melts. After allowing it to cool, the crystallised naphtha is pressed, and the acid adhering to the creasote is saturated with subcarbonate of potassa. The creasote is now to be shaken for a quarter of an hour with phosphoric acid,—the proportions being half an ounce of the acid to twenty ounces of the oil. The mixture ought then to be agitated with its bulk of water, and afterwards be distilled with a graduated heat, care being taken to separate the oil which floats on the surface. The rectified oil is now to be dis- solved in its own volume of a hot solution of caustic potassa, s. g. 1.120. When it has been allowed to cool for half an hour, the supernatant oil is again removed, and the heavy oil again treated with caustic potassa, only a fourth part of the solution being, however, employed this time. On uniting the solutions of potassa, a slight excess of diluted phosphoric acid is added, and the free creasote, which floats on the surface, is separated. It is again rectified; and the first product—which is chiefly water—being rejected, the creasote comes over pure. M. Koene recommends the substance, thus prepared, to be preserved in bottles, covered with black paper. A protracted and complex process, like the above, necessarily makes the drug expensive, especially as the quantity obtained is but small. M. Koene procured by it ten drams from thirty-two ounces of tar. M. Lemere, one of the first Parisian pharmaciens who made pure creasote, obtained from eight hundred pounds of tar about six pounds of creasote. Reichenbach generally prepared it from the tar of the beech by six distillations; dissolving it afterwards in a solution of caustic potassa three times, setting it free successively by sulphuric acid.* j j r Giordanof has recommended the following simplified mode for * For an account of this and other products of the destructive distillation of vegetable matter, see Cormack, Op. cit. Reichenbach's observations and ex- periments are contained in a work entitled » Das Kreosot in chemischer, phy- sischer und n.ed.c.mscher Beziehungr, von Dr.;K. Reichenbach, u. s. w. zweite mit Nachtragen und Zueataen von Schweijrger-Seidel verm. Ausgabe. Leipz. 1835; see, also, Annales de Chimie, hii. 325. Paris 1833 t Annah di Medicina, Aprile, 1835, and Br. and For. Med. Rev. July, 1836, ft? ifi^ ^^P'0^80; Calderini,Bee Edinb. Med. and Surg. Journ. for Oct. 1834; and for that of M. Cozzi, see Journal de Chimie Medicale, and Amencan Journal of Pharmacy, Jan. 1839, p. 339. CREASOTON. 167 obtaining it. Distil wood tar from the willow, at an elevated temperature, from a tinned copper retort, until the residue has the consistence of a soft pitch. Re-distil the liquor passed over till its residue resembles the former. The liquor, neutralised by sub- carbonate of potassa, or lime-water, is re-distilled till all the oil of creasote has passed over. The oil is dissolved in caustic potassa, from which, after simmering a little, in a porcelain vessel, and cooling, the eupione, which floats, is easily separated. The same operation is repeated with the eupione, to remove all the oil that is united with it. The saponaceous liquor, treated with dilute sulphuric acid, is distilled into water, from which the creasote is separated, and the water saturated with creasote is kept for ex- ternal use, or re-distilled for a concentrated acetic acid of a pun- gent and most agreeable odour. Creasote is a colourless, transparent fluid. Its refractive power is very great, and in angular glass vessels it is beautifully irides- cent. * Its odour is penetrating, and disagreeable, but not offen- sive : many compare it to that of castor. It adheres to every thing, and is somewhat^ permanent. Its taste is at first very burning and caustic to the tongue; but on admixture with the saliva, it becomes somewhat sweetish. It has an oleaginous feel, and is of about the consistence of oil of almonds. Its specific gravity, at 68° Fahr., is 1.037. It boils at 397°, and at—17° does not congeal. When placed on paper, it forms a greasy- spot, which, however, disappears after a while, and can be re- moved by the application of a heated body, without any residue. It is a non-conductor of electricity. With water at 68°, it unites in two different proportions;—one of the combinations consisting of U of creasote and 100 of water; the other of 10 parts of water and 100 parts of creasote. The taste of the first mix-. ture—creasote water—is very burning at first, and afterwards sweetish, like that of pure creasote, but of course weaker. A drop of creasote in 10,000 parts of water produces a marked im- pression on the tongue, and has a smoky smell. Litmus and tur- meric paper are not in the least changed by it; so that it has nei- ther an acid nor an alkaline reaction. At both poles of the galvanic battery, it furnishes numerous and striking combinations. It does not possess the property of the ordinary empyreumatic oils, of becoming yellow and inspissated. It dissolves iodine, phosphorus, and sulphur. Acetic acid at 1.070, and alcohol, dissolve it in all proportions. Ether and petroleum likewise com- bine with it in all proportions. With potassa, it forms two or three combinations, one of which crystallises. Resins and resi- nous bodies either decompose creasote, or it decomposes them. With balsams, fixed and volatile oils, camphor, and the vegetable alkaloids it unites readily. It coagulates albumen, and its anti- septic property is most remarkable, whence its'name, from xf ««?, ' preserver.' Fresh meat, placed in creasote water for half an hour or an hour, and then taken out and dried, may be exposed to the heat of the sun with- out undergoing putrefaction. Nay, when flesh has begun to be putrid, the process ceases after it has been washed with creasote water, and if suffered to remain immersed in it for an hour, it does not subsequently putrefy. There can be but little doubt, con- sequently, that creasote is the main antiseptic and conservative principle of the pyroligneous acid, and of tar water. From the experiments made by Reichenbach to determine the exact com- ponents of the flesh on which the creasote acts, he arrived at the following results. It unites with the albumen and red particles of the blood in the flesh, which it coagulates, without acting on the fleshy fibre, which serves merely as the frame-wrork for the coagulated matters; and it is well known that dried albumen does not putrefy, but becomes hard, brittle, and transparent. EFFECTS ON THE ECONOMY IN HEALTH. / Reichenbach has properly remarked that the excessive burning pain in the tongue, which creasote causes, must have at once suggested it to be a poisonous substance. It was soon found that plants, sprinkled with creasote water, died; that fish placed in it were convulsed; and that small animals, as wasps and flies, died when touched with pure creasote. If a small quantity of it be spread upon the hand, and washed off a minute afterwards, the place is found to present a white appearance, but without pain or inflammation. In the course of a few days, the place becomes dry, and the cuticle desquamates. When creasote is applied to a part where the epidermis is deficient, or to a wound, instanta- neously an extreme violent burning pain is experienced, which continues for eight or ten minutes, but if the part be carefully washed, it graudally ceases. The cause of this is conceived to be the property which creasote possesses of coagulating albumen; and, where blood is flowing, of arresting it. If the rapid disturb- ance, which it excites, affects important organs, death results sooner or later according to their importance in the economy; re- lief, however, may be afforded by those substances that dissolve coagulated albumen, as caustic alkalies, acetic acid, &c. It is probable, however, that the poisonous properties result from its acrid character. To appreciate the physiological effects of creasote, experiments have been undertaken by many individuals. Miguet gave a young dog, for eight days, an ounce a day of distilled water con- taining four drops of creasote, without any effect. When, how- ever, he doubled the dose, nausea, languor, subsultus tendinum CREASOTON. 169 and tremors occurred, followed in the course of a few days, by marked emaciation. On discontinuing the creasote, the functions gradually resumed their pristine condition, and the animal reco- vered its flesh. To another dog, he gave at once two drams in half an ounce of water, and immediately thereafter great prostra- tion of the muscular system ensued—vertigo, fixed eyes, stupor, dyspnoea, accumulation of mucus in the air passages, spasmodic, cough, discharge of large quantities of foamy saliva, with vomit- ing of a milky matter, although the animal had taken nothing of the kind. After two hours of suffering, the animal died of con- vulsions. The body was immediately opened; all the tissues, ex- cept the liver, exhaled a strong smell of creasote; and the whole of the mucous membrane of the intestinal canal was inflamed. The matters contained in the stomach coagulated when placed in con- tact with albumen. When heated, they yielded a thick smoke, and a marked smell of creasote. In the heart and large vessels the blood was more firmly coagulated than usual: the lungs were gorged with blood; in the brain there was no evidence either of congestion or hemorrhage. In another dog, into whose carotid equal portions of water and creasote were injected, death resulted with similar phenomena, but more rapidly. The precise quantity of creasote used in this experiment is not stated. Simon, in his experiments, found that when ten drops of creasote, diluted, were injected into a vein, scarcely any effect resulted. Reiter and Miiller, who likewise made experiments on ani- mals, agree with Simon as to the result of injections of creasote into the veins ; no special symptoms were induced by it, but this appeared to be owing to the blood being instantaneously coagu- lated by it, which not only prevented the farther progress of the creasote, but also of the blood, hence no evil consequences re- sulted ; and' it is probable, as Riecke has suggested * that the weaker the solution of creasote, within certain limits, the greater maybe its effect on the mass of blood.. Corneliani,t an Italian physician, has also instituted a series of experiments with creasote on lambs, rabbits, &c. All these ani- mals bore small doses of creasote—however unwillingly it might be taken—without any remarkable results, and without loss of appetite. Large doses, however, immediately occasioned gene- ral torpor, sudden inclination to pass the urine, paralysis—especi- ally of the lower extremities—with or without convulsions, and * Die neuern Arzneimittel, u. s. w, S. 153. f Giornale delle Scienze Medico-Chirurgiche, No. 8. Febrajo, 1835; Brit. and Foreign Med. Review, p. 265, Jan. 1836, and Journ.de Chimie Medicale, Fev. 1836! 15* 170 CREASOTON. frequently the ejection of a bloody foam. When the doses were large, and it was but little diluted, death took place in a few mi- nutes, and on examination, the inner lining of the stomach was generally found corroded, yet not so constantly as to allow of death being ascribed to that circumstance. It followed, farther, from his experiments, that pure creasote applied to a denuded nerve, or injected only in small quantities into a vein, may occasion death suddenly, and that the application of the creasote to extensive wounded surfaces in the same animals may be ultimately followed by fatal consequences. Where a very large dose of creasote was administered, imme- diate death was produced without organic lesion. In the trials made with it by Dr. Elliotson,* he found no action produced upon the bowels; but it sometimes augmented the quan- tity of urine. He once saw it, in doses of a minim three times a day, cause micturition nine times in 'an hour. In another case, in doses of three minims, it produced severe strangury. According to Simon, when applied to the muscles, it destroys the surface like a caustic. Miiller and Reiter, in their experi- ments found that it speedily rendered the muscular fibres of a dirty whitish appearance, and readily lacerable. When applied to the fresh blood of the hog, it converted the colour in an instant to an ashy gray; after which it became black and quickly coagu- lated^ Mixed, either pure or diluted, with blood, it thickemTit, the mixture assumes a brown red colour, and it is found studded with small white points, which are nothing more than coagulated albumen. On exposing the coagulum to the air, it assumes a yel- lowish red colour. Reich, on the other hand, who appears to have made many experiments with creasote, both in internal and external diseases, affirms, that he has never observed any caustic effect from it; from which assertion, as Riecke has remarked,! the only inference to be deduced is, that he must always have applied it largely diluted. Fremanger likewise asserts, that when pure creasote is applied to the epidermis, it does not destroy it; but merely occasions more or less redness of the skin. When applied to a suppurating surface, it caused, instantaneously, the formation of a white pellicle, owing to its coagulating the albumen contained in the secretion from the wound. Adventitious tissues, with which it is brought in contact, are destroyed by it. When placed between the lips of a wound it prevents healing by the first intention, by coagulating the albumen, and, consequently, it may be employed in all cases where it is desirable to prevent the growing together of parts. Fremanger is, indeed, disposed to refer all its efficacy to the action, which it exerts on albumen. * Medico-Chirurg. Transact, vol. "xix. Lond. 1835 t Op. cit. S. 154. CREASOTON. 171 Its long continued use often occasions an inflammatory condi- tion which, as Dr. J. L. Da Luz* observes, has nothing in com- mon with the disease, for the cure of which it may have been prescribed. In a case of porrigo favosa treated by it recently by the author, febrile irritation supervened, and the head was covered by an artificial eruption, which induced, however, a new action in the intermediate system of the scalp, and after its subsidence, the porrigo was cured. Dr. Cormack, of Edinburgh, has likewise instituted various ex- periments on the lower animals to test the physiological effects ot creasote.f In three experiments, about twenty-five drops of pure creasote were injected into the venous system of dogs. All the animals died. In every case of poisoning by it, which he has ob- served, Dr. Cormack found the following to be the symptoms:— Its first deleterious action was a powerful one of sedation on the heart; the vital energies of that organ seeming to be instanta- neously paralysed. In some instances, hurried and sonorous re- spiration went on for more than a minute after the heart had ceased to beat. In general, one or two convulsions, resembling the tetanic, preceded death; and, almost invariably before ex- piring, the animal uttered one or more shrill cries. In every in- stance, the atony of the heart immediately after death was very striking. From other experiments it appears, that when creasote is in- jected into the arteries the deleterious effects are of a much milder character, and if the dose is not large, the animal may experience but little inconvenience; a circumstance, which proves the impor- tance of a thorough admixture with the blood before the poison- ous article reaches the heart; such admixture not taking place, to the necessary extent, when the poison is injected into the veins, but being readily effected when injected into the arteries, and consequently distributed through the capillary or intermediate system. . . When taken for any length of time, the urine acquires a blaciush hue, and in some cases creasote can be recognised in the urine.J EFFECTS ON THE ECONOMY IN DISEASE. Creasote has been administered in various diseases, and the fol- lowing may be esteemed a summary of the therapeutical experi- ments made with it. 1. Hemorrhage. The discovery of creasote happened at a time, when the Aqua Binelli enjoyed more confidence as a styptic than * Jornal da Sociedadedas Sciencas Medicas de Lisboa, torn. v. Lisboa, 1837; reviewed in Zeitschrift fur die gesammte Medicin. Oct. 1838, S. 224. \ Op. cit. p. 66. .. X Dr. Macleod, in Medical Gazette, xvi. 599, and xvn. bM. 172 CREASOTON. it does now; and the fancied probability, that the nostrum was in- debted to the creasote for its properties, gave rise to many experi- ments with the latter in cases of hemorrhage. One of the first, who instituted experiments with it on rabbits, was G. Simon. Not being able to obtain any striking results from the aqua binelli, he tried the creasote, pure, as well as in the form of creasote water, and of an emulsion prepared with gum arabic ; and from the re- sults of these he was led to affirm, that although creasote occa- sioned the coagulation of the albumen of the blood, it acted no better as a styptic than cold water. With the aqua binelli he was not able to coagulate albumen. The rapid separation of the al- bumen in the form of a reddish gray coagulum under the influ- ence of the creasote, he found to be of no advantage, as the mass re- mained soft and pulpy; and the wound in the vessel could not close, but was immediately opened by the stream of blood. Neither did he esteem it adapted for arresting trifling hemorrhages; for, when very much diluted, it is still too exciting to the injured parts, and markedly delays their union. This, indeed, might, he thinks, be expected from the fact, that pure creasote, when placed on the skin for ten or twenty minutes, induces superficial inflamma- tion. The experiments of other physicians have been decidedly more favourable. Miiller and Reiter,* for example, in theirs, found that creasote was far more efficacious than the aqua binelli, for, when the latter was prescribed, it was always necessary to have re- course to other agents, before the hemorrhage was arrested. In their experiments on dogs, they found the hemorrhage from a divided crural vein quickly cease, when a compress of cotton, wetted with creasote, was placed on the vessel, with a moderate degree of pressure. Three days afterwards, the crural artery was exposed on the same dog, and divided; but it was afterwards ne- cessary to tie it, as the creasote, in consequence of the excessive hemorrhage, could not be brought into immediate contact with the vessel, but merely acted on the superficial layer of blood, and therefore did not arrest the hemorrhage. The crural artery of a young and tolerably strong dog was cut a short distance above its division, compression being at the same time exerted upon the trunk. The artery did not bleed. Nine minutes afterwards, a compress of cotton soaked in creasote was applied immediately to the divided extremity of the artery, with some degree of pressure. When the compress was removed, the bleeding was entirely arrested, and the wounded surface was dry, and had an ashy gray hue. In an old dog, hemorrhage from a di- vided crural artery was arrested by the same means, but not so * Schmidt's Jahrbvicb, cited in Encyclographie des Sciences Medicales, Mars, K37. CREASOTON. 173 speedily. When the artery was examined, it was found to be wholly closed, having a navel-like depression- at the extremity, which disappeared when the vessel was pressed upon, and ulti- mately became conical. Within the vessel was a conical coagulum, which could be readily detached; and for the space of a line, the artery appeared inflamed through its coats. In arteries that had been divided for a longer time, the union was likewise complete; but there was this difference, that the in- flammation at the end of the vessel had disappeared, and a pointed fibrous caruncle was observed in the vessel, which was doubtless the fibrinous portion of the previous coagulum. From their experiments, M tiller and Reiter were led to confirm the haemostatic properties of creasote, both when the hemorrhage occurs from veins and from arteries. The arteries divided were of considerable size, larger than the radial artery of an adult male. They consider pressure indispensable to occasion the creasote to act immediately on the artery; and the arrest of the hemorrhage, they ascribe,—not alone to the coagulation of the blood, but to the contraction of the arteries. In parenchymatous hemorrhage, the aqua creasoti was generally sufficient; as well as in tolerably extensive wounds of the surface. Horing, also, obtained satisfactory results from his experiments on animals. He exposed, on an old cat, the crural artery and vein of the right side; made a small incision into the latter, and pressed upon it to stop the copious flow which ensued: he then applied over the wound, for two minutes, a small compress of lint, wetted with a solution of creasote—two drops to one hundred of water—and the bleeding ceased. The artery was now opened, and a similar compress placed upon it with the same result. Two days afterwards, a second experiment was made of the same kind, except that, owing to the struggles of the animal, a larger open- ing was made into the crural artery. In this case, it was neces- sary to apply the compress for four minutes before the hemorr- hage ceased. In another cat, a large transverse incision was made on the inner surface of the right thigh, above the middle, by which muscles, arteries, veins, and nerves were divided. Two large com- presses of lint, wetted with a solution of creasote, were then pressed on the parts for five minutes, and the bleeding entirely- ceased. The like result was obtained in the case of an old horse, whose jugular vein was opened. But the creasote solution did not succeed in wholly arresting the hemorrhage in the same horse, when an opening was made into the crural vein and artery. To these experiments on animals may be added some that were instituted on the human subject, and which testify, more or less, to the efficacy of creasote as a haemostatic. Hahn applied it in some insignificant cases, but saw no better effect from it than from cold water. Most found it speedily arrest slight he- 174 CREASOTON. morrhages from small vessels. Hdring applied it successfully in cases of epistaxis, which had obstinately resisted other agents,— two plugs of lint, dipped in a solution of creasote being inserted in the nostrils, after which the hemorrhage soon ceased. Ficht- dauer employed it with equally advantageous results in violent bleeding from leech bites, after several haemostatics had been used in vain; and Heyfelder extols it for arresting hemorrhage from large wounded surfaces. Berthelot differs with Fremanger and Simon, who affirm that union by the first intention is prevented by it. The results of his observation were entirely opposite. Miguet applied it successfully as a haemostatic in fresh wounds on man and animals. Both pure creasote and a solution of it were, however, unsuccessfully used by Bardili in hemorrhage from the arteria tibialis postica, which he ascribed to the blood having lost its albumen, owing to the excessive discharge. Reich and Hauff found injections with creasote water very useful in haemorrhagia uteri. Schneider had a case of hemorrhage that had continued for seven hours in a man eighty years old, and which proceeded from the gums of the upper jaw; the blood oozing as from the pores of a sponge. He directed the man to take as much aqua creasoti into his mouth as he was able; and after three repetitions the hemorrhage ceased, and did not recur. Kohler* endeavoured to test the haemostatic operation upon himself. He made an incision in his forearm an inch long, and three or four lines deep, to which he applied creasote water. A lancinating pain was felt in the wound, but no other sensible ef- fect. A drop of pure creasote was now let fall between the lips of the wound: this was followed by a sensation of burning and drawing; for a moment coagulated flakes of a whitish gray co- lour covered the wound, and there was a temporary cessation to the flow: it soon, however, recurred. After a time the hemor- rhage ceased ; but not sooner—Kohler thinks—than if cold water had been applied. The feeling of burning and drawing continued however, for some time; the edges of the wound were somewhat swollen, and oedematous, and, in about four hours, were covered with a yellowish brown lymph; but there seemed to be no delav in the cicatrisation. J. L. da Luzf found it an excellent styptic in capillary hemor- rhage ; but in hemorrhage from great vessels it did not prevent a recurrence of the bleeding. In hamoptysis, too, the internal use of creasote has been found beneficial. SantmiJ prescribed it in a desperate case with com- + OeUciriSSenSChafUiCh' AnnaIen' "' s' w> Ri- H- a S- 285- Berlin, 1835. ^S^fS^S, dP: 5Vo2°na'Mar3'1834; and Amer-Journal of the CREASOTON. 175 plete success, and with Schmalz it was equally effective; on the other hand, it was of little avail in Guitti's hands. In hamatemesis, it succeeded in the hands of Dr. Isaac Par- rish of Philadelphia,* after the remedies generally employed in such cases had failed to produce any effect. 2. Burns.—Most used creasote with decided relief in burns of the second and third degree, applied by means of rags wetted with creasote water. Berthelot also cured two cases quickly with it; the slightly burnt places becoming desiccated; the more severe healing by the formation of a crust. Guitti applied both creasote water and creasote ointment with advantage in burns which had proceeded to profuse suppuration; hence, it has been advised,— 3. In profuse suppuration, on the authority of Levrat and Ber- thelot, but according to J. L. da Luz,f it has no marked influence on the secretion of pus, and is therefore useless in suppurating abscesses. In otorrhea it has been especially beneficial. 4. Lesions of the integuments.—According to Reichenbach, creasote is of essential service in the intertrigo of children, as well as in the excoriation induced by lying. In the latter case, Guitti used it with success. Hahn also frequently employed it. In cases where ulceration had not taken place, he washed the parts several times a day with creasote water, and was of opi- nion that he had prevented, in some cases, the occurrence of ulceration. Where ulceration had already taken place, he co- vered the parts with linen rags folded two or three times, which he soaked in creasote water, and fixed them on by means of ad- hesive straps. The superficial ulcers soon healed; and the deeper were transformed into hollow surfaces, secreting a homogeneous serous fluid, but no pus. Hdring employed creasote water with advantage in sore nip- ples; and in sprains and contusions, the creasote ointment has been recommended by Dr. Fife.J 5. In chilblains, whether ulcerated or not, Hahn§ used crea- sote washes successfully;—the affection yielding in a few days: and Dr. Herndon|| regards the creasote ointment as the best re- medy in that affection with which he is acquainted. 6. Ulcers.—Fissures of the skin and superficial ulcers, accord- ing to Hahn, were changed, under the application of the creasote water, into a blackish brown scab, which adhered for a long time, and when it fell off, left the parts healed; or by occasioning * Medical Examiner, Aug. 10, 1839, p. 501. f Op. cit. X Lond. Med. Gazette, April 7, 1838, p. 66. § Gazette Medicale de Paris, Dec. 1834. (I American Med. Intelligencer, for March 15,1838, p. 425. 176 CREASOTON. too much shrinking gave rise to fresh inflammation and suppura- tion. Deeper ulcers were affected in the same manner as those caused by long lying. The efficacy of this agent in atonic and varicose ulcers, espe- cially of the leg, has been attested by Levrat, Berthelot, Rossi, Hechenberger, and others; but Guitti, Heyfelder, and Schmalz were less satisfied with it. Very recently, a case of indolent ulcer, between the knee and ankle, accompanied with a good deal of inflammation, was cured by Dr. Crary, in five weeks, by the application of a solution of creasote (ten drops to the ounce of water,) with methodical compression to the limb, by means of a bandage.* Meister found the application of creasote water, in cases of carious, scrofulous, syphilitic, fistulous, and sanious ulcers, to be strikingly, and almost uniformly useful. Heyfelder, like- wise, found it extraordinarily useful in scrofulous ulcers, and Dr. Cormackf states, that he had recently an opportunity of seeing a case of this kind treated by Dr. Shortt, in the Royal Infirmary of Edinburgh, where an extensive scrofulous ulcer of the hip, after resisting a variety of treatment, at last yielded to creasote, and was ultimately completely cicatrised. On the other hand, Otto tried both the pure creasote and the watery solution in ulcers of various kinds, especially the scrofulous; the ulcers very generally put on, in the course of twenty-four hours, a cleaner appearance; still they did not cicatrise, on which account Otto prefers, in old ulcerations at least, the use of a solution of chloride of lime; for notwithstanding creasote diminished and improved the character of the suppuration from scrofulous ulcers, and rendered them cleaner, it did not ameliorate the general condition; after the di- minution of the suppuration, local pains, loss of sleep, and slight febrile movements generally supervening. On these accounts, Otto does not think creasote applicable to scrofulous ulcers in general. In scrofulous caries, many observers depose to the good effects of creasote. Among these may be mentioned Hahn, Coster, Ritgen, Fremanger, and Hauff. In fistulous ulcers—also of sy- philitic origin—several physicians have employed it beneficially. Dr, Fife,J of Newcastle-upon-Tyne, found it useful not merely in obstinate but in malignant ulcers. In no case of ulceration, he affirms, in which he tried it, did it disappoint his expectations. In a sloughing carbuncle, the alcoholic solution, (thirty drops to the ounce,) mixed with carrot poultices, was applied with advan- tage by Dr. Herndon,§ of Culpeper C. H., Virginia. * Boston Medical and Surgical Journal, July 3, 1839, p. 332. t Op. cit. p. 106. X London Medical Gazette, April 7,1S38, p. 65. \ Amer. Med. Intelligencer, March 15, 1838, p. 425. CREASOTON. 177 In scurvy and in scorbutic ulcers, M. Coen* found its use fol- lowed by excellent results, and he refers to cases in which it has been administered internally with very great advantage. J. L. da Luzf considers it an excellent cleansing remedy in atonic ulcers, but its prolonged use, he thinks, retards cicatrisa- tion. In hospital gangrene, he esteems it the best antiseptic, and the most powerful means for checking its terrific progress. In gangrenous or sloughing ulcers, Hahn used it. Several times a day he penciled the slough with pure creasote, and, in the intervals, fomented it with creasote water. According to Reichenbach, two offensive affections of the labia pudendi—the consequences of infiltration of blood—were cured by it; and Reich and Sir Francis Smith J treated with success cases of cancrum oris, and the former, one of scorbutic ulceration of the gums. In herpetic ulcers, Horing and Berthelot observed favourable effects from the creasote water; and it has been found especially useful in carcinomatous and syphilitic ulcers, in which it has been often employed. In cancer of the uterus, Wolff injected creasote water, in two cases, into the vagina. In one, the pain was so great, that, on the ninth day, after six pints of creasote water had been used, it was obliged to be discontinued. In the other case, the treatment was continued twenty-six days, and sixteen pints were used: in it, also, the pain was sensibly aggravated. The secretion was not improved in either case; nor was metrorrhagia prevented by it; for one of the patients died immediately after an attack of this kind: the other lingered a long time. Heyfelder found injections of creasote water, in conjunction with the extractum calendulas, of no use in cancer uteri. On the other hand, in a case of superficial ulceration of the os uteri with copious discharge of a puriform mucus, which had been treated unsuccessfully by other agents, for several months, Hahn found an injection of creasote water effectual in fourteen days. Tealier§ has likewise given a case of superficial ulcerations around the os uteri, to which nitrate of silver had been applied at least twenty times without inducing a cure. By touching the ulcers with lint fixed upon the end of a probe, and dipped in a mixture of one part of creasote and three parts of water, excessive pain was induced, but this gradually passed away, and in six days * Giornale per servire, &c. di Venezia, 1836. f Jornal da Sociedade das Sciencas de Lisboa, T. v. Lisboa, 1837; noticed in Zeitschrift fur die gesammte Medicin. Oct. 1838, S. 224. X Dublin Journal of Med. Science, for May, 1837. J Revue Medicale, Fevrier, 1834. For similar cases, see Dr. Friese, in Berlin, medicin. Zeitung, Nro. 13,1837. 16 178 CREASOTON. the signs of ulceration had disappeared. It is more than doubt- ful, however, whether either of the two last cases was carcino- matous. In a case of cancer of the breast, a solution of creasote was applied by the same gentleman. This excited, instantaneously, violent pain, but after a time the pain ceased, and relief was ob- tained. Rossi saw a cancerous ulcer of the face healed by creasote ointment, but it soon broke out again. The same gentleman cured a fungous tumor on the alveolar margin of the right os maxillare—which had occasioned the loss of all the teeth of that side except one, and which even the actual cautery had not pre- vented from returning—by a collutory of six drops of creasote in six ounces of water. Heyfelder saw creasote used without effect in a case of cancer of the skin, and Cormack* in a case of lupus of the nose. On the other hand, Guitti cured an ulcer, in appearance cancerous, by the application of pure creasote, for which, at a later period, the solu- tion was substituted, and Marchal has published a case of cancer of the lip in which he believes he accomplished a cure by means of creasote.f Garbiglietti cured a fungous ulcer with caries of the fibula by creasote, but it is questionable whether the ulcer was carcinoma- tous; and Meisinger saw a cancer of the face improved by the use of creasote ointment. It has been before remarked, that Meisinger used creasote with advantage in syphilitic ulcers. Hahn also applied creasote wa- ter in primary syphilitic sores; the small, superficial ulcers healed soon, the larger and deeper remained stationary. In a phage- dic ulcerated bubo, the spreading was arrested, but this was all. According to Heyfelder, creasote—probably the pure—excited! in a case of primary syphilitic ulcer, in a plethoric individual' violent inflammation, and so much sensibility, that it was obliged to be discontinued. Berthelot cured a chancre, which had re- sisted caustics and other cicatrising agencies, in a few days, by creasote water. Rehfeld, also, treated secondary syphilitic ulcers successfully with it, giving, however, at the same time, the corrosive sublimate, inwardly. Chronic venereal ulcers have in some cases yielded to it, after they had resisted every other kind of treat- ment.! Dr. Burkner, of Breslau,§ reports a case which, after having proved rebellious to every kind of general and local ma- * Op. cit. p. 115. t Gazette Medicale de Paris, Fev. 1835. J Cormack, Op. citat. p. 107 See, also, Kunchel, in Bulletin G^ner. de Thdrapeutique, p. 313. Paris, 1833. 5 Casper's Wochensclirift, Sepr. 9, 1837, S. 583. CREASOTON. 179 nagement that could be devised, at length yielded to the applica- tion of pure creasote by means of a camel's hair brush. The character of the secreted pus immediately improved; the wound began to heal by granulations from the base, and, at the end of four weeks, Dr. Biirkner found his patient quite well. In condy- lomata it has been equally successful. By the application of cre- asote water, Hahn found them contract and disappear; but the more obstinate required to be penciled with pure creasote. Hey- felder, Reich,* Fricke, and Coen,f also found the creasote effica- cious in these cases. The last gentleman but one had the most frequent opportunities for observation: by him the creasote, in a dilute state, was applied to the top of the condyloma by means of a pencil. In cases of small condylomata, touching them once or twice was sufficient for their removal; of larger, it had to be more frequently repeated. In some obstinate cases, it required two or three weeks before the condylomata disappeared; but when once they fell off, they did not return. 7. Gonorrhea and Fluor albus.—Most extols creasote water as a remedy in gleet. He applies it either in the-way of injection or by small tents wetted with it and introduced into the urethra. In fluor albus, he strongly recommends both the internal and external use of it. Reich injected creasote water in a case of gonorrhea, and in one of malignant fluor albus; yet its agency in these cases was doubtful as copaiba was given at the same time. HahnJ also used injections of creasote water in the second stage of gonor- rhoea, and in gleet; but he did not think that the discharge ceased sooner under its agency than under the ordinary means; whilst in some cases, the inflammation was even augmented. In two cases of benign fluor albus, after many other remedies had been em- ployed in vain, Schmalz saw good effects from the use of a solu- tion of creasote; but in a third case it afforded no relief. Dr. Elliotson§ gave it internally to a female labouring under gonor- rhea, at first, in the dose of two minims to an ounce of water, and afterwards in the dose of four, six, and even eight minims, but no good resulted from its use. We have administered it not unfrequently in leucorrhea and other mucous discharges, and when persevered in, it has at times appeared to be of decided service.|| Dr. Robert Dick,1f of Glasgow, has called the attention of the profession to its use in the chronic stage of gonorrhea, and * Hufeland's Journal, Jan. 1834, and Revue Medicale, Mai, 1834. f Giornale per servire a progressi della patologia. &c. di Venezia, An. 1836- \ Gazette Medicale de Paris, Dec. 1834. { Lancet, for Dec. 1835, p. 435. || See, also, Coen, in Giornale per servire, &c. di Venezia, 1836. IT Edinb. Med. and Surg. Journ. Apl. 1838, p. 602. 180 CREASOTON. in gleet. He thinks its beneficial effects are more obvious than those of copaiba. He administered it in doses of two drops with loaf sugar beaten into a syrup with water. 8. Chronic cutaneous affections.—Reich treated a case of crusta lactea externally by creasote, and internally by calomel and the black sulphuret of mercury. The result was favourable. In the itch, it was recommended by its discoverer. Wolff, too, saw three cases of not very recent itch, cured in eight days by lotions of creasote water. Reich and Coen* likewise extol the water and the, ointment in inveterate itch. J. L. Da Luzf also considers it as valuable as sulphur, but Otto did not find thewater particularly efficacious. He gives strong testimony, however, in its favour, in herpetic eruptions; in a very short time, it induced evident improvement, and often removed the affection in from eight to fourteen days. When the cases were more chronic, a longer time was of course required for the cure. He never ad- ministered it, however, without attaining his object. His rule was, to bathe the affected parts twice a day with creasote water, and in particular cases he directed, in addition, general baths of warm water. The eruption generally disappeared very rapidly under this management, but it speedily recurred unless general bathing was used at the same time. It again yielded, however, very readily to creasote water. Grandjean, Reich, and Koehler, also employed the water-successfully in herpes; and Guitti found both the water and the ointment most serviceable in herpetic af- fections when combined with appropriate internal treatment. Heyfelder recommends that alterative drinks, as the decoctum sarsaparillas, should be combined with them. Even in herpes exedens, the external application of creasote was found effectual by Ritgen, Grandjean, and Rossi. WolffJ cured a case of an- cient hhpetigo in about eight weeks, by a solution of creasote (5ss to gv of distilled water.) At first, the application caused so much heat and inflammation, that in eight days it was obliged to be discontinued, and afterwards it was alternated with fomenta- tions of warm water from day to day until the cure was com- pleted. Dr. Herndon of Culpeper C. H., Va., derived much bene- fit from the ointment in psoriasis. In acase of acne rosacea of seven years' standing, accompanied with headach, nervousness, thirst in the morning and acid eruc- tations, for which the patient was put under treatment for a month without success, Dr. Elliotson§ determined on trying creasote. * Op. cit. f Jornal da Sociedade das Sciencas Medicasde Lisboa, torn. v. Lisboa, 1837, noticed in Zeitschrift fur die ge.^ammte Medicin. Oct. 1838. S. 224. X Medicin. Zeitunar, u. s. w. No. 30. 1834. j Lancet, July 4, 1834, p. 459. CREASOTON. 181 The advantage was soon manifest, as in three days the eruption was evidently diminished. At first, she took two minims three times a day; this was gradually augmented to twenty minims; the farther increase of the dose being prevented by the superven- tion of giddiness and tremors. At the end of seven months, she was discharged; the eruption being scarcely perceptible, and the dyspeptic symptoms entirely removed. In a chronic pustular disease, not curable by antiphlogistics, the same gentleman ob- served better effects than from any previous remedy.* Dr. Cop- land, it is affirmed, found a saturated solution in water answer well as a lotion in porrigo favosa.\ We have often used in por- rigo, both creasote water and creasote ointment (see the formulas at the end of the article;) they have always appeared to us suf- ficiently strong, and when the quantity of creasote was increased, so much inflammatory irritation was induced that they had to be discontinued for a time. 9. In a case of chronic inflammation of the free edge of the eye- lids, with several ulcerated spots, a cure was effected by Coster, by the use, twice a day, of a dilute solution of creasote, (gtt.. xij ad aqua) destillat. gij) applied by means of a camel's hair pencil. The cure was effected in ten days. In different kinds of ophthalmia, M. Sanson used the creasote, but never observed the disease to be modified by the treatment.^ 10. In a case of prolapsus vagina, Schlesier tried the external use of a solution of creasote.. After astringent injections, and the application of the decoctum ratanhiae by means of a sponge, had been used in vain, he injected diluted creasote for seven weeks, omitting it onlv at the time of menstruation. It excited a burning sensation of a" few minutes' duration. At the expiration of the time mentioned, the prolapsus had strikingly diminished, and the great sensibility of the prolapsed parts had disappeared. Owing, however, to the supervention of irritation in the urinary bladder, it had to be discontinued when there was every prospect of ulti- mate success. > 11. Dr. Buttmann,§ of Viet-z, circle of Landsberg, has given the case of an old lady, upwards of seventy years of age, who had laboured for several years under edema of both legs to such an extent as to interfere materially with progression. She expe- rienced lancinating pains in both feet, and irregular paroxysms.of * Medico-Chirurg. Transact, xix. 237. Lond. 1835. f Gully's Edition of Magendie's Formulary, p. 204. Lond. 1835. See, also, Sir F. Smith, in Dublin Med. Journ. for May, 1837, and J. L. Da Luz, Op. cit. X Compte rendu des Seances de la Societe de Medecine, Seance du 7 Mars, 1834. ^ . , \ Beitragen zum Sanitats-Berichte des Frankfurter Regierungs-Bezirks; and Mediclnische Zeitung, Dec. 7, 1836, S. 252. 16* 182 CREASOTON. fever. Many external and internal remedies had been used in vain, when Dr. Buttmann, by way of experiment, applied cata- plasms of creasote, soon after which the swelling, very much to his astonishment, gradually disappeared, and with it the febrile attacks. 12. In toothach from carious teeth, creasote has often been used, being applied to the hollow of the tooth by means of a pencil, or of cotton imbued with it. The testimony in its fa- vour has been very great,—Coster, Reich, Hahn, Kneisel, Hey- felder, Fichtbauer, Hauff, Otto, Guitti, Kohler, Meisinger,* and numerous others. Some have advised a collutory of creasote, but this is more disagreeable, whilst it is less efficacious than creasote applied immediately to the carious tooth. It excites instantaneously acute pain and a considerable secretion of saliva. The pain is often relieved by it, but it generally recurs; and per- haps the advantage derived from this agent is not greater than from the stronger essential oils. As a palliative it is very useful. In rheumatic toothach, the insertion of a little cotton, imbued with creasote, in the ear of the same side, has been found ser- viceable.! 13. In deafness, apparently owing to a deficient secretion from the ceruminous follicles, advantage has been found from the use of the creasote, after the ear had been syringed. Perhaps as good a form as any is that recommended by Mr. Curtis,J which consists of one dram of creasote to four drams of lard. A little of this oil is inserted into the meatus night and morning, with a camel's hair pencil. He considers the preparation contra-indi- cated in cases of otorrhcea, where there is any pain or inflamma- tion. Dr. Partridge,^ who has seen many excellent effects from the creasote in such cases, prefers to commence with half a dram of creasote to four drams of oil of almonds, applied by means of a camel's hair brush. After a few days he usually increases the quantity of creasote as occasion may require, often using it as strong as one part of creasote to three of the oil. So far we have spoken mainly of the external use of creasote. Reference has been made to its internal administration in cases of hamopfysis, hccmatemesis and fluor albus only. In the follow- ing diseases, it has been chiefly given internally:— 14. Phthisis.—Reichenbach excited considerable expectations from the use of creasote in phthisis,—pulmonary, laryngeal, and bronchial; and as in so intractable a disease every suggestion is * Medicin. Jarbiich. des k. k. Osterreich. Staates, B. xv. S. 553. Wien, 1834. t Riecke, Op. cit. S. 167. X London Lancet, vol. i. p. 328, 1838-9; and Mr. Wright, ibid. p. 580. \ Medical Examiner, May 30, 1840, p. 348' CREASOTON. 183 immediately and eagerly embraced, numerous trials were in- stituted with it, the results of which were by no means accordant. Reich* affirmed, that he gave it both in laryngeal and tubercular phthisis with distinguished success. In a case in which the dis- ease appeared to be considerably advanced, the offensive expec- toration was changed into one of a tasteless, mucous character, although the fever and the night sweats experienced no modifica- tion. Subsequently, haemoptysis supervened, with violent fever; on which account the dose of creasote was diminished. Under the use of the remedy the condition of the patient appeared to improve,—except the cough, which was not mitigated; an ano- dyne was consequently substituted for the creasote; under which, his patient—a female—improved so much, that Reich was led to believe she might be saved, although the cough still remained severe and frequent. In another case, the creasote allayed the hectic fever, and transformed the purulent expectoration into one of a mucous character; yet, although the general condition of the patient seemed to be improved, the cough and uneasiness of the chest continued almost unchanged. Grandjean also had a case of phthisis in the third stage, the expectoration of which was soon diminished; the pain in the side removed; the appetite, sleep, and strength restored, under the administration of creasote; but the result of the case is not known. Levrat asserts, that he found creasote highly useful in chronic bronchitis, and in some kinds of phthisis. Hechenberger saw good effects from the inhalation of creasote in the form of vapour in a case of ulcerated lungs; five, ten, or fifteen drops of creasote, according to the degree of tolerance of the lungs, being dropped into hot water in an appro- priate vessel, and the vapour received through the tube of an in- verted funnel. Hechenberger was of opinion, that this mode of exhibiting creasote prevented the disagreeable effects apt to be induced by its internal use; and farther experiments have confirmed his view. In the chronic mucous affections of the lungs of old people it appears to have been especially useful. On the other hand, Elliotsonf derived no favourable results from his trials with creasote in phthisis; even inhalation of the vapour was generally unattended with any advantage; yet, he is of opinion that it may be useful where there are only one or two ulcers in the lungs, and there is no tendency to their farther production, as well as where there is much secretion from the bronchial mucous membrane. Either no advantage, or an injurious influence was derived from its use in phthisis, by Rehfeld, Haupt, Treumann, Gunther, Sch- malz, Meisinger, Otto, Kohler,J and others. * Hufeland's Journal, Jan. 1834; ami Revue Medicale, Mai, 1834. f Medico-Chirurg. Transact, xix. 221; Lond. 1835. X Heckcr's neuen wissenschaft. Anna!. B. i. H. 3. 184 CREASOTON. The published experiments by Wolff, in the Charite at Berlin, cannot be esteemed more favourable. It was tried in eleven cases of phthisis tuberculosa, of which one was in the first, eight were in the second, and two in the third stage. In two cases, there was scarcely any advantage after the remedy had been given for four- teen days. In one case, it had to be discontinued on the eleventh day, owing to the supervention of obstinate vomiting. The case ultimately terminated unfavourably. In six cases, the symp- toms appeared to be aggravated, and the patients died soon after- wards. In two cases,inwhich the disease was in its second stase, death supervened unexpectedly early, on the fourth and seventh day of the treatment,—in one case by suffocation; in the other, by sudden hydrothorax. The pulse, according to Wolff, was ge- nerally increased under its use; the hectic augmented; the urinary secretion diminished ; the expectoration neither changed in quan- tity nor quality; the cough not mitigated; or the dyspnoea dimin- isbed: on the other hand, they were in four cases, manifestly in- creased: once epistaxis occurred, and twice haemoptysis. From the results of all his trials, Wolff is disposed to think, that creasote should be banished from our list of agents employed in phthisis; both as respects the radical and the palliative treat- ment;* but although they may not sanction us in placing much value on creasote in the treatment of phthisis, it may be improper to ostracise it altogether^ as according to the testimony of others it would seem to have rendered essential service. Rampold and Spath assert, that they have derived advantage from it in con- firmed phthisis where no inflammatory complication was present; the expectoration and colliquative sweats being diminished under its use. M. PetrequinJ from his trials with it considered its effects to be more beneficial—as might be presumed—in incipient than in con- firmed phthisis; but in no case did he observe any thing approach- ing the radical cures described by some. He indeed o-ives the pre- ference to the tar water, (see Aqua Picea.) 15. In bronchorrhea or that state of the bronchial mucous membrane, which consists in a profuse secretion without inflam- mation, the inhalation of creasote has been found of essential service.^ 16. Rheumatism and Gout.—The success, Obtained by Reichll from a tincture of soot in gouty and rheumatic affections, and the Mll^ jK Used in cases of phagedenic ulceration, and to chancres; ap- plied by means of a camel's hair pencil. Shortt.* Unguentum Creasoti. Ointment of Creasote. R. Cerati, 01. amygdal. dulc. aa. 5j. Creasot. gtt. xxx. M. A dressing in scrofulous caries. Fremanger. The Unguentum Creasoti of the London Pharmacopoeia is composed of half a fluidram of creasote to an ounce of lard.f Linimentum Creasoti. Liniment of Creasote. R. Creasot. gtt. v. — xx. 01. olivar. 5ss. M. To be rubbed two or three times a day on the diseased parts, in chronic herpes. Corneliani. CUBEB.E. Synonymes. Piper Cubeba, P. Cubebarum, P. Caudatum, Cubebs. French. Poivre a queue, Cubebe. German. Kubebenpfeffer, Schwanzpfeffer. Cubebs are the fruit of the piper cubeba, which grows in India, Java, Guinea, &c. Sex. System, Diandria Trygynia; Nat. Ord. Piperacese. The corns of this plant have been long known in the shops; and in the old Wirtemberg Pharmacopoeia, they figure as calefacient, inciting, discutient, antinervous, and carminative agents, which seem to have a specific action in vertigo; hence they obtained the name " Schwindelkdrner " or " grains for ver- tigo." They had however fallen into oblivion, until they were re-introduced in modern times into practice, especially by the English physicians and surgeons. The shell of. the dried berry has a weak taste, but smells agree- ably; the kernel has a bitter aromatic flavour which is biting at * Cormack, Op. cit. p. 112. t Brande, Op. cit. p. 202. CUBEBA. 191 first, but afterwards cooling. The corns were analysed by Trommsdorf and by Vauquelin;* but the most recent analysis is by Monheim.t He found, in 100 parts, of lignin 65, of extrac- tive matter 6, of Kubebin 4.5, of a matter like wax 3, of green volatile oil 2.5; of yellow volatile oil 1.0, of balsamic resin— which, according to Vauquelin, is very analogous to the balsam of copaiba—1.5, of chloride of sodium 1.0, and 15.5 parts lost. The woody matter reduced to ashes contained much car- bonate and muriate of potassa and soda. The kubebin appeared to Monheim to be identical with the piperine, but to be united with an acrid soft resin. , The volatile oil may be obtained separate by distillation with water. EFFECTS ON THE ECONOMY. In addition to the general excitant properties of the peppers, the action of cubebs is exhibited on the urinary and genital organs. Under their use, the secretion of urine is augmented, and it becomes of a darker colour, and assumes an aromatic odour. Cubebs have been advised, in modern times—first, in cases of gonorrhea, m which they have been esteemed a specific by many. Yet that which applies to the copaiba is equally applicable to the cubebs. Although the revulsive effect induced by both on the kidneys may mitigate the imflammatory condition of the lining membrane of the urethra, which constitutes gonorrhoea—in violent inflammatory cases, and in the early stages of ordinary cases, they may be inju- rious, and there are many cases on record in which bad conse- quences appear to have resulted from their improper administra- tion. Still, there are many physicians who administer both them and the copaiba in every stage of the disease. Of 50 patients, treated by Mr. BroughtonJ by the cubebs, 10 were cured in from 2 to 7 days ; 17 in from 8 to 14 ; 18 in from 15 to 21 ; 1 on the 55th day; and in 4 only was no success obtained. In the chronic stage of gonorrhoea, M. Ricord§ prescribes the cubebs in combination with the peroxide of iron, and in addition the patient is directed to inject, four times a day, a solution com- posed of aq. destillat. ^viij. argent, nitrat. gr. ij. It has been affirmed, that different evils have ensued from the use of cubebs; which ought to suggest care in their administra- * Memoir, du Museum, vi. 225. f Journal de Pharmacie, xx. 403. X Medico-Chirurgical Transactions, xii. 1. Lond. 1822. § La Lancette Franchise, No. 33. Paris, 1838. 192 CUBEBA. tion: for example,—ardor urinae, fever, inflammation of the ure- thra, bladder and testicles, retention of urine, cutaneous eruptions &c* r In the blennorrhea of females the cubebs are equally extolled by many practitioners, as well as in leucorrhea.f Secondly. Spitta found them very efficacious in old and obstinate cases of coryza when given in the form of lozenges: they are said, likewise, to have been administered with advantage in defective audition caused by a catarrhal affection of the Eustachina tube. Thirdly. Rosen found the chewing of cubebs very serviceable in cases of aphonia. Fourthly. They have been prescribed successfully in cases of chronic rheumatism. Fifthly. PulJ gave them with striking advantage in intermittent fever. Sixthly. In India, they are re^ garded to be aphrodisiac.§ According to Dr. Paris, it is important to keep the bowels open during their use, for when hardened fasces are allowed to accumu- late, the spice insinuates itself into the mass, and occasions exco- riations in the rectum.|| MODE OF ADMINISTERING. Cubebs are commonly given in the form of powder, and in doses of from 1 to 2 and even 4 drams, repeated once or oftener in the day. Lozenges, boluses, and electuaries, are likewise prepared of them; and the London and Dublin Colleges have a Tinctura Cubeba (cubeb. ^iv. sp. tenuior. Oij. Dosef.^i.—3ij.) In conse- quence of the disorder at times induced by them in the digestive function, Velpeau proposed that they should be given in the form of glyster, to the amount of one or two drams of the powder, sus- pended m five or six ounces of an oily vehicle, and this method has its advantages.^ To attain the same object, M.Dublanc, Junr., prepared an oleo-resinous extract, one-sixteenth part of the weight of which possessed equal virtues with one part of the cubebs; five grains, three times a day, acting like the ordinary quantity of the powdered cubebs.** The volatile oil is sometimes given in the dose of 10 or 12 drops, suspended in water by the aid of sugar. * Lond. Med. and Physical Journal, Mar. 1832, and Merat & De Lens, Diet. Umvers. de Mature Med.cale, &c. Art. Piper Cubeba f Eclmb. Med. and Surg. Journal, xviii. 319. Blundell, Diseases of Women, p.loS. Lone.; or Dunghson s American Medical Library Edition. Philad. 1840 ; alBo, Lisfranc by Pauly, translated by Lodge, p. 243. Boston, 1839. X Recueil de MeU Chirurg. et Pharm. Militaire, xvi § Merat & De Lens, Art. cit. II Brande, Dictionary of Materia Medica, p. 205. Lond. 1839 IT Archives Generates de Medecine, xiii. 47. ** Journ. de Chimie Medicale, iii. 491, and Journ. de Pharmacie. xiv, 40. CUBEBiE. 193 Pulvis Cubebarum Compositus. Compound Powder of Cubebs. R. Piperis cubebse pulv. 5i. Ergotae pulveris, tss. Pulv. cinnam. comp. 9ij. Sacchari purificati 3j. Divide in chartulas viij. Dose.—One, three, or four times a day in gonorrhoea, leucor- rhcea, gleet, prostatic and involuntary seminal discharges. Ryan.* Electuarium Cubebarum. Electuary of Cubebs. R. Piper cubeb. pulv. ^ss. Mellis despum. q. s. Fiat electuarium Dose.—A tea-spoonful three or four times a day, in catarrhus vesicas, c.urethrae, &c. Radius. R. Balsam, cepaib. 5ivss. Subige cum Vitello ovi unius, et Adde Pulv. cubebar, Jivss. Conserv. rosar. ^ss. M. fiat electuarium. Dose.—A tea-spoonful three or four times a day. Vogt, R. Balsam, copaib. Pulv. cubeb. aa. ^ij. Aluminis, jj. Extract, opii, gr. v. M. Dose—A dram night and morning in the pulp of a prune. The quantity may be rapidly increased to two drams morning and evening. * Universal Pharmacopoeia, or a Practical Formulary of Hospitals, both Bri- tish and Foreign, by Michael Ryan, M. D. &c. &c. 3d edit. p. 160. London, 1839- n* 194 cubeba: . Trochisci Cubebarum. Lozenges of Cubebs. R. Pulv. cubeb. 5U Balsam, tolut. gr. vj. Admisce Syr. balsam, peruv. Succ. glycyrr. aa. 5j. Gum. arabic. q. s. ut fiat massa in trochiscos pond. gr. x. dividenda. Used in coryza. S pitta. Boli Cubebarum. Boluses of Cubebs. R. Balsam, copaib. Gum. arab. pulv. aa. qIJ. Aquae flor. aurant. ^ij. Terendo bene mixtis adde Cubebar. pulv. Jij. Misce, et fiant boli No. vj. Dose—One, three times a day. Henschel. M. Labelonye* has recently proposed the following method for separating all the principles of tbe cubebs from the ligneous matter. The cubebs, reduced to a coarse powder, are placed in an ap- paratus for displacement and exhausted by ether, which dissolves the wax, volatile oils and balsamic resin. The residue is submitted to the action of hydro-alcohol at 20° (.935,) which dissolves the extractive principle and chloride of sodium. The alcohol and ether are separated by distillation in part, and separately. Evapo- ration of the hydro-alcoholic solution is then carried on in a water bath until it possesses the consistence of a soft extract, to which the ethereal product is added; the evaporation being continued for a short time, the ether is completely volatilised, and a strongly aromatic extract is obtained, as consistent as honey. This it is improper to subject any longer to the action of heat, on account of the contained volatile oils; the presence of which in all cases interferes with complete desiccation. One part of this extract is conceived to be equal to five of the cubebs. This extract can be readily mixed with water by means of mu- cilage, and can be administered in potions, injections, &c. * Bulletin General de Therapeutique, and Amer. Journ. of Pharm. 2d series, vol. 2. p. 316. Philad. 1837. CUBEBjE. 195 The best form of exhibition, according to M. Labelonye, is in lozenges, or in an emulsive syrup. Trochisci Extracti hydro-alcoholici atherei Cubebarum. Lozenges of the ethereal hydro-alcoholic Extract of Cubebs. R. Ext. hydro-alcohol, aether, cubebar. ^viij. Alcohol, Oij. Solve et adde Sacchar. alb. in pulv. ten. fbj. 01. menthae pip. gtt. xviij. Pour the mixture into flat vessels upon a stove, and allow the alcohol to evaporate at a moderate heat. When the mass is com- pletely desiccated, reduce it to a fine powder, and add a sufficient quantity of mucilage of gum tragacanth to form lozenges—18,12, 9, or 6 grains each. Most persons, he says, can swallow with facility those weighing eighteen grains, and containing six grains of the extract; ten of these are equivalent to half an ounce of the powder. Syrupus Extracti hydro-alcoholici atherei Cubebarum. Syrup of the ethereal hydro-alcoholic Extract of Cubebs: R. Ext. hydro-alcohol, aether, cubebar. ^iij. Suspende ope mucilaginis in Aq. menthae pip. fKj- Adde Sacchar. alb. ffcij. M. Four ounces of this syrup contain two drams of extract, equi- valent to ten of powdered cubebs. Dose.—A tea-spoonful. M. Labelonye envelopes the extract also in sugar, as in the or- dinary sugar-plumb. 196 DELPHININA. DELPHININA. Synonymes. Delpbinia, Delphininum, Delphininium, Delphium, Delphia, Del- phinine, Delphine. German. Delphinin. This alkaloid was discovered in 1819, by MM. Feneulle and Lassaigne,* and, almost at the same time, by Brandes,f in the seeds of the Delphinium Slaphisagria, in which it is united with acetic acid. As a therapeutical agent, it has been chiefly recommended by Turnbull; but he did not employ it in its pure state. METHOD OF PE.EPARING. The plan recommended by MagendieJ is to boil a portion of the seeds of the delphinium, cleared of their coverings, and re- duced to a fine paste, in a little distilled water; to pass the de- coction through a linen cloth and filter. Pure magnesia is now added, and it is boiled for some minutes; the filtration is repeated; and the residues washed carefully and digested in highly rectified alcohol. On evaporating the alcoholic tincture, the delphinine is obtained in the form of a white powder, having some crystal- lised points. This is esteemed the most simple mode; but if a large quantity be required, the following plan is advised—on account of the time and patience necessary to decorticate the seeds. Submit the unclean seeds, when well bruised, to the action of weak sulphuric acid. Precipitate the liquor by ammonia, and re- dissolve in alcohol the delphinine, which is still slightly coloured. To purify it, draw off the alcohol by distillation, dissolve the resi- duum in muriatic acid, and boil with magnesia. The plan recommended by Couerbe, and adopted by Turnbull,§ is to evaporate a saturated tincture of the seeds to the consistence of a thin extract, and then to treat it with water acidulated by sulphuric acid. This solution, when filtered, is to be precipitated by ammonia. The precipitate—after being freed from its water —is to be taken up with alcohol, and again reduced to the con- * Annales de Chimie, torn. xi. xii., and Journal de Pharmacie, vi. 47 and 366. f Schweigger's Journal der Chimie, xxv. 369. X Formulaire, &c. 5 On the Medical Properties of the Natural Order Ranunculacese/chapter 2. Lond. 1835. r DELPHININA. 197 sistence of an extract, which is likewise to be dissolved in acidu- lated water; to this solution, filtered, a small quantity of nitric acid is to be added, as long as any precipitate is thrown down. The liquid, freed from this precipitate, is again to be subjected to precipitation by ammonia, and the powder dried. This is the delphinine of commerce; but like veratrine, it is a compound sub- stance, and consists of resinous matter, staphysagrine and delphin- ine; the delphinine is obtained by treating the powder with ether, which takes up the delphinine, and leaves the staphysagrine. When in a state of purity, delphinine is white, pulverulent, and devoid of smell; but like veratrine, when applied to the mucous membrane of the nose, it occasions sneezing, along with an abun- dant secretion of mucus. Its taste is at first bitter, and after- wards acrid, and it acts upon animals in the same manner as— but more energetically than—the seeds whence it is prepared. It is very sparingly soluble in water, but yet in sufficient quantity to communicate a bitter taste to the fluid. In alcohol and ether it dissolves readily, and these solutions have the property of ren- dering syrup of violets green, and of restoring the blue colour of litmus, when reddened by acids. It combines readily with acids, and forms neutral salts, which are possessed of much bitterness and acridity, and it may be precipitated from solutions of these in the form of a jelly by the addition of an alkali. EFFECTS ON THE ECONOMY. From the experiments of Orfila* with this substance, it appears to belong to the class of acro-narcotic poisons. In the dose of about five grains it proves fatal to dogs; and the fatal result is more speedily induced when the delphinine is dissolved in weak acetic acid; the animal, in the latter case, dies in the space of from forty to fifty minutes. When diffused through water intro- duced into the stomach of a dog, and retained there by a ligature placed around the gullet, efforts to vomit supervened, with rest- lessness, giddiness, immobility, slight convulsions, and death in two or three hours. In this case the mucous membrane of the stomach was generally found injected. From his administration of delphinine and its salts, Turnbull concludes, that the pure alkaloid has little effect on the mucous membrane of the stomach and bowels. It may be given, he says, in some cases, to the extent of three or four grains a day, in doses of half a grain each, without exciting vomiting; in this quantity, however, it sometimes operates upon the bowels, but causes very * Nouveau Journal de M£d. x.; and Toxicologie Gen. i. 739. 198 DELPHININA. little irritation. In most instances, it acts as a diuretic, and occa- sions a considerable flow of pale urine. When taken to the ex- tent of a few grains, it induces heat and tingling in various parts of the body, similar to those produced by rubbing it upon the skin; and its other effects are very nearly the same as those of the salts of veratrine. The preparations of delphinine have been used in the same diseases as those of veratrine, and they appear to exert a similar action: the test laid down by Turnbull, in the case of the veratrine, applies equally to the delphinine;—namely, unless a solution of delphinine in alcohol, in the proportion of four grains to a dram, occasions a distinct sensation of heat and pricking, when rubbed for three or four minutes on the forehead, the specimen ought not to be used, as no beneficial effect would arise from its application. When rubbed upon the skin, it gives rise to a sensation of burn- ing, not unlike that which manifests itself a short time after the application of a blister, but not to an unpleasant degree, unless the friction has been carried too far. The effects of the delphi- nine differ also from those of the veratrine in being generally more powerful and durable. The diseases in which the delphinine has been chiefly used, like the veratrine, are—tic douloureux, paralysis, and rheumatism. In the first of these, when the affection is seated in the tongue, or at the point where the infra-orbitar nerve escapes from its fora- men, the use of delphinine, according to Turnbull, is to be pre- ferred, because it can be applied to the tongue, or rubbed on the gums, without occasioning irritation of the mucous membrane. He thinks it, also, upon the whole, better adapted for the treat- ment of paralytic cases than veratrine, but principally on account of the property it has "of exciting the circulation in the diseased part." MODE OF ADMINISTERING. The manner of applying delphinine is the same as that recom- mended for veratrine. It may be used either in the form of oint- ment or in solution in alcohol; and the propordons to be employed, in either case, may vary from ten to thirty or more grains to the ounce, according to the severity of the affection, for the treatment of which it is prescribed. The duration of the friction should also be the same, or until the pungent sensation, produced by the rubbing, exhibits itself. DELPHININA. 199 DIOSMA CRENATA, (FOLIA.) Synonymes.—Barosma Crenata, (folia;) Agothosma Crenatum (folia;) Boc- choe, Bocho, Boocho, Buchu Leaves. German.—Buccublatter; Duftstrauchblalter. This plant is indigenous at the Cape of Good Hope. It belongs to the natural family Rutaceee; class Pentandria, order Mono- gynia. The smell of the leaves is penetrating and peculiar, but re- sembling that of rue and camphor. By some, it has been com- pared to that of the oil of juniper. The name appears to be de- rived from the smell,—$10$, " divine," and ««-a"?, " odour." The taste of the leaves is aromatic, somewhat pungent, and, in the opi- nion of Buchner, resembling that of peppermint; without any par- ticular bitterness, yet disagreeable. According to the analysis of Buchner, the most important constituents appear to be a volatile oil of a greenish yellow colour, a peculiar principle—diosmine, and a semi-resinous substance. The diosmine is a very tenacious adhesive matter, similar to the Peruvian balsam, and can be drawn out in fine threads. It has the same smell as the leaves, only somewhat weaker; the taste is pungent and bitter. The semi-resinous matter has a resinous lustre; is of a dark brown co- lour, becomes fluid when heated, and burns with a flame. Its odour is not remarkable: the taste is somewhat pungent and sourish.* EFFECTS ON THE ECONOMY IN HEALTH. The Hottentots have long used the leaves of several varieties of diosma both internally and externally; but they give the pre- ference to the diosma crenata. Through them its virtues became known to the European settlers. It was first brought to the no- tice of British practitioners by the notorious Richard Reece, who is more known for the part he took in the farce of Joanna South- coat than for any thing else. In Germany, it was chiefly promul- gated by Jobst, who published an extract from Reece's observa- tions in the Repertorium of Buchner.f Bardili instituted experiments for testing the action of the remedy * See Journal de Chimie Medicale, iii. 13, and Journal de Pharmacie, xiii. 106. t Band. xxii. S. 51. 200 DIOSMA CRENATA. on the healthy organism. It first acts as an excitant on the sto- mach, whence arises a feeling of increased heat in that organ, and the appetite becomes augmented; from the stomach, the ex- citement spreads to the vascular system; the heat of the body is increased; the pulse becomes more frequent, and the transpiration is favoured. It acts, likewise, on the urinary secretion; the urine is separated in larger quantity, contains flocculi, deposites a pu- rulent (?) sediment, and exhales an aromatic odour. On the di- gestive function, it seems to produce somewhat of a constipating effect. Bardili thinks, that he has also witnessed some narcotic operation in his experiments. The same results were produced by the diosma on animals. EFFECTS ON THE ECONOMY IN DISEASE. The inhabitants of the Cape administer this agent as a sto- machic, and the Dutch physicians give it with success in indiges- tion. It is said, also, to have afforded essential service in chronic cases of rheumatism and arthritis. Autenrieth extols it in rheu- matic pains, which have had their foundation in repelled itch; and its utility in chronic rheumatism has been confirmed by Jack- son and others. It has been extolled, moreover, in hamaturia, calculous pains, and in irritated and suppurative conditions of the bladder, urethra, and prostate. We have repeatedly administered it, but have observed no other effects than those of a moderate excitant and tonic. Reece found it efficacious in incontinence of urine, and in catarrhus vesica; and he gave it—united with tinc- ture of cubebs—in spasmodic stricture of the urethra, gonorrhoea, swelling of the prostate, and impotence. By the inhabitants of the Cape of Good Hope, the buchu leaves are often applied externally, both in the form of liniment and of baths, in luxations and rheumatic pains,—as well as of fomenta- tions and cataplasms, in wounds, especially the contused. It may be remarked, that this—like almost every similar remedy —has been given in cholera; and the Riga physicians assert, fre- quently with favourable results. MODE OF ADMINISTERING. The dose of the powder is 3ij in the day; this, at least, is the common dose at the Cape. The infusion necessarily contains more of the volatile oil than the decoction; but, on the other hand, the latter has more of the diosmine: as respects their action, how- ever, there is not much difference. A vinegar, oxymel, liniment, extract, and tincture of the diosma have been advised. The London and Dublin Pharmacopoeia have an infusum Dios- ma seu buchu, (§ss of the leaves to foss 0f water Dubl.;) dose ELECTROPUNCTURA. 201 5iss: and the Dublin a tinctura buchu (§ij of the leaves to foj of proof spirit;) dose %i] or 3UJ. Infusum Diosma Crenata Compositum. Compound Infusion of Buchu. R. Fol. diosm. crenat. ----uvae ursi, aa. ±ss. Aq. fervid. 5viij. Digere leni calore in vase clauso per semihoram. Colaturae adde Syrup, seneg. 5ss. Dose—One or two spoonfuls every two hours, in blennorrhcea, and in atony and paralysis of the bladder. Clarus. R. Infus. Diosmae crenatae ^vij. Tinct. Diosmae ----Cubebae aa. ^iv. M. Dose.—Two table spoonfuls three times a day. This formula is recommended by Dr. Joy* " in chronic diseases of the prostate, bladder, and kidneys, gravel, &c," as if the pathological condi- tion to be rectified were, in all these cases, identical! (See page 130.) ELECTROPUNCTURA. Synonymes.—Electropuncture. This consists in a union of acupuncturation with electricity. The idea of the conjunction appears to have originated with Ber- lioz ; but Sarlandiere was, doubtless, the first who put it in prac- tice, although J. Cloquet has contested the priority with him—a matter, by the way, as in all such cases, of extremely small mo- ment. The operation consists in employing acupuncturation in the usual way, either with a single needle, or with two or more; and making a communication between them and the prime con- ductor of an electrical machine; or they may be made to form part of the circuit in the discharge of a Leyden jar. In this way, the electrical influence may be graduated from the simple aura to * Tweedie's Library of Medicine, v. 311. Lond. 1840. 18 202 ELECTROPUNCTURA. a full shock. Sarlandiere appears to have employed electropunc- ture with great success, but he restricts its use to rheumatic or neuralgic pains, uncomplicated with organic mischief or inflam- mation: when such complications exist, he advises blood-letting and general antiphlogistics to be premised.* Guersent thinks it better, in all these cases, to use simple acu- puncturation, and only to employ electropuncture, when the first proves to be inadequate, as in paralysis, and in tremors produced by the immoderate use of mercury;—in all cases, indeed, in which the malady depends on a diminution of the nervous energy. A case of success from its use, in paralysis of the right arm, in which voluntary motion and sensibility were destroyed, has been recent- ly published.f The patient was, in the first instance, subjected to the use of blisters and moxas along the course of the radial nerve, from which he obtained some advantage. The remedy which succeeded best, however, was electropuncture along the nerves from the shoulder to the hand. At first, the punctures were but little felt, but afterwards they were very painful. The sensibility, mobility, and strength of the fingers and hand gradu- ally returned; and, three months after his admission, the patient left the hospital completely cured. Magendie affirms, that he has treated many cases of incom- plete amaurosis with great success by this agency. He employed it, however, in the form of what has been more* properly termed galvanopuncture; by fixing a needle in the frontal nerve, and an- other in the superior maxillary, and making these communicate respectively with the poles of a galvanic pile of twelve pairs of plates, each six inches square. Whenever the contact was made, the patient experienced a painful commotion in the course of the nerves, and at the bottom of the orbit; the light became better appreciated, and the pupil contracted. We have frequently used both electropuncture and galvano- puncture in rheumatic and neuralgic affections; but do not think the advantages were more marked than those of simple acu- puncture, whilst the suffering from the operation was certainly greater. J In cases of asphyxia, galvanopuncture has been proposed to arouse the dormant energies. The effect of electricity, in the different forms in which it is adopted in medicine, on the func- tions of sensibility and muscular contraction, could not fail to sug- gest it early to observers as a fit agent for this purpose; but it is rarely at hand, and, therefore, seldom available. J. P. Frank, Wiss'en^. 550. H£ff ST' " ^^ ^^ *" mediCiniSCb" OclYe^STp6 2r5.nS°iSe' DeC'2°'1836; and American M*d. Intelligencer, ELECTROPUNCTURA. 203 Thillaye,* and others have highly recommended it;—the latter gentleman, on the strength of numerous experiments on animals. As the object, in these cases, is to arouse the respiratory muscles to action, the electric shock may be passed through the shoulders or the chest in any direction. Neither common nor galvanic electricity is possessed of any power to restore the action of the involuntary muscles. We have frequently attempted to re-excite the action of the heart, intestines, fibres of the uterus, &c. soon after the cessation of respiration and circulation, by means of the galvanic stimulus, but without the slightest success, although the voluntary muscles responded to it energetically. Besides, were the action of the heart re-excited by it, this could be but momen- tary. A necessary stimulating agency to that viscus is disten- sion by the proper fluid, and unless the respiratory movements were restored, and conversion of venous to arterial blood effected, so that the latter could reach the left heart, the action of that or- gan could not be maintained. Every attempt, therefore, is pro- perly made to restore the action of the respiratory muscles, so that haematosis may be accomplished.! M. Leroy d'EtiolesJ has suggested galvanopuncture in a man- ner which, at the first aspect, appears most formidable; but which is really less so than it seems to be, in consequence of the impu- nity with which fine needles can be made to penetrate, as we have seen,§ even the most important organs. He introduced an acu- puncture needle on each side between the eighth and ninth rib, until it reached the fibres of the diaphragm. He then established a galvanic current between the needles by means of a pile of twenty-five or thirty pairs of plates, an inch in diameter. The diaphragm immediately contracted, and an inspiration was ac- complished. He then interrupted the circle, when the diaphragm, urged by the weight of the abdominal viscera, and aided by gen- tle pressure made on the abdomen by the hand, returned to its former position, and an expiration was effected. In this way, the two respiratorv acts were made to succeed each other, and regu- lar respiration was reinduced. A continuous current was like- wise emploved in some cases, but the respiratory movements were irregular, and nothing like natural respiration resulted. Leroy tried his method on animals asphyxied by submersion, * Archives Generates de Medecine, xii. f Art. Asphyxia, by the author, in the American Cyclopedia of Practical Me- dicine, part x. p. 486, Sept. 1836. X Magendie's Journal de Physiologie, torn. vii. 1827; torn. viii. and torn, ix.; also, Recherches Expe>imentales sur I'Asphyxie, Paris, 1829; and Bourgeois, Observations sur la possibility du retour a la vie dans plusieurs casd'Asphyxie. Paris, 1829. 5 See Art. Acupuncture. 204 EMETINA. and when they had not been under water more than five minutes, they were often restored. These experiments were witnessed by Magendie.* On differ- ent occasions, M. Leroy asphyxied animals of the same kind, and apparently of the same strength, and whilst those that were left to themselves perished, those that were treated by galvanism re- covered. As an aid, therefore, to pulmonary insufflation, and an import- ant one, galvanism, combined or not with acupuncturation, might be advantageously employed in asphyxia, but as has been already remarked, it can rarely be available. Certainly no time should be lost in adopting the other energetic and indispensable measures that are demanded.f It has been recommended, that as only a very small apparatus is necessary, batteries, consisting of a few plates, might be kept wherever there are station-houses for the reception of persons in a state of asphyxia.J The suggestion is good; and they might also with propriety form a part of the cabinet of apparatus of the private practitioner; but whilst an as- sistant is preparing the apparatus for action, the practitioner should be assiduously engaged in applying other means of resus- citation.§ EMETINA. Synonymes. Emetia, Emeta, Emetinum, Emetine. German.—Emetin, Brechstoff. • In the year 1817, MM. Pelletier and Magendie,|| byl series of chemical and physiological experiments, discovered, that the va- rious kinds of ipecacuanha are indebted for their emetic proper- ties to a peculiar substance to which they gave the name Emetine. This substance possesses the emetic power in a very concen- trated state, and has neither the disagreeable smell, nor the nau- * Journal de Physiologie, ix. t See Art. Asphyxia, Op. cit. p. 486. X Kay, in Edinb. Med. and Surg. Journ. xxix. and in his work on Asphyxia. Lond. 1834. § See Most, Art. Galvanismus, in Encyklopad. der gesammten medicin. und chirurgisch. Praxis, u. s. w. 2te Auflage. Leipz. 1836. II Journal de Pharmacie, iii. 145, and Magendie's Formulaire pour la prepa- ration de plusieurs nouveaux medicamens, &c. EMETINA. 205 seous taste of the ipecacuanha. They considered, therefore, that it mio-ht be advantageously substituted for ipecacuanha on all oc- casions.' There are two varieties of the active principle—the coloured and the pure, which, as Magendie remarks,* bear the same rela- tion to each other as moist sugar does to the white and crystal- lised. Ipecacuanha, derived from the cephaelis ipecacuanha, contains the most emetine. Emetine has been received into many of the Pharmacopoeias, as the Parisian, Batavian, Hannoverian, &c. MODE OF PREPARING. 1. Coloured Emetine.—Powdered ipecacuanha is digested with ether at 60° (.720) to dissolve the fatty matter, whence it de- rives its disagreeable odour, and which possesses no emetic vir- tue. When the powder yields nothing more to the ether, it is ex- hausted by means of alcohol: the alcohol is then evaporated in a water-bath, and the residue is dissolved in cold water. It thus loses some of the wax, and a little fatty matter, which still ad- hered to it; it is then only necessary to mix it with the carbonate of magnesia, whereby it loses its gallic acid,—to redissolve it in alcohol, and to evaporate to dryness. By a similar process, M. Boullay obtained from the roots, leaves, flowers, and seeds of the viola odorata, an active, alkaline, bitter and acrid principle, similar to emetine from ipecacuanha, which he denominates emetine of the violet, indigenous emetine or violine. According to Orfila, it possesses highly poisonous quali- ties.f 2. Pure emetine.—-This is obtained by substituting calcined magnesia, for the carbonate used in the process just described, in such quantity, that the acid existing in the liquid may be neutral- ised, and that which is associated with the emetine be separated from it. The precipitate of magnesia and emetine must now be washed with a little very cold water, to remove the colouring matter, which is not combined with the magnesia; and after being care- fully dried it must be treated with alcohol, which dissolves the emetine. The emetine, obtained by the evaporation of the alco- hol, must then be dissolved in a dilute acid, and treated with pure animal charcoal. After this purification, the emetine must be precipitated by a salifiable base. The waters, used to wash the magnesian precipitate, still con- * Op. cit. f Journal de Pharmacie, Janvier, 1824. 18* 206 EMETINA. tain emetine, which may be separated by a second series of opera- tions. Coloured emetine appears in the form of reddish brown, trans- parent scales; is almost inodorous, and of a bitter, but not nau- seous taste. It can withstand the heat of boiling water without experiencing change; is very deliquescent, soluble in water, and not crystallisable. Pure emetine has a white and frequently a somewhat yellowish appearance; is pulverulent, and does not deliquesce, like the for- mer, in the air. In cold water, it is but little soluble; more so in warm.* In ether and alcohol it dissolves readily. Its taste is feebly bitter. It has an alkaline reaction, is dissolved by all the acids—diminishing their acidity, but without wholly neutralising them. With the acids it forms crystallisable compounds, from which it may be precipitated by galls, which are the best agents for obviating the effects of emetine, when given in too large a dose. EFFECTS ON THE ECONOMY IN HEALTH. According to Magendie,* from half a grain to two or three grains of coloured emetine given to dogs and cats, excited vomit- ing, at times followed by a long sleep. In larger doses, ten grains for example, it occasioned, in dogs, repeated vomiting, after which the animal fell asleep, and generally died in twenty-four hours. On dissection, violent inflammation was found in the lungs, and in the mucous membrane of the stomach and bowels throughout their whole extent. The effects were the same when the emetine was injected into the jugular vein, or absorbed from any part of the body. In a healthy man, two grains of coloured emetine, taken fasting, produced repeated vomiting, to which succeeded decided disposition to sleep. Even a quarter of a grain at times induced nausea and vomiting. It acted also on the bowels. The effects of pure emetine are analogous, but more powerful; two grains were sufficient to kill a strong dog. EFFECTS ON THE ECONOMY IN DISEASE. The same effects are induced on the morbid as on the healthy economy. Magendie recommends the administration of the coloured eme- tine—as the pure is much too dear—in every case where it is desirable to excite vomiting, and especially where ipecacuanha is * Op. citat. EMETINA. 207 indicated. It has not, however, been much used, except by Ma- gendie himself. Lerminier, who prescribed it, says that one or two grains of coloured emetine are equal in strength to from ten to twenty of ipecacuanha; but that he observed no difference in their operation, and Dr. Domeier* appears to have arrived at the same results. The obvious advantages it possesses are—the con- venient and agreeable form under wdiich it may be administered, and the circumstance, that several spurious sorts of ipecacuanha are frequently passed off in commerce, and occasion, in conse- quence, considerable disappointment in the mind of the practi- tioner. The employment of the active principle of course pre- cludes these inconveniences.f Prollius, of Wolfhagen, has frequently administered the pure emetine, which he recommends as a substitute for ipecacuanha, on the grounds above mentioned; and he properly adds, that the price is not a matter of so much moment as it might seem to be by reason of the very small quantity required to produce the de- sired effects. MODE OF ADMINISTERING. To produce vomiting, three grains of the coloured emetine may be dissolved in any vehicle, and given in divided doses, at short intervals. In several cases, Dr. DomeierJ found one grain amply sufficient. Of the pure emetine, Magendie found, in a man eighty- five years of age, one sixteenth of a grain sufficient to induce vo- miting. He remarks, however, that the man was easily made to vomit. Prollius found the medium dose of the pure emetine, for an adult, to be from two sixteenths to three sixteenths of a grain; sometimes it was requisite to give another sixteenth. Very rarely was it necessary to give more than four sixteenths, or one fourth of a grain. As, on account of its sparing solubility, pure emetine, when given alone, might be restricted in its operation, Prollius adds an equal portion of tartaric acid and a little sugar. Mistura Emetina Vomitoria. Emetic Mixture of Emetine. R. Emetin. colorat. gr. iv. Infus. fol. aurant. ^ij. Syrup, flor. aurant. 5ss. M. * London Medical Gazette, Sept. 14, 1839, p. 929. f Clinique Medicale, vol. i. Paris, 1823. X Op. citat. 208 EMETINA. Dose.—A dessert-spoonful every half hour,—to excite vomiting. Any simple distilled water and syrup may be substituted for those of the orange flowers. . • Magendie. Pastilli Emetina Pectorales. • Pectoral Lozenges of Emetine. R. Emetin. colorat. gr. xxxij. Sacchar. alb. 5iv. Mucilag. q. s. ut fiant pastilli, pond. gr. ix, sing. These lozenges are commonly coloured red, .fo distinguish them from those of ipecacuanha. A little carmine may be added for this purpose. Given incases of catarrh, hooping-cough, chronic diarrhoea, &c. Dose.—One pastile occasionally. Magendie. Pastilli Emetina Vomitorii. Emetic Lozenges of Emetine. R. Emetin. colorat. gr. xxxij. Sacch. alb. 5ij. Mucilag. q. s. ut fiant pastill.. pond. gr. xyiij. Dose.—One of these lo'zenges taken fasting is generally enough to make a child vomit: three or four are Required for an adult. ... Magendie. Mistura Emetina Purificata Vomitoria. Emetic Mixture of Purified Emetine. R. Emitin. purif. in pauxil. acid. nitr. solut. gr. j. Infus. flor. tiliae, ±iij. Syrup, althseae, 5j. M. Dose.—A dessert-spoonful to be given every quarter of an hour, until vomiting is induced. Magendie. EUPHORBIA LATHYRIS. 209 EUPHORBIA LATHYRIS. Synonymes.—Cataputia Minor, Lathyris, Tithymalus Latifolius, Caper Spurge, Garden Spurge, Mole Plant. The oil of this plant, which is indigenous in France, and is monoecious, has been recently recommended in medicine. Although the euphorbia is is not a native of this country, it is sometimes met with in situations where it has the appearance of growing wild. It is easily cultivated, and in some parts of New Jersey, where it has been introduced, is found in abundance.* The oil, obtained from the seeds, resembles in colour the oleum ricini, but is less dense. It has no odour when newly prepared, and no perceptible taste. It is soluble in sulphuric ether, insoluble in alcohol, and forms a soap with the alkalies. Its s. g. is .920. EFFECTS ON THE ECONOMY IN DISEASE. Dr. Charles Calderini found, that, in the dose of from four to eight drops, it acted as a cathartic on the adult, without occasion- ing colic or tenesmus. In half the quantity, it proved cathartic to children. He gave it in sugared water, or in the form of an emul- sion ; and was of opinion that it might be advantageously substi- tuted for castor oil, especially for children. After him, it was employed by M. Grimaud, and subsequently by M. Bally ,f who carried the dose as far as ten drops. Louis Frank J has suggested its employment in cases of tania, hysteralgia, ascites, &c. It would appear from the remarks of Mr. Scattergood, that the oil, obtained from the beans grown in this country, does not pos- sess the mild qualities ascribed to the European article. Six, eight, ten, and twelve drops were given to several individuals as a cathartic; and, although administered in conjunction with aro- matic oils, and in one or two cases with an alkali in the form of soap, it invariably produced nausea, and even vomiting. Mr. Scattergood adds, that he has been informed by the manufacturer, Mr. Thomas Bellangee, of Crosswicks, New Jersey, that when * Scattergood, in Philad. Journ. of Pharmacy, iv. 124, Philad. 1833. See, also, Journal de Chimie Medicale, ii. 178. f Journal Universel des Sciences Medicales, xli. 254. \ Journal de Pharmacie, xi. 273; and Merat & De Lens, Diet, de Mat. MeU iii. 183. Paris, 1831. 210 FERRI PRjEPARATA. administered in small quantities, and repeated at intervals of half an hour or an hour, it operates on the bowels freely as a cathar- tic, without producing much nausea. Pichonnier* has proposed the following formula for a cathartic mixture. Mistura Olei Euphorbia. Mixture of the Oil of Euphorbia. R. Olei euphorb. lathyr. gtt. viij. Pulv. gum. arab. 5J« Sacchar. 5ij. Aquae destillat. giij . M. FERRI PR.EPARATA. Synonymes. Preparations of Iron. French.—Les Preparations de Fer. German.—Eisenpraparate. I. FERRI ARSENIAS. Synonymes. Ferruni Arseniatum, Ferrum Arsenicicum Oxydulatum. French.—Arseniate de Fer. German.—Arsensaures Eisenoxydul, Arseniksaures Eisenoxydul. This preparation has been recommended by Mr. Carmichael,f who often applied it externally in cases of cancerous ulcers. Na- turally, it presents itself in small, clear, bluish green crystals, of a' regular octaedral shape, and is called scorodite. Artificially, it is formed by double decomposition. METHOD'OF PREPARING. Glaser gives the following formula for its preparation. Eight ounces of semivitrified white arsenic, sprinkled with a little spirit * Journal de Chimie Medicale. Paris, 1827. f An Essay on the effects of the Carbonate and other Preparations of Iron upon Cancer, 2d edit. Dublin, 1809. FERRI ARSENIAS. 211 of wine and reduced to fine powder, are mixed with as much pu- rified saltpetre. The mixture is placed in an uncovered Hessian crucible, which should only be half filled with it, and then be placed in a wind furnace. At first, a slight degree of heat is ap- plied, under which the mass soon melts, giving off copious red fumes, the inhalation of which should be carefully avoided. The process had better, therefore, be carried on in the open air, or in a laboratory that has a chimney with a good draft. When the mass no longer gives off red fumes, and flows tranquilly, the cru- cible must be carefully removed from the fire, the contents be suffered to cool somewhat, and boiling distilled water be poured upon them: under active boiling they will dissolve altogether. Hot water, sufficient to fill the crucible, is now added, and the whole is allowed to remain at rest for twenty-four hours; at the expiration of which time a considerable quantity of beautiful cry- stals of acid, arseniate of potassa is found on the sides of the cru- cible. The fluid, holding the salt in solution, is now filtered into a clean porcelain or glass vessel; the crystals are collected, dried carefully in the shade, and put away amongst the poisons as the Arsenias potassa acidus. ^ The fluid poured from the crystals and filtered is now diluted with distilled water, and a solution of pure sulphate of iron added thereto so long as any precipitate is thrown down. The bluish green precipitate, insoluble in water, is the ferrum arseniatum, which must be collected on a filter, washed and dried in the shade. The process must be conducted with the greatest care, and the vessels used be cautiously cleansed or broken, for fear that mis- chief may arise. In these chemical operations, the acid of the saltpetre is decomposed by being heated with the arsenious acid or white arsenic, a part of its oxygen is taken by the latter, and arsenic acid is thereby formed, which unites with the potassa of the saltpetre and forms acid arseniate of potassa; the nitric acid being converted into nitrous acid is given off in the form of red fumes: by admixture of a solution of sulphate of iron with the so- lution of the acid arseniate of potassa, a double decomposition ensues, the result of which is the formation of sulphate of potassa and arseniate of iron, which last, being insoluble, falls to the bot- tom of the vessel. EFFECTS ON THE ECONOMY. According to Carmichael, this preparation acts more power- fully on the vitality of cancerous formations than any other agent, and the dead slough caused by it is much deeper than that caused by the application—which was at one time so much celebrated- called " Plunket's caustic." He allows, however, that the great- est caution should be observed in its use. Of late, he has em- 212 FERRI ARSENIAS. ployed a compound of the arseniate of iron with phosphate of iron; half a dram of the former to two drams of the latter. This mixture must be applied very thin by means of a camel's hair pencil, and not over the whole surface of the ulcer when it is ex- tensive. MODE OF ADMINISTERING. The compound just mentioned may be applied in the form of ointment, prepared in the following manner:— Unguentum Ferri Arseniatis Compositum. Compound Ointment of Arseniate of Iron. R. Ferri arseniat. zss. ---- phosphat. 3ij- Ung. cetacei. 3vi. M. This ointment must be spread on lint and applied to the ulcer. Werneck gives it the preference over all the usual arsenical pre- parations. The arseniate of iron has likewise been administered internally in cancerous affections. The following formula may be used. Pilula Ferri Arseniatis Composita. Compound Pills of Arseniate of Iron. R. Ferri arseniat. gr. iij. Extract, gentian. 3j- Pulv. glycyrrhiz. 3ij- Syrup, cujusvis q. s. nt fiat Massa, in pilulas xlviii dividenda. Dose.—One, three times a day. FERRI BROMIDUM. 213 II. FERRI BROMIDUM. Synonymes.—Ferrum Bromatum, Bromated, or Bromide of, Iron;—in solution, Hydrobromate of Iron, Ferri Hydrobromas. French.—Bromure de Fer. German.—Bromeisen. METHOD OF PREPARING. This preparation is made by heating equal parts of bromine and iron filings under water. As soon as the fluid becomes of a greenish color it is filtered, and evaporated to dryness: the red- dish residue—again dissolved in water and evaporated—is , the bromide of iron. It has a brick-red colour; dissolves readily in water, is deliquescent in the air, and has a very styptic taste.* EFFECTS ON THE ECONOMY AND MODE OF ADMINISTERING. Magendie has prescribed it successfully in cases, in which the preparations of bromine have been indicated. (See Brominum, p. 96.) He recommends the following formula. Pilula Ferri Bromidi. Pills of Bromide of Iron. R. Ferri bromid. pulv. gr. xij. Confect. rosar. gr. xviij. Gum. arab. gr. xij. Fiat massa in pilulas xx dividenda. j)ose.—Two, morning and evening. Magendie. R. Ferri bromid. 3j. Extract, glycyrrhiz. q. s. ut fiat massa in pilulas lx dividenda. D0Se.—One or two, morning and evening, in cases of scrofula and hypertrophy,—of the uterus especially. Werneck. * Magendie, Formulaire pour la preparation, &c, de plusieurs nouveaux medicameus, derniere 6dit. 19 214 FERRI carbonas. III. FERRI CARBONAS. Synonyme. Carbonate of Iron. I. FERRI PROTOCARBONAS. Synonyme. Protocarbonate of Iron. The precipitated carbonate of iron contains but little carbonic acid,—the remainder being chiefly peroxide of iron. The name has indeed been changed—in the last London Pharmacopoeia—to " sesquioxide of iron." The protocarbonate readily absorbs oxygen, and, consequently, becomes converted into the sesqui- oxide; and this is an objection commonly urged both against the Mistura Ferri Composita, and the Pilulae Ferri Composites of the Pharmacopoeias. This objection M. Vallet has discovered a method of obviating, which consists in mixing the protocar- bonate with saccharine matter. 1 MODE OF PREPARING. The following method is given by Mr. Procter* as a simpli- fication of M. Vallet's process. Take of protosulphate of iron (pure) 16 parts; carbonate of soda (crystallized) 19 parts; pure boney, 9 parts; syrup, a sufficient quantity. Dissolve the sul- phate in half a gallon of water, at the temperature of 180° Fah- renheit, and the carbonate of soda in a like quantity; to each of these solutions add four ounces of syrup; and then mix them in a jar, which should afterwards be entirely filled with sweetened water, and the access of air prevented. After the precipitate has subsided, decant the supernatant fluid, and then wash it with sweetened water, in the jar, until deprived of the adhering sul- phate of soda. After the carbonate is thus purified, throw the precipitate on a flannel cloth; express forcibly, and mix it with the honey. The mixture should then be reduced by evaporation as rapidly and carefully as possible to a pilular consistence. The mass constitutes the " Ferruginous Pills," of M. Vallet. When prepared in this manner, the protocarbonate has a dark olive colour, strong ferruginous taste, contains about 30 per cent of protoxide of iron, and if carefully prepared dissolves wholly and directly in acids. * The American Journal of Pharmacy. Jan. 1839, p. 272. FERRI PROTOCARBONAS. 215 EFFECTS ON THE ECONOMY. The pills of M. Vallet have been prescribed in most of the dis- eases in which chalybeates in general are considered to be indi- cated; and especially in chlorosis and amenorrhcea.* It has been affirmed, that in cases in which the alterative effects of iron are proper, Vallet's preparation is superior to any other derived from that metal.f This can only be decided therapeutically; and as yet the trials have been too few. The author has exhibited it freely, but has not had reason to assign it any pre-eminence. It is certainly preferable to any other form of preparing the proto- carbonate for medical use, in consequence of its stability, but it has to be determined, whether the conversion into the sesquioxide renders it less efficacious as a medicine. Blaud, as we shall see presently, says distinctly not. MODE OF ADMINISTERING. The mass of pilular consistence, described above, may be made up into pills, each weighing three grains, and containing somewhat less than a grain and a half of the protocarbonate. They may be given to the extent of eight or ten pills daily, and be continued for weeks, if necessary. A medicine, which greatly resembles the Pilulas Ferri Com- posite of the Pharmacopoeias, and in which the iron, when it is newly prepared, is in the state of protocarbonate, has acquired great celebrity in the south of France, on account of its benefi- cial effects in chlorosis. It is given in the form of pill, and is called after its inventor,—Dr. Blaud, senior physician to the Hos- pital of Beaucaire,—" Blaud's Pills." Blaud's formula for the preparation of his pills is as follows:— Take of Gum Tragacanth, in powder, six grains; water, one dram. Macerate in a glass or porcelain mortar, until a thick mucilage is formed; and if it be desired to prevent the for- mation of peroxide of iron, and to make the pills similar to those of Vallet, substitute—says Mr. Blaud—a dram of powdered sugar for the mucilage. Add, afterwards, of sulphate of iron, in powder, half an ounce. Beat well, until the mixture is quite homogeneous; and add subcarbonate of potassa,J half an ounce. Beat until the * Soubeiran, Rapport sur les nouvelles pilules ferrugineuses de M. Vallet, in Bulletin general de Therapeutique, Mai, 1833, and in Amer. Journal of Pharm. x. 244. See also Berthemot, in Bull, general de ThSrapeut. Juillet, 1839. f Wood and Bache's Dispensatory of the United States, 4th edit. p. 1170. Philad. 1839. X M. Giubourt substitutes the bicarbonate for the simple carbonate or sub- 216 FERRI PROTOCARBONAS. mass, which soon becomes of a yellowish green colour, passes to a deep green, and assumes a soft consistence. Divide into 48 pills; which M. Blaud considers sufficient for the cure of a chlo- rotic patient.* A proper objection made to these pills is their excessive size: and farther it has been urged, that a chemical change quickly occurs in the mass; the carbonate of the protoxide being, after "a short time, converted into the sesquioxide of iron.f Blaud,J however, maintains properly, that the virtues of medicines can- not be appreciated from chemical experiments; " It is," he re- marks, " to therapeutical trials, and not to chemical experiments that we must have recourse, to learn accurately the medical properties of any agent. What signifies it to practitioners that my pills contain little or no protoxide of iron, provided that they cure chlorosis?" To prove that they do possess this power, Blaud adduces a long list of cases in which a cure was obtained in three or four weeks. To prevent, however, the change to which the chemists object, but which Blaud appears rather to regard with favour, M. Adorne has suggested the addition of sugar and the pulvis althasae, accord- ing to the following form:—Take of sulphate of iron, recently prepared, according to the method of, Bonsdorff,§ which is a pure sulphate; subcarbonate of potassa, or what is better, subcarbonate of soda; powdered root of the marshmallow and sugar, each, half an ounce; mucilage of gum arabic and sugar, as much as is sufficient. Make into 96 pills, which must be covered with a very fine layer of gum and sugar, aromatized with essential oil, to correct the disagreeable odour.|| M. Blaud commences with his " antichlorotic pills," in the dose of one a day; and in the course of a few days gives two, and afterwards three, daily. Mr. Donovan0!! recommends the protocarbonate of iron to be administered in the following manner, for extemporaneous use:— Blue sulphate of iron, in fine powder, half an ounce: calcined carbonate; and he gives as reasons: First, The avoidance of a very alkaline saltpan excess of which may not prove beneficial to the stomach; and Second- ly, The formation of a double carbonate of potassa and iron, which is, of all the compounds of iron, the most fitted for absorption by the economy, as it is not only soluble, but not astringent. His form is the following :—Take of pure crystallized sulphate of iron, crystallized bicarbonate of potassa, each 4 drams; powdered gum Arabic, one dram ; powdered marshmallows, half a dram. Mix and divide.mto 96 pills. Pharmacopee Raisonnee, i. 383; and Amer. Journal of Pharmacy, April, 1839, p. 61. * Revue Medicale, Mars, 1832, Dec. 1838. f Soubeiran, Bull, general de Therap. Mai, 1838. J Ibid. $ Dr. Bache, in Wood and Bache's Dispensatory, 4th edit. p. 906. Philad. 1839. II Bulletin Medical du Midi, Janvier, 1839; Encyclographie des Sciences medicales, Mars, 1839. 17 Dublin Journal of Medical Science, Mar. 1840, p. 159. FERRI CABONAS PR^CIPITATUS. 217 magnesia, two scruples: water, six ounces: tincture of quassia, two drams. Divide into six draughts, one to be given night and morning. II. FERRI CARBONAS PR^ECIPITATUS. Synonymes.—F. Subcarbonas, Ferrum Carbonatum Prsecipitatum, Ferrum Carbonicum Oxydulatum, Oxydum Ferri Fuscum, Deuto-Carbonas Ferri Fuscus, Crocus Martis Aperiens, Ferri Sesquioxydum, Subcarbonate of Iron, Sesquioxide of Iron, Peroxide of Iron. French.—Souscarbonate de Fer, Safran de Mars Aperitif. German.—Kohlensaure Eisenoxydul. This preparation, which is officinal in the British, American, and other pharmacopoeias, is formed by adding a solution of car- bonate of soda to a solution of sulphate of iron: the precipitate is the carbonate, or subcarbonate, or—as it is now called in the London Pharmacopoeia—the sesquioxide of iron, which must be washed with water, and dried. EFFECTS ON THE ECONOMY. The precipitated carbonate of iron possesses the properties of the chalybeates in general, and has been highly recommended as a tonic, wherever such remedies are indicated. It is introduced here, mainly on account of the favour which it has received, of late years, as a remedy for neuralgia. Thirty years ago, its use was strongly advised in cancer and carcinomatous ulcerations of the uterus, by Mr. Carmichael;* and, subsequently, by Rust, Voelker, and Kopp; as well as in a case of lupus of the ala nasi, by Key:f but, in similar cases, it proved unsuccessful in the hands of Clarke, El. Von Siebold, Meissner, Richter, and others.J In chronic nervous diseases, of a spasmodic nature, and especially in tic douloureux of the face, it was first highly extolled by Mr. Benjamin Hutchinson, about twenty years ago,§ who published several cases of cure effected by its agency. Soon afterwards, cases, equally fortunate in their termination, were published by various observers, by Drs. A. T. Thomson,|| Stewart Crawford,1H R. Macleod,** Mr. J. E. Beale,ff and many others, and its effi- * An Essay on the Effects of the Carbonate and other Preparations of Iron upon Cancer, 2d edit. Dublin, 1809. f Lancet, xiv. 92. X Osann, in Encyclopad. Worterb. der medicinisch. Wissenschaft. x. 424. Berlin, 1334. § Cases of Tic Douloureux successfully treated. Lond. 1820. || Medical and Physical Journal, Feb. 1823. IT Ibid. ** Ibid. June, 1823. ft Ibid. Sept. 1823. 19* 218 FERRI CARBONAS PRiECIPITATUS. cacy is now almost universally admitted. Dr. Rowland* hag often witnessed the most happy results from its exhibition, even after various powerful medicines had been tried in vain. Dr. Elliotsonf published several cases, in which the remedy, in large doses, had been efficacious; and he remarks, that true chronic neuralgia, not arising from cold, and coming on in a vio- lent, stabbing, plunging form, aggravated by the least shake of the patient, and by touching the surface, is best treated by the subcarbonate of iron. He observes, however, in a recent publi- cation,;!, that he does not recollect that he ever cured the disease, but in almost every case improved it, and caused it to disappear for a time. In one of the severest cases of neuralgia, under the form of hemicrania, which we ever witnessed, and which had rendered the patient's life miserable for years, the subcarbonate of iron, in large doses, proved, in our hands, entirely successful. The patient had been bled repeatedly; and when we saw her, she was under the most favourable circumstances for the exhibition of the remedy,—with the surface pale and cool; the pulse small; complaining much of debility, and yet suffering under the most intense headach, which the least light and noise rendered almost intolerable; yei, after she had persevered in the use of the remedy for a month, in large doses, the symptoms gradually disappeared, and she has since remained entirely well. It need scarcely be said, that where plethora exists, or febrile irritation supervenes, it must be removed; the subcarbonate rarely, however, disagrees with the stomach, and where it does, the inconveniences are re- moved by the addition of an aromatic, or the administration of a cathartic. The subcarbonate of iron, in large doses, has, likewise, been found a valuable agent in a kindred condition of the nervous sys- tem—chorea. Dr. Elliotson§ affirms that he has had—he should suppose—forty cases, in succession, all cured by it; but perseve- rance in its use is demanded, the affection generally disappearing when the remedy has been given about six weeks or two months; but in some obstinate cases, it has been necessary to continue it for twelve weeks. Like other tonics, it has been prescribed in intermittents, and not long ago, M. Gimon,]| physician at Thouars, published two cases, elucidative of the effects of large doses in long protracted intermittents, complicated with ascites and enlargement of the * Treatise on Neuralgia, by Richard Rowland, M. D., p. 84. Lond. 1838 ; and the reprint in the author's American Medical Library. f Medico-Chirurgical Transactions, xv. 161. X Principles and Practice of Medicine, &c. by John Elliotson, M. D.; with Notes, &c. by Nathaniel Rogers, M. D. p. 507. Lond. 1839. § Op. citat. p. 515. || Journal des Connoissances Medico-Chirurgicales, Mai, 1837. FERRI CARBONAS PRjECIPITATUS. 219 spleen. One of these occurred in a boy nine years old, and the other in a young man of twenty-one. Both had taken the sul- phate of quinine in large doses, but ineffectually. To the former, he prescribed twelve grains of the subcarbonate in the twenty- four hours, augmenting the dose by six grains daily. The treat- ment was commenced in the latter end of July, 1835, and the quantity taken in the day was pushed progressively to one ounce. In six months, the traces of ascites and splenocele had disap- peared, and the cure was complete. The medicine was discon- tinued by gradually diminishing the dose. In the second case, the same dose was prescribed, in the first instance, and it was ulti- mately carried to six drams, with complete success. More recently, still, Dr. Steyman* has recommended the car- bonate of iron for the treatment of hooping-cough, in the dose of half a grain at the least, to be taken every three hours with sugar, and increased to as many grains as, and more than, the number of years of the child's age. It should not, he advises, be admi- nistered in the first stage of the disease; and, in all cases, should be preceded by an emetic. The great efficacy of this preparation—as of every tonic—in diseases that are paroxysmal, appears to consist in the new im- pression which it makes upon the nerves of the stomach, and, through them, upon those of the whole system; but to effect the revulsion to the requisite extent, it appears to be necessary—as in the cases of the artemisia and the indigo in epilepsy—to keep up the effect of the remedy by gradually increasing the dose. MODE OF ADMINISTERING. The dose of the subcarbonate of iron, in cases of neuralgia and chorea, should be large. Mr. Hutchinson prescribed it in the quantity of 3SS to 3ij twice a day; but where it fails to remove the complaint in those doses, Dr. Elliotson recommends, that, it should be increased gradually to one or two ounces. We have never found it necessary to carry it so high. The best vehicle is molasses. The following formula? have been recommended-! Pulvis Ferri Sesquioxydi—{P. Ferri Carbonati Pracipitati.) Powder of Precipitated Carbonate of Iron. R. Ferri carb. praecip. gr. x. Pulv. cinnam. comp. gr. v. M. fiat pulvis mane et meridie sumendus. * Medicin. Correspondenz-Blatt, and Gazette Medicale de Paris, June 20, 1838. f Brande, Dictionary of the Materia Medica, p. 248. Lond. 1839. 220 FERRICARBURETUM. Boli Ferri Carbonatis Pracipitati. Boluses of Precipitated Carbonate of Iron. R. Ferri carb. praecip. gr. x. Pulv. Valerianae, 3ss. Syrup, zingib. q. s. Fiat bolus. Pilula Ferri Carbonatis Pracipitati. Pills of Precipitated Carbonate of Iron. R. Ferri carb. praecip. Extract, anthemid. aa. Jss. Misce et divide in pilulas xij, quarum sumat binas ter quotidie. R. Ferri carb. praecip. 3j. Pilul. aloes cum myrrha, ^ss. Misce et divide in pilulas xviij: duae bis terve indies sumendae. Electuarium Ferri Carbonatis pracipitati. Electuary of Precipitated Carbonate of Iron. R. Ferri carb. praecip. Confcct. aurant. aa. Xj. Syrupi zingib. q. s. ut fiat electuarium cujus sumatur cochleare minimum bis vel ter die. IV. FERRI CARBTJRETUM. Synonymes—Ferrum Carburetum, F. Carbonatum, F. Supercarburetum; Graphites, Plumbago, Carbo mineralis, Black Lead, Carburet of Iron. French.—Carbure de Fer, Graphite, Crayon noir, Plombagine. German.—Kohlenstoffeisen, Graphit, Reissblei. This well known substance was formerly considered to be slightly astringent and desiccative. By Weinhold,* it has been advised strongly in certain cutaneous affections, but although it has been received into various pharmacopoeias of continental Europe, as the Antwerp, Bavarian, Brunswick, Spanish, Parisian, Finnish, Prussian, Saxon, and Swedish, it has never been recog- nised as a therapeutical agent in this country or in Great Britain. * Der Graphit als ein neu entdecktes Mittel gegen Flechten. Leipz. 1809. FERRI CARBURETUM. 221 MODE OF PREPARING. As crude graphite is frequently very impure from the attached matrix, the Prussian Pharmacopoeia has a formula for its purifi- cation, the product of which bears the name graphites depuratus. With this view, the graphite must be very finely pulverised; a pound of it is boiled in a proper quantity of common water, for an hour; the water is then decanted, and two ounces of nitric acid and of muriatic acid, and eight ounces of common water are poured upon the graphite. This mixture is digested for twenty- four hours,frequently shaking it; the acid fluid is then poured off, and, after the residuum has been washed, by an appropriate quantity of common water, it is dried. EFFECTS ON THE ECONOMY. The internal use of graphite produces no perceptible change on the organic functions, except that according, to Weinhold, un- der its protracted use, the urinary secretion is augmented, and a disposition to micturition excited. He found, however, that in herpetic and other cutaneous affections, it occasioned a very fa- vourable modification in the eruption, and wholly removed it. In consequence of the results of his observations, he published a mo- nograph in which he recommended the graphite to physicians in those affections. He employed it as well internally as externally. The urine, he asserts, after its administration, commonly began to make a deposite, and this continued until some change in the cutaneous affection announced its approaching cure. In cases of complication of herpes with other affections, Wein- hold combined it with other remedies; in syphilitic eruptions, adding corrosive sublimate, &c. The efficacy of the graphite in herpetic and other cutaneous affections, has also been attested by many other respectable phy- sicians, as Horn, Heim, Ruggieri, Brera, Bernstein, Hildenbrand, Richter, Hufeland, Marc,* &c. This gave occasion to its admis- sion into the Prussian Pharmacopoeia, yet it has not the confi- dence of physicians, even in those countries into the pharmaco- poeias of which it has been received, and is consequently but little used. * Riecke, Die neuern Arzneimittel, u. s. w. Stuttgart, 1837, S. 214; see, also, Weinhold, in Hufeland's Journal, B. xxxiv. St. 1. S. 118; Heim, in Horn's Archiv. 1810, xii. 326, and Ibid. 1811, B. 1. S. 91; Huber, in Med. Chir. Zeitung, 1811, No. 68, S. 282; Hufeland, Journ. der prakt. Heilkunde, B. xxxviii. St. 6; Bernstein, Ibid. B. xli. St. 5; Mayer, Ibid. B. lx. St. 2, and Osann, in Encyclop. Worterb. der Med. Wissensch. x. 434. Berlin. 1834. 222 FERRI CARBURETUM. Its use in chronic cutaneous diseases is said to have been sug- gested by the circumstance, that, in Venice, the makers of crayons are speedily cured of any such affections under which they may labour.* METHOD OF ADMINISTERING. Internally, graphite is given in doses of from five to fifteen grains, from two to four times daily; and the dose may be aug- mented, according to circumstances, to a dram in the day. It is given in powder, or in the pilular form. Externally, it is applied in the form of ointment or plaster—from 3ij to 3vj of the graphite to an ounce of the constituent. Pulvis Ferri Carbureti. Powder of Carburet of Iron. R. Ferri carburet, pur. Sacch. alb. aa. 3ss. M. Divide in partes eequal. vi. Dose.—One every two hours—in lichen leproides. HlLDENBRAND, Electuarium Ferri Carbureti. Electuary of Carburet of Iron. R. Ferri carburet, pur. ?ss. Mellis despumat. 5ij. M. Fiat electuarium. Dose.—A coffee-spoonful morning and evening. Weinhold. Pilula Ferri Carbureti. Pills of Carburet of Iron. R. Ferri carburet, pur. Extract, dulcamar. aa. 3j. M. fiant pilulae, pond. gr. ij. Dose.—Six, three times a day. Maerker, R. Ferri carburet. Jij. Flor. zinci. 3ss. Adipis. ?j. M. Mayer. * Merat & De Lens, in Diet, de Mat. Med. Art. Carbone. FERRI CYANIDUM. 223 Unguentum Ferri Carbureti. Ointment of Carburet of Iron. R. Ferri carburet, pur. Sulphur, depurat. aa. 5ij- Adipis, q. s. ut fiat unguentum. Brera. Emplastrum Ferri Carbureti. Plaster of Carburet of Iron. R. Ferri carburet, depur. 3'j- Emplast. sapon. 3iv. Misce intime. Weinhold. V. FERRI CYANIDUM. Synonymes.—Ferri Cyanuretum, F. Cyanogenatum, Kyanuretum Ferri, F. Oxydulatum Hydrocyanicum, F. Borussias, Ferro Sesquicyanidum, F. Per- cynidum, Ferrocyanas Oxydi Ferri, Ferri Fcrrocyanas, Ferrum Cyanure- tum, Ferrum Zooticum, F. Borussicum, Cceruleum Borussicum, C. Bero- liniense, Prussiate or Cyanide of Iron, Cyanuret of Iron; Prussian Blue. French.—Trito-hydro-ferro-cyanate de Fer; Deutoxicyanure de Fer Hydrate; Tritohydrocyanate Ferrure de Fer, Prussiate de Potasse et de Fer, Bleu de Prusse. German.—Cyaneisen, Blaustoffbisen, Blausaures Eisenoxydul, Eisenblausaures Eisenoxyd, Eisencyanarcyanid, Berliner Blau, Pariser Biau. In commerce, this preparation with us bears the name " Prus- sian blue," but in Germany it is called " Pariser Blau." It is not in a state of purity, and, consequently, that which the apothecary prepares is best adapted for internal use. MODE OF PREFARING. The form given by Buchner is as good as any. The ferrocy- anate of potassa, as commonly met with in commerce, is dis- solved in warm distilled water, and to the clear filtered solution is gradually added, in a glass vessel, a solution of chemically pure sulphate of iron so long as a precipitate is thrown down. After the precipitate has fallen to the bottom of the vessel, and the supernatant fluid, which contains sulphate of potassa, has been poured off, the precipitate is first digested with dilute sulphuric or muriatic acid, in order to dissolve the excess of oxide of iron; the 224 FERRI CYANIDUM. beautiful dark blue precipitate is then collected on a filter, care- fully washed with boiling water, and dried. The cyanide of iron is of a beautiful deep blue colour, and devoid of odour and taste. It is decomposed by heat, and is in- soluble in water, alcohol, ether, oils and dilute acids. Potassa and soda decompose it. According to Dr. ZoUickoffer, it adheres firmly to the tongue, which Riecke thinks, though erroneously, is owing to its containing argil. EFFECTS ON THE ECONOMY. Of the effects of the cyanide of iron on the human economy in health we have no evidence. Coullon gave it to various animals, but observed no action from it. It has been given, and not with- out success, in several diseases; and Dr. L. W. Sachs, who has not unfrequently administered it, considers it one of the most im- portant chalybeates with which we are acquainted. He thinks it probable, that the hydrocyanic acid has not much agency; yet it certainly seems to differ from all the other preparations of iron. It has been especially recommended in epilepsy by Kirckhoff* of Ghent. In very obstinate cases, not dependent upon organic mischief, he succeeded entirely with it; with the adult he com- menced with half a grain daily, and raised the dose gradually to three, four, and even six grains and upwards. When the patient was plethoric, he premised bloodletting, or applied leeches, from time to time, to the temples. Hildenbrand and Gergeres confirm its efficacy in epilepsy. It has also been administered by Dr. Zollickofferf successfully in a case of chorea; three grains being given in the form of pill, three times a day. In six days, the girl, twelve years old, was entirely cured, after camphor, opium, quinine, and assafoetida, the nitrate of silver, and subcarbonate of iron had been given in vain. In intermittent fever Dr. ZollickofferJ found the cyanide of iron so efficacious, that he even gave it the preference over the cinchona; and his experience has been confirmed by that of Eberle,§ Ho- sack,|| and others. Wutzer, in Germany, also exhibited it suc- cessfully; and Stosch gave it advantageously, in combination with cinchona and rhubarb, in a case of obstinate intermittent. Sachs likewise tried it frequently, but as often without as with success. When it has proved efficacious in intermittents the dose has been by no means large. Some have given six or eight grains every four hours during the apyrexia, and even as much * Journal de Chimie Medicale, iii. 285. f Medical Examiner, May 16, 1840, p. 314. X American Medical Recorder, v. 540. § Materia Medica, 21 edit, i, 233. || New York Medical and Physical Journal, 1823. FERRI CYANIDUM. 225 as a scruple has been administered. Sachs found it several times efficacious when four doses of two grains each were taken. Riecke,* affirms that his father obtained essential service from it in the leucophlegmatic conditions resulting from intermittent fever. ZoUickoffer extols the cyanide also in remittent fever, and there may doubtless be periods when it may be administered with benefit, but it is not often used. He recommends it also in dysen- tery,] when the inflammatory condition has passed away, either spontaneously or under the efforts of art: and Sachs remarks, that in those atonic conditions of the intestinal canal, which su- pervene on dysentery, it may doubtless be of great service. Ger- geres administered it successfully in chronic diarrhea. L. W. Sachs enters into a long theoretical disquisition on the precise action of the remedy, in which there is doubtless much that is speculative. He used it, he says, with success, in many cases which it would be difficult to classify under any formal nosology; their common bond, however, was, that they were dependent upon " nervous disorders, especially of the plastic functions of the abdominal organs, the mischief appearing first of all to be gas- tric." In such affections, he found a combination of the cyanide of iron with rhubarb especially serviceable. He gave it in not less than two grain doses, which he gradually augmented to six grains three times a day. Dr. Moll saw decidedly good ef- fects from its use in a case of immoderate menstruation from atony of the uterus with general elevation of the nervous excita- bility, after he had employed the remedies, commonly recommend- ed, unsuccessfully. He found it also extremely beneficial to chil- dren of a strumous habit, and great torpor. Stosch found it serviceable in a case of scrofula, in which ha?- matosis was imperfectly accomplished, and Dr. Bridges^ found great advantage from it in a case of severe and protracted facial neuralgia. Externally, the cyanide of iron has been used in the form of ointment, in cases of ill conditioned, torpid and foul ulcers, and even of noli me tangere. Stosch applied it in a case of fungous ulcer with marked advantage; forming it into a paste with water and applying it in that form. * Op. cit. S. 217. t Chapman's Philadelphia Journal, Aug. 1823. X Wood & Bache's Dispensatory, Art. Ferri Ferrocyanas. 20 226 FERRI CYANIDUM. MODE OF ADMINISTERING. Pulvis Ferri Cyanidi. Powder of Cyanide of Iron. R. Ferri cyanid. gr. iij ad xxxvj. Sacchar. alb. 3ij. M. et divide in pulveres vj. Dose.—A powder two or three times a day, in epilepsy. KlRCKHOFF. R. Ferri cyanid. gr. j, iv, vj ad xij. Sacch. alb. Jj. Fiat pulvis in partes xij aequales dividendus. Dose.—A powder every two hours, in epilepsy. HlLDENBRAND. R. Ferri cyanid. Pulv. guaiac. aa. 5j- Misce et divide in chartulas xij. Dose.—One three times a day.—Employed successfully in in- termittents.* Pilula Ferri Cyanidi. Pills of Cyanide of Iron. R. Gum. amnion. Rhad. Rhei, Ext. taraxac. aa. 3j- Ferri cyanid. gr. xviij ad xxxvj. M. et fiat massa in pilulas lx dividenda. Dose.—Four to six, twice a day, in disorder of the ganglionic system. Radius, according to L. W. Sachs. Unguentum Ferri Cyanidi. Ointment of Cyanide of Iron. R. Ferri cyanid. 5j« Unguent, cetacei, £j. M. et fiat unguentum. Applied to foul ulcers. * Ellis's Formulary, 5th edit. p. 161. Philad. 1838. FERRI IODIDUM. 227 VI. FERRI IODIDUM. SSynonvmes.—Ferri loduretum, Ferrum lodatum, Iodated Iron, Iodide of Iron, loduret of Iron, Protoioduret or Protoiodide of Iron. French.—Iodure de Fer, Protoiodure de Fer. German.—Iodeisen. In solution, Ferri Hydriodas, Ferrum Hydriodatum, Ferrum Hydroiodicum Oxydulatum, Hydriodated Iron, Hydriodate of Iron, Hydriodate of Protoxide of Iron. French.—Hydriodate de Fer. German.—Hydriodsaures Eisenoxydul. Although attention had been directed, several years ago, to this preparation, it was not much used, until Prof. A. T. Thom- son,* of the London University, recommended it strongly in a special monograph a few years since. It has been received into the London Pharmacopoeia. MODE OF PREPARING. The following method is recommended by Dr. Thomson. One part of iron wire should be rubbed in a porcelain or wedgewood mortar, with about three or four parts of iodine, gradually adding distilled water, until fifteen parts of the fluid have been used: the whole is then to be introduced into a Florence flask, with an addi- tional portion of wire and of distilled water. This excess of iron is a matter of indifference in the preparation of the hydriodate, and in that of the iodide it is necessary for preserving the combina- tion from decomposition during the evaporation of the solution. These materials are next to be boiled together, until the fluid ac- quires a pale greenish colour, when it must be filtered. This so- lution contains a hydriodate of the protoxide of iron; and, if the exact quantity of the iodine be previously ascertained, so as to enable us to procure the solution of a definite strength, it may be kept in this state for medicinal use. In general, however, the so- lution is evaporated to dryness, and for this purpose it may be poured into a clean flask, containing a piece of iron wire suffi- ciently long to reach from the bottom to the surface of the fluid, and the boiling should be continued until the bulk of the solution be reduced to one third. It must then be filtered, after which the evaporation should be continued to dryness. It is necessary to * Some observations on the preparation and medicinal employment of the loduret and Hydriodate of Iron, 8vo. pp. 64. Lond. 1834. 228 FERRI IODIDUM. break the flask as soon as the mass is cold, in order to obtain the solid iodide, which should be immediately transferred to a dry bottle, accurately fitted with a ground stopper. The bottle should not hold more than two ounces of the preparation; for when it is large and not full, the iodide deliquesces nearly as rapidly as when it is exposed to the free action of the atmosphere. When the flask is broken, and the iodide bottled before the mass is cold, deliquescence also takes place, a peroxide of the metal is formed, and iodine is evolved. The plan proposed by Mr. Durand,* of Philadelphia, after that by MM. Baup and Caillot,f for preparing the solution of the protoiodide of iron (hydriodate of protoxide of iron) is the fol- lowing :— Take of iodine 3x, iron filings, perfectly pure and unoxidised, 3v, distilled water ^xiiss. Put the iodine into a porcelain cap- sule, with one half the quantity of water, add the iron filings by small portions, stirring the mixture with a glass rod. The com- bination soon takes place; heat is evolved with the disengage- ment of a small quantity of vapour of iodine, and the mixture ac- quires an orange colour, which gradually deepens to a dark red. When the whole of the iron has been added, the capsule is put in a sand bath or over the flame of a spirit lamp and heated slowly; continuing to stir the liquid. An iodureted hydriodate of iron is first produced, which, under the action of heat, soon passes to the state of a simple hydriodate. This point is indicated by the en- tire discoloration of the solution. In this state it is filtered; and the dregs and filter are carefully washed with the remaining half of the distilled water, previously heated to the boiling point. In this manner, a solution forming twelve and a half fluid ounces is afforded, one ounce of which represents one dram of iodide of iron. The solution, which is at first colourless, acquires a deep red colour by standing, and precipitates some oxide of iron; by which it is reduced to the state of an iodureted hydriodate of iron; but it maybe easily restored to its former state by heating it again with a small quantity of iron filings, until the liquid becomes colour- less. The iodide of iron is obtained by evaporating to dryness the filtered solution, taking care, towards the end, to stir incessantly with an iron spatula, and to detach the salt from the bottom of the capsule as it forms. The heat must be managed most carefully, diminishing it gradually, and removing the capsule quickly from the fire as soon as the odour of iodine is evolved. The solution of this salt, when the iodide is well prepared, is of a light orange * Philad. Journ. of Pharmacy, iv. 287. Philad. 1833. t Ibid, i. 201. FERRI IODIDUM. 229 colour, and deeper in proportion to the decomposition which some parts may have undergone towards the end of the operation. The iodide requires to be well secured from the influence of the atmosphere, both on account of its deliquescent property, the rapid oxidation which the metal undergoes when deliquescence occurs, and the consequent decomposition which takes place. It is im- portant to prevent this, as the peroxide of iron is inert as a medi- cinal agent; whilst the free iodine extricated during its operation, according to Dr. Thomson, alters altogether the virtues of the medicine. This partial decomposition of the iodide is rendered immediately apparent on dissolving it in twenty times its weight of distilled water, and filtering: instead of a permanent, clear, very pale greenish yellow, we obtain an ochre-coloured, completely in- soluble precipitate. Much of the iodide, usually prepared, is of this description, and to this may, doubtless, be referred some of the disappointment and discrepancy amongst practitioners as to the operation of the medicine in cases apparently similar. Even when the iodide has been carefully prepared, it often contains a little free iodine; but, according to Thomson, it is chiefly owing to the carelessness of assistants and apprentices in compounding prescrip- tions, by frequently exposing the iodide to the air, that its proper-. ties, and, consequently, its medicinal powers, are impaired: hence, it is preferable to keep it in solution, or in the form of hydriodate, which it becomes, whenever water is added to it. If the solution be prepared with a definite quantify of iodine, as described, it will keep without changing its characters; but as it is usually made, by dissolving the iodide in distilled water, i+ requires to be rendered neutral by the following means :—Introduce into a flask the solution of any given strength, and place in it two or three doubles of clean and soft iron wire, sufficiently long to ex- tend to the surface of the fluid; boil for a few minutes, and then leave it at rest, until the solution becomes clear, after which it may be either decanted off from the precipitate which forms, or filtered': no farther change takes place in a solution thus treated, provided it be kept in a blackened or a green bottle, however long it may be preserved. In this process, the wire affords iron to saturate any free iodine present in the solution, or that may have been extri- cated bv the formation of the peroxide of iron in the iodide; and a perfect fy neutral solution being thus obtained, by the immediate conversion of the newly formed iodide into the hydriodate of the protoxide, no subsequent change takes place so long as the solution is kept secluded from the light. The best proportions, according to Dr. Thomson, for forming the medicinal solution, are three o-rains of the dry solid iodide to each fluidram of distilled water. If the water be not either distilled or filtered rain water, perfectly free from foreign ingredients, and particularly if it contain any earthy or saline carbonates, decomposition instantly takes place, 20 * 230 FERRI IODIDUM. iodine is extricated,and a carbonate of iron, which rapidly passes into the state of a peroxide of that metal, is precipitated. To protect the solution of the iodide from decomposition, it has been advised to associate it with sugar, which appears to exert the same protective agency as it does on the protocarbonate of iron. With this view, the following preparation has been pro- posed by Mr. Wm. Procter, Jumv* Take of iodine, 11 drams; iron filings, 4 drams; syrup, uncrystallizable honey, or uncrystal- iizable sugar, 4 ounces; distilled water, a sufficient quantity. Mix the iodine with eight fluid ounces of the distilled water, and gra- dually add the iron filings, stirring constantly; then apply a gentle heat until the solution shall have acquired a' light green colour, or shall not give a blue colour to a solution of starch; then add whichever of the three protecting saccharine substances may be chosen, continue the heat a short time, and filter. Lastly, wash the filter with as much distilled water as will make sixteen fluid ounces of solution of iodide of iron. Dr. Frederking has published a formula for the preparation of a syrup of this salt, which even when exposed to the air re- mains undecomposed for upwards of three months. His formula is as follows :—Iodine, 100 grains; iron filings, 50 grains; distilled water, one ounce. Digest these for some time, filter and wash the ferruginous mass with a little distilled water; unite the fluids and add half an ounce of sugar, then evaporate down to one ounce. This syrup, united with powdered marsh mallow, makes a good pilular mass; or, when mixed with water, a clear solution. Four parts of the syrup contain one of iron.f When iodide of iron is carefully prepared, it is of an iron gray colour, foliated texture, brittle, and exhibits a crystalline arrange- ment similar to metallic antimony, except that it is darker. In the dry state, it is inodorous; but when moist, it smells somewhat of iodine: the taste, when dry, is simply styptic ; when moist, some- what acrid, before it impresses the gustatory organs. At 350° of Fahrenheit it fuses; and, at a higher temperature, is decom- posed,—the iodine being volatilised, and the iron remaining in the state of oxide. It dissolves in all proportions in water,—the changes supervening, which have been already indicated. 11 is de- composed by chlorine, the mineral acids, oxide of arsenic, meco- nic acid—consequently by opium and laudanum—gallic acid, and tannin, the pure and carbonated alkalies, different metallic salts, and by the infusions of digitalis, belladonna, hyoscyamus, tobacco! amylaceous substances, &c: such substances ought not, therefore! to be given in combination with it. * American Journal of Pharmacy, for July, 1840, p. 13. fRepertor. fur die Pharmacie, 1839, and Amer. Jour. Med. Sciences Feb 1840. p. 449. "' FERRI IODIDUM. 231 EFFECTS ON THE ECONOMY IN HEALTH. From experiments made on his own person, Dr. Thomson states the following to be the physiological effects of the hydrio- date of iron. When taken in doses of from three to five grains, it makes no sensible impression on the stomach, although it sharpens the ap- petite, and improves the digestive function: it seems to stimulate moderately the digestive canal through its entire length; for it opens the bowels; and, whilst it produces the black colour of the alvine discharges characteristic of all the preparations of iron, it corrects their foetor. When it does not affect the bowels, it aug- ments the action of the kidneys, increasing the flow of urine; and if the solution be taken two or three times a day, for several days successively, the presence of both the iodine and the iron can be readily detected in the urine. The temperature of the skin is mo- derately elevated, and the insensible perspiration increased. On one occasion, having taken ten grains for a dose, it almost imme- diately caused an uneasy sensation at the epigastrium, accompa- nied with nausea that continued for several hours, and a slight degree of headach. These symptoms were relieved by a copious evacuation, which was perfectly black. Two hours after taking the medicine, a large quantity of urine was discharged; which, on being tested, displayed the presence of both the iodine and the iron. The experiments on animals, made by Dr. Cogswell,* induced him to infer:— 1. That the iodide of iron acts as a local stimulant, possessing the power of effecting peculiar disorganisation. 2. That its action is more particularly directed to the tract of the alimentary canal. When added to blood out of the body, the iodide of iron pro- motes its coagulation.j EFFECTS ON THE ECONOMY IN DISEASE. From the chemical composition of the iodide of iron, Dr. Thom- son considered it might be specially adapted for cases in which augmented activity of the capillary or intermediate system, with a tonic effect, might be indicated, and particularly in scrofulous affections, tabes mesenterica, chlorosis, incipient scirrhus, rickets, amenorrhea, bronchocele, atonic dyspepsia,—indeed in all cases * E^say on tho Iodine, p. 132. Edinb. 1S37. f Mao-endie, Lpgons sur le Sang, &c; and translation in the Lancet, Jan. 26, 1839. 232 FERRI IODIDUM. accompanied by debility. In such affections, he conceives the iodide will act more efficiently than any of the other preparations of iron. In secondary syphilis, it may be combined, he suggests, with iodide of potassium; and in incipient cancer, its efficacy, is aided by the administration of arsenic at the same time. Dr. Thomson has found it serviceable in atonic gastric dyspepsia, when combined with bicarbonate of potassa, and taken at the mo- ment of admixture, in the dose of from three to eight grains or more.* A great advantage it possesses is its ready solubility, owing to which it can enter the circulatory system with facility, and modify the condition of the fluids. In chronic scrofulous cases, it produces all the good effects of the preparations of iron, with- out any of the concomitant and subsequent symptoms that are so apt to supervene, especially in impressible individuals. Where tbe case is accompanied by vascular erethism, or fulness, they must be reduced before the iodide can be esteemed appropriate. In chlorosis, occurring in strumous habits, it has been found most serviceable. Its efficacy in cancer is elucidated by Dr. Thomson. by the details of a case of scirrhous mamma, which, after pro- tracted and fruitless treatment by other agents—as by other pre- parations of iron combined with conium—ultimately yielded to a combination of the hydriodate of iron and conium. Some cases are also detailed in which the hydriodate of iron was very effective in removing old syphilitic affections, especially of the skin. Prior to the publication of Thomson, Pierquin had given the iodide in cases of leucorrhaa and amenorrhea, and Eagerf had recommended it in scrofula. RicordJ found the very best effects from its internal use in cases where tonics required to be com- bined with antisyphilitic remedies, especially where any scrofu- lous vice (lymphatisme) constituted a complication. He adminis- tered it likewise with great success, to remove the consequences of syphilis, and found it advantageous in atonic ulcers of the legs and in spreading ulcers of the th mat, which had been aggravated or had not yielded to mercury. The strength of M. Ricord's so- lution was half a dram of the iodide to ?viij of water, »iven, we presume, in the twenty-four hours. M. Ricord§ also uses it in the form of injection in cases of blen- norrhea. Wherever, indeed, tonic astringent injections are * London Dispensatory, and Brando's Dictionary of Mat. Med. p. 25:2. Lond. 1839. See, ako, Solon, in Diet, de Wed. et de Chirurg. Pratiq. Art. lode ; and Ashwell, in Guy's Hospital Reports, p. 1. 128; and p. lii, p. 555. f Dublin Journal of Medical Science, 1834; also, Coo-swell on Iodine n 138, Edinb. 1837. ° ' ' X J. J. L. Rattier, in La Lancette Fran^aise, Fev. 4, 1837. § J. J. L. Rattier, Ibid. Fev. 16, 1837; see, also, Revue Medicale, Janvier, 1838, and Dunglison's American Med. Intelligencer, Sep. 15, 1838, p. 195. FEERI IODIDUM. 233 needed, the iodide, in his opinion, should occupy the first rank. Its use, he thinks, can only be contra-indicated when there is much inflammation or pain in passing the urine, or when cystitis exists. The strength of the injection should be three grains to the ounce of water. In consequence of its promoting the coagulation of the blood out of the body, Magendie* prescribed it recently in the form of injection (3i to fhij of water) employed several times a day in a case of severe uterine hemorrhage. The hemorrhage ceased. We have frequently given this remedy in public and private practice, and have considered it especially adapted for those cases in which there appears to be torpor in the system of nutrition, as in cases of asthenic dropsy, old visceral engorgements, and indeed of hypertrophy of any kind, accompanied by deficient action in the intermediate system of vessels. In oligemia, where there is paucity of red globules in the blood, and the fluid is altogether too thin, it would seem to be especially indicated, from its pro- perty, mentioned above, of promoting the coagulating of the blood, and therefore, of inspissating it. Hence, in all cases of scorbutic, hydropic nndother dyscrasies, and in hemorrhages occurring in such pathological conditions of the system, we have prescribed it large- ly and with the very best effects. It appears to us, indeed, to be the best remedy we possess wherever a sorbefacient and tonic are indicated. MODE OF ADMINISTERING. The dose of the iodide of iron, administered in the cases above referred to, was generally three or four grains two or three times a day. Liquor Ferri lodidi. Solution of Iodide of Iron. R-. Ferri iodidi, gr. xxiv. Aquae destillat. ^j. M Dose.—An ordinary tea-spoonful contains about three grains. A. T. Thomson. The following formulas are recommended by Pierquin :f * Op. cit. f Journal de Chimie Medicale, p. 310, Mai, 1831. ^34 FERRI IODIDUM. Vinum Ferri Iodidi. Wine of Iodide of Iron. R. Vin. Bordegalens. ffcj. Ferri iodidi, 5ss. M. Dose.—A tea-spoonful morning and evening. Tinctura Ferri Iodidi. Tincture of Iodide of Iron. R. Ferri iodidi, 3ij- Alcoholis, Aquae aa. 5ij. M. Dose.—A tea-spoonful morning and evening. Troschisci Ferri Iodidi. Lozenges of Iodide of Iron. R. Ferri iodidi, 5j. (3SS0 Croci pulv. 5ss. (3ij.) ' Sacchar. alb. 5viij. (5iv,) M. fiant Trochisci No. 240, (120.) Dose.—Six to ten daily. Solutio Ferri Iodidi. (French, Eau d'Hydriodate de Fer.) Solution of Iodide of Iron. R. Ferri iodidi, 5ss. Aqua3, fj^ij. M. Added to enemata, lotions, and injections. R. Ferri iodidi, ^ss ad ^ij. Aqua^ destillat. fhj. M. To be added to a general bath in cases of leucorrhcea, ame- norrhoca, &c. Pierquin. FERRI LACTAS. 235 Unguentum Ferri Iodidi. Ointment of Iodide of Iron. R. Ferri iodidi, 3iss. Adipis, 5j. M. ut fiat unguentum. A piece of the size of a hazelnut to be rubbed, morning and evening, on the inner part of the thigh, in cases of leucorrhcea and amenorrhoea. VII. FERRI LA.CTAS. Svnonymes.—Lactate of Iron, Lactate of protoxide of Iron. This preparation has been lately recommended by MM. Gelis and Conte, internes at La Charite, in Paris, and has been fa- vourably reported upon by M. Bouillaud, in the name of a com- mittee, consisting of MM. Bally, Fouquier, and Bouillaud.* MODE OF PREPARING MM. Gelis and Conte prepare the lactate of iron by treating pure iron filings with lactic acid, diluted with water. M. Loura- dourf extracts the lactic acid from the whey, which Jhe collects from the dairies in the neighbourhood of Paris, where much cheese is made. The whey, exposed a long time to fermentation under the influence of an elevated temperature, becomes charged with a large quantity of lactic acid. It is evaporated to one-third or one-fourth of its volume, decanted and filtered; and is then saturated with milk of lime, which produces an abundant deposit, chiefly of phosphate of lime. The filtered solution is precipitated by oxalic acid, and again filtered, and then concentrated to a syrupy consistence. It is now diluted with alcohol, which precipitates the lactine and the salts. The solution on being filtered, and the alcohol distilled off, yields pure lactic acid. The lactate of protoxide of iron is prepared by digesting in a sand-bath, at a low tempera- ture, this acid, diluted with water, upon iron filings. At the end of six or seven hours of the reaction, the liquid is boiled, filtered, and concentrated; when, on cooling, it deposits crystals. These crystals, drained on a flannel, and washed with alcohol by dis- * Bulletin G£n£ral de Th£rapeutique, Mars, 1840. f Journal de Pharmacie, and Mr. Fred. Brown, in American Journal of Pliarmacy, July, 1840, p. 121. 236 FERRI LACTAS. placement, should be rapidly dried, and preserved from any con- tact with the air. The salt presents itself under the form of crystalline plates, very white, and but slightly alterable. It is but sparingly soluble in water; reddens litmus paper, and possesses the ferruginous taste in a tolerable degree. When dissolved in water it attracts oxygen, and quickly becomes yellow. The sparing solubility of lactate of iron has permitted M. Lou- radour to simplify still more his process, by omitting the purifica- tion of the lactic acid by alcohol, and treating it immediately by the iron filings: the liquor, suitably, evaporated, affords crys- tals of the lactates: the foreign salts, and the lactine remain in the mother waters, wdiich are rejected. EFFECTS ON THE ECONOMY. The lactate of iron has been used in the cases in which the protocarbonate of iron is employed, and chiefly in chlo- rosis. MM. Gelis and Conte are disposed to refer the beneficial agency of the protocarbonate, to its becoming lactate of iron in the stomach, by uniting with the lactic acid, which is one of the gastric acids. The idea led them to administer the lactate of iron ready formed. In chlorosis the remedy has been given by MM. Fouquier, Bally, Beau, Rayer, Nonat, Andral, Bouillaud, and others, who have collected a great number of cases which show its success in that disease.* M. Bouillaudf made trial of the lactate in twenty-one cases, 14 of which were treated at La Charite. One of the last, not being decidedly chlorotic, may be excluded. Of the thirteen, ten were females, and 3 males. Of the ten females, eight presented well marked chlorosis; two were rather anaemic. The dose of the lactate was carried to six, eight, ten, twelve, and fifteen lozenges of five centigrammes each in the twenty-four hours. The remedy was well borne; and it always increased the ap- petite sensibly. MODE OF ADMINISTERING. MM. Gelis and Conte introduce the freshly prepared lactate of iron into lozenges, in which the sugar prevents the superoxidation * Bulletin General de Therapeutique, Mars, 1840; also, La LancetteFran- gaise, London Lancet, Feb. 8, 1840, p. 707, and Dunglison's American Medi- cal Intelligencer, April 1, 1840, p. 13. f Encyclopedic des Sciences Medicales, Mars, 1840, p. 226. Acad6mie Royale de Medecine de Paris, Seance du 4 Fevrier, 1840. FERRI NITRAS. 237 of the iron, and preserves the medicine, whilst, at the same time, a form is given which allows of great facility of administration. MM. Andral and Fouquier seldom exceed twelve grains of the lac- tate in the twenty four hours; and M. Bouillaud never gives more than twenty. VIII. FERRI NITRAS. Synonymes.—Ferrum Nitratum, Nitrate of Iron. LiaUOR FERRI PERSESCIUINITRATIS. Synonymes.—Liquor seu Solutio Nitratis Ferri, Liquor Ferri Nitrici Oxydati, Solution of Persesquinitrate of Iron, Solution of Nitrate of Iron. MODE OF PREPARING. This preparation, which has been introduced within the last few years into practice, may be formed in the following manner. Take of small chips or pieces of iron wire, an ounce and a half; nitric acid, three ounces by measure; water twenty-seven ounces; muriatic acid, one dram. Put the iron into an earthen- ware vessel, and pour on the nitric acid, previously diluted with fifteen ounces of the water. Set the vessel aside till the whole of the acid has united with the iron, so as to form a persesquini- trate, then decant the liquid from the portion of iron, which re- mains undissolved; strain and filter. Add the muriatic acid with the remainder of the water, or With as much of that liquid as will increase the whole solution to thirty ounces. When the process is finished—which takes some hours—the liquid has a red colour, so dark, that when viewed by reflected light, it seems almost black. Three ounces of nitric acid of the usual strength (1.4) gene- rally dissolve an ounce of iron, so that when the process is com- pleted, a portion of the metal remains undissolved. The solution then consists entirely of the persesquinitrate of iron; and, if speedily decanted, it may be preserved in that state, but if allowed to stand for a few hours longer on the iron, it will undergo a farther change, becoming gradually converted into pernitrate and protonitrate of iron. The first of these is insoluble, and ren- ders the liquid turbid; and the latter, which remains dissolved, has not the medical properties that render the persesquinitrate valuable. When the solution contains nothing but nitric acid and peroxide of iron, it slowly undergoes decomposition on standing, so that, at the end of a few weeks, the whole liquid begins to be- 21 238 FERRI NITRAS. come turbid. The addition of some muriatic acid prevents this decomposition, and the quantity sufficient for this purpose is too small to affect the medicinal powers of the persesquinitrate. The solution, when properly prepared, is of a beautiful dark red co- lour, when viewed with transmitted light. Its taste is very astringent, and not at all caustic* EFFECTS ON THE ECONOMY. This preparation greatly resembles the solution of the muriate of iron in its medicinal properties. Mr. Kerr considers, that to an astringent power it unites the property of diminishing the ir- ritability and tenderness of the mucous membranes with which it comes in contact. Kopp administered it with the greatest success in many cases of chronic diarrhea that had resisted every approved remedy. The fceces were blackened by it, as by the preparations of iron in general. He remarks, however, that it must, be continued for some time. The dose he gave was ten drops several times a day in oatmeal gruel, and this was gradually raised to twenty and twenty-five drops. When the cure was accomplished, the re- medy was gradually diminished, until it was left off altogether. Dr. Gravesf speaks in equally high terms of the persesquinitrate in these cases; and very recently Dr. T. C Adam of Lenawee county, Michigan, has recorded tbe remarkable assistance, which he has derived from its use in the treatment of several diseases, especially diarrhea and other affections of the mucous membranes accompanied by discharges.,J In chronic diarrhaa depending mainly on an excess in the sensibility of the organic nerves which supply the digestive tube, Dr. Adam rarely orders less than fifteen drops at the commencement, and after a few days' employment of the remedy, he increases the quantity to twenty, twenty-five and thirty drops. In leucorrhaa occurring in such as are pale, exanguious, feeble and languid, the internal, conjoined with the external, use of the persesquinitrate has been found very advantageous. In these cases, Dr. Adam adds such a quantity of water as a diluent as will still leave in the vagina a gentle degree of heat or smarting. Dr. Adam recommends it also in cases of aphthous sores; and he affirms that its application has afforded relief in toothach. It is doubtless a powerful astringent, but it is questionable whether it possess any advantage over the solution of the muriate of iron. * Mr. Kerr, in American Journal of the Medical Sciences, for May, 1832, cited from the Edinb. Med. and Surgical Journal. f Clinical Lectures, Dunglison's Amer. Med. Library Edition,p. 128. Phila. 2.838. X American Journal of the Medical Sciences, May, 1839, p. 61. FERRI OXYDUM HYDRA TUM. 239 IX. FERRI OXYDUM HYDRATUM. Synonymes.—Hydras Ferricus, Ferrum Oxydatum Hydratum, Hydro-oxide of Iron, Hydroxide of Iron, Hydrated Oxide of Iron, Hydrated Peroxide of Iron, Hydrated Tritoxide of Iron, Hydrated Sesquioxide of Iron. German.—Eisenoxydhydrat. The hydrated oxide of iron has been recently introduced into practice as an antidote to white arsenic. Dr. Bunsen, of Gdttin- gen, had already made frequent experiments with it, which satis- fied him that it was an efficacious agent, when, along with Dr. Berthold* he subjected it to fresh trials. The results of their in- vestigations were published, and since then it has received due attention every where. METHOD OF PREPARING. The best mode of preparing it, according to Dr. Bunsen, is to take a solution of pure sulphate of iron, increase its dose of oxygen by treating it with nitric acid, and precipitate the oxide by adding pure ammonia in excess, washing the precipitate. In order not to deprive the precipitate of its water, and to diminish its loose state of aggregation as little as possible, it is not filtered, but is put aside for a few days, until the precipitate is wholly deposited, after which the supernatant fluid is poured off. It is then kept in well- stopped vessels. Ilieckef has added the formula for pharmaciens, which is re- commended by Von Specz:— &. Vitrioli ferri purl crystallizali libram; teratur in pulv. subtiliss. et detur in vas. porcellan. aut murrhinum, impositum balneo arenae, dein adde acidi nitrici concentrati Jfess; terantur ope baculi vitrei usque dum massa resolvitur in pultem ; nunc, igne animato, massae pultaceae calidae affunde sensim terendo, sensim acid.nilric. concentrat. q. s. donee nul- lum amplius evolvatur gas nitrosum. Massa tunc leni igne evaporetur ad siccitatem et solvatur demum in aq. destill. q. s.; solutioni filtratae instilletur ammonise purse q. s. donee precipitatio cesset; stent nunc per horam unam alteramve et liquor limpidus a sedimento bruneo decantetur ; massae residuae fundum petenti adfunde aq. destillat. ftiij. et agitentur; nunc filtra, et praecipitatum in filtro aq. destill. q. s. edulcora donee aqua insipida defluat. Praecipitatum bene edulcoratum in umbra siccatum convertat. in pulv. subtilissim. qui servetur vase vitreo bene clauso.J * Das Eisenoxydhydrat, ein Gepengift der arsenigen S&ure. Getting. 1834. t Die neuern Arzneimittel, S. 227. Stuttgart, 1837. X " Take of pure crystallised sulphate of iron a pound: rub it into a subtle powder, and place it in a porcelain or glass vessel in a sand-bath; then add 240 FERRI OXYDUM HYDRATUM. Lassaigne advises it to be prepared as follows:—Take iron filings; pour gradually upon them four times their weight of the nitric acid of commerce in small portions. Heat is thereby de- veloped, and deutoxide of azote, which is transformed by the at- mospheric air into nitrous acid vapours. When the evolution of gas has ceased, ten or twelve parts of water are added; the mix- ture is then filtered, and ammonia added until the mixture begins to exhibit an alkaline reaction. The precipitate, thus formed, is the hydrated oxide of iron, which is collected on the filter, and washed with boiling water until it is tasteless, and ceases to exhibit any alkaline characters. The mode of preparation, recommended by Majeste, agrees with this, except that he boils one part of iron filings with four of nitric acid and four of muriatic acid. The following form has been advised by Dr. William R. Fisher,* who asserts that it was subjected to practice by Mr. Durand, an able pharmacien of Philadelphia, who obtained a perfect result, witb a satisfactory economy of material. Take of sulphuric acid (67° Baume) 8 oz. or 16 parts; iron wire, 8 oz. or 16 parts; nitric acid, (49° Baume,) hh oz. or 11 parts; water of ammonia, as much as is sufficient; water, a gallon and a half, or 384 parts. Mix the sulphuric acid with the wTater in a glass vessel. Add the iron, and after tbe effervescence has ceased, filter. Add the nitric acid in divided portions, and apply heat so long as orange coloured fumes are given off. To the heated so- lution, pour in the water of ammonia until a decided excess has been added; then wash the precipitate by decantation, until the washings give no precipitate with nitrate of baryta. The water is then to be drawn off until just enough remains to give the con- sistence of thick cream. It is not injured by keeping, as some have presumed. EFFECTS ON THE ECONOMY. If a solution of arsenious acid be decomposed by fresh precipi- tated oxyhydrate of iron suspended in water, traces of arsenic half a pound of concentrated nitric acid ; stir them with a glass rod until the mass is resolved into a soft paste; then—the fire being raised—pour gradually on the hot pultaceous mass concentrated nitric acid, until no more nitrous gas is evolved. Let the mass be evaporated by a gentle heat to dryness, and at last be dissolved in a sufficient quantity of distilled water. Into the filtered so- lution drop pure ammonia as long as any precipitate occurs; let it now stand tor an hour or two, and then pour off the limpid liquor from the brown sediment. On the residuary mass, remaining at the bottom, pour three pounds of distilled water, and shake them together: filter and wash the precipitate on the filter with distilled water, until the water is tasteless. The well-washed precipitate dried in the shade forms a subtle powder, which may be kept in a well closed vessel." * The American Journal of Pharmacy, Vol. vi. No. 1, April, 1840. FERRI OXYDTJM HYDRATUM. 241 can no longer be detected in the filtered liquid, made acid and tested by a stream of sulphuretted hydrogen gas. To throw down one part of arsenic, in this manner, requires a quantity of the oxyhydrate, which contains at least ten or twelve parts of oxide of iron. Yet, even where a smaller quantity is employed, the arsenious acid is almost wholly separated, as a stream of sul- phuretted hydrogen gas affords only very slight traces of sul- phuret of arsenic in the filtered and acidulated liquid. When the substances are previously heated, or the arsenious acid is exposed in small portions to the precipitating agent, the reaction is still slighter. If a few drops of ammonia be added to water in which the oxyhydrate of iron is suspended, and the mixture be digested with finely powdered arsenious acid, an insoluble arsenite of iron is formed; a circumstance, which would encourage the belief—even had it not been sanctioned by experience—that freshly prepared oxyhydrate of iron may serve as an antidote to arsenic: the union between it and arsenious acid forming—as. we have seen—an insoluble compound, devoid of all poisonous influence on the economy, and only exciting gastric oppression, when given in large doses. Accurate microscopical investigation in experiments on ani- mals that had taken arsenious acid in the solid form mixed with the oxyhydrate, exhibited to the discoverer of the antidote, that,. under the influence of animal heat and the peristaltic motion, it had become completely converted into the arsenite of iron, and thus rendered innocuous. Such was the result of the observa- tions of Boulet,* Orfila, Chevalier, Lassaigne, Soubeiran and Miquel,f Nonat, Borelli and Demaria,^ Lesueur, Boulay, fils,§ Monod,|| Von Specs and Mackenzie.8!! On the other hand, the experiments of Brett,** Reginald Orton,ff and Cramer, were un- favourable; but Messrs. Bunsen and Berthold remark, that the experiments of those gentlemen could not be expected to be suc- cessful, as they were made with doses of arsenic of from two to nine grains; and the stomach of the rabbit cannot retain more than from one ninth to. one half the quantity of the antidote pre- pared according to their formula, which is necessary to neutral- ise that quantity of the poison. Messrs. Bunsen and Berthold, from the results they have ob- tained, recommend the oxyhydrate as the chief antidote in all * Gnzette Med'cale de Paris, 1834. f Bullet. General de Thernp. Dec. 1834. { Br. and For. Med. Rev. April, 1836, p. 594. 5 Journal Hobdom. des Pmgres des Sciences Medic. Mars 14, 1835. || Gazette Medicale, Auat & De Lens, Diet, de Mat. Med. Art. Polypodium. t Nouvelle Bibliotheque Medicale, Sept. 1828, p. 151, and Biblioth. Univer. xxxi. 324,1826. FILIX MAS. 247 matter, green and red colouring matter, and a semi-resinous sub- stance. By some it is called the Oleum Filicis Maris. The ac- tive constituents of the fern are highly concentrated in it; and as the result of numerous trials, it was found, that from eighteen to twenty grains, given at night, and the same quantity in the morn- ing fasting destroyed taenia?, so that on the administration of a cathartic, the parasite was discharged—often in the form of a ball. Not unfrequently, indeed, it was voided before the cathar- tic was given. In Germany, this new preparation has been chiefly recom- mended by Hufeland, who maintained, that in rapidity, certainty and gentleness of action, it exceeds all known means, and many other physicians have testified to the accuracy of this opinion. Radius,* who frequently prescribed it, says he never gave it with- out bringing away large pieces of the worm, but frequently the head remained behind.f BuchnerJ thought, tbat the extract might be prepared with al- cohol, but many physicians have objected to this menstruum,— that it does not dissolve the fixed oil. MODE OF ADMINISTERING. The extract is commonly given in the form of pill; emulsion does not answer, because the active constituents are apt to be enveloped and masked in this form. In Geneva, it is now fre- quently united with castor oil, this renders it unnecessary to give a cathartic after it. For the cathartic when needed, they advise in Bern, infusion of senna with epsom salts, manna, and aniseed.§ To children it may be given in syrup. Mel. Filicis Maris. Honey of the Male Fern. R. Ext. aether, filicis maris, 3ss. Mellis rosat. 5ss. M. Half of this to be taken on going to bed; the other half early in the morning fasting. * Auserlesene Heilformeln, u. s. w. Leipz. 1836. f See, also, Ebers, in Hufeland & Osann's Journal, lxvi. St. 1. S. 43, and Gazette de Sante, Sept. 25, 1828. X Repertorium far Pharmacie, xxiii. 433, xxvii. 337, and Funk, in Medicin. Zeitung, Mai, 17, 1837, S. 102. } Hufeland unci Osann's Journal, lxiv. St. 1. S. 133. 248 FUCUS CRISPUS. FUCUS CRISPUS. Synonymes. Lichen Carrageen, Chondrus Crispus, Sphserococcus Crispus, Ulva Crispa, Chondrus Polymorphus, Irish Moss, Carrageen or Corigeen Moss. French. Mousse d'Irlande, Mousse Perlee. German. Krauser Tang, Seetang. Although the carrageen or Irish moss has long been used in Ireland, it was but little employed in other parts of Europe, or in this country, until within the last few years. Of late, it has been used precisely in those cases in which the Lichen Islandicus, or Iceland moss has been deemed appropriate. In Germany, the first trials were made with it in the year 1833, by Von Grafe of Berlin, and the results were given to the world in his report for that year,* of the Clinical surgical and ophthalmic Institute, at- tached to the Frederick William University. The fucus crispus, which belongs to the natural family Alga:, exists in the Atlantic Ocean, on the coasts of England, Ireland, western France, Spain, and Portugal, and as far as the tropics. It is also said to be a native of the United States. It is met with more abundantly, however, in Ireland, when it is used by the poor as an article of diet. It is thrown on the shore by the waves, and is gathered at the time of the ebb. The Irish moss, when fresh, is green, and somewhat resembles the Iceland moss; but when dried, as we meet with it in com- merce, it is of a bright yellow, and resembles laminae of horn, crisped, translucent, and frequently containing small shells, calca- reous concretions, and grains of sand. It has not much taste; the smell seems to betray iodine, which, however, has not been de- tected in it. When the moss is chewed, it feels like so much car- tilage, but, by the moisture and warmth of the mouth, it soon loses its brittieness. It contains little sea salt, but a good deal of sulphate of soda.f The jelly obtained from it is transparent and colourless; its taste is by no means disagreeable; it keeps several days, and is not converted by muriatic acid into mucus, like the jelly which is obtained from land plants. In its nature it is esteemed to be * Bericht iiber das klinische chir. augenarztliche Institut. der k. Friedr. VVilh. Univers. fur d. J. 1833. Berl. 1834. f E. Grafe in Art. Fucus, Encyclopad. Worterb. der medicinischen Wissen- schaft. xiii. S. 1. Berlin, 1835. FUCUS CRISPUS. 249 nearly allied to animal mucus.* It is easy of digestion, is readily borne by weak and irritable stomachs, and exerts a soothing in- fluence on the air passages and the intestinal canal. In order to obtain it, the moss is cut small, carefully cleared from impurities, boiled with the selected vehicle, and strained. Von Grafe obtained, from nine ounces of milk boiled with half a dram of the moss, five ounces of jelly; and as much from a dram and a half of the moss and twelve ounces of water. The for- mula, commonly used by him, is given below. To this jelly may be added any dietetic or remedial agent, which may be considered indicated in the particular case.f t EFFECTS ON THE ECONOMY. The fucus crispus is used in the affections that are considered to be benefited by the Iceland moss. As a diet, it is given in consumptive cases, and wherever there is erethism in the respira- tory or digestive apparatus. In diarrhea it is sometimes given along with astringent or other remedies. The jelly has been ad- vised as a diet in scrofulous cases. Von Grafe affirms, that he has often found it serviceable in hoarseness, in dry spasmodic cough, consumption, diarrhea, and dysentery, in the intestinal pain, which remains after inflamma- tion and ulceration of these parts, and after poison has been taken; in diseases accompanied by much emaciation, and in the prostra- tion ensuing on serious diseases and operations. In similar af- fections it has been extolled by Hufeland.J On the other hand, Heyfelder affirms, that not only he, but many physicians of his ac- quaintance have used the moss without either good or evil re- sults in phthisis, as well as in erethism of the respiratory and di- gestive organs; and Riecke§ remarks, that as it makes a very agreeable jelly, when boiled with milk, and with the addition of a little of the aqua laurocerasi, it may do for cases where we must prescribe " ut fecisse aliquid videamur." The truth is that it can render no more service than other sub- stances which contain a similar principle, and accordingly but few prescribe it with any other view than as a demulcent and nutritious aliment, in cases where such is needed. * Lucae, in Riecke, Die neuern Arzneimittel, S. 234. Stuttgart, 1837. f See L. Feuchtwanger, in Philad. Journ. of Pharm. vi. 204. Philad. 1833-4. X Hufeland und Osann's Journ. der practiech. Heilkund. B. 77, St. 5, p. 135. J Op. cit. S. 235. 22 250 FUCUS CRISPUS. Adde MODE OF ADMINISTERING. Decoctum Fuci Crispi. Decoction of Irish Moss. R. Fuci crispi elect, et concis. Jss. Lact. vaccin. recent. 5ix. Coq. ad remanent, colatur. ±v. Sacchar. albissim. ±ss. ad ±i. Aq. amygdal. amar. concentr. 9i. To be taken in the course of the day. Von Graefe. R. Fuci crispi elect, et concis. 3iss. Coq. cum aq. font. 5xij. ad remanent, colat. ^v. Syrup, rubi. idaei $iss. ad 5ij. Aq. amygd. amar. concentr. 9j. To be used through the day. When employed as diet, Von Grafe allows from ten to eighteen ounces of the jelly in the day. R. Fuci crisp, (elect, et concis.) 5ss. Coque cum aq. font q. s. ad reman. 5vj. Colatur. adde Sodse phosphat. 3iss. Syrup opii, gij. ad 5iij. Dose.—A spoonful every two hours in cases of haemoptysis. between the attacks. Clarus. R. Lactis vaccini, 5xxiv. Fuci crisp, ^iv. Sacch. alb. 5j. Cort. cinnam. cont. 9j. Coque per minut. x. leni igne; filtr. et exprime. Beral. R. Fuci crisp, (elect, et concis.) zij. Coque cum lactis fhj. ad consist, gelatin. Tere cum Sacch. alb. 5ij. Amygdal. amar. No. 2. To be used in the course of the day, and daily. Hufeland. FULIGO. 251 FULIGO. Synonymes. Fuligo Splendens, F. Ligni, Soot, Woodsoot. French. Suie. German. Glanzruss, Spiegelruss, Kaminruss, Ofenruss, Russ. The discovery of creasote, and its extensive application to the treatment of disease, gave occasion to the resuscitation of this article—much employed by the ancients, but subsequently fallen into oblivion. The older physicians frequently used soot as an exciting, dia- phoretic agent in cachexia of every kind, in chronic rheumatism, cutaneous affections, and especially in the evil results of their sudden repercussion; in glandular indurations, rickets, exostoses, &c. It has also been employed as a domestic remedy, in colic, and in the simple and dysenteric diarrhea, and cholera of chil- dren. Several modern recommendations—as by Schiitte and Weisenberg—remained unheeded until the attention of physicians was recently drawn to it, especially by Blaud.* He is of opi- nion, that the costly—and by no means easily prepared—creasote may be wholly replaced by soot. Both are products of the dry distillation of organic substances; their odours are analogous, and as soot is much cheaper and more easily obtained, it deserves, he thinks, to be tried more extensively in therapeutics. The soot has a nauseously empyreumatic, more or less bitter and acrid, saline taste. EFFECTS ON THE ECONOMY. Blaudf has exhibited the soot in different diseases, especially in the form of ointment, or in decoction, with excellent and rapid effects, in herpes, itch, tinea, gutta rosacea and pruritus vulva; and he asserts, that he even healed a cancer of the breast by fre- quent ablution with a tepid decoction of it, and an ointment com- posed of equal parts of lard and soot with one eighth part of the extract of belladonna; but the same applications were of no bene- fit in a case of cancer of the nose, and in one of cancer of the uterus. He also cured a scabby eruption of the mucous membrane of the nose by an ointment of soot. In diphtheritis, he used, in ■»-wo cases, a decoction of soot as a mouth-wash with the best effects. * Revue Medicale, Juin, 1834 et Janvier, 1835, and Dr. E. Grafe, in Grafe und Walther's Journal, xxiii. 310. Berlin, 1835. f Journal des Connaissances Medico-Chirurg. Mai, 1834. 252 FULIGO. Iii confirmation of Blaud's remarks, Voisin asserts, that he cured a case of cancer of the face by the soot ointment. Dr. J. R. Marinus* has found it very efficacious in chronic eruptions (dartres,) and in tinea, and his observations have been confirmed by M. Nobele.f His conclusions are,—1. That soot cannot be applied with any expectation of success, until the crusts have been removed, and the irritation of the parts diminished by means of emollient applications. 2. That the gray layer left by the soot on the skin, whether it be used in the form of ointment or of decoction should be removed by a weak wash of soap and water. 3. That in children an ointment made with equal parts of soot and lard, is frequently too irritating for the small wounds exposed by the falling off of the crusts; that it is better to com- mence with one part of soot to three parts of lard; and, lastly. that wood soot is alone useful; that from coal being devoid of any agency. Carron du VillardsJ advises a collyrium prepared from soot in cases of strumous ophthalmia. He infuses two ounces of soot in boiling water, filters and evaporates to dryness; the shining resi- duum is then infused in very strong boiling vinegar, and to every twelve ounces of the liquid, twenty-four grains of extract of roses are added. A few drops of this solution, in a glass of tepid water, form an excellent resolutive collyrium, which may be made stronger or weaker at pleasure. He has, also, in cases of spots on the cornea, used soot—either blown into the eye alone, or mixed with powdered sugar-candy, and has seen good effects from it. United with butter it forms an eyesalve, not inferior, he says, perhaps to any other. As, in the treatment of specks on the cornea by dropping laudanum into the eye, the organ quickly becomes accustomed to it, Carron du Villards advises, that the eye should be excited to a more lively action by means of the combination of soot and tincture of opium given below. It is, he says, an energetic agent and may be applied by means of a pen- cil to the granulations on the cornea. He likewise recommends a decoction of soot as an injection in discharges which are the consequence of chronic inflammation of the vagina. More recently, M. Andre Gibrin|| has detailed to the Academie Royale de Medecine of Paris, six cases of chronic inflammation of the bladder in which soot was beneficially used in the way of injection. He took from the chimney two ounces of compact soot, broke it up, washed it, and boiled it in a pound of water. * Bulletin Medical. Beige, Nov. 1838, p. 289. f Annales de la Societe de Medecine de Gand, Gazette Medicale, and En- cyclographie des Sciences Medicales, Mars, 1840, p. 540. X Gazette Medicale, Janvier, 1831; see, also, Baudelocque, on its use in Scrofulous Ophthalmia, in Bulletin General de Therapeutique. Mars, 1834. || Bulletin de l'Academie, 15 Mars, 1837. FULIGO. 253 The decoction was filtered through paper, and injected into the bladder twice a day. The good effects supervened so closely on the administration of the remedy, that there could be no doubt as to the cause. The pain ceased, and the patient obtained sleep, to which he had been for some time a stranger. The urine gra- dually became clear, and recovered its natural appearance. To these remarks it may be added, that, according to Schiitte, an ointment composed of two parts of fresh butter or hog's lard, and one part of soot, is a popular and efficacious remedy on the Rhine for cases of porrigo, itch, and herpes; not more than a dram being rubbed in at a time. Weisenberg ascribes to the soot a protective power against contagious affections of the skin, and recommends, especially, lotions of soot water,—partly as a pre- ventive agent, and partly as a therapeutical application in itch. But the soot has not been used, of late, externally only; its in- ternal use, in the form of the old " tincture of soot," has been re- vived. This was long known under the name of " soot drops " and " fit drops," and was employed as an antispasmodic in hys- terical and other affections; but its employment has been extended, and it is given in Chronic rheumatism, chronic affections of the chest, suppressed cutaneous eruptions,—in many cases under pre- cisely the same notions that prevailed years ago. From, thirty to sixty drops of the following tincture are given several times in the course of the day. MODE OF ADMINISTERING. Mistura Fuliginis. Tinctura Fuliginis {Clauderi.) Mixture of Soot. R. Fulig. splend. ~ss. Potassac carbonat. riss. Ammoniee carb. 3'j- Aq. sambuc. 2ix, Tfigere leni calore. Filtra. Dose.—From thirty to sixty drops several times a day. Loto Fuliginis. Lotion of Soot. R. Fulig. splend. manip. maj. ij. Coque cum. aq. font. ftbj per semihoram. Cola cum expressione. Used as a wash, several times a day, in herpetic, psoric and syphilitic ulcers. Blaud. 22* 254 FULIGO. Unguentum Fuliginis. Ointment of Soot. R. Fulig. splend. Adipis, aa. ?ss. Extract, belladon. 3j. M. exacte, To be spread upon lint or tents in cases of cancers. Blaud. R. Adipis. Fulig. splendent, aa. ±ij. Coque leni igne per horas vj. As a dressing in cases of tinea, and of foul ulcers. Blaud. R. Carbon, pulv. Sulph. depur. aa. 5j. Fulig. splend. Cort. Peruv. flav. aa. Sss. Cerati simplicis q. s. ut fiat unguentum. A dram to be rubbed in, once or twice a day, in cases of tinea. Carron du Villards. R. Opii, Jij. Caryoph. arom. xj. Fulig. splend. loti, ^ss. Aq. cinnam. 5viij. Alcoholis, ?iv. Digest in a gentle heat for six days; filter and express the residuum. Applied in cases of specks on the cornea. Carron du Villards. R. Fulig. ^ij. Album, ovi, No. vj. Tere simul. As a dressing for herpes and tinea. It is the Pommade resolu- tive of Sainte Marie.* R. Fulig. ^iss. Zinci. sulphat. 3yj. Adipis, liv. M. * Nouveau Formulaire Medicale et Pharmaceutique. Paris et Lyon, 1820. GALEOPSIS grandiflora. 255 Applied in cases of tinea. It is the Pommade contre la teigne, of Bories.* GALEOPSIS GRANDIFLORA; (SUMMITATES.) Synonymes—Galeopsis Ochroleuca, G. Villosa, G. Segetum, Herba Sideri- tidis. German.—Grossblfithigen Holzahns, Grossblumigte Hanfnessel. This plant, which belongs to the natural family Labiatse, and in the Linncean system to Didynamia Gymnospermia, grows in the western part of Germany, in sandy cornfields.f EFFECTS ON THE ECONOMY. The fresh plant has a peculiar, feeble, balsamic smell, and a somewhat bitter and saltish taste, and has been considered, in Germany to be worthy of a distinguished place amongst the "bitter resolvents." It has been much sold as a nostrum, under the name of" Blank- enheimer Tea," (Blankenheimer Thee,) or " Liebers pectoral and phthisical herbs," (Liebersche Brust oder Auszehrungskrauter,) and enjoyed great repute. In the Ardennes, also, particularly in the district of Malmedy, it has been long employed as a popular remedy. In the year 1828, LejeuneJ directed attention to the therapeutical importance of this plant. According to his observa- tion, it is very useful in diseases of the mucous membrane of the respiratory and digestive organs, and especially in chronic pulmo- nary catarrh, even when it exists to such a degree as to merit the name Phthisis mucosa (Schleimschwindsucht.) In actual phthisis the affection seemed to him to be diminished by it; the hectic being moderated, the expectoration rendered easier, or the cough as- suaged. Lejeune generally boiled half an ounce of the plant in a pint of water down to half; sweetened the decoction with sugar or honey, and directed the whole to be taken in the twenty-four hours. In other cases, in which a milk diet was appropriate, the decoction * Formulaire de Montpellier. Montpelher, 1822. f Von Schlechtendal, in Encyclopad. Worterb. der medicin. Wissenschaft. xiii. 115. Berlin, 1835. X Annales Generates des Sciences physiques, p. 331. Sepr. 1820. 256 GALEOPSIS GRANDIFLORA. was made with an equal quantity of milk. Wesener* found it advantageous in phthisis mucosa, and in chronic pulmonary ca- tarrh. Giinther, who had many opportunities for observing the action of the remedy, affirms, that the Lieberschen Kriiuter not unfrequently produced some amelioration in phithisis, especially in scrofulous phthisis, but he never saw any actual recovery there- from. It seemed to him to moderate the colliquative sweats, and to facilitate and diminish the expectoration. In one case especially, of scrofulous phthisis, in the last stage, it appeared to be of essen- tial service, and to prolong life; and from all his observations he is disposed to infer, that if it is not the sole or the main remedy to be employed in .every stage of phthisis, it may be used with ad- vantage throughout the disease as a supporting agent. Rieckef asserts, that he has seen many cases in which the Lie- berschen Kriiuter were of great service in thoracic affections threatening phthisis. In one case, which promised to terminate unfavourably in a short time, owing to the complication of violent hamoptysis with hectic fever, and in which an experienced phy- sician had exhausted every effort of art, they were given with the best effect. The thoracic affection ceased, and at this time—a period of five or six years since the use of the remedv—the patient —an officer—is capable of performing his military "duties without difficulty. On the other hand, Richter affirms, that in two cases in which he administered the galeopsis, no benefit resulted from it. In this country it has not been employed ; so that we can only judge from the testimony afforded by the German writers. This, as they themselves admit,J is not yet sufficient to enable them to lay down any positive rules as to the exact indications and counter-indica- tions that must regulate its employment. It is probably of no farther service than as a mild bitter, and its place may, therefore, be supplied, perhaps advantageously, by manv of the" tonics that are admitted into the lists of our remedial agents. Geiger§ sub- jected it to analysis, and found in it 2,765 parts of fatty matter, wax and chlorophylle; 0.247 of a brown bitterish resin, insoluble in ether; 0.312 of a yellowish stimulating and bitter resin, soluble in ether; yellow bitter extractive matter, soluble in ether, and a brownish matter insoluble therein; phosphate and malate of lime; salts of potassa; muco-saccharine matter and fecula, and 65.882 of ligneous matter. * Hufeland und Osann's Journ. der pract. Heilk. 1823 and 1824 f Die neuem Arzneimittel, u. s. w. S. 241. Stuttyart, 1837 X Ibid. § Magaz. fur Pharmacie, ix. 134. GENTIANINA. *57 METHOD OF ADMINISTERING. Decoctum Galeopsidis Grandiflora. R. Summitat. galeopsid. grandif. |j. Boil in a pint of water for a quarter of an hour and strain. To be used in the twenty-four hours. Wesener. R. Summitat. galeop. grandifl. Rad. althaeae, aa. ^j. ----glycyrrhiz. 3ij- M. The fourth part of this to be boiled in a pint and a half of water. To be used daily in chronic catarrh, and in the expectoration produced by the softening of pulmonary tubercles. R^DIUS-* The galeopsis versicolor, and the galeopsis villosa, which have also been examined by Geiger,T appear to be possessed of the same virtues as the galeopsis grandiflora.% GENTIANINA. Synonymes ■—Gentianeina, Gentiania, Gentia, Gentianeine, Gentianinum, Gen- tianin, Gentianine. The peculiar bitter principle of the root of the gentiana lutea, or yellow gentian, was discovered at the same time by M. Hen- ry,^ chef de la Pharmacie centrale of Paris, and by M. Caventou. Their results, indeed, were so identical, that it almost seemed as if they had acted in concert, and they therefore agreed to furnish them conjointly. According to these gentlemen, the gentiana lutea contains—1. A very fugacious odorous principle; 2. A yel- low bitter principle, (gentianin;) 3. A matter identical with birdlime; 4. A fixed oil; 5. A greenish substance; 6. A free or- ganic acid; 7. Uncrystallisable sugar; 8. Gum; 9. A yellow * Auserlesene Heilformeln, u. s. w. Leipz. 1836. t Allgem. med. Annalen, S. 1141. 1825. t Richter's Specielle Therapie, B. x. S. 397. Berlin, 1828. } Journal de Pharmacie, torn. v. *uo GENTIANINA. colouring matter; and, 10. Woody fibre.* Schrader discovered in addition, a resinous and narcotic principle, and M. Planche affirms, that he detected the latter. METHOD OF PREPARING. Powdered gentian is digested in water in the cold. At the end of forty-eight hours a yellowish green tincture is obtained, which must be filtered, and the liquid be sufficiently concentrated by ex- posure to heat in an open vessel. It then forms, on cooling, a yellow crystalline mass, which possesses strongly the taste and odour of gentian. This mass is digested in alcohol, until it ceases to yield a lemon colour. The products of the washings are added together, and exposed to a slight heat; the yellow crystalline mass reappears, which, towards the end of the evaporation, becomes solid. The mass is very bitter. It is then redigested in weak alcohol, which redissolves all, except a certain quantity of oily matter. . This last alcoholic solution contains, in addition to the bitter principle of the gentian, its odorous matter, and also an acid substance. By evaporating the liquor to dryness, dissolving the residue in water, adding a little well burned and washed magne- sia thereto, and by boiling and evaporating in a water bath, the greater part of the odorous matter of the gentian may be driven off. The bitter acid is also taken up by the magnesia, and the yellow bitter principle remains partly free, and partly combined with the magnesia, to which it gives a beautiful yellow colour. 1 he greater part of the bitter principle may then be obtained pure and isolated, by boiling the magnesia in ether, and evapo- rating the solution. If it be desirable to separate still more of the bitter principle, which the ether has failed to take from the mag- nesia, this maybe done by digesting in enough oxalic acid to make the liquor acidulous. The acid unites with the magnesia, and the bitter principle which is set free may be obtained by the means above mentioned. Gentianin is yellow, inodorous, and possesses very strongly the aromatic bitterness of gentian, especially when dissolved in an acid. It is very soluble in ether and in alcohol; and may be se- parated from them by spontaneous evaporation, in the form of very small, yellow, needle-like crystals. It is much less soluble in cold water, which it renders, however, very bitter. Boiling water has more action on it. Its colour is much deepened by the dilute alkalies, which dissolve rather more of it than water does. Acids weaken its yellow colour. Concentrated sulphuric acid * Journal General de Medecine, torn. Ixxiv, and Magendie's Formula! GENTIANINA. 259 carbonises it, and destroys its bitterness. When exposed in a glass tube to the heat of boiling mercury, it is partly decom- posed, and partly sublimed, in the form of small, yellow, crystal- line needles. It does not sensibly change the colour of litmus paper, either when blue, or reddened by an acid, but seems to be neutral. Henry and Caventou esteem it an acid; Richard, an alkali. It would seem that the experiments of MM. Trommsdorf and Leconte have demonstrated decisively, that gentianin, prepared according to the process of M. Henry, cannot be regarded as the active part of gentian.* Professor Dulk, of Konigsberg, recom- mends the following process for separating it:—The coarse powder of the root is treated with alcohol; the alcohol is distilled off, and the residuum dissolved in water. The solution is filtered; and the undissolved matter, treated with ether, furnishes a clear tincture, from which, by spontaneous evaporation, is procured the gentianin of M. Henry, entirely insipid. The aqueous so- lution has a very bitter taste, and is fermented to separate the sugar, which cannot easily be done in any other manner. The liquid is then precipitated by the neutral acetate of lead; and the precipitate is separated: into the bitter liquid filtered is poured basic acetate of lead, and a little ammonia, to precipitate the combination of vegetable matter with the oxide of lead ; but care must be taken not to add too much ammonia, because the latter, as a stronger base, will withdraw the vegetable matter from the oxide of lead. A yellow precipitate is obtained, which is washed in small quantities of water, as in a larger quantity the combina- tion is decomposed. The precipitate is dissolved in water, and decomposed by a current of sulphuretted hydrogen gas. It is fil- tered, and the solution evaporated, at a moderate temperature, to dryness: the residue is treated with alcohol, s. g. .820; filtered and by evaporation a mass is procured, which presents no trace of crystallisation. This gentianin is a brownish yellow matter. Dried and tri- turated, it affords a yellow powder, and possesses the bitter taste of the root in the highest degree. It is hygrometric; almost in- soluble in absolute alcohol; more soluble in common alcohol and very soluble in water. It reddens litmus paper; heated, it melts, swells up, and burns without any residuum. It contains no azote! In its reaction and relation to bases, it approaches the acids. * Journal de Pharmacie, Dec. 1838. 260 GENTIANINA. EFFECTS ON THE ECONOMY. Gentianin, according to the experiments of Magendie, is not possessed of any poisonous qualities. Several grains, injected into the venous system, produced no apparent effect. He himself swallowed two grains dissolved in alcohol, and the only incon- venience which he experienced, was an extremely bitter taste, and a slight sense of heat in the stomach. It does not seem to possess any advantages over the gentian itself. MODE OF ADMINISTERING. Magendie recommends a tincture and a syrup. Either of them may be substituted for the officinal tincture of gentian, wherever the latter is considered to be indicated. The syrup he regards as one of the best bitters that can be prescribed in scrofulous affec- tions, and he asserts, that he has observed permanently good effects from it. He does not give the dose of the gentianin,—which Radius* fixes at from one to four grains twice a day. Tinctura Gentianina. Tincture of Gentianin, R. Alcohol. 24° (.903) §j. Gentianin. gr. v. Digere. Magendie. Syrupus Gentianina. Syrup of Gentianin. R. Syrup, simplic. fhj. Gentianin. gr. xvj. M. Magendie. * Auserlesene Heilformeln, u. s. w. Leipz. 1836, GRANATUM. 261 GRANATUM (CORTEX RADICIS.) Synonymes. Punica Granatum, Malogranatum, Pomegranate, (the bark of the root.) French. Grenadier, Balaustier. German. Granatbaum, (Granatwurzelrinde.) The Punica Granatum appears to be a native of the northern coast of Africa, whence it was transported to Italy at the time of the Carthaginian wars. It is now cultivated in all civilised re- gions, where the climate is sufficiently warm to allow the fruit to ripen. It belongs to the natural family Myrtaceas, and, in the Linnsean system, to the class Icosandria, order Monogynia. All the parts of the plant contain more or less tannin. The bark of the root is externally of a yellowish gray or ash colour; inter- nally it is yellow, and has an astringent taste. According to Latour de Trie,* it contains wax, chlorophylle, a considerable quantity of resin, gallic acid, tannin, fatty matter, and a peculiar matter called Grenadine,—in German, Granatin. This grenadine, in its pure state, is of a white colour; inodorous, and of a sweetish taste; so much so indeed, that, according to Magendie, it might be presumed to be a variety of sugar, except that it differs from ordinary sugar in being devoid of the property of fermenting. According to the degree of its purity, it crystal- lises in grains, tufts or stars. When thrown on red-hot coals, it consumes without any residuum, and smells like burnt bread. It is fusible, and by a moderate heat may be almost wholly sublimed. It neither reacts as an acid nor an alkali, and is readily soluble in water. Cold alcohol dissolves only traces of it, but boiling alcohol dissolves it readily,—a property, which is to be taken ad- vantage of in the formation of crystals. In ether it is insoluble. Nitric acid, with the assistance of heat, converts it into oxalic acid. An ounce of the bark yields six grains of the grenadine; but it is not settled, whether it contains the whole of the medical properties of the bark. Cenedella/j- from whom we have the most recent analysis of the bark of the pomegranate root, also found the grenadine discovered by Latour. This substance is readily prepared. The bark in powder is treated with ether, and after- wards with boiling alcohol, and the fluid is evaporated to the con- sistence of a soft extract. By treating this extract with water, the grenadine is dissolved without difficulty, and it may be puri- fied by suffering it to crystallise frequently from alcohol. * Journal de Pharmacie, Fev. 1828, p. 109. f Giornale di Farmacia, Agosto, 1831, p. 55. See, also, Journal de Phar- macie, ix. 219; x. 352; and xvii. 503; and Prof. Dierbach, in Heidelberg khn. Annalen, B. x. H. 3, S. 365. Heidelb. 1834. 23 262 GRANATUM. EFFECTS ON THE ECONOMY. The therapeutical properties of the different parts of the pome- granate tree were known to the writers of antiquity. They em- ployed not only the bark of the root as a remedial agent, but also the flowers {Flores Balaustiorum, Balaustes,Balaustia,) " Balaus- tine Flowers," the whole fruit {Poma Granati, Malo-Granata, Granata, Mala Punica, Fr. Grenades.) "Pomegranate;" the rind of the fruit {Malicorium, Malichorium, Malaconum,) and the seeds Dioscorides, Pliny, Celsus and Marcellus Empmcus speak of the employment of the bark of the root in taenia.* In more modern times, the Punica granatum had been greatly neglected, although the juice of the fruit was recommended by Frederick Hoffman against worms in, children. In India, it has been long held in great estimation as a remedy in cases of tapeworm, and its efficacy having been noticed by some English physicians, it was recommended to the attention of European physicians, especially by Buchanan,! Fleming and Breton. J About the same time, a monograph was published by Gomez, a Portuguese physi- cian, which appears to have had considerable agency in extending the reputation of the remedy, especially in Germany, where the monograph was translated into the Journal of Gerson and Julius.§ Gomez directs two ounces of the fresh rind of the root to be boiled in a pint and a half of water down to a pint; and of this decoction two or three spoonfuls to be taken for a dose; the first early in the morning fasting, and then every half hour until the whole is used. The efficacy of the preparation he tested on fourteen cases, from which it appeared, that the worm could not withstand the action of the remedy more than forty-eight hours. He found it to exert most efficacy, when portions of the worm were per- ceptible in the evacuations, a period when the patient generally suffers most inconvenience. If the exit of the worm did not take place on the first day, after the use of the agent, the decoction was continued on the second day, when the worm was generally discharged. Did this, however, not happen, a farther continuance of the remedy was of no avail; and he thought it better to inter- mit it until the appearance of fresh portions of the worm in the evacuations. Gomez also administers the dried rind in pills. If the dose be too large, or the appropriate dose be too frequently , repeated, nausea, vomiting and diarrhcea at times supervene; should this be the case, the proper course is obvious. * Merat & De Lens, Diet, de Mat. Medical. Art. Punica Granatum. f Edinb. Med. and Surg. Journal, iii. 22,1827. t Medico-Chirurg. Transact, xi. 31. 5 Mawazin, u. s. w. vi. 427, and Journal ComphSmentaire des Sciences Medicafes, xvi. 24,1823. GRANATUM. 263 In countries, where the fresh rind can be obtained, Gomez advises, that it should be used; in colder countries, the dried rind, which is obtained from more southern regions, will have to be employed. According to Breton, the latter acts more powerfully; the dried rind loses more than half its weight, and two ounces of it may be esteemed equal to three of the fresh. The strong testimony, adduced in its favour by Gomez, gave occasion to numerous trials with it in England, France, Germany and Italy, which were generally attended with favourable results. Such favourable testimony has been afforded by Boiti, Marchese, Calabro, Majoli, Chevallier, Deslandes, Merat,* Pichonnier, Man- drux, Claret, Bayle, Delaporte, Gendrin, Grimaud, Chapotin, Bourgeoise, Housson, Goupil, Ferrus, Wolff, Kostler, Meisinger, Berthold, and others.p On the other hand, KeibelJ complains of its uncertainty; and, in the Polyclinical Institute of the University of Berlin, it was given without advantage; but Osann, in his report of that institution, is disposed to refer the want of success to some imperfection in the rind employed, which, he remarks, is found to vary greatly in its character, as met with in the shop of the apothecary. It would appear, also, that it is not unfrequently mixed with the rind of the root of the Boxtree, and the Guelder rose (Wasserhollunder.) To introduce more precision on this matter, Wolff* recommends that the druggists should purchase The bark of the root of the genuine East India, or at all events the Portuguese, tree. Boiti§ advises that the root should be obtained from mountainous regions, where the tree grows wild; that it should be taken only from young trees, and that it should not be more than an inch thick, that it should be carefully separated from the woody portion, and be collected in the spring of the year, when the tree has most sap, and be dried in the shade. Chevallier,!! also advises, that only the rind of the root of the wild tree should be used. Gendrin, Montault and Pichonnier all affirm, that the fresh rind was alone certain in its operation ; the dry frequently disappointing them. According to Breton, the rind of the trunk is to be preferred to that of the root, because it preserves its virtues longer. Chevallier recom- mends, before the decoction of the pomegranate tree bark is ad- ministered, that a gentle cathartic of castor oil with lemon juice should be premised. This may be taken the evening before, the patient fasting, during the following day. The decoction he di- * Du Taenia &c. et de sa cure radicale par l'ecorce de la racine de Grenadier. Paris, 1832; and Merat & De Lens. Op. cit. f Riecke, Die neuern Arzneimittel, S. 247. X Rust's Magazin, xvi. St. 3. S. 566. $ Revue Encyclop. xxxii. 234. || Journal de Chimie Medicale, i. 378 ; 1825. 264 GRANATUM. rects to be made of two ounces of the rind macerated for twenty- four hours, in two pints of water, and then boiled until a pint of the strained liquor remains. This must be divided into three por- tions, which are taken in half hourly doses. The first and second doses with many persons excite vomiting, but this need not prevent the administration of the third, as it rarely produces the same effect. This quantity of the decoction commonly occasions three or four evacuations, preceded by slight colic pains ; at other times, but one evacuation is produced, with which the worm is usually expelled. The period that elapses between the administration of the last dose of the remedy and the commencement of its opera- tion is from a quarter of an hour to a whole hour—rarely longer. Cenedella advises that the bark of the root should be macerated before boiling; that the decoction should be made in earthen, not in metallic, vessels, and that it should be filtered or strained whilst hot, different constituents—which are probably efficacious—being deposited as the liquor cools. According to Constant, the rind is commonly prepared in France in the following manner. The rind of the fresh root—or the bruised root dried—is mace- rated through the night in from a pint and a half to a quart of water; the liquor is then boiled to one half, strained, and in the morning, a third part is taken lukewarm, fasting, and repeated every three hours until the whole has been arlministered. The quantity of the rind, used fur the decoction, is, in the case of the adult, f j; of children, from six to fifteen years old, Jvj; and of those under six years of age, gss. At times, however, it has been administered in much larger doses. A girl, twenty-four years of age, had suffered from taenia from her infancy and had frequently passed fragments of worms in her evacuations. She took two ounces of the bruised bark of the promegranate root, boiled in two pounds of water, at thrice, with half an hour's interval between the doses, but without effect. The dose was now increased to three ounces, and two tapeworms were expelled; so that in two days, and without any abdominal disturbance, the patient took the decoction of five ounces of the bark of pomegranate root.* To ensure the proper action of the decoction, it must be given as directed above, without the addition of sugar or syrup, which changes its properties. During its operation, the patient should drink nothing, except when the tormina are urgent, and then a 'lit- tle of any aromatised water, without sugar, may be taken. The remedy should be given only on days in which portions of taenia are evacuated, or on the following morning; and the alimentary canal should be free from every evidence of inflammatory irrita- * Professor Forget, in Gazette des Hdpitaux, Fev. 19,1839, and Lond. Med. Gazette, Apl. 20, 1839. GRANATUM. 265 tion. By some, as by Latour de Trie and Ferrus, an infusion of the rind has been found serviceable; and Deslandes recommends an Extractum spirituosum, and an Extractum aquosum corticis radicis granatorum. Ferrus, Berthold, Goupil, and others, have published cases in which, along with the expulsion of the taenia, various neuroses were removed under the use of the rind, and accordingly it has been thought, that it might be usefully employed in such affec- tions where no taenia exists;—in epilepsy and hysteria, for ex- ample. Decoctum Corticis Radicis Granati. Decoction of Pomegranate Root Bark. R. Corticis radicis granati, 5ij. Aquae, Jfeij. Boil to a pint and a half. Dose.—gij every half hour. Three or four doses are usually sufficient to expel the worm.* The formula quoted by Dr. Parisf from Dr. Ainslie's Materia Medica of Hindustan, directs the de- coction to be prepared with §ij of the fresh bark, boiled in a pint and a half of water, until only three quarters of a pint remain. Electuarium Corticis Radicis Granati. Electuary of Pomegranate Root Bark. R. Extract, spirit, cort. rad. granat. Jvj. Aquae florum tiliae Succi. citr. aa. 5iij. Gum. tragac. q. s. ut fiat electuarium. Dose.—One half, from half hour to half hour. Deslandes. * Jourdan's Pharmacope'e Universelle, i. 638, Paris, 1828. f Pharmacologia, Beck's American Edition, p. 380. New York, 1831. 23* 266 guaco. Mistura Extracti Corticis Radicis Granati. Mixture of Pomegranate Root Bark. R. Extract, spirit, cort. rad. granat. 5vj. Aquae menthae, Aquas flor. tiliae.* Succ. citr. aa. |ij. M. To be divided into four parts, one of which may be taken every quarter of an hour. Deslandes. GUACO. Synonymes.—Huaco, Eupatorium Huaco. It would appear, that owing to some extracts in the Allgemeine Zeitung, the attention of the German physicians had been di- rected to this article as an important agent in the cure of epidemic cholera; and various testimonials have been brought forward in its favour, which, as Rieckef properly suggests, may not be con- firmed by farther experience, and yet the circumstance may have led to the introduction of a valuable article into the catalogue of medicinal agents. Many species of the genus Eupatorium, and of the kindred genus Mikania,—which has been recently separated from it, be- longing to the natural family Compositae, (Synanthereae, sub- division Corymbiferae,) and, in the Lynnaean system, to Syn- genesia iEqualis, have been prized in various parts of America, particularly in cases of the bites of serpents. This is especially the case with the Eupatorium ayapana, {E. triplinerve.) According to Martius, a quantity of the bruised leaves is applied to the scari- fied wound, and the application of fresh leaves is renewed, over and over again, until the patient is freed from the dangerous symp- toms, and especially from the violent suffering. At the same time, a few spoonfuls of the expressed juice are administered every now and then. The Mikania opifera, {Eupatorium cr'enatum,)—in Brazil termed Erva da cobra—and tbe Eupatorium saturejce- folium, {Mikania saturejafolia,) also belong to the many Synan- • Any simple aromatic water may be substituted for this. f Die neuern Arzneimitlel. u. s. w. S. 250. Stuttgart, 1837. GUACO. 267 thereae, which, in South America, are reputed specifics against the bites of serpents. The most important species appears to be that called, in Peru, Guaco, or Huaco, which is held there in high consideration, as well as in Columbia, New Grenada, and Vene- zuela, not only in these cases, but in the prevention of hydropho- bia.* This is presumed to be the mikania guaco of Humboldt. The guaco was made known to us, forty or fifty years ago,by Mutis,f who refers to its effects in cases of the bites of serpents. effects on the economy. Of the efficacy of the guaco in the Indian cholera, M. E. de Chaniac, Officier de Sante in the French navy, and Dr. Chabert, physician to the military hospital in Mexico, have published the results of their experience. When the brig Adonis, on her voyage from Havana to Mexico, in the year 1833, arrived at Vera Cruz, some of her crew were attacked with the cholera, which prevailed at the time in Mexico. Of all the remedies employed, the guaco was found the most beneficial; its effects, indeed, were so won- derful, that it was regarded almost as specific. Its action is chiefly exerted on the heart and the circulation, which it renders more energetic. All the patients, to whom it was exhibited in the commencement of the disease, were saved, and even of those, in whom the cholera had already reached a certain stage, the greater part were saved, as soon as a free and complete reaction was established. Dr. Chabert, who first administered the guaco in cholera, as well as in yellow fever, observes on its use in the former disease:—In simple cases, a small tea-cupful of a warm decoction of guaco was given every half hour, until a general diaphoresis and proper warmth of surface supervened, which was kept up for some days, when the remedy was gradually discontinued. To allay the thirst, the decoction was given, diluted with two-thirds, or half, water. In dangerous cases of cholera algida, with coldness, loss of pulse, &c, a spoonful of the spirituous tincture was mixed with six or eight spoonfuls of water, and, every quarter of an hour, a spoon- ful of this mixture was given alternately with a small cupful of the decoction. When the pulse returned, the warmth became re- * See W. R. Johnson, in Silliman's Journal, xxiv. 279 and 388, New Haven, 1833; and Ibid, xxvii. 171, New Haven, 1835; also, Dr. Hancock, in Quarterly Journal of Science, &c. from January to June, 1830, p. 333. Dr. Hancock affirms, that the names Guaco and Bejuco de Guaco were given—in the parts of America where he sojourned—to different species of Aristolochia. f Virey, in Bulletin de la Soci£t6 de Pharmacie, vi. 241; and Riecke, Op. cit. 251. 268 GUACO. stored and the perspiration re-established; the tincture was omitted, and the decoction continued alone at longer intervals. In the majority of cases, after the cessation of the cholera symptoms, pain was experienced in the epigastrium, with burning thirst, which yielded when the decoction was diluted with half or two- thirds water. When the decoction could not be retained by the stomach, it was given in clyster. Bloodletting, general and local, was employed along with other external means, but nothing was given internally, except the guaco. To make the decoction;—two drams of the stalks, and half a dram of the leaves, were boiled in two pints of water, down to one. The tincture was prepared like other tinctures. In consequence of the communications of Chabert and DeCha- niac, as well as of the parallel drawn by Harless,* between the cholera and the effects of the bites of serpents, Professor Beckers. of Miinchen, recommended that experiments should be made with the guaco; and it was accordingly tried in Miinchen, but not with as favourable results as had been expected. Romerio asserts, that it was given in the stadium' asphycticum, in the form of infusion, made of half an ounce of the stalks, but with uncertain results. It appeared to combine the effect of the valerian and ipecacuanha, yet it excited less vomiting than the latter. The tincture appeared to render greater service. It was given in the dose of a coffee- spoonful every half hour, and, subsequently, every hour, and every two hours. It would appear, that in the district of Prague, its administration was attended with very favourable consequences.! To account for the different results, it is affirmed, that different drugs are met with in commerce under the name guaco. Riecke says, that M. Jobst had sent him two kinds, which were evi- dently from different plants; the one variety was obtained from Hamburg and Bordeaux, the other from Paris; descriptions of which are given by Riecke. The truth, probably, is, that this, like most of the cholera specifics which have been brought for- ward, is efficacious in certain cases of the disease, but that its efficacy has been egregiously exaggerated. * Die Indische Cholera u. s. w. Braunschweijf, 1831. t Riecke, Op. cit. S. 256. HIPPOCASTANUM. 269 HIPPOCASTANUM, (CORTEX.) Synonymes.—.dEsculus Hippocastanum, Castanea Equina, C. Pavina, Horse Chestnut, Buck Eye, (the Bark.) French.—Marronier, Marronier d'lnde. German.—Rosscastanien, (Rinde.) The tree, whence this bark is derived, is the JEsculus Hippo- castanum, or Horse Chestnut—of the natural family Hippocas- tanese; in the Linnaean system, class Heptandria, order Mono- gynia—which is wild on the mountains of Asia Minor and Persia, and grows in this country, as well as in Europe. The bark has a very astringent taste, is somewhat bitter, and contains a great deal of tannin. Canzoneri thinks he discovered a peculiar prin- ciple in it, which he calls JEsculine, but the existence of this is contested. EFFECTS ON THE ECONOMY. The cortex hippocastani has long been advised as an astringent, but without receiving much attention.* In modern times, it lias been proposed by Zannichelli, Hufeland, Voigtel, and others, as the best substitute for the cinchona. These recommendations have caused the bark to be more frequently administered of late, in Europe, by which means it has been discovered to accord almost entirely in its effects with the willow bark; the latter, however, appears to be more effective, and to agree better with the digestive organs. In the wars of Napoleon, when bark was very scarce, it was much employed. Hufeland and Voigtel recommend it, especially in intermittents. Sinogowitzf advises that it, should be given after the removal of intermittents by the quinine, to prevent a relapse; and, also, in combination with diuretic agents, in the cases of dropsy which often succeed that disease. Krugelstein found it always extremely efficacious in atonic gout, and in removing the weakness of the digestive apparatus that remains after attacks of gout. The Austrian, Brunswick, Danish, Russian, and Saxon pharmaco- poeias;}; have an aqueous extract of the bark, which Voigtel admi- nistered with good results in intermittent fever, and which he often found serviceable in chronic discharges from the mucous mem- * M£rat & De Lens, Art. iEsculus Hippocastanum. f Rust's Magazin, B. xxix. H. i. p. 84. t Pharmacopee Universelle, ii. 14. Paris, 1828. 270 HIPPOCASTANUM. branes. It agrees better with the stomach than the powder or the decoction. Externally, the decoction has been advised as a good astringent. MODE OF ADMINISTERING. Decoctum Corticis Hippocastani. Decoction of Horse Chestnut Bark. R. Cort. hippocastan. ^iss. Coque cum aquae commun. ^xviij. ad reman, colat. oix; cui refrigerat, adde Spir. sulph. aether. 3j—ij- Syr. cort. aurant. §j. M. To be used during the apyrexia. Voigtel. Pulvis China Factitius. Factitious Powder of Bark. R. Cortic. hippocast. -------------------__=.---. satin. ---r- gentian, rubr. Calam. arom. Caryophyll. aa. 5ij- Misce et fiat pulvis. Hufeland* affirms, that this powder is an adequate substitute for tfie cinchona in three cases out of four. Hufeland, and Prussian Pharmacopeia. Decoctum China Factitia. Decoction of Factitious Bark. R. Pulv. gross, cort. salic. --------------hippocast. aa. ^ss. Rad. calam. Caryophyll. aa. 5ij. Coque cum aq. fontan. ^xvi. ad reman, colat. iviij. Prussian Pharmacopeia. * Armenpharmacopoe. 4te Ausgab. Berl. 1825. HYDRARGYRI PR^PARATA. 271 Decoctum Hippocastani Acidum. Acid Decoction of Horse Chestnut. R. Cort. hippocast. pulv. 5yj- Coque cum Acid, sulphur, dilut. 5J et Aquae font. 5x. Ad colat. ^yj. Used in the after treatment of intermitten s. Sinogowitz. Electuarium Corticis Hippocastani. Electuary of Horse Chestnut Bark. R. Cort. hippocast. pulv. ^ss. Rad. calam. aromat. 3ss. Roob. juniperi, 5iij. M. fiat electuarium. A tea-spoonful to be taken every hour, or every two hours, in dropsies supervening on intermittent fever. Sinogowitz. HYDRARGYRI PR^EPARATA. Synonymes.—Preparations of Mercury. French.—Les Preparations de Mercure. German.—Quecksilberpraparate. I. HYDRARGYRI BROMIDUM. Synonymes.—Hydrargyrum Bromatum, Bromide of Mercury. German.—Bromquecksilber. Mercury unites with bromine in more than one proportion. A solution of hydrobromate of potassa produces, with a solution of nitrate of protoxide of mercury, a white precipitate, which resem- bles calomel; and appears to be a bromide of quicksilver, answer- ing to the protoxide; {Hydrargyrum Bromatum, Hydrargyri Pro- tobromidum; German, Quecksilberbromur.) On the other hand, the bromide which is formed by the direct union of bromine with 272 HYDRARGYRI EROMIDUM. mercury, corresponds probably to the peroxide. A white sub- stance results, which can be sublimed by heat, is soluble in water, alcohol, and especially in ether; is coloured red or yellow by the alkalies, and exhibits considerable resemblance to corrosive subli- mate; {Hydrargyrum perbromatum, H. perbromidum, H. deuto- bromidum. German, Quecksilberbromid.) EFFECTS ON THE ECONOMY. The effects of these preparations on the sound and diseased organism are not yet well known. They have, however, been employed by some physicians. The protobromide strongly re- sembles calomel in its properties. In the dose of one or two grains, it produces no effect in health, even when taken fasting. In a higher dose—four or five grains, and upwards—it purges moderately, augmenting, at the same time, the secretion pf urine. When used in recent syphilitic affections, in the way of friction on the gums, or internally, in the form of pill, it cures them like calomel; but it does not seem to affect the mouth as speedily or as severely as calomel.* The deutobromide resembles the bichloride of mercury in its action,—producing, in too strong a dose, vomiting and purging, with colic and cramp of the stomach; affecting the mouth, and exciting violent salivation. Werneck, of Austria, has administered it frequently in syphilis. In recent cases, he prescribes the deu- tobromide in the form of pill, beginning with the one-twentieth of a grain. This dose he increases by two twenty-fifths every two days; the chancres being covered at the same time with com- presses, wetted with a solution formed of six grains of the same substance to a pint of distilled water. After a few days' treat- ment, he remarked, that the sores assumed a better appearance; and from twenty to thirty days were sufficient to effect their en- tire cicatrisation; the total quantity of the bromide administered was about five grains. It was rarely necessary to carry it as high as ten or twelve grains. It has been believed that the deutobro- mide of mercury is less liable to affect the salivary glands than the deutochloride of mercury, and to affect less severely the sto- mach and chest.f Desorgues has recommended the second (?) preparation as a prophylactic and curative agent in syphilis. It was doubtless, also, Riecke suggests—the second preparation, which was ad- ministered with excellent effects by Prieger, in porrigo favosa, of an obstinate character. He terms the preparation bromus mar- * Bulletin General de Th^rapeutiquc, No. 14, Juillet 30,1837. f Ibid. HYDRARGYRI CYANIDUM. 273 curii, but the true bromate is probably insoluble in ether.* The first of the following formulae is recommended by Prieger. Gutta Hydrargyri Perbromidi. Drops of Perbromide of Mercury. R. Bromatis mercurii, (vel potius hydrargyri perbromidi,) gr. vj. Solve in iEther. sulphuric. 5hj- M- Dose.—Ten to twenty drops, according to the age of the pa- tient, daily, in water. R. Hydrargyr. deuto-bromid. gr. j. iEther. sulphuric, gj. M. Dose.—Ten to twenty drops in barley water, a short time after taking dinner;—in syphilis. Werneck. II. HYDRARGYRI CYANIDUM. Synonymes.—Hydrargyri Cyanuretum, H. Prussia?, II. Bicyanidum, H. Borussias, Hydrargyrum Cyanogenatum, H. Hydrocyanicum, Cyanide, or Prussiate, or Hydrocyanate, or Bicyanide of Mercury. French.—Cyanure ou Hydrocyanate ou Prussiate de Mercure. German.—Cyanquecksilber, Blaustoftquecksilber, Blausaures Quecksilber. This mercurial preparation is contained in the pharmacopoeias of the United States, Dublin, London, Belgium, Paris, Ferrara, &c. METHOD OF PREPARING. According to Proust and Gay-Lussac, two parts of good and finely powdered Prussian blue must be boiled with one part of deutoxide of mercury and eight parts of water, until the mixture acquires a bright yellowish tint. It is then filtered; and the fil- tered liquor, which is the hydrocyanate of deutoxide of mercury —containing, however, some iron—is digested or boiled with an excess of the deutoxide of mercury, whereby the oxide of iron * Die neuern Arzneimittel, S. 261. Stuttgart, 1837, &. 2te Auflage, S. 371. Stuttgart, 1840. 24 274 HYDRARGYRI CYANIDUM. is completely precipitated. As, however, the hydrocyanate, is ' combined with an excess of the oxide of mercury, this must be saturated with free hydrocyanic acid, and the solution be evaporated to induce crystallisation. In this mode the cyanide is formed. The formula of the Pharmacopceia of the United States, into which the cyanide has been introduced to serve in the preparation of the hydrocyanic acid, is the same as that adopted in the Co- dex Medicamentarius of Paris, which was recommended by Ber- zelius. It is as follows :— Take of red oxide of mercury, three ounces; ferrocvanate of Iron, (Prussian blue,) six ounces; distilled water, three pints. Put the oxide of mercury and the ferrocyanate of iron, previously powdered and thoroughly mixed together, into a glass vessel; and pour upon them two pints of the distilled water. Then boil the mixture, stirring constantly, till it becomes of a yellowish colour; after which filter through paper. Wash the residue in a pint of the distilled water, and filter as before. Mix the solutions, and evaporate by the fire till a pellicle appears; then set the liquor aside that crystals may form. To purify the crystals, dissolve them again in distilled water; filter; evaporate the solution, and set it aside to crystallise.* The former of these methods is, doubtless, the best, as it ensures uniformity, whilst the Prussian blue of commerce being of variable strength, the cyanide made after the latter formula, must be so likewise. Schrader directs it to be prepared by mixing a solution of the red oxide or deutoxide of mercury with hydrocyanic acid, filtering- and evaporating.f The cyanide of mercury forms white, opake, four-sided prisms. It is inodorous, and its taste is extremely disagreeable and metallic. It is decomposed by heat; is readily soluble in water, and becomes converted thereby into hydrocyanate of mercury. It is insoluble in alcohol. The cyanide of mercury contains, at times, ferrohydrocvanate of potassa, proceeding from the Prussian blue, with which"it has been prepared.J * Wood and Bache's Dispensatory, Art. Hydrargyri Cyanuretum; sep, also, Mr. Ellis, in Journal of the Philadelphia College of Pharmacy, vi 24 Philad 1834-5. f See a new process for its preparation, by MM. Chevallier and Deleschamps, in Journ. de Chimie Medicale, Janv. 1830. X Orfila, Toxicologic, i. 331. HYDRARGYRI CYANIDUM. 275 EFFECTS ON THE ECONOMY IN HEALTH. According to Coullon, the poisonous action of the cyanide of mercury is as rapid as that of the hydrocyanic acid; but, in the dose of from two to five grains, M. Ittner found it produce on dogs only signs of indisposition, tremors, &c* It is one of the sub- stances which Magendie,j- in his experiments, found to promote the coagulation of the blood. EFFECTS ON THE ECONOMY IN DISEASE. Parent,^ who frequently used this preparation, prefers it greatly to corrosive sublimate, in consequence of its greater solubility, and the capability of more readily affecting the organism by it. In his experience, syphilis yields more readily under its use than under that of any of the mercurials. He did not observe pains in the abdomen accompanying its protracted employment, which he so frequently witnessed when the sublimate was taken. Another ad- vantage which it possesses, is, that it is not so readily decomposed. No salt, rto alkali—not even caustic alkali—disturbs it; neither do substances that contain azote or gallic acid, which speedily con- vert the sublimate into calomel. Moreover, the cyanide of mer- cury appears to act on the animal textures differently from subli- mate. When the latter is placed in contact with flesh, it becomes quickly changed, in part, into calomel; whilst the cyanide pre- serves the flesh equally well, without being decomposed. The hydrocyanic acid appears to play no important part in the action of the remedy. According to Olivier's experiments,^ the cyanide, like the corrosive sublimate, acts as a powerful excitant to the tissues on which it is applied. He saw a man destroyed by in- flammation of the intestines, who had taken twenty-three grains of it. The cyanide of mercury was first, perhaps, recommended in Italy, (Brera,) and Spain. Mendoza especially made many trials with it, from which- he was induced to conclude, that it is the best agent we possess in venereal affections—an opinion in which he was joined by several of his professional brethren in Malaga. He advises, that laudanum should be added to it, on account of its lia- bility to excite vomiting. When too large doses were administered, * Merat & De Lens, Diet, de Mat. Med. Art. Cyanogene. f Legons sur le Sang; and translation in Lond. Lancet, Jan. 20th, 1839, p. »336. J Journ. de Chimie Medicale, viii. 473. ) Journ. de Chimie Medicale, i. 269. 276 HYDRARGYRI CYANIDUM. or when the patient was unusually impressible, Mendoza found that the nervous system became especially disordered—as indi- cated by syncope, oppression, anxiety, and convulsions. Chaussier, likewise, as well as Thaer and Horn proposed the cyanide as a remedial agent at an early period. On the other hand, Wendt, Cullerier, and Plisson complain of its little efficacy; whence it has been inferred that the preparation must differ; when prepared, in- deed, according to the first form, it always contains more or less iron.* Neumannf advised it in chronic inflammation of the lungs, and of the membranous organs of the chest, and abdomen and of the ovaries. In particular cases, its use has to be soon pretermitted, in consequence of its powerful action, even in small doses—as one eighth of a grain three times a day—on the salivary glands. In other cases, it can be continued long without the supervention of any unpleasant consequences. In the Charite, at Berlin, it was used with advantage in a case of obstinate cephalalgia, the origin of which was syphilitic. Biett has employed it externally—in the form of the ointment given below—in cases of humid tetter, accompanied with inflam- mation and itching. Parent recommends it to be applied in cases of chancre, and Brera uses it in solution, as a gargle, in syphilitic ulceration of the fauces. MODE OF ADMINISTERING. The cyanide of mercury may be given in pills or in solution; Horn gave it in powder, but this form is less appropriate. The dose is from one-sixteenth of a grain to a grain several times a day. As a gargle, half a grain to a grain may be dissolved in ^j of water; as an ointment from one and a half to two grains to -yj of lard. Chaussier used it in friction on the soles of the feet, in the same way as the corrosive sublimate. Solutio Hydrargyri Cyanidi. Solution of Cyanide of Mercury. (Synonyme.—Liqueur Antisyphilitique de Chaussier.) R. Hydrargyri cyanid. gr. viij. Aquae destillat. ffj. Each ounce contains half a grain of the cyanuret. ChaussierJ and Parent. * Riecke, Die neuern Arzneimittel, u. s. w. S. 264. Stuttgart, 1837, & 2te Auflage, S. 376. Stuttgart, 1840. t Hufeland und Osann's Journal, lv. 66. X Rattier, Formulaire Pratique des Hopitaux civils de Paris, Seme £dit. Paris, 1827. HYDRARGYRI CYANIDUM. 277 R. Hydrarg. cyanid. 9ss. Solve in Aq. destillat. fbj- Adde Tincturae opii, 3j. M. Dose.—Morning and evening, a spoonful, in a decoction of sar- saparilla or barley. Mendoza and Parent. Pilula Hydrargyri Cyanidi. Pills of Cyanide of Mercury. R. Hydrarg. cyanid. gr. v. Opii puri, 9ss. Micae panis, 3j- Mellis, q. s. ut fiant pilulae xcvj. Dose.—One to four, three times a day. Parent. Gargarisma Hydrargyri Cyanidi. Gargle of Cyanide of Mercury. R. Hydrarg. cyanid. 9ss. Decoct, ten. sera, lini, (vel rad. althaea?,) jfoj. M. et fiat gargarisma. Parent. R. Hydrarg. cyanid. £)ss. Decoct, hordei, }f3J. Mellis rosati, ?j. M. et fiat gargarisma. Brera. Unguentum Hydrargyri Cyanidi. Ointment of Cyanide of Mercury. R. Hydrarg. cyanid. gr. xij. Adipis, ?j. M. ut fiat unguentum, Brera. R. Hydrarg. cyanid. gr. xvj, Adipis, §j. 01. limonis, gtt. xv. M. From half a dram to a dram, to be rubbed in, in cases of tetter. Biett. 24* 278 HYDRARGYRI PROTO-IODIDtiM. III. HYDRARGYRI PROTO IODIDUM. Synonymes.—Hydrargyri Proto-Ioduretum, Hydrargyrum lodatum flavum, H. Iodidum, H. Iodidulatum, H. lodatum (in contradistinction to the Perioda- tum,) Iodidum Hydrargyrosum, Hydrargyri Proto-iodidum, Proto-iodide or Proto-ioduret of Mercury. French.—Proto-iodure de Mercure. German—Gelbes Iodquecksilber, Gelbes Quecksilberiodid, Protoiodur des Quecksilbers, Quecksilberiodidul, Iodquecksilber im. minimum des Iods. METHOD OF PREPARING. According to Tunnermann, the best method of preparing the Proto-iodide is the following:—Take of the nitrate of protoxide of mercury, (not tinged yellow by the admixture of the nitrate of peroxide) 28.25 parts, and 16.5 parts of iodide of potassium; rub them together for some minutes in the dry state, and afterwards with a little distilled water, gradually adding the water so as to dissolve the saltpetre formed. The mixture is then passed through the filter, and tbe yellowish green precipitate of iodide of mercury is well washed, and then dried by a gentle heat. The objection to this process is the difficulty of obtaining the mercurial salt at a minimum of oxidation, and the consequent lia- bility of the resulting compound to contain uncertain quantities of the deuto-iodide. M. Boutigny* to avoid these disadvantages re- commends the following form. R. Hydrarg. proto-chlorid. 5iij & ^v. Potassii iodidi, Iij & 5iv- Pulverise the iodide in a glass mortar, and add the calomel; place the mixture in a porcelain capsule, and pour over it ten or twelve ounces of boiling distilled water. After cooling, decant the fluid, collect the precipitate on a filter, and wash with distilled water. Dry in the shade and keep in a well-stopped bottle. The proto-iodide, thus prepared, may, according to M. Bou- tigny, sometimes contain a minute portion of mercury or its pro- tochloride, but the quantity of either is so small as to be of no moment. In the new London Pharmacopceia, it is prepared by rubbing together an ounce of mercury and five drams of iodine, adding * Bulletin General de Therapeutique, and American Journ. of Pharmacy, 2d vol. 2d series, p. 326. Philad. 1837. HYDRARGYRI PROTO-IODIDUM. 279 gradually as much alcohol as may be sufficient until globules are no longer visible. The powder is dried immediately by a gentle heat, access of light being excluded, and is kept in a well stop- ped vessel.* The proto-iodide, according to Thomson, consists of 250 parts of mercury, and 156 parts of iodine. It has a greenish yellow colour, and is a preparation holding the same relation to iodine and mercury, that calomel holds to chlorine and mercury; it is more volatile, however, than calomel, but like it is almost insolu- ble in water. EFFECTS OF THE ECONOMY. This preparation has been less used than the deuto-iodide to be described next. Tunnermann remarks, as the results of his experience, that its action in respect to the mercury, is analogous to that of calomel, except that it appears to excite more the lym- phatic and glandular systems. When given in conjunction with a generous animal diet, he found it very efficacious in a case of scrofulosis, where colliquative sweats had appeared; and in a se- cond case, also, it rendered essential service. In one of the cases, he gave it internally in the dose of from one twelfth to one half a grain three times a day; in the other of from one half a grain to a grain. He directed it also to be rubbed, in the form of oint- ment, on the tumefied glands of the neck. Pelletan likewise found it serviceable in the cure of obstinate glandular swellings, when used in the form of ointment in combination with morphine, as well as in cases of obstruction of the liver. Biett recommends an ointment of the protoiodide in the treatment of chronic ve- nereal ulcers, the cicatrisation of which it expedites; Lugolf ad- vises it in phagedenic scrofulous ulcers, which present a syphil- itic aspect; and PoiretJ recommends it strongly in cases of pso- riasis ; the patient using at the same time simple alkaline or vapor baths alternately. According to the experience of Ricord,§ in the syphilitic affections of children, especially of a cutaneous character, it is to be preferred to other forms of mercurial, and is not apt to be followed by the bad effects, which, in adults, often supervene on the use of other preparations.|| * Brande, Dictionary of Materia Medica, p. 289. Lond. 1839. f Essays on the effects of Iodine in scrofulous diseases, &c. by Dr. O'Shaugh- nessy, p. 170. Lond. 1831. X Gazette des Hopitaux, Juillet 20,1837; see, also,Bulletin General de The- rapeutique, Juillet, 1837; and C. A. Porter, M. D. in American Journal of the Med. Sciences, Nov. 1839, p. 68. { La Lancette Franchise, No. 65, 1834. || Cogswell's Essay on Iodine, p. 158. Edinb. 1837. 280 HYDRARGYRI PROTO-IODIDUM. METHOD OF ADMINISTERING. On account of its insolubility, it is given only in the form of powder or pill, to the extent of from one-twelftb to half a grain, twice or thrice a day. Externally, it is applied, for the same reasons, in the form of ointment only. Pilula Hydrargyri Iodidi.—(Pharmac. Londin.) Pills of the Iodide of Mercury. R. Hydrarg. iodidi, 5j. Confect. rosae caninae, ^\\]. Zingiberis contritae, 5J- M. Pilula Hydrargyri Proto-Iodidi Composita. Compound Pills of Proto-iodide of Mercury. R. Hydrarg. proto-iodid. gr. vj. Extract, opii, gr. iv. Lactucarii, gr. xxiv. Ext. guaiac. gr. xlviij. M. Fiant pilulae xlviij. Dose.—For a child, half a year old, one pill; for older children, two, three, or four. In the syphilis of children. Ricord. R. Hydrarg. proto-iodid. gr. j, Ext. junip. gr. xij. Pulv. glycyrrhiz. q. s. Divide in pulv. viij. Dose.—At first, two, morning and evening; afterwards, three or four. Magendie and Biett. Pulveres Hydrargyri Proto-Iodidi. Powders of the Proto-iodide of Mercury. R. Hydrarg. proto-iodid. gr. i, (iv, vj, vel viij.) Magnes. alb. 3j. M. Et divide in part. xij. Dose.—A powder three times a day. HYDRARGYRI PROTO-IODIDUM. 281 Unguentum Hydrargyri Proto-Iodidi. Ointment of the Proto-iodide of Mercury. R. Hydrarg. proto-iodid. gr. vj. Morphin. acetat. gr. viij. Adipis, ?j. M. In obstinate glandular swellings. Pelletan. R. Hydrarg proto-iodid. 9j. Adipis, 5iss.* M. In old venereal ulcers. Magendie and Biett. R. Hydrarg. protOTiodid, 9ij. (vel iij, vel iv.) Adipis, iij. M. As a dressing to phagedenic and scrofulous ulcers. Lugol. When this salve is first prepared, it is of a canary yellow, sometimes of a greepish colour. By time, it becomes of an orange hue, when it must be thrown aside," as, owing to the formation of the deuto-iodide, it has become as corrosive as the ointment of corrosive sublimate. R. Hydrarg. proto-iodid. 5J- Adipis, gj. M. To be rubbed morning and evening on the parts affected. Poiret. Unguentum Hydrargyri Iodidi.—(Lond. Pharm.) Ointment of Iodide of Mercury. R. Hydrargyr. iodid. ^j. Cerae albae, 5ij. Adipis, |vj. M. * Tunnermann uses only ^ss. 282 HYDRARGYRI deuto-iodidum. IV. HYDRARGYRI DEUTO-IODIDUM. Synonymes.—H. Deuto-Ioduretum, Hydrargyrum lodatum Rubrum, H. Binio- didtim, H. Periodatum, Iodidum Hydrargyricurn, Deutoiodide of Mercury, Biniodide of Mercury. French.—Deuto-iodide de Mercure, Periodure de Mercure. German.—Rothes Iodquecksilber, Iodquecksilver im Maximum, Quecksil- beriodid, Deuto-Iodiir des Quecksilbers. METHOD OF PREPARING. According to Tiinnermann, this beautiful preparation may be obtained by double decomposition, by mixing 137 parts of corrosive sublimate with 165 parts of iodide of potassium, rubbing them to- gether, for a time, in the dry state, and afterwards with water, to dissolve the chloride of potassium formed. To prevent a solution of the precipitate in this salt, the mixture is put into a glass vessel, and agitated with a considerable quantity of water, until the super- natant liquid appears entirely clear, for which purpose a few minutes suffice. It is now filtered; the residue on the filter well washed, and gradually dried by warm air. By this process, the potassium unites with the chlorine of the mercury, and the mercury with the iodine in the dry way; the water is only useful in removing the chloride of potassium. The following is the process recommended in the London Phar- macopoeia :—An ounce of mercury and ten drams of iodine are to be rubbed together, alcohol being gradually added until the globules are no longer visible. The powder is to be dried with a gentle heat, and kept in a well-stopped vessel. The deuto-iodide of mercury is a beautiful vermillion coloured powder, which, when mbderately heated, becomes yellow, but, when exposed to the air, is gradually restored to red, and is vola- tilised. When volatilised, it crystallises in beautiful rhomboidal leaves, which, at a higher temperature, are of a golden yellow hue; but at the ordinary temperature of a shining red. The deuto-iodide is insoluble in water; but soluble in alcohol and ether. It contains 250 parts of mercury, and 312 of iodine. EFFECTS ON THE ECONOMY. This preparation, which was introduced into practice by the French physicians, has been particularly recommended in syphilis complicated with scrofula. Biett found it very efficacious in scro- fulo-venereal ulcers, in syphilitic swellings of the lymphatic glands, and in inveterate itch. He administered it also internally, dis- HYDRARGYRI DEUTO-IODIDUM. 283 solved in alcohol or ether, in scrofulous affections complicated with syphilis, and with advantage. In its effects, it resembles the corrosive sublimate, whilst the proto-iodide resembles calomel. Rayer,* indeed, considers the deuto-iodide more active than the corrosive sublimate. Paillard found it very efficacious in chronic cutaneous eruptions. He dipped a camel's hair pencil in a weak solution of the deuto-iodide in ether, and penciled the parts with it three or four times a day. In this way he cured several squamous, tuberculous, and other eruptions, exciting scarcely any pain. As, however, this mode of applying it often failed, he em- ployed 5j mixed with ^j of oil of almonds in the same manner. If the corrosive action was considerable, a sense of heat soon arose in the part, which gradually terminated in burning pain. The neighbouring parts were also hot, painful, and tumefied; and, in the course of an hour, an effusion of serum took place ; but, in four or five hours, the pain always disappeared.' If applied on the cheeks or lips, salivation at times ensued suddenly. Scabs formed, which fell off in a few days, and exposed a red surface much disposed to cicatrise- When frequently applied, symptoms oc- curred, which were probably the consequences of its being ab- sorbed,—namely,Tever, colic, diarrhoea, and dysentery. Brescheff applied it, in the form of ointment, with great success, in a case of obstinate ulceration, presumed to be carcinomatous, at the an- gle of the eye. Blasius advises it internally and externally in lupus, and it has been recently recommended highly by Dr. J. W. Schmidt, Junr., of New York,J in cases of the same affec- tion, and especially in the dartre vhnhienne. Both the protoio- dide and the deuto-iodide were given internally. These cases, as well as syphilitic sore throat, of'long standing, which had been previously treated by mercury withoutsuccess, Dr. Schmidt found to yield invariably to a pill of a quarter of a grain of the proto- iodide, and a grain of Extractum Conii, given night and morn- ing, and afterwards three times daily. After using these pills for from four to eight weeks, he substitutes the solution of iodide of potassium, changing, in the first place, the action of the parts bv cauterizing the throat with the solid argenti nitras. Dr. Schmidt has not found it necessary to carry the protoiodide so far as to touch the mouth, but should it accidentally do so, he stops the mercury, and goes on with the iodide of potassium. Tiinnermann used it with advantage, in the form of ointment, for the removal of furuncular inflammation of the glands of the neck. Riecke,^ likewise, employed it as a discutient, (gr. xvj to 5j of lard,) in a * Treatise on Skin Diseases, by Dr. Willis, p. 79. See, also, Puche, Jour- nal des Connaissances Medicales, Oct. et Nov. 1S;38, and Janvier, 1839. f Lugol's Essays on Iodine, by O'Shaughnessy, p. 204. X American Journal of the Medical Sciences, Feb. 1840, p. 301. { Die neuern Arzneimittel, u. s. vv. S. 270. 284 HYDRARGYRI DEUTO-IODIDUM. case of ganglion in the region of the knee—whence violent pain proceeded along the nerves when it was pressed upon—and in two cases of goitre, with great success. Whenever it has to be applied over an extensive surface, as in the disease last mention- ed, it has generally to be discontinued soon, in consequence of the supervention of inflammation of the cutaneous surface. In the form of a weak ointment—composed of the deuto-iodide which was usually doubled daily until the patient took ^iji daily, which quantity was perse- vered in for some weeks. In some of the cases the faeces, urine,. and perspiration were all coloured blue. In other trials, instituted in the same excellent charity, with the indigo, the results were not as favourable.* It is obvious, indeed, that a wide difference must exist amongst cases of epilepsy, and that where the organic modifications are considerable, as indi- cated by concomitant mania or idiocy, but little can be expected from any remedy; but even in such hopeless cases, the number of paroxysms appears to have diminished under its use. Where the cerebral affection is slight and more functional than organic, the indigo, like the artemisia and other remedies extolled in epi- lepsy, may be useful. Its main efficacy, perhaps—as we have said of the Ferrum Carbqnatum Pracipitatum (p. 208)—consists in the new impression which it makes, in adequate doses, upon the nerves of the stomach, and through them upon those of the whole system; but to effect the revulsion to the proper extent, it is necessary that the dose should be augmented day by1 day, and the remedy be continued in large doses for a sufficient length of time. MODE OF ADMINISTERING. As the indigo is extremely light, the powder is too bulky for administration; it is taken with disgust, and is apt to excite vo- miting. On this account, the form of electuary was selected in the Charite. It was generally combined with the pulvis aromati- cus, or the pulvis Doveri. As to the dose, Roth advises, that it should be commenced in grains but be elevated to drams, nay even to one or more ounces in the day. In the Charite", the fol- lowing formula? were generally employed:— Pulvis Indigi. Powder of Indigo. S. Indig. subtilissim. pulver. 3ss. Pulv. aromat. gr. v. M. et fiat pulvis. A powder to be given four times a day. * Dr. William H. McKee, in Dunglison's Amer. Med. Intelligencer, Sept. 16, 1839, p. 177. I0DINUM. 293 Electuarium Indigi. Electuary of Indigo. R. Indig. pulv. aquae guttis nonnullis subact ^ss. Pulv. aromat. Jss. Syr. simpl. ?j. M. et fiat electuarium. To be used in the course of the day. Ideler. IODINUM. Synonymes.—Iodinium, Iodium, Iodum, Iodina, Iodine. French.—lode. German.—Iod. Iodine was accidentally discovered, in the year 1812, by Cour- tois, a manufacturer of saltpetre at Paris, but it was chiefly through the labours of Gay-Lussac and Sir Humphry Davy,* that the chemical relations of this elementary body were appreciated. The discoverer first detected it in the mother waters of soda ob- tained from sea-weed; and as it was found to exist chiefly in se- veral of the sea-weeds, and especially in the sponges, it struck Coindet,p that experiments might be made with it in goitre; from these he obtained such valuable results that its reputation soon spread abroad, and it was employed in various other diseases,— often with the most marked advantage: By experience, too, the injurious effects which it is generally considered capable of inducing were appreciated, so that it could be administered more satisfactorily than at an earlier period. By the continued investigations of the chemist, iodine was found to be more largely distributed than was at first imagined. It was discovered in many of the marine mollusca, in sea-water, and in several mineral waters. * Annales de Chimie, lxxxviii. xc. and torn, xci., and Philos. Transact. 1814 and 1815. f Bibliotheque Universelle, Juillet, 1820, p. 190. 294 IODINUM. METHOD OF PREPARING. Iodine is obtained from the mother waters of the soda derived from sea-plants, in which it exists in the form of hydriodate of potassa. The waters are procured by burning different kinds of weeds which grow on the sea-shore, lixiviating the ashes, and con- centrating the liquor. To obtain the iodine from this liquor, an excess of concentrated sulphuric acid is added to it, and the whole is boiled gently in a glass retort furnished with a receiver. The sulphuric acid lays hold of the basis of the hydriodic salt, and of the hydrogen of the hydriodic acid; whence result sulphate of po- tassa, water, sulphurous acid and iodine; the last passing over into the receiver in violet fumes with a little acid, and there becoming condensed. To purify the iodine, it may be washed with water, containing a little potassa, and be redistilled.* Iodine is solid at the ordinary temperature, of a foliated ap- pearance, metallic lustre; of a grayish black colour similar to that of plumbago, and friable. Its taste is hot, notwithstanding its sparing solubility in water. It is soluble in 7000 parts of thai fluid, and the solution has an orange yellow colour. Its specific- gravity is 4.946 at 62° of Fahrenheit. Its smell is similar to that of chlorine, with which it accords in its property of destroying vegetable colours. It possesses in a high degree, electro nega- tive properties. It colours the skin yellow, which colour gradu- ally disappears. It fuses at 220° Fahrenheit. The vapour is of a beautiful violet colour, whence its name (<«^5, ' blue.') It is so- luble in ether and in alcohol; forms an acid both with oxygen and hydrogen, and enters into numerous chemical combinations.! EFFECTS ON THE ECONOMY IN HEALTH. Soon after the discovery of iodine, and the accurate investiga- tions of Gay-Lussac, MagendieJ instituted a series of experiments in order to appreciate its action on the animal organism. It was injected into the veins without any apparent effect. Several dogs were made to swallow it; they vomited, but it exerted no farther influence. He himself swallowed a coffee-spoonful of the tincture, and perceived no other result than a disagreeable taste, which continued for several hours, but gradually disappeared. In larger * For the method employed by Soubeiran, see Journal de Pharmacie, Jan- vier, 1837; and for that by Barrue], see Bossy, Ibid. f See, on Iodine and its combinations, Mr. Duhamel, in Philad. Journal of Pharmacy, vi. 101. Philad. 1823-4. X Formulaire pour la preparation, &c. de plusieurs nouveaux Me'dicamens. IODINUM. 295 doses, however, the effects were markedly injurious. OrfuV Ukewise instituted several experiments on dogs, from which he concludes:—that iodine, introduced into the stomach in mode- rate quantity, acts as a gentle stimulant, but may excite vomiting- —that in the dose of a dram, it almost always killed the animai in four or five days, when the oesophagus had been tied to prevent vomiting, and that in the part of the mucous membrane with which it came in contact, ulcers were gradually formed-—that when administered in the dose of from two to three drams' when the oesophagus was not tied, it excited vomiting for several hours even when a part of the poison had been evacuated by the bowels' —that it seldom caused death when given in the dose of one or two drams, the animal rejecting it by repeated vomiting; that it does not destroy life when applied externally, and that it must be classed amongst the irritant poisons. Dr. Cogswell^ in repeating one of Orhla s experiments, in which seventy-two grains of iodine were introduced into a wound on the back of a doo- without much effect on the health of the animal, did not attain exactly the same results. He introduced a scruple of iodine into the cellular tis- sue of the thigh of an adult rabbit, through a small openino- made in the skin. The animal manifested no symptom of pain and was able to make free use of the limb as freely as before the'ope- ration, but, in the course of a fortnight, it gradually lost flesh exhibiting an emaciated look, and the hair dropped off from manv parts of the head. At the end of this time, thick adhesive pus was found distending the cavity of the wound, from which the iodine had entirely disappeared. Dr. Cogswell properly suxmests however, the possibility, that the irritation of a large abscess might, have been the sole origin of the animal's unhealthy an- pearance. J ^ To discover the effects, which it induces on man, Orfila took two grains fasting. An extremely disagreeable taste, with some nausea, was the only consequence. On the next day, early he took four grains, when he immediately experienced a sense of constriction and heat in the throat, which continued for a quarter of an hour; soon afterwards he vomited a liquid yellowish mat ter, in which iodine was easily perceptible. Except a slight de- gree of oppression felt during the day, he observed no change in any of the functions. On the second day thereafter, he took six grains fasting, after which, he soon experienced a sense of heat constriction of the throat, nausea, eructation, increased flow of saliva, and pain at the pit of the stomach; ten minutes after- wards, he was attacked with copious bilious vomiting, and slight • Toxicologic, i. 556. MtDEpP21.mldtb.S18y3?.n l0dinG 8nd US COtnF°Unds' By C. Cogswell, A. B„ 296 IODINUM. colic pains, which continued for an hour, and were removed by two emollient glysters. The pulse, which, prior to the experiments, beat sixty times in the minute, became more frequent, beating from eighty-three to ninety, and was much stronger. The breath- ing was tolerably free; but from time to time, there appeared to be a great obstacle to the dilatation of the chest on inspiration. The urine was high'er coloured. All the symptoms were re- moved by the copious use of gum water as drink, and of emollient glysters. Dr. Gully says, that he has given as much as three drams of the tincture daily, and did not observe any effect. Dr. Kennedy,* of Glasgow, exhibited, within eight days, nine hundred and fifty- three grains of iodine in the form of tincture, the doses having been so proportioned, that towards the last, the patient—a girl- did not seem to be in any way particularly affected. Dr. Buchananf has given half an ounce of the iodide of potas- sium within twelve hours, without any unpleasant result, provided diluents were largely taken at the same time. It has been con- ceived, that where iodine proves mischievous, it is owing to its being in a free state, and that it then operates as a corrosive poi- son. The tincture of iodine, and the ioduretted hydriodates, are esteemed to be objectionable on this account.J From experiments, instituted by Jdrg§ on himself and on other healthy individuals, it appeared to him, that iodine, first of all, acts as a stimulant on the intestinal canal; soon afterwards, it excites, also, the different glands in the cavity of the mouth and stomach, the pancreas, the liver, and even the urinary and genital organs. An afflux of blood to the respiratory organs likewise ensues, which extends even as far as the Schneiderian membrane. There is no doubt whatever that the iodine enters into the blood, and, in this way, doubtless produces its modifications on the sys- tem of nutrition. Two drams, according to Dr. Buchanan,|| were given to a young man labouring under gonorrhoea, and, as soon as the medicine made its appearance in the urine, blood was drawn from the arm. On examining it, both the serum and the crassa- mentum were found deeply impregnated with iodine. The same dose was given to a boy affected with dropsy of the knee-joint. About five hours after the dose had been taken, a very small punc* ture was made into the joint, and upwards of twelve ounces of synovia were drawn off by a cupping-glass. The synovia con- * Lond. Med. Repository for 1822. f Lond. Med. Gazette, July, 1836. See, also, Fuster, in Bullet. General de Th£rap. F6v. 1837, & Sep. 1837. X Brande's Dictionary of the Materia Medica, p, 323. Lond. 1839. § Materialen zu einer kiinft. Heilmittellehre, u. s. w. i. 473. 1824. H Op. cit IODINUM. 297 tained iodine in abundance. To an old man, who had a very large hydrocele, two drams of iodide of potassium were given over night, and the same quantity the following morning : on tapping him some hours after he had taken the last dose, more than thirty ounces of serum were drawn off, containing a large quantity of iodine.* Dr. Gairdnerf observed the action of iodine on the human body when administered in particular doses, and pointed out the dis- advantages attendant upon an improvident use of the article. The most striking inconveniences were induced in the digestive organs: it excited diarrhcea, and, at times, obstinate constipation ; o-astro- dynia and violent vomiting, especially when food was received into the stomach. The emaciation occasioned by it, is, according to some, a striking phenomenon, and may attain an incredible extent; yet it is proper to remark, that Lugol,J in his frequent employment of iodine in scrofula, never observed this result: he affirms, indeed, that emaciated patients became stronger under its use; that the stout did not grow leaner, and that they who held the medium po- sition, in these respects, acquired strength under its employment,__ results which have been confirmed by others, and which would, therefore, seem to show that this, as well as some of the other unpleasant effects ascribed to iodine may have been owing to an incautious use of the article. In addition to the above effects, Gairdner noticed anxiety, de- pression of spirits, and other symptoms similar to those of hypo- chondriasis; obscurity of vision; hardness of hearing; palpitations; and tremors of the limbs, particularly of the hands, which last symptom indicated the full effect of iodine on the constitution. Dr. Gairdner found, however, that the remedy was extremely vari- able in its effects; and that it might frequently be given in large doses, for a long time, without disadvantage, whilst at other times, the unpleasant symptoms supervened rapidly; indicating that much must depend upon the peculiar impressibility of the indi- vidual. Coindet,§ who, as we have remarked, first used the iodine as a therapeutical agent, speaks of many of the above-mentioned phe- nomena as resulting from the administration of iodine: these he considers evidences of the saturation of the organism, as the effect on the mouth is an index of the same thing in the case of mer- cury. It appears, however, to be never necessary, in the admi- * Brande, Op. citat. p. 321, Lond. 1839. See also, M. Cantu, in Journal de Chimie Medicale, a. 291 &, 394; and Bennerscheidt, Ibid. iv. 383. f Essay on the Effects of Iodine, &c. Lond. 1824. I Memoiresurremploide l'fodedans les Maladies scrofuleuses. Paris 1829- and Observations on the Effects of Iodine, p. 17, Johnson's translation ' f nnA 1824. ' iiU,IU- § Bibliotheque universelle, Mars, Avril, Mai, et Septembre, 1821 26 298 IODINUM. nistration of iodine, to induce a saturation of the organism in order that the full sanative influence of the remedy shall be elicited. On the contrary, it seems to be advisable to avoid such satura- tion; and accordingly, whenever there are the slightest indica- tions of it, the dose of the iodine should be diminished, or it should be discontinued for a time; after which—according to the results of numerous cases—its curative agency, when it is resumed, is ex- erted afresh, and more decidedly. Several physicians, indeed, advise that frequent intermissions should be made in the use of the agent, in order that its action may be more certain. According to the observations of Coindet and Formey, iodine, when administered internally, occasions increase of appetite; but no influence is perceptible on the condition of the bowels and uri- nary organs; or on the perspiratory apparatus. On the other hand, when breathed for a few instants, the vapours of iodine twice caused in M. Chevallier* violent colic, which readily yielded to gum water and laudanum. Raspail, however, under analogous circumstances, experienced no other inconvenience than a disagreeable taste in the back part of the mouth. Accord- ing to Lugol, the vapour disengaged from tincture of iodine poured into the water of a bath, is liable to induce a state of " iodic intoxication," and even of cerebral congestion. He affirms, that it exerted a powerful diuretic influence on all his patients, the urinary secretion being so much augmented, that many of them, contrary to their usual habit, were compelled to rise from bed several times in the night to discharge their urine. In upwards of a third it had a cathartic effect, producing six or seven evacuations in the day, and occasionally tormina. In several, ptyalism ensued. Others, and especially females, com- plained of gastrodynia, which was always removed by the wine of cinchona, of which two or three ounces were taken shortly after the iodine. Dr. Manson,f who used the tincture of iodine, occasionally found it produce sickness of stomach, and Mr. Delisser affirms, that, in two months, he gave one thousand and nineteen grains of iodine to a female affected with cancer of the mamma,—the doses, at certain periods, amounting to thirty grains in the twenty- four hours. The consequences were anorexia, quick pulse, ulcer- ation of the mouth, and foetor of the breath, of a different kind, however, from that which arises from mercury. It would appear, that the effects of the remedy vary according to the form in which it is administered, and it is proper to observe, in viewing the different results obtained by Lugol and Coindet, that the latter commonly gave the tincture of iodine, whilst the * Journ. G£n£ral de M6d. ciii. 336. t Medical Researches on the Effects of Iodine. Lond. 1825. IODINUM. 299 former prescribed the solution in water, with a little muriate of soda. Lugol also observes, that the appetite of his patients was very much increased by it. Eager, who likewise administered the watery solution, but rarely observed diarrhcea and emacia- tion; and, in general, indeed, the appetite and nutrition im- proved under it. At times, ulceration took place in the mouth, whereby the breath assumed a mercurial foetor, and salivation has been observed from it, according to Manson,* Winslow,f Ely.J Mackall,§ and others; but Riecke|| suggests, that this, per- haps, only occurred in those, who, along with the use of iodine internally, had employed the iodide of mercury externally. On the genital organs, Eager found it to act as an excitant; it aug- mented the activity of the uterus, and rendered the catamenia more abundant. It is asserted, too, to have increased the sexual appetite, but this is questionable; during its use, indeed, the testes in men, and the mammae in women, have been observed to dis- appear:^ but this, as we shall see, is certainly not a common occurrence.** On the other hand, it has been imagined to cause sterility. Two cases are detailed by Dr. Robert H. Rivers/ft in which barrenness succeeded its administration. Magendie, on giving it as an emmenagogue to a young lady of unsuspected virtue, brought on abortion.JJ Krimer several times observed, even when the tincture was given in. small doses, considerable metrorrhagia, epistaxis, haemop- tysis, obstinate diarrhoea, leucorrhcea, &c. supervene under its use. Cases of suppression of the hemorrhoidal flux are asserted to have been restored by it.§§ Jahn|||| found, in the bodies of two persons, who had long made use of iodine, wasting of the fat; softness and laxity of all the organs and tissues; diminution and disappearance of the glands, and glandiform bodies,—the mesenteric glands, suprarenal cap- sules, &c,—and the cellular tissue appeared to exist in smaller quantity. In the case of a female, who died from the excessive * Op. citat. p. 61. t Lond. Med. Gaz. for 1836, p. 401. X Ibid. p. 480. I Mfidico-Chirurg. Review, Jan. 1836. || Die neuern Arzneimittel, u. s. w. S 282. 11 Christison, Treatise on Poisons, p. 180; Cogswell on Iodine, p. 47; Edinb. 1837. ** Pereira, in Lond. Med. Gaz. vol. xvii; and Diet, de Mat. Med., par M6rat & De Lens, Art. lode. tf American Journal of the Medical Sciences, Aug. 1831, p. 546. XX Formulary, Gully's edit. p. 105. ]] See Ash well, in Guy's Hospital Reports, vol. i.; and Cogswell, Op. cit. p. 43. |||| Archiv. fur medicin. Erfahrung, i, 342, 1829; and Journal Complement. du Diet, des Sciences Medicales, xxxv. 362. 300 IODINUM. use of the tincture, Zinck* found the bowels inflated with gas; in some parts highly inflamed; in others, exhibiting an approach to sphacelation, both within and without: the inner membrane of the stomach displayed redness, growing deeper from the cardiac to- wards the pyloric orifice, where the organ looked as if it had undergone corrosion; the liver was large and reddened; and there was ecchymosis of the spleen. Dr. Christisonf is of opinion that iodine is capable of inflaming the latter organ. From the testimony of many observers, it can scarcely be doubted that the iodine disease, or iodosis, or iodism, as it has been termed, may become dangerous to life: generally, however, it is not really so much so as it appears, and is considered to be, and the evil consequences may be readily avoided by proper fore- sight. Cases, however, have occurred, in which its use has been followed by fatal results ;j hence the necessity of circumspection in the employment of so energetic a therapeutical agent. Under the idea, that the unpleasant symptoms which the iodides of potassium and iron " are sometimes said to produce," are owing to the presence of free iodine in them, Dr. C. J. B. Wil- liams§ recommends that the patient should eat a piece of bread or biscuit after each dose: " the starch of this, combining with the free iodine, removes its injurious property." To avoid evil consequences, Wutzer advises that the iodine should be immediately discontinued, whenever a feeling of in- creased heat in the pharynx and stomach is experienced imme- diately after it is taken; but as this evidence cannot be available in small children, attention should be paid, whether, after the medicine has been taken, the temperature of the skin becomes more elevated; the pulse quicker, and whether there is any evi- dence of pain when pressure is made on the epigastric region. He, moreover, advises, that it should not be given internally to children at the breast. It has been affirmed, that if the iodine be combined with small doses of opium, all the disadvantages, immediate and remote, may be avoided; and it is always more advisable to give it in small doses for a longer, than in very large for a shorter, period. At times, it will happen, that in chronic affections—in which it is chiefly used—its beneficial agency may not be decidedly mani- fested until after the lapse of four or five months; and it is impor- tant to bear this in mind, as both practitioner and patient are apt to become dissatisfied, unless the remedy exhibits its action more * Journ. Complem. du Diet, des Sciences Medicales, xviii. 231. t Treatise on Poisons. X Sir B. Brodie, Lancet, Mar. 30, 1839. § The Library of Medicine, arranged and edited by Alexander Tweedie, M. D. F. R. S.—Practical Medicine, vol. iii. p. 124. Art. Pleurisy, bv Dr. Wil- liams. Lond. 1840. ' J IODINUM. 301 speedily. When the iodine acts beneficially, the appetite is aug- mented, or is not deteriorated; digestion improves, so that the patient is able to take more food, and experiences less inconve- nience therefrom: the secretion of the bile is increased, and the evacuations are more copious, and of a yellower hue; the peris- taltic action goes on more energetically, and the patient gains strength. Such, at least, are the signs that are considered by many to indicate that the iodine agrees; but the absence of all disagreeable consequences is a sufficient index. To remove the symptoms of iodine disease, iodosis or iodinia, (iodkrankheit,) general or local bloodletting has been employed; with warm bathing, the use of milk, emulsions of gum arabic, and the like, with rigid diet and rest. The preparations of hy- drocyanic acid have also been given with advantage in the pal- pitation, tremors, and other nervous symptoms that sometimes follow the use of iodine. Precaution is requisite in the case of impressible, and also—it has been conceived—in robust persons,* for fear of the superven- tion of hyperaemia. It is advisable, too, during its administra- tion, to let the diet be sparing, and devoid of all heating qualities. Kolleyf remarks, that iodine occasionally exerts a most unfavour- able influence on the nervous system, so that in those, who are easily excitable, unusual pains may be brought on by the use of even three or four drops of the tincture;—these pains, at times, ending in violent spasms. Such persons exhibit the impressibility, even under very minute doses, by fidgetiness or restlessness of the limbs, so that they can scarcely be kept quiet: after a time, numbness and heaviness in all the limbs: heaviness of the head,. and a species of inebriationj succeed, with violent cephalalgia, spasms, tremours of the limbs, paralysis,^ prostration, spasms, depravation of vision, and disposition to lamentation and distress. Some of these nervous symptoms we have occasionally noticed, when the dose of iodine has been rapidly augmented. Where the person is liable to gastric uneasiness, caution is requisite in the use of the remedy, as. it not unfrequently occasions dyspepsia and violent gastrodynia. All febrile and purely inflammatory diseases, according to Kolley, forbid its use. Dr. Andrew Buchanan|| affirms, that he has never witnessed * Riecke, Op. cit. S. 284. f Journal Complementaire, xvii. 307. X Giddiness was observed by Dr. Manson, (Researches on the Effects of Iodine, p. 61, Lond. 1825;) Ashwell, (Guy's Hospital Reports, i. 136;) and Lugol, Essays on the Effects of Iodine in Scrofulous Diseases, O'Shaughnes- sy's translation, p. 73, Lond. 1831. 5 Sir B. Brodie, Lancet, 1832; Manson, Op. citat.; and Sir A. Cooper, Lancet, ii. 147. H Lond. Med. Gaz. July 2 1336. 26* 302 IODINUM. any of the unpleasant symptoms that have been ascribed to the iodine. He asserts, that he has never seen its use " followed by wasting of the testicles or mammae, by palpitations, faintness, excessive debility, hurried, anxious breathing, dinginess of the sur- face, copious clammy sweats, increased menstrual discharge, or an oily appearance of the urine, which are enumerated amongst the smptoms characterising the supposed affection, termed iodism." As regards the wasting of the mammas and testicles, Mr. Pereira suspects it to be very rare. He has seen iodine administered, he remarks, in some hundreds of cases, and never met with one in which atrophy of either organ occurred. Magendie, also, remarks, that he has never witnessed these effects, although they are said to be frequent in Switzerland.* Our own experience accords with that of those gentlemen. We have prescribed, and seen it prescribed, largely, both in public and in private; yet no such re- sults have ever supervened. In the Philadelphia Hospital, great attention was paid to the condition of the testes, in several cases in which it was administered, yet no clear case of atrophy occurred.f Recently, Dr. J. Adair Lawrie,J of Glasgow, has advanced the opinion, that the iodides of potassium and starch exert a poison- ous influence on the mucous membranes of the air passages, not as direct irritants, but indirectly through the circulation, in the form of acute inflammation. He admits however, that he has never seen them act as irritants to the gastro-intestinal mucous membranes, nor has he ever seen them induce emaciation, atrophy of the mammas and testes, hectic and the other symptoms described un- der the term iodosis. EFFECTS ON THF ECONOMY IN DISEASE. Iodine exhibits itself as a most efficacious remedy in a variety of diseases, in which it is desirable to augment the activity of the ab- sorbent system. In referring to its use in the following diseases, the remarks apply not only to the pure iodine, but to the hydrio- dates of the alkalies, especially the hydriodate and the ioduretted hydriodate of potassa; the medical properties of which accord with those of iodine. Bronchocele.—The very first experiments made with iodine were on goitre. Coindet recommended it strongly in that affec- * Pereira, Elements of Materia Medica, pt. i. p. 114. Lond. 1839. f Dr. A. M. Vedder, in American Medicai Intelligencer, for Sept. 1, 1838. See, also, J. Davies, Practical Remarks on the use of Iodine locally applied in various surgical diseases and external injuries, &c. Lond. 1839. Reprinted in Dunglison's American Med. Library, 1839—40. X London Medical Gazette, July 3, 1840, p. 590. IODINUM. 303 tion, and Formey* first introduced it into Germany. Coindet gave, in the first instance, the tincture internally, and he remarked, that about a week after the commencement of its use, the skin over the goitre generally became less tense, the substance of the tumour felt softer, without the tumefaction having abated; the particular portions of the gland became more distinct, separated from each other, and less and less hard, until gradually a diminution was perceptible. Frequently, the goitre disappeared completely, in the space of from six to ten weeks, under the continued use of the remedy. At an after period, he employed the iodine externally, in which form of administration, the evil consequences, sometimes induced by it, are less to be apprehended; and often its internal and external administration were combined. The efficacy of iodine in bronchocele, has received the most ample confirmation. Cases have been published by Hufeland, Grafe, Baup, Helling, Ziegler, Vollmer, Reiss, Paulitsky, Hirsch, Ulrich, Jager, Barchewitz, Meissner, Vogel, Wutzer, Seiler, Fici- nus, Nieustiidt, Hoffmann, De Carro, J. Reid, Manson, Elliotson, Lugol, and numerous others.f We have administered it in fifteen cases of soft goitre, and in every one the disease was removed. In two of the cases, it recurred, but the hypertrophy was again dispersed under the use of the remedy. It has been recommended by some, that its exhibition should be preceded by a bleeding; and as the abstraction of blood fa- cilitates absorption, this may be advisable, especially where but little, if any, effect seems to be induced by it, after it has been ad- ministered for some time. Reid advises that we should commence with its external administration; and, at a later period, conjoin with it the internal. Although cases have been published, in which iodine has not answered the purpose of the prescriber, there can be no question, that, it is the riiost efficacious agent in goitre that we possess; but when the tumour has acquired a cartilaginous hardness, al- though it may be diminished under the use of the remedy, it can rarely, or never be wholly removed. Under such circumstances, however, every other remedy would be found equally fruitless. Glandular affections.—Besides the affections of the thyroid gland, there are others of different glandular bodies, in which iodine exhibits itself efficacious. Jahn used friction with it in induration of the liver, with advantage. Wutzer gave it in two * Bemerk. aber den Kropf, u. s. w. Berlin, 1820; and Hufeland's Journal, B. Ii. St. 4, S.91. f Richter's Specielle Therapie. Berlin, 1828, S. 214 ; Dictionnaire de Ma- ti re Medicale, &c. par. MM. Merat & De Lens, Art. lode, and Osann, art. Iod, in Enclyclopad. Wtfrterb. der. Med. Wissensch. Bd. xix. S. 17. Berlin, 1838. 304 IODINUM. cases of induration of the spleen, but no precise deductions could be made as to its individual efficacy, owing to its having been combined with other remedies. Milligan relates three oases of enlargement of the liver or spleen in children, in which he gave the tincture with success, after mercurials had been used ineffec- tually. M. Eusebe de Salle* and Jahn employed it with success in enlargement of the testes; Riecke,j* too, found it of essential ser- vice in a case of great induration and enlargement of the testicle, which n the opinion of several physicians would require an ope- ration. Jahn found it useful in a case of strumous induration of the submaxillary gland, and in one of tumefaction of the prostate, the consequence of mismanaged gonorrhoea. Krimer employed it beneficially in cases of tumefaction and induration of the mesen- teric glands; and CerchariJ found an ointment, composed of a scruple of iodine and an ounce of unguentum rosatum, very effi- cacious in the cure of enlarged tonsils. He applies it to the tonsils, morning and evening, by means of a small brush; and he asserts that under its use the tonsils will in two months be restored to their natural dimensions. Any inflammation must be subdued before the ointment is had recourse to. Sir B. Brodie§ has used it successfully in similar cases; the en- larged tonsils being touched every day with a camel's hair pencil dipped in the tincture. Of its administration in other glandular affections, mention will be made presently. Scrofula.—Soon after the introduction of iodine into the materia medica, it was used externally in scrofulous affections; and at an early period was prescribed by Gordon, Sir A. Halliday,|| and others, in such diseases, especially when combined with mercury. Their observations were confirmed by Magendie, Baup,*ff Sablai- roles,** Baron, Brera, Manson, and others. Wutzer used it in many cases of scrofula, and found it especially useful in the lymphatic (pastosen) form. In irritable cases, he was cautious of employ- ing it as well as in hyperasmic conditions; and he found that when aggravation of the symptoms occurred, some concealed inflam- matory disposition was the cause. Lugolff has contributed to the more entensive employment of iodine in scrofula, and has especially recommended the watery solution of io- dine internally, and baths of iodine externally. The fortunate * Journal Complement, xix. 193, and Journal Universal, xi. 346. f Die neuern Arzneimittel, u. s. w. S. 286. X American Journal of Pharm. 2d series ii. 83. Philad. 1837. $ Lancet, Mar. 30, 1839, p. 38. || Lond. Med. Repos. Sept. 1821. IT Bibliotheque Universelle, Dec. 1821. ** Bulletin des Sciences Medicales, Fev. 1824. ft Essay on the Effects of Iodine, &c. p. 48. IODINUM. 305 results of his trials, in the Hopital St. Louis, were corroborated by a committee appointed for the purpose, by the Royal Academy of Sciences. It afibrded eminent service in the different forms of scrofula; but in scrofulous caries it merely induced improvement, never entire cicatrisation. Lugol regards iodine as the most effi- cacious remedy-we possess in scrofula. Eager,* in speaking of LugoPs method of managing scrofula, properly lays great stress on the accompanying regimen—nutritious diet, cleanliness, bath- ing and exercise in the open air—which he regards as indispensa- ble to a fortunate issue. He prefers the watery solution of iodine internally to all other remedies. Lugol and Eager unite, with the internal use of iodine, the external, in the form of ointment or solution; for example in fistulae they employ it as an injection. To excite ulcers to cicatrisation, after appropriate pressure and injections have failed, Eager recommends that the skin, which has separated, at the margins of the ulcers, from the subjacent parts, should be destroyed by caustic or removed by the knife, but that this should not be practised until the scrofulous tendency has been somewhat got under. As a caustic, Eager recommends, pulv. calcis viv. 3vj; potass, caustic. 5v, to be made into a paste with spirit of wine, and to be applied a few lines thick; the skin will be destroyed in about five minutes. According to the same ob- server, iodine has exhibited its efficacy in various cases of perio- stitis, scrofulous swellings of the joints, and necrosis. ' In scrofu- lous ophthalmia, it was less beneficial. In scrofulous discharges from the nose and ear, iodine injections were commonly of ser- vice. Baudelocquef likewise extols the preparations of iodine in scrofula; but in scrofulous affections of the bones, and especially in caries, as well as in scrofulous diseases of the skin, it appeared to him to be inefficacious. Many cases have been related by Zinck, Maunoir, Manson, Weihe, Benaben, Bayle, and others, in which white swellings of the joints, of a scrofulous character, have been removed by its use. Wutzer has likewise offered fa- vourable testimony in regard to it in affections of the bones, some of which were of a strumous nature. In several cases, so much disorganisation had occurred, that the loss of the whole limb was to be apprehended, yet the iodine arrested the destructive process, and the limbs were preserved. In various scrofulous affections, the tincture of iodine was given by Dr. KiihneJ with great suc- cess, and without any evil consequences. He made it, however, of half the usual strength, beginning with three drops, and gra- dually increasing the dose to fifteen. In tumefaction of the joints. * Dublin Journal of Medical Sciences, July, 1834, p. 344. f Etudes sur la Maladie Scrophuleuse. Paris, 1834; and London Lancet May 25, 1839, p. 350; see, also, Cogswell on Iodine, p. 75. X Medicinische Zeitung, No. 34. August 24,1836. Berlin. 306 IODINUM. the iodine, administered externally, has afforded essential service. Wutzer was of opinion, that the tincture of iodine might frequent- ly be applied externally with greater advantage than the ointment; the alcohol readily evaporating and leaving the iodine on the skin; for which reason he recommends that the tincture should be ap- plied repeatedly by means of a camel's hair pencil. Tubercles.—The efficacy of iodine in scrofulous affections gave rise to the belief, that it might be serviceable in tubercles. Brera and Calloway administered it frequently in mesenteric tubercles with success, and the observations of Krimer, referred to above, correspond with theirs. It has also been given with advan- tage in cases of pulmonary tubercles. It was suggested, in such affections, by Dr. Baron, and a case is related by Mr. Haden of ap- parent tubercles in which it was markedly useful :* similar exam- ples are detailed by Jahn, Waldack, and others; and Berton af- firms, that he has found inhalations of the vapour of iodine of de- cided efficacy in confirmed phthisis, as well as in certain forms of catarrh. It has likewise been advised in the form of vapour by Sir James Murray,f and by Sir C. ScudamoreJ in phthisical affections. The addition of a little tincture of conium was found by the latter gen- tleman to be beneficial in subduing the irritating qualities of the gas. His first formula was the following: iodin. gr. viij, potass. iodid. gr. iij, alcohol, ^ss, aquae destillat. ^vss. M. Of this solu- tion from one dram to six, and from twenty to thirty-five minims of a saturated tincture of conium were used in each inhalation, which was continued from half an hour to forty minutes. Sir Charles considered it better to add the conium at the time of employing the inhalation. At the temperature of 90°, the volatile properties of iodine are given off very sensibly, but the conium requires more heat, and that of 120° is not too much for the iodine. Of late, Sir Charles has published the results of his farther observation with this remedy, of which he has as high an opinion as ever. He has somewhat modified his formula, however.§ He now recom- mends the following. R. Iodin. pur.; iodid. potass, aa. gr. vj: Aquae destillat. ^v. 3yj; Alcoholis 3i,j M. He now prefers to add the conium at the time of mixing the iodine solution with the water, and he recommends that it should be a saturated tincture, pre- pared with the most genuine dried leaves. In the commencement of the treatment, he advises very small proportions of the iodine * Formulary—the Author's edition, p. 37. Lond. 1824. f On Temperature, Aliment, &c. 1829. X Cases illustrative of the efficacy of various medicines administered by in- halation in pulmonary consumption, 2d edit. Lond.; and Lond. Med. Gazette, Feb. 17,1838, p. 804. { London Medical Gazette, Feb. 7,1840, p. 750. IODINUM. 307 mixture;__for example, from half a dram to a dram for an inhala- tian of eight or ten minutes duration, and this to be repeated two or three times a day. Of the tincture, to which Sir Charles gives the epithet " soothing," he directs half a dram, which he usually finds to be sufficient, but it may be increased if the cough be very troublesome. He soon augments the quantity of the iodine and progressively from 3J. to 3iv.; and at the same time prolonging the period of inhaling, he divides the iodine dose, putting two- thirds at first, and the rest after the expiration of seven or eight minutes. Although the temperature of 12° is the most favourable for vo- latilising the active principles of the iodine and conium, mixed with some watery vapour, Sir Charles considers the approximation will be sufficient, if equal parts of boiling and cold water be used, with which the inhaler should not be quite half filled. Care should be taken, however, to prepare the inhaler for this temperature by first washing it out with tepid water. During the process, the in- haler should be kept immersed in a vessel containing water of rather higher temperature than 120°. The feelings of the patient will be a great guide as to the strength of the inhaling mixture in any particular case. A learned reviewer in the British and Foreign Medical Review,* affirms, that his own experience leaves him no doubt as to the great value of the practice as a palliative in phthisis, and as an important remedy in bronchitis. It is true, however, he adds, that the relief has often been as great from the simple aqueous as from the medicated inhalation. Our own experience has not been favourable to it, and Mr. Pereiraf says he has repeatedly tried it in phthisis as well as in other chronic pulmonary complaints, but never with the least benefit. The inhalation may be practised in the method recommended under the head of Chlorine, (page 134.) The inhalation of iodine has been dreaded, because, in some in- stances, troublesome irritation of the larynx has followed its use; but Dr. CorriganJ considers that this injurious effect has resulted from the defective means of inhalation hitherto employed. Used in the manner he has recommended, and which we have de- scribed—under the article referred to above—gradual in its eva- poration, and ultimately combined with a large portion of aqueous vapour, its use, he says, is positively free from any injurious irri- tative effects. The vapour he found to diminish most remarkably the profuse and wasting purulent expectoration of phthisis. The ♦April, 1838, p. 606. + Elements of the Materia Medica, Pt. 1. p. 120. Lond. 1839. X Dublin Journal of Medical Science, for March, 1839, p. 103; and Lond. Med. Gaz. for April 6,1839, p. 50. 308 IODINUM. effects of iodine, thus used, on the digestive function were also very gratifying. In all the cases in which Dr. Corrigan employed it, the appetite and state of the intestinal canal were improved. It acted as a most useful tonic to the digestive organs, without any of the irritation, which its internal use, in the ordinary form, at times produces. It likewise greatly alleviated the cough, so that the patient was enabled to obtain bours of sound and refreshing sleep; and he consequently considers, that even should its use be of little avail against the destructive scrofulous ulceration, which constitutes phthisis, the palliative good, which is derived from it, renders it a valuable addition to our list of remedies. Dr. Cor- rigan has had his apparatus at work from eight to twelve hours in the twenty-four; and his mode of managing it is as follows:— at night when the patient is settling to sleep, the apparatus is sus- pended from the roof of the bed; and, when once arranged, it continues its work quietly and silently for four or five hours, while the patient, asleep, is all this time inhaling the medicated air. In the morning, for three or four hours before the patient rises, it is again at work; and, if necessary, in the midday, while the patient reclines on the bed, with the curtains drawn round three of the sides. The rate of evaporation, which generally, gives a suffi- ciently strong impregnation to the air, is when the tincture of io- dine drops from the cotton wick at the rate of from six to eight drops per minute. At this rate, about six drams of the tincture will be evaporated in an hour, and as every particle of the iodine is diffused in watery vapour through the air, there are thus dif- fused in the minutest state of division through the air, in every hour, about thirty grains of iodine. " If we suppose the patient to inhale only one-twentieth of the iodine evaporated he will inhale in each hour, and apply to the diseased surfaces, one grain and a half of iodine in a state of the most minute division or solution." " This quantity we know"—adds Dr. Corrigan—" is quite suffi- cient to exert a decided action upon scrofulous ulceration ; for we find on reference to Lugol's valuable work on the employment of iodine in scrofula, that in external scrofulous ulceration, the pre- paration of iodine which is found beneficial, is a solution which contains only about three grains of iodine in each pint of fluid. The duration of the inhalation can, of course, be extended'at pleasure. Fontana affirms, that he has observed decided benefit from iodine in a case of phthisis mucosa; when given in the form of the syrupus iodatus, and combined with the external applica- tion of the ointment of tartarised antimony. Duverney has com- municated some cases, which appeared favourable to the prophy- lactic agency of iodine in incipient or threatened phthisis, but he himself considers, that his observations have not been sufficiently numerous to effect the demonstration. We have frequently IODINUM. 309 administered iodine, in various forms, in pulmonary tubercles, but it must be confessed, not with that decided advantage, which the well known sorbefacient virtues of the remedy, and the re- corded observations of others, might seem to promise. We have never witnessed, on the other hand, the evil, which Riecke* men- tions, that it may under particular circumstances, occasion the speedy development of phthisis, where tubercles exist in the lungs. He refers to a case by Haser, as corroborative of his opinion. A woman, fifty years old, was affected with anchylosis spuria, for which an ointment of iodine was recommended; but it had not been employed more than three weeks, and not more than a dram of the hydriodate of potassa had been rubbed in, when symptoms of phthisis tuberculosa rapidly supervened, which, in half a year, terminated in death. There does not appear, how- ever, in this case, to have been any thing more than a coinci- dence. In chronic engorgements of the larynx, it was used in two cases by Trousseau and Belloq;f once without success, but the second time with marked advantage; and in tubercles of the liver it has been regarded worthy of special consideration.J Dropsy.—Many trials have been made with iodine in cases of dropsy, owing to its powerful sorbefacient agency.§ Bradfield and Bardsley exhibited it frequently with success in hydrothorax and ascites; and Kissam, in a case of dropsy, dependent probably upon induration of the liver. Dr. Coster|| says he has removed many dropsies by giving internally from six to fifteen drops for a dose of a mixture composed of iodin. gr. iii., potass, hydriod. gr. vi., aquae, ^j; aided by an ointment composed of fifteen grains of iodine, with double the quantity of hydriodate of potassa, to an ounce of lard. This is to be placed inside the thighs after re- moving the cuticle by a blister. The armpits and soles of the feet were also rubbed with the ointment. The same plan is recommended by Dr. Osborne.Tf Jahn re- gards iodine as one of the most important agents of modern dis- covery, and as an extremely valuable antihydropic.** He first * Die neuern Arzneimittel, u. s. w. S. 289; see, also, Gunther, in Harless's Neue Jahrb. B. xii. St. 3. S. 161. f Traite pratique de la Phthisie laryngee, p. 371, Paris, 1837, and Translation by Dr. Warder, Dunglison's Amer. Med. Library edit. p. 145, Philad. 1839. J Riecke, Op. cit. S. 290. $ Dr. Win. Stokes, in Amer. Journal of the Med. Sciences, May, 1834, p. 543, from London Med. and Surg. Journal. || Journal de Pharmacie, 1&34. IT On the Nature and Treatment of Dropsical Diseases, 2d editp. 48. Lond. 1837; and Dunglison's Amer. Med. Library edit. Philad. 1838. ** Elliotson, in Lancet, 1830—31. See, also, P. Spalding, in Boston Med. and Surg. Journal, Dec. 25,1839, p. 314. 27 310 IODINUM. used it in a case of hydrocele, in which it was doubtful whether degeneration of the testicle had not been a precursor. The effect of the ointment of hydriodate of potassa left nothing to be desired; and, accordingly, he afterwards employed it in all cases of hydro- cele of the tunica vaginalis, which he met with,—even in the new born,—united with mercury or extract of cicuta, and in every case, which was not of too chronic a character, it exhibited its sana- tive powers. The only unfavourable effects induced by it were a temporary disappearance of the testicle, in some cases; and a humid cutaneous eruption of the scrotum. He also found the iodine extremely useful in hydrothorax and ascites; especially in those cases of dropsy which succeed to exanthematous diseases, and that it acted more speedily and powerfully when combined with some diuretic. He found, farther, that the iodine was followed by the most beneficial results in the hydrocephalus of children—as well chronic as acute—especially when the latter form had attained its full development, that is, when the inflammatory stage was over, and the accumulation of fluid was the prominent condition. In these cases, he commonly used the iodine in the form of the hydriodate of potassa, made into an ointment, and rubbed on the head. Fre- quently, however, he gave the iodine also internally, in combina- tion with calomel and digitalis; but it may be objected to this combination, that iodine with calomel forms corrosive sublimate and the proto and deuto-iodides of mercury, so that, in very small doses, it might affect the stomach too violently.* M. Ricordf em- ployed the tincture of iodine with success in five cases of hydro- cele;—the tincture being diluted with distilled water, and applied by means of compresses wetted with it, and in which the scrotum was enveloped. He uses it of four different strengths—3J, 3ij, 3iij, and 3yj of the tincture, to ^itj of water. In hygroma, or dropsy of the bursae mucosae of the joints, an ointment of the iodide of potassium (5ij ad axung. ij) has been most, successfully used by M. Reynaud.f The limb is kept at rest, and morning and evening, or three times a day, friction is made with this quantity of ointment; after which the knee—the joint commonly affected—is covered with a large flaxseed poultice. From some trials made with the iodide of lead, there was reason to believe it more efficacious than the iodide of potassium. The treatment was generally successful in about a fortnight. As to its efficacy in nervous diseases, the testimony is somewhat * Riecke, Op. cit. S. 291. f Journal des Connoissances Med. Chirurg. Janvier, 1833. 1 Cabissol, in Bulletin G^n^ral de Th«rapeutique, Fev. 1838. IODINUM. 311 discordant. Manson* and Elliotsonf found it useful in paralysis* but Dr. Bardsley failed with it. Chorea was removed by Gib- neyj and Bardsley; and Franklin,§ by very large doses, relieved a case of epilepsy. The intimate affinity between iodine and the urinary organs, has given occasion to its employment in Incontinence of Urine.—Corter cured two cases by the tincture of iodine. Cutaneous Diseases.—Cases of dry, scaly, tetter were treated, commonly, by Tiinnermann, with an ointment made of the iodide of potassium, applied to the affected parts three or four times a day. For the most part, an increase of the evil was at first a pretty sure harbinger of a radical cure; when this attained a cer- tain degree, a change in the organic actions of the skin suc- ceeded; the remedy was then pretermitted, and the parts wrere washed a few times with soap, when the eruption faded away, and disappeared. In moist tetter, Tiinnermann applies only a very weak salve, with which the parts are touched daily two or three times; in the intervals, he envelopes them in a dry linen rag. The pain, which is always induced by the application, soon passes away. Magendie, Gimelle, and Jeffray|| have likewise applied it successfully in tetter. In chronic cutaneous diseases, in general, the various pre- parations of iodine are valuable remedies. They enter, as we have seen, the mass of blood, modify the condition of that fluid, and, in this manner, exert a new impression upon the capillaries of the diseased portions of the dermoid system. We have often employed them in these cases with success, and similar testimony has been afforded by MM. Biett, Gimelle, Kolley, Locher-Balber, Kennedy,Tf and others. Brehme succeeded in removing, rapidly and completely, a case of inveterate porrigo favosa, and ophthal- mia thereon dependent, by an ointment of iodine. Dr. G. Billingslea, of Alabama, asserts,** that, for the last twelve years he has used the tincture of Iodine, with the happiest effect, as a local application in the troublesome cases of herpes circinatus or ring-worm, that are so common in the southern part of this country. He adds, that he does not recollect a case in which it had been used, which was not radically cured. Amenorrhea.—According to Coindet, iodine is a powerful em- menagogue, and the possession of this property has likewise been * Op. cit. t Lancet, 1830-31. f Ibid. 1827-8, p. 54. I Lancet, 1830, and Cogswell, Op. cit. p. 24. |'| Cogswell, Op. cit. p. 80. IT Lond. Med. Gazette, May 8, 1840, p. 260. ** Dunglison's American Medical Intelligencer, May 1, 1839, p. 34. 312 IODINUM. ascribed to it by Brera * who frequently administered it success- fully in amenorrhcea; and Formey and Nieustadt confirm his ob- servations. Sablairoles cured three cases by frictions with iodine ointment on the breast, conjoined with the internal use of iodine. It was necessary, however, to give it in large doses, and for a long time. Locher-Balberj- found the iodine of use, at times, in those troublesome cases, which occasionally precede the establishment of menstruation; as well as Golis, who was, however, often de- terred from its use, in such cases, by the evil consequences it pro- duced on the respiratory organs,—such as dry cough, or cough accompanied by bloody sputa. Degeneration of the Ovaries.—Rochling observed a marked effect from the use of iodine in induration of the ovary. Jahn cured, by an ointment of iodine and mercury, an enormous dege- neration of the ovaries, which gave rise to two tumours, each of the size of the head; and Messrs. Thetford,^; Klaproth,§ Jewel,|| and AshwellH were equally successful. Baron employed the iodine beneficially in a case of dropsy of the ovarium. Of hypertrophy of the mamma, Delfiz** details a case which resulted favourably; and in hypertrophy of the thymus gland— the asthma thymicum of Kopp—iodine baths have recently been advised by Dr. Fingerhuth. In hypertrophy of the ventricles of the heart, Magendie long ago recommended it. In scirrhus of the uterus, mamma, &c, it has been advised by Heun', Klaprotii, Hennemann, Von dem Busch,ff Ullmann, Hill, Benaben, Magendie, Bermont, Hammer, Elwert, WagnerJJ Cop- land ;§§ and, from their recorded observations, it would seem, that great efficacy ought to be ascribed to it, both when internally and externally administered. Jahn extols it much in incipient scirrhus of the stomach, when combined with the application of leeches; and Riecke|||| asserts, that his father found an ointment of iodine extraordinarily useful in a case of induration of the pancreas; and, also, in a case of scirrhus of the pylorus. In induration of the female mamma, not of a malignant nature, he likewise found it frequently of essential assistance. Magendie extols it in cancer of the tongue; and Benaben and Triistedt employed it successfully * Saggio Clinico sull' Iodio. f Hecker's Litter. Annal. i. 275; and Cogswell on Iodine, p. 77. X Transactions of the Dublin College of Physicians, v. 510. Dublin, 1828. \ Revue Medicale, Mars, 1824. || Op. cit. IT Guy's Hospital Reports, vol. i. ** Froriep's Notizen, B. xiii. No. 5, S. 73. tf Hufeland's Journal, B. lx. St. 2, S. 81. XX Revue Medicale, Juin. 1833. \\ Dictionary of Practical Medicine, Art. Cancer. IHI Op. cit. S. 292. IODINUM. 313 in stricture of the urethra, supervening on badly managed gonor- rhoea* In several cases of chronic disease of the liver, attended with jaundice, Dr. Abercrombie* found an ointment composed of J^ss of iodine, and an ounce of lard, of great benefit; and Dr. Milligan: prescribed it, in the form of tincture, with good effect in three cases of hypertrophy of the spleen, j Leucorrhaa.—A Parisian physician made the observation, that during the employment of iodine in goitre, obstinate and protracted leucorrhcea disappeared; this induced him to try the remedy in the latter disease, and he found it very efficacious. Goden and Broglio, likewise, observed it useful in malignant fluor albus; and Benaben, Richond,J De Salle, Caswall,§ and Broglio, in gonor- rhea. The last two individuals gave it especially in those cases, in which, without any marked inflammation, a deeply rooted go- norrhoea existed, with ulcers in the urethra and prepuce, not ap- parently of a syphilitic character. In chronic fluor albus, it was used by Muller|| with marked,success. A young female had long suffered under this affection, which had reduced her strength, and did not yield to any of the means that had been employed, when the ointment of hydriodate of potassa was rubbed—morning and evening—on the inner surface of the thighs. After this plan had been continued for four weeks, the disease entirely ceased. MM. Gimelle and Jewell are also advocates for it.li In discharges from the nose, iodine, in the form of. hydriodate of potassa, has been used with advantage by Dr. Elliotson** and by Mr. George Fayrerff—given internally, as well as employed in the form of injection, Oj ad aquae 3iv.) In secondary syphilis, iodine has been recommended by Tyrrel, Saville, De Salle, Sehlesier,JJ and numerous others;—especially when the disease is complicated with scrofula, and the effects of mercurials. Wallace§§ has likewise communicated some for- tunate results from, the administration of the iodide of potassium * On the Stomach,. Edinb. 1828; and Amer. edit. Philada. 1830 f Cogswell, Op. ait. p. 83. See, also, Dr. Casey, New York Journal of Me- dicine, "bet. 1840, p. 324. X Archives Cenerales de Modecine, vol. iv. 5 Lond. Med. Gazette for 1834. || Wochenscrift fur die eresammte Heilkunde, No. 40, S. 633. Oct. 1836. IT Revue Medicale, vii.249; and Practical Observations on Leucorrhrea,&c. . by Geo. Jewell, p. 80. Lond. 1830. See, also, Solon, in Nouv.Diet, de Me- dec. et Chirurff. Art. lode. ** Lancet, Feb. 10, 1838, p. 725., ft Ibid. Feb. 24, p. 786. XX Casper's Wochenschrift. Feb; 4, 1837, S. 78. §§ Treatise on the Venereal Disease, Lond. 1833. 27* 314 IODINUM. in secondary syphilis, and Ebers,* Ricord/f Von Haselberg,J Cullerier and others have confirmed his observations. More re- cently, Mr. Bullock§ has reported the particulars of eleven cases of secondary syphilitic diseases, of a formidable character, re- lieved by the iodide of potassium, given internally, in doses of eight grains three times a day, in camphor mixture. The symptoms were:—destruction of the uvula and soft palate, or nodes, with nocturnal pains in the tibia, ulna, frontal and malar bones, and af- fection of the bones of the nose, or rupia and other tubercular eruptions. The period of cure was from one to two months. Mr. Mayo|| has described it as efficacious in certain disorders, which are the consequences of syphilis, as emaciation, with ulcers of the skin; ulcerated throat, affections of the bones, &c., occur- ring in those to whom mercury had been given. The iodide of potassium has been used with much success by M. Ilicordlf in deep seated syphilitic tubercles. Before the tuber- cles have become inflamed or softened whilst they are still indu- rated, he has constantly succeeded in dispersing them by the iodide of potassium with small doses of the iodide of mercury. Very commonly, however, he employs the iodide alone; and when the tubercles have become ulcerated, he still relies upon it as his principal remedy. Nocturnal pains in the bones, and diseases of the bones and perios- teum have likewise been particularly benefited by the iodide:** the latter, when localized for a longer or shorter period, have yielded sooner when blisters have been applied over the affected parts. An iodine suppository appeared to Mr. Keateff to be beneficial in enlarged prostate; and the iodide of potassium was adminis- tered successfully in the same disease by Dr. Casey.JJ In different forms of rheumatism, iodine has been given with success by Dr. Clendenning,§§ in the Mary-le-bone Hospital, and a series of cases in which it was employed has been published by * Medicinische Zeitung, Oct. 5, 1838, S. 201 and 207. | J. J. L. Rattier, La Lancette Francaise No. 34, Mars 19, 1839. Gazette des Hopitanx, Mars, 1839, and Lingstnn Parker's Modern Treatment of Syphilitic Diseases, &c. &c. Dunglison's Amer. Med. Library Edit. p. 77, Philad. 1840. X Medicinische Zeitung, No. 48 and 49, Berlin, 1837. \ Edinb. Med. and Surg. Journal, Jan. 2, 1837. See, also, Cogswell on Iodine, p. 80; and Laycock, Lond. Med. Gazette, Mar. 2, 1839, p. 821. || Lond. Med. Gaz. xi. 249. See, also, a Treatise on Syphilis, by Herbert Mayo, F. R. S. Lond. 1840. If Lanoston Parker, Modern Treatment of Syphilitic Diseases, &c. Dungli- son's Amer. Med. Libr. Edit. p. 77. Philad. 1840. ** See, also, Dr. Win. B. Casey, in New York Journal of Medicine and Sur- gery, Oct. 1840, p. 320. ft Lancet, for 1832-3, p. 672. It New York Journal of Medicine Oct. 1840, p. 324. \\ Lond. Med. Gazette, May, 1835. IODINUM. 315 him. Sir B. Brodie* twice relieved rheumatism by the tincture, although, in one of the cases, only temporarily. Cases of acute rheumatism, treated successfully by the iodide of potassium, used internally and externally, have been published by Dr. Mackayf and Mr. Wardleworth.J In gout, too, it has been prescribed. Jahn found it extremely effective in dispersing gouty tophi. Valentin found, that when iodine was given in a case of goitre, complicated with gout, the tumefaction of the joints and the depositions gradually disappeared. Adopting the hint, he gave it in several cases of gout, with the effect of always mitigating the disease, and, at times, of com- pletely curing it. Gendrin used the iodine not only in chronic gouty swellings with success, but also in acute cases. Ebers likewise confirms the efficacy of iodine in gout. In coxalgia, Buchanan recommends the tincture of iodine to be applied by means of a small brush, as well as in a case of false joint, of which he has detailed a successful instance. A similar case has also been given by Treusen. In adiposis, Von Grafe§ prescribed it, and not without advan- tage. The case was accompanied by great voracity and sense of suffocation. Bleeding and cathartics were premised. In stomacace or a scorbutic state of the gums, the use of iodine has been recommended by Friedrich; as well as in mercu- rial salivation, by Kluge, Knod,|| Klose,^[ Graves,** Asmus,ff and others; yet its efficacy appears to be somewhat doubtful in the last affection. Heyfelder found it of no value in three cases. In a case of stricture of the asophagus, it^was given with much benefit by Mr. Cumming, of New York.JJ A bougie had been previously used, but without advantage. An adventitious membrane was brought up in scales soon after commencing the iodine. For two or three weeks, the medicine was laid aside, but it was found necessary to resume it. In affections of the mucous membrane of the middle ear, it has been used by Dr. Manson, and also, by Mr. T. Wharton Jones ;§§ * Lancet, for 1832-3. t Ibid. Mar. 2, 1639, p. 830. t Ibid. Mar. 30, 1839. § VValther und Grafe's Journal fur Chirurgie. B. ix. St. 3. S. 367. || Gazette des Hopitaux, July 1837. IT Medicinische Zeitung, No. 34, 1836. See, also, Amer. Journal Med. Sciences, Feb. 1834, p. 533. ** Dublin Journal Med. Science, Jan. 1834. ff Casper's Wochenschrifl fur die gesammte Heilkunde, No. 45,1838, and Encyclographie des Sciences Medicales, Juillet, 1839. tt New York Journal of Medicine and Surgery, No. 2. Oct. 1839, p. 451. 55 Lond. Med. Gaz. Aug. 17, 1839, p. 754, and Dunglison's Amer. Med. Intel. Nov. 1, 1839, p. 233. 316 IODINUM. by the former with advantage, by the latter without any marked effect. Dr. Manson likewise succeeded in curing chronic Dacryocystitis by it. In cases of hydrocele, Velpeau* prefers a solution of iodine to wine as an injection. He employs the tincture in the proportion of from one to two drams to an ounce of water. He treated suc- cessfully twenty cases by this method. Mr. J. R. Martin,f of In- dia, appears, however, to have anticipated him in this applica- tion of the remedy. Up to the time of the presentation of his paper to the Medical and Physical Society of Calcutta, (January, 1835,) he had used it successfully in upwards of ninety cases. More recently, he has communicated to the Medical and Physical Society of Calcutta the results of his subsequent experience. The number treated since March, 1832, at the Native Hospital, was seven hundred and seventy-seven: of these, seven hundred and sixty-six had a solution of tincture of iodine injected. In order to ascertain, whether it was by mere stimulation that the cure by the tincture of iodine was obtained, Mr. Martin treated ten cases with a common urethra syringeful of undiluted port wine, and one with diluted tinctura lyttce, in the same proportion as that of iodine, 3ij to water ^vj. Of this, two drams were in- jected and retained; the pain during twenty-four hours was exces- sive, and the inflammation, although not proportionate to the pain, was much longer in subsiding than when the tincture of iodine solution was used: this was also remarkably apparent in the cases treated with the undiluted port wine. Of the seven hundred and sixty-six cases treated, it does not appear that more than four failed.J For hydroceles containing from six to thirty ounces of fluid, two drams of the solution of tincture of iodine are sufficient; for those containing from thirty to sixty ounces, three drams; and for those of a larger size,, four to five drams. When the hydro- cele contains less than three ounces, 3] of the injection is suf- ficient.§ The cure is effected much sooner by the iodine; and if any in- filtration takes place, it is readily absorbed. Highly favourable results have also been obtained by MM. Oppenheim|| and Fricke,^! and the method has been largely em- * Archives Generales de Medecine, Jan. 1837; La presse Medicale, Mai, 1837. See, also, Dunglison's Amer. Med. Intelligencer, July 15, 1837. p. 138; and Oct. 16, p. 263. t Amer. Journal of the Medical Sciences, Nov. 1837, p. 238. f Quarterly Journal of the Calcutta Med. and Physical Society, for Jan. 1837; cited in Amer. Journal of thG Med. Sciences, for Feb. 1839, p. 485. 5 Dujat, in Gazette Medicale de Paris, Sept. 1838. || Zeitschrift far die gesammte Medicin. August, 1838, S. 389. T Ibid. S. 405. IODINUM. 317 ployed in this country, and with equal advantage.* Two suc- cessful cases are likewise reported by Dr. Stewart.f It is said by Coindet and Formey to have been efficacious in cases of impotence; and, lastly, Mr. KeyJ regards it as one of the most efficacious remedies we possess in checking or control- ling the ulcerative process—the most active phagedenic ulcers often yielding in a surprising manner to its influence, and as- suming a healthy, granulating appearance. Very recently, Mr. John Davies'§ has published the results of his experience with the local application of Iodine—especially the tincture—in various local diseases. In erysipelas, no matter where present or of what description, he found the tincture, " painted," over the part with a camel's hair-brush, preferable to leeches, lo- tions, incisions, scarifications, or caustic. In phlegmon, where pain and throbbing only exist, one application of the tincture of the full strength cut short the disease; and where suppuration had commenced, its repeated use not only checked the progress of the disease, but caused the deposited matter to be absorbed. Not a sin- gle case of failure occurred, where the tincture was applied in super- ficial phlegmon before suppuration took place, and even then the pus was much less in quantity than where poultices were used. In extensive sloughing of the cellular membrane after phlegmonous erysipelas of the lower extremities, the tincture proved to be a most valuable application. Whilst the usual remedies had no effect in checking the inflammatory process, the iodine arrested it at once and gave the living parts a chance of casting off the dead slough. In acute inflammation of the joints it was more efficacious than any of the ordinary local applications. Over the knee—if the skin be delicate—it may be applied at first about half its strength, and be increased gradually as required. When the hip is affected, the strong tincture must be painted all around the upper part of the thigh and groin. In these cases, Mr. Davies prefers washing the joint, and then using the iodine as the bleeding ceases. In mastitis of inflammation of the mamma, the tincture of full strength must be laid extensively over the part, as soon as the disease is disco- vered; and if an abscess should form, its extent will be limited. In gout, its application cuts short the attack; and in anomalous pains of the joints, supposed to be gouty or rheumatic, its effect has been marked. In these cases, Mr. Davies dilutes the tincture to about two-thirds its full strength. In chronic inflammation and enlarge- ment of the joints, such as the hip and knee, leeches are first em- ployed and then the diluted tincture is laid extensively over the* * Dr. A. C. Post, New York Journ. of Medicine, April 1840, p. 369, and Dr. G. W. Norris, Amer. Journ. of the Med. Sciences, Feb. 1839, p. 299. f India Journal of Medicine, May, 1836. t Medico-Chirurgical Transactions, xix. 5 Practical Remarks on the use of iodine locally applied, &c. &c. Lond. 1839, and Dunglison's American Med. Library, 1839—40. 318 IODINUM. part, and the application is repeated every two or three days ac- cording to its effects on the skin. In the ankle or wrist, where the enlargement is of old standing, an iodine lotion—composed of 32 grains of iodide of potassium, dissolved in an ounce of distilled water, to which eight grains of iodine are added—is preferred to the tincture by Mr. Davies;—a rag being wetted in it three or four times a day and laid round the joint, and the strength of the lotion being determined by the discretion of the attendant. In inflammation of the absorbents, the strong tincture applied along the track of the vessels is generally sufficient to sub- due the affection. In anthrax, employed before or after incisions, it dispels the inflammation, and enables the parts to cast off the dead cellular tissue and form granulations. It is equally applicable to boils and buboes;—cutting short the progress of the latter; or if used after suppuration, limiting the extent of the abscess. In lupus or noli me tangere, the strong tincture laid upon the ulcerated sur- face has cured the disease without the use of internal remedies. In malignant ulcers of the tongue and tonsils, the tincture, of full strength, brushed all over the parts, has arrested the affection no matter how threatening. The only internal remedy was the iodu- retted solution in doses of ten drops twice a day, in water. In scrofulous swelling of the glands, it either resolved the inflamma- tion and caused absorption of the morbid deposits, or limited the formation of matter and assisted in the cicatrization of the sore. In whitlow, the strong tincture must be immediately painted over the whole finger or thumb, and the application must be repeated in twelve hours, unless the morbid sensation has ceased. Where this has been done prior to suppuration, it never fails, according to Mr. Davies, to subdue the disease. Should matter have been formed, a free incision must be made, and the tincture be applied over the finger or hand, if swollen. In chilblains, the tincture, of full strength, is to be applied over the part affected,, and beyond the boundary of the surrounding in- flammation. This must be repeated daily for some time, and the affected parts should be immersed every night in water, as hot as can be borne. When the ulceration looks healthy, and the skin around has lost its livid colour, the strength of the tincture may be reduced. After each application, the sore, if any, should be dressed with some stimulating ointment. In cases where the inflammation spreads along the foot or leg, the affected parts must be painted with the strong tincture. In lacerated, contused, and punctured wounds, the tincture was found by Mr. Davies to be preferable to every plan of local treatment. When the accident was one of simple laceration— after the blood or dirt had been wiped away, every point of the surface of the wound was touched over with the tincture, gene- rally of the full strength, and' the application was extended a little IODINUM. 319 distance beyond. After allowing it to dry, the edges of the wound were brought together with adhesive plaster, which was not re- newed for three or four days. At the end of this time, part of the wound was found to be united, and the rest granulating. The granulations with the surrounding skin were washed over, and then dressed with common wax ointment. The cure was gene- rally rapid. Where contusion only exists, the tincture is applied by Mr. Davies every day or two, to the surface; this quickly occa- sions the absorption of the extravasated blood. Where there is a combination of laceration and contusion, the treatment is com- pound. The surface of the wound and contusion is brushed over, and the edges of the former are approximated and kept together by a plaster or a roller. In punctured wounds, from whatever cause, the tincture, liberally applied, is used with the same suc- cess it exerts in local diseases, and injuries attended with inflam- mation. In such cases, it should be allowed to insinuate itself freely into the wound, and be thickly painted upon the surround- ing skin. In burns and scalds it appears to act as in erysipelas. When the integuments are not destroyed, although the cuticle may be in blisters, one or two applications of the tincture, of moderate strength, subdue the pain and redness, after which the parts only require to be kept free from injury. Lastly:—the remedy is said by Mr. Davies to be eminently successful in ulcers. Several cases of chancre yielded sooner than to the ordinary treat- ment, and in the malignant ulcerations about the lips, tongue or tonsils, no topical remedy would seem to be equal to it. In all cases of irritable or sloughing sores, the tincture, of full strength, must be applied to the surface and surrounding skin. After being allowed to remain some time, the ulcer must be covered with simple ointment in preference to a poultice. The application must be repeated daily till the sore becomes clean and healthy, when the granulations may be touched, with the diluted tincture every two or three days. Under this plan, the cavity of the ulcer fills up rapidly. Besides these affections, the tincture has been em- ployed with good effect in gouty and rheumatic swellings of the small joints from thickening of their ligaments, fistulous openings, malignant warts or adventitious excrescences, ganglions, the sting- ing of wasps, diseases of the spine, ununited fractures, orchitis> inflamed urethra and chordee, inflammation of the bursa, chronic ophthalmia, and opacities of the cornea (being much diluted,) dis- section wounds, &c. The strength of the remedy, in the several cases, must depend upon the judgment of the practitioner.* * British and Foreign Med.Review, Oct. 1839, p. 523. See, also, Dr. Lan- gon, Lon. Lancet, June 27,1840, p. 484. 320 IODINUM. With regard to the relative value of the preparations of iodine, Dr. A. Buchanan,* is inclined to place them in the following order:—Iodide of starch, hydriodic acid, (iodine,) and iodide of potassium; although he admits, that the superiority he ascribes to the first is, perhaps, owing to his having prescribed it most fre- quently. The action of all of these is, however, similar. The only mode, he thinks, of explaining the similarity of action on the body of substances so dissimilar in nature, is by considering the hydriodic acid as the active principle; free iodine being immedi- ately converted in the stomach into hydriodic acid. In the Glasgow Infirmary, they are in the habit of preparing a liquid hydriodic acid; by dissolving three hundred and thirty grains of the iodide of potassium in ^iss of distilled water; and two hundred and sixty-four grains of tartaric acid in a like quan- tity : the solutions are then mixed, and when the bitartrate of po- tassa has subsided, the fluid is filtered. Water enough is then added to make ^vj and 3ij- Each dram of this liquid acid contains five grains of iodine. The acid, thus prepared, is, however, very liable to change, and is necessarily variable in its effects.f Lastly; from his researches on the effects of the various prepa- rations of iodine, Dr. CogswellJ infers, 1. That iodine and hydrio- date of potassa act very much in the same way, but that there is still a difference, not merely in point of power, but of specific pro- perties. 2. That, whatever be the proper action of the iodide of sulphur, its facility of decomposition gives it a resemblance to iodine. 3. That the iodides of carbon, so far as examined, have an action peculiar to themselves: and, 4. That, in those metallic iodides which were submitted to examination, the preponderance of power is on the side of the bases. METHOD OP ADMINISTERING. The iodine is not easily given internally in substance—in the form of pill or powder; neither are these forms to be recommended. Coindet preferred it in the form of tincture; and this is one of the most common modes in which it is administered. When, how- ever, the tincture is taken with water, a great part of the iodine is thrown down, and, it has been conceived, may thus exert a noxious influence on the stomach ; but in the small doses in which it is taken, such an effect can scarcely be anticipated. It would * Med. Gazette, July 2,1836. f Guibourt, in Revue Medicale, Aoat, 1837; and Bulletin General deThe- rapeutique, Sept. 1837. X Essay on Iodine, p. 167. Edinb. 1837. IODINUM. 321 seem, however, that, in the generality of cases, when iodine has disagreed, it has been in the form of tincture. For this reason, of late years, iodine has been given more in watery solution; and, to promote the solution, the iodide of potassium, (q. v.) is added; or a little salt, according to Lugol's prescription. An ethereal solution is also prescribed. Externally, it is applied in the form of tincture, ointment, or watery solution, or in baths, or fumiga- tions. Frictions with iodine readily occasion a considerable ir- ritation of the skin, which commonly soon passes away, when the friction is suspended for a time. After bathing a part, painful rubefaction of the skin often ensues, which is usually followed by perspiration and sleep. The iodine is given inter- nally, in the dose of one-eighth of a grain to a grain, twice or thrice a day. The following are some of the forms in which the pure iodine is administered internally and externally. Tinctura Iodini. Tincture of Iodine. (Synonyme.—Tinctura seu Alcohol lodii.) R. Iodini, gr. xlviij, Solve in alcohol 35° (s. g. .842) ij. Dose.—Ten drops to be given in some mucilaginous or saccha- rine fluid, or in wine and water. Coindet and Magendie. The Tinctura Iodini, of the Pharmacopoeia of the United States, consists of half an ounce of Iodine to half a pint of Alcohol. Mr. Durand, an able pharmacien of Philadelphia, finds, that forty grains of the iodine and 3x of rectified spirit form a satu- rated solution. Based on this fact, the following formula has been given, which does not seem, however, to possess any advan- tages over the simple tincture. R. Iodin. optim. 9ij. Spirit, vini rect. 5j. Spirit, lavand. comp. 3ij. Dose.—Ten to twenty drops twice a day, gradually increasing it to forty.* & * Ellis's Medical Formulary, 5th edit. p. 91. Philad. 1838. 28 322 IODINUM. Tinctura JFtherea Iodini. Ethereal Tincture of Iodine. Synonymes.—Tinctura Iodii .Etherea. (French.-^Ether iodurt.) R. iEther. sulphuric. 3i. Iodini, gr. vj. M. Dose.—Eight or ten drops, two or three times a day. Magendie. Decoctum Cinchona cum Tinctura Iodini. Decoction of Cinchona with Tincture of Iodine. R. Decoct, cinchon. 5x. Tinct. iodin. gtt. xc. M. Dose.—Two spoonfuls, three times a day. In scrofulous ulcers. Rey. Mistura Iodini. Mixture of Iodine. R. Iodin. gr. v. Alcohol. 3ij« Solve et adde Aq. cinnam. ±iiss. Syrup, simpl. 5iss. M. To be taken in the twenty-four hours, in dram doses. Syrupus Iodini. Syrup of Iodine. R. Tinctur. iodin. gr. vj. Syrup, simpl. 5ij. M. Henry. Solutio Iodini. (Lugol's.) (French.—Boissoii iodee.) Solution of Iodine. (1. For internal use.) A. B. C. R. Iodin. gr. I gr. f. gr. j. Sodae muriat. gr. xij. gr. xij. gr. xij. Aquae destill. Jfej. ftj. foj. Solve. IODINUM. 323 (2. For external use.) A. B. C. R. Iodin. gr. ij. gr. iij. gr. iv. Aq. destill. fej. fbj- tbj- Solve. Lugol gives formulae for the solution of the three different strengths above. Unguentum Iodini. Unguentum lodatum, Ointment of Iodine. French.—Pommade d'lode. German.—Iodsalbe. R. Iodin. gr. iij. Adipis, 5y. M. Linimentum Iodini. Liniment of Iodine. g. Linirn. sapon. comp. ^j. Tinct. iodin. 3j. M. Manson, Cataplasma Iodini. Cataplasm of Iodine. R. Tinct. iodin. 5ss. Pulv. sem. lin. 5j. Farin. avenae, 5iij. Aquae destillat. q. s. ut fiat cataplasma. Used as a cataplasm in scrofulous tumours and goitre. The Iodide of Starch, Iodidum seu loduretum Amyli, Amylum lodatum; French, Iodure d'Amidon; German, Iodstarkmehl, lodstarke, Starkmehl-oder Satzmehliodure, has been extolled by Dr. Andrew Buchanan,* of Glasgow. It is prepared of iodine gr. xxiv.; starch, in fine powder, ^j. The iodine is first triturated with a little water, and the starch is gradually added, the tritura- tion being continued till the compound assumes a uniform blue colour. The iodide is then dried with a heat so gentle as not to * Lond. Med. Gazette, July 2, 1836; see, also, Soubeiran, in Revue Medi- eale, Aout, 1837. 324 IODINUM. drive off the iodine, and it must be afterwards kept in a well stopped bottle. Iodine, in the usual forms of exhibition, cannot in general be safely given in larger doses than four or six grains daily, whilst, in the above formula, Dr. Buchanan has given as much as seventy- two grains daily. Professor Forget, of Strasbourg, has published the case of a youth, seventeen years of age, who took in 48 days, 139 ounces, or nearly nine pounds, of this iodide, containing 3336 grains, or nearly six ounces, of iodine,—being nearly sixteen grains a day.* It is proper, however, to state, that Dr. Laurie, of Glasgow,f thought it proved fatal in a case, in which not more of the iodide than corresponded to a grain of iodine, had been given twice a day for five days. An Iodide or Ioduret of Quinine, Iodidum Quinine, is formed by precipitating sulphate of quinine by means of hydriodate of potassa. It is a yellow precipitate, soluble in alcohol, and crys- tallises from this solution in quadrangular prisms. It has been employed for the cure of scrofulous tumours, in cases where iodine and tonics are indicated.;}; The Iodide of Ammonium, Iodidum seu loduretum Ammonia, Hy- driodate of Ammonia (in solution,) loduret of Ammonia—is formed by saturating liquid hydriodic acid with caustic ammonia and evaporating the solution. It crystallises with difficulty and is deliquescent. It was introduced into medical practice by M. Biett, of Paris as a valuable therapeutical agent in certain diseases of the skin. Several successful cases of its employment in lepra and psoriasis, by M. Biett, are given by Dr. Pennock,§ accom- panied by interesting remarks by the latter. It is administered in the form of ointment, from a scruple to a dram of the iodide being added to an ounce of lard;—the weaker ointment being used in milder or more acute, and the latter in more inveterate cases. The ointment should be freshly prepared, or kept excluded from the air as it is readily decomposed. The other preparations of iodine are contained in different parts of this volume. * Gazette des Hdpitaux, Fev. 19, 1839, and Lond. Med. Gaz. April 20,1839, p. 127. f Lond. Med. Gaz. July 3, 1840, p. 590. X Journal de Chimie Medicale, Mars. J836. § Amer. Journ. of the Med. Sciences, Feb. 1835, p. 874. lactucarium. 325 LACTUCARIUM. Synonymes. Lettuce Opium, Thridace. German. Lattich-Opium. The ancient Greek and Roman physicians were well aware of the hypnotic property of the common garden lettuce {lactuca saliva,) the milky juice of which contains the lactucarium. It would appear, however, that Dr. J. R. Coxe, of Philadelphia, was the first to propose the use of the inspissated juice in medicine.* Dr. Duncan, Senr., of Edinburgh, subsequently paid particular at- tention to the subject, and recommended it as a remedy in phthisis, in place of opium.f The properties of the juice have also been investigated by M. Frangois,J a French physician. method of preparing. There are three kinds of lactucarium. The first and best, but the most costly, is obtained from incisions made into the stalks, whence the juice exudes, which is subsequently dried in the air. This preparation has a bitter taste, soon becomes of a brown co- lour, and solid, has a gummy fracture, but absorbs moisture from the air, becoming soft and clammy. The second variety is obtained by expression of the selected stalks, and subsequent desiccation of the obtained fluid, either in the air or by artificial warmth. This is said to be the variety most commonly met with in commerce;^ and the third variety is prepared in the same manner as any common extract, from all parts of the plant. This is the Thridace of some. The first is the strongest and most uniform, and therefore to be preferred. Chemical examination shows that the lactucarium contains neither morphine nor narcotine, as had been supposed. * Wood and Bache's Dispensatory, 4th edit. p. 400. Lond. 1839. f Observations on Consumption, 2d edit. Edinb. 1816. \ Archiv. General, de Medecine, 1825. Journal Univer. xl. 254, and xli. 147. See, also, Fischer, in Rust's Mao-azin. B. liii. Heft 1. \ Riecke, Die neuern Arzueimittel, S. 313; and 2te Auflao-e, S. 473, Stutt- gart, 1840. See, also, Merat & de Lens, Diet, de Mat. Med. art. Lactuca Sativa. 28* 326 LACTUCARIUM. EFFECTS ON THE ECONOMY. To investigate these, Rothamel* instituted experiments with the Paris lactucarium. Half a grain to a grain produced little or no effect. From three to five grains occasioned a peculiar inde- scribable feeling of lightness over the whole body, without any narcotic symptoms or modification in the pulse: from six to eight grains increased this sensation, and caused dilatation of the pupils. The same doses, repeated at intervals of three or four hours, through the day, diminished the number of pulsations of the heart, and the sleep was disturbed. From ten to fifteen grains caused more indisposition, nausea, oppression in the epigastrium, cold sweats, anxious respiration, cold sensation in the chest, great dulness, vertigo, considerable dilatation of the pupils, yawn- ing and stretching, slow pulse, disturbed sleep, general prostra- tion ; the tongue to be coated with mucus; disagreeable taste; loss of appetite; pains in the shoulders and bones, and uncertain gait; all which symptoms were speedily removed by a few drops of acetic ether or a glass of Rhenish wine. Coffee was much less efficacious. The lactucarium has been extolled by numerous physicians as equally effective with opium, whilst it is not—they assert—fol- lowed by the signs of narcosis and other inconveniences, so often induced by the latter. Accordingly it is frequently given where a pure sedative is needed—to allay cough, and where much ner- vous excitement is present. It has also been used topically in the form given below, by Rau,f of Berlin, in catarrhal ophthalmia, and a solution in the proportion of four grains to the ounce, has been advised in acute inflammation of the conjunctiva, by Gui- hext.% MODE OF ADMINISTERING. The lactucarium is given internally, either in the form of so- lution or pill, in the dose of from one third of a grain to three grains. Externally, it has been applied in the form of plaster or of ointment. * Ferussac's Bulletin des Sciences Medicales, xxii. Paris, 1830. f Berliner. Medicin. central-zeitungs Nov. 2,1838. t Froriep's Notizen, Bl. xxi. S. 320, and Osann. art. Lactuca, Encyclopad. Worterb. der medicinschen urssenchaiten, xx. 697. Berlin, 1839. MAGNES. 327 Mistura Lactucarii. Mixture of Lactucarium. R. Lactucar. 9j. Mucilag. gum. acac. q. s. ad subactionem. Perfecte unitis adfunde Aq. fontan ?vj. Syrup, rub. idaei, 5ss. M. Dose.—Two spoonfuls every two hours, in spasmodic cough. sleeplessness and hysteria. Hildenbrand. R. Acid, boracic. 3ij. Lactucarii, 9j. Solve in Aq. destillat. 5vj. Syrup, papav. 5ss. M. Dose.—A small spoonful—in cases of " spastic haemoptysis." Rothamel. Collyrium Lactucarii. Eye-Wash of Lactucarium. R. Lactucar. gr. iij. Aq. destillat. 3iij. Mucilag. cydon. gtt. xx. M. Rau. MAGNES. Synonymes.—Magnet. French.—Aimant, Pierre d'Aimant. The natural magnet was employed of old both externally and internally, and in the most diversified forms and affections.* The artificial magnet has been used within the last century only, and always with a view to,its magnetic action. * Art. Aimant, in Diet. Univers. de Matiere Medicale par Me>at and De Lens. 328 MAGNES. It is generally on the diseased part, or around it, that the mag- net is applied, and the application is made for a longer or shorter time according to circumstances—being at times drawn along the nerves of the affected part, at others applied in a more prolonged manner. It is on the nervous system—and chiefly through the influence of the imagination—that the magnet exerts its efficacy. Accord- ingly, the class of diseases in which it has been found most bene- ficial are those termed " nervous and spasmodic."* This is strikingly shown by the published observations of MM. Andry and Thouret,f Commissioners of the Societe Royale de Medecine, appointed to examine into this matter. In cases of spasms, pal- pitations, convulsions, epilepsy, tremors, cramps, neuralgia, rheu- matism, &c. the only agent employed was the magnet, and it was wholly successful. These gentlemen, however, were disposed to infer that the magnet exerts an incontestable magnetic action on the nervous system, to which, in part at least, the curative agency must be ascribed, and their conclusions were thought to be cor- roborated by cases observed by Alibert, Cayol, Chomel, Reca- mier, &c. The celebrated Laennec,J who employed the magnet in the manner recommended by HaHe, that is, by establishing a magnetic current through the diseased parts by means of several magnetised plates, affirms, that he frequently found it moderate the pain in pulmonary neuralgia, diminish the oppression in ner- vous asthma, suspend spasmodic hiccough, and exhibit its utility in simple neuralgia of the heart, and in angina pectoris. In the last disease, the application of a small blister under the an- terior plate appeared to render the effects of the magnet more marked. It is not many years since considerable interest was excited in London by the success, said to have been obtained in the treat- ment of neuralgia, toothach, and other affections of the nerves, by the application of the ordinary magnet or mineral magnet, as it was termed by Dr. Blundell who employed it.§ It would appear, too, that owing to a considerable demand for loadstone, the conductors of the Bulletino delle Scienze Mediche,|| of Bologna, were led to make inquiries concerning the uses to * See the Author's General Therapeutics, p. 58. Philad. 1836. f Mem. de la Societe Royale de Medecine de Pan*, pour 1776, p. 531, and Thouret, Art. Aimant, in Encycloped. Method. Purtie Medicale, i. 421. Paris, 1786. X Traite de l'Auscultation Mediate, 2d edit. torn. ii. I See Lancet for 1833, and American Journal of the Medical Sciences, Nov. 1833, p. 247. || Marzo et Aprile, 1835; and British and Foreign Medical Review, July, 1836, p. 246. MANNITUM. 329 which it was put. From these it appeared, that the Ex-Bey of Algiers, whilst at Leghorn, in 1831, mentioned to a Catholic dig- nitary, Father Campagnoli, who was suffering under gout, that the application of the loadstone was an oriental remedy for the disease, and of certain efficacy. He immediately procured a piece of loadstone, as he had been subject to regular and frequent attacks of gout since 1805, and its application removed the next paroxysm. Since this time, he has always had recourse to the same remedy, and has found, that the attacks come on less fre- quently and severely, and that they invariably yield, so that he has rejected all his former plans of treatment. On the first symp- tom he goes to bed, and places the loadstone in close contact with the pained part; he presently falls asleep, and awakes free from pain, and able to walk. The loadstone he uses weighs five pounds, and has smooth sides. He has recommended this plan to other gouty individuals, who have experienced similar relief. We have witnessed the application of the mineral magnet re- peatedly, in nervous diseases, in persons of highly impressible habits; but except in such,and apart from the effects of the ima- gination, we have seen no beneficial results. MANNITUM. Synonymes. Saccharum Mannse, Mannita, Mannite. German. Mannit, Mannazucker, Mannastoff. This principle, which was first discovered by Proust, belongs to the varieties of sugar that are not susceptible of fermentation, and constitutes the chief ingredient of manna. Its presence is not confined, however, to that substance. It is met with in several other vegetable juices—cucumbers, melons, celery, beets, &c. Yet in these it is first found after fermentation, so that chemists have been disposed to regard it as a product of fermentation.* * Art. Mannite, in Merat & De Lens, Diet, de Mat. Med. 330 MANNITUM. METHOD OF PREPARING. Mannite is commonly procured from manna. Manna in la- chrymis, as it is obtained in commerce, is treated with boiling alcohol, filtered, and suffered to crystallise; by rest and refrige- ration mannite is precipitated in small, beautiful, white needles. The manna in tears consists almost wholly of mannite. Com- mon manna, on the other hand, contains but little thereof, and in its place has a yellow extractive matter to which cathartic pro- perties have been assigned; the coarse manna consists almost wholly of the latter. To obtain the mannite, the manna in tears is consequently selected. Should the administration of mannite, as a remedial agent, be- come more common, it may be worth the trouble to inquire, whether it might not be advantageous to prepare it from the ve- getable juices above mentioned. Mannite, prepared in the above manner, is of a white colour; soluble in five parts of cold water, and in almost every propor- tion in boiling water; it seems to be entirely insoluble in cold abso- lute alcohol; is somewhat more so in boiling alcohol, and still more so in boiling alcohol which contains water. At from 221° to 230° Fahrenheit, it melts into a colourless, adhesive fluid, and crystallises on cooling. When more strongly heated, it burns, and is decomposed like sugar. From its alcoholic solutions it se- parates on cooling, in white, silky, shining, needle-shaped crys- tals, collected in stelliform roundish masses. When mannite is dissolved in an equal weight of boiling wa- ter, and the fluid is evaporated by a strong fire and rapid ebulli- tion, until a small portion placed on a cold glass plate rapidly be- comes solid, it may be poured out into shapes. The taste of the sugar of manna is feeble, but agreeably sweet; it is inodorous, or at least nearly so. According to Liebig, man- nite consists of 40.0228 of carbon, 7.6234 of hydrogen, and 52. 3537 of oxygen. The granatine of the pomegranate root agrees so much with the mannite in its properties, that both have been regarded as the same substance. EFFECTS ON THE ECONOMY. According to Magendie,* mannite may be advantageously sub- * Formulaire, &c. dern. £dit. MANNITUM. 331 stituted for manna; as it possesses the cathartic property without the nauseous flavour. The dose is two drams for children, and, at times, as much as half an ounce; but, in the latter case, Ma- gendie always found the catharsis too active; for this reason he considers the latter to be the best dose for the adult. He recom- mends, that a syrup should be prepared from it, and that this should be prescribed both as a cathartic for children at the breast, and as an addition to other articles in cases of pulmonary catarrh. M. Solon has likewise spoken favourably of the therapeutical advantages of the sugar of manna. He administered it in three cases of gastricism—in two of them combined with castor oil—in which it induced, in a few hours, critical evacuations ; and in a case of peritonitis occasioned by obstinate constipation, its use was followed by the best effects. In the last case, the inflamma- tion completely disappeared, without any other agency, when the constipation yielded. It was found, likewise, of essential service in convalescence from bronchitis and pneumonia. Only in two cases of females—the one labouring under ascites—the other under phlegmasia dolens, did the mannite fail to have any aperi- ent agency. This, it was presumed, was probably owing to both of the patients having been habituated to the use of powerful ca- thartics, and to there not being enough of the preparation to ad- mit of the administration of the appropriate quantity. According to Solon, mannite may be given in the dose of one or two ounces dissolved in from two to four ounces of a hot aro- matic water, the solution to be taken warm, otherwise it forms a stiff, adhesive mass; or it may be added to the ordinary cathartic potions. He assigns it the preference over manna and castor oil; first, because it has an agreeable saccharine taste, and secondly, because it is always equally good, whilst those substances are often deteriorated, and on that account uncertain in their effects. It appeared to him to be peculiarly adapted for cases in which it was desirable to evacuate the intestines with as little excitation as possible. Magendie, in his recent lectures on the blood, classes mannite amongst the substances that promote the coagulation of that fluid.* * Leepns sur le Sang, &c. &c. Translation in Lond. Lancet for Jan. 26 1839, p. 636. 332 MONESIA. MONESIA. This vegetable substance has been imported into Europe, from South America, within the last two or three years; and, in conse- quence of the trials that have been made with it, by the French practitioners more especially ,it has been introduced, within the pre- sent year, (1840,) into this country. It is imported into France in the form of hard, thick cakes, weighing upwards of twenty pounds. These cakes or loaves are much flattened, and have a yellowish coloured paper strongly adhering to them.* They are composed of an extract, prepared in South America, from the bark of a tree, the botanical name of which is yet unknown. It would seem, that a French merchant, who had dwelt for a long time in the interior of South America, and had witnessed the surprising effects in certain diseases, from the employ- ment of an extract, which they made from the bark of a tree of the country, determined to import it into France, and to sub- mit it to the experiments of his medical and pharmaceutical coun- trymen.! A quantity of the drug was accordingly sent to Paris, and placed in the hands of M. Derosne. About a year and a half after this, he obtained some specimens of the bark of the tree, from which he procured an extract presenting all the cha- racters of the extract previously sent to him, and identical in its composition. This bark is said, byM. Derosne, to be called by some travellers Goharem, and, by others, Buranhem; and the natu- ralists, who have examined it there, think that the tree, which fur- nished it, is a Chrysophyllum.J The bark of the Monesia is smooth and grayish like that of the plane tree; but with this difference, that it is much thicker; that its fracture is imbricated, and that its sweet taste contrasts singularly with the bitterness of the thin lamina? that are detached from the plane tree. The extract is pf a deep brown colour. It is very friable, and its fracture presents the same appearance as that of a well torre- fied Cacao Nut. It is wholly soluble in water, and its taste,— which is at first sweet like liquorice,—soon becomes astringent, * Martin Saint-Ange, Gazette Medicale de Paris, Oct. 19, 1839. f Bernard Derosne, Notice sur le Monesia, Paris, 1839; and Sigmond, Lond. Lancet, 1840. X See a Translation of a Communication by M. Saint-Ange, in Lond. Med. Gazette, Dec. 20, 1839, p. 491; in American Journal of Pharmacy, July, 1840, and in Dunglison's American Med. Intel. March, 1840, p. 363. MONESIA. 333 and leaves behind a well-marked and enduring acrid taste, which is felt especially in the tonsils. The chemical analysis of the bark has detected the following soluble principles:—chlorophylle; vegetable wax; a fatty and crystallizable matter; glycyrrhizine; an acrid and slightly bitter matter; a little tannin; an organic acid, not studied; a red co- louring matter, analogous to that of cinchona; phosphates of lime and magnesia; and salts of lime, Math an organic acid.* The extract contains nearly 8 per cent of glycyrrhizine, and 20 per cent of acrid matter; and no difference was found by M. Derosne on analysis between the imported extract and that pre- pared from the bark. An analysis by M. Persoz,f Professor at the Academie des Sciences, of Paris, gave the following as the constituents of the extract:—Tannin, rendering iron blue, 52; gum or mucilage, 10: sweet matter, 36; loss, 2. It has been recently suggested, that the bark of the Monesia is identical with that of the Quillaia Saponaria, of Chili. Neither the bark nor the extract would seem, however, to be identical, al- though in certain respects they resemble each other: moreover, the analysis of the Quillaia was made by MM. Henry fils and Bourtron-Charlard, and if the Monesia and the Quillaia were the same, the identity could not have failed to be detected, by these distinguished chemical analysts.J EFFECTS ON THE ECONOMY IN HEALTH. When Monesia is exhibited internally, in the dose of 15 grains to a scruple of the extract, daily, for eight or ten days, it exerts, at first, a direct action on the digestive passages, and accelerates in a remarkable manner, the action of the stomach. If the dose be pushed to a dram or more in the day, and it be continued for fifteen or twenty days, the appetite increases, but a feeling of heat is experienced in the epigastric region; and tenesmus and obstinate constipation may likewise supervene.§ Its action is manifestly excitant, and slightly astringent, and as such it may be adapted for many pathological conditions in which such agencies are in- dicated. * Bernard Derosne, and O. Henry, in Notice sur le Monesia, par B. De- rosne; and in Tableau Synoptique, &.c, du Monesia, par. M. Saint-Ange. See also, Saint-Ange, in Op. cit. f Forget, Bulletin General de Therapeutique, Avril, 1839. X See, on this subject, Drs. Chaloner and Ruschenberger, in Dunglison's Amer. Med. Intel. Sept. 15, 1840, p. 184-187. Merat and De Lens, art. Quil- laja; and the analysisof the Quillah, by Bourtron Charlard, and Henry fils, in Journal de Pharmacie, xiv. p. 247; and in Amer. Journ. Pharmacy, for Oct. 1840, p. 210, with remarks by Dr. Carson, the editor. { Martin Saint-Ange, Op. cit. 29 334 MONESIA. EFFECTS ON THE ECONOMY IN DISEASE. Possessed of the properties described above, monesia has been used in the various profluvia, and especially in such as are of an atonic character. In chronic bronchitis, and bronchorrhea, it has been success- fully employed by Alquie, Dagnac, Manec and others, sometimes alone, at others associated with opium ; and, in the majority of cases, benefit has appeared to accrue from its use. The same has been the result in hemoptysis, according to Alquie. On phthisis, it of course exerted no direct efficacy; but its administration ap- pears to have been followed by increased tone of stomach; and facility of expectoration. The first of these results has led to its use in languor of the digestive functions; and it has been given as atonic to females, who have been exhausted either by antecedent maladies, or by uterine hemorrhage. In one case,* where the de- bility was so great that syncope was induced on the least move- ment of the body, the extract was given in pills in the dose of six- teen grains in the course of the day, with the best effect. In chronic enteritis, it has been prescribed by Alquie, Baron, Manec, Monod and others, and, in many cases with decided ad- vantage. Its success is said to have been most marked in diarrhea, especially when owing to improper diet; and even in the colliqua- tive diarrhea of phthisis it has acted beneficially. B. Derosne affirms, that surprising results have followed its administration in the diarrhcea of phthisis with intestinal ulceration, after all astringents had been employed to no purpose. Notwithstanding the disadvantageous circumstances in these cases, the monesia is said to have constantly mastered the diarrhcea. Dr. Joseph S. Nancrede/j* gave it successfully in a case of diarrhcea of long standing, and Dr. BurnsJ in two cases of chronic diarrhcea suc- ceeding to cholera infantum. In leucorrhea, the efficacy of monesia, as of every other astringent, is less marked than in diarrhcea. Where the internal treatment is alone employed, the astringent has to pass into the mass of blood, and in this manner to act upon the parts concern- ed, whilst in every form of chronic enteritis, it can come into im- mediate contact with the seat of the disease. Injections of mo- nesia have accordingly been more advantageous in leucorrhcea. M. Baron, after having employed all the ordinary means in a case of inflammation of the vagina, had recourse to the mbnesia, which arrested the discharge. M. Payen gives a case in which * Bernard Derosne, Notice sur le Monesia, p. 7. t Philadelphia Medical Examiner, April 4,1840, p. 215. J Ibid. Aug. 15,1840, p. 517. MONESIA. 335 the monesia, taken internally, augmented the discharge, but when it was employed in the form of injection, the discharge yielded and did not recur. In all the cases of metrorrhagia or uterine hemorrhage, in which monesia has been given, it is said to have succeeded in moderating or suppressing the hemorrhage more perfectly than other agents. It has been given with excellent effects in these cases by MM. Daynac, Payen, Alquie, and Martin Saint-Ange. In an obstinate case of menorrhagia, of seven weeks duration, after the usual agents had been employed in vain, Dr. Chaloner* administered the extract in the dose of 3 grains in the form of pill, every hour and a half, until an effect on the discharge was manifest. After three pills had been taken, benefit was experienced, when the patient was directed to take three more, one every two hours. The cure was complete. It is proper to add, that perfect rest, and cold drinks were used at the same time; and the same may be said of a successful case reported by Dr. Burns.f In blennorrhea, it has exerted but little action, when administered by the stomach; but, when injected into the urethra, it effected a cure in half the cases, and diminished the amount of the discharge in the other half.J In a case of well marked scorbutus, with petechias of the inferior extremities, soft and bleeding gums, and frequent epistaxis, which had required plugging of the nasal fos- sae, M. Laurand obtained a complete cure by giving, daily, from 24 to 40 grains of the extract in the form of pill, washing the mouth, at the same time, with a collutory formed of a dram of the tincture to four ounces of honey and water, and inhaling, by the nostrils, acidulated water, containing an ounce of the tincture to a pint of water. In two cases of scrophula, the tincture was used internally by M. Dagnac, and with excellent effects. In ulcers of a bad character, the monesia has been applied ex- ternally with advantage; sometimes, in the form of ointment; at others, of the powdered extract. In venereal and scrophulous ulcers, excellent effects were obtained from it by MM. Baron and Martin Saint-Ange. M. Manec used it with benefit in an obsti- nate serpiginous ulcer of long duration. M. Monod cured a phagedenic ulcer by it, which had resisted the use of the nitrate of mercury and the arsenical paste. M. Payen was equally suc- cessful with an ulcer on the lower jaw, which, for ten months, had resisted all treatment, internal as well as external. He employed it likewise with much success in ulcerated chilblain; in two * Philad. Med. Examiner, July 11, 1840, p. 441. f Ibid. Aug. 15, p. 517. | Martin Saint-Ange, op. cit. 336 MONESIA. cases of stomatitis,* one of a gangrenous character; and in cases of fissure of the anus, the result of inflammation from hemor- rhoids. Two cases of purulent ophthalmia were cured by M. Saint- Ange; and M. Laurand was equally fortunate in a case of gan- grenous sloughs on the region of the sacrum. M. Buchey, Surgeon Dentist, has employed the extract of mo- nesia in cases of caries of the teeth, the progress of which it ap- peared to him to retard, and when united with opium, it seemed to assuage the pain more than when the latter was given singly. He recommends the use of the tincture to maintain a good state of the gums.f Such are the chief diseases in which the monesia has been used. Its employment can readily be extended to others, by bearing in mind the nature of its powers. It would appear, that experiments have been made in Dublin, and that much benefit had been derived from it as an astringent.J MODE OF ADMINISTERING. Monesia is generally given in pills of the Extract, in the dose of twelve to forty grains a day;—the medium dose, in the twenty- four hours, being fifteen to twenty grains, taken at twice or thrice. M. Martin Saint-Ange has given it to the extent of forty-five grains a day. The Syrup, which contains six grains of extract to the ounce, is given less frequently. It is esteemed to be less active than the pure extract, and is preferred only in the case of infants. The Hydro-alcoholic Tincture, which contains thirty-two grains of extract to the ounce, has been most commonly given in injec- tions, in the proportion of a dram, to a dram and a half, to six ounces of water. The Tincture has also been prescribed inter- nally in the dose of one or two drams a day in a bitter infusion. For external use, an Ointment, containing one eighth part of its weight of the extract, has been applied to ulcers; at-others, the powdered extract, and at others, again, the acrid matter itself referred to in the analysis. * See, also, J. G. Nancrede, Op. cit. f Bernard Derosne-, Notice sur le Monesia, (fee. &c. X Sigmond, Op. cit. See, also, Forget, Bulletin General deTherapeutique, Avril, 1839. MORPHINA. 337 MORPHINA. Synonymes.—Morphinum, Morphium, Morpheum, Morphia, Morphine, Pa- paverine.* German.—Morphin. The discovery of this principle is ascribed to Seguin and Ser- tiirner, who were engaged in the chemical analysis of opium up- wards of thirty years ago; but although the former may have first detected it, the latter deserves the credit of having improved our acquaintance with it, and of having attracted to it the atten- tion of chemists and physicians. METHOD OF PREPARING. The following is M. Robiquet's method :f—he boils a very con- centrated solution of opium with a small quantity of magnesia— ten grains of the latter to a pound of opium—for a quarter of an hour. By this means, a tolerably copious, grayish precipitate is formed, which is collected on the filter, and washed with cold water. The well dried precipitate is then digested with weak alcohol for some time, at a temperature short of ebullition; by which means a very small quantity of morphine, and a consider- able quantity of colouring matter, are separated. The liquid is then filtered, and the residue washed with a little cold alcohol. It is then boiled for some time in pure alcohol, and filtered again whilst the liquid still boils. On cooling, the morphine is obtained, which, by repeated crystallisation, may be freed from the attached colouring matter. The process of Hottot is greatly followed in France. It is a modification of that used by Serturner, and similar to that adopted in the Pharmacopoeia of the United States, and in the new London Pharmacopceia. In this, opium is exhausted by tepid water, and the clear liquid is evaporated to a density of 2° of Beaume. Whilst the liquid is still tepid, a small quantity of ammonia is added, in order to render it neutral or even slightly ammoniacal. In this manner, a brown, resinoid precipitate is thrown down, which contains only traces of morphine and narcotine. The liquor is filtered, and by the addi- f Jahn's Handworterbuch der Chemie, B. iii. S. 150. Annalesde Chimie et de Physiq. v. 276. 29* 338 MORPHINA. tion of a fresh quantity of ammonia to it when cold, crystalline morphine is thrown down, which, when collected, dissolved in alcohol, and evaporated, is set aside to crystallise.* Dr. F. Bache regards the process of the U. S. Pharmacopceia as an improvement upon the last, and as being essentially the same with that of Dr. Edward Staples, which was published in the Journal of the Philadelphia College of Pharmacy.f Mr. Brande considers the process proposed by Robertson and Gregory to be the simplest and the best.J Chloride of calcium is added to a strong aqueous solution of opium to precipitate the acids by which the alkaloids are held in solution; it is then filtered and evaporated to the consistency of syrup, and set aside to cry- stallise, the crystals are strongly pressed to squeeze out the mo- ther liquor, which contains narcotine and other impurities. The pressed crystals are then purified by solution, crystallisation, and the action of animal charcoal, till they are obtained colourless; they consist of the hydrochlorates of morphine and codeine; they are dissolved in hot water, and ammonia is added, which throws down morphine, and which, being separated upon a filter, may be redissolved in boiling alcohol, and obtained in crystals. The liquor, from which the morphine has been precipitated, contains codeine, together with hydrochlorate of ammonia, and some mor- phine; it must be evaporated until it crystallises, and the crystal- lised mass must be dissolved in a small quantity of water, and be decomposed by excess of a solution of caustic potassa; codeine is thrown down, and, when redissolved in ether, may be obtained in crystals. See Codeine, p. 150. Tilloy, Petit, and others, have obtained morphine on the large scale from the domestic opium.§ Morphine is composed of oxygen, hydrogen, carbon, and azote. The crystals are corhpletely white, translucent, almost transpa- rent, and slightly opaline; they are wholly inodorous. In the form of powder, morphine is of loose texture, and as fine as mag- nesia. It melts at a trifling degree of heat, and very much re- sembles, in this state, melted sulphur; but it crystallises again on cooling. It is sparingly soluble in hot water; and in cold water scarcely at all so. Boiling water, according to Choulant, dis- solves one eighty-second part; according to Jahn, only one four hundredth; and according to Bally,|| it is even less soluble than * Journal de Pharmacie, x. 479. f Vol. i. p. 15: see Dispensary of the United States, by Drs. Wood & Bache, 4th edit. Phil. 1839. For Faure's process, see Journal of the Philadel- phia College of Pharmacy, ii. 71. Philad. 1831. X Dictionary of Materia Medica, p. 383. Lond. 1839. I Art. Morphine, in M^rat pressible persons, occasions a sense of internal heat, especially in the epigastric region, and not unfrequently it causes perspiration, especially on the upper lip. Blom is, however, doubtful, whether these effects are ascribable to the piperine, or to a portion of the resin of the pepper remaining united with it. He is of opinion, that both in general debility, and in debility of the digestive appa- ratus, piperine merits a preference over the sulphate of quinine, both because it can be better borne by the stomach, and because it acts more tonically upon it. In inflammatory intermittents, as well as in those with gastric complications, the piperine is to be avoided. Magendie suggests that it should be given in blennorrhea, in place of the cubebs. METHOD OF ADMINISTERING. Pilule Piperina* Pills of Piperine. R. Piperin. gr. xij. Extract, gentian, q. s. ut fiant pilulae xij. Dose.—-One every hour during the apyrexia of fever. PLATINUM. Synonyme.—Platina. The Preparations of Platinum are not given here, as they are not used. According to Magendie, they possess analogous pro- perties to those of the salts of gold. See Auri Praparata. 380 PLUMBI IODIDUM. PLUMBI IODIDUM. Synonymes.—Plumbi loduretum seu Iodetum, P. Hydriodas, P. Iodhydras, Plumbum lodatum, P. Hydroiodicum, Iodide or loduret of Lead. French.—Iodure de Plomb. German.—Bleiiodid, Iodblei, Bleiiodiire, Einfach Iodblei, Hydriodsaures oder jodwasserstoffsaures Blei. MODE OF PREPARING. This preparation may be made by adding a solution of one hundred parts of iodide of potassium to a solusion of seventy-five parts of the acetate of lead. The London Pharmacopceia of 1836, gives the following form:— Take of acetate of lead, nine ounces; iodide of potassium, seven ounces; distilled water, a gallon (imperial measure:) dissolve the acetate of lead in six pints of the water, and filter; and to these add the iodide of potassium, previously dissolved in two pints of the water: wash the precipitate and dry it. The iodide of lead is in the form of a bright yellow colour, and according to Soubeiran,* is soluble in 1235 parts of cold water; and is somewhat more soluble in boiling water, which, on cool- ing, deposites the iodide in minute, shining, yellow, crystalline scales. Rieckef says it is soluble in 1200 parts of cold water, and in 200 of hot. When heated, it melts, and is dissipated in vapours, which are at first yellow, and afterwards violet. EFFECTS ON THE ECONOMY. The iodide of lead is not an irritant, when applied even to a denuded surface.J M. Paton§ administered twelve grains of it to a cat of moderate size. In four hours the animal did not ap- pear to experience any inconvenience; twelve more grains were then given; in twelve hours the animal became uneasy, and con- stantly refused every kind of food. It appeared to suffer in the * TraitS de Pharmacie; and Dr. Wood, in Dispensatory of the United States of America, by Drs. Wood and Bache, 4th edit. p. 998. Philad. 1839. f Die neuern Arzneimittel, u. s. w. 2te Auflage, S. 563. Stuttgart, 1840. \ Eager, in Dublin Journal for 1834. \ British Annals of Medicine, Mar. 3,1837; and Journal de Chimie Medi- cal, Jan. 1837. PLUMBI IODIDUM. 381 kidneys; subsequently, it was attacked with violent colic, which caused it to jump to great heights. Three days after taking the iodide, it died, suffering dreadfully. The dissection was made twelve hours afterwards, when no traces of irritation were percep- tible. M. Paton examined the exterior of the stomach chemically, but was unable to detect any of the iodide, nor could any portion of it be discovered in the fasces. He then boiled the intestines and their contained matters in distilled water; the liquid was filtered and decolourised by charcoal, but no effect was induced by the tests for lead. The matter remaining on the filter was digested in dilute nitric acid: the solution was filtered, and a precipitate obtained on pouring in a solution of chromate of potassa. The liquid was evaporated; the residue calcined along with what was left by the evaporation of the water, and the whole brought in contact with dilute nitric acid. Nitrous gas was disengaged, and the solution responded to reagents like the solutions of the salts of lead. M. Paton infers, that the iodide of lead introduced into the stomach is partly absorbed, and that it is this portion which causes death,—the remainder passing into the intestines, and ad- mitting of detection by the method described. When given internally, in the dose of a quarter or half a grain, Velpeau thought that it occasioned, in one instance, irritation in the alimentary canal; but Dr. O'Shaughnessy thinks that this re- sult must have been owing to idiosyncrasy, as ten grain doses can be borne with perfect impunity. The experiments of Dr. Cogswell* show, that it is by no means an active agent. Owing to its not exciting cutaneous irritation—like iodine, and the iodide of potassium—the iodide of lead has been applied ex- ternally. Velpeauf treated three cases of enlarged glands with very gratifying success, although the patients had used frictions with other preparations of iodine ineffectually. Similar o-00d ef- fects were observed by Guersent, Roots, and others. Pilula Plumbi Iodidi. Pills of Iodide of Lead. R. Plumbi iodid. gr. iv. Confect. rosae, 9j. M. et divide in pilulas xij. Dose.—One night and morning, in scrofulous affections of the glands, joints, &c. The dose may be gradually increased to three or four pills, or more. j0Y+ * Essay on Iodine, p. 142. Edinb. 1837. f Lugol, Essays on Iodine, &c, by O'Shaughnessy, p. 206. X Tweedie's Library of Medicine, v. 320. Lond. 1840. 33 382 PLUMBI TANNAS. Unguentum Plumbi Iodidi. (Pharm. Lond.) Ointment of Iodide of Lead. R. Plumbi iodid. 3j. Adipis, 3viij. M. Applied to scrofulous and other indolent swellings in the way of friction. PLUMBI TANNAS. SyNoKymes.—Tannate of Lead. French.—Tannate de Plomb. German.—GerbstofFblei. Autenrieth* has strongly recommended the tannate of lead in cases of paratrimma ad decubitum, that is, of sores produced by lying, and its advantages have been confirmed by others. METHOD OF PREPARING. The tannate is formed by precipitating an infusion of oak bark by acetate of lead, according to the following formula. R. Cortic. querc. gross, pulv. gj. Coque cum Aquae commun. Iviij. Ad colatursegiv. Admisce acetum plumbicum quamdiu prseci- patum inde oritur. Liquor filtretur per chartam bibulam. Praecipitatum in charta reraanens ad consistentiam unguenti tenuioris exsicca.1 The ointment is used, spread upon lint, three times a day. More recently, Dr. Tott has recommended the ointment in » British Annals of Medicine, June 2', 1837; and Journ. de Chimie Medi- cale, Mars, 1837. ....... + " Take of oak bark, in coarse powder, an ounce ; boil in eight ounces ol water until, when strained, four ounces remain: add acetate of lead as long as any precipitate falls: filter the liquor through bibulous paper, and dry the precipitate remaining on the paper to the consistence of a thin ointment." POTASSA CHLORAS. 383 cases of decubitus gangrenosus, or sloughing sores produced by lying.* In one case, in which it appeared to be inefficacious, he took two drams of the dried precipitate, mixed it with an ounce of unguentum rosatum, and applied this unguentum plumbico-tan- nicum with success. POTASSAE CHLORAS. Synonymes.—Kali Chloricum, K. Chlorinicum, Chloras Kalicus Depuratus, Chloras Potassicus, Alcali Vegetabile Salito-dephlogisticatum, Chloruretum Potassae Oxidatum, Haloidum Oxygenatum, Murias Potassae Hyperoxygena- tum seu Oxygenatum, Oxygeno-chloruretum Potassii, Kali oxymuriaticum, , Kali muriaticum Hyperoxygenatum, Potassae Euchloras, Chlorate of Potassa, Chlorate of Protoxide of Potassium, Oxymuriate of Potassa, Hyperoxymuri- ate of Potassa. French—Chlorate de Potasse. German.—Chlorsaures Kali. METHOD OF PREPARING. In the chemical manufactories, the chlorate of potassa is pre- pared by passing chlorine gas into a solution of carbonate of po- tassa. In this way, chlorate of potassa is obtained mixed with more or less muriate of potassa. The salt prepared in the labo- raties, before it is adapted to medical use, should be purified by recrystallisation. It is to be observed, that when the adequate quantity of chlorine gas is not employed in the preparation, the re- sulting compound is analogous to the chlorides of soda and lime, and in action it agrees rather with those preparations than with the true chlorate of potassa. This may tend to explain the dis- crepancy in the experience of different physicians. The chlorate of potassa crystallises in white leaves, having the splendour of mother of pearl, or in four or six-sided tables, having a specific gravity of 1.989. It is permanent in the air, and has a cool, saline, disagreeable taste, similar to that of saltpetre. Six parts are soluble, at the ordinary temperature, in 100 parts of wa- ter. When exposed to heat, oxygen escapes, and chloride of so- dium remains. When beaten forcibly in a mortar, it crackles, emits light, and sparks. When rubbed lightly with inflammable * Grafe und Walther's Journal der Chirurgie, B. xxiv. S. 676, Berlin, 1836; and Gazette Medicale, Jan. 1837. 384 POTASS^ CHLORAS. substances, or when struck, it inflames readily, and hence its well known employment in the formation of matcbes. EFFECTS ON THE ECONOMY. These have not been completely tested, in the opinion of some at least.* L. W. Sachs, who has frequently administered it, is of opinion, that in the chlorate of potassa tbe direct effect of the alkali is rendered milder by the chloric acid, whilst the alkali modifies that of the acid; in this manner, the caustic property of the alkali is destroyed; whilst the liquifying or resolvent (fluidisi- rende) property is moderated, but not removed. On the other hand, by the union of the chloric acid with the alkali, the power- ful excitant action on the nerves, which the former exerts, is at the same time markedly moderated, although certainly not destroyed; the mode in which it is exerted, he thinks, is probably changed. By such a union, a medicine has been supposed to be formed, which acts chiefly on the nervous system, and which is capable of mitigating and probably of removing any morbid erethism therein, with the hypercesthesia thereby induced. Such is the opinion of certain therapeutists. Others imagine, that it is capable of purifying the mass of blood in consequence of the chlorine which it contains; but a salt of chloric acid is not possessed of the same properties as chlorine; and, accordingly, when we have found occasion to administer it, we have never wit- nessed any of the effects ascribed to it; nor have we seen any evi- dence of the modus operandi on the nervous system mentioned above, or of its imparting oxygen to the blood as supposed by some.f From its excitant properties, and under the notion that it may act upon the blood, and through the blood on the functions of nu- trition as an excellent alterative, the chlorate of potassa has been recommended in chronic cutaneous diseases in general, as well as in hepatic and syphilitic affections. It has also been occasionally administered in cases of chronic asthenia. KdhlerJ employed it in several casesof tubercular phthisis, and although the general results of his experiments were unfavour- able, he thinks it ought to be admitted into the number of those remedies that are useful in phthisis, although its stimulating ac- * Riecke, Die neuern Arzneimittel, S. 300, and 2te Auflage, S. 451. Stutt- gart, 1840. f See Stevens on the Blood, p. 296. London, 1832; and Pereira, Elements of the Mat. Med. Pt. 1, 298. Lond. 1839. J; Rust's Magazin, B. xlvi. POTASS^ CHLORAS. 385 tion on the circulating and pulmonary systems cannot be denied. Its use is contra-indicated where the fever runs high, and where there is any sign of inflammation of the lungs, or tendency to hae- moptysis. Sachs, in accordance with the views before mentioned, in re- gard to its antineuropathic properties, has advised it in cases of prosopalgia. He affirms, that in a great many instances, it af- forded essential relief. Chisholm appears to have been one of the earliest to prescribe it in neuralgia faciei; and, after him, Her- ber, and subsequently, B. Schaffer, Jos. Frank, Meyer, and others, employed it both as a curative and palliative agent in that disease. Recently, it has been advised in obstinate rheumatism of the nervous kind, by Knod von Helmenstreit; and Eyr has extolled it in ulceration of the mouth after violent salivation. Sachs administered it in the dose of from three to six grains,. three or four times a day* but some give it in a much larger quan- tity. It may be administered either in the form of powder or of solution. Solutio Potasse Chloratis. Solution of Chlorate of Potassa. Synonymes*—Solutio Muriatis Potassae Oxygenati, Liquor ad Ulcera Atonica. R. Potassae chlorat. 3j. Aqua? destillat. 5xij. M. To be applied to indolent ulcers, by means of lint dipped in itr or of a camel's hair pencil, to excite the tissues. SwEDIAUR.* Potus Potasse Chloratis. Drink of Chlorate of Potassa. Synonymes.—Potus Oxygenatus. {French.—Tisane Oxygenee.> R. Solut. potass, chlorat. ftjij. Aquae, ffeiv. M. Given internally, in cases of general asthenia. Dose.—One or two pints a day. Sweduur. * Pharm. Med. Pract., Bruxelles, 1817, 2d edit. 33* 386 POTASSII BROMIDUM. Mistura Potasse Chloratis. Mixture of Chlorate of Potassa. R. Potassae chlorat. 3iss. Aquae destill. simpl. §iv. Solve. Dose.—A spoonful e\jery two hours. Helmenstreit. Eyr dissolves twenty-five grains of the chlorate of potassa in four ounces of distilled water, and administers a spoonful three imes a day. R. Potass, chlorat. 3j. Aquae destillat. ^iv. Syrup althaea?, 5j. M. Dose.—A table-spoonful four times a day. Koehlek. POTASSII BROMIDUM. Synonymes—Kalium Bromatum, Bromuretum Potassicum, B. Kalii,B. Potassii, Bromide of Potassium. In Solution, Hydrobromate of Potassa, Potassas Hy- drobromas, Kali Hydrobromicum, Bromhydras Potassae. French.—Bromure de Potasse. German.—Bromkalium, Kaliumbromid, Kaliumbromure, BromwasserstofFsau- res oder Hydrobromsaures Kali. METHOD OF PREPARING. According to Liebig, this preparation can be readily made by dissolving bromine in spirit of wine, and adding caustic alkali until the spirit begins to change colour, then evaporating and heating to redness. In the London Pharmacopceia, the bromide is directed to be made by adding first an ounce of iron filings, and afterwards two ounces of bromine to a pint and a half of distilled water. The mixture is set aside for half an hour, and frequently stirred with a spatula: a gentle heat is then applied, and when a greenish colour is produced, two ounces and a dram of carbonate of potassa, dissolved in a pint and a half of water, are poured in: what remains is filtered and washed with two pints of boiling dis- tilled water, and again filtered. The mixed solutions are then evaporated, that crystals may form. POTASSII BROMIDUM. 387 Liebig says it crystallises in four-sided shining tables; accord- ing to Balard,* commonly in tubes, and at times in long rectan- gular parallelopipedons. It has a pungent taste. By heat it cre- pitates, and melts into a red hot flux, without experiencing change. It is more soluble in hot than in cold water; producing, during its solution, evident cold, and becoming converted into hydrobromate of potassa. It is also soluble in alcohol^ilthough in small quan- tity. The solution of hydrobromate of potassa dissolves no more bromine than pure water. EFFECTS ON THE ECONOMY. The bromide of potassium excites the same phenomena as bro- mine, but with less intensity. From one dram and a half to 3ij is needed to kill a dog. The animal appears to suffer; is restless, and gradually falls into a state of prostration. In smaller doses, it appears to act powerfully on the human stomach. The bromide, like bromine, seems first to have been applied to therapeutical pur- poses by Pourche.f Two cases of scrofulous tumours are reported by him to have been removed by friction with an ointment com- posed thereof, and a cataplasm sprinkled with an aqueous solution of it. In a third patient, chronic otorrhea and scrofulous tumefac- tion of the testicle yielded to the same agency, combined with the internal use of bromine. A very large goitre was reduced two thirds by it. Pourche prescribed the bromide internally in the form of pill, in the dose of four to eight grains in the day. MagendieJ employed the preparations of bromine in scrofula, in amenorrhea, and in hypertrophy of the ventricles of the heart. Prieger recommended an ointment of the " Kali bromicum" in inveterate porrigo favosa as well as in obstinate and malignant tet- ter, and with good success; and Dr. Williams§ in cases of en- larged spleen. The last gentleman suggests, that it possesses " un- usual, if not specific powers in the cure of diseases of the spleen!" It was owing to these results that the bromide was introduced into the London Pharmacopceia, of 1836.|| Dr. Williams also gave it with success in a case of ascites. * Annales de Chimie, torn, xxxii. t Journ. de Chimin Medicale, iv. 594; see, also, Bulletin General de The- rapeutique, No. 14, Juillet, 30, 1837. X Formulaire, Ed. cit. 5 Elements of Medicine, i. 338. || Pereira, Elements of Materia Medica, Pt. i. p. 287. Lond. 1839; and Brande's Diet, of Mat. Med. p. 126. 1839. 388 POTASSII BROMIDUM. MODE OF ADMINISTERING. Solutio Potassii Bromidi. Solution of Bromide of Potassium. R. Potassii bromidi, gr. xviij. Aquee lactuca? destillat. ^iij. Syrup, althaea?, §j. M. To be given in the course of the twenty-four hours; in table- spoonfuls. Magendie. Unguentum Potassii Bromidi. Ointment of Bromide of Potassium. R. Adipis, I). Kalii bromat. gr. xxxvj. M. Half a dram to a dram to be rubbed on scrofulous swellings. Magendie. M. Pourche employs 3j of the bromide to the ounce of lard. R. Axung. Ij. Potassii bromid. gr. xxiv. Bromini liquid, gr. vi ad xij. M. Magendie. POTASSII CYANIDUM. Synonymes.—Potassii Cyanuretum, Cyanide or Cyanuret of Potassium. French.—Cyanure de Potassium. German.—Cyankalium. This preparation was proposed by MM. Robiquet and Viller- me,* as a substitute for the hydrocyanic acid. It is, in their opinion, far more certain in its effects than that preparation. * Bulletin de la Societe Medicale d'Emulation, Juillet, 1823. See, also, Dr. James Hamilton and Mr. Thos. G. Mackenzie, in the Maryland Medical and Surgical Journal, Apl. 1840. p. 201. POTASSII CYANIDUM. 389 METHOD OF PREPARING. The cyanide of potassium is formed whenever potassa is cal- cined with an animal matter, as in the preparation of the Prussian blue. It is commonly prepared, after the process of Robiquet, by exposing to long continued heat the ferruginous prussiate of po- tassa. The cyanide of iron is completely decomposed, and that of the potassium remains. The residuum, after this strong cal- cination, constitutes a solid, blackish mass, which consists whol- ly of the cyanide of potassium, soiled by the iron and the char- coal belonging to the cyanide of iron. The mass is dissolved in water, when the iron and charcoal are deposited; whilst the cy- anide of potassium dissolves, and is transformed into hydrocyan- ate of potassa. When the process has been well conducted, the solution is per- fectly colourless, and retains no portion of iron. M. Chevallier* considers this process to be impracticable, as the cyanide decom- poses water on coming in contact with it. The result, therefore, must be hydrocyanate of potassa; and, on heating this, all the hydrocyanic acid escapes, and the residue is merely potassa. He prepares the salt by calcining the ferro-hydrocyanate of potassa, and then separating the cyanide from the quadricarburet of iron by pure alcohol: on distilling this, the cyanide is obtained very pure. Dr. Hamilton and Mr. Mackenzie, of Baltimoref recommend the following process as most convenient and simple. Expose,— say four ounces of the dried ferrocyanide of potassium in a com- mon Hessian crucible to a red heat, until nitrogen ceases to pass over; (this generally takes from one and a half to two hours;) then, breaking the crucible, powder the black mass quickly, and add—say sixteen fluid ounces of alcohol, stirring the mixture re- peatedly, until it acquires the temperature of about 150° Fahr.; then filter, and evaporate by a sand or water bath regulated so as to be below the boiling point of alcohol; for if heated above this temperature, oil of wine is formed, which is gradually decom- posed during the process, and carbon is deposited, which blackens the mixture. The evaporation should be carried on so as to have as great an extent of surface exposed as possible. The ferro- cyanide will be found to have yielded six or seven drams of the cyanide, which is dry, inodorous and perfectly white. Pure cyanide of potassium is white and transparent; it may be * Journ. de Chimie Medicale, and Journal of Phila. College of Pharmacy, 1832. f Op. cit. p. 203. 390 POTASSII CYANIDUM. fused in the fire without being decomposed, and keeps for an in- definite period, provided it be kept dry. It is very soluble in water, but sparingly so in alcohol. All acids decompose it, even the carbonic: hence the solution, when exposed to the air, emits the smell of hydrocyanic acid; and carbonate of potassa is formed, in the place of the hydrocyanate of potassa. EFFECTS ON THE ECONOMY. MM. Robiquet and Villerme performed some experiments on animals in the presence of Magendie.* A tenth of a grain de- stroyed a male linnet in a minute; less than a grain killed a guinea pig in two or three minutes: a small drop of the hydro- cyanate of potassa, containing only the hundredth part of a grain of the cyanide in solution, caused a linnet to drop down dead in half a minute. Half a dram containing five grains of the cya- nide, killed a dog of large size in a quarter of an hour. Magendie proposes, that the cyanide of potassium should be dissolved in eight times its weight of distilled water, when it be- comes transformed into hydrocyanate of potassa. To this solu- tion, he gives the name medicinal hydrocyanate of potassa, and advises that it should be given under the same circumstances, and in the same doses, as the medicinal hydrocyanic acid, (see page 16 & 25.) He farther suggests, that to render it wholly inde- pendent of the action of the small portion of alkali contained in the cyanide, a few drops of some vegetable acid may be added, or it may be prescribed with an acid syrup. The dose of the cyanide is a quarter of a grain at first, gradually increased to a grain and more. M. Bally gave it to fifty-two in- dividuals labouring under different diseases; it produced no effect on thirty-five; and, on the others, the result was neither constant nor salutary, so that he is not inclined to place more reliance upon the cyanide than upon the hydrocyanic acid. By Dr. Lombard,f of Geneva, it has been applied externally, with success, in some cases of facial neuralgia. He uses it by friction, in the form of watery solution, or of ointment, according to circumstances. The watery solution is in the strength of from one to four grains to the ounce of water; and the ointment is composed of from two to four grains of the cyanide to an ounce of lard. The aqueous solution, however, is considered by Dr. Lombard to be the most prompt in its effects. Dr. Lombard re- gards the cyanide to be contra-indicated, where the nervous af- * Formulaire pour la Preparation &c. de plusieurs Nouveaux Medicament &c. t Gazette des Hopitaux, & Lond. Med. Gaz. Sept. 1831. POTASSII CYANIDUM. 391 fection is complicated with inflammatory action. He has found it, also, a useful remedy in chronic rheumatism. In sciatic neu- ralgia, it was not successful! In white swelling, attended with acute pains, poultices moistened with the solution, gave great re- lief. Dr. Lombard, indeed, affirms, that the soothing properties of the cyanide are superior to those of any remedy known. Lo- tions of hydrocyanic acid are not to be compared with it,—the acid being decomposed with facility, and not devoid of danger. MM. Trousseau and Rullier* also recommend the cyanide, in the proportion of four grains to an ounce of water, as a local ap- plication in various forms of neuralgia. M. Andralf employed the cyanide with complete success in a case of most intense cephalalgia, which, for ten months, had re- sisted the most powerful remedies, as bleeding, a seton in the neck, blisters and sinapisms. It was employed in solution, in the pro- portion of from six to eight grains to the ounce of distilled water; and compresses, wet with the solution, were applied, for eight days, to the forehead and temples. MODE OF ADMINISTERING. Mistura Potassii Cyanidi. Mixture of Cyanide of Potassium or of Hydrocyanate of Potassa. (Pectoral Mixture, of Magendie.) R. Potass, hydrocyan. med. 3j. Aquae destillat Oj. Sacchar.purif. 5iss. M. Dose.—About five drams (a table-spoonful) night and morning. (Pectoral Potion.) R. Potass, hydrocyan. med. gtt. xv. Infus. hederi terrestr. 5ij. Syrup, althaeae, 2j. M. Dose.—Five grammes (a tea-spoonful) every three hours. Magendie. R. Potassi cyanid. gr. 3. Aquae lactucae, 2ij. Syrup, althaeae, 5j. M. * Lond. Med. and Surg. Journ, Dec. 15,1832; and Amer. Journ. of the Med. Sciences, May, 1833, p. 238. f Gazette Medicale, Jan. 1832. 392 POTASSII IODIDUM. Dose.~Five drams (a table-spoonful) every two hours. Magendie. Syrupus Potassii Cyanidi. Syrup of Hydrocyanate of Potassa. R. Potass, hydrocyanat. medic. 3j. sy™pi> Ibj- This syrup may be added to pectoral draughts, and may be sub- stituted for other syrups. Pilule Potassii Cyanidi. Pills of Cyanide of Potassium. R. Potassii cyanid. Amyli, aa. gr. iv. Syrup, q. s. ut fiat massa in pilulas viij divenda. Dose.—A pill, night and morning, in convulsions, dyspnoea, &c. Hospital of La Pitie.* Lotio Potassii Cyanidi. Lotion of Cyanide of Potassium. R. Potass, cyanid. gr. xij. Mist. Amygdal, ^vj. M. To be used in lichen, and other chronic eruptions, attended with much itching. Louis. POTASSII IODIDUM. Synonymes.—Kalium lodatum, Iodidum Kalii, Kali Hydroiodinicum, K. Hydroiodicum, Hydroiodas Kalicus, H. Lixivse, lodhydras Kalicus seu Po- tassa}, Potassii loduretum, Iodide or loduret of Potassium. In solution—Po- tassse Hydriodas, Potassii Proto-hydriodas, Potassii Protoxidi Hydriodas, Hy- driodate of Potassa. French.—Hydriodate de Potasse, Iodure de Potasse. German.—Iodkalium, lodwasserstoffsaures Kali, Kalium Iodure, lodinwas- serstoff Kali, Hydriodsaures Kali, Kali-hydroiodat. method of preparing. According to Tiinnermann, the iodide of potassium is best pre- pared in the following manner: * Ryan's Formulary, 3d edit. p. 392. Lond. 1839. POTASSII IODIDUM. 393 One part of pure iron filings, with four parts of iodine, is put into a glass vessel—by many, into a glass retort—and six or eight parts of water are poured thereon; gentle warmth is then applied, and the mixture is frequently shaken until the liquid ap- pears clear and almost colourless. In this way, hydriodate of protoxide of iron is formed, which is dissolved in the water. It is now filtered; the residuum washed several times on the filter with distilled water, and under the application of a moderate heat, a concentrated solution of potassa is added, by small portions at a time, until a precipitate is no longer thrown down. In this pro- cess, the potassium separates the iodine from the hydriodic acid; the oxygen of the former unites with the hydrogen of the latter; protoxide of iron is precipitated, and carbonic acid given off,—heat being required for its entire disengagement, to prevent the formation of a carbonate of protoxide of iron with excess of acid, which would be soluble in the water. It is then filtered, the residue washed on the filter with distilled water, and the liquid evaporated so as to form crystals. Those chemists or pharmaciens, who are not very accurate in their preparations, evaporate the mother waters to dryness, satis- fying themselves, that although the saline residuum contains car- bonated alkali, it may answer for external use; which is decidedly objectionable. To prevent the loss of the iodide, owing to its admixture with a carbonate of potassa, in the mother waters, Tiinnermann finds it most advantageous to neutralise it with the hydriodic acid, which may be prepared in the following manner: Dissolve about one dram of iodine in not very strong spirit of wine, and pass a stream of sulphuretted hydrogen into the solution, ■until it is wholly deprived of colour. The hydrogen unites with the iodine,—the hydriodic acid, thus formed, remaining dissolved, whilst the sulphur is precipitated. The liquor is then filtered, the sulphur washed with a little water and the spirit and superfluous sulphuretted hydrogen gas are driven off by heating it in a glass vessel placed in a sand bath. The remaining fluid is diluted with water, filtered, and a warm alkaline ley added, until litmus paper is only feebly reddened. By evaporation the iodide of potassium is obtained, which by repeated solution in water, evaporation of the solution, and filtration, is obtained entirely pure.* The process of Turner is, to take any quantity of the solution of caustic potassa, and to add to it gradually, at a gentle heat, iodine sufficient to neutralise the alkali; then evaporating to dryness, calcining strongly, dissolving in water, and crystali- sing.f * Riecke, Die neuern Arzneimittel, S. 305. Stuttgart, 1837. f See Dr. Bache, in Wood and Bache's Dispensatory of the United States, 4th edit. p. 1018, Philad. 1839. 34 394 POTASSII IODIDUM. Dr. William Gregory* suggested an improvement on the pro- cess of Turner, which has been regarded as one of the simplest.f It consists in adding iodine to a hot solution of potassa until the fluid assumes a yellowish brown colour, then evaporating, and fieatino- the residuum to low redness, in a platinum crucible. The mass, which at first consists of iodide of potassium and iodate of potassa, thus loses all its oxygen, and becomes convert- ed into iodide of potassium. The formula of Caillot and Baup is—to take ten parts of iodine and fifty of distilled water; put them into a matrass, and add, in small successive portions, of pure iron filings, five parts, shaking the vessel each time. The liquor is then heated until it loses its colour, filtered, and the substance on the filter washed with boil- ing water, until the liquid is tasteless; the liquor, and the various liquids used in the washings, are united, and the whole is heated in a sand bath. When the temperature approaches that of ebul- lition, enough of a solution of subcarbonate of potassa is added, to precipitate all the oxide of iron; it is then filtered, and the sub- stance on the filter washed until it is completely exhausted. All the liquors are then united, tested by reddened litmus paper, and if there be any excess of base, a little hydriodic acid is added. It is then evaporated in a sand bath, until a slight pellicle forms; the fire is now discontinued, and the salt is suffered to crystallise. Lastly, the crystals are washed with a little water, and dried.J The iodide of potassium crystallises in beautiful cubes. These are readily fused, and are volatilised at a red heat. They do not decompose, even when heated with access of air. They are readily soluble in water, and in alcohol, and the addition of the iodide facilitates greatly the solution of the iodine. It would seem, that a slight contamination of iodide of potas- sium with carbonate of potassa is exceedingly common, as it can with difficulty be avoided in the manufacture of the salt; but Dr. Christison§ affirms, that he has examined specimens, where the carbonate, with its accompanying water, amounted, to 90 parts in the 100. " Can we wonder, then," he asks," that practitioners should complain of the iodide of potassium, that they have given it for months, nay, even for years, without observing any effect either on the constitution, or on the disease for which it was adminis- tered?" • Edinb. Med. and Surg. Journ., xxxvi. 369, for Oct. 1831. f Cogswell, on Iodine, p. 85. t Jourdan's Pharmacopee Universelle, i. 662. Paris, 1828; also the Lond. Pharmacopoeia, and Brande's Dictionary of Materia Medica, p. 317. Lond. 1839. J Edinb. Med. and Surg. Journal, April, 1838. POTASSII IODIDUM. 395 EFFECTS on the economy. As respects the action of the iodide, and its administration in disease, it is scarcely necessary to do more than refer to what has been said under the head of iodine. On the whole, its effects ap- pear to accord with those of iodine; at least, no difference is per- ceptible on the organism. It has been supposed, that it is to be preferred to pure iodine, where the object is to act especially on the urinary organs.* For external use, the iodide of potassium is usually preferred to pure iodine. It is constantly given inter- nally, and often in combination with the latter; the solubility of which, as was before remarked, is aided by it. Many of the fol- lowing formulas contain both one and the other. Dr. Buchanan asserts, that he has given the iodide of potassium in doses of Jss, and the only precaution he observed was to make the patient drink freely of diluents. It was chiefly to determine some physiological questions that he gave it in such large doses. Two drams of it were taken by a young man affected with gonor- rhoea, and as soon as the medicine made its appearance in the urine, blood was drawn from the arm. On examining the blood, both the serum and crassamentum were found deeply impregna- ted with iodine.f On the other hand, Dr. Lawrie, of Glasgow,J considers it very uncertain and at times dangerous, although he esteems it by far the best of the recent remedies, and prescribes it more frequently than any other medicine, and Mr. Mayo§ affirms, that no medicine, where it does good, produces amendment, in constitutional syphilis, so speedily as it. Lugol appears to have used it mainly as a solvent to iodine and considers it inferior to the latter as*a therapeutical agent; but no chemical or other prepossession can set aside the testimony just cited; or that of such observers as Eicord,|| C. J. B. Williams,! Joy and numerous others. In our own hands, it has appeared to afford as much bene- fit as any of the preparations of Iodine. (See the article Iodine, page 395.) A case of salivation from the use of iodide of potassium has been recently published by Sir Francis W. Smith.** * Riecke, Die neuern Arzneimittel, u. s. vv. S. 306. See, also, Cogswell on . Iodine, p. 96. f London Med. Gaz. July 2, 1836. t Lond. Med. Gaz. July 3, 1840, p. 591. \ A Treatise on Syphilis, by Herbert Mayo, F. R. S. Lond. 1840. || Parker, Modern Treatment, of Syphilitic Diseases, Dunglison's Amer. Med'. Lib. Edit. p. 77, Philad. 1840., and Bulletin Generale de Therap. Juillet, IT Lectures on the Physiology and Diseases of the Chest, Bell's Med. Library Edit. p. 246. Philadelphia, 1839. ** Dublin Journal of Medical Science, July, 1840. 396 POTASSII IODIDUM. According to recent experiments of Magendie,* the iodide is one of the substances that promote the coagulation of the blood. METHOD OF ADMINISTERING. Liquor vel Solutio Potassii Iodidi. Solution of Iodide of "Potassium. Synonymes.—Potio resolvens ex Iodio, Solution de Coindet, Coindet's So- lution. R. Potassii iodidi, gr. xxxvj. Aquae destillat. %). Solve. Dose___Same as that of the tincture of Iodine. Coindet and Magendie. R. Potassii iodidi, 3j- Aquae destillat. Ij. Solve. Dose.—Fifteen drops three times a day, gradually increased to forty-five : in cases of ovarian dropsy,—frictions with iodine oint- ment being used at the same time. Elliotson. Liquor vel Solutio Potassii Iodidi Iodureta. Solution of Ioduretted Hydriodate of Potassa. R. Iodin. 9j. Potassii iodid. £)ij. Aq. destillat. 5 vjj .t Solve. Dose.—Six drops early in the morning, and in the middle of the day, in a glass of sugared water. In tetter, scirrhus, &c. Lugol. Lugol has a solution of three strengths for internal use. I. II. III. R. Iodin. gr. ? gr. i. gr. 1|. Potass, iodid. gr. iss. gr. ii. gr. iiss. Aq. desillat. ?vbj- 1VUJ- 3vnJ# Dose.—Two thirds, daily, at first; afterwards, the whole. * Legons sur le Sang; & translation in Lancet, for Jan. 26,1839, p. 636. f Dr. Bache (Dispensatory of the United States, 4th Edit. p. 374,) remarks, that " in the original it is seven ounces, but from the context of the author, this is evidently a misprint for seven drachms." It is proper, however, to observe, that many of the successful cases were treated by the weaker solution. POTASSII IODIDUM. 397 Lugol recommends this threefold solution in the same cases as his threefold solution of iodine; the first being continued from fourteen days to three weeks; the second, from the fourth or fifth week of the treatment to its termination ; the third, the strongest, he did not often use. As Riecke has observed, it would be better to have in the hospitals but one solution, which might be prescribed in varied doses. Liquor Potassii Iodidi Compositus.—(Lond. Pharmacopoeia.) Compound Solution of Iodide of Potassium. R. Iodin. gr. v. Potass, iodid. gr. x. Aquae destillat. ^xx. M. Dose.—f. 3ij to f. 5yj. Tinctura Iodini Composita.—(Lond. Pharmacopoeia.) Compound Tincture of Iodine. R. Iodin. 5j. Potass, iodid. 5ij. Sp. rectif. Oij. M. Dose.—Ten minims. Mistura Potassii Iodidi Iodureta. Mixture of Ioduretted Hydriodate of Potassa. R. Iodin. gr. ss. Potass, iodid. 3ss. Syrup, papav. izss, Aq. destillat. ftjss. Dose.—'Two table-spoonfuls three times a day; in cases of complication of syphilis with scrofula. Tyrrel. R. Iodin. gr. iss. Potassii iodid. gr. iij. Solve in Aquae menth. pip. 5iv. Dose.—A spoonful two or three times a day. To children, a tea-spoonful. In cases of cancrum oris; also, in dropsy, gleet, 34* 398 POTASSII IODIDUM. and leucorrhcea. On renewing the prescription, the dose of the iodine may be increased one half, and of the iodide one grain, each time. Coster and Friedrich. R, Potass, iodid. 3iv. Aquae lactucae destill. ^viij. ----menth. pip. 3\j- Syrup, althaeae, ^j. M. Dose.—A spoonful morning and evening, in a little water, in- creasing the dose to two spoonfuls. In cases of hypertrophy of the ventricles of the heart. Magendie. R. Potass, iodid. 5iv. Aq. lactuc. destill. |viij. ----flor. napth. 3ij- Tinct. digit. 5j. ad 3ij. Syr. althaeae, ^iss. M. Dose.—Morning and evening, a spoonful, in a little water. In hypertrophy of the ventricles of the heart, with quickening of the heart's action. Magendie. R. Lign. quassiae. Rad. gentian, aa. 3J- Aquae fervent. 5xvj. Macera per horam et cola. Liquor, colat. add. Potass, iodid. gr. xxxvj. Potassae carbonat. 3ij- M. Dose.—A table-spoonful three times a day, in a glass of water. CuMMING. Pilule Potassii Iodidi. Pills of Iodide of Potassium. R. Potass, iodid. gr. xv. Aq. destillat. q. s. Pulv. spong. ust. Ext. dulcamar. aa. 31J Pulv. rad. glycyrr. q. s. Fiant pilulae clxxx. ]f)ose.—Six, two or three times a day, in scrofula, goitre, &c. Vogt. POTASSII IODIDUM. - 399 Unguentum Iodini Compositum.—(Pharm. Lond.) Compound Ointment of Iodine.—Ioduretted Ointment. R. Iodin. 3ss. Potass, iodid. 3j. Spirit, rectif. f. 3j. Adipis. Iij. Rub the iodine and iodide with the spirit; and mix with the lard. Unguentum Potassii Iodidi. Ointment of Iodide of Potassium. R. Potass, iodid. 3ss. Adipis, liss. M. Half a dram at first, and subsequently, a whole dram to be rubbed in. In goitre, scrofulous glandular affections, &c. This ointment is generally too weak, unless combined with the internal use of iodine in some form. Magendie. R. Potass, iodid. J)j. Adipis. gss. M. The wounded parts to be smeared with it two or three times a day: in moist tetter—serpigo. Between the applications, to be dressed with dry lint. Tuennermann. In dry tetter, the ointment applied is formed of 3J to 3iss of the iodide to ^j of lard. Unguentum Potassii Iodidi. (Unguentum Kali Hydroiodici. Pharmacop. Borussic.) Ointment of Hydriodic Kali. R. Potass, iodid. 3j. Magnis. carb. gr. vj. Aq. destillat. guttas nonnullas, M. terendo cum, Ung. rosat. 3j. M. Or, R. Potass, iodid. Sodae carbon, depur. sice. aa. gss. Ung. rosat. spv ad gvj. M. A piece of the size of a small bean to be rubbed in, morning and evening. In chronic enlargement of the testis. Walther. POTASSII IODIDUM. R. Potass, iodid. 3ss. Ext. opii. 9ss. Cerat. ^j. M. As a dressing to malignant cancerous ulcers. Unguentum Potassii Iodidi loduretum. Ointment of Ioduretted Iodide of potassium. R. Iodin. gr. xij. Potass, iodid. 9iv. Adipis, §ij. M. In scrofulous ophthalmia, ulcers, &c, Lugol. R. Iodin. gr. xv. Potass, iodid. 3j. Tinct. opii. gij. Adipis, gij. M. In painful scrofulous ulcers, white swellings, &c. Lugol. Emplastrum Potassii Iodidi loduretum. Plaster of Ioduretted Iodide of potassium. R. Iodin. Potass, iodid. aa. 9ss. ad Bj. Emplastr. hydrarg. sen Saponis. ^ij. Applied in syphilitic and gouty swellings of the bones. Ebers. Lotio Potassii Iodidi Iodureta. Lotion of Ioduretted Hydriodate of Potassa. R. Iodin. gr. i. ad ij. Potassii iodid. gr. ij. ad iv. Solve in Aquae destillat. gviij. This solution was commonly used by Lugol externally, to be injected under the eyelids in strumous ophthalmia, fistulae, &c. Lugol. R. Iodin. §ss. Potassii iodidi. ^j. Solve in Aq. destillat. §vj. This " rubefacient solution of iodine," may be used two or three times a week, when the last prescription loses its effect, or when it is desirable to stimulate more actively. It is also added POTASSII IODO-HYDRARGYRAS. 401 to baths—three or four ounces to any ordinary bath—as well as to poultices, being mixed with an ordinary cataplasm. Lugol. R. Iodin. 3j. Potass, iodid. gij. Solve in Aquae destillat. ^ij. This "caustic iodine solution" has to be used when the last loses its efficacy. It occasions a crust on the parts. Lugol employs it chiefly when the skin on the edges of the ulcers is greatly hypertrophied, red, and fungous, as well as in phagedenic or spreading tetters. It may be applied two or three times a week, or daily, should the case require it. Lugol. Collyrium Potassii Iodidi loduretum. Collyrium of Ioduretted Hydriodate of Potassa. R. Iodin. gr. ss. ad i. Potassii iodid. Qss. Solve in Aq. rosar. giij. M. To be applied four times a day, in cases of scrofulous ophthal- mia, with ulceration of the conjuctiva and cornea. Magendie. POTASSII IODO-HYDRARGYRAS. Synonymes.—Kali lodatum Hydrargyratum, Iodo-Hydrargyrate of Potassium. Iodhydrargyrate of loduret of Potassium. Dr. A. Channing,* who has highly extolled this preparation in various diseases, affirms, that this, with other new salts, was dis- covered by Bonsdorf, of the University of Finland, in 1826; and it is a fact well known to the chemist, that iodine, chlorine, &c. enter into combinations so as to form both acids and bases. By experiment, Dr. Channing ascertained, that a solution of eight grains of the pure iodide of potassium in ten or fifteen minims of water, would combine with a fraction less than eleven * American Journal of the Medical Sciences, Feb. 1834, p. 388. 402 POTASSII IODO-HYDRARGYRAS. grains of the deuto-iodide of mercury, maintaining the combina- tion in solution; when diluted with water or alcohol to any ex- tent. If more than eleven grains of the deuto-iodide be added, although a small excess is dissolved in the concentrated solution, on diluting with water, it is promptly precipitated. It would ap- pear, therefore, as Dr. Channing has remarked, that in preparing this salt for administration, the labour of crystallising it, in order to obtain a solution of a definite strength, is wholly unnecessary; inasmuch as a solution, combining a fraction more than eight grains of the iodide of potassium with eleven grains of the iodide of mercury may be used as containing twenty grains of the iodo- hydrargyrate of potassium. If it be desirable to obtain the preparation in a crystallised form, it is important, that the definite proportions of the two iodides be observed, and particularly that there be no excess of the iodide of mercury; for the saturated solution of eight grains of the iodide of potassium will dissolve, and enter into combina- tion with more than thirteen grains of the iodide of mercury. forming similar crystals soluble in alcohol, but in water precipi- tating more than two grains of the iodide of mercury. EFFECTS ON THE ECONOMY. These are similar to those of the iodides of mercury, but, ac- cording to Dr. Channing, in a less degree. The iodo-hydrargy- rate is not, however, much employed, experience seeming to have shown, that it possesses no essential, if, indeed, any advantages over those preparations. It has been recently highly extolled by Dr. Charles C. Hildreth,* of Zanesville, Ohio, in several diseases, in which a combination of iodine and mercury might be expected to be beneficial. In ordi- nary dyspepsia, his faith in its remedial powers is so strong, that he has prescribed but little else for the last four or five years. He speaks highly of it also in enlargement of the spleen, amenorrhea, dysmenorrhea, leucorrhea, dropsy, and glandular enlargements of a scrofulous- character. In these last cases, he combines the inter- nal use with the external, according to the form of ointment given below. Puchef has recommended it as not being so subject to produce salivation, or pains in the bones, as the other combinations of mercury and iodine. * American Journal of the Medical Sciences, Aug. 1840, p. 314. f Journal des Connaissances des Medicales, Oct. et Nov. 1838, and Janvier, 1839, and Annales de Chimie, Oct. 1838. POTASSII IODO-HYDRARGYRAS. 403 METHOD OF ADMINISTERING. Mistura Potassii Iodo-Hydrargyratis. Mixture of lodo-Hydrargyrate of Potassium. R. Hydrarg. deuto-iodid. gr. iv. Potassii iodid. 9j. Aquae destillat. ij. M. Dose.—Five drops three times a day. Channing. Tinctura Potassii Iodo-Hydrargyratis. Tincture of lodo-Hydrargyrate of Potassium. R. Potass, iodo-hydrarg. gr. j. Spiritus vini tenuioris %]. M. Dose.—Ten drops three times a day. Channing. Pilula Iodo-Hydrargyratis Iodureti Potassii. Pills of lod-Hydrargyrate of loduret of Potassium. R. Hydrarg. biniodid. gr. viij. Potassii ioduret. gr. viij. Sacchar. lact. gr. lxiv. Aquae gum. q. s. ut fiant pilulae xxxij. Dose.—One to eight, daily. Puche. Solutio Iodo-Hydrargyratis Iodureti Potassii. Solution of lod-Hydrargyrate of loduret of Potassium. R. Hydrarg. biniodid. gr. viij. Potassii ioduret. gr. viij. Aquae destillat. 5viij. M. Dose.—f. 3ij to f. gij in twenty-four hours. Puche. Unguentum Potassii Iodo-Hydrargyratis. Ointment of lodo-Hydrargyrate of Potassium R. Hydrarg. deuto-iodid. gr. vij. Potass, iodid. 9ij. Adipis----^j. M. 404 QUININA. To be applied to tumours two or three times a day. Should it prove too irritating, the proportion of lard must be increased. Hildreth. QUININA. Synonymes.—Chininum, Chininium, Chinium, Quininum, Quinium, Quinia, Kininum, Quina, Sal Essentiale Corticis Peruviani. French.—Quinine, Kinine. German.—Chinin, Quinin, Chinastoff. Quinine is a most important gift from modern analytical chemistry to medicine. Not many years have elapsed since the discovery of this substance, and yet, by general consent, it is now regarded as one of the most valuable remedies in the catalogues of the materia medica. The honour of the disco- very—which had been facilitated by the investigations of other chemists, as to the composition of the cinchona barks—belongs to Pelletier and Caventou, (1820,*) and so rapidly and extensively was its efficacy promulgated, that in the year 1826, in two labo- ratories in Paris for the preparation of quinine, fifty-nine thou- sand ounces of the sulphate—the form best known, and most fre- quently prescribed—were prepared. For this discovery, the Royal Academy of Sciences of Paris awarded MM. Pelletier and Ca- ventou the Monthyon prize of ten thousand francs. Quinine is obtained from the yellow bark by a similar process to the one described for the separation of the cinchonine.f In the pure state, it is of a white colour, and appears commonly in 'the form of powder; it crystallises, however, in silky, shining, tufted needles. In both cases, it contains from three to four per cent, of water. By a gentle heat, this escapes, and the quinine melts into a transparent fluid, which, on cooling, is translucent, and similar to a resin. When melted in vacuo, it has a crystal- line appearance. In a strong heat, it is decomposed. It has a very bitter taste, and is soluble in two hundred parts of boiling water; a portion being precipitated on cooling. It requires a much larger proportion of cold water to dissolve it. In alcohol, it is far more soluble than in water. It is, likewise, soluble in ether, and somewhat'so in oils. It exhibits an alkaline reaction,— * Annalee de Chimie et de Physique, xv.289 &337. t See page 147. QUININA. 405 restoring the colour of reddened litmus paper, and neutralising the acids. The observations of Piorry and Lavollee* and of Quevenne,f show, that the quinine, as well as its sulphate, passes into the urine of patients who use it in any considerable quantity. effects on the economy. Of the effects of quinine we shall speak at some length, under the head of sulphate of quinine, with which it seems to accord entirely in medicinal agency. Several physicians, who have ex- perimented in regard to the efficacy of pure quinine and its salts, have found the first in no respect inferior to the last. Such was the experience of Niewenhuis and Elliotson, the latter of whom exhibited the quinine in large doses—as much as five grains every four hours. A French physician, Blegnie,J even gives the prefer- ence to the pure quinine—because it possesses, he thinks, equal efficacy, is cheaper, easier taken, and better borne than the sul- phate. He advises, that after each dose an acidulous drink should be taken, to render its solution in the stomach more rapid. Wutzer§ and Harles|| have also recommended the more frequent use of pure quinine. It may be given either in the form of powder or pill, or in al- coholic solution. Tinctura Quinina. Tincture of Quinine. R. Quinin. 9j. Solve in alcohol, iss. Dose.—Twenty to forty drops every two hours. Wutzer. * Gazetto Medicale, 1836, p. 73. t L'Experience, Juillet, 1838. X Riecke, Die neuern Arzneimittel, S. 118. See, also, Bally, in Magendie's Journal de Physiolo Quinicus, Chlorhydras qui- nicus. French.—Muriate de Quinine. German.—Salzsaures Chinin, Hydrochlorsaures Chinin. Perhaps, next to the sulphate of quinine, this salt has most fre- quently been employed in practice. METHOD OF PREPARING. It is obtained by dissolving pure quinine in dilute muriatic acid, or by the decomposition of the sulphate of quinine dissolved in warm water by means of a solution of muriate of baryta, which is added so long as a white precipitate is thrown down; the hot mixture is then filtered; the precipitate washed, and the clear fluid evaporated, by a gentle heat, to crystallisation, so long as crystals shoot on cooling; these are collected, washed in cold water, and purified by repeated crystallisation. It forms fine, needle-shaped, white silky crystals, of a mother of pearl lustre; does not dissolve readily in water, but more so than the sulphate. EFFECTS ON THE ECONOMY. In this respect, the muriate agrees with the sulphate of quinine, and by those of weak digestive' powers is better borne. Spielman* asserts, that it is a more speedy and effectual remedy for inter- mittent fever than the sulphate, and it is more soluble. It is, how- ever, more expensive. The dose is generally considered to be the same as that of the sulphate. It is better given in solution than in powder. Spielman rates the dose at from half a grain to a grain. * Allgemein. medicinisch. Zeitung, and Journal des Connais. Medic. Fevrier, 183G; see, also, Prof. Dierbach, in Heidelb. klinisch. Annal. B. x. H. i. S. 33. Heidelb. 1834. 35* 110 QUININE NITRAS.--QUININE PHOSPHAS. V. QUININtE NITRAS. Synonymes.—Chinium seu Chininum Nitricum, Nitras Chinii, &c. Nitrate of Quinine. French.—Nitrate de Quinine. German.—Saltpetresaures Chinin. METHOD OF PREPARING. This salt is obtained, like the muriate, by the addition of nitric acid to quinine; or by the decomposition of nitrate of baryta by sulphate of quinine. It is, at first, a fluid oil-like mass, which gradually becomes solid. In union with water, it forms crystals. It dissolves with difficulty in water, but readily in alcohol. VI. QUININE PHOSPHAS. Stnontmes.—Chinium seu Chininum Phosphoricum, Phosphas Chinii, Ph. Chinini, Phosphate of Quinine. French.—Phosphate de Quinine. German.—Phosphorsaures Chinin. METHOD OF PREPARING. In the mode of preparation it accords with the preceding forms; dilute phosphoric acid being added to quinine, or phosphate of ba- ryta to the sulphate of quinine.* It appears in the form of needle-shaped prisms, of a mother of pearl lustre, which are, like the muriate of quinine, readily so- luble in water, and spirit of wine. Harles,f however, affirms, that in the neutral condition it dissolves, with difficulty, in water. The phosphate is regarded by some to stand next to the sul- phate in medicinal efficacy. * Winkler, in Buchnpr's Repert. and Phila. Journ. of Pharmacy, new series' vol. 2, p. !2. Phila. 1837. t Heidelb. klinisch. Annal. B. x. H. i. S. 36. Heidelb. 1834; and Journal de Chimie Medicale, 1837. QUININE SULPHAS. 411 VII. QUININE SULPHAS. Synontmes.—Chinium seu Chininum Sulphuricum, Disuiphas Quina?, Sul- phas Chinii, Sulphas Quinicus, Sulphate of Quinine. French.—Sulfate de Quinine. German.—Schwfelsaures Chinin, Chininsulphat. This preparation of quinine is by far the most frequently admi- nistered. It is in fine, silky, flexible needles, and at times, in rect- angular columns. Its taste is extremely bitter and resembles that of yellow bark. Exposed to a moderate heat, it loses its crystalline form, in consequence of the escape of its water of crystallisation. It is only slightly soluble in cold water, requiring 470 parts of water at the ordinary temperature, and 30 parts of boiling water for its solution. In alcohol, it is very soluble, but only slightly so in ether. With sulphuric acid, it forms a supersulphate, which is much more soluble in water than the neutral salt, and hence we usually add a few drops of dilute sulphuric acid to our mixtures of the sulphate of quinine. METHOD OF PREPARING. This salt is generally prepared on a large scale in the chemical laboratories of France; whence we obtain it. A formula has been admitted, however, into the Pharmacopceia of the United States, which is taken from the process of M. Henry, Junr.,* for which he received a prize from the Academie Royale des Sciences, of Paris. It is as fellows—Take of yellow bark, in powder, a pound; lime, in powder, four ounces; sulphuric acid, alcohol, animal charcoal, distilled water, each a sufficient quantity. Boil the bark for half an hour with eight pints of the distilled water, acidulated wTith a fluid ounce of the sulphuric acid. Strain the decoction through linen; then boil the residue with the same quantity of acidulated water, and filter as before. Mix the fil- tered liquors, and gradually add the lime, stirring constantly. Wash the precipitate with distilled water, and having dried it digest in alcohol with a moderate heat. Pour off the tincture, and repeat the digestion several times, till the alcohol is no longer rendered bitter. Mix the tincture, and distil over the alcohol, till a brown viscid liquid remains in the retort. Upon this sub- stance, removed from the retort, pour as much sulphuric acid, largely diluted with water, as may be sufficient for its perfect saturation. Then add the animal charcoal, and having evapo- * Journal de Pharmacie, vii. 296. Juillet, 1821. 412 QUININE SULPHAS. rated the liquor, sufficiently, filter it while hot, and set it aside to crystallise.* It results from the calculations of Pelletier and Caventou, that from a quintal of cinchona, two pounds, one dram and thirty grains of sulphate of quinine may be obtained, which makes two drams, sixty-six grains and a sixth per pound, or thirteen grains and two sixths per ounce; and as the sulphate of quinine is com- posed of nine parts and nine tenths of sulphuric acid, to ninety and a tenth of quinine, it follows that if the dose of cinchona in sub- stance be two drams, we should administer to the patient three grains and nine thirty secondths of a grain of the sulphate of qui- nine ; not taking into account a small quantity of sulphate of cin- chonine, which may be mixed with it. Four grains of the salt are, consequently, more than an equivalent for the dose of the cin- chona often prescribed in substance. Those practitioners, there- fore, who prescribe thirty-six or seventy-two grains of the sul- phate, give the representative of about twenty-seven drams of cinchona in the former case, and of fifty-four in the latter.j The quinine is liable to be adulterated,—for example, by man- nite, which is similar in external appearance, but—as elsewhere shown—destitute of all the properties of the quinine. The adul- teration can be readily detected by means of pure alcohol, which dissolves the quinine alone, but leaves the mannite untouched, which is freely soluble in water, and is known by its characteris- tic sweet taste. It is also adulterated with gypsum, the presence of which may likewise be detected by the alcohol, which does not dissolve it.J EFFECTS ON THE ECONOMY. The effects of the preparations of quinine on the healthy organ- ism, have not been much investigated. According to Caventou, they produce a general excitement, similar to that caused by coffee, and Wittmann affirms, that the sulphate induces an ex- citement similar to that of a paroxysm of fever. Hirschel,§ too, asserts, that in a child, four years of age, to whom the sulphate was given in a case of intermittent, a general chilliness of some minutes' duration supervened immediately on the taking of the re- medy, succeeded, in the course of half an hour, by general heat, and this again by a gentle perspiration, in all respects resembling a mild attack of fever. The excitant action of the salts of quinine formed by the vege- table acids is said to beless striking. * Wood & Bache's Dispensatory, Art. Quinise Sulphas. f Jourdan's Pharmacopee Universelle, ii. 375. Paris, 1828. X Vallet and Dubail, Journal de Pharmacie, Janvier, 1840. \ Hufeland's Journal, B. lxi. St. 6. S. 140. QUININE SULPHAS. 413 The sulphate of quinine, in large doses, appears, in some cases, to possess narcotic properties, yet it cannot be classed amongst poisons, as it has been given to healthy individuals in very large doses, without any unpleasant effects. Bally,* for instance, gave it to the extent of 110 grains in the day without any inconveni- ence. Dr. Thomas Fearn,f who administered it largely, regards it to be more narcotic than sedative,—usually, he thinks, stimulating in small doses, but in large doses the stimulant effects not being ob- vious, but rather the reverse. When Mr. Scott,J a medical gentleman and a martyr to dys- pepsia, took the quinine in very large doses, under the idea that his malady was intermittent neuralgia, he found several singular phenomena induced thereby. He was directed to commence with two grains three times a day, until he arrived at twenty grains for a dose, that is, a dram a day. Until the doses were increased to fourteen or sixteen grains, be did not experience any peculiar ef- fects, but he now began to feel heat of skin, dryness of mouth and fauces, and obstinate constipation. He likewise lost the power of naming substantives; was obliged for a long while to consider what familiar things were called, and was unable to cast up a line of six or eight figures correctly. His perceptions of quantity were likewise impaired, so that in prescriptions he wrote ounces for drams, drams for grains, &c. &c. He still, however, persevered, with the quinine until he took 9j four times a day, but he was un- able to continue these excessive doses long, the untoward symp- toms augmenting, so that he was often unable to stand, and fell several times in the street. Very similar results to those observed by Mr. Scott, and espe- cially as regards the inability of utterance—which, in their cases, was complete—are recorded by M. Menage,§ and Mr. G. O. Heming.|| Two cases of deafness caused by large doses of quinine have been lately detailed by Dr. Joseph Williams, of London,1[ and another by Mr. C. R. Bree,** of Stow-market, England. In impressible individuals, the sulphate and the muriate not un- frequently induce a sense of anxiety, restlessness, vertigo, confu- sion, depravation of vision, tinnitus aurium, and, in many cases, transient deafness, all which symptoms appear to be of a neuro- * Revue Medicale, v. 244. Juillet, 1821. f Transylvania Journal of Medicine, Oct., Nov , and Dec. 1836, p. 798, and Dung-lison's Amer. Med. Intell., June 15, 1837, p. 109. X Lond. Mod. ?md Physical Journal, March, 1833. \ Gazette Medical de Paris, April 25, 1840. || London Lancet, and Med. Examiner, July 18, 1840, p. 468. IT London Lancet, July 25,1840, p. 639. ** Ibid. Aug. 22, 1840, p. 786. 414 QUININE SULPHAS. pathic character, and, it has been affirmed, occur more frequently in females, especially in those who are pregnant or suckling— and in persons of slender and delicate confirmation.* In certain cases, the quinine and its salts seem to have caused ptyalism— the saliva being inodorous, and the teeth firm; and when calomel, has been given along with it, it has been conceived that ptyalism has ensued sooner than it otherwise might have done. The most striking agency of quinine and its salts, is in cases of periodical diseases of all kinds; and especially in intermittent fever: they have now, indeed almost wholly taken the place of the cinchona, over which they possess many points of preference. In the first place, their bulk is much less; they therefore do not op- press the stomach so much, whilst the impression of the cinchona on that organ not unfrequently interferes with its antipyretic pro- perties. In malignant fevers, too, it is often impossible to intro- duce the requisite quantity of cinchona, into the organism, to pre- vent the succeeding paroxysm, and the life of the patient is conse- quently placed in the greatest danger. In this case, the sulphate of quinine is invaluable ; possessing as it does, the febrifuge vir- tues of the cinchona in such a concentrated state, that but a small quantity is required to produce equal efficacy with a large quan- tity of the powdered cinchona. In such cases, indeed, the latter is apt to disagree with, or be rejected by the stomach, before its full influence can be exerted. In these pernicious fevers, that oc- cur especially in Italy and Holland, the sulphate of quinine has supported life in innumerable cases where the cinchona, in sub- stance, might have failed, and has thereby best exhibited its sana- tive agency.f In these cases the quinine is administered without regard to complications, which, in less urgent cases, might be al- lowed to interfere with its administration. Another advantage, ascribed to the quinine, is that in cases of paroxysmal fevers, in which the attacks follow each other so closely, that the second commences before the first has terminated, it may be given during the paroxysm, a time at which the cinchona would be apt to oc- casion oppression of the stomach and vomiting. It has likewise been found advantageous in large doses—twelve to thirty grains daily—in engorgement of the spleen, consequent on intermittent fever; and M. LevyJ has found the dropsical effusions, that not unfrequently supervene on neglected cases of the same disease, yield readily to the sulphate in full doses.§ * Riecke, Die neuern Arzneimittel, S. 120. f Repertorio Medico-Chirurgica por l'anno 1822, Torino. No. 22. Med. Chirurg. Zeitung. B. ii, S. 137, 1823; & Richter's Specielle Therapie, B. x. S. 326, Berlin, 1828. X Op. cit. \ Bulletin General de Therapeutique, Nov. 30, 1837, and M. Levy, Gazette Med. No. xxij, and Encyclographie des Sciences Medicales, Juillet, 1840. p. 287. QUININE SULPHAS. 415 Besides their febrifuge property, the salts of quinine possess a tonic virtue, which adapts them for numerous cases in which that class of remedies is indicated. Yet there are many who think that the cinchona is better calculated for such cases than the quinine, and who administer the latter to prevent the paroxysms of an intermittent, but have recourse to the cinchona, when they are desirous of fortifying the system to pi event a relapse. There are cases, too, whicb resist the quinine and its preparations, and which subsequently yield to the cinchona in substance, but this may be owing to the quantity of lignin, or woody matter in the bark in substance, aiding the quinine of the cinchona in producing that new impression on the nerves of the stomach, which is ne- cessary to break in upon the paroxysmal catenation. In its antiseptic virtues, also, the sulphate of quinine is inferior to the cinchona. It has been doubted, indeed, whether it possess any such virtues at all. Lastly: there is an advantage possessed by the sulphate of quinine,—that in irritable or impressible persons, it may be ex- hibited endermically, and thus no disorder be induced in the di- gestive powers. It need scarcely be said, that the cinchona is not adapted for this mode of administration. MODE OF ADMINISTERING. The sulphate of quinine may be administered internally in the form of powder or pill, and in solution in wrater, alcohol, or syrup. The average dose, in the twenty-four hours of apyrexia, is from four to ten grains; yet it has been given frequently to a much greater extent. As in the case of the cinchona, it has also been advised that a large dose should be given immediately before the expected paroxysm, so as to render the frequent administration during the apyrexia unnecessary; this dose need not be so great as the combined doses would amount to> so that there may be economy in the plan. Dupasquier, Elliotson * ourselves, and many others, have found this course eminently successful; but some ob- ject to it. A case of severe remittent has been detailed by Dr. Thomas Fearn,f in which he gave, at one dose, three tea-spoonfuls— weighing thirty-two grains. At the end of an hour, there was a diminution in the frequency of the pulse—" the invariable ef- fect of large doses of quinine, when its operation is favourable." The dose was repeated, and at the end of another hour, it was * Medico-Chirurgical Transactions, xii. 543, Lond. 1824. f Op. cit. 416 QUININE SULPHAS. again given, making ninety-six grains in two hours. Dr. Fearn remarks, that his usual practice in remittent fever had been to give three doses of twenty grains each, with an interval of an hour between. Generally, between the paroxysms, several doses are adminis- tered; and, according to tbe particular case, the efficacy of the salt of quinine is attempted to be increased by the addition of an- timonials, laxatives, carminatives, &c, and in pernicious or ma- lignant intermittents especially, of opium or morphine. Of late, much attention has been directed at New Orleans to the treatment of yellow fever by very large doses of the sulphate of quinine—from a scruple to a dram—and it is said that great success has attended its administration in the practice of Drs. Hunt, Beattie, Farrel, Mackay, and others.* By many, a combination of the quinine with moderate doses of the cinchona is highly recommended. Chapman advises its union with piperine: a combination with the alcoholic extract of cin- chona has also been prescribed. Mr. Sherwin,f of Hull, affirms, that a piece of apple, chewed for a moment, immediately annihilates the bitter taste left by it. The sulphate of quinine may be used in the way of enema, and endermically, when the condition of the stomach forbids its in- ternal employment. As an enema, four grains or more may be mixed with starch, and be thrown up a short time before the pa- roxysm, or at the inception of the same. In this wray it has been found efficacious.^ In administering the sulphate, or muriate of quinine endermi- cally, a space on the surface of the body is deprived of its cuticle by means of a blister, and on this denuded portion the agent is applied either in the form of powder or ointment. In testimony of the efficacy of this mode of administering the salts of quinine, many observers have come forward,—Lesieur, Lembert, Martin, Wesche, Lehmann, Reilingh, Stratingh, Lieber, and others. From four to eight grains may be placed on the denuded part once or oftener in the day. Dr. Lieber, of Berlin, seems to have prescribed the salt most frequently in this way: he mentions, that of sixty cases, in which he employed it, only eight or ten were unsuccess- ful; and there was reason to believe, that in these cases the in- ternal administration of the sulphate of quinine would have failed also. In the case of adults, he applies a blister in the evening— of the size of a dollar—over the epigastric region; in the morn- ing, during the apyrexia, the blister is cut: the cuticle removed, * Philad. Med. Examiner, Oct 19, and Oct. 26, 1839. t Lond. Med. Gazette, April 1, 1837. X Richter, Op. cit- S. 331. Berlin. Medicin. Zeitung. Jan. 4,1837. QUININE SULPHAS. 417 and five or six grains—in children two grains—of the sulphate are sprinkled over the denuded surface. The whole is then co- vered with adhesive plaster, which must extend to the breadth of a finger, over the edges of the blistered part. The sprinkling of the sulphate always occasions a violent burn- ing sensation, but if it be applied in the form of ointment this evil is avoided, or at least diminished. The pain, however, speedily, disappears. Some hours after the application of the remedy, op- pression is felt in the stomach, with a desire to vomit, without, however, vomiting supervening; borborygmi, or uneasiness in the bowels, and frequently fluid dejections, with augmented secretion of saliva, which, in some cases, continues for several days. In the course of from twelve to twfenty-four hours after the ap- plication, a very bitter taste is generally perceived over the whole tongue, similar to that of the quinine; and if the application has been made sufficiently long before the anticipated paroxysm, it may be entirely prevented, or be rendered much milder. After the effect has been produced, the adhesive plaster may be kept, applied for some days, and, if the sore is not healed, it may be dressed with simple applications. In only two cases did Dr. Lieber observe any extensive or offensive suppuration; and both healed under simple dressings with dry lint. Rubbing the quinine on the gums has, likewise, been occasion- ally recommended, as well as frictions with the alcoholic solution on these as well as other portions of the surface of the body—the thighs, groins, and pit of the stomach;* and it has been advised in cases of intermittent cephalalgia, and in iralgia, to be snuffed up the nostrils.f Syrupus Quinina Sulphatis. Syrup of Sulphate of Quinine^ R. Quinin. sulphat. gr. xvj. Syrup, simplic. 5viij. M. Dose.—A spoonful. Magendie. Syrupus Quinina Sulphatis Compositus. Compound Syrup of Sulphate of Quinine. R. Quinin. sulphat. gr. xvj. Acid, sulphur, dilut gtt. v. Syrup, limonis, 5viij. M. Dose.—Same as the last. * Dr. Schuster, cited in Amer. Journ. May, 1832, p. 242; and Antonini, Journal des Connoissances, Oct. 1838. f B. St. Hilaire, in Gazette Mddicale de Paris, Mars 26, 1836. 36 418 QUININ2E SULPHAS. Tinctura Quinina Sulphatis. Tincture of Sulphate of Quinine. R. Quinin. sulph. gr. vj. Solve in Alcohol. 34° (.847) |j. 00se._3j or 5ij, immediately before an attack of fever. Magendie. Gutta Quinina Sulphatis et Opii. Drops of Sulphate of Quinine and Opium. H. Quinin. sulphat. (seu acetat.) gr. xij. Solve in Spirit, vini rectif. (seu liq. anodyn. Hoffman.) ^ss. Adde Tinct. opii simpl. gtt. xij. Dose.—Morning and evening, twenty drops, in the summer fevers of Europe. Schmidt. Pulveres Quinina Sulphatis. Powders of Sulphate of Quinine. R. Quinin. sulphat. gr. iij. ad xij. Sacchar. alb. 3ij. Misce et fiat pulvis in partes vj aequales dividendus. Dose.—A powder morning and evening, in nervous debility and in intermittents. Radius* advises, that the powders should be taken in coffee, by which means the bitter taste is almost wholly counteracted. Radius. Pulveres Quinina Sulphatis et Sode Carbonatis. Powders of Sulphate of Quinine and Carbonate of Soda. R. Quinin. sulphat. gr. j.—ij. Sodae carbonat. gr. iv.—v. Sacch. alb. 9j. Misce et fiat pulvis. * Auserlesene Heilformeln, u. s. w. Leipz. 1836. QUININE SULPHAS. 419" Dose.—A powder, morning and evening, in scrofulous ophthal- mia. Von Ammon. Pulveres Quinina Sulphatis et Antimonii Tartratis. Powders of Sulphate of Quinine and Tartarised Antimony. H. Quinin. sulphat. gr. x. Potass, et antim. tartrat. gr. iij. Sacchar. alb. gr. xxiij. Misce exacte, et divide in partes sex aequales. Dose.—One, every two hours, during the apyrexia, in cases of obstinate intermittents. Gola.* Pulveres Quinina Sulphatis et Opii. Powders of Sulphate of Quinine and Opium. R. Opii puri, gr. j. Quinin. sulph. gr. iij. Sacchar. alb. Gum. acac. aa. gr. vj. M. fiat pulvis. To be taken a short time before the paroxysm in malignant intermittents. Neumann. Pulveres Quinina Sulphatis et Morphina Sulphatis. Powders of Sulphate of Quinine and Sulphate of Morphine. R. Quinin. sulph. gr. ij. ad vj. Morphinae sulph. gr. £ adj. Divide in dos. iv. Magendie. Pulveres Quinina Sulphatis Compositi. Compound Powders of Sulphate of Quinine. R. Quinin. sulph. gr. j. Pulv. cinchon. optim. gr. xv. Pulv. rhei, Oleosacchar. menth. aa. gr. v. Misce et fiat pulvis. * Annali Univers. di Medicina, torn. 35. 420 QUININE SULPHAS. Eight of these to be given in cases of intermittent fever. Naumann. R. Quinin. sulph. gr. |. Chocolat. gr. vij. Sacchar. lact gr. ij. Misce. Fiat pulvis tertiis omnibus horis sumendus. In debility of the stomach. Kopf. Pilula Quinine Sulphatis. Pills of Sulphate of Quinine. R. Quinin. sulphat. gr. v.—xij. Succ. glycyrrhiz. 3j- Misce et fiant pilulae xij. To be given, according to prescription, in nervous diseases. Radius. Pilule Quinine Sulphatis Composite. Compound Pills of Sulphate of Quinine. R. Quinin. sulphat. gr. x.—xv. Acid, phosphoric, sice. 9ij. Pulv. rad. althaeae, (vel rhei,) 9iv. Ext. centaur, minor, (vel gentian.) 9ij. Misce et fiant pilulae lx. Dose.—Three to six pills, two or three times a day, in cases of nervous debility, with disposition to hemorrhage, as after abor- tion. Radius. R. Quinin. sulphat. gr. xv. Pulv. cinnam. 3SS- Extract, cinchonae q. s. ut fiant pilulae xxx. Dose.—Four pills every two to four hours. Henschel. R. Quinin. sulphat. gr. xij. Extract, trifol. 3j. Pulv. rad. calam. aromat. q. s. Fiant pilulae xij. Dose.—One or two, every two hours. Hildenbrand. QUININE sulphas. 421 Mistura Quinina Sulphatis. Mixture of Sulphate of Quinine. R. Quinin. sulphat. gr. xij. Acid, sulph. dil. gtt. v. Aquae cinnam. simpl. 5vj. Syrup, cinnam. ?j. M. Dose.—A table-spoonful. Pulvis Sternutatorius ex Quinine Sulphate. Sternutatory Powder of Sulphate of Quinine. R. Quinin. sulphat gr. xv. Tabaci sternutator. com. 5j. M. To be snuffed up the nostrils in the course of five or six days,. in cases of intermittent headach. R. Quinin. sulphat. gr. vj. Pulv. sacchar. pur. Jj- Pulv. rad. iridis, ^\ss. M. Small pinches of this to be snuffed up the nose at night. B. St. Hilaiee.. Unguemtum Quinina Sulphatis. Ointment of Sulphate of Quinine. R. Quinin. sulphat. 5j. Alcohol (38° ad 40°) q. s. (gij.) Acid, sulphuric, q. s. (gtt. lxxx.) Adipis 5iv. M. Half an ounce at a time to be rubbed on the groins in malig- nant intermittents. It may be likewise placed in the axilla. Antonini. Vinum Quinina. Wine of Quinine. R. Quinin. sulphat. gr. xij. Vin. Mader. ftij. M. The wine of quinine may also be made extemporaneously, by adding two ounces of the tincture to a pint bottle of wine. 36* 422 QUININE, ET CINCHONINjE, TANNAS. VIII. QUININE, ET CINCHONINiE, TANNAS. Synonyme.—Tannate of Quinine, and Cinchonine. Dr. Otto* has drawn the attention of physicians to the effi- cacy of the Tannaies of Quinine and Cinchonine, as recom- mended by Dr. Rouander, the secretary to the Swedish Medical Association. He regards them as the most active ingredients in the cinchonas; and affirms that he has cured by their agency several cases of obstinate intermittent, which had resisted the use of sulphate of quinine and other powerful remedies. He found them likewise very useful in typhus and in states of general weak- ness and tendency to putrescency, where the sulphate of quinine seemed to be ineffectual. Dr. Rouander's experiments establish the belief that the tannin of the cinchonas may be instrumental in developing their full febrifuge powers.f The tannate of quinine is also a cheaper remedy than the sulphate. On separating the quinine from cinchona by means of acids, a resinous constituent of the bark remains behind, which affords no more quinine, but yet possesses considerable febrifuge power, and on that account has been much used by the Dutch physicians. Two grains of this residuum are said to act as well as one grain of quinine. Truessink adduces a series of observations of diffe- rent physicians, all of which confirm, this, and he cites the expe- rience of American physicians with the residuum. Accordingto Dr. Chapman,^ a grain of this may be given every two hours during the apyrexia, in the form of pill. Strathing ascribes its efficacy to the quinine still contained in it. In Italy, several physicians have found the mother waters or lees after the preparation of quinine, when boiled to the consistence of syrup, very efficacious in intermittents; and Roux recommends it highly for practice amongst the poor. Buchner advises the lees, evaporated to dry- ness—which he terms Chininum Resino-sulphuricum—to be in- troduced as a cheap, and, at the same time, efficacious prepara- tion of cinchona, which may be used in charitable institutions, * Dublin Journal of Medical Science, Sepr. 1836. f Rpvue Medicale, Mai, 1837, and Dunglison's Amer. Med. Intelligencer,. Oct. 16, 1837, p. 270. X Elements of Therapeutics, 6th edit. ii. 292. Philad. 1831. QUININ2E, ET CINCH0NIN2E, TANNAS. 423 rubbed up with sugar as a powder, or dissolved in alcohol, in place of the sulphate of quinine. These experiments and propositions, as Riecke* observes, merit more consideration than they have yet received; for the quinine, notwithstanding its price is much less than formerly, is yet so dear, that its administration does not adapt it well for charitable institutions, whilst the residue, which possesses valuable properties, is generally thrown away, and in this manner the price of the quinine is enhanced. Serturnerf thinks he discovered, besides the quinine and the cinchonine, other alkaloids of cinchona, especially one, which he calls Chinioidine, or Chinoidine, and which excels in medicinal properties all the other preparations of cinchona. Henry and Delondre—the French chemists—affirm that the chinioidine is nothing more than quinine, cinchonine, and a peculiar yellow re- sinous matter, intimately adherent to that alkaloid. It appears, also, from the experiments of different physicians with the pre- sumed new alkaloid, that it essentially resembles the preparations already mentioned in its medical properties. A Resina China Praparata is recommended by Plagge, which is prepared from the mother waters or lees of the quinine, by means of precipita- tion by a carbonated alkali, extraction by alcohol, and removal of the alcoholic liquor by distillation. It is said, likewise, to pos- sess markedly curative powers in intermittents. The Pharmacopceia of the United States gives a formula under the title Quinia Sulphas Impurus, which consists in evaporating the liquor poured off the crystals of sulphate of quinine to the consistence of a pilular mass. This has been known for years in Philadelphia under the name of Extract of Quinine, and its active ingredients.appear to be sulphate of quinine and sulphate of cin- chonine, which are prevented from crystallising by a peculiar resinoid substance united with them. Dr. WoodJ asserts that he has seldom found intermittents resist twenty-four grains of the impure sulphate, given between the paroxysms; although a larger quantity may be employed with safety and greater certainty of success. We have never pre- scribed it. * Die neuern Arzneimittel, u. s. w. S. 130. t Hufeland's Journal, Jan. 1829. X Art. Quinise Sulphas Impurus, in Wood & Bache's Dispensatory, 4th edit. p. 1032. Philad. 1839. 424 SALICINA. SALICINA. Synonymes.—Salicinum, Salicinium, Salicine, Salicin. German.—Salicin, Weidenstoff, Weidenbitter. The tonic virtues of the bark of the willow have been known for ages, and it has been regarded as one of the best substitutes for the cinchona in eleemosynary institutions. It was not much valued, however, in more modern times, until the discovery of an active principle in it again attracted to it the attention of practi- tioners. This discovery, if not made, was perfected, by Leroux,* an apothecary at Vitry, in France, who first obtained the sali- cine in a pure state in 1828, after it had been procured in an im- pure form by some German and Italian chemists.f It is prepared, by preference, from the ISalix helix, but it is found likewise in the barks of other varieties of the willow—the Salix alba, S. vi- tellina, S. purpurea, S. Lambertiana, S. pentandra, G. polyandra, S. fragilis, S. viminalis, &c, and in the leaves and barks of se- veral varieties of poplar,—the populus tremula, P. tremuloides, P. alba, and P. graeca.J METHOD OF PREPARING. According to the method of Leroux, three pounds of dried and powdered willow bark {salix helix) are boiled for three quarters of an hour in fifteen pounds of water, to which four ounces of subcarbonate of potassa have been added. To the cold decoc- tion are added two pounds of liquid subacetate of lead. The mix- ture is permitted to settle, is filtered, treated with sulphuric acid; and the remaining lead precipitated by a stream of sulphuretted hydrogen gas. The excess of acid is neutralised by carbonate of lime: it is then again filtered, the fluid inspissated and neu- tralised by dilute sulphuric acid. It is deprived of its colour by ivory black, and filtered whilst boiling. It is then twice crystal- lised—if still coloured after the first crystallisation—and dried in the dark. This process yields about an ounce of salicine. * Annales de Chimie, &c. xliii. and Journal de Chimie Medicale, torn vi. \ Dictionnaire de Mat. Med. par Merat & De Lens, art. Salicine. X Riecke, Die neuern Arzneimittel, S. 365, and 2te Auflage, 572. Stutt- gart, 1840. SALICINA. 425 Braconnot* obtains it by adding subacetate of lead to a decoc- tion of the bark, precipitating the excess of lead by sulphuric acid, evaporating the colourless liquid that remains, adding near the end of the process a little animal charcoal previously washed, and filtering the liquor while hot. The salicine is deposited, on cooling, in a crystalline form.f The following plan has been advised by Messrs. Fisher and Tyson, of Baltimore.J Willow bark is boiled with caustic lime in water; the decoction is filtered and sulphate of zinc added, so long as it produees a precipitate. The liquid, having been again filtered, is evaporated to the consistence of an extract, and the residue is treated with alcohol. The tincture, thus obtained, if carefully evaporated, yields crystals of salicine, which may be purified by washing with a saturated solution of the same princi- ple, in cold water. Salicine forms very fine silky masses of white crystals, which have the appearance of mother of pearl. It bears a distant re- semblance to the sulphate of quinine, yet it is not so loose and delicate. It is permanent in the air, inodorous, and has a strong, enduring bitter taste, with a striking accompanying balsamic fla- vour, like the bark of the willow.§ One hundred parts of cold water dissolve six parts of salicine. In warm water it is more soluble, and also in alcohol; but it is not soluble either in ether or the essential oils. It exhibits no alkaline reaction. By admixture with sulphuric acid salicine acquires a beautiful red colour.|| EFFECTS ON THE ECONOMY. The well known effects of the barks of the willows gave occa- sion to the immediate employment of salicine in cases of inter- mittent fever. MiquelTI appears to have been one of the first— if not the first—who instituted experiments with it; and he satis- fied himself, that it merits a distinguished place amongst our febri- fuge agents, although it requires larger doses than the quinine. Soon afterwards it was given by other physicians—by Husson and Bally, Girardin, Magendie, Andral, Blaincourt, Graff, Linz. * Journal de Chimie Medicale, Janvier, 1831. t For Peschier's method, see Annales de Chimie, vol. xliv. and Amer. Journ. Med. Sciences, May, 1831, p. 256. X Journal of the Philadelphia College of Pharmacy, iii. 214. § MM. Pelouze and Jules Gay Lussac, in Annales de Chimie, vol. xliv. || For an elaborate account of the chemical relations of salicine, see M.R. Piria, Annales de Chimie et de Physique, Novembre, 1838. IF Gazette Medicale de Paris, Janv. 1830; see, also, Annales de Chimie, xliii. and xliv. 426 SALICINA. Stegmayer, Amelung, Stam, Van Sneek, Blom, Grafe, Von dem Busch, Krombholz, Pleischl, and others. The sentiments, respecting its value, are discrepant; some classing it far beneath the quinine, whilst others assign it even a higher position. Its general properties are certainly analogous to those of quinine; but it in no respect merits a preference,* not even in the article of price: for, although an equal weight of sa- licine may cost less, it requires so much more to produce the same effect, that the cost is perhaps equal. Still as M. Pleischl,f of Prague, has suggested, even if the salicine were much the dearer of the two, it might be better to use it, because it is of home manufacture, and can be obtained in war as well as in peace. MODE OF ADMINISTERING. The ordinary dose of salicine, in a case of intermittent, is about four or six grains every three hours during the period of intermis- sion ; in the febres larvata, or masked fevers, smaller doses may be given, but in the very violent fevers at Calvi, in the Island of Corsica, Levy found it often necessary to give from forty to fifty grains in twenty-four hours. Of thirty cases of quotidian and tertian intermittents, twenty were cured by the use of the salicine; ten required afterwards the sulphate of quinine. He considers it to be preferable to the sulphate of quinine in intermittents that are accompanied by irritation in the primse viae: he never saw it rejected or produce vomiting; and in cases of manifest irritation of the digestive tube, it has been borne perfectly well.J Salicine is generally given in intermittents, in the form of pow- der. In other affections, to obtain its febrifuge or tonic agency, one or two grains may be given four or five times a day—gra- dually augmenting the dose. In cases of asthenia of the digestive organs, Von dem Busch prescribes a powder of salicine and sugar, with the addition of cinnamon; and lozenges of salicine, sugar, gum arabic, and oil of peppermint. In cases of copious secretion from the mucous mem- branes, especially in chronic bronchitis and leucorrhea, he directs * Richelot, in Archives Generates de Medecine, Sepr. 1833: see, also, Prof. Dierbach, in Heidelb. klinisch. Annal. B. x. H. 1. S. 62. Heidelb. 1834. f Medicinisch. Jahrbttcher des k. k. o. Staat. 1835; and Br. and For. Med. Rev. for April, 1836, p. 576. X Archives Medicales de Strasburg, and Gazette Medicale de Paris, Fevr. 25, 1837. SALICINA. 427 the salicine to be combined with a decoction of the polygala amara, or of the lichen islandicus. In intermittents, Stegmayer advices it to be associated with small doses of tartrate of antimo- ny and potassa. Pilule Salicine. Pills of Salicine. R. Salicin. Ext. gentian, aa. gr. xxiv. Pulv. rad. glycyrrh. q. v. ut fiant pilulae. xij. Vavasseur. Pulveres Salicine. Powders of Salicine. R. Salicin.gr. xij. Sacch. alb. 9ij. Misce et fiat pulvis in partes iv asquales dividendus. Dose.—One, three times a day. Krombholz. Pulveres Salicine Compositi. Compound Powders of Salicine. R. Salicin. gr. xv. Antim. et potass, tartrat. gr. j. Sacchar. alb. 9iiss, Misce et fiat pulvis, in partes x aequales dividendus. Dose.—A powder, every two hours. Stegmayer. Mistura Salicine. Mixture of Salicine. R. Rad. poly gal. amar. 3yj. Coque cum aquae fontanae 5xij. ad remanent. 5viij. Colaturae adde Salicin. gr. viij. ad. x. M. Dose.—One of two spoonfuls every two hours. VoN DEM BUSCH. 428 SAPO COCONEUS.--SAPO MOLLIS. SAPO COCONEUS. Synonymes.—Sapo Olei Cocos, Sapo Cacaotinus, Soap of the Cocoanut Oil. French.—Savon de Cacoa. German.—Cocosnussolseife, Cocosnussolsodaseife, Palmoiseife. This soap has been much employed in Europe, of late years more especially, as a cosmetic, and it seems well adapted for the purpose, except for its peculiar odour, which is by no means agreeable, but may be masked by the addition of some sweet- scented oil. Our object of mentioning it here is to state, that the veteran Hufeland extolled it highly as an efficacious and innoxious application in herpes, not only from numerous trials of it made by himself, but by others, and he affirms, that when it does not effect a cure, it allays the distressing burning and itching. The soap is dissolved in warm water, and the affected part washed with it three or four times a day> SAPO MOLLIS. Synonymes.—Sapo Vif idis, S. Niger, S. Kalicus, S. Domesticus mollis, Sapo exOlivae Oleo et Potassa confectus. French.—Savon Noir, Savon Mou, Savon a base de Potasse. German.—Schmierseife, Grttne Schmierseife, Kautliche Kaliseife. Under this name a soap is used, which is formed by a union of oil with potassa. It is the " sapo ex oleo et potassd confectus " of the London Pharmacopoeia, and has of late been brought for- ward in Germany as a remedial agent in cases of itch* and has been employed in many hospitals. MODE OF ADMINISTERING. The treatment of itch by soft soap is directed by Pfeuffer to be carried into effect in the following manner. Attention is paid to the general health of the patient for a day * Pfeuffer, Beobachtungen tiber die Kratze und ihre Behandlung durch die Schmier-oder grune Seife. Bamberg, 1833. SAPO MOLLIS. 429 before the soap is applied. His whole body, with the exception of the head, face, and genital organs, is then besmeared with it, and the application is repeated, morning and evening, for six days. According lo the extent of surface of the patient's body, at first two rubbings, of from four to six ounces, are used; at the third and fourth, from two to three ounces, and from the fifth to the seventh inclusive, from half an ounce to an ounce; but after this, the soap is applied only to those parts which are affected with the eruption or itching. On the eighth day the patient takes a bath of tepid soap and water, and the body and bed linen, which have not been shifted during the cure, may now be changed for cleaner. In dry and warm seasons, the patient is able to leave the infirmary on the tenth day, cured; but in moist and cold, not until the twelfth or fourteenth. The cure of the eruption is gene- rally effected in seven days, that is, by fourteen rubbings. During the period of treatment, the patient must remain in bed, avoid ex- posure to draughts of air, and reside in a chamber whose temper- ature is from 73° to 77° of Fahrenheit. On account of the strong smell of the soap, not more than ten patients ought to be permitted to occupy the same room. A full diet may be allowed them. From six to eight hours after the first or second rubbing, a sense of tension and pricking is felt in the skin, which, at times, gradually augments until it amounts to a feeling of burning heat. About the fifth or sixth rubbing, the skin appears of a scarlet hue, without the temperature being materially elevated. In several cases, irritative fever ensues, which disappears in the course of twenty-four hours, with augmented secretion of urine. Miliary vesicles form in groups; sweating takes place freely; the sleep which may have been disturbed for a night or two recurs; the skin desquamates, and the patient does not find his strength in the least exhausted. Should the inflammation of the skin occur earlier than the sixth rubbing, the friction must be pretermitted. Pfeuffer, however, never observed this to be the case. In scrofulous and syphilitic dyscrasies, the friction may have to be repeated once more, and the patient may have to remain from two to four weeks in the institution. It very generally happens, that this plan excites inflammation of the skin and desquamation of the cuticle: when this is not the case, no change whatever is produced in the eruption. In order to mitigate the distressing feeling of burning produced by the rubbing, one part of flowers of sulphur may be added to two parts of the soft soap. In those cases, in which the disease has existed for years, with greater or less intervals, and in those who were strumous in their youth, or were at a subsequent period affected with syphilis;—in all cases, indeed, in which the cutaneous affection has become, as 37 430 SECALE CORNUTUM. it were, habitual, Pfeuffer directs, that a cathartic should be pre- mised, and that in the course of the cure, a quart of the decoc- tion of the woods should be taken. This mode of treatment, according to Pfeuffer, is contra-indi- cated by febrile conditions, especially of the synochal kind; acute cutaneous affections; pulmonary and abdominal catarrhs; pul- monary and abdominal phthisis; chronic headach; and hereditary or acquired tendency to epilepsy. In such cases, he prefers the internal and external use of sulphur; and, after the cure, the esta- blishment of issues. The great recommendation of this plan of treatment, in hospi- tals and infirmaries, is said to be its cheapness, although it strikes us, that there cannot be any marked difference in this respect between it and the treatment by sulphur, which is greatly used, on this very ground, in many of the eleemosynary establishments of Germany at this time.* The efficacy of Pfeuffer's plan of treatment has been confirmed by numerous observers,—by Graff, Bermann, and Cramer, who is said to have first recommended the soap in scabies; and by Sicherer, Seyffer, Cless and others, all of whom agree as to its excellence: they regard it as one of the best methods of treatment in use. The soft soap forms an ingredient in many of the offi- cinal and other itch ointments.f SECALE CORNUTUM. Synonymes.—Ergota, Clavis Secalinus, Calcar, Secalis Mater, Secale Luxu- rians, Ustilago, Clavis Siliginis, Spurred Rye, Corned Rye, The Spur, Er- got, Hornseed. French.—Seigle ergote, BI6 cornu, Clou de Seigle, Mere de Seigle, Bled avorte, B. farouche, Faux Seigle, Seigle cornu ou corrompu ; S. a eperon, S. ergo- tism, S. ivre, S. noir. German.—Mutterkorn, Grbaxpulver, Afterkorn, Schwarzkorn, Aetzroggen. The effects, which this substance is capable of exerting on the uterus, are so well known as not to need any lengthened descrip- * H. Vezin, Ueber die Kratze und ihre Behandlung nach der englischen Methode. Osnabruck, 1836. See, also, Dunglison's American Medical Intel- ligencer, Aug. 15,1839, p. 158. t Riecke/Die neuern Arzneimittel, u. s. w. 2te Auflage, S. 584. Stuttgart, 1840. SECALE CORNUTUM. 431 tion. Its employment in parturition having been first revived in this country, there are but few who are ignorant of its reputed properties. Certain effects have, however, been ascribed to it, in very recent times, which require mention. The spurred rye or ergot—the latter being the common name it bears from its " spurred" appearance*—is generally considered to be the result of a disease in rye, occurring most frequently when a hot summer succeeds a rainy spring. Decandolle, however, regards it as a parasitic fungus, and calls it Sclerotium clavus; whilst Leveille esteems it to be a fungus giving a coating to the diseased grain—the medical virtues re- siding in the coating. This fungus he calls Sphacelia segetum. Brande refers it to the natural order, Fungaceee, and terms it Spermoedia clavus, and in the last edition of the London Phar- macopoeia, it is referred to the Acinula clavus of Fries;f but, ac- cording to Lindley, Fries has no such plant in any of his works, and the only species of acinula known, acinula candicans, is found on the rotten leaves of the common alder, and among melting snow; its organization is of another kind from that of the spermoedia; and Fries, who regards the other as a morbid state of the grain of certain grasses, considers acinula as a true fungus.J Recently, Mr. Smith§ and Mr. Quekett|| have maintained, that the ergot is not a fungus, but a diseased state of the grain oc- casioned by the growth of a fungus not previously detected: to this fungus Mr. Quekett gives the name Ergotaetia^f abortans. By the microscope, they discovered sporules, sporidia, or jointed * French, ergot, " a spur." t Syst. Mycol. X Brande's Dictionary of the Materia Medica, p. 233, Lond. 1839. See, also, Venus, Grundriss der medicin. Receptirkunst, u. s. w. S. 347. Weimar, 1838; and the opinions of Schreber, De Geer, Parmentier, Buffon, Von Man chauseu, Tessier, Zuckert, Rassig, Hube, Aymen, Robert, Tillet, &c, in Wright, op. cit. § Transactions of the Linnean Society of London, xviij, Pt 3. p. 449. Lon- don 1840. j| Ibid. p. 453, and London Lancet, June 22,1839, p. 465. See also an abridg- ment of a communication read by Mr. Quekett before the Linnsean Society, Dec. 4, 1838, with illustrative woodcuts, in American Journal of Pharmacy, for July, 1839, p. 116. For remarks on an insect met with in the diseased grain, see a pa- per by Mr. Muller, of Butler county, Pa., with comments by Dr. Carson, in Amer. Journal of Pharmacy for Jan., 1839, p. 269. M. Debourge considers, that the ergot is an animal product from the telephorous family. The insect deposits a liquid of its own formation on a grain of rye and produces the ergot; whence it follows, he conceives, that the ergot may be produced at pleasure by express- ing this liquid upon all the grains of rye that are within a certain period of their maturity. SocitUs Savantes, in Encyclographie des Sciences Medicales, Avril, 1838. 11 From ergota, and */t;«, " cause." 432 SECALE CORNUTUM. bodies, which appeared to be the reproductive particles of the fun- gus. Mr. Francis Bauer,* however, who has made the ergot a sub- ject of particular study, and who, about thirty years ago, under- took, at the suggestion of Sir Joseph Banks, a series of careful microscopical observations with a view to determine the nature and cause of that singular production, does not consider the ques- tion as to the cause of the ergot to be finally and satisfactorily settled. He states, that he is not convinced that the filamentous fungi with numerous sporidia, pointed out by various recent ob- servers, are the cause or the consequence of the ergot:—be- cause, first—every gramineous plant is equally infected with that minute filamentous fungus, yet very few of tbese plants produce ergots; and amongst agricultural grains, the rye is the only one that is subject to the disease ; and secondly; in autumn all decay- ing plants are infected with such filamentous fungi and minute sporidia. Mr. Bauer's investigations lead him, however, to deter- mine the ergot to be a morbid condition of the seed. As it is important to judge between a good and bad specimen of the ergot, Mr. Wright remarks,f that if it be clear and smooth on the surface, not powdery; of a deep purple colour; neither en- tirely black nor light brown; having a full strong odour; breaking clearly; exhibiting a pink blush interiorly; unpunctured by insects; burning with a clear jetting flame, and being of a less specific gravity than water, its activity may be trusted. EFFECTS ON THE ECONOMY. The effects produced on the animal economy by the ergot, when eaten as food, are extremely injurious: the aggregate of the symp- toms has been termed Ergotism. At times they are limited to vertigo, spasms and convulsions, with a peculiar tingling or formi- cation in the arms and legs, which has given the affection the name among the Germans of Kriebelkrankheit, or " creeping dis- ease." Most commonly, the limbs waste away, lose sensation and the power of motion, and separate from the body by dry gangrene—constituting gangrenous erethism or mildew mortifica- tion.\ These, however, are the toxical, not the therapeutical ef- fects of the agent.§ * Transactions of the Linnean Society of London, xviij. Pt. 3. p. 481. Lond. 1840. t Edinb. Med. and Surg. Journ. Oct. 1839, p. 296. \ See articles, Convulsio cerealis, and Ergotism, in the Author's Medical Lexicon. Philad. 1839; and his Therapeutics, p. 272, Philad. 1836. 5 See Christison on Poisons, 3d edit. chap. xl. Mr. Wright, op. cit. p. 307, and Jan. 1840, p. 9. SECALE CORNUTUM. 433 The extraordinary property, ascribed to the ergot, of assisting the parturient efforts has long been credited in Germany. Its old German names, Mutterkorn (" wombgrain") and Gebarpulver (" parturient powder ") are sufficient evidences of this notion; but, for a long time, this was rather a matter of popular than of scien- tific belief, although the " pulvis parturientis" of the Marburg Pharmacopceia consisted principally of ergot.* About tbirty years ago it wTas recommended in this country by Dr. John Stearns, of Saratoga county, New York, and since that time the weight of testimony adduced in its favour on both sides of the Atlantic has been overwhelming. Still there are many dis- tinguished individuals, who deny it all power over the uterus both in the unimpregnated and the impregnated state, and who affirm, that it acts only indirectly on that viscus through the general dis- turbance it occasions, and that, therefore—like every other in- ternal agent administered as an abortive—it ought to be esteemed rather indirect than direct in its action. Such is the decided opinion of Jorg,f whose attention has been directed to the effects produced by different medicinal agents on the sound and diseased economy, and who goes so far as to affirm, from his experiments and observations, that there is no " farther connexion between these degenerate grains and the uterus, than the word Mutter {' uterus ') which is common to both." From his various and- varied experiments, Dr. Jdrg infers, that the ergot when given in small doses, produces little or no effect upon the functions but when fresh dried in an oven, and adminis- tered in large doses, it oppresses the stomach, occasioning nausea, vomiting, colic, liquid evacuations, destroys the appetite, and in- jures the digestive powers ;—these effects being accompanied by a sense of weight in the head, vertigo, cephalalgia, and by general torpor of the system. Under these circumstances, he thinks, it is not difficult to understand that the connexion between the foetus and the uterus may be modified, and that abortion may take place. Recently, the author has caused various experiments to be in- stituted on the use of the secale cornutum in doses of half a dram and a scruple of the powder, and in the form of the oily matter referred to below. Tbese experiments were made on both males and females; and the general effects were those described by Dr. Jdrg;—when the dose was too large, nausea or vomiting • * Mr. Wright op. cit. p. 22. f Dass der Gebrauch inner Reizmittel zur Beforderung der Geburt des Kin- des unnothig, fruchtlos, uud gesunden Frauen sogar schadlich sei; u. s. w. S. 40. Zeitz. 1833. See, also, the author's General Therapeutics, p. 271. 37* 434 SECALE CORNUTUM. often resulted, with signs of narcosis. They were made, at the author's desire, by Drs. Cottman and McKee, resident physicians at the Philadelphia Hospital.* A case of narcosis, produced by this drug, in the dose of thirty grains—administered for the pur- pose of restraining a real or supposed tendency to hemorrhage after the expulsion of the placenta—was communicated to the au- thor by Dr. Beckwith, of Raleigh, North Carolina.^ Chemical analysis has thrown no light on the cause of those properties. According to the analysis of Vauquelin,J ergot con- tains a colouring matter of a yellowish hue; a white oily matter; a violet colouring matter insoluble in alcohol; a free acid, which is in part phosphoric; a very abundant vegeto-animal matter, which is greatly disposed to putrefaction, and furnishes much thick oil and ammonia on distillation; and a small quantity of free ammonia, which may be obtained at the temperature of boiling water. A more recent analysis has been made by Maas,§ of Hamburg. He found it to contain gluten; ammonia or a peculiar alkali; acetic acid; a violet colouring matter; resin; fixed oil; an alka- line acetate; but neither starch, hydrocyanic acid, narcotine, nor phosphoric acid, which some had discovered in it.|| The ergot has likewise been analysed by Bonvoisin, Pettenkofer, Winkler, Robert, WiggerslI and others. The analysis of the last gentleman is very elaborate. The results were,—a thick white oil, 35.000; white fatty matter, 1.0456; cerine, 0.7578; fungin, 46.1862; ergotine, 1.2466; osmazome, 7.7645; sugar, 1.5530; gum, extractive and colouring matter, 2.3250; vege- table albumen, 1.4600; phosphoric acid and phosphate of potassa, 4.4221; phosphate of lime and traces of iron, 0.2922; silica, 0.1394. Mr. Wright's** analysis furnished him with the follow- ing constituents and their proportions in 100 parts of the ergot: thick white oil, 31.00; osmazome, 5.50; mucilage, 9.00; gluten, 7.00; fungin, 11.40; colouring matter, 3.50; fecula, 26.00; salts, * Dunglison's American Medical Intelligencer, Sep. 1, 1839, p. 161. See, also, M. Cordier, in Journal G6n£ral de Med. Avril, 1823, and Dr. C. T. De Gravina, in Annali Universali di Medicina, Ottobre,, 1839, and Brit, and For. Med. Rev. Oct. 1840, p. 555. t Dunglison's American Medical Intelligencer, Oct. 15, 1839, p. 213. X Memoir du Museum, iii. 198, Paris, 1817. § Bulletin des Sciences Medicales de Ferussac,xix. 332; and M£rat& De Lens, Diet, de Mat. Med. Art. Ergot. || For Mr. Battley's Analysis, see Lond. Med. Gaz., Feb., 1831, and for that of Mr. Wigger, Lancet,. Nov. 10, 1832, from Allgem. Med. Zeitung. T Wright, Edinb. Med. and Surg. Journ, Oct., 1839, p. 298. ** Op. cit. SECALE CORNUTUM. 435 3.10; loss, 3.50. Ergot appears to him to differ from sound rye, chiefly in the presence of oil, osmazome and fungin. Its active principle is yet undetermined. Dr. Hooker, of New Haven,* found, that when a quantity of pulverised ergot was macerated for several days in sulphuric ether, and the liquid evaporated in a glass vessel until it no longer af- forded the smell of ether, there remained at the bottom of the vessel a small quantity of thick heavy oil, resembling in appear- ance fish oil; above this was a lighter oil, much more abundant than the former, of a light reddish-brown colour, and of a sweet- ish nauseous taste. This light oil was found to be possessed of decidedly narcotic properties. In two experimental cases, the ef- fects of the orgot continued apparent for nearly a week; the pupils of the eye were dilated; the pulse, respiration, and capil- lary action were very slow, and the skin livid,—with loss of ap- petite, general languor and lassitude, and rigidity and soreness of the muscles; those of the thighs and other parts of the lower ex- tremities being more particularly affected. For three days the pulse continued below fifty, with a proportionate infrequency of respiration.f In the experiments made with this substance by Dr. McKee,J he found that in every case, when given in doses of from ten to forty drops, it at first produced slight exhilaration of the spirits with increase of circulation; but these symptoms were soon fol- lowed by sedation, and in the larger doses by nausea also. More recently, an ethereal solution has been prepared by Dr. Rees, by digesting four ounces of the powdered ergot in four fluid ounces of ether for seven days. The ether dissolves the fatty matters contained in the drug. It is then poured off, evaporated to dryness, and the residue again dissolved in two fluid ounces of ether. Repeated trials of this preparation have been made by Mr. J. C. W. Lever ,§ who affirms, that it acts most powerfully on the parturient powers of the uterus during and after labour. What is singular,—Mr. Lever remarks,—whilst all the other prepara- tions of ergot not unfrequently produce acro-narcosis, he has not once seen these symptoms supervene on the use of the ethereal solution. He thinks they are most probably caused by some con- stituent of the drug, which ether does not dissolve,—a view which cannot be reconciled with the results of the experiments detailed above.. Each ounce of the preparation, Dr. Rees thinks, may be con- * Boston Medical and Surgical Journal, x. 298, Boston, 1837. f See Dunglison's Amer. Med. Intelligencer, Dec. 15, 1837, p. 329. X Ibid, Sept. 1,1839, p. 161- I Lond. Med. Gazette, Apl. 10,1840, p. 108. 436 SECALE CORNUTUM. sidered equivalent to two ounces of the ergot; or fifteen drops to a half dram dose of the powdered drug. Mr. Lever gave it in doses varying from fifteen drops to thirty, dropped upon sugar, and he found that uterine action commenced in twenty minutes or half an hour. Although the ergot is capable of producing the acro-narcotic effects described above, their supervention is not desired by those, who regard it to be possessed of peculiar powers by which it causes contraction in the uterine fibres of the parturient female, and who administer it with that view. When given in appropriate and properly repeated doses, the uterine action, they assert, becomes more energetic, and the con- tractions constant and almost unremitting; but there is no accom- panying disorder. It has been largely administered, and in no country, perhaps, more than in this: practitioners of the greatest eminence—here and elsewhere—have placed the fullest reliance on its powers to excite contraction of the uterine fibres, and al- though in many of the cases which fell under their observation, the parturient efforts might have recurred without the agency of the ergot, this could scarcely have been the case with the remainder. From the results, therefore, of these cases, we seem to be com- pelled to admit, that the ergot is possessed of expulsive properties by which it acts upon the parturient uterus; but that it is capable of producing any effect upon the unimpregnated uterus, or upon the impregnated at any time, except when parturition has com- menced, is denied by many. The experiments of Mr. Wright,* and of Dr. De Gravina,f seem, indeed, to exhibit the singular fact, that the ergot appears to have the power of prolonging gestation in the guinea pig and rabbit, when administered for a considerable pe- riod.J The result, however, of all observations precludes the belief, that the increased parturient efforts, resulting from its agency, are produced indirectly by violence done to the constitution of the mother, inasmuch as, in most of the recorded cases of benefit accruing from its administration, no such violence would appear to have been perpetrated. Yet, admitting the full power ascribed to the ergot in these eases, it can be rarely necessary to have re- course to it; and it is doubtless often employed, where the pro- priety of the administration of it, or of any other agent, is ex- tremely questionable. But the effect produced by the ergot upon the mother has not been the only topic of interest in regard to its use in parturition. It has been maintained by many, that since its introduction, the * Op. cit. t Op. cit. | Brit, and For; Med. Rev. Oct., 1840, p; 556. SECALE CORNUTUM. 437 number of the still-born has augmented, and that observation has sufficiently shown, that where it is given to expedite delivery, more or less danger always accrues to the offspring ;* either by the induction of asphyxia, or of positive death, owing to the vio- lence of the uterine contractions, or by the deleterious agency of the ergot on the foetus.f But even were we to admit the preju- dicial effect of the ergot on the foetus in utero to be true—and it has been deposed to by many obstetricians—and that the number of the still-born is greater tban formerly—which is, however, by no means the case—its influence could be but small, and could not account for the statistical differences that have been no- ticed.J In many cases, the ergot has been largely administered, and yet the child has been born alive. Dr. James Patterson,^ of Glasgow, details the particulars of a case in which the enormous quantity of four ounces was given, yet the movements of the child continued lively; and he refers to an excellent paper by Professor Von Busch,|| of Berlin, now before us, containing a reference to one hundred and seventy-five cases in which the secale cornutum was given on account of deficient labour-pains. One hundred and seventy-seven children were born ; of these one hundred and forty- two were born alive; eighteen in a state of asphyxia which was removed by appropriate treatment; and seventeen still-born. Of the seventeen dead, seven had evidently died before labour, and were more or less putrid; and ten during labour; of these, two lost their lives from turning; one from presentation of the breech; two from prolapsus of the funis; one from narrow pelvis and detention of the head therein; one from the long duration of the fourth stage of labour; one from a difficult forceps case, which required perforation afterwards; one from a peculiar deformity of the ex- tremities ; and one from no assignable cause: so that, of the one hundred and seventy-seven cases, there was but one which could be referred to the agency of the ergot, and there was no reason- able ground for such reference. * Chevasse, in Transact, of the Provincial Medical and Surgical Association, iv. 306, Lond. 1836. Prof. R. M. Huston, North Amer. Med. and Surg. Jour. 1829; and Mr. Chatto, in Lond. Med. Gaz. July 13.1839, p. 575; also, Reports of Medical Society of London, in Lancet, Oct. 26, 1839, p. 168, and Mr. Wright, Edin. Med. and Surg. Jour. Jan. 1840, p. 25. t Mojori, in Gazette Medicale de Paris, Janv. 19, 1839. X Avery, in Transact, of the Med. Society of the State of New York, vol. iii. Pt. 2. p. 185, Albany 1837. § London Medical Gazette, June 1, 1839, p. 337. || Die gebiirtshulfliche Klinik an der koniglichen Friedrich-Wilhelms-Uni- versitat zu Berlin, in neue Zeitschrift fur Geburtskunde, u. s. w. B. v. H. i. S. 107. Berlin, 1837. 438 SECALE CORNUTUM. Dr. Frank Ramsbotham* who regards the secale cornutum as capable of exerting specific powers on the uterus at all periods of utero-gestation, and who has recently referred to several cases of premature labour induced in his own practice by its use, is dis- posed to conclude, that although it may bring on labour without having recourse to any operation, yet that it does not present a more likely, or indeed so probable, a means of saving the infant as the older method of puncturing the membranes ; and he infers, from his experience, that whatever might have been the quantity administered, unless it exerted a decided influence over the uterus, the child suffered no detriment.f Dr. PatersonJ and Mr. Heane§ have likewise administered the ergot successfully in large doses with the view of inducing pre- mature labour. The former of these gentlemen is disposed to think, that the abortive properties of the ergot are not exerted upon the impregnated uterus at an early period of utero-gestation, but that, at a certain stage of developement, the uterine fibres are capable of being excited by it so as to expel the foetus. It would be strange were its agency to be thus restricted. When ergot was found to be possessed of the power of exciting uterine contractions, it was philosophical to employ it in retention of the placenta, in after-pains,|| and in cases of uterine hemorrhage and of convulsions*^ in the parturient state, accompanied with atony of the uterus.** In such cases, means of more speedy ac- tion are needed; but still cases might arise in which the admin- istration of ergot might be serviceable, and several such cases, attesting the services rendered by it, have been published. It has been .strongly recommended, likewise, for the preven- tion of uterine hemorrhage by Stearns,ff Dewees,JJ Bradley,§§ Abraham,|||| Kisch,.Trousseau,^ and others. Subsequently, the employment of ergot was extended to * Lond. Med. Gaz, June 15th, 1839, p. 420. See, also, Ibid, for June 28, 1834. f See, on this subject, Dr. J. J. Kelso, in Lond, Lancet, June 22,1839, p. 462; and Duparcque, in Revue M6dicale, Mars, 1838. X Lon. Med. Gaz. June 1, 1839, p. 332. See, also, Ibid. Sept. 1838. § Ibid. Jan. 26, 1839. For various opinions on this subject, sec Mr. Wright, in Edinb. Med. and Surg. Journal, Jan. 1840, p. 27. || Hoffman, in Berl. Med, ZeitunJE CHLORIDUM. 445 SOD.E CHLORIDUM. bvNONYMES.—Soda Chlorinata, Sodse Chloruretum, Chloruretum Oxidi Sodii, Sods Oxymurias, Natrum Chloratum, N. Chloricum, N. Oxymuriaticum, Chloride of Soda, Hypochlorite of Soda, Labarraque's disinfecting Liquid; Chloruretof Soda, Chlorite of Soda, Chlorinated Soda. French.—Chlorure de Soude, Chlorure d'Oxide de Sodium. German.—Chlornatron. This preparation resembles in almost all respects the chloride of lime. (See Calcis Chloridum p. 107.) Both it and the chloride of potassa were associated by Berthollet under the common name Eau de Javelle, or bleaching liquor, and it has of late generally received the name of Liqueur de Labarraque. METHOD OF PREPARING. Labarraque* recommended it to be prepared directly by pass- ing a current of chlorine into a solution of subcarbonate of soda. The following is the formula, in the last London Pharmaco- poeia, for the Liquor Soda Chlorinate, the Liquor Sodas Chloridi, L. Sodas Oxymuriaticae, L. Chloreti, seu Chlorureti Natri, seu Sodas, Natrum Chloratum Liquidum, L. seu Aqua Natri Oxymu- riatici; German, Oxydirt-salzsaures Natronwasser, Chlorsodafliis- sigkcit, or Labarraque's disinfecting liquid. " Take of carbonate of soda, a pound; distilled water forty-eight fluid ounces; chlo- ride of sodium, four ounces; binoxide of manganese, three ounces; sulphuric acid, four ounces. Dissolve the carbonate of soda in two pints of the water; then put the chloride of sodium and binoxide of manganese, rubbed to powder, into a retort, and add to them the sulphuric acid, previously mixed with three fluid ounces of water, and cooled. Heat and transmit the chlorine first through five fluid ounces of water, and afterwards into the solution of carbonate of soda above directed." When the solution of chloride of soda is properly prepared, it has a yellow colour, a sharp, saline, and astringent taste, and an odour of chlorine. By careful evaporation, it yields crystals which produce the original liquid when re-dissolved. When the solu- tion is exposed to the air, and allowed to evaporate spontaneous- * Gazette de Sante, April 25,1826. 38* 446 SOD;E CHLORIDUM. ly, it gives out chlorine, and yields crystals of carbonate of soda.* EFFECTS ON THE ECONOMY. In its general remedial agency, the chloride of soda resembles the chloride of lime, and has been administered both internally and externally in the same cases. It is preferred, however, for in- ternal, whilst the chloride of lime is generally chosen for exter- nal, use. By Bouillaud, Chomel and others it has been given, with ad- vantage, in typhous fevers; and by Kretschmar,f Lalesque, Col- son, and GouzeeJ in intermittents :§ ten cases are reported by the last named gentleman; in two, the intermittent yielded immedi- ately; two others were cured after a slight return ; in one there were four attacks, gradually diminishing; in two cases, the se- verity of the paroxysms abated, but it was thought necessary to have recourse to the sulphate of quinine; in two others, no effect was produced, and in one, the disease was aggravated. Gouzee infers, that these cases prove the febrifuge properties of the chlo- ride of soda to be less marked than those of the sulphate of qui- nine, and, therefore, that it ought not to be trusted to, except in the slighter cases, and where the patients are easily susceptible of the effects of medicine,—as women and children. In like manner, it has been found useful in scrofulous affections, and in various diseases in which the chloride of lime has proved serviceable. See Calcis chloridum. MODE OF ADMINISTERING. From ten drops to a dram may be given internally for a dose, mixed with plain or sugared water. The form in which it was prescribed by Gouzee, in inter- mittents, was a mixture, composed of half a dram of the chloride to four ounces of distilled water. This was taken by spoonfuls during the apyrexia; so that the last dose should be swallowed shortly before the next paroxysm was expected. The patients were restricted to their beds, or at least to their chambers. When applied externally, it is rarely used pure or diluted with * Faraday, Quarterly Journal of Science, N. S. ii. 84, cited by Brande, Dic- tionary of the Materia Medica, p. 508, Lond. 1839. f Venus, Grundriss der medicin. Receptirkunst, S. 67. Weimar, 1838. \ Revue Medicale, Fevrier, 1836. \ Riecke, Die neuern Arzneimittel, S. 334, and 2te Auflage, S. 511. Stutt- gart, 1840. SPILANTHUS OLERACEUS. 447 so little as one half water, except in cases of asphyxia, and gan- grene, and for dressing old ulcers, &c. Most commonly it is di- luted with five to ten parts of water, and in this strength is ap- plied to ulcers of various kinds, burns, cutaneous diseases, &c. When used as a disinfecting agent, it is most commonly diluted with ten, twenty or thirty times its weight of water.* SPILANTHUS OLERACEUS. Synonymes.—Spear-leaved Spilanthus. French.—Cresson de Para. German.—Falsche Fleckblume. This plant, which is a native of South America, being an an- nual of very rapid growth, succeeds well in the climate of the United States. A tincture of it has been much recommended in France and Germany, as an arcanum, in toothach. Of late, its preparation has become known. Rieckef terms it the Tinctura Spilanthi oleracei composita, (Paraguay-Roux, Paratinktur.) It is prepared in the following manner. Take of the leaves and blossoms of the inula bifrons—a species of elecampane growing in Italy and the southern Pyrenees—one part; the blossoms of the spilanthus oleraceus, obtained from South America, and from which the Drs. Bahi formerly made their elixir odontalgicum, four parts; roots of the anthemis pyrethrum, one part; alcohol at 33° (s. g. .863) eight parts. The solid matters are divided into small pieces, and with the alcohol are placed in a flask for digestion, which is closed; the mixture is suffered to digest for a fortnight, at the expiration of which time it is filtered, and then preserved in close vessels.J This tincture is said to relieve toothach instantaneously, when applied to the gums and tooth, and Hufeland affirms, that multi- tudinous experiments in Berlin have proved its value. If the re- lief be transient, the application must be repeated. It contains nothing narcotic, or which can injure the teeth; and consequently no unusual precaution is requisite in its use. Heyfelder, who often tried it, considered it very uncertain,—at first affording relief, but afterwards none at all. * Payan, Revue Medicale, Aout, 1839. f Die neuern Arzneimittel, S. 395,and2te Auflage, S. 620. Stuttgart, 1840. X Journal de Pharmacie, ix. 586. 448 STRYCHNINA. STRYCHNINA. Synonymes.—Strychninum, Strychnia, Strychna, Strychnine, Vauqueline. French.—Strychnine. German.—Strychnin, KrahenaugenstofF, Krahenaugenbitter. This alkaloid was discovered by Pelletier and Caventou,* in the nux vomica, St. Ignatius's bean, upas tieute, and in the wood of the strychnos colubrina; and experiment has shown, that these substances are indebted for their medicinal properties to it.f In those different substances, strychnine is found associated with another principle analogous to it in its properties—brucine.J In the St. Ignatius's bean, there is less brucine than in the nux vomica, so that it is best adapted for the preparation of strych- nine; but it is not as easily obtained, and consequently the nux vomica is almost always—if not always—used. METHOD OF PREPARING. A solution of liquid subacetate of lead is added to a solution of the alcoholic extract of nux vomica in water, until a precipitate is no longer thrown down; the foreign matters being thus preci- pitated, the strychnine remains in solution with a portion of co- louring matter, and sometimes an excess of acetate of lead. The lead is now separated by sulphuretted hydrogen; and the fluid is filtered and boiled with magnesia, which unites with the acetic acid, and precipitates the strychnine. The precipitate is next washed in cold water, and re-dissolved in alcohol to separate it from the excess of magnesia, and by evaporating the alcohol, the strychnine is obtained. If it be not perfectly white, it must be re- dissolved in acetic or hydrochloric acid, and reprecipitated by means of magnesia. Strychnine, obtained by crystallisation from an alcoholic solu- tion, which has been diluted by means of a small quantity of wa- ter, and left to itself, appears under the form of microscopic crys- tals, constituting four-sided prisms, terminated by pyramids with four flattened or depressed faces. When crystallised rapidly, it * Annales de Chimie, Tom. viii. ix. & x. t Magendie, in Annales de Chimie, x. 176r 1819. X See page 100. STRYCHNINA. 449 is white and granular, is insupportably bitter to the taste, and leaves an after taste similar to that caused by certain metallic salts ; it has no smell, and is not changed by exposure to the air; is neither fusible nor volatile; for, when subjected to the action of heat, it does not fuse until the moment of its decomposition and carbonisation, and it is decomposed by a degree of heat inferior to that which destroys most vegetable substances. When exposed to the naked fire, it swells, becomes black, and yields an empy- reumatic oil, a little water, acetic acid, carbonic acid, and car- buretted hydrogen. Distilled with deutoxide of copper, it gives out much carbonic acid, and only slight traces of azote. It is composed, therefore, of oxygen, hydrogen and carbon. Although strychnine has so strong a taste, it is scarcely soluble in water. At 50° Fahr., 6667 parts of water dissolve but one of it; boiling water dissolves a little more than double, so that it may be said to be soluble in 2500 parts of boiling water. It is remarkable, however, that a solution made in the cold, and con- taining, therefore, only ^Votn Part °f its weight, may be diluted 100 times, and still retain a very decidedly bitter taste. It is pretty soluble in strong alcohol, little so in weak, and not greatly so in ether or fixed oils, although they acquire a bitter taste from it. On the other hand, it is very readily soluble in volatile oils, and the hot saturated solution, on cooling, deposits crystals. It has an alkaline reaction, and forms, with acids, salts which are mostly crystallisable, and insupportably bitter, and are more solu- ble than pure strychnine.* EFFECTS ON THE ANIMAL ECONOMY IN HEALTH. The effects of strychnine on man and animals resemble, on the whole, those of the spirituous extract of nux vomica, except that they are more intense. According to Magendie, one eighth of a grain is sufficient to kill a strong dog. Pope, who made experi- ments on dogs, found, that Jfth of a grain was enough to para- lyse the lower limbs of a small dog in four or five minutes, and in half an hour to kill it. Christisonf considers strychnine the strongest poison after the hydrocyanic acid. He injected a solu- tion of a third of a grain in alcohol into the thorax of a wild boar, and in ten minutes the animal died. A dog was destroyed by £th of a grain in two minutes; and he believes that the same effect would be induced on man by half a grain introduced into a wound. LembertJ observed similar results from placing a grain in the * Magendie's Formulaire, &c. + Treatise on Poisons, 3d edit. Edinb. 1836. X Essai sur la Methode endermique, Paris, 1828, 8vo. 450 STRYCHNINA. thorax of a small dog, and from three grains introduced into the cellular tissue of a larger animal, on which tetanic spasms bwere induced in the thoracic muscles. Mr. Blake* injected a grain of strychnine, dissolved in a small quantity of acetic acid, into the veins of a dog. The first effect of the poison was to induce general convulsions in about thirty seconds after its injection, the action of the heart being at the same time rendered irregular, which Mr. Blake presumes was owing to the convulsive struggles of the animal. All external signs of life ceased in about a minute and a half after the injec- tion of the poison—the heart still continued to beat. He found, that when strychnine was introduced into the circulation in so small a quantity as not to produce any general symptoms, it did not appear to exert the least influence on the heart. That the action of strychnine is analogous to that of the nux vomica, has been proved by the experiments of Segalas,f Andral,J Bardsley,§ Redlich, Sandras, Liiders, Hennemann, and numer- ous others.|| It. affects especially the spinal marrow and the gan- glionic system.—less strikingly the brain; small doses excite the ganglionic system; larger, the spinal marrow; consequently, it has been properly imagined, that it might be an efficacious reme- dy in nervous diseases, which are dependent upon spasmodic dis- order in the ganglionic system, or on diminished sensibility and torpor of the nerves of motion. The following are the effects observed by Oppler from the in- ternal use of the nitrate of strychnine:—a sensation of. warmth and itching in the epigastrium; eructation ; nausea; vertigo; slight excitement like that of intoxication; great vividness, with more or less confusion of mind; dull pain over the eyes; spots before the same; dilatation of the pupils; diplopia; tinnitusaurium; difficult articulation and deglutition; slight trismus; sense of for- mication in the paralysed parts; convulsive motions or twitchings, at times, in those parts, at others over the whole body, similar to electric shocks; tremors of the muscles; occasionally violent spasms; tetanus; asthma; palpitations; febrile heat; general sweating; prostration; pale or livid countenance; pulse, some- times full and frequent, at others small and contracted; great sensibility over the whole body; involuntary laughter, succeeded always by difficulty of breathing and convulsions. The sleep was generally interrupted by convulsions; the secretion of urine * Edinburgh Medical and Surgical Journal, Apl. 1839, p. 338. f Magendie's Journal de Physiologie, ii. 4. 1 Ibid, Juillet, 1823. \ Hospital facts and observations, illustrative of the efficacy of strychnia, brucia, &c- Lond. 1830. |] Petrequin, Gazette Medicale de Paris, No. 44, Nov. 1838. STRYCHNINA. 451 scanty, and occasionally suppressed. These symptoms came on gradually, and disappeared in the same manner, when the dose was moderate, in the course of some hours. Large doses induce death by a sudden shock to the nervous system; smaller doses, when continued for a long time, may destroy by causing apo- plexy, of which Oppler saw many examples in his experiments on animals.* Dr. Blumhardt, of Stuttgart,-)-has published a case of poisoning by strychnine, which occurred to him in Stuttgart, and which is perhaps the only fatal case on record, of which we have the de- tails. He was called to a young man, seventeen years old, who had swallowed two scruples of strychnine after his dinner. A short time afterwards, experiencing great restlessness, he repented of what he had done, and immediately took four grains of tartar emetic, which excited considerable vomiting. When the physi- cian arrived, about a quarter of an hour after he had taken the strychnine, he found the patient on his back in bed, with his head thrown back, rigid and incapable of motion, but with a constant inclination to turn towards the right side. He could only move the upper limbs freely. The countenance was pale and haggard; the temperature of the skin natural, and the pulse quick and con- tracted. Consciousness remained unaffected; the speech was rendered difficult by an occasional contraction of the muscles that move the lower jaw; but it could not properly be said to be inter- rupted; deglutition was untouched. The trismus, however, be- came more and more frequent and violent, and the respiration thereby unequal and suspended; the pulse was small, suppressed and quick. The remedies—employed to save him—as the tinc- ture of iodine and the acetate of morphine were of no avail. With the periodical trismus was now associated spasmodic agitation of the whole body, to which—after a short interval—succeeded opisthotonos with violent symptoms of suffocation; the trismus attained the highest degree, and the upper extremities were de- prived of the influence of volition. With the increase of the ge- neral tonic spasm, the respiration was always more difficult and oppressed, and for a time wholly ceased; the pulsation of the heart and arteries became irregular, less distinct, and at length imperceptible. In this condition, the skin acquired a bluish ap- pearance ; the countenance was puffed, and of a violet hue; the lips dark blue, the neck swollen, the eyes protruded, fixed and di- rected towards the right side; the pupils enlarged and immova- ble, and the conjunctiva injected. At this period, the patient was * See, also, Tanquerel des Planches, Essai sur la Paralysie de Plomb. Pari?, 1834. f Medicinisch. Correspondenz-Blatt, in Encyclog. des Sciences Medicales, Sept. 1837. 452 STRYCHNINA. entirely unconscious; but from this condition he awoke once, and all the symptoms became mitigated; during this remission, the muscles, influenced by the spinal marrow, remained cramped, except the upper extremities, which could be moved voluntarily. In a quarter of an hour, the tetanic attack returned in its vio- lence, with intense commotion of the whole body ; this ended in asphyxia, from which he again recovered to consciousness. The same thing happened in a third attack. In the fourth, he suc- cumbed under the power of the poison. The whole scene from the taking of the poison to the occurrence of death lasted an hour and a half. During the last attack, as doubt existed whether he was really dead, the median vein of the left arm, which was turgid, was opened, and after the vessel was emptied of its thick, black blood, which resembled that of an animal, several bubbles of air, from the size of a pea to that of a small cherry, were forced out by pressure. The dissection was made twenty hours after death. In spite of the elevated summer heat there were no signs of putrefaction; the whole of the body was uncommonly rigid. The muscles of the back were of a brownish red colour, almost like that of smoked meat. On opening the spinal canal, a considerable quantity of thick, dark coloured blood, like that of an animal, flowed out. The plexus venosi spindles were turgid with the same kind of blood, as well as the vessels of the pia mater. Under this mem- brane, especially in the cervical portion, some watery fluid was effused. The. upper portions of the spinal marrow were soft, even pappy in some places, but lower down it became gradually harder. Within the cavity of the cranium, the same turgid con- dition of vessels existed; all the veins of the dura mater appeared as if injected; the veins of the pia mater were likewise engorged; and the whole mass of the brain indicated an unusual supply of blood, so that the cortical substance appeared quite blue. The cerebellum was softer than usual. In the cavities of the abdomen and thorax, a striking poverty of blood was perceptible. The heart was shrunken and empty, as' well as the large vessels of the thorax. The stomach was full of solid food, which appeared to have undergone no change; its blood vessels contained a consi- derable quantity of blood, and the mucous coat exhibited marked redness over its whole surface; but it was especially concentrated about the cardia and the fundus; the small intestine was likewise redder than natural, as is commonly the case in those who have died whilst digestion was going on. The liver was tolerably supplied with blood ; the gall bladder empty. STRYCHNINA. 453 When strychnine is used endermically, as is not unfrequently done, the course of the phenomena is somewhat different. G. H. Richter, employed it in this way in many cases of hemiplegia, in one of which it occasioned symptoms of actual poisoning. When the dose exceeded a quarter of a grain, a feeling arose in the part to which it was applied as if needles were run into the skin; this gradually spread over the whole limb; the temperature of the body was augmented; the pulse quickened, full and hard ; the breathing constrained; pain was experienced in the same side of the head; the secretion of urine was increased, and a general perspiration broke out, which persisted for about an hour, after which the pricking of the surface, and the excitement of the ves- sels ceased. To these symptoms—and seldom later than two hours after the application of the agent—convulsive movements succeeded in the paralysed limbs like those induced by electricity, which augmented in violence and frequency with the increase of the dose, being strongest and most severe during the night, at which time the limbs were moved involuntarily. When awake, a feeling of stiffness was experienced in all the limbs, which passed off when they were used. On digestion,.defecation, and the appetite, the nitrate of strychnine seldom exerted any influ- ence. Only in one case—in which no effects were induced on the nervous system, when the dose was gradually carried to three grains—was obstinate constipation produced. In general, when it was begun with in the dose of one-eighth of a grain, and on the next day one-fourth was given, on the third day one-half, and afterwards the dose was increased daily by one-fourth of a grain, until one and a quarter were given,—the following unpleasant symptoms supervened. The patient experienced'twitchings ear- lier than before, and first in the paralysed limbs. As these be- came, from minute to minute, more violent, a penetrating pain was felt in the occiput, with vertigo and tinnitus aurium. The twitchings now extended over the affected arm, and, subsequent- ly, to the sound side, whereupon the vertigo and headach aug- mented, and insensibility, with difficult and stertorous breathing. ensued. The pulse now became very full, hard, slow, and inter- mitting; the countenance bluish red and turgid; the paralysed lower extremities of a marbled blue; the pupils very much dilated and the mouth open, the convulsions being occasionally so strong as to toss him to and fro on the bed. When these phenomena declared themselves, Richter removed the dressing from the sur- face, which appeared inflamed, and still contained a quantity of strychnine, that had not been absorbed; the parts were then washed, and sprinkled immediately—according to Lembert's and Lesieur's recommendation—with two grains of the acetate of 454 STRYCHNINA. morphine; the face was washed with cold water, the soles of the feet brushed, and other excitants administered.* Morphine appears to be the most powerful antidote : under its use, the dangerous symptoms rapidly disappear, consciousness re- turns ; the patient sleeps for some hours, and a general perspira- tion breaks out, after which he awakes with a feeling of dulness, and with stiffness of the limbs, which soon, however, vanish. In respect to the topical application of strychnine by the endermic method, A. L. Richterf remarks, that the preparations of strych- nine produce much more powerful local effects than those of mor- phine ; they maintain the abraded portions of the skin in an in- flamed state, promote suppuration more than the morphine, and occasion violent itching and burning, with a feeling as if needles were run into the skin. Artus recommends, from his investigations, pure bartya (Aetz- baryt) as an antidote. It forms an insoluble precipitate with strychnine, and he esteems it to be more certain than the tinc- tures of iodine and bromine recommended by Donne,J the muri- ate of baryta, or the infusions of tar and galls recommended by Raspail.§ The effects, referred to above, were chiefly obtained from the administration of the nitrate of strychnine, but they may be es- teemed applicable to all the preparations of strychnine, as we know nothing of any difference in their agency. It is probable, however, that the salts of strychnine, owing to their greater solu- bility, may have more action than the strychnine itself, although the muriatic and acetic or lactic acids, which are almost always present in the stomach, it might be presumed, would readily unite with it. EFFECTS ON THE ECONOMY IN DISEASE. The following remarks apply equally to the pure strychnine, and its salts, and to the alcoholic extract of nux vomica, to which the reader is referred, (see page 351,) and which is pre- ferred by some.|| It has been administered in 1. Paralysis, especially in that arising from the action of lead, in which Bally, Lembert, Bardsley, Andral, Rayer, and Tan- * See some experiments, relative to the action of strychnine on the nervous system, by Dr. H. Stannius, in Mailer's Archiv. Heft. ii. 1837; and Brit, and For. Med. Review for Jan. 1838, p. 221. t Die endermatische Methode, u. s. w. Berlin, 1835. X Journal de Chimie Med. v. 494, Paris, 1829. \ Nouveau Systeme de Chimie organique. Paris, 1833. | Petrequin, Bulletin de Therapeutique, Mars, 1840. STRYCHNINA. 455 querel,* have employed it beneficially. In paraplegia and he- miplegia, it has been prescribed by Lesieur, G. H. Richter, Rom- berg, Bardsley, Bally, Lafaye, Oesterlen, Reinhardt, Heyfelder, Faye, Mart, Schaible, Raciborski, A. T. Thomson,f Gellie,J Pe- trequin§and numerous others.|| From the results of their observations it would seem, that strychnine is most efficacious in paraplegia; less so in hemiple- gia, although it has often been given with advantage in the latter affection; but its administration in hemiplegia requires special cir- cumspection, particularly when the paralysis has succeeded to apoplexy.TI Romberg affirms, that, as a general rule, in cases of paralysis dependent upon disease of the central organs of the nervous sys- tem, he has never seen any striking effect from the endermic use of strychnine, and that great care is needed lest it should react injuriously on the brain. He considers it especially adapted for cases of paralysis, that are dependent upon some affection of the spinal marrow induced by mechanical concussion ; as well as for the local paralysis that succeeds rheumatism, suppressed exan- thems, &c. Mr. Pereira** has seen it very serviceable in that shaking or trembling action of the muscles, which is produced by habitual intoxication. G. H. Richter cured a case of aphonia by it, and it has been much used, and successfully, in amblyopia and amaurosis, by Short, Liston, Guthrie, Middlemore,ff Henderson, Mart, Petrequin,JJ and others. In these cases, it is generally used endermically on the temporal region. Dr. Stevenson,§§ derived benefit from it—when applied in this way—in cases of amaurosis of many years' duration. Half a grain was repeated twice a day until tremors of the limbs were produced. He employed it in the same manner in other cases of local paralysis. In cases of amau- rosis, Henderson advises, in addition, that a solution of strychnine should be dropped into the eye. It has likewise been given suc- cessfully in cases of paralysis of the bladder by Schaible, Bally, Hennemann, Behrend,|||| and others, and in paralysis of the facial • Gazette Medicale, pour 1835, p. 383. t Lond. Med. Gaz. April, 1831. X La Lancette Frangaise, Aout 29,1837. 5 Op. citat. || Petrequin, Gazette Medicale, Nov. 1838. IF See Bally, Considerations sur la Strychnine, &c. in Bullet. General de Therapeutique, Fev. 1838. ** Medical Gazette, Vol. xix. ft Midland Medical and Surgical Reporter, May and August, 1831. $t Bulletin General deTherap. Juillet, 1838. \\ Transactions of the Medical and Physical Society of Calcutta, Vol. v. |H! Medicin. Zeitung, Sep. 1837, S. 190. 4 5 6 STRYCHNINA. nerve* In two cases of paralysis of the rectum in elderly peo- ple, accompanying a disordered state of the bowels, the Author found the best effects from the endermic use of the strychnine—in the quantity of a quarter of a grain, night and morning, to a blis- tered surface on the sacrum. In high grades of paraplegia, the interna] use of the remedy is to be preferred, but in general the endermic administration is more advisable. In paralysis of the limbs, a spot is selected in the vicinity of the spinal marrow. Strychnine is likewise given in other affections. Very favoura- ble reports have been made as to its efficacy in 2. Neuralgia. Mart found it beneficial in tic douloureux and in nervous headach; Magnus, in a case of neuralgia of the arm, and several successful cases have been recently published bv Dr. Pidduck.f 3. Traumatic tetanus. In this disease, it has been recommend- ed by Liiders. 4. In Hysteria,, Hypochondriasis, and Dyspepsia^ it has been advised by Schmidtmann and Basedow, but morphine appears to render more essential service. 5. In Chorea, Romberg saw good effects from it. It has like- wise been advised in epilepsy^ and catalepsy. Fricke has admi- nistered it successfully in— 6. Syphilitic Osteocopi. It has also been given with benefit in cases of 7. Dysentery and Diarrhaa, by Bardsley, Recamier, Ged- dings,|| and others; and it has been used endermically in cholera —two or three grains being applied to a blistered surface on the nape of the neck. By MM. Dreyfus, Grimaud d'Angers and Potton it was given internally in the same affection to allay vo- miting :—a quarter to half a grain being added to three ounces of water, and prescribed in the dose of a spoonful every hour.H Dr. Ryan,** asserts, that he has repeatedly known a few of the pills—the formula for which is given below—check a profuse * Dr. O'Brien, Med. Chirurg. Review, and L'Experience, Nov. 1838; and Beales, New York Journ. of Med. and Surg. July, 1839, p. 201. t Lond. Med. Gazette, Aug. 7,1840, p. 759. t Dr. Melcombe, in Lond. Med. Gaz. for Mar. 4,1837, p. 850. $ Brofferio, in Repertorio Medico-chir. di Torino, 1825, and Revue Medi- cale, iv. 488, Paris, 1825- || N. American Archives, No. 2, Nov. 1834. IT Merat & De Lens, Diet, de Mat. M6d. Art. Strychnine. ** Formulary, 3d edit. p. 335, Lond. 1839. STRYCHNINA. 457 diarrhoea with rice coloured evacuations, and even when the ex- tremities were blue in malignant cholera. 8. Amenorrhea. Of twelve cases of suppressed menstruation, treated by Bardsley, ten were cured, and two relieved. Dr. Churchill* had also two cases, in which the cure by it was com- plete and permanent. Lastly. From its efficacy in analogous affections of the diges- tive mucous membrane, Dr. Stokesf thinks there is good reason to hope, that it may prove useful in bronchitis. It has been em- ployed, indeed, in all the cases in which the alcoholic extract of nux vomica has been found of service, than which it is of course to be more relied upon, in consequence of its greater uniformity; the nux vomica itself being often found unequal. (See page 351.) MODE OF ADMINISTERING. Pure strychnine is best exhibited internally, in the form of pill,, or in spirituous solution; but if a little acid, especially the acetic, be added to it, it may be given in watery solution, as in this way a salt of strychnine may be formed extemporaneously. The dose is from one sixteenth to one eighth of a grain, which may be gra- dually increased until a grain is taken. In ordinary cases, it will be sufficient to raise the dose to half a grain, two or three times a day, but if any circumstance should arise to cause its disconti- nuance, it ought not to be recommenced in doses as large as the last, but with small doses, as at the beginning. In the endermic application of the remedy, we sprinkle, twice a day, a quarter of a grain on the denuded surface, and slowly increase the quantity to half a grain or more should this be necessary. If the larger doses do not act more beneficially, it will be advisable to discon- tinue the remedy for a few days—after which the smaller doses may again exert a signal influence—rather than to carry the dose still higher. M. PetrequinJ thinks, that the endermic use of the strychnine frequently fails owing to the vesicated surface, to which it is applied, becoming covered with a layer of coagulable llymph, in consequence of which the strychnine is unable to make its appropriate impression. This layer of lymph should be removed as far as possible at each application ; and as the vesi- cated surface daily becomes less and less sensible, the dose must be proportionably increased. M. Petrequin recommends that * Outlines of the principal diseases of females, Dunglison's Amer. Med. Library edit., p. 54. Philad. 1839. f Treatise on diseases of the chest, p. 125, Dublin 1837, and Amer. Med. Library edit., Philad. 1838. X Bulletin de Therapeutique, Mars, 1840. 39* 458 STRYCHNINA. a third or a fourth of a grain of strychnine should be mixed with two or three grains of the powdered nux vomica, and the compound be sprinkled on the surface; but it would seem to be far preferable to increase the dose of the strychnine than to place so much insoluble and irritating powder on the sensitive surface. v Pilula Strychnina. Pills of Strychnine. R, Strychnin, pur. gr. ij. Conserv. rosar. Jss. Divide in pilulas xxiv. Dose.—One to two, morning and evening. Magendie. R. Strychnines, gr. j. Confect. ros. 3ss. Pulv. glycyrrhiz. 9ss. Divide in pilulas xij. Dose.—One, night and morning. The quantity may be in- creased to four or five daily, Ryan. Tinctura Strychnine. R. Strychnin, pur. gr. iij. Alcohol, 36° (.837) §j. M. Dose.—Six to twenty-four drops, twice or thrice a day. Magendie. Mistura Strcyhnina. {Potion Stimulante.) Mixture of Strychnine. R. Aq. destillat. 5ij. Strychnin, gr. i. Sacch. alb. Jij. Acid. acet. gtt. ij. M. Dose.—A dessert-spoonful, morning and evening. Magendie. STRYCHNINE ACETAS. 459 Collyrium Strychnina. Collyrium of Strychnine. R. Strychnin, gr. ij—iv—vj—viij. Acid. acet. dil. Aq. destillat. aa. 3j. M. Two drops to be let fall into the eye, a few times a day, in amaurosis. Henderson. I. STRYCHNINE ACETAS. Stnontmes.—Strychnium Aceticum, Acetas Strychnii seu Strychnicus, Ace- tate of Strychnine. German.—Essigsaures Strychnin, Strychninacetat. In addition to the acetate, formed extemporaneously, as men- tioned under strychnine, the proper acetate of strychnine has been administered, especially by Liiders and Fricke. It may be made, like the acetate of quinine, from the direct combination of the strychnine with acetic acid. According to Thenard, it is very soluble, and crystallises with difficulty. Even when diluted 40,000 times, its solution occasions a sense of bitterness on the tongue. The following formulee have been given by the physicians cited. Gutta Acetatis Strychnina. Drops of Acetate of Strychnine. R. Strychnin, acet gr. iij. Alcohol. 3j- Aq. cinnam. 5vij. M. Dose.—Five drops, twice a day, gradually increasing the dose. Ltjeders. 460 STRYCHNINE IODAS. Tinctura Acetatis Strychnina. Tincture of Acetate of Strychnine. R. Strychnin, acet. gr. iss. Alcohol. Iss. M. Dose.—From three or four, to twenty or thirty drops, to be taken at bed time, in cases of syphilitic pains of the bones. Fricke. II. STRYCHNINE IODAS. Synonymes.—Strychnina Iodata, Strychnium lodicum, lodas Strychnu seu Strychnicus, Iodate of Strychnine. German.—Iodsaures Strychnin, Strychninjodat. method of preparing. The preparation of this salt, according to Magendie, is easy. It is sufficient to add a concentrated solution of iodic acid to powdered strychnine; in a moment, the mass swells up, absorbs water, becomes thicker and at times very consistent. It is now treated with boiling alcohol, filtered, and left to spontaneous eva- poration. In this way, beautiful crystals of iodate of strychnine are obtained. The iodic acid, proper for this preparation, is ob- tained, according to Geiger, in the following manner. Nine parts of the iodate of baryta are boiled with two parts of oil of vitriol, previously diluted with ten times as much water, for half an hour. It is then filtered, and evaporated by a gentle heat to the consis- tence of a thin syrup, and is exposed to the air for spontaneous evaporation. The iodate of strychnine may likewise be formed by double decomposition, by mixing a soluble iodate, as iodate of soda, with a solution of sulphate or muriate of strychnine. The iodate of strychnine is precipitated, which may be treated with boiling alcohol, and crystallised as above directed. The iodate is of a white colour, and crystallises in beautiful prismatic needles: it is but slightly soluble in cold water, but more so in boiling water and alcohol. STRYCHNINE NITRAS. 461 EFFECTS ON THE ECONOMY. " This salt," says Magendie, " is one of the most active poi- sons with which I am acquainted. A single grain is sufficient to destroy a strong dog under tetanic symptoms. It acts, likewise, powerfully on the diseased organism. I gave it to several per- sons with a success which far exceeded my expectations. It proved effectual in some old paraplegic affections, which had been esteemed incurable, and after all the usual remedies had been ad- ministered in vain." He gave it in pills, each of which contained one eighth of a grain. One of tbese was prescribed night and morning, and the dose was gradually increased, until ultimately a grain was taken in the twenty-four hours. The greatest circumspection was, how- ever, necessary in its use. Magendie is of opinion, that the Hydriodate of Strychnine, Strych- nium Hydroiodicum, Hydriodas seu lodhydras Strychnii seu Strychnicus, Germ. lodwasserstoffsaures Strychnin, Iodwasser- stoff Strychnin, might be advantageously introduced into medicine. It is prepared by mixing a solution of iodide of potassium with a concentrated solution of acetate of strychnine: a white crystalline powder is precipitated, which is soluble in alcohol, and is the pure hydriodate of strychnine. It does not appear to have been as yet used in medicine. III. STRYCHNINE NITRAS. Synonymes.—Strychnium Nitricum, Nitrate of Strychnine. German.—Salpetersaures Strychnin. This preparation of strychnine has been more used in Germany than any other. It has been received into the Prussian Pharma- copoeia, (Landespharmakopde,) where it is directed to be pre- pared in the following manner. METHOD OF PREPARING. On eight pounds of nux vomica sixteen pounds, of spirit of wine (Kornbranntwein) are poured, and the liquid is distilled to one half. The nux vomica is then freed from the liquor by filtering, is dried and reduced to coarse powder. This is digested two or 462 STRYCHNINE SULPHAS. three times with a sufficient quantity of the spirit, and after diges- tion it is strained. The tinctures are then subjected to distillation, and what remains is evaporated along with the fluid that remained after the boiling; to this, acetate of lead, dissolved in a sufficient quantity of distilled water, is added so long as a precipitate falls. The fluid, separated as much as possible from the precipitate, bv means of the filter, is now evaporated to one half, by a gentle heat. When cold, it is mixed with two ounces of calcined mag- nesia, and is suffered to stand for three days, when the deposit is separated by the aid of the filter, and is washed, and dried. This, after having been rubbed to powder, is digested two or three times in alcohol, and the tinctures are subjected to distillation, until only a few ounces remain. The strychnine, which on cooling appears in the retort in the form of a white powder, is separated by the filter, washed two or three times with rectified spirit of wine diluted with an equal quantity of common water, and is neutral- ised by a proper quantity of dilute nitric acid. The filtered fluid is evaporated by a gentle heat so as to allow the formation of crystals. These crystals are needle-shaped, colourless, of a silky splendour, and a very bitter taste; they are soluble with difficulty in alcohol, but dissolve in ether. METHOD OF ADMINISTERING. The dose and mode of administering the nitrate of strychnine are the same as in the case of the pure strychnine. Its endermic application will sometimes succeed when the internal administra- tion has been more limited in its results. The experiments insti- tuted by Dr. Stannius, and others, and referred to in a former page (454,) were with the nitrate of strychnine. Magendie found, in his experiments, that this salt completely prevented the coagulation of the blood.* IV. STRYCHNINE SULPHAS. Synonymes.—Strychnium Sulphuricum, Sulphas Strychnii seu Strychnicus, Sulphate of Strychnine. German.—Schwefelsaures Strychnin, Strychninsulphat. The same effects have been observed from this preparation as from the others. It is also dispensed in the same forms and doses. It may be obtained by the simple union of strychnine with sul- * Lecons sur le Sang; and translation in Lond. Lancet, Jan. 26,1839, p. 637' SULPHURIS CARBURETUM. 463 phuricacid. According to Pelletier, 100 parts of the alkaloid saturate 10.486 of the acid. It is soluble in less than sixteen parts of cold water, and crystallises, when neutral, in transparent cubes; when acid, in needles. Its taste is extraordinarily bitter. It is decomposed by every soluble salifiable base. SULPHURIS CARBURETUM. Synonymes.—Sulphuretum Carbonii seu Carbonei, Carbonium Sulphuratum, Alcohol Sulphuris, Bisulphuretum Carbonii, Sulphuret of Carbon, Bisul- phuret of Carbon, Carburet of Sulphur. French.—Sulfure de Carbon, Carbure de Soufre, Soufre Carbure, Alcool de Soufre. German.—Schwefelalcohol, Schwefelhohlenstoff, fliissiger Kohlenschwefel, Kohlensulfurid. The carburet of sulphur or sulphuret of carbon was discovered by Lampadius in the year 1796. It is a transparent and colour- less fluid at the ordinary temperature, has a very penetrating and disagreeable odour; and a taste, cooling at first, but afterwards burning, acrid, and somewhat aromatic. Its specific gravity is 1.263. It boils at 134° of Fahrenheit. It is not decomposed at the highest temperatures; but volatilises rapidly in the air, and burns readily. It is not soluble in water, but is so in alcohol, ether, and in the fixed and volatile oils. Water separates it im- mediately from those solutions. It unites intimately with the alkalies; but, of the acids, the aqua regia—which is a"mixture of the nitric and muriatic acids—alone lays hold of it. It dissolves potassa, camphor, sulphur, and phosphorus. Lampadius, in the first instance, regarded the sulphuret of carbon as a compound of sulphur and hydrogen; it is now, however, decided, that it consists of sulphur and carbon,—according to Vauquelin, in the proportion of 85 or 86 to 15 or 14; according to Berzelius, and Marcet, of 84.84 to 15.16. MODE OF PREPARING. The following method is recommended by Mitscherlich :* The temperature, at which sulphur enters into ebullition is not sufficient to make the two substances combine, but if burning * Elemene de Chimie, traduits par AI. B. Valerius, i. 156, Bruxelles, 1835. 464 SULPHURIS CARBURETUM. coals be placed in contact with vapours of sulphur, the combina- tion takes place immediately. With this view, a tube of porce- lain may be used, or, what is better, one of cast iron, lined inter- nally with a coat of clay by running it several times through a paste of clay and water, and heating the tube each time. In this manner, the crust of dry clay will become strong enough to pre- vent the sulphur from attacking the iron. The tube is then filled with strongly calcined coals, and is heated to redness in an oblong furnace. One end of the tube is closed by a cork, and a small hole is made at the upper part of the tube, through which the sulphur is introduced, and which is closed by a plug. The other end, which has passed through the furnace, is likewise closed by a large cork, traversed by a glass tube. To make the stoppers close the tube hermetically, they are boiled with glue. The long glass tube passes into a large jar, through a hole in which it is adapted hermetically by means of a cork. The ordinary aperture of the jar is closed by a cork in which a tube is fitted hermetically, which passes through the window. At the bottom of the jar is contained a little water. The long tube, passing from the furnace to the jar, may be kept cool by water made to drop upon it, or by covering it with snow or ice. When the charcoal is heated to redness, small fragments of sulphur are dropped in, from time to time, by means of the aper- ture before mentioned, which must be carefully closed each time afterwards. The sulphur, in melting, runs towards the hottest parts of the tube, to which a slight inclination has been given in placing it in the furnace. It enters into ebullition, and is trans- formed into sulphureous vapour, which, by passing over the hot coals, combines with them: the sulphuret of carbon, or carburet of sulphur formed, condenses in the long tube, from which it runs into the jar, and falls to the bottom of the water. As the coal always retains a little hydrogen, the sulphur likewise unites with it, to form a gaseous body, which is carried off by the tube pass- ing through the window. The carburet of sulphur is preserved in well-stopped bottles, and is covered with about an inch of water, whence it can be best obtained for use by means of a small glass or ivory syringe. EFFECTS ON THE ECONOMY. The carburet of sulphur holds a place amongst the transient or diffusible stimulants.* Its most marked effects are said to con- * Wutzer, Journal de Chimie M6d.; and Amer. Journ. Med. Seiencea Nov. 1831. p. 215. SULPHURIS CARBURETUM. 465 sist in its "exciting the function of cutaneous transpiration to copious sweating; increasing the secretion of urine, elevating the temperature of the body, quickening the pulse, and causing con- gestions towards the bead and those parts of the body whose vitality may have been already somewhat augmented."* Its most striking agency is exhibited in the more active exercise of the functions of the skin. According to Mansfeld, it acts like- wise as an emmenagogue; but, in this respect, probably only like similar excitants. On account of its great volatility, it produces on the skin the feeling of considerable cold. The discoverer of the carburet of sulphur first recommended it as a remedial agentf He particularly advised it, both inter- nally and externally, in rheumatic and gouty affections. In Frei- berg, a mixture of one part of camphor, two of carburet of sulphur, and four of spirit of wine, is a very common external application in rheumatic pains. Kappe found decided advantage from it in gout and rheumatism, and Mansfeld and Wutzer, rest- ing upon a series of observations, maintain, that in rheumatism unaccompanied by fever, or where the fever is slight, it exceeds every other remedy of the class. Dr. Otto,{ of Copenhagen, prescribes four drops of a mixture composed of one part of the carburet of sulphur, and four parts of highly rectified spirit of wine, to be taken every two hours: and he directs the affected parts to be rubbed with an embrocation, composed of one part of the sulphuret of carbon, and four parts of olive oil. The cure, he states, was ordinarily effected in from eight to fifteen days. In deep-rooted dyscrasies, however, these gentlemen found no ad- vantage from it. On the other hand, in trials at the Berlin Charity, it was found to be of no avail in chronic rheumatism, although it was used for a long time, and given in by no means small doses. Mansfeld, also, employed it in cases of after-pains, rubbed, without admixture, on the abdomen; and he affirms, that good effects resulted from it, even when the secale cornutum had failed. In hysteric fainting, the same gentleman found it very useful when internally exhibited. Lampadius, likewise, recommended it in fainting, as well as in asphyxia. Krimer found it extremely efficacious in asphyxia from carbonic acid, but he frequently thought it necessary to premise blood-letting. In this way, he * Riecke, Die neuern Arzneimittel, S. 109.; and 2te Auflage, S. 166. Stuttgart, 1840. + Lampadius, in Bulletin des Sciences Medicales de Ferussac, xi. 315. t Annales de Chimie Medicale, and Amer. Journal of the Med. Sciences, for Nov. 1836, p. 222. 40 466 SULPHURIS CARBURETUM. treated eleven cases; and only one case—in which apoplexy had already supervened—terminated fatally. The same physician exhibited it in some cases of drunkenness, attended with loss of consciousness, and found its effects very beneficial. He gave it with great advantage once in a case of goitre; and, in incarcer- ated hernia, no agent, he says, facilitates so much the taxis as the cold produced by dropping the carburet of sulphur on the tumour.* Lampadius found, that slight burns were instantane- ously cured by it. Clarus recommends it in hypertrophy of the coats of the stomach, and in contraction of the esophagus—ad- ministered according to the formula given below. Every thing, indeed, says Riecke, encourages the further trial of the sulphuret as a remedial agent.f MODE OF ADMINISTERING. - Internally, the carburet of sulphur may be given in doses of from one drop to four, every five or ten minutes, in cases of faint- ing and asphyxia; but where such a rapid analeptic agency is not demanded, it may be given every two or three hours. It may be administered dropped on sugar, or in a spoonful of sugared water or barley water. Clarus thinks it is best given in cow's milk. Externally, it is either applied pure, when a rapid development of cold is needed—as in cases of burns and incarcerated hernia— or dissolved in alcohol or oiL Gutta Sulphuris Carbureti. Drops of Carburet of Sulphur. R. Sulphur, carbur. ^ij. iEther. sulphur, gj. M. j)ose.—A few drops on sugar. Lampadius. R. Sulphur, carbur. 3j- Sp. vini rectif. 5ss. M. Dose.—Four to six drops, every two hours, in cases of rheu- matism. Wutzer. R. Sulphur, carbur. 5J- Sp. vin. rectif. 5ij. M. * Journ. de Pharmacie, and Amer. Journal of Pharmacy, ix. 264. f Die neuern Arzneimittel, u. s. w. S. 110- SULPHURIS CARBURETUM. 467 Dose.—Five, ten, or fifteen drops, three times a day, in cases of rheumatism. Wutzi ZER. Mistura Sulphuris Carbureti. Mixture of Carburet of Sulphur. R. Sulphur, carbur. 9j. Lact. vaccin. 5vj. Sacch. alb. 3ij. M. Dose.—A table-spoonful, four times a day, or oftener. Clarus. Embrocatio Sulphuris Carbureti. Embrocation of Carburet of Sulphur. R. Sulphur, carbur. 2ss. Olei amygd. dulc. 5j. M. To be rubbed in, in cases of old gouty nodes. Mansfeld, and Otto.* R. Sulphur, carbur. 3ij. 01. oliv. seu Linim. amnion, camphor. ?ij. M. To be rubbed in, in cases of rheumatism. Wutzer. R. Camphor. 3ij. Solve in Sulphur, carbur. 5ss. Adde Sp. vini rectif. 5j. M. To be used in friction, in cases of rheumatism, and especiallv in rheumatic adontalgia. Lampadius. * Bibliothek for Lseger, 1835, and Brit, and For. Med. Review, July, 1836, p. 252. J 468 SULPHURIS iodidum. SULPHURIS IODIDUM. Synonymes.—Sulphuris loduretum, Sulphur lodatum, Ioduret, or Iodide of Sulphur. French.—Soufre Iodure, Iodure de Soufre. German.—Iodschwefel, Iodinschwefel, Schwefeliodiire. MODE OF PREPARING. The iodide of sulphur is prepared by heating slightly a mixture of four parts of iodine, and one of sublimed sulphur. The excess of iodine is driven off, and the iodide of sulphur remains as a grayish mass, very deliquescent, and readily decomposed by water. EFFECTS ON THE ECONOMY. Biett has exhibited this agent in squamous, pustular, and papu- lar diseases of the skin. It has been found especially effective in psoriasis, in the form of frictions. Patients, who had been long affected with diseases of this kind, which had resisted every other remedy, were cured in four or five months by the iodide of sul- phur alone. To prevent relapses, Biett advises that the frictions should be continued after the eruptions have scaled off. He found it equally efficacious in the lepra vulgaris of Willan; and in acne —the gutta rosacea of Alibert—when the inflammation of the skin had passed away. Even the acne indurata was often completely cured by it. He found it also beneficial in inveterate porrigo of the scalp.* At times, after the rubbing, a diffuse red inflamma- tion of the skin arises, with subsequent desquamation; and, in particular cases, the inflammation extends even to the subjacent cellular membrane. In old standing lepra, Rayerf prefers it for external use to calomel and white precipitate, and he ranks it highly with the iodides of mercury, for the cure of lupus non ex- edens; and by Dr. VolmarJ it has been used, with great success, in herpes pustulosus labialis. * Cazenave et Schedel, Maladies de la Peau, p. 219; and Cogswell on Iodine, p. 120, Edinb. 1837. t Diseases of the Skin, p. 634. X Die neuesten Entdeckung. in d. Mat. Med.; cited by Pereira, Elements of Materia Medica, Pt. i. p. 270. Lond. 1839. SULPHURIS IODIDUM. 469 The iodide of sulphur is likewise extolled by Lugol as a very active therapeutical agent. Cless affirms, that in chronic squa- mous affections of the skin, especially in psoriasis, he has em- ployed it with advantage, but he was not able to cure lepra vul- garis with it. It has been strongly recommended, also, in Tinea capitis, in the proportion of ten grains of the iodide to an ounce of lard. A writer, in an English periodical* affirms, that he was induced to make trial of it in some obstinate cases, and was much aston- ished at the remarkable power it possessed over the disease. He rubbed it on the head night and morning, and increased the strength of the ointment according as the affected part was able to bear the stimulus, until the iodide bore the proportion of half a dram to the ounce of lard or spermaceti cerate. The inhalation of the vapour of this substance has been em- ployed in humoral asthma, by Dr. Copland,f with temporary ad- vantage, and fumigations of iodine and sulphur have been used advantageously in certain atonic ulcers, and chronic cutaneous diseases.% With this view, the sulphur and the iodine may be combined extemporaneously,—say four parts of iodine to one part of sulphur. MODE OF ADMINISTERING. Unguentum Sulphuris Iodidi. Ointment of Iodide of Sulphur. R. Sulphur, iodid. 9j—3ss. Adipis, ^j. M. et fiat unguentum. Biett.—Rayer* * Lond. Med. Gazette, for Sept. 9,1837, p. 879. f Diet, of Practical Medicine, Art. Asthma. X London Lancet, vol. 1,1838, and Encyclographie des Sciences Medicales, Aout, 1838. 40* 470 TANNINUM PURUM. TANNINUM PURUM. Synonymes.—Tannicum, Acidum Tannicum, Principium Adstringens, P. Scy- todephicum, Tannin, Tannic acid. German.—Tannin, Gerbestoff, Gerbsaure. This article, in its pure state, has been subjected to experiment very recently only. METHOD OF PREPARING.. * According to Buchner,* Tannin should be prepared for medi- cal use in the following manner. From eight to twelve parts of hot water must be poured on one part of powdered galls, and the mixture be allowed to digest for an hour, frequently agitating it. The infusion must then be filter- ed, and the residue be again treated in the same manner with a little hot water. The different infusions, which generally pass through the filter turbid, must be mixed together, and a little dilute sulphuric acid be added by drops, constantly shaking the mixture, so long as any precipitate of tannin follows. The tannin is de- posited in this way, very soon in a collected yellowish white, gelatiniform mass, which by the influence of air gradually assumes a brown colour. After the fluid is poured off, the residue is washed twice with cold water acidulated with sulphuric acid; carbonate of baryta, or carbonate of potassa, is then added to it in small portions, care- fully shaking the mixture, until there is no farther effervescence, and until a portion of the mass dissolved in water and tested by muriate of baryta affords no more evidence of the presence of sulphuric acid. The yet moist mass is then put into a retort with alcohol of about ninety per cent., which is added repeatedly in small portions; the alcohol is made to boil, to dissolve the tannin and separate it from the sulphate of baryta or sulphate of lime; the alcoholic solution is then poured off clear, and by a gentle heat evaporated to dryness. Tarinin, prepared in this manner, is friable, resinoid, almost as shining as glass, of a pale yellow colour, translucent, reducible, by rubbing, to a white powder, of an astringent taste, soluble in * Repertorium, B. xxxiv, H. 3 also, A. W. Buchner, Neueste Entdeckung. aber die Gerbsaure, u. s. w. Frankf. 1833, and Dierbach, in Heidelberger klinische Annalen, B. x. H. 3, S. 339, Heidelb. 1834. TANNINUM PURUM. 471 water, alcohol and ether, reddening litmus paper, and forming salts with a base, like an acid. EFFECTS ON THE ECONOMY. Tannin is a strong astringent,* which has hitherto been mainly used in uterine hemorrhage, and especially by the Italian physi- cians. Portaf was, perhaps, the first who tried it. He found it very efficacious in cases of uterine hemorrhage not dependent upon any organic mischief in the uterus. It exhibits its powers, according to him, even in small doses—as of two grains, and is well borne by the stomach. FerrarioJ likewise administered it with advantage in the same affection, but he does not consider it adapted for cases in which either partial or general plethora, or local excitement of the uterus, or any organic disease, exists: it is indicated only where pure atony is present. He gives it in the form of powder or pill, in two grain doses, six times a day. The effect, according to him, is generally good: the hemorrhage diminishes and soon ceases, and, at the same time, the strength augments, and recovery succeeds, without any disturbance of the functions. Giadorow§ details two cases of diabetes cured by it, when given in combination with opium, as in the precription at the end of this article. The first patient was cured in ten ; the second in twelve days. According to Ricci,|| tannin has frequently been employed in Italy both in internal and external hemorrhages. On the other hand, G. A. RichterTI affirms, that he has given it in habitual me- trorrhagia without any advantage whatever. Within the last few years, M. Cavarra** has instituted many experiments on ani- mals, as well as on himself, from which he concludes, that when tannin is placed in contact with certain parts of the living econo- my, it exerts upon them the same chemico-vital action, which it does on an inert organic tissue, or, in other words, it tans them as it tans leather. " These parts," he says, " are the mucous membranes of the urethra, vagina, intestines and lungs. The action of the tannin appears to be, to cause such a condensation * See, on the action of this agent ,Mitscherlich .Medicinische Zeitunfi- No 43, 1838, and Bullet. General de Therap. Mars 30, 1837. t Delpech, Memorial des Hopitaux du Midi. &c, Fevrier, 1829, p. 51. X Annali universali di Medicina, Gennajo, 1829. j Annali universali di Medicina, and Gazette Medicale, Sep.f15, 1832. || Bulletin des Sciences Medicales, Sept. 1828. IT Arzneimittellehre, Supplement, p. 60, also Cavalier, in Archiv. Generates xix. 589. ** Bulletin de l'AcadSmie Royale de Medecine, Janvier, 1837; also Dunglison's Medical Intelligencer, Oct. 16, 1837. p. 258. and Bulletin Gene- ral de Therapeutique, Mars 30,1837. 472 TANNINUM PURUM. or contraction in them, that the glands with which they are studded no longer afford passage for the mucus which they se- crete." M. Cavarra, asserts, that he has proved these positions by nu- merous experiments and demonstrations. When tannin is taken internally, its immediate effect is constipation, by arresting the secretion from the mucous membrane. When it has reached the stomach, it is absorbed, and carried into the current of the cir- culation. There exists between this organ and the vagina, the urethra, and the lungs no communication except through the cir- culatory system, and, consequently, the tannin—it is fair to pre- sume—must be absorbed to cure leucorrhcea, gonorrhoea, and the most obstinate chronic catarrhs. M. Cavarra concludes, that of all the effects of tannin, two of the most surprising are, the cures operated by it in cases of the most obstinate nervous coughs, and the excellent action it exerts in phthisis. Farther experi- ments are, however, demanded before this last point can be ad- mitted. From our knowledge of the properties of tannin, it is not easy to see how it, or any other astringent, can be of much ser- vice in the latter malady. Of late, M. Amedee Latour* has highly extolled tannin for its efficacy in hamoptysis. In one case it completely succeeded when other remedies had failed; and in three cases of hemorrhage to a slighter degree, it was wholly successful. M. Charvetf has also recommended it in the sweats of phthisis. He gives it in the dose of from half a grain to a grain and a half, alone, or associ- ated with opium, and generally at bed-time. Hiiter affirms, that tannin, prepared from dried galls, in the form of ointment or diluted with distilled water, is very ser- viceable in most cases of Egyptian ophthalmia. In the hypere- mesis, induced by ipecacuanha or emetine, it may be administered as an antidote. According to the experiments of Magendie,;}; tannic acid is one of the substances that oppose the coagulation of the blood. METHOD OF ADMINISTERING. It may be given in the form of pill, or draught, or as a lave- ment, and in the dose of from a quarter of a grain to two grains, * Journal de Medecine et de Chirurg. Pratiq. Nov. 1839. t Bulletin General de Therapeutique, Mai, 1840, and Encyclographie des Sciences Medicales, Juin, 1840. X Lond. Lancet, Jan. 26,1839, p. 636. TANNINUM PURUM. 473 without producing any unpleasant constipation, but its effects must be observed with care.* Vinum Aromaticum Cum Tannini. R. Vini. aromat.t Sjviij. Tannin, 9ij. M. R. Vini. aromat. Iviij. Tannin. 9y. Ext. opii. purif. gss. M. Used as a local dressing to chancres. Ricord. Injectio Tannini. Injection of Tannin. R-. Vin. rubr ?vj. Tannin, gr. xviij. M. / Used in chronic blennorrhcea or what is called an old gleet.| Ricord. In the case of the female, the quantity of tannin may be doubled or still farther increased. Pilula Tannini. Pills of Tannin. R. Tannin, in pulv. gr. vj. Gum acac. in pulv. gr. xij. Sacchar. pulv. gr. lxxij. Syrup, q. s. ut fiat massa in pilulas pond. gr. iv. sing. Dose.—One to four, morning and evening, where an astringent is needed. Cavarra. * Cavarra, in Bulletin General de Therapeutique, Mars 30, 1837. f The Vinum Aromaticum of the French Codex, used by Ricord, is com- posed of four ounces of aromatic herbs, (rosemary, rue, sage, hyssop, lavender, absinthium, origanum, thyme, laurel leaves, red rose leaves, chamomile, meli- lotum, and elder, digested in two pints of red wine for eight days. X La Lancette Franchise, No. 33, Paris, 1838, and Parker, Modern Treat- ment of Syphilitic Diseases, Dunglison's American Med. Library edit., p. 44. Philad. 1840. 474 THUVA OCCIDENTALIS. Pulveres Tannini et Opii. Powders of Tannin and Opium. R. Tannin. 9ij. Pulv. opii. gr. i. Misce et divide in pulveres tres. Dose.—One, morning, noon and night; gradually increasing the quantity of tannin to four scruples daily. Giadorow. Pomatum Tannini. Pomatum of Tannin. {Liparoli de Tannin.) R. Adipis suill. Jxij. Tannin. Jij. Aquae pur, 3ij- Dissolve the tannin in the water, by triturating them in a glass mortar; add the fat and mix.* Beral. Lotio Tannini. Lotion of Tannin. {Hydrolotif de Tannin, pour Vurtthre.) R. Aquae destillat. 5viij. Tannin, gr. xxxij. Solve. Employed in obstinate blennorrhcea. Beral. THUYA OCCIDENTALIS (FOLIA.) Synonymes.—Thuya, American Arbor vitse. French.—Thuya du Canada, Cedre blanc. German.—Blatter des gemeinen Lebensbaumes. The leaves of the thuya, a small indigenous evergreen tree, which grows wild from Canada to Carolina, and is cultivated for * Bulletin General de Therapeutique, Janvier, 1838. THUYA OCCIDENTALIS. 475 ornament in gardens—of the natural family coniferae; sexual system, monoecia monadelphia, have been long used as an article of the Materia Medica,* but they had of late fallen into oblivion until the Homceopathists restored them to notice. Hahnemann advises that condylomata should be touched with the expressed juice, and Jahn in his homoeopathic experiments found it was not unworthy the attention of experimenters. In two cases in which several celebrated agents had been fruitlessly employed, he applied the juice of the thuya with apparent advan- tuge: he does not, however, consider those cases to be decisive, as the patient had taken mercury for a long time, and perhaps the effects began only to be evident, whilst the thuya was ad- ministered. Fricke likewise made trial of it, as wrell as of the tinctura thuya, which he formed of five parts of spirit of wine, and one part of the juice; but his trials were not favourable. Even in a dilute form, the tincture acted so powerfully as an excitant, on the parts surrounding the condylomata, that it could not be con- tinued, but after three, four, or six weeks' use, was put aside, and other approved remedies substituted for it. Generally, in the course of a few days, the parts of the skin, surrounding the con- dylomata, became sore and very painful, and the condylomata either remained as before, or began to increase in size; in a few cases only did they disappear under the use of the dilute tinc- ture, and then more slowly than Fricke had noticed from other agents. The testimony of Dr. Kohler, of Warsaw, is, however, entirely opposite. For five years, he says, the tincture of thuya was em- ployed by many physicians of that city, both in hospital and pri- vate practice, and with the most decided success. Riecke,f too, affirms, that in the year 1831 he had treated a great number of patients with it, always with the best effect; and without the occurrence of a relapse, or the least sign of inflammation, excoria- tion or other inconvenience supervening. It was commonly but necessary to apply the remedy for a fortnight or three weeks, in order that the removal of every condylomatous growth should be effected. In the generality of cases, the internal use of mer- cury was conjoined, but even where the external employment of the thuya was alone had recourse to, the result was entirely satis- factory. Riecke not only touched the condylomata with the tincture, but kept constantly applied to them lint dipped in it, and without the supervention of any unpleasant consequences. It would seem to be probable, from these discordant results, * Wood and Bache's Dispensatory, 4th edit, p, 1181. Philad. 1839. t Die neuern Arzneimittel, S. 394. and 2te Auflage, S. 618. Stuttgart, 1840. 476 UREA. that there must have been some difference in the preparation. The following form is given by Riecke: R. Folior thuya? Occident. 5i. Contunde et tere in mortario vitreo affundendo sensim sensimque spiritus vini Jfjss. Massam immitte in cucurbitam vitream; digere per aliquot dies, dein cola et serva.* Riecke remarks, that he never found it necessary to dilute this tincture. UREA. Synonymes.—Ureum, Uricum, Nephrine, Nephrin. French.—Ur6e, Extrait savonneux de Purine. Germ«ra.-j-Harnstoff. This immediate principle of the urine of men and quadrupeds was discovered in an impure state by Rouelle, in 1773; and since then it has been studied by Cruickshanks, Fourcroy and Vauquelin, Berzelius and Proust more especially,—by the last of whom it was obtained pure.f METHOD OF PREPARING. Urea is obtained by placing a mixture of equal volumes of urine, reduced to the consistence of syrup, and nitric acid at 20° in a refrigerative bath; by which means the crystallised nitrate of urea is precipitated. On decomposing this—washed in the cold and dissolved in water—by carbonate of potassa, reducing it almost to dryness, and treating the residue by alcohol at 40°, which takes up the urea, crystals may be obtained by evapora- tion, which may subsequently be procured colourless by the agency of animal charcoal. * " Take of the leaves of the thuya occidentalis, an ounce; bruise and rub in a glass mortar, gradually adding of spirit of wine, half a pint; put the mass into a glass cucurbit; digest for some days; then filter and keep for use." Die neuern Arzneimittel, u. s. w. 2te Auflage, S. 618. Stuttgart, 1840. f Annales de Chimie et de Physique, x. 369, and Me>at & De Lens, Art. Uree. UREA. 477 M. Henry,* who was not satisfied with the scanty product yielded by this process, recommends the following:—Add to fresh urine a slight excess of subacetate of lead ; a precipitate is thus formed, which consists of oxide of lead united to the various acids of the urine, together with the mucus, and a great part of the ani- mal matter; the decanted liquid is then treated with sulphuric acid in slight excess to separate the lead, and afterwards, in the pro- gress of the evaporation, to decompose the acids of soda and lime, that may have been formed. After having separated the white precipitate, concentrate rapidly over a steady fire, adding a por- tion of animal charcoal during the ebulition. When the whole has become a clear syrup, pass it through linen of close texture, and then reduce it one third by evaporation. On coolino-, the liquid is converted into a yellow mass, crystallised in needles, formed of a great proportion of urea and some salts. The crys- tals being drained and pressed are added to those obtained from the mother waters treated in a similar manner. They are next treated with a very small quantity of carbonate of soda, with the view of separating any remaining acetate of lime, and then digested in alcohol of 38° to 40°. The alcoholic solution being filtered, and the alcohol separated by distillation, the urea remains, which may be crystallised afresh' from water, if neces- sary.f Urea, thus obtained, is in silky or prismatic needles, verv soluble, and of a coolino- taste. EFFECTS ON THE ECONOMY. The experiments of M. Segalas have established, that urea is devoid of any noxious action on animals into whose veins it has been injected, and, consequently, that we cannot ascribe the se- rious symptoms to it, which arise from the absorption of urine in certain morbid cases. They demonstrate farther what has been confirmed by the trials of Fouquier, that urea is a diuretic, and, therefore, might be useful in dropsy: the latter gentleman em- ployed it, also, but unsuccessfully in diabetes.% Laennec used it with advantage in a case of dropsy. According to the author's friend, Prof, b ee,§ urea is received into the lists of the materia medica m the Batavian Pharmacopceia, and in some others less * Journal de Pharmacie, xi. 161, Paris, 1829. t Manual of Materia Medica and Pharmacy; by MM. H. M. Edwards and P. Vavaseur, p. 231. Philad. 1829. X Journal de Physiol, de Magendie, ii. 344, & Formulaire pour la Prepara- tion, &c. de plusieurs nouveaux Medicamens. § Cours d'Hist. Naturelle Pharm. ii. 764: cited in Merat & De Lens, Diet. de Mat. Med. Art. Urde. 41 478 UREA. known. It has also been admitted into the French Pharmaco- poeia. MODE OF ADMINISTERING. Urea has been given in solution in distilled water, sweetened, in the dose of twenty-four to thirty grains, and even as high as several drams, in the day. VERATRINA. Synonymes.—Veratria, Veratrinum, Veratrine. French.—Veratrine. German.—Veratrine, Niesswurzstoff This alkaloid, which was discovered in 1819, by MM. Pelle- tier and Caventou,* and almost at the same time by Meissner,f is commonly prepared from the seeds of the veratrum sabadilla. It is contained in several of the plants belonging to the family Col- chicaceae. METHOD OF PREPARING. The seeds of the veratrum sabadilla are repeatedly treated with boiling alcohol. These tinctures, filtered, when almost boiling, al- low whitish flakes of wax to be deposited on cooling; the dissolved matters, brought to the consistence of an extract, are now dis- solved in cold water, and filtered, whereby a small quantity of fatty matter remains on the filter. The solution is then slowly evaporated, when a yellowish orange-coloured precipitate is formed, which possesses the characters of the colouring matter found in almost all woody vegetables. On adding a solution of acetate of lead to the still deeply coloured liquid, a new and very abundant»yellow precipitate is thrown down, which can be sepa- rated by means of the filter. The liquor, now nearly colourless, contains, besides other substances, acetate of lead, which had been added in excess; this is separated by means of a stream of sul- phuretted hydrogen: the liquor is then filtered, and concentrated by evaporation; treated by magnesia, and again filtered. The magnesian precipitate is digested in boiling alcohol, and on eva- * Annales de Chimie et de Physique, xiv. 69. i Gilbert's Annalen der Physik, Ixv. 335. VERATRINA. 479 porating the alcholic liquors, a pulverulent, extremely acrid mat- ter is obtained, which possesses all the properties of the alkalies. It appears at first yellowish; but, by solutions in alcohol, and sub- sequent precipitations, caused by pouring water into the alcoholic solutions, it is obtained in the form of a very white and perfectly inodorous powder.* Veratrine has been received into the London Pharmacopceia.f It is scarcely at all soluble in cold water; but boiling water dissolves one-thousandth part of its weight, and becomes sen- sibly acrid. It is very soluble in ether, and still more so in alcohol. It is not soluble in alkalies, but is so in all the vegetable acids: with these it forms uncrystallisable salts, which, on evapo- ration, present the appearance of gum. The sulphate alone affords rudiments of crystals, when its acid is in excess. Nitric acid combines with it; but, if added in excess, it does not colour it red, as in the case of morphine, brucine, and impure strychnine, but very rapidly resolves the vegetable substance into its elements, and gives rise to a yellow detonating matter. Veratrine has an alkaline reaction. When exposed to heat, it liquefies at a temperature of 122° Fahrenheit, and has then a waxy appearance. On cooling, it forms a translucent mass, having the appearance of amber. When distilled on the naked fire, it swells up, is decomposed, and forms water, much oil, and leaves behind a bulky coal. The taste of veratrine is very acrid, but without bitterness. Of late, new light has been thrown on veratrine by the investi- gations of Couerbe. According to him, when prepared in the mode above mentioned, it still contains several other substances, sabadillin, veratrin, gum resin of the sabadilla, and a black, greasy substance, which unites the other matters, and conceals their properties. The following is the form given by Couerbe for obtaining veratrine in its greatest purity:— Sabadilla seeds are treated with boiling alcohol at 36° (.847) and after they have been exhausted in this manner, the liquor is distilled to obtain the extract, which contains a greenish fatty matter in great quantity. This extract is treated with dilute sul- phuric acid, and the solution is suffered to boil a few minutes, when it is filtered. In this manner, the veratrine, sabadillin, the gum resin, and the brown colouring matter are dissolved; and, by precipitation with potassa, all these matters are obtained. It * Magendie's Formulaire pour la Preparation, &c. de plusieurs nouveaux M£dicatnens. t See Brande's Diet, of Mat. Med. p. 463. London, 1839. Dr. Wood, in Wood & Bache's Dispensatory, 4th edit. p. 1102, Phila. 1839. For M. Righini's method of obtaining what M. Soubeiran calls " medicinal veratrine," see Journal de Pharmacie, Oct. 1837. 480 VERATRINA. is sufficient to treat the precipitate again with alcohol, and distil it, in order to obtain the impure veratrine, which is subjected to purification, by being dissolved afresh in dilute sulphuric acid, precipitated by an alkali, and dried. In this manner, a delicate white powder is obtained, of very acrid taste, with an alkaline reaction, uniting with acids without forming crystals,—in short, the veratrine of authors in its greatest purity. In order to separate the substances newly discovered by Couerbe, the veratrine must be dissolved in water acidulated by sulphuric acid, and to the solution nitric acid is added by drops, so long as there is a precipitation of very tenacious matter—the black greasy substance above mentioned. The fluid is then decanted; precipitated by potassa or ammonia, and the precipi- tate washed with cold water. It is then treated with alcohol, to separate any inorganic salts which it may contain; the alcohol is next evaporated, when a matter—in appearance resinoid—is ob- tained, which contains all the above-mentioned constituents of the common or impure veratrine, with the exception of the dark greasy matter which was separated by the nitric acid. By means of boiling water, two of the constituents are sepa- rated—the sabadillin and the gum resin: the first crystallises from the liquid on cooling, and the second is procured by suffering the mother waters of the sabadillin to evaporate in vacuo, or by a gentle heat, to dryness. The water has left two other matters undissolved, the pure veratrine and the veratrin. By treatment with ether, which dissolves the former, they may be separated: the veratrin remains undissolved. Pure veratrine does not crystallise, but unites with acids, form- ing combinations that readily crystallise. It is white, solid, and friable, and fuses at 212° Fahrenheit. It is not soluble in water, but is readily so in ether and alcohol. The sulphate forms long, loose needles, fuses on the application of heat, and loses thereby two atoms of water. It contains 100 parts of veratrine, and 14.66 of water. The muriate of veratrine is very soluble in water and alcohol, but is easily decomposed by heat. According to Couerbe, pure veratrine agrees in it's properties with the impure, and is the ac- tive principle of the latter. Sabadillin, obtained in the mode above mentioned, forms small crystals, which appear to be hexaedral prisms. It is of a white colour, and very acrid. It is not volatilisable ; fuses at 200° of the centigrade scale, and loses thereby two atoms of water. It dissolves completely in water and alcohol, but in ether it is wholly insoluble. The sulphate of sabadillin crystallises in prismatic needles, is fusible, and contains four atoms of water, which may be driven off by simple fusion. The sabadillin agrees in its effects with veratrine, but is weaker. VERATRINA. 481 The gum resin—{sabadillin-monohydrat,) is yellowish, uncrys- tallisable, and feebly alkaline. When it is entirely dry, it is easily reduced to powder. Alcohol dissolves it in every propor- tion, as well as water and acids. It' requires a temperature of 165° cent, to fuse it. Sulphuric ether dissolves only traces of it. In its properties, it bears much resemblance to the sabadillin, but differs essentially from it in not being crystallisable. Its composi- tion varies but little from that of the sabadillin. The veratrin* whose effects on the animal economy are not yet known, is of a brownish colour, is insoluble in water and in ether, but not so in alcohol, and fuses at 185° of the centigrade scale. Concentrated acids decompose it, and nitric acid converts it into the oxalic. Simon, an apothecary of Berlin, has recently affirmed, that he has found two alkaloids in the veratrum album ; one of which pos- sesses the property of being precipitated from its solution in acetic or phosphoric acid by the sulphuric acid and its salts, like baryta ; hence he has given it the name barytin.-f EFFECTS ON THE ANIMAL ECONOMV. Regarding the effects of veratrine on animals, MagendieJ has the following remarks:—A very small quantity of acetate of vera- trine placed in the nostrils of a dog, instantly excited violent sneezing, which continued for a long time. One or two grains, placed in the mouth, immediately occasioned profuse ptyalism. When a small quantity was introduced into any part of the intes- tinal canal, and the body was opened to notice its effects, the intestine was observed to be much indurated, and to relax and contract alternately for a certain length of time. The part of the mucous membrane, with which the veratrine is made to come in contact, is inflamed; the irritation spreads, and vomiting and purging are excited. In much stronger doses,, the circulation is accelerated, as well as the respiration, and tetanus supervenes, soon followed by death. The effects are still more rapid, if one or two grains be thrown -into the cavity of the pleura, or tunica * Riecke properly animadverts on the nomenclature of Couerbe. According to him, we have to distinguish not only the veratrine of commerce—that which was previously esteemed the simple alkaloid—but, also, the pure veratrine, (la veratrine.) and the veratrin, (le veratrin.) The slight difference in the terms is insufficient to obviate confusion. Riecke, Die neuern Arzneimittel, u. s. w. S. 400. Stuttgart, 1837. f Pharmaceut. Centralblatt. 1837, p. 191, & Medicinische Annalen B. iv. H. i. S. 9 Heidelb. 1838. X Journal de Physiologie Experiment, i. 56 ;& Formulaire pour la Prepa- ration, &c. de plusieurs Medicamens. 41* 482 VERATRINA. vaginalis. In less than ten minutes death occurs, preceded by tetanic convulsions. The same quantity, thrown in to the jugularvein, induced te- tanus and death in a few seconds. Dissection showed, that, even in this case, the veratrine had acted on the intestinal canal, the mucous membrane of which was found injected. The lungs, also, exhibited traces of inflammation and engorgement. Veratrine, in large doses, would, doubtless, exhibit the'same effects on the human organism. The taste is very acrid, but without bitterness : it excites a copious flow of saliva, even when a small quantity only has been introduced into the mouth. Al- though it has no smell, it must not be brought too close to the nose, when in the state of powder, as it occasions, even in very minute quantity, violent sneezing, which may prove dangerous. A quarter of a grain immediately induces copious evacuations, and, in a somewhat larger dose, more or less- violent vomiting. According to Turnbull, who has immoderately, we think, ex- tolled this remedy, its effect is very different, according as it is exhibited internally or externally. Externally, it may be applied for weeks and months, without the supervention of any of the effects that succeed its internal administration. Exhibited in this way, it diminishes internal nervous excitement, assuages pain, but does not act on the intestinal canal. In dropsical cases, it is Stated to.be one of the greatest promoters of the urinary secretion that we possess. The part of the skin on* which it is rubbed, either in solution or ointment, even when the friction has been continued for a long time, exhibits no evidence of irritation: when, however, the dose of veratrine has attained a certain extent, the patients feel a considerable degree of heat, and a kind of pricking sensation in the rubbed part, whence it may be concluded, that the veratrine is active, pure and genuine: under a more prolonged Vise of the remedy, this feeling of warmth and pricking extends over the surface of the whole body; and, in some cases, involun- tary twitchings have been observed in the muscles of the mouth and eyelids. These symptoms, however, pass off, when the fric- tions are discontinued for a day or two. Only in a few cases, according to Turnbull, was any eruption induced by its applica- tion. The endermic use of the remedy, always, however, excited so much irritation as to prevent its repetition. Thus much for Turnbull :— His views and experience have by no means been confirmed by the generality of observers. The external application of ve- ratrine cannot always be used without local irritation enduing. An English physician, labouring under rheumatism of the arm, rubbed upon it an ointment composed of twenty grains of VERATRINA. 483 veratrine to an ounce of lard; and, immediately afterwards, so much pain was induced in the part, that he was obliged to take opium to obtain rest; an eczematous eruption subsequently ap- peared on the arm, but the rheumatism remained uncured. Ebers applied it endermically, but witnessed nothing more than a violent burning in the part, such as is commonly the case with other agents. He frequently observed the pricking sensation mentioned by Turnbull, and it was often to such an extent as to be almost insupportable. According to the trials of Ebers, its diuretic ef feet was not restricted to dropsy, but was usually evinced in other diseases. The sensorium appears never to have been im- plicated, but when applied in small doses over the pit of the sto- mach it produced striking effects on the spinal marrow, and the nerves connected therewith,—as the nerves of the thorax and ab- domen: violent pain was experienced, which spread through the whole extent of the nerves distributed to the parietes of the abdo- men, with a sense of traction along the spinal marrow, twitchings, great anxiety, orthopncea, nausea and vomiting, and a feeling, which the patient was unable to describe, except that it was almost intolerable. When given internally, veratrine speedily caused nausea, retch- ing vertigo, and complete loss of appetite; so that Ebers soon aban- doned its internal use, and, like Turnbull, gave the preference to the external. Owing to the presumed effects of veratrine on the nervous sys- tem, and especially on the spinal marrow, and the nerves con- nected with it, its use was suggested in nervous diseases—parti- cularly in neuralgia, prosopalgia, and ischias—in which it is said to have been found most efficacious by Turnbull, Ebers,* Briick, Suffert,f Professor S. Jackson,J Cunier,§ and others. In no class of diseases, according to the first of these writers, have the bene- ficial effects of the ointment of veratrine exhibited themselves more strikingly, and by no other remedy has the same amount of relief been induced in so short a time. Even in tic douloureux, a single friction is said to have been sufficient to remove the dis- ease without relapse. Two circumstances have here chiefly to be borne in mind,—-first, the extent of the pain, for when it is not concentrated on a point, but spreads along the branches of the * Casper's Wochenschrift, 1837, No. 47. t Berlin. Medicin. Centralzeitung, 1837, p. 670, & Heidelberg. Medicin. Annal. B. iv. H. 1, S. 11. X American Journal of Pharmacy, vol. iii. new series, p. 186. Philad. 1838. \ Bulletin Medical Beige, Dec. 1837, & Bullet. Ge"ne>al de Therap. Dec. 1838. See, also, Forcke, Physiologisch-therapeutische Untersuchungen iiber das Veratria. Hannov. 1837: cited in Bib. Generate, Encyclographie des Sci- ences Medicales, Aout, 1838. 484 VERATRINA. nerves, the cure is easier, and a weaker ointment is needed; and, secondly, the duration of the affection. In long protracted cases, a complete cure is far more difficult, and can, in general, be ef- fected only after a long period. The paroxysms, however, may be relieved by an ointment composed of from twenty to forty grains to an ounce of lard. In this case, it must be strongly- rubbed in, so as to excite itching of the skin: care must be taken, however, that the ointment does not touch the conjunctiva, as the smallest quantity of veratrine would induce violent inflam- mation. Ebers, likewise, found advantage from its use in chorea, hypochondriasis, and hysteria; and Turnbull in paralysis. Both extol it in rheumatism and gout, in relation to which Ebers re- marks, that the remedy has appeared to him more efficacious when the nervous system, or some nervous branches, were pre- dominantly affected, and when the gastric affection was entirely removed. In the cases treated by veratrine, relief was sooner obtained, and the cure was more speedy and complete, than when other agents were employed; the secretion of urine was augmented; restlessness disappeared; and sleep returned, with- out any evidences of narcosis. As regards acute rheumatism, Turnbull remarks, that the veratrine is not to be preferred to an- tiphlogistics: in these cases, a weaker ointment must be used, (ten grains to the ounce :) in chronic cases, the quantity may be carried much higher; and—especially when extensive organic changes have supervened in the parts—it must be continued for a great length of time. In lumbago, ischias, and rheumatism of the chest, not more than one or two rubbings were generally ne- cessary. In gout, according to Turnbull, it may be exhibited both internally and externally ; in the former mode of adminis- tration, he compares its efficacy with that of colchicum: the latter method has been recommended, also, by Sir C. Scudamore. It was, likewise, found very advantageous by Bardsley* in chronic rheumatism. Veratrine wTould seem, however, to have been most efficacious in cases of dropsy. " Unadulterated veratrine," says Ebers, "acts often on the urinary secretion with magical powers, and it may seem fabulous, when I remark, that friction with a very weak ointment of veratrine tv/o or three times in the twenty-four hours on the inner part of the thigh, or the back, epigastric region, or around the navel, has excited such a copious secretion of urine, that the patients, under its long continuance, began to feel weak; and the anasarca, and' even the dropsical accumulation in the abdomen, in a short time almost disappeared—circumstances * Hospital Facts and Observations, illustrative of the efficacy of Strychnia, Brucia, Veratria, Iodine, &c. Lond. 1830. VERATRINA. 485 which indicate the caution that ought to be observed in appor- tioning the dose, when we are satisfied of the goodness of the article." He properly remarks, however, that the veratrine, by augmenting the secretion of urine, may not remove the dropsy, but, by occasioning the absorption of the effused fluid, it allows the physician to examine as to the existence of organic mischief. Ebers gave the veratrine in many of the lighter hydropic cases. which follow intermittents and other forms of fever, and often with great and rapid success; likewise in twenty-four more serious cases, fifteen of which recovered, and one experienced relief: eight very complicated cases terminated fatally, and in four of these diuresis occurred; in four not. Fricker* likewise obtained very good effects from the use of an ointment of veratrine in dropsy: but, on the other hand, Spath found it of no avail. Turnbull observed, from the internal use of veratrine, as well as from its application to the pit of the stomach, a diminution in the frequency and force of the pulsations of the heart; and in cases where these were more excited than natural, restoration of a regular circulation. He exhibited it, consequently, in heart diseases, especially in those of gouty and rheumatic diatheses, in simple nervous and gouty palpitation, and as a diuretic in organic heart diseases, in which it frequently seemed to afford relief. The observation of Turnbull—that by the external application of veratrine, in chronic rheumatism, with swellings of the joints, these disappeared—induced him to try it in glandular swellings; he found, that in goitre, in swellings of the mammary glands un- accompanied with pain, in buboes and in scrofulous tumours of various parts, even in cases in which iodine had failed, it rendered essential service. It has, according to him, the advantage, that the skin is not subsequently irritated by it, and when, after the rubbing, the superfluous ointment is washed off with soap and water, the affected parts can soon afterwards be exposed to the air. Of an ointment formed of ten grains of veratrine to half an ounce of lard, a piece, about the size of a nut, is rubbed in for ten minutes twice a day, and every week the strength of the ointment is increased. Magendief recommends, that the veratrine should be given, also, as a drastic cathartic, especially where a speedy action on the bowels is needed. Prescribed with this view, it has been found effective in several aged persons, in whom a collection of * Wurtemb. Medic. Corresponrlenzblatt, B. vi. S. 157 &, 341; & Heidelb. Medicin. Annal. B. iv. II. i. S. 15. f Formulaire pour la Preparation, &c. de plusieurs nouveaux Medica- mens. 486 VERATRINA. excrement had formed in the large intestine. Turnbull advises it in the opposite condition of the bowels—in diarrhea—given in the dose of half a grain—a disease in which, it is well known, our ordinary cathartics often prove extremely serviceable. It would appear, that veratrine is an article which is frequently adulterated. Such, at least, is the opinion of many practitioners, and in this way they account for the discordance amongst observers as to its virtues.* The veratrine, with which Ebers made his first trials, was obtained from the French laboratories; it exhibited the whole power of this heroic agent: on employing. however, a new preparation, he found it entirely useless; and afterwards, with another, he derived all the benefit obtained from the first. The observations of Ebers would induce us to give farther trials to the veratrine; but we must confess, that our experience, thus far, has by no means confirmed the eulogiums of Turnbull; and this is the general sentiment, we think, of the profession.! ^ has often been used externally by ourselves, as well as by many other American physicians, but has almost always fallen short of the mark. RieckeJ affirms, that he has not seen the slightest effect from the application of the veratrine ointment.§ MODE OF ADMINISTERING. Veratrine may be given either in pills or in spirituous solution; the dose being from one-twelfth to one-sixth of a grain several times a day. Externally, it is best administered in the form of ointment, or endermically. In the latter case, Ebers generally strews two grains on the denuded skin. Pilule Veratrine. Pills of Veratrine. R. Veratrin. gr. ss. Gumm. acaciae, Syrup, gum. acac. q. s. ut fiant pilulae vj. pond. gr. j. * Ebers, & Riecke, Die neuern Arzneimittel, u. s. w. S. 407. and 2te Auflage, S. 641. Stuttgart, 1840. f Gully's Translation of Magendie's Formulary; and Joy, in Tweedie's Library of Medicine, v. 289. Lond. 1840. X Op. cit. j See, on the preparation, employment, action, and medicinal virtues of veratrine, Ebers, in Hufeland's Journal, B. lxxxvi. 1838. VERATRINA. 487 Dose.—One pill, to be repeated two or three times a day, ac- cording to circumstances. Magendie. R. • Veratrin. gr. ij. Pulv. rad. glycyrr. gr. xij. Ext. hyoscyam. gr. vj. M. fiant pilulae xij. Dose.—One, three times a day. Turnbull. Tinctura Veratrine. Tincture of Veratrine. R. Veratrin. gr. iv.* Spiritus vini, 5j. M. Dose.—Ten, fifteen, twenty, to twenty-five drops in a glass of water.—Given in dropsy. Magendie.! Unguentum Veratrine. Ointment of Veratrine. R. Veratrinae, gr. v. x. vel xx. Adipis, gj. Misce intime. For external use. The size of a hazel-nut to be carefully rubbed in, morning and evening, or oftener, for from five to fif- teen minutes. Turnbull. R. Veratrin. 9j. Tere cum. 01 olivae, 3J« Et adde Unguent, cetacei, Jvij. Misce. * In the Pharmacopee Universelle, of Jourdan, (ii. 643,) there is the serious error of directing giv. in the preparation of this tincture, in place of four grains! t Magendie recommends that the tincture should also be used externally, in cases of dropsy or gout. 488 VERATRINA. Solutio Veratrine. Solution of Veratrine. R. Veratrinae, gr. j. Aquae destillat. 5ij. M. A dessert-spoonful to be taken in one Or two ounces of sugared water, in cases of tic douloureux. Magendie. Linimentum Veratrina. Liniment of Veratrine. R. Veratrin. gr. viij. Solve in Alcohol. Linim. sapon. aa. ±ss. The Sulphate of Veratrine—veratrine sulphas—possesses the same virtues as veratrine. Magendie gives the following form for internal administration:— Solutio Veratrine Sulphatis. Solution of Sulphate of Veratrine. R. Veratrinae sulphat. gr. j. AqnaB destillat. 5ij. Misce. Dose.—5j to 3iv in a mixture. The preparation has been suggested as a substitute for the Eau medicinale d'Husson. ZINCI CHLORIDUM. 489 ZINCI CHLORIDUM. Synonymes.—Zinci Chloruretum, Zincum Chloratum, Z. Muriaticum (Oxy- datum,) Z. Salitum, Chloruretum Zincicum seu Zinci, Chloretum Zinci seu Zincicum, Butyrum Zinci, Murias Zinci seu Zincicus, Chloride, or Chlo- ruret, Hydrochlorate, Muriate, or Butter of Zinc. German.—Zinkchlorid, Salzsaures Zinkoxyd, Cblorzink, Zinkchlorure, Zink- butter. MODE OF PREPARING. The chloride of zinc results,—when to any given quantity of pure muriatic acid, pure oxide of zinc be added by the aid of gentle heat, until no more is dissolved: the solution is then filtered, and evaporated in a porcelain dish to dryness; whereby a jelly-like__ and, by high drying—firm, white, and, by careless drying, light brownish substance remains, of an austere, sourish, metallic taste, which must be rubbed to powder, and preserved in a closely stopped vessel. The chloride of zinc is very deliquescent in the air, forming the butter of zinc, {butyrum zinci; German, Zinkbutter.) It is very soluble in water. EFFECTS ON THE ECONOMY. The chloride of zinc has been exhibited both internally and externally, but chiefly in the latter mode, especially in this country. Papenguth* found a very dilute solution useful in flabby scrofu- lous ulcerations, applied in the form of lotion; and in sinuous ulcers, in the form of injections. It has been especially recommended as a caustic, that does not exert any disagreeable influence, like the corrosive sublimate, arsenic, or the potassa fusa;—never causing violent pain in the affected parts, or any kind of irritative fever; or disordering the digestive organs, as some of the articles just mentioned. Hancke, indeed, advises that arsenic should be entirely banished from the- rapeutics as a caustic agent, and that the chloride of zinc should be substituted for it. He employed it with success in old, atonic ulcerations on the feet, in the strength of two grains to the ounce * Nouveau Journal de Medecine, 1819. 42 490 ZINCI CHLORIDUM. of distilled water: with this he wetted lint, and applied it two or three times a day. With like success he used it in old syphi- litic ulcers, with extremely morbid surfaces and secretions: the chloride destroyed the degenerate formation, and effected cica- trisation. In scrofulous and malignant herpetic ulcers, he pre- scribed a concentrated solution; in pityriasis he used it as a wash, and in wounds and ulcerations, with fungous formations, he ap- plied it in a concentrated state: in phagedenic ulcers of the face, it effected a more certain cure than the method of Cosme,—the chloride being strewed a line thick, in a dry state, over the whole surface of the ulcer, the edges surrounded with adhesive plaster, and a plaster placed over the chloride of zinc, with compresses and an appropriate bandage. In nevi materni, angiectasis, &c, he applied it in the same manner, as well as in the pustule ma- ligne, (Milzbrandkarbunkel.) Mr. Callaway,* of Guy's Hospital, London, employed it with considerable success in the cure of cutaneous and subcutaneous nevi materni. It was directed to be rubbed on the part until the skin became slightly discoloured, and to be repeated at intervals. Dr. Alexander Ure has found it ex- tremely useful in the varieties of erosive ulcer called lupus, which were often speedily checked, and the disease permanently cured by the local use of the chloride. He applied it in a paste, made with one part of the chloride and two or three parts of the anhy- drous sulphate of lime—a modification of Canquoin's formula, (see below,) which he recommended some years ago.f One or two applications of the paste were generally sufficient to produce a proper eschar, and when this was detached, the sore was treated with water dressing.J A case, is related by Dr. David- son,§ of malignant ulcer under the left ear, which was cured by the unmixed chloride of zinc, applied repeatedly until the ulcer assumed a healthy character. Hancke used it likewise for the formation of issues, which it establishes in from six to eight hours; and, lastly, to excite rube- faction on the surface, either applied in the form of a solution of the chloride in water or wine, or mixed with oil or lard into an ointment, and rubbed on the skin: in this way, a gritty kind of eruption of a scarlet hue is induced, which is said to have afforded relief in paralysis of the limbs. Wendt, Vogt, and Canquoin have highly extolled the chloride as a caustic, and it has been largely employed by the physicians * British Annals of Medicine, May 19, 1837. t Loud. Med. Gazette, Dec. 19, 1835. j Ibid, Dec. 3, 1836. See a case of noli me Tangere of the nostril, and one of phagedenic ulcer of the arm, cured, in London Lancet, cited in Boston Med. and Surg. Journ. Nov. 4, 1840, p. 215- § Edinb. Med. and Surg. Journ. Jan. 1838. ZINCI CHLORIDUM. 491 and surgeons of this continent, especially in the Philadelphia Hospital, and Pennsylvania Hospital, in similar cases to those mentioned above. Dr. Davidson* is of opinion, that the chloride of zinc is only superior to many other caustics in cases where the destruction of a considerable thickness of texture is required, or where the removal of an excrescence by a caustic is preferred by the patient to the knife: the nitrate of silver seems, he considers, to be supe- rior in promoting a sound action, when the unhealthy surface or stratum of the ulcer is superficial. Hanckef has, likewise, used the chloride of zinc internally, with advantage, in cases of epilepsy, as well as in St. Vitus's dance; and has prescribed it, united with hydrocyanic acid, in proso- palgia. Hufeland, also, extols the solution of the chloride in all those neuroses in which the oxide of zinc is indicated, and espe- cially in such patients as are not readily impressible. J MODE OF ADMINISTERING. Gutte Zinci Chloridi. Drops of Chloride of Zinc. R. Zinci. chlorid. gr. j. Sp. aether, muriat. seu sulphuric. Jij. Solve. Dose.—Five drops, every four hours, in a little sugared water; gradually increasing the dose to ten drops. Lotio Zinci Chloridi. Lotion of Chloride of Zinc. R. Zinc, chlorid. gr. viij. Ext. aloes aquos. ^ij Aquae destill. ?iv. Solve. Applied to the dressings, in cases of atonic, scrofulous ulcers. Vogt. The chloride of zinc may be applied as a caustic, by means of a moistened hair pencil, either alone, or mixed with an equal portion of oxide of zinc, or sulphate of lime, or according to the following forms:— * Op. cit., and American Journal of the Med. Sciences, May, 1839, p. 238. f Rust's Magazine, xxii. 373; and Journal de Pharmacie, xvi. 549. X See Merdt & De Lens, Art. Zinc, (chlorure de.) ZINCI CYANIDUM. Canquoin's Caustic Pastes. A. B. C. R. Zinci. chlorid. p. i. i. i. Farinae tritici p. iv. iij. ij. Aquae fontan.* q. s. ut fiat pasta. R. Zinci chlorid. p. j. Farinae tritic. p. iss. Butyri antimonii, p. ss. Aq. font. q. s. ut fiat pasta. ZINCI CYANIDUM. Synonymes.—Zincum Cyanogenatum, Z. Borussicum, Z. Zooticum, Z. Hydro- cyanicum, Z. Cyanuretum, Cyanuretum Zincicum seu Zinci, Cyanetutn Zinci, Prassias seu Hydrocyanas seu Cyanhydras Zinci seu Zincicus, Hydrocyanate, Prussiate, or Cyanuret of Zinc. French.—Cyanure de Zinc. German.—Cyanzink, Blausaures Zynkoxydul, Blaustoffzink, Zinkcyanare. This preparation wTas used in Germany for a long time before tho process was made known.f METHOD OF PREPARING. According to Kunze, it is directed, in the Leipzic shops, to be prepared as follows :j Any quantity of pure sulphate of zinc is dissolved in ten times as much distilled water; the fluid is then filtered, and decomposed by a solution of hydrocyanate of potassa, or hydrocyanate of lime; added by drops so long as a precipitate is formed. This precipi- tate, which consists of cyanide of zinc, must be carefully washed, dried, and preserved in a glass jar, from which the entrance of light is prevented.§ "■ To each ounce of the chloride of zinc twenty-four to thirty drops of water may be added. f Magendie, Formulaire pour la Preparation, &c. de plusieurs nouveaux M^dicamens, &c. t Riecke, Die neuern Arzneimittel, u. s. w. S. 410. Stuttgart, 1837. 5 For M. Pelletier's method, see Magendie, Formulaire, &c. ZINCI FERROHYDROCYANAS. 493 It has been admitted into the French Pharmacopceia. The hydrocyanate of zinc has the appearance of a white, taste- less powder, which is insoluble in water and spirit of wine, but dissolves in the stronger acids, with the disengagement of hydro- cyanic acid. Well prepared and rubbed, it has a strong odour of hydrocyanic acid, and when moistened, or exposed to heat, it ex- hales hydrocyanic acid. As to its medicinal effects and mode of administering, they are analogous to those of the following preparation: they are, there- fore given together. ZINCI FERROHYDROCYANAS. Synonymes.—Zinci Ferrocyanidum, Cyanetum seu Cyanuretum Zinci et Fer- ri, Cyaneturn Ferrosozincicum, Cyanuretum Ferrozincicum, Zincum Fer- rohydrocyanicum, Z. Ferroborussicum, Z. Ferrocyanogenatum seu Ferrocy- anatum, Prussias Zinci et Ferri, Hydrocyanas Zinci Ferruginosus, Ferro- hydrocyanas Zinci, Ferro-Hydrocyanate, or Ferrocyanate of Zinc. German.—Eisenblausaures Zink, Blausaures Eisenzink, Eisenhaltiges Blau- saures Zink, Blausaures Eisenoxydul-Zinkoxyd, ZinkeisencyantireT Cyanei- senzink. METHOD OF PREPARING. According to Schindler,* this preparation is best made by the mutual decomposition of boiling hot solutions of eighty-three parts of sulphate of zinc, and sixty parts of ferrocyanate of po- tassa. If tbe sulphate of zinc be not entirely free from iron, it has a bluish lustre, which, after long washing with lime water, becomes of a reddish hue. If the bluish colour be manifested, some more sulphate of zinc must be added, and it must be di- gested until the precipitate appears entirely white. Ferrohydrocyanate of zinc forms a white, insoluble, almost in- odorous powder, which is somewhat soluble in the stronger acids, without exhaling a smell of hydrocyanic acid in the cold; but by boiling, hydrocyanic acid is slowly disengaged. * Riecke, Op. cit. S. 411, and 2te Auflage, S. 646. Stuttgart, 1840. 42* 494 ZINCI FERROHYDROCYANAS. EFFECTS ON THE ECONOMY. Hufeland recommends the cyanide, or perhaps, the ferrocya- nate of zinc in nervous diseases. According to him, from one to four grains may be given for a dose, two or three times a day, without any injurious effects;—the only inconvenience being, at times, slight nausea, but no diarrhcea, or disposition to obstruc- tions, and no narcotic symptoms. In cardialgia, it afforded, in his hands, essential service, as well as in some cases of epilepsy and in paralysis. Henning,* likewise, found it useful in cramp of the stomach, in hysteria, and in spasmodic diseases of children, induced by worms. In epileptic attacks from teething, he also gave it with advantage;—the dose being from half a grain to a i^rain, three or four times a day. Clarus gave the cyanide of zinc in epilepsy, but he observed no other result than less fre- quent and less severe attacks. Pohl saw no very decided effect from the remedy, which he gave in the dose of from one fourth to half a grain. In the Berlin Polyclinic Institute, advantage ac- crued from it in two cases of St. Vitus's dance ; it was begun with in the dose of one-third of a grain twice a day, which was gradually raised to fourteen grains a day. Klokow gave the cyanide of zinc—which Riecke suggestsf was the cyanide of zinc and potassium, (Cyanzink-cyankalium,)—in spasmodic af- fections,—beginning at first with one-tenth of a grain, as larger doses occasioned colic, diarrhcea, and vomiting; and, when the patient became accustomed to it, gradually augmenting the dose to half a grain. Success, he affirms, followed its ad- ministration.;}; Muhrbeck gave it, in violent periodical cephalal- gia in the region of the left frontal sinus, with great benefit. He began with one-twelfth of a grain, and gradually raised the dose to a grain and a half. Miiller and Giinther confirm the re- ports of its efficacy in St. Vitus's dance: the first gave daily a grain; the latter, from half a grain to a grain, four times a day. Kopp, who distinguishes the two preparations from each other, instituted experiments with each. The ferrocyanate of zinc he used with advantage in cramp of the stomach, general nervous disorder, nervous debility, neuralgia, nervous headach, and noc- turnal pains in the bones. He gave it in the form of powder, with some sugar of milk, every two hours, or four times a day, in doses of one-twelfth to one-eighth of a grain, gradually increasing the dose. According to his observations, it occasions, with many * Hufeland's Journal, 1823. t Op, cit. S. 413. X Hufeland und Osan s Journal, B. lxx. St. 2. ZINCI FERROHYDROCYANAS. 495 persons, obstructions, but does not disorder the stomach. Kopp found the cyanide of zinc still more efficacious in the same dis- orders. Impressible patients, who suffered under unusual sensi- bility of the abdomen, took four powders daily, of one-sixteenth of a grain each, with marked benefit. In one case of neuralgia, in a man, he elevated the dose very gradually to half a grain four times a day. When, however, this quantity was exceeded, and the patient took five-eighths of a grain four times a day, hy- peraemia occurred in the head, with constipation. In two cases of chorea of one side of the body, the ferrocyanate had no effect whatever. Riecke* asserts, that his father used it several times in scirrhus of the pylorus with advantage. MODE OF ADMINISTERING. The cyanide was applied externally, by Von Ammon, in scrofulous and incipient rheumatic inflammation of the eyes, as well as in catarrhal inflammation of the eyelids : he prescribed it suspended by means of gum arabic in a mixture of cherry-laurel water and tinctura opii. On account of the insolubility of both the cyanide and the fer- rocyanate, they are best given in the form of pill or powder. The common dose of the cyanide is from one-sixteenth to one- twelfth of a grain several times a day, gradually increasing the dose to one quarter of a grain; of the ferrocyanate, the dose is from one to four grains two or three times a day. Rieckef ad- vises—to prevent confusion—that when these articles are ordered, they should be respectively denominated, Zincum hydrocyanicum sine ferro, and Zincum /erro-hydrocyanicum. Pilule Zinci Cyanidi. Pills of Cyanide of Zinc. R. Zinci cyanid. gr. xv. Succ. glycyrrh. 3U- Misce et fiant pilulas lx. Dose.—One, morning, noon, and night, gradually increasing the quantity. Kopp. R. Zinci cyanid. gr. vj. Magnesiae, gr. iv. Pulv. cinnam. gr. iij. Misce. * Op. cit. S. 414. t Ibid. 496 ZINCI IODIDUM. This dose to be repeated every four hours, in nervous affections of the stomach, especially in cases of cramp. Henning. ZINCI IODIDUM. Synonymes.—Zincum lodatum, Zinci loduretum, Iodetum Zinci seu Zinci- cum, Protoioduretum Zinci, Iodide, or Ioduret of Zinc. German.—lodzink, Zinkiodtire. This preparation is made by boiling together iodine and zinc- in atomic proportions, or rather with an excess of zinc, in a flask of water, down to dryness, and subliming the residue. Iodide of zinc is thus procured in beautiful, colourless, prismatic crystals.* The Iodide of zinc is very deliquescent, and cannot easily be retained in the solid form. When heated in open vessels, it is re- solved into iodine and oxide of zinc. It is very liable to undergo spontaneous decomposition. It has a caustic taste, and, when applied to a denuded surface, gives rise to considerable smarting. Dr. Uref recommends an ointment, formed of a dram of the iodide to an ounce of lard, in cases where the external use of the iodide of potassium is indicated. Proutet advises it as a collyrium in scrofulous ophthalmia, of the strength of fifteen grains to six ounces of distilled water; and it has been employed to form an astringent injection, in the propor- tion of one or two grains to an ounce of water. * Annales de Chimie, xci. t Diet, of Chemistry, 2d edition, p. 516. SUPPLEMENT. I.—COMPRESSIO. Svnonymes.—Compression, Methodical Compression. German.—Druck. This valuable method of modifying the condition of the capillary or intermediate system of vessels, and, through it, the function of nutrition, has lately become more extensively employed in the treatment of dis- ease. As a sorbefacient, in various hypertrophies, it has long been used wherever its agency was applicable, and its effects have been very de- cided.* Of late years, however, it has been proposed in inflammatory and other affections, in which it had been previously esteemed inappli- cable. Upwards of twenty years ago, it was highly recommended in rheumatic affections by Dr. William Balfomyf of Edinburgh, and nume- rous cases were brought forward by him, and by others, to attest its efficacy. Since then, it has been advised by Guerin,| in cases of phleg- monous erysipelas of the extremities; by Velpeau,§ in severe burns and phlebitis, and in inflammation of the synovial apparatus;^ and still more recently, Mr. James Allan^f has related three cases of phlegmasia bene- fited by a similar treatment;—two were of erysipelas of the lower ex- tremities, and one of the face. In these, compression was of speedy and permanent benefit—the pain caused by it being very transient. He states, moreover, that he has found the bandage of very great service in removing the pain and swelling of joints affected with acute rheumatism after the more active degree of inflammation had passed away. * Clinique Medicale de l'Hdpital Necker, p. 247, Paris, 1835; or the translation in Dunglison's American Medical Library, first year. Sec, also, the author's Gene- ral Therapeutics, p. 228. Philad. 1836. t A new mode of curing Rheumatism and Sprains without debilitating. Edinb. 1817. X Journ. Analyt. i. 90. § Ibid, and Bulletin General de Therapeutique, No. 16, Aotit 30, 1836. || Nouv. Bib. Med., Aout, 1826; and Merat & De Lens, Diet, de Mat. Med., Art. Compression. T British Annals of Medicine, Jan. 27, 1837. 498 SUPPLEMENT. In cases of external inflammation, compression acts probably in two ways;—first, by diminishing the circulation in the intermediate system of vessels concerned in the pathological condition; and, secondly, by restoring tone to the over-dilated vessels; for it is in erysipelatous affec- tions, in which this form of hyperaemia more especially exists, that we have found it of greatest advantage. At this very time, we have cases of erysipelas of the extremities under treatment by compression, which are greatly benefited. We are constantly, also, in the habit of employ- ing compression, under the circumstances mentioned by Mr. Allan, in arthritic affections, which are usually attended with great effusion, and with the most satisfactory results. From an observation of the good effects resulting from compression in analogous cases, it occurred to Dr. Fricke,* of Hamburg, that it might be employed with advantage in cases of orchitis, or swelled testicle, (hernia humoralis;) which is frequently very tedious, and requires means that are by no means easy of application. He, accordingly, had recourse to it, and the result was most satisfactory: he found that " the disease could be removed by it in a simple, easy, and surprisingly rapid way." He is of opinion, that, generally speaking, compression may be employed in every kind of inflammatory engorgement of the testicle, whatever may have been its cause, and at all stages of the disease. In many cases, the pain was at first, in some degree, increased; and in some— especially when applied too tightly—it induced great pain; but this never continued long, the patient, in a short time, finding himself so much relieved as to be able to leave his bed and walk about the room. In many cases of recent origin, a single application of the compression was found sufficient; but when the disease was of longer duration—say from three to eight days—it was found necessary to repeat the compres- sion two or three times. Swelling of the spermatic cord, if not very considerable, did not contraindicate its use; nor did other coexistent local affections, as buboes, ulcers, &c. When a general febrile state accompanied the orchitis, compression was found to be the best means for removing it, where the vascular action, at least, was not too conside- rable; although, in extremely rare cases, such was the effect of the com- pression itself. When the pain was very severe, it was generally owing to the com- pression having been too strong, and the same was the case with certain signs of gastric derangement that occasionally supervened. In these cases, it was necessary to suspend the remedy, until the derangement was removed, by the use of an emetic, or the application of a poultice to the stomach. These cases were, however, extremely infrequent. The good effects of compression exhibited themselves very soon after its employment, and the speedy abatement of the pain was always the surest sign of its efficacy. If the pain continued for some hours to any considerable degree, a general disorder of the system might be looked for as explaining the failure of success. In the summer of 1835, Dr. Fricke treated, in this manner, seventeen * Zeitschrift fur die gesammt. Medicin. B. i. H. 1, Hamburg, 1836. See, also, Brit, and For. Med. Rev. for July, 1836, p. 253. compressio. 499 cases. Of these were cured ;—in one day, one ; in two days, four; in three days, four; in four days, two ; in five days, three ; in nine days, one ; and in ten days, two. The last three were severe and unfavour- able cases. For the purpose of compression, Dr. Fricke employs sticking plaster, made very adhesive, but not of too irritating materials, and spread on strips of linen, of the breadth of the thumb. No preparatory measures, as leeches, cataplasms, &c. are required. In slighter cases, the patient may stand before the surgeon leaning against the wall, or he may sit on the edge of a bed or sofa, in such sort that the scrotum may hang freely down. If the scrotum and neigh- bouring parts are much covered with hair, it must be removed; but, generally speaking, this is unnecessary. The following is the method he adopts of applying the compres- sion :— The surgeon takes the scrotum in one hand, and separates the dis- eased from the sound testicle ; whilst, with the other, he gently stretches the skin of the scrotum over the former: the spermatic cord is isolated in the same manner. If the swelling of the testicle be considerable, it must be held by an assistant. The surgeon now applies the first strip over the isolated spermatic cord, about a finger's breadth above the tes- ticle, holding the end of the strip with his thumb, and passing it round the cord. He proceeds in the same manner with the second strip, which must cover the former either in part or altogether. The first part of the process must be carefully done ; the strips must compress the cord closely ; for this purpose, the cord must be kept approximated to the skin, which must be tightly stretched over it; otherwise, when the other extremity of the testicle is compressed, the upper end will be apt to slip upwards through the loose rings of adhesive plaster, which will not onlv occasion pain, but render the whole operation abortive. In this manner the surgeon proceeds, applying strip after strip, the last always lying over its precursor by a third of its width, until the thickest part of the testicle—where it begins rapidly to decrease in diameter—is reached. The mode of procedure is now changed ; the surgeon lays hold of the part of the testicle already covered, and passes his strips longitudinally from above downwards over the lower portion of the testicle. In this way, the rest of the testicle is closely enveloped and compressed. The proper degree of compression will, in most cases, be indicated by the speedy disappearance of the pain which had previously existed. When both testicles are affected, they must both be included in the circular strapping—the testicle already covered serving as a point of support for the other, as there is not room enough for the application of the circular strips over the second, in the same way as over the first In some cases, where the skin is irritable, ulcerations take place : small slits may then be cut in the plaster, and a Goulard lotion be ap- plied. Generally speaking, the patient may leave his bed immediately after the strapping has been attached, and walk about the room ; and, where the inflammation has not been great, he may even attend to light labour out of doors. 500 supplement. When the strapping becomes loose, it may have to be reapplied, but often one application is sufficient. In orchitis, caused by blows or pressure, compression is regarded by Dr. Fricke as the best agency. If the inflammation runs very high, he usually applies leeches, in the first instance, and keeps on poultices for a day or two; but, in slighter cases, he has recourse immediately to com- pression. The principal advantages, which he considers this mode of treating orchitis to have over others, are: First. The speedy removal of the pain ; Secondly. The quick removal of the disease itself; Thirdly. The simplicity of the plan, and the slight trouble given thereby to the patient; Fourthly. Its small expense : and, Fifthly. The comparatively slight care and attendance required on the part of the surgeon. The last two points, as he properly remarks, are of considerable importance in hospital practice. Since this plan of treating orchitis was suggested by Fricke, it has been successfully employed by our hospital and other surgeons, although by no means extensively adopted. Several cases, too, have been men- tioned by M. Dechange,* of Liege, formerly chef de clinique chirurgi- cale at the Hopital de Baviere. Of twelve cases of acute orchitis, thus treated, three were cured in three days ; and the remainder before the seventh day. Mr. Langston Parkert has also recently extolled this remedy not only in ordinary swelled testicle, but in chronic or subacute inflam- mation of the testes, whether dependent on syphilitic causes or not; and a still more recent writer^ affirms, that he has adopted the practice in many cases, and can speak most unequivocally in its praise. It may be employed, he remarks, in very acute forms; and he has seen several instances, where the patients had not lain in bed an hour, " whilst un- der the ordinary antiphlogistic treatment they would have been confined from ten days to a fortnight." Of late, Compression of the arteries, as an antiphlogistic agent, has been revived by Goyrand, Malapert, and others ; the object being to prevent the afflux of blood to a part labouring under hyperemia. The origin of this idea has been a matter of controversy ;§ but, as De- zeimeris|| has remarked, it certainly is not due to the gentlemen who have engaged in it. Blaud compressed the carotid in brain fever; Au- tenrieth did the same, before Blaud, in cases of convulsions. Earl, in epilepsy; Livingston and Kellie, in rheumatism ; Ludlow, in gout; and Parry, of Bath, half a century earlier, employed compression of the vessels in different diseases, with the clearest appreciation of its modus operandi. Still more recently, Allier^ has published a case of intermittent neu- ralgia of the lobe of the right ear, cured by compression of the primi- tive carotid of the same side: half an hour before the paroxysm, the compression was exerted, with interruptions of five minutes every quar- * Bulletin Medical Beige, AoM, 1838, p. 218. t London Lancet, July 25, 1840, p. 640. % British and Foreign Medical Review, Oct. 1840, p. 393. § Gazette Medicale de Paris, No. 46, Nov. 18, 1837, and No. 47. II Ibid. *f L'Experience, No. 16, Jan. 20, 1838. compressio. 501 ter of an hour. He has, also, reported a case of neuralgia of the or- bito-frontal nerve; and, subsequently, of the nervous pudendus supe- rior, respectively cured by compression of the carotid, and abdominal aorta. The compression of the carotid of the affected side was con- tinued for the whole forenoon, with pauses of five minutes every quar- ter of an hour. For the pudic neuralgia, the abdominal aorta was compressed for the space of three quarters of an hour: the neuralgia, in both instances, gradually ceased. M. Dufresne* has published a case of Hemicrania and facial neural- gia of the right side, cured by the same means. Compression of the right primitive carotid for ten seconds occasioned instantaneous disap- pearance of the pain, which returned in one minute after the removal of the pressure. Compression of the same vessel for 12 seconds, caused instantaneous disappearance of the pain from its position, but it shifted to the posterior part of the head. This pain ceased with the removal of the pressure, and in two minutes afterwards the original pain reappeared on the right side. When graduated, compression was made on the same vessel for 30 seconds, the pain, as before, moved to the posterior left part of the skull. M. Dufresne then pressed on the left carotid, and easing the force as he diminished that on the right side, the posterior pain disappeared, and no return of either had taken place ten minutes after. The patient slept well, and made no complaint of pain in the morning. Compression of the abdominal aorta has likewise been employed by M. Baudelocque, and many others, with the view of arresting uterine hemorrhage occurring in labour, as well as the hemorrhages which fol- low wounds of the arteries of the inferior half of the body.X In a re- cent case of uterine hemorrhage, detailed by Dr. Ehrenreich,J external compression by the hand on the abdomen, which is the only way of acting on the aorta when any obstacle exists to the introduction of the hand into the uterus was tried without success, owing to the thickness of the abdominal parietes. The hemorrhage was, however, completely controlled by introducing the entire right hand into the uterus, and making forcible pressure with thejingers gathered into a conical shape on the aorta immediately above its bifurcation. Lastly: M. Allier§ employed compression of both carotids in a case of hydrophobia at the commencement of an attack; immediately, the convulsion ceased, and the patient became apparently exanimate. The family were alarmed, and would not permit a repetition of the experi- ment. The case ended fatally. In paroxysmal diseases, the ratio medendi of compression is not the same as in inflammatory diseases. In the latter, the flow of blood towards the inflamed part is prevented by the compression of the arte- * L'Experience, No. cxxviii. Dec. 1839. \ See an account of M. Baudelocque's views, by Mr. J. C. Oistophers, in Lan- cet, July, 20, 1839, p. 599. X Medicinische Zeitung, No. xxxvii, 1839, and British and Foreign Medical Re- view, July, 1840, p. 279. § Ibid. 43 502 SUPPLEMENT. rial vessels proceeding to it; but when compression is exerted on the vessels in neuralgia and congenerous diseases, the new impression caused by the resulting irregularity in the circulation, and the modification in the nervous function induced thereby, break in upon the morbid catena- tion like the different agents that are classed under the head of antispas- modics, of which class we have elsewhere endeavoured to show—what, by the way, is not now contested by any eminent therapeutist—that we have none that can be regarded in any other light than as indirect agents.* II.—CONTRA-IRRITATIO. Synonymes.—Counter-irritation, Counter-action. German.—Gegenreizung. It is not the object of the author to enter into an explanation of the therapeutical application of counter-irritants, or revellents in general. This he has done at considerable length elsewhere;! but to refer to some agents not mentioned in the body of the work, to which attention has been revived, or first directed, of late years more especially. I. ammoniated counter-irritants. Gondret's Ammoniacal Ointment; Granville's Counter-irritants—Antidy- nousj Counter-irritants. Ammonia has long been used in different formulae for exciting rube- faction and vesication of the cutaneous surface. When two parts of liquid ammonia are united with one part of suet, and one part of oil of sweet almonds, the mixture forms the pommade ammoniacale of Gon- dret, which has been used for a long time to excite a speedy revulsion in cases of chronic affections of the brain, incipient cataract, amaurosis, &c, as well as to cauterise the integuments deeply.§ To the advan- tages of this preparation, as well as of derivation in various diseases, M. * General Therapeutics, p. 380. t General Therapeutics, p. 333. X A term coined by Dr. Granville. It ought to be " Antodynous," from ttvri, " against," and oHej>sy. 3. Convulsions lmdndmS f St. Vitus's Dance. {_ J Hysterics. 4. Cramp, 5. Brow-ague. 6. Tetanus or lock-jaw. 7. Highly acute toothach. 8. Nervous headach. B. Principally affecting the Muscles and Tendinous Tissues. 9. Rheumatism. 10. Lumbago. 11. Swelled and highly painful articulations. * General Therapeutics, p. 341. t Lancet, Oct. 27, 1838. CONTRA-IRRITATIO. 507 C. Principally affecting the Circulation. 12. Headach from fulness of blood in the head. 13. Congestions and sudden attacks of blood in the head. 14. Sore throat. 15. Early in-1 * °f *e *""*<». *\d bronchia, ] TendinS flammation. f L °* /,he iunSs an,d their membranes, S^ y c. of the heart and pericardium. consump- -J J tion. D. Diseases of a Mixed Character. 16. Suppressed gout.l «• Affecting the heart. r ° J 0. Affecting the stomach. 17. Genuine gout. 18. Paralytic debility. E. Accidental, Mechanical, and Cutaneous Derangements. 19. Violent sprains. 20. Pimples. 21. 5i/es. 22. Ringworm. Dr. Granville does not affirm, that all these disorders, and their modi- fications, have yielded to the ammoniated counter-irritants; or that the counter-irritants were always the sole agents employed. On the con- trary, a few of them, he says, on particular occasions, resisted that agency; others were only momentarily benefited; and a few more re- quired the simultaneous employment of ordinary and internal remedies to assist in, and complete, the cure. Among the exceptions to the general rule of success, he enumerates chronic tic douloureux; chronic rheumatism of long standing; epilepsy dependent on organic mischief in the brain, or any part of the spinal apparatus; and rheumatic gout, in persons whose constitutions had been completely shaken by that disorder, or by any other previous disease, although, even in this case, some good was obtained from using the am- moniated counter-irritants. The second and fourth of these disorders are of that number which require, in addition to the ammoniated appli- cations, an appropriate internal treatment. The other two, Dr. Gran- ville has found to be only partially relieved, but never cured by coun- ter-irritating lotions.* In many of the disorders, referred to by Dr. Granville in the table given above, his ammoniated counter-irritants have been employed both in public and private in this country, and especially, perhaps, in this city. The effect in nervous and spasmodic diseases, in neuralgic and * Op. cit, p. 29. 508 SUPPLEMENT. deep-seated rheumatic pains, has at times been very striking. Severe pains have yielded rapidly, as described by Dr. Granville; hyperemia' of particular organs have been diverted elsewhere, especially after blood- letting and sedatives had been premised; and, in short, whenever revel- lents, sudden and rapid in their action, have been demanded, the ammo- niated counter-irritants have effected every thing that similar powerful revellents were capable of accomplishing,—but no more. We are in the habit of having recourse to the moxa in congenerous affections, and—as we have before remarked—with equally satisfactory results. There is one objection, too, that applies to the use of these strong lotions;—the sloughs and sores induced by them are often considerable, and remarkably difficult to heal. This, it is true, may be partly pre- vented, by being careful that the application is not too long continued ; but, with the greatest caution, these results will, at times, supervene. When such is the case, simple dressings, with emollient poultices, will be found the best applications. 2. MOXA. Synontmes.—Moxiburium. By the term moxa, the Chinese and Japanese designate a cottony sub- stance, which they prepare by beating the dried leaves of the artemisia chinensis, a kind of mugwort. With this down they form a cone, which is placed upon the part intended to be cauterised, and is set fire to at the top. This mode of exciting counter-irritation has been long practised by the Chinese and Japanese, and by the ruder nations of the old world- but it was not much employed in Great Britain and France until about the commencement of the seventeenth century, when it was introduced through the agency of a physician* who had resided in India. It fell again, however, into disuse, until attention was redirected to it, during the last century, by Pouteaut and Dujardin, and, at the commencement of this century, by Percy and Laurent,^ and others.§ MODE OF PREPARING. Various agents have been used by different people, in " moxibustion," —for so the mode of cauterisation has been termed, which consists in * Ten Rhyne, Medit. de veteri Medicin.; Dissert, de Arthritide, Lugd. Bat. 1672: and Ksempfer's History of Japan, translated by Scheuchzer, vol. ii. append! sect. iv. Lond. 1728. t Melanges de Chirurgie, p. 49. X Dictionnaire des Sciences Medicales, Art. Moxibustion. § See, for a history of the moxa, the author's translation of Baron Larrey's Me- moir on the use of the moxa. Lond. 1822. MOXA. 509 placing some combustible substance on a part of the body, and suffering it to burn down. From the earliest ages, the Nomades employed the fat wool of their flocks, as well as certain spongy substances growing upon oaks,* or springing from the hazel;t the Indian the pith of the reed,| and flax or hemp impregnated with some combustible material;^ the Persian, the dung of the goat; the Armenian, the agaric of the oak; the Chinese and Japanese, the down of the artemisia; the Thessalian, dried moss;|| the Egyptians, the Arracanese, and several oriental nations, cotton;^ the Ostiaks** and the Laplanders,!! the agaric of the birch; and the aborigines of this continent, rotten and dried wood. Hippo- cratesJJ was in the habit of employing fungi and flax for the same pur- pose. In modern times, also, various substances have been used for the fabrication of the moxas. Whatever article is selected, it ought to be a spongy, light, vegetable matter; readily combustible, and so prepared as to burn down slowly. In Germany, they use the tinder—amadou— which is known to be an agaric prepared for the purpose; and it is not uncommonly employed in our hospitals,—a small disc or cylinder being placed on the part, and set fire to. It is now generally U6ed in the French Hospitals.§§ The match used by artillerists was recommended by Percy,|||| after Bontius:^ it is composed of hemp steeped in a solution of nitre. He likewise proposed the pith of the sun-flower—helianthus annuus—recommending, that the stalk should be cut into cylinders of the desired length, the bark being left on ; so that, when ignited, it may burn in the centre and be held with the hand.*** This, he calls moxa de voleurs."X\X The moxa, used by Larrey, and very generally employed by many practitioners, is made by taking a quantity of cotton wool, pressing it somewhat closely together, and rolling over it apiece of fine linen, whieh is fastened at the side by a few stitches. Larrey advises, that it should have the shape of a truncated cone—the form usually adopted—and be about an inch long. Commonly the cylinder is shorter than this, six or eight lines—as, when above six lines high, the combustion is not felt—and about four or five lines broad. The moxas, employed by Dr. * Hippoc. lib. de Affect, cap. xxx. t Paulus iEginet. lib. vi. cap. 49. X Kampfer, vol. ii. app. sect. iv. p. 36. § Bontius de Medicina Indorum, p. 32. || Percy, in Pyrotechnie Chirurgicale pratique, p. 12. T" Prosper. Alpin. de Medicina. iEgyptiorum, lib. iii. cap. 12. ** Voyages de M. Pallas, iv. 68. ft Acerbi's Travels through Sweden, Finland, and Lapland, ii. 291, and Linnaeus, in Lachesis Lapponica, translated by Sir James Smith, i. 274. XX De Affect, cap. viii. §§ Bulletin General de Therapeutique, Juillet, 1840. Ill Op. cit. p. 77. Paris, 1811. TIT Op. cit. p. 32. Paris, 1645. *** Art. Moxibustion, in Diet, des Sciences Medicales. t+t Me" rat & De Lens, Diet, de Mat. MeU, Art Moxa. 510 SUPPLEMENT. Sadler,* of St. Petersburg, are about half an inch in diameter, and three quarters of an inch in height. They are composed of a nucleus formed of the pith of the sunflower, wrapped in layers of cotton, of various thickness, and surrounded with an external envelope of thin muslin; both of the latter being previously steeped in a solution of nitre. Thev are held, while burning, by means of two long hair pins, the legs of which are slightly bent, in order to accommodate them to the shape of the moxa; and, when the latter is burned down to the place where it is held by the first hair-pin, it can be held with the other, and retained in its proper position. With this last view, Larreyt has a special porte- moxa, consisting of a ring to receive the cylinder, with a handle attached to it, and three small supports or knobs of ebony, placed beneath the ring, to prevent the heated metal from acting upon the surface. Professor Gr'dfel employs moxas made of wafers, dipped in a mix- ture of three parts of oil of turpentine, and one part of sulphuric ether. Before applying this inflammable matter to the skin, it is necessary to carefully remove the superfluous liquid. These moxas are said to ignite readily, burn promptly and uniformly, and not to crepitate. Of late years, a plan for raising vesication on the surface has been adopted, which, as Dr. Granville remarks, must be regarded as a kind of moxa.§ This, he admits, is equally successful with the one he proposes, and which we have already described, (p. 503,) in forming a rapid vesi- cation ; " but it is, at the same time, so complicated, and attended by such intense pain," that, in practice, he says, it will not bear comparison with the preparations which he recommends. A piece of linen or paper, being cut of the requisite size, is immersed in spirit of wine, or brandy. It is then laid on the part to be blistered, care being taken, that the moisture from the paper or linen does not wet the surrounding surface. The flame of a lighted taper is applied quickly over the surface, so as to produce a general ignition, which is exceedingly rapid. At the con- clusion of this operation, the cuticle is found detached from the true skin beneath. In the application of the various moxas, or of most of them, their agency can be so graduated as to produce either simple rubefaction, vesication or the formation of an eschar. Where it is desirable to produce the first result only, the cylinder of cotton may be removed when the pain becomes somewhat severe; or the burning material may be held close to the surface, and be moved gradually along it. In this manner, a counter-irritant effect may be exerted along the spine or any extensive surface. Any burning substance—a lighted coal for example—will answer for this purpose. When vesication is needed, it must be kept on longer; and if it be desirable to produce an eschar, the moxa may have to remain on until it is wholly consumed. Larrey,|| indeed, * Zeitschrift fur die gesammte Medicin. B. iii. H. ii. & iii. and British and Foreign Medical Review, July, 1837, p. 217. t The author's translation of his Essay on the Moxa, p. 5. X La Lancette Franchise, Jan. 26, 1839. § Counter-irritation, its Principles and Practice, Dunglison's Amer. Med. Librarv edit. p. 21 and p. 42. Philad. 1838. II Op. citat. p. 5. GALVANISMUS. 511 advises, that the blowpipe should be occasionally employed to hasten the combustion. When the integument has once become disorganized, the slough will be thrown off in due time, leaving an ulcer. Larrey says the sloughing can be prevented by the application of liquid ammonia* to the burnt surface, after the moxa has been removed. This will do when the disorganization is partial; but we know, from experience, that it often fails. EFFECTS ON THE ECONOMY IN DISEASE. The moxa—in its different forms—is doubtless a most valuable agent, where rapid counter-irritation is indicated. It resembles, indeed, in its action, the ammoniated counter-irritants of which we have already treated, and is applicable to the same diseases;—the only difference between them—when cauterisation is effected—being, that the agent in the case of the ammoniated lotion is a potential, in that of the moxa an actual, cauterant. The moxa must be regarded as one of our most valuable revellents. Hi.--GALVANISMUS. SruoNYMES.—Galvanism, Elcctricitas Animalis, E. Galvanica seu Metallica Irri- tamentum Metallorum seu Metallicum. French.—Galvanisme. The ordinary effects of common and galvanic electricity and of elec- tro-magnetism are so well known, as to require but little comment. They are decidedly excitant; and, like all excitants, when applied to a part of the frame, are counter-irritant or revellent. All have been em- ployed in paralysis,—general and local,—amaurosis, deafness and dumbness of recent duration, asthma, rheumatism, neuralgia, &c. The effect, however, which galvanism exerts on the contractility of the mus- cular fibre, and the great similarity, in its agency, to the nervous influ- ence,! has led to its employment more frequently in the various nervous and spasmodic diseases referred to, and in others belonging to the same class. Resting on his views of the absolute identity between the ner- vous and the galvanic fluids,^ Dr. Wilson Philip employed it in many diseases, and especially in asthma. In a paper read by him before the Royal Society of London, in January, 1816, he details some experi- ments, which he made on rabbits. The eighth pair or pneumogastric nerves were divided by incisions made in the neck. After the opera- tion, the parsley, which the animals had eaten, remained unchanged in * Ibid, p. 9. t See the author's Physiology, i. 88, 3d edit. Philad. 1838. X Experimental Inquiry into the Laws of the Vital Functions, Lond. 1817. 512 SUPPLEMENT. their stomachs, and after evincing mnch difficulty of breathing, they seemed to die of suffocation. But when, on other animals, whose nerves had been divided, the galvanic agency was transmitted along the nerve, below its section, to a disc of silver, placed closely in contact with the skin of the animal, opposite to its stomach, no difficulty of breathing occurred. The galvanic action being kept up for twenty- six hours, the rabbits were then killed and the parsley was found di- gested. The removal of dyspnea in these cases led Dr. Philip to employ gal- vanism as a remedy for asthma; and, by transmitting its influence from the nape of the neck to the pit of the stomach, he gave decided relief in every one of twenty-two cases, of which four were in private practice, and eighteen in the Worcester infirmary. The power employed varied from ten to twenty-five pairs of plates. Since then, galvanism has been repeatedly used in such cases, and at times with marked relief. Com- monly, however, the plates, described hereafter, are employed for this purpose. The disease appears to be in the majority of cases dependent upon erethism of the pneumogastric nerves; all the phenomena indicate that there is a spastic constriction of the small bronchial tubes, occa- sioned by irritation at the extremities or in the course of the nerve. The new impression, made by the galvanic agency, breaks in upon the con- centration of nervous action, by exciting other portions of the nervous system, in the same manner as we observe spasms or ordinary cramp relieved, or paroxysmal diseases warded off, by agents that are capable of suddenly impressing some part of the nervous system. Not long after these researches of Dr. Philip, galvanism was em- ployed satisfactorily by Mr. Mansford* in a congenerous disease—epilepsy —and his plan was afterwards—although tardily—extended to some other paroxysmal disorders. The mode of application, recommended by Mansford, is as follows: A portion of the cuticle, of the size of a sixpence, is removed by means of a small blister on the batik of the neck, as close to the root of the hair as possible, and a similar portion is removed from the hollow, be- neath, and on the inside of the knee, as the most convenient place. To the excoriated surface on the neck, a plate of silver, varying—ac- cording to the age of the patient—from the size of a sixpence to that of a half a crown, is applied, having attached to its back part a handle or shank, and to its lower edge—and parallel with the shank—a small sta- ple, to which the conducting wire is fastened. This wire passes down the back, until it reaches a belt of chamois leather, buttoned round the waist; it then follows the course of the belt to which it is attached, until it arrives opposite the groin of the side on which we desire to employ it; it then passes down the inside of the thigh, and is fastened to the zinc plate in the same manner as to the silver one. The apparatus, con- trived in this way, is thus applied. A small piece of sponge, moistened in water, and corresponding in size to the blistered part of the neck, is first placed directly upon it; over this, a large piece of the same size as the metallic plate, also moistened, is laid, and next to this, the plate it- * Researches into the nature and causes of Epilepsy, &c, Bath, 1819. GALVANISMUS. 513 ™LJ?|, u T^l^r-ltS S,ltUation ^ a striP of adhesive Plaster passed hrough the shank in its back; another above, and another below it. It these be properly placed, and the wire, which passes down the back be allowed sufficient room that it may not drag, the plate will not be moved from its position by any ordinary motion of the body The zinc plate is fastened in the same manner, but in place of the second layer of sponge, a piece of muscle answering in size to the zinc plate in interposed;—that is-a small piece of moistened sponge beinsr first fitted to the exposed surface below the knee, the piece of muscle moistened, or—what we have found equally effectual and less inconvenient-a piece of moistened flannel* follows, and on this the plate of zinc 1 he apparatus, thus arranged, will continue, according to Mr Mans- ford, in gentle and uninterrupted action from twelve to twe°nty-four hours accord.ng to circumstances. « This last is the longest period that it can be allowed to go unremoved ; the sores require cleaning and dressing, and the surface of the zinc becomes covered with a thick oxide, which must be removed to restore its freedom of action: this may be done bV scraping or polishing; but it will be better if removed twice a day, both (or the greater security of a permanent action, and for the additional comfort of the patient." The adoption of this plan of treatment in cases of tic douloureux the confidence reposed by Laennec in the use of plates on the breast and back in angina pectoris and similar neuralgic affections of the chest and the communications of Drs. Harris and Chapman, brought it into extensive use, so that ample trial was given to it in this country both in public and private practice. In three cases, it was—to employ the lan- guage of Professor Chapmant—" triumphantly directed" by Dr. Harris ; but it was only found effectual in affections of the face; and in these cases it had to be persevered in for some time before marked benefit was experienced.:}:' About the same period, this mode of applying galvanism was recommended by Dr. Miller,§ of Washington University, Baltimore, and a case of paraplegia and another of general paralysis were published by him in which it was found highly efficacious. Recently, Dr. Hays has stated, that the most useful remedy in certain cases of amaurosis, which fell under his care,|| was unquestionably o-al- vanism. This was evinced not only in the improvement, which follow- ed its application, but in the " still more striking fact," that the patient saw better whilst subjected to the galvanic action. Dr. Hays found a Cruikshank's battery of fifty pairs of plates three inches square__when in full activity—too powerful for the purpose, so that only one-half or two- thirds of the plates were usually employed. The connexion was made by means of leaden wire conductors, to one end of each of which was soldered a slip of copper, and to the other a hemisphere of brass, the flat surface of which was filed into grooves crossing at right angles, so as * Dr. Chapman says soft buckskin or parchment. American Journal of the Medical Sciences, Aug. 1834, p. 311. ■j- Op. citat. p. 311. X Dr. Harris, in Amer. Journal of the Medical Sciences, Aug. 1834, p. 384. § Ibid, p. 321. || American Jour, of the Medical Sciences, Aug. 1840, p. 288, 44 514 SUPPLEMENT. to form a number of sharp points. Over these were tied thin discs of sponge, which were kept moist with a solution of common salt, and when it was considered desirable to introduce strychnine into the system, the sponge, attached to the negative pole—and sometimes that of the positive pole, also—was moistened with a solution of it. When the whole force of the battery was not wanted, instead of placing the slips in the extreme cells, they were placed in cells more or less remote, according to the power required, and the force was easily regulated. The galvanic current may be made to pass from the mastoid process to the superciliary ridge. Dr. Hays expresses his persuasion, that galvanism, properly employ- ed, is a valuable and effective remedy for certain forms of amaurosis. Electro magnetism was tried by him in several cases in Wills Hospital, and in a number of cases in private practice ; but without its seeming to be productive of the slightest benefit in a single instance ; whence he infers, that, for remedial puposes, a regular and constant galvanic cur- rent would appear to be more useful than the violent shocks produced by interrupted currents, such as are induced by the electro-magnetic ap- paratus. There are doubtless—as we have observed—cases of disease in which the excitant and revulsive agency of galvanism may be employed with advantage, but they are not so numerous as was at one time believed. We have used the plates extensively—in neuralgic cases especially—but have not experienced so much success, as to induce us to advise them frequently, under the inconvenience that necessarily accompanies their employment. They are, indeed, at this time, but little used. Some years ago, Professor Von Hildenbrand, of Pavia,* recommend- ed, in cases of frontal neuralgia an anodyne metallic or galvanic brush, which appears to have been as effectual in his hands as the galvanic plates in those of Dr. Harris. It consists of a bundle of metallic wires not thicker than common knitting needles, firmly tied together by wire of the same material, so as to form a cylinder of about four or five in- ches long, and an inch or three fourths of an inch in diameter. This is applied to the pained part, previously moistened with a solution of common salt; and, according to Von Hildenbrand, it at times produces relief so instantaneous, that it appears to the patients to act like a charm. In his first experiments, he employed brushes constructed or two kinds of metal,—for instance, of silver and copper wire, copper and zinc wire, or zinc and brass wire, the individual wires being mutually commingled ; but he subsequently ascertained, that bundles of wires of one and the same metal produced an effect scarcely less speedy, and that solid me- tallic bodies acted in a similar manner, but in a much feebler degree. The nature of the metal he thinks occasions no difference. It is not probable, however, that, in these cases, galvanism is the agency concerned. Like the metallic tractors of Perkins, the effect is probably induced by the new nervous impression made through the ex- cited imagination of the patient. Animal Magnetism.—Mesmerism, Neurogamia, Biogamia. Biomag- * Edinburgh Medical and Surgical Journal, April, 1833. INJECTIONS INTO THE EUSTACHIAN TUBE. 515 netismus, Zoomagnetismus, Tellurismus, Exoneurism, as it has been termed—exerts an anodyne influence in probably the same manner. In highly impressible persons, more or less prolonged impressions made upon the senses—as by the operator looking steadfastly in the eyes of the patient, holding the thumbs or hands in his at the same time, or making passes in front of the patient—will induce an hysteric or hysteroid condition, in which the patient may fall into what is called " magnetic sleep," of a very sound, and at times cateleptic, character : during the existence of this sleep, she may be insensible to certain irritants, and yet extremely alive to others, so that operations—as the extraction of teeth, and even some of a more serious character—may be performed without eliciting the ordinary evidences of feeling. In cases of delirium tremens, accompanied by watchfulness, in which we. have the whole nervous system extremely impressible, sleep may be at times induced by the employment of this agency, which has resisted the ordinary anodynes.* Lastly. Of late years, it has been proposed to introduce into the rectum, in cases of constipation, a kind of galvanic suppository, made of two metals—zinc and copper—and various forms of instruments have been devised by the prolific imaginations of the inventors; those intended for the rectum simply were doubtless of advantage, at times, by virtue of the excitation they induced in the nerves of the mucous membrane. Others, formed somewhat like a bassoon—and so arranged as to have one metal in the mouth and the other in the rectum connected together by metal—did not appear to act differently from those of the simpler form. Both have gone into disuse, and—as we have said elsewhere!— if their efficacy on the frame has not been well marked, they have not failed to minister to the pockets of their inventors. III. INJECTIONS OF AIR, VAPOUR OF ETHER, &c. INTO THE EUSTACHIAN TUBE. An important improvement, in the understanding and treatment of diseases of the ear, has resulted from the attention that has been paid, of late, to the pathological condition of the Eustachian tube, and the means through it of rectifying certain morbid states of the organ of hearing. A mystery has been thrown, or attempted to be thrown, over the diseases of the ear, and as a consequence, they have furnished largely to empiricism ; so that an exclusive aurist has been, too often, perhaps, esteemed synonymous with an exclusive empiric. Now, that the phy- siology of the outer and middle ear is better understood, their patholo- gical relations are no longer environed with the same difficulties. The attention of the surgeon has to be first directed to the meatus externus, and if he discovers any obstacle,—as hardened cerumen,—which pre- vents the vibrations of a sonorous body from reaching the membrana * Dr. Vedder, in Dunglison's American Medical Intelligencer, Feb. 1, 1839 p 331. f General Therapeutics, p. 248, Philad. 1836. 516 SUPPLEMENT. tympani, such obstacle must be removed. If no defect exists there, he inquires into the state of the Eustachian tube, to detect, whether it be pervious so as to permit a free passage for the air from the throat to the middle ear—any impediment to which is a common cause of deafness ; and, lastly, if the tube is found in a state of integrity, his attention is turned to the condition of the nerve, to discover whether the defect__ organic or functional—be seated there. Such are the main subjects of investigation in cases of deafness ; although the condition of the mem- brana tympani, of the ossicles, and the mastoid cells become interesting incidental objects of inquiry. Chronic inflammation of the Eustachian tube occasionally gives rise to stricture or narrowness of the tube ; at others, to obstruction of the tube by means of mucus, or to accumulation of mucus in the tympanic cavities. In the former case, catheterism is demanded; in the latter, injections of air, in addition. For the purpose of catheterism, various instruments have been em- ployed. The catheter of Itard is a conical silver tube, curved at the extremity, with a slight enlargement to prevent laceration of the mem- brane. Kramer's instrument is a modification of that of Itard; the curve is more gradual, and the enlarged or button point is omitted. It is made of silver, six inches long, and of a calibre varying from the size of a small crow-quill to that of a large goose-quill. The extremity iswell rounded, and it is curved only to thedistance of five lines from the point, exactly at an angle of 144°, so as to correspond with the lateral situ- (Reduced one half.) ation of the mouth of the Eustachian tube. It is of the same calibre throughout its whole length, and provided with a funnel-shaped dilata- tion at the outer extremity, half an inch in length, to admit the pipe of the injecting syringe, &c. To this part is attached a ring, on the same level with the beak of the catheter, by means of which the situation of the beak can be ascertained, when the instrument is introduced. The catheter is farther graduated in inches, which is convenient in repeated introductions.* When it is requisite to sound the Eustachian tube, a piece of catgut may be passed through the instrument. The catheter recommended recently by Mr. Pilchert admits of being passed farther into the tube, and has a more gradual curve. DeleauJ employs a flexible elastic gum catheter, which the patient * Kramer, on Diseases of the Ear, chap. 2, Amer. Med. Library Edit. Philad. 1838. t A Treatise on the Structure, Economy and Diseases of the Ear, p. 304 Lond. 1838. X Op. cit. p. 305. INJECTIONS INTO THE EUSTACHIAN TUBE. 517 learns readily to pass into the Eustachian tube, and by turning down the outer extremity, is able to inflate the tube with his own breath. This we have seen done repeatedly. The silver instrument being slightly warmed and oiled is introduced, with its convexity upwards, along the floor of the nostrils until the point reaches the pharynx; it is then gently turned, so that the point shall be outwards and a little upwards, the aperture of the Eustachian tube being above the level of the floor of the nose: in this way, the tube enters, and is readily felt by the operator to have done so. The instrument is then carried onwards, until its farther progress is prevented by the nar- rowness of the tube. Mr. Pilcher's instrument is of such dimensions as to frequently occupy three quarters of an inch of the tube; but if it be pushed beyond the fibro-cartaliginous portion—or that part of the tube, which readily admits it—the mucous membrane may be lacerated, and pain will certainly be produced.* When Mr. Pilcher's catheter is fairly introduced, it will remain with- out support, an advantage it possesses—in the opinion of its proposer- over those of Itard and Kramer, which require a frontal bandage to retain them in situ. Itard's bandage is represented in the accompanying figure. It consists of a middle piece made of metal, bent so as to fit the arch of the forehead, and slightly padded within; to this are attached two straps, which fasten with a buckle. To the centre of the middle piece, a pair of forceps are attached, which move in a ball and socket joint, and the blades of which are brought together by a screw. The bandage is ap- plied, before the catheterism is commenced; and when the instrument is introduced, the forceps are brought down, and screwed tight on the catheter, so as to retain it in position. Through the catheter, thus introduced, aurists were in the habit of sending lukewarm water through the Eustachian tube into the cavity of the tympanum,! but owing to certain objections that apply to the employment of fluids, Deleaut suggested the air-douche or injections of air for the purpose of clearing the cavity; and this is regarded by Kramer§ * Op. cit. p. 305. t See some cases of deafness relieved in this way, by Dr. John H. Dix, in Bos- ton Medical and Surgical Journal, Sept. 25, ]839, p. 105. X Sur le Cath6terisme de la trompe d'Eustache, &c, Paris, 1828; Itard in Mem de l'Academ. Royale de Medecine, Tom. v. Fasc. 4, Paris, 1836; and trans- lation in Medical and Surgical Monographs, vol. 1, p. 75, of Dunglison's Amer. Med Library, p. 86, Philad. 1838. § Op. citat. p. 164. 518 SUPPLEMENT. as a great improvement. With the view of increasing and regulating the force with which the air is sent into the Cavity, both these gentlemen invented air-pressers or condensers. The figure beneath represents that of Kramer. c 6 is a cylinder, 10J inches high, made of molten brass; the diameter of its calibre is 4<| inches, and it is fastened at /; with strong screws, on a strong oaken stand of the height of an ordinary stool. Within the cylinder c b is a pump barrel of wrought brass screwed into it, which measures 10§ inches in height', and 2£ inches in diameter, rising at da 3 inches out of the cylinder, so that the whole machine a b is about 13 inches high. In the piston of the pump barrel, there is a valve for the pas- sage of the air, which besides passes in at the opening situate at d. There is a second valve in the bottom of the pump barrel, through which the air is forced into the interior of the cylinder. When air is injected into the tympanum, it may be heard to strike against the membrane, and to rush through the cavity into the mastoid cells, and thus may become a means of exploring the condition of the middle ear. Mr. Pilcher,* however, observes, that—from his daily experience of the great facility with which air and fluids may be introduced into the tympanum, and regulated, both as to quantity and force, by means of a common syringe accurately fitted to the catheter—he does not hesitate to declare his conviction, that the ceremony and inconvenience of the air- press may be dispensed with. He recommends that the operator should merely steady the instrument with his left hand, whilst he uses the syringe with his right. By this means, any fluid or gas injected through * Op. cit. p. 307. INJECTIONS INTO THE EUSTACHIAN TUBE. 519 the catheter, may be brought in contact with the mucous membrane, and thus stimulate the nerves of the cavity. Nor is the air-press entirely devoid of danger. Inflammation and even suppuration is sometimes caused by the air douche. This occurred in seven cases to M. Itard; and Mr. Henry Savage* refers to five cases, which came under his cognizance, where perfect deliquium was caused, which continued for several hours. A case, too, has been detailed in which, after "pumping air" four times through the nostrils into the Eustachian tube, immediately on removing the instrument from the nos- tnl, the patient fell back in the chair and never spoke afterwards.! The sudden shock to the nervous system was probably the cause of death- and it has been suggested, that to avoid too great a degree of pressure' the nozzle of the tube of the air-press should be held during the opera- tion so loosely in the dilated end of the catheter, that there may be room for air to regurgitate^ and likewise, that instead of sending in the air by douches or charges—it should be transmitted in a gentle and con- tinued stream. Another circumstance, which shows the importance of care, is the fact, that the mucous membrane may be ruptured, and serious emphyse- matous tumefaction be occasioned. It is proper, moreover, to observe, that the results of 258 cases, treated by Itard,§ are far from encouraging. Of these, but two cases of cure are said to have been effected, and in this result, according to Itard, other causes occurred; whence he infers, first, that as a means of exploring obstructions of the tympanum by the crepitation, which often accom- panies them, douches of air can afford no certain index; and secondly, that as a mechanical agent for deterging or evacuating obstructing mat- ters, they can only dislodge and force them together; and, consequently, that both in the second and first point of view, douches of air do not de- serve the confidence of the profession.il The vapour of acetous ether has recently been injected into the mid- dle ear, in cases of nervous deafness, of which Kramer^ makes too va- rieties, noise in the ear constituting the essential point of difference between them. The noise in the ear belongs, without exception, to the erethitic form, whilst it is foreign to the torpid. In cases of nervous deafness, Itard proposed to introduce ethereous vapour through the catheter, and to generate this vapour in an apparatus, in which the ether is dropped on a saucer of red hot iron, by the heat of which it is vapour- ised. The ether is, however, decomposed in this manner! so that it is not ethereous vapour, which enters the tympanum, but an acrid very irritating * Lond. Med. Gaz., for July 20, 1839, p. 616. Dr. M. Lynch, in Lancet, Aug. 3, 1839, p. 683. and Ibid, p. 690; and Dr. Joseph Williams, Treatise on the Ear; in- cluding its Anatomy, Physiology and Pathology, &c. p. 242. Lond. 1840. t London Med. Gazette, July 6, 1839, p. 538, and Dunglison's American Medi- cal Intelligencer, Aug. 15, 1S39, p. 150. X British and Foreign Medical Review, July, 1839, p. 95. § Op. citat. || See, on this subject, Mr. T. Wharton Jones, in Lond. Med. Gaz., Aug 3 10,*17 and 24. 1839. f Op. citat. 211. 520 SUPPLEMENT. kind of gas, which, according to Kramer, is well suited to the torpid form of nervous deafness, but is positively injurious in the erethitic va- riety. He considers the attempt to vapourise acetous ether in a flask, placed in warm water, and connected by means of a tube with the cavity of the tympanum, to belong to the same class of methods, which act in too irritating and injurious a manner, owing to the vapour being given off far too rapidly. This inconvenience he proposes to remedy, in the erethitic form of nervous deafness, in the following way. A large glass flask—represented in the accompanying figure—holding about ten quarts is firmly and closely stopped with a cork through which are passed two brass tubes, each provided with a cock; one of these tubes is connected above with a funnel for dropping in the fluid, and the other with an air- tight tube to conduct the vapour, generated and enclosed within the flask, into the cavity of the tympanum. When the apparatus is to be used, the cork is to be firmly fixed into the neck of the flask, with the two tubes attached, and the cocks closed; the proper quantity of ether is then to be poured into the funnel, and forced into the flask by a gen- tle expiration, where it is converted into thin vapour at the ordinary tem- perature of the room. This vapour fills the interior of the flask equably, and is, indeed, in a state of slight condensation, so that when the metallic tip of the tube is connected with the catheter, and the cock is opened, the vapour issues with a whizzing sound. Having previously introduced the catheter, through the nose, into the mouth of the Eustachian tube, and placed it in connexion with the tube of the vapour apparatus, the patient is to sit near a table, and leaning his arm upon it, with the corresponding hand he is to hold the tube of the apparatus, in such a manner that it may remain in close connexion with INJECTIONS INTO THE EUSTACHIAN TUBE. 521 the catheter. Each sitting occupies a quarter of an hour, and is repeated daily, applying the vapour alternately to the right and to the left ear It is unnecessary to make use of warm water to pour into the flask, ether0 ^ tGmperatUre of the room is sufficient to japourise the In the torpid form of nervous deafness this method of procedure does not answer, owing to the necessity for greater excitation than it is capa- ble of effecting. In such ease, a modification of the apparatus of Itard has been proposed by Kramer. In consequence of the metallic saucer in Itard s becoming cool more than once during a single sitting, and re- quiring to be exchanged for a hot one; as a necessary consequence the temperature of the vapour generated never remains, for a moment, the same, but varies extremely; immediately after the insertion of the red- hot saucer, the vapour issues burning hot into the ear, and, in a few minutes sinks to a very low temperature. These evils Kramer pro- poses to rectify in the following manner. For the floor on which the bell-glass of the apparatus rests is substituted a thin metal plate, which is warmed, at pleasure, by an oil lamp placed beneath, so that the ethereous fluid falling on it is thus conducted through the catheter into the mid- dle ear. Through the cover of the apparatus, a thermometer, with a metallic scale, passes down almost to the bottom, and indicates the tem- perature at which the ethereous vapour passes into the ear. After a sitting or two—if the individual is to be benefited by the plan —in either form of deafness, an improvement ought to be perceptible. This course of treatment, aided, occasionally, by attention to the state of the system, has, in Kramer's hands, been attended with satisfactory results, and has been adopted with advantage by others with a more or less modified apparatus.* * Pilcher, Op. cit. p. 318. See some observations on this subject, with two by no means satisfactory cases, by Mr. T. Wharton Jones, in London Med. Gazette, for Aug. 31, and Sept. 7,1839. 522 SUPPLEMENT. The only published case, in this country, of the successful appli- cation of the acetous ether in erethitic deafness, is by Dr. Bolton of Richmond, Virginia.* The hearing distance was amazingly improved by it, and the success far exceeded the operator's most sanguine ex- pectations. The vapour proves, however, at times too irritating, or occasions results by no means to be desired. The Author was applied to in one case in consequence of inflammation having supervened in the mucous membrane, which subsequently extended, in the erysipelatous form. over the cutaneous surface. It yielded, however, to appropriate treat- ment. * Dunglison's American Medical Intelligencer, April 1, 1839. p. 1. INDEX DISEASES AND THEIR REMEDIES. Abdomen, inflammation of the (hydrag. cyanid.) Absorbents, inflammation of the (iodi- nam,) Abscesses, suppurating (creasoton.) Acidity of the stomach (argilla.) Acne (sulphur, iodid.) Indurata (sul- phur, iodid.) Rosacea (acid, hydro- cyan, creasoton.) Adiposis (ballota lanata. Iodinum.) After pains (sulphuris carburetum.) Amaurosis (acupunct. Ammoniated counter-irritants. Galvanismus. Nux vomica. Strychnina.) Incomplete (electro-punct.) Amblyopia (strychnina.) Amenorrhoea (artemisia. Brominum. Cainca? radix. Calendula. Ferr. proto- carbonas. Ferr. iodid. Iodinum. Po- tassii bromid. Potassii iodohydrar- gyras. Secale cornutum Sulphuris carburetum.) Anaesthesia, local (Nux vomica.) Anasarca (acid, hydrocyan. Acupunct.) Aneurism (acupunct.) Angiectasis (zinci chlorid.) Angina pectoris (galvanism. Magnes.) Anthrax, (iodinum.) Malignant (chlorin. Aphonia (chlorin. Cubebse. 01. Tiglii Strychnina.) Aphthee, asthenic (chlorin. aq.) Aphthous sores (liq. ferr. persesquinit.) Ulceration (creasoton.) Arthritis, chronic (brominum. Com- pressio.) Arthrocace (ol. jecinor. aselli.) Ascites (acupunct. Caincse radix. Eu- phorb. ol. Iodinum.) Asphyxia (acupunct. Galvanopunctur. Sulphuris carburetum.) Asthenia, chronic (potassae chloras.) Asthma (bignonia catalpa. Creasoton. Galvanism. Ol. Tiglii.) Humoral (sulphur iodid,) Nervous (magnes.) Pulverulentum (acid, hydrocy.) Spas- modic (acid, hydrocyan. Iodinum.) Atrophy (brucina. 01. jecinor. aselli.) Partial (nux vomica.) Biles (Iodinum. Ammoniated counter- irritants.) Bladder, atony of the (diosma.) Catarrh of the (cort. adstring. brazil.) Diseases of the (diosma.) Inflammation of the (fuligo.) Bleeding from leech bites (creasoton.) Blennorrhoea (acid, hydrocyan. Chima- phila. Cort. adstring. brazil. Ferr. Iodid. Monesia. Piperina. Tanninum purum.) Of the bladder, (diosma.) Of the eye (calcis chlorid.) (See go- norrhoea.) Boils, see biles. Bones, pains in the (zinci ferrohydrocy- anas.) Tumors of the (auri praepar.) Bowels, painful affections of the (acid. hydrocyan.) Brain, chronic affections of the (ammo- niated counterirritants.) Bronchi, dilatation of the (chlorin.) In- flammation of the (ammoniated coun- ter-irritants.) Bronchitis (acid, hydrocyan. Iodinum. Mannitum. Strychnina.) Chronic 524 INDEX OP DISEASES A Bronchitis—continued. (aq. picea.) Chronic (chlorin. Ci- micifuga.) Chronic (colchicum.) Chro- nic (creasoton.) Chronic (galeopsis. Monesia.) Chronic (salicina.) Bronchocele (ferr. iodid.) See goitre. Bronchorrhcea (creasoton. Monesia.) Bubo, (Iodinum.) Ulcerated (creasoton.) Burns (calcis chlorid. Iodidum. Creaso- ton. Sodac chlorid. Sulphuris carbu- retum.) Severe (compressio.) Bursae, inflammation of the, (Iodinum.) Cachexia (acid. acet. empyr. Chlorin.) Mercurial (auri praepar.) See Dys- crasy.) Calculous pains (diosma.) Calculus (chimaphila.) Expulsion of fragments of (Secale Cornutum.) Phos- phatic (acid, lact.) Cancer (acid. acet. empyr. Aur. nitrico- muriat. Auri. praepar. Calcis chlorid. Calendula. Ferr. arseniat. Ferr. carb. praec. Ferr. iodid.) Of the heart (ca- lendula.) Of the breast (creasoton.) Of the breast (fuligo.) Of the face (creasoton.) Of the integuments (calendula.) Of the lip (creasoton.) Open (carbo animalis.) Of the skin (creasoton.) Of the tongue (iodin.) Of the uterus (auri praeparat.) Of the uterus (calendula.) Of the uterus (creasoton.) Of the uterus (morphinae acetas.) Cancerous ulcers (chlorin. aq. Potass. iodid.) Of the face (creasoton.) Cancrum oris (acid. acet. empyr. Calcis chlorid. Chlorin. aq. Creasoton.) Carbuncle, sloughing (creasoton.) Carbunculus malignus (aq. chlorin.) Cardialgia (artemisia. Calendulua. Nux vomica. Zinci ferrohydrocyanas.) Carditis (ammoniated counter-irritants.) Caries of bones (acid. acet. empyr.) Of the fibula, &c, (creasoton.) Scrofulo- sa (ol. jecinor. aselli.) Scrofulous (creasoton.) Of the teeth (calcis chlo- rid. Monesia.) Catalepsy (strychnina.) Catamenia, obstruction of the. (See Amenorrhcea.) Cataract, disintegrated (carbo animalis) Incipient (ammoniated counter-irri- tants.) Catarrh, chronic (acid, hydrocyan. Aq. picea. Chimaphila. Chlorin.) Catarrh, pulmonary (galeopsis. Manni- tum.) Catarrhus urethrae (cubeba?.) Vesicae (aq. picea.) Vesicae (caincae radix.) Vesicae (cubebse.) Vesicae (diosma.) ND THEIR REMEDIES. Cellular Membrane, sloughing of the (Iodinum.) Cephalalgia (acupunct.) Chronic (arte. misia.) Intermittent (quininae sul- phas.) Nervous (acid, hydrocyan.) Periodical (zinci ferrohydrocyanas.) Syphilitic (hydrarg. cyanid.) See headach. Ceramen, defective (acid. acet. empyr. Chancre (creasoton. Hydrarg. cyanid, Iodinum.) Chaps (ol. jecin. aselli.) Chest, diseases of the (chlorin.) Affec> tions of the (fuligo.) Chilblains (calcis chlorid. Creasoton. Iodinum) Ulcerated (Monesia.) Chlorosis (artemisia. Ferr. iodid. Ferr. Protocarbonas. Ferr. Lactas. Paulli- nia.) Cholera (creasote. Diosma. Guaco. Mor- phinae acetas. Nux vomica. Strych- nina.) Morbus (artemisia.) Infantum (Argilla pura.) Chordee (Iodinum.) Chorea (acid, hydrocyan. Cimicifuga. Ferr. carb. praec. Ferr. cyanid. Iodi- num. 01. jecinor. aselli. Strychnina. Veratrina. Zinci ferrohydrocyanas.) Colic, hysterical (ol. sinapis.) Colica pictonum (nux vomica.) Condylomata (creasoton. Hydrarg. deuto. iodid. Thuya occidentalis.) Congestions in the head (ammoniated counter-irritants.) Conjunctiva, inflammation of the, chro- nic, (Cad m it sulphas.) Constipation (galvanism. Veratrina.) Contagion (calcis chlorid. Chlorin.) Contusions (acupunct. Creasoton. Iodi- num.) Convalescence, tedious (Paullinia.) Convulsions (ammoniated counter-irri. tants. Auri praepar. Magnes. Com- pression of arteries. Potass, cyanid.) During dentition (chlorin. aq.) Hyste- rical (indigum.) Convulsive affections (acupunct.) Dis- eases of childhood (artemisia.) Cornea, granulations on the (fuligo.) Ob- ' scurity of the (calcis chlorid.) Opacity of the (hydrarg. deuto-iodid. Iodi- num.) Opacity of the (ol. jecinor. aselli.) Spots on the (Cadmii Sulphas Fuligo.) Coryza (cubebae.) Cough (cimicifuga. Lactucarium.) Ner- vous (tanninum purum.) Spasmodic (lactucarium.) Spasmodic, dry (fu- cus crispus.) Violent (asparang. tu- rion.) INDEX OP DISEASES AND THEIR REMEDIES. 525 Coxalgia (iodinum.) Coxarthrocace (ol. jecinor. aselli.) Cramp (ammoniated counter-irritants Magnet.) Of the stomach (nux vomi! ca.) Of the stomach (zinci ferrohy- drocyanas.) Croup, (hysteric creosoton.) Crusta lactea (asparag. turion. Creaso- ton.) Cutaneous diseases (arsenias ammonia. Acid, hydrocyan. Anthrakokali. As- parag. turion. Auri cyanidum. Cal- cis chlorid. Chlorin. Chlorin. aq, Creasoton. Ferr. carbur. Fuligo. Hydrarg. deuto-iodur. Hyd. et Arsen. Iodid. Iodidum ammonia?. Iodid. sulph. Iodinum. 01. jecinor. aselli. Potassa? chloras. Soda? chlorid. Sul- phur, iodid.) Syphilitic (hydrarg. pro. to-iodur.) Cynanche (cort. adstring. Brazil.) Ton. llaris. (See Sore throat.) Dacryocystitis (Iodinum.) Deafness (acid. acet. empyr. Creasoton. Galvanism. Erethitic nervous (injec- tions of vapour of acetous ether.) Ner- vous (injections of vapour of acetous ether.) Nervous, torpid (injections of of vapour of ether.) Debility (ferr. iodid. Nux vomica. Pi- perina) General (quininae et cincho- ninae tannas.) Nervous (Quininae sul- phas.) Paraiytic (ammoniated coun- ter-irritants.) Decubitus gangraenosus (plumb, tannas.) Delirium tremens, (magnetism, animal.) Dentition (chlorin.) Diabetes mellitus (creasoton. Tanni- num purum. Urea.) Diarrhoea (acid. acet. empyr.) Argilla. Artemisia. Carbo animalis. Fucus crispus, Indigum. Liq. ferr. perses- quinit. Strychnina. Veratrina. Mo- nesia. Paullinia. Choleric (nux vomica.) Chronic (ferr. cyanuret.) Chronic (morphinae acetas.) Chronic (nux vo* mica.) of phthsis (monesia.) Diathesis phthisica (chlorin. aq.) Diphtheritis (fuligo.) Diplopia (acupunct.) Discharges from the nose (iodinum.) Offensive (acid. acet. empyr.) Disinfection (chlorin. Chlorin. aq.) Dropsy (acid, hydrocyan.) Acid. acet. empyr. Asparag. turion. Aurum muriat. Aur. muriat. natron. Auri praeparat. Ballota lanata. Caincae ra- dix. Chimaphila. Chlorin. aq. Cim- icifuga. Colchicum. Ferr. iodid. Hip- pocastanum. Iodinum. 01. sinapis., 45 I Dropsy—continued Potassii Iodohydrargyras. Urea. Vera- trina.) Of the ovary (iodin.) After scarlatina (colchicum.) Dumbness (galvanism.) Dyscracy (ferr. iodid. Sulphuris carbu- return.) After intermittents (ferr. cy- anur.) See Cachexia. Dysentery (argilla. Artemisia. Calcis chloridum. Ferr. cyanur. Fucus cris- pus. Nux vomica. Paullinia. Secale cornutum. Strychnina.) Putrid (chlo- rin. aq.) Dysmenorrhoea (Potassii Iodohydrargy- ras. Secale cornutum.) Dyspepsia (acid. lact. Argil. Berbernia, Carbo animalis. Chimaphila. Diosma. Ferr. iodid. Gentiana chirayita. Hip- pocastanum. Nux vomica. 01. sinapis. Piperina.) Potassii Iodohydrargyras. Quininae sulphas. Strychnina.) Dysphagia (artemisia.) Spasmodic (acid. hydrocyan.) Dyspnoea (galvanism. Potass, cyanid.) Dysuria (chimaphila.) Ear, middle, affections of the mucous membrane of the (iodinum.) Eclampsia infantum (artemisia.) Eczema (ol. jecinor. aselli.) Engorgements, visceral (ferr. iodid.) Enlargements, glandular, scrofulous (po- tassii iodohydrargyras.) Enteralgia (acid, hydrocyan.) Enteritis (acid, hydrocyan.) Chronic (monesia.) Epilepsy (acid hydrocyan. Acupunct. Ammoniated counter-irritants. Arte- misia. Compression of arteries. Crea- soton. Ferr. cyanur. Galvanism. Gran- atum. Indigum. Iodinum. Magnes. Nux vomica. Strychnina. Zinci chlor- id. Zinci ferrohydrocyanas.) Epistaxis (cort. adstring. Brazil. Crea- soton. Secale cornutum.) Erethism, morbid (potassae chloras ) %■ Ergotism, 432. Erysipelas (chlorin. aq. Colchicum. Compressio. Iodin.) Of the face (Cort. adstring. Brazil.) Eustachian tube, obstructed. (Injections of air, &c.) Exanthemata, febrile (chlorin. aq.) Exanthematous diseases (cort. adstring. Brazil.) Excoriation from lying (creasoton.) Of the skin (ol. jecinor. aselli.) Syphili. tic (aurum metallicum.) Excrescences, adventitious, (iodinum.) Syphilitic (aurum metallicum.) 526 INDEX OF DISEASES AND THEIR REMEDIES. Eye, black (calcis chlorid.) Fainting, hysteric (sulphuris carburet- um.) Febrile affections (colchicum.) Diseases (morphina.) Fever, brain (compression of arteries.) Gastric (artemisia.) Gastric (chlorin. aq.) Hectic (chlorin. aq.) Intermit. tent (cetrarina.) Intermittent (chlorin. aq.) Irritative (chlorin. aq.) Nervous (chlorin. aq.) Paroxysmal (quininae sulphas.) Petechial (aq. chlorin.) Pu- trid (acet. empyr.) Putrid (chlorin. aq.) Summer (quininae sulphas,) Typhous (sodae chloridum.) Yellow (quin. sul- phur.) Fissures of the anus (monesia.) Of the skin (creasoton. 01. jecinor. aselli.) Fistulse (acid, hydrocyan. Calcis chlorid. 01. jecinor. aselli. Potass, iodid.) Fistulous openings (iodinum.) Flatulence (creasoton.) Fluor albus. (See Leucorrhcea.) Foetor oris (calcis chloridum. Chlorin. aq.) Fractures, ununited (iodinum.) Frost bites (calcis chlorid.) Fungous tumour (creasoton.) Fungus of the neck of the uterus (aur. nitrico.muriat.) Ganglion (acupunct. Hydrarg. deuto- iodur. Iodinum.) Ganglionic system, disorder of the (ferr. cyanur.) Gangrene (acid. acet. empyr. Calcis chlorid.) Hospital (calcis chlorid.) Hospital (creasoton.) Of the lungs (chlorin.) Of the scrotum (calcis chlo- rid.) Gangrenous sloughs (monesia.) Gastralgia with acid (cinchonin.) Gastricism (carbo animalis. Mannitum.) Gastritis (codeina.) Gastrodynia (acid, hydrocyan. Acupunct. Creasoton. Nux vomica. 01. sinapis.) Gastromalacia (acid. acet. empyr. Chlo- rin. aq.) Genital organs, atony of the (cubebae) Debility of the (cort. adstring. Brazil.) Debility of the (nux vomica.) Glanders, chronic (creasoton.) Glands, enlarged (carbon, sesqui-iodid.) Enlarged (plumbi iodid.) Induration of the (hydrarg. deuto-iodur.) Mam- mary, enlarged (veratrina.) Meibo- main, ' copious secretion from the (calcis chlorid.) Mesenteric, enlarged (iodinum.) Of the neck, inflamed (hydrarg. deuto-iodur.) Scrofulous swellings of the (calcis. chlorid. Chlo- Glands—continued. rin. aq, Iodinum.) Submaxillary, enlarged (iodinum.) Tumefied, stru- mous (hydr. proto-iodur.) Glandular affections (aurum muriat. Iodinum. Veratrina.) Gleet_(creasotoD. Secale cornutum.) Old (tanninum purum.) Goitre (brominum. Calcis chlorid, Hy. drarg. deuto-iodur. Iodinum. Potassii bromid. Potass, iodid.) Scirrhous (carbo animalis. Sulphuris carbure. turn. Veratrina.) Gonorrhoea (auri praepar. Calcis, chlorid. Chlorin. aq. Creasoton. Cubeba?. Di- osma. Secale cornutum.) See Blen- norrhea.) Gout (aconit. Acupunct. Ammoniated counter-irritants. Ballota lanata. Col- chicum. Compression of arteries Creasoton. Iodinum. Magnes. Moxa. 01. croton. Ol. jecinor. aselli. Sul- phuris carburetum. Veratrina.) Atonic (hippocastanum.) Chronic (chima- phila.) Chronic (diosma.) Suppressed (ammoniated counter-irritants.) Gouty swellings of bones (potass, iodid.) Of the joints (iodinum.) Gravel, white (acid, lact.) Growths, morbid (baryum iodatum.) Gums, scorbutic ulceration of the (crea- soton.) Gutta rosacea (fuligo. Sulph. iodid.) Haematemesis (creasoton.) Hematuria (diosma. Secale cornutum.) Haemoptysis (cort. adstring. Brazil. Cre- asoton. Galeopsis. Lactucarium. Mo- nesia. Secale cornutum. Tannin.) Head, determinations to the (chlorin. aq.) Headach, intermittent (quininae sulphas.) Nervous (strychnina.) Nervous (am- moniated counter-irritants.) See Ce- phalalgia.) Hearing, defective, , from otorrhcea (cubebae.) Heart, active diseases of the (aconitin.) Diseases of the (asparag. turion.) En- largement of the (acid, hydrocyanic) Hypertrophy of the (asparag, turion.) Hypertrophy of the (brominum.) Hy- pertrophied (iodin.) Hypertrophy of the (potass, bromid.) Hypertrophy of the (potass, iodid.) Palpitation of the (asparag. luriones.) Spasmodic affec- tions of the (acid, hydrocyan.) Hectic fever (chlorin. aq.) Hemicrania(acid. hydrocyan. Paullinia.) Hemiplegia (nux vomica. Strychnina.) Hemorrhage (acid, hydrocyan. Aq. Binelli. Cort. adstring. Brazil. Creaso- INDEX OF DISEASES A] Hemorrhage—continued. ton. Ferr. iodid. Secale cornutum Tanninum purum. Hemorrhage from arteries of the lower limbs. (Compression of the aorta.) Active (acid, hydrocyan.) Capillary (crea- soton.) From the gums (creasoton.) From leech bites (creasoton.) From the lungs. (See Hemoptysis.) Uterine (creasoton.) Uterine, (Compression of the aorta. Ferr. iodid. Monesia. Uterine (Secale cornutum.) Uterine (tanninum purum.) Hemorrhoids, inflammation from (Mo- nesia.) Hepatic diseases. (See liver affections.) Hernia humoralis. (See Orchitis.) In- carcerated (sulphuris carburetum.) Herpes (acid, hydrocyan. Calcis chlorid. Chlorin. aq. Creasoton. Ferr. carbur. Fuligo. Hydrarg. cyanur. Hydrarg. deuto-iodur. 01. jecinor. aselli. Po- tass, bromid. Potass, iodid. Sapo coco- neus.) Exedens (creasoton.) Pha- gedenic tuberculous (arsenic, iodat.) Herpetic ulcers (creasoton.) Hiccough, spasmodic (magnes.) Hoarseness (fuous ortapuwr Ot.-oroton.) Hooping cough (acid, hydrocyan. Ferr. carb. praec. Ol. croton.) Hordeolum (hydrarg. deuto-iodur.) Hydrocele (acupunct, Chlorin. Iodinum ) Hydrocephalus (iodinum.) Hydrocyanic acid, poisoning by (chlorin. Chlorin. aq.) Hydrophobia (chlorin. aq. Compression of the arteries.^ Hydrothorax (acid, hydrocyan. Colchi- cum. Iodinum.) Hygroma (iodinum.) Hyperemia (ammoniated counter-irri- tants.) See inflammation. Hyperesthesia (potassae chloras.) Hyperemesis (tanninum purum.) Hypertrophy (baryum-iodatum. Ferr. bromat. Ferr. iodid.) Of the coats of the stomach (sulph. carburet.) Of the heart (brominum.) Of the heart (io- din.) Of the heart (potass, bromid.) Of the heart (potass, iodid.) Of the mammae (iodinum.) of the spleen (iodin.) Of the thymus (iodin.) Of the uterus (secale cornutum.) Hypochondriasis (auri prseparat. Chlo- rin, Strychnina. Veratrina.) Hysteralgia (euphorb. ol.) Hysteria" (Cimicifuga. Creasoton. Fu- ligo. Granatum. Lactucarium. Strych- nina. Veratrina. Zinci ferrohydro- cyanas,) ND THEIR REMEDIES. 527 Hysteric croup (creasoton.) Fainting (sulphuris carburetum.) Convulsions (indigum.) Hysterics (ammoniated counter irritants.) Impetigo (acid, hydrocyan. Arsen. iodat. Creasoton. Ol. jecin. aselli.) Impotence (cubebae. Diosma. Iodinum. Nux vomica.) Incontinence of urine (iodin. Nux vo- mica.) Indigestion. (See Dyspepsia.) Indurations, glandular, chronic (carbo animalis. Hydrarg. deuto-iodur.) Of the pancreas (carbo-animalis.) Of the pancreas (iodin.) Chronic (calendula.) Chronic, of the mammae (carbo ani- malis.) Inflammation (acid, hydrocyan. Aconi- tin. Compression of arteries.) Of the absorbents (Iodinum.) Of the bursae (Iodinum.) Of the bronchia. (See Bronchitis.) Chronic (acid, hydrocyan.) Chronic (baryum iodatum.) Chronic. (ol. croton.) Chronic, of the eusta- chian tube (catheterism.) Chronic, of the lungs and stomach (ol. jecinor. aselli.) Of the mouth and fauces chlorin. aq.) External (compressio.) Of the heart. (See Carditis.) Inter- nal (acid, hydrocyan.) Of the joints (Iodinum.) Of the liver (chlorin. aq.) Of the lungs (ammoniated counter-ir- ritants.) Of the mamma (Iodinum.) Of the lungs. (See Pneumonia.) Of the pleura (ammoniated counter-irri- tants.) Synovial (compressio.) Tho- racic (acid, hydrocyan.) Of the tra- chea (ammoniated counter-irritants.) Inflammatory diseases (colchicum. Cort. adstring. Brazil. Morphina. 01. Si- napis.) Integuments, lesions of the (creasoton.) Intermittent (eetrarina. Chlorin. aq. Cinchonin. Cubeba. Ferr. carb. praec. Ferr. cyanur. Gentiana chi- rayita. Hippocastanum. Indigum. Narcotina. Phloridzina. Piperina. Quinina. Quininx et cinchon. tannas. Quinina? sulphas. Quininx sulphas. impurus. Resina chinae. pra?par. Sali- cina. Sodae chlorid,) Intertrigo of children (creasoton.) Iodkrankheit, 301. Iodosis, 301. Iralgia (quininae sulphas.) Ischias (oleum sinapis. Veratrina.) Ischuria (colchicum.) Itch (calcis chlorid. Chlorin. aq. Crea- soton. Fuligo. Sapo mollis.) Joints, inflamed (Iodinum.) Anomalous 528 INDEX OF DISEASES AND THEIR REMEDIES. Joints—continued. pains of the (Iodinum.) Chronic in- flammation and enlargement of the (Iodinum.) Swelled (ammoniated counter-irritants. Calcis chlorid.) Kriebelkrankheit, 432. Labia pudendi, infiltration of (creasoton.) Labour, premature, inducing (secale cor- nutum.) Larynx, chronic engorgements of the (Iodinum.) Leechbites, hemorrhage rfom (creasoton.) Lepra (arsen. iodat. Auri praeparat. Carbon, sesqui-iodid. Chlorin. Hyd. et. arsen. Iodid. Iodidum ammoniae. Sulphur, iodid.) Leucorrhcea (chlorin. aq. Colchicum. Cort. adstring. Brazil. Creasoton. Gentiana chirayita. Cubebae. Ferr. iodid. Iodinum. Liq. Ferr. persesqui- nit. Monesia. Potassii iodohydrargy- ras. Salicina. Secale cornutum.) Lichen leproides (ferr. carbur.) Liver, affections of the (potassa? chloras. Berberina. Chlorin. Iodin.) Indura- tion of the (hydrarg. deuto iodur.) In- durated (iodinum.) Inflammation of the (chlorin. aq.) Obstruction of the (hydrarg.. proto-iodur.) Tubercles of the (iodinum.) Lumbago (acupunct. Ammoniated counter-irritants. Veratrina.) Lungs, affections of the (cimicifuga.) Gangrene of the (chlorin.) and stomach, chronic inflammation of the (Ol. jeci- nor. aselli.) Lupus (hydrarg. deuto-iodur. Hyd. et. arsen. iodid. Iodinum. Zinci chlorid.) Non exedens (sulphur, iodid.) Of the ala nasi (ferr. carb. prssc.) Of the nose (creasoton.) Luxations (diosma.) Lymphatism (ferr. iodid.) Measles (chlorin. aq.) Mammae, hypertrophied (iodinum.) In- flamed (Iodinum.) Mastitis (Iodinum.) Menorrhagia (cort. adstring. Brazil. Ferr. cyanur. Monesia.) Mental af- fections (auri praeparat.) Metritis (acid, hydrocyan.) Metrorrhagia (cort. adstring. Brazil. Monesia.) See hemorrhage, uterine. Miasmata, destroying (calcis chlorid.) Milzbrandkarbunkel (chlorin. aq. Zinci chlorid.) Mortification, mildew, 452. Mouth, inflammation of the, chronic (chlorin. aq.) Offensive conditions of Mouth—continued. the (calcis chlorid,) Ulceration of the (calcis chlorid.) Naevi materni (zinci chlorid.) Nephralgia (chimaphila.) Nephritis (acid, hydrocyan.) Nervous coughs (tanninum purum.) Nervous diseases (auri pra?parat. Cort. adstring. Brazil. Creasoton. Ferr. carb. praec. Ferr. cyanur. Fuligo. Iodinum. Magnes. Morphina. Mor- phinae acetas. 01. sinapis. Quininae sulphas. Zinci ferrohydrocyanas. Ve- ratrina.) Chronic (acid, hydrocyan.) Nervous excitement (lactucarium.) Neuralgia (acid, hydrocyan. Aconitin. Ammoniated counter-irritants. Aspa- rag. turion. Compression of arteries. Creasoton. Delphinin. Electropunct. Ferr. carb. pra?c. Ferr. cyanur. Gal- vanism. Magnes. Morphinaeacetas. Morphin. bimeconas. Moxa. Nux vomica. 01. sinapis. Potass, cyanid. Strychnina. Veratrina. Zinci ferrohy- drocyanas.) Of the abdomen (codei- na.) Faciei (acid, hydrocyan. Arte- misia. Faciei (codeina.) Faciei (po- tasses chloras.) Faciei. (Sco Tic Dou- loureux^) Frontal (galvanism.) Of the heart (magnes.) Pulmonary (magnes.) Neuroses (ol. croton.) Nipples, excoriated (acid. acet. empyr.) Catarrhal (lactucarium.) Sore (crea- soton.) Nodes, gouty (sulphur, carb.) Noli me tangere (iodinum. Zinci chlo- ridum.) Noma (chlorin. aq.) Odontalgia (ammoniated counter-irri- tants. 01. sinapis. See Toothach.) Rheumatic (01. croton.) Odour, offensive (calcis chlorid.) ffidema (creasoton.) Of the feet (acupunct.) OEsophagus, stricture of the (Iodinum.) Offensive evacuations (calcis chlorid.) Ophthalmia (acid, hydrocyan. Acu- punct. Creasoton.) Catarrhal (calcis chlorid.) Chronic (calcis chlorid. Iodinum.) Egyptian (tanninum pu- rum.) Neonatorum (calcis chlorid.) Purulent (calcis chlorid. Monesia.) Rheumatic (zinci ferrohydrocyan.) Scrofulous (auri praeparat.) Scrofu- lous (aurum muriat.) Scrofulous (calcis chlorid.) Scrofulous (potass. iodid.) Scrofulous (quininae sul- phas.) Strumous (fuligo.) Strumous INDEX OF DISEASES AND THEIR REMEDIES. 529 O pthalmia—continued. (ol. jecinor. aselli.) Tarsi (acid. py. rohgn.) Tarsi (creasoton.) Tarsi (hydrarg. deuto-iodur.) Tarsi (zinci ferrohydrocyanas.) Tarsi (zinci iodi- dum.) Orchitis (compressio. Iodinum.) Osteocopi, syphilitic (strychnina.) Otalgia (ol. sinapis. Ol. tiglii.) Otorrhcea (creasoton. Cubebae. Potassii bromid.) Ovaries, degenerated (iodin.) Dropsy of the (iodin.) Inflammation of the (hydrarg. cyanur.) Ozaena (calcis chlorid. Carbo animalis. Iodinum.) Pain, anomalous, of hip and thigh (mor- phin. bimeconas.) Nervous and mus- cular (ammoniated counter-irritants.) Nervous and muscular (moxa.) Noc- turnal, in the bones (zinci ferrohydro- cyanas.) Severe (acid, hydrocyan.) Palpitations (magnes. Veratrina.) Pancreas, induration of the (carbo ani- malis.) Paralysis (acupunct. Arnica. Brucina. Delphinin. Galvanism. Electropunct. Iodinum. Nux vomica. Paullinia. Strychnina. Veratrina. Zinci chlorid. Zinci ferrohydrocyanas.) Of the blad- der (diosma.) Of the bladder (secale cornutum.) Of the bladder (strych- nina.) Of the upper eye-lid (ol. cro- ton.) Of the facial nerve (strychni- na.) Lead (brucina.) Partial (nux vomica.) Of the rectum (nux vomi- ca.) Succeeding to apoplexy (nux vomica.) Paralytic debility (ammoniated counter- irritants.) Paraplegia (secale cornutum. Strych- nina.) Paroxysmal diseases (secale cornutum.) Paturient efforts, defective (cimicifuga, Secale cornutum.) Pericarditis (ammoniated counter-irri- tants.) Phlebitis (compressio.) Phlegmasia (compressio.) Phlegmon (iodinum.) Phthisis (acid.' hydrocyan. Acid. acet. empyr. Aq. picea. Calcis chlorid. Chlorin. Creasoton. Fucus crispus. Galeopsis. Iodinum. Monesia 01. croton. Ol. jecinor. aselli. Paullinia. Potassae chloras. Tanninum purum.) Cough of (codeina.) Mucosa (galeop- sis.) Mucosa (iodinum.) Pituitosa (chimaphila.) Sweats of (boletus la- ricis.) Pica (caincae radix.) Pimples (ammoniated counter-irritants.) Pityriasis (zinci chlorid.) Plague (chlorin. aq.) Prevention of (chlorin. aq.) Pleuritis. (See inflammation of the pleura.) Pleurodyne (acupunct.) Pneumonia (mannitum.) Chronic (hy- drarg. cyanuret.) Poisoning by arsenic (ferr. oxyd, hydrat.) By hydrocyanic acid (chlo- rin. aq.) Polypi, cartilaginous (carbo animalis.) Mucous (carbo animalis.) Porrigo (acid. acet. empyr. Carbon, ses- qui-iodid. Fuligo. 01. jecin. aselli.) Favosa (creasoton.) Favosa (hydrarg. bromid.) Favosa (iodinum.) Favosa, (potassii bromid.) Scrofulous (auri praeparat.) See Tinea. Prolapsus vaginae (creasoton.) Prosopalgia (ol. sinapis. Potassae chlo- ras, Veratrina. Zinci chlorid. Prostate, disease of the (diosma.) En- largement of the (carbo animalis.) Enlarged (iodinum.) Prurigo (colchicum.) Pruritus pudendi muliebris (calcis chlo- rid.) Vulvae (fuligo.) Psora. (See Itch.) Psoriasis (chlorin. Creasoton. Hydrarg. proto-iodur. Hyd. et. arsen. iodid. Io- didum ammoniac. Sulphur, iodid.) Pustule maligne (zinci chlorid.) Putrefaction, checking (calcis chlorid.) Putrescency, tendency to (quininae et cinchonin. tannas.) Pyrosis (nux vomica.) Rectum, catarrh of the (cort. adstrins-. Brazil.) Remittent fever (ferr. cyanur.) Rhagades (ol. jecin. aselli.) Rheumatic, pains (hydrarg. deuto-iodur.) Swellings of the joints (Iodinum.) Rheumatism (Aconit. Acupunct. Ammo- niated counter-irritants. Anthrakokali. Ballota lanata. Caincae radix. Chlorin. Cimicifuga. Colchicum. Compres- sion. Compression of arteries. Crea- soton. Delphinin. Electropunct. Fuli- go. Galvanism. Iodinum. Magnes. Morphinae acetas. Moxa. 01. croton. 01. jecinor. aselli. 01. sinapis. Potas- sae chloras. Potass, cyanid. Sulphu- ris carburetum. Veratrina.) Articu- lar (aconit.) Chroisic (chimaphila.) Chronic (cubebse.) Chronic (dios- ma.) 530 INDEX OF DISEASES AND THEIR REMEDIES. Rickets (ferr. iodid. 01. jecinor. aselli.) Ringworm (ammoniated counter-irri- tants.) Roseola (chlorin. aq.) St. Vitus's dance (ammoniated counter- irritants. Liq. argent, muriat. am- nion. Artemisia. Nux vomica, Zinci chlorid.) Salivation, mercurial (calcis chlorid.) Mercurial (iodinum.) Profuse (auri praeparat.) Scabies (acid. acet. empyr. Chlorin.) Scalds (Iodinum.) See Itch. Scarlatina (acid. acet. empyr. Calcis chlorid. Chlorin. aq. Col-chicum.) Sciatica . (acupunct. Potass, cyanid.) Gouty (acid, hydrocyan.) Rheumatic (acid, hydrocyan.) Scirrhus (auri praepar. Ferr. iodid- Potass, iodid.) Of the lips (carbo ani- malis.) Of the mammae (calendula.) Of the mamma? (carbo animalis.) Of the mammae (iodin,) Of the prostate (carbo animalis.) Of the pylorus (acid, hydrocyan.) Of the pylorus (auri praeparat.) Of the pylorus (zin- ci ferrohydrocyanas.) Of the stomach (artemisia.) Of the stomach (iodin.) Of the tongue (auri praeparat.) Of the uterus (acid, hydrocyan.) Of the uterus (auri praepar.) Of the uterus (iodin.) Scrofula (acid, pyrolign. Anthrakokali. Auri cyanidum. Auri praepar. Bro- minum. Chlorin. Ferr. bromat. Ferr. cyanur. Ferr. iodid. Fucus crispus. Gentianin. Hydrarg. deuto-iodur. Io- dinum. Monesia. 01. jecin. aselli. Potassii bromid. Potass, iodid.) Scrofulosis (hydrarg. protoiodur.) Scrofulous affections (sodae chloridum.) Diathesis (carbo animalis.) Diseases (baryum iodatum.) Habit (ferr. cy- anur. Aurum mur. natronat.) Swell- ings (calcis chloridum.) Swellings (carbo animalis.) Swellings (chlorin. aq.) Swellings (iodid. quinin.) Swell- ings (iodinum.) Swellings (plumbi iodid.) Swellings (potassii bromi- dum. Potassii iodohydrargyras. Vere- trina.) Swellings of the glands (cal- cis chlorid.) Tumefaction of the up- per lip (aur. muriat. natronat.) Ul- cers (potass, iodid. Hyd.ct arsen. io- did. Monesia.) Scurvy (creasoton.) Seasickness (creasoton.) Sensibility, unusual, of the abdomen (zinci ferrohydrocyanas.) ' Serpents, bites of (caincse radix. Gu- aco.) Serpigo (potass, iodid.) Sleeplessness (lactucarium. Magnetism, animal. Morphin. bimeconas.) Sloughing, of cellular membrane (io- din.) Gangrenous (monesia.) Ulcers (calcis chlorid.) Small-pox (calcis chlorid. Chlorin. aq.) Sore throat (ammoniated counter-irri- tants.) Sores, sloughing, gangrenous (acid. py. rolig.) Syphilitic (hyd. deuto-iodid,) Spasmodic diseases (acid, hydrocyan. Acupunct. Colchicum. Indigum. Magnes. Zinci ferrohydrocyanas.) Spasmodic erethism (creasoton.) Spasms (ammoniated counter-irritants. Magnes.) Sphacelus (acid. acet. empyr.) Spina ventosa (ol. jecinor. aselli.) Spine, diseases of the (iodinum. Potassii iodohydrargyras.) Spleen, diseases of the (potass, bromid.) Engorgement pf the (quininae sulphas.) Enlarged (hydrarg. deuto-iodur.) Enlarged (iodin.) Indurated (iodi- num.) Sprains (creasoton.) Violent (ammoni. ated counter-irritants,) Staubasthma (acid, hydrocyan.) Stings of wasps (iodinum.) Stomacace (iodinum.) Stomach, coats of the, hypertrophy of the (sulph. carbur.) Irritation of (co- deina.) Neuropathic disorders of (acid, hydrocyan.) Lungs, chronic in- flammation of the (ol, jecin. aselli.) Stomatitis (monesia.) Stricture of the Eustachian tube (cathe- terism.) Of the oesophagus (iodin.) Of the urethra (iodin.) Spasmodic, of the urethra (diosma.) Struma varicosa (carbo animalis.) Suffocation, sense of (acid, hydrocyan.) Suppuration, profuse (creasoton.) Sweating, profuse (boletus laricis. Tan- nin.) Syphilis (argenti preeparat. Auri cyan- idum. Auri praeparat. Aurum muriat. Chlorin. Hydrarg. bromid. Hydrarg. cyanur. Hydrarg. deuto-iodur.) Se- condary (ferr. iodid.) Secondary (iodinum.) With scrofula (potass. iodid.) Syphilitic affections (potassa? chloras. Eruptions (ferr. carb.) Eruptions (hyd. et arsen. iodid.) Excoriations (aurum metallicum.) Excrescences INDEX OF DISEASES AND THEIR REMEDIES. 531 Syphilitic affections—continued. (aurum metallicum.) Osteocopi (strychnina.) Sore throat (hyd. deu- to-iodid.) Swellings of the bones (potass, iodid.) Ulcers (aurum me- tallicum.) Tabes mesenterica (ferr. iodid.) Taenia (acid, hydrocyan. Brayera an- thelmintica. Creasoton. Euphorb. ol. Filix mas. Granatum. 01. croton.) Tarsi inflamed, chronic (creasoton.) Teeth, caries of the (calcis chlorid. Mo- nesia.) Testes, enlarged (iodinum.) Enlarged (potass, iodid.) Scrofulous swelling of the (potassii bromid.) Tetanus (acid, hydrocyan. Ammoni- ated counter-irritants. Colchicum.) Traumatic (strychnina.) Tetter (iodinum.) See Herpes. Thoracic inflammation (hydrarg. cy- anur.) Thymus, hypertrophied (iodin.) Tic douloureux (acid, hydrocyan. Aco- nitin. Ammoniated counter-irritants. Delphinin. Galvanism. Strychnina, Veratrina.) See Neuralgia. Tinea (calcis chlorid.- Chlorin. aq. Fu- ligo. Iodid. sulph.) Tongue, induration of the (auri praepa- rat.) Malignant ulcers of the (iodi- num.) Tonsils, enlarged (iodinum.) Malignant ulcers of the (iodinum.) Toothach (acid, hydrocyan. Acid. acet. empyr. Acupunct. Creasoton. Liq. ferr. persesquinit. Magnes. Spilanthus oleraceus.) Rheumatic (sulph. car- bur.) Tophi, gouty (iodinum.) Tremors (Magnes. Strychnina.) From mercury (electro-punct.) Trismus (ammoniated counter-irritants.) Tubercles (iodinum. 01. jecinor. aselli.) Of the lung (chlorin. Iodinum.) Me- senteric (iodinum,) Tumours of the bones (auri. pra?parat.) Of the mamma? (ol. jecinor. aselli.) Scrofulous (iodid. quinin.) Scrofulous (iodinum.) Typhoid fever (aq. chlorin.) Typhus (calcis chlorid. Chlorin. aq. Quinines et cinchonina? tannas. So- das chloridum.) Abdominalis (chlorini aq.) Bilious (calcis chloridum.) Ulceration of the mouth (calcis chlo- rid.) Ulcerative process (iodinum.) Ulcers (chlorin. aq. Creasoton. Iodi- num. 01. jecinor. aselli. Sodae chlo- ridum.) Atonic (creasoton.) Atonic (iodid. sulph.) Atonic (zinci chlori- dum.) Cancerous (calendula.) Can- cerous (chlorin. aq.) Cancerous (ferr. carb. praec.) Cancerous (hydrarg. deuto-iodur.) Cancerous of the face (creasoton.) Carious (creasoton.) Erosive (zinci chlorid.) Fistulous (creasoton.) Flabby (acid. acet. em- pyr.) Fungous (acid. acet. empyr.) Gangrenous (calcis chloridum.) Gan- grenous (creasoton.) Herpetic, &c. (acid. acet. empyr.) Herpetic (creaso- ton.) Herpetic (zinci chlorid.) In- dolent (creasoton.) Malignant (crea- soton. Monesia.) Malignant (zinci chlorid.) Of the mouth after saliva- tion (potassa? chloras.) Phagedenic (monesia. Zinci chlorid.) Sanious (creasoton.) Scorbutic (creasoton.) Scrofulous (creasoton.) Scrofulous (hydrarg. protoiodur.) Scrofulous (io- dinum. Monesia.) Scrofulous (zinci chlorid. Hyd. et arsen. Iodid.) Ser- piginous (monesia.) Sloughing (acid. acet. empyr. Creasoton.) Sloughing from lying (plumb, tannas.) Syphi- litic (aurum metallicum.) Syphilitic (creasoton.) Syphilitic (ferr. iodid.) Syphilitic (hydrarg. cyanuret.) Sy- philitic (hydrarg. proto-iodur. Mo- nesia.) Syphilitic, old (zinci chlorid.) Torpid, foul, &c. (calcis chlorid.) Torpid, foul, (ferr. cyanur.) Varicose (creasoton.) Urethra, diseases of the (diosma.) In- flamed, mucous membrane of the, tu- mefied (carb. anim.) Urinary organs, diseased (chimaphila.) Urine, incontinence of (diosma. Iodin.) Retention of (secale cornutum.) Urticaria (cort. adstring. Brazil.) Uterus, cancers of the (ferr. carb. pra?c.) Hypertrophy (secale cornutum.) Neck of the, fungus of the (aur. nitrico-mu- riat.) Pain of the (acid, hydrocyan.) Spasmodic pains of the (acid, hydro- cyan.) Vagina, inflammation of the (fuligo. Monesia.) Varicose veins (acupunct.) Venereal inaction, prevention of (chlo- rin. aq.) Vomiting (acid, hydrocyan. Argilla. Creasoton. Strychnina.) Chronic (arte- 532 INDEX OF DISEASES AND THEIR REMEDIES. misia.) Chronic (calendula.) Obsti- nate (calendula.) Warts, malignant (iodinum.) Whitlow (iodinum.) Worms (cainca? radix. 01. croton. Zin- ci ferrohydrocyanas.) Wounds (calcis chlorid.) Contused (diosma. Iodinum.) From dissection (calcis chlorid. Iodinum.) From gun- powder (calcis chlorid.) Lacerated (iodinum.) Painful (acid, hydrocyan.) Punctured (Iodinum.) INDEX OF NEW REMEDIES, Acetum ligneum, 9. Acid, auric, 85, Cyanhydric (acid. hy. drocyan.) Hydriodic, liquid, 320. Hydrocyanic, 13. Hydrocyanic, me- dicinal, 13, 25. Lactic, 27. Nitro- muriatic, 136. Of milk, 27. Oxy- muriatic, liquid, 138. Prussic, 13. Pyroligneous, 9. Pyrolignic, 9. Tan- nic, 470. Acide hydrocyanique, 13. Lactique, 27. Prussique, 13. Pyro-acetique, 9, Pyroligneux, 9. Pyrolignique, 9. Acidum aceticum empyreumaticum, 9. Borussicum, 13. Cainca?, 104. Hy- drocyanicum, 13. Lacteum,27. Lac- tis, 27. Ligni pyro-oleosum, 9. Ma- rinum dephlogisticatum, 131. Muri- aticum oxygenatum, 131. Muriaticum oxygenatum ad contagia, 131. Prus- sicum, 13. Pyroaceticum, 9. Pyro- lignosum, 9. . Zooticum, 13, Zooti- nicum, 13. Aconitia, 29. Aconite, extract of, alcoholic, 33. Ex- tract of, ammoniated, 33. Aconitine, 29. Aconitium, 29. Acqua Binelli, 45. Actaea racemosa, 144. Actee, 144, Acupuncturation, 34. Acupuncture, 34. jEsculine, 269. ^Esculus hippocastanum, 269. JEther hydrocyanicus, 42. Prussicus, 42. ^Etzroggen, 430. Afterkorn, 430. Agaric blanc, 94. Agaricus albus, 94. Agothosma, crenatum, 199. ' Aimant, 327. Air douches into the Eustachian tube, 515. Akonitin, 29. Akupunktur, 34. Alaunerde, reine, 58. Alcali vegetabile salito-dephlogistica- tum, 383. Alcool de soufre, 463. Alcohol sulphuris, 463. Alexiterium chloricum, 131. Alumina, pure, 58. Alumine factice, 58. Ammonia, arseniate of, 62. Ammoniaque, arseniate d', 62. Ammoniated counter-irritants, 502. Ammonium arsenicum, 62. Arsenik- saures, 62. Iodide of, 324. Amylum iodatum, 323. Anthrakokali, iv. Antidynous counter-irritants, 502. Aqua amygdalarum, 44. Balsamica arterialis. 45. Binelli, 45. Chlorini, 138. Natri oxy muriatici, 411. Oxy- genata muriatica, 138. Oxygeno- muriatica, 139. Oxymuriatica, 138. Picis, 47. 534 INDEX OF NEW REMEDIES. Arbor vita?, American, 474. Argent, chlorure d\ 53. Cyanure d\ 55. Iodure d', 57. Oxide d', 57. Et d'ammoniaque, chlorure d', 53. Argenti chloridum, 53. Cyanidum, 55. loduretum, 57. Muriatico-ammoniati liquor, 55. Oxidum, 57. Et ammo- niaci chloruretum, 54. Et ammonia? chloridum, 54. Praeparata, 50. Argentum chloratum, 53. Cyanogena- turn, 55. Divisum, 56. lodatum, 57. Limatum, 56. Muriaticum, 53. Mu- riaticum ammoniatum, 54. Oxyda- tum, 57. Salitum, 53. Argil, pure, 58. Armoise commune, 65. Arnica, 61. Montana, 61. Plauensis, 61. Arnique, 61. Arsenias ammoniae, 62. Arseniate of soda, 62. Arsenias potassae acidus, 211. Arsenic, iodide of, 64. Arsenici iodidum, 64. Arsenici et hydrargyri iodidum, 286. Arsenite of potassa, 62. Arsenikiodur, 64. Artemisia vulgaris, 65. Extractum re- sinosum, 69. Asparagi officinalis turiones, 71. Asparagus shoots, 71. Aspidium filix mas, 246. Athyrium filix mas, 246. Auri chloretum, 77. Chloretum cum chloreto natrii, 80. Chloridum, 77. Chloruretum, 77. Cyanidum, 83. Cyanuretum, 83. Iodidum, 84. lo- duretum, 84. Murias, 77. Nitromu- rias, 84. Oxydum, 85. Praeparata, 72. Pulvis, 87. Terchloridum, 77. Teroxidum, 85. Et sodii chloridum, 80. Et sodii chloruretum, 80. Et sodii perchloruretum, 80. Et sodii perchloruretum, 80. Aurico-natricum murias, 80. Aurum chloratum, 77. Chloratum na- tronatum, 80. Limatum, 87. Metal- licum, 87. Muriaticum, 77. Muri- aticum natronatum, 80. Nitrico-mu- riaticum, 84. Oxydatum, 85. Oxy- dulatum muriaticum, 77. Salitum, 77. Bachelor's buttons, 351. Balaustier, 261. Ballota lanata, 88. Bark, resinous constituent of the, 422. Barosma crenata, 199. garyi iodati hydras, 90. Iodidum, 90. £>aryt hydriodsaurer, 90. Baryta, hydriodate of, 90. Barytin, 481. Baryum, iodide of, 90. Beifusswurzel, 65. Gemeiner, 65. Berberina, 91. Bergerthran, 358. Berliner Blau, 223. Betoine des Savoyards, 61. Bignonia catalpa, 93. Binellisches Wasser, 45. Biogamia, 514. Biomagnetismus, 514. Bisulphuretum carbonii, 463. Bitter almonds, water of, 44. Bittermandelwasser, 44. Blaud's pills, 215. Blausaure, 13. Blausaures eisenoxydul zinkoxid, 492. Blaustoffeisen, 223. Blaustoffquecksilber, 273, Blaustoffsilber, 55. Blaustoffzink, 492. Ble cornu, 430. Bled avorte, 430. Farouche, 430. Blei hydriodsaures, 380. Bleiiodid, 380. Blei iodwasserstoffsaures, 380. Bleu de Prusse, 223. Blue, Prussian, 223. Bocchoe, 199. Bocho, 199. Bole, Armenian, 58. Boletus Albus, 94. Laricis, 94. Pur- gans, 94. Boocho, 199. Brayera anthelmintica, 95. Brechstoff, 204. Brom, 96. Brome, 96. Bromeisen, 213. Bromhydras potassae, 386. Bromidum potassii, 386. Bromine, 96. Brominum, 96. Bromkalium, 386. Bromquecksilber, 271. Bromuretum kalii, 386. Bromuretum potassicum, 386. Bromwasserstoffsaures kali, 386. Brucine, 100. Buccublalter, 199. Buchu, 199. Buckeye, 269. Bugbane, 144. Cadmii sulphas, iv. Cadmium schwefelsaures sulphuricum, iv. Caeruleum Beroliniense, 223, Borussi- cum, 223. Cahincae radix, 103. Cainanae radix, 103. INDEX OF NEW REMEDIES. 535 Cainca toot, 103. Caincae acidum, 104, 106 Calcar, 430. Calcaria chlorat'a, 107. Chlorica 107 Chloretum, 107. Calcariae chlorum, 107. Calcii oxychloruretum, 107. Oxydichlo- ruretum, 107. Proto-chloruretum, 107. Calcis bichloruretum, 107. Chloridum' 107. Hypochloris, 107. Oxymurias! 107. J Calcium, oxide de, chlorure d', 107. Pro- toxichlorure de, 107, Calendula Alpina, 61. Officinalis, 119. Sativa, 119. Calendulnie, 119. Caltha Alpina, 61. Sativa, 119. Calx chlorinata, 107. Oxymuriatica, 107. Caninanae radix, 103, Caper spurge, 209. Carbo animalis, 122. Carnis, 122. Mi- neralis, 220. Carbon, sesqui-iodide of, 126. Sesqui- ioduret of, 126. Carboneum sulphuratum, 463. Carbonis sesqui-iodidum, 126. Sesqui- ioduretum, 126. Carbure de soufre, 463. Carburet of sulphur, 463. Carrageen moss, 248. Castanea equina, 269. Pavina, 269. Catalpa, 93. Arborea, 93. Arbor- escens, 93. Cordifolia, 93. Tree, 93. Cataputia minor, 209. Catawba tree, 93. Cathetherism of the Eustachian tube, 516. Cedre blanc, 474. Cetrarine, 126. Charbon animal, 122. Charcoal, animal, 122, Chaux, chlorure de, 107. Chlorate de, 107. Muriate suroxigene ou oxi- gene de, 107. Oxichlorure de, 107. Oximuriate de, 107. Souschlorate de, 107. Chestnut, horse, 269. Chimaphila, 128. Chimophila, 128. Chinastoff, 404. Chinicus citras, 377. Hydrochloricus, 409. Chinii acetas, 406. Ferrocyanas, 407. Hydrochloras, 409. Nitras, 410. Phos. phas, 410. Sulphas, 411. Chinin, 404. Chinin, eisenblausaures, 407. Essig saures, 406. Hydrochlorsaures, 409. Phosphorsaures, 410. Saltpeter- saures, 410. Salzsaures, 409. Schwe- felsaures, 411. Sulphat, 411. Zitron- saures, 406. Chinini citras, 406. Phosphas,416. Chininum, 404. Chinioidine, 423. Chininum resino-sulphuricum, 422. Chinium, 404. Aceticum, 406. Ferro- cyanogenatum, 407. Hydrochlori- cum. 409.. Muriaticum, 409. Nitri- cum, 410. Phosphoricum, 410. Sa- litum, 409. Chinoidine, 423. Chiococcae radix, 103. Chlor, 131. Chloras kalicus depuratus, 383. Chloras Potassicus, 383. Chlorate de potasse, 383. Chlore, 131. Eau de, 138. Liquide, 138. Chloretum zinci, 489. Chlorgas, 131. Chlorgold, 77. Chlorgoldnatronium, 80. Chlorhydras quinicus, 409. Chlori aqua, 138. Liquor, 138. Chloride of soda, 445. Of zinc, 489. Chlorine, 131. Solution of, 138'. Chlorini aqua, 138. Chlorinum, 131. Chlorkalk, 107. Chlorsaures kali, 430. Chlornatron, 445. Chlorsilber, 53. Chlorum, 131. Chlorure d'oxide de sodium, 445. De soude, 445. Chloruretum oxidi sodii, 445. Potassa? oxidatum, 383. Chlorwasser, 138. Chlorzink, 489. Chondrus crispus, 248. Polymorphus 248. r ' Christophskraut traubenformiges, 144. Chrysanthemum, 119. Cimicifuga, 144. Cinchonine, 147. Clavis secalinus, 430. Sih>inis, 430.' Clou de seigle, 430. Cocosnussolseife, 428. Codeine, 150. Codliver oil, 358. Cohort, 144. Cohosh, 144. Colchicine, 156. Colchicum, 155. Autumnale, 155. 536 INDEX OF NEW REMEDIES. Colchique, 155. Compression, 497. Methodical, 497. Contra-irritation, 466. Cortex adstringens Brasiliensis, 162. Counter-action, 502. Counter-irritant lotions, Granville's, 502. Ammoniated, 502. Antidynous, 502. Gondret's, 502. Granville's, 502. Counter-irritation, 502. Crayon noir, 220 Creasote, 165. Creosote, 165. Cresson de Para, 447. Crocus martis aperiens, 217. Croton oil, 368. Crusadinha raiz, 103. Cubebarum extracti hydro-alcoholici setherei syrupus, 194. Cubebine, 191. Cubebs, 190. Cyanather, 42. Cyaneisen, 223. Cyaneisenzink, 457. Cyanidum potassii, 388. Cyankalium, 388. Cyanquecksilber, 273. Cyansilber, 55. Cyanure de potassium, 388. De zinc, 492. Cyanuretum ferrozincicum, 493. Cyanwasserstoffsaure, 13, Cyanzink, 492. Delphinine, 196. Derosne's opiumsalz, 348. Diosma crenata, 199. Diosmine, 199. Doronic d'Allemagne, 61. Doronicum Germanicum, 61. Planta- ginis folio, 61. Druck,461. Duftstrauchblatter, 199. Eau d'amandes ameres, 44, De gou- dron, 47. De Javelle, 445. Medici- nale d'Husson, 158. Eisencyamircyanid, 223. Eisenoxyd, eisenblausaures, 223. Eisenoxyhydrat, 239. Eisenoxydul arseniksaures, 210. Blau- saures, 223. Hydriodsaures, 227. Kohlensaures, 217. Eisenpraparate, 210. Electricitas animalis, 511. Galvanica seu metallica,511. Electro-magnetism, 511. Electropunctura, 201. Elixir odontalgicum, 447. Emetina, 204. Ergot, 430. Ether, hydrocyanic, 42. Acetous, injec- tions of, into the Eustachian tube, 519. Prussic, 42. Eupatorium huaco, 266: Euphorbia lathyris, 209. Exoneurism, 514. Extraetum opii aceticum, 347. Extrait savonneux de l'urine, 476. Fallkraut,61. Farrenkraut, 246. Fer, arseniate de, 210. Bromure de, 213. Carbure de, 220. Hydrate deutocyanure de, 223. Hydriodate de, 227. Iodure de, 227. Prepara- tions de, 210, Proto-iodure de, 227. Souscarbonate de, 217. Tritohydro- cyanate ferrure de, 223. Trito-hydro- ferro-cyanate, de, 223. Fern, male, 246. Ferri arsenias, 210. Borussias, 223. Bromidum, 213. Carbonas, 214. Car- bonas praecipitatus, 217. Carburetum, 220. Cyanuretum, 223. Deuto-car- bonas fuscus, 217. Ferrocyanas, 223. Hydriodas, 227. Hydrobromas, 213. Iodidum, 227. loduretum, 227. Lac- tas, 235. Nitratis liquor, 237. Nitri- ci oxydati liquor, 237. Oxydi ferro- cyanas, 223. Oxydum fuscum, 217. Oxydum hydratum, 239. Percyani- dum, 223. Persesqui nitratis liquor, 237. Pra?parata, 210. Protocarbo- nas, 214. Sesqui-cyanidum, 223. Sesquioxydum, 217. Subcarbonas, 217. Supercarburetum, 220. Ferrum arseniatum, 210. Arsenicicum oxydulatum, 210. Borussicum, 223. Bromatum, 213. Carbonatum, 220, Carbonatum praecipitatum, 217. Car- bonicum oxydulatum, 217. Carburet- um, 220. Cyanogenatum, 223. Cy- anuretum, 223. Hydriodatum, 227. Hydroiodicum oxydulatum, 227. lo- datum, 227. Nitratum, 237. Oxy- datum hydratum, 239. Oxydulatum hydrocyanicum, 223. Zooticum, 223. Filix mas, 246. Fleckblume falsche, 447. Fleischkohle, 122. Fougere male, 246. Fucus crispus, 248. Fuligo, 251. Ligni, 251. Splendens, 251. Fumigatio muriatieo-oxgenata, 131. Fumigation de chlor, 131. De Guyton, 131. Guytonienne, 131. Hygien- ique, 131. Fungus of the larch, 94. Laricis, 94. INDEX OF NEW REMEDIES. 537 Galeopsis grandiflora, 256. Ochrolcuca v1,losa!le6tUm'256- V--lor,256. Gts^5:514- p,ates-513- Sup- Galvanism, 511. Galvanopuncture, 201, Gebarpulver, 430. Gegenreizung, 502. Gentiana chirayita, iv. Gentianine, 257. Gerbsaure, 470. Gerbestoff, 470. Gerbstoffblei, 382. Gichtthran, 358. Glanzruss, 251. Gold, chloride of, 77. Cyanide of, 83. Cyanurct of, 83. Iodide of, 84. Me- tallic, 87. Muriate of, 77. Natrium- chlorid, 80. Natrum chlorid, 80. Na- trum salzsaures, 80. Oxide of, 85. Oxydirtes, 85. Oxydulsalzsaures 77. Peroxide of, 85. Praparate, 72. Pul- ver, 87. Saltpetersalzsaures, 84. Salz- saures, 77. Tercyanide of, 83. And soda, hydrochlorate of, 86. And soda, muriate of, 86. And sodium, chloride of, 80. Gondret's counter-irritants, 502. Granatbaum, 261. Granatin, 261. Granatum, 261. Granatwurzelrinde, 261. Granville's counter-irritants, 502. Graphites, 220. Grenadier, 261. Grenadine, 261. Guaco, 266. Haloidum oxygenatum, 383. Hanfnessel, grossblumigte, 255. Harnstoff, 476. Henricea pharmacearcha, iv. Herba sideriditis, 255. Hcrbe a pisser, 128. Herbe Saint Christophe, 144. Herbsblume, 155. Herbstzcitlose, 155. Hippocastanum, 269. Hohlzahns, grossblilthigen, 255. Holzessig, 9. Holzsaure, 9. Brenzliche oder bran- dige, 9. Hornseed, 430. Horse chestnut, 269. Huaco, 266. Huile de foie de poisson, 358. De Mo- rue, 358. De pignon d'Inde, 365. Volatile de moutarde, 368. 46 Hydrargyri bicyanidum, 273. Borus- sias, 271. Bromidum, 271. Deuto- bromidum, 271. Cyanuretum, 273. Deutoioduretum, 282. Iodidulatum, 278. Iodidum, 278. Perbromidum, 271. Praeparata, 271. Protobromi- dum/271. Proto-iodidum, 278. Pro- to-ioduretum, 278. Prussias, 273. Hydrargyri et arsenici iodidum, 286. Hydrargyrum biniodidum, 282. Bro- matum, 271. Cyanogenatum, 273. Hydrocyanicum, 273. lodatum, 278. lodatum flavum, 278. lodatum ru- brum, 282. Perbromatum, 27]. Pc- riodatum, 282. Hydras ferricus, 239. Hydriodate of potassa, 392, Hydriodic acid, liquid, 320. Hydrobromsaures kali, 386. Hydrocyanate of potassa, 388. Hydrocyanicus aether, 42. Hydrocyansaure, 13. Hydriodas kalicus, 392. Lixivje, 392 Indicum, 288. Indicus color, 288. Indigo, 288. Infusum picis liquida?, 47. Picis empy- reumaticae liquida?, 47. Injections of air, &c. into the Eustachian tube, 515. Iod, 293. lode, 293. Iodarsen, 64. lodarsenik, 64. Iodbaryum, 90. Iodblei, 380. lodeiscn, 227. lodhydras Kalicus seu Potassa?, 392. Iodide of ammonium, 324. Arsenic, 64. Quinine, 324. Of starch, 323.' Of sulphur, 468. Of zinc, 496. Iodidum amyli, 323. Arsenici, 64. Ba- ryis, 90. Hydiargyricum, 282. Ily. drargyrosnm, 278. Plumbi, 380 Potassii, 392. Quinina;, 324. Iodine, 293. lodinschwefel, 468. Iodkalium, 392. Iodquecksilber, jrclbes, 278. Im maxi- mum, 282. Im minimum des Iods 278. Rothes, 282. lodschwefel, 468. Iodsilber, 57. Iodstarke, 323, Iodstakmehl, 323. Iodum, 293. Iodure d'amidon, 323. Dc potasse, 392. De soufre, 468. 538 INDEX OF NEW REMEDIES. Ioduret of sulphur, 468. loduretum amyli, 323. Iodohydrargyrate of potassium, 401, Iodzink, 496. Iron, arseniate of, 210, Bromated, or bromide of, 213. Carburet of, 220. Cya- nuret of, 223. Hydriodate of, 227. Hydrobomate of, 213. Hydro-oxide of, 239. Iodide of, 227. Ioduret of, 227. Lactate of, 235. Nitrate of, solution of, 237. Oxide of, hydrated, 239. Perox- ide of,217. Peroxide of, hydrated, 239. Persesquinitrate of, solution of, 237. Preparations of, 210. Proto-carbonate of; 214. Proto-iodide of, 227. Proto- ioduret of, 227. Protoxide of, hydri- odate of, 227. Protoxide of, lactate of, 235. Prussiate of, 223. Sesquiox- ide of,217. Subcarbonate of, 217. Tri- toxide of, hydrated, 239. Irritainentum metallorurn seu metalli- cum, 511. Johanniswurzel, 246. Kahinca? radix, 103. Kali chloricum, 383. Chlorsaures, 383. Hydriodsaures, 392. Hydrobromicum, 386. Hydroiodinicum, 392. lodwas- serstoffsaures, 392. Bromwasserstoff- saures, 386. Hydroiodicum, 392. lo- datum Hydrargyratum, 401. Oxymu riaticum, 383. Kalium bromatum,386. Bromid,386. Mu- riaticum hyperoxygenatum,386. loda- tum, 392. Iodure, 392. Bromure,386. Kalkchlorid, 107. Kaminruss, 251. Kinine, 404, Kininum, 404. Klaprothii, sulphasw. Klaprothium schwelfelsaures, iv, Kodein, 150. Kohle, thierische, 122. Kohlenschwefel, flilssiger, 463. Kohlenstoffeisen, 220. Kohlensulfurid, 463. Krahenaugen, 351 bitter, 448. Geistiges Extrakt der, 351. Stoff, 448. Kreasote, 165. Kreosote, 165. Krotonol, 368. Kubebenpfeffer, 190. Kubebin, 190. Labarraque's dissinfecting liquid, 117, 445. Lactucarium, 325. Lathyris,209. Lattichopium, 325. Lead, black, 220. Iodide of, 380. Tan- nate of, 362. Le bensbaume, gemeine, 474. Leberthran, 358. Leonurus lanata, 88. Leopard's bane, 61. Lerschenschwamm, 94. Lettuce opium, 325, Lichen carrageen, 248. Lime, chloride of, 107. Liqueur desinfectante de Labarraque, 117. Liquor acidi muriatici oxygenati, 138, Alexiterius oxygenatus, 138. Disin- fecting, of Labarraque,l 17. Natri Chlo- reti, 445. Morphina? citratis, 347. Ferri nitratis, 237. Ferri nitrici oxydati, 237. Opii sedativus, 347. Sodse chloridi, 445. Sodae chlorinataa, 445. Macrotrys racemosa, 144. Magnes, 327. Magnet, 327. Magnetism, animal, 514. Malogranatum, 261, Mannastoff, 329. Mannazucker, 329. Mannite, 329. Marigold, garden, 119. .Single,'119. Marronier, 269. D'Inde, 269. Matiere de Derosne, 348. Matter of Derosne, 348. Melini Sulphas, iv. Mercure, cyanure de, 273. Duto-iodidc de,282. Hydrocyanate de 273. Pen- odure de 282. Preparations de, 271. Protoiodure de, 278, Prussiate de, 273. Mercury, bicyanide of, 273, Biniodide of, 282. Bromide of, 271. Cyanide of, 273. Deutoiodide of, 282. Hydrocya- nate of, 273. Preparations of, 271. Proto-iodide of, 278. Prussiate of, 273. Mercury and arsenic, Iodide of, 286. Mere de Seigle, 430. Mesmerism, 514. Milchsaure, 27.. Moleplant, 209. Monesia, 332. Morphei acetas, 342. Morpheum, 337. Morphin essigsaures, 342. Schwefel- saures, 346. Morphinae Bimeconas,348. Sulphas, 346. Tartras, 347. Morphine, 337. Acetate of, 342. Bime- conate of, 348. Citrate of, 347. Muri- ate of, 347. Sulfate de, 346. Tartrate of, 347. Morphinum, 337. Morphium, 337. INDEX OF NEW REMEDIES. 531) Mort aux chiens, 155. Moss, carrageen, 248. Corrigeen, 248. Irish, 248. Mousse d'Irlande, 248. Pcrlee, 248. Moxa, 508. Moxiburium, 508. Mugwort, 65. Muride,96. Murigene, 131. Mustardseed oil, 368. Mutterkorn,430. Nadelstich, 34. Narcotine, 348. Muriate of, 325. Narda celtica altera, 61. Narkotin, 348. Natrum chloratum, 445. Chloricum, 445. Oxymuriaticum,445. Nephrine, 476. Neurogamia, 514. JNiesswurzmstoff, 478. Nitro-Muriatic mixture, 136. Noix vomique, 351. Extrait alcoolique de, 351. Nux vomica, 351. Extract alcoholic of, 351. Ofenruss, 251. Oil, codliver, 358. Croton, 368. Of mus- tard seed, 363. Oleum aethereum florum .arnicae, 61. M- thcreum seminum sinapis, 368. Cro- tonis, 365. Jecinoris aselli, 358. Mor- rhuae, 358. Sinapis, 368. Tiglii, 368. Volatile seminum sinapis, 365. Opiane, 348. Opium, lettuce, 325. Or, chlorure d\ 77, Cyanure d', 83. Divise, 87. Metallique, 87. Muriate d', 77. Oxide, 85. Preparations d\ 72. Protoiodure d', 84. Et sonde, hydrochlorate d', 80. Et soude muri- ate d', 80, Oxydirt-salzsaures Natronwasser, 445. Palmolseifc, 428. Panacea lapsorum, 61. Papaverine, 337. Paraguay roux, 447. Paratinktur, 447. Pariser blau, 223. Paullinia, v. Pfeffcrstoff, 376. Phloiorrhizin, 313. Phloridzine, 373. Pierre d'aimant, 327. Pigmentum indicum, 288. Pills, Blaud's, 215. Ferruginous, of Vallet, 214. Piper caudatum, 190. Cubeba, 190. Piperine, 376. Pipsissewa, 128. Platinum, 379. Plomb, iodure de, 380. Tannate de 382. Plombagine, 220. Plumbago, 220. Plumbi iodidum, 380. loduretum, 380. Tannas, 382. Pneumokatharterion, 115. Poison nut, 351. Poivre a queue, 190. Polypodium filix mas, 246. Polyporus officinalis, 94. Pomegranate, 261. Potass, arsenite of, 62. Hyperoxymuri- ate of, 383. Chlorate of, 3&3. Hy- drocyanate of, 38S. Hydriodate of, 392. Hydriodate of, ioduretted, 392. Hydrobromate of, 386. Oxymuriate of, 383. Potassae, hromhydras, 386. Chloras, 383. Euchloras, 383. Hydrobromas, 386. Murias hyperoxygenatum, 383. Mu- rias oxygenatum, 383. Potasse hromure de, 336. Hydriodate de, 392. Iodure de, 392. Potassii bromidura, 381. Cyanidum, 388. Cyanuretum, 388. Iodidum, 392. Iodohydrargyras, 401. lodu- retum, 392. Oxygeno-chloruretum, 383. Proto-hydriodas, 392. Protox- idi hydriodas, 392. Potassium, bromide of, 386. Cyanide of, 388. Cyanuret of, 388. Iodide of, 392. lodo-hydrargyrate of, 401. Ioduret of iodohydrargyrate of, 401. Ioduret of, 392. Protoxide of, chlo- rate of, 383. Potio picea, 47. Poudre de blanchement, 107. De Ten- nant, ] 07. Powder, bleaching, Tennant's, 107. Principium adstringens, 470. Scytode- phicum, 470. Prussiate de potasse et de fer, 223. Ptarmica montana, 61. Pulvis ad fumigationes muriaticas, 131, Punica granatum, 261. Pyrola umbellata, 128. Pyrole en ombelle, 128. Quecksilber blausaures, 273. Bromid, 271. Bromiir, 271. Deutoiodur des, 282. Iodid, 278. Iodid gelbes, 278. Iodidul, 278. Praparate, 271. Pro- toiodiir des, 278. Quininx disulphas, 411. Quillaia, 333. Quina, 404. Qninia, 404. Quiniae sulphas impuru3, 423. Quinina, 404. Quinine, 404. Acetate of, 406. Citrate 540 INDEX OF NEW REMEDIES. Quinine—continued. of, 406. Extract of, 423. Ferrocy- anure de, 407. Iodide of; 324. Ni- trate of, 410. Quinine, phosphate of, 410. Sulphate, 411. And cinchonine, tannate of, 422. Quininum, 404. Quinium, 404. Raiz crusadinha, 103. Preta, 103 Reissblei, 220. Resina chinae praeparata, 423. Ringelblume, 119. Rosscastanicn, 269. Rnss, 251. Rye, corned, 430. Spurred, 430. Sabadillin, 478. Saccharum mannse, 329. Safran batard, 155. De mars aperitif, 217. Des pres, 155. Saffron meadow, 155. Saint Christophe, herb, 144. Sal cssentiale corticis Peruviani, 404. Salicine, 424. Salt of Derosne, 348, Sapo oacaotinus, 420. Coconeus, 420. Kalicus, 420. Mollis, 420. Nie-er! 420. Viridis, 420. Sitzmehliodtir, 323. Savon de cacoa, 420. Mou, 420 Noir 420. Schmierseife, 420. Giune, 420. Schwanzpfeffer, 190. Schwarzkorn, 430. Schv\efclalcohol, 463. Schwefeliodiire, 468. Schwefelkohlcnstoff, 463. Schwererde, iodwasserstoffsaure, 90. Secale cornutum, 430. Luxurious, 439. Secalis mater, 430. Seife, kali, 428. Sectang,248. Seigle, cornuou corrompn, 430. a epe- ron, 430. Ivre, 430. Noir, 430 Er- gote*, 430. Faux, 430. Sel de Derosne, 348. Essentiel d'opium 343. Senfol, aethcrisches, 365. Serpentariffl Braziliensis radix, 103. Silberammcnium salzsaures, 53. Silberoxyd, 57. Silber, oxydirtes, 57. Praparate, 50. Salmiak, 54. Salzsaures, 53. Zur- theiltes, 53, Silver, chloride of, 53. Cyanide of, 55. Iodide of, 57. Ioduret of, 57, Me- tallic, 56. Muriate of, 53. And am- monia, chloride of, 54. And ammo- nia, chloruret of, 54. Preparations of, 50. Sinapis oleum, 368. Snake root, black, 144. Soap of thecocoanut oil, 428. Soft, 428 Soda, arseniate of, 62. Chlorinata, 445. Chloruret of, 445. Chlorite of, 445* Hypochlorite of, 445. Sodae chloridum, 445. Chloruretum, 445. Oxymurias, 445. Sodii auro-terchloridum, 80. Sodium, auro-terchloride of, 80. Solutio alcxiteria oxygenata, 138. Solution de Pearson, 62. Solution, Fowler's, 62. Soot, 252. Souei, 119. Ordinaire, 119. Soude, chlorure de, 445. Soufre carbure, 463. Iodure, 468. Spargelnsprossen, 71. Species pro vaporibus superoxydi muri- atici, 131. Sphaerococcus crispus, 248, Spiegelruss, 251. Spilanthus oleraceus, 447. Spear-leaved 447. Spiritus salis marini dephlo-jisticatus, 131. Sponsa solis, 119. Spur, the, 430. Spurge, caper, 209. Garden, 209. Starch, iodide of, 323. Starkmehliodur, 323. Stockfisch leberthran, 358, Strychnin, acetat, 459. Essigsaures, 459. Iodsaurcs, 460. Saltpetersaures, 461. Schwefelsaures, 462. Strychnine, 448. Acetate of, 459. Hydriodate of, 460, Iodate of, 460. ^ Nitrate of, 461. Sulphate of, 462. Strychninum, 448. Strychnium, 448. Suffitus chlorini, 131. Oxymuriaticus, 131. Suie, 251. Sulfure de carbon, 463. Sulphuret of carbon, 463. Sulphuretum carbonii, 463. Sulphuris carburetum, 463. Iodidum, 468. loduretum, 468. Swertia chirayita, iv. Tabac de Montagne, 61. Des Savoy- ards, 61. Des Vosges, 61. Tang krauser, 248. Tannas plumbi, 381. Tannic acid, 470. Tanninum, 470. Tannin, 470. Tar water, 47. Tellurismus, 514. Terra aluminis, 58. Aluminosa pura, 58. Argillacea pura, 58. Bolaris, 58. Sigillata, 58. INDEX OF NEW REMEDIES. 541 Theerwesser, 47. Thierkohle, 122. Thonerde, reine, 58. Thridace, 325. Thuya, 474. Du Canada, 474. Occi- dentalis, 474. Tithymalus latifolius, 209. Tue-chien, 155. Ulva crispa, 248. Urea, 476. Uree, 476. Uricum, 476. Ustilago, 430. Vallet's furruginous pills, 214. Vauqueline, 448. Veratrine, 478. Sulphate of, 488. Verrucaria, 119. Vieillotte, 155. Vinaigre de bois, 9. Vomic nut, 351. Wasserstoffblausaure, 13. Weidenbitter,424. Weidenstoff, 424. Wiesensafran, 155. Winter green, 128. Wintergriin, holdenbliihtigen, 128. Wohlverlei, 61. VVohlverleiol, 61. Wolfstrapp wolliger, 88. Woodsoot, 251. Zeitlose, 155. Zinc, butter of, 489. Chloride of, 489. Cyanuret of, 492. Ferrocyanate of, 493. Ferrohydrocyanate of, 493. Hydrochlorate of, 489. Hydrocyanate of, 492. Iodide of, 496. Muriate of, 489. Prussiate of, 492. Zinci butyrum, 489. Chloridum, 489 Chloruretum, 489. Cyanhydras, 492. Cyanidum, 492. Cyanuretum, 492- Ferrohydrocyanas, 492. Iodidum, 496 loduretum, 496. Zincum Borussicum, 492. Chloratum, 489. Cyanogenatum, 492. 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Simple and unambitious in its language, free from the technicalities, and embracing the most important facts on Anatomy, Physiology, and Hygiene, or the art of preserving health; and the treatment of those affections which require immediate attention, or are of an acute chnracter, this should be in the hands of every one, more particularly of those who, by their situations are prevented from resorting to the advice of a physician, nor would the careful perusal of its pages fail to profit the inhabitants of our cities, by giving them a more accurate knowledge of the structure of the human frame, and the laws that govern its various functions; whose perfect integrity is absolutely essential to health, and even to existence; the various systems of medical charla- tanry, daily imagined to take advantage of the credulity and ignorance of mankind, would he rendered far less prejudicial to the community than they now are. We would particularly di- rect attention to the Chapter on Hygiene, a science in itself of the utmost importance, and ably treated in the small space allowed to it in this volume."—New York American. DR. CLARK ON CONSUMPTION. A Treatise on Pulmonary Consumption, comprehending an inquirv into the Nature Causes Prevention, and Treatment of Tuberculous and Scrofulous Diseases in General By Jaines Clark, M. D., F. R. S. ELLIS' MEDICAL FORMULARY. The Medical Formulary, being a collection of prescriptions derived from the writings and practice of many of the most eminent Physicians in America and Knrope. To which is added an Appendix containing the usual Dietetic preparations and Antidotes for Poisons the whole accompanied with a few brief Pharmacuetic and Medical observations. Bv Benjamin Ellis M. D. Fifth edition, with additions. In one volume. * x>Liij«iiiiin aitis, CHITTY'S JURISPRUDENCE. A Practical Treatise on Medical Jurisprudence, with so much of Anatomy, Physiology Pa- thology and the Practice of Medicine and Surgery, as are essential to be known by Member, of the Bar and Private Gentlemen ; and all the laws relating to Medica] Practitioners- wiMi pv planatory plates. By J. Chitty Esq. Second American edition: w th Notesaid Addith>n," adapted to American works and Judicial Decisions, 8vo. Auditions, A TREATISE ON THE PRACTICE OF MEDICINE ; Or, a Systematic Digest of the Principles of General and Special Pathology and Theraneu tics. By E. Geddings, (now preparing.) '""' dIlu *neiapeu- MEDICAL ESSAYS. Essays on ASTHMA, APHTHA, ASPHYXIA, APOPLEXY APVFNlr ATROPA, AIR ABORTION ANGINA-PECTORIS, and Jer Subjects Embraced m the Articles from A to Azote, prepared for the Cyclopedia of Prac- tical Medicine. By Dr. Chapman and others. Each article is complete within itself, and embraces the practical experience of its author and as they are only to be had in this collection will be found* great valueTo the profess.on ' eve^y P?a!uureraX1udenr0ffered " * *" S° ^ as t0 *"» *•» -thin the reach of NATIONAL LIBRARY OF MEDICINE NLM 031=13305 fl NLM031933058