t» . * - 2,%Srfr d*~' '//*■ >rOQ>CQZQLQV}£ZQZQZQuQtQblyo^: r_ A Surgeon General's Office ^cM |^»KE^v Sfefe N< <3/j~yr Oil % jgKaggGao r-G^gocagGg -'. ?oc-aoo>5-esg \ NEW REMEDIES: ROBLEY DUNGLISON, M.D, PROFESSOR OF THE INSTITDTES OF MEDICINE, ETC., IN THE JEFFERSON MEDICAL COLLEGE OF PHILADELPHIA. FIFTH EDITION, WITH EXTENSIVE ADDITIONS. PRODESSE QUAM CONSPICI. Qtrst PHILADELPHIA: " LEA AND BLANCHARD, 1846. Qv 1846 Entetefc, according to Act of Congress, in the year 1843, BY ROBLEY DCNGLISON, M.D., the Clerk's Office of the District Court of the Eastern District of Pennsylvania. WM. 8. YOUNG, PRINTER. PREFACE TO THE FIFTH EDITION. The enlarged experience of observers, since the appearance of the fourth edition of this work, has.tested the value of many of the articles contained in it, and given occasion to the incorpo- ration of much new matter with the text. New remedies have also been proposed in no small number; so that the present edi- tion is much larger, and describes many more articles than the last. The therapeutical agents added which may be regarded as newly introduced into the Materia Medica, together with old agents brought forth with novel applications, and which may, therefore, be esteemed « new remedies," are the following:—-Ben- zoic Acid, Chromic Acid, Gallic Acid, Nitric Acid, Phosphate of Ammonia, Binelli Water, Brocchieri Water, Atropia, Be- beeria, Chloride of Carbon {Chloroform,) Digitalia, Electro- Magnetism, Ergotin, Ox-gall, Glycerin, Hsemospasy, Hsemos- tasis, Hagenia Abyssinica, Honey Bee, Protochloride of Mer- cury and Quinia, Iodoform, Carbonate of Lithia, Sulphate of Manganese, Matico, Double Iodide of Mercury and Morphia, lodhydrate of Morphia, Iodide of Iodhydrate of Morphia, Muriate of Morphia and Codeia, Naphthalin, Piscidia Ery- thrina, Chloride of Lead, Nitrate of Potassa, Arseniate of Quinia, Iodide of Quinia, Iodide of Cinchonia, Iodide of Iod- hydrate of Quinia, Lactate of Quinia, Pyroacelic Spirit, {Naphtha, Acetone,) Hyposulphite of Soda, Phosphate of Soda, Iodide of Iodhydrate of Strychnia, Double Iodide of Zinc and Strychnia, Double Iodide of Zinc and Morphia, and Vale- rianate of Zinc. ROBLEY DUNGLISON. Philadelphia,') Oct. 1846. 5 PREFACE TO THE FIRST AND SECOND EDITIONS The information concerning the remedies of more recent introduction, lies scattered in so many works, that it cannot be accessible 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 avail- able 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 advantage, that—when properly prepared—they are not liable to uncertainty in their operation; whilst the various plants from which strychnia, emetia, quinia, &c, are obtained, are liable to ir- regularity 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 de- manded. Anatomy, physiology, pathology, and materia medica are, in- deed, 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 institute empirical trials, in every case of dis- ease, with various articles in and out of the received lists of the materia medica, and from such vague trials to endeavour to deduce what is termed "experience." The erroneous idea prevails too extensively, that every one is capa- ble of profiting by observation, and that, therefore, all who 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 attention has not been properly directed to the study of the preliminary branches which have been enumerated, VI PREFACE. 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 conditions, 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 observations, 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 hypothetically 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. Before 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 no- thing—soon after the thermometer was placed in his mouth, believing this to be the great curative agent—declared that he felt somewhat bet- ter. Nothing more was, therefore, done; and he was requested to re- turn 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 dis- missed cured, no agent of any kind having been employed except the thermometer. Now, if the reasoning powers were not duly exerted, experience 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 inquires into the mode in which the effect was induced, and he is not long in referring it to the influence exerted by the moral over the physique; and he classes the thermometer with Perkinism, 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 * Propterea sola ekperientia absque doctrina et ratione incerta est et conjecturalis. Qui enim novit rhabarbarum purgare bilem, nescit tamen quando, quibus, et cui morbo prosit, nisi sit medicus doctus et peritus. Primeros. De vulgi erroribus in medicina, lib. i. cap. xl. Amstelod. 1639. PREFACE. Vll could be deduced, and that it has been the custom with the profession for ages to bestow all due caution and the most rational inquiry 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 nations, 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 Pharmacopoeia of Sardinia; and the aqua hirundinum cum castor eo, or " water of swallows with castor," in those of Manheim and Wirtemberg. 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 disgusting preparation was given in hysteria and epilepsy. Again; the bufones exsiccati, or " dried toads," were in the Pharmacopoeias of Spain and Wirtemberg,—having been formerly administered in powder, as a diuretic, in dropsy. In another work,* the author has cited many examples as strange as those instanced, and it would be easy to enumerate still more. In a recent French journal, and in an article by M. Ricord—the dis- tinguished physician to the Venereal Hospital of Paris—we have an ex- ample of the pertinacity with which ancient prepossessions and inculca- tions adhere to us, and how difficult it is to think and to act according to the unbiassed suggestions of our own observation and reflection. In the treatment of blennorrhagic epididymitis, or swelled testicle from gonor- rhoea, M. Ricord recommends compression to be made by means of the " sparadrap," or plaster of Vigo with mercury. The history of the plas- ter of Vigo is singular. Although still in the Pharmacopoeia of Paris, it re- sembles its prototypes but in name. In the Pharmacopoeia of Wirtem- berg, it is directed to be formed of living frogs and living earth-worms, 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 bayberries, turpentine, yellow wax, olibanum, euphorbium, and liquid storax, all melted together. Yet, it is scarcely possible to conceive, that the frog's spawn could have been supposed to yield a product on distillation, differing from that of other animal substances when subjected to the same process; that the swallows—in the preparation cited—added any thing to the antispas- modic virtues of the castor, or that the living frogs and earthworms ex- erted any efficacy in the sparadrap de Vigo—a plaster employed for compressing tumours, and for which purpose we use one of simple ad- hesive constituents. They have all been properly rejected from the lists * General Therapeutics, p. 55. Philad. 1836. [See, also, his General Therapeutics and Mat. Medica, 3d edit. i. 59. Philad. 1846.] * Viii PREFACE. of our medicinal agents, and are looked upon as irrational; yet we are compelled 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 experience. In the darker periods of medical history, monstrous and revolting poly- pharmacal preparations were inlroduced, 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 Antidotum Mithridatum—was dismissed from the British pharmacopoeias. 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 Parisian 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; um- belliferous aromatics, 7; balsams and resinous substances, 8; fetid in- gredients, 6; narcotics, 1; earthy substances, 1; gummy or amylaceous, 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 prin- cipal 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 phar- macopoeia,—on a division, it was found that there were thirteen votes for retaining and fourteen for rejecting it. Its ostracism was determined by a majority of one only, in a learned body twenty-seven of whose mem- bers 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 ages—a confidence un- questionably founded, in their belief, on experience, but experience based upon defective observation, and, consequently, on erroneous inferences —the results being consecutive 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 PREFACE. IX 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 ab- surd and revolting agents, that are still retained in the books of authority of some European countiies. 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 redundancies which have been proved to be such by the more accurate attention that is daily paid to tracing the due relation between 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." Everyone will be compelled to admit, that it is the duty of the correct therapeutist to doubt the existence of qualities in any article 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, especially 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 unconse- quential. 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 in- dertaken by the author. In Germany, several works exist on this sub- ject, and that of Riecke — to which the author has repeatedly referred — served as a basis for many of the articles; his observations, how- ever, do not come down farther than the year 1836. Some of the statements —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 assertions could be tested.* It has been a great object with the author to furnish exact references 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 at- tention to the subject. He has likewise added the results of his own * Recently, a second and enlarged edition of Riecke's work has appeared; but the thera- peutical 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, Be- reitungsweisen, Wirkungen auf den gesungen und kranken Organismus, und therapeutische Benut°zung. Von Victor Adolf Riecke, Dr. Med., Mitglied des Vereins fur Heilkunde in Preussen, u. s. w.; zweite, vollig umgearbeitete Auflage. Stuttgart, 1840." X PREFACE. experience in public and in private. The motto which he has selected —prodesse quam conspici—conveys, in epitome, his feelings. His sole object has been, " to be useful "—and if he has succeeded, the reward is ample. ROBLEY DUNGLISON. Philadelphia, October 15,1839. ALPHABETICAL LIST OF REMEDIES. Abeille mellifique, 610. Acetas chinicus, 522. morphicus, 442. morphii, 442. quinicus, 522. strychnicus, 574. Acetone, 558. Acetum ligneum, 13. Acid, acetic, empyreumatic, 13. auric, 112. benzoic, 17. chromic, 609. cyanhydric, 22. gallic, 20. hydriodic, liquid, 418. hydrocyanic, 22. medicinal, 22. lactic, 36. muriatic dephlogisticated, 162. oxygenated, 162. nitric, 609. nitro-muriatic, 167. of milk, 36. oxy muriatic, liquid, 169. prussic, 22. pyroligneous, 13. pyrolignic, 22. tannic, 38. Acide hydrocyanique, 22. benzoique, 17. chromique, 609. gallique, 20. lactique, 36. nitrique, 609. prussique, 22. pyro-acetique, 13. pyroligneux, 13. pyrolignique, 13. tannique, 38. Acidum aceticum empyreumaticum, 13. benzoicum, 17. benzoicum per sublimationem, 17. borussicum, 22. cahincicum, 130. caincae, 130. chromicum, 609. gallicum, 20. hydrocyanicum, 22. lacteum, 36. lactis, 36. ligni pyro-oleosum, 13. marinum dephlogisticatum, 162. muriaticum natronatum, 107. Acidum muriaticum oxygenatum, 162. muriaticum oxygenatum ad contagia, 162. nitricum, 609. prussicum, 22. pyroaceticum, 13. pyrolignosum, 13. quercitannicum, 38. tannicum, 38. zooticum, 22. zootinicum, 22. Aconite, extract of, alcoholic, 50. extract of, ammoniated, 50. Aconitia, 43. Aconitine, 43. Aconitium, 43. Acqua balsamica arteriale, 68. Acqua B belli, 68. Acqua Brocchieri, 70. Actaea racemosa, 178. Actee, 178. Acupuncturation, 50. Acupuncture, 50. Adstringirende Brazilische Rinde. ^Esculin, 351. ^Esculus hippocastanum, 351. JEther chloricus, 612. hydrocyanicus, 59. prussicus, 59. pyroaceticus, 558. sulphuricus phosphoratus, 468. Aetzroggen, 265. Afterkorn, 265. Agaric blanc, 122. white, 122. Agaricus albus, 122. Agathosma crenatum, 249. Agathotes chirayita, 343, Aimant, 427. Air douches into the Eustachian tube, 374. Akonitin, 43. Akupunktur, 50. Alaunerde, reine, 87. Alcali vegetabile salito-dephlogisticatum,500. Alcohol, mesitic, 558. sulphuris, 578. Alcool de soufre, 578. Alexiterium chloricum, 162. Almond, bitter, water of, 66, Alumina, acetate of, 60. pure, 87. salts, 60. sulphate of, 60. Aluminse sales, 60. Xll ALPHABETICAL CONTENTS. Alumine factice, 87. sels d', 60. Aluminum, chloride of, 60. Ammonia, arseniate of, 90. hydriodate of, 421. phosphate of, 62. Ammonia; arsenias, 90. phosphas, 62. Ammoniaque, arseniate d', 90. phosphate d', 62. Ammoniated counter-irritants, 203. Ammonii iodidum, 421. Ammonium arsenicum, 90. arseniksaures, 90. iodide of, 421. phosphorsaures, 62. Amylum iodatum, 421. Anthrakokali, 66. sulphuretted, 66. Antidynous counter-irritants, 203. Apis domestica, 610. mellifica, 610. Aqua amygdalarum, 66. arsenicalis Pearsonii, 91. balsamica arterialis, 68. Binellii, 68. Brocchierii, 70. chlorini, 169. lauro-cerasi, 30, 67. natri oxymuriatici, 556. oxygenata-muriatica, 169. oxygeno-muriatica, 169. oxymuriatica, 169. picis liquids, 75. Argent, chlorure d', 80. et d'ammoniaque, chlorure d', 81. cyanure d', 83. iodure d', 84. oxide d', 85. preparations d', 78. Argenti chloridum, 80. chloruretum, 80. cyanidum, 83. cyanuretum, 83. et ammoniaci chloruretum, 81. et ammonia? chloridum, 81. ioduretum, 84. iodidum, 84. muriatico-ammoniati liquor, 82. oxidum, 85. prceparata, 78. Argentum chloratum, 80. cyanogenatum, 83. cfivisum, 87. iodatum, 84, limatum, 70. muriaticum, 80. muriaticum ammonia turn, 81. oxydatum, 85. salitum, 80. Argil, pure, 87. Argilla pura, 87. Armoise commune, 93. Arnica, 89. montana, 89. plauensis, 89. Arnique, 89. Arsenias ammonia?, 90. potassae acidus, 286. Arseniate of soda, 91. Arsenic, iodide of, 91. and mercury, double iodide of, 366. Arsenici iodidum, 91. et hydrargyri hydriodas, 366. et hydrargyri iodidum, 366. Arsenicum iodatum, 91. Arsenikiodur, 91. Arseniksaures ammonium, 90. Arsenite of potassa, 91. Artemisia vulgaris, 93. extractum resinosum, 93. Aspidium filix mas, 326. Athyrium filix mas, 326. Atropia, 98. Atropin, 98. Atropina, 98. Atropine, 98. Atropinum, 98. Atropium, 98; Auri chloretum, 104. chloretum cum chloreto natri, 107. chloridum, 104. chloruretum, 104. cyanidum, 109. cyanuretum, 109. et sodii chloridum, 107. et sodii chloruretum, 107. et sodii perchloruretum, 107. iodidum, 111. ioduretum, 111. murias, 104. nitromurias, 111. oxidum, 112. praeparata, 100. pulvis, 113. terchloridum, 104. teroxidum, 112. Aurico-nitricurrt murias, 107. Auri tercyanidum, 109. Auro-terchloride of sodium, 107. Aurum chloratum, 104. chloratum natronatum, 107. limatum, 113. metallicum, 113. muriaticum, 104, 107. muriaticum natronatum, 107. nitro-muriaticum, 111. oxydatum, 112. oxydulatum muriaticum, 104. salitum, 104. Bachelor's buttons, 463. Balaustier, 343. Ballota lanata, 114. Bandwurmwaldfarrn, 326. Bang, 148. Barii iodati hydras, 116. ALPHABETICAL CONTENTS. Xlll Barii iodidum, 116. Barium, iodide of, 116. Bark, resinous constituents of, 549. astringent, of Brazil, 210. Barosma crenata, 249. Baryt hydriodsaurer, 116. Baryta hydriodica, 116. hydriodate of, 116. Barytin, 589. Bebeeria, 117. Bebeerin, 117. Bebeerina, 117. Bebeerine, 117. Bee, 610. Beifiisswurzel, 93. gemeiner, 93. Benzoesaure, 17. Berberin, 120. Berberina, 120. Berberine, 120. Berberinum, 120. Bergerthran, 470. Berliner Blau,293. Betoine des Savoyards, 89. Biene, 610. Bignonenbaum, 121. Bignonia catalpa, 121. Bile, ox, 613. Bile, swine, 616. Bilis porcina, 616. Bilis taurina, 613. Biogamia, 342. Biomagnetismus, 342. Bisuiphuretum carbonii, 578. Bitter almonds, water of, 66. oil of, 66. Bittermandelwasser, 66. Blau, Berliner, 293. Pariser, 293. Blaud's pills, 320.. Blaus'aure, 22. Blausaures eisenoxydul zinkoxid, 602. quecksilber, 354. Blaustoffeisen, 293. Blaustoffgold, 109. Blaustoffkalium, 506. Blaustoffquecksilber, 354. Blaustoffsilber, 83. Blaustoffzink, 602. Ble cornu, 265. Bled avortfe, 265. farouche, 265. Blei hydriodsaures, 497. iodwasserstofisaures, 497. Bleichpulver, 136. Bleiiodid, 497. Bleitannat, 500. Bleu de Prusse, 293. Blue, Prussian, 293. Berlin, 293. Boccho, 249. Bocchoe, 249. Bole, Armenian, 87. Boletus albus, 122. laricis, 122. purgans, 122. Boocho, 249. Brayera anthelmintica, 123. Brechnuss, 463. BrechstofT, 261. Brom, 124. Brome, 124. Bromeisen, 288. Brometum ferricum, 288. hydrargyrosum, 353. Bromhydras potassae, 504. Bromidum potassii, 504. Bromin, 124. Bromina, 124. Bromine, 124. Bromineum, 124. Brominium, 124. Brominum, 124. Bromium, 124. Bromkalium, 504. Bromquecksilber, 353. in maximum, 353. Bromum, 124. Bromure de potassium, 504. Bromuretum kalii, 504. potassii, 504. Bromwasserstoffsaures eisenoxyd. kali, 504. Brucia, 128. Brucin, 128. Brucina, 128. Brucine, 128. Brush, galvanic, 341. metallic, 341. Buccubl'atter, 249. Buchu, 249. Buckeye, 351. Buckhu, 249. Bugbane, 178. Buranhem, 438. Caeruleum Beroliniense, 293. borussicum, 293. Cahincae radix, 130. (Jainana? radix, 130. Cainca root, 130. Caincoe acidum, 130. Caincawurzel, 130. Calcar, 265. Calcaria chlorata, 135. chloretum, 135. chlorica, 135. Calcariae chlorum, 135. Calcii oxychloruretum, 135. oxydi chloruretum, 135. proto-chloruretum, 135. Calcis bichloruretum, 135. cliloridum, 135. hypochloris, 135. oxymurias, 135. Calcium, oxide de, chlorure d', 135. protoxichlorure de, 135. XIV ALPHABETICAL CONTENTS. Calendula Alpina, 89. officinalis, 132. sativa, 132. Calendulin, 132. Caltha Alpina, 89. sativa, 132. Calx chlorinata, 135. oxymuriatica, 135. Ganinanai radix, 130. Cannabis indica, 147. Caper spurge, 285. Carovitulina tosta, 154. Carbo animalis, 154. carnis, 154. mineralis, 288. Carbon, chloride of, 612. sesqui-iodide of, 157. sesqui-ioduret of, 157. terchloride of, 612. Carboneum sulphuratum, 578. Carbonis chloridum, 612. sesqui-iqdidum, 157^ sesqui-ioduretum, 157. Carbonium iodatum, 157. Carbure de soufre, 578. Carburet of sulphur, 578. Carragaheen moss, 175. Carrageen moss, 175. Castanea equina, 351. pavina, 351. Catalpa, 121. arborea, 121. arborescens, 121. cordifolia, 121. tree, 121. ' Cataputia minor, 285. Catawba tree, 121. Catheterism of the Eustachian tube, 374. Cerussa nigra, 288. Cetrarin, 158. Cetrarina, 158. Cetrarine, 158. Cetrarinum, 158. Chanvre Indien, 147. Charbon animal, 154. Charcoal, animal, 154. Chaux, chlorate de, 135. chlorure de, 135. muriate suroxigene ou oxigene de, 135. oxichlorure de, 135. oximuriate de, 135. souschlorate de, 135. Chestnut, horse, 351. Chimaphila, 159. Chimophila, 159. Chinastoff, 521. Chinicus citras, 524. hydrochloricus, 528. Chinii acetas, 521. citras, 524. ferrocyanas, 525. hydrochloras, 528. murias, 528. Chinii nitras, 529. phosphas, 529. sulphas, 530. Chinin, 521. arsenigsaures, 523. arsenit, 523. citronensaures, 524. citronsaures, 524. eisenblausaures, 525. essigsaures, 522. gerbesaures, 548. gerbstoffsaures, 548. hydrochlorsaures, 528. iodwasserstoffsaures, 526. milchsaures, 527. phosphorsaures, 529. saltpetersaures, 529. salzsaures, 528. schwefelsaures, 530. sulphat, 530. tanninsaures, 548. valeriansaures, 546. zitronsaures, 524. Chinini acetas, 522. citras, 524. phosphas, 529. Chininum, 521. aceticum, 522. citricum, 524. lacticum, 527. resino-sulphuricum, 549. Chinioidine, 549. Chinium, 521. aceticum, 522. citricum, 524. ferro-cyanogenatum, 525. ferro-hydrocyanicum, 525. hydrochloricum, 528. muriaticum, 528. nitricum, 529. phosphoricum, 529. salitum, 528. sulphuricum, 530. tannicum, 548. Chinoidine, 549. Chiococcffi radix, 130. Chirayita, 343. Chiretta, 343. Chlor, 162. Chloras kalicus depuratus, 500. Chloras potassicus, 500. Chlorate de potasse, 500. Chlorblei, 624. Chlorcalcium oxyd,' 136. Chlore, 162. eau de, 169. liquide, 169. Chloretum auri, 104. cum chloreto natrii, 107. calcaris, 135. zinci, 596. Chlorfliissigkeit, 169. Chlorgas, 162. ALPHABETICAL CONTENTS. Chlorgold, 104. natricum, 107. saures, 104. Chlorgoldnatronium, 107. Chlorhydras morphicus, 453. quinicus, 528. Clilori aqua. 169. liquor, 169. Chloride of formyle, 612. of gold and sodium, 107. of soda, 555. of zinc, 596. Chlorine, 162. solution of, 169. Chlorini aqua, 169. Chlorinum, 162. Chlorkalk, 136. Chlornatron, 555. Chlornatrum, 555. Chloroform, 612. Chlorplatin, 496. Chlorsaures kali, 500. Chlorsilber, 80. Chlorsodaflussigkeit, 556.J Chlorum, 162. calcarise, 135. Chlorure d'argent, 80. de carbone, 612. d'or, 104. d'or et de sodium, 107. d'oxide de sodium, 555. de soude, 555. Chloruretum argenti, 80. argenti et ammonia?, 81. auri, 104. auri et sodii, 107. oxidi calcii, 135. oxidi sodii, 555. potassa? oxidatum, 500. zincicum, 596. Chlorwasser, 169. Chlor wasseriges, 169. Chlorzink, 582. Chondrus, 175. crispus, 175. polymorphus, 175. Christophskraut traubenfomiiges, 178. Chrysanthemum, 132. Churrus, 148. Cimicifuga, 178. Cinchonia, 180. iodide of, 526. Cinchonin, 180. Cinchonine, 18(1. Cinchonin um, 180. Citras chinicus, 524. quinicus, 524. Clavus secalinus, 265. siliginis, 265. Clou de seigle, 265. Codeia, 183. Codeine, 183. Codeinum, 183. Cod-liver oil, 470. Cohort, 178. Cohosh, 178. Colchicia, 188. Colchicum, 188. autumnale, 188. Colchique, 188. Compressio, 196. Compression, 196. methodical, 196. Contra-irritation, 203. Contre-irritation, 203. Corrigeen moss, 175. Cortex adstringens Brasiliensis, 210. Corylus rostrata, 212. Counter action, 203. Counter-imtant lotions, Granville's, ammoniated, 203. antidynous, 204. Gondret's, 203. Granville's, 204. Raspail's, 204. ? Counter-irritation, 203. Cravon noir, 238. Creasote, 212. Creosote, 212. Crocus martis aperiens, 323. Croton oil, 481. Crusadinha raiz, 130. Cubeba, 237. Cubeben, 237. Cubsbenpfeffer, 237. Cubebin, 238. Cubebs, 237. Cyanather, 59. Cyaneisen, 293. Cyaneisenzink, 602. Cyanetum kalii, 506. zinci, 602. zinci et ferri, 602. Cyangold, 109. Cyanhydras kalicus, 506. Cyanidum kalii, 506. potassii, 506. Cyankalium, 506. Cyanquecksilber, 354. Cyansilber, 83. Cyanure d'argent, 83. de mercure, 354. de potassium, 506. dezinc, 602. Cyanuret of ethule, 59. Cyanuretum ferrozincicum, 602. argenti, 83. potassicum, 506. zincicum, 602. zinci et ferro, 602. CyanwasserstofTsaures, 22. Cyanzink, 602. Delphia, 242. Delphin, 242. Delphina, 242. Delphinia, 242. XVI ALPHABETICA Delphinine, 242. Derosne's opiumsalz, 461. Digitalia, 245. Digitalin, 245. Digitalina, 245. Digitaline, 245. Digitalinum, 245. Diosma, 249. Diosmin, 249. Dogwood, Jamaica, 623. Donovan's solution, 366. Doronic d'Allemagne, 89. Doronicum Germanicum, 89. plantaginis folio, 89. Druck, 196. Duftstrauchbl'atter, 249. Eau d'amandes ameres, 66. de Binelli, 68. de Brocchieri, 70. de chlore, 169. de goudron, 75. de Javelle, 555. m^dicinale d'Husson, 191. styptique de Brocchieri, 70. Eisenblausaures, 293. Eisenbromid, 288. Eisencyaniircyanid, 293. Eiseniodiir, 297. Eisenkohlensaures, 323. Eisenoxyd, braunes, 323. eisenblausaures, 293. iodwasserstoffsaures, 297. kohlensaures, 223. milchsaures, 306. Eisenoxydhydrat, 310. Eisenoxydul arsensaures, 286. arseniksaures, 286. blausaures, 293. citronsaures, 291. hydriodsaures, 297. kohlensaures, 318, 323. Eisenpraparate, 186. Eisenzink blausaures, 602. Electricitas. See Galvanismus. animalis, 337. galvanica seu metallica, 337. Electricity, magnetic, 251. Electro-magnetism, 251. Electro-magnetismus, 251. Electropunctura, 256. Electropuncturation, 256. Elixir of opium, M'Munn's, 456. Emeta, 261. Emetia, 261. Emetina, 261. Emetium, 261. Emetine of the violet, 262. indigenous, 262. Ergot, 265. Ergota, 265. Ergotin, 282. _ Ether, acetic, injections of, into the Eusta- chian tube, 374. lL CONTENTS. Ether, chloric, 612. hydrocyanic, 59. prussic, 59. pyroacetic, 558. Etherine, hydrocyanate of, 59. Eupatorium huaco, 348. Euphorbia lathyris, 285. Exoneurism, 342. Extract, alcoholic, of nux vomica, 463. Extractum nucis vomica? alcohoUcum, 463. opii aceticum, 452. Extrait alcoholique de noix vomique, 463. savonneux de l'urine, 584. Extrakt geistiges der Krahenaugen, 463. Fallkraut, 89. Farrenkraut, 326. mannlein, 326. m'annliches, 326. Fel bovinum, 613. bovis, 613. tauri, 613. Fer, arseniate de, 286. bromure de, 288. carbure de, 288. ci*ratede, 291. cyanure de, 223. hydrate, deutocyanure de, 288. hydriodate de, 297. iodure de, 297. lactate de, 306. nitrate de, 309. preparations de, 186. protocarbonate de, 318. proto-iodure de, 297. souscarbonate de, 323. tritohydrocyanate ferrure de, 293. trito-hydroferro-cyanate de, 293. Fern, male, 326. shield, male, 326. Ferri arsenias, 286. borussias, 293. bromidum, 288. carbonas, 318, 323. carbonas pracipitatus, 323. carbonas saccharatum, 319. carburetum, 288. carburetum nativum, 288. citras, 291. cyanuretum, 293. deuto-carbonas fuscus, 323. et quinia? citras, 293. ferrocyanuretum, 293. ferrosesquicyanidum, 293. hydriodas, 297. hydrobromas, 288. iodidum, 297. ioduretum, 5897. lactas, 306. nitras, 309. nitratis liquor, 309. nitrici oxydati liquor, 309. oxydi ferrocyanas, 293. oxydulatum hydrocyanicum, 293. ALPHABETICAL CONTENTS. xvii Ferri oxydum fuscum, 323. oxydum hydratum, 310. oxydum rubrum, 323. percyanidum, 293. persesquinitratis liquor, 309. praparata, 286. protocarbonas, 318. prussias, 293. sesquicyanidum, 293. sesquioxydum, 310, 323. subcarbonas, 323. Ferrugo, 310. Ferrum arseniatum, 286. arsenicum oxydulatum, 286. borussicum, 293. bromatum, 288. carbonatum, 318, 323. carbonatum praecipitatum, 323. carbonicum oxydulatum, 323. carbonicum saccharatum, 319. carburetum, 288. cyanogenatum, 293. cyanuretum, 293. hydriodatum, 297. hydrobromicum oxydatum, 288. hydroiodicum oxydulatum, 297. iodatum, 297. nitratum, 309. nitricum oxydatum, 309. oxydatum hydratum, 310. oxydulatum hydrocyanicum, 293. oxydum hydricum, 310. supercarburetum, 288. zooticum, 293. Fiel de Bceuf, 613. Filix mas, 326. Fleischkohle, 154. Flores Benzoes, 17. Benzoini, 17. Flowers of Benjamin, 17. Fougere male, 326. Fucus amylaceus, 328. crispus, 175. lslandicus, 175. Fuligo, 330. fornacum, 330. ligni, 330. splendens, 330. Fuligokali, 334. Fumigatio muriatico-oxygenata, 162. Fumigation de chlor, 162. de Guy ton, 162. Guytonienne, 162. hygienique, 162. Fumigations, Guyton-Morveau, 168. Fungus of the larch, 122. laricis, 122. Galeopsis grandiflora, 335. ochroleuca, 335. prostrata, 335. segetum, 335. versicolor, 336. villosa, 336. Gall, ox, 613. swine, 613. Galluss'aure, 20. Galvanic brush, 341. plates, 338. suppository, 342. Galvanism, 337. Galvanopuncture, 256. Gebarpulver, 265. Gegenreizung, 203. Gentiana chirayita, 343. Gerbsaiire, 38. Gerbestofr; 38. Gerbestoffblei, 500. Gichtthran, 470. Glanzruss, 330. Glycerin, 616. Glycerina, 616. Glyzerin, 616. Goharem, 438. Gold and soda, hydrochlorate of, 107. muriate of, 107. and sodium,"chloride of, 107. chlorid, 104. chlorid, saures, 104. chloride of, 104. cyanide of 109. cyanuret of, 109. iodide of, 111. ioduret of, 111. krystalle, 104. metallic, 113. metallisches, 113. muriate of, 104. natrium-chlorid, 107. natrumchlorid, 107. natrum, salzaures, 107. nitro-muriate of, 111. oxyd, blausaures, 109. oxyd, hydrochlorsaures, 104. oxide of, 112. oxydirtes, 112. oxydiil, salzaures, 104. oxynatrium, salzsaures, 107. peroxide of, 112. praparate, 100. preparations of, 100. pulver, 113. saltpetersalzsaures. 111. salz, Figuiers, 107. salzsaures, 104. sodahaltiges, salzaures, 107. terchloride of, 104. tercyanide of, 109. Gondret's counter-irritants, 203. Granatin, 344, 430. Granatum, 343. Granatwurzelrinde, 343. Granati radicis cortex, 343. Granville's counter-irritants, 204. ' Graphites, 288. Green, winter, 159. Grenadier, 343. B XV111 ALPHABETICAL CONTENTS. Grenadin, 344, 430. Guaco, 348. Guarana, 489. Gunjah, 147. Hachisch, 147. Haemospasia, 617. Haemostasis, 618. Hagenia Abyssinica, 620. Hahnensporn, 265. Haloidum oxygenatum, 500. Hanf, 147. Hanfhessel grossblumigte, 335. Harnstoff, 584. Hazel, beaked, 212. Hemospasie, 617. Hemostasie, 618. Hemp, Indian, 147. Henricea pharmacearcha, 343. Herba sideriditis, 335. Herbe a pisser, 159. Herbe Saint Christophe, 178. Herbstblume, 188. Herbstzeitlose, 188. Hippocastanum, 351. Hohlzahns, grossbliithigen, 335. Holzessig, 13. Holzsaure, 13. brenzliche oder brandige,l3. Honeybee, 610. Honigbiene, 610. Hornblei, 624. Homseed, 265. Homsilber, 80. Horse chestnut, 351. Huaco, 348. Huile de foi de poisson, 470. de morue, 470. de pignon d'Inde, 481. volatile de moutarde, 479. Hundsnessel, gelbe oder grossbluthige, 335. Hydrargyri bibromidum, 353. bicyanidum, 354. biiodatum, 362. borussias, 354. bromidum, 353. cyanetum, 354. cyanidum, 354. cyanuretum, 354. deuto-bromidum, 353. deuto-ioduretum, 362. et arsenici iodidum, 366. et quinia? proto-chloridum, 620. hydrocyanas, 354. iodidulatum, 358. iodidum, 358. rubrum, 352. perbromidum, 353. periodidum, 362. pra?parata, 353. protobromidum, 353. proto-iodidum, 358. proto-ioduretum, 358. prusslas, 354. Hy drargy rum biiodatum,cum kalio iodato,510 Hydrargyrum biniodidum, 362. borussicum, 354. bromatum, 353. cyanetum, 354. cyanogenatum, 353. hydrocyanicum, 354. iodatum, 358. flavum, 358. rubrum, 362. iodidum, 358. iodidulatum, 358. perbromatum, 353. periodatum, 362. zooticum, 354. Hydras ferricus, 310. Hydriodas kalicus, 513. lixivia?, 513. Hydriodate of ammonia, 421. of potassa, 513. Hydriodic acid, liquid, 418. Hydrobromsaures kali, 504. Hydrochloras morphicus, 453. chinicus, 528. Hydrocyanas kalicus, 506. Hydrocyanate of etherine, 59. Hydrocyanicus a?ther, 59. Hydrocyans'aure, 22. Hypochloris sodicus aqua solutus, 556. Indicum, 369. Indicus color, 369. Indig, 369. Indigo, 369. Indigum, 369. Infusum picis liquidae, 75. picis empyreumatica? liquidae, 75. Injections of air, &c into the Eustachian tube, 374. lod, 380. Iodarsen, 91. Iodarsenik, 91. Iodatum hydrargyrosum, 358. Iodbaryum, 116. lodblei, 497. lode, 380. Iodeisen, 297. Iodetum zinci, 605. Iodgold, 111. lodhydras kalicus seu potassa?, 513. lodhydrargyrate of ioduret of potassium, 510. Iodide of ammonium, 421. of arsenic, 91. of carbon, 157. of potassium, 513. of quinia, 526. of silver, 84. of starch, 121. of sulphur, 582. of zinc, 605. Iodidum ammonii, 421. amyli, 421. argenti, 84. arsenici, 84. baryi, 116. carbonis, 157. ALPHABETICAL CONTENTS. XIX Iodidum hydrargyricum, 362. hydrargyrosum, 358. plumbi, 497. potassii, 497. quinia?, 526. Iodine, 380. Iodinum, 380. Iodinschwefel, 582. Iodium, 380. Iodkalium, 513. lodkohlenstoff, 157. Iodoforms, 422. lodohydrargyrate of potassium, 510. of ioduret of potassium, 510- lodquecksilber doppeltes, 362. gelbes, 358. in maximum, 362. in minimum des iods, 358. rothes, 362. Iodschwefel, 582. Iodsilber, 84. Iodst'arke, 421. lodst'arkmehl, 421. lodura, 380. Iodure d'amidon, 421. de carbon, 157. de potassium, 513. de soufre, 582. Ioduret of quinia, 526. of silver, 84. of sulphur, 582. Ioduretum ammonii, 421. amyli, 421. arsenici, 91. ' argenti, 84. carbonii, 157. hydrargyrosum, 358. potassicum, 513. IodwasserstofFsaures eisenoxydul, 297. Iron, ammonio-citrate of, 291. and quinia, citrate of, 293. arseniate of, 286. bromated, or bromide of, 288. carbonate of, 318. carburet of, 288. citrate of, 291. cyanuret of, 293. hydriodate of, 297. hydrobromate of, 288. hydro-oxide of, 310. iodated, 297. iodide of, 297. ioduret of, 297. lactate of, 306. nitrate of, solution of, 309. oxide of, hydrated, 310. oxyhydrate of, 310. peroxide of, 318. peroxide of, hydrated, 310. persesquinitrate of, solution of, 310. potassio-citrate of, 291. preparations of, 286. proto carbonate of, 318. proto-iodide of, 297. Iron, proto ioduret of, 297. protoxide of, hydriodate of, 297. protoxide of, lactate of, 306. prussiate of, 293. sesquioxide of, 323. sesquioxide of, hydrated, 310. sodio-citrate of, 291. subcarbonate of; 323. tritoxide of, hydrated, 310. Irritamentum metallorum seu metallicum, 337. Johanniswurzel, 326. Juglans regia, 423. Kabliauthran, 470. Kahinca? radix, 130. Kali bromwasserstofFsaures, 504. chloricum, 500. chlorsaures, 500. elainicum, 553. hydriodicum, 513. hydriodsaures, 513. hydrobromicum, 504. hydrocyanicum, 506. hydroiodat, 513. hydroiodinicum, 513. hyperoxygenirt salzsaures, 500. iodwasserstoffsaures, 513. iodatum hydrargyratum, 510. muriaticum hyperoxygenatum, 500. olsaures, 553. oxydirt, salzsaures, 500. % oxymuriatjgum, 500. salpetersaures, 624. Kalii cyanuretum, 506. cyanetum, 506. cyanidum, 506. iodidum, 513. Kaliseife, 553. Kalium bromatum, 504. bromid, 504. bromiir, 504. cyanogenatum, 506. cyaniir, 506. iodatum, 513. iodiir, 513. Kalk, chlorigsaures, 136. oxydirt salzsaures, 136. Kalkchlorid, 136. Kaminruss, 330. Katalpa, 121. Katzermaul, 335. Kinine, 521. Kinini citras, 524. Kininum, 521. Knorpeltang, krauses, 175. Kodein, 183. Kohle rnineralische, 288. thierische, 154. Kohlenschwefel, fliissiger, 578. Kohlenstofichlorid, 612. Kohlenstoffeisen, 288. Kohlensulfurid, 578. Kosso, 620. Kr'ahenaugen, 463. XX ALPHABETICAL CONTENTS. Krahenaugen bitter, 561. geistiges extrakt der, 463. stoff, 561. Krauser Tang, 175. Kreasot, 212. Kreasote, 212. Kreasoton, 212. Kreasotum, 212. Kreosote, 212. Krotonbl, 481. Kubebenpfeffer, 237. Kubebin, 238. Labarraque's disinfecting liquid, 146, 555. Lactucarium, 424. Lathyris, 285. Lattichopium, 424. Lattigbitter, 424. Lattigmilchsaft, 424. Lead, black, 288. chloride of, 624. iodide of, 497. ioduret of, 497. tannate of, 500. Leberthran, 470. Leonurus lanata, 114. Leopard's bane, 89. Lerschenschwamm, 122. Lettuce opium, 424. Lichen carrageen, 175. Lime, chloride of, 135. chlorinated, 135. chlorite of, 135. ? chloruret of, 135. hypochlorite of, 135. oxymuriate of, 135. Liqueur desinfectante de Labarraque, 146, 555. Liquid, disinfecting, Labarraque's, 146, 555. Liquor acidi muriatici oxygenati, 169. alexiterius oxygenatus, 169. argenti muriatico-ammoniata, 82. chlori, 169. disinfecting, of Labarraque, 146. ferri iodidi, 300. ferri nitratis, 309. ferri nitrici oxydati, 309. ferri persesquinitratis, 309. hydrargyri et arsenici iodidi, 366. hydrodatis arsenici et hydrargyri, 366. morphia? citratis, 455. natri chloreti, 556. opii, 452. opii sedativus, 452. soda? chloridi, 556. chlorinata?, 556. Lithia, carbonate of, 621. Lithia? carbonas, 621. Limine, carbonate de, 621. Lithium, kohlensaures, 621. Macrotrys racemosa, 178. Magnes, 427. Magnet, 427. Magnetes, 427. Magnetic electricity, 251. Magnetism, animal, 342. Magnetstein, 427. Malambo, 431. Malogranatum, 343. Manganese, sulphate of, 621. Manganesii sulphas, 621. Manganoxydul, schwefelsaures, 621. Manganum sulphuricum oxydulatum, 621. Mannastoff, 429. Mannazucker, 429. Mannite, 429. Mannitum, 429. Mannleinwurmtupfelfarrn, 326. Marigold, garden, 132. single, 132. Marronier, 351. d'Inde, 351. Matias, 431. Matico, 432. Matiere de Derosne, 461. vomitive, 261. Matter of Derosne, 461. Melambo, 431. Mercure, cyanure de, 354. deuto-iodure de, 362. hydrocyanate de, 354. periodure de, 362. preparations de, 353. protoiodure de, 358. prussiate de, 354. Mercury and arsenic, hydriodate of, 366. iodide of, 366. and morphia, iodide of, double, 369. bicyanide of, 354. biniodide of, 354. bromide of, 535. cyanide of, 354. deutoiodide of, 362. hydrocyanate of, 354. iodide of, 358. iodide of, red, 362. iodoarsenite of, 366. periodide of, 362. preparations of, 353. protoiodide of, 353. proto-ioduret of, 358. prussiate of, 354. Mere de Seigle, 265. Mesitylene, bihydrate of, 558. Mesmerism, 342. Milchsaure, 36. Mixture, Scudamore's, 195. Mohnstor? 442. Moleplant, 285. Monesia, 438. Monesin, 438. Moosbitter, 158. Moos, carragaheen, 175. Moos, lriandisch, 175. Morphei acetas, 442. Morpheum, 442. Morphia, 442. ALPHABETICAL CONTENTS. XXI Morphia, acetate of, 449. [ "jand codeia, muriate of, 436. bimeconate of, 455. hydriodate of, 452. iodhydrate of, 452. iodide of iodhydrate of, 452. ioduret of, 452. muriate of, 453. salts of, 442. sulphate of, 454. Morphia? acetas, 449. hydriodas, 452. Morphii murias, 453. sulphas, 454. Morphin, 442. essigsaures, 449. iodwasserstofBaures, 452. salzsaures, 453. schwefelsaures, 454. Morphina, 442. Morphina? acetas, 449. bimeconas, 455. hydrochloras, 453. murias, 453. sulphas, 454. tartras, 455. Morphine, 442. acetate of, 449. and zinc, double iodide of, 606. bimeconate of, 455. citrate of, 455. et codeine, double muriate de, 456. hydriodate de, 452. hydrochlorate de, 453. iodhydrate de, 452. muriate of, 453. sels de, 442. sulphate of, 454. tartrate of, 455. Morphinsalze, 442. Morphinum, 442. Morphium, 442. acetat, 442. aceticum, 442. muriaticum, 453. sulphuricum, 454. Mort aux chiens, 188. Moss, carrageen, 175. Ceylon, 328. corrigeen, 175. Irish, 175. marine, 328. Mousse d'lrlande, 175. perlee, 175. Moxa, 456. Moxiburium, 456. Moxibustion, 456. Mugwort, 93. Murias aurico-nitricum, 107. Muriate d'or, 104. Murid, 124. Muride, 124. Murigene, 162. Murin, 124. Murine, 124. Mustardseed oil, 479. Mutterkorn, 265. Nadelstich, 50. Naphtha, 558. phosphorata, 468. wood, 558. Naphthalin, 623. Naphthaline, 623. Narcotina, 461. muriate of, 461. Narda celtica altera, 89. Narkotin, 461. Natron phosphorsaures, 627. Natronwasser, oxydirt salzsaures, 556. Natrium-gold-chlorid, 107. Natrum chloratum, 555. chloricum, 555. chlorsaures, 555. oxydirt oder hyperoxygenirt salzsaures. 555. oxymuriaticum, 555. Nephrine, 584. Nephrodium filix mas, 326. Neurogamia, 342. Nierenfarrn, mannliches, 326. NiesswurzstofF, 586. Nitras ferricus, 309. Nitre, 624. Nitro-muriatic mixture, 167. Noix vomique, 463. extrait alcoolique de, 463. Noyer, 423. Nux vomica, 463. alcoholic extract of, 463. Ochsengalle, 613. Ofenruss, 330. Oil of bitter almonds, 67. cod, 470. codliver, 470. croton, 481. of mustard seed, 479. Oleum aethereum riorum arnica?, 90. a?thereum seminum sinapis, 479. crotonis, 481. euphorbia? lathyridis, 285. jecoris aselli, 470. morrhua?, 476. ricini officinale, 485. seminis crotonis, 481. sinapis, 479. tiglii,481. volatile seminum sinapis, 479. Opiane, 461. Opium, alkaloid, 442. lettuce, 424. Opiumsalz, Derosne's, 461. Or, chlorure d', 104. cyanure d', 109. divise, 113. XXU ALPHABETICAL CONTENTS. Or et de sodium, chlorure d', 107. et soude, hydrochlorate d', 107. et soude muriate d', 107. metallique, 113. muriate d', 104. nitromuriate d', 111. oxide d', 112. preparations d', 100. protoiodure d', 111. Oxide d'argent, 85. Oxidum ferricum hydratum, 310. Oxydirtes silber, 85. Oxydirt-salzsaures Natronwasser, 555. Oxydum argenti, 85. Panacea lapsorum, 89. Papaverine, 442. Fariser blau, 293. Paullinia, 489. Perlmoos, Irlandisch, 175 PfeffcrstofT, 492. Phloiorrhizina, 490. Phloridzin, 490. Pierre d'aimant, 427. Pigmentum Indicum, 369. Pills, Blaud's, 320. ferruginous, of Vallet, 319. Piper angustifolium, 432. caudatum, 237. cubeba, 237. Piperin, 238,492. Piperina, 492. Pipsissewa, 459. Piscidia erythrina, 623. Platina, bichloride of, 496. perchloride of, 496. preparations of, 495. Platinchlorid, 496. Platine, bichlorure de, 496. et sodium, chlorure double de, 497. perchlorure de, 496. preparations de, 495. Platini bichloridum, 496. perchloridum, 496. praeparata, 495. Platinpraparate, 495. Platinum, 495. Platinum and sodium, double chloride of, 497. Plomb, chlorure de, 624. iodure de, 497. tannate de, 500. Plombagine, 288. Plumbago, 288. Plumbi chloridum, 624. hydriodas, 497. iodhydras, 497. iodidum, 497. ioduretum, 497. tannas, 500. Plumbum iodatum, 497. hydroiodicum, 497. nigrum, 288. scytodepsicum, 500. Plumbum tannicum, 500. Pneumokatharterion, 445. Poison nut, 463. Poivre a queue, 237. Polypodium filix mas, 326. Polyporus officinalis, 122. Pomegranate, 343. Potass, arsenite of, 91. chlorate of, 500. hydrocyanate of, 506. hydriodate of, 513. ioduretted, 513. hydrobromate of, 504. ■ hyperoxymuriate of, 500. nitrate of, 624. oxymuriate of, 500. Potassa? bromhydras, 504. chloras, 500. cyanhydras, 506. euchloras, 500. hydriodas, 498. hydrobromas, 504. hydrocyanas, 506. murias hyperoxygenatum, 500. murias oxygenatum, 500. nitras, 624. Potasse, bromure de, 504. chlorate de, 500. hydriodate de, 513. iodure de, 513. nitrate de, 624. Potassii bromidum, 504. cyanidum, 506. cyanuretum, 506. hydrargyro-iodidum, 510. iodidum, 513. iodohydrargyras, 510. ioduretum. 513. oxygeno-chloruretum, 500. proto hydriodas, 513. protoxidi hydriodas, 513. Potassium, bromide of, 504. cyanide of, 506. cyanuret of, 506. dihydrargyro-biniodide of, 510. hydrargyro iodide of, 510. iodide of, 513. iodohydrargyrate of, 510. ioduiet of iodohydrargyrate of, 510. ioduret of, 513. protoxide of, chlorate of, 500. Potio picea, 75. Poudre de blanchement, 135. de Tennant, 135. Powder, bleaching, Tennant's, 135. Preta raiz, 130. Principium adstringens, 38. scytodephicum, 38. Prussiate de potasse et de fer, 293. Pseudoangasturinum, 128. Ptarmica montana, 89. Pulvis ad fumigationes muriaticas, 162. Punica granatum, 343. ALPHABETICAL CONTENTS. XX111 Pyrola umbellata, 159. Pyrola corymbosa, 158. Pyrole en ombelle, 159. V Quecksilber blausaures, 354. bromid, 353. bromur, 353. cyanid, 354. deuto-bromiir, 353. deuto-iodur, 362. deuto-iodur des, 362. iodid, 358, 362. iodid, gelbes, 358. iodidul, 358. oxyd, blausaures, 354. praparate, 353. proto-iodiir des, 358. Quecksilbers, proto-bromure des, 353. Quillaia, 438. Quina, 521, see Quinia?. acetica, 522. citrica, 524. Quinia, 521, (for its salts, see Quinine.) Quinia? acetas, 522. arsenias, 523. citras, 524. ferrocyanas, 325. hydriodas, 526. iodidum, 526. lactas, 527. murias, 528. nitras, 529. phosphas, 529. sulphas, 530. impurus, 549. valerianas, 546. Quinin, 521. Quinina, see Quinine. Quinine, 521. acetate of, 522. amorphous, 550. brute, 559. citrate of,' 524. disulphate of, 530. extract of, 549. ferrocyanuret of, 525. hydriodate of, 526. iodide of, 526. iodide of iodhydrate of, 527. lactate of, 527. muriate of, 528. nitrate of, 529. phosphate of, 529. sulphate, 533. valerianate of, 546. and cinchonine, tannate of, 548. Quininum, 521. Quiniodine, 549. Quinium, 521. Raiz crusadinha, 130. preta, 130. Reissblei, 288. Resin a china? pra?parata, 536, 549. Rindsgalle, 613. Ringelblume, 132. Rosscastanien, 351. Russ, 330. Russkali, 334. Rye, corned, 265. spurred, 265. Sabadillina, 589. Saccharum manna?, 429. Safran batard, 178. de mars aperitif, 323. des pres, 188. wilder, 188. Saffron meadow, 188. Saint Christophe, herbe, 178. Sal essentiale corticis Peruviani, 521. Salicina, 550. Salicinum, 550. Salpetersaure, 609. Salt of Derosne, 461. Salzsaure, dephlogistisirte oder oxydirte, 169. iibersaure, 169. Salzsaures silberammonium, 81. Sapo domesticus mollis,' 553. ex oleo et potassa confectus, 553. elainicus, 553. kalicus, 553. mollis, 553. niger, 553. viridis, 553. Satzmehliodtir, 421. Savon a base de potasse, 553. mou, 553. noir, 553. Schmierseife, 553. griine, 553. Schwanzpfeffer, 237. Schwarzkorn, 265. Schwefelalcohol, 578. Schwefeliodiir, 582. Schwefelkohlenstoff, 578. Schwererde, iodwasserstoflsaure, 116. Schwindelkorner, 237. Scorodite, 286. Scudamore's mixture, 195. Secale clavatum, 265. cornutum, 265. luxurians, 265. Secalis cerealis, semina monstrosa, 265. mater, 265. Seemoos, Irlandisch, 175. geperltes, 175. Seetang, 175. Seife, kali, 553. schwarz, 553. Seigle, cornu ou corrompu, 265. §. eperon, 265. ivre, 265. noir, 265. ergote, 265. faux, 265. Sel de Derosne, 461. de Gregory, 456. essentiel d'opium, 461. XXIV ALPHABETICAL CONTENTS. Senfol, atherisches, 479. Serpentaria? Braziliensis radix, 130. Sidhee, 148. Silberammonium salzsaures, 81. chloriir, 80. oxyd, 85. oxydirtes, 85. praparate, 78. salmiak, 81. salzsaures, 80. zertheiltes, 87, Silver, ammonio-chloride of, 81. chloride of, 80. chloruret of, 80. cyanide of, 83. cyanuret of, 83. iodide of, 84. ioduret of, 84. metallic, 87. muriate of, 80. and ammonia, chloride of, 81. chloruret of, 8|. preparations of, 78. Sinapis oleum, 479. Sipeerine, 118. Snake root, black, 178. Soap, soft, 553. Soda, arseniate of, 91. chlorinata, 555. chloruret of, 555. chlorite of, 555. hypochlorite of, 555. hyposulphite of, 627. phosphate of, 627. Soda? chloridum, 555. chloruretum, 555. hyposulphis, 627. oxymurias, 555. phosphas, 627. Sodii auro-terchloridum, 107. chloroplatinas, 497. Sodium, auro-terchloride of, 107. chloroplatinate of, 497. chlorure d'oxide de, 555. Soldier's weed, 432. Solutio alexiteria oxygenata, 169. chlorinii, 169. ferri nitratis, 309. Solution of chlorine, 169. •> Coindet's, 515. de Pearson, 91. Donovan's, 366. Fowler's, 91. Lugol's, 516. of nitrate of iron, 309. of persesquinitrate of iron, 309. Soot, 330. Souci, 132. ordinaire, 132. Soude, chlorure de, 555. hyposulfite de, 626. phosphate de, 627. sulfite sulfure de, 626. Soufre carbure, 578. iodure, 582. Species pro vaporibus superoxydi muriatici, Sphaerococcus crispus, 175. Spiegelruss, 330. Spinnblume, 188. Spirit, pyro-acetic, 558. Spiritus pyro-aceticus, 558. salis marini depbJogisticatus, 162. Sponsa solis, 132. Spur, the, 265. Spurge, caper, 285. garden, 285. Starch, iodide of, 422. Starkmehliodiir, 422. Stinkstoff, 124. Stockfisch leberthran, 470. Stockung des Blutes in der Gef assen, 418. Strychna, 561. Strychnia, 561. acetate oi, 574. hydriodate of, 575. iodate of, 574. iodide of iodhydrate of, 575. nitrate of, 576. sulphate of, 577. Strychnia and zinc, double iodide of, 576. Strychnin, 561. ace tat, 574. essigsaures, 574. iodsaures, 574. iodwasserstoffsaures, 575. nitrat, 576. salpetersaures, 576. schwefelsaures, 577. sulphat, 577. Strychnine, see Strychnia. Strychninum, 561. aceticum, 574. iodicum, 574. nitricum, 576. sulphuricum, 577. Strychnium, 561. Subjee, 148. Suffitus chlorini, 162. oxymuriaticus, 162. Sugar of manna, 429. Suie, 330. Sulfure de carbon, 578. Sulphas manganosus, 621. " morphicus, 454. quinicus, 530. Sulphur, iodide of, 582. Sulphuret of carbon, 578. Sulphuretum carbonii, 578. Sulphuris carburetum, 578. iodidum, 582. ioduretum, 582. Suppository, galvanic, 342. Swertia chirayita, 343. Tabac de Montagne, 89. des Savoyards, 89. ALPHABETICAL CONTENTS. XXV Tabac des Vosges, 89. Tang krauser, 175. Tannas chinii seu cinchonicus seu quinicus, 548. H plumbi, 500. Tannic acid, 38. Tannin, 38. Tanninum, 38. Tar water, 75. Tellurismus, 342. Terra aluminis, 87. aluminosa pura, 87. argillacea pura, 87. bolaris, 87. sigillata, 87. The de seigle noirci des sages-femmes Ame- ricaines, 279. Theerwasser, 75. Thierkohle, 154. Thonerde, reine, 87. Thonerdensalze, 60. Thridace, 424. Tithymalus latifolius, 285. Todtenblume, 132. Tue-chien, 188. Ulva crispa, 175. Urea, 584. Uree, 584. Uricum, 584. Ustilago, 265. Vallet's ferruginous pills, 319. Vauquelin, 56J. Veratria, 586. sulphate of, 596. Veratrin, 586. Veratrina, 586. Veratrium, 586. Verrucaria, 132. Vieillotte, 188. Vinaigre de bois, 13. Violine, 261. Voltaism, 337. Vomicina, 128. Vomic nut, 463. Wallnussbaum, 423. Walnut tree, 423. Wasser, Binellisches, 68. Brocchierisches, 70. oxydirt salzsaures, 169. Wasserstoffblaus'aure, 22. Water, Binelli, 70. of bitter almonds, 66. Brocchieri, 70. tar, 75. Weed, soldier's, 432. Weidenbitter, 550. Weidenstoff, 250. Weisensafran, 188. Winter green, 159. Wintergriin, 159. holdenbliithigen, 159. Wohlverlei, 89. Wohlverleiol, 90. Wolfetrapp wolliger, 114. Woodsoot, 330. Yerba del Soldada, 432. Zeitlose, 188. Zinc and morphia, double iodide of, 606. and strychnia, double iodide of, 576. butter of, 596. chloride of, 596. cyanuret of, 602. ferrocyanuret of, 602. ferrohydrocyanate of, 602. hydrochlorate of, 60$. hydrocyanate of, 602. iodide of, 605. muriate of, 596. prussiate of, 596. Zinci butyrum, 596. chloridum, 596. chloruretum, 596. cyanhydras, 602. cyanidum, 602. cyanuretum, 602. ferrocyanuretum, 602. ferrohydrocyanas, 602. iodidum, 605. ioduretum, 605. valerianas, 606. Zincum borussicum, 602. chloratum, 576. cyanogenatum, 602. ferrohydrocyanicum, 602. hydrocyanicum, 602. iodatum, 605. muriaticum oxydatum, 596. salitum, 596. zooticum, 602. Zinkbutter, 596. Zinkchlorid, 596. Zinkchloriir, 596. Zinkcyaniir, 602. Zinkeisenblausaures, 602. Zinkeisencyaniir, 602. Zinkiodiir, 605. Zinkoxyd eisenoxydul blausaures, 602. salzsaures, 596. valeriansaures, 606. Zinkoxydul blausaures, 602. Zoomagnetismus, 342. C NEW REMEDIES. I. ACIDUM ACETICUM EMPYREUMAT'ICUM. Synonymes. Acidum pyro-aceticum, A. Ligni pyro-oleosum, A. pyrolig- nosura, Acetum ligneum, Pyroligneous. and Pyrolignic acid. French. Acide pyro-acetique, A. pyrolignique, A. pyroligneux, Vinaigre de bois. German. Brenzliche oder brandige Holzsaure; Holzsaure; Holzessig. 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 em- balmed 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.t The virtues of pyroligneous acid are often also referred to by Boerhaave.| METHOD OF PREPARING. 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 farmed during distillation. If the distillation be continued, more empyreumatic oil passes over, and lastly tar. The chief constituent of pyroligneous acid is vinegar, which can be deprived of its empyreumatic constituents by rectification with fine porous animal charcoal. Besides vinegar, it contains 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.) Reichenbach discovered in it the new substance, creasote,§ which seems to be the most important ingredient, its medicinal efficacy appearing to be dependent upon that substance. * Hist. Nat. xxxiv. 11. » t De Simpl. Medic. Facult lib. vii. See Cormack on Creosote, p. 59. Edinburgh, 1836; or the American edit, in Dunglison's American Medical Library. \ Riecke, Die neuern Arzneimittel. u. s. w. S. 6. Stuttgart, 1837. § See the article Creasote. 2 14 ACIDUM ACETICUM EMPrREUMATlCUM. 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 aceticum empyreumati- cum rectificatum. This differs from the impure pyroligneous acid in containing less empyreumatic resin and extract, and crea- sote. The London College, 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 pyroligneous acid in large doses occasions vomiting of a considerable quantity of frothy fluid, having a strong odour of the acid; tremors of the limbs, convulsions, tetanus, protrusion of the eyes, insensibility, paralysis of the limbs, dys- pnoea, croupy cough, hoarseness, &c. The death of the animal supervenes with symptoms of suffocation, and the fatal termina- tion is often rapidly induced. Inspection after death exhibits manifest venous congestion in the brain, spinal marrow, lungs,N liver, and spleen, and in the right side of the heart,—with, at times inflammation of the stomach. According to Berres, it occasions marked narcolic 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 decided effect upon the vascular system. In smaller doses, it is said to produce a sensa- tion 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 pro- perties.* As an antiseptic, its efficacy is undoubted, and this has been long known. Creasote is, doubtless, a main agent in producing this result; and wherever the administration of creasote is indicated, the use of pyroligneous acid may be proper. EFFECTS ON THE ECONOMY IN DISEASE. Possessed of the properties described above, 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 pro- duced by caries—the acid being dropped upon cotton and applied to the hollow tooth. In most of these cases, it was generally ex- * Richter's Specielle Therapie, S. 255. Berlin, 1828. ACIDUM ACETICUM EMPTREUMATICUM. l5 hibited both internally and externally. Numerous experiments have been made with it in various affections by different ob- servers; but its use has been more especially extolled in cases of gangrene, in which it corrects foetor, and promotes the sepa- ration 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, mixed with white of egg, in excoriated nipples,\ in cancerous and scrophulous affections, in cancrum oris, in caries of the bones, and as a gargle in scarlet fever. It has, moreover, been recommend- ed 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;f in phthisis by Harless, and in dropsy, diarrhoea, putrid nervous fevers, &c, by Ampach;** yet, as was before remarked, it is rarely em- ployed internally; indeed, both externally and internally, it has been greatly supplanted 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. Externally, it is applied both in a pure and dilute state; in 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. * Dr. T. Y. Simons, in American Journal of the Medical Sciences, vol. v. t Riecke, Op. cit. S. 9. I Dr. Bursharat, in Gazette Medicale, and Amer. Journ. of the Medical Sciences, Feb. 1833, p. 503. § Illustrations of Acoustic Surgery, Lond. 1825. || Med. Chirurg. Zeitung, No. 7, 1825. T Annal. fur die gesammte Heilkund. unter der Redact, d. Mitjlied. der Badensch. Sanitatsk. 2ter Jahrg. 1825. ** Rust's Magazin, B. xvi. H. 2. S. 353, and Richter, Op. cit. B. x. S. 257, Eerlin, 1628 16 ACIDUM ACETICUM EMPYREUMATICUM Mel acidi acetici empyreumatici. Honey of pyroligneous acid. R. Acid. acet. empyreum. crud. f.jjiss. Mellis rosas, gj. M. To be applied by means of a pencil. Buchanan advises the following form of injection in cases of purulent discharges from the meatus auditorius. lnjectio acidi acetici empyreumatici. Injection of pyroligneous acid. R. Acid, acetic, empyreum. f.^ij. Aqua? destillatae, f.|vj. M. Fiat injectio bis die utenda. * The following drops he recommends in cases where the ceru- men is deficient in quantity. Gulta; acidi acetici empyreumatici. Drops of pyroligneous acid. R. Acidi acet. empyreum. crud. Oiei. terebinth, rectif. Sp. aetheris sulphur, comp. aa. partes aequales. M. Two drops of this compound are to be dropped every night into the meatus auditorius. Cataplasma acidi acetici empyreumatici. Cataplasm of pyroligneous acid. R. Furfur. Ibss. Lin. pulv. gj. 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. ^ss. Myroxyl. 31 j. 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, f.gss. Aquse cinnamomi f.giv. Syrup, mori f.§ij. M. ACIDUM BENZOICUM. 17 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. II. ACIDUM BENZOICUM. Synonymes. Acidum Benzoicum persublimationem, Flores Benzoes, Flores Benzoini, Benzoic Acid, Flowers of Benjamin. French. Acide Benzoique. German. Benzoesaure. Benzoic acid exists in the various balsamic substances, as ben- zoin, storax, tolu balsam, &c* METHOD OF PREPARING. In pharmacy it is obtained from benzoin by sublimation. The following process is given in the last edition of the Pharmacopoeia of the United States (1842.) Take of benzoin, in coarse powder, a pound. Put the benzoin, previously thoroughly mixed with an equal weight of fine sand, into a suitable vessel, and by means oi a sand bath, with a gradually increasing heat, sublime until vapours cease to rise. Deprive the sublimed matter of oil, by pressure on bibulous paper, and again sublime. A superior method, according to Messrs. Ballard and Garrod,t is to boil the benzoin in powder with hydrate of lime, so as to form a benzoate of lime, which is dissolved in the water, while the resin remains combined with the lime in the form of an inso- luble compound. Muriatic acid being added to the filtered liquid the benzoic acid is set free, and crystallizes on cooling. Benzoic acid obtained by the process of the Pharmacopoeia of the United States, is in white feathery crystals, of an agreeable odour, fusible, wholly volatilizable if cautiously heated, and sparing- ly soluble in cold water, more so in boiling water, which deposits it on cooling; very soluble in alcohol, and readily dissolved by solution of potassa, from which it is precipitated by chlorohydric acid. EFFECTS ON THE ECONOMY. In another work J the author has remarked:—"The therapeutical action of benzoic acid is doubtless excitant, and it has been imagined by Dr. Pereira§ and others, that its influence is principally directed * See the author's General Therap. and Mat. Med. 3d edit 1, 230, Fhila. 1846. t Elements of Mat. Med. and Therap. p. 275, Lond. 1845. % Op. cit. p. 230. § Elements of Mat. Med. and Therap. 2d Amer. edit. 1, 373. Phila. 1846. IS ACIDUM BENZOICUM. to the mucous surfaces, and especially to the aerian membrane.'' The author has not had the slightest reason for believing in this special affinity, and such would appear to be the general feeling of the profession, as it is now scarcel)7 used except in one or two special preparations, in which it seems to be retained only from old prepossessions and associations. Of late years, howrever, it has been introduced for a special pur- pose, and on this account is noticed here. In a paper commu- nicated by Mr. A. Ure to the Medico-chirurgical Society, January 7th, 1841,* he stated, that when a certain portion of benzoic acid or of a soluble benzoic salt is introduced into the stomach, the urine, in the course of a couple of hours, is found, upon adding a portion of muriatic acid, to yield a copious precipitate of beau- tiful rose pink acicular crystals of hippuric acid. In pursuing his investigations farther, he ascertained, that no trace whatever of uric acid or of any of its salts could be discovered in the urine in question. It had been wholly superseded by the hippuric, and as the salts which this acid forms with the ordinary bases occurring in the animal fluids, as socla, ammonia and potassa, are all of easy solubility, Mr. Ure inferred that in benzoic acid we have an agent of great value in the uric acid diathesis; and he affirmed, that "the application of the above principle had proved of material be- nefit in the treatment of certain unhealthy conditions of the urine occurring in subjects of a calculous or gouty diathesis; since it enabled the practitioner to obviate entirely the various depositions resulting from excess of uric acid, the fruitful source of that most distressing malady, stone in the bladder; as also to control and prevent the formation of the so called tophaceous concretions or chalkstones, which occasion so much inconvenience, deformity and pain to individuals labouring under gout." The observations of Mr. Ure attracted the attention of chemists, whose observations did not however confirm the inference, that the hippuric acid was formed at the expense of the uric acid in the urine,f although they established, that the benzoic acid was converted into the hippuric.:{: Neither, therefore, in the uric acid diathesis, nor in cases of the formation of gouty or tophaceous de- posits, the chief constituent of which is generally urate of soda, can the administration of benzoic acid be of service, and its ineffi- ciency in these diseases is now admitted ;§ but from its power of causing increased acidity of the urine, it has been considered to slightly stimulate the mucous membrane of the urinary organs, * Provincial Medical and Surgical Journal, July 17, 1841. t Keller, in appendix to Liebig's Animal Chemistry, p. 315, Cambridge, 1842. X Garrod, Lond. Edinb. and Dubl. Phil. Mag. June, 1842, Lond. Lancet, vol. 2, 1844, p. 239, and Profs. Booth and Boye, Transactions of the Amer. Philos. Soc., vol. ix pt. 2, p. 185. Phila. 1845. § Ballard and Garrod, Elements of Mat Med. and Therap. p. 408, Lond. 1845. ACIDUM BENZOICUM. 19 and has been found useful in catarrh of the bladder, and in cases where there exists a secretion of granular mucus mixed with phosphates.* The suggestions of Mr. Ure, in regard to the action of the ben- zoic acid on the urates, induced Dr. Walker of Huddersfield,t to administer it in chronic dysuria incidental chiefly to persons in the decline of life, or in what he terms dysuria senilis,—an affection, which is of course, dependent upon various pathological condi- tions,—and he asserts, that he was disposed to augur favourably of its utility. " In some instances," he says, " we may account for the benefit resulting from its use by its chemical action on the urates, which if in excess may add to the acrimony of the urine, and thus prove a source of irritation to the mucous membrane of the bladder. But it is often of service where the gravel in the urine is incon- siderable, and where the irritation and pain would seem to have arisen from some other cause." Dr. Walker, however, used it in association with copaiba; and his remarks induced Mr. Soden^: to employ the combination in some urinary affections, accompanied with vesical irritation and increased secretion from the mucous mem- brane. The most remarkable result appeared to Mr. Soden to be its decided efficacy in diminishing, and in some instances of com- pletely suppressing the muco-purulent deposition in the urine, which is so prominent a symptom in most cases of affection of the bladder. He properly remarks, however, that a doubt ma}7" be very fairly entertained, whether this effect be attributable to the benzoic acid or to the copaiba, or to their combination; and in the doubt Mr. Ure deduces no inference in regard to the precise agency of the benzoic acid.§ It may be concluded, then, that the benzoic acid has been intro- duced as a remedy in lilhuria on erroneous chemical deductions: and hence that the favourable results have been fallacious, or de- pending on other causes. MODE OF ADMINISTRATION. The dose of benzoic acid may be from five grains to half a drachm. Mistura Acidi Bcnzoici et Copaibse, Mixture of Benzoic acid and Copaiba. R. Acid. Benzoic, gj. Copaib. f. ,!f ss. Vitell. ovi. q. s. Aq. Camphor, f. gvij. M. Dose. Two tablespoonfuls three times a day. * Ballard and Garrod, p. 409, and Mr. Ure, Provincial Med. and Sur. Joum. Feb. 11. 1843, and Lond. Lancet, Nov. 16, 1844. t Ibid. Feb. 26,1842. J Ibid July 29, 184:2. § Ibid. Feb. 11,1843. 20 ACIDUM GALLICUM. III. ACIDUM GALLICUM. Synonymes. Gallic acid. French. Acide Gallique. German. Gallussaure. Gallic acid is by no means so abundant as tannic acid. A solu- tion of the latter in water, exposed to the air, gradually absorbs oxy- gen, and deposits crystals of gallic acid, formed by the destruction of tannic acid. METHOD OF PREPARING. A strong extract of gall-nuts in cold water may be precipi- tated in the cold by sulphuric acid: the thick mass must be mixed with dilute sulphuric acid; be expressed whilst still humid, and be introduced, in this state, into a mixture of sulphu- ric acid with two parts of water at the boiling temperature. The liquid is boiled for some minutes, and then allowed to cool. Crystals of gallic acid are deposited, which may be purified by crystallizing again from water;—converting the new product— which is still coloured—by means of acetate of lead—into an in- soluble gallate of lead, which is washed, then diffused through water, and decomposed by a stream of sulphuretted hydrogen gas. The sulphuret of lead, thus formed, assists in carrying down the colouring matter.* It may also be procured by adding sulphuric acid to a solu- tion of tannic acid, which causes a precipitation of the tannic acid in combination with the sulphuric: the precipitate is dissolved in dilute sulphuric acid by the aid of heat, and the solution is boiled for a few minutes; the tannic acid is all decomposed; and, on cooling, crystals of gallic acid, coloured, are obtained.t Gallic acid is in thin silky needles. It requires one hundred parts of cold water, and three of hot water to dissolve it. It is very soluble in alcohol, and slightly so in ether. The solution in water has an acid and astringent taste, and is gradually decomposed by keeping. EFFECTS ON THE ECONOMY. Gallic acid has long been esteemed a valuable astringent; yet doubts appear to have been entertained in regard to its being pos- sessed of such property; and until its use was revived of late it * Graham's Elements of Chemistry, American edit, p. 637, Phila. 1843. t Elements of Materia Medica and Therapeutics, p. 415, London, 1845. ACIDUM GALLICUM. 21 had fallen into disrepute. Sir Benjamin Brodie, according to Dr. A. T. Thomson,* gave a patient, who had a frightful hemorrhage from the prostate gland, and in whose case all other remedies had failed, a dose of " Ruspini's styptic," and repeated the dose twice in the course of twelve hours. About halt an hour after the first dose was taken, the bleeding ceased, and it never recurred. This styptic is said to consist of gallic acid, a small quantity of sul- phate of zinc, and opium, dissolved in a mixture of alcohol and rose water; but as the quantity of sulphate of zinc and of opium appears to be too small to influence the medicine, a simple solu- tion of gallic acid in diluted alcohol, it has been conceived, may answer all the purposes of the expensive nostrum. Hence, gallic acid has been used in cases in which the styptic had been found efficacious. In a paper read before the medico-chirurgical society of Edin- burgh, Professor Simpsont stated, that in the previous year he had employed gallic acid in menorrhagia with the most suc- cessful results. Some of the cases which had completely yield- ed under its use, were of old standing, and of an aggravated de- scription. He gave it during the interval, as well as during the discharge; and he was first induced to prescribe it from finding that a case of very obstinate menorrhagia got well under the use of Ruspini's styptic, after many other remedies had failed, and from its being alleged that gallic acid was the active ingredient in that styptic. Professor Simpson suggests, whether the anti-hemor- rhagic properties of some of our common astringent drugs may nut depend upon the gallic acid, as much as or more than upon the tannic acid which they contain, or upon the tannic acid be- coming converted into gallic acid within the body. Dr. Stevenson^: has published several cases to show the value of this acid in uterine hemorrhage and hsematm'ia; and Messrs. Ballard and Garrod§ declare it to be one of the most powerful as- tringents that chemical art has derived from the vegetable king- dom; and that a tolerably extensive experience by them of its use enables them to declare it to be an invaluable remedy in most forms of passive hemorrhages and fluxes. The chief of the cases in which they have employed it, and where they have found it of the greatest service, are menorrhagia and leucorrhoea, as well as for checking the distressing night-sweats of phthisis. In the first two of these especially, no astringent that they had em- ployed would bear a comparison with this, either for the rapidity * Elements of Mat. Med. and Therap., 3d edit, and Dr. Watson, in Lond. Med. Gaz. July 8, 1842, p. 547, or in his Lectures on the Principles and Practice of Physic, Amer. edit p. 921. Phila. 1845. t Lond. and Edinb. Monthly Journal of Med. Science, July, 1343, p. 661. X Edinb. Med. and Surg. Journal, July, 1843. § Elements of Mat. Med. and Therap., p. 415. Lond. 1845. 22 ACIDUM HTDROCYANICUM. with which the cure was effected or the permanency of the result. Their eulogy, however, of its action in the night-sweats of phthisis is calculated to throw some doubts on the accuracy of their expe- rience in other cases. No medicine can be expected to exert much efficacy on them, any more than on the hectic, inasmuch as they are mere morbid expressions of the condition of the lungs and general system. Messrs. Ballard and Garrod state, that if the use of the acid be continued beyond two or three days, it mani- fests some constipating tendency, whilst Professor Simpson affirms that it has the advantage over most other anti-hemorrhagic medi- cines, that it has no constipating effect upon the bowels! The observations of Messrs. Ballard and Garrod are probably the most accurate. They affirm, also, that the excessive expectorations of chronic bronchitis and phthisis are much influenced by its ad- ministration. In leucorrhoza, they have found it highly useful as an injection. MODE OF ADMINISTRATION. Gallic acid may be given in doses of from two grains to five or more, in the form of pill, repeated every two or three hours. Pilulse acidi gallici. Pills of gallic acid. R. Acid, gallic, gr. ij.—v. Confect. rosfe. q. s. ut fiat pilula. Injectio acidi gallici. Injection of gallic acid. R. Acid, gallic. 9j. ad 3j. Aquae Oij. M. IV. ACIDUM HYDROCYAN'ICUM. Synonymes. Acidum Prussicum, Acidum Borussicum, A. Zooticum, A. Zootinicum, Hydrocyanic, Prussic, Cyanohydric or Cyanhydric Acid. French. Acide Hydrocyanique, Acide Prussique. German. Blausaure, Wasserstoffblausaure, Hydrocyansaure, Cyanwasser- Ptoffs'aure. 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 appreciated. It was discovered by Scheele in 1780; but its preparation in a state of purity, and its exact chemical constitu- ACIDUM HVDROCYANICUM. 23 tion, 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 for preparing hydrocyanic acid at one time received into the pharmacopoeias were 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 phar- macopoeias of Paris and Ferrara; and the third by those of Belgium, Paris, and the United States.—(Edition of 1830.) 1. Schcele's M e t ll 0 d.—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, Porphy- rized 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 liquor 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, 8 parts, of Carbonate of lime. Distil again, and draw off 128 parts, which must be kept in a bottle covered with black paper. This process of Scheele always affords an acid mixed with a variable quantity of water. 2. G a y-L u s S a C' S M C t h o d.—Take Cyanuret of mercury, at plea- sure. Introduce it into a tubulated retort, the neck of which is furnished 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 cyanuret to the height of afinger; heat gradually and moderately,and receive the condensed product into the bell glass. The acid obtained in this way is anhydrous, and of the specific gravity .700. o. Vauquelin's method.—Take of Cyanuret of mercury, 1 part; Distilled icater, 8 parts. Pass a current of sulphohydric acid * Annales de Chimie, torn, lxvii. p. 128, and torn. xcv. p. 136. 24 ACIDUM HYDROCYANICUM. gas into the solution, until the gas is in excess; pour into the liquid pulverized subcarbonate of lead in sufficient quantity to re- move the excess of sulpho-hydric acid; shake the mixture con- stantly, 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 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 de- gree of concentration renders it dangerous, it is diluted with dis- tilled 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 quantity 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 mixture Acide prussique medicinal,] Medicinal prussic or Medicinal hydrocyanic acid. Others have advised the employ- ment 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 quarter strength.":}: Dr. Bache asserts, that he had the process (Proust's or Vau- quelin's) of the United States' Pharmacopoeia (1830) repeated, when he found the acid obtained to have the specific gravity .998. In the last edition of the Pharmacopoeia of the United States (1842,) the following form was introduced. It is essentially that of the London Pharmacopoeia. Take of Ferrocyanuret of potassium, ^ij.; Sulphuric acid, 5iss.; Distilled water, a sufficient quantity. Mix the acid with four fluid ounces of distilled water, and pour the mixture, when cool, into a glass retort. To this add the ferrocyanuret of potassium, pre- viously dissolved in ten fluid ounces of distilled water. Pour eight fluid ounces of distilled water into a cooled receiver, and, having attached this to the retort, distil, by means of a ssnd bath, with a moderate heat, six fluid ounces. Lastly, add to the product five fluid ounces of distilled water, or as much as may be sufficient to render the hydrocyanic acid of1 such a strength, that 12.7 grains of nitrate of silver, dissolved in distilled water, may be accurately saturated by 100 grains of the acid. * See Notes on Hydrocyanic acid, by Dr. R. E. Griffith, in Philad. Journ. of Phar- macy, iv. 17. Philad. 1833; also, Pereira, Elements of Materia Medica, 2d edit. i. 429. Lond. 1842. The Dispensatory of the United States of America, by Drs. Wood and Bache, 6th edit. p. 786. Philad. 1845, and Mr. David Stewart, Maryland Medical and Surgical Journal, April, 1840, p. 264. t Formulaire pour la preparation etc. de plusieurs nouveaux medicamens. t Pharmacopee Universelle, par Jourdan, i. 31. Paris, 1828. ACIDUM HYDROCYANICUM. 25 When hydrocyanic acid is wanted for immediate use, lhe follow- ing formula is recommended:—Take of Cyanuret of silver, fifty grains and a half; Muriatic acid, forty-one grains; Distilled xoater, a fluid ounce. Mix the muriatic acid with the distilled water, add the cyanuret of silver, and shake the whole in a well-stopped vial. When the insoluble matter has subsided, pour off the clear liquor and keep it for use. No matter how prepared, hydrocyanic acid should be kept in well-stopped bottles from which the light is excluded. The characters that hydrocyanic acid should possess, accord- ing to the forms last given, are as follows:—It is colourless, of a peculiar odour, and wholly volatilizable by heat. One hundred grains of it produce, with solution of nitrate of silver, a white precipitate, which, when washed and dried, weighs ten grains, and is readily dissolved by boiling nitric acid. The acid of the Pharmacopoeia of the United States contains two per cmt. of pure anhydrous acid.* EFFECTS ON THE ECONOMY IN HEALTH. Hydrocyanic acid is usuallv classed amongst the narcotic poisons, f 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 would seem to occasion the latter results only. It is the most powerful of our poisons, at times producing, in an adequate dose, the fatal result so suddenly, that the animal ex- perimented upon can scarcely be removed from the lap of the ex- perimenter before all signs of life are extinct. This rapidity of action is unfavourable to 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 membrane 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 wTe esteem it an agent possessed of powerfully penetrating properties. In very large doses, the sensibility of the whole nervous system be- comes annihilated almost with the rapidity of lightning. * Pharmacopoeia of the United States, p. 59. Philadelphia, 1842. t Christison's Treatise on Poisons, 1st Amer. from 4th Edinb. edit. p. 582. Phila. 1845. + An Essay on the Operation of Poisonous Agents upon the Living Body. Lond. 1829. 26 ACIDUM HYDROCYANICUM. 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- 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 hy- drocyanic acid in a vial with a ground stopper, and, as it had been prepared almost three months, thinking that it was decomposed, 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 in- jected 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.| On the other hand, when received into a wound in its concentrated state, it, acts most violently. * Hufeland, Journal der practisch. Heilkund. Band. xl. St. 1, S. 85—92, and Osann, in Art. Blausaure, in Encyc. Worterb. der Medicinischen Wissenschaft, Band. v. S. 528' Berlin, 1830. t Journal de Chimie Medicale. Juin, 1831. X Osann, loc. cit. S. 580. ACIDUM HYDROCYANICUM. 27 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 discordant statements of different experimenters, inasmuch as we are ignorant of the precise strength of the acid employed. A French physician made some experiments on the uncertainty of the strength of the medicinal acid; and found, that he could swallow a whole ounce of one sample, and a drachm of a stronger sample, without sus- taining any injury; but on trying some, which had been recently prepared by Vauquelin, he was immediately taken ill, and nar- rowly escaped with his life.* Dr. Pereiraf caused the instan- taneous 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.^ 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 even be placed with impunity 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,|| however, says this was probably a mistake. On repeating some of the experiments, he found, that a single drop, weighing scarcely a third of a grain, dropped into the mouth of a rabbit, killed it in eighty-three se- conds, 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 af- fected 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.IT * Revue Medicale, xvii. 265, and Christison on Poisons, 1st Amer. Edit. p. 582. Phila. 1845 t Elements of Mat Med. &c., 2d edit. i. 437, Lond. 1842. X Magendie, in Annales de Chimie et de Physique, vi. 347, and Formulary. § Toxicologic. || Op. cit. p. 592. H See also, Dr. Geoghegan, in Dublin Medical Journal, for 1835. Pereira, Op. cit. p. 242. 28 ACIDUM HYDROCYANICUM. 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 with atmospheric 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 I hat are primarily acted upon by the hydrocyanic acid, there can be but little doubt in designating the nervous system.! 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; dis- position 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 faeces, augmentation of the cutaneous and urinary depurations; palpitations, anxiety at the praecordia, 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 cheeksj and salivation. This last symptom is given 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 corrosive chloride of mer- cury, particularly if the acid had been prepared—according to the process of the Dublin College—with bicyanuret of mercury, mu- riatic acid and water. Mercury is, indeed, asserted to have been actually discovered in the acid by Sylvester's test. Thirdly. In * Annales de Chimie, xcii. 59. ,ot,Pr- ^nsdale, Edinb. Med. and Surg. Journ., Jan. 1839, and Lond. Lan. June 15 1839, p. 440. I Magendie, Lectures on the Blood. Lect. xvii. in Lancet, for Jan. 26 1839 p 636 On its Action when injected into the Vessels, see Mr. Blake, in Edinb. Med. and Sure' Journ. April, 1839, p. 339. 6' § Richter, Specielle Therapie, Band. x. S. 280. Berlin, 1828; and Osann, loc. cit S. 527 \\ Encyc. Worterb. B. u. S. 315. U Bom, in Rust's Magazine, B. xiii. S. 282." Op citat it Lond. Med. and Phys. Journ. xlvi. 359 and 363. ACIDUM HYDROCYANICUM. 29 still larger doses, it induces violent affections of the spinal marrow, convulsions, trismus, opisthotonos, emprosthotonos, fainting, &c. From the results of all his observations, Osann* infers, that hydrocyanic acid acts dynamically on the nervous system, by di- minishing, depressing, and annihilating its life; and, through the nervous system, affecting the organs of vegelation or nutrition, and of haematosis;—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 Jorg,t 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. There would seem to be no distinct evidence of the hydrocyanic acid being a cumulative poison, although this has been at times suspected. Its operation must be diligently watched at first, un- til the proper dose is ascertained. This, says Dr. Christison,| is the only secret for using it with safety and confidence. 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 decided^ 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 giv- ing 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 occasioned unfortunate results. Orfila,§ mentions the case of a sick person, who had used for a length of time the hydrocyanic acid, in in- creasing closes, with advantage; when, being compelled to send her prescription to another apothecary, the acid he employed was * L02. citat S. 526. t Materialien zu einer kunftigen Heilmittellehre, B. i. S. 53,117. X On Poisons, edit, cit p. 588 § Toxicologie. 3 30 ACIDUM HYDROCYANICUM. so strong as to produce death, with all the symptoms of poisoning by hydrocyanic acid. For these and other reasons, Riecke, L. W. Sachs, and Osann greatly prefer the Aqua laurocerasi and the Aqua amygdalarum amararum (q. v.,) which, although in other respects not less objectionable, are far less dangerous* Sir George Lefevre,t indeed, affirms, that the cherry-laurel-water is a far more effective preparation than hydrocyanic acid. In many ner- vous affections, as palpitation, hysteria, &c, he generally pre- scribes the following draught: R. Aq. lauro-cerasi irj^ xx. ----flor. aurant. f. §i. Syrup, tolut. f. 3]. M. The draught to be taken pro re nata. Possessed of the powerful sedative agency, which has been de- scribed, it is not to be wondered at, that hydrocyanic acid should have been given in a multitude of cases; and, as constantly happens, that unsuccessful trials, suggested by the merest empi- ricism, should have been made with it. It is rarely employed in fevers,—intermittent, remittent, or continued. By man}'', it has been esteemed beneficial in hectic; but here its agency must be doubtful.£ 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 contra-stimu- lant school esteem it as one of their most efficacious contra-stimu- lants. 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 tartrate of antimony and potassa 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, Ma- gendie, Heller, Elwert, Behr, Roch, &c , especially in chronic ca- tarrh, bronchitis, and hooping cough. In the last affection it is con- ceived by Dr. A. T. Thomson§ to be " the sheet anchor of the practitioner;" and by Dr. RoelJ to possess a "specific" (?) power. In warm weather, he thinks, it will cure almost any case of simple hooping cough in a short time; in all seasons it will abridge its duration, and in almost every instance, where it does not cure, it will, at least, materially relieve the severity of the cough. * Die neuern Arzneimittel, u. s. w. von V. A. Riecke, S. 5. Stuttgart, 1837; Osann, loc. citat. and Encyclop'ad. Worterb. ii. 315. t An Apology for the Nerves, &c, p. 291. Lond. 1844. + Seethe author's General Therapeutics and Materia Medica, 3d edit. ii. 182, Phila. 1846. § Elements of Mat. Med. and Therapeutics, i. 435. Lond. 1832. || A Treatise on the nature and Treatment of Hooping Cough, &c, p. 10. Lond. 1838. ACIDUM HYDROCYANICUM. 31 In pulmonary consumption it has been recommended by Granville, Magendie, S. G. Morton,* Fantonetti,t and others, particularly where there is any inflammatory or spasmodic com- plication; but others, as Neumann, Weitsch, Sir James Clark, Andral,f 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 the cough and fever, diminished the expectoration and occasioned a sense of suffocation :|| it has been, moreover, as- serted, that its depressing and destructive agency has acted inju- riously 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, 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 spasmodic dysphagia. Its efficacy, too, has been marked, according to Elliotson,** 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 boxcels, of a similar character—enteralgia—it has been found useful by Dr. Pereira.f f 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 accom- panied by great pain in the breast, Dr. Rees observed, after the admi- nistration of Vauquelin's acid, great diuresis, with the removal of the dropsy and its concomitant symptoms.|| In the asthma pulverulentum of the Germans, (Staubaslhma,) that is, in the variety to which millers, bakers, grinders and others are liable, Creutswicher is said to have found it highly service- able^ 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 * Illustrations of Pulmonary Consumption, p. 131. Philad. 1834. t Gazette des Hopitaux, Fev. 19, 1839. X Bulletin General de Therapeutique, Mars, 1840. § L'Experience, Nov. 14, 1839; and Amer. Med. Intel., Sept 1, 1840, p. 170. || Schneider, Med. Prakt. Adversarien am Krankenbette, Erstc Liefer. S. 62, referred to by Osann. Ii Siebergundi, in Hufeland's Journal der pract. Heilkund. B. liii., St. 6. S. 15. ** On the Efficacy of Hydrocyanic or Prussic Acid in Affections of the Stomach, &c. Lond. 1820. 11 Op. citat., p. 443. XX Osann, Op. cit, and Harless, Rhem-Westph'al. Jahrbuch. Bd. x. St 1, S. 82. § § Rust's Magazin, Bd. xxii. S. 335. 32 ACIDUM HYDROCYANICUM. 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 render- ing death more easy.f It has likewise been advised in spasmodic pains of the uterus. Yet, although it would seem to be soothing and antispasmodic in many cases of erethism, Grindel and OsannJ consider it by no means adapted for the radical cure of spasmodic diseases. In violent neuralgia, especially in an impressible condition of the vascular system, in nervous cephalalgia, hemicrania, tic dou- loureux, and in gouty and rheumatic sciatica, it has been extolled. Dr. E. S. Bonnet,§ of Charleston, treated successfully some cases of facial neuralgia of great severity, by applying it externally in the form of the distilled water of prunus lauro-cerasus. It is pro- per, however, to remark, that in two of the three cases described, belladonna was employed in combination. The mode of apply- ing it was by lotion, composed of four ounces of the laurel water, one ounce of sulphuric ether, alone, or with half a dram or a dram of extract of belladonna. With this lotion the affected parts, pre- viously covered with carded cotton or cotton wadding, were kept constantly wet. It has likewise been recommended by Elliotson|j in the cure of vomiting, not dependent upon inflammation. These are the chief cases in which its internal use has been prescribed. It has been employed externally in the following cases. As a soothing agent in severe pain;—for example, in toothach from caries; one to two drops, according to Elwert, being put into the hollow tooth. Krimer applied it in a dilute state to painful wounds; and it has been injected with advantage into fistuloe. In neuralgia, the application of a cataplasm of belladonna and hydrocyanic acid has been advised by some. In cutaneous affections, of an itching, painful or inflammatory nature, it has been used with much success. In five cases of obstinate herpes, Schneider used a solution of the acid in alcohol: t in similar cases Dr. A. T. Thomson, besides the use of a purga- tive of calomel and colocynth, applied compresses to the parts > wetted with the dilute acid. In two cases of impetigo, the local application completely allayed the distressing and intolerable itching and tingling, after other external applications, and the internal use of anodynes, had been of no avail. The discharge was diminished and rendered milder: alterative doses of mercury, * Froriep's Notizen, Bd. xiv. No. 15, S. 324. t Heidelberger Klinische Annalen, Bd. ii. S. 112. X Loc. citat, S. 535. § North American Archives of Medical and Surgical Science, April, 1835. || Lond. Med. Gazette, 1831, and Amer. Journ. of Med.. Sciences, May, 1831, p. 242. ACIDUM HYDROCYANICUM. 33 combined with sarsaparilla, formed the internal treatment.* Dr. Thomson found the lotion useful, in combination with small doses of corrosive chloride of mercury, in acne rosacea, and in several other cutaneous affections. In herpes, Magendie advises a lotion of hydrocyanic acid and lettuce water in the proportions mentioned hereafter. The acid has likewise been used, in the form of glyster, in scir- rhus of the pylorus, in the strength of six drops of Vauquelin's acid to eight ounces of water;t and in uterine pain from scirrhus, injec- tions of the acid, combined with infusion of belladonna, have been employed with advantage. In ophthalmia, especially of the scrofulons kind, with engorge- ment of the conjunctiva, it has been advised by Elwert^:—two drops of the acid being mixed with a dram of water, and a littl dropped frequently into the eye; and it has been given in the ac- tive inflammatory stage of blennorrhea.^ Its vapour has been advised in amaurosis, and in opacity of the cornea;\\ but it does not seem to be entitled to much credit in those affections. Lastly, when a portion of toenia has protruded from the rec- tum,—with the view of destroying it, it has been advised by Cag- nola, Gelnecke, and others, that hydrocyanic acid should be ap- plied to it.1T Such are the principal affections in which the hydrocyanic acid has been used. The author has often employed it internally in many of the cases recommended, especially in painful affections accompanied by great nervous impressibility, and in consumption, but he has not had sufficient reason to place it high in rank amongst medicinal agents.** He has certainly had no evidence, that it can cure consumption when not beyond its first stage, as remarked by Magendie.tt If the practitioner will bear in mind the effects which the acid is capable of inducing upon healthy man, when the dose is carried to the requisite extent, he will have no difficulty in deciding upon the cases in which its agency may be appropriate. If not a true sedative, it is the nearest ap- proach to one in the catalogue of the materia medica; and there- fore its employment is clearly indicated in all diseases in which * London Medical and Physical Journal, Feb. 1822; and the author's edit, of Magen- die's Formulary, p. 112. Lond. 1824. Philad. 1825. t Bernd, in Rust's Magazin. Bd. xiii., S. 273, t Ibid. B.xiiL.S. 182. § Ibid. B. xiii., S. 228. || Mr. Paterson in Lond. Med. Gaz., May 15, 1844, p. 808. IT Osann, Op. cit, and Gerson and Julius, Magaz. d. Auslandischen Litteratur der gesammt Heilkund. B. ii., 177. Also, Hufelancl und Osann's Journal der prakt Heilkund. Bd. lviii., St G, S. 122. See also Richter, Op. cit, S. 313. ** See, also, Becquerel, Gazette Medicale de Paris, Jan. 13,1840. tt The author's edit of the Formulary, p. 108. 34 ACIDUM HYDROCYANICUM. there is much erethism,—administered alone or along with other appropriate agents. MODE OF ADMINISTRATION. After the remarks that have been made on the varying strength of the hydrocyanic acid, according to the particular form by which it may have been prepared, it is hardly necessary to say, that the physician must be acquainted with the character of the acid he prescribes. The ordinary dose of the acid of the Pharmacopoeia of the United States is a drop, given three times a day in a little sugared water: it must be borne in mind, however, that the spe- cific gravity of the acid is less than that of water, and hence the necessity of dropping the quantity of acid at the time of using it, rather than forming a mixture with a larger quantity of the acid, which will certainly rise to the surface, if the mixture be put to one side: and unless the vial is shaken, a much larger dose may be administered than was intended. It must also be recollected, that the acid loses its strength by keeping. Magendie remarks,* that when left to itself in a close vessel, it sometimes becomes de- composed in less than an hour, and that it rarely preserves its in- tegrity for more than a fortnight. The substances, that are incompatible with it in the same pre- scription, are most metallic oxides, particularly those of mercury and antimony, nitrate of silver, salts of iron, sulphurets, mineral acids and chlorine. The proper plan is to begin with a small dose and to augment it carefully until some effect is induced, but if any of the signs— mentioned above as indicating the supervention of the sedative effects of the acid—should supervene, it ought to be discontinued. Magendie, it has been seen, uses the hydrocyanic acid of Gay- Lussac, diluted with 8.5 times its weight of water; and this mix- ture he denominates medicinal prussic acid. The following are forms in which the acid may be administered. Mistura acidi hydrocyanici. Mixture of hydrocyanic acid. {Melange pectoral.) R. Acidi hydrocyanici medicinalis, f. 3j. Aquas destillatse, Oj. Sacchari albi, §iss. M. A dessert-spoonful of this is directed to be taken every morn- ing and evening at bed time—the dose being gradually increased to six or eight spoonfuls in the 24 hours. Magendie. * Op. citat. p. 104. ACIDUM HYDROCYANICUM. 3 5 R. Acidi hydrocyanici (Scheele's) rr^xij. Vin. antimon., f. gj. Tinct. opii camphoratae, f. giiss. Aquae camphorae, f. ^vijss. Fiat mistura. Dose—In hooping cough; a tablespoonful every four hours for a delicate boy four years old, to be given in some warm drink. The child to remain in a warm room, and to live upon light pud- ding and broth. Roe. R. Acidi hydrocyanici (Scheele's,) vt^ xx. Vin. antimon., f. giss. ----ipecacuanhas, f. giss. Aqua?, f. gxiij. Fiat mistura. Dose—A tea-spoonful every two hours for a healthy-looking female child, five years of age. Roe. Syrupus acidi hydrocyanici.— Syrup of hydrocyanic acid. R. Syrupi purificat. Oj. Acidi hydrocyanici medicinalis, f. Jjj. M. This syrup may be added to common pectoral mixtures, and used as other syrups are. Magendie. Lotio acidi hydrocyanici. Lotion of hydrocyanic acid. R. Acidi hydrocyanici, f. §ss. Alcohol f. 3J. Aquas destillat. f. §xss. M. This was the lotion employed by Professor Thomson in cases of impetigo. The following was used by Schneider, in herpes. R. Acidi hydrocyanici, f. giss. Alcohol, f. gvi. M. And in the same cases, Magendie employed the subjoined formula. R. Acidi hydrocyanici, f. sjij. Aquae lactucse, Oij. M. The distilled water of the garden lettuce probably contains no- thing to recommend it over common distilled water. Dr. Joy* advises the following lotion, in acne and impetigo, to correct itching; and in ulcerated cancer to diminish pain. R. Acid, hydrocyan. dil., f. gi—Z'lv. Decoct. malvEe Oj. M. * Tweedie's Libr. of Med., v. 288. Lond. 1840. 36 ACIDUM LACTIS. The bottle should be shaken before each application. All these formulas 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. V. ACIDUM LACTIS. Synontmes. Acidum Lacteum, Lactic Acid, Acid of Milk. French. Acide Lactique. German. Milchs'aure. This acid has been recommended as a therapeutical agent by Magendie.* 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 entirely 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, that have not yet been examined. The alcoholic ex- tract is then dissolved in water, which occasions a fresh precipita- tion. 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, previously washed in muriatic acid, has been added: the fluid is then filtered, and the lactate of zinc is deposited in per- fectly 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. This is finally concentrated in vacuo.~\ * Formulaire pour la preparation et l'emploi de plusieurs nouveaux medicamens, &c. Edit. 9eme. Paris, 1836. * t Gay-Lussac and Pelouze, Annales de Chimie et de Physique, Avril, 1833. (Tom. lii.410.) ACIDUM LACTIS. 37 Mitscherlich* 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 crystallized by evaporation; this is at first yellow, but by re- peated crystallizations, it is obtained of a pure white. The splu- tion of the lactate is decomposed by pure baryta; the oxide of zinc separated, and the lactate of baryta, which is in solution, is decomposed by sulphuric acid, and the fluid evaporated; this yields a clear, colourless, syrupy, not volatile acid, which is de- composed, and leaves a residue of charcoal when heated at a suffi- ciently 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 ex- posed to the air, it attracts moisture. Water and alcohol dissolve it in all proportions. One of its most striking properties, which is of especial interest to the physician, is, that it quickly dissolves phosphate of lime, especially that which is contained in bones. EFFECTS ON THE ECONOMY. As lactic acid was conceived to play a part amongst the juices which effect the solution of the food in the stomach, Magendie thought it might be given with advantage in cases of dyspepsia produced by simple debility of the digestive apparatus; and his experiments afforded him very encouraging results. According to Liebig,f however, no lactic acid is formed in the stomach in a state of health; but in certain diseases lactic acid and mucilage are produced from the starch, sugar, &c, of the food. In consequence of the facility with which lactic acid dissolves phosphate of lime, it has been suggested, whether it might not be administered with advantage in cases of ivhite gravel, or, in other words, of phosphatic depositions from the urine. Magen- die has not yet been able to institute experiments on this matter. At the time when the edition of his Formulary, to which we have referred, was published, he had commenced some clinical experiments with lactate of potassa, and lactate of soda, but with- out any results worthy of being communicated to the profession. He recommends these salts, however, to the attention of physi- cians. * Report to British Association, 2d meeting, and Philad. Journ. of Pharmacy, vi. 83. Philad. 1834-5. t Animal Chemistry, edited by Gregory and Webster, p. 107, Cambridge, 1842. 3S ACIDUM TANNICUM. MODE OF ADMINISTRATION. Magendie gives lactic acid either in the form of lemonade or of lozenges. Potus acidi lactis. Lemonade of lactic acid. R. Acid. lact. liquid, f. £j. ad sjiv. Aquae Oij. Syrupif. gij. M. Pastilli acidi lactis. Lozenges of lactic acid. R. Acid. lact. pur. ^ij. Sacch. pulv. gj. 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 conse- quences. VI. ACIDUM TAN'NICUM. Synonymes. Acidum Quercitannicum, Tanninum Purum, Tannicum, Prin- cipium Adstringens, P. Scytodephicum, Tannin, Tannic acid. French. Acide Tannique. German. Tannin, Gerberstoff, Gerbsaure. This article, in its pure state, has been subjected to experiment of late years only. METHOD OF PREPARING. According to Buchner,* tannic acid should be prepared for medical 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 filtered, 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 tannic acid follows. The acid is deposited very soon in this way, in a collected yellowish- white, gelatiniform mass, which by the influence of air gradually assumes a brown colour. * Repertorium, B. xxxiv. H. 3; also, A. W. Buchner, Neueste Entdeckung. iiber die Gerbsaure, u. s. w. Frankf. 1833, and Dierbach, in Heidelberger Klinische Annalen, B. x. H. 3, S 339, Heidelb. 1834. For the process of M. Duval, see Annal. de Chimie et de Physique, and Amer. Journ. of Pharm. July, 1841, p. 171. ACIDUM TANNICUM. 39 After the fluid is poured off, the residue is washed twice with cold water acidulated with sulphuric acid: carbonate of bary- ta, or carbonate of potassa, is then added to it in small portions, carefully shaking the mixture, until there is no farther efferves- cence, and until a portion of the mass dissolved in water and test- ed by chloride of barium 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 tan- nic acid and separate it from the sulphate of baryta or sulphate of lime; the alcoholic solution is then poured off clear, and by a gen- tle heat evaporated to dryness. The following form for its preparation is given in the last edi- tion of the Pharmacopoeia of the United States (1842.) Take of Galls, in powder; Sulphuric ether, each a sufficient quantity. Put into a glass adapter, loosely closed at its lower end with card- ed cotton, sufficient powdered galls to fill about one half of it; and press the powder slightly. Then fit the adapter accurately to the mouth of a receiving vessel; fill it with the sulphuric ether, and close the upper orifice so as to prevent the escape of the ether by evaporation. The liquid which passes separates into two unequal portions, of which the lower is much smaller in quantity and much denser than the upper. When the ether ceases to pass, pour fresh portions upon the galls, until the lower stratum of liquid in the receiver no longer increases. Then separate this from the upper, put it into a cap- sule, and evaporate with a moderate heat to dryness. Lastly, rub what remains into powder. The upper portion of liquid will yield by distillation a quantity of ether, which, when washed with water, may be employed in a subsequent operation. Tannic acid, thus prepared, is of a yellowish-white colour; of a strongly astringent taste; very soluble in water, and less so in al- cohol and in ether. It reddens litmus paper.* EFFECTS ON THE ECONOMY. Tannic acid is a strong astringent,! which has hitherto been mainly used in uterine hemorrhage, and especially by the Italian physicians. Porta:}: was, perhaps, the first who tried it. He found it very efficacious in cases of uterine hemorrhage not de- pendent upon any organic mischief in the uterus. It exhibits its powers, according to him, even in small doses—p.s of two grains, and is well borne by the stomach. Ferrario§ likewise adminis- * Pharm. of the United States, p. 63, Philad. 1842. t See, on the action of this agent, Mitscherlich, Medicinische Zeitung, No. 43, 1838, and Bullet. General de Therap. Mars 30, 1837. X Delpech, Memorial des Hopitaux du Midi, &c. Fevrier, 1829, p. 51. § Annali universali di Medicina, Gennajo, 1829. 40 ACIDUM TANNICUM. tered it with advantage in the same affection, but he does not con- sider 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 dimi- nishes and soon ceases, and, at the same time, the strength aug- ments, 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 prescription at the end of this article. The first patient was cured in ten, the second in twelve, days. M. Dumarst extols it in the same disease, administered by the mouth as well as by the rectum. According to Ricci^-, tannic acid has frequently been employed in Italy both in internal and external hemorrhages. On the other hand, G. A. Richter,§ affirms, that he has given it in habi- tual metrorrhagia without any advantage whatever. Within the last few years, M. Cavarra|| has instituted many experiments on animals, as well as on himself, from which he concludes, that when tannic acid is placed in contact with certain parts of the living economy, it exerts upon them the same chemico-vital ac- tion 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 tannic acid appears to be, to cause such a condensa- tion or contraction in them, that the glands with which they are studded no longer afford passage for the mucus which they secrete." M. Cavarra asserts, that he has proved these positions by nu- merous experiments and demonstrations. When tannic acid 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 circulation. There exists between this organ and the vagina, the urethra, and the lungs, no communication except through the cir- culatory system, and, consequently, the tannic acid—it is fair to presume—must be absorbed to cure leucorrhoza, gonorrhoea, and the most obstinate chronic catarrhs. M. Cavarra concludes, that of all the effects of tannic acid, two of the most surprising are, the cures operated by it in cases of obstinate nervous coughs, and the * Annali universali di Medicina, and Gazette Medical, Sep. 15, 1832. t Cited in the Provincial Medical and Surgical Journal, Nov. 18, 1842, and in Braith- waite's Retrospect, vii. 253. Lond. 1843. X Bulletin des Sciences Medicales, Sept. 1828. § Arzneimittellehre, Supplement, p. 60; also, Cavalier, in Archiv. Generates, xix. 589. || Bulletin de l'Academie Royale de Medecine, Janvier, 1837; also, Dunglison's Medical Intelligencer, Oct. 16, 1837, p. 258, and Bulletin General de Therapeutique, Mars 30, 1837. ACIDUM TANNICUM. 41 excellent action it exerts in phthisis. Farther experiments are, however, demanded before this last point can be admitted. From our knowledge of the properties of tannic acid, it is not easy to see how it—or any other astringent—can be of much service in the latter malady. M. Subregondi* strongly recommends it in hooping-cough, when the period of excitement has passed away. His practice is to give from a quarter to half a grain every two hours along with some soothing agent, as the extractum conii. M. Amedee Latourf has highly extolled it for its efficacy in hemoptysis. 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. Charvet^ 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 associated with opium, and generally at bed-time. Hiiter affirms, that tannic acid, prepared from dried galls, in the form of ointment, or diluted with distilled water, is very service- able in most cases of Egyptian ophthalmia. In the hyperemesis, induced by ipecacuanha or emetia, it may be administered as an antidote. Mr. Druitt§ thinks, that in any case in which a vegetable as- tringent is indicated, tannic acid should have the preference. A simple solution in distilled water, he says, is much more easily and quickly prepared, as well as much more elegant than the ordinary decoctions or injections of oak bark, catechu, &c. It can be made, moreover, of uniform strength, and free from foreign inert matter, and is not liable to decompose quickly. In sore nipples, he found it to be invaluable. He employs it in solution—five grains to the fluidounce of distilled water—on lint covered with oiled silk. He has also found it of great service in toothache. The gum around the tooth is first scarified with a fine lancet, and then a lit- tle cotton wool, imbued with a solution of a scruple of tannic acid, and five grains of mastich in two fluidrachms of ether, must be put into the cavity; and, "if the ache is to be cured at all, this plan will put an end to it in nine cases out of ten." According to the experiments of Magendie,j| tannic acid is one of the substances that oppose the coagulation of the blood. * Cited in Northern Journal of Medicine, Dec. 1844, and in Braithwaite's Retrospect, Amer. edit. viii. 54. New York, 1845. ( Journal de Medecine et de Chirurg. Pratiq. Nov. 1839. X Bulletin General de Therapeutique, Mai, 1840, anJ Encyclographie de3 Sciences Medicates, Juin, 1840. § Provincial Med. Joum. Oct. 9, 1844. || Lond. Lancet, Jan. 20, 1839, p. 636. 42 ACIDUM TANNICUM. MODE OF ADMINISTRATION. It may be given in the form of pill, or draught, or as a lave- ment. In the dose of from a quarter of a grain to two grains, it does not produce any unpleasant constipation, but its effects must be observed with care.* Vinum aromatieum cum acido tannico, Aromatic wine with tannic acid. R. Vini aromat. f. 3viij. Acid, tannic. J)ij. M. R. Vini aromat. f. 3viij. Acid, tannic, f. Qij. Ext. opii. purif. ^ss. M. Used as a local dressing to chancres. Ricord. The vinum aromaticum of the French Codex, used by Ricord, is composed of four ounces of aromatic herbs, (rosemary, rue, sage, hyssop, lavender, absinthium, origanum, thyme, laurel leaves, red rose leaves, chamomile, melilotum, and elder,) digested in two pints of red wine for eight days. Injectio acidi tannici- Injection of tannic acid. R. Acid, tannic. %iv. Infunde per minut. x. in. Aqua? bullientis Oj. To be injected slowly into the rectum in cases of uterine he- morrhage. Dumars. R. Vin. rubr. f. gvj. Acid, tannic, gr. xviij. M. Used in chronic blennorrhoea, or what is called an old gleetA Ricord. In the case of the female, the quantity of tannic acid may be doubled, or still farther increased. ?ilulae acidi tannici. Pills of tannic acid. R. Acid, tannic, pulv. gr. vj. Acac. pulv. gr. xij. Sacchar. pulv. gr. Ixxij. Syrup, q. s. ut fiat massa in pilulas pond. gr. iv. sing. * Cavarra, in Bulletin General de Therapeutique, Mars 30 1837. * ka,L.anceUe Franchise, No. 33, Paris, 1838, and Parker^ Modern Treatment of Sv- philttic Diseases, Dunghson s American Med. Library edit, p. 44. Philad. 1840. ACONITIA. 43 Dose.—One to four, morning and evening, where an astringent is needed. Cavarra. Pilula; acidi tannici cnm opio. Pills of tannic acid with opium. {Pilules narcotiques astringentes.) R. Acid, tannic. £ss. Extract, opii. gr. J. Confect. rosse, q. s. M. et divide in pilulasxx. One every hour in uterine hemorrhage. Dumars. Pulveres acidi tannici et opii. Powders of tannic acid and opium. R. Acid, tannic, gij. Pulv. opii. gr. %. Misce et divide in pulveres tres. Dose.—One, morning, noon, and night; gradually increasing the quantity of tannic acid to four scruples daily. Giadorow. Pomatnm acidi tannici. Pomatum of tannic acid. (Liparole de tannin.) R. Adipis suill. 3-xij. Acid, tannic, gij. Aquae pur. f. ijij. Dissolve the tannic acid in the water, by triturating in a glass mortar; add the fat and mix.* Beral. Lotio acidi tannici. Lotion of tannic acid. (Hydrolotif de tannin, pour Vurethre.) R. Aquse destillat. f. §viij. Acid, tannic, gr. xxxij. Solve. Employed in obstinate blennorrhea. Bern!. VII. ACONITIA. Synonymes. Aconitina, Aconita, Aconitium, Aconitine. German. Akonitin. This active principle, which was discovered by Peschier,f and by Brandes, has been recommended by Dr. Turnbull.f whose eulo- * Bulletin General de Therapeutique, Janvier, 1838. t TrommsdorfTs Journal der Pharmacie, v. 84. t On the medical properties of the natural order Ranunculacese, and more particularly on the uses of sabadilla seeds, delphinium staphysagria and aeonitum napellus, and tlieir alcaloida, veratria, sabadilline, delphinia and aconitine. Chap. iii. Lond. 1835. I 44 ACONITIA. gies on the medical virtues of the natural order Ranunculaceee are evidently overstrained. METHOD 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 Aeonitum 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 pre- vent 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 ex- tract, thus prepared, liquid ammonia is to be added, drop by drop, and mixed well with it, to precipitate the alkaloid: 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 pre- cise 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 aconitia, mixed with a quantity of ex- tractive, 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 quanti- ties of cold water, which will leave the aconitia. This latter pro- cess, 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 off 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 solu- tion 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, carefully decanting 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, cr drawn off by ACONITIA.. 45 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 suffi- 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 pre- cipitate thus formed is to be carefully dried. The product ob- tained by this process is white. The London College, in their Pharmacopoeia of 1836, give the following form:—Take of aconite root, dried and bruised, two pounds; rectified spirit, three gallons; diluted sulphuric acid, solution of ammonia, and purified animal charcoal, of each a sufficient quan- tity. 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 another 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. Evapo- rate the remainder to the proper consistence of an extract. Dis- solve this in water and filter. Evaporate the solution with a gentle heat, so that it may thicken like syrup. To this add diluted sulphuric acid, mixed with distilled water sufficient to dis- solve the aconitia. Next drop in solution of ammonia, and dissolve the aconitia which is thrown down in dilute sulphuric acid, mixed as before with water; then mix in the animal charcoal, occasion- ally shaking for a quarter of an hour. Lastly, filter; and having again dropped in solution of ammonia so as to precipitate the aconitia, wash and dry it. This process, according to Messrs. Bal- lard and Garrod,* mostly fails in procuring the alkaloid. Aconitia occurs in the form of an amorphous powde/, having an intensely acrid and bitter taste. It is not volatile, and should leave- no ash when heated to destruction. When well prepared, accord- ing to Geiger, it 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. It does not dissolve readily in water; at the ordinary temperature requiring one hundred and fifty parts thereof, but only fifty parts of boiling water. It is soluble in al- cohol, and in ether. Tincture of iodine occasions in the solution a reddish-brown precipitate; tincture of galls a white one. It forms, with the acids, for the most part, salts that are not crystal- lizable, which readilv dissolve both in water and alcohol. * laments of Mat Med. and Therap. p. 1C4. Kond. 1^45. 4 46 ACONITIA. EFFECTS ON THE ECONOMY. The effects of aconitia appear to be essentially analogous to those of delphinia. A grain of the first of the two preparations described by Turnbull was dissolved in a dram of alcohol: tiventy 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'aconitia or veratria or delphi- nia be mixed 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 delphinia and aconitia. When a small quantity of aconitia, says Dr. 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 expe- rienced; to this succeeds a feeling of numbness and constriction :n the part, as if a heavy weight were laid upon it, or as if the skin were drawn together by the powerful and involuntary con- traction of the muscles beneath. This effect lasts from two or three to twelve or more hours, according to the quantity rubbed in. So small a portion as the one hundredth part of a grain has produced a sensation that has continued a whole day. A minute portion of it mixed with lard, and applied to the eye, occasions contraction of the pupil according to Dr. Pereira, whilst Geiger and Hesse affirm that the aconitia which they obtained produced dilatation o£ the pupil. Dr. Pereira states, that the aconitia pre- pared by Mr. Morson of London is so powerful, that one-fiftieth of a grain has endangered the life of an individual. It is, he con- siders, the most virulent poison known, not excepting hydrocy- anic acid.* Whilst employing 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 wns 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 aconite employed internally ren- dered the pulsations less frequent, but not irregular, and con- sii icntly that it exerted a decidedly sedative effect on the heart; whence he infers, that it is a proper remedy in active diseases of * Elements of Mat. Med. &c 2d edit. ii. 1811. Lond. 184-2. 1 Gazetti Medicaleds Paris, Oct, 10, 18J5. ACONITIA. 47 that organ, and indeed in inflammatory affections in general, in which he exhibited it with success. In cases of poisoning by it, the contractions of the heart have been found diminished and almost suspended.* The homceopathists regard it as an ener- getic antiphlogistic. Dr. Eadesf concludes from his own observations, that the most remarkable symptoms exhibited by animals from the use of aco- nite or its alkaloid, are—weakness; staggering; gradually in- creasing insensibility of the surface; slowly increasing weakness of the voluntary muscles, ending, perhaps, in paralysis; great lan- guor of the pulse; more or less blindness, and convulsive twitch- ings before death. The ablest investigation yet undertaken into the actions of aco- nite, according to Dr. Christison,| is contained in the inaugural dissertation of Dr. FIeming§ since published, and with a copy of which the author has been favoured by Dr. Fleming. He found that the most remarkable symptoms are weakness and staggering, gradually increasing paralysis of the voluntary muscles, slowly increasing insensibility of the surface, and more or less blindness. He farther observed, that the pupil becomes much contracted; that the irritability of the voluntary muscles is impaired; that the veins are congested after death, the blood unaltered, and the heart capable of contracting for some time after respiration has ceased. From the action of the aconite upon the cerebro-spinal and muscular systems Dr. Fleming deduces the following practical in- ferences. First, that it is calmative, anodyne and antispasmodic. Secondly, that it is an advisable antiphlogistic in apoplexy, phre- nitis or any disease in wThich the circulation of the brain is exciled. Thirdly, that it is contra-indicated in head-ache arising from anae- mia or chlorosis, and wherever there is a torpid or paralytic con- dition of the muscular system, and, Fourthly, Its properties sug- gest its employment in convulsive or spasmodic diseases. From its action on the circulation he infers, First, that it is a powerful antiphlogistic. Secondly, that it is calculated to be of great value in all cases where there is inordinate activity of the circulation. Thirdly, that it is contra-indicated when there is obvious mechanical impediment to the pa.^sage of the blood, parti- cularly through the heart or lungs: it is requisite, therefore, in every case, to ascertain that no such obstruction exists before com- mencing its use; and fourthly, that it is contra-indicated when- ever there is irritability of the circulation, with great diminution of power, such as occurs after severe hemorrhage. * Orfila, Toxicologic, ii. 221. t Dublin Journal of Med. Science, March, 1H45, p. .15. X Treatise on Poisons. Anier. edit. p. 60>5. Phila 1845. § An Inquiry into the Physiological and Medicinal Properties of the Aeonitum Napellus, ike. Lond. Ib4.r), / 48 ACONITIA. Its results on the respiratory system led him to the inference, First, that it will probably be found a highly advantageous anti- phlogistic in pneumonia, pleuritis, &c. Secondly, it seems calcu- lated to be serviceable in spasmodic asthma. Thirdly, it is con- tra-indicated in difficulty of breathing, arising from any other cause than inflammation or spasm; and fourthly, in cases of ad- vanced bronchitis, with excess of secretion, it would prove highly injurious, by diminishing still farther the power of expectoration. Dr. Fleming has not met with an}' convincing evidence that aconite is a cumulative remedy; although in two cases he was in- duced to suspect it. The individuals were affected with general tremors, severe pain in the head and eye-balls, constant lachry- mation, intense photophobia, heat of skin, quick pulse, and great restlessness. In many other instances, however, where the admi- nistration of the remedy was continued for weeks, and even months, no such effects were observed. The diseases in which Dr. Turnbull chiefly employed aconitia externally, were of the neuralgic kind; but he used it as well in gouty and rheumatic cases; and its success, he remarks, fully an- swered his anticipations. He employs it either in the form of so- lution in alcohol, in the proportion of one or more grains to the dram,—or of ointment, made according to the following formula: R. Aconitise, gr. ij. Alcohol, gtt. vj. Tere optime et adde Adipis, 3j. ut fiat unguentum. The alcohol is added to prevent the aconitia from forming a thick compound with part of the lard, so as to render it difficult to make a proper ointment. In one case of tic douloureux, of ex- treme severity, as much as eight grains was prescribed in the oint- ment 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 aconitia being increased at every second or third rubbing. Dr. Turnbull found, in the case of the aconitia—as well as in that of veratria and delphinia—that unless the friction occasioned a full development of the peculiar impressions caused by the aconitia when rubbed on the skin, no benefit whatever was to be looked for from its employment; and he obserres, that if there be the slightest abrasion of the skin, an application of such activity should not be resorted to; and that it should be carefully kept from coming in contact with any of the mucous membranes. Aconite and its alkaloid have been used internally and exter- ACONITIA. 49 nally in neuralgia, with marked advantage by Jahn, Tealier, Hufeland, Wildberg, Fleming* and others; but Drs. Copland, A. T. Thomson and others have prescribed it in several cases without success. By many, the external application of the remedy is con- sidered to be more likely to be beneficial; whilst others give a pre- ference to its internal use. Mr. F. C. Skeyf 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. The observations of Turnbull and Skey have been confirmed by Drs. Roots, Sigmond, Fleming and others.^ In neuralgia of the heart it was found highly serviceable by Dr. Copland.§ Aconitia is not much used. The extravagance of its price, which is said to have been in England 3s. 6d. or upwards of three quarters of a dollar, per grain|| would necessarily limit its use, had it proved to be more advantageous than it has. It would appear, that all its powers are possessed by the tincture of aconite or by the alcoholic extract. Dr. 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 aco- nitia, to the consistence of an extract. To every dram of this, eight or ten drops of liquor ammonise 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 oint- ment, according to the following prescription: Ungnentnm extracti aconiti ammoniati. Ointment of ammoniated extract of aconite. R. Ext. aconit. ammon. %]. Adipis 25iij. Misce ut fiat unguentum. When this ointment is rubbed upon the skin, it occasions sen- sations in the part similar to those produced by the aconitia oint- ment: they are, however, rather more pungent. In less severe cases, Dr. Turnbull advises the simple saturated tinc- ture of the dried root, with or without the addition of a little am- * Op. cit p. 5C. t London Med. Gaz. Nov. 5, 1836. X Dr. Cowan, Provincial Med. and Surg. Journ. May, 184'J; cited in Braithwaite's Retrospect, Amer. edit. viii. 26. New York, 1844. § Dictionary of Practical Medicine, vi, 893. || Pereira, Elements of Mat. Med. and Therap. 2d Amer. edit p. 757. Phila. 1846. 50 ACUPUNCTTJRA. monia. The external use of this tincture of aconite has been re- commended in neuralgia and chronic rheumatism by Dr. Pe- reira* and Mr. Jos. Curtis, f and in hemicrania\ by Dr. Fleming. The alcoholic exlract of aconite—Extractum aconiti alco- holictjm—which, is officinal in the last edition of the Pharma- copoeia of the United States, 1842—has likewise been advised by Drs. Lombard of Geneva,§ Busse, J. B. Watkins|| and others in articular rheumatism. Dr. Lombard gives it in doses of half a grain every two hours, and gradually augments the dose to six or nine grains in the same period. A case of poisoning by five grains of this extract—from which, however, the patient recovered—has been published by M. E. L. Pereyra, of Bordeaux. 1" The applications of the different preparations of aconite to the- rapeutics have been given elsewhere.** VIII. ACUPUNCTU'RA. Synonymes. Acupuncture; Acupuncturation. German. Die Akupunktur; der Nadelstich. Although acupuncturation is really an ancient therapeutical agent, attention to it has been so much revived of late years, and its use has been so largely extended, that it may be looked upon as constituting one of the novelties of therapeutics. It consists in the introduction of needles into different parts of the body with a view of removing or mitigating disease; and ap- pears to have been entirely unknown to the Grecian, Roman, and Arabian physicians.f f From the most ancient times, however, it has been in use with the Chinese and Japanese, by whom it was regarded as one of the most important of remedial agencies. By thesa people it was systematically taught on appropriate phan- toms or mannekins, called T'soe-Bosi, and the practice of the operation was permitted to those only who were able to pass a rigid examination thereon. In Europe, it was first known about 160 years ago, from the writings of a Dutch surgeon, Ten-Rhyne, who wrote in 16S3;|J and attention was subsequently drawn to it * Elements of Materia Medica, 2d edit. ii. 1808. Lond. 1842. t Lond. Lancet, June 26, 1841. X Op. cit. p. 60. § Gazette Medicale, Juin 23, 1834. See, also, Dr. Sigrnond, in Lancet for August 5. 1837. ' || Philad. Med. Examin. No. 33. IT La Lancette Franchise, No. 37, Mars 26, 1839. "* General Therap. and Materia Medica. i. 371. 3d edit. Philad. 1846. tt V. A. RiecUe, Die neuern Arzneimittel u. s. w. S. 12, Stuttgart, 1837. tt Mantissa schematica de Acupunctural ad dissert, de Arthritide. London, 1683. ACUPUNCTTJItA. 51 by Kampfer;* but after this it was almost forgotten, until Berlioz in 1S16, drew attention to its employment. His example was soon followed by Beclard.f Bretonneau,^: Haime,§ Demours,j| Sarlandiere,^f Pelletan, Segalas, Dantu, Velpeau, Meyranx,** Dance, in France; by Churchill, Scott, Elliotson,tt and others in England; by Friedrich,|| Bernstein,§§ L. W. Sachs, Heyfelder, Michaelis,|||| Grafe,^[lT and others, in Germany; by Carraro,*** Ber- gamaschi,ttt Bellini, and others, in Italy; and by Ewing,JU E. J. Coxe,§§§ Bache,|||||| and others, in this country. M. Jules Cloquet had much to do in reviving its employment in his own country and elsewhere, by his treatise on the subject published at Paris, in 1826, where it was for a long period a fashionable article in the hospitals; so much so, it is affirmed, that attempts were even made to heal a fractured bone by it without the application of any ap- propriate apparatus; and at one time, it is said, the patients in one of the hospitals actually revolted against the piqueurs mt- decins.'^m MODE OF ADMINISTRATION. In the operation of acupuncture, needles are employed, which are very fine, well polished and sharp pointed. They are usually from two to four inches long, the length being adapted to the depth it may be desired to make them penetrate. If steel needles are selected, they are heated to redness, and allowed to cool slow- ly, in order that they may be less brittle. At the blunt extre- mity of the needle, a head of lead, or sealing wax is attached—to prevent it from being forced entirely into the body. This is the simplest method of acupuncturation, and it is as effectual as any other. By various acupuncturists, needle-holders or handles of * Amcenitat exotic, politico-physioo-medic. p. 583. Lemgov. 1712; and his Histoiy of Japan, vol. ii., Appendix, sect. 4, p. 34. t Mem. de la Societe Medic. d'Emulation, viii. 575. X Journal Universel des Sciences Med. xiii. 35. Paris, 1817. § Journal Gener. de Medec. torn, xiii., and Journal Univers. des Sciences Medic, torn. xiii. If I'J. || Ibid. torn. xv. IT Mem. sur 1' Electrbpuncture. Paris, 1825. ** Archives Generates de Med. torn. vii. Paris, 1825. tt Med. Chir. Trans, xiii. 467. Lon. 1827; and art. Acupuncture, in Cyclop. Pract. Med. Amer. edit. Philad. 1845. tt Translation of Churchill's work in German, p. 40. § §Hufeland's Journal, lxvii. Berlin, IfSvi*. |||| Gnife und Walther"s Journal, B. v. St. 3. S. 552. ' TT TT E. Griife, in art. Acupunctur. in Encyc. Worterb. der medicinisch. Wissenschafi B. i. S. 312. Berlin. 1828. *** Annali Universali d'Omodei, 1825. ttt Ibid 1826. tit North Amer. Med. and Surg. Journal, ii. 77. Philad. 1806. §§§ Ibid. ii. 276. Philad. 1826. ||||il Ibid. i. 311. Philad. It26; and art. Acupuncture, in Cyclop, of Pract Me.,'!, i. 200. Philad. 1*33. TITT1T Riecke, Op. cit S. 13. 52 ACUPUSCTTJRA. ivory have been devised, to some of which the needle is perma- nently attached. Perhaps the porte-aiguille, or 'needle-holder' recommended by Prof. F. Bache,* is as good as any that has been invented. The needle, with its porte-aiguille, consists of a handle with a steel socket to receive the end of the needle, which may be fixed securely, after having been inserted, by the pressure of. a small lateral screw. By this construction, the operator can at pleasure fix in the handle a needle of the length he may de- sire, and after inserting it he is enabled to detach the handle by relaxing the screw. After all, however, needles prepared in the simple manner mentioned above are adequate to every useful purpose. Besides common steel needles, those of gold, silver and pla- tinum have been used, but it does not appear that one metal is preferable to another. To introduce the needle, the skin is stretched, and the needle inserted by a movement of rotation performed in opposite direc- tions, aided by gentle pressure. As a general rule, the seat of pain will indicate the place where the needle should be introduced; but where the feelings of the patient do not point out the spot, it must be suggested by our knowledge of anatomy and physiology. From the experiments of Beclard, Bretonneau, Segalas, Dantu, Velpeau, and others, it would appear, that perforation of arteries, nerves, and even of important viscera with very fine needles, has not been followed by any injurious results; yet, at times, accidents have been produced thereby; and, therefore, it may be laid down as a rule, that the greater nerves and arteries of a certain size, should be avoided. Prudence would likewise suggest, that im- portant viscera, as the heart, stomach, intestines, &c, should not be penetrated. The number of needles to be used varies according to the extent of the parts affected. In the opinion of many experienced physi- cians, we ought not to be afraid of the number, but rather insert too many than too few, and not at too great a distance from each other. The length of time, during which the needles should be suffered to continue in the part, differs: no fixed rule can be laid down. Some suffer them to remain for an hour and a half, or two hours: at times, a period of five minutes is sufficient. In other cases, they have been kept in for two or three days. It appears to be by no means settled what medicinal influence is exerted by their longer or shorter continuance in the parts. EFFECTS ON THE ECONOMY. Allusion has already been made to the impunity with which, in the generality of cases, acupuncturation may be practised even on important organs. * Cyclop, p. 202. ACTJPUNCTURA. 53 As respects the nerves, Cloquet has seldom or never seen the puncture of them give rise to so much pain as to render it neces- sary to withdraw the needles: the pain was generally trifling and speedily passed away. He inserted needles into the brain and spinal marrow, and into the crural nerve of a cat, without any evi- dence of severe suffering or of change of function. Similar experi- ments were made by E. Grafe with the same results.* Nor was inconvenience found by Delaunay, Beclard and Cloquet to be sus- tained on puncturing the arteries and veins. A few drops of blood perhaps issued, but the flow was readily stopped by pressure with the finger. The slight ecchymosis, which, at times super- vened, disappeared rapidly of itself. In Grafe's experiments, he never found much bleeding ensue, although he properly esteemed it advisable to keep clear of the nerves and blood-vessels, in order to avoid any unnecessary pain or mischief. As regards the fasciae and periosteum, Grafe found, that the in- sertion of needles into them was always very painful, and he re- commends, therefore, that the operation should be performed with care on those parts. Should, however, the needles be introduced, and much pain be experienced, it rapidly ceases when they are withdrawn. Lastly—MM. Haime, Bretonneau, Velpeau, and Meyranx, insti- tuted several experiments on dogs by passing needles into the brain, heart, lungs, stomach, &c, and little or no inconvenience, as remarked above, was experienced, provided the needles were extremely fine. Cloquet passed his needles so deeply into the chest of an animal as to leave no doubt, that they had penetrated the lungs, and he subsequently pierced the liver, stomach, and tes- ticles without the supervention of any unpleasant results. The pain occasioned by acupuncturation is generally easily tolerated; but at times it is so violent, that the patients cry out; the violence, however, usually passes away either when the needle is drawn out or forced in deeper. It would seem, that the opera- tion is, as a general rule, most successful when it occasions the least pain. Cloquet asserts, that a kind of electric shock is some- times experienced in the surrounding parts at the moment of the introduction of the needle; in other cases, a tremulous motion is observable in the fibres of the muscles penetrated. Almost always, some time after the entrance of the needles, a more or less regular aureola or halo of a red colour, and without tumefaction, is per- ceptible around the needles, which soon disappears after they are withdrawn; but when tiny are suffered to remain long in the part it may persist for hours. When the operation is productive of benefit, relief is speedily experienced. * Art. Acupunctur. in Encyc. Worterb. u. s. w. S. 317. Berlin, 1828. 54 ACUPUNCTURA. The extraction of the steel needles is ordinarily accompanied by more pain than their bisection, especially if they have penetrated deeply, a-nd been retained in the flesh for a long time. The diffi- culty is owing to their having become oxidized, and consequently rough on the surface. In withdrawing them, it is advisable to give them a movement of rotation, and at the same time to press upon the skin surrounding them with the thumb and index finger. In the hospitals of St. Louis, LaPitie, and the Hotel Dieu of Paris, acupuncturation was practised some thousands of times, and in every case, according to Guersent, without the occurrence of any thing unpleasant. Pelletan, however, affirms, that he saw it on four occasions followed by slight faintness at the hospital St. Louis, but none of the cases assumed the characters of full syn- cope. Gaultier de Claubry has frequently seen faintness, febrile movements, spasm, and insupportable pain produced by it, and Heyfelder saw it followed by convulsions and fainting. Beclard has related a case where the needle penetrated to the bene, and occasioned intense pain. The patient remained a long time faint, and afterwards violent delirium ensued, which gradually ceased in the course of the day, and was followed by great debility. Subsequently^ an abscess formed in the part on which the opera- tion was practised. As to the modus operandi of acupuncturation, we cannot con- ceive its effects to be any thing more than a new nervous im- pression, produced by the needle on the parts which it penetrates. The needles having been found oxidized, especially at the point, it has been supposed by some, that the oxidation is connected with the remedial agency, and it has been even affirmed, that in some diseases they oxidize more readily than in others.* It is a suffi- cient reply to this view, that beneficial results arc obtained from the use of needles made of metals that do not become oxidized, and that the steel needles oxidize in the sound, as well as in the diseased body, and even in parts that have been removed from the body, and placed in warm water; for in the cold dead body, it is affirmed, the phenomenon is not observed. Cloquet and Pel- letan think, from their experiments, that the effects of acupunctu- ration are a consequence of the development of the nervous fluid —which they liken to the galvanic—around the needles; a view which is denied by Pouillet and Beclard, but adopted in a modi- fied form by Dr. Bache,f who throws out the conjecture, "that in many cases of local pain this accumulation of the nervous (elec- trical) fluid depends upon the altered state of the various fascia? or condensed sheets of tissue, giving them the power, to a certain extent, of insulating the parts which they serve to embrace.'-' * GKIfe, loc. cit. S. 319. \ Op. citat. 305. ACUPUNCTURA. 55 The explanation is ingenious, but we do not think it necessary, if adequate, to explain the phenomena. We have no doubt,'that the effects are owing to a concentration of the nervous power towards the part transfixed by the needle, so that a derivation of the ner- vous influx induced towards the seat of pain, or towards the nerves particularly concerned in the production of tthe pain; but farther than this we know not. There is one phenomenon, by the way, which is dependent on the oxidation of the needle. When the free extremity of an in- serted needle is connected with the ground by means of a con- ducting substance, or is put in connexion with a soft part of the patient's body, it becomes the seat of a galvanic current, which is exhibited by the multiplier of Schweiger. That this pheno- menon is dependent upon the oxidation of the metal, is proved by the circumstance that it does not take place when an unoxidizable metal is employed.* Acupuncturation has been used by Berliozt in gouty and rheumatic cases; by Haime in rheumatic, spasmodic, and con- vulsive affections, and by Demours in amaurosis, and ophthalmia, the needles being inserted into the temples; Finch advised it in anasarca, practised on the feet; he also discharged, in this way, the fluid of ascites.^ Pipelet§ employed it advantageously in a violent convulsive affection. The needles did not remove or markedly diminish the symptoms, but they postponed their recur- rence. Michaelis|| cured a case of rheumatism by it, but he did not find it so serviceable in ozdema of the feet, as the fluid would not flow readily through the minute apertures. Friederich pro- posed, that in cases of asphyxia, when every other remedy had been employed unsuccessfully, the cavities of the heart should be penetrated by a needle to excite its contraction, and this plan was subsequently advised by Carraro,Tj who found, from his experi- ments on cats, that they could in this way be resuscitated after drowning, when every manifestation of vitality had ceased. His experiments, however, when repeated by Dr. E. J. Coxe,** of Philadelphia, were not found to succeed. J. Cloquet obtained the happiest results from acupuncturation in neuralgia, rheumatism, muscular contractions, spasms, pleurodyne, cephalalgia, ophthalmia, toothache, epilepsy, gout, gaslrodynia, contusions, lumbago,periodical amaurosis, diplopia, paralysis, &c. A case of neuralgia, after am- * Riecke, S. 16. 1 Op. citat. Paris, 1816. X Lond. Med. Repos. Mar. 1823. § Journal Complem du Diet, des Sciences Medic, t. xvi. 1823. || Grafe und Waliher's Journal. B. v. St. 3. H Annal. univ. di Medicin, 1825. See, also, Provincial Med. and Surg. Journ., May 15, 1841. ** North. Amer. Med. and Surg. Journal, ii. 292. 56 ACUPUNCTURA. putation, has been reported as cured by it.* The patient was at- tacked by agonizing pains, not only in the stump, but also in the opposite thigh, accompanied by convulsions and fainting. In this state, two needles were planted in the course of the sciatic nerve. These produced no effect, but as soon as the third was introduced, the patient exclaimed, " The doctor has struck the toe of my foot." The needle was then pressed still deeper, so as to pass through the nerve, when the pain immediately ceased. After the needles had remained in half an hour, they were removed, and the patient en- joyed a sound sleep and awoke free from pain. About twenty days afterwards, the pain recurred; £he needles were again applied, and relief as instantaneously followed. Several cases of neuralgia removed by it have been published by Prof. Riberi, of Turin.f A case has been recently published by LV. Seller,! in which it was employed with beneficial results in protruded lockjaw, con- nected with attacks of suppurating sore throat, and accompanied with hysterical and also with inflammatory symptoms. The needles were usually inserted to the depth of half an inch, and sometimes an inch: most commonly one was placed on each side of the mesial line, between the chin and hyoid bone; whilst sometimes two or three were introduced, one above another, as near as possible along the mesial line in the same region, and were kept in about a minute. It is in rheumatic affections that its success has been most marked. Dr. Elliotson§ cured 30 out of 42 cases by it in St. Thomas's hos- pital. In sciatica its efficacy has been evident.|| By Velpeau it has been proposed to cure aneurism by acu- puncturation. In performing some experiments on animals he found, that arteries punctured by the needle became the seat of a coagulum, and were ultimately obliterated. In 1830, he read a paper before the Academie des Sciences, of Paris, proposing the operation in the cases in question.IT He found in his experi- ments, that whenever the needle remained three days in the flesh, the transfixed artery was completely obliterated. M. Bonnet, Chirurgien-en-chef to the Hotel Dieu at Lyons,** has affirmed, that he treated eleven cases of varicose veins by in- * Bulletino delle Scienze Medich. Ottobre, 1838, and Brit, and For. Med Review Jan 1840, p. 252. v ' t Medico-Chirurg. Rev. April, 1841, p. 501. \ Northern Journal of Medicine, April, 1845, cited in Braithwaite's Retrospect, Amer. edit. xi.. 189. New York, 1845. § Art. Acupuncture, Cyclop. Pract Med. Amer. edit, by the author, Philad. 1845. || Renton, in Edinb. Med. and Surg. Journ. for 1830, xxxiv. 100; and Dr. Graves in Lond. Med. Gaz. July, 18:51, and Lond. Med and Surg Journal, April. 1*33. TT Lond Med Gaz.. and Amer. Journal of Med. Science, Au<*. 1831, p. 510. ** Bulletin General de Therapeutique, and Dunglison's American Medical Intelligencer for Dec. 1, 1837, p. 317. ° ' ACUPUNCTURA. 57 troducing pins through their cavities, and allowing them to re- main there some time. Nine of these cases were cured. The same treatment was applied to herniary sacs. He passed three or four pins through the herniary envelopes close to the inguinal ring, and in order that they might exert a certain degree of com- pression, as well as of irritation, on the sac, he twisted the points and heads upwards so as to give them a circular direction. The inflammation and pain usually commenced on the third or fourth day after the operation, and the pins were removed a few days afterwards. M. Bonnet had treated four cases of inguinal hernia by acupuncturation. In two, the hernia was small, and three weeks sufficed for the cure: the third was more troublesome. Cau- tion is of course requisite not to injure the spermatic cord. In a subsequent communication, M. Bonnet inculcates the ne- cessity of causing the obliteration of the veins in several places separated from each other by short spaces.* Of late, acupuncturation has been revivedf in the treatment of hydrocele by Mr. Lewis, Mr. King,J and others. It consists in carrying a common sewing needle—of the size used for sewing a button to a shirt—through the skin, the dartos and cremaster, into the bag containing the fluid, so that a drop of the fluid follows the instrument as it is withdrawn. It is executed in nearly the same manner as the ordinary method of tapping with a trocar, ex- cept that the needle, which should be oiled, cannot be plunged in so easily as that instrument. Mr. King suggests, that the needle should be fixed in a handle, by which means it can be made to enter with comparative facility. After the operation, a compress, moistened with a discutient lotion, may be kept on the scrotum, and the patient may walk about or remain at rest, as may best suit him. The phenomena which present themselves in a few hours are as follows:—the swelling begins to be less circumscribed, and to lose its tenseness, and the cellular tissue of the scrotum be- comes gradually more and more infiltrated with the fluid, which before distended the tunica vaginalis, and which, in the space of from twenty-four to forty-eight hours, will, according to Mr. King, have entirely changed place. In five or six days, the infiltration disappears, and the patient is cured. Mr. Lewis first introduced the method as a palliative cure, but he has seen cases where a ra- dical cure was effected by it.§ He considers the principle of puncturing with a fine pointed needle not only applicable to pro- * Archives Generates de Medecine, Mai, 1839. See, also, Mr.Dodd, in Medical Gaz., Dec. 20, 1839. t Mr. Travers, in Lond. Med. Gazette, Feb. 1837, p. 737. Mr. Lewis, Ibid. Feb. 1837, p. 788. Mr. Robert Keate, Ibid. p. 789. X British Annals of Medicine, No. 1, p. 13. § Dr. Davidson, in Edinb. Med. and Surg. Journ. for Jan 1838. 58 ACUPUNCTURA. mote the absorption of the fluid in hydrocele, but in every case of encysted dropsy* Reference has already been made to the use of acupuncturation in anasarca. The author has used it advantageously to drain off the fluid from the cellular membrane: in such cases larger needles are needed; some prefer them to be of the size of an ordi- nary glover's needle, and of a triangular shape; a puncture of this kind being less likely to close.f In the mass of cases, it need scarcely be said, this course can act merely in a palliative manner,—the cause of the dropsical accumulation persisting. Still, as Dr. Graves has remarked, under favourable circumstances, and in a good constitution, the simple operation of evacuating the fluid, by punctures made through the skin, has been, of itself, sufficient to effect a cure. In a lady, under his care, general anasarca came on after fever, and resisted every form of treatment he could devise. When he had made many fruitless attempts to produce absorption by means of in- ternal remedies, another practitioner was called in, who practised acupuncturation of the lower extremities, and succeeded com- pletely. Mr. Vowell| has published a case in which acupuncturation was successfully employed for the removal of a ganglion. A young lady under his care had been affected with a ganglion of a considerable size on the extensor tendons of the foot, which pro- duced not only disfiguration, but some uneasiness. Mr. Vowell applied blisters, and afterwards iodine ointment and pressure, for above a month, without benefit. He then inserted the tambour porte-aiguille of his patient. Pressure was applied, and within a week the tumour had completely disappeared. M. Wiesel,§ has narrated a case of fracture of the two bones of the forearm, in which reunion of the bones not having taken place at the end of nine weeks, he had recourse to acupuncture with full success. He introduced between the two moveable fragments of the ulna two needles, sufficiently long to traverse the false articu- lation from side to side, and kept the needles in that position for the six following days, after which he withdrew them, because they had excited by their presence considerable swelling of the part and severe pain. Fifteen days afterwards, he traversed in the same manner the false articulation of the radius, with two other needles, which, at the end of a few days, caused sharp pain * Lancet, May 7, 1830, and Jan 14, 1837. Sec a case of Ovarian Dropsy, in which it was employed by Dr. Robert D. Thomson, in Lancet. May 25, 1«39, p 344- and one of Ascites by Mr. Campbell, Lond. Med Gaz., Nov. 1838. t Dr. Graves, Lond. Med. Gazette, Oct. 1838. See, also, Mr. King, Ibid Oct 7 1837, and Nov. 25, Ih37. " ' X Lancet, Aug. 25, 1838, p. 770. § Gazette des Hopitaux, Dec. 1843, and Braithwaite's Retrospect, Amer edit ix 18(;. New York, 1844. 2ETHER HYDROCTANICUS. 50 and slight suppuration. He then applied «a simple bandage to the limbs, and in the space of six weeks, complete consolidation had taken place. When acupuncturation is conjoined with electricity or galvanism, it constitutes electro-punclure, and galvano-punclure. (q. v.) IX. ESTHER HYDROCYAN'ICUS. Synonymes. iEther Prussicus, Hydrocyanic, or Prussic Ether, Hydrocya- nate of Etherine, Cyanuret of Ethule. French. Ether Hydrocyanique. German. Cyana.ih.er. This preparation was discovered some;)*ears ago by Pelouze,* and, according to Magendie,! it resembles in its effects hydro- cyanic acid, without being so violent a poison, and, consequently, he esteems it worthy of regard as an addition to the materia medica. METHOD OF PREPARING. Equal parts of sulpho-vinate of baryta and cyanuret of potas- sium are mixed intimately together, put into a glass retort, to wfliich a tubulated receiver is adapted, and exposed to a moderate temperature. 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 hy- drocyanic acid. In order to purify it, it must be strongly shaken, and, with four or five limes its bulk of water, must be exposed for some time to a temperature of 60° or 70° centigrade; it must be again agitated with a little water, decanted, suffered to remain in contact with chlorinated lime for twenty-four hours, and then distilled. The ether thus obtained is pure. It is a colourless fluid, of a penetrating, disagreeable garlicky odour. Specific gravity 0.78. It boils at S2° centigrade; is very slightly soluble in wat.:r, 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. Potassa 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. * Journal de Pharmacia, xx 399. Park, 1833. t Formulaire—derniere edition 60 ALUMINJE SALES. 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 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 often necessary to discon- tinue its use, on account of the invincible nausea which its smell induced. Magendie advises it in those diseases in which mix- tures of hydrocyanic acid have been found of service. X. ALU'MIN^ SALES. Synonymes. Salts of Alumina. French. Sels d'Alumine. German. Thonerdensalze. In making experiments on the agency of various substances as antiseptics, M. Gannal* found, that the aluminous salts are alone possessed of the property of preserving animal matters,— "their bases combining with geline to form a special compound, the acid being set free." He found the aluminous deliquescent salts to be, of all saline substances, those that afford the most satis- factory results. The acetate of alumina and chloride of alu- minum succeeded perfectly. A mixture of equal parts of chloride of aluminum at 20° Beaume (s. g. 1.161,) and of the acetate of alumina at 10° (s. g. 1.075,) proved as good an injection as we possess for the preservation of dead bodies. The preservation of animal substances appears to depend upon the combination of geline with alumina; but the acid sulphate does not possess enough of the preservative element; and hence M. Gannal was driven to the employment of the salts of alumina, that are richer in alumina, and more soluble in water. Of all these, the sulphate of alumina was found to merit the prefer- ence, owing to its being of simple preparation and moderate price.t It may be made by the direct combination of alumina and sul- * History of Embalming, Ac, by J. N. Gannal, Paris, 1838, translated by R. Harlan M. D., p. 20:i. Philad. IS40. t Ibid p. 233. ALUMINiE SALES. 61 phuric acid; and contains 30 per cent, of the former to 70 per cent, of the latter. A kilogramme—about two pounds, eight ounces, and a dram and a half troy—dissolved in two quarts of water, and costing twenty cents, M. Gannal found to be sufficient, in winter, to preserve a body fresh by injection for three months. To preserve it for a month or six weeks, it was not even neces- sary to inject the blood-vessels,—an enema of one quart, and the same quantity injected into the oesophagus being sufficient for tin- purpose. In hot weather, the solution must be stronger, or in greater quantity, and it should be injected into the carotids. The acetate of alumina, of which M. Gannal made use, was prepared by the addition of acetate of lead to sulphate of alu- mina and potassa. The acetate of alumina, thus prepared, at N 1S° of Beaume's areometer, and in the quantity of five or six quarts, was sufficient to preserve a body for five or six months. This salt of alumina is, however, too costly; and, therefore, cannot be employed in amphitheatres, where large quantities are required. In the report on M. Gannal's memoir presented to the Insti- tute of France, the commission adduce, in favour of his plan, the experience of MM. Serres, Dubreuil, Bourgery, Azous, Velpeau,. and Amussat. " In the month of June, 1836," says M. Serres, " in the amphitheatre of the hospital, the body of a man, 22 years of age, was injected. Left to the open air, in a room exposed to the south, and upon a wooden table, it was preserved until the month of September, and was ultimately mummified. In the month of July, eight bodies were injected for dissection, and kept fifteen days. During the months of August and September, sixty subjects were injected. They were kept for twenty days'/5. From these experiments, M. Serres concludes, that the liquid furnished by M. Gannal, permits the dissection of bodies during summer, which had not been practicable in the anatomical schools of the hospitals of Paris; and that it gave to the instruction in operative medicine a development, which it had not previously enjoyed; for, during the months of August and September, they were enabled to have thirty bodies at a time on the tables, as in the middle of winter, so as to enable them to repeat before the students all the operations required in a regular course of opera- tive surgery. For his discovery the Institute of France awarded M. Gannal the grand Monthyon prize of 1600 dollars, which was established for the discovery of any means calculated to remedy the unwhole- someness of any art or profession. A useful application of M. Gannal's process is said to have been made by the police of Paris, in preserving bodies for many weeks in the Morgue pr dead-house, where suspicions of murder required an unusual retention of the body above ground.* * Harlan. Appendix to Gannal, op. cit., p. 254. 5 C2 AMMONIA PHOSPHAS. The specimens of pathological anatomy, preserved in the liquid of the injection, were not exempt, according to Dr. Harlan, from the usual inconvenience attached to similar preparations in a solu- tion of chloride of sodium and other salts,—being equally liable to incrustations, so as to require a change or renewal of the solution. The salts of alumina have been used in this city with the view of temporarily preserving the dead; and a case has been pub- lished in which the acetate was employed; but the corrosive chloride of mercury was used along with it, which was altogether unnecessary. In the afternoon of the day on which the individual died, the abdominal aorta was injected upwards and downwards with a saturated solution of corrosive chloride in alcohol; and on ' the following day, a saturated solution of acetate of alumina was thrown in, "which," says Dr. Sharpless,* "had the immediate effect of giving the whole body a manifest rose colour, making it resemble life in a remarkable degree." The salts of alumina have been chiefly employed to prevent putrefaction in the dead body; but they might be used with emi- nent advantage as external applications in cases that require the topical use of antiseptics. At the author's suggestion, they were so used at the Philadelphia Hospital, and were found to have an excellent effect in ulcers requiring antiseptic and detergent ap- plications.! Two drams of the sulphate to half a pint of water is a good wash in such cases; but it may be made much stronger than this. Dr. George Johnson, of Georgia, used an injection of the sulphate with the happiest results in cases of fetid, discharges from the vagina;% after handling pathological specimens, the au- thor has found a saturated solution of the salt remove the offensive odour from his hands more speedily and effectually than any other antiseptic. XI. AMMONITE PHOSPHAS. Synonymes. Phosphate of Ammonia. French. Phosphate d'Ammoniaque. German. Phosphorsaures Ammonium. Phosphate of ammonia has been recommended in some of the unofficial pharmacopoeias and formularies, as an excitant, diapho- retic and discutient;§ but it could scarcely be said to be employed in medicine, when it was brought forward by Dr. Thomas Buck- * Medical Examiner, Aug. 13, 1842, p. 513. t Dr. M. J. Pcnnypacker, Medical Examiner, April 1, 1843 p 63 X Ibid. May 27. 1*13, p. 112. ' r . ' §?rterat and De Lens, Diet Univ. de Mat. Med. &c., edit de Bruxelles 1 in Bruxelles, 1838. ' ' AMM0NIJE PHOSPHAS. 63 ler, of Baltimore, on chemical considerations, as "a new remedy for gout and rheumatism, as a solvent of uric acid calculus, and for diseases, acute and chronic, connected directly with the lit hie acid diathcsis.,'>* METHOD OF PREPARING. For the mode of preparing this salt,* the treatises on chemistry must be consulted. EFFECTS ON THE ECONOMY. From the fact of the frequent existence of lithuria in gout and rheumatism, and the sudden elimination of uric acid,—and that when chemists have examined the structural thickenings in those diseases, they have found a variable abnormous per centage of earthy matter, consisting for the most part of soda and lime,—and from other considerations, Dr. Buckler infers that uric acid exists in the blood,—not in a free state, or it would be passed continu- ously, but in a state of combination with soda or lime, or both. The predominance of lithic acid in the urine, he considers, gene- rally heralds recovery from an acute attack of gout or rheuma- tism. "Taking into account," he observes, "these two prominent facts, namely, the excess of lithic acid found in the urine at the period of convalescence from an attack of gout or rheumatism, and the subsequent deposit of soda and lime in the white tissues, it occurred to me, that during the existence of these diseases, the lithic acid might exist in the blood in a state of combination with soda and lime, in the form of insoluble compounds, which the kidneys and skin refuse to eliminate. If, then, any agent could be found capable of decomposing the lithates of soda and lime existing in the blood, and of forming in their stead two soluble salts, which would be voided by the kidneys and skin, we should thereby get rid of the excess of fibrin in the blood, the symptomatic fever and the gouty and rheumatic inflammation, wherever seated, which have been excited by the presence of these insoluble salts; it occurred to me that phosphate of ammonia might be-the agent, provided it could be given in doses sufficient to answer the end, without producing any unpleasant physiological symptoms. If our theory were true, phosphate of ammonia seemed to be the proper reagent, for it would form in place of the insoluble lithate of soda, two soluble salts, the phosphate of soda, which is remark- ably soluble, and the lithate of ammonia, which is also soluble, and both capable of being readily passed by the skin and kidneys. The excess of uric acid would thus be got rid of in the form of lithate of ammonia, and the soda floating in the round of the cir- culation, instead of being deposited, as it were, like an alluvial * American Journal of Medical Sciences, Jan, 1846, p. 108. 64 AMMONUE PHOSPHAS. formation in the substance of the fibrous and cartilaginous tissues, would be taken up by the phosphoric acid and eliminated from the circulation." With such views, Dr. Buckler administered the phosphate of ammonia, and found that thickening of the ivhite tissues, of long standing, disappeared under its continued use; that it was de- cidedly serviceable in attacks of gout and acute rheumatism, and that in manyold hospital cases of chronic rheumatism, the patients, without a single exception, declared themselves better, and begged for a continuance of the medicine. In every instance, in the cases reported, it was found that where lithic acid was present in the urine, it at once disappeared under the use of the phosphate of ammonia. From this rapid disappearance of the acid from the urine, in every case, he was led irresistibly to the conclusion, that the phosphate of ammonia must prove the best agent for dissolving uric acid calcxdus; but he had had no opportunity for testing its efficacy in this respect. The cases adduced by Dr. Buckler do not demonstrate to us, so strongly as they do to him, the marked efficacy of phosphate of ammonia in the cases in question. It is proper also to remark that, according to the analysis of Berzelius, this salt exists in the urine in health, and we have no reason to believe that it is not pre- sent in gouty and rheumatic diseases also. Moreover, although there may be generally a predominance of uric acid in the urine in gout and rheumatism, it is by no means clear that these diseases are dependent on contamination of the blood with undischarged urea and uric acid, as has been maintained by many.* "Several considerations," say Messrs. Ballard & Garrodf—able chemists— "prevent our subscribing fully to this doctrine, which we are not aware to be established upon aught but hypothetical grounds." Phosphatic deposites are frequently, indeed, observed in conjunc- tion with gouty affections, and in many instances it would seem that tophaceous concretions contain no urate of soda, but in its stead phosphate of lime. In numerous cases of gout, the phosphatic predominance is indeed marked.% Keller,§ again, in animadverting on the views of Mr. A. Ure, referred to under Acidum Benzoicum, remarks, that Mr. Ure "is certainly too hasty in recommending benzoic acid as a remedy for the gouty and calculous concretions of uric acid. He seems to suppose that the uric acid has been employed in the conversion of benzoic acid into hippuric acid ; but as his observations were made on a gouty patient, it may be supposed that the urine, even without the internal use of benzoic acid, would have been found to contain no uric acid." * Williams, Principles of Medicine, Amer. edit, by Clymer, p. 131. Philad. 1844. t Elements of Mat. Med. and Therap., p. 352. Lond. 1845. t Mr. A. Ure, Provincial Med. and Surg. Journal, Feb. 11,1843; cited in Braithwaite'n Retrospect, vii. 47. Lond. 1843. § Liebig's Animal Chemistry, Amer. edit., p. 315. Cambridge, 1842, t AMMONIA PHOSPHAS. 65 Sufficient time has not elapsed for experiments to have been made on a great scale, to test the qualities of the phosphatic salt in the cases described by Dr. Buckler. It has been already seen, that in the case of the benzoic acid, examples were not wanting to prove its efficacy in lithuria; although no one now c*an believe that it could' have exerted any efficacy in the manner suggested. So far as the phosphate of ammonia has been given, it does not seem to have generally fulfilled the expectations excited by Dr. Buckler. In a trial made with it by Dr. C. Voigt,* in the dose of only about three grains, a series of alarming and highly irritative phenomena succeeded, caused, he thinks, by the violently irritating action of the salt on the stomach; yet Dr. Voigt had good reason to suppose that the preparation employed was pure. In commenting on this case, Dr. Ruschenberger,t of the United States Navarl Hospital, New York,, states that be has employed phosphate of ammonia in nine cases in closes of ten grains, re- peated every four hours. In no case was the article used for less than a week, and in several it was continued three, four, and even six weeks. The urine was tested before the medicine was pre- scribed, and during its use; but no change in its constitution was detected by reagents, nor was there any modification in its quantity or specific gravity. In one case only did any amelioration occur in the symptoms after the use of the salt; but whether this was owing to it he could not decide. Inasmuch, however, as no per- ceptible effects were induced in any of the other cases, his impres- sion was that the phosphate is useless in the treatment of chronic rheumatism. More recently, Dr. H. Hartshorne, resident physician at the Pennsylvania Hospital,;}; has reported some cases of rheumatism in which the phosphate was prescribed by Dr. Pepper. The smallest dose given to an adult was ten grains, and in several cases it reached thirty grains, continued three times daily for a number of days. In two or three, in doses of twenty grains, it disordered the alimentary canal. Several of the cases recovered; but additional treatment was generally used—as Dover's powder at night, the warm bath, cupping, blisters dressed with morphia, mercurial ointment combined with narcotics, Veratria ointment, &c. These, Dr. Hartshorne considers may perhaps claim much of the credit of the cures, which were mostly very slow. The phosphate, he says, has been used by his father, Dr. Joseph Harts- horne, with such results as to incline him to think that it may be a valuable addition to our means of treatment of rheumatism. MODE OF ADMINISTRATION. The dose of the phosphate of ammonia is from ten to twenty grains, which may be given, dissolved in water, three times a day. * Med. Examiner, May, 1846, p. 289. t Ibid. June, 1846, p. 342. t Ibid. July, 1846, p. 397. t 68 AQUA AMYGDALARUM CONCENTRATA. XII. ANTHRAKQ'KALL* This article was first proposed by Dr. Polya, of Pesth, in the year 1S37. METHOD OF PREPARING. 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 slaked lime as will separate the potassa. The solution thus obtained con- tains 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 parts to 192 parts of potassa. The mixture is stirred and re- moved from the fire, and the stirring is continued until a black homogeneous powder results. This powder is kept in a dry place. To obtain the sulphuretted anthrakokali, 16 parts of sul- phur must be mixed accurately with the coal, and the mixture be dissolved in the potassa as directed above. EFFECTS ON THE ECONOMY IN DISEASE. M. Polya affirms, that Anthrakokali exerts its influence on the skin generally, and especially on chronic cutaneous affections. It has also been given beneficially in scrofula and chronic rheu- matism. The dose of the simple and sulphuretted preparations is 10 cen- tigrammes (gr. iss.) three times a day. Fuligokali (q. v.) is an analogous substance. XIII. AQUA AMYGDALA'UUM CONCENTRATA. Synonymks. Water of Bitter Almonds. French. Eau d'Amandes Ameres. German. Bitterrmindehvasser. The water of bitter almonds has been received into many of the modern Pharmacopoeias;—into those of Bavaria, Paris, Fer- rara, 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 * From aifloat, 'coal,' and kali, 'potassa.' See MM. Jacobovics, in Gazette M6dicalo de Paris, Nos. 9 & 12, and Riecke. Die neuern Arzneimittel, u s. w. 2te Auflage, S.37. Stuttgart, 1840; also, Mr. Duhamel, American Journal of Pharmacy, Jan. Ic4:'. AQUA AMYGDALARUM CONCENTRATA. 67 them 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 ves- sel, and then distil two pounds. The product must be kept in a well stopped bottle. 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 much employed in this country, or in great Britain. The inequality in the strength of the Aqua lauro-cerasi and of 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. Owing, indeed, to the uncertainty in strength of both these preparations, Liebig thinks, that physicians would act very judiciously were they to discard them; and substitute a certain amount of amygdalin dis- solved in water, and mixed with emulsion of sweat almonds; as the remedy, prepared fresh every time when it is to be adminis- tered, will always possess the same composition. Seventeen grains of amygdalin yield one of anhydrous hydrocyanic acid; conse-* quently, by mixing 34 grains of amygdalin with 66 grains of emulsion of sweet almonds, so that the total amounts to 100 grains, a fluid is obtained corresponding to the medicinal hydrocyanic acid of the Prussian Pharmacopoeia (2 per cent.) A third of a grain of amygdalin corresponds to one grain of medicinal acid: the so- lution of one grain of amygdalin in three fluidounces of emulsion of sweet almonds contains, consequently, one grain of medicinal acid in every fluidounce of the mixture.* Water of bitter almonds has been used by Dr. Hodgkinf as a means of allaying distressing itching, as in prurigo senilis. In some cases, it produced immediately a beneficial effect; in others, it caused no benefit, but produced smarting and irritation. Mr. May keeps a solution of the oil of bitter almonds in the propor- tion of one part to seven of alcohol. This he uses as a substitute for hydrocyanic acid for internal administration; he gives about half a drop for a dose. Externally, he employs it of the strength of a drop of the solution to an ounce of water. * Ranking's half yearly Abstract of the Medical Sciences, pt. ii., vol .l,p. 346. Amer edit. New York, 184(5. t Pharmaceutical Transactions, Sept. 1841; and Amer. Journ of Pharmacy, Jan. 1842, p. 3o2. t38 AQUA BINELLII. XIV. AQUA BINELLII. Svnontmes. Aqua Balsamica Arterialis. Italian. Acqua Binelli, Acqua Balsamica Arteriale. French. Eau de Binelli. German. Binellisch.es Wasser. Many years ago, this Italian nostrum was vaulted throughout Europe as a styptic in every kind of hemorrhage, both when em- ployed internally and externally. By several Italian physicians— Cotugno, Antonucci, Santoro and others—it was found highly serviceable; and Von Grafe* thought that he had observed good effects from it. This opinion was confirmed by the observations of Kosch, Vrolick, Metzger,f and Lesser. Subsequently, how- ever, not only Von Grafe, but Sirrion,}: Dieffenbach,§ and Dr. John Davy|| found that it was not possessed of more efficacy than simple cold water.IT This hasmastatic received its name, Acqua Binelli, from Dr.Fideli Binelli, the inventor. The first public trials to test its efficacy were instituted at Turin, in 1797, by order of the government; the results of which were esteemed favourable. Soon after this Binelli died; the secret of the composition and of the mode of preparing the nostrum were, however, communicated before his death to Gaetano Pironti, and Andrea Ferrara, who carried on a profitable trade with it for some time. The secret appears to have been lost; but in the years 1829 and 1830, it was affirmed to have been rediscovered, and fresh experiments were instituted, and over and over again repeated in Germany. Various blood-vessels were divided on animals,—the femoral and carotid arteries, and the jugular veins,—and the cuts were made in every direction,—some longitudinally, some obliquely, others completely across; and in all cases the hemorrhage yielded as soon as charpie or lint steeped in the Acqua Binelli was applied and pressed gently against the wound for five or ten minutes. Encouraged by the result of these experiments, the liquid was tried on man and with seeming advantage; but it was soon found, that the results were not owing to any properties of the liquid, but rather to the cold, moisture, and appropriate pressure. The author has given at length in another work** the results of the experiments and observations of Dr. Davy. They con- vey interesting information as regards the physiology, pathology, and therapeutics of wounded vessels, and impart a useful lesson to * Grafe's Journal. Ed. xvii. S. G50. 1 Ibid Bd xxvii X Horn's Archiv. 1833, Sept. and Oct S. 926. § Decker's Literarische Annalen, 1833, S. 480. || Edinb. Med. and Surg. Journ.. July, 1833, or Researches Physiological and Ana- tomical, Dunglison's Amer. Med. Library, edit p. 371). Philad. 1840. IT E. Grafe, Art. Kreosot. in Encyclop'ad. Worterbuch der Medicin. Wessensch. Bd xx. S. 53(5. Berlin, 1839. ** General Therapeutics and Mat. Med. 3d edit. ii. 111. Philad. 1846. AQUA BINELLII. 69 the inquirer,—not to deduce inferences from inadequate data, without having investigated every 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 arrested by moderate compression with several folds of linen or cotton moistened with plain water; and they further show how, under this moderate compression, the wound in the artery may heal, and the vessel remain pervious, without the supervention of aneurism. Dr. Davy lays'great stress on moderate pressure, such as may allow the blood to continue to pass through the canal of the artery. At the meeting of the British association in 1S39, Dr. Macart- ney, of Dublin,* in alluding to the powers which nature possesses to repress hemorrhage, provided the surfaces be treated as an open wound with cold applications, related a case in which after ampu- tation 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 re- „ quired. This Dr. Macartney believed to be the first case on re- cord in which amputation had been performed without the appli- cation of a ligature. The Acqua Binelli was a perfectly transparent fluid, almost tasteless, and having a slightly empyreumatic odour; but neither the presence of salt, alkali, earth nor acid could be detected by the senses. It has been generally considered to be indebted for its fancied haemastatic property to creasote in some form; but Dr. Davy's explanation appears to be sufficient to account for the phe- nomena. M. Bouchardatt gives the following complex formula for the Acqua Binelli or Acqua Monterossi, of which, he says, great use is made in the civil and military hospitals of Naples. Take of the roots of calamus aromaticus, bistort, consolida offi- cinalis, and tormenlilla—each 250 parts: oak bark, logwood; of each 500 parts; leaves of greater plantain; eupatorium of Avicenna; athanasia maritima; European sanicle; alchemilla vulgaris; sumac; and nettle; flowering tops of rosemary, and sage; of each 1000 parts; flowering tops of teucrium marum; dittany of Crete, peppermint, of each 250 parts; flowering tops of pennyroyal, catmint, lesser centaury; and achillea millefolium, of each 1000 parts; balsamide, 250 parts; Cyprus nuts, 1000 parts; white agaric and black pilch, of each 500 parts. All the ingredients must be cut into small frag- ments, and be macerated in a sufficient quantity of water for twenty-four hours. When the liquid is wholly absorbed, a fresh quantity is added, so that the mass may be covered with water to the height of about four or five inches. It is then distilled so as to draw over about two thirds of the fluid employed. * London Athenaeum, Aug. 31, 1839, or Med. Intelligencer, Oct. 15, 1839, p. 217. t Annuaire de Therapeutique, &c., pour. 1843, p. 227. Janv. 1843. 70 AQUA BROCCHIERII. The product of this distillation is, however, possessed of more marked properties than those of the Acqua Binelli described above. It is said to be astringent, and to corrugate bleeding and injured tissues, causing the formation of coagula, which prevent a farther discharge. It coagulates albumen. It is also employed internally in the various profluvia. A substitute for the Acqua Binelli prepared by Professor Schultz is the following.* Aqua Binelli i factitia. Factitious Acqua Binelli. R. 01. empyreumat. tabaci. f. ^ij. ----animal. Dippel. gtt. xij. ----Aq. destillat. f. §viij. m» Used externally only. XV. AQUA BROCCHIERII. Svnonymes. Brocchieri, or Brocchiari water. Italian. Acqna Brocchieri. French. Ean de Brocchieri. F.au styptique de Brocchieri. German. Brocchierisches Wasser. This water strikingly resembles the Binelli water, both in sen- sible properties and action; and the same discordance of sentiment in regi;-d to its virtues has existed amongst observers. It was largely used in Paris upwards of fifteen years ago; and the profession generally appear to have decided at that time that it was devoid of efficacy. Dr. Parisf examined it, but it appeared to him to be nothing more than water perfumed by some vege- table essence. "This supposed styptic," he remarks, "has made much noise in Paris, and is said to be even capable of arresting the flow of blood from a divided carotid artery! The method of applying it is to saturate tow with the liquid, and slightly press it upon the bleeding vessel, where it is to remain for fifteen or twenty minutes: the rapidity with which a coagulum is said to form, and the tenacity of it, are attested to be most extraordinary. In order to ascertain the fact, having procured a supply of it from Paris, through the kindness of my friend, Dr. Badham. I proceeded to the Veterinary College,and with the assistance of the professional gentlemen of that establishment, I made a very careful experiment upon an ass without the least effect." A few months ago, a gentleman who had visited Paris brought it over to this country, and it was again subjected to various * Bouchardat. p. 229. t Pharmacologia, Amer. edit, from the 9th London edit, by Dr. Lee, p. 122. New York, 1844. AQUA BROCCHIERII. 71 trials, and whilst some deposed most strongly to its potency as a haemostatic, others considered it to possess slight power, and others, again, denied that it had any styptic virtues whatever. Experiments, it is affirmed, were instituted before MM. Blanqui, Amussat, Lisfranc and others,* of Paris, in which the effusion of blood from the carotid artery of a sheep was speedily arrested by it. Similar experiments were tried in New York by Dr. Barrabino of the United States navy, and others; and in Charleston, by Dr. J. Lawrence Smith, and S. D. Sinkler, editors of the Southern Journal of Medicine and Pharmacy.f These last gentle- men thought it certain, that it arrests hemorrhage in a most marked manner, without either being styptic or cauterizing in its action. They considered that both it and ergotin, "operate by a peculiar action upon the blood, or upon the walls of the artery. In the case oftheBrocchieri water,nothing decisive is yet known,although it is slated, tint the calibre of the artery is restored to its natural integrity," and they add:—"'the composition of this water is un- known. It is colourless, of very slight acid reaction, very little taste, and this not astringent. Its odour is aromatic, and the only , idea we are yet capable of forming of its nature, is, that it is water containing the volatile principle of some plant, over which it has been distilled." In a subsequent communication, however,^ after having experi- mented farther with the Brocchieri water, as well as with ergo- tin and creasote, they arrive at the following conclusions:— First. When Brocchieri water, ergotin or a watery emulsion of creasote is applied to the wounded artery of a sheep, it depends greatly, if not altogether, upon the manner in which the lint is applied to the wound of the artery whether the hemorrhage is ar- rested or not. If it be placed immediately upon the orifice of the cut vessel, the success is certain; if, however, the vessel shrink from contact with the lint, the animal is almost certain to bleed to death. Secondly. B}r a small pledget of simple lint placed immediately upon the incision made into the carotid artery of a sheep, the hemorrhage is arrested in a few moments; and after a lapse of from twenty to thirty minutes, the animal may be let loose, without any apprehension of the return of the hemorrhage. If the lint be applied so as not to touch the wound in the artery, all effort to arrest the hemorrhage will be ineffectual. "From these results, it will be seen how many difficulties often attend the simplest experiments; and how important it is to leave no point, not the most, apparently trivial, without close examination: it is true, it requires both time and trouble, but both are more than compensated for, by a knowledge that, we become in possession of truths that are important to ourselves and to others." Thirdly * Boston Med'cal and Surgical Journal, Jan. 14, 184(5. p. 4^0. t See Ihe No. for March, 1646, p. 158. X Ibid. July, 1840, p. 406. 72 AQUA BROCCHIERII. The sheep is an unfit animal to try the hemostatic powers of sub- stances as regards the human subject; for although sheep will bleed to death by a wound in one of the larger arteries, still, by the application of a small pledget of lint, sustained with a little pressure immediately upon the wound in the vessel, the hemor- rhage will cease, and the animal survive. The same, they are convinced, may be said of all the like experiments upon the lower classes of animals, as in many of them the hemorrhage from a large vessel will be arrested spontaneously. This is true—they say—of the dog, and so far as their knowledge extends, the sheep is more ready to bleed to death than any other quadruped. " Furthermore, the blood of an animal is more plastic, coagulating with far greater rapidity than that of man; and as the arresting of the hemorrhage in these experiments is dependent upon the for- mation of a clot around the opening, and in the cavity of the ves- sel, it ought, therefore', to happen more readily in them than in man." Fourthly and lastly; they conclude, that if the haemosta- tic1 virtues of the agents, which they employed, are to be correctly ascertained, it is only by experiments upon.the human subject, and no value, they think, should be given to those made in any other way. Whether the Brocchieri water, ergotin, and creasote will stand the test, they are not as yet prepared to say, owing to the discordant character of the results of experiments. They have no doubt that these substances hasten the coagulation of the blood, and that they may, under some circumstances, arrest hemorrhage from the smaller arteries; but in the case of the larger vessels, they are of no manner of use, at least not more so than the lint without them. The experiments made on the human subject that have come to their notice are:—wound on the hand; oozing for some time after the operation for hydrocele; oozing from a tumour on the back tried with Brocchieri water. In the first case there seemed to be no effect; in the two last some slight effect: the oozing in the case of the hydrocele, although diminished, could not be arrested. Hence they think, there is no danger of the liga- tures of vessels being supplanted by it. ' Professor Mott, in a clinical lecture delivered on the 10th of January, 1846,* has the following remarks.—"Iv knew M. Brocchieri when I was in Paris: he is an uneducated man, and a perfect charlatan. When his discovery was made known in Paris, it created some stir; and I made several experiments with it, in connexion with several other gentlemen, one of whom was engaged in the preparation of the water. The subjects of the ex- periments, were strong and healthy sheep, upon whose carotid arteries we operated, and we found that its power to stop hemor- rhage was next to nothing, and where the bleeding was arrested, it was principally from the pressure made by the large quantities * New York Medical and Surgical Reporter. AQUA BROCCHIERII. 73 of lint, with which the wound was filled. Therefore, I say, as the result of my experience, that the styptic powers of this preparation are not to be relied upon for a moment; that it is infinitely less use- ful than an infusion of rhatany or tannin, and that it can never take the place of needles and ligatures. The other qualities that have been ascribed to it of curing disease, and arresting haemoptysis are equally non-existent." The Acqua Brocchieri was brought to the notice of the Medico- Chirurgical Society of Louisiana, at its sitting in March, 1846, by a communication from one of the venders of the nostrum, accom- panied by some bottles of the article, with the request that the So- ciety would examine and report upon its styptic powers. The Society, on the ground that it would be setting a bad precedent, declined the proposition. Several of the members, however, de- termined to avail themselves of the earliest opportunity to test its properties, and Dr. A. Mercier has published the result of his experiments.* After detailing two cases of wounds, on which it was used as a hasmastatic, he remarks:—" The pain, which these two patients experienced from the application of the Eau Brocchieri, a pain incomparably greater than that from the application of strong salt and water, or any other styptic solution, together with its utter inefficacy in cases of hemorrhage, have induced me to abandon any farther trials with it, except, perhaps, in cases of hemorrhage from mucous membranes, as from the nose, rectum, &c. &c, which are so common in this country." With the same view of testing the virtues of this famous hsema- static, the author's friend and colleague, Professor Mutter, last winter, (1846,) in the presence of Dr. Kearney of the United States Navy, Dr. King of the Army, Dr. .1. W. Wallace, and several other medical gentlemen, conducted a series of experiments on some ten or twelve sheep, the results of which were as follows: "When the carotid artery," says Professor Mutter, in a letter to the author, " was opened, especially if the incision ran parallel to the long diameter of the vessel, and the Acqua Brocchieri was freely applied, the hemorrhage ceased in the course of ten, fifteen, or twenty minutes; and the sheep, recovering speedily from its pros- tration, would eat with avidity. On examining the wound it was found filled with a coagulum, but there was no adhesion between it and the walls of the vessel, and of course no organization could be detected. Similar results were obtained with several other styptics, such as creasote, tincture of chloride of iron, oil of tur- pentine, &c. &c. " On the whole I was led to consider this agent a tolerably good styptic, but not better than those already in daily use. "To test the vis medicalrix natural, Dr. Wallace divided complete- * New Orleans Medical and Surgical Journal, May, 1846, p. 816. f Amer. Journal of the Medical Sciences, July, 1846, p. 146. 74 AQUA BUOCCHIEUII. ly both carotids, and applied nothing to the wound; yet recovery took place in the course of 30 minutes, the animal walking about and eating with ihe others. " When the vessel was partially divided, so as to prevent con- traction and retraction, death speedily ensued." It is proper to add, that the first experiments of Drs. J. Smith and Sinkler satisfied them, "that a sheep would bleed to death with his carotid cut, and that no application of water, even in the form of ice, could arrest the hemorrhage." With this conviction on their mind, they considered themselves "fully prepared to form* just conclusions concerning the two experiments" which they made on sheep. Yet in Dr. Wallace's case, it will be observed, the sheep recovered after both carotids had been divided; and without any application whatever. A committee of the Medical Society of Virginia, consisting of Dr. C. P. Johnson, G. G. Minor and R. W. Haxall,f appointed to investigate the qualities of the Acqua Brocchieri, reported, as the results of their experiments, First, that it has no power of co- agulating blood. Secondly, that it has no power of producing contraction of the coats of an artery. Thirdly, that it does not arrest hemorrhage from an incised wound sooner than the unaided power of nature would accomplish the same result. Fourthly, that in the case of incised arteries, its application is no more to be depended upon to arrest the hemorrhage than that of simple cold water. Thavommittee are of opinion that the true and only cause of the arrest of the hemorrhage in their experiments, "as in all of the cases which have been reported, is pressure, the pressure being continued for a sufficient length of time to allow a coagulum to form which will be firm enough to resist the impulse of the blood from the orifice in the vessel." On the whole, the remarks made on the Acqua Binelli apply equally to the Acqua Brocchieri. Neither, it would seem, is pos- sessed of the haemastatic virtues that have been ascribed to it. According to M. Martius* the Brocchieri water may be made as follows:—Macerate for twelve hours pine wood (bois de sapin) cut small and bruised, in double its weight of water. Then distil until a product is obtained equal in weight to the wood employed. Leave this distilled water at rest for twenty-four hours; after which the volatile oil that collects on the surface must be sepa- rated. Before using the water it is necessary to shake it. M. Deschamps has proposed the following substitute for the Eau Brocchieri. Take of turpentine, 500 parts, water, 600 parts. Boil for a quarter of an hour,f then add a sufficient quantity of water to obtain 1000 parts of turpentine and water. Let it be- come cold, and filter. * L'Abeille Medicale, Fevrier, 1846, p. ,r>4. t Bouchardat, Nouveau Formulaire Magistral, 3e ddit. p 291. Paris, 1845. AQUA PICIS LIQUIDS. 75 A new haemastatie water under the name Eau hemastalique de Tisserand has been experimented with in Paris, and M. Fremy, Interne at the Hotel Dieu, reports several cases in its favour. M. Rocamier has also used it, and considered it to be possessed of the same properties as the Acqua Brocchieri: he esteems it to be even more advantageous, and affirms that he has succeeded with it in cases of haimoplysis, intestinal hemorrhage, and dysentery. The fol- lowing formula is given by M. Bouchardat* for a haemastatie water which may be substituted for the Eau hemastalique de Tisserand. R. Sang^iin. Dracon. Terebinth, {des Vosges,) 5a 3iij. Aquaj, Oij. Digest for twelve hours, and filter. XVI. AQUA PICIS LIQ'UID/E. Synonvmes. Aqua Ticis. Aqua Picea, Infusum Picis Liquids; seu Picis Empyreumaticse Liquids?. Potio Picea, 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 contaift creasote. It was first employed extensively in England about the middle of the last century, and was drunk not simply as a therapeutic but as a prophylactic a^ent, so that Riecke facetiously remarks, almost as much tar-water was consumed by the inhabitants of London, as beer and other drinks.f As commonly happens in such cases, practitioners passed from one extreme to the other, and as they gradually found that tar water was not capable of accomplishing all that had been ascribed to it, they ultimately neglected it altogether. Still formulas for its preparation exist in many Pharmacopoeias—in those of Dublin, Bavaria, Brunswick, Paris, Russia, Saxony, Sweden, and Wirtem- berg, for example. Water takes up from tar a small portion of acetic §cid, crea- sote, and resinous matter; and tar-water was formerly much praised as a remedy in pulmonary consumption, and as a diu- retic; its virtues, however, appear to rest almost vvholly on the contained creasote. Some years ago, Arnheimer, of Duisburg, recalled the attention of practitioners to it as a remedy in many chronic cutaneous * Op cit. t Die neuem Arzneimittel, S. 38. Stuttgart, 1837. 76 AQUA PICIS LIQUIDS. affections, 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 was 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 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 gene- rally taken without any repugnance. The process in the Dublin Pharmacopoeia is the following:— Take of Tar, two pints; Water, a gallon: mix, and stir with a wooden rod for fifteen minutes; then, when the tar has subsided, filter the liquid, and keep it in well closed jars. Since the discovery of creasote, tar-water has received fresh consideration, and it is not improbable, that it may come again into more general use, as it appears, from experiments, that there are cases where it would seem to merit a preference over creasote. M. Petrequin has made some trials with both, in chronic catarrh, and in different stages of phthisis* The num- ber of cases reported by him is twenty-three; of these seven were of chronic catarrh, in which creasote was given; generally the cough was mitigated by it, but in two no effect was produced on that symptom. The expectoration was usually diminished or facilitated; in two cases, however, no advantage was derived from it, and in one case the sputa were bloody. In the majority, 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 num- ber of the evacuations. In two it excited vomiting, and common- ly produced nausea. On the whole, in the greater number, 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, 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 disease, also, * Gazette Medicale de Paris, No. 45, Nov. 5, 1836. AQUA PICIS LIQUIDS. 77 creasote excited burning in the epigastrium or chest, and in one instance fugitive sensations of heat and creeping 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, the cough was more or less improved,—never increased; the oppression remain- ed 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 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 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 facilitated; the dyspnoea alleviated or removed, and the pains in the chest were improved or dissipated. In two cases, it appeared to act benefi- cially on vomiting which accompanied the cough. The appetite was improved, and in one case diarrhoea seemed to be dimi- nished, whilst in two others existing constipation yielded during its use. In all the cases, sleep was restored. On the urinary se- cretion it exerted no influence, and it neither excited thirst nor nausea like creasote. In three cases of incipient phthisis, its ac- tion was more beneficial 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 thirst. It excited or improved the appetite, and aided digestion. In one case of advanced phthisis, the alleviation pro- duced 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 enable us to infer positively on matters that must as yet be considered involved in doubt.* The author has administered it freely in phthisis, as well as in chronic bronchitis. In the latter affection, it has relieved cases, in which the accustomed excitant expecto- rants are found to be serviceable. The same has been the fact in * Deslandes, Diet de Medec. et de Chirurgie prat. xi. 233. 6 78 ABGENTI PRJEPARATA. the former disease; but farther than this no advantage has accrued from its administration. In a French periodical,* some cases are published from the records of the hospiials for 1829 and 1830, during the attendance of the late Professor Dupuytren, in which injections of tar water were successfully administered in calarrhus vesicas, along with the use of pills of turpentine. The tar water was made by in- fusing 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 injected through an elastic gum ca- theter, which was forthwith withdrawn and the patient directed to retain the injection as long as possible. The injection was re- peated daily, and Venice turpentine was administered internally in the form of pill. A syrup op tar may be made by dissolving sugar in tar water, f 0 XVI. ARGENTI PR^PARA'TA. Svnontmes. Preparations of silver. French. Preparations d'Argent. 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. Recently, however, the attention of physicians has been directed to the internal use of many of those preparations, and especially by M. Serre,^: 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 were selected for treatment by the preparations of silver—the chloride, cyanuret, and iodide. Trials were also made with divided metallic silver, oxide of silver, and chloride of ammonia and silver. At first, these preparations were administered iatraleiptically; the chloride, the cyanuret, and the iodide in the quantity of one-twelfth of a grain; the chloride of silver and ammonia in the quantity of one-fourteenth 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. M. Serre soon found, that these doses were generally too small: he, therefore, raised that of the chloride and iodide to one-tenth, and to one- eighth of a grain, without the slightest inconvenience resulting. The other preparations were also increased in the same propor- * La Lancette Franchise, Avril 8, 1837. t Soubeiran, Journal de Pharmacie, Janvier, 1842, p. 70. X Bulletin General de Therapeutique, 1836. ARGENTI PRiEPARATA. 79 tion, with the exception of the chloride of silver and ammonia, which requires more precaution than any of the other prepara- tions. M. Serre did not restrict himself to the iatraleiptic admi- nistration of these substances, but employed them internally in the form of pill, and externally as local applications. M. Serre describes several cases of syphilis in which the pre- parations of silver were administered. The first patient was a sol- dier, 26 years old, of athletic constitution, who, at the time of his admission into the hospital, had several extensive chancres on the prepuce, so close to each other as to seem to form one large cir- cular 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 discontinuance of the remedy. Scarcely had a grain of the chloride been employed, when the secretion from the ulce- rated parts became less; the,surface of the chancres lost the kind of grayish border which they possessed, and cicatrization pro- ceeded rapidly. The frictions were continued, and the condition of the patient went on improving. At the end of two months, he left the hospital. In the five subsequent cases, the same plan of treatment was pursued. The chloride was used exclusively ac- cording 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 third, 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 suffered 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 occasion salivation, nor do they induce in the intestinal canal or in the respiratory organs the disagreeable effects that are too ofien caused by mercury. Secondly. 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. Patients can be treated by them in secret as well as when travelling, without fear of detection. Fourthly. The preparations of gold are to be preferred in these respects; but SO ARGENTI CHLORIDUM. gold has the disadvantage of exciting too much, and cannot, there- fore, be exhibited to those of a nervous and excitable tempera- ment, or who have weak and delicate chests. In such cases the preparations of silver merit the preference. Fifthly. The pre- parations 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 prepared, which is a consideration of some moment, as regards the pharma- ciens of small towns. Sixthly, and lastly. There are cases in which mercurial and gold preparations fail, and where preparations of silver might be of advantage. The observation of others has not confirmed the assertions of M Serre. M. Ricord* employed the various preparations, made after the formulae given by M. Serre, in the same doses; but not being able to observe any effect that could be fairly ascribed to these agents, he ventured upon considerably larger doses,—as much, for example, as twelve grains a day of the iodide and cyanuret,— 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.t XVII. ARGENTI CHLO'RIDUM. Synonymes. Argentum Muriaticum, A. Salitum, Chloruretum Argenti, Argentum Chloratum, Chloride, Chloruret or Muriate of Silver. French. Chlorure d'Argent. German. Salzsaures Silber, Chlorsilber, Hornsilber, Silberchlomre. Chloride of silver is prepared by the decomposition of a solution of nitrate of silver, by an excess of a solution of chloride of so- dium. The resulting product or chloride of silver appears under the form of a flaky, clotted, very thick precipitate: it must be washed repeatedly with boiling water, and be exposed to the heat of a sand-bath, so that it may dry as speedily as pos- sible. 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 vvhen much divided, or when moist; and assumes a somewhat dark violet hue, as the chlorine is given off. It suffers no decomposition when united with vegetable matters. It must be dried and kept protected from the light4 Its uses have been referred to under the head of the preparations of silver. As nitrate of silver is probably always converted into chloride * J. J. L. Rattier, La Lancette Francaise, No. 122, Oct. 13, 1836. 1 Dr. W. P Johnson, Medical Examiner, Nov. 23, 1839, p. 743. X O.i the mode of forming the various preparations of silver, see Chamou, in Bulletin General de Therapeutique, No. xvi. Aug. 30, 1836. ARGENTI ET AMMONIA CHLORIDUM. 81 of silver by meeting with the chlorohydric acid in the stomach, it occurred to Dr. Perry,* at the time resident physician of the Phila- delphia Hospjtal, to administer the chloride, which he did with ad- vantage in epilepsy, chronic dysentery, chronic diarrhoea, and other affections in which nitrate of silver is given internally. Twelve grains given daily for three months produced no unplea- sant symptoms; and in no case did discoloration of the skin suc- ceed. In epilepsy, three grains, given four or five times a day, pro- duced effects similar to those of nitrate of silver, but more marked. In chronic dysentery, half a grain to three grains, given three times a day, produced immediate diminution in the number of the evacua- tions, and relieved the tormina; inducing, at the same time, an im- provement in the character of the stools and other symptoms. The author has very frequently prescribed the chloride; and on the whole it has appeared to him to be equal to the nitrate of sil- ver in the cases mentioned by#Dr. Perry. It has been affirmed recently, that a combination with iodine will prevent the discoloration of the skin; and that the use of iodine will remove it where it has already occurred; but farther experience is necessary to establish this. See Argenti Iodidum (p. 84.) Pulvis argenti chloridi. Powder of chloride of silver. R. Argent, chlorid. gr. j. Irid. florent. pulv. gr. ij. Reduce to a fine powder, and divide into eight or ten portions; to be rubbed on the tongue. Serre. XVIII. ARGENTI ET AMMO'NI^ CHLO'RIDUM. Synonymes. Argentum Muriaticum Ammoniatum, Chloruretum Argenti et Ammonise, Chloride or Chloruret of Silver and Ammonia, Ammonio- chloride of silver. French. Chlorure d'Argent et d'Ammoniaque. German. Silbersalmiak, Salzsaures Silberammonium. This preparation is obtained, vvhen we saturate, by the aid of heat, liquid ammonia with freshly 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 crys- tals 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. Chloride of silver and ammonia has a bluish white colour, the * Dunglison's American Medical Library and Intelligencer, Feb. 1841. S2 ARGENTI ET AMMONIA CHLORIDUM. peculiar smell of ammonia, and a burning, almost caustic, taste. In the air, it gradually exhales ammonia, and acquires all the pro- perties 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 influen.ce of light When treated with distilled water, the chloride is decomposed. A portion saturated with ammonia is again dissolved; yet a much greater portion remains undissolved; this contains only a small quantity of ammonia. It 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 before remarked, has also been used with ad- vantage by Serre in cases of syphilis. Another preparation, the Liquor argenti muriatico-ammo- niati, has been long recommended by Kopp, in cases of chronic nervous affections. It is prepared according to the following formula:— R. Argent, nitrat. fus. gr. x. Aquae destillat. f. ^ij. Soluto filtrato instilla liquoris natri muriatici, (Sodii chloridi,) q. s. ad praecipitandum. Prascipitatum sedulo ablutum solve in liquoris ammon. caust. giss: adde acidi muriatici giij. vel q. s. ut prascipitatio evitetur et argentum muriaticum in statu solutionis permaneat. Pondus fluidi filtrati asquale sit unciis duabus cum dimidia..* This preparation is transparent; but, under the effect of light, it 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 the 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 wat-er. (See page 78.) Pilule argenti et ammonise chloridi. Pills of chloride of silver and ammonia. R. Argent, et ammon. chlorid. gr. j. Irid. florent. pulv. gr. ij. Conserve flor. tiliae q. s. ut fiat massa in pilulas xiv. dividends. For external use. Serre. * "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 that the chloride of silver may remain in a state of solution. The weight of the filtered fluid should be equal to two ounces and a half." ARGENTI CYANURETUM. 83 XIX. ARGENTI CYANURETUM. Synonymes. Argenti Cyanidum, Argentum Cyanogenatum, Cyanuretum Argenti, Cyanide or Cyanuret of Silver. Frer.ch. Cyanure d'Argent. German. Blaustoffsilber, Cyansilber. Cyanuret of Silver 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 re- peatedly washed with distilled water, and be reduced to dryness in a moderately heated oven. In the preparation of the cya- nuret 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 decomposition of the nitrate of silver. If too much hydrocyanic acid be used, a part of the precipitate will be separated in the form of hydrocyanate of silver. If, instead of hydrocyanic acid, hydrocyanate of potassa be used, the latter, if added in too great proportion, will unite with the cyanuret of silver, and form a soluble double salt. Cyanuret of silver is of a white colour, devoid of taste, not soluble 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. It is dry, and should be kept preserved from the light. It experiences no decom- position when mixed with neutral vegetable matters. From experiments made by Dr. Letheby,f he concludes, that it is a local irritant, producing great vomiting and a congested state of the vessels of the stomach;—that when it has been dried before its introduction into the system, no other ill effects follow: but if it be administered in a moist state, it is then capable of being absorbed and perhaps decomposed, " for an albuminous so- lution has the property of dissolving the cyanide, and moreover, the contact of it with any of the chlorides of the systemic fluids would produce a double decomposition, and the formation of a soluble cyanide, whose effects would be similar to that of cyanide of potassium." The dose capable of killing a dog is five grains: its specific action appeared to Dr. Letheby to be on the brain, producing occasional convulsions, always coma, paralysis, a peculiar sighing respiration; a fluttering, irregular, and tumultuous action of the heart, and it ultimately kills by a gradual exhaustion of the in- voluntary acts, death taking place in from one to three hours after its administration. Its use in disease has been referred to under the preparations of silver. " Pharm. of the United States, p, 77. Philad 1842. I Lond. Med. Gaz. Jan 9, Feb. 4 and 17,1845, cited in Ranking's half-yearly Abstract of the Med. Sciences, Amer. edit. i. 359. New York, 1845. 84 ARGENTI IODIDUM. XX. ARGENTI IO'DIDUM. Synonymes. Argentum Iodatum, Ioduretum Argenti; Iodide or Ioduret of Silver. French. Iodure d'Argent. German. Iodsilber. Iodide of silver is obtained by mixing a solution of nitrate of silver with one of 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 po- tassium would form with the already precipitated iodide of silver a soluble and crystallizable double salt of iodine, whereby the quantity 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 cya- nuret 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 preparations of silver. It may be added, however, that Dr. Chas. Patterson has been convinced of its de- cided efficacy in hooping-cough. It has been already remarked (p. 81) that a combination with iodine is said to prevent the discoloration apt to be induced by nitrate of silver.* The following form for this purpose is given by Dr. Patterson:— PilulBB argenti iodidi composite. Compound pills of iodide of silver. R. Argenti iodid. Potassae nitrat. aa gr. x. Tere simul ut fiat pulvis subtil, dein adde. Glycyrrhiz. pulv. gss. Sacchar. Qj. Mucilag. acacias q. s. ut fiant pil. xl. Dose.—One, three times a day. * Dr. Patterson, Dublin Medical Press, Aug. 25,1842, and April 19, 1843; or Braith- waite's Retrospect, vi. 1, and vii. 112. Lond. 1843. ARGENTI OXIDUM. 85 XXI. ARGENTI OX'IDUM. Synonymes. Argentum Oxydatum, Oxydum Argenti. French. Oxide d'Argent. German. Silberoxyd, Oxydirtes Silber. Oxide of silver is obtained by the reaction of potassa on a so- lution 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. The following form has been given:*— R. Argent, nitrat. crystallizat. gj. Potassas, §vij. Aquae, gxviij. Dissolve the nitrate of silver in two or three ounces of the water, and the potassa in the remainder: mix the two solutions; stir with a glass rod, and throw the whole upon a filter. Lastly, wash the precipitate from adhering alkali, and dry it carefully. In the state of hydrate, the oxide is black; when anhydrous, it 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 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 preparation, which was also recommended by M. Serre, has been used by Van Mons in syphilis.^ (See p. 79.) Mr. Lane|—under the idea, that nitrate of silver is always decomposed in the stomach by chlorohydric acid, whence results chloride of silver, which enters into the circulation, is conveyed to the cutaneous surface, and is converted into an oxide by the action of light and by its strong affinity for albumen—has admi- nistered the oxide of silver, and with advantage, in diseases of the uterine system, in which there is undue secretion and great ir- ritation. He gave it for two months, at intervals, without the slightest tendency to discoloration; and Dr. Golding Bird has prescribed it for four months without any bad effects. Mr. Lane found it very beneficial in half-grain doses, twice a day, in cardialgia and pyrosis; gastrodynia; irritability of the sto- mach, accompanied by gnawing and constant pain, and nausea, &c. It seemed, likewise, to be beneficial in uterine hemorrhage, both in the impregnated and unimpregnated state. * A. Duhamel, Amer. Jour, of Pharmacy, July, 1842, p. 100. t Riecke, Op. cit. S. 440. } London Lancet, July 10,1841. 86 ARGENTI OXIDUM. Mr. Lane* gives the oxide to subdue undue secretion, whether of a sanguineous or other character. In epistaxis and haemoptysis, especially when they occur in chlorotic females; and in the profuse purulent expectoration and colliquative perspirations of phthisis he has found its employment of much advantage. He esteems it to be essentially sedative, and employs it both in- ternally and externally. In cases of irritable ulcer, its action is highly beneficial; and he thinks it is decidedly preferable to the nitrate, where the stimulant caustic action of the latter is not re- quired. In the external forms of ophthalmia, an ointment, of the strength of a dram to the ounce, often exerts a rapid influence. In cases of ulceration of the cornea, with thickening and con- gestion of the eyelids, it has proved highly beneficial. The oint- ment of the oxide of silver is softened to the consistence of thick cream by the addition of olive oil, and is applied to the eye by means of a camel's hair pencil. When a patient is taking it for any length of time, he considers it well to suspend its administra- tion for a few days every month. Sir James Eyret found the oxide uniformly successful in curing pyrosis; but he gave at the same time a cathartic pill of the compound extract of colocynth and extract of hyoscyamus every night. He found similar successful results in haernatemesis and haemoptysis: he does not, however, restrict himself to the oxide, but assists its use by bleeding, blistering, and other means. From having found the remedy much superior to all other agents during an active pro- fessional life of upwards of thirty years, Sir James urges a trial of it. In the cases detailed by him the dose never exceeded three grains a day. Its employment is not advised where febrile action exists. In addition to its value in gastrodynia, pyrosis, haemoptysis, haernatemesis, and menorrhagia, Sir James says it will be found of infinite benefit in restraining hemorrhage from the intestinal canal, obstinate chronic diarrhoea, colliquative perspirations, and leucorrhcea.\ The ordinary dose of the oxide is half a grain three times a day. Unguentum oxidi argenti, Ointment of oxide of silver. R. Argent, oxid. gr. xx. Adipis. gj. Misee ut fiat unguentum, When the iodide or cyanuret is substituted for the oxide of silver, ten or twelve grains of one of these may be added to the ounce of lard. Serre. * Lond. Med. Gaz., April, 1846, p. 640. t Dublin Journal of Med. Sciences, May, 1845. X See, also, Dr. Allnatt, Lond. Med. Gaz., May 2,1845. ARGILLA PURA. 87 XXII. ARGENTUM DIVI'SUM. 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, is 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- tum, which agree with it in chemical relations, had been admi- nistered many years before in cases of intermittent fever, by Dr. Meyer, of Biickeburg.* Notwithstanding the testimony adduced in its favour, it is pro- bably wholly inert, or exerts but a mechanical agency. XXIII. ARGIL'LA PURA. Synonymes. Alumina pura, Terra aluminosa pura, Terra aluminis, Terra bolaris seu argillacea pura; pure Argil or Alumina. French. Alumine factice. German. Reine Thonerde; 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, poi- soned wounds, &c, and was also applied externally in cases of erysipelas. It had almost fallen into complete oblivion, when its use was resumed by some of the German practitioners. With us, it is scarcely ever, or never, prescribed. METHOD OF PREPARING. Tne purest argil is prepared by drying sulphate of alumina und 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. Formerly, it was prepared by dissolving alum in water, and pre- cipitating the argil from the solution by means of carbonate of potassa or of soda, or by potassa. It is affirmed, however, that, * Riecke, Op. cit. S. 436. S8 ARGILLA PURA. generally, more or less sulphuric acid remained with the earth, so ihat it required to be purified by repeated washing, until there was no longer any acid reaction. If a still higher degree of purity be needed, the precipitate is dissolved in muriatic acid, and the argil precipitated by 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 ex- tolled by the Dresden physicians, Ficinus and Seiler.* Accord- ing to the former, it merits a preference over all other absorbents, inasmuch as it forms astringent salts with acids. He found it es- pecially useful in diarrhoea and dysentery, particularly in children. Seiler recommends 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 diarrhoza, which neither starch glyster, nor opium, nor any other therapeutical agent had succeeded in diminishing. He made a mixture of two drams of argil, and four ounces of a decoction of logwood, and administered it to children by the teaspoonful. Weese,:[ also employed it suc- cessfully in several cases of infantile diarrhoza where there was evidently a predominance of acid. One of the latest encomiasts of the argilla depurata is Diirr, who, for several years, has administered it in the diarrhoza and cholera of infants, and has found it highly efficacious. The chemical reasons, urged by Ficinus and others, merit at- tention. The article is worthy of employment in affections of the intestinal tube, in which astringents are indicated. The chlorohydric 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 com- pound must possess astringent properties. MODE OF ADMINISTRATION. r The dose, in the 24 hours, for a very young child, is from 3ss. 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.§— * Zeitschrift f iir Natur. und Heilkunde der Dresdner Professoren, B. 1, H. 1, S. 82. t Bemerkungen iiber die gebrauchlichsten Arzneimittel. von Dr. Karl Georg Neumann, S. 55. Berlin, 1840. X Rust's Magazin, B. xii. H. 2, S. 247. § Die neuern Arzneimittel. S. 41. Stuttgart, 1837. ARNICA. 89 Mistura argillae, Mixture of argil. R. Emuls. sem. papav. (ex ^ss. parat.) giiiss. Argilke purse, J}ij. Syrup, althajes, f. gss. M. Dose.—A teaspoonful to a child two years old affected with diarrhoea. R. Argill. pur. ^ss. Acacias, sjj. Sacch. s;ij. Aq. fcenicul. f. giij. M. Dose.—The same as the last to a child one year old. R. Emuls. oleos. cum vitell. ovor. parat. gj. Syrup, alth. f. gj. Argill. depurat. gss. Aq. cinnam. simpl. f. gj. Extract, conii, gr. ij. M. Dose.—The same as the two last to a child three months old, affected with cholera infantum. Durr. XXIV. AR'NICA. Synonymes. Arnica Montana, A. Plauensis, Doronicum Germanicum, Pa- nacea Lapsorum, Ptarmica Montana, Caltha Alpina, Calendula Alpina, Narda Celtica altera, Doronicum plantaginis folio, Leopard's Bane. French. Arnique. Tabac oil Betoine des Savoyards, Tabac de Montagne, Doronic d'Allemagne, Tabac des Vosges. German. Wohlverlei, Fallkraut. This plant, which belongs, in the sexual system, to Syngenesia polygamia superflua, and to the natural order Compositae Synan- thereae, is in the secondary list of the Pharmacopoeia of the United States, but it is not much used in this country; nor does there ap- pear 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," says MM. Merat and De Lens,t*'that we have as vet insufficient data to pronounce posi- tively on the affections in which arnica can be unequivocally effi- cacious; we must, consequently, always bear in mind its heating and active qualities when we prescribe it." According to Sir George Lefevre,| the Germans class arnica among sacred remedies; and its virtues are extolled throughout two pages of the Pharmacopoeia Ruthensis. Sir George was much * Dr. Wood, in Dispensatory of the United States, by Drs. Wood and Bache, Art. Jlrnica. t Dictionnaire Universel de Matiere Medicale, &c. i. 423. Paris, 1829. ; An Apology for the Nerves, p. 292. Lond. 1844. 90 ARSENIAS AMMONIJE. / disappointed in its effects. It is much more uncertain than strychnia in its operation, and he has known it given in large doses without producing any sensible results. In Germany, the flowers and root are much employed in para- lysis, as an excitant to the nervous system; and it is chiefly to in- troduce the volatile oil—the oleum azlhereum florum arnicae, (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 himself often administered it with evident success; the paralytic limbs be- comins warmer, more active, and more serviceable under its use. He mixes four drops of arnica oil with half an ounce of spiritus selheris sulphurici composilus or spiritus setheris nitrici, 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 elaeosaccharum* XXV. ARSENIAS AMMO'NI^E. 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 invelerata.\ METHOD OF PREPARING. It may be prepared by taking arsenic acid one part, dissolving it in water, and adding pure ammonia or carbonate of ammonia suf- ficient to saturate the acid;—or, as follows:—Take of arsenious acid, one part; nitric acid, four parts, muriatic acid, half a part; sa- turate the solution with carbonate of ammonia, and let the arsenical salt crystallize. »• 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 given 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 other forms of arsenic, that have * Riecke, Die neuem Arzneimittel, u. s. w. S. 337. Stuttgart, 1837. i Cazenave, in Diet, de Medec. 2de edit. iv. 30; and Cazenave and Schadel's Prac- tical Synopsis of Cutaneous Diseases, translated by R. E. Griffith, M.D. Philad. 1821). ARSENICI IODIDUM. 91 been received into the Pharmacopoeias. Arsenious acid itself, as well as Jirsenite of potassa and .Arseniate of soda—the officinal so- lution of the former well known every where under the name of '^Foioler's Solution;" that of the latter known, in continental Eu- rope especially, under the name " Jlqua Arsenicalis PearsonU^ or Solution de Pearson, are possessed of precisely the same properties as arseniate of ammonia, and, like it, have been found equally effi- cacious 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,*1 and Girdlestone,f and subsequently by Willan,J Pearson,§ and others; but no one administered the arsenical preparations more extensively in these diseases than M. Biett, of Paris, whose situa- tion afforded him ample opportunities for testing the virtues of the different articles of the Materia Medica in skin complaints. He succeeded by means of the arsenical preparations, and espe- pecially of the one now under consideration, in removing several inveterate affections of the skin, that had resisted every other reme- dy. 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 ap- pear to be but two vvays in which those vessels can be reached, so that a new action may be impressed upon them;—in the one case, through the medium of the general circulation; and, in the other, through the agency of topical applications, made to come in con- tact with the diseased surface. 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 cir- culation, 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, un- til the use of the arsenical preparation had been persevered in for several weeks. These diseases are chronic in their nature, and they require a chronic medication. Time is, indeed, in every case, an element in the cure. XXVI. ARSEN'ICI IO'DIDUM. Synonymes. Ioduretum Arsenici, Arsenicum Iodatum, Iodide of Arsenic. German. Iodarsenik, Arsenikiodure, Iodarsen. * Medical Reports. London, 1786. t Kssays on the Hepatitis, &c, of India. London, 1787. X 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, I cW. 92 ARSENICI IODIDUM. Of late years, this preparation has been highly extolled by Biett, in the 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 ar- senious acid and one hundred parts of iodine. The combination sublimes in the form of orange-coloured needles. 2. Thirty parts of pulverized arsenious acid, 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 evapo- rated to dryness. If it be thought advisable, this can be sublimed. A formula, employed by Plisson, is to digest three parts of ar- senious acid, in fine powder, with ten parts of iodine, and one hun- dred and nine parts of water, until the odour of iodine is no longer manifested. The clear liquid is then decanted, and subjected to evaporation. At a certain degree of concentration, the iodide forms in red crystals: or the solution may be evaporated to dry- ness, and then sublimed in close vessels without decomposition, when it forms beautiful crystalline scales. Water, in large quantity, dissolves it wholly; but if it be di- gested with a small quantity, it is decomposed, hydriodic acid being formed in sc^ution, and white crystalline scales, composed of water, acid, and iodide in variable proportions.t 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. Blake:}: 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. Professor A. T. Thomson has employed the iodide in several cases of lepra and impetigo, with very great success.§ He begins with one 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. The iodide has been given with success in a case of cancerous disease of the breast, by Dr. F. C. Crane.|| The dose was an eighth of a grain, which was reduced to one-twelfth, and gradually in- creased to a third of a grain, beyond which it could not be borne. * Formulaire, edit. cit. t A. Duhamel, American Journal of Pharmacy, Oct. 1840, p. 187. X Edinburgh Medical and Surgical Journal, April, 1839, p. 336. § Lancet, Jan. 19, 1839, p. 621. || Lancet, Aug. 31, 1839. ARTEMISIA VULGARIS. 93 In a case of inveterate lepra vulgaris, it was carried to the extent of one grain the dose, with the most decided curative effecis. Biett has frequently applied an ointment of it in cases of phage- denic tuberculous cutaneous diseases.* MODE OF ADMINISTRATION. Mr. Erichsen thinks with Dr. A. T. Thomson, that iodide of arsenic is most advantageously exhibited in combination with the extractum conii, which appears to sheathe its irritating quali- ties, and prevents it from exciting too powerfully the mucous mem- brane of the stomach. By the addition of red iodide of mercury a compound pill may be formed, which resembles, in its* effects, the iodide of arsenic and mercury, and has been much, and suc- cessfully, employed by Dr. A. T. Thomson in the treatment of lupus and other diseases of the skin, and which Mr. Erichsen has found of particular service in certain syphilitic eruptions, of the squamous kind more especially.f Biett gives, asv the usual proportion for an ointment, three grains of the iodide to an ounce of lard. An extemporaneous preparation, which is considered to com- bine the virtues of both arsenic and iodine, is said to have been employed successfully in Philadelphia.^ It is formed as follows: R. Liquor iodin. compos, f. §i. -----potassae arsenit. f. giv. M. When mixed together in these proportions, a change is observed in the appearance of the mixture, which is instantaneously ren- dered almost colourless. The dose is five drops. XXVII. ARTEMISIA VULGA'RIS (RADIX.) Synonymes. Mugwort. French. Armoise commune. German. Beifusswuizel, Gemeiner Beifusswurzel. Almost all the species belonging to the genus arlemisia are pos- sessed of bitter and aromatic properties, and several afford "worm- seed." Artemisia vulgaris was employed by many of the older physicians, but it had fallen into oblivion, when its use was re- vived in Germany, by Burdach, a physician at Triebel, near So- race,§ who recommended it strongly as a preventive of epilepsy. * See, also, Ballard and Garrod, Elements of Mat. Med. &c., p. 387. Lond. 1845. t Lond. Med. Gaz., May 12, 1843, or Braithwaite's Retrospect, viii. 10, Amer. edit. New York, 1844. X A. Duhamel, Amer. Journ. of Phannacy, Oct. 1840, p. 187. § Hufeland's Journal, B. lviii. St. 4 und 5. 7 94 ARTEMISIA VULGARIS. Since that time, it has been much prescribed in that country, but its employment has not extended much to other countries of Eu- rope, or to this side of the Atlantic. The root is the part pre- ferred:—formerly the herb and the tops were solely used. The root was employed in epilepsy, centuries ago, but it had been ne- glected, or was only exhibited as a nostrum, when Burdach en- tered 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 pe- riod 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 carefully removed, and the fresh young side roots (fibrillae,) which are distinguished by their smell, clear colour, and greater juiciness, must be spread on paper, and dried in the shade, and as soon as they become brit- tle they must be carefully preserved. Besides the fibrillae, the soft, sound, and juicy parts of the root, especially the fleshy rind of the thicker roots, must be used. The period, requiredfor 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 pulverizing, 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 pulverizing, the inner, hard, woody parts are separated from the smaller roots: they must be removed and thrown away, as the powder of the cortical substance of the small radicles has alone been found effica- cious. The smell of the well dried root is very strong, pungent and peculiar, especially vvhen we open a vessel in which it has been stored away in quantity. The taste is sweetish, sharp and nauseous. 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. It is most efficacious when given about half an hour before the attack, which it usually pre- * Casper's Wochenschrift, Oct 22, 1830, S. 675. ARTEMISIA VULGARIS. 05 vents; 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, be covered up warm and allowed warm small beer to drink, so as to occasion diaphore- sis—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, however, 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 critical sweat follows; Burdach then aids the operation by giving the liquor cornu cervi succinalus, (spiritus ammonias succlnatus,) in an infusion of serpentaria, valerian root and arnica flowers; but the effect, he says, was always better vvhen the diaphoresis was produced by 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 improvement 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 certain in its operation, either in removing or miti- gating the disease. In such cases, two doses were given on the first day, and afterwards 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 benefi- cially; the paroxysms soon became somewhat weaker and 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 especially well. It is equally efficacious in the epi- leptic 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 hap disappeared. On the other hand, it was found to aggravate cases of epilepsy occurring as a disease of growth, (Enlwickelungskrank- 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 noclurna, 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 con- dition ensued from two to three times every twenty-four hours, consisting of repeated epileptic attacks, with great prostration in the intervals. These are the main results of the communications of Burdach 96 ARTEMISIA VULGARIS. 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. Tosettit gives the proportion of cases in women and chil- dren to that of men, as eight to six. In the Berlin Charite, artemisia is said to have been used with equal success. The German journals contain numerous cases, on the authority of E. Grafe,! Wagner,§ Van Maanen,|| Wolf,^[ Osann, Bonorden,** Schluter, Bird,tt 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 inappro- priate, or to the preparation of the artemisia not having been properly attended to.^f^f In consequence of a German physician having recommended Artemisia absinthium to Professor A. T. Thomson, Dr. El- liotson*** was induced to try it in epilepsy. The patient to whom he gave it was a girl, seventeen years of age, who had been affected with epileptic fits for four months—three or four occur- ring daily. A dram of the powder 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. Besides epilepsy, artemisia has been used with advantage in other diseases, as in St. Vitus's danceMi Wutzer employed it successfully in the convulsive diseases of childhood, and it was recommended by BiermannJJJ in eclampsia infantum, occurring during the period of dentition. He recommended it to be given to children in gradually increasing doses, commencing with half \ grain; and giving,an hour afterwards, a grain, and in two hours, two grains, vvhich is usually the last dose required. The gradual * Riecke, Die neuern Arzneimittel, u. s. w. S. 49. Stuttgart, 1837. t Diss, inaug. de Radice Artemis, vulg. remed. antiepilept. Berolin, 1827; and Osann in Art. Artemisia, Encyc. Worterb. iii. 313. Berlin, 18211. X Grafe und WaltheT's Journal, B. vi. H. 2. § Hufeland's Journal, lix. S. 6. || Ibid. lxi. 5. U Ibid. lxii. 3. ** ibid lx. 1. tt Ibid. lxv. 3. XX Ibid. Ixv. 3. S S Ibid lxv 3 || || R chter's Specielle Therapie. B. x. S. 377. Berlin, 1828. HIT Op. cit. S. 49. *** Lancet, July 9, 1836. ttt Gittermann, in Hufeland's Journal, lxii. 1. Bonorden, Op. cit. XXX Riecke, Op. cit. S. 50. ARTEMISIA VULGARIS. 97 augmentation of the dose he considers advisable, " to prevent the crisis which the artemisia induces from being too turbulent." Kolreuter, of Carlsruhe, administered artemisia in different dis- eases with great success. He prefers the extractum resinosurn radicis artemisiae vulgaris to the root in substance. This is prepared in the following manner. A quantity of the dried and powdered root is covered with alcohol, and permitted to digest for some time: the filtered liquor is then evaporated in an earthen- ware 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 tor- mina unaccompanied by inflammation; in the diarrhoza 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 obstruction of the catamenia, as well as in epilepsy. The dose in the twenty-four hours, is 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 advan- tages to be derived from it in epilepsy have been exaggerated. Where there is no organic disease of the encephalon, substances, which, like it, are nauseous, bitter and aromatic, may be produc- tive of advantage as 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 to be pewerfully diaphoretic; and doubtless, therefore, in appro- priate cases—especially where there is much nervous impressi- bility—it may be productive of the good effects ascribed to it by Burdach, Kolreuter, and others. Yet—as Osann has remarked* —it must be improper where polyaemia, or a tendency to active hypersemia, is present. The analysis of Hergt, Hummel, and Jii- nike afforded, along with traces of volatile oil, some balsamic re- sin, both of which are excitants to the living economy. MODE OF ADMINISTRATION. The following forms for its administration have been adopted by some of the German authorities:— Decoctnm artemisiae. Decoction of Mugwort. R. Artemis, vulg. rad. concis. jfj. Coque cum aqua? q. s. per semihoram. ad. colat. Oj. Half a tea-cupful of this may be taken every two hours in cases of epilepsy. Hildenbrand. * Art. Artemisia in Encyc. Worterb. iii. 313. Berlin, 1829. 98 ATR0P1A. Pulvis artemisis. Powder of Mugwort. R. Artemis, vulg. rad. pulv. 3j. Sacch. alb. 9j. M. et fiat pulvis. The powder to be administered daily in the evening, in warm beer, in cases of epilepsy. Loivenstein. Mistura artemisia. Mixture of Mugwort. R. Ext. artemis. vulg. alcoholic, gr. iv. Acacia?, 9j. Sacch. giij. Mist, amygd. f. §iij. A coffee-spoonful* to be given every half hour in eclampsia infantum. The dose may be gradually raised to two coffee- spoonfuls. Kolreuter. XXVIII. ATROP'IA. Synonymes. Atropina, Atropium, Atropinum, Atropine. French. Atropine. German. Atropin. This is the active principle of Atropa belladonna, and was dis- covered many years ago, in the leaves, by Brandes. To it is pro- bably owing the whole of the medicinal efficacy of the plant. In 1825, M. Pauquy found it in the root, and affirms, that he de- tected it also in the stalks of datura, hyoscyamus, and solanum.t METHOD OF PREPARING. The most improved processes for extracting this alkaloid, ac- cording to Dr. Pereira,^: are those of Mein, Thomson, and Richter. The process of Mein is contained in the Pharm. Cenlral-Blalt. fur 1833. The following is given in the United States Dispen- satory^ from the Journal de Pharmacie, vol. xx., p. 87. The roots of plants two or three years old are selected, of these, reduced to an extremely fine powder, twenty-four parts are digested for twelve days, with 60 parts of alcohol of S6 or 90 per cent. The liquid having been separated by strong evaporation, the residue is then treated anew with an equal quantity of alcohol; and the tinctures, poured together and filtered, are mixed with one part of hydrate of lime, and frequently shaken for twenty-four hours: * About two ordinary tea-spoonfuls. t Merat & De Lens, Diet, universel de Mat. Med. Art. Atropine. Bruxelles, 1838. X Elements of Mat. Med. and Therap., 2d. Amer. edit. ii. 312. Philad. 1846. § Sixth edition, p. 138. Philad. 1845. ATR0PIA. 9ss. ------dulcam. 5J. AlthseEe pulv. q. s. ut fiant pilulae lxxx. Three pills to be taken three times a day. Grotzner. " Op. cit B. iii. S. 351. t Die neuern Arzneimittel, u. s. w. S. 442. AURI CYANURETUM. 109 Pastilli auri et sodii chloridi. Lozenges of chloride of gold and sodium. R. Auri et sodii chlorid. gr. v. Sacchar. pulv. §j. Misce exacte in mortar, vitreo et adde. Mucilag. acacia; q. s. ut fiant pastilli lx. Each of these will contain about one-twelfth of a grain of the salt. A. T. Chrestien. Pilulce auri et sodii chloridi. Pills of chloride of gold and sodium. R. Amyli. solan, tuberos. gr. iv. Acacia? 3J. In mort. vitr. exacte mistis adde terendo Aur. et sod. chlorid.—in 3j. aq. destillat. solut.—gr. x. Fiant pilulas 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. §ss. Misce exacte. Fiat unguentum. Used in friction. Grotzner. R. Aur. et sod. chlorid. gr. iiss. Adipis, -5iss. M. The size of a bean to be placed in the nasal fossae in scrofulous cases* along with the iatraleiptic use of the powder before de- scribed. Riecke. XXXI. AURI CYANURETUM. Svnonymes. A. Cyanidum; A. Tercyanidum, Cyanuret, Cyanide or Tercy- anide of gold. French. Cyanure d'Or. German. Blausaures Goldoxyd, Blaustoffgold, Cyangold. The mode of preparing this combination, recommended by M. 0. Figuier,f of Montpellier, is as follows. He decomposes chlo- ride of gold by cyanuret of potassium, but states, that many pre- cautions are necessary to procure it in a pure state. The chloride must be as neutral as possible, which can only be effected by re- * See p. 108. t Journal de Pharmacie, xx. S. 99, and Amer. Journ. of Pharm. vL 82. Philad. 1833-4. See, for another mode of preparing it, Defcrre, in Bulletin General de Therapeutique, Fevrier, 1838. S 110 AURI CVANURETUM. crystallizing the salt several times. The cyanuret must not be al- kaline, or contain any formiate or carbonate of potassa. This salt is to be added to the solution of the chloride of gold very cau- tiously as long as there is any precipitate, taking care that there is not the slightest excess of the cyanuret, as this would cause a so- lution of part of the product, and the formation of soluble double cyanurets. The cyanuret, thus made, is to be well washed with pure water, and dried in a dark place. The process in the French "Codex" consists essentially in adding very carefully a solution of pure cyanuret of potassium. to a solution of chloride of gold, until a precipitate—vvhich is cy- anuret of gold—ceases to be formed. The chloride of gold, prior to solution, should be deprived of all excess of acid by heating it in a salt water bath. It is a yellow powder, which is insoluble in water.* In some experiments Magendief found, that cyanuret of gold 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,^: who has used it successfully in syphilis and scrofula, recommends its ad- ministration—in the form of frictions on the tongue—mixed with powdered orris root, well washed in alcohol, and dried. Pulvis auri cyanureti. Powder of cyanuret of gold. R. Auri cyanur. gr. j. hid. florent. pulv. gr. iij. M. Chrestien. In pills he prescribes it as follows:— Pilulae auri cyanureti. Pills of cyanuret of gold. R. Auri cyanur. gr. j. Ext. mezereon. gr. iij. Altha3EB pulv. q. s. ut fiat massa. Each pill to weigh five grains. To children, the dose at first should never exceed one-fifteenth of a grain. Mistura sen Liquor auri cyanureti. Mixture or solution of cyanuret of gold. R. Auri cyanur. gr. iij. Aquts alcoholisat. f. ~viij. M. * Pereira, Elements of Mat. Med. &c, 2d edit. i. C8G. Lond. 1842; or 2d Amer edit- by Dr. Carson, Philad. 1846. t Legons sur le Sang, &c, and Translation, in Lancet, January 20,1839, p. 636. X Journal de Pharmaeie, xx. 599 and 649. AURI NITROMURIAS. Ill Dose.—A tea-spoonful twice a day, gradually increasing the dose. Chrestien. XXXII. AURI IO'DIDUM. Synonymes. A. Ioduretum, Iodide or Ioduret of Gold. French. Proto-iodure d'Or. German. Iodgold. According to the French Codex, this is made by adding a solu- tion of pure iodide 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. M. Meillet* recommends the following pro- cess in preference. To a solution of gold as neutral as possible is added by degrees neutral hydriodate of ammonia so long as a precipitate falls. The solution must not be too far diluted. A small quantity of alcohol must now be added, not more than about one-third of the whole volume of the liquid. After some hours' rest, this is decanted, when a precipitate of a blackish colour is obtained, composed of iodine, and iodide of gold. It is then washed by decantation with a little alcohol; when an almost white and half crystalline iodide of gold is obtained. This is dried in the open air on plates, and is kept free from light in stopper bot- tles. In this process, the gold is completely precipitated, vvhich never occurs when the iodide of potassium is employed; and the iodide has an invariable composition.t 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. XXXIII. AURI NITROMU'RIAS. Synonymes. Aurum Nitrico-Muriaticum. Nitromuriate of Gold. French. Nitromuriate d'Or. German. Saltpetersalzsaures Gold. Nitromuriate of gold has been recommended, of late years, by Recamier, whose attention was directed to it by accident. 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 went away in a short time. Recamier thought it probable, that the workman had received some of the solution upon his fingers, which had thus been applied to the tumour. Under such impressions, he em- * Journal de Pharmacie, Nov. 1841, p. 665. t For another process for forming the iodide of gold, see M. J. Fordos, Journal de PhaT- macie, Nov. 1841, p. 653. 112 AURI OXIDUM. ployed it in the case of a female, who was affected with an exten- sive 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 advantageous. Recamier prepares it by dissolving six grains of pure chloride of gold in an ounce of nitromuriatic_acid: 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 cauterize, 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 re- peated as often as may be necessary. The pain caused by the operation is generally insignificant, and in cases where it is vio- lent it can be allayed by pledgets dipped in laudanum. XXXIV. AURI OXIDUM. Synonymes. Auri Teroxidum, Aurum Oxydatum, Oxide of Gold, Peroxide of Gold, Auric Acid. French. Oxide d'Or. German. Goldoxyd, Oxydirtes Gold. Oxide of gold, prepared by calcination, is the crocus soils of the Wirtemberg Pharmacopoeia. The oxide is received also into the Pharmacopoeias of Ferrara and Hanover. 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 crys- tallized baryta gradually, until the liquid is no longer acid, as shown by a strip of litmus paper. The liquid is then boiled, per- mitted to> cool, and filtered. The precipitate is washed several times with warm loater; 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 toater 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 in- stillation of sulphuric acid occasions no longer any white precipi- tate, which indicates that it is free from baryta. The oxide is * Formulaire, &c. AURUM METALLICUM. 113 then dried at a heat of from 167° to 190° of Fahrenheit, after vvhich 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 chloride 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 dilute nitric acid, which removes all the magnesia, and leaves the oxide in a pure state. This is to be again well washed, and dried between sheets of bibulous paper, but without compression or exposure 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. It is then washed, first with water to remove the chloride of magnesium, and afterwards with dilute nitric acid to dissolve the excess of magnesia.t In the condition of hydrate, the oxide of gold is of a yellow colour; vvhen dried, of a blackish violet. It is never entirely soluble in chlorohydric acid, always leaving behind a small portion which is reduced to the metallic state during desiccation. Neither sulphuric nor nitric acid has any action upon it. Oxide of gold has been administered by many physicians, and especially by Westring, Niel, Chrestien,:]; and Legrand,§ in the same diseases as the other preparations. XXXV. AURUM METAL'LICUM. Synonymes. Metallic Gold. French. Or Metallique. German. Metallisches Gold. Metallic gold is either administered in the form of the aurum limatum, "gold filings"—formed by filing the finest gold with a fine-toothed file—or in that of the pulvis auri, (Fr. Or divis6— Germ. Goldpulver,) which is obtained by amalgamating gold with quicksilver, and driving off the quicksilver by heat.|j Ac- cording to Trommsdorff, 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 vvhen polished exhibits the most beautiful golden splendour.TT * Amer. Journ. of Pharm. 2d series, ii. 110. Philad. 1837. t Pereira, Elements of Materia Medica, 2d edit. i. 685. Lond. 1842, or 2d Amer. edit. by Dr. Carson, Philad. 1846. i Op. citat. § Op Cit. and De l'Or, de son Emploi dans le traitement de la Syphilis, &c. Paris, 1828. || Jourdan's Pharmacopee Universelle, ii. 215. Paris, 1828. it Riecke, Die neuera Arzneimit. S. 58. Stuttgart, 1837. 114 BALLOTA LANATA. It may also be prepared by rubbing leaf gold with sulphate of potassa, sifting and washing with boiling water to remove the sulphate.* MM. 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, to conceive, that a substance so difficult of oxidation can have much, if any, effect. The former gentlemen 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. It 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; and has been rubbed daily upon the tongue, in the quantity of from one to three grains, mixed with starch powder, or the powder of 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; gradually augmenting the quantity of gold to two grains. In syphilitic ulcers and excoriations, metallic gold is applied externally, amalgamated with the proper quantity of mercury, and united with 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 serviceable. The following formulae are given by Riecke:t— « R. Auri pulv. gr. vj. Amyli. gr. lxvj. M. f. pulv. in part. xij. asquales divid. A powder to be given four times a day. R. Auri pulv. Lycopod. 5a gr. ij. M. f. pulvis. A powder to be rubbed once a day upon the tongue. XXXVI. BALLOTA LANATA. Synonymes. Leonurus Lanatus. German. Wolliger Wolfstrapp. This plant belongs to the Natural Family, Labiate; Sexual System, Didynamia Gymnospermia. It grows exclusively and commonly in Siberia, in dry mountainous regions. In its native * Pereira, Elements of Materia Medica and Therapeutics, 2d edit. i. 682, Lond. 1842- or 2d Amer. edit, by Dr. Carson, Philad. 1846. t Die neuern Arzneimit. S. 59, Stuttgart, 1837. . BALLOTA LANATA. 115 country, it has been long administered as a powerful 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 leonurus cardiaca, ballota nigra, and marrubium;* 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 ballota lanata has been administered abroad—for it has not been employed in this country—are, ac- cording to Riecke,t the following: — 1. Dropsy—Rehmann prescribed it several times with decided advantage; and where organic disease prevented the cure, the uri- nary secretion was always largely augmented by it. The chemical condition of the urine was likewise strikingly changed during its use: at first, it was whitish, afterwards darker, and ultimatedy al- most black or of a deep.brown, like the darkest beer. At times, vvhen the accumulation of fluid was pretty well removed, a pain would occur in the hypochondres, which indicated that its use should be laid aside. Schilling, in Werchny-Udinsk, asserts, that he cured several cases of dropsy by it. Rupprecht and Muhr- beck administered it with the best effects, and BreraJ 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 Heyfelder, who gave it according to the prescription o£»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, ballota is adminis- tered in Siberia. Brera, as well as his compatriots, Ghidella, Fon- tebuoni and Luzzato, have tested its efficacy by repeated trials. The pains generally soon disappeared under its use, and a cure took place without relapse. 3. Adiposis.—In a case of this kind, it was exhibited in St. Peters- burg by Dr. Weisse. The fatness was inordinate, and the remedy acted most favourably. It did not, however, occasion diuresis, but under its use a hemorrhoidal flux returned, vvhich had previously been arrested. * Schmidt's Jarbuch der in-und auslandisch. gesammt. Medicin. B, iv. S. 275. t Op. cit. S. 68. X Antologia .Medica, No. 2, Febbrajo, 1835. 116 BARII IODIDUM. MODE OF ADMINISTRATION. Decoction is the best form for administering the plant; from gss, to 5j. to 5viij. of water;—this portion to be divided into two halves, and to be taken in the course of the day. Rehmann boils iiss. to Iij. of the coarsely poiuderedplant in Oij. of water down to half; to which he adds, according to circumstances, some diffu- sible excitant or a few drops of laudanum. Of this mixture, he directs a cupful to be taken morning and evening, gradually in- creasing the dose. XXXVII. BA'RII IO'DIDUM. Synonymes. Barium Iodatum, Iodide of Barium. German. Iodbaryum. In solution, Baryta? Hydriodas, Hydras Barii Iodati, Baryta Hydriodica; Hydriodate of Baryta. German. Iodwasserstoffsaure Schwererde; Hydriodsaurer Baryt. This preparation has been introduced recently. METHOD OF PREPARING. Iodide of barium is obtained by boiling baryta earth in a solu- tion 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 applying warmth gently until the fluid appears clear and almost colourless,) or, what is cheaper, by boiling a solution of iodide of iron with car- bonate of baryta, which must be added in small portions as 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 ferrocyanuret of potassium: if it yield a precipitate, the de- composition of the salt of iron is incomplete. Should the solution, 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, and kept in a well-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. EFFECTS ON THE ECONOMY. Jahn instituted several experiments with iodide of barium, on plants, on animals, and on man in a state of health and disease. BEBEERIA. 117 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 scro- fulous and similar morbid conditions, and as an alterative in morbid growths, hypertrophy, chrpnic inflammation, &c, in which conditions it proved equally useful with chloride of barium, mercur}', or iodine.* Jahn's observations, it appears, did not 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 IS30, and according to Riecke, he has been since silent on the subject. Rothamel ad- ministered the iodide 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 thre£ grains were taken four times daily. Biett has adminislered it frequently in cases of scrofulous swellings, and at times externally, according to the following form:— Ungnentum barii iodidi. Ointment of iodide of barium. R. Barii iodid. gr. iv. Adipis, gj. M. fiat unguen*um. XXXVIII. BEBEE'RIA. Synonymes. Bebeerina; Bebeerine; Bebeerin. A tree known in Demarara by the Indian name Bebeeru, and by the Dutch name Sipeeri, had been observed by M. Rodie, a surgeon in the British navy, to possess a bitter-tasted bark, vvhich, on examination, was found by him to contain a vegetable alkali, to which he gave the name Bebeerine. From this alkali he pre- pared a sulphate, which he exhibited with success as an antipe- riodic. Dr, Maclagan having received some of the bark, and likewise some of the fruit of the plant, subjected them to chemical examination. The bark occurs in large, flat pieces, from one to two feet long, and varying in breadth from one to six inches. It is about four lines thick, of a cinnamon-brown colour, without aroma, pungency, or acrimony, but of a strong, persistent, bitter taste, with considerable astringency. The fruit is a nut, with two plano-convex cotyledons, of the size and figure of a walnut. The plant is unknown. It was supposed by Mr. Lindley and Sir Wil- liam Hooker, to whom the fruit was sent, to be lauraceous; but Dr. Maclagan could not discover any genus or tribe of lauraceae to * KiecKe, Op. cit. S. 71. IIS BEBEERIA. which it could be referred. Dr. Ranking refers it to Noctan- dra Rodiei.* The timber of the tree is well known by the name of greenheart. It is much employed by ship-builders. METHOD OF PREPARING. Dr. Maclagan treated the bark with water, acidulated with sulphuric acid; precipitated the alkaloids by ammonia; dried the precipitate over a water-bath, and purified them by redis- solving, by means of sulphuric acid; treating with animal char- coal, and reprecipitating by ammonia. In this way the alkaline matter is obtained in the form of a hydrate, nearly quite white. If this be dissolved in alcohol, it forms a clear orange solution, which, on evaporation, leaves a shining, totally uncrystalline mat- ter, a good deal resembling in appearance a transparent resin. This, however, is not a homogeneous product, for in some parts it seems pale yellow, in others, orange brown, and if agitated with anhydrous ether it is separated into two portions, one soluble, the other insoluble in that fluid. Both of these are distinct vegetable alkalies. To the former, Dr. Maclagan applied M. Rodie's name Bebeerine; the other he called Sipeerine—often erroneously written Sisseerine;—from the Dutch name of the tree. As obtained by evaporating its solution in ether or alcohol, bebeeria is in thin layers, in the form of a transparent, yellow, shining film, but when in mass, or powder, it is opaque. The alcoholic solution has a strong alkaline reaction on litmus paper. Its,taste is strongly and permanently bitter, with a slight resinous flavour, and it evolves feebly a corresponding odour when united with sulphuric acid. Bebeeria is soluble in five times its weight of absolute alcohol, and it dissolves with great facility in alcohol— pure and diluted. Ether takes up a thirteenth of its weight. It is very sparingly soluble in water, requiring 1766 parts of hot, and 6650 of cold water for its solution. It forms with the sulphuric, muriatic and acetic acids, yellow, shining, uncrystallizable salts, all of which are very soluble in water, and intensely and durably bitter, with a slight degree of astringency on the tongue. Sipeerine is that portion of the alkaline precipitate which, is insoluble in ether. It is of a dark brown, shining appearance, and forms neutral com- pounds with acids, some of which are crystallizable. Dr. Macla- gan had not, however, obtained it in quantities sufficient to enable him to examine its properties minutely.f Sulphate of bebeerine, according to Messrs. Ballard and Gar- rod,:}: is an article of commerce, usually found in brown, crystalline 'scales, soluble in water, sparingly so in alcohol, and possessing an * Half-yearly Abstract of the Med. Sciences, i. 221. Amer. edit. New York, 1845. t Transactions of the Royal Society of Edinburgh, vol. xv., pt. 3, or London and Edinburgh Monthly Journal of Medical Sciences, July, 1843, p. 653. t Elements of Materia Medica and Therapeutics, p. 411. Lond. 1845. BEBEERIA. 119 intensely bitter taste. The solutions of*the salt are neutral, and ammonia precipitates the alkaloid. Dr. Maclagan was led to in- stitute experiments, with a view of ascertaining how far, in point of cheapness, the salts of the alkalies of the bebeeria might be sub- stituted for quinia; and he found, that by a modification of the ordinary processes for sulphate of quinia, he could prepare a sul- phate of bebeeria, which could be sold at a price below the r.verage of sulphate of quinia, during late years.* Recently, a great improvement has been effected in the manufacture of the article for medical use, and it is now said to be sold at less than half the price of the sulphate of quinia.t EFFECTS ON THE ECONOMY IN DISEASE. Dr. Maclagan sent some of the sulphate to Demarara, where it was tried with marked success in the treatment of intermittents. It appears, indeed, to possess all the antiperiodic properties of the sulphate of quinia, and has, accordingly, been found of the great- est service in intermittent and remittent fevers, neuralgia, &c. Many such cases are related by Dr. Maclagan as occurring in his own practice,:}: as well as in that of Dr. Watt, of Georgetown, Demarara; of Dr. J. Anderson and Mr. D. Falconer, and of Pro- fessor Simpson, of Edinburgh. The last gentleman made trial of it in periodic neuralgia, occurring during utero-gestation, and with beneficial results.§ Dr. Gairdner, of Edinburgh, has, also given the particulars of a case of intermittent headache occurring in a young, and recently married lady, who, there was some reason to suspect, was pregnant, which was cured by the sulphate of bebeeria. It is said not to produce the unpleasant phenomena that occa- sionally follow the use of the sulphate of quinia. Dr. Maclagan states, that a secret preparation, sold under the name of " Warburg's Fever Drops," appeared, from chemical examination, to be a tincture of bebeeria, probably of the seeds. MODE OF ADMINISTRATION. The sulphate of bebeeria may be given in the same manner and doses as the sulphate of quinia. * Elements of Materia Medica and Therapeutics, p. 411. Lond. 1845. t Edinburgh Med. and Surg. Journal, April, 1845. X Lond. and Edinb. Monthly Journal, Aug. 1843, p. C&r>. § Edinb. Med. and Surg. Journal, April, 1845, or Braithwaite's Retrospect, xi. 93. Amer. edit, New York, 1845. 120 BERBERINA. 9 XXXIX. BERBERI'NA. Synonymes. Berberinum, Berberine, Berberin. French. Berberine. German. Berberin. The inner bark of 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 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.! The bitter principle of the root was discovered a few years ago by Buchner and Herberger, and its properties have been investi- gated by Brandes4 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 berberis vulgaris is pre- pared, to which water is added. This throws down a pulveru- lent brown substance; the fluid is poured off; and the substance dried; it is then treated with alcohol, which takes up the ber- berin, leaving a small portion undissolved. By evaporating the alcohol, the berberin remains.§s Thus prepared, berberin resembles an extract: it is of a brown- ish-yellow colour, translucent, and smells like the root; its taste is a pure bitter, and it becomes soft in the air. Buchner|| suc- ceeded in obtaining the bitter principle pure, and in a crystalline 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 for- mer. When crystallized, jt requires 600 parts of water for its solution; whilst in alcohol, at a medium temperature, it is soluble in 100 parts. It approximates the alkaloids in its nature, as with certain acids it forms crystallizable 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 apprehended from the administration of berberin as a therapeu- tical agent; of this he had an opportunity of satisfying himself both on his own person and on others. When labouring under * Ray's Historia Plant ii. 605. 1 Lond. Med. Repos., new series, i, 38. X Archiv. der Apotheker Vereins, ii. 29. § Riecke, Op. cit. S. 442. || Journal de Pharmacie, xxi. 309, and Philadelphia Journal of Pharmacy, vii. 328. Philadelphia, 1835. BIGNONIA CATALPA. 121 indigestion, he took it with the best effects; not only was the dyspepsia removed, 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 ap- petite; 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 berberin. He treated several cases with it as prepared by Buchner himself, when he found all his results con- firmed, and that it merited a high rank amongst bitter agents. He gives two cases of marked disturbance of the digestive func- tion, in which berberin afforded essential service. XL. BIGNO'NIA CATAL'PA. Synonymes. Catalpa, Catalpa Cordifolia, C. Arboresqens, C. Arborea, Ca- talpa or Catawba Tree. French. Catalpa. German. Katalpa, Bignonienbaum. Bignonia Catalpa belongs to the Natural Family, Bignonia- ceoe; Sexual System, Didynamia 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 (Siliquse) 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 de- cidedly favourable. Brera also extols it in asthma. As to the precise mode in which it acts, we have no exact information. Dierbach and Richter, according to Riecke,* place it amongst the Acria; whilst, according to the analysis of Grosso,t it seems more likely that its active principle is of a fatty nature, resembling the butter of the cacao. It is extremely probable, that it possesses no other virtues than those of a simple demulcent, and that the properties ascribed to it have been mainly, if not wholly, derived from the substances associated with it. Brera, for example, admi- nistered it with the following additions:t— R. Catalp. siliquar. £ss. Aquae q. s. ad. colatur. f. ^viij. Adde Oxymel. scillae, f. §ss. * Op. cit S. 72. t Gazette Medicale de Paris, 1834, p. 8. X Ricettario Clinico, Pad. 1825. 122 BOLETUS LARIC1S. Or R. Catalp. siliquar. gss. Senegas rad. gij. Aquse q. s. ad colatur. f. §viij. Adde Oxymel. scillae f. *j. To be taken by little and little. Brera. XLI. BOLETUS LA'RICIS. Synonymes. Boletus purgans, B. albus, Agaricus albus, Fungus Laricis. Polyporus officinalis, Fungus of the Larch, White Agaric. 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 has been retained in many Pharmaco- poeias; for example, in those of Amsterdam, Bavaria, Brunswick, Paris, Ferrara, Geneva, Hamburg, Hanover, Oldenburg, Poland, Prussia, Saxony, Sweden, Wirtemburg, and Wurzburg. Recently, it has been administered frequently in the colliquative sweats of phthisis. Barbut, of Nismes, made many trials with it,* which were favourable; and the experience of Andral was similar.f More recently, hovvever, he has expressed the opinion, that no great advantage has been derived from it.| By several of the German physicians equally advantageous results have been obtained—as bvT Toel and Trautzsch—so that, according to Riecke§ 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 powdered boletus was given. In profuse diaphoresis it is administered in doses of from two to six grains. The dose, repeated for a few evenings, according to Barbut, arrests the sweating, which, Riecke thinks, is effected 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. * Burdach, in Journal der Praktisch. Heilkund. von Hufeland, Mar. 1830. t Journal de Pharmacie, vol. xx. X Cours de Pathologie Interne, &c, recueilli et redige par A. Latour, p. 157. Edit, de Bruxelles, 1837. § Op. cit. S. 73. H Denkwiirdigk. in der arztlich. Praxis. Frankf. 1836, S. 344, cited by Riecke BRAYERA ANTHELMINTICA. 123 Pi 1 nlae boleti laricis cum opio. Pills of white agaric and opium. R. Bolet. laricis, gr. xv. Extract, opii, gr. iiss. M. Divide in pil. vj. One or two at bed-time in the colliquative sweats of phthisis. Rayer* XLII. BRAYERA ANTHELMINTICA. This plant is a native of Abyssinia, and belongs to Nat. Ord. Rosacese Sanguisorbeae (Decandolle,) Sex. Syst. Icosandria Di gynia. It was first taken from Abyssinia to Europe by Dr. Kraj-er, from whom it received its name. The flowers are the parts used in medicine, and they yield, on examination, an extrac- tive matter, containing tannic acid, which is most readily taken up by hot water; and consequently the decoction is,the best pre- paration. In Abyssinia, the flowers of brayera are said to have been em- ployed with the greatest success in tapeworm, but in Europe, 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 them from him,f which he submitted to his friend, Dr. Kurr, who detected, on examination, the constituents 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 5iss. and boiled them in gxvi. of water down to one half, adding to the strained liquor as much honey as counteracted, in some measure, the objec- tionable taste. This decoction was taken by a delicate woman, about 30 years of age, who had previously taken the extractum filicis maris in pilular form, according to Peschier's plan, with- out success. In the course of the day, she passed numerous frag- ments of taenia, mixed with mucous discharges, without experi- encing any striking inconvenience from the remedy. From this time, she remained free from the parasite. A robust man, 3S years of. age, who had taken large quantities of tartrate of antimony and potassa in consequence of violent in- flammation of the lungs,—whilst he lay sick of this disease, dis- charged a great many portions of taenia, without having previously experienced any inconvenience from the presence of the entozoon. In July, 1S34, 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 brayera has * A. Bouchardat, Annuaire de Therapeutique, p. 8, Paris, 1842, t Riecke, Op. cit S. 73. 124 KROJIINUM. been administered in European practice, Dr. Plieninger considers, that it is a valuable addition to the materia medica, inasmuch 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 anthelmintics. The article has not been import- ed in sufficient quantities into-Europe to admit of the necessary trials for fully testing its efficacy. In this country—so far as the author knows—it has not yet been seen. XLIII. BRO'MINUM. \ Synonymes. Bromium, Bromum, Brominium, Bromineum, Bromina, Mu- ride. Murina, Bromine. French. Brdme. German. Brom, Bromin, Murid, Murin, StinkstofF. This elementary substance was discovered in 1826, by Balard, of Montpellier. In its chemical properties it is allied to chlorine and iodine;—to the former, according to a recent writer,* more than to the latter. Balard detected it whilst occupied in some in- vestigations on the water of saltponds, and gave it the name bro- mine—from j3^toj, "a stench or smell"—on account of its dis- agreeable odour. It is met with chiefly in sea water, and in cer- tain animal and vegetable substances that live therein. It has likewise been found in many mineral waters, of this and other countries, and especially in salt springs—as in those of Salina, by Professor Silliman, and of Kenawha by Professor Emmet. It is in the secondary list of the Pharmacopoeia of the United States (1842.) 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 bromide of magnesium—the form in vvhich bromine exists in the bittern—and converts the bromide into a chloride of mag- nesium, setting the bromine free. The ether dissolves the evolved bromine, the mixture assuming a hyacinth-red colour. The ethe- real solution is agitated with caustic*potassa, by which bromide of potassium and bromate of potassa are generated; the ether be- coming colourless and pure, and fit to be used for dissolving fresh portions of bromine. When a sufficient quantity of the bromide has been obtained, it is mixed in a retort with peroxide of man- ganese, and acted on by dilute sulphuric acid, by which the bromine is given off*. The sulphuric acid sets free hydrobromic acid, which, at the moment of its disengagement, is deprived of * Dr. Glover, Edin. Med. and Surg. Journ., July, 1842. BROMINUM. 125 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 pow- der, and 24 of common sulphuric acid at 66° are added. The mixture is then put into a tubulated glass retort, to which a tubu- lated receiver 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, vvhich would be destroyed by the chloride. 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 apparatus, 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 rejected, until it is evident, on the addition of a fresh quantity of sulphuric acid and oxide of manganese, that they contain ne> more bromine. Bromine, at the ordinary temperature, is a fluid of a blackish- red colour, wrhen regarded in quantities,—but of a hyacinth-red when placed in a thin layer between the eye and the light. Its smell is strong, peculiar, acrid and disagreeable, resembling that of chlorine. Its tuste is acrid. It colours the skin yellow—the co- lour gradually disappearing of itself. Its specific gravity is 2-.966.. It is readily set free; and, when volatilized, assumes the form of dark red vapours. It boils at 117°; is sparingly soluble in water; and the solution is of a yellow colour. It is more soluble in al- cohol, and still more so in ether. In its chemical relations with other bodies, bromine, as before observed, resembles chlorine and iodine; but chlorine appears to have more power, and iodine less than bromine,—as bromine is separated from all its combinations by chlorine, whilst it decomposes the compounds of iodine, and assumes the place of the latter. It forms acids both with oxygen and hydrogen. Its test is the production of an orange colour with starch. EFFECTS OX THE ECONOMY IX HEALTH. Experiments have been instituted to discover the influence of * Journal de Pharmacie, Janvier, 1837. 9 126 BROMINUM. bromine on the animal economy, and especially by Barthez.* In this respect, also, bromine resembles iodine, and, like it, belongs to the class of irriiant poisons. Twelve grains of bromine, dis- solved in water, and injected into the jugular vein of a dog, de- stroyed it almost instantaneously. Cough ensued; the respiration and circulation were accelerated; the pupils dilated; the male organ was erect; and these signs were followed by involuntary discharge 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 fluid; in the venae cavae there were dark coagula; and in the stomach and intestines, small, bloody, blackish cylinders. similar to sticks of lunar caustic. The same quantity introduced into the stomach caused death in three or four days, when the (esophagus 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 anxi- ety, and debility gradually augmenting until death. On opening the body the stomach has been found contracted; the mucous membrane wrinkled, at times softened, and frequently the seat of roundish ulcerations of an ashy-green colour. Near the pylorus, Barthez found black spots, vvhich 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 experiments. In one case, only, in vvhich 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 paralyzing influence of the poison on the nervous system.f Two series of effects, according to Dr. Glover, are produced by the introduction of bromine in large doses into the stomach: one arising from volatilized bromine getting into the fauces and air-passages; and the other from its corrosive and irritant action on the stomach and intestines. Another series, he conceives, may be due to its entrance into the circulation. It appears to be more irritant when diluted than when pure. The vapours of bromine do not seem to exert any organic in- fluence on the workmen who prepare it.i * De FAction du Brome, &c, (These) Paris, 1828. See, also, Fournet in Bulletin General de Therapeutique, Fevrier, 1838. I Christison on Poisons, 3d edit p. 186. * A. Chevallier, Annales d'Hygiene Publ. &c, Avrii, 1842. BROMINUM. 127 EFFECTS ON THE ECONOMY IN DISEASE. Pourche first used both pure bromine and hydrobromate of potassa for therapeutical purposes. He found it very efficacious in scrofula, especially in dispersing strumous swellings, both when given internally and applied externally.* In a case of very large goitre, it was highly serviceable. According to Pourche's observation, it excited heat in the face, headach, dryness of the throat, &c, which, however, soon disappeared. Pourche gave 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 bromine, but more com- monly some of its preparations. He prescribed it in cases in which iodine did not appear to exert the proper efficacy, or where the patient had become accustomed to its use. The chief dis- eases in which he gave it were scrofula, amenorrhea, and hyper- trophy of the ventricles of the heart. It has also been administered by M. Fournet,t in cases of chronic arthritis, both internally and externally; but his facts, as he himself remarks, were too few to enable him to deduce any general conclusions as to the thera- peutical 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 application, consisted, at the commencement, of ten drops of bro- mine to an ounce of alcohol: this was augmented daily by five drops until it reached one hundred and twenty drops. Dr. Glover:}: considers the solution of bromine in water an ele- gant and useful application in scrofulous, syphilitic, and specific ul- cers, as well as in eczemalous eruptions. He gives a case of obsti- nate tuberculous eruption, where an ointment of bromine and bro- mide of potassium, eight minims of bromine, and half a dram of the bromide to an ounce of lard, effected a cure; and also, a case of sarcomatous tumour of the knee removed by a similar but stronger ointment. He thinks that, physiologically, bromine and the bromides are nearer the group of chlorine and the chlorides, than that of iodine and the iodides. He maintains, that the che- mical and physiological relations are alike, and that the same is true of the medicinal properties.§ * Bulletin General de Therapeutique, No. 14. Juillet 30," 1837. t Ibid. Fevrier, 1838. X Edinb. Med. and Surg. Journal, Oct 1842. § Ibid., and Lond. and Edinb. Monthly Journal of Med, Science, Nov. 1842, p. 1011. 12S BRUCIA. The preparations of bromine are described in other parts of this volume. XLIV. BRU'CIA. Synonymes. Brucina, Brucinum, Brucium, Pseudangusturinum, Vbmicina, Brucine. French. Brucine. German. Brucin. This alkaloid was discovered by Pelletier and Caventou, in 1819T in the bark of the false angustura (Brucea antidysenterica.) It is found also in small quantities in nux vomica, and in St. Ignatius's bean. METHOD OF PREPARING. An alcoholic extract of 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 sulpho- hydric acid gas, and the brucia by an alkaline base, for vvhich purpose magnesia may be employed. The precipitate from the magnesia is then washed, dried, and treated with alcohol, which lays hold of the brucia: this is obtained by evaporation. As brucia is somewhat soluble, the precipitate ought not to be washed too much. Brucia, thus obtained, is coloured, but it may be procured colour- less by forming an oxalate of brucia, and treating it with a mixture of equal parts of alcohol and ether. The oxalate is thus deprived of its colouring matter; after vvhich it is decomposed by magnesia: brucia is thus obtained wholly pure and devoid of colour. Pure brucia is of a white colour, and in regular crystals of the form of oblique prisms, having a base representing a paralle- logram; it has a pearly lustre, very bitter taste, 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 crys- talline 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 ve- getable substances that do not contain azote. With the acids, brucia forms neutral salts, which differ from the salts of strychnia. The sulphate of brucia crystallizes in very fine needles, and re- sembles the sulphate of morphia, but it has a much more bitter taste. Nitrate of brucia does not crystallize, which constitutes an essential difference between brucia and strychnia. With an excess of nitric acid, the salt has a beautiful pearly (nacre) aspect. EFFECTS ON THE ECONOMY. Brucia acts energetically on the animal economy in the same manner as false angustura, but much more strongly. It is similar BRUCIA. 129 :n its operation, to strychnia, but is considered to be weaker in the proportion of one to ten, according to Pelletier; one to twelve, ac- cording to Magendie;* and one to twenty-four, according to An- dral.t It requires four grains to kill a rabbit, whilst half a grain of strychnia is sufficient. A tolerably strong dog, to which three grains of brucia had been given, was affected with symptoms re- sembling tetanus, but did not die. Pelletier is of opinion that brucia, or rather the alcoholic extract of false angustura, might be substituted in practice for the extract of nux vomica; its operation is nearly the same, whilst there is no danger of its acting too violently. Andral has frequently pre- scribed it, and his deductions are, that it is far more under our control than strychnia. Like strychnia, it has been given in cases of paralysis with varying success. It would appear to have acted most beneficially in that resulting from lead poisoning. Magendie administered it with success in two cases of atrophy, one of the leg, and the other of the arm. MODE OF ADMINISTRATION. Brucia, 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 alka- loid should always be that obtained from false angustura,—the bru- cia of nux vomica being mixed with a portion of strychnia, which adds to its activity, and renders it difficult to determine the dose. The following formulas are recommended by him:— PilulaB umciae. Pills of brucia. R. Bruciae pur. gr. xij. Confect. rosae, gss. M. exactiss. et fiant pilulae xxiv. One pill to be begun with—twice a day. Magendie. Tinctura br u c ise. Tincture of brucia. (French, Alcool de Brucine.) R. Alcohol (36° Areom., s. g. 84?,) f. %]. Brucise, gr. xviij. M. Of this tincture, from six to twenty-four drops may be given. in the form of mixture, in any vehicle. Magendie. Wistnra brucia. Mixture of brucia. (Potio Stimulans.) R. Bruciae. gr. vj. Aquas destillat. f. giv. Sacchar. ^ij. M. Dose>.—A table-spoonful night and morning. Magendie. * Formulaire, &c, des Nouveaux Medicamens, &c. f Journal de Physiologic de Magendie, iii. 267, Juillet, 1823. I 130 CAINC.E RADIX. XLV. CAIN'C^ RADIX. Synonymes. Rad. Chiococca?, R. Cainanee, R. Caninanae, R. Cahincse, R. Kahincse, R. Serpentarise Brazili^nsis; 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 Chiococca anguifuga, of the Family Rubiaceae, Sexual System, 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 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 the branches; and, on the outside, is of an amber, or brownish yellow green co- lour; yellower and brighter on the youngest parts; the epidermis is not easily separated. According to the chemical investigations of Pelletier and Caventou,f the following are found to be the con- stituents of the bark:—1. A bitter principle, crystallizable in small, white, silky, shining needles; inodorous, and very soluble in hot alcohol, which communicates to the whole plant a degree of astringent bitterness, and at the same time has an acid reaction on litmus paper. In order to separate this acid, which has been termed by those chemists Acidujn cahincicum, in a pure state, the alcoholic extract of the root must be dissolved in water, fil- tered, and precipitated by lime, until the fluid loses all bitterness; the precipitate is then decomposed by oxalic acid, and boiling al- cohol; or the acetic, or muriatic acid may be dropped into an 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 cahincic acid, prepared in this way, how- ever, some colouring matter is still united. 2. A fatty, green, nauseous-smelling substance, which communicates to the plant its smell. 3. Yellow colouring matter; and 4. A viscid colouring matter.^ EFFECTS ON THE ECONOMY. The effect of cainca root seems to be especially exerted on the digestive and urinary organs. It occasions watery evacuations, * Art. Chiococca, in Encyclop'ad. Worterb. vii. 521. Berl. 1831 ; and Von Martius, Spec. Mat. Med. Brasil, i. 18. t Journal General de Medecine, Mai, 1830, and Phil. Journ. of Pharmacy, iii. 165, Philad. 1831. X Journal de Pharmacie, xvi. 465. CAINC.E RADIX. 131 and diuresis. From the experiments, however, of Albers,* 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 helleborus niger. Wolff was of the same opinion. According to Von Langsdorff,! it is a highly efficacious emmenagogue, possessing also—to use his own language—considerable resolvent virtues, and hence em- ployed in dropsies, that are connected with obstructions in the abdomen. Riecke:}: asserts that he had occasion to employ it in two cases of ascites complicated with induration of the liver. He had no expectation of effecting a radical cure, but it afforded no palliation; diuresis was not excited, whilst nausea, colic, and diar- rhoea supervened, so that he discontinued it: he gave it in decoc- tion. Others have observed the same inconvenience from its use. or have found it wholly ineffectual; for example, B. Heyfelder, Reinhardt, Bartels,§ and others. Riecke suggests the possibility. in these cases, of adulteration of the drug. On the other hand, cainca has been highly extolled by Francois, Ribes, Wagner, So- lieer, Lowenstein,|| &c., but particularly by Von Langsdorff. The main diseases in which cainca is recommended, are, 1. Dropsies, in which many favourable trials have been made by Von Langsdorff, Spitta,1F Guddoy, Engler, Francois, Wagner, Solieer, Robredo,** &c. 2. Intestinal worms, against which it appears to act like other drastics. 3. Obstructed menstruation: on this sub- ject, 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. 4. M. Francois has recommended it highly in catar- rhus vesicoz, but the experience of others has not confirmed this.jf It may be mentioned, that in its native country it is used for rheu- matic 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 ADMINISTRATION. Cainca is given in various forms—powder, infusion, and de- coction; and, besides these, a tincture and an extract have been made of it. A syrup and a wine have also been recom- mended. 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 * Medicin. Zeitung. No. iv. Sept. 1832. t Hecker's Litter. Annal. B. iv. S. 395, and Rust's Repertorium, B. xiv. S. 458. + Die neuem Arzneimittel, u. s. w. S. 84. Stuttgart, 1837. § Grafe und Walther's Journal der Chirurgie, u. s. w. xxiv. S. 470. Berlin, 183d || De radice Cainca ejusque in morbis hydropicis virtute. Berol. 1828. IT Hecker's Litterar. Annal. in 396. ** Journal de la Academia de Medicina de Megico. Oct. 1836, cited in Brit, and For. Med. Review, p. 562, Apl. 1838. It Bulletin Gen6ral de Therapeutique, No. 13, Juillet, 1837. 132 calendula officinalis. root and eight parts of alcohol at 20°. The alcoholic extract is considered to be the most uniform in strength, and has, there- fore, been preferred by many. The syrup is formed by dis- solving Jiiss. 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 9j, to 5ss. in the twrenty-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 decoction should be preferred. Ac- cording to Caventou and Pelletier, boiling extracts very well the efficacious parts of the root, and there are cases in which the de- coction has rendered essential service after the infusion had been administered without success. Of the decoction, from f. 5j. to f. 5'ij- are given in the day. Of the extract, the dose, in the twenty- four hours, is from twenty to thirty grains; of the tincture f. 3j. to f. 3ij * The decoction, used by Spitta and others, was made as follows: Decoctum radicis cainca. Decoction of cainca root. R. Caincss rad. ^ij. Coque cum aquae Oiss. ad dimidiam partem, et cola. Dose.—A table-spoonful three times a day. Von Langsdorff^ fy Francois. By others, the following form has been employed: R. Cainc. rad. gj. Aquae, Oij. , Coque ad dimidiam partem et cola. Dose.—Two table-spoonfuls three or four times a day. Engler. Dr. John H. Griscom,J of New York, considers there is a re- markable analogy between cainca and apocynum cannabinum. The Acidum cahincicum, described above, is said to possess tonic, cathartic and diuretic powers, and has been used successfully in some cases by Francois, in the dose of six grains gradually in- creased to fifteen. XLVI. CALENDULA OFFICINALIS. Synonymes. Calendula Sativa, Caltha Sativa, Verrucaria, Chrysanthemum, Sponsa Solis, Single Marigold, Garden Marigold. French. Souci, S. Ordinaire. German. Ringelblume, Gemeine Ringelblume, Todtenblume. * Journal de Chimie Me'dicale, Mai, 239-242. Paris, 1827. t Hufeland und Osann's Journ. B. lxii. St. 2. J Amer. Journal of the Medical Sciences, for May, 1838, p. 5* CALENDULA OFFICINALIS. 133 This plar£ belongs to Family Synanthereae; Sexual System, 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, vvhich is not, however, unpleasant. The taste is bitter and somewhat pungent. It was examined chemically by Geiger and Stoltze,* who found it in a peculiar glutinous matter, readily soluble in alcohol, insoluble in ether, and in ethereal or volatile oils, and but little in water: to this they gave the name calendulin. EFFECTS ON THE ECONOMY. The term officinalis indicates, that the calendula was formerly received into the lists of the1 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 noticed its good effects b}* accident. Visiting an aged female, who had suffered, for a long time, under an extremely painful induration 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 em- ployed in that frightful malady. He never, however, employed it alone, but associated with it other active remedies, so that but little attention was paid to his recommendation;—a great portion of the efficacy of the agents employed, being—it was thought pro- bable-—ascribable to the associated articles. Some time after Westring's publication, the remedy was u?ed by others, when his observations were confirmed. Rudolph:]: employed it with advantage internally, in a case of induration of the mamma in a young female; but the acetate of iron was at the same time applied externally in solution. Fehr§ 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 }7oung 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 burning arises, which speedily becomes absolute pain. This soon, how- * Berlin. Jahrb. d. Pharmac. B. xxi. S. 282. t Erfahrung liber die Heilung der Krebsgeschwiire, u. s. w. Translated from the Swedish into German by K. Sprengel. Hal. 1817. X Hufeland und Osann's Jour, der prakt Heilk. B. Iviii. St. 1, S. 119. § Verhandlungen der verein. arztlich. Gesellschaft. der Schweiz. Jahrg. 1831, and Dierbach, in Heidelberger Annalen, B. x. H. 4, S. 501. Heidelberg, 1834. 134 CALENDULA OFFICINALIS. ever, abates, and almost wholly disappears; and if it be too vio- lent, more butter may be added; the ichorous discharge becomes improved; 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 calendulse in cancerous ulcers and as a discutient in chronic indurations, in combination, however, with other efficacious agents. Schnei- der affirms, that he prescribed the extract with the best effects in induration of the stomach, and in tumefaction and decided in- duration of the glands and uterus. He employed a decoction of the flowers and plant in cancer of the uterus, and found it an excellent soothing, and discutient agent. Muhrbeck* used the extract with eminent success in chronic vomiting; Carterf in extremely obstinate vomiting; and De Camp in a case of car- dialgia, 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 in amenorrhoea, in which disease it was celebrated with the older physicians; but as Riecke\ has remarked, the amount of experience with calendula is yet small—too small for us to pronounce whether it merit a fixed place in the lists of the materia medica. MODE OF ADMINISTERING. The extractum calendulse is contained in the Hanoverian and Saxon Pharmacopoeias; in the latter it is directed to be prepared in the following manner:— R. Calendul. officinal, part j. Aquae, part viij. 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 ob- servers. Muhrbeck gave four grains, five times a day. Fehr allows 3ij. to Jvj. Phobus directs the dose of the extract, pre- pared according to the Prussian Pharmacopoeia, to be from eight to sixteen grains, gradually increasing it to Jss. and more, from two to four times a day. It may be given either in the form of pill or mixture. 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 f.5j. to f.5ij. * Hufeland's Journal der prakt. Heilk. B. lxii. St. 5, S. 128. Rust's Ma"-azin. der gesammt. Heilk. B. xi. S. 350. t London Med. Rep. April, 1826, p. 347. See, also, Link und Osann, in art. Calen- dula, in Encyc. Worterb. u. s. w. B. vi. S. 520. Berl. 1831. X Op. cit. S. 101. § Pharmacopee Universelle, &c, par. Jourdan, ii. 536. CALX CHLORINATA. 135 The Sardinian Pharmacopoeia has a Conserva fiorum calendulse. made by beating together one part of the flowers and two parts of powdered sugar. It has, also, an Acetum fiorum calendulse, made of one part of the petals digested in four parts of vinegar; and the Wirtemberg Pharmacopoeia has an Unguentum fiorum calendu- lse, 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. PilulBe calendula*. Pills of calendula. R. Ferri subcarb. Calend. pulv. Extract calend. as jjj. Mucilag. acac. q. s. ut fiant pilulse xc. Dose.—Five to eight, three times a day, as a soothing agent in cancerous ulcers. Rust. R. Hydrarg. chlorid. mil. 9ss. * Antim. sulphur, aur. gj. Extr. calendul. ----• conii, 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. ------anthemid. aa gij. Solve in Aq. lauroceras. f. gij. Adde Tinct. opii f. 3j. As a dressing wash (Verbandwasser) in cancerous ulcerations. Rust. It is obvious, that the precise agency of the calendula cannot be tested in any of these formulae, the substances associated with it being themselves active agents. In this country, it is never perhaps used. XLVII. CALX CHLORINATA. Synonymes. Calcis Chloridum, Calcis Hypochloris, Oxychloruretum Calcii, ProtochloruretumCalcii; Chloruretum OxydiCalcii,BichloruretumCalcis; Oxymurias Calcis, Calx Oxymuriatica, Calcaria Chlorata, Chlorum Cal- cariae, Chloretum Calcariae, Calcaria Chlorica, C. Chlorinica, Chlorinated Lime, Chloride or Chloruret, Hypochlorite, Chlorite or Oxymuriate of Lime, Tennant's Bleaching Powder. French. Protoxichlorure de Calcium, Oxichlorure de Chaux, Chlorure d'Oxide de Calcium, Bichlorure de Chaux, Oximuriate de Chaux, Mu- 136 CALX CHLORINATA. riate Suroxigene ou Oxigene de Chaux, Chlorate ou Souschlorate de Chaux, Poudre de Blanchement, Poudre de Tennant. German. Kalkchiorid, Chlorkalk, Chlorigsaurer Kalk, Chlorcalciumoxyd, Oxydirt Salzsaurer Kalk, Bleichpulver. Chlorinated lime is a compound of chlorine and oxide of cal- cium. METHOD OF PREPARING. It may be prepared either in the dry or moist way. In the former case, chlorine is made to act on hydrate of lime in a pulveru- lent form; in the latter, 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 Pharmacopoeia, 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 chlorohy- dric acid, by a^gentle heat.* It is generally, however, prepared in large chemical establishments for the use of bleachers, and is therefore in the list of the Materia Medica in the Pharmacopoeia of the United States (1842.) Chlorinated 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.t Its nature and composition are a subject of dispute, and hence the term "chlori- nated lime," which has been adopted by the London, Edinburgh, and United States Pharmacopoeias, in place of chloride of lime. M. Hunoux DesfontenellsJ affirms, that having prepared pills of chlorinated lime, extract of opium and honey, they experi- enced a .spontaneous combustion a short time after they were prepared; and he states, that the reaction took place at times whilst the mixture was being made. He found, that powdered marshmallow root and liquorice, when united with chlorinated lime and honey, produced the same result. It would hence ap- pear that chlorinated lime and organic substances ought not to be associated in the same prescription. EFFECTS ON THE ECONOMY. The action of chlorinated lime is generally esteemed to be analogous to that of liquid chlorine; Hufeland, however, assimi- lates it to that of chloride of calcium. The data have been con- sidered as scarcely, perhaps, sufficient to determine its precise operation. It appears to us, however, to act mainly by means * Brande's Dictionary of Materia Medica, p. 135. Lond. 1839. .Qto,Link, Art Clllor• in Encyc" W°rterb- der Medicin. Wissenschaft. vii. 579. Berlin, J: Journal de Chimie Medicale, and Soubeiran, Jour, de Pharmacie, Fevrier, 1842, p. 121. CALX CHLORINATA. 137 of its chlorine, which, being loosely combined, is readily disen- gaged,—all acids, even the carbonic, occasioning its separation. It is not much employed internally; but, according to Cima, it occasions slight pains in the abdomen, burning in the stomach, and at times diarrhoea. As to its internal administration, Cima gave it in cases of scro- fulous swellings. By Cloquet, it was used both internally and externally in gangrenous ulcers; and by Grafe, Deschamps. Graves,* and the author in fcelor oris. In a case of pectoral disease, toith great foztor of the breath and expectoration, it was administered by Drs. Graves and Stokes with remarkable benefit,—a pill of three grains 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 it. It has been used with advantage by the author in a similar case; and in gangrene of the lungs. By Reid,f it was prescribed in dysentery, and in a bilious typhus occurring in summer; by Copland^ in the last stage of typhus fever, when the evacuations were highly offensive, given in draughts of aromatic water with mucilage. Dr. Pereira§ also states, that he can bear testimony to the good effects of it in bad cases of fever; but the same results were not observed in the/e?;er of Edinburgh-^ It was likewise given by Groh, Cohen, and Schlesier8^ in phthisis, and by Grate in gonorrhoea. In none of these cases is it presumable, that chlorinated lime possesses 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 is pro- per for torpid ulcers of almost all kinds—the phagedenic, the scrofu- lous, &c. In syphilitic ulcers, it appears to be of use when the chancre is sloughing, and eats deeply into the flesh.** Trusen employed a solution formed by rubbing from 3iij. to 3iv. with a pint of water, pouring off the supernatant fluid after it had stood a quarter of an hour, and applying it by means of pledgets of lint to the ulcer, renewing the application whenever the lint became dry. In this way, he found the profuse ichorous secretion from old ulcers diminish; the offensive odour abate, and fresh and healthy gra- nulations spring up. By the same kind of treatment, phagedenic, herpetic and scrofulous ulcers generally cicatrised speedily and per- manently.1t Trusen employed, at the same time, crude antimony * Dublin Hospital Reports, vol. v. t Transactions of the Association of Fellows and Licentiates of the College of Physi- cians in Ireland, vol. v. 18138. X Houlton's Appendix to translation of Magendie's Formulary, p. 1(53. § Elements of Materia Medica, &c., 2d edit. p. 593, Lond. 1842; or 2d Amer. edit. by Dr. Carson, Philad. 1846. || Christison, Dispensatory, p. 242. Edinb. 1842. IT Casper's Wochenscrift fur die gesammte Heilkunde, No. 37, 1838. ** Dr. Mene, in Gazette Medicate, Feb. II, 1832. tt See, also, Houlton's Appendix to Magendie's Fonnulary, p. 1(52. 138 CALX CHLORINATA. 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 ozsena, good effects were observed from it by Horner,* Awl,f Heron,J Detmold,§ and Strathing: and a solution of it, in the form of injection, was found serviceable in fistula, by Trusen and Ricord. Even in can- cerous ulcers, recourse has been had to it by Heiberg, Labarraque, Duparcque, Martinet, &c: in all cases, it corrected the offensive odour, and, at times, the ulcer itself assumed a more favourable ap- pearance. Dr. Frohlich|| used it with advantage in a cancerous affection of the face, in the strength of one part 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 prescribed, also, in cases of ulceration of the mouth, by Kopp, Angelot, Heiberg, &c, applied either in the form of so- lution or of a soft paste. In cases of wounds, the application of a solution of it has been recommended by many, as by Trusen, Ekl, Lisfranc,^[ to promote cicatrisation after the inflammation has sub- sided. In a case of punctured wound received in dissecting, and when the inflammation was proceeding up the arm with alarm- ing rapidity, and the pain and tension were extreme, the patient ex- perienced immediate relief from a solution used as a lotion, com- bined with the free use of leeches.** Gubiantt has proposed to apply it to prevent 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, it has been applied in cancrum oris, by Labarraque, Richter, Berndt, and numerous others, and in sloughing affections of the female organs of gene- ration of an analogous nature, by Labarraque and Ekl; in hos- pital 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 it has been of decided efficacy. + J In such cases it may be applied either in the form of the paste above mentioned, or in strong solution—5ij to Oj of water. * Amer. Jour, of the Medical Sciences, No. xi. t Ibid. No. xxii. for Feb. 1833, p. 543. X Ibid. Nov. 1836, p. 271. § Holscher's Annalen, 1840, Bd.v.Heftl; and Brit and For. Med. Rev., Oct 184l,p.549. || Medicin. Jahrbiicher des k. k. osterreich. Staates. B. xvii. S. 168. Wien, 1834. IT Bulletin General de Therapeutique, Juillet, 1838. ** Alcock, Essay on the Use of the Chlorurets, &c. London, 1827. ft Journal de Chimie Medicate, vi. 315. U Riecke, Die neuern Arzneimittel, u, s. w. Stuttgart, 1837. CALX CHLORINATA. 139 In burns of the second and third degree, vvhen they are not spread over too great a surface of the body, a solution of chlorinated lime, according to Trusen, markedly diminishes the pain, moderates the too great suppuration, and excites, especially in the second degree, sound granulations; in the third, speedy separation of the dead portions, and in both cases a smooth and firm cicatrix. Either a solution united with mucilaginous substances, or a liniment pre- pared of it may be applied. Lisfranc's observations* entirely accord with those of Trusen. He applies compresses spread with cerate over the burnt parts; the compresses having holes in them so that the burnt surfaces are exposed; they are then covered with lint soaked in a solution of chlorinated lime, which is kept in situ and moistened as it be- comes dry. A solution of it, as well as of chlorinated soda, may be applied, indeed, with advantage in the first stage of a burn or scald; and Mr. Holtf affirms, that he knows nothing so'efficacious in a "black eye.'7 Dr. Chopin,J too, affirms, that in wounds pro- duced by contusion, laceration, or by the explosion of gunpowder, where there is much pain, speedy and certain relief is produced by keep- ing the dressings constantly wet with a solution of it: he found it, as well as chlorinated soda, very serviceable in cases of sore nip- ples. In chilblains, it has been used, both in the form of solution and of liniment with advantage; and not only in ulcerated chilblains, but where the skin was unbroken, by Trusen, Lisfranc, Grafe, and others. In many cases, however, it has been found advan- tageous to diminish the inflammation first by the application of leeches. In cases of deeper frost bites it has likewise proved beneficial. In salivation caused by mercury, it has been found valuable,§ especially when administered at the beginning of the increase of secretion. When the ptyalism has proceeded to a greater extent, Trusen uses, at the same time, sulphureous baths. A collutory of chlorinated lime not only diminishes the excessive 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, the author has frequently emplo}'ed it and with advantage, al- though 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 it, but it excited the salivary glands in a disagreeable manner. On the other hand, E. Grafe * Gazette Medicate, Mars 21, 1835. See, also, Bulletin General de Therapeutique, Juillet, 1838; and Clinique Chirurgicale de I'Hopital de la Pitie, Paris, 1311. t Lancet, April Gth, 1834. 1 Gazette Medicate, Oct. 31, 1835. § Elliotson, in Mr. Houlton's Appendix to translation of Magendie's Formulary. Amer. edit. p. 162. Philad. 1834. 140 CALX CHLORINATA. recommends it strongly in this very case, and even in caries, both inwardly,and externally, as a collutory and tooth powder. In the latter form, it is said to remove speedily the tartar and yellow de- positions on the teeth. By Chevallier and Kluge, it is strongly recommended for cleansing the mouth. The latter gives a for- mula for a collutory, which will be found amongst the prescrip- tions at the end of this article. It effectually cleanses, whilst it does no injury to the enamel of the teeth. In scarlatina, a solution of chlorinated lime may be employed most advantageously as a gargle, and in the form of ablution to the surface.* In scrofulous swellings of the glands, according to Cima, it may be applied with advantage in the form of ointment;, and by Grafe it is recommended in swellings of the joints. It has like- wise been used successfully by Werneck in goitre. In several chronic eruptions, it has been much extolled—as in herpes, by Kopp; in itch, by Heiberg, Derheims,t Cluzel, Fan- tonetti4 Hospital,§ Wittzack,|| and Napoli.^f Dr. Christison** affirms, that he never uses any other remedy in itch;—a solu- tion, containing between a fortieth and a sixtieth part of chlori- nated lime, applied five or six times a day, or continuously with wet cloths, allays, he says, the itching in the course of twenty- four hours, and generally accomplishes a cure in eight days. In pruritus pudendi muliebris, it has been advised 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 itch. Take of chlorinated 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 S)Tstem; put this in a common flask or bottle full of rain or river water, so that as much as possible may be dis- solved. 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 three or four times a day. Every third or fourth day, vvhen the skin becomes somewhat rough or irritated, he is made to take a tepid bath, or to wash himself with warm soap and water; and this until the cure is ac- complished. The internal management is the same as in other * Dr. Copland, in the Appendix to Houlton's edition of Magendie's Formulary, p. 16?. Dr. S. Jackson, of Northumberland, (now of Philadelphia,) in Amer. Journal of Meet Sciences, xii. 261 and 550, and Ibid, for May, 1838, p. 56. (Dr. J. uses chlorinated soda.) t Journal de Chimie Medicate, ii. 575. X Bulletin de Therapeutique, 1833; and American Journal of the Medical Sciences, August, 1833, p. 533. § Amer. Journal of the Medical Sciences, Nov. 1834, p. 240 (extracted.) || Casper's Wochenschrift, Feb. 4, 1837, S. 79. It' Jonrn. de Chimie Med., cited in Amer. Jour, of Pharmacy, July, 1841, p. 172. " Dispensatory, p. 242. Edinb. 1812. CALX CHLORINATA. 141 plans of treatment. In the case of young children, the mixture must of course be weaker,—about one ounce to a pint of water. By this plan, the patient, it is said, is entirely cured, without any unpleasant concomitants, in from seven to ten days. Chlorinated lime has likewise been applied in purulent ophthal- mia. Varlez* cured contagious blennorrhaza of the eye, by dropping upon it a solution of it. Colson, Delatte, and Reynaudt 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 Meibomian glands. Guthrie:}: applied a solution successfully in three cases of ophthalmia neonatorum; and Pereira§ advises a weak solu- tion in the same cases. Farvagnie used it beneficially in scro- fulous and catarrhal ophthalmia.^ Dr. Radclyffe HaM has treated purulent ophthalmia, both in the adult and in children, with success, by a saturated solution of chlorinated soda. His plan of using it is as follows. The eye-1, lids are slowly and gently separated, until the cornea can be seen, when that is manageable; and all secretion is wiped away with a fine soft sponge. A large bushy camel's hair pencil, charged with the strong solution, is then insinuated beneath the upper eyelid, and swept round the front of the eye; the pencil is again charged with the solution, and applied to the lower eyelid everted. Unless plenty of the fluid be thus applied, it will be less effectual, but equally painful. There is considerable pain, of a smarting, burning character, for half an hour or longer, and the already swollen eyelids become still more tumid. In a few hours, a serous discharge oozes out from between the eyelids, and the swelling partially subsides. This is followed by a secretion of matter; but, after two or three applications of the solution, in per- ceptibly diminished quantity, and the discharge gradually loses its characteristic yellow colour, and is seen in flakes on opening the eyelids. After three or more applications, the eyelids no longer swell, and the pain is much less. As the inflammation lessens, the eyes must be kept clean with warm water, matter never being suffered to collect beneath the upper eyelid; a little spermaceti ointment is smeared on the edges of the eyelid, and the strong solution is applied once in every twenty-four hours, until the secretion ceases to be in the least degree puriform. The longest period required for the cure was a month; the shortest four days. * Cited American Journal of Med. Sciences, i. 459. 1 Journal fur Chirurgie, u. s. w. B. xiv. H. 4. X Medical and Physical Journal, Nov. 1827. § Elements of Mat. Med. 2d edit. i. 593, Lond. 1842; or 2d Amer. edit, by Dr. Carson, Philad. 1846. || Verhandlung. der vereinigt arztlich. Gcsellschaft. der Schweiz. Jahr. 1829. Zurich, 1830. 1T Provincial Med. and Surg. Journal, Dec. 18, 1844. 10 142 CALX CHLORINATA. It has likewise been employed advantageously in other blen- norrheas besides the one mentioned, and especially in the gonor- rheal.* Grafe, of Berlin,t 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 f. ^vj. of vjater, and adding Jss. of ivine of opium. His observations are confirmed by Dr. Radclyffe Hall,! wno observes, that in the treatment of diseases attended with a contagious discharge it is desirable not only to lessen the inflammatory action which causes the secretion, but at the same time to alter the contagious character of the matter secreted; and he advises chlorinated lime as capable of fulfilling these indications. In the first stage of gonorrhoea, before the discharge has become completely puriform, or the scalding great, a single injection of about two fluidrams of a saturated solution in water will always, he says, put a stop to the disease. In the second stage, where there is a considerable discharge of pus and more pain, several injections are required. In gleet, also, pro- vided the discharge be not kept up by some structural change in the urethra, the strong injection is useful, but not to so striking a degree. The effects of injecting this strong solution are,—sharp pain, and often erection for the moment; slight puffi- ness and eversion of the orifice of the urethra, and tenderness on pressure, with a feeling of unusual firmness for two or three inches down the corpus spongiosum, where these did not al- ready exist. In a short time the pain subsides, and in a quarter or half an hour, a serous discharge issues from the mouth of the urethra. Occasionally, oedema of the prepuce, with its attend- ant sense of numbness in the part, ensues. There is scalding, but usually not to any very great degree for the first two or three times of passing the urine, which may be in a great measure obviated by injecting a little oil of almonds a short time pre- viously. In about eighteen or twenty-four hours, the lips of the urethra are found to be separated by a clot of firm yellow pus. This is removed by the stream of urine, and may or may not form a second time. If the disease be only in its first stage, it will now, according to Dr. Hall, be cured; but if more established, the injection will have to be repeated as often as the peculiar tingling sensation and gonorrhceal secretion reappear. In this case, the small, firm clot is not formed; but in its stead there is a discharge of more fluid pus. The number of injections, and consequently the length of time required for cure, depend chiefly upon the an- terior duration of the disease. In the acute stage of a first attack, * Alcock, Essay on the Use of Chlorurets, &c. Lond. 1827. t Amer. Journal of Medical Sciences, and Amer. Journal of Pharmacy, 2d series, vol. ii. 86. Philad. 1838. See, also, M. Roussf, Bulletin General de Therap. Janv. 1842. X Op. cit CALX CHLORINATA. 143 where both pain and discharge are considerable, Dr. Hall has never seen any harm from employing this strong injection,— using, at the same time, mild aperients, lartrate of antimony and potassa and opium internally, enjoining perfect rest and absti- nence, and frequently washing out the urethra with some weak astringent solution, as that of acetate of zinc, formed by the double decomposition of sulphate of zinc and acetate of lead. On the contrary, the course of the disease has appeared to be materially shortened. When the inflammation is subacute, but the discharge still purulent, as in persons habituated to the disease, or after a certain period of a first attack, copaiba or cubebs have been given in the usual way, but the injection has been manifestly of service. In gleet, a single injection has some- times cured, after the failure of almost every other kind of injec- tion. More frequently, several injections have been required. In a few instances, the chlorinated lime has wholly failed; but in these cases, no other injection has succeeded afterwards. But one of the most important of the applications of chlorinated lime is as an antiseptic and disinfecting agent.* It is admirably adapted for preventing and checking putrefaction, and for cor- recting the offensive odour of parts already putrefied :f and hence its application is most useful in anatomical investigations.:}: Some time before dissection, the body may be enveloped in a cloth wetted with a solution of it (Calc. chlorin. iij., Aquse, Oj.,) which must be kept wet by sprinkling it from time to time: in this manner the offensive odour is speedily corrected. It is equally well adapted for purifying the air of the wards of hospi- tals, jails, or ships; a little of the solution being sprinkled from time to time on the floors; or shallow vessels, containing it, being placed in different parts of the room. It is used, moreover, for neutralizing 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 dis- eases. Nay, it has been affirmed to be positively injurious, by deteriorating the atmosphere, and in this there may be truth, un- less the precautions, mentioned above, be taken. In various cases, in wThich such diseases have prevailed, it has destroyed all offen- * Labarraque, on the Use of the Chlorides of Soda and Lime, translated by Jacob Porter. New Haven, 1829. f Alcock, Op. cit. X Magendie, Formulaire, &c. § Observation on the Chlorides and Chlorine as "disinfecting agents," and as Preven- tives 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, Elements of Mat Med. &c., 2d edit. i. 591, Lond. 1842; or 2d Amer. edit by Dr. Carson, Philad. 1846. 144 CALX CHLOSee, on the various modes of inhala- tion, Sir C. Scudamore, in Lond. Med. Gaz., Feb. 7, 1840, or Dunglison's Amer. Med. Intel. April 15, 1840, p. 25; and E. J. Coxe, Practical Treatise on Inhalation. Philad. 1841. X Archives Generates, Avril, 1834; and a communication on the excellent effects of chlorine vapour in catarrh, in Gazette Medicale de Paris. June, 1838. CHL0RINTJM. 167 sulphuretted hydrogen, chlorine is a most efficacious agent. Chlo- rinated lime may be used for this purpose. 2. By Fumigation.—Fumigations of chlorine have been parti- cularly recommended by Dr. 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, un- accompanied 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.t The good effects of chlorine, in such cases, have likewise been tested by Zeise,J in his bathing establishment at Altona. When chlorine is brought into contact with the skin, in this way, 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. Dr. Mettauer is disposed 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 intro- duced the nitro-muriatic acid to notice, about twenty-six years ago (IS17,) that a solution of chlorine in water will answer, in all cases, as well as the acid. In the last edition of the Pharmacopoeia of the United States, the following formula has been introduced for the preparation of the Acidum Nitro-muriaticum. Take of Nitric acid, f. giv., Muriatic acid, f. iviij. Mix them in a glass vessel, and, when effervescence has ceased, keep the product in a well stopped glass bottle, in a cool and dark place. * Dr. Wallace found chlorine fumigations serviceable not only in hepalic diseases with disordered secretion of the liver, but in several dther 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 are esteemed servicea- ble,—hence, in old cases of syphilis, scrofula, chronic catarrh, and rheumatism. Generally, cathartics were combined with the fu- migations, and the evacuations were constantly observed to present a highly bilious character. In chronic cutaneous affections, as in lepra, psoriasis, and scabies,these fumigations have been found useful; but, generally, fumigations of sulphurous acid are employed in preference, in consequence of the greater facility with vvhich they can be prepared.§ * Researches respecting the Medical Powers of Chlorine, &c. Lond. 1822. 1 See, on the JNitro-Muriatic Mixture, as a remedial agent, Dr. J. P. Mettauer, Amer. Journ. Med. Sciences, Feb. 1840, p. 291. X Nye Hygea udgived af C. Otto, 1825, and Hufeland und Osann's Journ. der prakt. Heilkund. B. Ixiii. St. 1. § Green on Diseases of the Skin. Dunglison's American Library edit. Philad. 1838. 168 CHLORINUM*. Injections of chlorine gas have been employed for the radical cure of hydrocele by M. Deblois, of Tournay, and M. Deconde.* The chlorine gas is contained in a bladder, to which is attached a pipe and stopcock adapted to the canula of the trocar, into vvhich 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 va- ginalis. When this is distended, the pipe and bladder are re- moved, 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 allowed to pass, 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 matter of contagion, and of preventing the spread of contagious diseases, have long been used.f As long ago as the year 1773, they were pro- posed for these purposes; and were subsequently extensively used by Guy ton de Morveau; hence they have been called the " Guy- tonian," or the " Guyton Morveau fumigations." They are the best agents 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 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.J When chlorine is evolved in the manner described, it is liable, like all the acid gases, to the objection, that it i^ extremely irri- tating when respired. It cannot, therefore, be used in the sleep- ing apartments of the sick, although it may be employed bene- ficially after they have been withdrawn, and the object is to disinfect the chamber. It ruins all polished surfaces, but this can be effectually obviated 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.§ * Bulletin Medical Beige, Janvier, 1836. t Link, Art. Chlor. in Encyclopad. Worterb. der medicin. Wissenschaft. B. vii. S. 575- Berlin, 1831. X Pereira, Op. cit p. 228. § See the author's General Therapeutics, p. 509. Philad. 183G; and his General The- rapeutics and Mat. Med. ii. 376. Philad. 1843. CHL0RINI AQUA. 169 LIV. CHLO'RINI AQUA. Stnonvmes. Aqua Chlorinii, A. Chlorinei, Solutio Chlorinii, Liquor Chlori, Aqua Chlori, Aqua Oxymuriatica, Liquor Acidi Muriatici Oxygenati, Aqua Oxygenata Muriatica, Aqua Oxygeno-Muriatica, Liquor Alexite- rius Oxygenatus, Solutio Alexiteria Oxygenata, Solution of Chlorine, Li- quid Oxymuriatic Acid. French. Chlore Liquide, Eau de Chlore. German. Chlorwasser, Wasseriges Chlor, Chlorfliirsigkeit, Dephlogistisirte u oder Oxydirte Salzsaure, Uebersaure Salzsaure, Oxydirt Salzsaures Wasser. 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, Edinburgh, Parisian, Finnish, Hanoverian, Polish, Prussian and Swedish.* 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 underwater, 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 chloro- hydric acid is formed, so that it has at times to be purified by treating it with a solution of nitrate of silver. The process of the Dublin Pharmacopoeia is similar to this. That of the Edinburgh Pharmacopoeia differs; and is as follows: Take of Chloride of sodium, sixty grains; Sulphuric acid (com- mercial,) two fluidrams; Red oxide of lead, three hundred and fifty grains; Water, eight fluidounces. Triturate the chloride of sodium and oxide together; put them into the water contained in a bottle with a glass stopper; add the acid, and agitate occasionally till the red oxide becomes almost white. Allow the insoluble matter to subside before using the liquid. EFFECTS ON THE ECONOMY IN HEALTH. From experiments made by Orfilaf on dogs, it appears, that 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 * Pharmaeopes Universelle, i. 405. Paris, 1828. f Toxicologic G6ne>ale, i. 141. 1 170 CnLORIXI AQUA. to the acids, and especially to the chlorohydric. Introduced into the stomach in moderate doses, 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 of the nervous system, and thereby to moderate inordinate action in any part; and is, to a certain extent, antiphlogistic, without possessing any of the debilitating qualities of the antiphlogistic? proper. In the opinion of some of the German pathologists, it powerfully stimulates the organic actions, especially the lymphatic and glandular systems, moderating inordinate secretion. Its anti- septic 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 mo^,us operandi on the human organism.* EFFECTS ON THE ECONOMY IN DISEASE. Although 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 admi- nister chlorine internally, and that in every case in which it was believed to have been given, the article really taken was the chlo- rohydric or muriatic acid; for, owing to the affinity of chlorine for hydrogen, whenever any union takes place between it and or- ganic matters, the chlorine, he affirmed, disappears, and chlorohy- dric acid*alone exists, as he had proved by repeated experiments. In this assertion, however, he was opposed by many observers. Herzog and Barmann came forward with experiments to show, that Meurer had gone too far in his deductions; and from all the experiments, it would appear, that in prescribing aqua chlorini many mistakes had been, and—we may add—still are, committed. From B&rwald's experiments, it would appear, that if water which has rested on aromatic or other vegetable substances be chosen for the dilution of the solution of chlorine instead of distilled water, a difference is produced in the rapidity of the decomposi- tion. In a mixture of aqua chlorini, distilled water, and simple syrup, the decomposition takes place tardily; but if, in place of syrup, a mucilaginous juice be substituted—for example, the syru- pus althrese—acids are speedily formed; as well as when a decoc- tion of althaea is substituted for distilled water; whereas a mixture of the decoction of salep, (gr. v. to water |j.) syrup, and aqua chlorini, in well stopped bottles, remained undecomposed above * Riecke, Die neuern Arzneimittel, u. s. w. S. 30, Stuttgart, 1837. CHLORINI AQUA. 171 twenty-four hours. In these experiments, however, the persis- tence of the smell and taste of the chlorine exhibited, that the whole of the chlorine had not been converted into chlorohydric acid. In the same manner as in the case of the decoction of marsh- mallows, the addition of infusym senna? and infusum Valeriana?, as well as of the solutions of extracts, and especially of liquorice, de- stroyed the smell of the aqua chlorini instantaneously, even when the taste of chlorine could still be detected. When the solution was combined with remedial agents that contained much colouring matter, the decomposition took place with great rapidity. From the results of these experiments, Barwald advises 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 trans- parent substances—water, simple syrup, gum Arabic or decoction of salep. In respect to its administration in disease, it may be well to 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 re- commeqded:— 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 acti- vity of vessels; and he affirms, that he has prescribed no remedy, which, in all respects, answered so well. 2. Nervous fever, especially vvhen tending to the putrid charac- ter. In the plague, according to Wagner, it is of no avail; but in putrid fever, according to Kopp, it is highly useful. Spangenberg observed good effects from it in an epidemic typhus with hepatic derangement. It is likewise extolled in lyph\s by Wolf, 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 typhus abdominalis, which corresponds to our typhoid fever, to op- pose the origin and development of the intestinal 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 premised the use of an emetic. Trusen considers the emetic unnecessary. He first applies leeches to the epigastrium, and then prescribes immediately aqua chlorini in considerable - Op. cit S. 30. t Archiv. d. med. Erfahrung, Marz und April, 1S25. 172 CHLORINI AQUA. doses;—in lighter cases, a dram every two hours; and if the disorder of the head be already great, the tongue chapped and the peculiar expression of countenance 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, but not. unfrequently increases the abdominal symptoms so palpa- bly, that the physician is compelled to have recourse to other agents. Riecke* thinks, however, that it may be of essential ser- vice in this disease, which so frequently mocks the best directed efforts of the practitioner; and he suggests, that farther experi- ments are highly desirable, especially as those instituted by Trusen and others are not free from objections, by reason of their having associated with chlorine substances that quickly decompose it. 3. Carbunculus malignus (Milzbrandkarbunkel.)—In the variety of malignant anthrax caused by handling the skins of cattle, the in- ternal and external use of chlorine has been found of essential ser- vice by Ettmiiller, 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,—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, that advised chlorine in scarlatina, sup- posed that it acted as specifically as the bark in intermittent, or mercury in syphilis; and Trusen asserts, that it may be advan- tageously used in cases where other remedies have been found ineffectual. It is especially recommended by Braun and Spiritus in malignant scarlatina. Dr. Watsont says, that from several dis- tinct and highly respectable sources, chlorine has been strongly pressed upon his notice as a most valuable remedy in the severest forms of scarlatina. His informants have stated, that whereas they formerly dreaded to be summoned to cases of that disease, they now, having had experience of the virtues of chlorine, felt no mis- givings in undertaking its treatment. Dr. Watson himself has not had opportunities enough for trying it to speak confidently of its sanative power, but presumes that its disinfecting properties may account in part for the good it does. It probably deprives the foul secretions of their noxious quality. The author has often used it but, in highly malignant forms of the disease, like every other agent, it fails. He gives it internally; sponges the surface with it; and employs it, or a solution of chlorinated lime or chlorinated soda, as a gargle. * Op. cit. S. 33. t Lectures on the Principles and Practice of Physic, 2d Amer. edit, p. 1024. Philad. 1845. CHLORINI AQUA. 173 5. In other febrile affections,—small-pox, measles, rubeolse, &c, it has been prescribed with advantage. In putrid dysentery, (faulige Ruhr,) it is extolled by Nysten and Kopp; and in in- termittent, by Kopp and Kretschmar. Trusen recommends it in the irregular, and especially in the anticipating forms, where danger exists of their becoming continued. Under its use, he found the paroxysms become regular, with perfect apyrexia, so that the ordinary febrifuges could be given advantageously. 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 that disease. 6. In gastromalacia, it has been prescribed by Rhades,Blasius, and Winter, but as Riecke,* from whom this detail of the experi- ence of the German practitioners has been chiefly taken, properly 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 ob- tained from it in.the Children's Hospital at St. Petersburg; and it exhibited, in these ca>ses, 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, how ever, that much fallacy may arise as to the precise agency of re- puted preventives. Every one, for example, who may be bitten by a mad dog is not attacked with hydrophobia; and, unless great caution be used, any article may be regarded as a preventive. This is the main reason why we have so many preventives of hy- drophobia and other diseases. 10. The solution of chlorine has been advised by Ruppius and Mertzdorf in dropsy, especially such as supervenes on the acute exanthemata. 11. In the diathesis phthisica, it has been recommended by Goden, 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 consi- derable time. 12. In many cases of chronic cutaneous affections, with dimi- nished plastic energy, it has been used with success by Kopp. * Op. cit. S. 34. t Pratiohe Osservazioni sull' Idrofobia, &c. Milan, 1820. 12 174 CHLORINI AQUA. 13. In noma or cancrum oris, and in fcetor of the mouth, it has been recommended internally as well as topically; and, ac- cording to the experiments of Persoz, Nonat, and others, it ren- ders eminent service in cases of poisoning by hydrocyanic acid. 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, Culle- rier, and Blache recommend it—at times pure, at others diluted — in the way of injection, in gonorrhaza and leucorrhaza. It is em- ployed, al*o, in flabby,putrid, and offensive ulcers, in carbun- culus malignus, in chronic cutaneous affections,—as tinea capitis, itch (Deimann,) herpes (Alibert,) asthenic aphthae, &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 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 chlo- rini and water, which he prefers to ablution with cold water. Finally:—aqua chlorini is occasionally sprinkled in the sick chamber, to purify the atmosphere during the prevalence of con- tagious or other diseases. MODE OF ADMINISTRATION. As already remarked, whenever 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 exter- nal use, water alone should be associated with it. As to the pre- cise 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 in 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. " Lepage, Journ. de Chimie Med. cited in Encyclog. des Sciences Med. Janv. 1842, p. 22. CH0NDRUS. 175 Unguentum chlorini. Ointment of chlorine. Unguentum oxygenatum ex tempore parandum. R. Aquae chlorin. p. j. Adipis, p. viij. M. Used in itch. Pharmacopoeia of Austria. Linimentnm aquae chlorini, Liniment of chlorine. R. Aquae chlorin. f. sjj. Olei olivae, f. gj. M. Externally, in obstinate itch, tinea capitis, and herpes. Deimann 8? G. A. Richter. R. Cera albae, ^ij. Leni calor. liquef. adde 01. amygdal. q. s. ut fiat linimentum cui refrig. adde Aq. chlorin. ^iss. M. Used externally in ulcers. Ludwig. Gargarisma aqua; chlorini. Gargle of chlorine. R. Tragac. pulv. gr. xij. Aquae, f. giv. Aquae chlorin. Syrup, aa. f. gss. M. To be used as a gargle in ulceration and chronic inflamma- tion of the mouth and fauces. Ratier* LV. CHONDRUS. Synonymes. Fucus Crispus. F. Irlandicus, Lichen Carrageen, Chondral Crispus, Sphaerococcus Crispus, Ulva Crispa, Chondrus Polymorphus, Irish Moss, Carrageen, Carragaheen or Corigeen Moss. French. Mousse d'lrlande, Mousse Perlee. German. Krauser Tang, Seetang, Carragaheenmoos, Irlandisch Moos, Ir- landisch Perl-oder Seemoos, Geperltes Seemoos, Krauser Knorpeltang. Although 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 Lichen Islandicus or Iceland moss has been deemed appropriate. In Germany, the firs! 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,t of * Formulaire Pratique des Hopitaux Civils de Paris, 3me edition. Paris, 18527. f Bcricht uber das klinische chir. augenarztliche Institut. der k. Friedr. Wilh. Univei- fur d. J. 1833. Bed. 1834. 176 CHONDRUS. the Clinical, Surgical and Ophthalmic Institute, attached to the Frederick William University. Chondrus, 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, especially in Clare, where 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.* Irish moss, when fresh, is purple-brown or purple-red, and somewhat resembles Iceland moss; but when dried, as we meet with it in commerce, it is mostly yellowish or dirty white, but intermixed with purplish-red particles, and resembles laminae of horn: it is crisped, translucent, and frequently containing small shells, calcareous concretions, and grains of sand. It has not much taste; the smell seems to betray iodine, which, however, has not been detected in it. When the moss is chewed, it feels like so much cartilage, but, by the moisture and warmth of the mouth, it soon loses its brittleness. It contains a little chloride of sodium.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. It exists in the proportion of 79.1 ]jer cent., and has been considered to consist of pectin in large proportion, and starch; but Dr. Pereira^ esteems it a peculiar principle, and gives it the name Carrageenin. It is easy of di- gestion, is readily borne by weak and irritable stomachs, and ex- erts a soothing influence 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 formula, 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.§ Chondrus is in the secondary list of the Pharmacopoeia of the United States;—cetraria in the primary; but the assignment ap- pears to be arbitrary, as one is perhaps as valuable an agent as the other. || * Pereira, Elements of Materia Medica and Therapeutics, ii 874. Lond. 1842; or 2d Amer. edit, by Dr. Carson, Philad. 1846. t E. Grafe in Art. Fucus, Encyclop'ad. Worterb. der medicinischen Wissenschaft. xiii. S. 1. Berlin, 1835. J Op. cit. § L. Feuchtwanger, in Philad. Journ. of Phann. vi. 204. Philad. 1833-4. || See the author's General Therapeutics and Mat Med., 3d edit. p. 1,247. Philad. I84G, CHONDRUS. 177 EFFECTS ON THE ECONOMY. Chondrus is used in the affections that are considered to be benefited by Iceland moss. As a diet, it is given in consumptive cases, and wherever there is erethism in the respiratory or di- gestive apparatus. It is sometimes prescribed in diarrhoea 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, dry spasmodic cough, consumption, diarrhoea, and dysentery, in the intestinal pain which remains after inflammation and ulceration of these parts, and after poison has been taken; in diseases ac- companied by much emaciation, and in the prostration en- duing on serious diseases and operations. In similar affections it has been extolled by Hufeland.* On the other hand, Heyfelder affirms, that he, and many physicians of his acquaintance, have used the moss without either good or evil results in phthisis, as welltas in erethism of the respiratory and digestive organs; and Rieckef remarks, that as it makes a very agreeable jelly, when boiled with milk, and with the addition of a little of the aqua lau- rocerasi, 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 substances, 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. MODE OF ADMINISTRATION. Decoctum ehondri. Decoction of Irish moss. R. Chondri (elect, et concis,) 33s. Lact. recent, f. §ix. Coq. ad remanent, colatur. f. §v. Adde Sacchar. §ss. ad §j. Aq. amygdal. amar. concentr. 7)j. To be taken in the course of the day. Von Grafe. R. Chondr. (elect et concis.) ijiss. Coq. cum aq. font. f. ^xij. ad remanent, colat. f. gv. Syrup, rubi idaei f. §iss. ad f. §ij. 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. Chondr. (edect et concis.) 35%. Coque cum aq. font. q. s. ad reman, f. gvj. colatur. adde * Hufeland und Osann's Joum. der Practisch. Heilkund. B. 77, St 5, p. 135. t Die neuem Arzneimittel. Stuttgart, 1837, S. 235. 178 CIMICIFUGA. Sodse phosphat. giss. Syrup opii, f. gij. ad f. giij. Dose.—A spoonful every two hours in cases of hsemoptysi. between the attacks. Clarus. R. Lactis. f. §xxiv. Chondr. (elect, et concis.) Qiv. Sacch. §j. Cinnam. cont. $j. Coque per minut. x. leni igne; filtr. et exprime. Beral. R. Chondr. (elect, et concis.) gij. Coque cum lactis Oj. ad consist, gelatin. Tere cum Sacch. §ij. Amygdal. amar. No. 2. To be used in the course of the day, and daily. Hufeland. LVI. CIMICIF'UGA. Synonymes. Cimicifuga Racemosa, C. Serpentaria, Actaea Racemosa, Ma- crotrys Racemosa, Black Snake-root, Cohosh, Bugbane, Cohort. French. Actee, Herbe Saint Christophe. German. Traubenfomiiges 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, Ranunculacese. The root is the part used in medicine. It yields its virtues to boiling water, and was found by Mr. Tilghman, of Philadelphia, to contain gum, starch, sugar, resin, wax, fatty matter, tannic and gallic acids, a black colouring matter, a green colouring matter, lignin, and salts of potassa, lime, magnesia, and iron.* EFFECTS ON THE ECONOMY. Cimicifuga belongs to the class of Acro-narcotics. Until re- cently, 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 enco- miums 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 many instances.^ Dr. Wood§ also states, * Journal of Philadelphia College of Pharmacy, vi. 20; and Dr. Wood, in Dispensatory of the United States, by Drs. Wood and Bache, Art. Cimicifuga. t Dr. F. J. Garden, Amer. Med. Recorder, Oct. 1823. j: Amer. Journ. of the Med. Sciences, ix. 310. § Op. citat. CIMICIFUGA. 179 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. More recently, Dr. T. S. Kirk- bride,* has published some cases of success, obtained in the same disease, from its administration; after free purging had been em- ployed. 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, headache, and pain frequently shooting down the left arm, cups were applied to the back of the head and neck once; stimulating pediluvia were prescribed, with friction with salt over the surface of the body, and she was mode- rately purged every day for a week before the Cimicifuga was begun with. Dr. Kirkbride refers to a very intractable case, that fell under the care of Dr. Otto, and that yielded ultimately to this drug. 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 chronic cases. Dr. Beadlef of New York treated a case success- fully in a girl eighteen years of age. There was considerable gastric derangement, icith suppression of the catamenia, for nearly five months, from pregnancy. She was put upon the use of Cimi- cifuga, 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 Cimicifuga in popular practice, in cases of rheumatism. Like other narcotico- acrids, vvhen 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. Wheeler§ affirms, that he has found it useful in several cases of severe and protracted cough; and especially in the chronic cough or bronchitis of old people. Dr. Wheeler states farther, that by some eminent physi- cians, it has been thought to be a good substitute for ergot in * American Journal of the Medical Sciences, February, 1840, p. 289. t New York Journal of Medicine and Surgery, July, 1840, p. 191. See, also, Dr. (_'. C. Hildreth, Amer. Journ. of the Med. Scienc Jan. 1843, p. 31; and Dr. F. J. Garden, Ibid. p. 247. X Drs. E. A. Anderson, and Alexander Vedder, in Dunglison's American Medical In- telligencer, vol. ii. p. 296. Philadelphia, 183!). Also, Boston Medical and Surgical Jour- nal, Oct 2, 1839, p. 126. § Boston Med. and Surg. Journal, Sept. 4, 1839, p. 0". ISO CINCHONIA. parturition, being dissimilar, however, in its mode of action,— relaxing the parts and thereby rendering labour short and easy. This, hovvever, requires confirmation. It has been advised by Dr. C. C. Hildreth* "in acute phthisis, uncomplicated with much inflammation in the vesicular structure, or pulmonary mucous or serous membranes;" who states, that he has "often seen the most prompt action of the decoction alone, in throwing off febrile excitement or the hectic paroxysm, allaying cough, reducing the rapidity and force of the pulse, and inducing gentle perspiration." "In those intercurrent congestions and in- flammations, so frequent in the second and third stages of phthisis, from atmospheric exposures," he states, that he has " often seen the same happy influence exerted;" but the testimony in regard to its beneficial action in these cases is certainly wanting in pre- cision.t MODE OF ADMINISTRATION. The dried root of cimicifuga may be given in powder. Dr, Kirkbride administered it in the dose of a tea-spoonful; and Dr. Wheeler in the d'ose of 5j- from three to five times a day. It is most commonly, however, given in the form of the Decoctnm cimicifngse. Decoction of black snake-root. R. Cimicifug. contus. gj. Coque paulisper in Aqua? Oj. Dose.—One or two fluidounces—two to four table-spoonfuls— several times a day. Tinctura cimicifugBE. Tincture of black snake-root. R. Cimicifug. contus. giv. Alcohol. (.835,) Oj. Dose.—Twenty drops three or four times a day. An idea prevails that the stronger the alcohol the better is the prepara- tion, but this may be questioned. LVII. CINCHO'NIA. Synonymes. Cinchonina, Cinchoninum, Cinchonin, Cinchonine. French. Cinchonine. German. Cinchonin. Although Duncan, of Edinburgh, Reuss, of Moscow, and Gomez,i of Lisbon, had endeavoured to separate the active prin- * Amer. Journ. of the Med. Sciences, Oct 1842, p. 288. 1 See the author's General Therapeutics and Mat. Med. 3d edit. ii. 196. Philad. 1846. X Richter's Specielle Therapie, B. x. S. 325. Berlin, 1828; and Magendie's Formulaire. CINCHONIA. 181 ciple of the cinchonas, and had given the term cinchonine to a resinous extract obtained in their investigations, the honour of discovering both cinchonia and quinia, and of applying them to practical purposes, belongs to the French chemists—Pelletier and Caventou.* Cinchonia is commonly obtained from the gray or pale varie ties of cinchona; the yellow furnishing the quinia, and the red both cinchonia and quinia. It is an alkaloid strikingly analo- gous to quinia in its chemical and medical relations, but is not as much used. METHOD OF PREPARING. Cinchonia is obtained by boiling cinchona 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' boiling, will fix all the red colouring matter, and render the liquid clear. When cold, the liquid is filtered, and the magnesian precipitate washed with cold water; it is then dried in a stove, and all the bitterness separated by repeated digestions in boiling pzlcohol; the alcoholic liquors are mixed, and the cinchonia crys- tallizes as the fluid cools. Cinchonia, thus obtained, still contains 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 defeated.-j- Cinchonia may also be obtained by treating pulverized pale cinchona by weak sulphuric acid, precipitating the solution by means of lime in excess; collecting the precipitate on a filter, wash- ing, and treating it, after drying, with boiling alcohol.% Cinchonia is white,translucent,crystallizing in needles; requiring, 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 ex- tremely bitter, as well as the salts formed by its union with acids, which resemble the salts of quinia. It does not dissolve readily in fixed or volatile oils, or in ether. At a certain temperature, it volatilizes; a great part, indeed, is destroyed by the operation, yet a sensible portion escapes the decomposing power of the caloric. In medicine, pure cinchonia, as well as the sulphate and acetate, 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, * Annales de Chimie et de Physique, xv. 289 and 337. t Magendie, Formulaire, &c. \ Pharmacopee Universale, i. 41-1. Paris, 1828. 182 CINCHONIA. does not crystallize; 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 cinchonia and its preparations to disease, as they have been almost vvholly superseded by quinia and its salts. It is a weaker article, and therefore requires to be given in larger doses; Magendie and Git- termann assert that it has been found ineffective as an antiperiodic. Bally,* Chomel,f 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 taste- less, or at least that the bitter taste is but tardily developed; and that it need not be given in combination with acids, as the acid contained in the gastric secretions will, render it soluble.** He gave it in inlermiltents, during the apyrexia, in the quantity of from six to twenty grains, and he found it of marked use in the cases of gaslralgia with formation of acid, which are so often met with in young females, and are not unfrequently associated with leucorrhcea, hypochondriasis, melancholy, &c. MODE OF ADMINISTRATION. The following formulae have been recommended, but, as be- fore remarked, they are rarely used, the preparations of quinia being now almost universally prescribed. Syrupus cinchoniae. Syrup of cinchonia. R. Cinchonia? sulphat. gr. xlviii. Syrup. Oj. Used in the same cases as the Syrupus quinioz; a table-spoonful for a dose. Magendie. V inn in cinchoniae. Wine of cinchonia. R. Cinchonia? sulphat. gr. xviij. Vini Maderens. Oij. Magendie. Tinclura cinchonise. R. Cinchonia? sulphat. gr. ix. Alcohol (34° or s. g. -847,) f. gj. M. Magendie. * Nouv. Biblioth. Medicale, ix. 189. t Nouv. Journ. de Medecine, Mars, 1821. X Osservaz. sulla Pratica del Solfato de Cinconina, &c. § Rust und Casper's Krit. Repert. B. xxi. and Bulletin des Sciences Medic. Sept. 1827. || Art. Cinchonine, in Merat and De Lens, Diet, de Mat. Med. IT Bibliotheque Universelle, Mai, 1831, p. 89. ** See, also, Ganz, in Bulletino delle Scienze Mediche di Bologna, Agosto et Settembre, 3836, p. 121. C0DE1A. 1S3 Magendie recommends, that thus tincture should be used for preparing, extemporaneously, wine of cinchonia, by adding two ounces of the tincture to a pint of Madeira wine. Boli cinchoniBe. Boluses of cinchonia. Boli antifcbriles. Febrifuge boluses. R. Cinchonia? sulphat. gr. iij. Mica? panis. Mellis. Glycyrrhiz. aa. q. s. ut fiat bolus. Dose.—One, every two hours. Brera.* Mistura cinchonia?. Mixture of cinchonia. R. Cinchonia? sulphat. gr. vi. ad xlviij. Potassa? acetat. Sacchar. aa. §ss. Solve in Aqua? anthemid. §vj. Dose.—A table-spoonful every two hours, in intermitlents. Sundelin. For the iodide and other preparations of cinchonia, see the cor- responding preparations of Quinia. LVIII. CODEIA. Synonymes. Codeina, Codeinum, Codeine. ( French. Codeine. German. Kodein. Although opium had been repeatedly examined by the chemists, 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,f and as it has been exhibited a? a therapeutical agent, it requires notice. METHOD OF PREPARING. According to Winkler,J this new alkaloid may be prepared in the following manner. Morphia is first thrown down from a solu- tion of opium, made in the cold, by means of ammonia; the meco- nic acid is precipitated by the chloride of calcium; for the removal * Ricettario Clinico di Brera. Padov. 1825. t Journal de Pharmacie, xix. 91 and IC2. Paris, 1833. t Buchner's Report, xlv. p. 459, cited in Journal de Pharmacie, xxi. 251. Paris, 1835. 134 CODEIA. of the colouring matter, the fluid is then treated with the extract or subacetnte of lead; and the extract of lead contained in the fluid poured off from the precipitates, is afterwards decomposed by sul- phuric 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 eva- porate spontaneously, after which a yellowish, highly transparent, but not crystalline compound remains, which forms with muriatic acid a crystalline salt, and resembles exactly the codeia of Robi- quet. Merck* procures codeia in a very simple manner. He treats morphia, precipitated by soda, with cold alcohol; the spirituous tincture is carefully saturated with sulphuric acid; the alcohol 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 saturated, that codeia crystallizes from it in a few hours. By evaporating the ether,,aiid treating the residue with alcohol, the codeia is obtained, by degrees, vvholly pure, and separated from an oily matter, which is a great obstacle to crystallization. Codeia, according to Pelletier, consists of 31 parts of carbon; 40 parts of hydrogen; 5 parts of oxygen, and 2 of azote. It is an al- kaloid, soluble in water, alcohol and ether; but not so in alkaline solutions. It unites readily with acids, and, with the chlorohy- dric especially, forms a salt, which crystallizes with great facility. When the crystals of codeia are heated on a plate of platinum, they burn with a flame without leaving an)r residue. Heated in a tube, they melt at about 150° centigrade; and, if allowed to cool immediately, they form a crystalline mass; if, however, the heat be' continued, the oleaginous fluid rises along the sides of the tube, appearing to shun the heat; but it does not volatilize. When dis- solved in water, codeia communicates to it decidedly alkaline pro- perties. 1000 parts of water at 60° Fahrenheit, dissolve 12.6 parts of it; the same quantity at 100°, 37 parts, and at 212°, 58.8 parts. If more codeia be added to boiling water than can be taken up, the surplus melts, and forms, like meconin, an oleaginous layer on the bottom of the vessel. This aqueous solution, by careful refrigeration, affords a translucent and uncommonly well defined metal. The tincture of galls forms a copious precipitate with a solution of codeia, in which respect, the latter differs essentially from morphia, as it does in many other of its properties, as in * Journal de Pharmacie, cited in American Journal of Pharmacy, new series, i. 171. Philad. 1835. J CODEIA. 1S5 being soluble in ether, but insoluble in a solution of potassa; in not decomposing iodic acid, nor forming a red compound with ni- tric acid; whilst it is not precipitated from the dilute solution of its salts by means of ammonia.* EFFECTS ON THE ECONOMY. As morphia does not represent the whole of the activity of opium, Robiquet concluded, that other substances might concur thereto, and he conjectured that codeia might be one of them. Under this idea, Kunkelf instituted experiments with it on rabbits and dogs, from vvhich he obtained the following results. First. Codeia dif- fers from morphia in this, that it does not, like the latter, paralyze the lower extremities. Secondly. It appears to exert a power- fully excitant action. It occasions convulsions 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 cerebellum 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 vvhich it comes in immediate contact. Its action is more ener- getic, when introduced into the cellular membrane, than inro the stomach. It seems, also, to exhibit a special action on the urinary organs, for animals to which it is given never evacuate their blad- der as Jong as they are under its influence. Thirdly. The action of codeia differs from that of the watery extract of opium, in not paralyzing the hinder extremities; but it approximates it in this, that it acts, as has been said, more powerfully when introduced into the cellular membrdne than into the stomach,and accelerates respira- tion and circulation. Kunkel, however, remarks upon the results of his experiments, that they demand repeated trials for confirma- tion, as he was only able to experiment with a very small quan- tity of the substance. Robiquet observes, that KunkePs experi- ments have led to the inference, that when codeia is combined with acids, it loses much of its efficacy—the very opposite, by the way, to the inferences of Magendie. BarbierJ has taken considerable pains to fix the value of codeia 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 alka- loid, of such strength, that a table-spoonful or half an ounce con- tained one grain of codeia. In his opinion, it exerts a peculiar agency on the nerves of the ganglionic system, whilst it appears to possess but little influence on the hemispheres of the brain, and to make no impression upon the spinal marrow. In the epigas- * Ballard and Garrod, Elements of Mat. Med. and Therap. p. 160. Lond. 1845. 1 Journal de Chimie Medicale, ix. 223. X Gazette Medicale, Mars 8, 1834. \ 18G CODEIA. trie region, he remarks, its agency is powerfully manifested. and here in the centre of the ganglionic system, its effects may be investigated, and their extent and magnitude appreciated. If a spoonful, or, at an interval of from one to two hours, two spoonfuls of the syrup of codeia be administered to one affected with the symptoms to be described immediately, it will be found, that it exhibits a considerable and remarkable effect upon the economy. If the person complain of pain in the epigastric re- gion, beneath the lower extremity of the sternum, and stretching to the sides and back; and if, with these symptoms, there is com- bined a feeling of heat, with indescribable anxiety, marked debili- ty, paleness, decided alteration of the features; a sense of painful traction sometimes on one side, at others on the other of the epi- gastric region, with tendency to syncope, frequent sighing, de- spondency, and more or less sensibility to pressure in the epigas- tric region, &c, Barbier considers the seat of the disease to be the epigastric nervous plexus; and in such cases, he says, he has found no remedy superior to syrup of codeia. He has observed it afford decided relief, where the coats of the stomach were manifestly in a state of degeneration. A common effect of codeia is sleep; vvhich is never accompanied by heaviness of the head, nor by de- termination of blood to the brain. When the persons awake from the sleep produced by it, 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 ver- tebral portions of the centre of the nervous system. In his obser- vations 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 codeia relieved the abdominal uneasiness, it left the others untouched,—a singular cir- cumstance 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 codeia had used laudanum un- successfully. Codeia, he adds, occasions no manifest change in the circulation and respiration; it does not disturb the digestive function; seems merely to diminish the feeling of hunger, and oc- casions no constipation. During its use, itching of the surface is frequently experienced. When applied to the skin, it induces no striking phenomena. When placed, in the quantity of two grains, on 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 which it may have been thus em- ployed, not appearing to be modified by it. Dr. W. Gregory made experiments upon himself and some of his pupils with nitrate of codeia. None of them experienced any effect from a dose of three grains and under; from four to six codeia. 187 grains, however, occasioned striking symptoms—quickness of pulse, sense of heat in the head and face, remarkable excitement, like that following the use of intoxicating liquors; agreeable, 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, a dis- agreeable sense of relaxation, with nausea, and often vomiting. 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 observations, that codeia loses its efficacy when combined with acids. In the year 1S34, M. Martin Solon, at one of the sittings of the Academie Royale de Medecine, when the experiments of Barbier with codeia were the subject of discussion, confirmed his views re- garding its soporific property. It appeared to him to allay the cough of the consumptive. He remarked, hovvever, that he had not observed the effects on the ganglionic nervous system, vvhich Bar- bier had witnessed. Magendief took a grain of codeia, dissolved it in a little water, and injected it into the jugular vein of a middle-sized dog, which was immediately thrown into 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 codeia: a single grain of this salt, introduced in the same manner into the organism, suddenly induced deep sleep; but, after the animal had slept five or six hours, it died. Several similar experiments afforded a like result. Magendie ad- ministered codeia in the Hotel Dieu to different patients. He found that one grain, given once or twice, succeeded, in many cases, in inducing a quiet and soft sleep, to which no confusion succeeded the next day, as is commonly the case with morphia. As respects intensity of action, he compares one grain of codeia to half a grain of morphia. Two grains often excited nausea, and even vomiting. Magendie found the muriate to be decidedly stronger than pure codeia. Two grains commonly induced, be- sides sleep, vertigo, nausea, and even vomiting; but this dose suc- ceeded like a charm, in cases of neuralgia faciei and in sciatica, that had resisted the most valued agents.:}: v Dr. Miranda, of the Havana, has published§ the results of hi* experience with codeia in what he calls powerful nervous irritations * Die neuern Arzneimittel, u. s. w. S. 140. Stuttgart, 1837. t Formulaire pour la preparation et l'emploi de plusieurs nouveaux m6dicamens. Edit. ['me. Paris, 1836. X Gully's Translation of the 8th edit of,Magendie's Formulaire. Lond. 1835. § Journal de Pharmacie, xxiv. 145. Paris, 1838. I 1SS COLCHICUM. of the mucous membrane of the stomach, and he affirms, that he cured eleven cases by the syrup of codeia alone. He began with a dram of the syrup night and morning, and gradually increased the quan- tity to an ounce in the twenty-four hours. His success was so striking that he is induced to "regard the discovery of codeia to he fortunate for humanity, especially in climates like that of the Havana, in which gastrites are so multiplied." Syrupus codcise, Syrup of codeia. This is directed by M. Cap* to be prepared in the following manner:— R. Codeiae gr. xxiv. Aquae destillat. f. §iv. Sacchar. gviij. Reduce the codeia to an impalpable powder in a glass or por- celain 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 codeia 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 dissolved. Each ounce of the syrup contains two grain? of codeia. The muriate of codeia has been used in this city, but it has not been found to possess any virtues vvhich the salts of morphia do not; whilst its price has been enormous—as much, we are in- formed, as four dollars the dram. LIX. COL'CHICUM. Synonymes. Colchicum Autumnale, Meadow Saffron. French. Colchique, Tue-Chien, Mort aux Chiens, Safran des Pres, Safran Batard, Vieillotte. German. Herbstzeitlose, Zeitlose, Wiesensafran, Herbstblume, Wilder Safran, Spinnblume. Meadow saffron is a well-known plant in the temperate parts of Europe, where it grows wild in moist meadows. It belongs to the Family Colchicacese; Melanthacese (Lindlcy;) and to Sexual System Hexandria 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 employ- ment, not. only in animals, but in consequence of its too free use * Journal de Pharmacie, xxiii. 418. Paris, 1837. COLCHICUM. 189 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 suffering much from vomit- ing, acute pain in the stomach, colic, purging, and delirium.* The cases of 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.-j* 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 to three pints of water. *He was soon afterwards attacked by vomiting, purging, and died two days afterwards under symp- toms of narcosis and endo-enteritis. Another fatal case, which was caused by the leaves,! is referred to in the same journal.§ And more recently a fatal case from the administration of the tincture has been published by Professor A. T. Thomson.|| Colchicum is not of modern introduction. It is, indeed, the Hermodactyl of the ancients. It had, however, almost wholly lallen 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, into the Pharmacopoeias of the United States, Austria, Amsterdam, and Anvers, and in the Batavian, Belgic, Brunswick, Danish, Dublin, Spanish, Edinburgh, Paris, Ferrara, Geneva, Hamburg, Hano- verian, London, Lisbon, Russian, Saxon, Swedish, and Wir- temberg;. Several chemists have investigated the composition of the plant. Pelletier and Caventou believed, that they had found veratria in it; but, from the examination of Geiger and Hesse, it appears that the alkaloid, discovered by those gentlemen, was not vera- tria, but a peculiar principle, colchicia or colchicine, which is found in every part of the plant; crystallizes in slender needles, is in- odorous, and of a very bitter and afterwards biting taste. In- troduced into the nose, it does not occasion sneezing like veratria. * Edinb. Med. and Surg. Journal, xiv. 262. t Christison on Poisons, 3d edit p. 791. Edinb. 183G. + See a case of overdose of Colchicum, by Mr. T. A. Henderson, in Lond. Med. Gaz. Aug. 17, 183!), p. 763. § Medicinisches Correspondenzblatt, 1840, or Encyclographie des Sciences Medicale*. Mai, 1840, p. 492. || Lond. and Edinb. Monthly Joum. of Med. Sciences, June, 1843. p. 537. 13 190 COLCHICUM. It has a feeble alkaline reaction; but neutralizes acids completely, and forms with them crystallizable 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 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 sense of feeling in 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 cormi lose somewhat of their efficacy. Dr. Houlton* recommends the following method to ensure their drying spontaneously without being sliced. They are to be stripped of their loose dry coat^, and the bud or little bulb, the rudiment of the future plant, is to be carefully picked out. This part, according to him, has a high vital endowment; and is very tenacious of life, and unless removed the cormi will not readily become dry: yet when it is removed, and they are put in a dry place, they will dry without any trouble, and in a short time. The seeds have of late come much into use. They are inodo- rous, 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, thej>- must be gathered wholly ripe, when they first become entirely black. They have been highly recom- mended by Dr. Williams and others. The flowers are the mildest part of the plant. They like- wise have been successfully administered by several English phy- sicians. EFFECTS ON THE ECONOMY IN HEALTH. In its effects, colchicum resembles digitalis in one thing, that it renders the pulse less frequent,f according to Thomson and Willis; but, in other respects, Osann and Riecke:}: 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 cathartics. On the digestive organs, they are conceived to produce less debilitating effects than the squill. Sir Everard Home ascribes much of the griping and nausea- ting effect, that sometimes follows the use of the vinous and other tinctures of colchicum, which have not been carefully filtered, to the sediment vvhich forms in them, and which may be removed without injury to the desired effect of the medicine.|| Sir C. Scu- * Pharmaceutical Transactions, July 1, 1844. t Art. Colchicum, Encyc. Wbrterb. der Med. Wissensch. viii. 136. Berlin, 1832. X Op. cit. S. 142. § See the author's General Therapeutics and Materia Medica, 3d edit. i. 286. Philad. 1846. || Brande's Dictionary of Materia Medica, p. 189. Lond. 1839. COLCHICUM. 191 damore,* however, found the sediment to be inert. Several experiments were made with 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 pro- duced, 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, 60, and 40 drops; nausea and vomiting, and six co- pious evacuations followed. Third case; a youth, aged 15, 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 evacuations 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 faintness, 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 24£ hours, in four doses, of 20, 15, 25, and 20 drops; great sickness and vomiting, and nine evacuations resulted. Dr. John Aldridgef states, that he has seen three cases in vvhich profuse ptyalism followed the use of half a dram of the tincture of the seeds taken for some time thrice a day. In one of these cases at least, mercury had never been taken; nor had the patient ever been salivated. They were all cases of ophthalmia. i 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, Air. Battley, Dr. Armstrong, Sir Everard Home, Sir C. Scudamore, Mr. Haden, Dr. Copland, Dr. Graves, Sir Henry Halford, Dr. Wall is, Dr. Barlow, J and Mr. Wigan,§ in England; and Locher-Balber, Kahleis, Gumpert, Plasse, Weber, Klokow, Biermann, &c, in Germany.|j Colchi- cum is presumed to be the active ingredient of the celebrated gout remedy—Eau medicinale d'Husson—which has been considered to be formed of two ounces of colchicum root, macerated in eight ounces of sherry wine; the dose being from twenty to eighty drops. * Treatise on Gout, 3d edit p. 513. t Dublin Hospital Gazette, Oct. 1, 1845; cited in Amer. Joum. of the Medical Sciences, Jan. 1846, p. 215. X Art. Gout, in Cyclopaedia of Pract. Med., Amer. edit. Philad. 1845. § Lancet, and Med. Gaz., June 30, 1838. || Riecke, Op. cit., and Richter's Specielle Therapie, x. 180. Berlin, 1828. 192 COLCHICUM. Dr. R. B. Todd* considers colchicum to be chiefly applicable to the sthenic form of gout, vvhich occurs in robust constitutions, and in the prime of life, and that it is almost inadmissable in per- sons advanced in years, who have had several attacks, and in whom the malady would seem to be too deeply rooted to be influenced by the temporary administration of this remedy. In acute rheumatism, as well as in various inflammatory affections, colchicum was proposed by the author's friend, Mr. Charles T. Haden,"j" as an excellent sedative to reduce excited organic action, which he conceived it capable of effecting to such an extent, that bloodletting might generally be rendered unnecessary in febrile and inflammatory disorders;:}: yet, in the very cases in which it was esteemed so appropriate by Mr. Haden and by Carminati,§ 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, but that it was soon found necessary to restrict its employment within narrower limits, and to pretermit it when any considerable febrile condition existed. The author has often exhibited the different preparations of colchicum in gout, and frequently with decided advantage; but very often it has failed altogether. In his 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 his experience: many physicians, however, testify most strongly in its favour. Like other acro-narcotics, as the cimicifuga, when pushed to the extent 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 rheuma- tism. A severe case of acute rheumatism, under the author's care, yielded rapidly to colchicum, pushed to the extent of in- ducing painful diarrhoea, accompanied by distressing tenesmus. In this case, twenty-five drops of the tincture of the seed were given three times a day. When the bowels become affected, the remedy must be discontinued altogether, or the quantity be dimi- nished. By attending to these rules, Dr. ChristisonlF affirms, that he has never had occasion to observe any unpleasant effects from the use of colchicum, or any symptoms, which a dose of opium did not readily subdue. He adds, that he has never seen a case of rheumatism essentially benefited, till the patient suffered from colic * Practical Remarks on Gout, Rheumatism, Fever, &c, p. 105. Lond. 1843. t Practical Observations on Colchicum Autumnale in Inflammatory Diseases. Lond. 1820. X See, also, Dr. Levvins, in Edinb. Med. and Surg. Journal for April, 1837, or in Brit. and For. Med. Review, for Oct 1837, p. 565. § Memor. dell' Institute; del Regno Lombardo-Venet 1819. || Op. cit S. 143. IT Dispensatory, p. 355. Edinb. 1812. <% COLCHICUM. 193 and diarrhoea on the one hand, or from frontal headach and giddi- ness on the other. The ill success, which some practitioners have encountered in using colchicum, he thinks may have arisen from inattention to this circumstance. In chronic rheumatism, it has exhibited less marked results; yet there is no agent, perhaps. which is so much employed in rheumatic cases in general. In none of these cases, according to most observers, need any sensible evacuation be produced by it, although some, it has been seen, have affirmed—and such is the result of the author's observation—that it is more efficient when it evinces its influence upon the alimentary canal.* Such, too, is the experience of M. Monneret,t who found that the powerful revulsion on the bowels caused by the tincture in the dose of one dram to four drams in the twenty-four hours, given in one, two or four divided doses, was sufficient to suspend or remove the disease,—the improvement always coinciding with the diarrhoea; and Dr. Wigan^: asserts that he gives colchicuni' powder in rheumatic gout in the dose of eight grains every hour, until "active vomiting, profuse purging or abundant perspira- tion takes place, or at least until the stomach can bear no more/' and, when 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 [London] pharmacopoeia. The vinous tincture of the seeds, has been extolled in the teta- nus of warm climates, by Dr. W. G. Smith,§ of Port-au-Prince. He begins with Jss. and increases the dose every half hour, re- peating it until emesis or catharsis has been produced. The re- medy 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, and especially by Drs. Armstrong|| and Hastings,! with advantage; and Dr. Pereira** found it of great service, in hu- moral asthma, and other chronic bronchial affections, especially when these complaints were accompanied with anasarcous swell- ings. By Rittontt it has been advised as an extremely efficacious remedy in leucorrhaza, in the dose of five grains of the powder three times a day; and in several spasmodic diseases it has been * See Wood and Bache's Dispensatory, Art. Colchicum; and Lewins, Op. citat 1 Archives Generates de Med. Mar. 1844, cited in Lond. Med. Gaz., May, 1844. X Lond. Med. Gaz., June 30, 1838. § American Journal of the Medical Sciences, for Nov. 1835, p. 66. || Pathology of Consumptive Diseases. Lond. 1822. IT Inflammation of the Mucous Membrane of the Lungs. Lond. 1821. ** Elements of Materia Medica, &c, ii. p. 947, Lond. 1842; or 2d Amer. edit by Dr. Carson, Philad. 1846. it Lancet, Aug. 2, 1834. n 194 COLCHICUM. 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; by Chisholm and Baumbacht it was exhibited succes- fully against tape-worm, and Dr. Chapman:}: states that from ten drops of the tincture of the root repeated several times in the twenty-four hours, and persisted in for some time, as much may be anticipated in functional constipation, with a view merely to the restoration of the lost susceptibility of the bowels, as from any thing else within his experience. He has rarely, indeed, seen it fail. Colchicum is sometimes applied externally as a liniment to rheumatic joints,in the form of the tincture of the seeds or bulb.§ 'It has been recommended by Mr. Wansborough in gout;\\ two drams of the tincture of the seeds being added to ^iv. of a spirit lotion. It is affirmed, however, that the local use of morphia had the same effect, 11—the part being bathed in hot water for a mi- nute, and then lint being applied, spread with simple cerate, on , which about three grains of acetate of morphia were distributed. Mr. Laycock** has advised the tincture of the root as an exter- nal application in rheumatism, alone or combined with tinctura camphorse. It has been used in the author's Clinique at the Philadelphia Hospital, and often with advantage; but whether much or any of the benefit was produced by the colchicum, he was unable to decide. MODE OF ADMINISTRATION. Colchicum is not so frequently given in substance, although it is often prescribed in this form. The dose of the powdered root is from three grains to ten, several times in the day. The offici- nal preparations of this country and Great Britain are:—acetum colchici (United States and London;) oxymel colchici (Dub- lin;) syrupus colchici (Edinburgh;) vinum colchici radicis (United States and London;) and extractum colchici aceticum (London;) than which Dr. Hollandtt affirms, he knows no preparation more certain in effect or better capable of fulfilling the peculiar purposes of the medicine. These are made from the bulb. The officinal preparations from the seeds are tinctura colchici * Amer. Journ. of the Medical Sciences, May, 1838, p. 205. t Rust's Magazine, B. xxi. S. 270; and Osann, in art Colchicum, in Encyc. Worterb. der Medicin. Wissenschaft. B. viii. S. 136. Berlin, 1832. X Lectures on the more Important Diseases of the Thoracic and Abdominal Viscera, d. 209. Philad. 1844. ' v § Diet, de Matiere Medic, par MM, Merat and De Lens, ii. 361. || Lancet, July 29, 1837. U Ibid. Aug. 5, 1837. ** Lond. Med. Gaz., March 16, 1839, and June 8, 1839, p. 388. tl Medical Notes and Reflections, 2d edit. p. 153. Lond. 1840. COLCHICUM. 195 seminis (United States and 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. Mr. Battley recommends an extractum colchici e succo bulborum recenler expresso, and such a pre- paration is in the Pharmacopoeia of Austria.^ 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 are 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 fluidram; of the syrupus colchici, from one fluidram to half a fluidounce; of the vinum colchici, radicis, from fifteen minims to one and a half fluidram; and of the vinum colchici seminis from one to two fluidrams. 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. Scudamore's mixture. R. Magnes. sulphat. §j. ad §ij. Solve in Aquas menth. crisp, f. §x. Adde Acet. colchic. f. gj. ad f. giss. Syrup, croc. f. §j. Magnes. 9 viij. M. To be well shaken. Three table-spoonfuls to be administered, so that from four to six evacuations may be produced in twenty- four hours. Given in paroxysms of gout. Sir C. Scudamore. Guttic colchici composite, Compound drops of colchicum. R. Extract, aconit. 9j. ad gss. Solve in Vin. colchic. sem. f. gss. M. Fifteen, twenty, thirty, or forty drops to be given three times a day. Weber. R. Tinctur. colchic. sem. -------guaiac. aa. f. ^iij. M. * See the author's General Therapeutics, Philad. 1836, and his General Therap. and Mat. Med. 3d edit ii. 192, fhilad. 1846; also, the Dispensatory of Messrs. Wood and Bache. t Jourdan's Pharmacopee Universelle, i. 436. Paris, 1828. } Lond. Med. Repos. 1823. 196 C0MPRESSI0. Dose.—Thirty or forty drops three times a day, in chronic rheu- matism. Blasius. R. Tinct. colchic. sem. ----- digit, aa. f. 31J. Sp. Eether. nitric. JJss. M. Dose.—Twenty drops, on sugar. Hildenbrand. Pilula colchici. Pills of colchicum. R. Colchic. pulv. gr. iij. Saponis q. s. ut fiat pilula. Dose.—Three daily, increasing the quantity to five or six. Ritton. Pilulae colchiei composite. Compound pills of colchicum. R. Extract, colchic. acet. gr. iij. Pulv. ipecac, comp. Ext. colocynth. comp. aa. gr- j—ij. M. et fiat pilula. In gout. Sir H. Half or d. Linimentum colchici et camphoric. Liniment of colchicum and camphor. R. Tinctur. colchic. rad. ------camphorae, aa. partes aequales. M. Laycock. LX. COMPRES'SIO. Synonymes. Compression, Methodical Compression. German. Druck. This valuable method of modifying the condition of the capil- lary or intermediate system of vessels, and, through it, the function of nutrition, has lately become more extensively employed in the treatment of disease. As a sorbefacient,in various hypertrophies and dropsies, anasarca, ascites, ovarian dropsy,* chronic hydrocephalus,! &c, it has long been used wherever its agency was applicable, and its effects have been very decided.:}: Of late, it has been proposed in inflammatory and other affections, in which it had been pre- viously esteemed inapplicable. Upwards of twenty years ago, it was highly recommended in rheumatic affections, by Dr. William * Mr. Isaac Brown, London Lancet, May, 9, 1844, and April 5, 1845. t Hirsch, Casper's Wochenschrift, cited in Provincial Med. and Surg. Journ. Apl. 29, 1843. Engelmann, cited from Gaz. Med. de Paris, Jan. 28, 1843, in Amer. Journ. of the Med. Sciences, Oct 1843, p. 458. X Clinique Medicale de l'Hopital Necker, p. 247, Paris, 1835; or the translation in Dunglison's American Medical Library, first year. See, also, the author's General The- rapeutics, p. 228, Philad. 1836; or his General Therap. and Mat. Med. 3d edit. ii. 289,353. Philad. 1846; likewise, Morelli, Annali Universali di Medicin. Marzo, 1840, or in Brit. and For. Med. Rev. Jan. 1841, p. 237. COMPRESSIO. 197 Balfour,* of Edinburgh: and numerous cases were brought for- ward by him, and by others, to attest its efficacy. Since then, it has been advised by Guerin,t in the cases of phlegmonous erysipe- las of the extremities; by Velpeau,+ in severe burns, and phlebitis, and in inflammation of the synovial apparatus;§ and, Mr. James Allan || has related three cases of phlegmasia benefited by a simi- lar treatment;—two were of erysipelas of the lower extremities, and one of the face. In these, compression was of speedy and per- manent benefit,—the pain caused by it being very transient. He states, moreover, that he has found the bandage of very great ser- vice in removing the pain and swelling of joints affected with acute rheumatism, after the more active degree of inflammation had passed away. In cases of external inflammation, compression acts probably in two ways,—first, by diminishing the circulation in the interme- diate system of vessels concerned in the pathological condition; and, secondly, by restoring tone to the over-dilated vessels; for it is in erysipelatous affections, in which this form of hyperemia more especially exists, that it has been found of greatest advantage. Numerous cases of erysipelas of the extremities have been treated by the author by compression, and with the greatest benefit. He is constantly, also, in the habit of employing compression, under the circumstances mentioned by Mr. Allan, in arthritic affections attended with great effusion, and with the most satisfactory results. From an observation of the good effects resulting from com- pression in analogous cases, it occurred to Dr. Fricke,1" of Ham- burg, 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 applica- tion. 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." Dr. Fricke was not, however, the first to employ compression in this disease. It would seem, that as long ago as the year 1S03, it was used at the Pennsylvania Hospital, by Dr. Physick, and by Dr. Harts- horne.** Dr. Fricke is of opinion, that, generally speaking, com- pression may be employed in every kind of inflammatory engorge- ment of the testicle, whatever may have been its cause, and at all stages of the disease. In many eases, the pain was at first, in some degree, increased; and in some—especially when applied too tightly—it induced great suffering: but this never continued long, * A new mode of curing Rheumatism and Sprains without Debilitating. Edinb. 1S17- t Journ. Analyt. i. 90. X Ibid., and Bulletin General de Therapeutique, No. 16, Aout 30, 1836. § Nouv. Bib. Mud., Aout, 1826; and Merat and De Lens, Diet de Mat. Med. art Compression. || British Annals of Medicine, Jan. 27, 1837. U Zeitschrifl fur die gesammt Medicin. B. i. H. 1, Hamburg, 1836. See, also, Brit and For. Med. Rev. for July, 1836, p. 253. ** American Journal of the Med. Sciences, Jan. 1842, p. 258. 198 COMPRESSIO. —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 sufficient; but when the disease was of longer duration—say from three to eight days—it was found necessary to repeat the com- pression 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 ac- tion was not too considerable; although, in extremely rare cases, such a state was the effect of the compression itself. When the pain was very severe, it was generally owing to the compression 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 poul- tice to the stomach. Such cases were, however, extremely un- frequent. 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 it continued for some hours in any considerable degree, a general disorder of the system might be looked for to explain the failure of success. In the summer of 1835, Dr. Fricke treated, in this manner, seventeen cases. Of these were cured,—in one day, one; 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 unfa- vourable cases. For the purpose of compression, he employed sticking plaster, made very adhesive, but not of too irritating ma- terials, 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 lean- ing 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 scro- tum and neighbouring parts are much covered with hair, this must be removed; but, generally speaking, it is unnecessary. The following is the method adopted by Dr. Fricke for apply- ing the compression:—The surgeon takes the scrotum in one hand, and separates the diseased*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 iso- lated spermatic cord, about a finger's breadth above the testicle, 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, vvhich must cover the former either in part or altogether. The COMPRESSIO. 199 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 com- pressed, the upper end will be apt to slip upwards through the loose rings of adhesive' plaster, which will not only 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 com- pression will be indicated, in most cases, by the speedy disappear- ance of the pain which had previously existed. When both tes- ticles are affected, they must both be included in the circular strap- ping—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 applied. 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 door. When the strap- ping becomes loose, it may have to be reapplied, but often one application is sufficient. In orchitis, caused by blows or pressure, compression is re- garded 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 compression. The principal advan- tages which he considers this mode of treating orchitis has 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 it has been by no means extensively adopted. Several cases, too, have been mentioned by M. Dechange,* of Liege, * Bulletin Medical Beige, Aout, 1838, p. 218. 200 COMPRESSIO. formerly chef de clinique chirurgicale 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 Parker* has also extolled this remedy, not only in ordinary swelled testicle, but in chronic or subacute inflammation of the testes, whether dependent on syphilitic causes or not; and a more recent writerf aflirms, 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 under the ordinary antiphlogistic treatment they would have been confined from ten days to a fortnight." Methodical compression has been employed with advantage in mammary abscess, by MM. Trousseau and Contour.| They found it frequently produce a cure when used at the commencement of the inflammation; relieve the pain when suppuration was esta- blished; and of great service after the abscess was emptied. The compression was made by means of strips of diachylon plaster, an inch broad, and several feet long, carried round the body, so as to produce regular compression of the whole breast.§ M. Brachet, of Lyons,|| has reported four cases of spermatorrhoea treated by compression of the prostate gland. He states, that pres- sure cannot be employed indiscriminately in every case, often by removing the cause we can cure the disease; but he thinks it will succeed in all cases of atony produced by venereal excesses, ona- nism or blennorrhagia. The effects produced by compression are, in his opinion, of two kinds. In the first place it keeps the seminal fluid in its reservoirs, which are thus accustomed to its contact and enabled to retain it longer; and in the second place, it modifies the condition of the urethra, prostate, and seminal excre- tory ducts. The bandage is composed of a waist-band of leather, the extremities of which unite on the abdomen : from its centre behind a strap descends, which, on reaching the genital organs, bifurcates, and is finally buckled in front to the cincture. On the descending strap a small cushion is placed opposite the part on which pressure has to be made. Dr. Batchelder,1T of Utica, affirms, that he has been in the habit of using compression of the perinaeum as a remedy in this affection for upwards of twenty years. * London Lancet, July 25, 1840, p. 640. See, also, J. Dixon, Lond. Lancet, Dec. 5, 1840. t Brit and For. Med. Rev., Oct. 1840, p. 393. X Journal des Connaissances Med. Chirurg., Fevrier, 1841. See, also, J. Bell, Lond. Med. Gaz., or Dunglison's Med. Intelligencer, Dec. 1841, p. 121. § See, also, Littre, Joum. des Connaiss. Med. Chirurg., Janvier, 1841; or Encyclogr. vdes Sciences Med., Marz, 1841, p. 523. || Medical Times, May 24, 1845, cited in Braithwaite's Retrospect, xii. 219, Amer. edit. New York, 1846. IT New York Medical and Surgical Reporter, cited in Buffalo Med. Journ., and from it in the St. Louis Med. and Surg. Journ., June, 1846, p. 43. COMPRESSIO. 201 Compression op 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 hypersemia. The origin of this idea has been a matter of controversy;* but, as Dezeimerisf has remarked, it certainly is not due to the gentlemen who have engaged in it. Blaud com- pressed the carotid in brain fever; Autenrieth 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. Compression of the carotids has been used by M. Strohlin^ in hysteric convulsions, and has almost always succeeded in modifying the form of the attack. He used it in two cases of epilepsy with similar success. Compression of the carotids at the commence- ment of the paroxysm always caused them to cease in a minute afterwards. M. Allier§ has published a case of intermittent neuralgia of the lobe of the right ear, cured by compression of the primitive caro- tid of the same side: half an hour before the paroxysm, the com- pression was exerted, with interruptions of five minutes every quarter of an hour. He has, also, reported a case of neuralgia oj the orbilo-frontal nerve; and, subsequently, of the nervus pudendus superior, respectively cured by compression of the carotid, and abdominal aorta. The compression of the carotid of the affected side was continued the whole forenoon, with pauses of five mi- nutes every quarter of an hour. For the pudic neuralgia, the ab- dominal 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 neuralgia of the right side, cured by the same means. Compression of the right primitive carotid for ten seconds occasioned instantaneous disappearance of the pain, which returned in one minute after the removal of the pressure. Compression of the same vessel for twelve seconds also caused immediate cessation of the pain, 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 com- pression was made on the same vessel for thirty seconds, the pain. as before, moved to the posterior and left part of the skull. M. Dufresne then pressed on the left carotid, and, increasing the force as he diminished that on the right side, the posterior pain disap- peared, and no return of either had taken place ten minutes after- wards. The patient slept well and made no complaint of pain in the morning. * Gazette Medicale de Paris, No. 46, Nov. 18, 1837, and No. 47. t Ibid. t Archives General, de Medecinc, Mars, 184]. § L'Experience, No. 16, Jan. 20, 1838. H Ibid. No. exxviii. Dec. 1839. 202 COMPRESSIO. Compression of the abdominal aorta has been revived by M. Baudelocque, and many others, with the view of arresting uterine hemorrhage occurring in labour, as well as the hemorrhages which follow wounds of the arteries of the inferior half of the body* In a case of uterine hemorrhage, detailed by Dr. Ehrenreich,f external compression by the hand on the abdomen, which is the only vyay 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 the fingers in a conical shape on the aorta immediately above its bi- furcation. Many similar cases have been published, and referred to by M. Piedagnel, in a memoir communicated to the Societe Medicale d'Emulation, of Paris, on which an excellent report was read by MM. Velpeau and Briere de Boismont, giving a history of the process. It is necessary, at times, that the compression should be continued for a considerable period, even for an hour or two, should the case seem to require it. The gentlemen last cited, advise that it should be associated with ergot.:}: The mode adopted by M. Seutin§ for compressing the aorta in these cases is as follows. The woman is to be placed on a ho- rizontal plane, with the head and shoulders raised, and the thighs flexed upon the pelvis, in order to relax the abdominal muscles as much as possible, and to avoid mechanical engorgement of the uterine vessels. The surgeon, placed on the right side of the patient, uses the left hand to compress the vessel, keeping the right dis- engaged for any other purpose which the case may demand. The intestines being pushed on one side by gentle manipulation, the three fingers of the left hand are pressed firmly and deeply be- hind and to the left of the uterus, nearly on a level with the um- bilicus. By this plan, the aortic pulsations will be evident, and farther pressure is then to be made in a direction downwards and backwards. In order, that the operator may not be too much fa- tigued by continued exertion, his hand may be compressed by those of an assistant. Lastly: M. Allier|| employed compression of both carotids in a case of hydrophobia at the commencement of an attack; imme- diately, the convulsion ceased, and the patient became apparently exanimate. The family wrere alarmed, and would not permit a repetition of the experiment. The case ended fatally. * See an account of M. Baudelocque's views, by Mr. J. C. Christophers, in Lancet, July 20, 1839, p. 599. t Medicinische Zeitung, No. xxxvii. 1839, or British and Foreign Medical Review, July, 1840, p. 274. X La Lancette Frangaise, May 12, 1840. § Bullet, de l'Acad. Med. Beige, cited in Banking's Abstract, pt. 1, p. 180, Amer. edit New York, 1845. || L'Experience, No. xvi., 20 Janv., 1838. CONTRA-IRRITATIO. 203 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 compres- sion of the arterial 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 catenation like the different agents that are classed under the head of antispasmodics, of vvhich 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.* LXI. CONTRA-IRRITATIO. Svnoxtjtes. Counter-irritation, Counter-action. French. Contre-irritation. 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 this work, to which attention has been revived, or first directed, of late years more especially. AMMONIATED COUx\TER-IRRITANTS. Gondret's ammoniacal ointment; Granville's counter-irritants —AntidynousJ counter-irritants—Raspail's counter-irri- tant. Ammonia has long been used in different formula? for exciting rubefaction and vesication of the cutaneous surface. When two parts of liquid ammonia are united with one part of suet, and one of oil of siceel almonds, the mixture forms the Pommade ammonia- cale of Gondret, 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 cauterize the integuments deeply.|| To the advantages of this preparation, as well as of de- * See the author's General Therapeutics, p. 380; or his General Therapeutics and Mat Med. 3d edit i. 393. Philad. 1840. t General Therapeutics, p. 333; or General Therapeutics and Mat. Med. ii. 218. Philad. 1840T + A term coined by Dr. Granville. It ought to be " Antodynous," from am, " against," and oSvvri, "pain.'' § Bouchardat, Annuaire de Therapeutique pour 1844, p. 215, Paris, 1844, and Lisfrana, Ibid. 1845, p. 255, Paris, 1845. || Considerations sur l'emploi du feu en medecine, suivies de l'expos6 d'un moyen epis- pastique propre a suppleer la cauterisation, et a. remplacer I'usage des cantharides. Paris, 1819; and Nouv. Biblioth. Med. iii. 441, 1828. / 204 CONTRA-IRRITATIO. rivation in various diseases, M. Gondret has called the attention of practitioners in an ex professo treatise.* The formula, given 'above, is that of the French Codex; but, according to M. Trousseau,t it is much too hard for use, unless the weather is warm. He proposes two different formulae,— one for summer, and the other for winter. In the former, he di- rects three parts of lard, one of suet, and four of liquor ammonia; in the latter, equal parts of lard, and liquor ammonia. Of late, M. Gondret has communicated to M. Miquel a formula for his Pommade, which differs from that of the Codex, and accord- ing to him, succeeds much better. It is as follows:—Take of lard, 32 parts: oil of sweet almonds, 2 parts. Melt by a gentle heat; and add liquid ammonia at 25°, 17 parts, stirring until it be- comes cold.;}: Since the appearance of M. Gondret's treatise, Dr. Granville§ has published one on counter-irritation, which gave rise to much attention on both sides of the Atlantic,—partly in conse- quence of the strong encomiums he passed on certain counter- irritant applications employed by him; and still more in conse- quence of the mystery, vvhich he threw around them, by keeping their preparation a secret, until the united voice of the profession had expressed the mingled feelings of surprise, indignation, and regret, which such conduct on the part of an individual, holding an elevated position in the ranks of the profession, naturally en- gendered. It is due, however, to Dr. Granville to remark, that on subsequently publishing his formulae, he stated, that he ad- dressed his work to the public to impress all with the value of the agency, but that it would have been unwise in him to give precise formula? to those who could not estimate the proper proportions of the ingredients; that every physician can apportion them; and that he had never concealed the formulas from his friends, and al- ways intended to give them to the world.|| Dr. Granville describes two sorts of ammoniated lotions, of different degrees of power, which are prepared in the following manner: Eich kind of lotion consists of three ingredients:—1st. The strongest liquor of ammonia, A. 2d. Distilled spirit of rose- mary, B. 3d. Spirit of camphor, C. These are made as follows:— A. The strongest liquor of Ammonia.—Saturate a given quantity of distilled water, contained in a glass receiver surrounded by ice, with ammoniacal gas obtained in the usual way from a mixture of equal parts of muriate of ammonia and recently slacked * Traite theorique et pratique de la Derivation contre les affections les p'lus communes, en general, telle que la Plethore, 1'Inflammation, l'Hemorrhagie, &c. Paris, 1837. t Joum. des Connaiss. Med., cited in Medico-Chirurgical Review, July, 1840. X Bouchardat, Op. cit. 1845, p. 254. § Counter-irritation, its Principles and Practice, illustrated by one hundred Cases of the most painful and important Diseases effectually cured by External Applications. London, J838; or Dunglisotfs Amer. Med. Lib. edition. Philad. 1838. || London Lancet, Oct. 27,1838. contra-irritatio. 205 lime, both reduced to a fine powder. The water may be made to take up nearly 800 times its bulk of ammoniated gas under the circumstances described; its specific gravity will then be about .872, and 100 parts of it will contain thirty-three parts of real am- monia, according to Sir H. Davy's tables. This solution of am- monia will, therefore, be more than three times the strength of the liquor ammonioz of the Pharmacopoeia of London, 100 parts of which, at a specific gravity of .960, contain only ten parts of real ammonia. Dr. Granville, therefore, called this "liquor ammoniae fortissimus." The liquor ammoniae fortior of the last United States' Pharmacopoeia (1S42,) which is of the specific, gravity 0-882, is of sufficient strength. B. Distilled Spirit of Rosemary.—Take two pounds of the tips or small leaves of fresh rosemary, and eight pints of alcohol; leave the whole in infusion for twenty-four hours in a well co- vered vessel, and after adding as much water as will just prevent the empyreumatic smell, distil over seven pints. The Pharmaco- poeias of London and the United States direct the essential oil of rosemary to be distilled with alcohol to form the spirit of rose- mary. Such a preparation Dr. Granville found unsuited for his purpose. C. Spirit of Camphor.—To four ounces of pure camphor add two pints of alcohol, so as to dissolve the camphor, which solution should be filtered. The three ingredients thus prepared, every medical man should keep always ready at hand, in well-stoppefed glass bottles, so as to be able to make, extemporaneously, a counter-irritating lotion » of any requisite strength, according to the nature of the case. But, for ordinary purposes, Dr. Granville advises, that both a milder and a stronger ammoniated lotion should be kept ready for use. Lotio ammoniata mitior. Milder ammoniated lotion. Assuming the quantity of lotion desired to be divided into eight parts, the proportion of the ingredients will stand thus:— A—four-eighths. B—three-eighths. C—one-eighth, or as follows:— R. Liq. ammon. fort. f. gj. Spirit, rosmarin. f. ijvj. Tinct. camphor, f. gij. M. Lotio ammoniata fortior. Stronger ammoniated lotion. If the quantity desired be also divided into eight parts, then the proportions of the ingredients will run as follows:— A—five-eighths. B—two-eighths. C—one-eighth, or as fol- lows:— 14 206 contra-irritatio. R. Liq. ammon. fort. f. gx. Spirit, rosmar. f. gss. Tinct. camph. f. 31 j. M. Although the changes of proportion may be deemed trifling, yet the strength of this lotion is such, that Dr. Granville never employs it, except in cases of apoplexy, and for the purpose of cauterization. Directions in Mixing the Ingredients.—A and B are gradually mixed together. The mixture becomes opalescent and somewhat turbid, and a peculiar, highly agreeable, ethereal smell is given out, different from the individual odour of either ingredient, although the extreme pungency of the ammonia is still discerni- ble. "I have strong reasons to believe," says Dr. Granville, •' that, at this point of the operation, some particular change takes place, which imparts to the mixture of the two ingredients some of its valuable peculiarities as a counter-irritant described in my work; but what that change is, it is not my business to enter upon in this place: suffice it to say, that in a great number of experi- ments made with the ingredients separately (for each of them acts as a counter-irritant on the skin,) and with them combined, the effects were uniformly different; those in the former case being found unequal to the production of those complete results which I trust I have justly promised to the profession. Ammonia alone (how- ever strong) will not give rise to the effects I have described, though it has often stopped internal pain, and produced small blisters; but never has it succeeded in almost immediately pro- ducing a full vesication, as I have seldom failed to produce with the two ingredients mixed together, particularly after the third ingredient had been added." Before, however, that third ingre- dient is so added, it is desirable to clear the previous mixture, by the addition of a small quantity of alcohol, and to set the whole in a cool place. All the various precautions here mentioned may, upon an emergency, be dispensed with, when an immediate action is required, either to arrest pain or relieve deep-seated inflamma- tion. But for the more delicate uses, particularly for instanta- neous vesication, Dr. Granville recommends, that the preparations should be obtained in the manner specified. The lotion must always be kept in bottles with a glass stopper. M. Raspail* has recommended the following lotion, the effects of which, he says, are often instantaneous in relieving intolerable headach: R. Liquor, ammon. p. 100. Aquae destillat. p. 900. Sodii chlorid. purif. p. 20. Camphor, p. 2. Essentia rosar. q. s. The whole to be mixed cold. * L'Experience, 24 Juillet, 1640. C0NTRA-IRR1TATI0. 207 A piece of linen is to be steeped in this solution, and applied over the part of the head which is the seat of pain, care being taken that none of the fluid passes into the eyes. EFFECTS ON THE ECONOMY IN HEALTH. The various counter-irritants, described above, act essentially in the same manner; differing only in the intensity of the counter- irritation which they induce. In all, the liquor ammonias is the main effective ingredient. The stronger of Granville's lotions is a powerful agent. It gives rise in a few minutes to vesication over the whole surface to which it may be applied; almost as rapidly, indeed, as if boiling water were placed upon the part. It need scarcely be said, that the strength of these lotions may be regulated so as to produce either full vesication, or simply rubefaction, by varying the quantity of the liquor ammonia?. The mode of applying these liquid counter-irritants is, as in the case of the Oleum Sinapis (q. v.,)—first to impregnate with them a piece of cotton or linen, folded six or seven times, or a piece of thick or coarse flannel; and then lay either of these on the spot, pressing with the hand at the same time very steadily and firmly on the compress, over which there should be placed a thick towel, doubled several times, so that not only the evaporation of the lo- tion may be impeded, but the hand, employed in pressing the ap- plication to the part, may not suffer from direct or indirect contact with the liquid. Care must be taken that the ammonia does not reach the eyes or nose.* As a general rule, the application should seldom be kept on longer than from one to six or eight minutes; and, Dr. Granville affirms, it has often happened to him to find, that less than a minute was sufficient to produce the desired alle- viation of pain and spasm. But in order to excite the higher de- grees of counter-irritation, as vesication and cauterization, as many as ten or twelve minutes may be necessary. EFFECTS ON THE ECONOMY IN DISEASE. There can be no doubt, that the ammoniated counter-irritants are valuable agents in all those diseases which are capable of being benefited by a sudden and powerful revulsion. It is chiefly, as elsewhere stated,f when the diseased action has been prolonged for a considerable period, and in affections which belong to the neuralgic class, that rapid revulsions are productive of the most marked advantage. When the disease is of an acute character— as in the different phlegmasiae—revellents vvhich are more pro- longed in their action, are—as a general rule—preferable. It is in the first class of affections, chiefly, that his lotions are extolled by Dr. Granville; he urges the importance of the sudden vesica- tion effected by them in the treatment of many serious disorders; * Granville, Op. cit., Amer. edit p. 39. t General Therapeutics, p. 341 j and General Therapeutics and Materia Medica, 3d edit. u.225. Philad. 1S46. 208 CONTRA-IRRITATIO. and affirms, that they arrest " nervous and muscular pain almost immediately, provided it does not depend on structural disease."* There is perhaps no agent—he remarks—except boiling water, which can, in the space of between three and ten minutes, give rise to as ample a vesication. But, as powerful and effective a revulsion can be accomplished by the actual cautery in various forms, and especially in that of the moxa (q. v.) This we say from observation; and it is a result to which just theory would lead us. The ammoniated lotions are, however, devoid of the painful mental impression, which the dread of actual fire occa- sions; although we doubt not that, in many of the cases above referred to, such mental impression may exert an important agency in the cure. Dr. Granville gives the following, not very classically arranged, list of diseases, vvhich, in the course of nine years, have appeared to him to be benefited by his counter-irritants. DISEASES. A. Principally affecting the Nervous System. 1. Acute neuralgia 3 Pen l C Tic douloureux. ° I permanent J> 2. Spasms. \ includi f St> yitus's Dance. 3. Convulsions ) V tr * • „ £ ) 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. 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. a. of the trachea, and bronchia, j en mS >b. of the lungs and their membranes, V- t0 c. of the heart and pericardium. consump- J J tion- D. Diseases of a Mixed Character. \nnrewd p-out I a' Affecting the heart. uppressed gout. £ b Affecting the stomach< nine gout. "'tic debility. * Lancet, Oct 27,1838. 15. Early in- flammation. C0NTRA-IRRITATI0. 209 E. Accidental, Mechanical, and Cutaneous Derangements. 19. Violent sprains. 20. Pimples. 21. Biles. 22. Ringworm. Dr. Granville does not affirm, that all these disorders, and their modifications, have yielded to the ammoniated counter-irritants; or that the counter-irritants were always the sole agents employed. On the contrary, a few of them, he says, on particular occasions, resisted that agency; others were only momentarily benefited; and a few more required the simultaneous employment of ordi- nary and internal remedies to assist in, and complete the cure. Among the exceptions to the general rule of success, he enume- rates chronic tic douloureux; chronic rheumatism of long standing; epilepsy dependent on organic mischief in the encephalon, 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 ammoniated counter-irritants. The second and fourth of these disorders are of that number which require, in addition to the ammoniated applications, an appropriate internal treatment. The other two, Dr. Granville has found to be only partially relieved, but never cured by counter-irritating lotions.* In many of the disorders, referred to by Dr. Granville in the table given above, the ammoniated counter-irritants have been em- ployed both in public and private in this country. They have been largely used by the author, and their effect in nervous and spas- modic diseases, in neuralgic and deep-seated rheumatic pains, has at times been very striking. Severe pains have yielded rapidly, as described by Dr. Granville; hyperozmice of particular organs have been diverted elsewhere, especially after blood-letting and seda- tives had been premised; and in short, whenever revellents, sud- den and rapid in their action, have been demanded, ammoniated counter-irritants have effected every thing that similar powerful revellents were capable of accomplishing,—but no more. The author has been in the habit of having recourse to the moxa in con- generous affections, and—as before remarked—with equally satis- factory 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 prevented, by being careful that the appli- cation 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. * Op. cit p. 29. 210 CORTEX ADSTRINGENS BRASILIENSIS. LXII. CORTEX ADSTRIlVGENS BRASILIENSIS. Synonymes. Cortex adstringens Brasiliensis verus, Cortex adstringens ve- rus, Astringent Bark of Brazil. German. Adstringirende Brasilische Rinde. This bark was introduced into Germany, in the year 1S18, by Schimmelbusch, a merchant, who carried it from Brazil, where 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 Acacia jurema, but this is not certainly determined. J. Oesterlen§ assigns it to mimosa (Acacia) cochlia carpa seu vaginalis. Merremj] 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 gray- ish-brown colour, traversed by longitudinal and transverse fur- rows, 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 splendour. The older bark, which is thicker, is unequal, and may often be separated into fibrous layers, which are readily lacerable. When chewed, it has a tolerably strong, astringent, somewhat 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 rhatany.^" EFFECTS ON THE ECONOMY. Merrem, who made numerous experiments with the bark, af- firms, 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, hozmoptysis, and metrorrhagia; and Gunther** found * Von Schlectendal, in Encyclop. Worterb. der Medicin. Wissenschaft. B. viii S 538 Berlin, 1822. t Reise, ii. 788. X Riecke, Die neuern Arzneimittel, S. 146. § Handbuch der Heilmittellehre S. 484. Tubing, 1845. || Ueber den Cortex adstringens Brasiliensis. Koln, 1828. IT See the analysis by Hofrath Trommsdorff, in Brande's Archiv., B. xxxiii. S. 260; and Dierbach in Heidelberg. Annalen, B. x. H. 3, S. 357. Heidelb. 1834. *'* In Harless Rein-Westphal. Jahibuch, B. viii. St. 1, S. 72; and Brande's Archiv. an J xi. S. 200. CORTEX ADSTRINGENS BRASILIENSIS. 211 it very efficacious in profuse menstruation arising from atony of the uterus. Secondly; in mucous discharges, as leucorrhoza, blen- norrhcea, &c. Thirdly; in inflammatory and exanthemalous affec- tions—as cynanche, urticaria, and in periodical erysipelas of the face. Fourthly; in nervous diseases, especially when associated with dis- turbance of the menstrual function, and leucorrhoza: and, fifthly; in iceakness and catarrhs of the genital organs, bladder and rec- tum. 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 leucorrhoza; and in many, after the cinchona had been adminis- tered without effect.* MODE OF ADMINISTRATION. 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 func- tions; and he found, that the powder was better borne by some than the decoction, which is singular, as the woody matter is more apt, in such cases, to disagree. He rarely 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 f. iviij.; 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 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 leu- corrhoza, and in blennorrhoza; 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. Brasil. f. §vij. Copaib. cum vitelli ovi, q. s. suhact. Tinct. ferri pomati, aa. f. gij. Syrup, balsam, f. ^j. M. Dose.—A spoonful every two hours, in obstinate gonorrhoea and leucorrhoza. Merrem. R. Cort. adstring. Brasil. gss. Coque cum aqua? fontan. q. s. Sub fin. coction. adde. Sabin. gss. Colaturas, f. §viij. adde. Syrup, aurant. cort. f. %]. * Osann, in Encyc. Worterbuch der Medicin. Wissensch. viii. 541. 212 CREASOTUM. Dose.—A spoonful every hour, in cancer of the uterus, and in the hemorrhage thence arising. Merrem. LXIII. COR'YLUS ROSTRA'TA. Synonyme. Beaked Hazel. Beaked hazel is a shrub two or three feet high; Natural Or- der, Amentaceae; Suborder, Cupuliferae; Sexual System, Monce- cia Polyandria; which grows in the mountainous regions of North America. The nut which it produces, is of an ovate shape, sur- rounded by a coriaceous and scaly involucre or cupula, terminating in a tube an inch and a half long, covered with short and thick bristles, very similar to those of mucuna or cowhage.* EFFECTS ON THE ECONOMY. The short, stiff, bristles have been found to possess similar an- thelmintic virtues with mucuna, and to be equal to it in all re- spects. Mr. Duhamel states, that Dr. Heubener of Bethlehem, Pennsylvania, from whom he obtained the specimen described by him, had employed it in cases of worms, and was much pleased with it. MODE OF ADMINISTRATION. It may be given, like mucuna, in syrup, molasses or other con- sistent vehicle, and in the same doses. LXIV. CREASOTUM. Synonymes. Creasoton, Creosoton, Creosotum, Kreosoton, Kreosotum, Oxy- hydro-carburetum ex oleo pyroxilico paratum, Creosote, Creasote, Kreo- sote, Kreasote. French. Creosote. German. Kreosot. This substance was first discovered, several 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 character; and it is not surprising, as in every similar case, that there should have been great discrepancy in the results, and in the opinions deduced therefrom. There can be no doubt, however, that crea- sote forms a valuable addition to the list of our remedial agents. * A. Duhamel, Amer. Journal of Pharmacy, Jan. 1843. CREASOTUM. 213 METHOD 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. Hence it is in the Materia Medica list of the Pharmacopoeia of the United States (1842,)—not amongst the preparations. Tar, derived from pit-coal, is distilled in a retort provided with a long tube, having a large mouth. Under this is placed a receiver. The oil, which comes over first, swims on water; and it is neces- sary to remove, from time to time, the products of the distillation, until an oil is obtained, which sinks in water. When this 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, forming a buty- raceous substance. By applying a gentle heat, the mass drops 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 crystallized naphtha is pressed, and the acid adhering to the creasote is saturated with carbonate 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 dissolved 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 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 sepa- rated. 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 bot- tles 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 * Annates de Chimie et de Physique, Juillet, 1835. See Cormack on Creosote, p. 3G, Lond. 1836; or the Amer. edit, in Dunglison's American Medical Library; also, Turner's Chemistry, 5th edit. p. 872, and Christison, Dispensatory, p. 374, Edinb. 1842. §14 CREASOTUM. six distillations; dissolving it afterwards in a solution of caustic potassa three times, setting it free successively by sulphuric acid.* Giordanof has recommended the following simplified mode for obtaining it. Distil wood tar from the willow, at an elevated temperature, from a tinned copper retort, until the residue has the consistence of soft pitch. Re-distil the liquor passed over till its residue resembles the former. The liquor, neutralized by carbon- ate of potassa, or lime-water, is re-distilled till all the oil of crea- sote 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 opera- tion is repeated with the eupione, to remove all the oil that is united with it. The saponaceous liquor, treated with dilute sul- phuric acid, is distilled into water, from which the creasote is separated, and the water saturated with creasote is kept for exter- nal use, or re-distilled for a concentrated acetic acid of a pungent 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 stated by Reichenbach to be 1037; but Dr. ChristisonJ affirms, that he has never found it lower than 1065 or higher than 1067. The fact is, of course, of interest in relation to its adulterations. 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 removed 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 li of creasote and 100 of water; the other of 10 parts of water and 100 parts of creasote. The taste of the first mixture—creasote water—is very burning at first, and afterwards sweetish, like that of pure creasote, but of course weak- er. A drop of creasote in 10,000 parts of water produces a marked impression on the tongue, and has a smoky smell. Lit- mus and turmeric paper are not in the least changed by it; so that * For an account of tUis and other products of the destructive distillation of vegetable matter, see Cormack, Op. cit. Reichenbach's observations and experiments are contained in a work entitled " Das Kreosot in chemischer, physischer und medicinischer Beziehung, von Dr. K. Reichenbach, u. s. w. zweite mit Nachtragen und Zus'atzen von Schweigger- Seidel verm. Ausgabe. Leipz. 1835;" see, also, Annales de Chimie, liii. 325. Paris, 1833, t Annali di Medicina, Aprile, 1835, and Brit, and For. Med. Rev. July, 1836, p. 283. For the process of Calderim, see Edinb. Med. and Surg. Journ. for Oct. 1834; and for that of M. Cozzi, see Journal de Chimie Medicale, or American Journal of Pharmacy, Jan. 1839, p. 339. % Dispensatory, p. 374, Edinb. 1842. CREASOTUM. 215 it has neither an acid nor an alkaline reaction. At both poles of the galvanic battery, it furnishes numerous and striking combina- tions. It does not possess the property of the ordinary empyreu- matic oils, of becoming yellow and inspissated. It dissolves iodine, phosphorus, and sulphur. Acetic acid at 1.070, and alco- hol, dissolve it in all proportions, and with the latter it is often adul- terated.* Ether and petroleum likewise combine with it in all proportions. With potassa, it forms two or three combinations, one of which crystallizes. Resins and resinous bodies either de- compose creasote, or it decomposes them. With balsams, fixed and volatile oils, camphor, and the vegetable alkaloids it unites readily. It coagulates albumen, and its antiseptic property is most remarkable, whence its name, from xesat, ' flesh,' and cco£«, ' I preserve:'—awtw, '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 without undergoing putre- faction. 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 pu- trefy. There can be but little doubt, consequently, that creasote is the main antiseptic and conservative principle of pyroligneous acid, and of tar water. From the experiments made by Reichen- bach to determine the exact components 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-work 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 burn- ing 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 the pure article. 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 become's dry, and the cuticle desquamates. When creasote is applied to a part wThere the epidermis is deficient, or to a wound, instantane- ously an extremely violent burning pain is experienced, which continues for eight or ten minutes; but if the part be carefully washed, it gradually ceases. The cause of this is conceived to be the property vvhich creasote possesses of coagulating albumen; and, where blood is flowing, of arresting it. If the rapid disturbance * Journal de Chim. Med. and Amer. Journal of Pharmacy, July, 1841, p. 112. 216 CREASOTUM. which it excites, affects important organs, death results sooner or later according to their importance in the economy: relief, how- ever, may be afforded by those substances that dissolve coagulated albumen, as caustic alkalies, acetic acid, &c. It is probable, hovv- ever, 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 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 contact 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 crea- sote, diluted, were injected into a vein, scarcely any effect resulted. Reiter and Miiller, who likewise made experiments on animals, agree with Simon as to the result of injections of creasote into the veins; no special symptoms were induced by it, but this ap- peared to be owing to the blood being instantaneously coagulated by it, which not only prevented the farther progress of the crea- sote, but also of the blood; hence no evil consequences resulted; and it is probable, as Riecke has suggested,* that the weaker the solution of creasote, within certain limits, the greater may be its effect on the mass of blood. Corneliani,f an Italian physician, has also instituted a series of * Die neuern Arzneimittel, u. s. w. S. 153. t Giornale delle Scienze Medico-Chirurgiche, No. 8, Febrajo, 1835; Brit, and For. Med. Review, p. 265, Jan. 1836, and Journ. de Chimie Medicale, Fev. 1836. CREASOTTJM. 217 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 general torpor, sudden inclination to pass the urine, paralysis—especially of the lower extremities—with or without convulsions, and fre- quently the ejection of a bloody foam. When the doses were large, and it was but little diluted, death took place in a few minutes, 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 occa- sion 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 crea- sote was administered, immediate 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 quantity of urine. He once saw it, in the dose 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 caustic. Muller and Reiter, in their experiments, 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 coagulated. Mixed either pure or diluted with blood, it thickens it; the mix- ture assumes a brown-red colour, and is found studded with small white points, which are nothing more than coagulated albumen. On exposing the coagulum to the air, it assumes a yellowish-red colour. Reich, on the other hand, who appears to have made many experiments with creasote, both in internal and external diseases, aflirms, that he has never observed any caustic effect from it; from which assertion, as Riecke has remarked,f 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 suppu- rating surface, it caused, instantaneously, the formation of a white pellicle, owing to its coagulating the albumen contained in the secretions 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 * Medico-Chirurg. Transact vol. xix. Lond. 1835. t Op cit. S. 154. 218 CREASOTUM. 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. 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 with it by the author, febrile irritation supervened, and the head was covered by an artificial eruption, which induced, however, a new action in Ihe system of nutrition of the scalp, and after its subsidence, the porrigo was cured. Dr. Cormack, of Edinburgh, has likewise instituted various experiments on the lower animals to test the physiological effects of 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 observed, 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 instantane- ously paralyzed. In some instances, hurried and sonorous respi- ration 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 expiring, the animal uttered one or more shrill cries. In every instance 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 be not large, the animal may experience but little inconvenience,—a circumstance, which proves the importance of a thorough admixture with the blood before the poisonous 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 system of nutrition. When taken for any length of time, the urine acquires a black- ish hue, and in some cases creasote may be recognised in it.| EFFECTS ON THE ECONOMY IN DISEASE. Creasote has been administered in various diseases; the follow- ing may be esteemed a summary of the chief therapeutical expe- riments made with it. 1. Hemorrhage.—The discovery of creasote happened at a time when the Acqua Binelli enjoyed more confidence as a styptic than k does now; and the fancied probability, that the nostrum * Journal da Sociedade das Sciescas Medicas de Lisboa, torn. v. Lisboa, 1837; reviewed in Zeitschrift fur die gesammte Medicin. Oct. 1838, S. 224. t Op. cit. p. 66. X Dr. Macleod, in Med. Gaz. xvi. 590, and xvii. 653. CREASOTUM. 219 was indebted to creasote for its properties, gave rise to many ex- periments 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 Acqua Binelli, he tried creasote, pure, as well as in the form of creasote water, and of an emulsion prepared with gum Arabic; and from the results of these he was led to affirm, that although creasote occasioned the coagulation of the albumen of the blood, it acted no better as a styptic than cold water. With the Acqua Binelli he was not able to coagulate albumen. The rapid separation of the albumen in the form of a reddish-gray coagulum under the influence of creasote, he found to be of no advantage, as the mass remained soft and pulpy; and the wound in the vessel would not close, but was immediately opened by the stream of blood. Neither did he es- teem it adapted for arresting trifling hemorrhages; for, when very much diluted, it was still too exciting to the injured parts, and mark- edly delayed 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 inflammation. The experiments of other physicians have been decidedly more favour- able. Miiller and Reiter,* for example, in theirs, found that creasote was far more efficacious than the Acqua Binelli; for, when the latter was prescribed, it was always necessary to have recourse 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 necessary 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 divided crural artery was arrested by the same means, but not so speedily. When the artery was examined, it was found to be vvholly closed, having a navel-like depression at the extremity, which disappeared when the vessel * Schmidt's Jahrbuch, cited in Encyclographie des Sciences Medieales, Mars, 1837. See, also, Burdach, Medicin. Zeitung. Jahrgang, 1840, No. 31, cited in Lond. and Edinb. Monthly Journal of Med. Science, May, 1342. 220 CREASOTUM. was pressed upon, and ultimately became conical. Within the vessel there was a conical coagulum, which could be readily de- tached; 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 differ- ence, that the inflammation 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, Miiller and Reiter were led to con- firm the haemastatie properties of creasote, both when the hemor- rhage 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 crea- sote to act immediately on the artery; and the arrest of the hemor- rhage, they ascribe, not alone to the coagulation of the blood, but to the contraction of the arteries. In parenchymatous hemor- rhage, creasote water was generally sufficient; as well as in tole- rably extensive wounds of the surface. Horing, also, obtained satisfactory results from his experiments on animals. He ex- posed, 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 se- cond experiment was made of the same kind, except that, owing to the struggles of the animal, a larger opening was made into the crural artery. In this case, it was necessary to apply the com- press for four minutes before the hemorrhage 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 compresses of lint, wetted with a solution of creasote, were then pressed on the parts for five minutes, and the bleeding entirely ceased. The like re- sult 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 hsemastatic. Hahn applied it in some insignificant cases, but saw no better effect frbm it than from cold water. Most found it speedily arrest slight hemorrhage from small vessels. Horing 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 CREASOTUM. 221 which the hemorrhage soon ceased. Fichtdauer employed it with equally advantageous results in violent bleeding from leech bites, after several hsemastatics had been used in vain; and Hey- felder extols it for arresting hemorrhage from large wounded sur- faces. 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 suc- cessfully as a haemastatie in fresh wounds on man and animals. Both pure creasote and a solution of it were, however, unsuccess- fully used by Bardili in hemorrhage from the arteria tibialis poslica, 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 hsemorrhagia 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 creasote water into his mouth as he was able; and after three repetitions the hemorrhage ceased, and did not recur. Kohler* endeavoured to test the haemastatie operation upon himself. He made an incision in his forearm an inch long, and three or four lines deep, to vvhich he applied creasote water. A lancinating pain was felt in the wound, but no other sensible effect. 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 colour covered the wound, and there was a temporary cessation to the flow: it soon, however, recurred. After a time the hemorrhage 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 cedematous, and, in about four hours, were covered with a yellowish-brown lymph; but there seemed to be no delay in the cicatrization. In a case of lithotomy, it was found impossible to arrest the hemorrhage by any of the usual means, and no particular vessel could be discovered from which the blood flowed. The patient was at last reduced to the lowest ebb, from the continued loss of blood, and had already lost consciousness, when a sponge, dipped in pure creasote, was introduced into the wound, and pressed against the bleeding parts for an instant or two. The hemorrhage was immediately arrested. No particular pain was experienced; no unpleasant symptoms occurred; thin eschars were thrown off, and the patient recovered.f J. L. da Luz£ found it an excellent styptic in capillary hemorrhage; but in hemor- rhage from great vessels it did not prevent a recurrence of the * Neuc Wissenschaftlich. Annalen, u. s.w. B. i. H. 3, S.285. Berlin. 1835. t Dr. Daser, Edinb. Medical and Surgical Journal, Oct. 1841. X Op. cit. 15 222 CREASOTUM. bleeding. In haemoptysis, the internal use of creasote has been found beneficial. Santini* prescribed it in a desperate case with complete success, and with Schmalz it was equally effective; on the other hand, it was of little avail in Guitti's hands. In hozma- lemesis, it succeeded in the hands of Dr. Isaac Parrish of Philadel- phia,! after the remedies generally employed in such cases had failed to produce any effect. Dr. Wm. T. WraggJ employed it internally with advantage in a considerable variety of hemor- rhages—as flooding after abortion; flooding where there was no pregnancy; hemorrhage from the stomach and bowels, hemorrhage from the bowels, hemorrhage from the bladder, and haemoptysis; and the result of his observations induces him to conclude, that, on the whole, they "entitle the remedy to a place amongst the means upon which reliance may be placed in the treatment of a class of diseases, in the management of which we are often embarrassed." He extols it also as a hae- mastatie in traumatic hemorrhage; and a case is given by Drs. L. Lawrence Smith and S. D. Sinkler,§ in which a mixture of creasote," a watery emulsion of creasote," (the formula for which is given hereafter,) with proper pressure by means of a dossil of lint arrested the hemorrhage produced by an oblique slit in the carotid of a sheep. They express their belief, hovvever, that when the emulsion of creasote is applied to the divided artery of the sheep, it depends greatly, if not altogether, upon the manner in which the lint is applied to the wound in the artery, whether the hemor- rhage is arrested or not. If it be placed immediately on the orifice of the cut vessel, success is certain ; " if, however, the vessel shrink from contact with the lint, the animal is almost certain to bleed to death." 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; and Dr. Sutro|| strongly recom- mends an ointment of creasote, the formula for which is given hereafter; and advises it to be kept ready prepared under the name of'burn ointment.' 3. In profuse suppuration, it has been advised, on the authori- ty of Levrat and Berthelot, but according to J. L. da Luz,1F it has no * Gazetta Terapeutica di Verona, Mars, 1834; or American Journal of the Medical Sciences, Feb. 1836, p. 502. t Medical Examiner, Aug. 10, 1839, p. 501. I Southern Journal of Medicine and Pharmacy, March 1846 p. 128. § Ibid, July, 1846, p. 403. || Medical Times, Jan. 4, 1815. p. 314. fl Op. cit CREASOTUM. 223 marked influence on the secretion of pus, and is therefore useless in suppurating abscesses. In otorrhaza 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,—bed-sores. 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 opinion that he had prevented, in some cases, the occurrence of ulceration. Where ulceration had already taken place, he covered the parts with linen rags, folded two or three times, which he soaked in creasote water, and fixed them on by means of adhesive straps. The superficial ulcers soon healed; and the deeper were transformed into hollow surfaces, secreting a homogeneous serous fluid, but no pus. Horing employed creasote water with advantage in sore nipples; and creasote ointment has been recommended by Dr. Fife,* in sprains and contusions. 5. In chilblains, whether ulcerated or not, Hahnt used creasote washes successfully;—the affection yielding in a few days; and Dr. Herndon^: regards creasote ointment as the best remedy in that affection with whkh he is acquainted. M. Devergie also ex- tols an ointment of creasote, subacetate of lead and opium in the proportions given hereafter. 6. Ulcers.—Fissures of the skin and superficial ulcers, ac- cording to Hahn, were changed, under the application of 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 too much shrinking, gave rise to fresh inflammation and suppuration. Deeper ulcers were affected in the same manner as those caused by long lying. Its efficacy in atonic and varicose ulcers, especial- ly of the leg, has been attested by Levrat, Berthelot, Rossi, Hechen- berger, and others} but Guitti, Heyfelder, and Schmalz were less satisfied with it. 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 applica- tion of creasote water, in cases of carious, scrofulous, syphili- tic, fistulous, and sanious ulcers, to be strikingly, and almost uniformly advantageous. Heyfelder, likewise, found it extraor- dinarily useful 4n scrofulous ulcers, and Dr. Cormack|| states, that he had an opportunity of seeing a case of the kind treated by Dr. Shortt, in the Royal Infirmary of Edinburgh, where an ex- * Lond. Med. Gaz., April 7, 1833, p. 60. t Gazette Medicale de Paris, Dec. 1834. X American Med. Intelligencer, March 15, 1838, p. 425. § Boston Medical and Surgical Journal, July 3, 1830, p. 332. || Op. cit. p. 10G. 224 CREASOTUM. tensive scrofulous ulcer of the hip, after resisting a variety of treatment, at last yielded to creasote, and was ultimately com- pletely cicatrized. On the other hand, Otto tried both pure creasote and the watery solution in ulcers of various kinds, espe- cially the scrofulous: the ulcers very generally put on, in the course of twenty-four hours, a cleaner appearance; still they did not cicatrize, on which account Otto prefers, in old ulcerations at least, the use of a solution of chlorinated 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 diminution 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. Many observers depose to the good effects of creasote in scro- fulous caries. Among these may be mentioned Hahn, Coster, Ritgen, Fremanger and Hauff. In fistulous ulcers—also of syphi- litic origin—several physicians have employed it beneficially. Dr. Fife,* 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,t of Culpeper C. H., Virginia. In scurvy and in scorbutic ulcers, M. Coen| found its use followed by excellent results, and he refers to cases in which it has been administered internally with very great advantage. J. L. da Luz§ considers it an excellent cleansing remedy in atonic ulcers, but its prolonged use, he thinks, retards cicatrization. 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 pencilled 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 Ber- thelot observed favourable effects from 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. * Lond. Med. Gaz., April 7, 1838, p. 65. t Dunglison's Amer. Med. Intelligencer, March 15, 1838, p. 425. X Giornale per servire, &c., di Venezia, 1836. § Jornal da Sociedade das Sciencas de Lisboa, T. v. Lisboa, 1837; noticed in Zeit- schrift fur die gesammte Medicin. Oct. 1838, S. 224. || Dublin Journal of Med. Science, for May, 1837. CREASOTUM. 225 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 discon- tinued. 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 hemorrhage 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 con- junction with the extractum calendulae, 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 reported 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 the signs of ulceration had disappeared. It is more than doubtful, however, whether either of the two last cases was carcinomatous. 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 obtained. Rossi saw a cancerous ulcer of the face healed by creasote ointment, but it soon broke out again. The same gentleman cured a fungous tumour on the alveolar margin of the right os maxillare—which had occasioned the loss of all the teeth of that side except one, and vvhich even the actual cautery had not prevented 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 Cormackf in one of lupus of the nose. Guitti cured an ulcer, in appearance cancerous, by the application of pure creasote, for which, at a later period, the solution was substituted, and Marchal has published a case of cancer of the Up, the cure of which he believes he accomplished by means of creasote.£ Garbiglietti cured a fungous ulcer with caries of the fibula by creasote, but it is questionable whether the ulcer was carcinomatous; and Meisinger saw a cancer of the face im- proved by the use of creasote ointment. It has been before re-. marked, that Meisinger used creasote with advantage in syphi- litic ulcers. Hahn also applied creasote water in primary syphi- litic sores; thesmall, superficial ulcers healed soon; the larger and deeper remained stationary. In a phagedenic ulcerated bubo, the * Revue Medicale, Fevrier, 1834. For similar cases, see Dr. Friese,in Berlin. Median. Zeitung, Nro. 13, 1837. f t Op. cit. p. 115. X Gazette Medicale de Paris, Fev. 1835. 226 CREASOTUM. spreading was arrested, but this was all. According to Heyfel- der, 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 resisted caustics and other cicatrizing agencies, in a few days, by creasote water. Rehfeld, also, treated secondary syphilitic ulcers successfully writh it, giv- ing, however, at the same time, the corrosive chloride of mercury inwardly. Chronic venereal ulcers have in some cases yielded to it, after they had resisted every other kind of treatment.* Dr. Biirkner, of Breslau,t reports a case, vvhich, after having proved rebellious to every kind of general and local management that could be devised, at length yielded to the application of pure crea- sote by means of a camel's hair brush.% The character of the se- creted pus immediately improved; the wound began to heal by- granulations from the base; and, at the end of four weeks, Dr. BLirkner found his patient quite well. In condylomata, it has been equally successful. By the application of creasote water, Hahn found them contract and disappear; but the more obstinate required to be pencilled with pure creasote. Heyfelder, Reich,! Fricke, and Coen,§ also found creasote efficacious in these cases. The last gentleman but one had the most frequent opportunities for observation; by him 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 they disap- peared; but when once they fell off, they did not return. 7. Gonorrhoea and Leucorrhoza.—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 leucorrhoza, he strongly recommends both its inter- nal and external use. Reich injected creasote water in a case'of gonorrhoea, and in one of malignant leucorrhoza; yet its agency in these cases was.doubtful, as copaiba was given at the same time. Hahn|| also used injections of creasote water in the second stage » of gonorrhoea and in gleet; but he did not think that the dis- charge ceased sooner under its agency than under the ordinary means; whilst in some cases the inflammation was even augment- ed. In two cases of benign filuor albus, after many other reme- dies had been employed in vain, Schmalz saw good effects from the use of a solution of creasote; but in a third case it afforded no * Cormack, Op. citat. p. 107; and in Lond. and Edinb. Monthly Journ. of Med. Science, Oct./1842. See, also, Kiinchel, in Bulletin Gener. de Therapeutique, p. 313. Paris, 1833. t Casper's Wochenschrift, Sepr. 9,1837, S. 583. j: Hufeland's Journal, Jan. Ib34, and Revue Medicale, Mai, 1834. § Giornale per servire a progressi della patologia, &c, di Venezia, An. 1S36. || Gazette Medicale de Paris, Dec. 1634. • CREASOTUM. 227 relief. Dr. Elliotson* gave it internally (o a female labouring un- der gonorrhoea,—at first, in the dose of two minims to an ounce of water, and afterwards in the dose of four, six, and even eight mi- nims, but no good resulted from it. Dr. R. H. Allnattt has used creasote injections in gonorrhoea and ir leucorrhoza with very satisfactory results. He proposes the remedy also for cases of gleet occurring in flabby leucophleginatic males. The formula for an injection used by him is given hereafter. The author has administered it not unfrequently in leucorrhoza and other mucous discharges, and when persevered in, it has at times appeared to be of decided service.\ Dr. Robert Dick,§ of Glasgow, has called the attention of the profession to its use in the chronic stage of gonorrhoea, and in gleet. He thinks its bene- ficial effects are more obvious than those of copaiba. He adminis- tered 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 the mild chloride and the black sulphuret of mercury. The result was fa- vourable. In 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|| extol the water and the ointment in inveterate itch. J. L. Da Luz^[ considers it as valuable as sulphur, but Otto did not find the water 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 administered 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 wTarm water. The eruption commonly disappeared very rapidly under this manage- ment, but it speedily recurred unless general bathing was used at the same time. It again yielded, hovvever, very readily to crea- sote water. Grandjean, Reich, and Kohler, also applied the \vater successfully in herpes; and Guitti found both the water and the ointment most serviceable in herpetic affections when combined with appropriate internal treatment. Heyfelder recommends that alterative drinks, as the decoctum sarsaparillae, should be combined with them. Even in herpes exedens, the external application of creasote was found effectual by Ritgen, Grandjean, and Rossi. * Lancet, for Dec. 1835, p. 435. t London Lancet, Dec. 31, 1842, p. 504. X See, also, Coen, in Giornale per servire, &c., di Venezia, 1836; and Dr. Wm. T. Wragg, Southern Journal of Medicine and Pharmacy, March, 1846, p. 128. § Edinb. Med. and Surg. Journ. Apl. 1838, p. 602. || Op. cit. TT Jornal da Sociedade das Sciencas Medicas de Lisboa, torn. v. Lisboa, 1837, noticed in Zeitschrift fur die gesammte Medicin. Oct. \9ii>, S. 224. 228 CREASOTTJM. Wolff* cured a case of ancient impetigo in about eight weeks, by a solution of creasote (Credsot. f. gss.; Aq. destillat. f. 3v.) 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 fomentations of warm water'from clay to day until the cure was completed. Dr. Herndon, of Culpeper C. H., Va., derived much benefit from the ointment in psoriasis. In a case of acne rosacea of seven years' standing, accompanied with headach, nervousness, thirst in the morning and acid eructations, for which the patient—a female—was put under treatment for a month, without success, Dr. Elliotsonf determined on trying crea- -sote. The advantage was soon manifest, as in three days the erup- tion was evidently diminished. At first, she took two minims three times a day; this was gradually augmented to twenty mi- nims,—the farther increase of the dose being prevented by the supervention of giddiness and tremors. At the end of seven months, she was discharged ; the eruption being scarcely percep- tible, and the dyspeptic symptoms entirely removed. In a chronic pustular disease, not curable by antiphlogistics, the same gentle- man observed better effects than from any remedy previously prescribed.! Dr. Copland, it is affirmed, found a saturated solu- tion in water answer well as a lotion in porrigo favosa.^ The author has often used in porrigo both creasote water and creasote ointment (see the formulae at the end of the article ;) they have always appeared to him sufficiently strong, and when the quantity of creasote was increased, so much inflammatory irritation was in- duced, that they had to be discontinued for a time. 9. In cases of chronic inflammation of the free edge of the eye- lids, cures were effected by Coster, and Mr. G. T. Black ;|| by the former from the use, twice a day, of a dilute solution of creasote (Creasot. gtt. xij.; Aq. destillat. f. ^ij.) applied by means of a camel's hair pencil. The cure was effected in ten days. The formula for the lotion used by Mr. Black is given afterwards. An ointment of creasote has also been found of essential service in various forms of strumous ophthalmia by Dr. C. C. Hildreth, of Zanqpville, Ohio.^J In different kinds of ophthalmia M. Sanson used creasote, but never observed the disease to be modified by the treatment.** 10. In cases of prolapsus vaginae, Schlesier tried the external use of a solution of creasote. After astringent injections, and the application of decoctum krameriae by means of a sponge, had been used in vain, he injected diluted creasote for seven weeks, omit- * Medicin. Zeitung, u. s. w. No. 30, 1834. t Lancet, July 4, 1834, p. 459. X Medico-Chirurg. Transact, xix. 237. Lond. 1835. § Gully's edition of Magendie's Formulary, p. 204. Lond. 1835. See, also, Sir F. Smith, in Dublin Med. Jour, for May, 1837, and J. L. Da Luz, Op. cit. || London Lancet, Aug. 7, 1841. U Amer. Journ. of the Med. Sciences, Oct. 1842, p. 364. x ** Compte rendu des Seances de la Societe de Medecine, Seance du 7 Mars, 1834. CREASOTUM. 229 ting it only 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, vvhen there was every prospect of ulti- mate success. 11. Dr. Buttmann,* of Vietz, circle of Lansberg, has given the case of an old lady, upwards of seventy years of age, who had la- boured for several years under an oedema 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 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 vvhich 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 pen- cil, or of cotton imbued with it. The testimony in its favour has been very great,—Coster, Reich, Hahn, Kneisel, Heyfelder, Fitch- bauer, Hauff, Otto, Guitti, Kohler, Meisinger,f 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 instantaneous^ acute pain and a considerable secretion of saliva. The pain is often re- lieved by it, but it generally recurs; and perhaps the advantage derived from this agent is not greater than from the stronger es- sential 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 serviceable.^ Although, however, it alleviates the pain of toothach, it has been considered to hasten the destruction of the tooth.§ 13. In deafness, apparently owing to a deficient secretion from the ceruminous follicles, advantage has been found from the use of creasote, after the ear had been syringed. Perhaps as good a form as any is that recommended by Mr. Curtis,|| 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-indicated in cases of olorrhoza, where there is any pain or inflammation. Dr. Par- tridge^ who has seen many excellent effects from creasote in such * Beitr'agen zum Sanitats-Berichte das Frankfurter Regierungs-Bezirks: or Medicin. Zeitung, Dec. 7, 1836, S. 252. t Medicin. Jahrbiich. des k. k. osterreich. Staates, B. xv. S. 553. Wien, 1834. X Riecke, Op. cit. S. 167. § Connack, Lond. and Edinb. Monthly Journ. of Med., Oct., 1842. || London Lancet, vol. i. p. 328, 1838-9; and Mr. Wright, ibid. p. 580. TT Medical Examiner, May 30, 1840, p. 348. • 230 CREASOTUM. 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 crea- sote to three of oil. 14. In cases of nsevi, Dr. Thornton* found the most effectual of all applications to be creasote. He applies it two or three times daily, more or less diluted; excoriation, ulceration, and gradual disappear- ance of the naevus ensue,—the cicatrix being always smooth and sound. Thus far we have spoken mainly of the external use of creasote. Reference has been made to its internal administration in cases of haemoptysis, hsematemesis and leucorrhoza. In the following diseases, it has been chiefly given internally:— 15. 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 immediately and eagerly embraced, numerous trials were insti- tuted with it, the results of which were by no means accordant. Reichf 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 expecto- ration 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 vvhich 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 anodyne was consequently substituted for the creasote; under which his patient—a female—improved so much, that Reich was led to be- lieve she might be saved, although the cough still remained severe and frequent. In another case, 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 re- sult of the case is not known. Levrat asserts, that he found it 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 fif- teen drops, according to the degree of tolerance of the lungs, being dropped into hot water in an appropriate vessel, and the vapour * Northern Journal of Medicine, Dec. 1844; cited in Braithwaite's Retrospect, xi. 186, Amer. edit N. Y. 1845. t Hufeland's Jour. Jan. 1834; and Revue Med, Mai, 1834. CREASOTTJM. 231 received through the tube of an inverted 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. On the other hand, Elliot- son* 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, Giinther, Schmalz, Meisin- ger, Otto, Kohler,| and others. The published experiments by Wolff, in the Charite at Berlin, cannot be esteemed more favourable. It was tried in eleven cases of tubercular phthisis, 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 fourteen days. In one case, it had to be dis- continued on the eleventh day, owing to the supervention of ob- stinate vomiting. The case ultimately terminated unfavourably. In six cases, the symptoms appeared to be aggravated, and the pa- tients died soon afterwards. In two cases, in which the disease was in its second stage, death supervened unexpectedly early, on the fourth, and the seventh days of the treatment,—in one case by suf- focation; in the other, b)7 sudden hydrothorax. The pulse, according to Wolff, was generally quickened under its use; the hectic augmented; the urinary secretion-diminished; the expectoration neither changed in quantity nor quality; the cough not mitigated; nor the dyspnoea diminished: on the other hand, in four cases, they were manifestly increased: 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 a» respects the radical and the pallia- tive treatment;]: 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 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; and M. Petrequin,|| from his trials with it, considered its effects to be more beneficial—as might be presumed—in incipient than in confirmed phthisis; but in no case did he observe anything * Medico-Chirurg. Transact, xix. 221; Lond. 1835. t Hecker's Neuern Wissenschaft. Annal. B. i. H. 3. X See, also, Kohler, in Rust's Magazin, B. xlvi. or Amer. Journ. of the Med. Sciences, Fgb. 1837, p. 497. § Riecke, Op. cit. S. 170. || Gazette Medicale de Paris, Nov. 1836. 232 CREASOTUM. approaching the radical cures described by some. He indeed gives the preference to tar water (see Aqua Picis Liquids, p. 75.J 16. In bronchorrhcea, or that state of the bronchial mucous mem- brane which consists in a profuse secretion without inflammation, the inhalation of creasote has been found of essential service.* In the chronic mucous affections of the lungs of old people, it appears to have been especially useful. 17. Rheumatism and Gout.—The success, obtained by Reichf from tincture of soot in gouty and rheumatic affections, and the probability that its efficacy might depend chiefly on the creasote it contained, induced him to prescribe the latter remedy internally in those diseases. He made the first trial upon himself. After exposure to cold, he was attacked with lancinating pain in the whole, of the right leg, for the removal of which the ordinary re- medies were employed in vain: it yielded to the use of creasote given for nine days. He relates another case of rheumatism and one of atonic gout, in which creasote was equally successful. Marcus, of Hadersleben, recommends it in cases of rheumatism, unaccompanied by excitement of the vascular system, or tendency to congestion and febrile reaction. It is proper, however, to ob- serve, that he combined other agents with it, so that his experi- ments are by no means decisive as to its efficacy. Of the three patients, to whose cases he refers, one only was cured: the other experienced improvement. Karsten found none of the advan- tages, described by Reich, in rheumatic and gouty cases, from its use. In a case of rheumatic headache, Tschopke found surprising benefit from frictions of creasote, and plugging the ear with cotton dipped in it. The creasote immediately excited acute pain, and some rubefaction of the skin; and as the burning ceased, the pain ceased along with it. In Most's experience, lotions of creasote water greatly alleviated the pain of the joints in rheumatism and atonic gout. 18. In vo,miting, not arising from inflammation or other organic disease of the stomach, ElliotsonJ found creasote very efficacious. In the vomiting of pregnancy it has been found highly valuable. If the sickness comes on regularly after rising in the morning, Dr. Cormack§ prescribes two or three drops to be taken five or ten minutes before getting out of bed. This he has generally found effectual; but if it should not be, the patient is directed to repeat the dose in two hours. In more troublesome cases, when the sickness occurs at intervals during the day, one or two drops are given every two, three, or four hours. Pie has also found it serviceable in the sickness and vomiting following a drinkino- de- bauch. Even in Asiatic cholera and in sea-sickness, it appeared to allay the vomiting. In various affections of the stomach, as in * Elliotson, in Med. Chirurg. Transact, xix. 221. Lond. 1835. t Hufeland's Journal, Jan. 1834, and Revue Med., Mai, 1834. * i Medico-Chirurgical Transactions, vol. xix., or Lancet, Aug. 20,1836. § Lond. and Edinb. Monthly Journal of Med. Science, Oct. 1842. CREASOTUM. 233 cardialgia and gastrodynia, it may be found useful.* In cases of vomiting from nervous excitability it has been affirmed to excel all known medicines.-}- After Dr. Elliotson had recommended it, Dr. Shortt tried it in about a dozen cases, and found it equally successful, as did also Prof. A. T. Thomson, of London, Dr. Bo- dington of Erdington in Warwickshire, Dr. Christison,± and many others. Dr. John Walker of Glasgow, in a case published by him,§ does not appear to have been equally fortunate; and with Dr. Paris it entirely failed.|| The author's own success has been by no means as great as that of Dr. Elliotson. In many cases, indeed, it has developed irritability of the stomach, where this did not pre- viously exist.1" Dr. Elliotson admits, that in large doses it seems to excite vomiting, and that when given in such quantities with a view to check it, no good, but evil, results from a large dose. As a preventive of sea-sickness it has been extolled by Dr. El- liotson, and by Mr. A. B. Maddock.** It has been administered, also, as an excitant to relieve gastrodynia and flatulence, and where hydrocyanic acid and creasote have been separately tried unsuccessfully, Dr. Elliotson recommends, that they should be combined. Dr. J. B. Wilmotttt has extolled the use of creasote in- jections in camp dysentery. One was administered every night composed of a dram of creasote to twelve ounces of starch. 19. Several portions of tsenia having been observed to be dis- charged after the administration of creasote, Kraus was induced to prescribe it as a powerful anthelmintic. This he did in numerous cases, and with|the best success; from five to eight drops being given to adults with castor oil; or where the bowels were not freely opened with half a drop or a drop of croton oil. 20. In diabetes mellilus, creasote was first given by Berndt,^ and with striking success. One or two cases of the same kind are related by Gadolin; but Rehfeld used it without advantage. Dr. Elliotson agrees with Berndt in the opinion, that it is some- times of use in diabetes, and may even be greatly instrumental in accomplishing a cure.§§ 21. Dr. Elliotson|||| tried creasote in nervous diseases. In some cases of epilepsy, the paroxysms appeared to be rendered less frequent and more mild; but in the generality of cases, they re- turned with fresh violence. In some cases, the remedy had no influence on the disease; in others it appeared to aggravate it. * Riecke, Op. cit S. 172. t Cormack, on Creasote, p. 133. X Dispensatory, p. 377. Edinb. 1842. § Lancet, Dec. 19, 1835, p. 447. See, also, Mr. Taylor, ibid. Aug. 15,1835, and Dr. Macleod, in Lond. Med. Gazette, xvi. 598, and xvii. 653. || Pharmacologic 8th edit, append. Lond. 1838. See, also, Pereira, Elem. of Mat. Med. and Therap. 2d edit. p. 420, Lond. 1842; or 2d Amer. edit, by Dr. Carson, Philad. 1846. V. Cormack, Lond. and Edinb. Monthly Journal of Med. Science, Oct. 1842. ** Amer. Journ. of the Med. Sciences, Feb. 1838, p. 496. It London Medical Gazette, May 23, 1845, p. 162. tt Kleinert's Repertorium, Jan. 1835, and Lancet, July 18,1835. §§ Medico-Chirurgical Transactions, xix. 132-135. Lond. 1835. |||| Op. cit 234 CREASOTUM. In neuralgia, great advantage was at times derived from it, al- though, here, again, it was frequently of no service.* In the treatment of neuralgia, inoculation with a mixture consisting of 10 or 15 grains of acetate of morphia in one dram of creasote, was employed with much advantage by Mr. Rynd.f Punctures were made over the nerves affected and the solution was introduced. In a very short space of time the pain was relieved or wholly disappeared, Dr. Elliotson also observed good effects from it in hysteria, where there was no inflammatory complication, in spas- modic erethism of the nervous system, and in palpitation; and Dr. Herndon,^ of Virginia,used it with much benefit as an inhalation in hysteric croup (thirty drops to the quart of hot water.) In asthma, dependent upon morbid excitability of the bronchial mucous mem- brane, Dr. Elliotson§ found its inhalation to be often useful. 22. In two cases of chronic glanders, the same gentleman|| accomplished a cure in the course of a few weeks, by the sedu- lous use of an injection of a dilute solution of creasote (Creasot. gtt. j; Jlquoz, f. gj.) thrown up the affected nostril; combining the treatment, in one of the cases, with the internal use of the re- medy; and a similar case of success is given in a more recent number of a British medical periodical. •)[ MODE OF ADMINISTRATION. The dose for internal use is one or two drops, given several times a day, in gum water.** In cases of tape-worm, the dose should be larger. Some give it in emulsion, but this form is objectionable on account of its disagreeable taste. It is best ad- ministered in pill. Externally, it is at times applied pure; at others diluted,—commonly with water, with or without the addi- tion of alcohol, or in the form of ointment. Carminatif-j- affirms that oil and mucilage, when combined with it, render it milder, but that vinegar increases its action. Dr. Cormack,\\ however, doubts the assertion in regard to vinegar. In three comparative experiments, which he made with a view of testing the justice of Carminati's conclusion, there was no apparent difference in the activity of creasote, when given with acetic acid or alone. He was led to believe, however, that the addition of albumen caused it to act more powerfully, which, if true, would be singular. The inhalation of creasote vapour may be accomplished by dif- fusing a few drops of creasote through water or a mucilaginous v liquid, in an ordinary inhaling vessel, or in the mode described under the head of Chlorine.§§ * Cormack, loc. cit 1 Dublin Medical Press, March 12,1845; or Ranking's Half-yearly Abstract, &c, Pt p. 29, Amer. edit. New York, 1845. X Dunglison's Amer. Med. Intelligencer, March 15, 1838, p. 425. § Op. cit || Lancet, for June 20, 1833. TT Ibid. Jan. 20, 1839, p. 145. ** It may be well to remark, that the fluidram contains one hundred and fifty drops of creasote. tt Op. cit. Xt Op. citaUp. 88. §§ See page 1G6. CREASOTUM. 235 Pilula; creasoti. . Pills of creasote. R. Creasoti, ttlx. Glycyrrhiz. pulv. gj. Mucilag. acac. q. s. ut fiat massa. in pilulas xx. dividenda. Dose.—Two pills three times a day. In neuralgia, atonic rheumatism, and chronic bronchitis. The number of pills may be gradually increased to eight or ten at a time. Joy* R. Creasot. gj. Ext. glycyrrhiz. Galban. aa. gss. Althaese pulv. gij. Fiat massa in pilulas cxx. dividenda. Dose.—Six pills, four times a day. In consumption. Reich. R. Creasoti, Ext. glycyrrhiz. aa. gj. Althaeas pulv. gij. Fiat mass, in pil. cxx. dividend. Dose.—Five pills morning and evening, in atonic gout. \ . R^eich. Haustus creasoti. Creasote draught. R. Creasot. rt^i. Aquae camphorae. Infus. gentian, compos, aa. f. gvj. M. fiat haustus. To check vomiting. Mistura creasoti. Mixture of creasote. R. Creasot. gtt v. Mucilag. acaciae, f. Siij. Syrup, althajae, f. gj. M. Dose.__A 'spoonful every three hours in haemoptysis. Santini- Tinctura creasoti pro gingivis. Tincture of creasote for the gums. R. Creasot. f. gj. Alcohol, f. gij. M. As much of this to be added to cold water as is necessary to give it a piquant taste, with which the teeth may be washed and the mouth rinsed. Used in cases of foztor of the mouth from ca- rious teeth, and to limit the caries. Buchner. ' Tweedie's Library of Medicine, v. 282, Lond. 1840; or 2d Amer. edit iii. Philad. 1*42. 236 CREASOTUM. R. Alcohol. (36° B.) f. giss. Creasot. f. gj. Tinct. cocci, f. gvj. 01. menthae, gtt. xxxvj. Used for the toothach: and, diluted, as a wash for the gums. Righini* R. Creasot. Alcohol, aa. gss. M. To be applied to carious teeth. Radius. R. Creasot. p. i. Alcohol, p. viij. M. This is the ordinary strength of the tincture. Used where fractions of a drop of pure creasote are prescribed. Lotio creasoti, Lotion of creasote. R. Creasot. gss. Aquas destillat. f. gv. M. Used as a lotion in impetigo sparsa and itch. Wolff. R. Creasot. f. gj. Acacias pulv. gj. Aquce f. gviij. M. et fiat emulsio. •" Creasote emulsion," used as a haemastatie. Smith «§' ointcier. The author has occasionally found a lotion composed of f. Jss. of creasote to Oj. of water too irritating. R. Creasot. gtt. xij. Aq. destillat. f. gij. M. To be applied by means of a camel's hair pencil twice a day to inflamed eyelids. Coster. R. Creasot. ItLiij. Tinct. lavand. compos, mxx. Aquae destillat. f. gss. M. G. T. Black. R. Creasot. gtt. iv. Aq. destillat. f. gij. M. In irritation of the gums. Freman°-er. R. Creasot. f. gss. Acaciae, giss. Aquas camphor, f. gxss. M. Used every two hours in cases of aphthous ulceration of the mouih. Magendie. R. Creasot. gtt. x. Aceti f. gij. Aquae f. |ij. M. Used in cases of phagedenic ulceration, and to chancres; ap- plied by means of a camel's hair pencil. Shortt.f * Journal de Chimie Med. Avril, 1841. t Connack, Op. cit. p. 112. CTJBEBA. 237 Unguentum creasoti. Ointment of creasote. R. Cerati, 01. amygdal. aa. gj. Creasot. gtt xxx. M. A dressing in scrofulous caries. Fremanger. The Unguentum Creasoti of the London and United States Pharmacopoeias is composed of half a fluidram of creasote to an ounce of lard. linimentum creasoti. Liniment of creasote. R. Creasot. gtt. v.—xx. 01. oliv. f. gss. M. To be rubbed two or three times a day on the diseased parts in chronic herpes. Corneliani. Injectio creasoti. Injection of creasote. R. Creasot. ir^xx. Liq. potass, f. gij. Sacchar. gij. Tere in mortario, et adde gradatim Aquas f. gviij. M. The injection to be used three times a day. R. A. Allnatt. Unguentum creasoti compositum. Compound ointment of creasote. R. Creasot. Liq. plumb, subacetat. aa. gtt. x. Extract, opii, gr. iss. Adipis gj. M. An application to chilblains. Devergie. R. Creasot. gss. Carbon, animal, prasparat. gj. Alcohol, f. giss. Ung. cetacei giss. M. A "burn ointment." This may be modified according to age as follows:—for children under five years of age, it should be weakened by mixing it with four times its bulk of spermaceti ointment; for children from five to ten with^twice its bulk; and so on, gradually increasing the strength according to the age of the patient. In protracted cases, the strength should be gradually in- creased. Sigismund Sutro. LXV. CUBE'BA. Synonymes. Cubeba?, Piper Cubeba, P. Cubebarum, P. Caudatum, Cubebs. French. Poivre a queue, Cubebe. German. Cubeben, Cubebenpfeffer. Kubebenpfeffer, SchwanzpfefFer; Schwindelkbrner. 16 23S CUBEBA. Cubebs are the fruit of Piper cubeba, vvhich grows in India, Java, Guinea, &c. Sexual System, Diandria Trygynia; Natural Order, 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 carmina- tive agents, which seem to have a specific action in vertigo: hence they obtained the name "Schwindelkbrner" or "grains for verti- go." They had, however, fallen into oblivion, until they were re- introduced in modern times into practice, especially by the En- glish physicians and surgeons. The shell of the dried berry has a weak taste, but smells agreeably; the kernel has a bitter aromatic flavour, which is biting at first, but afterwards cooling. The corns were analyzed by Tromsdorff and by Vauquelin;* but the most recent analysis is by Monheim.f He found in 100 parts,—lignin 65; extractive mat- ter 6; Cubebin (Piperin) 4.5; matter like wax, 3; green volatile oil 2.5; yellow volatile oil 1.0; balsamic resin—which, according to Vauquelin, is very analogous to balsam of copaiba—1.5; chloride of sodium 1.0, and 15.5 parts loss. Cubebin appeared to Mon- heim to be identical with piperin, but to be united with an acrid soft resin. The volatile oil may be obtained separately 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; it becomes of a darker colour, and assumes an aromatic odour. Cubebs have been advised, in modern times—first, in cases of gonorrhoea, in which they have been esteemed a specific by many. Yet the consi- derations that apply to copaiba are equally applicable to cubebs. Although the revulsive effect induced by both on the kidneys may mitigate the inflammatory condition of the lining membrane of the urethra, which constitutes gonorrhoea; yet, in violent inflam- matory cases, and in the early stages of ordinary cases, they may be injurious,and there are many cases on record in vvhich bad conse- quences appear to have resulted from their improper administration. 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 cubebs, 10 were cured in from 2 to 7 days; 17 in from 8 to 14; IS 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 cubebs in combination with sesquioxide of iron; and in addition the patient is directed to inject, * Memoir, du Museum, vi. 225. f Journal de Pharmacie, xx. 403. t Medico-Chirurgical Transactions, xii. 1. Lond. 1822. § La Lancette Francaise, No. 133. Paris, 1633. CUBEBA. 239 four times a day, a solution composed of Aq. destillat. f. iviij., Argent, nit rat. gr. ij. It has been affirmed, that different evils have ensued from the use of cubebs: which ought to suggest care in their administra- tion: for example,—ardor urinae; fever; inflammation of the ure- thra, bladder, and testicles; retention of urine; cutaneous erup- tions, &c.x In the blennorrhaza of females, cubebs are equally extolled by many practitioners, as well as in leucorrhoza.] Spitta found them very efficacious in old and obstinate cases of coryza, when given in the form of lozenges: they are said, like- wise, to have been administered with advantage in defective au- dition, caused by a catarrhal affection of the Eustachian tube. Ro- sin found the chewing of cubebs very serviceable in cases of aphonia. They have also been prescribed successfully in cases of chronic rheumatism. Piilf gave them with striking advan- tage in intermittent fever; and in India, they are regarded to be aphrodisiac.§ According to Dr. Paris, it is important to keep the bowels open during their use, for when hardened faeces are allowed to accumu- late, the spice insinuates itself into the mass, and occasions exco- riations of the rectum. || MODE OF ADMINISTRATION. 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 pre- pared of them ; and the London, Dublin, and United States Phar- macopoeias have a Tinctura Cubebje (C'ubeb. ^iv., Alcohol, dilut. Oij. Dose, f. 3.j•—f-3\j-) In consequence of the disorder at times in- duced 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, suspended in five or six ounces of an oily vehicle ; and this method has its advantages.1T To attain the same object, M. Dublanc, Junr., prepared an oleo-resinous extract, one sixteenth part of which possessed equal virtues with one part of cubebs; five grains, three times a day, acting like the ordinary dose of powdered cubebs.** The volatile oil is sometimes given in the dose of 10 or 12 * Lond. Med. and Physical Journal, Mar. 1832, and Merat and De Lens, Diet. Univers. de Matiere Medicale, &c., art Piper Cubeba. t Edinb. Med. and Burg. Journal, xviii. 319. Blundell, Diseases of Women, p. 158, Lond.; or Dunglison's American Medical Library edition, Philad. 1840; also, Lisfranc by Pauly, translated by Lodge, p. 243, Boston, 1839; and Ricord, Practical Treatise on Ve- nereal Diseases, by Drummond, Amer. edit Philad. 1843. X Recueil de Med. Chirurg. et Pharm. Mililaire, xvi. § Merat and De Lens, Art. cit || Brande, Dictionary of Materia Medica, p. 205. Lond. 1839. TT Archives Generates de Medecine, xiii. 47. ** Journ. de Chimie Medicale, iii. 491, and Journ.de Pharmacie, xiv. 40. 240 CUBEBA. drops, suspended in water by the aid of sugar or associated with oil of copaiba. Gelatinous capsules of cubebs, containing the oil, are sometimes taken. M. Piorry * has strongly recommended an Infusion of Cubebs (Cubeb. ^j., Aquas Oij.) to be used six or eight times a day as an injection in urethritis and vaginitis. Pulvis cubebse compositus. Compound powder of cubebs. R. Cubebse pulv. ij. Ergotse pulv. gss. Pulv. aromat. Qij. Sacchari, gj. Divide in chartulas viij. Dose.—One, three or four times a day in gonorrhoea, leucor- rhoza, gleet, prostatic and involuntary seminal discharges. Ryan.] R. Cubeb. pulv. gij. Aluminis pulv. gss. M. et divide in chart, ix. One to be taken three times a day. Ricord.% Electuarium cubebse. Electuary of cubebs. R. Cubeb. pulv. gss. Mellis despum. q. s. Fiat electuarium. Dose.—A tea-spoonful, three or four times a day, in catarrhus vesicas, c. urethras, &c. Radius. R. Copaib. givss. Subige cum Adde Vitello ovi unius, et Cubeb. pulv. givss. Confect. rosa3 gss. M. et fiat electuarium. Dose.—A tea-spoonful three or four times a day. Vogt. R. Copaib. Cubeb. pulv. aa. gij. Aluminis, gj. 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 mornin0, and evening. R. Copaib. part. i. Cubeb. pulv. part. xij. Tinct. vanillse, q. s. M. Dose.—3j. three times a day. Cazenave.§ * Gazette des Hopitaux, Mai, 1842. t Universal Pharmacopoeia, or a Practical Formulary of Hospitals, both British and Foreign, by Michael Ryan, M. D. &c, &c, 3d edit. p. 160. Lond. 1839. X Mathieu, Journal des Connaiss. Med. Chirur. Juin, 1840. § Bouchardat, Annuaire de Therapeutique pour 1842, p. 44. Paris, 1842. CUBEBA. 241 Trochisci cubebs. Lozenges of cubebs. R. Cubeb. pulv. gij. Tolut. gr. vj. Admisce Syr. myroxyl. Ext. glycyrr. aa.gj. Acaciae q. s. ut fiat massa in trochiscos pond. gr. x. dividenda. Used in coryza. Spitta. Boli cubebae. Boluses of cubebs. R. Copaib. Acac. pulv. aa. gij. Aquae flor. aurant. Qij. Terendo bene mixtis adde Cubeb. pulv. gij. 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 cubebs from the ligneous matter.— Cubebs, reduced to coarse powder, are placed in an apparatus for displacement and exhausted by ether, which dissolves the wax, volatile oils and balsamic resin. The residue is submitted to the action of dilute alcohol at 20° (.935,) which dissolves the extrac- tive principle, and chloride of sodium. The alcohol and ether are separated by distillation in part, and separately. Evaporation 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 volatilized, 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 vola- tile 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. It can be readity mixed with water by means of muci- lage, and can be administered in potions, injections, &c. The best form of exhibition, according to INI. Labelonye, is in lozenges, or in an emulsive syrup. Trochisci extracti hydro-alcoholici aetherei cubebae. Lozenges of the ethereal hydro-alcoholic extract of cubebs. R. Extract, hydro-alcohol, sether. cubeb. gviij. Alcohol. Oij. Solve et adde Sacchar. in pulv. ten. ftj. 01. menthse pip. gtt xviij. * Bulletin General de Therapeutique, or Amer. Journ. of Pharmacy, 2d series, vol. 2, p. 316. Philad. 1837. 242 DELPHINIA. 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 six grains each. Most persons, M. Labelonye says, can swal- low 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 aetherei cubebae. Syrup of the ethereal hydro-alcoholic extract of cubebs. R. Ext. hydro-alcohol, aether, cubeb. giij. Suspende ope mucilaginis in Aq. menthas pip. Oj. Adde Sacchar. Tbij- M. Four ounces of this syrup contain two drams of extract, equi- valent to ten of powdered cubebs. Dose.—A tea-spoonful. M. Labelonye also envelops the extract in sugar, as in the ordinary sugar-plumb. An extract of cubebs has been recommended to be prepared as follows:—The cubebs are exhausted by repeated digestion in alcohol, vvhich readily takes up all the active principles of the pepper; viz., a resin resembling that of copaiba, and a coloured resin, with an almost concrete essential volatile oil. The alcohol is distilled from those tinctures at a temperature so moderate as not to volatilize the essential oil. When the operation can be car- ried no farther in this manner, the evaporation must be continued in an open vessel by the aid of a water bath, at a still lower degree of heat; a little finely pulverized Spanish soap must now be added to prevent the separation of the resin, and preserve the extract of a uniform consistence. The ordinary dose of this in blennorrhaza is about fifteen grains three times a day.* Dr. Puchet employs a liquid aqueous extract of cubebs; a liquid alcoholic extract; a syrup of the alcoholic extract; a bolus of cubebs; and one of cubebs, copaiba and turpentine. The last he covers with a gelatinous mixture to obviate the unpleasant taste. LXVI. DELPHI'NIA. Synonymes. Delphinina,Delphininum, Delphininium, Delphium, Delphina, Delphia, Delphinine, Delphine. German. Delphinin, Delphin. * Mr. W. H. Judd, Medico-Botanical Transactions, vol. i. p. 4. Lond. 1839. t Journ. de Connaiss. Medical. Aout, 1840; and Bouchardat, Nouveau Formulaire Magistral, 3eme edit. p. 129. Paris, 1845. DELPHINIA. 243 This alkaloid was discovered in 1819, by MM. Feneulle and Lassaigne,* and, almost at the same time, by Brandes,f in the seeds of Delphinium staphisagria, 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 PREPARING. The plan recommended by Magendie^ is to boil a portion of the seeds of delphinium, cleared of their coverings, and reduced to a fine paste, in a little distilled water; to pass the decoction through linen cloth, and filter. Pure magnesia is now added, and the mixture is boiled for some minutes; the filtration is re- peated: and the residues arc washed carefully and digested in alco- hol. On evaporating the alcoholic tincture, delphinia is obtained in the form of a white powder, having some crystallized 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 un- clean seeds, when well bruised, to the action of weak sulphuric acid. Precipitate the liquor by ammonia, and redissolve in alcohol the delphinia, which is still slightly coloured. To purify it, draw off the alcohol by distillation, dissolve the residuum 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 consist- ence of a thin extract, and then to treat it with water acidulated with sulphuric acid. This solution, when filtered, is to be pre- cipitated by ammonia. The precipitate—after being freed from its water—is to be taken up by alcohol, and again reduced to the consistence of an extract, which is likewise to be dissolved in acidulated water; to this solution, filtered, a small quantity of nitric acid is 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 is dried. This is the delphinia of commerce; but, like veratria, it is a compound sub- stance, and consists of resinous matter, slaphysagrin and del- phinia; the delphinia is obtained by treating the powder with ether, which takes up the delphinia, and leaves the staphysagrin. When in a state of purity, delphinia is white, pulverulent, and devoid of smell; but like veratria, when applied to the mucous membrane of the nose, it occasions sneezing, along with an abundant secretion of mucus. Its taste is at first bitter, and afterwards acrid, and it acts upon animals in the same manner as—but more energetically than—the seeds whence it is prepared. It is very * Annates de Chimie, torn. xi. xii., or Journal de Pharmacie, vi. 47 and 3G6. t Schweigger's Journal der Chimie, xxv. 369. t Formulaire, &c. § On the Medical Properties of the Natural Order Ranunculaceoe, chapter 11. Lond. 1835. 244 DELPHINIA. sparingly soluble in water, but yet in sufficient quantity to communi- cate a bitter taste to the fluid. In alcohol and ether it dissolves readily; and these solutions have the property of rendering 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,* delphinia 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 delphinia 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 introduced into the sto- mach of a clog, and retained there by a ligature placed around the gullet, efforts to vomit supervened, with restlessness, 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 delphinia 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 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 veratria. The preparations of delphinia have been used in the same dis- eases as those of veratria, and they appear to exert a similar ac- tion: the test laid down by Turnbull, in the case of veratria, ap- plies equally to delphinia;—namely, unless a solution of delphinia 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 burning, 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 delphinia differ from those of veratria in being generally more powerful and durable. * Nouveau Journal de Med. x.; and Toxicologic Gen. L 739. \ DIG1TALINA. 245 The diseases in which delphinia has been chiefly employed, like veratria, 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 delphinia, 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 veratria, but principally on account of the property it has "of exciting the circulation in the diseased part." MODE OF ADMINISTRATION. The manner of applying delphinia is the same as that recom- mended for veratria. It may be used either in the form of oint- ment or in solution in alcohol; and the proportions to be em- ployed, 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 be regulated in the same manner, or it should be con- tinued until the pungent sensation, produced by the rubbing ex- hibits itself. LXVII. DIGITALINA. Synonymes. Digitalin, Digitalia, Digitalinum, Digitaline. French. Digitaline. German. Digitalin. The active principle of digitalis was supposed to have been separated by Le Royer, and by Lancelot;* yet these substances excited but little attention either from the pharmacien or the physician. Recently, however, the labours of MM. Homolle and Quevenne would seem to have separated it, and, it has received much notice, especially from Bouchardat,f who has entered fully into its pharmaceutical and remedial properties. METHOD OF PREPARING. The following formula is given by M. Bouchardat.:): One kilo- gramme (about 2rbs Soz.) of dried digitalis leaves of the year, coarsely powdered and previously moistened, is put into a displace- ment apparatus furnished with its plug of carded cotton, and is treated with cold water so as to obtain a concentrated solution. The liquid must be immediately precipitated by a slight excess of subacetale of lead, and be thrown upon a filter, vvhen it will pass * Pereira, Elements of Mat. Med. and Therap., 2d Amer. edit. ii. 297, Philad. 1846; and art Digitaline, in Merat and De Lens, Diet, de Mat Med. t Annuaire de Therapeutique et de Mat. Med. &c, pour 1845, p. 60. Paris, 1845. X Op. cit p. 69. 246 DIGITALINA. through limpid and colourless. A solution of carbonate of soda is now added until a precipitate is no longer thrown down ; and the filtered liquor is deprived of the magnesia, which it still retains, by phosphate of ammonia. The filtered solution is again precipi- tated by tannic acid in excess, and the precipitate, collected on a filter, is mixed, whilst still moist, with one fifth of its weight of powdered oxide of lead (litharge.) The resulting soft paste, placed between unsized paper, dried on a stove and pulverized, is ex- hausted by concentrated alcohol in a displacement apparatus. The alcoholic solution, deprived of colour by means of animal char- coal, leaves as a residue of evaporation, a granular yellowish mass, which, when washed with a little distilled water, drained and treated by boiling alcohol, suffers the digitalis by evaporation to be deposited on the parietes of the capsule under a granular mamelonated form.* When drained and dried, the digitalis ought still to be twice treated with boiling concentrated ether, which separates from it, among other substances, a white crystalline matter, traces of green matter, and an odorous principle.t Digitalin is a neutral product, not an alkaloid,as said by some;| having the appearance of a white powder; a confused or amor- phous crystallization, and is but little soluble in water; insoluble in ether, but very soluble in alcohol; and of an intensely bitter taste, so much so, that the 15th of a grain is sufficient to com- municate a decided bitterness to two quarts of water. When diffused in small quantity in the air, it causes violent sneezing. It is not susceptible of any combination with acids or bases. EFFECTS ON THE ECONOMY IN HEALTH. MM. Bouchardat and Sandras^ injected into the subcutaneous veins of the abdomen of a robust dog one tenth of a grain of impure digitalin dissolved in a few drops of alcohol and about two fluid- ounces of water. Scarcely was the dog untied, when it made several attempts to vomit; walked in a straggling manner, like an intoxicated individual; evacuated the bowels with much straining, and in a few minutes fell down. Whenever it was raised up, it staggered, and renewed its efforts to vomit. During this time, the pulsations of the heart exhibited the greatest irregularity in their rhythm. The pulsations were jerking (brusques) and strong; several of them succeeding each other rapidly, and then a manifest interval occurring. The number of pulsations, which in the nor- mal state was from 100 to 120 a minute, was reduced to 36 or 40. The dog died at the expiration of four hours. The whole venous system was found gorged with black blood, the clots of which dis- * See farther, on the preparation, &c. of this substance, Bouchardat, Annuaire de The- rapeutique, pour 184G, p. 89. Paris, 1846. t Oesterlen, Handbuch der Heilmittellehre, S. 769. .Tubingen, 1845. X Bouchardat, Op. cit. p. 60. DIGITAL1NA. 247 tended the principal veins. There was no other appreciable disorder. In another dog, pure digitalin furnished by MM. Homolle and Quevenne was injected in the same quantity and dissolved in the same manner into the external jugular vein. The animal walked for an instant as if giddy; it then stopped and suddenly fell; the pulsations were slow, unequal, and about 40 per minute. The dog died in about a minute and a half after the injection. No appre- ciable disorder was observed on dissection. Other experiments were made by administering digitalin by the mouth, and the same phenomena ensued. They injected it also into the venous system of animals, and they conclude from the whole of their experiments, lhat digitalin is unquestionably an ex- cessively active substance, especially when pure. It modifies in a singular manner the circulation, and is capable of exciting intense irritation of the digestive organs, when taken by the mouth. EFFECTS ON THE ECONOMY IN DISEASE. Having satisfied themselves as to the energy and modus operan- di of digitalin, it became important to obtain its sedative effects on the circulation, without its acrid action on the digestive organs. By means of mucilage and marsh-mallow powder, MM. Bou- chardat and Sandras made pills, each of which contained a demi- centigramme (the 10th part of a French grain) of digitalin. These pills they gave under their own eyes to patients to whom a retarda- tion of the circulation might be useful, and where there was nothing dangerous to be apprehended from the use of an agent capable of irri- tating the digestive tube. In all, the pulse was markedly retarded ; and irregularity was induced. In only one case were they told of any increase in the urinary secretion. When the toxical effects appeared, they were indicated by disorders of the senses, distur- bance of the head, distressing dreams, and hallucinations, vvhich were soon followed by diarrhoea, or more or less bilious vomiting. When these phenomena appeared, the digitalin was stopped, but in spite of every precaution, the vomiting continued at times for two or three days. It would appear from these observations that digitalin represents digitalis in all its active properties,and thatitmay beadministered in every morbid condition in vvhich the plant has been found ser- viceable. By employing it—as properly remarked by MM. Bou- chardat and Sandras—the physician always knows exactly the quantity of the active principle which, he administers. When applied endermically, its action is so irritating that it can scarcely be used in that manner.* * See, also, Bouchardat, Annuaire, &c, pour 1846, p. 92. 248 DIGITALINA. MODE OF ADMINISTRATION. Comparative trials satisfied M. Bouchardat* that 4 milligrammes (gr. 0616 Troy) of digitalin, correspond in energy of action with about 40 centigrammes (gr. 6. 176 Troy) of powdered digitalis, prepared with the greatest care. It is a hundred fold stronger than the most active preparation of digitalis. The following formulae have been recommended-! Pilulae digitalinae. Pills of Digitalin. R. Digitalin. gr. .7720 (5 centigrammes.) Acaciae pulv. Mucilag. acacise, q. s. ut fiant pilulae xx. Dose,—1 to 4 daily in hypertrophy of the heart. Bouchardat. Granula disritalinse. Granules of digitalin. R. Digitalin. gr. 1544 (1 gramme.) Sacchar. giss. (50 grammes.) Make into one thousand granules like comfits. Each of these contains a milligramme (gr. .0154) of digitalin. Dose. Four to six in the 24 hours. Homolle fy Quevenne. Syrupus digitalinae. Syrup of digitalin. R. Digitalin. gr. iss. (10 centigrammes.) Syrupi 02| (1500 grammes.) Dissolve the digitalin in alcohol, and add the syrup. In every 15 grammes (40 grains) of the syrup there is a milligramme (gr. •0154) of digitalin. Dose, four to six spoonfuls in the day, or in some appropriate infusion. Homolle fy Quevenne. Mistura digitalinae. Mixture of digitalin. R. Digitalin. gr. -0770 (5 milligrammes.) Aquee lactuca? %\u\ (100 grammes.) Syrup, fior. aurant. gviss. (25 grammes.) Dissolve the digitalin in a few drops of alcohol; then add the distilled water and the syrup. To be taken by table spoonfuls in the 24 hours. • Homolle # Quevenne. Unguentum digitalin&s. Ointment of digitalin. R. Digitalin. gr. -770 (5 centigrammes.) Dissolve in a few drops of alcohol at 22° (s. g. -923;) and incor- porate in lard (axonge balsamique) 10 grammes (3iiss.) * Op. cit p. 77. 1 Bouchardat, Op. cit. p. 76; and Nouveau Formulaire Magistral, 3eme edit. p. 237. Paris, 1845. DI0SMA. 249 LXVIII. DIOS'MA. Synonymes. Diosma Crenata (folia;) Barosma Crenata (folia;) Agothosma Crenatum (folia;) Bocchoe, Bocho, Boocho, Buckha, Buchu Leaves. French. Diosmee crenelee. German. Buccublatter; Duftstrauchblatter. Diosma crenata is indigenous at the Cape of Good Hope. It belongs to the Natural Family Rutaceae; Sexual System Pentandria Monogynia. The smell of the leaves is penetrating and peculiar, but resembling that of rue and camphor. By some, it has been compared to that of oil of juniper; by others, to rose- mary; by others, to cumin, and by the others, again, to that of the urine of the cat. The name is, therefore, by no means expressive. It appears to be derived from the smell,—Sioj, "divine," and ogfiy, "odour." The taste of the leaves is aromatic; somewhat pungent; and, in the opinion of Buchner, resembling that of peppermint; without any particular bitterness, yet disagreeable. According to the analysis of Buchner, Brandes, and Cadet, the most important constituents appear to be a volatile oil of a greenish-yellow colour, a peculiar principle—diosmin, and a semi-resinous substance. Diosmin is a very tenacious adhesive matter, similar to 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 colour, becomes fluid when heated, and burns with a flame. Its odour is not remarkable; the taste is somewhat pun- gent 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 prefe- rence to 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- cote than for any thing else. In Germany, it was chiefly promul- gated by Jobst, who published an extract from Reece's obser- vation in the Repertorium of Buchner.j* Bardili instituted ex- periments for testing its action on the healthy organism. It first acts—he says—as an excitant on the stomach, whence arises a feeling of increased heat in that organ, and the appetite becomes augmented: from the stomach, the excitement spreads to the vas- cular system; the heat of the body is increased; the pulse becomes more frequent, and the transpiration is favoured. It acts, like- wise, on the urinary secretion; the urine is separated in larger * See Journal de Chimie Medicale, iii. 13, and Journal de Phannacie, xiii. 106. t Band. xxii. S. 51. , 250 DIOSMA. quantity, contains flocculi, deposits a purulent (?) sediment, and exhales an aromatic odour. On the digestive 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 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 gout. Autenrieth extols it in rheuma- tic pains, which have had their foundation ,in repelled itch (?); and its utility in chronic rheumatism has been confirmed by numerous others. It has been extolled, moreover, in hsematuria, calculous pains, and in irritated and suppurative conditions of the bladder, urethra, and prostate. The author has repeatedly administered it, but has observed no other effects than those of a moderate excitant and tonic* Reece says he found it efficacious in incontinence of urine, and in catarrhus vesicae; and he gave it—united with tincture of cubebs—in spasmodic stricture of the urethra, gonorrhoea, swelling of the prostate, and impotence. At the Cape of Good Hope, buchu leaves are often applied ex- ternally, in the form of liniment and baths, as well as of fomen- tations and cataplasms, in luxations and rheumatic pains,—and in wounds, especially the contused. It may be remarked, that this—like almost every similar re- medy—has been given in cholera; and, as the Riga physicians assert, frequently with favourable results. MODE OF ADMINISTRATION. 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 diosmin: as respects their action, how- ever, there is not much difference. A vinegar, oxymel, liniment, extract, and tincture of diosma have been advised. The London, Edinburgh, Dublin, and United States Pharmaco- poeias have an Infusum DiosMiE (gss. of the leaves to Oss. of water, Pharm. U. S.;) dose, f.giss: and the Dublin, a Tinctura Buchu (gij. of the leaves to Oj. of proof spirit;) dose, f. Jij. or f. Jiij. Infusum diosma compositum. Compound infusion of buchu. R. Diosm. Uvae ursi, aa. gss. Aq. bullient. Oss. Digere leni calore in vase clauso per semihoram. Colaturee adde Syrup, seneg. f. gss. * See his Genera^Therapeutics and Materia Medica, 3d edit. ii. 297. Philad. 1S4C. electro-magnetismus. 251 > Dose.—One or two spoonfuls every two hours, in blennorrhaza, and in atony and paralysis of the bladder. Clarus. R. Infus. diosmae, f. gvij. Tinct. diosmEe, ----Cubebae, aa. f. gss. M. Dose.—Two table spoonfuls three times a day. This formula is recommended b}^ Dr. Joy* "in chronic diseases of the pros- tate, bladder, kidneys, gravel, &c," as if the pathological con- dition to be rectified were, in all these cases, identical! ELECTRICITAS, see MAGNETISMUS. LXIX. ELECTRO-MAGNETISMUS. Synonymes. Electro-magnetism. Magnetic Electricity. Electro-magnetism has been recently introduced amongst the- rapeutical agencies adapted for the same cases as electricity and galvanism. Various forms of apparatus have been designed; but, perhaps— as Dr. Pereira has remarked!—the most convenient, simple and powerful is the magneto-electric machine of Mr. E. M. Clarke, of London; which consists of a battery of six curved permanent mag- nets, and an intensity armature, around whose cylinders 1500 yards of fine insulated copper wire are coiled. The ends of this wire communicate respectively with a pair of directors, each holding a piece of sponge, dipped in vinegar, or a solution of common salt. When the armature is rotated, and a portion of the body is in- terposed between the directors, a succession of shocks is ex- perienced. As this machine is not affected by the moisture of the atmosphere, and acids are not required to excite it, it is possessed of advantages which the galvanic battery has not. EFFECTS ON THE ECONOMY IN DISEASE. Electro-magnetism has been employed in all cases on vvhich vol- taic electricity has been deemed advisable. Mr. E. S. Clarke, who applied it in the wards of Dr. Graves at the Meath Hospital, states that he found it act more quickly in neuralgia% than in any other disease. Some varieties it removed in two or three applications, but others often required a feeble electro-current for many succes- sive days. Next in order of facility came " rheumatic and sciatic cases; then cases of deafness; after those, some varieties of cata- menial suppression. It also acted readily on certain curable forms of amaurosis; then in partial paralysis, and with greater * Tweedie's Library of Medicine, v. 311. London, 1840; or 2d American edit. vol. iii. Philad. 1842. t Elements of Mat Med. and Therap., 2d Amer. edit. p. 83. Philad. 184G. X Graves, System of Clinical Medicine, p. 434. Dublin, 1843. 252 electro-magnetismus. difficulty in hemiplegia than in almost any other form." Dr. Golding Bird,* and Dr. Neliganf too, have found electro-magnetic currents of immense advantage in many forms of paralysis. An anomalous case belonging to the neuroses was laid before the Sheffield Medical Society; and a summary of it given by Mr. Law.:}: A lady, 51 years of age, had suffered from neuralgia of the right inferior maxillary nerve, when she was suddenly seized with vomiting, fainted, and lost power over the arms when in the upright, but not when in the recumbent posture. Soon afterwards she found it impossible to swallow, and the sickness subsided: after this she had paralysis of the left side of the face, and of the right arm and leg. Nothing could be introduced into the stomach exceptthrough an oesophagus tube. Electro-magnetism was applied to the back of the neck and chest in the course of the oesophagus, to the left side of the face, and from the spine in the course of the nerves to the right arm and leg. This was done for one hour at least three times a day for a month, and afterwards three a day. Nutritious and stimulating substances were passed down into the stomach, and quinia and other tonics were ad- ministered. Under this management she completely recovered. " With respect to the treatment," says Mr. Law, " the writer doubts whether the electro-magnetism is entitled to the credit of having effected the cure; or whether this should be attributed to the quinine, stimulating tonics and great attention which was paid to the digestive organs. Paralysis occasionally terminates favoura- bly quite irrespectively of medical treatment, and the acknow- ledged obscurity in which the proximate cause, in the case under consideration, was involved, demands especial caution in assign- ing to each of the various means employed in the treatment its due share of credit. It is by no means impossible, that the electro- magnetism, instead of having carried off the complaint, retarded the cure, and that this was ultimately accomplished by nature as- sisted by the general treatment. Until a series of cases treated with, have been contrasted with a parallel series treated without, electro-magnetism, it would be unphilosophical to pronounce a decided opinion on this principle as a curative agent in paralysis. Although the writer has employed electro-magnetism in a variety of cases during the last twelve months, yet he has hardly been able to verify a single observation of any one of its numerous and zealous advocates. Dr. Shearman used either the negative or posi- tive pole, as chance directed. Now, Retter asserts, that the former diminishes, whilst the latter augments the powers of life; and J. D. Humphreys, medical galvanist, with Chas. Woodward and others, says, that the positive pole exerts a salutary influence, by exhilara- * London Lancet, June 13,1846, p. 649. t Lond. and Edinb. Monthly Journ. of Med. Science, April, 1846; or Braithwaite's Retrospect, January—June, 1846, p. 39. Lond. 1846. X Provincial Medical and Surgical Journal, May 15, 1844; cited, also, in Braithwaite's Retrospect, ix. 89. New York edit. 1844. electro-magnetismus. 253 ting the spirits, and infusing feelings of energy and strength; while the negative "excites a sense of exhaustion and of irritation. These writers distinctly state, that the only effect of the negative pole, if applied to the seat of a disease, would be to aggravate its worst symptoms. How are these opinions to be reconciled with Dr. Shearman's belief, that he had cured his patient by the indiscriminate use of the oxidating and deoxidating electricities? Dr. Wilkinson. Dr. Hodgkin, Mr. Ware and Mr. Carpue, ascribed wonderful power to electro-magnetism in diseases affecting respiration, circulation, digestion and secretion. According to these gentlemen, there is hardly a complaint which it will not either cure or relieve, or an indication in therapeutics, which it will not satisfactorily fulfil. The writer can reconcile the discrepancies between the statements of authors and his own experience only by supposing, that the publications on this subject contain many errors. With respect, however, to the case under consideration, it is right to say the society generally agreed with Dr. Shearman, in ascribing the cure to electro-magnetism; and that Dr. Abercrombie speaks rather favourably of this agent." This case was doubtless one of the large class of anomalous nervous maladies, which require new nervous impressions, and a tonic system of medication. To fulfil the former indication, nothing could be more appropriate than electro-magnetism. Dr. Hays,* who, as remarked under Galvanismus, found gal- vanism the most useful remedy in certain cases of amaurosis which fell under his care, employed electro-magnetism in several cases in Wills Hospital, and in a number in private practice, but with- out its seeming to be productive of the slightest benefit in a single instance; whence he too hastily infers, that for remedial purposes a regular and constant galvanic current would appear to be more useful than the violent shocks produced by inter- rupted currents, such as are induced by the electro-magnetic ap- paratus. This is obviously a non scquitur, for the shocks may be diminished so as scarcely to be felt; and moreover, theory would suggest, and experience has shown, that there are numerous cases in which the excitant and revulsive effect of properly graduated shocks is more serviceable than the regular and constant current. Dr. Thomas Radfordf has employed galvanism with great suc- cess in the treatment of cases of uterine hemorrhage, accidental or unavoidable, accompanied by exhaustion, and occurring before, during, or after labour. He considers, from positive trial, that it will be found a most important agent in tedious labour, depending upon want of power in the uterus, and where no mechanical ob- stacles exist4 He also suggests the probability of its proving * American Journal of the Med. Sciences, Aug. 1840, p. 288. t Provincial Medical and Surgical Journal, Sept 18, 1844, p. 386. X See a case by Mr. Clarke, Dublin Hospital Gazette, March 1, 1845, cited in Braith- waite's Retrospect, January—June, 1846, p. 423. 17 254 ELECTRO-MAGNETISMUS. valuable in originating uterine action de novo in cases where it may be deemed necessary to induce premature labour; and that it may be worthy of trial in certain cases of menorrhagia in the ungravid state, where, on examination per vaginam, the uterus is found to be atonic, as evidenced by its large, flaccid condition, and the patulous state of the os uteri. His mode of applying it is as follows. Slight shocks are carried through the long axis of the uterus by means of a conductor introduced along the vagina to the os uteri, another being placed externally over the fundus. Shocks may be also passed transversely through the uterus by applying simultaneously the conductor on each side of the abdomen. The application must be made at intervals, so as to approximate, as nearly as possible, its effects to the natural labour pains; and be con- tinued so as to meet the exigencies of the case. Successful cases are related by Messrs. Thomas Dorrington,* and H. Wilson.f In a case of amenorrhea, electro-magnetism was used with suc- cess by Dr. Collins.^: He had applied the electro-magnetic ma- chine in some other cases with the happiest effects; and was in- duced to try it in this. He applied one of the buttons on the lumbar region of the spine, and the other in front over the pubic region, using the negative and positive poles alternately to the spine and abdomen; the remedy was continued five days, from five to ten minutes each day, when the catamenia were fully re-established. Dr. Collins adds, that he has used it with good effect in rheuma- tism. It has likewise been employed with success in amenorrhea and dysmenorrhea by Dr. Robert L. M'Donnell, of Montreal, and by Dr. Walkly, of Mobile. § The former prefers the apparatus sold under the name of the vibrating magnetic machine. When this is in operation, one of the buttons at the free extremity of the electrodes is applied by the physician to the lower portion of the spinal column, corresponding to the point of exit of the sacral nerves, and the other is applied by the patient herself, or by a female attendant, immediately over the pubes. In order to pro- tect the patient from the inconvenience of receiving the shock through the hand which holds the button, a thick glove should be worn. Having desired that one button be kept firmly pressed upon the os pubis, the physician commences by passing the other button along the spine from the occiput to the os coccygis. After this has been done slowly four or five times, the button is kept for five or six minutes immediately over the sacrum, and the electricity is thus passed in an uninterrupted current through the uterus. It is not necessary to put the patient to great torture by increasing the strength of the shocks. More benefit, according to Dr. M'Donnell, will be derived from an uninterrupted and steady * Provincial Medical and Surgical Journal, March 11 and 18 1840 t Ibid. April 29, 1846. X London Lancet, Jan. 25, 1845, p. 91. § New Orleans Med. and Surg. Journal, July, 1846, p. 52. ELECTRO-MAGNETISMUS. 255 transmission of a moderate current than by occasional shocks of great intensity. The current may also be sent transversely through the pelvis, by placing a button on each hip, above the great tro- chanter. Dr. Walkly* thinks electro-magnetism as a parturifacient far preferable to ergot, for the reason, that the pains induced by it are regularly intermittent as in natural labour, and hence not likely to injure either the mother or the child. The electricity may be applied by placing the negative electrode in a foot-bath with the feet, whilst the positive electrode is placed over the lumbar region, and a sucpession of shocks passed for from three to five minutes. The application of galvanism to induce and increase parturient contractions of the uterus has often, indeed, been proposed. It was suggested by Herderf in 1803, and by Dr. F. Ramsbotham in 1834,| but does not appear to have been employed by them. Several trials were instituted by Professor Simpson, of Edin- burgh, with the view of ascertaining the exact degree of influence which galvanism possesses over the contractile action of the uterus during labour, and consequently the amount of aid which may be expected to be derived from it in any case in which its assistance is had recourse to. His general results were not favourable to it. In one instance the pains were more frequent in their recur- rence, but shorter in their duration during the application of gal- vanism; in five other cases it neither increased the average fre- quency of the pains, nor their average duration. In one case, the pains ceased whilst the galvanism was applied, and returned upon its removal. In another, the action ceased whilst the galvanism was applied, and did not return on its withdrawal, nor for 24 hours afterwards. Professor Simpson concludes, that as employed at the present time and in its present mode, it is not a means which can be in any degree relied on to directly excite or increase the contractile action of the uterus; "and is so far practically and en- tirely useless as a stimulant to the parturient action of the uterus." An interesting case of poisoning from opium is recorded, by Dr. Thomas S. Page,§ of Valparaiso, in which electro-magnetism was successfully employed to cure the patient. The patient's breath- ing had becbme short and hurried; the mouth widely ex- tended and jaw fallen; nothing seemed capable of rousing him; the exhaustion was extreme; the pulse could be felt feeblv, at the wrist, and was maintained there, in Dr. Page's opinion, by the agitation which he had undergone. Electro-magne- tism was now applied. Whilst an assistant rapidly rotated the wheel, Dr. Page applied the balls at first to each side of the neck, * Op. cit t Diagnostische Praktische Beitrage zur Erweiterung der Geburtshulfe, Leipz. 1803, cited by Professor Simpson, in Monthly Journal of Medical Science, July, 1846, p. 33. X Simpson, Op. cit. § Amer. Journ. of the Medical Sciences, Aug, 1843, p. 301. 256 ELECTRO-PUNCTURA. and ran them down behind the clavicles. The arms and body now moved convulsively, but the patient lay as unconscious as before. He now passed one ball over the region of the heart, and the other to a corresponding point on the right side. In an instant his eyes opened, and with a ghastly expression of countenance his head and body were thrown convulsively toward Dr. Page, and he groaned. He now sank back into his reclining posture, and was again asleep. The balls were reapplied in the same situation with similar results a third and a fourth time, when he cried "no more!" Reaction was now positively established. Dr. Page suggests, that electro-magnetism will not only be found a most useful agent in cases like the above; but in highly congestive forms of disease, where oppression of the nervous sys- tem prevents reaction and speedily destroys life. In all cases of asphyxia he considers it will be useful, and believes that in very many instances it might be applied with the happiest effects in asphyxia neonatorum. LXX. ELECTRO-PUNCTU'RA. Synonymes. Electro-puncture, Electro-puncturation, Galvano-punctura, Galvano-puncture, Galvano-puncturation. Electro-puncture consists in a union of acupuncture with elec- tricity. The idea of the conjunction appears to have originated with Berlioz; but Sarlandiere was, doubtless, the first who put it in practice, although J. Cloquet has contested the priority with him—a matter, by the way, as in all such cases, of extremely small moment. The operation consists in employing acupunctu- ration in the usual way, either with a single needle, or with two or more; and making a communication between them and the prime conductor of an electrical machine in action; 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 a full shock. Sarlandiere appears to have em- ployed electro-puncture with great success, but he restricts its use to rheumatic or neuralgic pains, uncomplicated with organic mis- chief or inflammation: when such complications exist, he advises that bloodletting and general antiphlogistics should be premised.* Guersent thinks it better, in all these cases, to use simple acu- puncturation, and only to employ electro-puncture 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 vvhich * E. Grafe, art. Electro-punctura, in Encyclop'ad. Worterb. der Medicinisch. Wissensch. x. 550. Berlin, 1834. ELECTRO-PUNCTURA. 257 voluntary motion and sensibility were destroyed, has been pub- lished."* 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 electro-puncture 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 gradually returned; and, three months after his admission, the patient left the hospital completely cured. Galvano-puncture has likewise been used by M. Jobertf for the treatment of deafness dependent upon paralysis of the acoustic nerve. He introduces Itard's sound through the nasal fossae into the Eustachian tube; and into this sound a long thin acupuncture needle is passed, so as to fix itself in a point of the parietes of the tube, whilst the other extremity projects from the end of the sound. Another acupuncture needle is implanted in the membrana tympani. This being done, one of the conducting wires of a galvanic battery, the trough of which is filled with water and muriatic acid, is passed through the eye of one of the needles, and the end of the other conducting wire is made to touch the opposite needle. M. Jobert has used in the beginning eight pairs of plates of the battery; afterwards ten and twelve pairs, and as high as eighteen; and he asserts, that he has patients who have been acted upon by the entire pile, which contains forty pairs. At the moment the poles are placed in contact, there is a very painful shock in the ear and head, with convulsive movements; but the shock and pain usually cease immediately. In one patient, the impression wras felt for eight days; but it never exceeded a slight pain, and ceased of itself. When the patient was irritable, but one shock wTas given; but he has given two and even three shocks to persons whose sensibility was obtuse, and who had been already subjected to electro-puncture. In general, M. Jobert per- mitted eight days to elapse between each trial. He relates four cases of well marked deafness, which were completely cured, one after a single shock; another after two shocks; and a third after two sittings, each consisting of three galvanic shocks. The author has frequently used both electro-puncture and galva- no-puncture in rheumatic and neuralgic affections; but he does not think the advantages were more marked than those of simple acupuncture, whilst the suffering from the operation was certainly greater. Magendie regards electro-puncture as the remedy par excellence in the treatment of obstinate neuralgia.$ In rheu- * La Lancette Frangoise, Dec. 20, 1836; or Amer. Med. Intel., Oct. 16,1837, p. 265. t Cited from L'Examinateur Medicale, in Lond. Med. Gaz., June 2,1843, p. 356. ; Medico-Chirurg Rev. July, 1841, p. 202; or Dunglison's Amer. Med. Intel. Sept. 1841, p. 69. See, also, Dr. Shuster, cited in Lond. and Edinb. Monthly Journ. of Med. Science, June, 1844, p. 510; and Dr. Cowan, in Address before the Provincial Med. and Surg. Association, cited in Braithwaite's Retrospect, Amer edit. xii. 36. N. Y. 1845. 2 58 ELECTRO-PUNCTURA. matism, of the chronic form, it has afforded almost instantaneous relief; and M. Raciborski* has found it of essential advantage in cases of spraifis. Magendie affirms, that he has treated many cases of incomplete amaurosis with great success by galvano-puncture. He fixed a needle in the frontal nerve, and another in the superior max- illary, 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 experi- enced 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. In cases of asphyxia, galvano-puncture has been proposed to arouse the dormant energies. The effect of electricity, in the dif- ferent forms in which it is adopted in medicine, on the functions of sensibility and muscular contraction, could not fail to suggest it early to observers as a fit agent for this purpose: but it is rarely at hand, and, therefore, seldom available. J. P. Frank, Thillaye,t and others have highly recommended it;—the latter gentleman, on the strength of numerous experiments on animals. As the ob- ject, 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 much—if any—power to restore the action of the in- voluntary muscles. The author has 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 momentary. A necessary stimulating agency to that viscus is distention by the proper fluid, and unless the respiratory move- ments were restored, and conversion of venous to arterial blood effected, so that the latter could reach the left heart, the action of that organ could not be maintained. Every attempt, therefore, is properly made to restore the action of the respiratory muscles, so that haematosis may be accomplished.^ M. Leroy d'Etioles§ has suggested galvano-puncture in a man- ner vvhich, at the first aspect, appears most formidable; but vvhich is really less so than it seems to be, in consequence of the impu- * Cited in Southern Medical and Surgical Journal, July, 1846, p. 436. t Archives Generates de M6decine, xii. X Art. Asphyxia, by the author, in the American Cyclopedia of Practical Medicine, part x. p. 486, Sept. 1836; and in his Practice of Medicine, 2d edit. i. 424. Philad. 1844. § Magendie's Journal de Physiologie, tom. vii. 1827; torn. viii. and torn, ix.; also, Re- cherches Experimentales sur l'Asphyxie, Paris, 1829; and Bourgeois, Observations sur la possibilite duVetour a la vie dans plusieurs cas d'Asphyxie. Paris, 1829. ELECTRO-PUNCTURA. 259 nity with which fine needles can be made to penetrate, as has been seen,* even the most important organs. He introduced an acu- puncture needle on each side between the eighth and ninth ribs, 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 accom- plished. 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 respiratory acts were made to succeed each other, and regular respiration was reinduced. A continuous current was likewise employed in some cases; but the respiratory movements were ir- regular, and nothing like natural respiration resulted. Leroy tried his method on animals asphyxied by submersion, and when they had not been under water more than five minutes^ they were often restored. These experiments were witnessed by Magendie.f On diffe- rent occasions, M. Leroy asphyxied animals of the same kind, and apparently of the same strength, and while those that were left to themselves perished, those that were treated by galvanism re- covered. As an aid, therefore, to pulmonary insufflation, and an important one, galvanism,—combined or not with acupunctura- tion,—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 indispen- sable measures that are demanded.]: It has been recommended, that as only a very small apparatus is necessary, batteries, con- sisting of a few plates, might be kept wherever there are station- houses for the reception of persons in a state of asphyxia.§ 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 assistant is preparing the apparatus for action, the prac- titioner should be assiduously engaged in employing other means of resuscitation.|| In a paper read before the French Academy of Sciences, in January, 1843, Dr. ShusterlF reported the following conclusions as the result of his employment of electro-puncture in disease. First. Electricity is only useful as a therapeutical agent when in- troduced into the substance of the affected organs by means of acupuncture. Secondly. Galvanic electricity and the electro- * See art. Acupuncture, p. 53. t Journal de Physiologie, ix. X See art. Asphyxia, Op. cit p. 486. § Kay, in Edinb. Med. and Surg. Journ. xxix. and in his work on Asphyxia. Lond 1834. || See Most, art. Galvanismus, in Encyklop'ad. der gesammten medicin. und chirurgisch. Praxis, u. s. w. 2te Auflage. Leipz. 1836. U Op. cit. 260 ELECTRO-PUNCTURA. magnetic fluid, when employed by acupuncture, constitute the most powerful and harmless agents that we possess. Thirdly. The affections in which electro-puncture may be employed suc- cessfully are:—First. Hydrocele, ascites (idiopathic or sympto- matic of curable lesions,) hydrothorax, and articular dropsies. Its use may be extended to chronic hydrocephalus, dropsy of the pericardium, and the greater part of dropsical effusions. Secondly. Lipomatous, steatomatous, atheromatous, melicerous, serous and synovial cysts. Thirdly. Congestions and indurations, chiefly those of the lymphatic glands, of the testicles and epididymis, in- durations of the cellular tissue in the neighbourhood of cerlain kinds of ulcers, and in the walls of fistulous passages and certain indolent tumefactions; and there would be nothing irrational, he properly remarks, in attacking cancerous affections in the same way. Fourthly. Goitre. Fifthly. Varicose dilatations, especially vvhen electro-puncture can be aided by rest and compression; and he does not despair to employ it with advantage in case of aneu- risms and erectile tumours. Sixthly. Chronic rheumatism, neu- ralgia, and certain nervous diseases. Seventhly. Paralytic affec- tions in general, but especially those of the retina, (amaurose as- thinique,) and the muscles of the voice (mutisme paralytique.) M. Zenobi Pechioli* has detailed a case of double hydrocele, in which he employed electro-puncture. Two needles were in- serted, one into the upper, the other into the under, part of the tumour. These were connected to opposite poles of a voltaic pile, and the electric fluid was passed in a continued current for five minutes, when it had to be discontinued in consequence of the right testicle becoming painful. Five minutes after the re- moval of the needles, both hydroceles disappeared completely. -In the evening, redness and heat of the scrotum occurred, and the right side of the scrotum became oedematous. The operation was repeated in ten days, and was followed by a like result. Ten days afterwards, it was again resorted to, after which he had no return of the disease. M. Pechioli is of opinion, that the open- ings made by the common mode of acupuncturation are too small to allow the fluid to escape, and he thinks, that by passing a cur- rent of electricity through the hydrocele, the contained fluid is forced out through the sac into the cellular tissue of the scrotum, whence it is removed by absorption. M. Petrequin,f of Lyons, has applied electricity to the cure of aneurism in three cases. Two of these he had lost sight of before the influence of the treatment could be duly appreciated. In another case of aneurism of the temporal artery, galvano-puncture was performed by the introduction of two sharp steel pins crossing * Bulletin delle Scienze Medic, di Bologna, Sept. 1841; and Dublin Journal of Med. Sciences, Nov. 1842, p. 311. t Amer. Journ. of the Med. Sciences, Jan. 1846, p. 229; cited from Med. Times, Nov. 15,1845. EMETIA. 261 each other at right angles into the tumour; the heads of the pins were then placed in communication with the wires of a voltaic pile, and a shock and sharp pain were experienced, the pain in- creasing with the intensity of the electric action. The operation lasted ten minutes, and fifteen plates were employed. The pul- sations gradually diminished in the tumour during the operation, and at its close had entirely disappeared. No accident followed the experiment; and in ten days neither tumefaction nor pulsation could be detected in the spot where the aneurism had existed. M. Petrequin lays down the following precepts, an observance of which, he thinks, will ensure a complete coagulation of the blood contained in an aneurismal tumour. First. Compression of the artery between the aneurism and the heart during the application of the galvanic agency. Secondly. The pins introduced into the tumour should be numerous, cross each other at right angles, and their surface should be protected by a coat of varnish in order to prevent unprofitable loss of the electric fluid. Thirdly. After the operation, ice should be applied to the tumour. There can be no doubt, that electro-puncture is capable of ma- terially modifying the nutrition of the part on which it is prac- tised, and that it will, consequently, be found to exert power over morbid depositions, solid as well as fluid. LXXI. EMETIA. Synonymes. Emetina, Emeta, Emetinum, Emetium, Emetine. French. Emetine, La Matiere Vomitive. German. Emetin, Brechstoff. In the year 1817, MM. Pelletier and Magendie,* by a series of chemical and physiological experiments, discovered, that the vari- ous kinds of ipecacuanha are indebted for their emetic properties to a peculiar substance to which they gave the name Emetine. This substance possesses the emetic power in a very concentrated state, and has neither the disagreeable smell, nor the nauseous taste of ipecacuanha. They considered, therefore, that it might be advantageously substituted for ipecacuanha on all occasions. There are two varieties of the active principle—the coloured and the pure, which, as Magendie remarks,f bear the same rela- tion to each other as moist sugar does to the white and crystal- lized. Ipecacuanha, derived from Cephaelis ipecacuanha, contains the most emetia. Emetia has been received into many of the Pharmacopoeias, as the Parisian, Batavian, Hanoverian, &c. * Journal de Pharmacie, iii. 145; and Magendie's Formulaire pour la preparation de plusieurs nouveaux medicamens, &c. t Op. cit. 262 EMETIA. METHOD OF PREPARING. 1. Coloured Emetia.—Powdered ipecacuanha is digested in ether at 60° (.720) to dissolve the fatty matter, whence it derives its disagreeable odour, and which possesses no emetic virtue. When the powder yields nothing more to 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 ivater. 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 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 Viola odoruta, an active, alkaline, bitter and acrid principle, similar to emetia from ipecacuanha, which he de- nominates emetine of the violet, indigenous emetine or violine. Ac- cording to Orfila, it possesses highly poisonous qualities.* 2. Pure emetia.—This is obtained by substituting calcined mag- nesia for the carbonate used in the process just described, in such quantity, that the acid existing in the liquid may be neutralized, and that which is associated with the emetia be separated from it. The precipitate of magnesia and emetia must now be washed with a little very cold water, to remove the colouring matter, which is not combined with magnesia; and after being carefully dried it must be treated with alcohol, which dissolves the emetia. The emetia, obtained by the evaporation of the alcohol, must then be dissolved in a dilute acid, and treated with pure animal char- coal. After this purification, the emetia must be precipitated by a salifiable base. The waters, used to wash the magnesian precipitate, still contain emetia, vvhich may be separated by a se- cond series of operations. Coloured emetia 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 crystallizable. Pure emetia has a white and frequently a somewhat yellow- ish appearance; is pulverulent, and does not deliquesce, like the former, 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 neutralizing them. With the acids it forms crystallizable compounds, from which it may be precipitated by galls, which are the best agents for obviating the effects of emetia, when given in too large a dose. * Journal De Pharmacie, Janvier, 1824. EMETIA. 263 EFFECTS ON THE ECONOMY IN HEALTH. According to Magendie,* from half a grain to two or three grains of coloured emetia given to dogs and cats, excited vomit- ing, at times followed by long sleep. In larger doses,—ten grains, for example,—it occasioned, in dogs, repeated vomiting, after vvhich 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 through- out their whole extent. The effects were the same when the emetia was injected into the jugular vein, or absorbed from any part of the body. In a healthy man, two grains of coloured emetia, taken fasting, produced repeated vomiting, to which succeeded a 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 emetia 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 coloured emetia—as the pure is much too dear—in every case where it is desirable to excite vomiting, and especially where ipecacuanha is indicated. It has not, hovvever, been much used, except by Ma- gendie himself. M. Lerminier, who prescribed it, says that one or two grains of coloured emetia are equal in strength to from ten to twenty of ipecacuanha; but that he observed no difference in their operation, and Dr. Domeierf appears to have arrived at the same results. The obvious advantages it possesses are—the convenient and agreeable form under which it may be administered, and the circumstance, that several spurious sorts of ipecacuanha are fre- quently passed off' in commerce, and occasion, in consequence, considerable disappointment in the mind of the practitioner. The employment of the active principle of course precludes these in- conveniences. :£ Prollius, of Wolfhagen, has frequently administered pure emetia, which he recommends as a substitute for ipecacuanha, on the orounds 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 desired effects. MODE OF ADMINISTRATION. To produce vomiting, three grains of coloured emetia may be dissolved in any vehicle, and given in divided doses, at short in- tervals. In several cases, Dr. Domeier§ found one grain amply sufficient. Of pure emetia, Magendie found, in a man eighty-five * Op. citat t London Med. Gaz., Sept. 14, 1839, p. 929. X Clinique Medicale, vol. L Paris, 1823. § Op. citat. 264 EMETIA. years of age, one-sixteenth of a grain sufficient to induce vomiting. He remarks, however, that the man was easily made to vomit. Prollius found the medium dose ofpure emetia, 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 ne- cessary to give more than four-sixteenths, or one-fourth of a grain. As, on account of its sparing solubility, pure emetia, when given alone, might be restricted in its operation, Prollius adds an equal portion of tartaric acid, and a little sugar. Mistura emetise vomitoria. Emetic mixture of emetia. R. Emet. colorat. gr. iv. Infus. flor. aurant. f. gij. Syrup, flor. aurant. f. gss. M. Dose.—A dessert-spoonful every half hour,—to excite vomit- ing. Any simple distilled water and syrup may be substituted for those of the orange flowers. Magendie. Pastilli emetisB pectorales, Pectoral lozenges of emetia. R. Emetic colorat. gr. xxxij. Sacchar. giv. Mucilag. q. s. ut fiant pastilli, pond. gr. ix. sing. These lozenges are commonly coloured red, to distinguish them from those of ipecacuanha. A little carmine may be added for this purpose. Given in cases of catarrh, hooping-cough, chronic diarrhoea, &c. Dose.—One lozenge occasionally. Magendie. Pastilli emetise vomitorii. Emetic lozenges of emetia. R. Emetia? colorat. gr. xxxij. Sacch. gij. Mucilag. q. s. ut fiant pastill. pond. gr. xviij. singul. Dose.—One of these lozenges, taken fasting, is generally enough to make a child vomit: three or four are required for an adult. Magendie. Mistura emetise purificatse vomitoria, Emetic mixture of purified emetia. R. Emetiae purif.—in pauxil. acid. nitr. solut.—gr. j. Infus. flor. tilias, f. giij. Syrup, althaea?, f. gj. M. Dose.—A dessert-spoonful to be given every quarter of an hour, until vomiting is induced. ERG0TA. 265 LXXII. ER'GOTA. Synonymes. Secale Cornutum, Clavus Secalinus, Calcar, Secalis Mater, Semina Monstrosa Secalis Cerealis, Secale Luxurians, S. Clavatum, Ustilago, Clavus Siliginis, Spurred Rye, Corned Rye, The Spur, Ergot, Hornseed. French. Seigle ergote, Ble cornu, Clou de Seigle, Mere de Seigle, Bled avorte, B. farouche, Faux Seigle, Seigle cornu ou corrompu, S. a. eperon, S. ergotise, S. ivre, S. noir. German. Mutterkorn, Gebarpulver. Afterkorn, Schwarzkorn, Aetzroggen, Hahnensporn. The effects, which this substance is capable of exerting on the uterus, are so well known as not to need any lengthened descrip- tion. Its employment in parturition having been revived in this country, there are but few who are ignorant of its reputed proper- ties. Certain other effects have, however, been ascribed to it, in very recent times, which require mention. Spurred rye or ergot—the latter being the common name, from its "spurred" appearance*—is generally considered to be the result of a disease in Tye, occurring most frequently when a hot summer succeeds a rainy spring.f Decandolle, hovvever, 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 residing in the coating. This fungus he calls Sphacelia segetum. Brande refers it to the Natural Order Fungacese, and terms it Spermoedia clavus, and in the last edition of the London Pharmacopoeia, it is referred to Acinula clavus of Fries ;\ but, according to Lindley, Fries has no such plant in any of his works, and the only species of Acinula known, Acinula caRdicans, is found on the rotten leaves of the c'ommon alder, and among melting snowr; its organization is of another kind from that of thespermoedia; and Fries, who regards the other as a morbid state of the grain of certain grasses, regards acinula as a true fungus.§ M. Debourge considers, that ergot is an animal product from the telephorous family. The insect deposits a liquid of its own for- mation on a grain of rye and produces the ergot; whence it fol- lows, he conceives, that ergot may be produced at pleasure by ex- pressing this liquid upon all the grains of rye that are within a certain period of their*maturity.|| Mr. SmithlF and Mr. Quekett,** however, maintain that ergot is v French, ergot, " a spur." t Dr. Wright, Edinb. Med. and Surg. Journ., Jan. 1841. X Syst. Mycol. § 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 nf Schreber, De Geer, Parmentier, Buffon, Von Munchausen, Tessier, Zuckert, Rossig, Hube, Avmen, Robert, Tillet, &c., in Wright, op. cit. || Socieles Savantes, in Encyclographie des Sciences Medicales, Avril, 1838. it Transactions of the Linnean Society of London, xviii. Pt. 3, p. 449. Lond. 1840. ** Ibid. p. 453, and London Lancet, June 22,1839, p. 4R5. See also an abridgment of a communication read by Mr. Quekett before the Linnean Society, Dec 4, 1838, with 266 ERGOTA. not a fungus, but a diseased state of the grain occasioned by the growth of a fwngus not previously detected: to this fungus the latter gives the name Ergotielia* abortans or Ergotastia abor- tifaciens. By the microscope, they discovered sporules, sporidia, or jointed bodies, which appeared to be the reproductive particles of the fungus. Mr. Francis Bauer,f who has made ergot a subject of parti- cular study, and wdio, about thirty years ago, undertook, 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 question 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 observers, are the cause or the consequence of the ergot:—because, first—every gramineous plant is equally infected with that minute filamentous fungus, yet very few of these plants produce ergots; and amongst agricultural grains, the rye is the only one that is subject to the disease; and secondly, in autumn all decaying plants are infected with such filamentous fungi and minute sporidia. Mr. Bauer's investigations led him, however, to determine the ergot to be a morbid condi- tion of the seed. Ergot is in*grains, from a third of an inch to an inch and a half long, and from a line to three lines in diameter, usually curved like the spur of a cock, having commonly two longitudinal fur- rows, and often irregularly cracked and fissured. Externally, it is of a dingy-purple hue; internally, of a pale grayish-red or gray- ish-white. Its odour is peculiar, fishy and nauseous; taste ob- scurely acrid and disagreeable. Unless excluded from the air, it swells and softens, acquiring a deep black colour and heavy smell; and becoming infested by a little acarus, which is about one-fourth the size of the mite of cheese, and destroys the interior of the er- got, leaving the grain as a mere shell. In four months, seven and a half ounces of fecal matter of the acarus were formed from seven pounds of ergot.J The powder becomes quickly damp, and full of animalcules. It ought, therefore, to be fresh: certainly not to be kept for a longer period than two years. To prevent the formation of the parasites, Mr. Rowle§ keeps a small piece of camphor in the stopper bottle which contains the ergot. This soon annihilates the whole race of insects, and adds gently to the certainty of the effect of the medicine. This plan had illustrative wood-cuts, in American Journal of Pharmacy, for July, 1S39, p. 116. For re- marks on an insect met with in the diseased grain, see a paper by Mr. Muller, of Butler county, Pa., with comments by Dr. Carson, in Amer. Journal of Pharmacy for Jan. 1839. p. 2b!J. * From ergota, and curia, "cause." t Transactions of the Linnean Society of London, xviii. Pt. 3, p. 481. Lond. 1840. X Pereira. Elements of Mat. Med. and Therap. ii. 910. Lond. 1842; or 2d Amer. edit. by Dr. Carson, Philad. 181(5. § Lond. Lancet, Aug. 10, 1844 ERGOTA. 267 been recommended before by Dr. Bright.* It has been advised that the camphor should be mixed with the ergot, in the propor- tion of a grain to a scruple.f It has been proposed to dip the dried ergot in a concentrated solution of gum Arabic; to dry this on a plate of white iron; and when it is dry, to repeat the process two or three times; keep- ing it afterwards in a well stopped bottle.:}: A recent wrriter§ has advised the following method for preserving it in good con- dition for several years. First. To reduce fresh well dried ergot to powder. Secondly. To expose the powder to a temperature of 112° or 120° Fahrenheit, in order to dry it thoroughly and quickly. Thirdly. To put it into glass bottles not exceeding a hectogramme, (about three ounces) in size, and seal them herme- tically. Fourthly. To withdraw it from the action of light by shutting it up either in a dark place, or by covering the bottles with black paper. Mr. R. M. Nunn, of Wexford, extols the following plan of pre- servation, of which he speaks from experience. j| Procure a choice specimen of ergot; reduce it to powder; have in readiness a suffi- cient number of two dram bottles; into each bottle put one dram of sulphuric ether, (alcohol may do as well) and then press in two drams of the powdered drug: (if the bottles are of the proper size a slight pressure will be necessary to make them hold this quantity:) then cork well, and either seal with wax or cover with bladder. When required for use, put the contents of one of the bottles into a tumbler; and pour on them a small quantity of boiling water: violent effervescence takes place, which speedily subsides, and during which the ether is evaporated. As much boiling water may then be added as is necessary. It is instantly fit for use. As it is important to judge between a good and a bad specimen of ergot, Dr. Wright remarks,1T that if it-be clear and smooth on the surface; not powdery; of a deep purple colour; neither entirely black nor light brown; having a full strong odour; breaking clear- ly; 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. It has been affirmed, as the result of actual trials, that ergot picked from growing rye is much more powerful than that which is gathered on the barn floor after the grain has been threshed.** * Edinb. Med. and Surg. Journ. No. 141, and Lond. Lancet, Aug. 24, 1844. t Mr. Simpson, Lond. Lancet, Sept 7, 1844. X M. Martin, Journ. de Chim. Med. Avril, 1841. § V. Legrip in. Journal de Chimie Medicale, cited in Lond. and Edinb. Monthly Joum. of Med. Science, April, 1845. || London Lancet, cited in Med. Examiner, Oct. 19, 1844, p. 251. 11 Edinb. Med. and Surg. Journ. Oct 1839, p. 296. " Bottcher and Kluge, cited by Christison, Dispensatory, p. 414. Edinb. 1842. 268 ' ERGOTA. EFFECTS ON THE ECONOMY. The effects produced on the animal economy by 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 for- mication 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 gan- grene—constituting gangrenous erethism or mildew mortifica- tion.* These, however, are the toxical, not the therapeutical effects of the agent.f The extraordinary property, ascribed to ergot, of assisting the parturient efforts, has long been credited in Germany. Its old German names, Mutterkorn ("wombgrain") and Gebdrpulver ("parturientpowder,"pulvis adpartum,) are sufficientevidences of this notion; but, for along time, this was rather a matter of popular than of scientific belief, although the "pulvisparturien- tis" of the Marburg Pharmacopoeia consisted principally of ergot.:}: About forty years ago, it was 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 internal agent administered as an abortive—it ought to be esteemed rather indirect than direct in its action. Such is the decided opinion of Jorg,§ 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 obser- vations, that there is no "farther connexion between these dege- nerate grains and the uterus, than the word Mutter (' uterus') which is common to both." From his various and varied experiments, Dr. J6rg infers, that ergot, when given in small doses, produces little or no effect upon the functions; but that vvhen fresh dried in an oven, and administered in large doses, it oppresses the stomach, * See articles, Convukio cerealis, and Ergotism, in the author's Medical Lexicon, Philad. 1843; also, his Therapeutics, p. 272, Philad. 1836; or his General Therapeutics and Mat. Med. 3d edit, ii., 198. Philad. 1846. t See Christison on Poisons, 3d edit chap. xl. Dr. Wright, op. cit. p. 307, and Jan. 1840, p. 9. X Dr. Wright, op. cit. p. 22. See, on the history of Ergot, Ramsbotham, Principles and Practice of Obstetric Medicine and Surgery; appendix, Amer. edit. Philad. 1845. § Dass der Gebrauch inner Reizmittel zur Beforderung der Geburt des Kindes unnothig, fruchtlos, und gesunden Frauen sogar schadlich sei; u. s. w. S. 40. Zeit. 1833. See, also, Pereira, op. cit. p. 919, and M. Bonjean, in Rapport de MM. Bussy, Pelletier, Dubail, Fremy pere et F. Boudet, in Journ. de Pharmacie, Fevrier, 1842, p. 175. ERGOT A. 269 occasioning nausea, vomiting, colic, liquid evacuations; destroys the appetite, and injures 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 be- tween the foetus and the uterus may be modified, and that abortion may take place. The author has caused various experiments to be instituted • with ergot in doses of half a dram and a scruple of the pow- der, and in the form of the oily matter referred to below. These experiments were made on both males and females; and the ge- neral effects were those described by Dr. Jorg;—when the dose was too large, nausea or vomiting often resulting, with signs of nar- cosis. They were made, at the author's desire, by Drs. Cottman and M'Kee, at the time resident physicians at the Philadelphia Hospital.* A case of narcosis, produced by this drug, in-the dose of thirty grains—administered for the purpose of restraining a real or supposed tendency to hemorrhage after the expulsion of the placenta—was communicated to the author by Dr. Beckwith, of Raleigh, North Carolina.t When examined by the microscope, its internal structure is found to consist of minute roundish cells, many of vvhich contain particles of oil. The bloom seen, at times, on its surface, seems to be composed of the sporidia of the fungus, to which it is be- lieved by many to owe its origin.! Chemical analysis has thrown no light on the cause of its pro- perties. According to the analysis of Vauquelin,§ ergot contains a colouring matter of a yellowish hue; a white oily matter; a vio- let-colouring matter insoluble in alcohol; a free acid, which is in part phosphoric; a very abundant vegeto-animal matter, vvhich 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 ; fixedoil; an alkaline acetate; but neither starch, hydrocyanic acid, narcotina, nor phosphoric acid, which some had discovered in it.IT It has likewise been * Dunglison's Amer. Med. Intelligencer, Sept. 1, 1839, p. 161. See, also, M. Cordier, in Journ. Gen. de Med. Avril, 1823, and Dr. C. T. De Gravina, in Annali Universali di Medicina, Ottobre, 1839, cited in Brit, and For. Med. Rev. Oct. 1840, p. 555. t Dunglison's Amer. Med. Intelligencer, Oct. 15,1839, p. 213. See, also, Trousseau and Pidoux, Traite de Therap. L 546, Paris, 1837. X Christison, Dispensatory, p. 411. Edinb. 1842. § Memoir, du Museum, iii. 198, Paris, 1817. || Bulletin des Sciences Medicales de Ferussac, xix. 332; and Merat and De Lens, Diet. de Mat. Med. art Ergot. TT For Mr. Battley's Analysis, see Lond. Med. Gaz., Feb. 1831, and for that of Wigger's, Lancet, Nov. 10, 1832, cited from Allgem. Med. Zeitung. 18 270 ERGOTA. analyzed by Bonvoisin, Pettenkofer, Winkler, Robert, Wiggers,* Legrip,t and others. The analysis of Wiggers is very elabo- rate. The results were,—a thick white oil, 35.000; white fatty matter, 1.0456; cerin, 0.7578; fungin, 46.1862; ergotin, 1.2466; osmazome, 7.7645; sugar, 1.5530; gum extractive and colouring matter, 2.3250; vegetable albumen, 1.4600; phosphoric acid and phosphate of potassa, 4.4221; phosphate of lime and traces of iron, 0.2922; silica, 0.1394. Dr. Wright's* analysis furnished him with the following constituents and their proportions in 100 parts of ergot; thick white oil, 31.00; osmazome, 5.50; mucilage, 9.00; gluten, 7.00; fungin, 11.40; colouring matter, 3.59; fecula, 26.00; salt, 3.10; loss, 3.50. Ergot appears to him to differ from sound rye, chiefly in the presence of oil, osmazome and fun- gin. He gives the following process for preparing the oil of ergot.§ Digest ergot in liquor potassae, at a temperature of from 120° to 150°, until a perfeet saponaceous mixture is formed. The liquid must then be diluted with half its weight of water, be accu- rately neutralized by sulphuric acid, and submitted to distillation from a salt-water or oil bath. The product is white, adhesive, and fatty-looking, almost free from empyreuma, and nearly tasteless. The readiest and best, but most expensive mode of obtaining it, is to pass ether through ergot in fine powder by the process of displacement. By allowing the ether to evaporate spontaneously, the oil is left in its purest form.|| This Dr. Wright con- siders to be the active matter of ergot; and he states—as the re- sult of positive experiment—that it has the same effect in inducing powerful uterine contractions as ergot itself. Dr. Hooker, of New Haven,1T found, that when a quantity of pulverized ergot was macerated for several days in sulphuric ether, and the liquid evaporated in a glass vessel until it no longer afforded a smell of ether, there remained at the bottom of the vessel a small quantity of thick heavj' oil, resembling in appearance fish oil; above this was a lighter oil, much more abundant than the former, of a light reddish brown colour, and of a sweetish nauseous taste. This light oil was found to be pos- sessed of decidedly narcotic properties. In two experimental cases, the effects of ergot continued apparent for nearly a week; the pupils of the eye were dilated; the pulse, respiration, and capillary action were very slow, and the skin livid, — with loss of appetite, general languor and lassitude, and rigidity and sore- ness of the muscles; those of the thighs and other parts of the lower extremities being more particularly affected. For three * Wright, Edinb. Med. and Surg. Journ. Oct. 1839, p. 298. t Bouchardat, Annuaire de Therapeutique, pour 1845, p. 41. Paris 1845 t Op. cit § Edinb. Med. and Surg. Journal, July, 1840. || A. Duhamel, Amer. Journal of Pharmacy, July, 1841, p. 95. 11 Boston Med. and Surg. Journal, x. 298, Boston, 1837. ERG0TA. 271 days, the pulse continued below fifty, with a proportionate infre- quency of respiration.* In the experiments made with this substance by Dr. M'Kee,f 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. The sedative properties were equally exhibited in experiments insti- tuted on the healthy individual by Dr. Q. Gibbon,^ Salem, New Jersey, with the decoction, extract, and oil. The experi- ments of Dr. Gravina,§ led him to infer that ergot is a direct seda- tive, like digitalis, and hence he considers it a good antiphlogistic remedy, and well calculated to lower the vital powers. An ethereal solution has been prepared by Dr. Rees, by digest- ing four ounces of powdered ergot in four fluidounces 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 fluidounces 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 preparations of ergot not un- frequently produce acro-narcosis, he has not once seen these symp- toms supervene on the use of the ethereal solution. He thinks they are most probably caused by some constituent 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 considered equivalent to two ounces of 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 ergot is capable of producing the acro-narcotic effects described above,1F their supervention is not desired by those, who regard it to be possessed of peculiar powers by which it causes contraction of 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 contractions constant and almost unremit- ting ; but there is no accompanying disorder. Cases are on record** in which it has appeared to induce rupture of the uterus, where * See Dunglison's Amer. Med. Intelligencer, Dec. 15,1837, p. 329. t Ibid. Sept 1,1839, p. 161. X Amer. Journal of the Med. Sciences, Jan. 1844, p. 244. § Op. cit || Lond. Med. Gazette, April 10,1840, p. 108. TT Bonjean, cited in Bouchardat, Annuaire de Th6rapeutique, pour 1843, p. 85. Paris, i843. ** M. Delmas, Journal de Medecine de Montpellier, and Journal de Pharmacie, Juin, 1842, p. 54C. 272 ERGOTA. the obstacles to delivery were invincible. It has been largely administered, and in no country, perhaps, more than in this: prac- titioners of the greatest eminence—here and elsewhere—have placed the fullest reliance on its powers to excite contraction of the uterine fibres, and although 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 compelled to admit, that ergot is possessed of ex- pulsive 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 par- turition has commenced, is denied by many. It has been lately affirmed, indeed, that in the neighbourhood of Trois Croix, in France, there was, during the season of 1841, an epizootic abortion amongst the cows, which had produced much consternation amongst the farmers; and that M. Bodin,* director of the school of agricul- ture, had discovered, that the grains of rye, and of many other of the gramineae contained a considerable quantity of ergot. This he concluded was the cause of the epizootic. On the other hand, the experiments of Dr. Wright,t and of Dr. De Gravina, J seem to exhibit the singular fact, that ergot appears to have the power of prolonging gestation in the guinea pig and rabbit, when ad- ministered for a considerable period !§ The result of all observa- tions 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, ad- mitting the full power ascribed to ergot in these cases, it can be rarely necessary to have recourse to it; and it is doubtless often employed, where the propriety of the administration of it, or of any other agent, is extremely questionable. A recent writer, who places the discovery of its powers in the same rank with that of the vaccine virus, states, that he has administered it in 1500 cases !|| But the effect produced by 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 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 in- * Journal de Med. et Chirurg. Pratiq. Oct. 1841. t Op. cit. X Op. cit § Brit and For. Med. Rev. Oct. 1840, p. 556. || H. Wardleworth, Essay on the Chemical, Botanical, Physical, and Parturient Pro- perties of the Secale Cornutum. Lond. 1840. IT Chevasse, in Transact of the Provincial Med. and Surg. Association, iv. 300, Lond. 1836. Prof R. M. Huston, North Amer. Med. and Surg. Journ. 1829; and Mr. Chatto, in Lond. Med. Gaz. July 13,1839, p. 575; also, Reports of Med. Society of London, in Lancet, Oct. 26, 1839, p. 168, and Dr. Wright, Edinb. Med. and Surg. Journ. Jan. 1840, p. 25. ERG0TA. 273 duction of asphyxia, or of positive death, owing to the violence of the uterine contractions, or by the deleterious agency of ergot on the foetus.* But even were we to admit its prejudicial effect 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 than formerly—which, however, appears to be by no means the case—its influence could be but small, and could not account for the statistical differences that have been noticed.f Mr. BraithwaiteJ affirms, that in order that ergot should act perniciously on the child, it is necessary that its action on the uterus should be uninterrupted. He has seldom or never seen any bad effects on the child when the patient had some rest between the pains. In many cases it has been largely administer- ed, and )^et 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 the author, which contains a reference to one hundred and seventy-five cases, in which it 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 extremities; 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 reasonable ground for such reference. A recent vvriterll is disposed to think, that ergot, improperly administered, produces puerperal convulsions as a remote effect,— that it gives rise to hour-glass contraction; and that it gives a predisposition to hydrocephalus in the early stage of infantile life! The chief or only cases in which Dr. Catlett seems to think * Mojon, in Gaz. Med. de Paris, Janv. 19, 1839; and Dr. T. E. Beatty, Dublin Jour- of Med. Science, May, 1844, p. 218. 1 Avery, in Transact, of the Med. Society of the State of New York, vol. iii. Pt 2, p. 185, Albany, 1837. X Retrospect of Pract. Med. and Surg. vol. i. No. 1, p. 181, 3d edit. Lond. 1842. § Lond. Med. Gaz. June 1, 1839, p. 337. See, on this subject, Dr. E. Warren, New- England Quarterly Journal of Medicine and Surgery, July, 1842, p. 10. || Die geburtshulfliche Klinik an der koniglichen Friedrich-Wilhelms-Universitat zu Berlin, in neue Zeitschrift fur Geburtskunde, u. s. w. B. v. H. i. S. 107. Berlin, 18o7. H Dr. Catlett, Edinb. Med. and Surg. Journ. Jan. 1842. 274 ERGOTA. it admissible are when there is serious hemorrhage owing to detachment of the placenta, accompanied by deficient uterine tone; and, in the latter stage of labour, in checking hemorrhage from whatever cause. Dr. Frank Ramsbotham,* who regards ergot as capable of ex- erting specific powers on the uterus at all periods of utero-gestation, and who has referred to several cases of premature labour, induced in his own practice by its use, is disposed to conclude, that al- though 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.t Dr. PatersonJ and Mr. Heane§ have directed ergot success- - fully in large doses with the view of inducing premature la- bour. The former of these gentlemen is disposed to think, that its abortive properties are not exerted upon the impregnated uterus at an early period of utero-gestation, but that, at a certain stage of development, 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 reten- tion of the placenta, in after-pains,^ and in cases of uterine hemorrhage, and of convulsions^ in the parturient state, accom- panied by atony of the uterus.** In such cases, means of more speedy action are needed; but still, cases might arise in which the administration of ergot might be serviceable, and several such, attesting the services rendered by it, have been published.-j--]- It has been strongly recommended, likewise, for the prevention of uterine hemorrhage by Stearns,:}:i; Dewees,§§ Bradley,|||| Abra- ham,^ Kisch, Trousseau,*** T. E. Beattyttt and others. In a case of copious hemorrhage from the uterus connectedwith polypus, Mr. MoyIe^| administered two drams of the tincture of ergot, * Lond. Med. Gaz. June 15th, 1839, p. 420. See, also, Ibid, for June 28, 1834. t See, on this subject, Dr. J. J. Kelso, in London Lancet, June 22, 1839, p. 462; and Duparcque, in Revue Medicale, Mars, 1838. t Lond. Med. Gaz., June 1, 1839, p. 332. See, also, Ibid. Sept. 1838. § Ibid. Jan. 26, 1839. For various opinions on this subject, see Dr. Wright, in Edinb. Med. and Surg. Journ. Jan. 1840, p. 27. || Hoffman, in Berl. Med. Zeitung, June 29, 1836. H Dupar.'que, Revue Med. Mars, 1838. ** Von Busch, Op. cit i. 105. tt Wm. ("amps, Lond. Med. Gaz. Jan. 13, 1843. XX Philad. Joum. of Med. and Phys. Science, v. 44. § § System of Midwifery. |||| Lancet, April 15, ^837. m Jbid. April 22, 1837. Journal des Connoissances, 1839. , ttt Dublin Quarterly Journal of Med. Science, May, 1846, p. 322. XXX Lond. and Edinb. Monthly Journ. of Med. Science, June, 1841. ERGOTA. • 275 which was repeated at intervals, with the effect of inducing uterine contraction and the expulsion of the polypus, "which equalled in size two large placentae." Mr. Moyle was equally successful in a similar case. Other cases in which the effect of the ergot was to force down the polypus so that a ligature could be applied to it, have been related by Dr. Somerville and Dr. M'Farlane.* The employment of ergot has been extended to amenorrhoea,] and dysmenorrhaza, and to uterine hemorrhage in the unim- pregnated female, and many cases have been published in confir- mation of its being possessed of decided virtues.^ It was thought, also, that it might be serviceable,—and was found so by Bazzoni,§ Negri, Langlet,|| and others,—in leucorrhoza,and in gonorrhoea,^ dysentery,** &c; and again, as it proved to be useful in uterine hemorrhage, it was conceived, that it might exhibit like powers in other hemorrhages; and, accordingly, it was given in cases of epistaxis,ff haemoptysis, haernatemesis, hsematuria, &c. In these last cases, it has not been so often employed.^ The author has often administered it in them, but has never had * reason to believe, that it exerted any efficacy; and such has been the case with MM. Trousseau and Pidoux,§§ Dr. Pe- reira, |||| and others.TIF The narcotic or sedative property, how- ever, which it exhibits in certain cases and doses, and the sedative action which it exerts in others, may render it, at times, serviceable in these affections, whatever may have been the process of reason- ing which led originally to its employment.*** Where hysteria depends upon simple atony of the generative system; or of the nervous and generative systems combined, Dr. Nardo,ttt has found the internal administration of ergot followed * Lond. and Edinb. Monthly Joum. of Med. Science, Aug. 1841. t Enriotti, in Repertorio Med. Chirurg. del Piemonte, cited in Journ. des Connoissances, Mars, 1838. Langlet, Bulletin Medical Beige, Juin, 1839, p. 125. Dewees, Midwifery. chap. Amenorrhoea; Locock, Cyclop, of Practical Medicine, i. 70. Nauche, Nouveau Diet de Med. et Chirurg. art. Ergot; and Dr. Wright, in Med. and Surg. Journ., Jan. 1840, p. 34. See, also, Churchill, (with whom it failed,) Diseases of Females, Dungli- son's Amer. Med. Library edit. p. 54. Philad. 1839; and Dr. G. Fyfe, Med. Gazette, June 18, 1841. X Dr. G. Fyfe, Op. cit;and Dr. John Yale, Boston Med. and Surz. Journ. July 8,1846, p. 459. § Annali Universali di Medicina, Feb. 1831: and Ryan, Medical Formulary, p. 2G4, 3d edit Lond. 1839. || Op. citat U Muller, in Rust's Magazine, B. xl. H. iii., cited in Amer. Journ. of the Med. Sciences. Feb. 1835, p. 527; Ryan, Op. cit. and Desruelles, Gazette des Hopitaux, Juin 2, 1842. ** Mojon, Op. cit tt Dr. John Yale, loc. cit. XX Duparcque, op. cit, and De Gravina, Annali Universali di Medicina, Ottobre, 1839. § § Traite de Therap. i. 546. Paris, 1837. |||| Elem. of Mat. Med. and Therap. ii. 925. Lond. 1842. ITU See the author's General Therap. and Mat. Med. 3d edit. ii. 198. Philad. 1846. *** See some remarks on this subject, by the author, in his Amer. Med. Intel, vol. i. p. 219. . Itf Cited in Edinb. Med. and Surg. Journ. Jan. 1843, p. 225, and in Bouchardat, An- nuaire de Therapeutique, pour 1843, p. 93. Paris, 1843. 276 ERGOTA. by the rapid removal of the disease. His practice consists in giving about a scruple of the powder mixed with sugar, in divided doses each day, intermitting the dose every third or fourth day. Many cases are related by him to show the efficacy of the practice,— the hysteria, and the irregularity or absence of the menstrual se- cretion being removed at the same time. Dr. Wright* affirms, that when applied to an abraded surface, it gives rise to profuse sloughing. He tried it upon wounds nearly healed, and in less than 24 hours they discharged purulent matter abundantly. The matter was generally of an offensive character; and the wounds, thus treated, even under the application of proper curative means, were long and tedious in healing. In the form of powder, he found it very serviceable in arresting hemorrhage; and not simply in a mechanical manner, as was proved by experi- ment. Even in the form of infusion, it possessed the power in an extraordinary degree. Muller divided the popliteal artery in the sheep, and completely arrested the bleeding by lint dipped in an infusion of ergot. The caudal artery, and the anterior crural ' artery of a horse were cut, and the bleeding was similarly subdued. Dr. Wright says, that he has several times divided the external jugular and the saphena major veins, and has never failed to arrest the hemorrhage by an infusion of ergot, although with arteries he has been generally less successful. In the greater number of his experiments, he used a dilute solution of ergot, in the place of warm water, to sponge the bruised parts, and always succeeded in preventing that continued flow of blood, which is often a serious obstacle to the safe direction of the knife. He consequently re- commends it as a valuable means of preventing the troublesome hemorrhage from small vessels in the course of surgical operations; and upon the same principle he believes the injection of a similar solution into the uterus, in cases of flooding, will be found to an- swer every practical end that can be desired. The decoction has proved to be an equally efficacious haemastatie in the hands of others.f In a severe case of epistaxis, Dr. Wright^ arrested the hemor- rhage by injecting up the nostrils equal parts of very dilute spirit and oil of ergot; and he has little doubt, that in the severe cases of uterine hemorrhage that follow delivery, the injection of the oil diffused through water into the uterus would be productive of the happiest results. It proved also serviceable in arresting he- morrhage after the extraction of a tooth and from leech-bites. It will be seen presently, however, that the styptic properties of the ergot have been supposed to reside chiefly, if not exclusively, in the ergotin or extract, of ergot. Dr. Wright found the oil a valuable external application in cases * Op. cit., Jan. 1840, p. 20. 1 Mr. Wright, cited in Liston's Lectures, Lond. Lancet, Aug. 31, 1844, p. 691. X Edinb. Med. and Surg. Journ. July, 1840. ERGOTA. 277 of local rheumatism. In three instances it was entirely success- ful. The affected part was well rubbed with it for a quarter of an hour night and morning, until relief was obtained. He states far- ther, that it is one of the most valuable remedies with vvhich he is acquainted in toothach. He has repeatedly known it subdue the pain when creasote had failed. By M. Lisfranc,* the powder was employed, in the dose of from two to eight grains, in cases of hypertrophy of the uteims of various kinds, whenever reduction of the organ to a less size seemed to be the prominent indication; and Dr. Perrinet has published some cases of periodical diseases, in which it was administered with advantage during the intervals; but no further results appear to have been elicited. M. Payan^: thinks it demonstrated, that ergot is primarily and essentially an excitant of*1 the spinal marrow; and he conceives, that its action on the uterus, bladder, and muscles of the lower extremities is but secondary, from a reflex action transmitted from the spinal marrow to those organs through the nerves distributed to them. He has given the details of some cases of paraplegia, which seemed to be relieved by ergot; an infusion of fifteen grains in water being given at first in the course of the day, and the dose being gradually augmented.§ M. Allier, fils,|| from having observed, as he believed, contrac- tion of the fibres of the bladder under the administration of ergot, has recommended it highly in cases of retention of urine; and feels himself justified in inferring, from the results of varied ob- servation, that it is capable of restoring to the bladder the con- tractility it may have lost owing to immoderate distention of its coats by accumulation of urine;—that its action has been evinced in cases in which this kind of paralysis has resisted all known therapeutical agents; and that, owing to the fugacious character of its operation, it ought to be administered at short intervals, in broken doses, and these should be long continued. He re- commends, that it should be commenced in the quantity of a scru- ple in the day, divided into six equal parts, that the quantity should be afterwards raised to forty grains, and then gradually diminished to a scruple; and afterwards discontinued by degrees in eight or ten days after the cure, in order to consolidate it. A case of retention in the male cured by ergot, is recorded by Dr. KingsleylFof Roscrea. Ten grains were given three times a day. * Pauly's Lisfranc, translated by Dr. Lodge, p. 330. Boston, 1839. t Amer. Journ. of the Medical Sciences, Nov. 1833, p. 279. X Revue Medicale, Fevrier et Mars, 1839; and Encyclograph. des Sciences Medicales, Avril, 1829; also, Journal de Pharmacie, Juin, 1842, p. 545. § See, also, Petrequin, Bulletin de Therapeutique, Mars, 1840. || Journal des Connoissances Medico-Chirurgicales, Nov. 1838. If Dublin Med. Press, April 26,1843; cited in Braithwaite's Retrospect, Amer. edit. viii. 163. New York, 1844. 27S ERGOTA. / Similar testimony is also afforded by Dr. J. J. Ross,* of Cambus- more, Dr. Houston, of Dublin, and others, f It has been recommended by Dr. Steinbeck,:}: in inconti- nence of urine, from want of power in the sphincter of the bladder. It was associated, however, with extract of belladonna, nux vomica, and phosphoric acid; so that it is impossible to say what precise influence was exerted by the ergot. Lastly, In the Annates de la Societe de Medicine de Gand, M. Guersant§ has published two cases in which he administered ergot with the greatest advantage to effect the expulsion of frag- ments of calculi after the operation of lithotrity. Twenty-four grains were first given in three doses during the day, but no effect having been produced, the dose was increased to thirty grains in the day, vvhen the patient experienced frequent desire to-rjass the urine, followed by pain in the hypogastric region, pricking in the limbs, and slight derangement of vision. After using the medi- cine for five days, fragments of calculi were passed, and, during twenty-four hours, in three times the quantity that had been dis- charged during the whole previous period subsequent to the opera- tion. MODE OF ADMINISTRATION. The great difference which has been observed in the effects of ergot has led to the belief, that there must be much difference in the article, and that every care must be taken to have it good. Dr. Ryan,|| indeed, affirms that not one druggist or chemist in a hundred has it genuine. According to Dr. Wright, if it be clear and smooth on its sur- face; not powdery; of a deep purple colour; neither entirely black nor light brown; have a full strong odour; break clearly, exhibit- ing a pink blush internally; be unpunctured by insects; burn with a clear jetting flame, and be of less ^specific gravity than water, its activity may be trusted. It must be recently pulverized, too, if we are desirous to count upon its action when given in this form.^[ When prescribed with the view of augmenting parturient energy, it is most commonly perhaps given in powder, in the dose of from ten to twenty grains, repeated every twenty minutes until the effect upon the uterus is elicited. Professor Von Busch** found the best results when it was given in the dose of ten grains at short intervals—from ten to fifteen minutes. In one case it was requi- site to repeat it eight times; in four cases, six doses were sufficient; in twelve, five; in thirty-three, four, and in the remainder of the * Lond. and Edinb. Monthly Journal of Med. Science, Jan. 1844, p. 43. t Provincial Medical and Surgical Journal, April 24, 1844; cited in Braithwaite's Re- trospect, Amer. edit. ix. 63. New York, 1844. J: Medicin. Zeitung, cited in Lond. Lancet, March 4, 1843. § Journal de Mcdecine et de Chirurg. Pratiq. November, 1839. || Formulary, p. 264. IT Allier, op. cit. ** Op. cit. S. 106. ERG0TA. 279 one hundred and seventy-five cases, three and less: the smallest quantity exhibited was a single dose of ten grains; the largest, nine doses of ten grains. Dr. Ryan* says the maximum dose is a dram and a half; but it, obviously, cannot be thus limited. Dr. Samuel Hardy, of Dublin,f has observed, that it has always commenced its action within 25 minutes at the farthest, when the child has been expelled alive; and that if a longer time than this has elapsed, instruments have been necessary, and the child has been born dead. The beneficial effects of ergot are evidenced by the pains running into one another without any appreciable inter- val. Professor Beatty, of Dublin, affirms, that when delivery was not effected within two hours from the exhibition of ergot, the child's life was generally lost. Several cases are, however, reported by Mr. J. Pratt, which disprove this statement. In one, three hours elapsed between the taking of the medicine and delivery; in another five hours; in another three and a half; and in a fourth, six hours; and in all the cases fine healthy children were born.:}: Dr. Hooker, who considers that the ecbolic and the narcotic properties of ergot may be separated, recommends, in these cases, the clear infusion, which possesses, he conceives, the former pro- perty only. The powder of course contains both. Dr. Bishop, of New Haven,§ asserts, that he has seen but once any unpleasant effects from the use of ergot, and then he gave it in powder; the labour was protracted and narcotism in- duced. In New Haven, it is the general practice to administer the infusion, and in that form it is considered safe and effective in parturition. It is not easy, however, to see how the fixed oil can be taken up by hot water.|| The infusion is termed in France, " The de Seigle noirci des sages-femmes AmericainesP''^ By some as will be seen hereafter, the sedative and other properties of ergot have been affirmed to exist in the aqueous extract o'r ergotin. It is proper to remark, that the form of infusion as well as of decoction was found by Dr. Jorg to be highly unpleasant to the stomach, and it could not be repeated in his experiments— which it must be remembered, were not made on the parturient female—in large doses for any length of time, without irritating the bowels, producing loss of appetite, and general impairment of the digestive function. Dr. Wright,** recommends the oil of ergot to be given in the dose of 20 to 50 drops in tea, weak spirit and water, some aro- matic water, or made into an emulsion with mucilage and syrup. It would seem to be the most advisable form of exhibition, as the * Op. cit. 1 Dublin Journal of Medical Science, May, 1845. X Dublin Hospital Gazette, cited in Amer. Journ. of the Med. Sciences, Jan. 1846, p. 244. § Dunglison's Amer. Med. Intel. Dec. 15,1837, p. 330. || See the author's General Therapeutics and Materia Medica, i. 427. Philad. 1843. U Journal de Pharmacie, Fevrier, 1842, p. 177. ** Edinb. Med. and Surg. Joum. July, 1840. 280 ERGOTA. oil retains its properties for several years, if kept in well closed bottles excluded from light. As to the form of tincture, Mr. Battley affirms, that alcohol will not extract the active property, and Dr. Ryan* states, that he has certainly found the tincture to fail in the majority of cases. Mr. Battley prefers the watery extract. For the purpose of inducing premature labour, it has been ne- cessary to give ergot in larger doses. Dr. Patersonf gave it in the form of infusion, until the patient took six drams of the medicine. The infusion was likewise given by Dr. F. Rams- botham,| and the quantity which each of his patients took varied from two to twelve drams. As a parturifacient, Dr. W. R. Gore§ has recommended the ammo niacal solution of ergot, a formula for vvhich is given here- after. This, he says, contains all the active principles in a con- venient form, and with increased efficacy, the ammonia causing the ergot to act more rapidly, and with greater certainty. When ergot is given with other views, the usual dose is 10 or 15 grains of the powder, three or four times a day: the results of the observations of Dr. Cottman|| have shown, however, that in 30 grain doses its sedative effects are more marked. This, too, was the dose in vvhich it was administered by Dr. Hooker. In such cases, the tincture, and the light oil described by Dr. Hooker, may also be prescribed;—the latter in the dose of ten to thirty drops. Infusum ergotae. Infusion of ergot. ' R. Ergot. 3j. Aquae bullientis f. giv. Infunde. Dose.—One third, to be repeated every 15 or 20 minutes, in deficiency of uterine contractions. R. Ergot. §ss. Aquas bullientis, f. gxxiv. Colaturae adde Syrup, simpl. f. 3j. Dose.—Two ounces every three or four hours, to induce pre- mature labour. Paterson. R. Ergot. 3ss. Infunde per semihoram in Aquas bullientis f. giss. et cola. This quantity to be taken for a dose, and repeated every four hours. F. Bamsbotham. " °P- cit. p. 266. t Lond. Med. Gaz., June 1,1839. p. 333. X Ibid. June 15, 1839, p. 421. § Medical Times, Nov. 5, 1842. ' || Dunglison's American Medical Intelligencer, Sept. 1, 18,39, p. 161. ERG0TA. 2S1 R. Ergot, gss. Infunde in Aqua? bullient. f. giij. Cola et adde Ergot, in pulv. gr. x.—gr. xv. M. This quantity sweetened with sugar to he taken for a dose. To be repeated in twenty minutes; and if the uterus should not contract well, to be given a third time. S. Hardy. Liquor ergotse ammoniacalis. Jlmmoniacal solution of ergot. Into half a pint- of spiritus ammonias aromaticus, put four ounces of fresh ergot, bruised coarsely. Let them stand for a month, frequently stirring with a glass rod, after which squeeze out every drop of the spirit. In a glass stoppered bottle, it may be preserved for any length of time without deterioration. Dose.—Thirty drops in a wineglassful of cold water, every ten minutes, until the action required is sufficient, applying at the same time a gentle pressure with the flat of the hand on the abdomen. When the pains are present, three doses are usually enough. W. R. Gore. Decoctum ergotse. Decoction of ergot. R. Ergot, gj. Aquae Oijss. Coque ad Oij. et cola. Dose.—A table-spoonful every quarter of an hour. Tinctura ergots. Tincture of ergot. R. Ergot, gijss. Alcohol, dilut. Oj. Macera per dies quatuordecim et cola. Dose.—Twenty minims to two fluidrams, two or three times a day, as a sedative agent. Guy's Hospital. Syrupus ergots. Syrup of ergot. (Shop de Calcar.—Desgranges.) R. Ergot, gr. xx. Extract, opii, gr. f. Syrup, f. §viij. M. Dose.—Two table-spoonfuls (one ounce) in cases of engorge- ment of the uterus. Lisfranc. Pulveres ergots compositi. Compound powders of ergot. (Antihemorrhagic powders.—Ryan.) R. Ergot, gss. Pulv. aromat. Qss. Sacch. gss. M. et divide in chartulas. x. 2S2 ERGOTA. i Dose.—One, every hour or every second or third hour, in ac- tive hemorrhage from any outlet. In leucorrhoea and gleet, one may be given three or four times a day, and should they fail the following may be substituted. R. Ergot, pulv. Qij. Cubeb. pulv. §j. Pulv. aromat. gss. Sacchar. gj. M. et divide in chartulas viij. Dose.—One, three or four times a day. Ryan. Piluls ergots. Pills of ergot. R. Ergot, pulv. gr. ix.; xij. vel xviij. ; Ext. hyoscyam. gr. i. Potass, nitrat. gr. xv. Camphor, pulv. gr. iij. M. et divide in pil. xl. Two to four, every two hours, in cases of urethritis of the pros- tatic or membranous portion of the canal. Desruelles. Vinum ergots. Wine of ergot. R. Ergot, contus. gij. Vini Oj. Macerate for 14 days, shaking occasionally; then express, and filter through paper. . Dose.—f. 3j. to f. gij. Pharm. U. S. 1842. Injcctio ergots, Injection of ergot. R. Ergotas gss. Aq. bullient. Oss. Used in cases of erythemoid vaginitis and urethritis. Desruelles. Extractum ergots. Extract of ergot.—Ergotin. (Ergotine ou extrait hemostatique, of Bonjean.) Powdered ergot is exhausted by water, by the process of dis- placement, and the watery solution is heated in a water bath. At times it coagulates, owing to the presence of a portion of albumen; at others, it does not. In the former case, the coagulum is sepa- rated by the filter, and the filtered liquor is evaporated in a water- bath, until it has the consistence of a clear syrup. A considerable excess of alcohol is then added, vvhich precipitates all the gummy matters. The mixture is left at rest, until the whole of the gum is precipitated, and the liquid has assumed a state of limpidness. The liquor is then decanted to reduce it in a water-bath to the consistence of a soft extract. In the latter case, the watery solu- tion is brought directly to a half syrupy state, and is treated by alcohol as mentioned above, to obtain from it the extract, which, ERG0TA. 283 obtained by this process, is soft; of a red or brown colour; very homogeneous; of an agreeable odour of roast meat, and of a slightly piquant and bitter taste, more or less analogous to that of damaged wheat. It forms with water a limpid solution of a beautiful red colour. 500 parts of ergot furnish from 70 to 80 parts of extract. M. Bonjean affirms, contrary, as has been seen, to the opinions of other observers, that whilst ergotin contains the medicinal property of ergot, the oil and the resin contain the poisonous properties. He considers it a real specific[?] in hemorrhage in general. "When my ergotin," he remarks, "shall have been tried, observers will be struck with the immediate effect it pro- duces in the most frightful (foudroyantes) hemorrhages : the most rebellious cases of hsematemesis yield in a short time under its use; and relapses are generally rare, especially when the precaution is taken to continue its employment some time after the cessation of the symptoms. To be convinced that the ergotin is also the obstetrical principle, we have only to treat pow- dered ergot with ether, by the process of displacement, until the whole of the matter that is soluble in the liquid is exhausted: in this manner the poison is removed—that is all the oil of ergot and the resin. A powder remains, which is no longer unctuous, but rough like sand, without any disagreeable taste or poisonous influ- ence, and which, in the dose of 6 or 8 grains, powerfully excites uterine contractions, in every case of inertia of the womb, in which the employment of ergot would be esteemed proper.* Dr. Sachero,f Professor of clinical medicine in the University of Turin, prepared two extracts of ergot, the one aqueous, and the other alcoholic. The former had the characters described above, whilst the latter was of a deep brown colour, with no particular smell, and was very pungent and slightly bitter to the taste. The watery extract he regards as a hyposthenic remedy, well adapted for cases of hemorrhage; the resinous extract, he thinks, probably acts as an excitant; whilst the oily is the poisonous principle.— "The action of the ergot," he remarks, "when administered in its natural state, appears to be of two kinds; the one, as in labour, affects the sanguineous system, the energy of which it diminishes (hyposthenises,) by means of the ergotin: the other affects the nerves of the uterus, which it stimulates by its resinous principle. To this double action must be added a third, equally hypos- thenic, that of the oily or poisonous principle." Dr. Ebers^: has found ergotin of very marked advantage in uterine hemorrhage. He has employed it " with the most perfect success" in those forms that are attendant upon cancer of the uterus, * Bouchardat, Annuaire de Therapeutique, pour 1843, p. 8b', pour 1844, p. 21. t Cited in Lond. and Edinb. Monthly Journ. of Med. Science, Aug. 1844, and in the Amer. Journ. of the Med. Sciences, Oct. 1844, p, 463. X London Medical Gazette, Nov. 1845. 2S4 ERGOTA. and which so greatly exhaust the patient's strength, and lead ra- pidly to death. These he has treated exclusively with ergotin, in doses of two grains every two hours. In almost all the cases, twelve doses were sufficient to arrest the hemorrhage. In ute- rine hemorrhage occurring at different periods of life, in youth, and especially at the critical period, he has found it of equal ad- vantage. It is proper to remark, that Drs. J. Lawrence Smith and S. D. Sinkler infer, from the results of a trial of ergotin on the divided carotid of a sheep, that it depends greatly, if not altoge- ther upon the manner in which the lint is applied to the wound of the artery, whether the hemorrhage'is arrested or not. If it be placed immediately upon the orifice of the cut vessel, "success is certain; if, however, the vessel shrinks from contact with the lint, the animal is almost certain to bleed to death."* (See page 74.) Mistura extracti ergots. Mixture of extract of ergot. (Potion d'ergotine.) R. Extracti ergotae gr. xv. Aquae f. giij. Syrup, flor. aurant. seu limonis f. gj. M. Dose: A table spoonful every quarter of an hour, in cases of hemorrhage, or of inertia of the uterus. In very violent cases of hemorrhage the quantity of ergotin must be increased, and the doses be given more frequently. Bonjean. Syrupus extracti ergots. Syrup of extract of ergot. (Sirop cVergotine.) R. Extract, ergot, giiss. Solve in Aq. flor. aurant. seu Aq. rosae f. gj. Syrupi f. gxvj. Coque syrupum et adde solutum. Dose: Two to four table spoonfuls a day, more or less, according to the urgency of the case. Bonjean. Piluls extracti ergots. Pills of extract of ergot. (Pilules d'Ergotine.) R. Extract, ergotas gj. Glycyrrhiz. pulv. q. s. ut fiant pil. 1. Dose: Six to ten in the day. Bonjean. * Southern Journal of Medicine and Pharmacy, July, 184C, p. 406. EUPHORBIA LATHYRIS. 285 LXXIII. EUPHOR'BIA LATH'YRIS. Synonymes. Cataputia Minor, Lathyris, Tithymalus Latifolius, Caper Spurge, Garden Spurge. Mole Plant. The oil of spurge—Oleum Euphorbia Lathyridis—has been recently recommended in medicine. Although the euphor- bia 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 vvhen 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 emulsion; and was of opinion that it might be advantageouslv substituted for castor oil, especially for children. After him, it was employed by M. Grimaud, and subsequently by M. Bally,+ who carried the dose as far as ten drops. Louis FrankJ has sug- gested its employment in cases of taenia, hysteralgia, ascites, &c. It would appear, from the remarks of Mr. Scattergood, that the oil obtained from the beans growing 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 ca- thartic; and although administered in conjunction with aromatic- 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 administered in small quantities, and repeated at intervals of half an hour or an hour, it operates on the bowels freely as a cathartic, without producing much nausea. i Pichonnier§ has proposed the following formula for a ca*:hart:c mixture. Mistura olei euphorbis. Mixture of the oil of euphorbia. R. Olei euphorb. lathyr. gtt viij. Acac. pulv. gj. Sacchar. gij. Aquae destillat. f. giij. M. * Scattergood, in Philad. Journ. of Pharmacy, iv. 124, Philad. 1833. Sec, also, Journ. de Chimie Med. ii. 178. t Journal Universel des Sciences Medicales, xli. 254. X Journ. de Pharm. xi. 273; and Merat and De Lens, Diet, de Mat Med. iii. 18:!. Paris, 1831. § Journ. de Chimie Medicale. Paris, 1*27. 19 286 FERRI PRJEPARATA. FERRI PR^PARATA. Synonymes. Preparations of Iron. French. Les Preparations de Fer. German. Eisenpraparate. LXXIV. FERRI ARSE'NIAS. Synonymes. Ferrum Arseniatum, Ferrum Arsenicicum Oxydulatum. French. Arseniate de Fer. German. Arsensaures Eisenoxydul, Arseniksaures Eisenoxydul. This preparation has been recommended by Mr. Carmichael,* who often applied it externally in cases of cancerous ulcers. Naturally, it presents itself in small, clear, bluish-green crystals, of a regular octahedral 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 of wine and reduced to fine powder, are mixed with as much purified saltpetre. The mixture is then 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 applied, 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 crys- tals of acid arseniate of potassa is found on the sides of the crucible. 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 potassae 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 ferri arsenias, 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 * An Essay on the Effects of the Carbonate and other Preparations of Iron upon Cancer, 2d edit. Dublin, 1809. v FERRI ARSENIAS. 287 used be cautiously cleansed or broken, for fear that mischief may arise. In these chemical operations, the acid of the saltpetre is de- composed by being heated with the arsenious acid or white arsenic,a part of its oxygen is taken by the latter, and arsenic acid is there- by formed, which unites with the potassa of the saltpetre and forms acid arseniate of potassa; the nitric acid being converted into ni- trous acid is given off in the form of red fumes: by admixture of a solution of sulphate of iron with the solution 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 bottom of the vessel. EFFECTS ON THE ECONOMY. According to Carmichael, this preparation acts more powerfully 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 wras at one time so much celebrated—called "Plunket's caustic.''^ He allows, however, that the greatest cau- tion should be observed in its use. Of late, he has employed a compound of 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 extensive. MODE OF ADMINISTRATION. 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. gss. ----• phosphat. gij. Cerat. cetacei gvi. M. This ointment must be spread on lint and applied to the ulcer. Carmichael fy Wcrneck. Werneck gives it the preference over all the usual arsenical pre- parations. Arseniate of iron has likewise been administered inter- nally in cancerous affections. The following formula may be used : Pilulee ferri arseniatis composite. Compound pills of arseniate of iron. R. Ferri arseniat. gr. iij. Extract, gentian, gj. Glycyrrhiz. pulv. gij. Syrup, cujusvis q. s. ut fiat massa, in pilulas xlviii. dividenda. Dose.—One, three times a day. 28S FERRI PRJEPARATA. LXXV. FERRI BRO'MIDUM. Synonymes. Ferrum Bromatum, Brometum Ferricum, Bromated Iron, Bro- mide of Iron;—in solution, Hydrobromate of Iron, Ferri Hydrobromas, Ferrum Hydrobromicum Oxydatum. French. Bromure de Fer. German. Bromeisen, Eisenbromid, BromvvasserstofFsaures Eisenoxyd. 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 colour it is filtered and evaporated to dryness: the reddish residue—again dissolved in water and evaporated—is 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 ADMINISTRATION. Magendie has prescribed it successfully, in cases in which the preparations of bromine have been indicated. (See Brominum, p. 124.) He recommends the following formula. PilulEE ferri bromidi. Pills of bromide of iron. R. Ferri bromid. pulv. gr. xij. Confect. rosae gr. xviij. Acaciae pulv. gr. xij. Fiat massa in pilulas xx. dividenda. Dose.—Two, morning and evening. Magendie. R. Ferri bromid. gj. Extract, glycyrrhiz. q.. s. ut fiat massa in pilulas Ix. dividenda. Dose.—One or two, morning and evening, in cases of scrofula, and hypertrophy—of the uterus especially. Werneck. , LXXVI. FERRI CARBURETUM. Synonymes. Ferrum Carburetum, F. Carbonatum, F. Supercarburetum; Carburetum Ferri Nativum; Graphites, Plumbago. Plumbum Nigrum, Carbo Mineralis, Cerussa Nigra, Black Lead, Carburet of Iron. French. Carbure de Fer, Graphite, Crayon noir, Plombagine. German. KohlenstofTeisen, Graphit, Reissblei, Mineralische Kohle. This well known substance was formerly considered to be slightly astringent and desiccative. By Weinhold,f it has been advised strongly in certain cutaneous affections, but although it * Magendie, Formulaire pour la preparation, &c., de plusieurs nouveaux medicamens, derniere edit t Der Graphit als ein neu entdecktes Mittel gegen Flechten. Leipz. 1809. FERRI CARBURETUM. 289 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. METHOD OF PREPARING. As crude graphite is frequently very impure from the attached matrix, the Prussian Pharmacopoeia has a formula for its purifica- tion, the product of which bears the name graphites depuratus. With this view, the graphite must be very finely pulverized: 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, under 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 favourable modification in the eruption, and wholly removed it. In consequence of the results of his observations, he published a monograph in which he recommended it to physicians in those diseases. 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 cu- taneous affection announced its approaching cure. In cases of complication of herpes with other affections, Weinhold combined it with other remedies;—in syphilitic eruptions, adding corrosive sublimate, &c. The efficacy of graphite in herpetic and other cutaneous affec- tions has also been attested by many other respectable physicians, as Horn, Heim, Ruggieri, Brera, Bernstein, Hildenbrand, Richter, Hufeland, Marc,* &c. This circumstance gave occasion to its ad- mission into the Prussian Pharmacopoeia; yet it'has not the con- fidence of physicians, even in those countries into the pharmaco- poeias of which it has been received, and is consequently but little prescribed. Its use in chronic cutaneous diseases is said to have * 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; Hufe- land, Journ. der prakt Heilkunde, B. xxxviii. St. 6; Bernstein, Ibid. B. xli. St. 5; Mayer, Ibid. B. Ix. St. 2, and Osann,in Encyclop. Worterb.der Med. Wistensch. x.434. Berlin, 1834. 290 FERRI PR.EPARATA. been suggested by the circumstance, that in Venice the makers of crayons are speedily cured of any such affections under which they may labour.* MODE OF ADMINISTRATION. 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 gij. to gvj. of the gra- phite to an ounce of the constituent. Pulvis ferri carbureti, Powder of carburet of iron. R. Ferri carburet. Sacch. aa. gss. M. Divide in partes sequal. vi. Dose.—One every two hours—in lichen leproides. Von Hildenbrand. Electuarium ferri carbureti. Electuary of carburet of iron. R. Ferri carburet, gss. Mellis despumat. gij. M. Fiat electuarium. Dose.—A coffee-spoonful, morning and evening. Weinhold. Pilulae ferri carbureti, Pills of carburet of iron. R. Ferri carburet. Extract, dulcarnar. aa. gj. M. fiant pilute, pond. gr. ij. sing. Dose.—Six, three times a day. Marker. R. Ferri carburet, gij. Zinci oxid. gss. Adipis gj. M. Unguentum ferri carbureti. Ointment of carburet of iron. R. Ferri carburet. Sulphur, aa. gij. Adipis q. s. ut fiat unguentum. Mayer. Brera. Emplastrum ferri carbureti. Plaster of carburet of iron. R. Ferri carburet, gij. Emplast. sapon. giv. Misce intime. Weinhold. * Merat and De Lens, in Diet de Mat. Med. art Carbone. FERRI CITRAS. 291 -LXXVII. FERRI CITRAS. Synonyme. Citrate of Iron. French. Citrate de Fer. German. Citronsaures Eisenoxydul. Two citrates of iron have been proposed, of late years, by M. Beral*—the one the sesqtjicitrate or citrate of the sesqui- oxide of iron; the other the citrate of the protoxide of iron. An ammonio-citrate, a potassio-citrate, and a SODIO- citrate have likewise been introduced. METHOD OF PREPARING. The citrate of the sesquioxide, according to Mr. Duhamelf i> prepared as follows:—Take of Citric acid, crystallized, ^iij. or 3 parts; Hydrated oxide of iron, dry, gij. or 2 parts; Distilled water, gxij. or 12 parts. If the moist hydrate be used, about gvj. are required; but as the degree of moisture is not always the same, Mr. Duhamel suggests, that the oxide should be in excess. The water may be heated to about 180°: a boiling temperature should be avoided, as it renders the sesquioxide less readily soluble.! The solution is filtered, and the filter washed with distilled water sufficient to obtain 12 parts of liquid. This forms what is kept by the French Pharmaciens under the name Liquid Citrate of Iron, marking 24° of Beaume. It holds in solution one-third of its weight of dry citrate of iron. The solution is evaporated to the consistence of thick syrup. It is then spread out on glass- or porcelain plates, where it speedily dries in thin layers, which are separated and broken into fragments. Its taste is acid, but not disagreeable, and it is said to be of all chalybeate salts the least unpleasant to the taste. The citrate of protoxide of iron is prepared by M. Beral,§ by treating iron filings with citric acid previously dissolved in dis- tilled water*. It has a strongly marked chalybeate taste. Citrate of sesqui-oxide of iron is a rather insoluble salt: it occurs in transparent laminae of a garnet hue, which are permanent in the air. Citrate of the protoxide is of a dark green colour: is soluble, and the solution does not change its green colour by exposure to air. Ammonio-citrate of iron is prepared by neutralizing the ex- cess of acid in preparing the citrate of the sesquioxide by ammonia. and evaporating as before. It is a much more soluble salt than the citrate of the sesquioxide, and is slightly deliquescent. If the acid or the citrate be neutralized by soda or potassa in place of am- * Journ. de Chimie Medicale, and Amer. Journ. of Pharm. April, 1341, p. 72. t Amer. Journ. of Pharmacy, Oct. 1342, p. 225. X Wm. Procter, Junr.: cited in Dispensatory of the United States, 6th edit p. 1243. Philad. 1^ 15. § Ibid. April, 1341, p 72. 292 FERRI PR^PARATA. monia, the sodio-citrate, and the potassio-citrate of iron, are formed, vvhich greatly resemble the ammonio-citrate.* EFFECTS ON THE ECONOMY IN HEALTH. The citrates of iron resemble, in their properties, the tartrate and the lactate of iron, and may be given in the same cases. The author has used the citrate largely, and is much pleased with it. It is unquestionably one of the most agreeable of the chalybeates, and equally effective perhaps with any. MODE OF ADMINISTRATION. The dose of citrate of iron may be the same as that of the salts above mentioned. The author generally prescribes it in the quan- tity of 10 grains three times a day. The citrates are not decom- posed by alkalies, and hence may be given with them if desirable. The ammonio-citrate, according to MM. Ballard and Garrod, is the most used, and may be conveniently administered in porter, vvhich conceals its taste, without its own flavour being impaired. It has been long administered in wine, of which the following are two forms;—the first from the Hamburg, and the latter from the Wirtemburg, Pharmacopoeia. Vinum ferri citratis aromaticum. Aromatic wine of citrate of iron. R. Ferri limatur. gj. Limon. succ. giij. Macera per noctem, et adde Gentian, gss. Cinnam. gij. Vini f. gxvj. Dose.—Of the decanted wine, f. 3ss. to f. 5ij. and more. This preparation, or one analogous to it, is said to be prescribed by cer- tain physicians of this country—of Charleston, for example.-j- Take of Iron filings, four ounces; Bitter oranges, four. Remove the peel, the white, and the seeds; beat them "in a stone mortar, and let the paste remain at rest for two days; then pour upon it Madeira wine, ten ounces, and Spirit of orange peel, two ounces. After sufficient digestion, express and filter. This preparation is called, in the Wirtemberg Pharmacopoeia, Tinctura Ferri Aurantiaca seu Tinctura Martis cum Vino Malvatico et Pomis Aurantiis.l According to Mr. Gore,§ it possesses the most agreeable odour and taste of any medicinal compound ever intro- duced into practice. It is aromatic, carminative and tonic; and he adds, that he has no doubt it will supersede the preparations in * Ballard and Garrod, Elements of Mat Med. and Therap. p. 389. Lond. 1845. t Duhamel, loc. cit. X Jourdan, Pharmacopee Universelle, i. 545. Paris, 1828. § Dublin Medical Press, April 29, IS40, and Braithwaite's Fvetrospect, vol. i. p. 24, 3d edit. London, 1842. FERRI FERROCYANURETUM. 293 general use, when once it has been fairly tried. In strumous habits; in passive uterine hemorrhage; in anasarca from general debility; in chlorosis; in malignant disease, in which iron has been extolled by Mr. Carmichael and others; and in all diseases that arise from a general deficiency of tone, Mr. Gore considers this preparation to be "of exceeding utility,from its agreeable and chalybeate qualities." He suggests, also, its use in chronic bronchitis, in which he gives it in combination with ipecacuanha wine. Aqua clialybeata effervcscens. Effervescing chalybeate water. R. Aquae Oiss. Ferri citrat. sice. 9j. Acid, citric. J)iv. Sodas bicarb. 9 v. Add first the citrate of iron and citric acid, then the bicarbo- nate of soda, corking the bottle at once, and securing the cork.* This is a delicate but active chalybeate. M. Beral has likewise introduced a Cilrate of Protoxide of Iron and Quinia—Ferri et Quinue Citras, which is formed by the union of four parts of Cilrate of iron with one part of Cilrate of quinia in solution, and evaporating. It may be given in the form of pill, wherever a combination of these tonics is needed. An extemporaneous formula may be made by uniting citrate of iron, and citrate or even sulphate of quinia together, vvhich may be given either in pills or solution. LXXV1II. FERRI FERROCYANURETUM. Synonymes. Ferri Cyanidum, F. Cyanuretum, F. Borussias, F. Sesqui- eyanidum, F. Ferrosesquicyanidum, F. Percyanidum, F. Ferrocyanas, Ferrum Cyanogenatum, F. Cyanuretum, F. Zooticum, F. Borussicum, F. Oxydulatum Hydrocyanicum, CoGruleum Borussicum, C. Beroliniense, Prussiate or Cyanide of Iron, Cyanuret of Iron, Prussian Blue, Berlin Blue. French. Trito-hydro-ferro-cyanate de Fer; Deutoxicyanurede Fer Hydrate, Tritohydrocyanate Ferrure de Fer, Prussiate de Potasse et de Fer, Bleu de Prusse. German. Cyaneisen, Blaustoffeisen, Blausaures Eisenoxydul, Eisenblau- saures Eisenoxyd, Blausaures Eisen, Eisencyaniircyanid, Berliner Blau, Pariser Blau. In commerce, this preparation with us bears the name of " 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. * Bullet, de Therap. cited in Provincial Med. and Surg. Journ. Dec. 10, 1842, and in Braithwaite's Retrospect, vii. 116. London, 1843. 294 FERRI PR.EPARATA. METHOD OF PREPARING. The form given by Buchner is as good as any. Ferrocyanuret of potassium, as commonly met with in commerce, is dissolved 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 precipi- tate has fallen to the bottom of the vessel, and the supernatant fluid, which contains sulphate of potassa, has been poured off, the pre- cipitate is first digested with dilute sulphuric or muriatic acid, in order to dissolve the excess of oxide of iron; the beautiful dark blue precipitate is then collected on a filter, carefully washed with boiling water, and dried. The following form for the preparation of "pure Prussian blue," is admitted into the last edition of the Pharmacopoeia of the Uni- ted States:—Take of Sulphate of iron, §iv.; Sulphuric acid, f. 3iiiss.; JVitric acid, f. 3yj., or a sufficient quantity; Ferrocyanuret of Potas- sium, ^ivss.; Water, Oij. Dissolve the sulphate of iron in a pint of water, and, having added the sulphuric acid, boil the solution. Pour it into the nitric acid in small portions, boiling the liquid for a minute or two after each addition, until it no longer produces a dark colour; then allow the liquid to cool. Dissolve the ferro- cyanuret of potassium in the remainder of the water, and add this solution gradually to the first liquid, agitating the mixture after each addition; then pour it upon a filter. Wash the precipitate with boiling water until the washings pass tasteless. Lastly, dry it and rub into powder.* Ferrocyanuret 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. It adheres firmly to the tongue, which Riecke thinks is owing to its containing argil. EFFECTS ON THE ECONOMY. Of the effects of ferrocyanuret of iron on the human economy in health we have no evidence. Coullon gave it to various ani- mals, but observed no action from it. It has been given, how- ever, and not without success, in several diseases; and Dr. L. W. Sachs, who has not unfrequently administered it, considers it one of the most important chalybeates with which we are ac- quainted. He thinks it probable, that the hydrocyanic acid has not much agency; yet it certainly seems to differ from all the other pre- parations of iron. It has been especially recommended in epilepsy by Kirckhofff of Ghent. In very obstinate cases, not dependent upon organic mischief, he succeeded entirely with it; with the * Pharmacopoeia of the United States, p. 109. Philad. 1842. 1 Journal de Chimie Medicale, iii. 285. See, also, Journ. des Connais. Med. Chirur. Aout, 1841; or Encycl. des Sciences Med. Sept. 1841, p. 468. FERRI FERROCYANURETUM. 295 adult, he commenced 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 blood-letting, or applied leeches, from time to time, to the temples. Hildenbrand and Ger- geres confirm its efficacy in epilepsy. It has also been adminis- tered by Dr. Zollickoffer* 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, quinia, and asafoetida, nitrate of silver, and subcarbonate of iron had been given in vain. In intermittent fever Dr. Zollic- kofferf found it so efficacious, that he even gave it the preference over cinchona: 3nd his experience has been confirmed by that of Eberle,+ Hosack,§ J. E. Craighead,|| and others. -Wutzer, in Ger- many, also exhibited it successfully; and Stosch gave it advanta- geously, 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 as a scruple has been administered. Sachs found it several times efficacious, when four doses of two grains each were taken; and Riecke^f affirms, that his father obtained essential ser- vice from it in the leucophlegmatic conditions resulting from intermittent fever. Zollickoffer extols the ferrocyanuret also in remittent fever; and there may, doubtless, be periods when it may be administered with benefit; but* it is not often used. He recom- mends it, likewise, in dysentery,** when the inflammatory condi- tion has passed away, either spontaneously or under the efforts of art; and Sachs remarks, that in atonic conditions of the intesti- nal canal, which supervene on dysentery, it may doubtless be of great service. Gergeres 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 for- mal nosology; their common bond, hovvever, was, that they were dependent upon "nervous disorders, especially of the plastic func- tions of the abdominal organs, the mischief appearing first of all to be gastric." In such affections he found a combination of the ferrocyanuret of iron with rhubarb especially serviceable. He gave it in not less than two grain doses, which he gradually aug- mented to six grains, three times a day. Dr. Moll saw decidedly good effects from its use in a case of immoderate menstruation from * Medical Examiner, May 16, 1840, p. 314. t American Medical Recorder, v. 540. X Materia Medica, 2d edit. i. 233. § New York Medical and Physical Journal, 1823. || Dunglison's American Medical Intelligencer, May, 1842, p. 230. IT Op. citat. S. 217. ** Chapman's Philadelphia Journal, Aug. 1823. 296 FERRI PRiEPARATA. atony of the uterus with general elevation of the nervous excitability, after he had employed the remedies, commonly recommended, un- successfully. He found it also extremely beneficial to children of a strumous habit, and of great torpor. Stosch found it serviceable in a case of scrofula, in which hae- matosis was imperfectly accomplished; and Dr. Bridges* obtained great advantage from it in a case of severe and protracted facial neuralgia. Externally, the ferrocyanuret has been used in the form of oint- ment, 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; making it into a paste with water and applying it in that form. - MODE OF ADMINISTRATION. Pulvis ferri ferroeyanurcti. Powder of ferrocyanuret of iron. R. Ferri ferrocyan. gr. iij. ad. xxxvj. Sacchar. gij. M. et divide in pulveres vj. Dose.—A powder two or three times a day, in epilepsy. Kirckhoff. R. Ferri ferrocyan. gr. j., iv., vj.. ad xij. Sacch. 3j. Fiat pulvis in partes xij. aequales dividendus. Dose.—A powder every two hours, in epilepsy. Von Hildenbrand. R. Ferri ferrocyan. Guaiac. pulv. aa. gj. Misce et divide in chartulas xij. Dose.—One, three times a day.—Employed successfully in in- termittents.'f PilulBB ferri ferrocyanureti. Pills of ferrocyanuret of iron. R. Ammoniac. Rhei Ext. taraxac. aa. gj. Ferri ferrocyan. gr. xviij. ad. xxx*j. M. et fiat massa in pilulas lx. dividenda. Dose.—Four to six, twice a day, in disorder of the ganglionic system. L. W. Sachs, &r Radius. Unguentum ferri ferrocyanureti, Ointment of ferrocyanuret of iron. R. Ferri ferrocyan. gj. Unguent, cetacei |j. M. et fiat unguentum. Applied to foul ulcers. * Wood and Bache's Dispensatoiy, art. Ferri Ferrocyanuretum. t Ellis's Formulary, 8th edit p. 186. Philad. 184(5. FERRI IODIDUM. 297 LXXIX. FERRI IO'DIDUM,. Synonymes. Ferri Ioduretum, Ferrum Iodatum, lodated Iron, Iodide of Iron, Ioduret of Iron, Protoioduret, Protoiodide or Protiodide 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 Pro- toxide of Iron. French. Hydriodate de Fer. German. Hydroiodsaures Eisenoxydul, Iodeisen, Iodvvasserstoffsaures Ei- senoxydul, Eiseniodiire. Although attention had been directed, several years ago, to this preparation, it was not much used, until Prof. A. T. Thomson,* of the London University, recommended it strongly in a special monograph several years since. It has been received into different Pharmacopoeias. METHOD 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 ad- ditional 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 combi- nation 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, vvhen it must be filtered. This solu- tion contains a hydriodate of the protoxide of iron; and, if the exact quantity of the iodine be previously ascertained, so as to enable the solution to be procured of a definite strength, it may be kept in this state for medicinal use. In general, however, the solution 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 is reduced to one-third. It must then be filtered, after which the evaporation should be continued to dryness. It is necessary to break the flask as soon as the mass is cold, in order to obtain the solid iodide, vvhich should be immediately transferred to a dry bottle, accurately fitted with a ground stopper. The bottle should not hold more 'I.an two ounces of the preparation; for vvhen 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 * Some Observations on the Preparation and Medicinal Employment of the Ioduret and Hydriodate of Iron, 8vo. p. 04. Lond. 1834. 298 FERRI PR.EPARATA. is cold, deliquescence also takes place, a peroxide of the metal is formed, and iodine is evolved. The form for the preparation of the solid iodide recommended in the last edition of the Pharmacopoeia of the United States is the following:—Take of Iodine, ^ij., Iron filings, ^i., Distilled water, a pint and a half. Mix the iodine with a pint of the distilled water in a porcelain or glass vessel, and gradually add the iron filings, stirring constantly. Heat the mixture gently until the liquid ac- quires a light greenish colour; then filter, and after the liquid has passed, pour upon the filter half a pint of the distilled water boiling hot. When this shall have passed, evaporate the filtered liquor at a temperature not exceeding 212°, in an iron vessel, to dryness. Keep the dry iodide in a closely stopped bottle.* The plan proposed by Mr. Durand,f of Philadelphia, after that by MM. Baup and Caillot4 for preparing the solution of the pro- tiodideof iron (hydriodate of protoxide of iron) is the following:— Take of Iodine, %x., Iron filings, perfectly pure and unoxidized, J v., Distilled water, gxiiss. Put the iodine into a porcelain capsule, with one half the quantity of water, and add the iron filings by small portions, stirring the mixture with a glass rod. The combination soon takes place; heat is evolved with the disengagement of a small quantity of vapour of iodine, and the mixture acquires an orange colour, vvhich 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 ioduretted hydriodate of iron is first pro- duced, which, under the action of heat, soon passes to the state of a simple hydriodate. This point is indicated by the entire dis- coloration of the solution. In this state it is filtered ; and the dregs and filter are carefully washed with the remaining half of the dis- tilled water, previously heated to the boiling point. In this man- ner, a solution forming twelve and a half fluidounces 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 ioduretted hydriodate of iron ; but it may be easily restored to its former state by heating it again with a small quantity of iron filings, until the liquid becomes colourless: or, to prevent these changes, a coil of soft iron wire may be kept immersed in it; a fact, which has been long known,§ but which M. Dupasquier has recently rediscovered.|| 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 * Pharm. of the United States, p. 110. Philad. 1842. t Philad. Journ. of Pharmacy, iv. 287. Philad. 1833. } Ibid. i. 201. § Mr. Squire, Annals of Philosophy, May, 1836, p. 79. || Journal de Pharmacie, Mars, 1842, p. 224. FERRI IODIDUM. 299 the capsule as it forms. The heat must be managed most care- fully, 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 pale greenish colour, and deeper in proportion to the decomposition which some parts may have undergone towards the end of the operation. Iodide of iron 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 important to prevent this, as the peroxide of iron is compara- tively inert as a medicinal agent; whilst the free iodine extricated during its oxidation, 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 per- manent, clear, very pale greenish-yellow, we obtain an ochre-co- loured, completely insoluble 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 appa- rently similar. Even vvhen 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 prescriptions, by frequently exposing the iodide to the air, that its properties, and, consequently, its medicinal pow- ers, 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 quantity of iodine, as described, it will keep without changing its characters; but as it is usually made by dissolving the iodide in distilled water, it requires to be rendered neutral by the following means:—Intro- duce 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 extend 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, hovvever long it may be preserved, provided it be kept in a black- ened or a green bottle. In this process, the wire affords iron to saturate any free iodine present in the solution, or that may have been extricated by the formation of the peroxide of iron in the iodide; and a perfectly neutral solution beipg thus obtained, by the immediate conversion of the newly formed iodide into the hydriodate of the protoxide, no subsequent change takes place so 300 FERRI PR^PARATA. long as the solution is kept secluded from the light. The best proportions, according to Dr. Thomson, for forming the medicinal solution, are three grains 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 particu- larly if it contain any earthy or saline carbonates, decomposition instantly takes place, 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 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, Junr.* Take of Iodine, 11 drams; Iron filings, 4 drams; Syrup, Uncrystallizable honey, or Uncrystalli- zable sugar, 4 ounces; Distilled water, a sufficient quantity. Mix the iodine with eight fluidounces of the distilled water, and gradually 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. The Liquor Ferri Iodidi or Solution of Iodide of Iron of the last edition of the Pharmacopoeia of the United States (1S42,) is essentially the same as this. The saccharine matter employed in it, is prepared honey. The solution, thus obtained, is of a pale greenish colour. It has little or no sediment. M. Oberdorffer, of Hamburg,! gives the following form for the preparation of the sesqui-iodide of iron; whose effects, and mode of administration, are the same as those of the iodide. It may be preserved a long time without undergoing decomposition. Mix in a glass vessel half an ounce of iodine; a dram and a half of iron filings; and an ounce of water. When the reaction is com- pleted, the mixture is to be slightly shaken, until it becomes of a clear green colour, which is due to the iodide of iron. It is then diluted with four ounces of water, filtered, and some water is passed through the filter. To the solution two drams of iodine are afterwards added, which are readily dissolved. A deep red- dish-brown liquid results, to which a sufficient quantity of water is added to make the weight of the whole ten ounces. Each dram contains about four grains and a half of iodine. When iodide of iron is carefully prepared, it is of an iron-gray colour, foliated texture, brittle, and exhibits a crystalline arrange- * Amer. Journ. of Pharmacy, for July, 1840, p. 13; and ibid, for Jan. 1841, p. 323. t Zeitschrift fur die gesammte Medicin. Juin, 1840, S. ferri iodidum. 301 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, somewhat acrid, before it impresses the gustatory organs. At 350° of Fahrenheit it fuses; and, at a higher temperature, is de- composed,—the iodine being volatilized, and the iron remaining in the state of oxide. It dissolves in all proportions in water,— the changes supervening, which have been already indicated. It is decomposed by chlorine, the mineral acids, oxide of arsenic, meconic acid—consequently by opium and laudanum—gallic and tannic acids, the pure and carbonated alkalies, different metallic salts, and by the infusions of digitalis, belladonna, hyoscyamus, tobacco, amylaceous substances, &c.: such articles ought not, there- fore, to be given in combination with it. EFFECTS ON THE ECONOMY IN HEALTH. From experiments made on his own person, Dr. Thomson states the following to be the physiological effects of iodide of iron. When taken in doses of from three to five grains, it makes no sensible impression on the stomach, although it sharpens the appetite, and improves the digestive function: it seems to stimu- late 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 fcetor. When it does not affect the bowels, it augments 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 in succession, the presence of both the iodine and the iron can be readily detected in the urine. The temperature of the skin is moderately elevated, and the insensible perspiration in- creased. On one occasion, having taken ten grains for a dose, it almost immediately caused an uneasy sensation at the epigastrium, accompanied with nausea, that continued for several hours, and a slight degree of headach. These symptoms were relieved by a copious evacuation, vvhich was perfectly black. Two hours after taking the medicine, a large quantity of urine was discharged; vvhich, on being tested, displayed the presence of both iodine and iron. The experiments on animals, made by Dr. Cogswell,* induced him to infer:—1. That iodide of iron acts as a local stimulant. possessing the power of affecting peculiar disorganization.—2. That its action is more particularly directed to the tract of the alimentary canal. When added to blood out of the body, it promotes its coagula- tion.f * Essay on Iodine, p. 132. Edinb. 1837. t Magendie, Legons sur le Sang, &c.; or translation in the Lancet, Jan. 26,1839. 20 302 FERRI PRJEPARATA. EFFECTS ON THE ECONOMY IN DISEASE. From the chemical composition of iodide of iron, Dr. Thomson considered it might be specially adapted for cases in which augment- ed activity of the capillary or intermediate system, with a tonic effect, might be indicated, and particularly in scrofulous affec- tions, tabes mesenterica, chlorosis, incipient scirrhus, rickets, amenorrhoea, bronchocele, atonic dyspepsia,—indeed in all cases accompanied by debility. In such affections, he conceives the io- dide 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 aid- ed by the administration of arsenic at the same time. Dr. Thom- son has found it serviceable in atonic gastric dyspepsia, when com- bined with bicarbonate of potassa, and taken at the moment of ad- mixture, 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 con- dition of the fluids. In chronic scrofulous cases, it produces all the good effects of the preparations of iron, without any of the con- comitant and subsequent symptoms that are so apt to supervene, especially in impressible individuals. Where the case is accompa- nied by vascular erethism, or fulness, it must be reduced before the iodide can be esteemed appropriate. In chlorosis, occurring in strumous habits, it has been found most serviceable. Dr. Ashwell,t prescribed it with success in such cases, in association with colom- ba or gentian, according to the formula given hereafter. Its effica- cy in cancer is elucidated by Dr. Thomson, by the details of a case of scirrhous mamma, which, after protracted and fruitless treat- ment by other agents—as by other preparations of iron combined with conium—ultimately yielded to a combination of iodide of iron and conium. Some cases are also detailed in which it was very effective in removing old syphilitic affections, especially of the skin. M. Baumes,| who employed the iodide wrilh the most sa- tisfactory results in old and obstinate syphilitic ulcers, especially* when the patient was feeble and scrofulous, gave it in the form of pills with extract of opium,—increasing the dose of the iodide from two or three to twelve or twenty grains in the twenty-four hours. Along with the cicatrization of the sores, the improve- ment of the general health was most remarkable. Prior to the publication of Thomson, Pierquin had given the iodide in cases of leucorrhoza and amenorrhoea; and Eager§ had re- commended it in scrofula. Ricord|| found the very best effects * London Dispensatory, and Brande's Dictionary of Mat. Med. p. 252. London, 1839. See, also, Solon, in Diet de Med. et de Chirurg. Pratiq. art lode; and Ashwell, in Guy's Hospital Reports, p. i. 128; and p. iii. p. 555. t A Practical Treatise on the Diseases Peculiar to Women, Amer. edit. p. 32. Philad. 1845. X Medico-Chirurgical Rev., Oct. 1840. § Dublin Journ. of Med. Science, 1834; also, Cogswell on Iodine, p. 138. Edinb. 1837. || J. J. L. Rattier, in La Lancette Frangaise, F/:v. 4, 1837. FERRI IODIDUM. 303 from its internal use in cases where tonics required to be combined with antisyphilitic remedies, especially where any scrofulous vice (lymphalisme) constituted a complication. He administered it, likewise, with great success, to remove the consequences of syphilis; and found it advantageous in atonic idcers of the legs and in spread- ing ulcers of the throat, vvhich had been aggravated or had not yielded to mercury. The strength of M. Ricord's solution was half a dram of iodide to 5viij. of water, given, we presume, in the twenty-four hours. M. Ricord* also uses it in the form of injec- tion in cases of blennorrhoza. Wherever, indeed, tonic astringent injections are needed, the iodide, in his opinion, should occupy the first rank. Its use, he thinks, can only be contraindicated 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 fluidounce of water. In consequence of its promoting the coagulation of the blood out of the body, Magendief prescribed it in the form of injection (f. 3i. to Oij. of water,) several times a day in a case of severe uterine hemorrhage. The hemorrhage ceased. A case of confirmed diabetes% was treated in the Hotel Dieu of Paris, by the iodide given in the form of pill, each pill containing five grains of the iodide. Four pills were taken in the twenty four hours. In this case, the iodide must have been efficacious, for the usual animal diet recommended in such cases had failed previ- ously to do good until it. was associated with the iodide. It has likewise afforded apparent benefit in cases of tubercular phthisis, and in the mass of such cases is as well adapted for mo- difying the morbid action of the system of nutrition, so deeply implicated in that fatal malady, as an}' other agent. The syrup is perhaps the best preparation. Dr. C. J. B. Williams|| considers the iodide to answer better than any other chalybeate in chorea. It pervades the system more rapidly, he thinks, and keeps the secretions more free. He gives it in doses of one grain three times a day, increased to four or five grains, taking care, at the same time, that the bowels are open. Mr. B. PhillipsIT prefers the iodide of iron in scrofula to any of the preparations of iodine. The minimum dose hasbeen agrain twice a day; the maximum three grains three times a day. In 232 cases, it was only necessary to intermit its use for a few days in three cases. * J. J. L. Rattier, Ibid. Fev. 16, 1837; see, also, Revue Medicale, Janvier, 1838, cited in Dunglison's Amer. Med. Intel. Sept. 15, 1838, p. 195. t Op. cit. X Cited in Provincial Med. and Surg. Journ. Nov. 5, 1842, and in Braithwaite's Retro- spect, vii. 66. Lond. 1843. \ The results obtained in the Hotel Dieu are referred to in Lond. Lancet, July 8,1843, 6517; and in Braithwaite's Retrospect, Amer. edit, viii 64. New York, 1844: see,also,M. oissiere, Gazette Med. de Paris, Dec 24, 1842; cited in Lond. and Edinb. Monthly Journal, Feb. 1843; and in Amer. Jour, of the Med. Sciences, April, 1843, p. 454. || Medical Times, May 24, 1845, p. 133. If Lond. Med. Gazette, Jan. 10, 1840; see, also, Scrofula; its Nature, Causes, Ac., by B. Phillips, F. R. S., Amer. edit. p. 248. Philad. 1846. 304 FERRI PR^EPARATA. In'one it excited ptyalism. About once a week he gives an aperient or cathartic. In cases of scrofulous ulceration, as a consequence of abscess, or from other causes, he employs, with the best effect, a lotion containing three or four grains of the iodide to an ounce of distilled water. Where parts are irritable, he usually recommends the ointment of iodine to be applied to the part on lint. The author has frequently given this remedy in public and pri- vate practice,and has 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 system of nutrition. In oligsemia, where there is paucity of red globules of the blood, and the fluid is altogether too thin, it would seem to be especially indicated, from its property, mentioned above, of promoting the coagulation of the blood, and therefore, of inspis- sating it. Hence, in all cases of scorbutic, hydropic and other dyscra- sies, and in hemorrhages occurring in such pathological conditions, the author has prescribed it largely, and with excellent effects. It appears to him to be the best remedy we possess wherever a eutrophic and tonic are indicated. MODE OF ADMINISTRATION. The dose of iodide of iron, administered in the cases above referred to, was generally three or four grains two or three times a day. Pilulae ferri iodidi, Pills of iodide of iron. These pills may be prepared in the following manner, according to a formula communicated by Mr. Robert Leslie, of Glasgow, to Dr. Christison of Edinburgh.* Take of iodine, 127 grains; iron wire, of about the thickness of a thin quill, half an ounce; distilled water, 75 minims. Agitate them briskly together in a strong ounce phial provided with a well fitted glass stopper, until the froth which forms becomes white. This will happen in less than ten minutes. Pour the liquid upon two drams of finely powdered loaf sugar in a little water, and triturate immediately and briskly for a few minutes; add gra- dually a mixture of the following powders,—liquorice powder, half an ounce; powder of gum Arabic, a dram and a half; flour, a dram. Divide the mass into 144 pills. Each pill will contain about a grain of iodide of iron. Vinum ferri iodidi. Wine of iodide of iron. R. Ferri iodidi gss. Vin. Bordegalens. Oj. M. * Pharmaceut. Transact. Aug. 1, 1844, p. 79, cited in Braithwaite's Retrospect. Amer. edit, ptx.p. 100. New York, 1845. FERRI IODIDUM. 305 ,f Dose.—A tea-spoonful, morning and evening. Pierquin.* Tinctura ferri iodidi. Tincture of iodide of iron. R. Ferri iodidi gij. Alcoholis. AquEe. aa. f. gij. M. Dose.—A tea-spoonful, morning and evening. Pierquin. Mistura ferri iodidi eomposita. Compound mixture of iodide of iron. R. Ferri iodidi gr. xvj. Tinct. colomb. seu ------gentianas comp. f. gj. Aquae destillat. f. gvij. M. Dose.—Two table-spoonfuls two or three times a day. Ashwell. Syrupus ferri iodidi. Syrup of iodide of iron. Various forms have been given for this preparation.f The following is the one admitted into the last edition of the Edin- burgh Pharmacopoeia:—Take of Iodine (dry,) 200 grains; Fine iron wire, recently cleaned, 100 grains: White sugar in powder, four ounces and a half; Distilled water, six fluidounces. Boil the iodine, iron and water together in a glass matrass, at first gently, to avoid the expulsion of iodine vapour, afterwards briskly till about two fluidounces remain. Filter this quickly, while hot, into a matrass containing the sugar; dissolve the sugar with a gentle heat, and add distilled water to make up six fluidounces. Twelve minims of this syrup contain one grain of the iodide. It ought to be nearly colourless or pale yellowish-green, and with- out sediment. Dr. Christison states, that it will always be defec- tive in strength "when made with British iodine as now commonly met with in the market, unless allowance be made for the water, which it very generally contains in large proportion.'^ Trochisci ferri iodidi. Lozenges of iodide of iron. R. Ferri iodidi gss. Croci pulv. gij. Sacchar. giv. M. fiant Trochisci No. 120. Dose.—Six to ten, daily. Pierquin. * Journal de Chimie Medicale, p. 310, Mai, 1831. t Frederking, Repertor fur die Pharmacie, 1839, cited in Amer. Journ. Med. Sciences, Feb. 1840, p. 499; Dupasquier, Journ. de Pharm. Mars, 1841,p. 116, and Mars, 1842, p. 225; F. Boudet, ibid. Sept. 1841, p. 335; M. Beral, Journ. de Chim. Med. cited in Amer. Jouni. of Pharmacy, April, 1841, p. 74; Dr. A. T. Thomson, Lond. Pharmac. Transactions, Aug. 1841; cited in Amer. Journ. of Pharmacy, April, 1842, p. 60; and M. Leistner, Joum. de Pharmacie, Fevrier, 1842, p. 122. X Dispensatory, p. 431. Edinb. 1842. 306 FERRI PR^PARATA. Solutio ferri iodidi, Solution of iodide of iron. (French, Eau d'1'Hydriodate de Fer.) R. Ferri iodidi gss. Aquae Oij. M. Added to enemata, lotions, and injections. R. Ferri iodidi, gss. ad gij. Aquae destillat. Oj. M. To be added to a general bafh in cases of leucorrhoza, amenor- rhoea, &c. Injectio ferri iodidi. Injection of iodide of iron. R. Ferri iodid. gr. iij. Aquas destillat. f. gvi. M. The quantity may be increased to nine grains to the ounce of water, care being taken to avoid irritation. Used in gonorrhoea. Ricord* Unguentum ferri iodidi. Ointment of iodide of iron. R. Ferri iodidi giss. Adipis gj. M. ut fiat unguentum. A piece the size of a hazelnut to be rubbed, morning and evening, on the inner part of the thigh, in cases of leucorrhoza and amenorrhoea. LXXX. FERRI LACTAS. Synonymes. Lactate of Iron, Lactate of Protoxide of Iron. French. Lactate de Fer. German. Milchsaures Eisenoxyd. This preparation has been recommended by MM. Gelis and Conte, internes at La Charite, in Paris, and has been favourably reported upon by M. Bouillaud, in the name of a committee, con- sisting of MM. Bally, Fouquier, and Bouillaud.f METHOD OF PREPARING. MM. Gelis and Conte prepare lactate of iron by treating vure iron filings with lactic acid, diluted with icater. M. Louradour| extracts lactic acid from whey, which he 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 »« o^aCo?M Tr?o!o °n Venereal leases, translated by Drummond, Amer. edit p. 4At, tuy. rnilad. 184o. l t Journal de Pharmacie, cited in Amer. Journal of Pharmacy. July, 1840,p. 121. See.also, ♦ if'V • °^m^e ^lm,e ^edlcale- cited Jn Amer. Journ. of Pharm. April, 1841, p. 74. \ Bulletin General de Therapeutique, Mars, 1840. FERRI LACTAS. 307 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, vvhich precipitates the lactine and the salts. The solution on being filtered, and the alcohol distilled off, yields pure lactic acid. Lactate of protoxide of iron is prepared by digesting in a sand-bath, at a low temperature, this acid, diluted with water, upon iron filings. At the end of six or seven hours of reaction, the liquid is boiled, filtered, and concentrated; when, on cool- ing, it deposits crystals. These crystals, drained on a funnel, and washed with alcohol by displacement, should be dried rapidly, and be preserved from any contact with the air. The salt presents itself under the form of crystalline plates, vvhich are very white, and but slightly alterable. It is but sparingly soluble in water; reddens litmus paper, and possesses the ferruginous taste in a tole- rable 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 purifi- cation of lactic acid by alcohol, and treating it immediately by iron filings: the liquor, suitably evaporated, affords crystals of the lactate : the foreign salts, and the lactine remain in the mother waters, which are rejected. As the lactate would seem to be often adulterated with efflo- resced sulphate of iron, or the same precipitated with alcohol, or with starch or sugar of milk, M. Louradour recommends, that no lactate should be used except what is under the form of crystal- line plates, which do not readily admit of fraud.* EFFECTS ON THE ECONOMY. Lactate of iron has been used in cases in which protocarbonate of iron is employed, and chiefly in chlorosis. MM. Gelis and Conte are disposed to refer the beneficial agency of the protocarbo- nate to its becoming lactate of iron in the stomach, by uniting with the lactic acid, which has been presumed, but erroneously, to be one of the healthy gastric acids. This idea led them to administer lac- tate 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.f M. Bouillaud:}: made trial of the * Joum. de Pharmacie, and Amer. Joum. of Pharmacy, Oct. 1840, p. 230. t Bulletin General de Therapeutique, Mars, 1840; also, La Lancette Franoaise, cited in London Lancet, Feb. 8, 1840, p. 707, and Dunglison's Amer. Med. Intel. April 1. 1840, p. 13. X Encyclographie des Sciences Medicates, Mars, 1810, p. 226. Academie Royale de Medicine de Paris, Seance du 4 Fevrier, 1840. SOS FERRI PR.EPARATA. lactate in twenty-one cases, 14 of which were treated at La Charite. One of the last cases not being decidedly chlorotic may be excluded. Of the thirteen, ten were females, and three males. Of the ten females, eight presented well marked chlorosis; two were rather anaemia. The dose of the lactate was carried to six, eight, ten, twelve, and fifteen lozenges, each containing about five centigrammes of the salt (gr. |) in the twenty-four hours. The remedy was well borne; and it always sensibly increased the appetite. MODE OF ADMINISTRATION. MM. Gelis and Conte introduce freshly prepared lactate of iron into lozenges, in which the sugar prevents the superoxidation 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 lactate in the twenty-four hours; and M. Bouillaud never gives more than twenty. The following formulas have been proposed by Mr. Cap:* Trochisci ferri laotatis. Lozenges of lactate of iron. R. Ferri lactat. gvij. gr. 43 (30 grammes.) Sacchar. gxiss. (360 grammes.) Mucilag. acacia?, q. s. Make into lozenges each weighing gr. x. (65 centigrammes) which will contain gr. | (5 centigrammes) of the salt. Syrnpns ferri lactatis. Syrup of lactate of iron. R. Ferri lactat. gi. (4 grammes.) Aquse destillat. bullient. gviss. (200 grammes.) Sacchar. alb- gxiij. (400 grammes.) M. Cap considers the use of this syrup to be more convenient than that of the lozenges, because the ferruginous taste does not remain so long in the mouth. Pilnlff ferri lactatis. Pills of lactate of iron. R. Ferri lactat. Althaea pulv. aa.gr. xvss. (1 gramme.) Mellis, q. s. ut fiant pil. xx. ' Chalybeate bread has been administered in one of the largest hospitals of Paris to chlorotic patients, and with the best effects *rom four to five grains of the lactate of iron may be mixed with every three and a half ounces of bread, without giving it any un- pleasant taste or injuring its quality.f * Journal de Pharmacie, and Amer. Journ. of Pharmacy, Oct. 1840 p 228 M^SetSTs^ort^'031 J°Umal' "^ ,Ml' dted * ^ J'°Um- °f the FERRI NITRAS. 309 LXXXI. FERRI NITRAS. Synonymes. Ferrum Nitratum, Ferrum Nitricum Oxydatum, Nitras Ferri, Nitras Ferricus, Nitrate of Iron. French. Nitrate de Fer. German. Salpetersaures Eisenoxyd. LIQUOR FERRI PERSESQUINITRATIS. Synonymes. Liquor seu Solutio Nitratis Ferri, Liquor Ferri Nitrici Oxvdati, Solution of Persesquinitrate of Iron, Solution of Nitrate of Iron. METHOD 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 persesquinitrate; then decant the liquid from the portion of iron, which remains undissolved; strain and filter. Add the muriatic acid with the remainder of the water, or with as much of that liquid as will in- crease 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) generally dissolve an ounce of iron, so that when the process is completed, a portion of the metal remains undissolved. The solution then consists entirely of 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 protoni- trate of iron. The first of these is insoluble, and renders 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 become tur- bid. The addition of some muriatic acid prevents this decom- position, and the quantity sufficient for this purpose is too small to affect the medicinal powers of the persesquinitrate. The solu- tion, when properly prepared, is of a beautiful dark red colour, when viewed with transmitted light. Its taste is very astringent, and not at all caustic* * Mr. Kerr, in American Journal of the Medical Sciences, for May, 1832, cited from the Edinb. Med. and Surg. Journal. 310 FERRI PRiEPARATA. EFFECTS Otf THE ECONOMY. This preparation greatly resembles the solution of chloride of iron in its medicinal properties. Mr. Kerr considers, that to an astringent povfrer it unites the property of diminishing the irrita- bility and tenderness of the mucous membranes with which it comes in contact. Kopp administered it with the greatest success in many cases of chronic diarrhoza, that had resisted every approved remedy. The faeces were blackened by it, as by the preparations of iron in general. He remarks, 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 remedy was gradually diminished, until it was left off altogether.* Dr. Gravesf speaks in equally high terms of the persesquinitrate in these cases; and Dr. T. C. Adam of Lenawee County, Michigan, has recorded the remarkable assistance which he has derived from its use in the treatment of several diseases, especially diarrhoza and other affections of the mucous membranes accompanied by dis- charges.\ * In chronic diarrhoza, 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 com- mencement, and after a few days' employment of the remedy, he increases the quantity to twenty, twenty-five, and thirty drops. In leucorrhoza, 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 tincture of chloride of iron. LXXXII. FERRI OX'IDUM HYDRATUM. Synonymes. Ferri Sesquioxidum Hydratum, Ferrugo, Hydras Ferricus, Ferrum Oxydatum Hydratum, F. 0. Hydricum, Oxidum Ferri seu Ferri- cum Hydratum, Hydro-oxide of Iron, Hydroxide of Iron, Hydrated Oxide of Iron, Hydrated Peroxide of Iron, Hydrated Tritoxide of Iron, Hydrated Sesquioxide of Iron, Oxyhydrate of Iron. German. Eisenoxydhydrat, Wasserhaltiges Eisenoxyd. Hydrated oxide of iron has been introduced into practice as an antidote to white arsenic Dr. Bunsen, of Gottingen, had already * See, also, Twining on the Diseases of India, i. 217. Calcutta, 1835. 1 Clinical Lectures, Dunglison's Amer. Med. Library edition, p. 128. Philad. 1838. X Amer. Journ. of the Medical Sciences, May, 1839, p. 61. FERRI OXIDUM HYDRATUM. 311 made frequent experiments with it, which satisfied him, that it was an efficacious agent, when, along with Dr. Berthold,* he subjected it to fresh trials. The.results of their investigations 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 oxy- gen by treating it with nitric acid, and precipitate the oxide by adding pure ammonia in excess, washing the precipitate. In or- der 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 deposit- ed, after vvhich the supernatant fluid is poured off. It is then kept in well-stopped vessels. Rieckef has added the formula for pharmaciens, which is recom- » mended by Von Specz:— R. Vitrioli ferri puri crystdllizati libram; teratur in pulv. subtiliss. et de- tur in vas. porcellan. aut murrhinum, impositum balneo arena, dein adde acidi nitrici concentrati B5ss.; terantur ope baculi vitrei usque dum massa resolvitur in pultem; nunc, igne animato, massae pultaceae calidae affunde sensim terendo, sensim acid, nitric, concentrat. q. s. donee nullum amplius evofvatur gas nitrosum. Massa tunc leni igne evaporetur ad siccitatem et eolvatur demum in aq. destill. q. s.: solutioni filtratae instilletur ammonia pura q. s. donee precipitatie cesset; stent nunc per horam unam alteramve et liquor limpidus a sedimento bruneo decantetur; massas residua? fundum petenti adfunde aq. destillat. fbiij. et agitentur; nunc filtra, et prEecipitatum in filtro aq. destill. q. s. edulcora donee aqua insipida defluat. Praecipita- tum bene edulcoratum in umbra siccatum convertat. in pulv. subtilissim. qui servetur vase vitreo bene clauso.t , 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 deve- loped, and deutoxide of azote, which is transformed by the atmo- spheric air into nitrous acid vapours. When the evolution of gas has ceased, ten or twelve parts of water are added; the mixture is then filtered, and ammonia added until the mixture begins to exhi- bit an alkaline reaction. The precipitate, thus formed, is the hy- * Das EisenoxyBhydrat ein Gegengift der arsenigen Saure. Gotting. 1834. t Die neuem Arzneimittel, S. 227. Stuttgart, ].*37. + "Take of pure crystallized 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 half a pound of con- centrated nitric odd,- 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 concen- trated 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 solution drop pure ammonia so long as any precipitate occurs; let it now stand for an hour or two, and then pour off the limpid liquor from the brown sediment. On tbe residuary mass remaining at the bottom, pour three poimds 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 pow- der, which may be kept in a well closed vessel." • 312 FERRI PRiEPARATA. drated oxide of iron, which is collected on the filter, and washed with boiling water until it is tasteless, and ceases to exhibit any al- kaline characters. The mode of preparation recommended by Majest6, 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 was advised by the late Dr. William R. Fisher,* who asserted that it was subjected to practice by Mr. Durand, an able pharmacien of Philadelphia, who obtained a per- fect result, with a satisfactory economy of material. Take of sul- phuric acid, (67° Baume,) 8 oz. or 16 parts; iron wire, 8 oz. or 16 parts; nitric acid, (49° Baume,) 5h oz. or 11 parts; water of ammo- nia, as much as is sufficient; water, a gallon and a half, or 384 parts. Mix the sulphuric acid with the water in a glass vessel. Add the iron, and, after the 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 solution, 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 consistence of thick cream. It has been supposed that this preparation is not injured by keeping; but some careful experiments by Mr. Wm. Procter, Junr.,f show, that even when kept under water its power of neu- tralizing arsenious acid gradually decreases; that if kept in the form of a thick magma, it will retain its properties longer than when mixed with much water; and that this decrease of power is probably owing to a change in the relative proportion of the ox- ide, and the water chemically combined with it, as well as to an alteration in its state of aggregation. Mr. Procter advises, that a ferruginous solution similar to that advised in the United States Pharmacopoeia should be kept in every shop as a source for ob- taining the peroxide; and that the solution of ammonia should be added to it when the demand occurs, and the peroxide be separated in the manner advised in the Pharmacopoeia. In this mode the first doses may be given in ten or fifteen minutes. In the mean time, however, the moist peroxide prepared according to the Pharmacopoeia should be given, and if recently prepared it may be sufficient; but for the reasons adduced by Mr. Procter it is advisable that the recent oxide should always be administered, especially where the amount of poison taken has been large.:}: The form for its preparation admitted into the last edition of the Pharmacopoeia of the United States (1842), is the following: Take of Sulphate of iron, giv.; Sulphuric acid, f. 5iijss.; Nitric * American Journal of Pharmacy, vol. vi. No. 1, April, 1840. I Ibid, April, 1842, p. 37. t Procter, loc. citat. • FERRI OXIDUM HYDRATUM. 313 acid, f. 3yj., or a sufficient quantity; Solution of ammonia, a sufficient quantity; Water, Oij. Dissolve the sulphate of iron in the water, and, having added the sulphuric acid, boil the solution; then add the nitric acid in small portions, boiling the liquid for a minute or two after each addition, until the acid ceases to pro- duce a dark colour. Filter the liquid, allow it to cool, and add solution of ammonia in excess, stirring the mixture briskly. Wash the precipitate with water, until the washings cease to yield a pre- cipitate with chloride of barium, and keep it in close bottles with water sufficient to cover it.* EFFECTS ON THE ECONOMY. If a solution of arsenious acid be decomposed by freshly preci- pitated oxyhydrate of iron suspended in water, traces of arsenic can no longer be detected in the filtered liquid made acid and tested by a stream of sulpho-hydric acid gas. To throw down one part of arsenic, in this manner, requires a quantity of the oxyhy- drate, wmich 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 sulpho-hydric acid gas affords only very slight traces of sulphuret of arsenic in the filtered and acidulated liquid. When the substances are previously heated, or the arsenious acid is exposed in small por- tions 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 pow- dered 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 has been seen—an insoluble com- pound, 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 (he discoverer of the antidote, that under the influence of animal heat and the peristaltic motion, it had become completely converted into subarseniate of protoxide of iron, and thus rendered innocuous. Such was the result of the observa- tions of Boulet,f Orfila, Chevallier, Lassaigne, Soubeiran and Mi- quelj Nonat,Borelli and Demaria,§ Lesueur, Boulay,fils,|| Monod,1F * Pharmacopoeia of the United States, p. 112. Philad. 1842. t Gaz.Med.de Paris, 1834. X Bullet. General de Therap. Dec. 1834. § Br. and For. Med. Rev. April, 1836, p. 594. || Journal Hebdom. des Progres des Sciences Medic. Mars, 14, 1835. IT Gazette Medicale, Aug. 22, 1835, and Annates d'Hygiene, &c. xiv. 135. 314 FERRI PRJEPARATA. Von Specs, Mackenzie,* D. Maclagant and others.:}: On the other hand, the experiments of Brett,§ Reginald Orton,|| and Cramer, were unfavourable; but Messrs. Bunsen and Berthold remark, that the experiments of those gentlemen could not be expected to be successful, 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 neutralize 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 cases of poisoning by arsenic; and they advise emetics to be associated with it—along with the agents hitherto employed; first, when the quantity of the poison taken has been considerable, and, therefore, a very large quantity of the antidote is demanded; secondly, when, at the same time, substances containing tannic acid, as infusion of green tea, or sulpho-hydric acid, developed after the eating of eggs, may be suspected in the alimentary canal,—as these sub- stances are closely related to the antidote, and may weaken its action; and, thirdly, when, prior to taking the poison, the stomach has been overloaded with food, and is, therefore, capable of re- ceiving only a small quantity of the antidote. But, whether vomit- ing may be excited or not, recourse must be had to the oxyhydrate as speedily as .possible. Tepid mucilaginous drinks may also be given to envelop the particles of arsenic that may exist in the compartments of the stomach. If the quantity of the poison taken be unknown, the antidote may be administered in a considerable dose, and if the patient should vomit, it may be exhibited after- wards in smaller quantity. But, if no vomiting should arise, it is recommended that he should continue to take the oxyhydrate until the arsenite of iron formed has had time to pass into the intestinal tube; and even after this it may be persevered with in small doses for a time, as portions of arsenic may possibly remain behind un- changed. With the same view, the oxyhydrate may be thrown up in the way of clyster, whenever it is presumable, that the com- pound, formed by the oxyhydrate and the arsenic, has reached the lower portion of the bowels. To aid this, cathartics may be ad- ministered. Of these, castor oil, which would first suggest itself, might interfere, it has been conceived, with the operation of the antidote. Sulphate of magnesia, or any of the neutral salts, should have the preference. The antidote may be given suspended in water. Experience has shown Messrs. Bunsen and Berthold, that from ten to twenty * London Lancet, April 4,1840. 1 Edinb. Med. and Surg. Journal, July, 1840. t Dr. T. R. Beck, Amer. Journ. of the Medical Sciences, Ju'y, 1811, p. 90. § Lond. Med. Gaz. xv. 220. || Lancet, Nov. 8, 1834. II See, also, Dr. Maclagan, op. cit. FERRI OXIDUM HYDRATUM. 315 parts of hydrated oxide of iron are more than sufficient to convert one part of arsenious acid into ihe basic salt of iron. As the quantity of arsenic in the stomach and intestines can scarcely ever be appreciated, it is considered by them advisable, to allow the patient to take as large doses of the oxyhydrate as the stomach can tolerate; and it is of essential importance that it should be taken as hot as it can be borne. When the arsenious acid has been swallowed in the undissolved state—in the form of powder, or in larger or smaller pieces—it is necessar}?-, in order to aid its solution, and to effect a speedy union with the oxide of iron, to add a small quantity of pure ammonia to the antidote, until a slight alkaline reaction is evinced. As the ammonia does not enter into the composition of the salt formed, and, consequently, only plays a secondary part, ten or twenty drops may be sufficient for the purpose. In the uncertainty as to the precise quantity of poison that has been taken, it has been recommended, that to an adult a table-spoonful, and to children a dessert-spoonful, should be given every five or ten minutes until relief from the urgent symp- toms is obtained.* The various experiments that have been instituted on animals have shown the protective power of the hydrated oxide: it must be borne in mind, however, in all such experiments made on dogs, that they readily reject the poison by vomiting; but if the poison be retained in the stomach by a ligature passed round the oeso- phagus, it exerts its accustomed deleterious effects.f It would seem, also, that the same result occurs if the dose of the arsenic be too small to induce vomiting. The animal may then die of .the poison.£ It would appear, that cases have occurred, in which this anti- dote has saved the lives of some, who might have been destroyed without its agency. Buzorini§ had a case in which about thirty- five grains of arsenic had been swallowed, and where it was suc- cessful, although twenty-four hours had elapsed since the poison had been taken; but this cannot be regarded as very satisfactory, inasmuch as the patient might probably have been saved by ordi- nary means. In another case, which was also treated by the anti- dote at a late period, marked alleviation of the sufferings was in- duced. Three cases are related by Majeste, two by Bineau,|| one by Benoist, and one by GeoffroylT of Paris, which were treated suc- cessfully in the same manner. The subject of the last was a hair- dresser, thirty-five years of age, who, in a paroxysm of delirium * T. R. Beck, Amer. Journ. of Med. Sciences, July, 1841, p. 95. t MM. Miquel and Soubeiran, Bullet General de Therapeutique, Dec. 1834. See on this subject, Dr. Joseph E. Muse, in Dunglison's Amer. Med. Intel, for April 2, 1838. X Dr. Robert B. Hall, in Amer. Med. Intelligencer, for Sept. 15, 1838, p. Ibl. § La Lancette Frangaise, Nov. 17, 1835. || Journal des Connaissances Medico-Chirurgicales, Nov. 1835. TT Journal de Med. et de Chirurg. Pratiq. Sept. 1835; cited in Brit, and For. Med. Rev. April, 1836, p. 572. 316 FERRI PRiEPARATA. tremens, swallowed a dram and a half of arsenic. Half an hour afterwards the antidote was given, suspended in water. He drank, in twelve hours, all the hydrated oxide produced by the decom- position of five ounces and five drams of the sulphate of iron. He had no violent colic; and, twenty-four hours afterwards, experi- enced scarcely any uneasiness. A successful case has, also, been related by Mr. John Robson, house-surgeon to the Warrington Dispensary.* Dr. Richard H. Thomas, of Baltimore,t has published a case, in which it was believed that twenty grains of arsenic had been taken, which was relieved by the hydrated oxide, administered six hours after the poison was swallowed: there was no vomiting; but thirst, burning pain, and exquisite tenderness at the epigastrium existed, denoting endo-gastritis. Half a fluidounce of hydrated oxide, which was in the wet state, and about the consistence of thick cream, was given in a tumbler of cool water, and the dose was directed to be repeated every ten or fifteen minutes in two ounces of water: eight ounces of the suspended oxide were taken in the twenty-four hours, after vvhich the patient seemed free from disease. "The length of time—six hours"—says Dr. Thomas, "before any very severe symptoms supervened, and before the antidote was administered, at first caused me to think that the patient might have been deceived. Professor Von Specs, of Vienna, however, asserts, 'that a dram of arsenic, in powder, does not produce its deadly effect on the system in less than six or eight hours, while the same quantity, dissolved in warm water, destroys life in a much shorter time.' In the present instance, it was swallowed in a dry state, covered with sugar. The prompt relief which followed the exhibition of the peroxide is also con- firmatory of the impression that the poison was really taken." A case has been published by M. Deville,| which was treated by this remedy, but as the patient vomited much, and the vomited matters were not examined, it is doubtful what was its agency. Between five and six hours elapsed before it could be procured. These remarks apply still more forcibly to a case reported by Dr. Chaloner,§ the subject of which took at eight o'clock, p.m., about half an ounce of arsenic, after which he vomited incessantly, and did not take the hydrated oxide until three p. m., on the day fol- lowing. He got well: and the vomiting appeared to be relieved by it. More recently, several cases of the successful exhibition of the hydrated oxide have been published; one by M. Ansroul, of * Lond. Med. Gaz. Nov. 5, 1836; cited in Amer. Journ. of the Med. Sciences, p. 222, May, 1837. ^ v t Dunglison's American Medical Intelligencer, for July 16, 1838, p. 167. X Revue Medicale Frang. et Etrangere, Sept. 1838; see, also, Br. and For. Med. Rev., and Johnson's Med.-Chir. Rev. for April, 1839; and Amer. Journ. of the Med. Sciences, May, 1839, p. 243. § Medical Examiner, April 18, 1840, p. 251. FERRI OXIDUM HYDRATUM. 317 Brussels;* seven by Puchelt,f of Heidelberg; one by Dr. Mac- donald;^ one by Dr. Chilton ;§ and one by Dr. Murray,|| of India. Drs. Smiley and Wallace,lF of Philadelphia, administered it to a family of eight persons. Death followed in two cases. The antidote could not be retained by them, but was rejected imme- diately. In all the other cases, which recovered, the symptoms were mitigated. As recommended in the Pharmacopoeia of the United States, the hydrated oxide should be kept in the shops, ready mixed with a definite quantity of water, in order that it may be always at hand, so as to be administered without delay ; and the recommen- dation is good. Even if not to be trusted to alone, the evidence is quite sufficient to show, that it ought to be regarded as an im- portant element in the treatment of every case in which arsenic has been taken. A commission of the Academie Royale de Medecine,** com- posed of MM. Deville, Sandras, Nonat and Guibourt, recommend that four ounces of dry hydrated oxide of iron, the subcarbonate of iron of the shops or sesquioxide of iron, should be suspended in twenty-four ounces of water, and a good glassful of the mixture be taken every ten minutes. After four ounces are consumed, fresh doses of the same mixture may be administered in like manner, and the patient should not be considered out of danger, until he has taken at least half an ounce of the peroxide for each grain of arsenious acid supposed to have remained in the stomach. Instead of the pure hydrated oxide, Von Specstt employed substances in which the peroxide is known to exist in consider- able quantity, and which require no previous preparation, as rust of iron, and haematite, (red iron ore,) and, from his experiments, he is led to conclude, that although these substances do not prevent all the bad effects of arsenic on the system, they may—in the / absence of the hydrated oxide—be employed as antidotes to that poison. The rust of iron has the advantage of being readily procurable. A case has been published by M. Batilliat,^ which induced him to infer, that the hydrated oxide, dried in the air, is as effica- cious as that vvhich is kept moist. It certainly would seem tha: * Annales de la Societe de Medecine de Gand, Avril, 1840, cited in Encyclographif des Sciences Medicales, Mai, 1840, p. 494. t Heidelberg Medicinisch. Annal. B. v.; cited in Encyclographie des Sciences Mec?- cales, Mai, 1840. t New York Journal of Med. and Surg. iii. 205. § Ibid. p. 54. || Calcutta Med. Journ. Dec. 1837, cited in Amer. Journ. of the Med. Sciences, Feb. 1839, p. 503. TT Philad. Med. Examiner, iii. 679. ** Revue Medicale, Mai et Juin, 1839. tt Med. Jahrbiicher des k. k. 6. St B. xix. S. 021. Wien, 1836; and ibid. B. xx. S. 149. Wien, 1836. Cited in Brit, and For. Med. Rev.. July, 1837, p. 237; and Amer. Journ. Med. Sciences, Feb. 1838, p. 519. XX Journal de Chimie Medicale, Janvier, 1840. 21 318 FERRI PR.EPARATA. the dry hydrated oxide—the Ferri Subcarbonas of the Pharma- copoeia of the United States (1S42)—possesses the power to a considerable extent of neutralizing arsenious acid;* and hence it ought to be used in the absence of the moist and fresh prepa- ration. The latter, hovvever, as already remarked, may be ob- tained in a condition fit for use in 10 or 15 minutes, by using^a solution of the persulphate of iron.f The experiments of M. Guibertf would seem to show, that the subcarbonate of iron, as Ordinarily prepared, is about three times less active in neutraliz- ing arsenic than the dry hydrate prepared with ammonia, and six times less active than the same hydrate in the moist state. A case has been reported by Dr. Spath, of Esslingen,§ in which the hydrated oxide was administered as an antidote to Scheele's green—Arseniate of Copper. A boy, three years of age, poison- ed himself by licking a shell covered with the poison. Half an hour afterwards, he became pale: violent vomiting soon came on, with diarrhoea, pain in the abdomen and burning thirst. The hydrated oxide was given in divided doses in warm water, and in half an hour the vomiting, diarrhoea, colic and thirst had ceased, and the next day all the symptoms had disappeared. LXXXIII. FERRI PROTOCAR'BONAS. Synonymes. Ferri Carbonas, Protocarbonate of Iron, Carbonate of Iron. French. Protocarbonate de Fer. German. Kohlensaures Eisen. 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 oxy- gen, and, consequently, becomes converted into the sesquioxide; and this is an objection commonly urged both against the Mis- tura Ferri Composita, and the Pilulas Ferri Compositse, of the Pharmacopoeias. M. Vallet has discovered a method of obviating the objection, which consists in mixing the protocarbonate with saccharine matter. METHOD OF PREPARING. The following method is given by Mr. Procter|| as a simplifi- cation of M. Vallet's process. Take of Protosulphate of iron * Dr. T. R. Beck, loc. citat. t W. Procter, Junr., Amer. Journ. of Pharm. April, 1842, p. 37, and the Report of the Committee of the College of Pharmacy on his paper, ibid. p. 39. X Bullet. General de Therap. Dec. 1841, cited in Amer. Journ. of the Med Sciences, Oct. 1842, p. 490. § Journal des Connaissances Medico-Chirurg. Mars, 1840. Archives de Medecine, Fevrier, 1842; cited in Journal de Pharmacie, Mars, 1842, p. 269. || Amer. Journ. of Pharmacy, Jan. 1839, p. 272. FERRI PR0T0CARB0NAS. 319 (pure) 16 parts; Carbonate of soda (crystallized) 19 parts; Pure honey, 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, vvhich should afterwards be entirely filled with sweetened water, and the access of air be 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. The following form, founded on the above, has been introduced into the Pharmacopoeia of the United States (1842.) Pilulae ferri carbonatis, Pills of carbonate of iron. (Vallefs Ferruginous Pills.) Take of Sulphate of iron, giv.; Carbonate of soda, 5 v.; Cla- rified honey, 5iiss.; Syrup, Boiling ivater, each a sufficient quantity. Dissolve the sulphate of iron and carbonate of soda, each, in a pint of the water, and to each solution add a fluidounce of syrup; then mix the two solutions in a bottle just large enough to contain them, close it accurately with a stopper, and set it by that the carbonate of iron may subside. Pour off the supernatant liquid, and, having washed the precipitate with warm water, sweetened with syrup in the proportion of a fluidounce of the latter to a pint of the former, until the washings no longer have a saline taste, place it upon a flannel cloth, and expresses much of the water as possible; then immediately mix it with the honey. Lastly, heat the mixture by means of a water bath, until it attains a pilular consistence. A formula for the Ferri Carbonas Saccharatum is intro- duced into the last edition of the Edinburgh Pharmacopoeia. On the continent of Europe the preparation is known under the name of Klauer's Ferrum Carbonicum Saccharatum.* It is in the Pharmacopoeia of Baden.f When prepared in this manner, the protocarbonate has a dark olive colour, strong ferruginous taste, contains about 30per cent. of protoxide of iron, and if carefully prepared dissolves wholly and directly in acids. 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- * Pereira. Elements of Materia Medica, &c. 2d edit. p. 861. Lond. 1842, or 2d Amer. edit. Philad. 1846. 1 Oesterlen, Handbuch der Heilmittellehre, S. 457. Tubing. 1845. 320 FERRI PRiEPARATA. cated; and especially in chlorosis and amenorrhoea* 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 will be seen presently, says distinctly not. Fifteen grains of this preparation have been observed to occasion sickness; and ten grains twice a day have produced headache and a sense'of fulness in the head.:}: The author has never witnessed such effects from its administra- tion. MODE OF ADMINISTRATION. 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 proto-carbonate. The}7 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 Pilulae 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 beneficial effects in chlorosis. It is given in the form of pill, and is called after its inventor,—M. Blaud, senior physician to the Hospital of Beaucaire,—"Blaud's Pills." Blaud's formula for the prepara- tion 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 de- sired to prevent the formation of peroxide of iron, and to make the pills similar to those of Vallet, substitute—says M. 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 Carbonate of potassa, half an ounce. Beat until the mass, which soon becomes of a yel- lowish green colour, passes to a deep green, and assumes a soft con- sistence. Divide into 48 pills or boluses; which M. Blaud^considers sufficient for the cure of a chlorotic patient.§ M. Guibourt sub- stitutes the bicarbonate for the simple carbonate or subcarbonate; * Soubeiran, Rapport sur les nouvelles pilules ferrugineuses de M. Vallet, in Bulletin General de Therapeutique, Mai, 1838, cited in Amer. Journ. of Pharm. x. 244. See, also, Berthemot, in Bull. General de Therapeut. Juillet, 1839. + Wood and Bache's Dispensatory of the United States, 6th edit. p. 1066. Philad. 184."). X Christison, Dispensatory, p. 426. Edinb. 1842. § Revue Medicale, Mars, 1832, Dec 1838. FERRI PROTOCARBONAS. 321 and he gives as reasons: First, the avoidance of a very alkaline salt, an excess of which may prove prejudicial to the stomach; and, Secondly, 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 as- tringent. His form is the following:—Take of pure crystallized sulphate of iron, crystallized bicarbonate of potassa, each four drams; powdered gum Arabic, one dram; powderedmarshmallows, half a dram. Mix and divide in ninety-six pills.* A proper objection made to Blaud's 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,| hovvever, maintains properly, that the virtues of medicines cannot be appre- ciated from chemical experiments: "It is," he remarks,"to thera- peutical 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, hovvever, the change to vvhich the chemists object, but which Blaud appears rather to regard with favour, M. Adorne has suggested the addition of sugar and the pulvis althseae, according to the following form:—Take of Sulphate of iron, recently pre- pared, according to the method of Bonsdorff,§ which is a pure sulphate; Carbonate of potassa, or what is better, Carbonate of soda; Powdered root of the marshmallow and Sugar, each, half an ounce; Mucilage of gum Arabic, as much as is sufficient.— Make into ninety-six pills, which must be covered with a very fine layer of gum and sugar, aromatized with essential oil, to cor- rect the disagreeable odour.|| With similar views, M. Simonin, of Nancy, has proposed the following formula for the preparation of Blaud's pills, which he considers has the double merit of prompt and easy execution, and of furnishing pills vvhich keep without undergoing alteration. Take of Protosulphate of iron and Pure carbonate of Potassa, each equal parts. Reduce them separately to a fine powder; mix accurately, by triturating them together until they begin to liquefy; then add enough clarified honey to o-ive the mixture complete liquidity: afterwards heat the mass over a very gentle fire, until it has acquired the pilular consistence. This process was repeated by M. Felix Boudet^f by employing * Pharmacopee Raisonnee, i. 383; cited in Amer. Journ. of Pharmacy, April, 1839, p. 61. t Soubeiran, Bull General de Therap. Mai, 1838. . X Ibid. S See Dr. Bache, in Wood and Bache's Dispensatory, 4th edit. p. 906. Philad. 1839. || Bulletin Medical du Midi, Janvier, ld39; cited in Encyclographie des Sciences Me- dicates, Mars, 1^39. % Journal de Pharmacie, Mars, 1811, p. 153. 0 322 FERRI PR.EPARATA. pure crystallized sulphate of irbn, 100 grammes;* pure carbonate of potassa, 100 grammes; white honey, 50 grammes; from which he obtained 130 grammes of a deep green mass, very duc- tile and easily rolled into pills, as M. Simonin had said. The addition of the honey prevents the farther oxidation of the iron. Dr. W. H. Robert, of Madison, Georgia,! who considers Blaud's pills to be a capital remedy in chlorosis, the best he has ever used, recommends that after pulverizing the sulphate of iron and the carbonate of potassa, they should be mixed intimately, and be formed into a pilular mass with freshly made corn bread. If fluid be added, the mass will be entirely too soft to be divided into pills. 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 after- wards three, daity. Mr. Donovan:}: 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 Magnesia, two scruples; Water, six ounces; Tincture of quassia two drams. Divide into six draughts, one to be given night and morning. Mr. Carmichael,§ of Dublin, has advised the following mode of exhibiting the precipitated carbonate:—Take one dram of Bi- carbonate of soda; dissolved in four ounces of Springwater, and add a dram of tincture of chloride of iron. This draught to be taken three times a day during effervescence. Mr. Carmichael remarks, that although ttoe quantity of carbonate of iron formed is not considerable, yet it is in such a state of minute sub-division, and combined with a solution of chloride of sodium equally mi- nute—"the saline most congenial to the system of red-blooded ani- mals, as it renders the hematosine active and vivifying," that he always found it answer the object of a chalybeate thus given much better than the large doses of from one to two drams of the subcarbonate. If ulceration existed, he found it very generally improved ; and he has seen many cases of lupus attacking the face cured by its joint internal and external use. He formerly thought the phosphate of iron possessed of superior advantages to the carbonate administered internally ; but now thinks the carbo- nate given during precipitation answers every purpose of a chaly- beate, without causing any derangement of stomach. * A gramme is gr. 15.444 Troy. 1 Southern Med. and Surg. Journ., July, 1840. []] { Dublin Journal of Medical Science, Mar. 1840, p. 159. § Dublin Medical Press, March 4, 1840. % FERRI SUBCARBONAS. 323 LXXXIV. FERRI SUBCARBONAS. Synonymes. F. Carbonas, F. Carbonas Praecipitatus, Ferrum Carbonatum Praecipitatum, Ferrum Carbonicum Oxydulatum, Oxydum Ferri Fuscum, F. Oxidum Rubrum, Deuto-carbonas Ferri Fuscus, Crocus Martis Ape- riens, Ferri Sesquioxidum, Subcarbonate of Iron, Sesquioxide of Iron, Peroxide of Iron. French. Souscarbonate de Fer, Safran de Mars Aperitif. German. Kohlensaures Eisenoxydul, Kohlensaures Eisen, Kohlensaures Eisenoxyd, Braunes Eisenoxyd. This preparation, which is officinal in the British, United States 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 subcarbonate, or—as it is now called in the London Pharma- copoeia—the sesquioxide of iron, which must be washed with water, and dried. EFFECTS ON THE ECONOMY. Subcarbonate of iron possesses the properties of the chalybeates in general, and has been highly recommended as a tonic, wher- ever 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. Nearly forty years ago, its use was strongly advised in cancer and carcinomatous ulcerations of the uterus, by Mr. Carmichael,* and, subsequently by Rust, Volker, and Kopp; as well as in a case of lupus of the ala nasi, by Key it^but, in similar cases, it proved unsuccessful in the hands of Clarke, El. Von Sie- bold, Meissner, Richter, and others.| In chronic nervous diseases, of a spasmodic nature, and especially in tic douloureux of the face, it was first highly extolled by Dr. Benjamin Hutchinson, about twenty-six 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,«ff R. Macleod,** Mr. J. E. Beale,ff and many others, and its efficacy is now almost universally ad- mitted. Dr. Rowland,|| has often witnessed the most happy re- sults from its exhibition, even after various powerful medicines had been tried in vain. Dr. Elliotson§§ published several cases, in vvhich the remedy, in large doses, had been efficacious; and he remarks, that true chronic neuralgia, not arising from cold, and coming on in a violent, stabbing, plunging form, aggravated by * A n Essay on the Effects of the Carbonate and other Preparations of Iron upon Cancer, 2d edit Dublin, 1809. 1 Lancet, xiv. 92. X Osann, in* Encyclop'ad. Worterb. der Medicinisch. Wissensch. x. 424. Berlin, 1834. § Cases of Tic Douloureux successfully treated. Lond. 1820. || Medical and Physical Journal, Feb. 1823. ■j Ibid. ** Ibid. June, 1823. II Ibid. Sept. 1823. XX Treatise on Neuralgia, by Richard Rowland, M. D., p. 84. Lond. 1838; or the reprint in the author's American Medical Library. §§ Medico-Chirurgical Transactions, xv. 161. I 324 FERRI PRiEPARATA. the least shake of the patient, and by touching the surface, is best treated by subcarbonate of iron. He observes, however, in a more recent publication,* 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, vvhich the author ever witnessed, and which had rendered the patient's life miserable for years, the subcarbonate of iron, in large doses, proved entirely successful. The patient had been bled repeatedly; and when the author saw her, she was under the most favourable circumstances for the ex- hibition of the remedy,—with the surface pale and cool; the pulse small; complaining much of debility, and yet suffering under the most intense headache, which the least light and noise rendered almost intolerable ; yet, after she had persevered in the use of the remedy for a month, in large doses, the symptoms gradually dis- appeared, 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, hovvever, disagrees with the stomach, and where it does, the inconveniences are removed by the addition of an aromatic, or the administration of a cathartic. Subcarbonate of iron, in large doses, has, likewise, been found a valuable agent in a kindred condition of the nervous system— chorea. Dr. Elliotsonf affirms, that he has had—he should sup- pose—forty cases, in succession, all cured by it; but perseverance 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,:j: physician at Thouars, published two cases elucidative of the effects of large doses in long protracted intermittents, complicated with ascites and enlargement of the 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 quinia 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 treatment 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 disappeared, and the cure was complete. The medicine was discontinued by gra- dually diminishing the dose. In the second case, the same dose * Principles and Practice of Medicine, &c., by John Elliotson, M. D.; with Notes, xc. by Nathaniel Rogers, M. D., p. 507. Lond. 1839. f Op. citat. p. 515. + Journal c'es Connaissances Medico-Chirurgicales, Mai, 1837. FERRI SUBCARBONAS. 325 was prescribed, in the first instance; and it was ultimately carried to six drams, with complete success. Dr. Steyman* has recommended the subcarbonate in the treat- ment of hooping-cough, in the dose of half a grain at 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 administered 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 dis- eases that are paroxysmal, appears to consist in the new impres- sion 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 artemisia and indigo in epilepsy—to keep up the effect of the remedy by gradually increasing the dose. MODE OF ADMINISTRATION. The dose of subcarbonate of iron, in cases of neuralgia and chorea, should be large. Dr. Hutchinson prescribed it in the quantity of 3ss. to gij., 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. The best vehicle for it is molasses. The following formulas have been re- commended:! Pulvis ferri subcarbonatis. Powder of subcarbonate of iron. R. Ferri subcarb. gr. x. Pulv. aromat. gr. v. M. Fiat pulvis mane et meridie sumendus, Boli ferri subcarbonatis. Boluses of subcarbonate of iron. . R. Ferri subcarb. gr. x. Valeriana? pulv. gss. Syrup, zingib. q. s. Fiat bolus. Pilulae ferri subcarbonatis. Pills of subcarbonate of iron. R. Ferri subcarb. Extract, anthemid. aa. gss. Misce et divide in pilulas xij. quarum sumat binas ter quotidie. R. Ferri subcarb. gj. Pilul. aloes cum myrrha, gss. Misce et divide in pilulas xviij.: duas bis terve indies sumendae * Medicin. Correspondenz-BIatt, cited in Gazette Medicale de Paris, June 20, 1838. t Brande, Dictionary of the Materia Medica, p. 248. Lond. 1839. 326 FILIX MAS. Pilulae ferri subcarbonatis et hydrargyri. Pills of subcarbonate of iron and mercury. R. Ferri subcarbonat. gj. Hydrargyr. gij. Confect. rosse Gallic, giij. Rub until the globules are no longer seen. This formula is proposed as a substitute for blue pill. It is made in five minutes, whilst blue pill requires a week. Dr. Collier* recommends it as especially eligible for the strumous, the irritable, and for reduced anaemic constitutions requiring mercury. Five grains of the subcarbonate are sufficient to amalgamate and divide a large quantity of mercury; but Dr. Collier proposes the larger quantity as a remedy. Collier. Electuarium ferri subcarbonatis. Electuary of subcarbonate of iron. R. Ferri 'subcarb. Confect. aurant. aa. §j. Syrupi zingib. q. s. ut fiat electuarium cujus sumatur cochleare minimum bis vel ter die. LXXXV. FILIX MAS. Synonymes. Nephrodium Filix Mas, Aspidium Filix Mas, Athyrium Filix Mas, Polypodium Filix Mas, Filix, Male Fern, Male Shield Fern.- French. Fougere Male. German. Farrenkraut, Johanniswurzel, Mannlich.es Farrenkraut, Farren- krautmannlein, Mannlicher Nierenfarrn, Bandwurmwaldfarm, Mann- leinwurmtupfelfarrn. The rhizoma of male fern, which is indigenous in this country, and in the secondary list of the Pharmacopoeia of the United States, has long been celebrated—since Dioscorides indeed—as an anthelmintic; and especially for the destruction of taenia.^ For these properties, it has been introduced into most of the Pharmacopoeias. It was the basis of Madame Nuffer's or Nouffer's celebrated remedy for taenia, which was purchased by Louis XVI. in 1775, for 18,000 francs.J It is noticed here, on account of the proposition of Peschier,§ of Geneva, to administer the ethereal extract, which has since been carried into effect, and apparently with the best results. It appears to possess the advantage of * From his second edition of the London Pharmacopoeia, cited in Lond. Lancet, Mar. 24, 1843. t Merat and De Lens, Dict.de Mat. Med. art. Polypodium. X For the various forms in which it has been given as an anthelmintic against taenia, as well as for the methods of Von Beck, Herrenschwand, Matthieu, Measeed, Nuffer, Odier, and Wawruch: see Linke, Vollstandiges Recept-Taschenbuch, u. s. w. i. 232. Leipzig, 1840. § Nouvelle Bibliotheque Medicale, Sept. 1828. p. 151, and Biblioth.Univer. 324,1826. FILIX MAS. 327 being by no means unpleasant to the taste, and to be accompanied by none of the disagreeable effects that are associated with the action of most of the other vermifuges. To prepare the extract, the root is cut small, and digested for ten or twelve days, in the cold, in a sufficient quantity of sulphu- ric ether,—the tincture is then pressed, concentrated by distillation, and the ether thereby fully removed. From a pound of the root, about eighteen drams of a brownish-green thick extract are ob- tained, which possesses the repulsive odour of the plant, and has an acrid taste. In Germany, the extract is generally prepared according to the formula of the Prussian Pharmacopoeia, which is as follows— Take an ounce of the powdered root, and pour thereon eight ounces of the sulphuric ether of commerce; close the vessel, shaking it occasionally, and let. it stand until the fluid has acquired a yellowish colour; then separate the fluid as before described; distil off the sulphuric ether until only a third remains, and evaporate the remainder in a water bath, until a thin brownish-yellow coloured extract remains. This extract contains not only the volatile oil of the fern, but also a fixed oil, tannic acid, acetic and gallic acids, a muco-sac- charine matter, green and red colouring matter, and a semi-resi- nous substance. By some it is called oleum filicis maris. The active 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 morning, fasting, destroyed tsenia; 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 cathartic was given. In Germany, this new preparation has been chiefly recommend- ed 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 without bring- ing away large pieces of the worm, but frequently the head re- mained behind.f Peschier had found it to be successful in 150 cases vvhen he wrote;± Ullersberger had used it in 60 cases, and a me- dical friend of his in 200 cases, with invariable success. It is affirmed to have proved more successful in cases of Bothriocepha- lus latus than of Taenia solium; and a part of the discrepancy of results amongst observers has been ascribed to this circumstance. For example, it has not been found as effective in the treatment of * Auserlesene Heilformeln, u. s. w. Leipz. 1836. t See, also, Ebers, in Hufeland und Osann's Journal, Lxvi.St. 1, S. 43, cited in Gazette de Santo, Sept. 25, 1828. X Merat and De Lens, loc. cit s 328 FUCUS AMYLACEUS. taenia at Paris, and the taenia most common there is the Taenia solium* i Buchnert thought, that the extract might be prepared with alcohol, but many physicians have objected to this menstruum,— that it does not dissolve the fixed oil. The male fern is preferred by M. Rouzelj: to the bark of pome- granate root in the treatment of taenia. MODE OF ADMINISTRATION. The extract is commonly given in the form of pill: an emul- sion 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, which 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. An ethereal tincture of the buds (one part of the buds to eight of ether) has been used with advantage as an anthelmintic;|| and a decoction (one ounce of the rhizomu to a pint of water) has been occasionally prescribed. Mel filicis maris. Honey of the male fern. R. Ext. aether, filicis maris JJss. Mel. rosas gss. M. Half of this to be,taken on going to bed: the other half early in the morning fasting. LXXXVI. FUCUS AMYLACEUS. Synonymes. Ceylon Moss, Marine Moss. The attention of physicians has been directed to this vegetable by Dr. O'Shaughnessy, of Calcutta.1T Like Chondrus (p. 175,) it belongs to the Natural Order Alga?, and was first introduced, some years ago, into India from England. As met with in com- merce, it is white, filiform, and fibrous, and has the usual odour of sea-weeds. When analyzed by Dr. O'Shaughnessy, it was found to be composed as follows:—Of vegetable jelly, 54.50; true starch, * Christison, Dispensatory, p. 451. Edinb. 1842. t Repertorium fur Pharmacie, xxiii. 433, xxvii. 337, and Funk, in Medicin. Zeitung, Mai 17, 1837, S. 102. X Revue Medicale, Oct. 1840. See, also, M. Wawruch, Oesterreich. Med. Jahrbucb, cited in Encycl. des Sciences Med., Nov. 1841, p. 264; Brit, and For. Med. Rev. Oct. 1844, or Braithwaite's Retrospect, x. 70. New York, 1845; and M. Daumerie, Archives de la Med. Beige, Sept. 1841, p. 5. § Hufeland und Osann's, Journal, lxiv. St. 1, S. 133. || London Lancet, for 1834-5, ii. 597. IT Medico-Botan. Transactions, vol. i. pt iv. p. 184. FUCUS AMYLACEUS. 329 15; wax, a trace; ligneous fibre, IS; gum, 4; sulphate of soda, and chloride of sodium, 6.50; sulphate and phosphate of lime, 1; iron, »trace; loss, 1:—Total, 100. When boiled in water, a liquid re- sults, which gelatinizes on cooling. EFFECTS ON THE ECONOMY. The medical properties of fucus amylaceus are similar to those of chondrus. The decoction is an agreeable, light, nutritions article of food. According to Dr. O'Shaughnessy, its nutritive qualities are best obtained in the following manner:—Put into a clean stew-pan a table-spoonful of prepared marine moss, add to it a pint and a half of hot or cold water, and boil gradually for twenty minutes; then take a little in a spoon, and let it cool for a minute or two, to see if the liquid is sufficiently boiled to congeal firmly; if not, let it boil until it is; then strain it through a cloth into an- other stew-pan while it is warm, so as to draw all the liquid from the sediment produced by the moss. The sediment must be well squeezed. Add to the liquid a table-spoonful of fine loaf sugar,' half a table-spoonful of lemon juice, a table-spoonful of honey, or not, at the option of the maker; add a small piece of lemon peel, and a very small piece of cinnamon: boil the whole gradually for ten minutes, and pass it once or twice through a piece of flannel into a basin or tumbler, and in ten minutes it will be fit for use. Should it be required to be very clear and transparent—which is not considered necessary for an invalid, as by clarifying it partly loses its strength—add the white of an egg, well beaten into froth, before the second boiling; taking care, that after the second boil- ing it rests for some minutes by the fire-side, with some hot char- coal on the cover of the stew-pan so as to render it perfectly clear; otherwise, by adding the whole of an egg, it will have a milky- white appearance, which is not so pleasing lo the eye, although its quality may be the same. When clear, and of a lemon colour, it may he passed two or three times through a flannel bag. It may then be suffered to cool, or be taken in a liquid state, if preferred by the patient. The jelly is as good for the table as for the sick chamber.— Blancmanger and Italian cream can be made with it without isin- glass; but in such case, the jelly must be made much stronger be- fore it is mixed; and at all times it must be blended whilst warm. The quantity it takes for a mould of either is two table-spoonfuls of moss to a quart of water, which must be reduced to half a^pint. Ceylon moss has the advantage over isinglass and the other mosses, that it will stand firm and good for twenty-four hours in the hottest days of India; whilst, neither isinglass nor any other jelly will stand firm for half an hour, even with the aid of ice. It also possesses the advantage, that a delicious jelly can be made from it in about fifteen or twenty minutes. It has been pro- 330 FULIGO. nounced by all the medical faculty of Calcutta to be unequalled for its delicate and nutritious qualities, and it has been especially and highly recommended for the use of the sick. When all other nourishment hasfailed, this has proved successful; and Dr. O'Shaugh- nessy says he has no doubt that when the article is better known by the faculty in England, it will be much more appreciated, and receive the same patronage and support, which it has done from the whole of the faculty in India for the last fifteen or sixteen years.* LXXXVII. FULI'GO. Synonymes. Fuligo Splendens seu Fornacum, 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 it as an ex- citing diaphoretic agent in cachexias of every kind, in chronic rheu- matism, 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 diarrhoza, and cholera of children. Several modern recommendations—as by Schi'itte and Weisen- berg—remained unheeded until the attention of physicians was re- cently drawn to it, especially by Blaud.f He is of opinion, that the costly—and by no means easily prepared—creasote may be vvholly replaced by soot. Both are products of the dry distilla- tion 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. Soot has a nause- ously empyreumatic, more or less bitter, and acrid, saline taste. EFFECTS ON THE ECONOMY. Blaud^: has exhibited soot in different diseases, especially in the form of ointment, or in decoction, with excellent and rapid ef- fects, in herpes, itch, tinea, gutla rosacea, and pruritis vuloaz; and he asserts, that he even healed a cancer of the breast by frequent ab- lution with a tepid decoction of it, and an ointment composed of equal parts of lard and soot with one-eighth part of the extract of belladonna; but the same applications were of no benefit in a case of cancer of the nose, and in one of cancer of the uterus. He * Braithwaite's Retrospect of Pract. Med. and Surg. No. ], Jan. to June, 1840, 3d edit. p. 70. Lond. 1842; and*Drs. Sigmond and Farre on the Ceylon Moss. Lond. 1840. t Revue Medicale, Juin, 1834, et Janvier, 1835, and Dr. E. Grafe, in Grafe und Wal- ther's Journal, xxiii. 310. Berlin, 1835. X Journal des Connaissances Medico-Chirurg. Mai, 1834. FULIG0. 331 also cured a scabby eruption of the mucous membrane of the nose by an ointment of soot. In diphtherilis, he used, in two cases, a de- coction, as a mouth-wash, with the best effects. In confirmation of Blaud's remarks, Voisin asserts, that he cured a case of cancer of the face by 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 MM. Nobelef and Le Montagnier4 M. Nobele's conclusions are,—1. That soot cannot be applied with any expec- tation of success, until the crusts have been removed, and the ir- ritation of the parts has been 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 commence with one part of soot to three parts of lard; and, lastly, that wood soot is alone useful,—soot from coal being devoid of any agency. Dr. Ebers, of Bourdeaux,§ has employed a decoction of soot with great advantage in a case of severe burn in which the pa- tient was suffering from the profuse discharge. A handful of soot was boiled in eight pounds of water, until the fluid was re- duced to two pounds. Lint was then soaked in it and applied to the granulating surface. Carron du Villards|| advises a collyrium prepared from soot in cases of strumous ophthalmia. He infuses two ounces in boiling water, filters and evaporates to dryness; the shining residuum 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 eye-salve, not inferior perhaps, he says, to any other. As in the treatment of specks on the cornea, by dropping laudanum into the eye, the organ quickly becomes ac- customed to it, Carron du Villards advises, that the eye should be * Bulletin Medical Beige, iNov. 1838, p. 289. For farther testimony in its favour, see Lond. Lancet, Nov. 25, 1843. t Annales de la Societe de Medecine de Gand, Gazette Medicale, or Encyclographie des Sciences Medicales, Mars, 1840, p. 540. X Bullet. Gener. de Therap. Nov. 1840, or Encycl. des Sciences Med. Fcv. 1841, p- 299. , § Journ. de Med. et Chirurg. Pratiq. Juin, 1841, cited in Amer. Journ. of the Medica Sciences, Jan. 1842, p. 231. || Gazette Medicale, Janvier, 1831; see, also, Baudelocque, on its Use in Scrofulous Ophthalmia, in Bulletin General de Therapeutique. Mars, 1834. 332 FULIGO. 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 ao-ent, and may be applied by means of a pencil to granulations on the cornea. He likewise recommends a decoction of soot as an injection in discharges, which are the consequence of chronic inflam- mation of the vagina. 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. M. Gibrin took from the chimney two ounces of compact soot, broke it up, washed it, and boiled it in a pound of water. The decoc- tion was filtered through paper, and injected into the bladder twice a day. The good effects supervened so closely on the administra- tion 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 gradually became clear, and recovered its natural appearance. To these remarks may be added, that, according to Schutte, an ointment composed of two parts 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. Employed as an injection, an infusion of soot has been found by Dr. Hewson, of Philadelphia, an efficacious remedy in ascarides vermiformes.'f Buti 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 (isoot drops," "hysteric mixture''' and "fit drops," and was employed as an anti- spasmodic in hysterical 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 precisely 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 ADMINISTRATION. Mistura fnliginis. Mixture of soot. Tinctura Fuliginis Clauderi. R. Fulig. ^ss. Potassae carbonat. i|iss. '* Bulletin de 1'Academie, 15 Mars, 1837. < United States Dispensatory, 6th edit. p. 1297. Philad. 1845. FULIG0. 333 Ammoniae carb. gij. Aq. sambuc. f. gix. Digere leni calore, et filtra. Dose.—From thirty to sixty drops several times a day. A similar preparation has been used in Philadelphia, under the names medical lye, soot tea, alkaline solution, and dyspeptic lye, as a popular remedy in dyspepsia. It is made by infusing a pint of clean hickory ashes and a gill of soot in half a gallon of boiling water, allowing it to stand for twenty-four hours, and then decant- ing. Of this, a small wine glassful is taken three or four times a day. Lotio fnliginis. Lotion of soot. R. Fulig. manip. maj. ij. Coque cum. aq. Oi. per semihoram. Cola cum expressione. Used as a wash, several times a day, in herpetic, psoric and syphilitic ulcers. Blaud. Unguentum fuliginis. Ointment of soot. R. Fulig. Adipis aa. gss. Extract, belladon. gj. M. exacte. To be spread upon lint or tents in case of cancer. Blaud. R. Adipis, Fulig. aa. gij. Coque leni igne per horas vj. As a dressing in cases of tinea, and of foul ulcers. Blaud. R. Fulig. Cinchon. flav. aa. gss. Carbon, pulv. Sulph. aa. gj. 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. Fulig. gss. Opii gij. Caryoph. gj. Aq. cinnam. f. gviij. Alcoholis f. giv. Digest in a gentle heat for six days; filter and express the residuum. Applied in cases of specks of the cornea. Carron du Villards. R. Fulig. giss. Zinci sulphat. gvj. Adipis |iv. M. Applied in cases of tinea. It is the Pommade contre la teigne, of Bories.* * Formulaire de Montpellier. Montpellier, 1822. 22 334 FULIGOKALI. Cataplasma fuliginis. Cataplasm of soot. R. Fulig. gij. Album, ovi No. vj. Tere simul. Asa dressing for herpes and tinea. It is the Pommade resolu- tive of Sainte Marie* LXXXVIII. FULIGO'KALI. Svnonyme. German. Russkali. This new remedy called fromfuligo, 'soot,' and kali, 'potassa/ has been introduced as an analogous preparation to anthrakokali (p. 66.)t ^ ' METHOD OF PREPARING. Fulio-okali is prepared as follows:—Take of Potassa, 20 parts; Shinino- soot, in powder, 100 parts; Wafer, a sufficient quantity. Boil fior an hour; suffer the decoction to cool; dilute with water so that filtration maybe better accomplished; filter, evaporate, and dry, in order to obtain the fuligokali in scales or powder; and en- close it in dry and warm bottles. A sulphuretted fuligokali has been prepared as follows:— Take of Fuligokali, 60 parts; Potassa, 14 parts; Sulphur, 5 parts. Dissolve the sulphur and potassa in a little water; then add the fuligokali; evaporate, dry, and enclose in dry and warm bottles. EFFECTS ON THE ECONOMY IN DISEASE. Fuligokali has been employed by M. Gibert at the Hopital Saint-Louis of Paris, both internally and externally, but chiefly in the latter mode, in various chronic cutaneous diseases. An oint- ment may be made of either the simple or the sulphuretted article; by mixing one or two parts with thirty of lard. M. Gibert as- cribes to these ointments resolvent, detergent and slightly excitant virtues.:}: Mr. E. Wilson§ thinks it probable, that both anthrakokali and fuligokali owe much of their therapeutic value to the alkali which forms their basis. He has employed fuligokali in several cases, and especially in psoriasis palmaris, and with better success than he has obtained by the usual remedies. The preparation referred to on the last page as having been used in Philadelphia under the names of medical lye, &c, may be regarded as a weak solution of fuligokali.|| * Nouveau Formulaire Medicale et Pharmaceutique. Paris et Lyon, 1820. t Journ. des Connaiss. Med. Chir. and Encyclogr. des Sciences Med. Juillet, 1842,p. 9. i See, also, A. Duhamel, Amer. Journ. of Pharmacy, Jan. 1843, p. 284, and Deschamps, in Bouchardat, Annuaire de Therapeutique, pour 1843, p. 153. Paris, 1843. § A Practical and Theoretical Treatise on the Diagnosis, Pathology, and Treatment of Disease of the Skin, p. 397. Lond. 1842; or Amer. edit. Philad. 1843. || A. Duhamel, op. cit. GALEOPSIS GRANDIFLORA. LXXXIX. GALEOP'SIS GRANDIFLO'RA. Synonymes. Galeopsis Ochroleuca, G. Prostrata, G. Villosa, G. Segetum, Herba Sideritidis. German. Grossbliithiger Holzahns, Grossblumige Hanfnessel, Gelbe oder Grossbluthige Hundsnessel, Katzermaul. This plant, which belongs to Natural Family Labiatse. Sex- ual System Didynamia Gymnospermia, grows in the western part of Germany, in sandy corn-fields.* 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 "Blankenheimer Tea," (Blankenheimer Thee,) or "Lieber's pectoral and phthisical herbs," (Liebersche Brust oder .duszehrungskrauler,) and enjoyed great repute. In the Ardennes, also, particularly in the district of Malmedy, it has been long em- ployed as a popular remedy. In the year 182S, Lejeunef direct- ed attention to the therapeutical importance of this plant. Ac- cording to his observation, it is very useful in diseases of the mu- cous membrane of the respiratory and digestive organs, and especially in chronic pulmonary catarrh, even vvhen 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 assuaged. 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 vvhich a milk diet was ap- propriate, the decoction was made with an equal quantity of milk. Wesenerj found it advantageous in phthisis mucosa and in chronic pulmonary catarrh. Gunther, who had many opportunities for observing the action of the remedy, affirms, that the FJeberschen Krauler not unfrequently produced some amelioration in phthisis, especially in scrofulous phthisis, but he never saw any actual re- covery therefrom. It seemed to him to moderate the colliqua- tive sweats, and to facilitate and diminish the expectoration. In one case especially, of scrofulous phthisis in the last stage, it ap- peared to be of essential service, and to prolong life; and from all his observations he is disposed to infer, that if it be not the sole or the main remedy to be employed in every stage of phthisis, it may * Von Schlechtendal, in Encyclopad. Worterb der Medicin. Wissenschaft. xiii. 115. Berlin, 1835. t Annales Generates des Sciences Physiques, p. 331, Sepr. 1820. X Hufeland und Osann's Journ. der Pract. Heilk. 1823 and 1824. 336 GALEOPSIS GRANDIPLORA. be used with advantage throughout the disease as a supporting agent. Riecke* asserts, that he has seen many cases in vvhich the Lie- berschen Krauter were of great service in thoracic affections threat- ening phthisis. In one case, which promised to terminate unfa- vourably in a short time, owing to the complication of violent haemoptysis with hectic fever, and in which an experienced physician had exhausted every effort of art, they were given with the best effect. The thoracic affection ceased, and at that time—a period of five or six years since the use of the remedy—the patient—an officer—was capable of performing his military duties without dif- ficulty. 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 have chiefly the testimony afforded by the German writers. This, as they themselves admit,f is not yet sufficient to enable them to lay down any positive rules as to the exact indications and coun- ter-indications that must regulate its employment. It is probably of no farther service than as a mild bitter; and its place may there- fore be supplied, perhaps advantageously, by many of the tonics that are admitted into the lists of our remedial agents. GeigerJ subjected it to analysis, and found in it 2.765 parts of fatty matter, wax and chlorophyll; 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 65.8S2 of ligneous matter. MODE,OF ADMINISTRATION. Decoctnm galeopsidis grandiflorae. R. Galeopsid. grandifl. summitat. gj. Coque in Aquas Oj. per minut. xv. et cola. To be used in the twenty-four hours. Wesener. R. Galeop. grandifl. summitat. Althaea: aa. gj. Glycyrrhiz. gij. M. A 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 pro- duced by the softening of pulmonary tubercles. Radius.§ Galeopsis versicolor, and galeopsis villosa, which have also been examined by Geiger,|| appear to be possessed of the same virtues as galeopsis grandifiora.^ * Die neuem Arzneimittel, u. s. w. S. 241. Stuttgart, 1837. * Ibid. X Magaz. fiir Pharmacie, ix. 134. § Auserlesene Heilformeln, u. s. w. S. 274. Leipz. 1836. 11 Allgem. Med. Annalen, S. 1141. 1825. If Richter's Specielle Therapie, B. x. S. 397. Berlin, 1828. GALVANISMUS. 337 XC. GALVANIS'MUS. Synonymes. Electricitas Animalis. E. Galvanica seu Metallica, Irritamen- tum Metallorum seu Metallicum, Galvanism, Voltaisra, Galvanic Elec- tricity. French. Galvanisme. German. Galvanismus. The ordinary effects of common and galvanic electricity and of electro-magnetism are so well known, as to require but little com- ment. They are decidedly excitant; and, like all excitants, vvhen applied to a part of the frame, are counter-irritant or revellent. All have been employed in paralysis,— general and local,— amaurosis, deafness and dumbness* of recent duration,asthma, rheumatism, neuralgia, amenorrhoea,^ incontinence of urine,! &c. The effect, hovvever, which galvanism exerts on the contrac- tility of the muscular fibre, and the great similarity, in its agency, to the nervous influence,^ has led to its employment more fre- quently 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 nervous and galvanic fluids,T 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 experiments, which he made on rabbits. The eighth pair or pneumogastric nerves were divided by incisions made in the neck. After the operation, the parsley, which the animals had eaten, remained unchanged in their stomachs, and after evincing much difficulty of breathing, they seemed to die of suffocation. But when, in other animals, whose nerves had been divided, the galvanic agency was transmitted along the nerve, below its section, to a disc of silver, placed close- ly 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 digested. The removal of dyspnoea, in these cases, led Dr. Philip to em- ploy galvanism 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 * See a case of aphonia cured by Galvanism, cited in London Lancet, May 27, 1843. t G. Bird, Guy's Hospital Reports, April, 1841, p. 84. X Froriep, $ted in Edinb. Med. and Surg. Journ. 1844, p. 491. § See the author's Physiology, i. 88, 6th edit Philad. 1846. || Pereira, Elements of Mat Med. 2d edit p. 42. Lond. 1842; or 2d American edit. Philad. 1846. See, also, the author's General Therapeutics and Mat. Med. 3d edit i. 502. Philad. 1846. 11 Experimental Inquiry into the Laws of the Vital Functions. Lond. 1817. 33S GALVANISMUS. cases, and at times with marked relief. Commonly, however, the plates, described hereafter, are employed for this purpose. The disease, in the majority of cases, appears to be dependent upon erethism of the pneumogastric nerves; all the phenomena indi- cating that there is a spastic constriction of the small bronchial tubes, occasioned by irritation at the extremity, or in the course of the nerve. The new impression, made by the galvanic agency, breaks in upon the concentration of nervous action, by exciting other portions of the nervous system, in the same manner as we ob- serve spasms or ordinary cramp relieved, or paroxysmal diseases warded off, by agents that are capable of suddenly impressin. some part of the nervous system. Not long after these researches of Dr. Philip, galvanism was employed satisfactorily by Mr. Mansford* in a congenerous dis- ease—epilepsy—and his plan was afterwards—although tardily— extended to some other paroxysmal disorders. The mode of ap- plication, 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 back of the neck, as close to the root of the hair as possible, and a similar portion is removed from the hollow beneath, and on the inside of, the knee, as the most convenient place. To the excoriated surface on the neck, a plate of silver, varying—according to the age of the patient— —from the size of a sixpence to that of 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 staple, 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 at- tached, 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, contrived in this way, is thus applied. A small piece of sponge, moistened in water, and cor- responding 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 itself, which is secured in its situation by a strip of adhesive plas- ler pasred through the shank on its back; another above, and ano- ther below it. If 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 ordi- nary motion of the body. The zinc plate is fastened in the same manner, but in place of the second layer of sponge, a pfece of mus- cle answering in size to the zinc plate is interposed;—that is, a small piece of moistened sponge being first fitted to the exposed * Researches into the Nature and Causes of Epilepsy, &c. Bath, 1819. GALVANISMUS. 339 surface below the knee, the piece of muscle moistened, or—what has been found equally effectual and less inconvenient—a piece of moistened flannel* follows, and on this the plate of zinc. The apparatus, thus arranged, will continue, according to Mr. Mansford, in gentle and uninterrupted action from twelve to twenty-four hours, according 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 by scraping or polishing; but it will be better if removed twice a day, both for the greater se- curity of a permanent action, and for the additional comfort of the patient." The adoption of this plan of treatment in cases of tic doulou- reux; 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 language of Professor Chap- manf—"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 ex- perienced. % About the same period, this mode of applying gal- vanism was recommended by Dr. Miller,§ formerly 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. The effect of galvanism on the uterus has been referred to under Electro-Magnetismus. M. Matteucci,|| from his researches, is induced to think, that pa- ralysis and tetanus are the diseases in which galvanism is most likely to prove beneficial. In its application, however, in these diseases, he considers it necessary to bear in mind two electro- physiological facts. The first is, that an electric current, if trans- mitted through a nerve for a certain time, destroys the sensibility of the nerve, or in other words paralyzes it; but if the nerve be allowed to remain at rest, after a certain interval it recovers its exci- tability. But it has been ascertained by M. Matteucci, that the ex- citability may be restored in a much shorter period by passing a second current through the nerve in the reverse direction. The second fact to be borne in mind, is that if the nerves of a living animal be subjected to the passage of an electric current, renewed * Dr. Chapman says soft buckskin or parchment. American Journal of the Medical Sciences, Aug. 1834, p. 311. t Op. citat p. 311. X Dr. Harris, in American Journal of the Med. Sciences, Aug. 1834, p. 384. § Ibid. p. 321. || Cited in Med. Chirurg. Rev. April, 1845, and in Braithwaite's Retrospect, xi. 33, Amer. edit. New York, 1845. 340 GALVANISMUS. at short intervals, tetanic contractions are excited; and if the expe- riment be continued for some time, the nerves entirely lose their excitability. "These facts," says M. Matteucci, "independently of all theory or hypothesis, should guide us in the therapeutical application of the electric current to paralysis. It may in fact be admitted, that in some cases of paralysis, the nerves of the affected limb are in a condition similar to that produced by the continued passage of an electric current. We have seen, that to restore the excitability to a nerve which had been deprived of it by an electric current, it is requisite to conduct the current in the opposite direc- tion. Hence, to cure the paralysis, the current should be passed in a contrary direction to that which has produced it. In a para- lysis of motion, the inverse current should be employed; whilst, on the contrary, in a paralysis of sensation, the direct current should be used. In a case of complete paralysis—that is, of both motion and sensation, there is no reason to prefer the one current to the other. Theory also teaches a rule in its application:—never to continue the passage of the current too long, lest we augment the disease we wish to cure. The more intense the current, the shorter should be its duration; and as we have seen, that the passage of the electric current in the nerves, repeated at short intervals of time, considerably enfeebles their sensibility, when continued for a long time, we must take care and not pass from one extreme to another. Theory advises us to apply the electric current of an in- tensity which should vary with the degree of the malady, and con- tinue its passage for two or three minutes at intervals of some se- conds. After these two or three minutes, during which we shall have communicated from twenty to thirty shocks, we should leave the patient at rest for some time, and then renew the treatment." In a recent periodical* it is affirmed that Dr. Krusell, of St. Pe- tersburg, has employed galvanism successfully in the treatment of syphilitic ulcers. To this method he gives the name " electrolytic." It is not clearly described by the translator—and the author does not possess the original article; but it would appear, that of forty- three patients whose treatment commenced between the 4th of July and the 11th of September, 1844, inclusive, twenty-one were free from all appearances of disease on the 13th of September, and all the others, with the exception of three or four, were in the best condition,—the sores being nearly healed. Dr. Krusell employs an uninterrupted current. Dr. Hays has stated, that the most useful remedy in certain cases of amaurosis, which fell under his care,| was unquestionably galvanism. This was evinced not only in the improvement which followed its application, but in the "still more striking * Journ. fur Chirurg. und Augenheilkunde von Walther und Ammon. Bd. v. S. 92; cited in Lond. Med. Gaz. June 5, 1846, p. 1015. t American Journal of the Medical Sciences, Aug. 1840, p. 28S. GALVANISMUS. 341 fact," that the patient saw belter whilst subjected to the gal- vanic 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 which was sol- dered 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 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 vvhen it was considered desirable to introduce strychnia into the system, the sponge attached to the negative pole —and sometimes that to 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 Jess remote, according to the power required; and the force was easily regulated. The galvanic cur- rent may be made to pass from the mastoid process to the super- ciliary ridge. Dr. Hays expresses his persuasion, that galvanism, properly employed, is a valuable and effective remedy for certain forms of amaurosis. There are doubtless—as already observed— cases of disease, in which the excitant and revulsive agency of gal- vanism may be employed with advantage, but they are not so nu- merous as was at one time believed. The author has used the plates extensively—in neuralgic cases especially—but has not ex- perienced so much success as to induce him to advise them fre- quently, under the inconveniences that necessarily accompany their employment. They are, indeed, at this time, but little used. The ordinary modes of applying galvanism are referred to in another work.* An apparatus has been devised by Mr. Coad, of Philadelphia, which enables galvanism to be communicated either continuously, or in an uninterrupted manner, and the dose to be re- gulated according to the wishes of the practitioner. It is conve- nient, and well adapted for all cases in vvhich it may be deemed advisable to apply galvanism.t Some years ago, Professor Von Hildenbrand, of Pavia,| recom- mended, 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-nee- dles, firmly tied together by wire of the same material, so as to form a cylinder of about four or five inches long, and an inch or three-fourths of an inch in diameter. This is applied to the pained part, which has been previously moistened with a solution of com- * General Therapeutics and Materia Medica, 3d edit i. 501. Philad., 1846. t Art Galvanism, in Cyclop, of Practical Medicine, Amer. edit, by the author. Philad. 1845. + Edinburgh Medical and Surgical Journal, April, 1833. 342 GALVANISMUS. mon salt; and, according to Von Hildenbrand, it at times produces relief so instantaneously, that it appears to the patients to act like a charm. In his first experiments, he employed brushes construct- ed of two kinds of metal,—for instance, of silver and copper wire, copper and zinc wire, or zinc and brass wire, the individual wires bein °f simple ointment, which quantity is to be daily rubbed into the part affected. The strength of the ointment of red iodide used by him is 3j. to §j. of simple ointment. This ointment spread upon leather vesicates: and the cuticle separates in the form of a crust. Its efficacy has been great in bronchocele: according to M. Moj'sisovics on the fall- ing off of the dried cuticle, the size has been found to be sensibly diminished. No preparation of iodine, he thinks, is comparable in this disease to the red iodide. " It performs in one month what the other forms will scarcely do in three or four." He has treated goitres of enormous size with it, and at the first application all the threatenings of suffocation or apoplexy—where they existed— ceased. Condylomata about the anus and perinaeum, or even * Die neuern Arzneimittel, u. s. w. S. 270. t Grafe und Walther's Journ. fur Chirurg. Bd. xiii., cited by Pereira, Elements of Ma- teria Medica, 2d edit. i. 762. Lond. 1842, or 2d Amer. edit. Philad. 1846. X Darstellung einer sicheren und schnellen Heilmethode der Syphilis durch Iodpraparate. Wien, 1845: noticed in Brit, and For. Med. Rev. April, 1845, p. 516. HYDRARGYRI IODIDUM RUBRUM. 365 within the rectum and vagina, were cured by this ointment; and unless they were very extensive and indurated, a single applica- tion—which is very painful—combined with the internal use of iodine, has been found sufficient. The author has frequently administered the red iodide in pub- lic and in private practice, in cases where an active modifier of the system of nutrition appeared to be needed, and where a com- bination of remedies so potent as mercury and iodine suggested itself. In chronic glandular enlargements, especially of the liver and spleen, and in habits where the use of mercury was not contra- indicated, both the red iodide and the iodide have, in his hands, proved extremely serviceable. Perhaps there are no preparations, which, under the circumstances in question, merit more attention. MODE OF ADMINISTRATION. Red iodide of mercury is given internally in the form of pow- der or pill, or dissolved in alcohol or ether, in the dose of one-six- teenth to one-fourth of a grain, gradually increased daily. Exter- nally, it is applied in the form of ointment. Pilnla; hydrargyri iodidi rnbri. Pills of red iodide of mercury. R. Hydrarg. iodid. rubr. in syrup, coraraun, pauxill. terendo bene distribuend. gr. v. Mica? panis alb. Sacch. pulv. aa. q. s. ut fiant pilulas lx. Dose.—Two, morning and evening, drinking afterwards a cup- ful of oatmeal gruel. The dose to be raised gradually. Blasius. Tinctura hydrargyri iodidi rnbri. Tincture of red iodide of mercury. R. Hydrarg. iodid. rubr. J}j. Alcohol, 36° (.837) f. giss. M. Dose.—Ten to twenty drops, in a glass of distilled water. Magendie fy Biett. Syrupus hydrargyri iodidi rnbri compositas. Compound syrup of red iodide of mercury. R. Hydrargyr. iodid. rubr. gram. i. (gr. 15.44 Troy.) Potass, iodid. gram. 50. Aquas gram. 50. Dissolve, filter through paper, and add Syrup. (30° when cold,) gram. 2400. A tablespoonful of this syrup is a dose. It represents, provided it holds 25 grammes of the syrup, a centigramme of red iodide of mercury, and 50 centigrammes of iodide of potassium. Gibert. * * Journal de Pharmacie, Oct 1841, p. 634. 24 366 HYDRARGYRI PR.EPARATA. Jther snlphuricus cnm hydrargyri iodidi rnbro. Sulphuric ether with red iodide of mercury. R. Hydrarg. iodid. rubr. 9j. iEther. sulphur, f. giss. M. Administered like the last. Magendie fy Biett. Ungnentnm hydrargyri iodidi rnbri. Ointment of red iodide of mercury. R. Hydrarg. iodid. rubr. in pulv. subtiliss. gr. vj. Adipis 3VJ. M. Kopp. R. Hydrarg. iodid. rubr. in pulv. subtilissim. gr. J to £. Adipis Qij. Cera? albse gr. ij. M. fiat unguentum. For an eye-salve. Kopp. R. Hydrargyri iodid. rubr. gr. xv. Adipis gss. M. exactissime. Fiat. ung. As a dressing in lupus. Blasius. R. Hydrarg. iodid. rubr. gr. xv. Adipis gij. 01. bergamot. gtt. x. M. To be rubbed on the parts in chronic cutaneous affections. Biett. R. Hydrarg. iodid. rubr. 9j. Adipis giss. M. Biett. To be spread on lint in old venereal ulcerations. The unguentum hydrargyri biniodidi of the London College is prepared like the ung. hydrarg. iodidi. XCIX. HYDRAR'GYRI ET ARSENICI IO'DIDUM. Synonymes. Arsenici et Hydrargyri Iodidum, Hydriodas Arsenici et Hy- drargyri, Iodide or Hydriodate of Mercury and Arsenic, Double Iodide of Arsenic and Mercury, Iodo-arsenite of Mercury. Mr. Donovan* has proposed this new compound, which he re- gards as more efficacious than either the iodide of mercury or the iodide of arsenic. METHOD OF PREPARING. Triturate 6.08 grains of finely levigated metallic arsenic; 14.82 grains of mercury, and 49 of iodine, with one fluidram of alcohol, until the mass has become dry, and, from being deep brown, has * Dublin Journal of Medical Science, Nov. 1839, p. 281. See, also, M. Soubeiran, Dee. 1841, p. 744. HYDRARGYRI ET ARSENICI IODIDUM. 367 become pale red. Pour on eight fluidounces of distilled water; and after trituration for a few moments, transfer the whole to a flask; add half a dram of hydriodic acid, prepared by the acidifi- cation of two grains of iodine, and boil for a few moments. When the solution is cold, if there be any deficiency of the original eight ounces, make it up exactly to that measure with distilled water. Finally filter.* By the long continued trituration of arsenic, mercury, iodine, and alcohol, the metals are converted into iodides, which combine. The mass, by solution in water, is converted into a hydriodate of arsenic and mercury. The quantities of the two metals are so adjusted, that, when converted into protoxides by decomposition of a portion of the water in which they are dissolved, there will be eight grains of arsenious acid, and sixteen of protoxide of mer- cury. The quantity of water is such, that each dram by measure of the solution will contain exactly one-eighth of a grain of arse- nious acid, and one-fourth of a grain of protoxide of mercury. Mr. Donovan conceives, that the quantity of mercury ought to be double that of the arsenic, in order to ensure a slow, and moderate, yet adequate mercurial action, along with the proper effect of the arsenic. Of the preparation above described, which Mr. Donovan calls liquor hydriodatis arsenici et hydrargyri, (liquor arsenici et hydrargyri iodidi,) each dram by measure consists of water, one dram; arsenious acid, one-eighth of a grain; peroxide of mercury, one-fourth of a grain; iodine, converted into hydriodic acid, about three-fourths of a grain. The colour of the solution is yellow, with a pale tinge of green: its taste is slightly styptic. It is in- compatible with tincture of opium, or with sulphate, muriate, or acetate of morphia. The test of the perfection of the preparation, according to Mr. Donovan,f is, that the whole of the iodine, arsenic and mercury shall disappear, and be dissolved during the process of preparing it. This cannot happen unless the three elements employed have been chemically pure, and unless the trituration has been suffi- ciently long continued. EFFECTS ON THE ECONOMY. Numerous trials have been made with this preparation in cutaneous diseases, especially in psoriasis, lepra and lupus; and the testimony of some of the most eminent of Mr. Donovan's coun- trymen has been brought forward in its favour. Mr. Carmichael has given it in five or six cases of lupus, and in one of psoriasis, with decided benefit.:}: Mr. Colles administered it in two extreme * Mr. Donovan, Dublin Journal, Nov 1842, p. 171. t Ibid. Sept. 1840, p. 106. X Dublin Medical Press, Jan. 18, 1840. 36S HYDRARGYRI PR.EPARATA. cases of scrofulous ulceration in the adult with some benefit: Dr. Croker gave it internally and applied it externally with com- plete success, in a case of psoriasis guttata: Dr. Graves treated a very inveterate case of psoriasis with decided advantage; Dr. Irvine completely cured a most virulent case of the same affection by the internal use of it; Mr. Cusack found, that venereal erup- tions yielded rapidly to half dram doses, three times a day; and Sir Henry Marsh had a case of impetigo figurata, of strumous origin, covering the face, chest, arms, and thighs, but particularly well marked at the flexures of all the joints, which was cured by the administration of fifteen minims, twice a day, gradually in- creased to one scruple, and finally to half a dram. The treatment was cautiously pursued for somewhat less than a month, with a gradual amendment of the disease, which subsequently disappeared entirely. Since those cases were published, Mr. Donovan has given nu- merous others from the practice of Dr. Charles O'Reilly, Sir Hen- ry Marsh, Dr. Robert J. Hickson, Dr. J. D. White, Mr. Richard Jones, Dr. Bigger, Mr. O'Ferrall, Dr. Ferguson, Dr. Osbrey, Dr. W. T. Hamilton, Dr. Graves, Dr. Kirby, Mr. Gabriel Stokes, and Dr. C. P. Croker, which lead him to infer, that the diseases, in which the preparation has been found of most service, are the va- rious forms of psoriasis, impetigo,porrigo, lepra, venereal erup- tions—both papular and scaly,pityriasis, sycosis, ephelis, lupus, sibbens, and some uterine diseases.* In several of the cases, slight ptyalism was induced. Dr. Isaac E. Taylor, of New York,y prescribed this preparation in a number of cutaneous diseases; and he testifies, that it pro- duces a more marked and prompt effect than the various remedies usually resorted to in lupus, rupia,psoriasis, secondary syphilis, &c. It is also spoken of in high terms by Dr. Gerald Osbrey,J in inveterate psoriasis, lichen urticatus, and scrofulous ophthal- mia. MODE OF ADMINISTRATION. The dose of the liquor arsenici et hydrargyri iodidi is from fifteen minims to half a fluidram, two or three times a day. Mr. Donovan§ recommends the following form:— Haustns liquoris arsenici et hydrargyri iodidi. Draught of the solution of iodide of arsenic and mercury. R. Liq. arsenic, et hydrarg. iodid. gij. Aquae destillat. f. giiiss. Syrup, zingib. f. gss. M. Divide, in haustus iv. * Dublin Journal of Medical Science, Nov. 1842, p. 199, and Mr. Erichsen, London Medical Gazette, May 12, 1843, p. 238, and May 19, 1843, p. 241. 't American Journal of the Medical Sciences, April, 1843, p. 319. X Dublin Journal of Medical Science, July, 1842. § Ibid. Nov. 1839, p. 282. INDIGUM. 369 Dose.—A draught, night and morning. The division into draughts Mr. Donovan considers necessary, —first, to ensure accuracy of the dose; and next to prevent injury to the ingredients by the use of a metallic spoon, as a measure;— the general way in which doses of medicines are administered. When applied externally in cutaneous affections it may be diluted with an equal portion of water, or farther—should a weaker lotion he indicated. Mr. Donovan states, that the employment of this preparation is rapidly extending, as shown by the fact, that within two years and a half, about three hundred pints of it have been sent out of his establishment alone, which—as he properly remarks—is a vast quantity of an article prescribed in minim doses.* A double iodide of mercury and morphia, French, iodure double de mercure et de morphine, has been recommended by M. Bouchardat.f It is obtained by treating in boiling alcohol, a mixture of equal parts of red iodide of mercury, and iodhydrate or hydriodate of morphia. On cooling, crystallized grains are deposited of a double compound, having a white, slightly yellow- ish colour. According to M. Bouchardat, it is almost as energetic -as the red iodide of mercury, and ought to be employed with great caution. A quarter of a grain is a dose, vvhich may be given once a day in the form of pill in constitutional syphilis; gra- dually increasing the dose, especially in syphilitic pains of the bones. C. IN'DIGUM. Synonymes. Indicum, Indicus Color, Pigmentum Indicum, Indigo. French. Indigo. German. Indig. This well-known colouring material is obtained from several* species of the genus Indigofera (I. tinctoria, I. anil, I. disperma, I. argentea, and I. hirsuta,) belonging to the Natural Family Leguminosae, and, in the Linnaean System, to Diadelphia Decan- dria. As we receive it, it is in small, solid, brittle masses, of a deep azure colour, without smell or taste, and assuming a coppery lustre on being rubbed. It is entirely soluble in sulphuric acid, and is wholly consumed on burning coals. According to the analysis of Chevreul, 100 parts of Guatemala indigo of commerce contain only 45 parts of pure indigo, or indigo-blue—with vvhich no therapeutical experiments have as yet been made: the greater part of the residue consists of a green matter soluble in spirit of wine (indigo-green;) and a red resin (indigo-red;) the rest is ex- tractive matter, gum, and some carbonate of lime, oxide of iron. * Dublin Journal of Medical Science, Nov. 1842, p. 199. t Nouveau Formulaire Magistral, p. 303. Paris, 1845. 370 indigum. argillaceous and siliceous earth. With hydrogen, pure indigo form3 isatic acid, which has considerable resemblance to the hydrocyanic. EFFECTS ON THE ECONOMY. The natives of the countries, where the different kinds of indigo grow, employ it occasionally as a therapeutical agent, especially in diarrhoea and intermittent fever. It is only within the last few years that attention has been paid to it in Europe. Professor Von Stahly,* of Ofen, appears to have first employed it with suc- cess in various spasmodic diseases, especially in epilepsy. To these cases Lenhossek alludes, in detailing certain trials which he himself had made with it. In 1833, Grossheimf made known a case, in which he found it extremely useful. A lady, twenty-eight years of age, had suffered for eleven years with violent hysterical convulsive attacks, for which she had employed almost every remedial agent. The attacks began with a feeling of heaviness over the whole body, with slight convulsive twitchings of the limbs, which extended to the trunk, and were followed by total, or almost total, loss of consciousness: this, after an uncertain pe- riod, terminated in a comatose state, from vvhich she was gradually restored—but in a languid condition—to perfect consciousness. Under the use of indigo for half a year, with pediluvia—which had been previously employed without advantage—she completely recovered. These results gave occasion to the institution of experiments, touching the remedial properties of indigo, in the Charite at Berlin, the results of which have been given by Roth.:}: In most of the cases, the indigo excited nausea, and even vomiting, pre- ceded by a metallic taste on the tongue. At times, the vomiting was so violent and prolonged, that it was necessary to discontinue it; but generally on continuing its use, the vomiting ceased in three or four days, and diarrhoea took its place. All the patients did not vomit, and many escaped the diarrhoea. When once diarrhoea occurred, however, it commonly persisted as long as the indigo was used. The evacuations were seldom entirely fluid, but usually semifluid, and of a dark bluish-black colour. While the vomiting and purging continued, more or less uneasi- ness was experienced in the digestive apparatus. The vomiting and diarrhoea were frequently accompanied by pains in the sto- mach and bowels, which were commonly slight, but occasionally so violent that the indigo had to be discontinued. In every pa- tient at the Charite, the urine was of a dark violet hue. Stahly affirmed that the perspiration was coloured blue, but this Roth never observed. He remarked, moreover, that after the use of * Hecker's Neue Annalen, B. i. H. 1. Berlin, 1835. t Medicinische Zeitung, No. 51, 1833. X Hecker's Neue Annalen, B. i. Heft. 1. Berlin, 1835. INDIGUM. 371 indigo for several weeks, certain patients were easily thrown into slight convulsions, similar to those caused by the use of nitrate of strychnia, and that they were affected with slight subsultus tendinum. Almost all the patients, indeed, who took indigo, were at first more frequently attacked with spasms than prior to the use of the remedy. In the beginning, the attacks of the dis- ease were, in all cases, stronger, but of less duration, than previ- ous to its employment. These changes continued for one, two, three, and even as long as eight weeks, whether the patients took small or large doses. At the expiration of this time, all the epileptic symptoms were diminished in intensity and duration, until the last attacks were mere premonitions. The number of epileptic cases, treated by indigo, which Roth had an opportunity of observing in the Charite, was twenty-six; of these nine were cured, eleven improved, and six remained. Dr. Ideler,* who instituted the experiments at the Charite, has also given publicity to the results; and his testimony accords with that of Roth. It is proper to observe, however, that, of the nine cases cured, three experienced relapses in from eight to twelve months; but from causes, according to Riecke,t which of themselves might have induced epilepsy. Dr. Strahl,! of Berlin, likewise experimented with indigo, but his results were by no means favourable. In ten cases of old standing epilepsy, it was not of the slightest service, and the same may be said of two cases of St. Vitus'* dance. In four cases of hysteria, it excited violent nephralgia, and in one of the cases only, after the affection of the kidney was removed, was the pa- tient cured. It acted, however, signally on the uterus; in two cases of spasmodic affections, complicated with amenorrhoea, the latter derangement was removed, whilst the spasms still continued, even after the recurrence of the catamenia. In the Charite of Berlin, the purest Guatemala indigo of commerce was used, and it has been a question, whether Strahl did not employ one of feebler powers. It is worthy of remark, that he observed a dark green colour of the urine during its use, whilst in the cases in the Charit6 a dark violet hue was constantly noticed. Favourable cases are also detailed by Drs. Mankiewicz, of Nackel,§ and Hohnhorst, of Frankfort.|| M. PodrecalF found it especially efficacious when associated with asafoetida and castor. Dr. Noble, of Versailles,** administered it in three cases, in * Medicinische Zeitung, No. vi., cited in Lancet, June 6,1835. 1 Op. cit S. 276, and 2te Auflage, S. 389. Stuttgart, 1840. t Hecker's Neue Wissenschaft. Annalen, 1836; cited in Edinb. Med. and Surg. Jour. 1837. § Medicin. Zeitung, Mai 31, 1837, S. 109. || Ibid. S. 110, and Medicin. Zeitung des Vereins fur Heilkunde in Preussen, 1837, No. 22. IT Bouchardat, Annuaire de Therapeutique, pour 1843, p. 69. Paris, 1843. ** Bulletin General de Therapeutique, 1836. 372 INDIGUM. which the disease had continued for four, twelve, and twenty years respectively. At the time of making known the results, a month had elapsed in the first case, and two months in the second, since an attack had been experienced, and the last case he con- sidered entirely cured. In the first patient, who was eighteen years old, four drams occasioned vertigo, slight depravation of vision, and convulsions similar to those produced by strychnia; and in both the other cases, diarrhoea was induced, which ceased, however, as soon as the indigo was discontinued or the dose re- duced one-half. He gave it in the dose of one dram gradually increased to four drams daily. The observations of Rech, of Montpellier, were not as favour- able to it. In nope of the epileptics to whom he gave it was there any thing more than a slight amelioration. In the Hospice d'Hommes Incurables du Faubourg St. Martin, trials were also made with it by Dr. Blanche. Of ten cases, five were either cured or improved. One of these had existed for three years, and the paroxysms recurred every five or six days; but after the administration of the indigo, he had no return at the expiration of five months; in a second case, a youth fifteen years old— who had been epileptic from birth, and had regularly one or two paroxysms a day, from the 19th of July, when the exhibition of the indigo was begun with, until the middle of August, when the results were published—had only two insignificant attacks. The improvement in the other three cases was not as marked, yet it was unquestionable. The other five children experienced no improvement, yet no inconvenience was sustained, although the indigo was given in doses of four, six, and eight drams in the day. It was administered in water or in a tisane; and in one or two cases it excited vomiting, but after having been discontinued, it was borne subsequently. In all it induced tormina, and acted upon the bowels, but did not interfere with the appetite or any of the other functions. Dr. Benjamin F. Hardy,* one of the senior resident physicians at the Philadelphia Hospital, published the results of some trials made with indigo, which, so far as they go, confirm its antipa- roxysmal power. Two of the seven cases reported were appa- rently cured, two ameliorated, and three without any decisive results—the medicine not having been continued perhaps for a sufficient length of time. In tb^ese cases, it was commenced in the dose of Jj., which was usually doubled daily until the patient took ^ij? daily, which quantity was persevered in for some weeks. In some of the cases, the fasces, urine, and perspiration were all coloured blue. In other trials, instituted in the same charity with the indigo, * Dunglison's American Medical Intelligencer, for July 15, 1839, p. 122. \ INDIGUM. 373 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 in- dicated by concomitant mania, or idiocy, 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, indigo, like artemisia and other remedies extolled in epilepsy, may be useful. Its main efficacy, perhaps—as has been said of the Ferri Subcarbonas (p. 325)—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 by day, and the remedy be continued in large doses for a sufficient length of time. Dr. Pereira,f states that he has tried it in a considerable num- ber of epileptic cases at the London Hospital, but without de- riving the least benefit from it. MODE OF ADMINISTRATION. As indigo is extremely light, the powder is too bulky for admi- nistration; it is taken with disgust, and is apt to excite vomiting. On this account, the form of electuary was selected in the Charite. It was generally combined with the pulvis aromaticus, or the pulvis ipecacuanhas et opii. 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 formulae were generally employed:— Pulvis indigi. Powder of indigo. R. Indig. in pulv. subtilissim. gss. Pulv. aromat. gr. v. M. et fiat pulvis. A powder to be given four times a day. Pilulae-indigi composite. Compound pills of indigo. (Antiepileptic pills.) R. Indig. gr. Ixxv. Asafetid. gr. xv. Castor, gr. vij. M. et divide in pilulas xx. One to be given every hour. Podreca. * Dr. William H. M'Kee, in Dunglison's American Med. Intelligencer, Sept. 16,1839, 177 t Elements of Materia Medica, &c., 2d edit p. 1620. Lond. 1842; or 2d Amer. edit. Philad. 1846. 374 INJECTIONS INTO THE EUSTACHIAN TUBE. Electuarium indigi. Electuary of indigo. R. Indig. pulv. aqua? guttis nonnullis subact. gij.—gss. Pulv. aromat. gss. Syr. simpl. f. gj. M. fiat electuarium. To be used in the course of the day. Ideler. CI. INJECTIONS OF AIR, VAPOUR OF ETHER, ETC., 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 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 ex- clusive empiric. Now that the physiology of the outer and middle ear is better understood, their pathological 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,—vvhich prevents the vibrations of a sonorous body from reaching the membrana tympani, such obstacle must be removed. Should no defect exist 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 be 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 membrana 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 ac- cumulation 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 employed. The catheter of Itard is a conical silver tube, curved at the extremity, with a slight enlargement to prevent laceration of the membrane. 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 is of s INJECTIONS INTO THE EUSTACHIAN TUBE. 375 a calibre varying from the size of a small crow-quill to that of a large goose-quill. The extremity is well rounded, and it is curved only to the distance of five lines from the point, exactly at an angle of 144°, so as to correspond to the lateral situation of the mouth (Reduced one half.) of the Eustachian tube. It is nearly of the same calibre through- out its whole length, and provided with a funnel-shaped dilatation 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 by Mr. Pilcherf admits of being passed farther into the tube, and has a more gradual curve. De- leauj employs a flexible elastic gum catheter, which the patient 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 the author has seen repeatedly done. The silver instrument, 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 Eusta- chian 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 narrowness 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-cartilaginous 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 without support, an advantage it pos- sesses—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 next figure. It consists * 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. § Op. cit. p. 305. 376 INJECTIONS INTO THE EUSTACHIAN TUBE. of a middle piece made of metal, bent so as to fit the arch of the fore- head, 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 applied 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 posi- tion. 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, Deleauf suggested the air- douche, or injections of air for the purpose of clearing the cavity; and this is regarded by Kramer^ 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-presses or condensers. The marginal figure represents that of Kramer. c b is a cylinder, 10| inches high, made of molten brass; the diameter of its calibre is 4^ inches, and it is fastened at b with strong screws, on a strong oaken stand of the height of an ordinary stool. Within the cy- linder c b is a pump barrel of wrought brass screwed into it, which measures 10| inches in height, and %\ inches in diame- ter, rising, at d a, 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 passage 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. * See some cases of deafness relieved in this way, by Dr. John H. Dix, in Boston Me- dical and Surgical Journal, Sept. 25, 1839, p. 105. t Sur le Catheterisme de la trompe d'Eustache, &c. Paris, 1828; Itard, in Mem. de l'Academ. Royale de Medecine, Tom. v. Fasc. 4. Paris. 1836; and translation in Medical and Surgical Monographs, vol. i. p. 75, of Dunglison's Amer. Med. Library, p. 86. Philad. 1838. X Op. citat. p. 164. INJECTIONS INTO THE EUSTACHIAN TUBE. 377 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* 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 re- commends 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 the catheter, may be brought into contact with the mucous membrane, and thus stimu- late 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 Savagef 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 nostril, the patient fell back in the chair and never spoke afterwards.]: The sudden shock to the nervous system was pro- bably 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 operation, so loosely in the di- lated end of the catheter, that there may be room for air to regur- gitate ;§ and likewise, that instead of sending in the air by douches or charges—it should be transmitted in a gentle and continued stream. Another circumstance, which shows the importance of care, is the fact, that the mucous membrane may be ruptured, and serious emphysematous tumefaction be occasioned. It is proper to observe, that the results of 258 cases, treated by Itard,|| are far from encouraging. Of these, but two of cure are said to have been effected, and in this result, according to Itard, other causes concurred; whence he infers,—first, that as a means of exploring obstructions of the tympanum by the crepitation which often accompanies them, douches of air can afford no certain index; and secondly, that as a mechanical agent for deterging or evacu- ating obstructing matters, they can only dislodge and force them * Op. cit p. 307. 1 Lond. Med. Gaz. for July 20,1839,p.616. Dr. M. Lynch, in Lancet, Aug. 3,183'.), p. 683, and ibid. p. 690; and Dr. Joseph Williams, Treatise on the Ear; including it? Anatomy, Physiology and Pathology, &c. p. 242. Lond. 1840. X Lond. Med. Gazette, July 6, 1839, p. 538, cited in Dunglison's American Medical Intelligencer, Aug. 15, 1839, p. 150. § British and Foreign Medical Review, July, 1839, p. 95. [| Op. citat. 378 INJECTIONS INTO THE EUSTACHIAN TUBE. together; and, consequently, that both in the second and first point of view, douches of air do not deserve the confidence of the pro- fession. The vapour of acetic ether has recently been injected into the middle ear, in cases of nertous deafness, of which Kramer* makes two varieties; noise in the ear constituting the essential point of difference between them. This noise belongs, without exception, to the erethitic form; whilst it is foreign to the torpid. In cases of nervous deafness, Itard proposes 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 vaporized. The ether is, however, decomposed in this manner, so that it is not ethereous vapour which enters the tympanum, but an acrid very irritating kind of gas, which, according to Kramer, is well suited to the torpid form of nervous deafness, but is positively injurious in the erethitic variety. He considers the attempt to vaporize acetic 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 vvhich are passed two brass tubes, each provided with a cock; one of these tubes is connect- ed above with a funnel for dropping in the fluid, and the other with an air-tight tube to conduct the vapour, gene- rated 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 * See, on this subject, Mr. T. Wharton Jones, in Lond. Med. Gaz., Aug. 3,10.17, and 24: 1839. t Op. citat. 211. INJECTIONS INTO THE EUSTACHIAN TUBE. 379 funnel, and forced into the flask by a gentle expiration, where it is converted into thin vapour at the ordinary temperature 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, leaning his arm upon it, and with the corresponding hand he is to hold the tube of the apparatus, in such manner that it may remain in close connexion with 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 unne- cessary to make use of warm water to pour into the flask, as the ordinary temperature of the room is sufficient to vaporize the ether. In the torpid form of nervous deafness, this method of proce- dure does not answer, owing to the necessity for greater excita- tion than it is capable of effecting. In such case, a modification of the apparatus of Itard has been proposed by Kramer. Owing to the metallic saucer in Itard's becoming cool more than once during a single sitting, and requiring 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 ex- tremely; 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 proposes to rectify in the following manner:—For the floor on which the 380 IODINUM. bell-glass of the apparatus rests a thin metal plate is substituted, 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 middle ear. Through the cover of the appa- ratus, a thermometer, with a metallic scale, passes down almost to the bottom, and indicates the temperature at which the ethereous vapour passes into the ear. After a sitting or two—if the indi- vidual 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.* A case, of the success- ful application of the acetic ether in erethitic deafness, has been published by Dr. Bolton, of Richmond, Virginia, f The hearing distance was amazingly improved by it, and the success far ex- ceeded the operator's most sanguine expectations. 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 mueous membrane, which subsequently extended, in the erysipelatous form, over the cutaneous surface. It yielded to appropriate treatment. On the whole, the treatment of deafness by injection is by no means so effective as was at one time supposed. CII. IOTJINUM. Synonymes. Iodinium, Iodium, Iodum, Iodina, Iodine. French. lode. German. Iod. Iodine was accidentally discovered in the year 1812, by Courtois, a manufacturer of saltpetre at Paris, but it was chiefly through the labours of Gay-Lussac and Sir Humphrey Davy,:}: that the chemi- cal relations of this elementary body were appreciated. The dis- coverer first detected it in the mother waters of soda obtained from sea-weed, (kelp;) and as it was found to exist chiefly in several of the sea-weeds, and especially in the sponges, it struck Coindet,§ that experiments might be made with it in goitre: from these he obtained such striking 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 by many considered capable of inducing were appreci- * Pilcher, op. cit. p. 318. See some observations on this subject, with two by no means satisfactory cases, by Mr. T. Wharton Jones, in Lond. Med. Gaz. for Aug. 31, and Sept. 7, 1839. 1 Dunglison's American Medical Intelligencer, April 1, 1839, p. 1. X Annales de Chimie, Ixxxviii. xc. and torn, xci., and Philos. Transact 1814 and 1815. § Bibliotheque Universelle, Juillet, 1820, p. 190. I0DINUM. 3S1 ated, 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. METHOD OF PREPARING. Iodine is obtained from the mother waters of the soda derived from sea-plants, in which it exists—it is believed—in the form of iodide of sodium. The waters are procured by burning different kinds of weeds which grow on the sea-shore, lixiviating the ashes, and concentrating the liquor. To obtain 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 base of the hydriodic salt, and of the hydrogen of the hydriodic acid; whence result sulphate of soda, 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.* It is manufactured in large quantity in Scotland, from the kelp of the Hebrides and Orkney Islands, f According to Dr. Traill, the greatest quantity is produced by kelp, made from driftweed, which is in a great measure composed of Fucus digitatus, and F. loreus;—catweed, which consists of F. vesiculosus and F. serratus, yielding much less of it. One hundred tons of Caithness kelp afford, according to the experience of a manufacturer, one thousand pounds of iodine, or about a 224th part.:}: It is always prepared on the large scale, and hence is placed in the Materia Medica list of the Pharma- copoeia of the United States. Iodine is solid at the ordinary temperature; of a foliated appear- ance, and metallic lustre: of a grayish or bluish-black colour simi- lar to that of plumbago, and friable. It is soluble in 7000 parts of water, 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 vvhich it accords in its property of destroying; vegetable colours. It possesses, in a high degree, electro-negative properties. It colours the skin yellow, which colour gradually- disappears. It fuses at 220° Fahrenheit. The vapour is of a beautiful violet colour, whence its name (tuS^s, 'blue.') It is solu- ble in ether and in alcohol; forms an acid both with oxygen and hydrogen, and enters into numerous chemical combinations^ * For the method employed by Soubeiran, see Journal de Pharmacie, Janvier, 1837; and for that by Barruel, see Bussy, ibid. t Christison, Dispensatory, p. 552. Edinb. 1842; and the author's General Therapeu- tics and Materia Medica, 3d edit. ii. 310. Philad. 1846'. X Christison, loc. cit. § See, on Iodine and its Combinations, Mr. Duhamel, in Philad. Journal of Pharmacy vi. 101. Philad. 1323-4. 25 382 IODINUM. In consequence of its high price, iodine is very liable to adul- teration; and it is said, that coal, black lead, oxide of manganese, and charcoal, have been added to it; but neither Dr. Christison* nor Dr. Pereiraf has met with any of these impurities, which would remain behind when heat was applied, and admit, there- fore, of easy detection. Water is the chief adulterant, and its unusual presence may be suspected if the iodine adheres to the sides of the bottle in which it is kept. Dr. Christison states, that until within the eighteen months before he wrote, he had not met with any British iodine, that did not contain between 15 and 20 per cent, of water. EFFECTS ON THE ECONOMY IN HEALTH. Soon after the discovery of iodine, and the accurate investiga- tions of Gay-Lussac, Magendie| instituted a series of experi- ments in order to appreciate its action on the animal organism. It was injected into the veins without any apparent effect. Se- veral 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 doses, however, the effects were markedly injurious. Orfila§ likewise instituted several experiments on dogs, from which he concludes:—that iodine, introduced into the stomach in moderate quantity, acts as a gentle stimulant, but may excite vomiting:—that in the dose of a dram, it almost always killed the animal in four or five days, when the oesophagus had been tied to prevent vomiting, and that in part of the mucous mem- brane, with which it came in contact, ulcers were gradually formed;—that when administered in the dose of from two to three drams, the oesophagus not being 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 poi- sons. Dr. Cogswell,||—in repeating one of Orfila's experiments, in which seventy-two grains of iodine were introduced into a wound on the back of a dog without much effect on the health of the animal,—did not attain exactly the same results. He in- troduced a scruple of iodine into the cellular tissue of the thigh * Dispensatory, p. 553. Edinb. 1842. t Elements of Mat. Med. and Therap. i. 235. Lond. 1842; or 2d Amer. edit by Dr. Carson, i. Philad. 1846. X Formulaire pour la preparation, &c, de plusieurs nouveaux Medicamens. § Toxicologic, i. 556. || Experimental Essay on Iodine and its Compounds. By C. Cogswell, A. B., M. D., p. 21. Edinb. 1837. I0DINUM. 383 of an adult rabbit, through a small opening made in the skin. The animal manifested no symptom of pain, and was able to make use of the limb as freely as before the operation, but, in the course of a fortnight, it gradually lost flesh, exhibiting an emaciated look, and the hair dropped off from many parts of the head. At the end of this time, thick adhesive pbs was found distending the cavity of the wound, from which the iodine had entirely disappeared. Dr. Cogswell properly suggests, however, the possibility, that the irritation of a large abscess might have been the sole origin of the animal's unhealthy appearance. 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 quar- ter of an hour; soon afterwards he vomited a liquid yellowish matter, in which iodine was easily perceptible. Except a slight degree 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 colic pains, which continued for an hour, and were removed by two emollient glysters. The pulse, which, prior to the experi- ments, beat sixty times in the minute, became more frequent. beating from eighty-three to ninety, and was much stronger. The breathing 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 higher coloured. AH the symptoms were removed by the copious use of gum water as drink, and of emollient glysters. Dr. Gully, on the other hand, 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 eighty days, nine hun- dred and fifty-three grains of iodine in the form of tincture, the . doses having been so proportioned, that towards the last, the pa- tient—a girl—did not seem to be in any way particularly affected: and Dr. Buchananf gave half an ounce of iodide of potassium within twelve hours, without any unpleasant result, diluents being largely taken at the same time. See Potassii Iodidum. It has been conceived, that where iodine proves mischievous, it is owing to its being in a free state, and that it then operates as a corrosive poison. The tincture of iodine, and the ioduretted ia- * Lond. Med. Repository, for 1822. t Lond. Med. Gazette, July, 1836. See, also, Fuster, in Bullet. General Therap. Fev. 1837, and Sept. 1837. 384 IODINUM. dides are esteemed objectionable on this account.* It does not appear, that the vapours of iodine exert any injurious effect on the workmen concerned in its preparation.! From experiments, instituted by JorgJ on himself and on other healthy individuals, it seemed to him, that iodine, first of all, acts as a stimulant on the intestinal canal; soon afterwards, it ex- cites, also, the different glands in the cavity of the mouth and sto- mach, the pancreas, the liver, and 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 system of nutrition. Two drams of iodide of starch, according to Dr. Bu- chanan^ 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 crassamentum 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 puncture was made into the joint, and upwards of twelve ounces of synovia were drawn off by a cupping-glass. The syno- via contained 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 tap- ping 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. GairdnerlT observed the action of iodine on the human body when administered in particular doses, and pointed out the disad- vantages attendant upon an improvident use of the article. The most striking inconveniences were induced in the digestive organs: it excited diarrhoea, and, at times, obstinate constipation; gastro- 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 ex- . tent; yet it is proper to remark, that Lugol,** in his frequent em- ployment of iodine in scrofula, never observed this result: he af- firms, indeed, that emaciated patients became stronger under its use; that the stout did not grow leaner, and that they who held the medium position in these respects acquired strength under its * Brande's Dictionary of the Materia Medica, p. 323. Lond. 1839. t A. Chevallier, Annales d'Hygiene Publiq. &c, Avril, 1842. X Materialen zu einer kttnft. Heilmittellehre, u. s. w. i. 473. 1824. § Op. cit. || Brande, op. citat. p. 321. Lond. 1839. See, also, M. Cantu, in Journal de Chimie Medicale, ii. 291 and 394; and Bennerscheidt, ibid. iv. 383. IT Essay on the Effects of Iodine, &c. Lond. 1824. ** Mcmoire sur l'emploi de l'lode dans les Maladies Scromleuses. Paris, 1829; and Observations on the Effects of Iodine, p. 17, Johnson's translation. Lond. 1824. IODINUM. 385 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 phenomena, Dr. Gairdner noticed anxi- ety, depression of spirits, and other symptoms similar to those of hypochondriasis; obscurity of vision; hardness of hearing; palpi- tations; and tremors of the limbs, particularly of the hands, vvhich last symptom indicated the full effect of iodine on the constitution. Dr. Gairdner found, however, that the remedy was extremely va- riable in its effects; and that it might frequently be given in large doses, for a longtime, without disadvantage; whilst, at other times, the unpleasant symptoms supervened rapidly, indicating that much must depend upon the peculiar impressibility of the individual. Coindet,f who, as already remarked, first used iodine as a thera- peutical agent, speaks of many of the above-mentioned phenome- na as resulting from its administration: these he considers evi- dences of the saturation of the organism, as the effect on the mouth is an index of the same thing in the case of mercury. It appears, however, to be never necessary, in the administration of iodine, to induce 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 saturation; and accordingly, whenever there are the slightest indications of it, the dose of ia- dine should be diminished, or it should be discontinued for a time; after which—according to the results of numerous cases—its cura- tive agency, when it is resumed, is exerted afresh, and more de- cidedly. Several physicians, indeed, advise that frequent inter- missions 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 caused twice in M. Chevallier§ violent colic, which readily yielded to gum water and laudanum. Raspail, however, under analogous cir- cumstances, experienced no other inconvenience than a disagreea- ble taste in the back part of the mouth. According to Lugol, the vapour,Misengaged 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 * B. Phillips, Lond. Med. Gazette, Jan. 10, 1840; and in Scrofula, its Nature, Causes' &c, Amer. edit. Philad. 1846. 1 Bibliotheque Universelle, Mars, Avril, Mai, et Septembre, 1821. X See, also, Ricord, op. cit § Journ. Gener. de Med. cm. 336. 386 IODINUM. 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 oc- casionally tormina. In several, ptyalism ensued. Others, and especially females, complained of gastrodynia, which was always removed by the wine of cinchona, of which two or three ounces were taken shortly after the iodine. Iodide of potassium would seem to act more powerfully on the kidneys. A patient of M. Ricord* at the Hopital des Veneriens, Paris, whilst under its in- fluence, passed daily from forty to fifty litres or quarts of urine, drinking, however, in an equivalent ratio. This enormous secre- tion always ceased whenever the use of the iodide was suspended. In its character the fluid differed little from ordinary urine, except in containing evident traces of the salt. Dr. Manson,f who used the tincture of iodine, found it occa- sionally 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, ulceration of the mouth, and foetor of the breath; of a different kind, however, from that which arises from mercury. M. Ricord \ affirms, that of all the tissues of the body, the skin is decidedly the most susceptible of the action of iodine, and that there is scarcely a variety of cutaneous disease, which, in different idiosyncrasies, may not be excited by iodide of potassium, although they may mostly be made to disappear, under the discontinuance of the medicine. The author has never observed such effects from it. 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, whilst the former pre- scribed the solution in water, with a little chloride of sodium. Lu- gol observes, that the appetite of his patients was very much in- creased by it. Eager, who likewise administered the watery so- lution, rarely observed diarrhoea and emaciation; in general, in- deed, the appetite and nutrition improved under it. At times, ulceration took place in the mouth, whereby the breath assumed a mercurial fcetor; and salivation has been observed from itf accord- ing to Manson,§ Winslow,|| Ely,1T Mackall,** Sir F. W. Smith,tt * Bulletin de Therap. Sept. 1842: cited at length in Provincial Med. Journ. March 18, 1843; and Amer. Journ. of the Med. Sciences, July, 1843, p. 191. t Medical Researches on the Effects of Iodine. Lond. 1825. X Op. cit. § Op. citat. p. 61. || Lond. Med. Gaz. for 1836, p. 401. IT Ibid. p. 480. *» Medico-Chirurg. Rev. Jan. 1836. If Dublin Journal of Med. Science, July, I84IO, and Jan. 1841. I0DINUM. 387 and others; but Riecke* suggests,that this,perhaps,only occurred in those, who, along with the use of iodine internally, had employed iodide of mercury externally. Ricord, however, f affirms that sa- livation is a common effect; and that, at times, the quantity of sa- liva secreted is equal to that in the highest degree of mercurial ptyalism; but it would appear to be of a different character. He says it resembles greatly the ptyalism of pregnant women. The saliva is not viscous, and it seems not only to emanate directly from the mouth, but to be regurgitated. The mucous membrane of the mouth may be a little oedematous and irritable; but no inflamma- tion or ulceration is perceptible as in mercurial ptyalism; neither, according to him, is the health tainted, nor are the salivary glands the seat of any tumefaction. On the genital organs, Eager found iodine act as an excitant; it augmented 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 mammse in women, have been observed to disap- pear :f but this, as will be seen hereafter, is certainly not a common occurrence.§ It has been imagined, also, to cause sterility. Two cases are detailed by Dr. Robert H. Rivers|| in vvhich barrenness succeeded its administration. Magendie, on giving it as an em- menagogue to a young lady of unsuspected virtue, brought on abor- tion.1T Krimer several times observed, even when the tincture was given in small doses, considerable metrorrhagia, epistaxis, haemoptysis, obstinate diarrhoea, leucorrhoea, &c, supervene under its use. Dr. J. B. Biddle** exhibited five grains of the iodide of potassium, four times a day, to a female patient, aged 35. After thirty-five grains had been taken, he was suddenly called, and found her suffering from intense cephalalgia, considerable nervous disturbance, nausea, and remarkable tumefaction of the whole face. Jahntt found, in the bodies of two persons who had long made use of it, wasting of the fat; softness and laxity of all the organs and tissues; diminution and disappearance of the glands, and glan- diform bodies,—the mesenteric glands, suprarenal capsules, &c,— and the cellular tissue appeared to exist in smaller quantity. In the case of a female, who died from the excessive use of the tinc- * Die neuern Arzneimittel, u, s. w. S. 282. t Op. cit. X Christison, Treatise on Poisons, p. 180; Cogswell on Iodine, p. 47. Edinb. 1837. § Pereira, in Lond. Med. Gaz. vol. xvii.; or Diet, de Mat. Med. par Merat and De Lens, art. lode. || American Journal of the Medical Sciences, Aug. 1831, p. 546. IT Formulary, Gully's edit. p. 105. ** Philad. Med. Examiner, Jan. 29, 1842, p. 65. See, also, Dr. R. Coates, ibid.; Dr. J. C. L. Carson, New York Med. Gaz. Dec. 1, 1841, p. 333, and the Report of a Con- versation on the Occasional Injurious Effects of Iodine, at the London University College Med. Society, in Med. Examiner, Jan. 15, 1842, p. 48. tt Archiv. fur medicin. Erfahrung, i. 342, 1829; and Journal Complement, du Diet des Sciences Medicates, xxxv. 362. 388 IODINUM. ture, 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 dis- played redness, growing deeper from the cardiac towards the py- loric orifice, where the organ looked as if it had undergone corro- sion ; the liver was large and reddened; and there was ecchymosis of the spleen. Dr. Christison,y is of opinion, that iodine is capa- ble of inflaming the latter organ. Professor J. K. MitchellJ affirms, that he has not unfrequently witnessed very distressing effects not only from an extravagant quantity, but from the too prolonged use of even moderate por- tions of iodine. As regards iodide of potassium—he properly re- marks—large doses have been given so often and so long as to show, that while there is hazard and injury, the danger has been greatly overrated. The author has administered iodine very freely, but he has sel- dom seen unpleasant phenomena ensue, which he was disposed to refer to it; with the exception of such as so nauseous an article was likely to cause in the stomach;§ yet from the testimony of many observers, it can scarcely be doubted that the iodine disease, or iodosis, iodinia, or iodism, as it has been termed, may become dangerous to life: generally, 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 foresight. Cases, however, are related, in which its use seemed to have been followed by fatal results;j| hence, the necessity of circumspection in the employment of so energetic a therapeutical agent. The author has never witnessed the vascular injection and tumefaction of the conjunctiva, with cedema and infiltration of the subcutaneous cellular tissue adjacent, described by M. Ricord.1T In this inflammation, he says, there is little, or no, tendency to suppuration, and it is a phenomenon, vvhich most usually appears only at the commencement of a course of the iodide of potassium, and rarely recurs; but it is important to avoid mistaking it for a venereal or gonorrheal ophthalmia to which it appears to bear some analogy. A somewhat similar af- fection, under the use of the iodine, he observes, sometimes ex- tends to the mucous membrane of the nose, producing coryza, but unattended with sneezing, and without any disposition to pass into a suppurative stage. 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. Williams** re- * Journ. Comptem. du Diet, des Sciences Medicales, xviii. 231. t Treatise on Poisons. X Medical Examiner, Aug. 1846, p. 160. § See his General Therapeutics and Mat. Med. 3d edit. ii. 312. Philad. 1846. || Sir B. Brodie, Lancet, Mar. 30, 1839. If Op. cit *" The Library of Medicine, arranged and edited by Alexander Tweedie, M. D., F.R. S. —Practical Medicine, vol. iii. p. 124, art. Pleurisy, by Dr. Williams. Lond. 1840. 10DINUM. 389 commends, 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 iodine should be immediately discontinued, whenever a feeling of increased heat in the pharynx and stomach is experienced immediately after it is swallowed; but as this evidence cannot be available in small chil- dren, attention should be paid, whether, after the medicine has been taken, the temperature of the skin become more elevated; the pulse quicker, and whether there be any evidence 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 iodine be combined with small doses of opium, all the disadvantages, immediate and remote, may be avoided; and it is generally considered more advisable to give it in' small doses for a longer, than in large doses 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 manifested until after the lapse of four or five months; and it is important to bear this in mind, as both practitioner and patient are apt to become dissatisfied, unless the remedy exhibits its action more speedily. When it acts beneficially, the appetite is augmented, or is not de- teriorated ; digestion improves, so that the patient is able to take more food, and experiences less inconvenience therefrom: the se- cretion of the bile is increased, and the evacuations are more co- pious, and of a yellower hue; the peristaltic action goes on more energetically, and the patient gains strength. Such, at least, are the signs that are considered by many to indicate that iodine agrees; but the absence of all disagreeable consequences is a suffi- cient index. To remove the symptoms of iodine disease, general or local bloodletting has been employed; with warm bathing; the use of milk; emulsions of gum Arabic, and the like; and rigid diet and rest. The preparations of hydrocyanic acid have also been given with advantage in the palpitation, tremors, and other nervous symptoms that sometimes follow the use of the remedy. Precaution is requisite in the case of impressible, and also—it has been conceived—of robust persons,* to avoid the supervention of hyperaemia. It is advisable, too, during its administration, to let the diet be sparing, and devoid of all heating qualities. Kol- leyt remarks, that iodine occasionally exerts a most unfavourable 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 * Riecke, op. cit. S. 284. t Journal Complementaire, xvii. 307. 390 IODINUM. 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 inebriation* succeed, with violent cephalalgia, spasms, tremors of the limbs, paralysis,f prostration, spasms, depravation of vision, and disposition to lamentation and distress. Some of these ner- vous symptoms, the author has 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, accord- ing to Kolley, forbid its use. Dr. Andrew Buchanan:): affirms, that he has never witnessed any of the unpleasant symptoms that have been ascribed to iodine. He asserts, that he has never ?een its use "followed by wasting of the 'testicles or mammse, by palpitations, faintness, excessive debility, hurried, anxious breathing,dinginess of the surface, copious clammy sweats, increased menstrual discharge, or an oily appearance of the urine, which are enumerated amongst the symptoms character- izing the supposed affection, termed iodism." As regards the wasting of the mammse and testicles, Dr. 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, states, that he has never witnessed these effects, although they are said to be frequent in Switzerland.§ The author's own experience accords with that of those gentlemen. He has prescribed, and seen it prescribed, largely, both in public and in private; yet no such results 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 case of atrophy occurred.|| Dr. J. Adair Lawrie,1F of Glasgow, has advanced the opinion, that the iodides of potassium and starch exert a poisonous influ- ence on the mucous membrane 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 membrane, nor has he ever known them induce emaciation, atrophy of the * 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 Ef- fects of Iodine in Scrofulous Diseases, O'Shaughnessy's translation, p. 73. Lond. 1831.) f SirB. Brodie, Lancet, 1832; Manson, op. citat; and Sir A. Cooper, Lancet, ii. 147. X Lond. Med. Gaz. July 2, 1836. § Pereira, Elements of Mat. Med. and Therapeutics, i. 238. Lond. 1842; or 2d Amer. edit Philad. 1846. || Dr. A. M. Vedder, in American Medical 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, potass. %v., to be made into a paste with alcohol, and to be applied a few lines thick: it destroys the skin in about five minutes. Ac- cording to the same observer, iodine has exhibited its efficacy in various cases of periostitis, scrofulous swellings of the joints, and necro- sis. In scrofulous ophthalmia, it was less beneficial. It will be seen hereafter, however, that in the last affection, the application of the tincture to the eyelids, has been beneficial. In scrofulous discharges from the nose and ear, iodine injections were commonly of service. 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. Dr. Isaac Parrish| found the iodide of potassium,serviceable in certain diseases of the eye, which had a constitutional origin, or were closely allied to a scrofulous or cachectic condition of the general system. The dose in which he gave it was from two to six grains three times a day in a table-spoonful of the compound syrup of sarsaparilla. The author has found excellent effects from it in such cases, when given in simple syrup. 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, were removed by * Dublin Journal of Medical Science, July, 1834, p. 344. t Etudes sur la Maladie Scrofuleuse. Paris, 1834; and London Lancet, May 25,1839, . 350; see, also, Cogswell on Iodine, p. 75; and Lisfranc, Annales de Therap., cited in led. Times, Jan. 11, 1845, and in Braithwaite's Retrospect, xi. 104, Amer. edit. New York, 1845. X Med. Examiner, Ap. 16, 1842, p. 241. IODINUM. 395 its use. Wutzer has likewise offered a favourable testimony in regard to it in affections of the bones, some of which were of a strumous nature. In several cases, so much disorganization 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. Kiihne* with great success, and without any evil consequences. He made it, however, of half the usual strength, beginning with three drops, and gradually increasing the dose to fifteen. In tumefaction of the joints, iodine, administered externally, has afforded essential service. Wutzer was of opinion, that the tincture might frequently be applied externally with greater ad- vantage than the ointment; the alcohol readily evaporating and leaving the iodine on the skin; for which reason he recommends, that the tincture should be applied repeatedly by means of a ca- mel's hair pencil. Commonly, in every form of cachexia espe- pecially, it is necessary that iodine or its preparations should be given for a considerable time. The disease is often chronic, and a chronic system of medication is demanded. Occasionally, how- ever, it would appear to have acted speedily. Professor J. R. Mitchellf relates the case of a man who had an enormous tumefac- tion of the thyroid gland, and of the lymphatic glands of the neck, ac- companied by severe dyspnoea, difficult deglutition, and threatening dissolution. "We proposed then," says Dr. Mitchell, "to try iodine, a remedy in which neither of us," Dr. Mitchell and a skilful sur- geon, "had much direct knowledge. Within a single day, the patient, breathed better, and became thoroughly convinced of ap- proaching recovery, and at the end of a week experienced very little inconvenience from, though still deformed by his malady. In a few months the thyroid no longer hung over his sternum— not an abnormal gland could be felt in his neck, and he recovered both his health and personal appearance entirely." Tubercles.—The reputed efficacy of iodine in scrofulous affec- tions gave rise to the belief, that it might be serviceable in tuber- cles. 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 advantage in cases of pulmonary tubercles. It was suggested, in such affections, by Dr. Baron, and a case is related by Mr. Haden of apparent tubercles in which it was markedly useful;:}: similar examples are detailed by Jahn, Waldack, and others; and it has been recommended in conjunction with decoction of cimicifuga by Dr. C. C. Hildreth,§ of Zanesville, Ohio, but the evidence ad- duced by him is not strong. * Medicinische Zeitung, No. 34, Aug. 24, 1836. Berlin. f Med. Examiner, Aug. 1846, p. 46. X Formulary—the author's edition, p. 37. Lond. 1824. § American Journ. of the Med. Sciences, Oct 1842, p. 280. 396 IODINUM. Berton affirms, that he has found inhalations of the vapour of iodine of decided efficacy in confirmed phthisis, as well as in certain forms of catarrh. They have likewise been advised in phthisical affections, by Sir James Murray,* and by Sir C. Scudamore.f The addition of a little tincture of conium was found by the latter gentleman to be beneficial in subduing the irritating qua- lities of the gas. His first formula was the following:—R. Iodin. gr. viij., Potass, iodid. gr. iij., Alcohol, ^ss., Jlquoz destillat. 5vss. M. Of this solution 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 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 recommends the fol- lowing:—R. Iodin. pur., Potass, iodid. aa. gr. vj., Jlquoz destillat. §v. 3yj., Jllcoholis, 3ij- M. He prefers to add the conium at the time of mixing the iodine solution with the water, and recom- mends that it should be a saturated tincture, prepared with genuine dried leaves. In the commencement of the treatment, he advises very small proportions of the iodine mixture;—for example, from half a dram to a dram for an inhalation 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 mixture, 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 120° is the most favourable for volatilizing 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, hovvever, to prepare the inhaler for this temperature by first washing it out with tepid water. During the process, the inhaler should be kept immersed in a vessel containing water of a rather higher temperature than 120°. The feelings of the patient will * On Temperature, Aliment, &c, 1829. t Cases Illustrative of the Efficacy of Various Medicines Administered by Inhalation in Pulmonary Consumption, 2d edit. Lond.; and Lond. Med. Gaz. Feb. 17, 1838, p. 804. X London Medical Gazette, Feb. 7, 1840, p. 750. See, also, Dr. E. J. Coxe, Practical Treatise on Medical Inhalation, pp. 51-65. Philad. 1841. I0DINUM. 397 be a great guide as to the strength of the inhaling mixture in any particular case. A reviewer in the Britisji and Foreign Medical Review,* affirms, that his own experience leaves him no doubt as to the great value of this practice as a palliative in phthisis, and as an important re- medy in bronchitis. It is true, however, he adds, that the relief has often been as great from the simple aqueous as from the medi- cated inhalation. The aothor's own experience has not been favourable to it,f and Dr. Pereira^: 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 166.) The inhalation of iodine has been dreaded, because, in some instances, troublesome irritation of the larynx has followed its use; but Dr. Corrigan§ 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 described—under the article referred to above—gradual in its evaporation, and ultimately combined with a large portion of aqueous vapour, its use, he says, is positively free from any inju- rious irritative effects. The vapour he found to diminish most remarkably the profuse and wasting purulent expectoration of phthisis. The effects of iodine, thus used, on the, digestive func- tion were also very gratifying. In all the cases in vvhich Dr.Corrigan employed it, the appetite and state of the intestinal canal were improved. It acted as a useful tonic to the digestive organs, without any of the irritation which its internal use, in the ordi- nary form, at times produces. It likewise greatly alleviated the cough, so that the patient was enabled to obtain hours 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. Corrigan 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 suspended 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 medi- cated air. In the morning, for three or four hours before the patient rises, it is again at work; and, if necessary, in the mid-day, while the patient reclines on the bed, with the curtains drawn * April, 1838, p. 606. 1 Practice of Medicine, 2d edit, i 374. Philad. 1844. X Elements of the Materia Medica, i. 245. Lond. 1842; or 2d Amer. edit Philad. 1846. § Dublin Journal of Medical Science, for March, 1839, p. 103; cited in London Med. Gaz. for April 6, 1839, p. 50. 26 398 IODINUM. round three of the sides. The rate of evaporation, which gene- rally gives a sufficiently strong impregnation to the air, is when the tincture of iodine 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 iodine is diffused in watery vapour through the air, there are thus diffused in the minutest state of division through the air, in every hour, about thirty grains. "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 preparation 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 syrup, and combined with the external application of the ointment of tartarized antimony. Duverney has communicated some cases, which appeared favourable to the prophylactic agency of iodine in incipient or threatened phthisis, but he himself considers, that his observations have not been sufficiently numerous to effect the de- monstration. The author has frequently administered iodine, in various forms, in pulmonary tubercles, but it must be confessed, not with that decided advantage, which the well known sorbefa- cient virtues of the remedy, and the recorded observations of others, might seem to promise.* He has never witnessed, on the other hand, the evil, which Rieckef mentions,—that it may, under particular circumstances, occasion the speedy development of phthisis, where tubercles exist in the lungs. Riecke refers to a case by Haser as corroborative of his opinion. A woman, fifty years old, was affected with anchylosis spuria, for which an 'oint- ment of iodine was recommended; but it had not been employed more than three weeks, and not more than a dram of iodide of potassium had been rubbed in, when symptoms of tubercular phthisis rapidly supervened, which, in half a year, terminated in death. There does not appear, however, in this case, to have been any thing more than a coincidence. Mr. Leigh| directs the patient to apply a sufficient quantity of * Practice of Medicine,2d editi.372. Phila. 1844,and General Therapeutics and Materia Medica, 3d edit i. 253 and iL 313. t Die neuern Arzneimittel, u. s. w. S. 289; see, also, Gunther, in Harless's Neue Jahrb. B. xii. St. 3, S. 161. X London Medical Gazette, May, 1841. I0DINUM. 399 iodine ointment on the ribs and under the axillae, and to cover the head with the bed-clothes, in order to breathe the iodine volatilized by the heat of the body. The ointment produces counter-irritation on the skin where it is placed, and must be repeated according to circumstances. This method, Mr. Leigh thinks, has arrested the progress of phthisis. Pneumonia.—In the advanced stage of pneumonia, iodide of potassium has been strongly recommended by Dr. George L. Up- shur,* of Norfolk, Va., on the strength of several observed cases. The indications for its use he has found to be the following:— First, In cases of pneumonia occurring in anaemic individuals, where the disease is characterized in its early stages by adynamic symptoms. Secondly, In cases where inflammatory action, in the commencement high, has been reduced by antiphlogistic treat- ment, and the suppurative stage is just beginning. "This stage is easily recognised b}r a sudden depression of the vital powers, by a soft but irritable pulse, and by the bronchial respiration being accompanied by a harsh mucous rhonchus." Lastly, In cases grafted upon long continued intermittents, " which have left the blood in a degree impoverished." The iodide was given in the dose of a scruple in the twenty-four hours. In spasmodic asthma, it has also been found very beneficial by Dr. YV. S. Oke,f and by Dr. Casey,J and others. Dr. Casey gave it in upwards of five and twenty cases, and in no instance, where a fair trial was made, did it fail "to afford unequivocal and decided relief." The dose va- ried from two to five grains three times a day. In chronic engorgements of the larynx, iodine was used in two cases by Trousseau and Belloq;§ once without success, but the second time with marked advantage; and in tubercles of the liver it has been regarded worthy of special consideration.|| Dropsy.—Many trials have been made with iodine in cases of dropsy, owing to its powerful eutrophic agency.IF Drs. Bradfield and Bardsley exhibited it frequently with success in hydrothorax and ascites; and Dr. Kissam, in a case of dropsy, dependent pro- bably 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. iodid. gr. vi., aquae, f. §j.; aided by an ointment composed of fif- teen grains of iodine, with double the quantity of iodide of po- tassium, to an ounce of lard. This is to be placed inside the thighs after removing the cuticle by a blister. The arm-pits and * Med. Examiner, June 29, 1844, p. 145: and June, 1845, p. 323. t Provincial Med. Journ. April and May, 1844. X Boston Med. and Surg. Journal, 1845. § 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. || Riecke, op. cit. S. 290. IT Dr. Wm. Stokes, in Amer. Journal of the Medical Sciences, May, 1834, p. 543, cited from Lond. Med. and Surg. Journal. ** Journal de Pharmacie, 1834. 400 IODINUM. soles of the feet were also rubbed with the ointment. The same plan is recommended by Dr. Osborne.* Jahn, also, regards iodine as one of the most important agents of modern discovery, anjd as an extremely valuable antihvdropic.t He first 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 iodide of potassium left nothing to be desired; and, accordingly, he afterwards employed it in all cases of hydrocele of the tunica vaginalis, vvhich he met with,—even in the new-born,—united with mercury or extract of conium; and in every ca.se which was not of too chronic a character, it exhibited its sanative powers. The only unfavourable effects induced by it were a temporary dis- appearance 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; and especially in cases of dropsy that succeeded to exanthematous diseases,—and that it acted more speedily and powerfully when combined with some diuretic. He found, farther, that it 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, vvhen the inflammatory stage was over, and the accumu- lation of fluid was the prominent condition. In these cases, he commonly used iodine in the form of iodide of potassium made into an ointment, and rubbed on the head. Frequently, hovvever, he gave iodine also internally, in combination with calomel and digitalis; but it may be objected to this combination, that iodine with calomel forms corrosive chloride, iodide and red iodide of mercury; so that, in very small doses, it might affect the sto- mach too violently.:{: Dr. Roser,§ of Wurtemburg, likewise advo- cates the use of the iodide of potassium, in large doses, in cases of acute hydrocephalus, where the ordinary remedies have failed, paralysis has occurred, and death appears to be impending; and three successful cases bave been recorded by Mr. C. Fluder.|| All the ordinary means had been employed in vain, when he suggested a trial of the iodide of potassium in half grain doses, every two or three hours. In all the cases, there was speedy diuresis, and dribbling of the saliva. A similar successful case has been re- corded by Dr. John Christie.^" The child was eight years old, and before Dr. Christie saw him had been ill a week. He had * On the Nature and Treatment pf Dropsical Diseases, 2d edit p. 48. Lond. 1837; or Dunglison's Amer. Med. Library edit. Philad. 1838. t Elliotson, in Lancet, 1830-31. See, also, P. Spalding, in Boston Med. and Surg. Journal, Dec. 25, 1839, p. 314. + Riecke, op. cit. S. 291. § Hufeland's Journal,for April, 1841, S. 84; cited in Lond. and Edinb. Monthly Journ. of Med. Science. See, also, Dr. Fluder, in Lond. Med. Gaz. Sept 30, 1842, and K. G. Zimmermann, Zeitschrift fur die gesammte Medicin., Aug. 1842, S. 418. || Lond. Med. Gaz. Sept. 30, 1842. 11 Lond. and Edinb. Monthly Journal, March, 1843: cited in Braithwaite's Retrospect, vii. 64. Lond. 1843. ^ I0DINUM. 401 experienced an attack of convulsions the evening before. He lay with the eyes half closed, moaning frequently, and now and then uttering a loud scream; the pupils were fixed; the urine was passed involuntarily, and there were frequent automatic movements of the left arm and leg: the pulse was also rapid and weak. Dr. Christie determined to make trial of iodine in a mode mentioned by Drs. Evanson and Maunsell,* and he prescribed a mixture consisting of iodide of potassium, sixteen grains; iodine, four grains; and water, one ounce; of which a teaspoonful was ordered every four hours. The head was also directed to be rubbed with a weak ointment of red iodide of mercury. M. Ricordf employed iodine with success in five cases of hy- drocele;—the tincture being diluted with distilled water, and ap- plied by means of compresses wetted with it, in which the scro- tum was enveloped. He used it of four different strengths—3j., 3ij., 3'ij., and 3yj. of the tincture, to f. 3iij. of water. In hygroma or dropsy of the bursas mucosae of the joints, an ointment of iodide of potassium (3ij., ad adipis Sj.) has been suc- cessfully used by M. Reynaud.J 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 com- monly affected—is covered with a large flaxseed poultice. From some trials made with iodide of lead, there was reason to believe it more efficacious than iodide of potassium. The treatment was generally successful in about a fortnight. Typhus and Typhoid Fever. Dr. Morrison,^ states, that there is a condition in typhus fever, which is materially benefited by iodide of potassium. It is marked by a dry, parched, brown or black tongue; by dark sordes on the teeth and gums; by a dispo- sition to dark fetid discharges from the bowels; by a weak and compressible pulse; and by the ordinary signs of depraved secre- tions, vitiated fluids, and debility. The dose, which Dr. Morrison is in the habit of administering, is three grains every four or five hours, dissolved in water, or mixed with wine, &c. A case of ty- phoid fever is reported by Dr. C. B. Voigt|| in which the iodide of potassium was apparently beneficial. Variola. Iodine has been successfully employed in variola to prevent pitting. Dr. Crawford,1" of Montreal, tried the compa- rative merits of tincture of iodine and nitrate of silver, and gives the preference to the former. He found the application "very ma- nageable and very bearable." Dr. Jackson,** formerly of Northum- * On Diseases of Children. t Journ. des Connaissances Med. Chirurg. Janvier, 1833. X Cabissol, in Bulletin General de Therapeutique, Fev. 1838. § Dublin Medical Press, Oct. 21, 1840. || Medical Examiner, Dec. 1845, p. 715. H Montreal Medical Gazette, April 1, 1844. ** Medical Examiner, August, 1846, p. 464. 402 IODINUM. berland, Pa., now of Philadelphia, informs the author, that he was led to make an experiment of aborting small-pox by the tincture of iodine, from having contemplated its wonderful influence over erysipelas. He applied it in April, 1845, to one arm of a child eleven months old, in confluent small-pox, on the third day of the eruption, and to the arm which appeared the worst, rubbing it freely on with a sponge three times that day and twice the next. On the 11th day, when the pocks over the whole body were at their height, elevated, with hard bases,—those,on the arm to which the iodine had been applied were entirely flat, with thin purulent matter under the dead cuticle without any swelling of the part. The abortion at the time was considered to be complete. There were, however, some very slight pits to be seen afterwards, but they were very inconsiderable compared with those on the other arm. Dr. Sargent stated to Dr. Jackson, that he had subse- quently used iodine on one side of the face in 25 cases: the swell- ing, soreness and tenderness were very much less than on the side not covered: each pock remained flattened, but he could not say that pitting was prevented. Dr. Goddard, again, tried it in five cases; " not one of the patients showed the least pit or mark; none of them had been vaccinated, and the disease was confluent in most of them." Dr. Jackson considers, that no fair trial of its ec- trotic powers in variola can be had without applying it on the first day of the eruption, and continuing it for several days,—say five or six. Dr. Schreiber* states, that he has found the administration of iodine useful in preventing the family of a person labouring under variola from being infected.[?] The formula employed by him was as follows : R. Potass, iodid. gr. viij. Tinct. iodin. g»- xvi. Aquae f. gij. M. A teaspoonful of this was given night and morning. Dr. Schrei- ber invites practitioners to a farther investigation of the anti-vari- olous power of iodine. Measles and Scarlatina. It has been already remarked, that M. Ricord considers that iodine determines diseased action to the skin; and it has been affirmedf that in cases of suppressed measles and scarlatina, it will frequently induce a healthy reaction under the most desperate circumstances. One or two grains of the iodide of potassium, according to the age of the patient, under twelve, may be dissolved in sugared water, and be administered repeatedly as an ordinary drink, the whole quantity being taken in the 24 hours for three or four days. In measles, a small plaster to the chest is said to assist the peculiar action of the iodine. In scarlatina, the * Northern Journ. of Med. July, 1844, cited in Braithwaite's Retrospect, x. 187. New York, 1845. t London Lancet, Jan. 21, 1843, p. 632. IODINUM. 403 compound tincture of iodine, diluted with three or four parts of water, may be frequently applied, by means of a camel's hair brush, to the front and sides of the throat and neck. Nervous Diseases.—As to the efficacy of iodine in these diseases, testimony is somewhat discordant. Drs. Manson* and Elliotsonf found it useful in paralysis, but Dr. Bardsley failed with it. Chorea was removed by Gibney,! Bardsley, Manson, and Oke;§ and Frank- lin, || by very large doses, relieved a case of epilepsy. Dr. Bennetts found the iodide of potassium of great use in cases of nervous headache, when the circulation was not affected; and the local use of the tincture of iodine has been found beneficial in neuralgia.** In a patient, whose life had been imbittered for five years with neuropathic maladies, and who suffered at the time from a very painful affection of the head and neck, with occasional and frequent pain of the arms and legs, Prof. J. K. Mitchelltt gave seven grains of iodide of potassium three times a day, which speedily relieved, and within six weeks completely cured the patient, after arsenic, mercury, and most of the narcotics had been prescribed in vain. Equally beneficial and speedy effect was produced in a case of protracted erratic pains. The intimate affinity between iodine and the urinary organs has given occasion to its employment in Incontinence of Urine.—Of which Corter cured two cases by the tincture. Chronic Diseases.—Cases of dry, scaly tetter were treated, by Tunnermann, with an ointment made of 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 certain degree, a change in the organic actions of the skin succeeded; the remedy was then pretermitted, and the parts were washed a few times with soap, when the eruption faded and gradually disappeared. In moist tetter, Tunnermann applies only a very> weak salve, with which the parts are touched daily, two or three times: in the intervals, he envelops them in a dry linen rag. The pain, which is always induced by the application, soon passes away. Magen- die, Gimelle, and JeffrayH have likewise applied it successfully in tetter. In chronic cutaneous diseases in general, the various preparations 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 morbid * Op. cit 1 Lancet, 1830-31. X Ibid. 1827-8, p. 54. § Provincial Med. and Surg. Journal, April and May, 1844. || Lancet, 1836, and Cogswell, op. cit p. 24. See, also, Dr. Scott, Provincial Med. and Surg. Journ. April 3, 1844, p. 9. IT London Lancet, Dec. 21, 1839. ** Dr. Crawford, Montreal Med. Gaz. April 1,1844. tt Medical Examiner, Aug. 1846, p. 460. }| Cogswell, op. cit p. 80. 404 IODINUM. tissues. The author has often employed them in these cases with success; and like testimony has been afforded by MM. Biett, Gimelle, Kolley, Locher-Balber, Kennedy,* and others. Brehme succeeded in removing, rapidly and completely, a case of invete- rate porrigo favosa, and ophthalmia thereon dependent, by an oint- ment of iodine. Dr. G. Billingslea, of Alabama, asserts,! that, for twelve years he had 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 employed, which was not radically cured; and in porrigo of the scalp it is highty extolled by Drs. Graves, and J. J. Ross.J Dr. Graves advises that it should be strongly rubbed into each spot by means of a small piece of sponge covered with fine linen, and tied, to the end of a quill or slender stick. When effectually done the application must not be repeated oftener than once a week; and immediately after the application, the scald must be covered with a spermaceti dressing, which must be renewed at least four times daily, so as to keep the head con- stantly moistened with it. The head is not washed for three days after the application of the tincture, when it may be well to wash it gently with yellow soap and water twice a day, taking care to cover it as before with spermaceti dressing after each washing. Dr. Barpsch§ cured an inveterate darlrous eruption, affecting the perinaeum and scrotum, by a lotion consisting of fifteen grains of iodine, and two scruples of iodide of potassium dissolved in five fluidounces of distilled water, and one fluidounce of alcohol. In lupus, the tincture applied locally has proved highly beneficial. Under its use, the process of ulceration has stopped, and cicatriza- tion has taken place. It is recommended to be applied not only to the ulcerated portion, but to the parts around.|| A case of elephantiasis, or of enormous enlargement of the leg, has been recorded by M. Cazenave,1F which was cured by iodine associated with other remedies. The patient—a woman—was or- dered a strong decoction of guaiac and mezereon; the leg was carefully bandaged from the toes, and every other day the ban- dages were removed, and an ointment of iodide of potassium rubbed on. She was put on generous diet and wine, and kept in bed. This treatment was continued for a little more than three months, by which time the leg was reduced to its former dimen- sions. M. Cazenave states, that he has met with several similar * Lond. Med. Gazette, May 8, 1840, p. 260. t Dunglison's American Medical Intelligencer, May 1,1839, p. 34. X London and Edinb. Monthly Journ. of Med. Science, Sept. 1842, p. 292. § OSsterreich. Medicinisch Wochensch. cited in Provincial Med. and Surg. Joum. ApL 29, 1843, p. 99. || Pereira, Elements of Mat Med. and Therap. i. 246. Lond. 1842, or 2d Amer. edit Philada. 1846. TT L'Experience, Oct. 19, 1843, cited in Edinb. Med. and Surg. Journ. April, 1844. 10DINUM. 405 cases, which have been all more or less benefited, and some even cured by this plan of treatment. Mr. Ogier Ward* cures itch by a simple lotion of the iodide of potassium, a single washing with which, in some instances, com- pletely eradicates the disease. To ensure complete success he ap- plies the sulphur ointment at night, and the lotion during the day. It usually effects a cure in seven days. The lotion consists of one dram of the iodide to eight or sixteen fluidounces of fluid, accord- ing to the delicacy of the cutaneous surface. Amenorrhoea.—According to Coindet, iodine is a powerful emmenagogue, and the possession of this property has likewise been ascribed to it by Brera,f who frequently administered it successfully in amenorrhoea; and Formey, Nieustadt, and AshwellJ confirm their observations. Sablairoles cured three cases by fric- tions with iodine ointment on the breast, conjoined with the in- ternal use of iodine. It was necessary, however, to give it in large doses, and for a long time. Dr. Aldridge§ of Dublin, states,* that benefit may be expected from its use, vvhen the absence of the catamenia is dependent upon uterine irritation, whether from exposure to cold, mental emotion or other causes, and accompa- nied by pain in the loins, headache, palpitations, &c. Locher- Balber|| and Golis found iodine of value, at times, in those trou- blesome cases, which occasionally precede the establishment of menstruation; the latter was, however, often deterred from its use, in such cases, by the evil consequences it produced on the respi- ratory 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 the size of the head; and Messrs. Thetford,^[ Klaproth,** Jewel,yy and Ashwell|| were equally successful. Baron employed it bene- ficially in a case of dropsy of the ovarium. In hypertrophy of the ventricles of the heart, Magendie re- commended it long ago. In scirrhus of the uterus, mammae, &c, it has been advised by Heun, Klaproth, Hennemann, Von dem Busch,§§ Ullmann, Hill, Benaben, Magendie, Hammer,Elwert,Wagner,|||| Copland,H1F Zim- * Lond. Med. Gazette, April 3,1846, p. 608. \ Saggio Clinico sull' Iodio. X Guy's Hospital Reports, No. 1. Lond. 1836, and Cogswell, op. cit p. 43. § Dublin Hospital Gazette, Oct. 1, 1845, cited in Braithwaite's Retrospect, xxii. 295, Amer. edit. New York, 1845. || Hecker's Litter. Annal. i. 275; and Cogswell on Iodine, p. 77. 11 Transactions of the Dublin College of Physicians, v. 510. Dublin, 1828. ** Revue Medicale, Mars, 1824. tt Op. St. XX Guy's Hospital Reports, vol. i. § § Hufeland's Jour. B. Ix. St. 2, S. 81. || || Revue Medicale, Juin, 1833. II IT Dictionary of Practical Medicine, art. Cancer. 406 IODINUM. mermann ;* and, from their recorded observations, it would seem, that great efficacy ought to be ascribed to it, both when internally and externally administered. A case is published by Dr. Thet- fordf in which the uterus was of bony hardness, and so large as nearly to fill the pelvis; yet it gave way in six weeks to the use of iodine. Seven cases of hard tumours of the uterus are like- wise reported by Dr. Ashwell,:}: which were removed by iodine, with occasional depletion, and regulated diet. It was given inter- nally, and at the same time applied externally in the form of oint- ment (Iodin. gr. xv., Potass, iodid. 9ij., Ung. cetacei, giss.,) of which a piece of the size of a nutmeg was introduced into the va- gina and rubbed into the cervix uteri for 10 or 12 minutes every night. The average time required for theremoval of these tu- mours was from 8 to 16 weeks. Jahn extols it much in incipient scirrhus of the stomach, when combined with the application of leeches. Riecke asserts, that his father found an ointment of iodine extraordinarily useful in a case of induration of the pancreas; and, also, in one of scirrhus of the pylorus. Magendie extols it in cancer of the tongue; and Benaben and Triistedt employed it successfully in stricture of the urethra, supervening on badly managed gonorrhoea. In a case of scirrhous tumour of large size seated in the neck and protruding into the isthmus faucium, which was attended by a prolonged ceaseless pain of an aching and depressing character, Professor J. K. Mitchell§ found the most marked relief follow the administration of eight grain doses of iodide of potassium. " After the second dose the pain ceased for some days, although the tumour continued to enlarge. The pain returned at irregular intervals, but was always, as speedily as at first, relieved by iodide of potassium." Leucorrhoza and gonorrhoea.—A Parisian physician made the ob- servation, that during the employment of iodine in goitre, obsti- nate and protracted leucorrhoea disappeared: this induced him to try the remedy in the latter disease, and he found it effica- cious. Goden and Broglio, likewise, observed it useful in malig- nant fluor albus; and Benaben, Richond,|| De Salle, Caswall,^f and Broglio, in gonorrhoea. The last two individuals gave it espe- cially in those cases, in which, without any marked inflammation, a deeply rooted gonorrhoea existed, with ulcers in the urethra and prepuce, not apparently 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 * Journal de Pharmacie, Juin, 1842, p. 598. t Trans, of the King and Queen's College of Physicians of Ireland, vol. v. i Op. cit. § Medical Examiner, Aug. 1846, p. 462. || Archives Generates de Medecine, vol. iv. IT Lond. Med. Gazette, for 1834. ** Wochenschrift f iir die gesamrate Heilkunde, No. 40, S. 633, Oct. 1836. I0DINUM. 407 reduced her strength, and did not yield to any of the means that had been employed, when the ointment of iodide of potassium 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 advo- cates for it.* M. Ricord,f however, who considers that the ge- nito-urinary organs are amongst those that are most susceptible of the action of iodide of potassium, says, that he has been able to trace the fresh access of blennorrhazas ineffectually got rid of pre- viously, or the exasperation of those actually existing, so frequently to its use, that he regards the existence or recent presence of a blennorrhoea as its temporary contra-indication. "Perhaps, how- ever," he adds, "(on the principle siniilia similibus probably) ad- vantage may be derived from the iodide of potassium in some cases of blennorrhoea." A dilute tincture of iodine has been used by M. Steenkiste with great success in cases of obstinate chronic leucorrhoea. He dissolves a dram of iodine in twelve fluidounces of alcohol; and adds about forty fluidounces of water. About a fluidounce of this is thrown into the vagina as an injection; vvhich is repeated every day, or every other day, according to the excitement it oc- casions. In discharges from the nose, iodine, in the form of iodide of potassium, has been used with advantage by Dr. Elliotson:}: and by Mr. George Fayrer,§—given internally, as well as employed in the form of injection (9j. ad aquae f. 3iv.) In secondary syphilis, iodine has been recommended by Tyr- rel, Saville, De Salle, Schlesier,|| Dietrich,!! A. Cade,** Acton,ff and numerous others;—especially when the disease is complicated with scrofula, and the effects of mercurials. Wallace J:}: has like- wise communicated some fortunate results from the administra- tion of iodide of potassium in secondar}' syphilis, and Ebers,§§ Ricord,|||| Von Haselberg,1T1! Cullerier and others have confirmed * Revue Medicale, vii. 249; and Practical Observations on Leucorrhoea, &c, by Geo. Jewell, p. 80. Lond. 1830. See, also, Solon, in Nouv. Diet de Med. et Chirurg. art lode. t L'Experience, cited in Lancet, Jan. 28, 1843. X Lancet, Feb. 10, 1838, p. 725. § Ibid. Feb. 24, p. 786. || Casper's Wochenschrift, Feb. 4, 1837, S. 78. IT Journ. des Chirurg. und Augenheilkunde, von Grafe und Walther; cited in Ency- clog. des Sciences Med. Jan. 1841, p. 165. ** Bull. Gen. de Therap. Mai, 1841, and Encycl.des Sciences Med. Aout, 1841,p. 319. tt London Lancet, Jan. 31, 1846. tt Treatise on the Venereal Disease. Lond. 1833. § § Medicinische Zeitung, Oct. 5, 1836, S. 201 and 207. |||| J. J. L. Rattier, La Lancette Frangaise, No. 34, Mars 19,1839. Gazette des H6- pitaux, Mars, 1839, and Langston Parker's Modern Treatment of Syphilitic Diseases, &c. &c. Dunglison's Amer. Med. Library edit p. 77. Philad. 1840. %': Medicinische Zeitung, No. 48 and 49. Berlin, 1837. 408 IODINUM. his observations. Mr. Bullock* has reported the particurars of eleven cases of secondary syphilitic diseases, of a formidable character, relieved by iodide of potassium, given internally, in doses of eight grains three times a clay, in camphor mifcture. The symptoms were:—destruction of the vulva and soft palate; or nodes, with nocturnal pains in the tibia, ulna, frontal and malar bones, and affection of the bones of the nose, or rupia, and other tu- bercular eruptions. The period of cure was from one to two months. Mr. Mayof has described it as efficacious in certain disorders, vvhich are the consequences of syphilis, as emaciation, with ulcers of the skin; ulcerated throat, affections of the bones, &c, occurring in those to whom mercury had been given. Iodide of potassium has been used with much success by M. Ricord^ in deep-seated syphilitic tubercles. Before the tubercles have become inflamed or softened, whilst they are still indurated, he has constantly succeeded in dispersing fhem by iodide of potassium, with small doses of iodide of mercury. Very com- monty, however, he employs iodide of potassium alone: and when the tubercles have become ulcerated, he still relies upon it as his principal remedy. M. Ricord§ considers its results to be most happy in the tertiary forms of syphilis, in which he considers it the great remedy. He employs it in gradually increasing doses, commencing with ten grains dissolved in three fluidounces of dis- tilled water, given at intervals during the day in any convenient vehicle. When the remedy agrees, which it most commonly does if the stomach be healthy, the dose is increased ten grains every two or three days, till it is carried to a dram, a dram and a half, or even more, in the course of the day. In the great number of patients, who have been treated by M. Ricord, the beneficial effects of the iodide were constantly exhibited, but not always with the same degree of rapidity. From an examination into the comparative value of the differ- ent preparations of mercury and iodine, and the best modes of administering them, Dr. Hocken|| concludes, that iodine is inert in almost all the symptoms of primary syphilis, with the exception of some forms of phagedcena, attended with great debility and derangement of the health;—that in constitutional syphilis it is a less valuable remedy, in the majority of secondary symptoms, than mercury, with the exception of some severe cases of pustular * Edinb. Med. and Surg. Journal, Jan. 2, 1837. See, also, Cogswell on Iodine, p. 80; Laycock, Lond. Med. Gaz. Mar. 2,1839, p. 821; and Lisfranc, cited in Med. Times, Jan. 11, 1845: and in Braithwaite's Retrospect, xi. 103, Amer. edit New York, 1845. t Lond. Med. Gaz. xi. 249. See, also, a Treatise on Syphilis, by Herbert Mayo, F. R. S. Lond. 1840. X Langston Parker, op. cit. p. 77. § Traite Pratique des Maladies Veneriennes, &c. Paris, 1838; also, Acton, Complete Treatise on Venereal Diseases, &c. Lond. 1841; or Amer. edit New York, 1846; M. Lafargue, Encycl. des Sciences Med. Fevrier, 1841, p. 359, and M. Seeuin, Bull. Gen de Therap. Dec 1841. || Edinb. Med. and Surg. Journ. April, 1844, p. 325. I0DINUM. 409 eruptions, phagedenic sore throat, rupia, and secondary ulcerations of a bad character, all of them marked by a cachectic and debilitated constitution; whilst in tertiary symptoms iodine is far more valu- able than mercury, and its effects more certain and decided than in any other set of symptoms;—that'mercury and iodine are most , advantageously combined, in cases presenting both secondary and tertiary symptoms; and that the only form of iodine, safely appli- cable to the treatment of syphilis, is the iodide of potassium, which should never be carried beyond moderate doses; and hence, that however valuable the iodide of potassium may be in some forms of syphilis, it cannot be substituted with advantage for mercury in the great majority. JYocturnal pains in the bones, and diseases of the bones and perios- teum have likewise been particularly benefited by the iodide:* the latter, vvhen localized for a longer or shorter period, have yielded sooner when blisters have been applied over the affected parts. Mr. A. Uref repeats a case of periostitis of the left ulna, of two months' standing, which, after leeching, blistering, &c, had been employed, was cured by two grains of the iodide of potas- sium given twice a day in a compound infusion of gentian, with a grain of opium at bed-time for a fortnight;—bran poultices being applied, to the arm. An iodine suppository appeared to Mr. Keatef to be beneficial in enlarged prostate; and iodide of potassium was administered successfully in the same disease by Dr. Casey.§ In enlargements of the third lobe of the prostate, M. R. A. Stafford,|| has recom- mended it to be applied, by charging a bougie at its point with iodine, or iodide of potassium, and then dipping it into melted tallow, so that a coating may be formed upon it. The bougie having been passed so as to reach the desired spot, its point- is allowed to rest upon the diseased part, when the tallow gradually melts, and brings the iodine or iodide of potassium into contact with it, and by drawing the bougie gently backwards and for- wards, the necessary friction is produced. He has found it ad- visable to be very cautious as to the strength of the application, as the prostate will not bear a strong preparation either of iodine or iodide of potassium at first. He has found it necessary to employ belladonna, opium, hyoscyamus, &c, to quiet irritation and pain. When these have subsided, he begins carefully by introducing iodide of potassium in the proportion of one grain to the dram of unguentum cetacei, and increasing it as the patient * Dr. Wm. B. Casey, in New York Journal of Medicine and Surgery, Oct 1840, p. 320; and J. M. Ferrall, Lond. Med. Gazette, April 18, 1840, Dr. W. S. Oke, Provincial Med. and Surg. Journ. April 24, 1844. t London Medical Gazette, March 21, 1845, p. 785. X Lancet, for 1832-3, p. <;7'->. § New York Journal of Medicine, Oct. 1840, p. 324. || Brit, and For. Med. Rev. Oct. 1840, p. 529, being a notice of Mr. Stafford's Essay on the Prostate Gland. 410 IODINUM. can bear it. He then goes on with two, three, four, five, and even as far as ten grains or a scruple to the dram, according as the case requires it. After this, he adds iodine to it;—half a grain, one, two, three, four, or even more grains in the same manner. In different forms of rheumatism, iodine has been given with success by Dr. Clendinning,* in the Mary-le-bone Hospital, and a series of cases in which it was employed has been published by him. Sir B. Brodief twice relieved rheumatism by the tincture, although, in one of the cases, only temporarily. Cases of acute rheumatism, treated successfully by iodide of potassium, used in- ternally and externally, have been published by Dr. Mackay,| Mr. Wardleworth§ and M. Bouyer.|| Dr. CowanH" gave the iodide of potassium in fifty-two cases, in average doses of five grains three times a day. In no instance, was either bleeding or leeching prescribed. Its action in rheumatism he considers to be, on the whole, satisfactory: in many cases it may be regarded as heroic, while in others, not a priori distinguishable, almost negative. In chronic rheumatism its success appears to have been equally decided; given alone in full doses—six grains, for example, three times a day—or' associated with sarsaparilla. This combi- nation has been highly extolled by Dr. Graves in sciatica and lumbago;** and by Dr. Heygatett in chronic rheumatism, second- ary syphilis; &c4+ In gout, too, it has been prescribed. Jahn found it extremely effective in dispersing gouty tophi. Valentin observed, that when iodine was given in a case of goitre compli- cated 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 completely curing it. Gendrin used 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 cases of false joint, of which he has detailed a successful instance. A similar case has also been given by Treusen. Painting the affected sur- face with it, even in acute rheumatism, has been found useful.§§ In various rheumatic affections of the joints, especially of the chronic * London Med. Gazette, May, 1835. t Lancet, for 1832-3. X Ibid. March 2, 1839, p. 830. § Ibid. March 30, 1839. || Gazette Med. de Paris, No. 32,1840; see, also, Mr. Davies, op. cit p. 317, and Dr. Crawford, Montreal Medical Gazette, April 1, 1844. H Provincial Med. and Surg. Journ. May 27, 1843. ** Dublin Journal of Med. Science, Nov. 1840, and M. Ebrard, Journ. de Med. et Chi- rurgie Pratiques, Nov. 1845, cited in Amer. Journ. of the Med. Sciences, July, 1846, p. 225. tt London Lancet, Mar. 6, 1841; see, also, Dr. E. D. Connor, Dunglison's American Medical Intelligencer, Dec. 1, 1840, p. 257. tt See, also, Dr. W. S. Oke, Provincial Med. and Surg. Journ. May 1, 1844, p. 54. §§ Dr. Cowan, Provincial Med. and Surg. Journal, May 27, 1843. I0DINUM. 411 kind, Dr. R. B,. Todd* has employed "with unquestionable bene- fit," the local application of iodine to the affected joints,—both in the form of the tincture, and of a stronger compound, used at the King's College Hospital, London, under the name of "Iodine Paint;" the formula for which is given hereafter, (see Potassii Iodidum.) The mode of application is to paint the part freely by means of a camel's hair pencil. More or less smarting is produced, and frequently vesication, or an herpetic eruption may ensue. The painting may be repeated as often as circumstances demand. Dr. Todd considers it to be extremely useful, when an effusion has taken place into synovial membranes or sheaths. In adiposis, Von Grafef prescribed it, and not without advantage. The case was accompanied by great voracity and sense of suffocation. Bleeding and cathartics were premised. In siomacace or a scorbu- tic state of the gums the use of iodine has been recommended by Friedrich; as well as in mercurial salivation, by Kluge, Knod,J Klose,§ Graves.|| Asmus,^j 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 oesophagus, it was given with much benefit by Dr. dimming, of New York.** A bougie had been previously used, but without advantage. An adventitious membrane was brought up in scales soon after com- mencing 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;ff by the former with advantage; by the latter without any marked effect. Dr. Manson likewise succeeded in curing chronic dacrocystitis 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, and even four, drams to an ounce of water.§§ Mr. J. R. Martin,|||| of India, appears, however, to have anticipated him in this application of the remedy. Up to the time of the pre- sentation of his paper to the Medical and Physical Society of Cal- cutta, (January, 1835,) he had used it successfully in upwards of * Lond. and Edinb. Monthly Journal of Med. Science, Dec. 1843, p. 1084; Dr. Craw- ford, Montreal Med. Gazette, April 1, 1844. t Walther und Gr'afe's Journal fur Chirurgie, B. ix. St 3, S. 367. X Gazette des Hopitaux, July, 1837. § Medicinische Zeitung, No. 34, 1836. See, also, Amer. Journal Me8. Sciences, Feb. 1834, p. 533. || Dublin Journ. Med. Science, Jan. 1834. H Casper's Wochenschrift fur die gesammte Heilkunde, No. 45, 1838, and Encyclo- graphie des Sciences Medicales, Juillet, 1839. ** New York Journal of Medicine and Surgery, No. 2, Oct 1839, p. 451. It Lond. Med. Gaz. Aug. 17, 1839, p. 754, and Dunglison's Amer. Med. Intel. Nov. 1, 1839, p. 233. XX Archives Generates 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. § § Bouchardat, Annuaire de Therapeutique, pour 1844, p. 338. Paris, 1844. |||| Amer. Journal of the Medical Sciences, Nov. 1837, p. 238. 412 IODINUM. ninety cases. More recently, he has communicated* to the Medi- cal 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 ir> 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 lyttae, in the same proportion as that of iodine,—3ij. to water gvj. Of this, two drams were injected and retained; the pain during twenty-four hours was excessive, 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 undiluted port wine. Of the seven hundred and sixty-six cases treated, it does not appear that more than four failed.* 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 hydrocele contains less than three ounces, a dram of the injection is sufficient.! The cure is effected much sooner by iodine; and if any infiltration takes place it is readity absorbed. Highly favourable results have also been obtained by MM. Oppenheim^: and Fricke,§ and by Mr. Bransby Cooper,|| and the method has been largely employed in this country with equal ad- vantage.^" Two successful cases are reported by Dr. Stewart.** Encouraged by the success which attended the use of iodine injections in hydrocele, M. Velpeauyy has adopted a similar mode of treatment for various kinds of serous cysts, enlarged bursas, &c, about the knee, in the axilla, breast, neck, and other parts. He punctures the cyst with a trocar proportioned to its size; emptying it in this manner, and then injects through the cannula a mixture of one part of tincture of iodine and two parts of water. In a few seconds this is drawn off. In a day or two, the cyst in- flames, though never greatly, and it ultimately shrivels and disap- pears. Since, he has used the injection successfully in five cases of goitre, which is often formed of cysts filled with a thin serous or a blackish fluid. In hydrarthrosis, the operation appeared to him to be more formidable. He practised it in two cases; one * Quarterly Journal of the Calcutta Med. and Physical Society, for Jan. 1837; cited in American Journal of the Medical Sciences, for Feb. 1839, p. 485. t Dujat, in Gazette Medicale de Paris, Sept. 1838. X Zeitschrift fur die gesammte Medicin. Aug. 1838, S. 389. § Ibid. S. 405. || Medico-Chirurg. Rev. Apl. 1841, p. 541. 1T Dr. A. C. Post, New York Journal of Medicine, April, 1840, p. 369, and Dr. G. W. N orris, Amer. Journ. of the Med. Sciences, Feb. 1839, p. 299. ** India Journal of Medicine, May, 1836. tt Bulletin General de Therapeutique, Nov. 1841. I0DINUM. 413 recovered; the other did not* The plan has been employed by M. Bonnet,| of Lyons, in one case of hydrarthrosis. He prefers for the injection a watery solution, consisting of one part of iodine, two parts of iodide of potassium, and eight of water, in order to avoid the possible coagulation of the effused fluid by the alcohol of the tincture. He only withdraws through the trocar a portion of the fluid: and the quantity of injection thrown in is nearly the* same as that of the fluid which has been withdrawn. In all M. Bon- net's cases, the acute arthritis which supervened subsided within a few days, and was never followed by suppuration. M. Velpeau likewise tried the effect of iodine injections into the sac of a reducible hernia, and repeated the experiment on two other cases; but the difficulty of reaching the sac with certainty, and the unsatisfactory results obtained in these three cases have been regarded as serious objections to the practice. The plan has been adopted by Prof. Pancoast, who has, likewise, used the tinc- ture of cantharides as the material of the injection. M. Velpeau:}: is disposed to go even farther, and as he considers it to be proved by his experiments, that the tincture of iodine does not induce either suppuration or gangrene when thrown into serous cavities; he suggests whether we may not hope that certain varie- ties of spina bifida, hydropericardium, hydrothorax and ascites may respectively find an efficacious remedy in this kind of medi- cation? "It would doubtless," he remarks, "be rash to reply affirmatively to this question, before having invoked experience, and direct observation; but the facts which I possess, and analogy, are sufficient, 1 think, to justify fresh trials in this direction. I may add, that the iodine injection has succeeded with me in purely liquid haematocele as well as in hydrocele." A case of ovarian dropsy has lately been published by Dr. Benjamin A. AlIison,§ of Indiana, in which a solution of iodine— the strength is not mentioned—was injected into the dropsical sac. " The symptoms that followed were truly alarming, and could not be entirely controlled.|| They subsided, however, in a few days, and she continued improving. The discharge rapidly in- creased until it almost entirely ceased." In a case of empyema after paracentesis, Dr. Suytgaerens, of Puers, repeatedly injected the pleura with an iodine solution, and * Recherches sur les Cavites closes, &c., pp. 112—165, and Bouchardat, Annuaire de Therapeutique pour 1843, p. 256. Paris, 1843. t Braithwaite's Retrospect, vii. 231; cited from Medico Chirurgical Review, Apl. 1843; also, Traite des Maladies des Articulations, &c Paris, 1845; reviewed in Brit and For. Med. Rev. July, 1846, p. 71. This Review, by the way, contains a condensed account of the different cases in which the injection has thus far been employed in hydrarthrosis. t Bouchardat, Annuaire de Therapeutique pour 1844, p. 132. Paris, 1844. § Medical Examiner, June, 1846, p. 336. || Gazette des Hopitaux, Fev. 1845. See, also, on this case and subject, Proceedings of the Royal Academy of Medicine of Paris, Jan. 27, 1846, in Med. Times, Feb. 7, 1846. p. 363. 27 414 IODINUM. the patient recovered. In a case of ascites, M. Dieulafoy, of Tou- louse, threw a quantity of iodine injection into the peritoneum, and after diffusing it over the entire cavity drew off about half the quantity injected. About a month after, half the cavity seemed obliterated; but the fluid having again collected, the injection was repeated with similar consequences. A third injection was em- ployed about six weeks afterwards: after this the ascites disap- peared.* Iodine is said by Coindet and Formey to have been efficacious in cases of impotence; and, Mr. Keyf regards it as one of the most efficacious remedies we possess in checking or controlling the ulcerative process—the most active phagedenic ulcers often yielding in a surprising manner to its influence, and assuming a healthy, granulating appearance. M. Lisfranc:}: employed the iodide of potassium with success in atonic ulcers of long standing, which had resisted other modes of treatment. The only topical application used by him was simple cerate and charpie. The iodide of potassium was prescribed in doses of a scruple daily, which was subsequently increased to six grains every six hours. Mr. John Davies§ has published at length the results of his ex- perience with the local application of iodine—especially the tinc- ture—in various 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, lotions, in- cisions, scarifications, or caustic.|| Mr. Wm. ReevesT uses in these cases the compound iodine ointment. 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 its progress, but caused the deposited matter to be absorbed. Not a single case of failure occurred, where the tincture was applied in superficial 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 phlegmo- nous 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 * British and Foreign Medical Review, July, 1846, p. 78. 1 Medico-Chirurgical Transactions, vol. xix. X Cited in London Lancet, Jan. 7, 1843. § Practical Remarks on the Use of Iodine Locally Applied, &c. &c. Lond. 1839; or Dunglison's Amer. Med. Library, 1839-40. || See, also, Dr. Bums, in Philad. Med. Examiner, Nov. 6, 1841; and Dr. Crawford, Montreal Medical Gazette, April 1, 1844. IT London Lancet, Oct 22, 1842, p. 119. I0DINUM. 415 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 leeching the joint, and then using the iodine as the bleeding ceases. Mr. William Reeves* employs the compound iodine ointment in these cases. In mastitis or inflammation of the mamma, the tincture of full strength must be laid extensively over the part, as soon as the disease is discovered; 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 of its full strength. In chronic inflam- mation and enlargement of the joints, such as of the hip and knee, leeches are first employed, and then the diluted tincture is laid ex- tensively over the part, and the application is repeated every two or three days according 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 a fluid- ounce of distilled water, to vvhich 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 at- tendant. In inflammation of the absorbents, the strong tincture, ap- plied along the track of the vessels, is generally sufficient to sub- due the affection. Employed in anthrax, 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 applica- ble 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 ul- cerated surface has cured the disease without the use of internal remedies. In malignant ulcers of the tongue and tonsils, the tinc- ture, of full strength, brushed all over the parts, arrested the affec- tion no matter how threatening. The only internal remedy was the ioduretted solution,—in doses of ten drops twice a day, in wa- ter. In scrofulous swellings of the glands, it either resolved the inflammation 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 shall have ceased. Where this has been done prior to suppuration, it never fails, according to Mr. Davies, to subdue the disease. Should mat- ter have been formed, a free incision must be made, and the tinc- ture be applied over the finger or hand if swollen. In chilblains, * Op. cit 416 IODINUM. the tincture, of full strength, is to be applied over the part affected, and beyond the boundary of the surrounding inflammation. 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 stimula- ting ointment. In cases where the inflammation spreads along the foot or leg, the affected parts must be painted with the strong tincture. Mr. James Henderson* has likewise found a compound preparation of iodine useful in chilblains. The form is given hereafter. Three applications have generally been sufficient. In lacerated, contused, and punctured wounds, the tincture was found by Mr. Davies to be preferable to every plan of local treat- ment. 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, generally of the full strength, and the application was extended a little distance beyond. After allowing it to dry, the edges of the wound were brought together with adhesive plaster, which was not renewed 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 granula- tions with the surrounding skin were washed over and then dressed with common wax ointment. The cure was generally rapid. Where contusion only exists, the tincture is applied by Mr. Davies every day or two to the surface; this quickly occasions the absorp- tion of the extravasated blood. Where there is a combination of laceration and contusion, the treatment is compound. 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 success it exerts in local diseases, and injuries attended with inflammation. In such cases, it should be allowed to insinuate itself freely into the wound, and be thickly painted upon the surrounding 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 treatment, and in 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 tinc- ture, of full strength, must be applied to the surface and surround- ing skin. After being allowed to remain some time, the ulcer * London Lancet, April 18, 1840. I0DINUM. 417 must be covered with simple ointment in preference to a poultice. The application must be repeated daily till the sore becomes clean and healthy, vvhen the granulations may be touched with the di- luted tincture every two or three days. Under this plan, the cavity of the ulcer fills up rapidly. Mr. Fergusson* has published a most obstinate case of old ulcers, vvhich were cured by the use of the corrosive chloride of mercury internally, and the tincture of iodine externally. M. Ricordt considers the tincture to be the very best topical application in phagedenic chancre, and Dr. Samuel Jackson, of Philadelphia, (formerly of Northumberland, Pa.,) has found it an admirable remedy in the irritable ulcer with inflamed sur- face and erysipelatoid margins. It soon fills the surface, and with this the whole inflammation disappears. A little lunar caustic then disposes the ulcer to granulate. Besides these affections, the tincture has been employed 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 stinging oficasps, diseases of the spine, ununited fractures, orchitis, inflamed urethra and chordee, inflammation of the bursoz, chronic ophthalmia, and opacities of the cornea^ (being much diluted), in strumous ophthalmia, when applied to the outside of the eyelids,|| in ulcerations of the tonsils and fleeces, specific and non-specific,1F and in dissection wounds. The strength of the remedy, in the several cases, must depend upon the judg- ment of the practitioner.** It has also been used as a counter-irri- tant in many internal affections. Painting the trachea and larynx with a strong tincture of iodine has been found beneficial by Mr. E. Copemantt in inflammation of the air passages. Iodine has been employed by M. ReinigerJ^: to remove sparks of iron from the cornea. A small particle of steel struck the eye of a cutler whilst at work, and fixed itself in the substance of the cornea, from which it was found impossible to remove it either by the forceps or the needle. It soon excited inflammation, and after eight days, the eye was still red, hot and painful, and the patient complained of a pricking sensation on moving it. The fragment of steel could be distinctly seen retaining its polish. As a strong magnet also failed to remove it, it was resolved to have recourse to a chemical solvent, but one which would not * London Lancet, Nov. 13, 1841. See, also, Lisfranc, cited in Med. Times, Jan. 11, 1845, and Braithwaite's Retrospect, xi. 103, Amer. edit. New York, 1845. 1 Bulletin Generate de Therapeutique, 15 et 18 Fevrier, 1841. X Medical Examiner, August, 1846, p. 465. § See, also, Dr. Lohsse, Medicinisch. Zeitung, Mar. 3,1841; and Brit and For. Med. Rev. July, 1841, p. 258; also, Dr. W. S.Helmuth, Med. Examiner, Sept 11,1841, p. 583. || Dr. Fumivall, Lancet, Dec. 10, 1842, p. 405. IT Dr. J. J. Loss, Lond. and Edinb. Monthly Journ. of Med. Science, Sept. 1842, p. 792. ** Provincial Medical and Surgical Journal, August 12, 1843. ti British and Foreign Medical Review, Oct. 1839, p. 523. See, also, Dr. Langon, London Lancet, June 27, 1840, p. 484. XX Journal de Pharmacie et de Chimie, Juin, 1815: cited in Edinb. Med. and Surg. Journal, July, 1846, p. 251. 418 IODINUM. injure the eye. A weak solution of iodine and iodide of potassium was therefore used as a collyrium, and its very first application sensibly deadened the lustre of the spark of steel. By its conti- nued use, the steel was rendered soluble, and was gradually re- moved. 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 potas- sium; although he admits, that the superiority he ascribes to the first is perhaps owing to his having prescribed it most frequently. The operation 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 immediately con- verted in the stomach into hydriodic acid. Mr. B. Phillipst prefers the iodide of iron in all cases. M. Moj'sissovics, of Vienna,:}: considers iodide of potassium and the iodides of mercury to be decidedly the most valuable prepara- tions, when pure: but they are often, he affirms, given in prescrip- tions with matters that decompose them. In the Glasgow Infirmary, they are in the habit of preparing a liquid hydriodic acid; by dissolving three hundred and thirty grains of iodide of potassium in f. giss. of distilled water; and two hundred and sixty-four grains of tartaric acid in a like quantity: the solutions are then mixed, and when the bitartrate of potassa has subsided, the fluid is filtered. Water enough is then added to make 5vj. and 3ij.§ Each dram of this liquid acid contains five grains of iodine. The acid, thus prepared, is, hovvever, very liable to change, and is necessarily variable in its effects.|| Lastly; from his researches on the effects of the various prepa- rations of iodine, Dr. CogswelllT infers, 1. That iodine and iodide of potassium act very much in the same way, but that there is still a difference, inot merely in point of power, but of specific proper- ties. 2. That, whatever be the proper action of the iodide of sul- phur, 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 vvhich were submitted to examination, the preponderance of power is on the side of the metals. MODE OF ADMINISTRATION. Iodine is not easily given internally in substance—in the form of pill or powder; neither are these forms to be recommended. * Medical Gazette, July 2, 1836. t London Medical Gazette, Jan. 10, 1840. X Oesterreich, Med. Jahrbuch. cited in Encyclog. des Sciences Med. Avril, 1841, p. 8. § Dr. Buchanan, op. cit. || Guibourt, in Revue Medicale, Aout, 1837; and Bull. Gen. de Therap. Sept. 1837. IT Essay on Iodine, p. 167. Edinb. 1837. iodinum. 419 Coindet preferred it in the form of tincture; and this is one of the most common modes in vvhich 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, it 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 seem, hovvever, that, in the generality of cases, when iodine has disagreed, it has been in the form of tincture. For this reason, it has been given more,of late years, in watery solution; and, to pro- mote the solution, the iodide of potassium (q. v.) is added; or a little chloride of sodium, 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 fumigations. Frictions with iodine readily occasion considera- ble irritation of the skin, vvhich 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. Iodine is given internally, in the dose of one-eighth of a grain to a grain, twice or thrice a day. In Dr. Pereira's opinion,* the most effectual method of employ- ing iodine externally is the endermic,—applying an ioduretted ointment to the cutis vera after the epidermis has been removed by a blister. The plan is not, hovvever, often used. The following are some of the forms in which pure iodine is administered internally and externally:— Tinctura iodini. Tincture of iodine. Tinctura seu Alcohol Iodii. R. Iodini gr. xlviij. Solve in Alcohol. 35° (s. g. .842) gj. Dose.—Ten drops to be given in some mucilaginous or saccha- rine fluid, or in wine and water. Coindet 8? Magendie. The tinctura iodini, of the Pharmacopoeia of the United States, consists of an ounce of iodine to a pint of alcohol. Mr. Durand, an able pharmacien of Philadelphia, finds, that forty grains of iodine and 3x. of alcohol form a saturated solution. Based on this fact, the following formula has been given, vvhich does not seem, however, to possess any advantages over the simple tincture. R. Iodin. Qij. Alcohol, gj. Spirit, lavand. comp. gij. Dose.—Five to ten drops, twice a day, gradually increasing it.f * Elements of Mat. Med. and Therap. 2d edit p. 242. Lond. 1842, or 2d Amer. edit. Philad. 1846. , __ 1 Ellis's Medical Formulary, 8th edit p. 113. Philad. 1846. 420 IODINUM. Tinctura setherea iodini. Ethereal tincture of iodine. Tinctura iodii cetherea.—-French. Ether iodure- R. iEther. sulphuric, f. %i. Iodini gr. iv. 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. f. gx. 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, f. gij. Solve et adde Aq. cinnam. f. giiss. Syrup, simpl. f. giss. M. To be taken in the twenty-four hours, in dram doses. Syrupus iodini. Syrup of iodine. R. Tinctur. iodin. gr. vj. Syrup, simpl. f. gij. M. Henry. Liquor iodini. (Lugol's.) Solution of iodine. (1. For internal use.) French. Boisson iodee. A. B. C. R. Iodin. gr. h. gr. f. gr. j. Sodii chlorid. gr. xij. gr. xij. gr. xij. Aquas destill. Oj. Oj. Oj. Solve. (2. For external use.) A. • B. C. R. Iodin. gr. ij. gr. iij. gr. iv. Aq. destillat. Oj. Oj. Oj. Solve. Lugol gives formulas for the solution of the three different strengths above. Lotio iodini. Lotion of iodine. R. Tinct. iodin. f. gss. Ferri iodid. gr. xij. Antim. chlorid. gss. M. Used for corns. To be applied by means of a camel's hair pen- cil, after the corn has been well pared. James Henderson. I0DINUM. 421 Gargarisma iodini. Gargle of iodine. R. Tinct. iodin. f. gj.—gij. ----Opii f. gi. Aquae f. gvj. M. To be used three or four times a day. J. J. Ross. Unguentum iodini. Ointment of iodine. Unguentum Iodatum.—French, Pommade d'lode.—German, Iodsalbe. R. Iodin. gr. iij. Adipis gij. M. The Unguentum Iodini of the Pharmacopoeia of the United States, (1S42,) is made as follows:— R. Iodini gr. xx. Alcohol, ttlxx. Adipis gj. Rub the iodine first with the alcohol, and then with the lard, un- til they are thoroughly mixed. Linimentum iodini. Liniment of iodine. R. Linim. sapon. f. gj. Tinct. iodin. f. gj. M. Manson. Cataplasma iodini. Cataplasm of iodine. R. Tinct. iodin. f. gss. Lin. pulv. gj. Averies farin. giij. Aquae destillat. q. s. ut fiat cataplasma. Used as a cataplasm in scrofulous tumours, and goitre. Iodide of Ammonium, Iodidum seu Ioduretum Jlmmonii, Hydri- odate of Ammonia, Ioduret of Ammonium—is formed by saturating liquid hydriodic acid with caustic ammonia and evaporating the so- lution. It crystallizes with difficulty, and is deliquescent. It was introduced into medical practice by M. Biett, of Paris, as a valua- ble therapeutical agent in certain diseases of the skin. Several suc- cessful cases of its employment in lepra and psoriasis, by M. Biett, are given by Dr. Pennock,* accompanied 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. Iodide of Starch, Iodidum seu Ioduretum Amyli, Amylum Iodatum; French, Iodure d'Arnidon; German, lodstdrkmehl, * Amer. Joum. of the Med. Sciences, Feb. 1835, p. 374. 422 IODINUM. Iodstarke,Starkmehl-oder-Satzmehliodure, has been extolled by Dr. Andrew Buchanan,* of Glasgow. It is prepared of iodine, gr. xxiv.; starch, in fine powder, gj. 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 drive off the iodine, and it must be afterwards kept in a well stopped bottle. Iodine, in the usual forms of exhibition, is not in general 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 Strasburg, 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.y It is proper, however, to state, that Dr. Laurie, of Glasgow,}: 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. Iodofor'ma, Iodoform; French, Iodoforme. This substance is so called on the same principle as chloroform (q. v.) It con- tains, according to M. Bouchardat, nine-tenths its weight of iodine, and yet its taste is sweet, and not at all corrosive. He gives the fol- lowing form for its preparation.§ Take of iodine, 100 parts; bi- carbonate of potassa, 100 parts; ivater, 750 parts; alcohol, 250 parts. Mix the whole in a flask, which must be placed in a water bath, the heat of which must be gradually raised to favour reaction. When the liquor has lost its colour (sera decolorize) add of iodine, 25 parts; heat again; renew the addition of iodine when the liquor has lost its colour; and a short time after the point has been passed at which it no longer changes by heat, add a few drops of a solu- tion of potassa to deprive the liquor of colour. Filter, and wash the precipitate produced, which will consist of crystalline plates of iodoform, of a beautiful citrine colour. The evaporated liquor will yield a large quantity of crystals of pure iodide of potassium. According to M. Bouchardat, iodoform furnished by this process, will be as economical as any other product of iodine; and he does not doubt it will occupy a useful rank amongst the preparations of io- dine employed internally. He gives it in the form of pill, united with extractum absinthii in scrofulous affections, and of lozenges. Dose one grain, three times a day. The other preparations of iodine are described in different parts of this volume. * Lond. Med. Gaz. July 2,1836; see, also, Soubeiran, in Revue Medicale, Aout, 1837. t Gazette des Hopitaux, Fev. 19,1839, cited in Lond. Med. Gaz. April 20,1839, p. 127. X Lond. Med. Gazette, July 3, 1840, p. 590. § Annuaire de Therap. pour 1844, p. 11G. Paris, 1844; and Nouveau Formulaire Ma- gistral, p. 333. Paris, 1845. JUGLANS REGIA. 423 CIII. JUGLANS RE'GIA. Synonymes. Walnut Tree. French. Noyer. German. Wallnussbaum. The walnut tree, Sexual System, Monoecia Polyandria: Na- tural Order, Terebinthaceae or Juglandeae, is a native of Persia whence it was carried to Greece, Italy, France, &c. EFFECTS ON THE ECONOMY. The leaves of the walnut have been highly extolled bv M. Ne- grier* as superior to all other antiscrofulous remedies. " He pre- scribed them to 56 patients affected with different forms of scro- fula. Of these, 31 were unequivocally cured, 18 experienced a very manifest improvement, and the majority were in course of cure. Four derived no benefit as regarded their sores. Four children died during the treatment,—two of tubercular phthisis; one of acute encephalitis, and the fourth of double pneumonia! The extract of the leaves, which may be ranked in the class of slightly aromatic bitters, M. Negrier found to be almost constantly efficacious in scrofulous affections, and in no case did he observe it exert any unpleasant action on the economy. The preparations of walnut leaves excite, in the first instance, digestion and circulation, and, according to M. Negrier, communi- cate remarkable energy to all the functions; and he is disposed to think that they have a special action on the lymphatic system. MODE OF ADMINISTRATION. The preparations used by M. Negrier are the following:— Infusum juglandis regis. Infusion of walnut leaves. This infusion is made by throwing a largepugillus (pincee) of the cut leaves into eight ounces of boiling water. This is sweet- ened with sugar or with the syrup mentioned below. Two or three cups were prescribed daily, and sometimes as many as five. Decoctum juglandis regise. Decoction of walnut leaves. The decoction may be made by boiling, for ten or fifteen mi- nutes, a small manipulus (poignee) of the leaves in Oijss. (un kilo- gramme) of water. It is advantageously used as a lotion; and as a dressing to scrofulous ulcers,—lint being wetted with it and applied to them. It has, also, been used as a partial and general bath; and as an injection into fistulous openings. * Archiv. Genoral. de Medecine, Avril et Mai, 1841, or Bullet. General de Therapeu- tique, 15 et 30 Mai, 1841. 424 LACTUCARIUM. Extractum juglandis regis. Extract of walnut leaves. This extract is prepared by the method of displacement. Syrupus juglandis regis. Syrup of walnut leaves. The syrup is prepared from the extract by mixing six grains with an ounce of simple syrup. A syrup may, also, be made of the green leaves, which is more aromatic than that formed from the extract. To little children M. Negrier gives two or three dessert-spoonfuls in the 24 hours; to adults he has never given more than two ounces. The ordinary dose for the last is from eight to ten drams. Piluls extracti juglandis regis. Pills of extract of walnut leaves. Each of these may be made of three grains of the extract ren- dered solid by a sufficient quantity of the powder of the leaves. Two are given by M. Negrier in the day. He has never exceeded four. Where it has been necessary to have recourse to frictions on the diseased part, he has employed the following ointment: Unguentum extracti juglandis regis. Ointment of extract of walnut leaves. R. Extract, juglandis regice %i. Adipis gx. 01. bergamot. itiiij. The friction must be gentle, and for about a quarter of an hour, twice a day. M. Negrier properly remarks, that in all such deeply rooted affections, it may be necessary to persevere in the remedy for some time; as not only have we to combat the effects of the disease, but to induce a profound modification in the constitution of the individual.* Injections of a very concentrated decoction of walnut leaves, of the temperature of the room whatever may be the season, have been used with much success in leucorrhoea by M. Vidal.t CIV. LACTUCA'RIUM. Synonymes. Lettuce opium, Thridace. German. Lattigopium, Lattigmilchsaft, Lattigbitter. The ancient Greek and Roman physicians were well aware of * Archiv. General, de Medecine, Mai, 1841, or Encyclographie des Sciences Med., Juin, 1841, p. 466. t Essai sur un Traitement Methodique de quelques Maladies de la Matrice, &c. Paris, 1840; noticed in Brit, and For. Med. Rev. for July, 1841, p. 215. LACTUCARIUM. 425 the hypnotic property of the common garden lettuce (lactuca sativa,) the milky juice of which contains 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 atten- tion to the subject, and recommended it as a remedy in phthisis, in place of opium.y The properties of the juice have also been investigated by M. Francois,:}: 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, vvhich is subsequently dried in the air. This preparation has a bitter taste, soon becomes of a brown colour, 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 man- ner as any common extract, from all parts of the plant. This is the Thridace of some. It is unworthy of confidence. The first is the strongest and most uniform, and therefore to be preferred. Chemical examination shows that lactucarium contains neither morphia nor narcotina, as had been supposed. It has been recently examined by M. Aubergier,|| who found it to have the following composition:—Bitter crystallizable matter; mannite; asparamide; free acid; brown colouring matter; resin; cerin; myricin; albumen, and gum; nitrate of potassa; chloride of potassium; and phosphates of lime and magnesia. M. Aubergier regards the crystalline matter as the active principle of the lactu- carium.^" 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 S}7mptoms or modification in the pulse: from six to eight * Wood and Bache's Dispensatory, 6th edit. p. 424. Philad. 1845. t Observations on Consumption, 2d edit Edinb. 1816. X Archiv. General.de Medecine, 1825. Journal Univer. xl. 254, and xli. 147. See. also, Fischer, in Rust's Magazin. B. liii. Heft. 1. § Riecke, Die neuern Arzneimittel, S. 313; and 2le Auflage, S. 473. Stuttgart, 1840. See, also, Merat and De Lens, Diet, de Mat Men. art Lactuca Sativa. || Joum. de Pharm. Jan. 1842, p. 78. 1 Bouchardat, Annuaire de Therapeutique pour 1843, p. 14. Paris, 1843. ** Ferussac's Bulletin des Sciences Mcdicales, xxii. Paris, 1830. 426 LACTUCARIUM. 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 at the epigastrium, cold sweats, anxious respiration, cold sensation in the chest, great dul- ness, vertigo, considerable dilatation of the pupils, yawning and stretching, slow pulse, disturbed sleep, general prostration; the tongue coated with mucus; disagreeable taste; loss of appe- tite; 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. 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 nervous excitement is present. It has also been used topically in the form given below, by Rau,* of Berlin, in catarrhal oph- thalmia, and a solution, in the proportion of four grains to the ounce, has been advised in acute inflammation of the conjunctiva, by Guibertf The results of the author's experience with lactucarium have been negative. He is unable to affirm, that it is possessed of any marked sedative and hypnotic powers;:}: and such would seem to have been the general results of extensive trials made with it by others.§ MODE OF ADMINISTRATION. Lactucarium is given internally, either in the form of solution 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 oint- ment. Mistura lactucarii, Mixture of lactucarium. R. Lactucar. 9j. Mucilag. acac. q. s. ad subactionem. Perfecte unitis adfunde Aq. f. gvj. Syrup, rub. idaji f. §ss. M. Dose.—Two spoonfuls, every two hours, in spasmodic cough, sleeplessness and hysteria. Von Hildenbrand. * Berliner. Medicin. Central-zeitung, Nov. 2, 1838. t Froriep's Notizen, Bd. xxi. S. 320, and Osann, art. Lactuca, Encyclopad. Worterb. der Medicinischen Wissenschaften, xx. (597. Berlin, 1839. X General Therapeutics and Mat. Med. 3d edit i. 375. Philad. 1846. § Bouchardat, op. cit. p. 26, and M. Homolle, in Bouchardat's Annuaire, &c, pour 1845, p. 27. Paris, 1845. MAGNES. 427 R. Acid, boracic. gij. Lactucarii J)j. Solve in Aq. destillat. f. gvj. Syrup, papav. f. gss. M. Dose.—A small spoonful—in cases of "spastic haemoptysis^ Rothamel. Collyrium lactucarii. Eye-wash of lactucarium. R. Lactucar. gr. iij. Aq. destillat. f. Jjiij. Mucilag. cydon. gtt xx. M. Rau. M. Aubergier* (considers the alcoholic extract to be the best form of preparation. The lactucarium is twice successively di- gested in alcohol of .922: the fluids are then mixed, distilled, and evaporated in a water bath. During evaporation, the fluid must be constantly stirred. The extract, thus procured, is of a brown colour, and very bitter. It may be given in pills, or in the form of syrup. For the latter—Syrupus lactucarii—M. Aubergier recommends that every 501 parts should contain one of the extract. He gives it either alone or in association in the quantity of from f. ?iss. to f. 5ij. in the twenty-four hours, in cases of bronchitis or phthisis. CV. MAGNES. Synonymes. Magnetes, Magnet. French. Aimant, Pierre d'Aimant. German. Magnet, Magnetstein. The natural magnet was employed of old both externally and internally, and in the most diversified forms and affections.y The artificial magnet has been used within the last century only. It is generally on the diseased part, or around it, that it 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 has been recently affirmed,\ that magnets of 10 pounds support- ing power, when drawn along the body downwards, without con- tact, produce certain sensations in a certain, or rather uncertain, pro- portion of human beings. Occasionally, in twenty persons three or four sensitive individuals are found; and in one case out of twenty-two females, examined by Von Reichenbach, eighteen were sensitive. The sensation is said to be rather unpleasant than * Bouchardat, Annuaire, &c, pour 1845. t Art Aimant, in Diet Univers. de Matiere Medicale, par Merat and De Lens. X Abstract of Researches on Magnetism and certain allied Subjects, &c, by Baron Von Reichenbach; translated by Dr. W. Gregory: or notice of the same in the Bulletin of Med. Science. Philad. July, 1846, p. 217. 428 MAGNES. ' agreeable, and is like an aura, in some cases warm, in others cool; or it may be a pricking, or a sensation of the creeping of insects on the skin; and at time3 headache rapidly supervenes. These effects, it is said, occur vvhen the patient does not see the magnet or know what is being done. They ensue both in males and females, but more frequently in the latter: they are sometimes seen in strong healthy people, but oftener in those whose health, although good, is not so vigorous, and in nervous persons. Children are often found to be sensitive. Persons affected with spasmodic diseases—epi- lepsy, catalepsy, chorea, paralysis and hysteria are especially sen- sitive, and lunatics and somnambulists, he says, are uniformly so. It is, then, on the nervous system that the magnet exerts its effi- cacy. Accordingly, the class of diseases in which it has been found most beneficial are those termed "nervous and spasmodic." This is strikingly shown by the published observations of MM. Andry and Thouret,* Commissioners of the Societe Royale de Medecine, appointed to examine into the matter. In cases of spasms, palpitations, convulsions, epilepsy, tremors, cramps, neuralgia, rheumatism, &c, the only agent employed was the magnet, and it was vvholly successful. These gentlemen were disposed to infer, that the magnet exerts an incontestable mag- netic action on the nervous system, to which, in part at least, the curative agency must be ascribed, and their conclusions were thought to be corroborated by cases observed by MM. Alibert, Cayol, Chomel, Recamier, &c. The celebrated Laennec,f who employed the magnet in the manner recommended by Halle,—that is, by establishing a magnetic current through the diseased parts by means of several magnetized plates, affirms, that he frequently found it moderate the pain in pulmonary neuralgia, diminish the oppression in nervous 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 anterior 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,,r as it was termed by Dr. Blundell who employed \t.% It would seem, too, that owing to a considerable demand for loadstone, the conductors of the Dulletino delle Scienze Mediche,§ of Bologna, were led to make inquiries concerning the uses to which it was * Mem. de la Societe Royale de Medecine de Paris, pour 1776, p. 531, and Thouret, art Aimant, in Encycloped. Method. Partie Medicale, i. 421. Paris, 1786; also, Du- mont, in Bouchardat, Annuaire de Therapeutique pour 1843, p. 79. Paris, 1843. t Traite de l'Auscultation Mediate, 2de edit. torn. ii. X See Lancet for 1833, cited in Amer. Journ. of the Med. Sciences, Nov. 1833, p. 247. § Marzo et Aprile, 1835; cited in Brit, and For. Medical Review, July, 1836, p. 246. MANNITA. 429 put. From these it appeared, that the Ex-Bey of Algiers, whilst at Leghorn, in 1831, mentioned to a Catholic dignitary, Father Campagnoli, who was suffering under gout, that the application of the loadstone was an oriental remedy for the disease, and of cer- tain 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 frequently and severely, and that they invariably yield, so that he has rejected all his former plans of treatment. On the first symptom he goes to bed, and places the loadstone in close contact with the, pained part; he pre- sently falls asleep, and awakes free from pain, and able to walk. The loadstone, which he uses, weighs five pounds, and has smooth sides. He has recommended this plan to other gouty individuals, who have experienced similar relief. The author has witnessed the application of the mineral mag- net repeatedly in nervous diseases, in persons of highly impres- sible habits; but except in such, and apart from the effects of" the imagination, he has seen no beneficial results from it. It has been affirmed,* that in the workshops of Fairbairne in Belgium, an artificial magnet was put up some years ago at the level of the eye; and at every instant, a turner, or an adjuster, or some other workman, who has had a particle of iron driven into bis eye, is seen running to the magnet, which draws it out as soon as the eyelids are separated, and the eye is held near its pole. For Electricity, see Galvanismus; and for Magnetic Elec- tricity, see Electro-Magnetismus. CVI. MANNITA. Synonymes. Mannitum, Saccharum Mannse, Mannite, Sugar of Manna. 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.f * Gazette des Hopitaux, Juin 14, 1842; cited in Brit, and For. Med. Rev., Oct. 1842, p. 557. 1 Art Mannite, in Merat and De Lens, Diet, de Mat. Med. 28t 430 MANNITA. 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 crystallize: by rest and refrigera- tion, mannite is precipitated in small, beautiful, white needles. The manna in tears consists almost wholly of mannite. Common manna, on the other hand, contains but little thereof, and in its place has a yellow extractive matter to which cathartic properties have been assigned: coarse manna consists almost wholly of the latter., To obtain mannite, consequently, the manna in tears is se- lected. 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 vege- table 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 proportion in boiling water; it seems to be entirely insoluble in cold absolute 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 crystal- lizes on cooling. When more strongly heated, it burns, and is decomposed like sugar. From its alcoholic solutions it separates on cooling, in white, silky, shining, needle-shaped crystals, col- lected in stelliform roundish masses. When mannite is dissolved in an equal weight of boiling water, and the fluid is evaporated by a strong fire and rapid ebullition, until a small portion placed on a cold glass plate rapidly becomes 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. Granatin or Grenadin of pomegranate root agrees so much with 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- stituted for manna, as it possesses the cathartic property without the nauseous flavour. The dose is two drams for a child, and, at times, as much as half an ounce; but, in the latter dose, Magen- die always found the catharsis too active: for this reason he con- siders it to be the best dose for the adult. He recommends, that a syrup should be prepared from it, and that this should be pre- scribed both as a cathartic for children at the breast, and as an ad- * Formulaire, &c, dern. edit. MATIAS. 431 dition to other articles in cases of pulmonary catarrh. M. Solon has likewise spoken favourably of the therapeutical advantages of mannite. 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 occa- sioned by obstinate constipation its use was followed by the best effects. In the last case, the inflammation completely disappeared, as the constipation yielded, without any other agency. It was found, likewise, of essential service in convalescence from bron- chitis and pneumonia. Only in two cases of females—the one labouring under ascites—the other under phlegmatia dolens, did mannite fail to have any aperient agency. This, it was presumed, was probably owing to both of the patients having been habituated to the use of powerful cathartics, and to there not being enough of the preparation to admit of the administration of the appropriate quantity. According to M. Solon, mannite may be given in the dose of one or two ounces dissolved in from two to four ounces of a hot aromatic water, the solution to be taken warm, otherwise it forms a stiff, adhesive mass; or it may be added to ordinary ca- thartic 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 ef- fects. It appeared to him to be peculiarly adapted for cases in vvhich it was desirable to evacuate the intestines with as little ex- citation as possible. Magendie, in his lectures on the blood, classes mannite amongst the substances that promote the coagulation of that fluid.* CVII. MATIAS. Synonyme. Malambo, Melambo. A paper on the Matias bark was read before the Medical Sec- tion of the British Association for the Advancement of Science at their meeting in 1S40, by Dr. Mackay. The plant, from which the bark was obtained, grows in great abundance in South Ame- rica ; but its botanical characters have not been given. From what Dr. Mackay heard, it would seem to belong to the genus Wintersonia. It contains an intensely bitter extractive matter,and vields, on distillation, two distinct essential oils, which differ in specific gravity, and are soluble in alcohol and ether; and but very sparingly so in water. The principal characteristic substance derived from it was a bitter resinous matter. No alkaloid was * Legons sur le Sang, &c. &a Translation in Lond. Lancet for Jan. 26,1839, p. 636. 432 MATICO. discovered in it. Mr. Ure* considers it to be identical with ma- lambo, the Indian name for the bark of a tree which grows in New Grenada, and is held in high esteem by the natives as an antiperiodic, and stomachic. He describes the bark as three , or four lines thick; brittle, although somewhat fibrous; of a brown colour, and covered with an ash-coloured tuberculated epi- dermis. Malambo bark was analyzed by Cadet, and afterwards by Vau- quelin, who found it to contain resin, a light volatile oil, and an extract very soluble in water. No tannic acid was found in it; scarcely any gallic acid, and none of the alkalies of the cincho- nas.f EFFECTS ON THE ECONOMY. In its native country, matias bark is extensively used as a sub- stitute for cinchona in intermittents. Its principal therapeutical properties are tonic, aromatic and astringent. Dr. Mackay stated, that it had been exhibited with marked success in dyspepsia accom- panied by loss of appetite, which it quickly restored. In phthisis, where tonics were admissible, it supported the strength and pre- vented rapid sinking. In dropsy, it was found to be a valuable adjunct to diuretics; and in intermittent, to deserve its native re- putation of being a good substitute for cinchona. The virtues ascribed to it by Dr. Mackay are confirmed by Dr. Neubigging, who has used it extensively.^: Mr. Ure has often administered it with good effect as a substitute for cinchona. In scrofulous ophthalmia, after having removed feculent accumulations from the bowels, he has known an infusion made with two drams of the bark to a pint of water, cause a speedy and complete removal of the inflammation and morbid sensibility of the eyes. The dose of the infusion was from one to two fluidounces, repeated twice or thrice in the course of the day. "It may, in some instances, be advantageously conjoined with salts of iron or of mercury, with both of which it is compatible. The addition of a little syrup of orange peel, and compound tincture of cardamoms, forms a draught by no means disagreeable." CVIII. MATI/CO. Synonymes. Piper Angustifolium, Soldier's Weed. Spanish. Yerba del Soldado. The name of this plant is said to have been derived from a Spa- nish soldier called Matico, who, lying desperately wounded, and * Pharmaceutical Journal, vol. iii. No. 4, p. 170. 1 Annales de Chimie, xcvi. 113; and Journ. de Pharmacie, ii. 172. See, also, Merat and De Lens, Diet, de Mat. Med. &c, art. Malambo. ; Lond. Athenaeum, Oct 1840; cited in Amer. Journ. Med. Sciences, Jan. 1841, p. 209. I MATICO. 433 bleeding to death, caught accidentally hold of some of its leaves, and by their application arrested the hemorrhage. At a meeting of the Medico-Botanical Society of London, holden in 1827, Mr. Frost brought a specimen of this plant before their notice; which appeared to him be a species of pepper.* A specimen of Matico leaves was brought from Peru to the United States, in 1S34, by Dr. Ruschenberger, of the United States Navy, who has recently received other specimens from Lima, with a portion of which he has kindly favoured the author. The leaves are considered to be those of Piper angustifolium, of Ruiz and Pavon;f but Dr. Ruschenberger observes, the proper- ties of the plant, so far as we can judge from the imperfect dried specimens, differ somewhat from the pepper family, when we compare different parts of the plants. The dried leaves are deeply reticulated, and of a greenish ashy-gray colour: the stem is herba- ceous and jointed; but the specimens are so much broken, as to render it difficult, if not impracticable, to form an accurate idea of the plant. It has been introduced of late into Great Britain, and, according to Messrs. Ballard and Garrod,| promises to maintain the reputation it has enjoyed in South America as a most power- ful styptic. Dr. Carson! states that the specimens he has examined consist of the broken, and, in most cases, crumbled leaves, with portions of twigs, and flower spikes or fruit ;§ and such is the character of the specimens examined by the author. Dr. Hodges has seen two samples,—the one consisting of the dried leaves, whilst another, which he procured more recently, had mixed with the leaves a considerable quantity of the flowering twigs, and woody stems of the plant compressed together, and flattened into a cake. The leaves, according to him, have a strong aromatic and slightly as- tringent taste; and both the smell awd taste of their infusion in water very much resembled that of the tea prepared by the country people in Ireland, from the leaves of the indigenous Salvia verbenaca. Dr. J. H. Scrivener, in a letter to Dr. Ruschenberger, dated Lima, April 30, 1845, says that Matico grows abundantly along the sides of the mountains of Monobamba and Huanuco in the department of Junin. There are three species, distinguished by the colour of their stems, which are red, brown and white. The red is considered superior to the others, and is carried to Lima in large quantities by the Indians, and sold to the druggists. When the Flora Peruana was published, the medicinal properties of the plant were unknown. Their discovery is attributed to a sol- * London Medical and Physical Journal, cited in the North American Medical and Sur- gical Journal, iv. 419. Philad. 1827. 1 Persoon, i. 32, Cramer's edit; cited by Dr. Jeffreys, in Transactions of the Provincial Med. and Surg. Association, xi. 351. Lond. 1843; Carson, 2d Amer edit, of Pereira's Elements of Mat Med. and Therap. ii. 222. Philad. 1846: and Ballard and Garrod, Elements of Mat. Med. and Therap. p. 411. Lond. 1845. X Op. cit. § Op. cit k 434 MATICO. dier, uho was wounded on the 9th of December, 1824, at the bat- tle of Ayacucho.* The specimens examined by the author had no marked sen- sible properties. When analyzed by Mr. Clay of Liverpool,t Matico seemed to have gallic acid in its composition; but from the experiments of Dr. Hodges, he concluded, that besides the ordinary constitu- ents of leaves, it contains a soft dark green resin, some aromatic volatile oil, and a bitter principle, to vvhich, he gave the name maticin. Its virtues are imparted to dilute alcohol, and to hot and cold water. Decoction, according to Messrs. Ballard and Garrod, volatilizes the essential oil, and if so, it would be an im- proper mode of preparation. Dr. Ruschenberger, however, affirms, that the oil is heavier than a saturated solution of common salt.J EFFECTS ON THE ECONOMY. Matico, under the name Verba del Soldado, ('Soldier's Weed') has a popular reputation in Peru of being a remarkably powerful styptic; and it is said, that soldiers on going to battle carry with them a supply of it to stanch the blood. It is asserted, and popularly believed, that a Matico leaf applied at once, will arrest hemorrhage in a fowl after decapitation. It is very generally used in Lima, and along the coast, in cases of hemorrhage, and of all kinds of ulcers. The leaves are well pounded, and then applied to the wound: the vessels contract, and the hemorrhage ceases. An in- fusion of the plant is used as a wash to ulcers, and after washing, a small quantity of the powder is applied; but it does not appear that Matico has ever been used in Lima as an internal remedy. In the province of Chequas, however, in the eastern extremity of Bolivia, where it is equally regarded as a valuable haemastatie, it is said to be given as a diuretic.§ In a case of hemorrhage from the tongue, occurring in a lad of the hemorrhagic diathesis, Mr. J. Hamilton of Dublin, arrested the flow of blood by the application of the under surface of a small piece of Matico leaf. In one case Dr. Ruschenberger employed the leaves to arrest hemorrhage after an operation below the angle of the jaw, where there was considerable bleeding, and difficulty in taking up the vessels, owing to the indurated condition of the parts, attributable to inflammation of long standing caused by the pressure of ^ mo- lar tooth, which had been driven in by a musket ball to a point between the base of the tongue and the angle of the jaw. The tooth was removed by incision, and the application of the Matico was successful. The wound, an inch and a half in depth, was filled with leaves moistened with water, and the bleeding ceased almost instantaneously. In enlarging a burrowing bubo, Dr. Ruschenberger divided the * Ruschenberger. t Jeffreys, op. cit. p. 352. t Med. Exam., July, 1840, p. 401. § Dr. Jeffreys, Lond. Lancet, Jan. 5, 1839, p. 567. MATICO. 435 arteria ad cutem abdominis, which bled freely. He directed that an attempt should be made to arrest the hemorrhage by lint and pressure. After a trial of ten minutes, which totally failed, he directed moistened Matico leaves to be applied. The assistant re- ported in a few moments, that the Matico exerted no influence, and proposed to secure the bleeding vessel by ligature. Dr. Rus- chenberger now visited the patient, who had lost six or eight ounces of blood, and was still bleeding. Coarsely powdering some Matico leaves in the palm of his hand, he formed the mass into a paste with cold water. He then removed the clot, through which the arterial blood had formed a passage of the size of a crow's quill: the blood flowed per saltum, forming a jet at least three- fourths of an inch high. The paste was applied lightly with the fingers, and filled the wound. The surrounding skin was imme- diately sponged clean: the hemorrhage ceased instantly, and not a single drop of blood flowed afterwards. No pressure was used, nor dressing applied. On the first application, vvhich failed, the entire Matico leaf had been simply dipped in water, and applied. A cupper and leecher in Brooklyn, informed Dr. Ruschenberger, that he found the Matico, applied as described above, arrest instantly bleeding from leech-bites in children, which, before he obtained the leaves, often caused him great anxiety. He expressed himself perfectly satisfied, that there need be no difficulty in arresting he- morrhage from leech-bites where Matico can be obtained. Mr. Edward Young* has also found it a valuable agent in arresting the bleeding from leech-bites. When first introduced into England, it was found by Dr. Jef- freysy to possess the povver of controlling obstinate accidental hemorrhages; such as arose from leech-bites, the removal of naevi, incisions, &c, when the under side of the leaf was applied to the bleeding surface. Testimony of its haemastatie powers was also fur- nished by Dr. Kendrick,:[ Dr. Monroe,§ Dr. Scott, and others. Possessed apparently of such powers as a styptic, it was soon administered internally in cases where astringents appeared to be indicated. By Dr. Jeffreys and others, it was found to be valu- able in gonorrhoea, leucorrhoza, menorrhagia, hemorrhoids, catarrhus vesicoz, &c. In a case related by Dr. Jeffreys, the patient had been subject for two months to excessive discharges of blood and coagula from the vagina, occurring every ten days or a fortnight, and fol- lowed by a serous or muco-purulent discharge. The usual treat- ment had been unsuccessful; when a wine-glassful of infusion of Matico was given foqr times daily; and in ten days she recovered * Dublin Hospital Gazette, cited in Braithwaite's Retrospect, xii. 179, Amer. edit. New York, 1800. t London Lancet, Jan. 5, 1839, p. 567, and Transactions of the Provincial Medical and Surgical Association, xi. 347. Lond. 1843. X Jeffreys, op. cit p. 357. § Provincial Med. and Surg. Joum. June 18,1842, p. 209, and London and Edinburgh Monthly Journal of Medical Science, Aug. 1842, p. 737. 436 MATICO. from all severe symptoms. In another case of discharge of blood from the bowels, with scarcely any feculent matter in the evacu- ations, a decoction of Matico, in the proportion of half an ounce to the pint, was prescribed, of which two table-spoonfuls were taken every four or six hours. Three doses were sufficient for the cure. Dr. Hunter Lane* found the infusion and tincture very ser- viceable in similar cases. In chronic diarrhoza, it did not prove of very eminent service, but as an injection in leucorrhoza, it had, he thought, all the advantages, and none of the disadvantages, of a solution of nitrate of silver. He also found it serviceable in me- norrhagia, and in the varicose and ulcerated condition of the reQtum for vvhich Dr. Houston proposes the topical application of nitric acid.y (See Acidum Nitricum, in the supplement.) Mr. Butler| used the Matico infusion internally, and by injection, with the best results in two cases of uterine hemorrhage accompanying abortion. Mr. Edward Young§ also found great benefit from it in leucorrhoza,\n the form of injection, made by boiling an ounce of the leaves in a pint of water for ten minutes; and he considers it unsurpassed as an external application in hemorrhoids, when made into an oint- ment with opium, according to the form given hereafter, and ap- plied night and morning. Dr. Ruschenberger used the tincture advantageously in a case of hozmatemesis, after other plans of treatment had been resorted to in- effectually. In several cases of gonorrhoea, its impression was very slight. He does not think it equal to cubebs. He used the syrup in teaspoonful doses, with decided advantage, in leucorrhoza of long standing. In certain cases of chronic ophthalmia, where astringent applications were indicated, he prescribed the watery infusion, dilute tincture, and watery solution of the extract, and in every case with beneficial results. From the whole of the testimony, then, there is encouragement to expect beneficial results from the Matico. The difficulty, how- ever, of establishing the action of styptics is considerable, as is sufficiently exemplified in the history of the Acqua Binelli, (q. v.,) and the Acqua Brocchieri, (q. v.) The same difficulty likewise exists in regard to the determination of its powers as an internal astringent. After the discharge of an uncertain amount of blood, hemorrhage generally ceases spontaneously; and hence any article that may have been administered, may acquire a haemastatie repu- tation. This probably is the history of the employment of chloride of sodium to check the flow of blood in haemoptysis. Doubtless, however, Matico is worthy of more extensive trials, although its sensible properties, taken alone, would not encourage us to place more faith in it than in the overrated haemastatie 'Waters' re- ferred to. * Lond. Med. Gazette, Oct. 6, 1843, p. 9. t See, on this subject, Dr. O'Ferrall, Dublin Hospital Gazette, Oct 1, 1845; cited in Braithwaite's Retrospect, xii. 203, Amer. edit New York, 1846. X London Lancet, Jan. 18, 1845, p. 73. § Op. cit. MATICO. 437 MODE OF ADMINISTRATION. Matico may be given internally in powder, in the dose of from half a dram to a dram, in infusion, decoction, tincture, syrup, or extract. Externally, it has been employed in the three first forms; and also in ointment. In epistaxis, the powdered herb, used as snuff, has been found a convenient mode of application.* Infusum piperis angnstifolii. Infusion of matico. R. Piper, angustifol. fol. gj. Aqua? bullientis Oj. Infuse for two hours. Dose, two table-spoonfuls twice or thrice a day, or oftener. Jeffreys. Decoctum piperis angnstif olii. Decoction of matico. R. Piperis angustifol. gj. Aquas----Oj. Boil for ten or fifteen minutes, and strain. Dose the same as that of the infusion. Jeffreys. Tinctura piperis angustifolii. Tincture of matico. R. Piperis angustifolii fol. giij. Alcohol, dilut. Oj. Digest for fourteen days, and filter. Dose from 30 to 60 drops in water. „ Jeffreys. Syrupus piperis angustifolii. Syrup of matico. R. Piperis angustifol. fol. %iv. Alcohol, dilut. Oj. Exhaust by displacement; evaporate to one half, and add the proper quantity of sugar. Dose, a tea-spoonful or two. Ruschenberger. Extractum piperis angustifolii. Extract of matico. This is made by treating Matico with alcohol and with water successively, and reducing to the consistence of a fluid extract. Dose—ten to twenty grains. Ruschenberger. Unguentum piperis angustifolii et opii. Ointment of matico and opium. R. Piper, angustifol. fol. pulv. ^iij. Opii pulv. gr. iij. Adipis gi. M. Applied night and morning in hemorrhoids. Young. * Dr. Jeffreys, Provincial Med. and Surg. Journal, June 12, 1844, p. 161. 438 MONESIA. CIX. MONESIA. This vegetable substance has been imported into Europe, from South America, within the last few years, and, in consequence of the trials that have been made with it, by the French practitioners more especially, it was introduced in the 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 vvhich 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 employment of an extract, which the natives made from the bark of a tree of the country, determined to import it into France, and to submit it to the experiments of his medical and pharmaceu- tical countrymen.f 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 charac- ters of the extract previously sent to him, and identical in its com- position. This bark is said by M. Derosne to be called by some travellers Goharem, and, by others, Buranhem; and the naturalists, who have examined it there, think that the tree which furnished 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 la- minae that are detached from the plane tree. The extract—monesia —is of a deep brown colour. It is very friable, and its fracture presents the same appearance as that of a well torrefied cacao nut. It is wholly soluble in water, and its taste,—which is at first sweet like liquorice,—soon becomes astringent, and leaves behind a well-marked and enduring acrid impression, which is felt especially in the tonsils. Chemical analysis of the bark has detected the following sepa- rate principles:—chlorophyll; vegetable wax; fatty and crystal- lizable matter; glycyrrhizin; an acrid and slightly bitter mat- ter; a little tannic acid; an organic acid, not studied; a red colour- ing matter, analogous to that of cinchona; phosphates of lime and * Martin Saint-Ange, Gazette Medicale de Paris, Oct. 19,1839. 1 Bernard Derosne, Notice sur le Monesia. , Paris, 1839; and Siemond, Lond. Lancet, 1840. X See a translation of a communication by M. Saint-Ange, in Lond. Med. Gaz. Dec 20, 1839, p. 491; in American Journal of Pharmacy. July, 1840, and in Dunglison's Amer. Med. Intel. March, 1840, p. 303. MONESIA. 439 magnesia; and salts of lime, with an organic acid.* The extract— monesia—contains nearly 8 per cent, of glycyrrhizin, and 20 per cent. of acrid matter (monesin;) 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 Sci- ences of Paris, gave the following as the constituents of the ex- tract:—tannic acid, rendering iron blue, 52; gum or mucilage, 10; sweet matter, 36 ; loss, 2. It has been recently suggested, that the bark of the tree, which furnishes monesia, is identical with that of the quillaia sapo- naria of Chili. Neither the bark nor the extract would seem, however, to be identical, although in certain respects they re- semble 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 able chemical analysts.| EFFECTS ON THE ECONOMY IN HEALTH. When monesia is exhibited internally, in the dose of from 15 grains to a scruple daily, for eight or ten days, it exerts at first a direct operation on the digestive passages, and accelerates in a re- markable manner the action of the stomach. If the dose be pushed to a dram or more in the day, and it be continued for fif- teen or twenty days, the appetite increases, but a feeling of heat is experienced in the epigastric region ; and tenesmus and obsti- nate constipation may likewise supervene.§ Its action is mani- festly excitant, and slightly astringent, and as such it may be adapted for many pathological conditions in which such agencies are indicated. EFFECTS ON THE ECONOMY IN DISEASE. Being 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 bronchorrhcea, it has been successfully employed by Alquie, Daynac, 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 hozmoptysis, according to Alquie. On phthisis, it of course exerted no direct efficacy; but * Bernard Derosne, and O. Henry, in Notice sur le Monesia, par B. Derosne; and in Tableau Synoptique, &c, du Monesia, par M. Saint-Ange. See, also, Saint-Ange, in op. cit, and MM. Bernard Derosne, O. Henry, and J. F. Payen, in Journal de Pharmacie, Janvier, 1841, p. 20, and in Journ. des Connois. Med. Chir. Jan. 1841. t 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. Quillaia; and the analysis of the Quillaia, by Boutron, Charlard, and Henry, fils, in Journal de Pharmacie, xiv. p. i>47; and in Amer. Journ. of Pharmacy, for Oct. 1840, p. 210, with remarks by Dr. Car- son, the editor. § Martin Saint-Ange, op. cit 440 MONESIA. its administration appears 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 a tonic to females, who have been exhausted either by antecedent maladies, or by uterine hemorrhage. In one case,* where the debility was so great that syncope was induced on the last movement of the body, the extract was given in pills in the dose of sixteen 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 advantage. Its success is said to have been most marked in diarrhoza, especially when owing to improper diet, and several fortunate results have been published by M. Adrien;f and by Dr. Q. Gibbon, of Salem, N. J.| Even in the colliquative diarrhoza of phthisis it has acted beneficially. B. Derosne affirms, that surprising results have followed its administration in the diarrhoza of phthisis with intestinal ulceration, after all astringents had been employed to no purpose. Notwithstanding the disadvantageous circumstances in such cases, monesia is said to have constantly mastered the diarrhoea. Dr. Joseph G. Nancrede,§ gave it suc- cessfully in a case of diarrhoza of long standing, and Dr. Burns|| in two cases of chronic diarrhoza succeeding to cholera infantum. In leucorrhoza, the efficacy of monesia, as of every other astringent, is less marked than in diarrhoea. Where the internal treatment is alone employed, the astringent has probably to pass into the mass of blood, and in this manner to act upon the parts concerned, whilst in every form of chronic enteritis, it can come into imme- diate contact with the seat of the disease. Injections of monesia have accordingly been more advantageous in leucorrhoea. M. Baron, after having employed all the ordinary means in a case of in- flammation of the vagina, had recourse to them, and arrested the dis- charge. M. Payen gives a case in vvhich, vvhen taken internally, it 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 flow more perfectly than any other agent. It has been given, with excellent effects, in these <;ases 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. Chalonerl" administered the extract in the dose of three grains in the form of pill, every hour and a half, until an effect on the discharge was manifest. After three pills had been * Bernard Derosne, Notice sur le Monesia, p. 7. t Journ. des Connoiss. Med. Chirurg. Nov. 1840. X Dunglison's American Medical Library, Jan. 1842, p. 143. § Medical Examiner, April 4, 1840, p. 215. II Ibid. Au;r. 15,1840, p. 517. IT Ibid, July 11,1840, p. 441. MONESIA. 441 taken, benefit was experienced, and the patient was then 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.* In blennorrhoea, 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 diminish- ed the amount of the discharge in the other half.f In a case of well marked scorbutus, with petechias of the inferior extremities, soft and bleeding gums, and frequent epistaxis, wmich had required plugging of the nasal fossae, 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 scrofula, the tincture was used internally by M. Daynac, and with excellent effects. In ulcers of a bad character, monesia has been applied externally with advantage;—sometimes, in the form of ointment; at others, of the powdered extract. In venereal and scrofulous ulcers, ex- cellent effects were obtained from it by MM. Baron and Martin Saint-Ange. M. Manec used it with benefit in an obstinate ser- piginous ulcer of long duration. M. Monod cured a phagedenic ulcer by it, vvhich had resisted the use of the nitrate of mercury and the arsenical paste. M. Payen was equally successful 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 cases of stoma- titis,^ one of a gangrenous character; and in cases of fissure of the anus, the result of inflammation from hemorrhoids. Two cases of purulent ophthalmia were cured by M. Saint-Ange; and M. Laurand was equally fortunate in a case of gangrenous sloughs on the region of the sacrum. M. Buchey, surgeon den- tist, has employed the extract of monesia in cases of caries of the teeth, the progress of which it appeared to him to retard, and, vvhen united with opium, it seemed to assuage the pain more than vvhen the latter was given singly. He recommends the use of the tincture to maintain a good state of the gums.§ Such are the chief diseases in which 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 de- rived from it as an astringent.|| Still, it is not much used. * Medical Examiner, August 15, p. 517. t Martin Saint-Ange, op. cit. X See, also, J. G. Nancrede, op. cit. § Bernard Derosne, Notice sur le Monesia, &c. &c. || Sigmond, op. cit. See, also, Forget, Bulletin General de Therapeutique, Avril, 1839. 442 MORPHIA. MODE OF ADMINISTRATION. Monesia is generally given in pills 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 Hvdro-alcoholic Tincture, which contains thirty-two grains to the ounce^ has been most commonly used in injections, in the proportion of a dram to a dram and a half, to six ounces of water. It has also been prescribed internally 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 monesia, has been applied to ulcers; at others, pow- dered monesia; and at others again, the acrid matter itself referred to in the analysis. MOR'PHTA ET EJUS SALES. Synonymes. Morphia and its Salts. French. Morphine et Sels de morphine. German. Morphin und Morphinsalze. CX. MOR'PHIA. Synonymes. Morphina, Morphinum, Morphium, Morpheum, Morphine, Papaverine.* German. Morphin, Mohnstoff, Opiumalkaloid. The discovery of this principle is ascribed to Seguin and Sertiir- ner, who were engaged in the chemical analysis of opium up- wards of forty 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 attention of chemists and physicians. METHOD OF PREPARING. The following is M. Robiquet's method.f He boils a very concentrated 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 al- cohol for some tifte, at a temperature short of ebullition; by vvhich means a very small quantity of morphia, and a considerable quan- tity of colouring matter, are separated. The liquid is then filtered, * Jahn's Handworterbuch der Chimie, B. iii. S. 150. I Annates de Chimie et de Physiq. v. 276. MORPHIA. 443 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 morphia is obtained, which by repeated crystallization 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. 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 precipi- tate is thrown down, which contains only traces of morphia and narcotina. The liquor is filtered, and by the addition of a fresh quantity of ammonia to it vvhen cold, crystalline morphia is thrown down, which, vvhen collected, dissolved in alcohol, and evaporated, is set aside to crystallize.* Dr. Wood regards the process of the U. S. Pharmacopoeia 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.| 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 crys- tallize; the crystals are strongly pressed to squeeze out the mother liquor, which contains narcotina and other impurities. The pressed crystals are then purified by solution, crystallization, and the action of animal charcoal, till they are obtained colourless; they consist of the chlorohydrates of morphia and codeia; these are dis- solved in hot water, and ammonia is added, vvhich throws down morphia, and which, being separated upon a filter, may be redis- solved in boiling alcohol, and obtained in crystals. The liquor, from which the morphia has been precipitated, contains codeia, together with chlorohydrate of ammonia, and some morphia; it must be evaporated until it crystallizes, and the crystallized mass must be dissolved in a small quantity of water, and be decomposed by excess of a solution of caustic potassa ; codeia is thrown down, and, vvhen redissolved in ether, may be obtained in crystals. See Codeia, p. 183. In the London Pharmacopoeia, morphia is directed to be prepared from the hydrochlorate or muriate. Take of Hydrochlorate of mor- phia, %}; Solution of ammonia, f. 5v.; Distilled water, Oj.; (imperial * Journal de Pharmacie, x. 479. t Vol. i. p. )5: see Dispensatory of the United States, 6th edit p. 1035. Philad. 1845. For Fame's process, see Journal of the Philadelphia College of Pharmacy, ii. 71. Philad. 1831; and for Mohr's process, Journal de Pharmacie, cited in American Journal of Phar- macy, April, 1841, p. 60. X Dictionary of Materia Medica, p. 383. Lond. 1839. 444 MORPHIA. measure.) Add the hydrochlorate of morphia, dissolved in a pint of water, to the solution of ammonia diluted with an ounce of wa- ter, and agitate. Wash the precipitate with distilled water, and dry it with a gentle heat. Tilloy, Petit, and others, have obtained morphia on the large scale from domestic opium.* The crystals are completely white, translucent, almost trans- parent, and slightly opaline; they are wholly inodorous. In the form of powder, morphia is of loose texture, and as fine as magnesia. It melts at a trifling degree of heat, and very much resembles in this state melted sulphur; but crystallizes again on cooling. It is sparingly soluble in hot water; and in cold water scarcely at all so. Boiling water, according to Choulant, dissolves one eighty- second part; according to Jahn, only one four-hundredth; and according to Bally,y it is even less soluble than strychnia, which, he says, requires 6000 parts of water for its solution. It is more readily soluble in alcohol, and still more so in ether, as well as in fixed and volatile oils: the solutions have a nauseous, bitter taste. It is alkaline in its nature. The crystals appear to be rectangu- lar four-sided prisms. With all the acids, it forms peculiar, readily soluble, and very bitter salts, of which the sulphate, acetate, and muriate are the most used. EFFECTS ON THE ECONOMY IN HEALTH. Generally—it has been affirmed—morphia acts on the nervous system like opium, but does not exert the same agency on the vascular system. Magendie! asserts, that it possesses all the ad- vantages of opium without any of its disadvantages. Bally§ took especial pains to investigate the effects of morphia on the organ- ism, and the results were communicated to the Academie Royale de Medecine, of Paris. The most striking was its action on the brain, which, when sufficient doses were administered, appeared to cause death by sanguineous apoplexy, as Bally had an opportu- nity of observing, in one case, on dissection. In this, there were no traces of injection of the membranes of the brain, whilst under the arachnoid much albuminous serum was effused, and there was an extravasation of blood into the left hemisphere of the brain. This result is especially to be apprehended in those persons who have experienced an apoplectic attack previously. Bally found, moreover—which does not accord with our experience— that morphia was more soothing and soporific in small doses than in larger. It occasioned, in the latter case, cerebral confusion, vertigo, perversion of the senses, and a feeling of electric agency, which commenced in different parts of the trunk, and also in the * Art. Morphine, in Merat and De Lens, Diet, de Mat. Med. t Memoires de 1'Academie Royale de Medecine, i. 99. X Formulaire pour la Preparation, &c. de plusieurs nouveaux Medicamens. § Revue Medicale, F6v. 1824; and Mem. de la Societe Royale de Medecine, i. 142. MORPHIA. 445 extremities ; but no delirium supervened, and the intellectual facul- ties experienced no alteration. In consequence of these effects on the sensorium, the energy of the motory apparatus suffered. By long administration, morphia, like opium, excited troublesome tre- mors. Bally found the pupils contracted under its use when larger doses were given, vvhich is entirely opposed to the ordinary effect of narcotic agents. Not unfrequently, when mor- phia was continued, the soothing and soporific effect was pre- ceded, for some days, by restlessness, and loss of sleep. Very often it excited headach. On the vascular system it did not act as an excitant—neither rendering the pulse quicker, more frequent, nor tenser. The opposite effect seemed, indeed, to be induced. It has no action, Bally affirms, as an emmenagogue; produces no diaphoresis—vvhich does not, by the way, at all accord with the author's observation—does not even augment the animal heat, or redden the face, but frequently causes itching either over the whole surface of the body or topically; in the latter case, the sen- sation being chiefly felt in the face, neck, loins or genitals. At times, the itching is associated with an eruption of conical wheals or bumps, vvhich are either red or of the ordinary colour of the skin, and can generally be detected more readily by the touch than the sight. On the organs of respiration, morphia exerts no influence; and as to its effects on the digestive organs, it may be remarked, that it has no agency on the mouth, pharynx, or oeso- phagus, except that ptyalism has been observed to result from it. The tongue is not made red or dry, nor are the tonsils. It does not excite thirst; but, at times, there is a sense of bitterness in the mouth, vvhich is a forerunner of its effects on the stomach. The appetite is not diminished, except vvhen its emetic properties are developed in a high degree. Vomiting is not caused by large doses only, but in many individuals by small doses, and it may be very violent. Commonly, morphia causes constipation, on vvhich, at times, diarrhoea supervenes. Very frequently, also, colic is in- duced by it. Morphia possesses, according to Bally, vermifuge properties. In men, he found it frequently excite ischuria, but not in women. The urine, however, exhibited no change of character.* The author's own view of its action—when no idiosyncrasy interferes with its ordinary operation—is, that it exerts a decided sedative influence on the nervous and sanguiferous systems; and this accords with the experiments instituted on animals by Mr. Blake.t He found, when it was introduced into the veins, that it exhibited its effects upon the heart, by rendering its pulsations slower, and diminishing the pressure of the arterial system. As in the case of opium, the system may, under excessive pain * Richter's Specielle Therapie, 2te Auflage, S. 358. Berlin, 1828. t Edinb. Medical and Surgical Journal, April, 1839, p. 344. 29 446 MORPHIJE ACETAS. or long continued use, be so habituated to its action as to bear very large doses. Mr. Lingen* of Hereford, has published a case in which a female, under a painful affection, took scruple, and, accord- ing to her own report, half dram doses of the acetate; and Mr. Teevan,f of London, one of a gentleman, labouring under a disease of the spinal cord, attended with violent spasms of the muscles of the chest, abdomen, and inferior extremities, who took, on one occasion, twenty-five grains in the twenty-four hours. EFFECTS ON THE ECONOMY IN DISEASE. Morphia, it is thought, may often be administered advantage- ously, not only where opium is indicated, but where it disagrees. Riecke,| remarks, that where diaphoresis is needed, it cannot sup- plant opium; but in this we apprehend he is mistaken, at least in febrile and inflammatory diseases. In such cases, the author has observed a sedative dose of opium succeed in restoring the cuta- neous transpiration more effectually than any other agent, by al- laying the pathological condition on which the suppression of per- spiration was dependent. With many persons, and in many cases, it possesses decided advantages over opium, but the author has often found where opium disagreed, that morphia and its prepara- tions did so likewise. As a general rule, it may be said, morphia is proper where opium, in sedative doses, is demanded; hence it is had recourse to in febrile and inflammatory diseases, where there is much pain or sleeplessness—singly or combined, and in the various neurotic affections. On account of the very sparing solubility of morphia in water, it is but seldom prescribed; although Bally, in opposition to many experimenters, asserts, that he has found it equally efficacious with its salts. As, however, this result is doubtless owing to the exis- tence of acid in the stomach, and, consequently, is liable to uncer- tainty, it is advisable to give the salts of morphia the preference. These are administered in nearly the same doses as pure morphia itself. It has been likewise proposed to inoculate with morphia and its salts. If the point of a lancet, dipped in an aqueous solution of morphia, be inserted horizontally about one line in depth be- neath the epidermis, and be allowed to remain there a few seconds, the following effects, according to M. Lafargue, are observed:— About a minute and a half after the operation, a small pimple ap- pears, with a diffuse rosy areola, and slight itching: in about twenty minutes, the pimple becomes about four lines in diameter, and one line in thickness, and is flattened : its colour is some- * London Lancet, Jan. 26, 1839, p. 680. t Ibid, for February 9,1839, p. 738. X Die neuern Arzneimittel, u. s. w. S. 327. MORPHIA. 447 what deeper than that of the skin; it is hard; the areola very red, and about an inch and a half in diameter; its heat is increased, but the sensation of itching remains about the same. During the first hour, the pimple and its areola are at the highest degree of development, after which they gradually disappear. The general effects, which M. Lafargue experienced from thirteen punctures thus made on the anterior part of his forearm, were,—heaviness of the head, frequent yawnings, clamminess of the mouth, and an invincible desire to sleep ; yet the quantity of muriate of morphia employed could not have exceeded a quarter of a grain. He con- siders that the inoculation of morphia may supersede the use of blisters and ammoniacal plasters, and that it deserves employment more particularly where the object of the physician is to produce the local effects of morphia. Its influences as a rubefacient are marked, and hence its probable utility in superficial neuralgia and in chronic rheumatism* The experiments of M. Lafargue were repeated by M. Martin Solon, with nearly the same results.f M. Jaques of Anvers,:}: and Dr.Castiglioni,§ an Italian physician, also recommended inoculation with morphia—the sulphate—in neuralgia. In one case, the (brmer made about 40 punctures over the seat of pain. The same plan was used in sciatica,—the inocu- lations being made the whole length of the sciatic nerve. Poul- tices are useful in subduing the irritation produced by the punc- tures. The latter employs the acetate in a similar manner. He uses a solution of three grains of the salt in half an ounce of dis- tilled water, and makes numerous punctures in the course of the affected nerve. Dr. A. T. Thomson|| has drawn the following con- clusions in regard to the utility of inoculation with the salts of morphia in certain articular affections. First. In painful, swollen, and contracted joints, depending on rheumatism, or other causes, the topical application of muriate or acetate of morphia to a blis- tered surface, on the affected joint, is capable of reducing the swell- ing, abating pain, and restoring the motion of the joints. Se- condly. Tbese salts seem to produce their beneficial results, by reducing the sensibility of the nerves of the joint, and favouring absorption by their counter-irritant influence. Thirdly. They do not act as narcotics until the joints are relieved (?): and fourthly, they frequently excite a pustular eruption over the body; but this appears spontaneously soon after the use of the topical application is discontinued. Mr. Rynd,!^ too, has found the inoculation of morphia trium- * Qi. Gibbon, Dunglison's American Medical Intelligencer, July, 1841, p. 1. 1 Bulletin de 1'Academie Royale de Medecine, Nos. 1 & 7, 1836-7. X Bouchardat, Annuaire de Therapeutique, pour 1844, p. 24. § Provincial Medical and Surgical Journal, July 3, 1844, p. 208. || London and Edinburgh Monthly Journal of Medical Science, Oct. 1845, p. 774. 11 Dublin Medical Press, March 12,1845, cited in Ranking's Abstract, pt. 7, p. 29, Amer. edit New York, 1845. 448 MORPHIA. phantly successful in rebellious casde of neuralgia. He associ- ates the acetate of morphia, however, with creasote; in the pro- portion of ten, or fifteen grains of the salt of morphia, to a dram of creasote. In a case of inveterate facial neuralgia, the solution was introduced into the supra-orbitar nerve, and along the course of the temporal, malar, and buccal nerves, by four punctures of an instrument made for the purpose. In the course of a minute, all pain, except that caused by the operation, vvhich was very slight, had ceased. In another case—of sciatic neuralgia.—the fluid was introduced by one puncture behind the trochanter, and another halfway down the thigh. The man was instantly relieved from pain. Should the pain return, the fluid must be again introduced. M. Ebrard, of Bourg,* has employed with signal success in the cure of toothache, the muriate of morphia in friction on the gum of the pained part. These frictions are made in the following man- ner. The patient takes upon the moistened extremity of his fingers, 13 milligrammes,—about one-fifth of a grain, Troy,—of the salt, and applies it for two or three minutes to the pained gum. Then, while inclining the head on that side, taking care not to swallow or eject the saliva which holds the salt of morphia dis- solved, he must allow the saliva to be in contact with the gum, for five or ten minutes. He may afterwards swallow the saliva. Should there be no relief, and symptoms of narcosis be absent after a period of two hours, the application may be repeated; but the repetition is rarely required. In frontal neuralgia, M. Ebrard has found a successful treat- ment to consist, in causing the patient to take as a pinch of snuff, from four-tenths, to three-fourths of a grain, of muriate of morphia. He advises, however, that great caution should be used in employ- ing this powerful agent. MODE OF ADMINISTRATION. Pure morphia is only given internally in the form of powder or of pill, beginning with from one-sixteenth to one-fourth of a grain once or twice a day, and gradually increasing the dose to a grain and a half. If its use have been discontinued for some days, the dose, when resumed, must be again small, and be gradually increased. Its salts—as is shown hereafter, have been introduced into the system both endermically, and iatraleiptically, and by ino- culation. Haustus morphiae. Draught of morphia. (Potio Narcotica.) R. Morphia gr. \. Syrup, papav. f. 31. M. Aq. destillat. f. gj" To be taken at bed-time. * Gazette des Hopitaux, cited in Amer. Journ. of the Med. Sciences, July, 1846, p. 220. MORPHIAS ACETAS. 449 Enema morphia1 Injection of morphia. (Injectio leniens.) R. Morphia gr. ij. 01. amygdal. 01. lilior. aa. gss. To allay pain in the ear, the suffering in acute blennorrhagia, and the tenesmus in hemorrhoids, &c. Brera.* Linimentum morphia. Liniment of morphia. R. Morphiae gr. iij. Solve in 01. amygdal. ,^i.—giss. To be rubbed on the neighbourhood of the eye, as an anodyne, in cases of cancerous and other painful affections of the eye. A. Poli.f CXI. MOR'PHLE ACE'TAS. Synonymes. Morphines Acetas, 'Morphium Aceticum, Acetas Morphii. Acetas Morphicus, Acetate of Morphia. French. Acetate de Morphine. German. Essigsaures Morphin, Morphiumacetat. METHOD OF PREPARING. Acetate of morphia may be obtained by mixing morphia, acetic acid and distilled water in an appropriate vessel, and gradually evaporating to dryness, at a temperature of about 90° Fahr.J This mode of preparation is required, owing to the diffi- culty of obtaining the acetate crystallized, in consequence of its extreme deliquescence. Crystallized acetate of morphia may, however, be prepared by dissolving morphia in alcohol, saturat- ing with acetic acid, filtering the solution, and evaporating gradu- ally in a vessel covered over with thin rag. The acetate crystal- lizes in an arborescent manner on the sides of the vessel. Acetate of morphia is one of the substances, which, in the ex- periments of Magendie,§ were found to promote the coagulation of the blood. This salt of morphia has been highly recommended in arthritis and nervous affections, by M. V. Cristin,|| of the Hospital St. John, Turin, according to a form given below. When the pains * Ricettario Clinico. Fadova, 1825. t C. G. Lincke, Vollstandiges Recept-Taschenbuch, u. s. w. ii. 238. Leipz. 1841. X Pharmacopoeia of the United States, p. 144. Philad. 1842. § Legons sur le Sang, &c, and translation, in London Lancet, Jan. 26,1839, p. 63 ">. || Repertorio Medico-chirurgico del Piemonte, cited in British and Foreign Medical Re- view, Jan. 1840, p. 252. 450 MORPHIA. are relieved, or sleep is about to commence, the intervals between the doses are increased, or it is suspended altogether. Its good effects in neuralgia have been extolled by many others;—the effect of the remedy being kept up for days and weeks, if necessary. Mr. Braithwaite* remarks, that Dr. Cristin prescribes it in the dose of one-tenth of a grain every hour, but that he has generally found it necessary to give much larger doses without any other bad effect than severe sickness, which was easily abated by creasote or excitants—as the spiritus ammonias aromaticus. He pre- scribes one-fourth or one-sixth of a grain every hour or two, in severe cases, until the system is completely under its influence, and then keeps up its effects by smaller, and less frequently re- peated, doses. It is questionable, hovvever, whether the acetate be superior to opium. Dr. Francis Gerard of Avignon, has found it so highly useful in Asiatic cholera, that he prefers it to all other remedies. Of ninety-nine patients, treated thereby, eighty- one were cured. He found, when given early, that it especially checked the vomiting, and moderated the subsequent reaction, after which the other symptoms gradually ceased. When, how- ever, the resources of art had been long postponed, the effects of the remedy were less marked; the vomiting and the other symp- toms persisted longer; the supervening reaction was much more tardy, and frequently ended in a state of collapse, which, under the most trifling imprudence, produced an unfortunate result. Gerard administered the acetate at first in the dose of one-fourth of a grain every half hour, until the serious symptoms were re- moved, and he omitted it as soon as the spasms and the diarrhoea and vomiting had ceased, or as soon as reaction ensued. Acetate of morphia has been much used endermically in the diseases mentioned under the head of Morphia. A quarter or half a grain or more is placed on some part of the skin whence the cuticle has been removed ; and it may be repeated, as the case may require. In the severer neuralgic and neurotic cases, the quantity applied in this way is sometimes very large. In a case of hydrophobia, re- ported by Dr. Burne,f of London, ten grains at a time were sprin- kled on a blistered surface with excellent tranquillizing effects. At times, when applied to a blistered surface for several days in succession, a papular eruption has been observed, which quickly becomes vesicular, proceeding from the edges of the blister, and gradually spreading over the entire surface.^ A case of traumatic tetanus has been published, which was cured by the internal and endermic use of the acetate.§ * Retrospect of Practical Medicine and Surgery, vol. i. Jan. to July, 1840,3d edit. p. 15. London, 1842. t London Medical Gazette, April 14, 1838.-^ X Dr. A. T. Thomson, in London Lancet, for Jan. 19, 1839, p. 632. § L. Piquot, Journ. des Connais. Med. Chirurg. Dec. 1840. MORPHIA ACETAS. 451 MODE OF ADMINISTRATION. The dose of this article is from a quarter of a grain and less, to a grain or more. Its strength does not vary materially from that of pure morphia. Liquor morphiae acetatis. Solution of acetate of morphia. R. Morphia? acetat. gr. xvj. Acid, acetic, f. gij. Aquae destillat. f. gvj. M. This formula was proposed by the author* as a substitute for the "gouttes calmantes" of Magendie,f which permit the depo- sition of the morphia when kept for a short time. The dose is from six to twenty-four drops. R. Morphia? acetat. gr. xvj. Acid, acetic, gtt iij. vel iv. Alcohol, f. gj. Aquas destillat. f. gj. Fiat solutio. Magendie. Mistura morphia; acetatis. Mixture of acetate of morphia. R. Morphias acetat. gr. i. Syrup, acacias f. §i. Aquae destillat. f. giv. M. Dose.—A spoonful every hour in arthritis and nervous affec- tions, until the pains are removed. Cristin. Syrupus morphia acetatis. Syrup of acetate of morphia. R. Morphias acetatis gr. iv. Syrupi simplic. Oi. Dissolve the salt in half a dram of water acidulated with a few drops of acetic acid; filter, and add it to the syrup. This syrup is recommended and used in Paris, in place of the syrupus papaveris. It has the advantage of being always of uni- form strength. , Magendie. It has been suggested,:}: that the syrup of the acetate or sulphate of morphia should always be made of the strength of one grain to the ounce; and it is certainly desirable that uniformity should prevail in this respect. If this exist, it matters but little what the proportion is, within certain limits. The acetate may, also, be applied in the form of ointment ; and it is frequently added to glysters, in chronic diarrhoea. Hilden- brand recommends the following ointment to be rubbed on the pubes in cancer of the uterus:— * Formulary, &c., translated from Magendie, by C. T. Haden, Esq. 2d edit, by Robley Dunglison, M. D., p. 14. Lond. 1824. Amer. edit Philad. 1825. t Formulary, &c. X A. Duhamel, Amer. Joum. of Pharmacy, for Oct 1840, p. 187. 452 M0RPHL2E HYDRIODAS. Unguentum morphia; acetatis. Ointment of acetate of morphia. R. Morphias acetat. gr. iv. Ung. hydrarg. ciner. ----simpl. aa. gij. A piece, the size of a pea, to be rubbed on twice daily. A solution of acetate of morphia, which he terms liquor opii, has been proposed by Mr. Houlton.* He prepares it as follows:— Take two ounces and a half of the best Turkey opium; thirty- two fluidounces of Beaufoy's acid of the strength of pickling vinegar: macerate with a gentle heat for six days, frequently shaking the vessel; then filter, and evaporate the fluid to the con- sistence of the extracts of the pharmacopoeia, finishing the evapora- tion by the spontaneous method. This Mr. Houlton employs under the name extractum opii aceticum. To the above extract he adds alcohol, five fluidounces; distilled water, thirty-five fluid- ounces; macerating for eight days, and filtering. This liquor opii is about the strength of the tinctura opii in se- dative property, and Mr. Houlton affirms, from his observations, that it is in no respect inferior to Battley's liquor opii sedativus,— a secret preparation which has been much used. CXII. MORP'HI^ HYDRFODAS. Synonymes. Hydriodate or Iodhydrate of Morphia—called by some Iodide or Ioduret of Morphia. French. Iodhydrate ou Hydriodate de Morphine. German. Iodwasserstoffsaures Morphin. An Ioduret or Iodide of Iodhydrate of Morphia, has been introduced of late. It is prepared by mixing a solution of acid sulphate of morphia, with a solution of ioduretted iodide of po- tassium, keeping the liquors for an hour at a temperature of 140°: the liquid is then poured off; and the residuum washed, collected on a filter, and dried. The iodide of hydriodate of morphia is in small brilliant spangles, (paillettes,) of a beautiful deep purple colour. It is insoluble in water, very soluble in alcohol, and very little so in ether. It ap- peared from the few trials made of it by M. Bouchardat,y to possess the narcotic properties of morphia; without diminishing the appetite. It requires to be given in double the dose of the other preparations of morphia. * Lond. Medical Gazette, Aug. 12, 1837. See, also, M. Buchner, pere, in Journal de Pharmacie, Fevrier, 1842, p. 48. t Nouveau Formulaire Magistral, p. 70. Paris, 1845. MORPHIA murias. 453 CXIII. MOR'PHIiE MU'RIAS. Synonymes. Morphinas Murias, M. Hydrochloras, Morphias Hydrochloras, Morphium Muriaticum, Chlorhydras Morphicus, Hydrochloras Mor- phicus, Murias Morphii, Muriate of Morphia, Hydrochlorate of Morphia or Morphine. French. Hydrochlorate ou Muriate de Morphine. German. Salzsaures Morphin, Hydrochlorsaures Morphin. METHOD OF PREPARING. According to the last Pharmacopoeia of the United States, the muriate of morphia is prepared as follows:—Take of morphia in powder, ^i.; distilled xcaler Oss.; muriatic acid, a sufficient quan- tity. Mix the morphia with the water, then carefully drop in the acid, constantly stirring till the morphia is saturated and dis- solved. Evaporate the solution by means of a water bath, so that it may crystallize on cooling. Dry the crystals on bibulous pa- per. In the London and Edinburgh Pharmacopoeias, morphia is first separated from opium in the form of the muriate.* Muriate of morphia is in snow-white feathery crystals, which are wholly soluble in water. MODE OF ADMINISTRATION. It may be given in the same cases and doses as the other salts of morpbia. The following preparations are directed in the Edinburgh Pharmacopoeia:— Trochisci morphia. Morphia lozenges. R. Morphias muriat. £i. Tinct. tolut. f. gss. Sacchar. §xxv. Dissolve the muriate of morphia in a little hot water; mix it and the tincture of tolu with the sugar; and with a sufficiency of mucilage form a proper mass for making lozenges; each of which should weigh about 15 grains.f Each lozenge contains about one-fourth of a grain of muriate of morphia. Dr. Pereiraf states, that the morphia lozenges of the shops usually contain one-twenty- fourth of a grain of the muriate. It is a good mode of employ- ing morphia with the view of allaying cough. *■ * For Dr. Wm. Gregory's mode of preparing the muriate, see Edinb. Med. and Surg. Journal, for April, 1831; Amer. Journal for August, 1831, p. 531; or Philad. Journal of Pharmacy, iii. 124. See, also, Mr. M. Robertson, in Edinb. Med. and Surg. Journal, for April, 1832; and Dr. A. T. Thomson, Lond. Pharmaceut. Journ. and Transact, or Amer. Journ. of Pharmacy, July, 1842, p. 154. t Christison, Dispensatory, p. 643. Edinb. 1842. X Elements of Mat. Med. and Therap. ii. 1782. Lond. 1842; or 2d American edition, by Dr. Carson. Philad. 184(5. 454 MORPHINE SULPHAS. Trochisci morphiae et ipecacuanhas Morphia and ipecacuanha lozenges. R. Morphise muriat. Qi. Ipecac, in pulv. subtil, gi. Tinct. tolut. f. gss. Sacohar. §xxv. Proceed as for Trochisci Morphiae. Each lozenge contains about one-fourth of a grain of muriate of morphia, and one-thirteenth of a grain of ipecacuanha. They are used in the same cases as the last. CXIV. MOR'PHLE SULPHAS. Synonymes. Morphina? Sulphas, Morphium Sulphuricum, Sulphas Morphii, Sulphas Morphicus, Sulphate of Morphia or Morphine. French. Sulfate de Morphine. German. Schwefelsaures Morphin, Morphinsulphat. METHOD OF PREPARING. Morphia is dissolved in dilute sulphuric acid. The solution is then evaporated by heat, and suffered to crystallize, which it does in silken tufts, or snow-white feathery crystals that are wholly soluble in water. EFFECTS ON THE ECONOMY. The general effects on the economy in health and disease re- semble those of acetate of morphia, to which it is perhaps to be preferred on account of its greater uniformity. There is an ad- vantage, however, in retaining both preparations in the Materia Medica, as when the system becomes accustomed to the one, the other may be substituted. In his experiments on the blood, Magendie* found that the sulphate of morphia—unlike the acetate and the muriate—op- posed the coagulation of that fluid. A syrupus morphiaz sulphatis, a liquor morphiaz sulphatis, and an unguentum morphiaz sulphatis may be formed in the same manner as with acetate of morphia. The common form for the solution of sulphate of morphia is the following; it is that of the Phar- macopoeia of the United States; and it is to be regretted, that the strength is not the same as that of the Liquor morphiaz Acetatis. Liquor morphiae sulphatis. Solution of sulphate of morphia. R. Morphiae sulph. gr. viii. Aquse destillat. Oss. Fiat solutio. Dose.—A tea-spoonful (which is considered to be equivalent to * Leeons sur le Sang, &c.; or translation in London Lancet, January 26, 1839. MORPHIJE SULPHAS. 455 about twelve or fourteen drops of laudanum,) to be repeated as occasion may require. Lotio morphiae sulphatis et sodae horatis. Lotion of sulphate of morphia and borate of soda. R. Morphiae sulphat. gr. vj. Sodae borat. gss. Aqua? rosee f. §viij. JM. To be applied thrice a day to the affected parts by means of a piece of sponge, or a piece of linen, in pruritus vulvas, taking the precaution first to wash the surface with tepid water and soap, and to dry them before applying the lotion. Meigs* Citrate of Morphia is occasionally used; but it possesses no advantage over the preparations described above. Many years ago, Dr. Porter, of Bristol, recommended a liquor morphiae citra- tis to be prepared in the following manner:—Beat four ounces of the best crude opium in a mortar, with two ounces of crystallized citric acid; mix well with a pint of boiling water; and filter after twenty-four hours' maceration. Dr. Paris speaks well of this preparation.f Magendie recommends the substitution of the fol- lowing process: R. Morphias pur. gr. xvj. Acid, citric, crystalliz. gr. viij. Aquae destillat. f. §j. Tinct. cocci, q. s. Fiat solutio. Dose.—Six to twenty-four drops in the twenty-four hours. A Tartrate of Morphia was suggested by Mr. Hadenj: as a substitute for the liquor opii sedativus, of Battley. Mr. Haden made it by macerating the dregs, remaining after making the tincture of opium, in a solution of tartaric acid. Forty drops acted in all respects like twenty of the liquor opii sedativus. It neither stimulated nor induced costiveness. The bimeconate of morphia has been brought before the no- tice of the profession by Mr. Squire.§ It may be prepared by adding freshly precipitated morphia, to meconic acid in solution. It occurs in minute crystals of a white colour, soluble in water, —the solution giving the reaction due to meconic acid and mor- phia. It is an acid salt; for meconic acid is tribasic; and in the bimeconate of morphia, there are two equivalents of morphia, and one equivalent of water to each equivalent of acid.|| * A Treatise on the Diseases and Special Hygiene of Females, by Colombat de l'lsere; translated by Dr. C. D. Meigs, p. 272. Philad. 1845. t Pharmacologia, 4th Amer. from 7th Lond. edit. By Dr. J. B. Beck, p. 439. New York, 1831. X Translation of Magendie's Formulary, 2d edit. By Robley Dunghson, M. D. &c., p. 19. Lond.'1824. § Lond. Med. Gaz., Mar. 9, 1839. ' || Ballard and Garrod, Elements of Mat. Med. and Therap. p. 406. Lond. 1845. 456 moxa. Impressed with the idea, that the combination of the active principle of opium, as prepared by nature, would prove more be- neficial as a therapeutical agent than the artificial salts, Mr. Squire instituted a number of experiments, with the view of procuring the bimeconate as free from the other ingredients of opium as pos- sible; and he asserts, that at length he obtained a tolerably pure salt, which, from the trials that have been made with it, has fully answered his expectations as to its superior medicinal power over the other preparations of opium. The salt is given in solution made nearly of the same strength as laudanum. The dose of the bimeconate is gr. i and upwards. Dr. Macleod, who made trial of it, asserts, that it appeared to him to be a very mild and efficient preparation, rarely producing headach or other discomfort; and that it repeatedly answered, in the most satisfactory manner, where opium had disagreed, and suc- ceeded in some cases where other salts of morphia—the acetate and the muriate—had failed to give relief. Equally strong testi- mony in its fayour is afforded by Dr. A. T. Thomson, who de- tails three cases—one of neuralgic pain of the left side of the face; another of wakefulness, without any apparent cause, and a third of anomalous pain of the hip and thigh, all benefited strikingly by its use. A preparation termed M-Munn's Elixir of Opium has been recently introduced into American practice with many testimo- nials in its favour; but the formula for its preparation is kept se- cret; and therefore, it merits no farther notice here. M. Bouchardat* speaks of a double muriate of morphia and codeia; French, Chlorhydrate double de morphine et de codeine ou Sel de Gregory, which is obtained directly in the preparation of morphia by the process of Dr. Gregory. It is not used in France, but, he says, it is much employed in England,[?] where it is considered to enjoy decidedly sedative properties. It is given in the same cases as the salts of morphia, from which it differs but little. CXV. MOXA. Synonyme. Moxiburium. By the term moxa, the Chinese and Japanese designate a cot- tony substance, vvhich they prepare by beating the dried leaves of Artemisia Chinensis, a kind of Mugwort. Dr. Lindley, how- ever, states, that it is made from A. moxa.t With this down they * Nouveau Formulaire Magistral, p. 70. Paris, 1845. t Flor. Med. 463. M0XA. 457 form a cone, vvhich is placed upon the part intended to be cauter- ized, 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* whoi had resided in India. It fell again, hovvever, into disuse, until at- tention was redirected to it, during the last century, by Pouteauf and Dujardin, and, at the commencement of this century, by Percy and Laurent,t and others.§ METHOD OF PREPARING. Various agents have been used by different people, in "moxi- bustion,"—for so the mode of cauterization has been termed, which consists in 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;1" the Indian, the pith of the reed,** and flax or hemp impregnated with some combustible material ;tt 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 Ostiaksjj|| and the Laplanders,H1T the agaric of the birch; and the aborigines of this continent, rotten and dried wood. Hippocrates*"* was in the habit of employing fungi and flax for the same purpose. In modern times, also, various substances have been used for the fabrication of 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—vvhich 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 used in the French Hospitals.ttt The * Ten Rhyne, Medit. de Veteri Medicin.; Dissert de Arthritide, Lugd. Bat. 1672; and Ksmpfer's History of Japan, translated by Scheuchzer, vol. ii. append, sect. iv. Lond. 1728. \ Melanges de Chirurgie, p. 49. { Dictionaire des Sciences Medicales, art. Moxibustion. § See, for a history of the moxa, the author's translation of Baron Larrey's Memoir on the Use of the Moxa. Lond. 1322. || Hippoc. lib. de Affect, cap. xxx. IT Paulus ^Eginet lib. vi. cap. 49. ** Kcempfer, vol. ii app. sect. iv. p. 36. It Bontius de Medicina Indorum, p. 32. XX Percy, in Pyrotechnie Chirurgicale Pratique, p. 12. §§ Prosper. Alpin. de Medicin^ ^Egyptiorum, lib. iii. cap. 12. || || Voyages de M. Pallas, iv. 68. 1T1F Acerbi's Travels through Sweden, Finland, and Lapland, ii. 291; and Linnaeus, in Lachesis Lapponica, translated by Sir James Smith, i. 274. *** De Affect, cap. viii tit Bulletin General de Therapeutique, Juillet, 1840. 458 MOXA. match used by artillerists was recommended by Percy,* after Bontius:f it is composed of hemp steeped in a solution of nitre. He likewise proposed the pith of the sun-flower—helianthus an- imus—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, fee called moxa de voleurs.§ These moxas, called Percy's moxas, prepared by Robinet, are usually found in the London shops. They consist of pith, rolled in cotton and enveloped in muslin.|| 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 a piece of fine linen, which is fastened at the side by a few stitches. Lar- rey 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, vvhen above six lines high, the combustion is not felt—and about four or five lines broad. The moxas, employed by Dr. Sadler,H 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 sun-flower, wrapped in layers of cotton, of various thickness, and surrounded with an external envelope of thin mus- lin; both of the latter being previously steeped in a,solution of nitre. They are held, while burning, by means of two long hair pins, the legs of which are slightly bent, in order to accom- modate 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, Larrey** 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. Mr. Leneytt soaks a piece of lint in a strong solution of nitrate of po- tassa, dries it, and cuts off pieces of the size of the thumb nail, vvhich he fastens with thin adhesive plaster over the seat of pain; sets fire to the opposite extremity, and then applies the blow-pipe. The pain during the process is very severe, but he aflirms, that the Irish prefer it greatly to the application of a blister. Pro- fessor Grafe^| employs moxas made of wafers, dipped in a mixture * Op. cit. p. 77. Paris,"1811. t Op. cit. p. 32. Paris, 1645. X Art. Moxibustion, in Diet, des Sciences Medicales. \ Merat and De Lens, Diet, de Mat. Med., art Moxa. || Pereira, Elements of Mat. Med. 2d edit. p. 1352. Lond. 1842; or 2d Amer. edit, by Dr. Carson. Philad. 1846. TT Zeitschrift fur die gesammte Medicin. B. iii. H. ii. & iii., and British and For. Med. Review, July, 1837, p. 217. ** The author's translation of his Essay on the Moxa, p. 5. tt Lond. Med. Gaz., July 15,1842. ' XX La Lancette Frangaise, Jan. 26, 1839. MOXA. 459 of three parts of oil of turpentine, and one part of sulphuric ether. Before applying this inflammable matter to the skin, it is neces- sary to remove carefully the superfluous liquid. These moxas are said to ignite readily, burn promptly and uniformly, and not to crepitate. 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 to be equally successful with the one he proposes, and vvhich has been already"described (p. 203,) in form- ing a rapid vesication: " 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 recom- mends. 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 pro- duce 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 cases of convulsions, the region of the spine has been treated in this manner, and with good effects, f Dr. Osborne, of Dublin,% avails himself of the high temperature produced by lime in the act of slaking, for the purpose of a moxa. Some quicklime in powder is placed to the depth of about half an inch within a strip of card, bent and tied so as to form a circle. Some water is then dropped on the lime, and mixed with it. In about two minutes, it swells, and becomes dry; and, at the same time, a degree of heat is produced, vvhich—according to some ex- periments—may amount to 500° Fah. Dr. Osborne considers this moxa superior to all others;—-first, from the intensity of the heat, and secondly, from its convenience,—not requiring the assistance of any heated substance, and being unaccompanied by the emission of sparks or smoke, which frighten the patient. When the quan- tity of lime used is smaller than that mentioned above, or if it be not kept on long, an appearance results, resembling that produced by acetic acid; and a thick crust is formed, vvhich separates as the new skin is perfected beneath. But if the quantity of lime be large, and it be kept on as long as the heat continues, a complete destruction of the skin ensues; and in this manner issues may be made of greater depth, and in a much shorter time, than by the usual cauterants. Dr. Osborne gives a case of apparent ulceration of the upper part of the rectum and sigmoid flexure of the colon; in which all the symptoms of internal ulceration disappeared after * Counter-irritation, its Principles and Practice, Dunglison's Amer. Med. Library edit, p. 21 and p. 42. Philad. 1838. t Mr. C. J. Edwards, in Provincial Med. and Surg. Journal, Jan. 1842. X Dublin Journal of Medical Science, Jan. 1842. 460 MOXA. the application of a lime moxa, of about the size of a crown, over the region of the sigmoid flexure. In a case of incipient soften- ing of tubercles; and in another apparently of purulent infil- tration after pneumonia, its effects in arresting the ulcerative process was most decided. In a case of hip-joint disease, in which there was great pain, and consequent loss of sleep, the pa- tient slept well on the following night, and, in a few days, had gained much power over the limb; and in another case of the same disease, which had proceeded to destruction of the joint, and extensive enlargement of the parts around it, great relief was obtain- ed. The size of the ulcer formed by it is always much larger than that of the lime applied. When the lime is prepared from calca- reous spar, the heat, produced on the addition of wafer, is sudden and intense, and the pain is proportionably urgent. For ordinary purposes, however, well selected pieces of lime from a lime-kiln answer well if fresh, but not otherwise. In the application of the various moxas, or of most of them, their agency can be so graduated as to produce either simple ru- befaction, 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 burn- ing 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, 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. Lar- rey says the sloughing can be prevented by the application of liquid ammoniay 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. 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 cauterization is effected— being, that the agent in the case of the ammoniated lotion is a po- tential, in that of moxa an actual, cauterant. The moxa must be regarded as one of our most valuable re- vellents. * Op. citat p. 5. t Ibid. p. 9. NARCOTINA. 461 CXVI. NARCOTFNA. Synonymes. Narcotinum, Narcotin, Narcotine, Opiane, Matter or Salt of Derosne. French. Matiere ou Sel de Derosne, Sel Essentiel d'Opium. German. Narkotin, Opian, Derosne's Opiumsalz. On this substance, which is one of the immediate principles of opium, and which has attracted the attention of many chemists and therapeutists, much uncertainty exists in regard to its pre- cise properties. It seems, that it has not hitherto been found except in opium. METHOD OF PREPARING. It is commonly obtained, either from the crude extract of opium, by means of ether, which only dissolves the narcotina, and con- sequently requires but to be evaporated to obtain it; or from crude opium, which has been exhausted by cold water: it may hence be obtained from the residue after the preparation of the aqueous extract of opium of the shops. With this view, the opium or re- sidue is twice treated with boiling acetic acid at 2° or 3°; it is pre- cipitated by ammonia, and the washed precipitate is purified by treating it with hot alcohol at 40°, and a little animal charcoal; the liquid is theh filtered, and the pure narcotina is precipitated on cooling. It crystallizes in very white needles; is devoid of taste and smell, fusible in the manner of resins, and very slightly soluble in water; soluble with the aid of heat in alcohol, and in the volatile and fixed oils; very soluble in ether, which distinguishes it from morphia; very soluble also in cold acetic acid, whence it is pre- cipitated on heating the solution—another mode of separating it from morphia—and soluble in dilute acids. It is coloured of a vivid red by nitric acid; and is analogous, in some respects, to the crystallizable resins or sub-resins of M. Bonastre.* Narcotina is generally reckoned amongst the vegetable alkaloids; but by some it is considered to be neuter* | Dr. Christisonf states, that "opium contains no fewer than six crystalline active princi- ples;—morphia, codeia, and paramorphia, narcotin, narcein and meconin, of which the first three are alkaline and the others neutral." Dr. O'Shaughnessy^ prepares muriate of narcotina by taking of Bengal opium, two pounds; Alcohol, 20 pounds. These are rubbed together in a large mortar, adding the spirit by degrees, until the opium is exhausted of its soluble parts. The solution is then de- canted, and the insoluble part pressed. To the alcoholic solution * Merat and De Lens, Diet de Mat. Med. art. Narcotine. t Christison, Dispensatory, p. 672. Edinb. 1842. X Ibid. p. 671. § Calcutta Quarterly Journal, and Lond. Lancet, July 20, 1839, p. 606. 30 462 NARCOTINA. as much ammonia is added as renders the liquid slightly turbid. Fifteen pounds of the alcohol are then distilled from a common alembic; and the fluid in the still is drawn off, and set aside to cool. On cooling, a mass of coloured crystals is deposited, com- posed of narcotina, meconate of ammonia, and resin. This is washed with water, which dissolves the meconate of ammonia, and afterwards with a quart of water and a dram of muriatic acid, which dissolves the narcotina and leaves the resin. The solution is then filtered, and evaporated to dryness. Muriate of narcotina, thus prepared, is a transparent resinous mass, of a rosy colour, and brittle vitreous texture. It is very soluble in distilled water and spirits; and its salts are intensely bitter. EFFECTS ON THE ECONOMY IN HEALTH. These have been so contradictory, that it has been conceived the same preparations cannot have been used by different obser- vers.* According to Magendie,t morphia is the anodyne prin- ciple of opium, and narcotina the exciting. When a grain of nar- cotina dissolved in oil was given to a dog, it produced a state of stupor, which superficial observers might readily confound with sleep; but it differed evidently from sleep; the animal's eyes were open; the respiration was not deep, as in sleep, and it was impossible to arouse it from its sluggish condition. Death generally took place in twenty-four hours. When combined with acetic acid, it produced quite different effects. Animals could bear a dose of even twenty-four grains without dying, and whilst under its influence, they were agitated by convulsions like those which camphor induces—exhibiting the same signs of fright, the same backward motions, foaming at the mouth, convulsions of the jaws, &c. When morphia and narcotina were both given at the same time, the different effects of each occurred together. A grain of morphia, for example, and a grain of narcotina, dissolved in acetic acid, were placed in the pleura of a dog. The animal soon became drowsy, and fell asleep under the influence of the morphia; but a singular and remarkable strife appeared to go on for an hour and a half, between the stimulating effects of the narcotina and the anodyne effects of the morphia. At length, however, the ani- mal slept soundly, being probably, Magendie suggests, under the influence of the morphia alone. His opinion is, that narcotina is injurious when not united with an acid, and very exciting when so united. M. Orfila—the celebrated toxicologist—it appears, has entertained various views upon the action of narcotina; at one time considering it inert, at another to possess the same action as morphia; and at another, to concur, when combined with morphia, in the properties of opium, but to a slight degree—since opium, deprived of narcotina, is not less deleterious—and to possess a * Ibid, and Diet, des Sciences Medicales, xxxiv. 298. t Formulaire pour la Preparation, Ace., de plusieurs nouveaux Medicamens. NUX VOMICA. 463 different modus operandi from opium, without, however, our being able to regard it as the exciting principle.* Owing to all these uncertainties connected with it, narcotina is little if at all employed in medicine. It would seem, hovvever, that the exciting properties of opium do not appertain exclusively to it; for, as has been elsewhere remarked, there are many persons who are as disagreeably affected by morphia alone as they are by opium, which contains both morphia and narcotina. The salts of narcotina have been employed successfully as an antiperiodic, especially in intermittents,^ and Dr. O'Shaughnessy; has laid before the Medical Society of Calcutta, the results of his experience with them. Sixty cases were treated, of which all but two were successful. Dr. O'Shaughnessy remarks farther, that, besides the sixty cases recorded, more than one hundred ague pa- tients had been treated by his pupils and acquaintances with per- fect success by the remedy. CXVII. XUX VOM'ICA. Synonymes. Vomic Nut, Poison Nut. Bachelor's Buttons. French. Noix Vomique. German. Krahenaugen, Brechnuss. EXTRACTUM NUCIS VOMICA ALCOHOLICUiM. Synonymes. Extractum Nucis Vomica? Resinosum, E. Nucis Vomica; Spi- rituosum, Spirituous, Resinous or Alcoholic Extract of Nux Vomica. French. Extrait Alcoolique de Noix Vomique. German. Geistiges Extrakt der Krahenaugen. In the year 1809, Magendie discovered, that one entire class of vegetables—the bitter strychnos—has the power of exciting the spinal marrow without implicating, except indirectly, the functions of the brain.§ Since then, many have confirmed the observations of Magendie, and have attended especially to its agency in various diseases. The preparation of the strychnos, most used, if we ex- cept the active principle—has been the alcoholic extract of the nux vomica. METHOD OF PREPARING. Take any quantity of rasped nux vomica; exhaust it by repeated macerations in alcohol of 40° (.817,) and evaporate it slowly to the consistence of an extract. Alcohol of less strength may be used, but, according to Magendie, the product will be proportionably * Merat and De Lens, op. cit, and Orfila, Toxicologie Generale, ii. 69. 1 Dr. Roots, London Lancet, Sept. 1832, and T. W. Jeston, ibid. Oct 6, 1832, p. 41. X India Journal of Medical Science, Sep. and Nov. 1838, cited in British and Foreign Medical Review, No. xv. for July, 1839, p. 263. § Examen de Taction de quelques vegetaux sur la moelle epiniere. Paris, 1809, and Formulaire, &c. 464 NUX VOMICA. less active. A dried alcoholic extract is made by dissolving in water the alcoholic extract made by means of alcohol at 36° (.837;) filtering and evaporating in appropriate dishes, as in making the dry extract of bark. The Extractum Nucis Vomioze of the Pharmacopoeia of the United States is directed to be prepared as follows :—Take of Nux vomica, a pound ; Alcohol, a sufficient quantity. Expose the nux vomica to steam till it is softened, then, having sliced and dried it, grind into powder. Introduce it into an apparatus for displace- ment, and pour alcohol upon it gradually until the liquid passes without bitterness. Distil off the greater part of the alcohol from the filtered liquor, and evaporate the residue to the proper con- sistence. * EFFECTS ON THE ECONOMY. According to Magendie, a grain of this extract, absorbed from any part of the body, or mixed with food, promptly destroys a dog of considerable size, by inducing paroxysms of tetanus, which, by their continuance, arrest respiration sufficiently long to induce complete asphyxia. When the dose is much stronger the animal appears to die entirely from the action of the nux vomica on the nervous system.y If an animal be touched whilst under the action of the substance, it experiences a commotion similar to that of a strong electric sbock, and this takes place each time the contact is renewed. On dissection, no morbid appearances exist which can account for death. When introduced into the frog's stomach, Dr. Lombard,\ of Geneva, found, that it produced tetanic convulsions, which, in a few hours, caused death. The contractions of the heart were sometimes strong and complete, sometimes irregular, tumul- tuous and intermitting; always diminished in frequency. Ap- plied to the heart itself, it slightly stimulated it, rendering the pul- sations more energetic and frequent, whence Dr. Lombard con- cludes, that the nux vomica cannot be used with advantage in any diseases of the heart; for, although it diminishes the frequency of the pulsations, it renders them irregular. The action of the extract on healthy man is the same as that described by Magendie, and if the dose be sufficiently large, death speedily follows with the same symptoms.§ In those that are af- fected with paralysis, the effect is also the same; but what is sin- gular, it is particularly manifested on the paralyzed parts by tetanic convulsions, and a feeling of creeping, which indicate the operation of the remedy: a local perspiration is also often observed to break out on some parts of the body. When administered in cases of * Pharmacopoeia of the United States, p. 352. Philad. 1842. t S6galas, in Journal de Physioloaie, par Magendie, Oct. 1822. t Gazette Medicale de Paris, Oct 18, 1835.° § See the details of two cases of poisoning by nux vomica, in Lond. Med. Rep. xix. 448 and 456; Christison on Poisons, and Brande, Diet, of Mat. Med., p. 375. Lond. 1839. nux vomica. 465 hemiplegia, the contrast between the two sides of the body is ren- dered striking: whilst the sound side remains at rest, the other may be violently agitated; tetanic shocks may supervene and a copious perspiration break out. In a female, Magendie saw the affected side covered by a peculiar eruption, whilst the other side afforded no trace of it. There is a difference even between the two sides of the tongue, a decidedly bitter taste being occasionally per- ceived on the one, whilst the other exhibits nothing similar. If a much larger dose be given, both sides of the body participate, but unequally, in the tetanic spasms, so that the patient is sometimes thrown out of bed by the violence of the contractions. When given in very small doses, it has not any perceptible effects im- mediately, and some days elapse before its advantageous or nox- ious properties can be appreciated. According to Magendie,* the extract may be given in all dis- eases that are attended with debility, general or local, and in paralysis of all kinds, general or partial. He himself observed excellent ef- fects from it in marked cases of debility of the genital organs, incon- tinence of urine, &c. He also used it with advantage in several cases of partial atrophy of the upper and lower extremities. As re- gards its administration in cases of paralysis succeeding to apoplexy, he remarks, that it should not be given until some time after the coup de sang in the brain, which occasioned the palsy; and that even then beneficial results can be expected only vvhen no marked organic mischief exists; indeed, in the latter case, he considers the disease irremediable, and that bad effects might result from pushing the remedy. The efficacy of the alco- holic extract of nux vomica in various forms of paralysis has been confirmed by many observers. Even before Magendie had em- ployed it, Fouquier,f had given it in several cases, with the most satisfactory results. Since then, we have the testimonies of Chauf- fart,J Gendron,§ Perrussel, Recamier, Mauricet, Baxter,|| Galli, Hauff, Wenneis, Burkard, Petrequin,1T Gellie,** Debreyne,tt and numerous others in its favour. The author's own experience with it in cases of hemiplegia hns not been limited; yet although he has succeeded in inducing tetanic movements in the limb, he has not been satisfied that much advantage was derived from it ;|| and, in some cases, it appeared to induce serious encephalic excitement. After effusion has occurred into the encephalon time is required * Formulaire pour la Preparation, &a de plusieurs nouveaux Medicamens, &c. t Bulletin de la Faculte de Medecine, &c, vol. v. 1818. X Joum. Gener. de Med. Oct. 1824. § Ibid. Nov. 1829. || New York Medical Repos. vol. viii. If Gazette Medicale de Paris, Oct. 27 and Nov. 3, 1838, and Bulletin General de The- rapeutique, Mars, 1840. ** La Lancette Frangaise, Aout 29, 1837. tt Braithwaite's Retrospect, Amer. edit x. 26. New York, 1845; cited from Med. Chir. Rev. Oct 1844, p. 384-396. tt See the author's Practice of Medicine, 2d edit. ii. 198. Philad. 1844. Also, Chauffart, in op. cit. 466 NUX VOMICA. for its absorption, and but little beneficial agency can be expected from any remedy. Nor are the results of the experiments and observations of Jahn by any means in accordance with those of the practitioners above mentioned. He tried it in numerous cases of paralysis, but he affirms, that he did not see any good effect from it; and, with the exception of two cases, did not notice the slightest action, although the extract was carefully prepared according to the formula given by Magendie. Yet, he remarks, he was by no means sparing in the dose. In the two cases in which a change seemed to be induced, there was an evident increase of the paralysis. This discrepancy, as well as other evidences of the same contrariety of experience, may doubtless have been partly owing to difference in the strength and quality of the preparation ; and hence, according to some, the value of strychnia—its active principle—which is not liable to so much uncertainty.* Dr. Christison,-! however, affirms, that "there seems no particular reason why the powder and-extract should have been displaced by the principle strychnia; for their effects are precisely the same; and the principle is not only troublesome to prepare, but likewise, being seldom pure, is liable to the objection of irregular strength, which is brought against the Galenical preparations of the drug." In cases of partial paralysis, as in colica piclonum, amaurosis,^ palsy of the rectum, &c, both the alcoholic extract of nux vomica and its active principle have been used with good effect. (See Strychnia.) M. Barez§ affirms, that he has succeeded in readily removing prolapsus ani in the young, after diarrhoea, &c, by means of an aqueous solution of nux vomica. Four scruples of salep are boiled for twenty minutes in three ounces and a half of water, and after straining, he adds three-fourths of a grain of the aqueous extract of nux vomica. A spoonful of this mixture is given at intervals, so that the whole is taken in twenty-four hours. It need hardly be said that in the case of young children, this potent article should be given with great caution. Dr. Cerchiari|| treated two cases of incontinence of urine suc- cessfully with the extract. The first was that of a girl nineteen years of age—who, from her infancy, had passed her urine in- voluntarily every night in her sleep. She was ordered the third of a grain of the extract in pill, three times a day; and in eight days the cure was complete. The second case was that of a young married female, whose urine flowed involuntarily, day and night after her first delivery. As there was no fistulous opening to account for the involuntary discharge, and it appeared * Richter's Specielle Therapie, u. s. w. B. x. S. 352. Berlin, 1828. t Dispensatory, p. 658. Edinb. 1842. X Petrequin and Miquel, in Bulletin General de Therapeutique, Juillet, 1838. De- freyne, op. cit § Journ. de Medecine, July, 1845, cited in Edinb. Med. and Surg. Journ. July, 1846, p. 256. || Gazette Midicale, Avril 14, 1838. NUX VOMICA. 467 to arise from weakness of the neck of the bladder, in consequence of contusion by the head of the child, the extract was adminis- tered in the same doses as in the preceding case, and in fifteen days the cure was complete. Mondiere, in cases of incontinence of urine dependent upon atony, prescribed it advantageously in association with black oxide of iron;* and M. Petrequinf found, that local anaesthesia or loss of sensibility in a part, yielded, in numerous instances, to embrocations of the tincture referred to hereafter. Cazenave gave the extract successfully in a case of St. Vitus's dance, which had resisted every other remedy; and Professor Trousseau relates several cases of cure, from the employment of the alcoholic extract in the dose of about three-quarters of a grain; or of strychnia in the dose of one-sixth of a grain. Sir Charles Scudamore, M. Roclants,| and Mr. Pidduck,§ found it useful in neuratgia, the former especially in neuralgia faciei. Vogt gave it—not without advantage—in cardialgia ; Hildenbrand in epi- lepsy: by the Russian and Polish physicians it was administered advantageously in choleric diarrhoea, and by many it has been strongly advised in chronic diarrhoea and dysentery,^ as well as in dyspepsia, in the varieties termed pyrosis and gastrodynia, especially where they appeared to proceed from morbid irrita- bility of the nerves of the stomach,1^ as in the vomiting of the pregnant female.** (See the article Strychnia.) MODE OF ADMINISTRATION. The best form for exhibiting the alcoholic extract of nux vo- mica, according to Magendie, is in pill, when we are desirous of inducing the tetanic convulsions. Each pill may contain a grain. One or two pills may be given at first, and the dose be daily aug- mented until the required effect is induced. It may then be dis- continued to avoid accidents. It is better, he thinks, to give the pills in the evening, as night is the most favourable time for ob- serving the phenomena we are desirous of inducing. It is some- times necessary to increase the dose to twenty or thirty grains, before the tetanic effects supervene, but commonly from four to six grains are sufficient. Esquirol saw two cases, in one of which * A. Bouchardat, Annuaire de Therapeutique pour 1841, p. 8. Paris, 1841. i Bulletin Generate de Therapeutique, Mars, 1840. X Med.-Chir. Rev. from Edinb. Med. and Surg. Journal, Oct 1843. § Lond. Med. Gazette, Aug. 7, 1840. || Most's Encyclop'adie, 2te Auflage, art Dysenteria, i. 573. Leipz. 1836. Geddings, N. American Archives, No. 2, Nov. 1834. Roots, in St Thomas's Hospital Reports, No. iii for April, 1836; and Hufeland, in Bally, Bulletin General de Therapeutique. Fev.1838. 11 Mellor, in Med. Gaz. March 4, 1837, p. 850. Dr. H. S. Melcombe, ibid. March 25, 1837, p. 964; cited in Dunglison's Amer. Med. Intel. July 1, 1837, p. 124, and Dr. M. Huss, in Zeitschrift fur die gesammte Medicin. May, 1837, 393, cited in Amer. Med. Intel. Aug. 1, p. 162. ** Kroyher, in Annuaire de Therapeutique, pour 1842, par A. Bouchardat, p. 39. Paris, 1842. 468 NUX VOMICA. death took place after eighteen grains; in the other, after five: the stomach and bowels were found inflamed. Dr. Elliotson began with half a grain of a well prepared extract, and increased the dose every day, or every other day, by a quarter of a grain; but none of the patients bore a greater quantity than seven grains, and few more than four. If from any cause the administration of the remedy has been interrupted for some days, it is necessary to recommence with the small doses, and to increase them gradu- ally as before. When it is desirable to produce only the slow effects of the remedy, a grain or half a grain daily is sufficient. M. Petrequin* begins with one-eighth of a grain for a dose, and gradually increases it to two, three, and even five grains in the course of the day. Magendie directs a tincture to be made from the extract—the Tinctura Nucis Vomicae, T. Strychnos, T. Nucum Vomica- rum, which has been introduced into some of the pharmacopoeias. It is made by taking three grains of dried alcoholic extract of nux vomica, and dissolving it in an ounce of alcohol at 36° (.837.) It is given by drops, and in mixtures, in those cases in which the alcoholic extract itself is indicated. M. Petrequinf also employs a tincture of nux vomica, which he prepares with four ounces of the powder and a quart of brandy. This is used altogether ex- ternally as an embrocation to, and around, palsied parts. Tinctura nucis vomica; composita. Compound tincture of nux vomica. R. Extract, nuc. vomic. alcohol, gr. xxiv. Camphora gj. Tinct. pyrethri f. §j. M. Dose.—Twenty drops, four times a day, with arnica tea, in cases of paralysis. Vogt. R. Tinct. nucis vomicae, ----cantharid. Naph. phosphorat.t ^ij. M. Dose.—Thirty drops, three or four times a day, with arnica tea, in the paralysis of torpid subjects. Vogt. Mistura nucis vomica;. Mixture of nux vomica. R. Extract, nuc. vomic. alcohol, gr. ij.—iv.-r—vj. Mucilag. acac. f. gss. Aquae melissEe f. §vj. M. Dose.—Two spoonfuls, every two hours, in epilepsy. Hildenbrand. * Op. cit t Op. citat. X Naphtha phosphorala, JEther sulphuricus phosphoratus, is made by dissolving twenty-eight grains of phosphorus in four ounces of rectified ether. NTJX VOMICA. 469 A similar form is recommended by Richter* in dysentery. Two table-spoonfuls every two hours. R. Tinct. nucis vomicas gtt. ij. Aquae lauroceras. gj. M. Dose.—Ten drops every morning and evening in the vomit- ing of pregnancy Kroyher. Pilulae nucis vomica;. Pills of nux vomica. R. Ext. nuc. vomic. alcohol. 9j. Ext. glycyrrhiz. 9vij. Misce et fiant pilulas lxxx. Dose.—Two to six, two or three times a day, in paralysis. Pilula; nucis vomica; ferruginosa;. Ferruginous pills of nux vomica. R. Extract, nucis vomic. alcohol, gr. vj. Ferri oxid. nigr. gj. M. et divide in pil. xxiv. Dose.—Three, daily, in incontinence of urine dependent upon atony. Mondiere. Pulveres nucig vomica;. Powders of nux vomica. R. Ext. nucis vomicee alcohol. Bismuth, sub-nitrat. aa. gr. ss. Magnes. carbonat. gr. iij. Sacch. gr. xv. 01. menth. pip. gtt. ij. Misce, et fiat pulvis. Dose.—One every three hours, in cramp of the stomach. Vogt. R. Nucis vomic. pulv. gr. iij. Acaciae, Sacchar. aa. gr. xij. M. et fiat pulvis. Dose.—One of these powders to be repeated according to cir- cumstances during the twenty-four hours, in diarrhoea and dy- sentery. Hufeland. Embrocatio nucis vomica;. Embrocation of nux vomica. R. Tinct. nucis vomicae f. gj. Liquor, ammon. f. gij. M. To be rubbed on the paralyzed limbs, and on the surface, in cholera. See Strychnia, and its preparations. * Die Specielle Therapie, ii. 133. Berl. 1821. See, also, Joy, in Tweedie's Library of Medicine, v. 296. Lond. 1840; or 2d Amer. edit Philad. 1842. 470 OLEUM JECORIS ASELLI. CXVI1I. OLEUM JECORIS ASEL/LI. Synonymes. Oleum Morrhuae, 0. Jecinoris Aselli, Codliver Oil, Cod Oil. French. Huile de Morue, Huile de Foie de Poisson. German. Stockfischleberthran, Berger thran, Gichtthran, Leberthran, Kab- liauthran. The animal fat, which appears under this name in commerce, is obtained from several of the fishes belonging to the genus Gadus, order Malacopterygii thoracici, but especially from the codfish (Gadus morrhua;) the Torsk (Gadus callarias;) the Coalfish (Ga- dus Carbonarius,) and the Burbot (Gadus lota.) At Antwerp, it is said by M. Gouzee* to be prepared from the liver of a species of Ray—the Raja Pastinaca, and of the Skate. Skate-liver oil is by some preferred to cod-liver oil as a therapeutic agent. The dis- agreeable odour and taste of cod-liver oil led to the substitution of the oil obtained from the liver of the skate—Raia clavata and R. batis. In Holland and Belgium this oil is preferred to that of the cod, both as being less disagreeable to the taste, and also more efficacious in its therapeutic effects.f Several varieties of the oil are met with in commerce, which differ from each other by their brighter or darker hue, and by their greater or less transparency. The clearest sort is admitted, into the shops of continental Europe especially, under the name Oleum jecoris aselli album seu depuratum: as a remedial agent it is more used than the darker variety, although several physicians affirm, that they have found the latter more efficacious.:}: It would seem that only one variety is to be met with in com- merce, either in London or in this country. It is probably the second, and is used by curriers for dressing leather. METHOD OF PREPARING. According to Riecke,§ the oil is obtained by exposing to the sun the livers of the fishes above mentioned, cut in slices, and col- lecting the fixed oil that runs out. That which is first obtained resembles fine olive or poppy oil, and is called "yellow codliver oil"—Oleum jecoris aselli flavum (German, Hellblanker Le- berthran.) If the livers are running gradually to putrefaction, the oil becomes of a chestnut-brown colour—Oleum jecoris aselli subfuscoflavum — (German, Braunkblanker Thran:) and, again, after the oil has been obtained by the above methods, some can still be procured by boiling the livers, which constitutes the Oleum jecoris aselli fuscum.\\ At Newhaven, near Edinburgh, * Bullet Med. Beige, Janvier, 1838. 1 Edinb. Med. and Surg. Journ. Oct. 1842, p. 504. X See M. Taufflied, in Gazette Medicale de Paris, Aout 12,1837. § Die neuern Arzneimittel, u. s. w. S. 351, and 2te Auflage, S. 538. Stuttgart, 1840. || For the analysis of the yellow and brown varieties, by Marder, see Riecke, Die neuem Arzneimittel, u. s. w. 2te Auflage, S. 541. Stuttgart, 1840; Or Pereira, op. cit p. 1865. OLEUM JECORIS ASELLI. 471 the fishermen simply boil the livers in an iron pot, and then filter the oil through a towel containing a little sand.* Mr. Donovanf recommends the following process. Take any quantity of livers of cod; throw them into a very clean iron pot; and place it on a slow fire; stir them continually until they break down into a kind of pulp: water and oil will have separated. When a thermometer plunged in the pulp shall have risen to 192°, the pot should be taken from the fire, its contents transferred to a canvass bag, and a vessel placed underneath. Oil and some water will run through : after twenty-four hours, separate the former by decantation, and filter through paper. The properties of cod-liver oil are said to be different in the dif- ferent varieties met with in commerce. The colour varies from a bright yellow to a reddish-brown; and the oil is sometimes clear, but, at others, more or less turbid. The bright has the consistence of poppy oil; the brown is thicker. The smell is weaker in the former; in the latter, it resembles that of old salt herrings. The taste of the brown is an empyreumatic bitter; and resembles train oil; is somewhat acrid, and remains for a time on the tongue; that of the clearer oil is much less disagreeable. Litmus paper is feebly reddened by the clear, considerably so by the brown variety. Both sorts are soluble in alcohol and ether. A good deal of the difference in the appearance, and other sensible properties of the different varieties would appear, from the observations of Mr.' Do- novan, ^ to be owing to the comparative freshness, or the contrary, of the oil, or of the livers from which it has been prepared. According to Messrs. Gouzee and Gmelin, the brightest oil ought to be employed internally; but MM. Trousseau and Pidoux§ think that the limpid oil has no medical virtue. They prefer either the second, or that which is obtained by ebullition, and has a disagreeable acrid taste. Such, too, appears»to be the opinion of Richter,|j Delcourl" and others. EFFECTS ON THE ECONOMY. The oil, prepared by Mr. Donovan's process, is of a pale yellow colour; its smell is weak, and resembles that of a cod boiled for the table when in excellent condition. Its taste is bland, by no means disagreeable, and totally devoid of rancidity. It is very liquid. Its specific gravity, in Mr. Donovan's trials, was 0.934, although in all the published tables of specific gravities it is stated * J. H. Bennet, cited by Pereira, Elements of Mat Med. and Therap. ii 1866; or 2d Amer. edit by Dr. Carson. Philad. 1846. t Dublin Journal of Medical Sciences, July, 1840, p. 363. See, also, for a full account of the article, Mr. Donovan, ibid. Sept 1845; or Ranking's Abstract of the Med. Science, pt 2, p. 338, Amer. edit New York, 1846. t Op. cit Sept. 1845. § Traite de Therapeutique, &c, 2d partie, p. 111. || Medicinisch. Zeitung, No. 26, Juillet, 1835. TT Bulletin Modical Beige, Juin, 1841, p. 249. 472 OLEUM JECORIS ASELLI. to be 0.923.* In cold weather, it deposits much stearine, which ought not to be separated. Mr. Donovan has obtained as much as a gallon of pure oil from twenty-eight pound of livers, the produce of fifty cods; and he concludes, that in preparing the oil for medical purposes, three great points are to be attended to—1. The livers must be perfectly healthy; 2. They must be as fresh as pos- sible, the least putrescency being injurious; and 3. The heat at which the separation of the oil is effected must not exceed 192.° This pale oil is the only kind that Mr. Donovanf has supplied so abundantly to the profession for the last three years; and its effi- cacy, he says, has been in many cases most surprising. Cod-liver oil has long been used as a popular remedy in north- ern Germany, especially in Westphalia—as well as in Holland and England; it fell, however, into disuse in the British Isles, but in Germany it has maintained its character to the present day. In England, it appears to have been first recommended by Perci- val,| and in Germany by Schenck.§ In Dr. Percival's time, it was so largely employed in Manchester, in the hospital of that town, that nearly a hogshead of it was consumed annually. When administered internally, it excites a disagreeable taste in the mouth, and nausea. Yet patients soon become accustomed to it; and Riecke|| affirms, that he has frequently seen children take it without repugnance. When the nausea is once overcome, the oil does not oppress the stomach, except when the organ is embarrassed, or the digestive powers are greatly enfeebled. Nor does it seem to destroy the appetite by continued use. Yet many persons, espe- cially adults—less so children—according to Kopp, reject it im- mediately. It is necessary for the digestive powers to be ener- getic when it has to be given for any length of time. To those, whose digestive organs are very irritable, Kopp recommends that Bourdeaux wine should be taken after it. Cod-liver oil has no manifest effect on any of the secretions, ex- cept occasionally on the urinary and cutaneous depurations; and on the healthy organism, it appears to excite no marked change. In strumous affections, however, its favourable influence is said to be striking, as well as in rhachitic, rheumatic, and gouty disor- ders. In such cases, it is said, by the German writers, to excite powerfully the reproductive or nutritive functions, when adminis- tered for a proper length of time.IT The favourable effects are, in general, not rapidly exhibited; and to produce a cure, according to Kopp, the remedy must be persisted in for at least four weeks, and commonly for some months. Kopp suggested, that owing to the similarity of the effects of this oil to those of iodine, its effi- * Donovan, op. cit. t Op. cit. X Essays, Medical, Philosophical and Experimental. Warrington, 1790. Vol. 2. § Hufeland's Journal, 1822 and 1826. || Op. cit. IT Riecke, Die neuern Arzneimittel, S. 352, und 2te Auflage, S. 542. Stuttgart, 1840; also, Klencke, cited in Brit, and For. Med. Rev., Oct. 1842, p. 443. OLEUM JECORIS ASELLI. 473 cacy might be owing to its containing the latter; and some che- mical investigations, made by him in the year 1836, confirmed the suggestion.* The quantity is extremely small, but—Kopp sup- poses—like the steel in chalybeate waters, as the iodine is com- mingled naturally with the oil, it may exert a much greater effect than if it were added artificially irt the like quantity. This is the opinion, also, of Dr. J. H. Bennett;f but Delcour^ and Panck§ think it very problematical. Experiments by L. Gmelin|| seemed to show,.that the genuine oil contains iodine, whilst the spurious does not. Iodine has likewise been detected in it by Hausmann, Bley, Brandes, Springmiihl,^ and W. Stein.** Herbergeryf found both iodine and bromine in it. Owing to skate-liver oil appearing to be more efficacious thera- peutically than cod-liver oil, MM. Girardin and Prisser were induced to analyze it carefully, when they found it to contain a per centage more of iodide of potassium. They, consequently, recommend it as a valuable substitute for the more nauseous article in use.Ji On the other hand, Mr. Donovan§§ is of opinion, that every known fact impugns the notion, that the curative prin- ciple is iodine. In the first place, he says, many patients who have been cured by the oil were not in the least benefited by a previous course of iodine,—as shown by Dr. Taufflied. Secondly. Chemical analysis has discovered only minute traces of iodine in some specimens, whilst others were entirely destitute of it. One analysis, indeed, referred to by Dr. Bennett, gave 0.324 per cent., and another, 0.162; others gave still less. Thirdly. "The ten- dency of iodine is to render the person thin who uses it, while the effect of cod oil is to fatten." Lastly. None of the oil prepared by them, when agitated with alcohol, communicated any impres- sion of iodine, although the oil was eminently successful as.a me- dicine, and its colour contra-indicated the presence of free iodine. As respects the administration of cod-liver oil in disease, it has been employed—especially in Germany—as a remedy in 1. Rheumatism, in which its reputation has b.een favourable. In the year 1782, it was highly recommended in chronic rheu- matism by Dr. J. Percival,||f and in 1807 by Dr. Bardsley,f f who states, that it was in high repute in Lancashire. In the year 1835, Brefeld wrote a monograph on it, in which, resting upon nume- * Hufeland und Osann's Journal, 1836; Annalen der Pharmacie, xxi. und xii.; and Bulletin General de Therapeutique, No. xx. Oct. 30,1837. 1 Treatise on the Oleum Jecoris Aselli, or Cod Liver Oil, &c. &c. Lond. 1841. X Bulletin Medical Beige, Juin, 1841, p. 254. § Zeitschrift fur dje gesammte Medicin, Jul. 1842, p. 282. || Bulletin General de Therapeutique, Mai, 1840. IT Riecke, op. cit 2te Auflage, S. 541. Stuttgart, 1840. ** Journal fur Praktische Chemie, B. xxi., or Journal de Pharmacie, Fev. 1841, p. 94. 11 Pereira, op. cit p. 1866. XX Edinb. Med. and Surg. Journ. Oct. 1842, p. 504. § § Op. cit Sept. 1845. |||| Lond. Med. Journ. iii. 393. HA Reports from Hospital Practice, p. 18. Lond. 1807. 474 OLEUM JECORIS ASELLI. rous indigenous and foreign experiments, he maintained it to be a remedy of great and specific efficacy in every form of chronic and actual rheumatism; and since then his testimony has been cor- roborated by that of Spiritus,* Moning,f Schiitte,| Wesener,§ Osberghaus,|| Gunther,<|f Volkmann,** Kopp, Rust,ff Moll,;| Panck, and W. 0. Chalk.§§ By many, its use has likewise been advised in gouty affections; but Brefeld esteems it ineffectual in actual gout; and Taufflied|||| affirms, that it is of no avail in gouty arthritis. 2. Scrofula and Rickets.—In these diseases it would seem to be more efficacious than in rheumatism. Brefeld, indeed, asserts that he has found no remedy equal to it, in cases where the osseous tissue is permanently affected,—as in the different shades of rick- ets, arthrocace, spina ventosa, and caries scrophulosa:^ next to these, it has been extolled in affections of the chyliferous ves- sels and internal glands, especially when they present them- selves under the chronic form of atrophy. In affections of the external glands, its efficacy was less striking and rapid; Taufflied, indeed, states, that it is of no avail in the swellings of any lym- phatic glands excepting those of the abdominal cavity. Its action is almost null in scrofulous affections of the skin, ophthalmia, discharges from the ear, &c, unless when applied externally, in which cases, as well as in external glandular swellings of a scro- fulous character, it was especially useful. The slighter forms of scrofulous eruptions disappeared, without any unpleasant sequelae, by simply smearing them with the oil; the more obstinate forms, by the simultaneous use of appropriate internal agents, of which Brefeld prefers aethiops antimonialis to all others. Scrofulous inflammation of the eyes disappeared frequently and rapidly by simply smearing the eyelids with the oil.*** Where, in the case of scrofulous ophthalmia, there is inflammation of the eyelid with photophobia, M. Brefeld recommends, that the free edges of the eyelid should be anointed with pure cod-liver oil. Mr. Cunier advises it in association with the extract of belladonna, one part of the latter to two of the former. Introduced between the eye- lids by means of a camel's hair pencil, it acts, he says, beneficially on scrofulous ulcers of the cornea, and hastens in a remarkable man- ner, the absorption of the opacities of that membrane. In the inter- ciliary idcerations, it is likewise, very useful. In such cases, as well as in the opacities of the cornea, following vascular pannus, in cellular pannus, atonic ulcerations, &c, Mr. Cunier has found an ointment, * Rust's Magazin, Band. xvi. 566. t Ibid. X Horn's Archiv. 1824 (July and August) § Hufeland's Journal, 1821, Heft 1. (May.) II Ibid. 1825, Heft. iii. (September.') IT Ibid. 1824, Heft. ii. (August.) "Mbid. tt Rust's Magazin. xx. 563. X\ Richter's Specielle Therapie, x. 468. Berl. 1828. §§ Lond. Med. Gaz. Dec. 29, 1843, p. 414. |||| Gaz. Med. Nov. 9, 1839. HIT Sourzac, Journ. de Med. et Chir. Prat. Mars, 1842, p. 110. *** Piffard, Bullet General, de Therap. Mai, 1840. OLEUM JECORIS ASELLI. 475 the formula for which is given hereafter, very useful.* Mr. Wilde, of Dublin,f states, that in cases of pannus and long con- tinued chronic ophthalmia attended with granular lids, &c, where the constitutional powers had fallen below par, as shown by dimi- nution in volume, and increased quickness of pulse, pallor of countenance, coldness of the extremities, a clammy condition of skin during the day, and heat, and restlessness at night; together with loss of appetite, and "a large flabby, putty coloured tongue, which is usually attendant on such broken down strumous patients," he had found it a most useful remedy—in fact, in all cases in which tonics and nutrients were indicated. Kopp extols it in scrofula and rickets, both when internally and externally exhibited; and in porrigo, its external application was found by him to be highly serviceable. Numerous trials with the remedy by other physicians—as by Schenck, Schiitte, Von dem Busch, Gumpert, Fehr, Rosch, Schmidt, Knod von Helmenstreit, Heineken, MGnzenthaler, Beckhaus, Spitta, Gunther, Roy, Gou- zee,| Taufflied,§ Jiingken,|| W. 0. Chalk,! and others, confirm its great efficacy in scrofulous and rhachitic affections.** Schenck,tt indeed, esteems it as certain a remedy in scrofula and rickets as cinchona is in intermittent fever. Both Kopp and Brefeld recommend it highly in phthisispul- monalis of strumous origin, occurring especially in youth, and RayeJJ speaks in the highest terms of its efficacy in chronic in- flammation of the lungs and stomach. The efficacy of the oil in scrofula suggested its administration in cases of— 3. Tubercles;—and, accordingly, it was prescribed by Hankel, whose experiments led him to advise a further trial of it. Riecke§§ refers to "a case of the kind confirming Hankel's observations, which occurred to Dr. Pagenstecher, of Elberfeld; and Richter, of Weisbaden, Professor Alexander of Utreclit, and Haser, of Jena,|j|| seem to have experienced equally satisfactory results. M. Tauf- flied,^[^[ hovvever, considers its action to be doubtful or null in scrofulous phthisis when at all advanced. 4. Chronic cutaneous diseases.—In these affections, cod-liver oil has been given with advantage by Richter; and it is suggested, * Journal fur Kinderkrankheiten, cited from Annales d'Oculistique, May, 1845, and from it in Northern Journal of Medicine, June, 184o, p. 48, and Braithwaite's Retrospect, xii. 234, Amer. edit New York, 1846. t Mr. Donovan, Dublin Journal, &c., Sept. 1845. X Bulletin Medical Beige, Janvier, 1838, p. 6. § Gazette Medicale de Paris, Aout J2, 1837; and Nov. 9,1839. || Lond. Med. Gaz. April 20, 1839, p. 126. TT Op. cit. ** Riecke, op. cit. S. 356, und 2te Auflage, S. 542. Stuttgart, 1840. See, also, Tauf- flied, in Gaz. Medicale de Paris, Nov. 1839. tt Hufeland's Journal der Praktisch. Heilkunde, Mars, 1833. XX Annales de la Societe des Sciences, Nat. de Bruges, Encyclographie des Sciences Medicates, Mars, 1840, p. 100; and Sept 1840, p. 10. §§ Op. cit. S. 356. |||| Hufeland's Journal, B.lxxxvL 1838. HIT Gazette Medicale, Nov. 9, 1839. 476 OLEUM JECORIS ASELLI. that the greater success obtained by him than by Brefeld may have been owing to his having administered the remedy in much larger doses. Richter's trials were numerous, and were made through a period of three years; they are, therefore, highly de- serving of attention. He says;—that the impure, yellowish-brown, and odorous oil should be selected, as it is the most active;—that at least six, and never more than ten spoonfuls should be adminis- tered daily to adults;—that it must be continued for a long time, as the first traces of a favourable impression are generally somewhat late in presenting themselves,—commonly four weeks, and, in very obstinate cases, later;—so that usually from six to twelve weeks are required for a cure; and, lastly, that the diet must be regulated, and every thing difficult of digestion, flatulent, fatty, strongly salted, or acid, be carefully avoided. In this manner, he treats tetter, inveterate itch, and tendency to the formation of boils. Kopp's experiments agree with those of Richter, as to the internal use of th^ oil in tetter; he esteems it to act by "improving the humours." He found it, also, of use, in cases of dry tetter, when rubbed on the part. A severe case of lupus in a young female was successfully treated by M. Gibert* with the oil. The face was eaten away by tuberculous ulceration, the fleshy parts of the nose being completely destroyed. Independently of this, scrofulous abscesses existed in the neck, with caries of the malar bone, and white swelling of the wrist. Cod-liver oil was prescribed both internally and ex- ternally with success, after, iodine had been used both internally and externally without effect. The treatment was, howrever, con- tinued for more than a year. In some troublesome affections oj the skin, especially of the hands, conjoining the characters of impetigo, with erysipelatous redness and swelling, and inducing the most severe suffering, Dr.- Marshall Hallf speedily succeeded in restoring the textures to a healthy con- dition by the external use of the cod-liver oil, after all other remedies had been tried fruitlessly. For rhagades and chaps, he says, it is a preventive, and a speedy cure; and it is productive of great bene- fit in eczema, and other diseases inducing excoriation and fis- sures of the skin.% 5. Carron du Villards§ extols the cod-liver oil in opacities of the cornea, whether resulting from slight ulcerations, or from inter- lamellar effusion. It is only applicable after the inflammation has disappeared. A drop or two of the oil is then placed on the cor- nea with a camel's hair pencil. Sometimes, even the white oil is too stimulating: it is then necessary to dilute it with oil of sweet almonds: in other cases, the white oil is not sufficiently stimu- lating; when the brown must be used. * Bulletin de 1'Academie, Nov. 1844. t Lond. Med. Gaz. Sept 1832 X W. O. Chalk, op. cit § Bullet. Gener. de Therap. Oct 30, 1855. OLEUM JECORIS ASELLI. 477 6. In cases of tumours of the mammae in young females Kopp found the oil useful, when administered for some time, conjoined with the application of leeches to the affected part. 7. In the Charite, at Berlin, the oil was given with advantage in coxarthrocace, in doses of four ounces every morning;—the mouth being rinsed afterwards with peppermint tea, followed by a cupful of this,tea, or of coffee. 8. Kopp also affirms, that he cured a case of chorea by it, which had supervened on an attack of gout. Lastly.—Dr. Day* states, that he has used cod-liver oil exten- sively for several years, his attention having been first directed to it by Dr. Bennet, in 1840; and he can confidently bear out the statement of Mr. Donovan, that it " is a most useful addition to our Materia Medica; that it produces effects of which no other known remedy is capable; and that it is well worthy of the attention of the medical profession." The effect—as the author has remarked elsewheref—which it induces on the system of nutrition, when cachexia exists, is similar to that of eutrophics in general. It doubtless forms a modified chyle, and of consequence a modified blood; which induces a new action in the tissues through which it is distributed. MODE OF ADMINISTRATION. The dose of cod-liver oil for an adult is from half a spoonful to three spoonfOls, two or three times a day. To children, it is given in tea-spoonfuls. Its unpleasant taste can scarcely be cor- rected by admixture with other agents; for which reason, many prefer to give it in the pure state, taking afterwards some pepper- mint lozenges. It is also recommended to be given united with coffee, or with lemon juice, or in the form of emulsion. Kopp prescribes it in the pure state, advising that the mouth should be rinsed with water, and that some dry bread should be eaten after it. Dr. UreJ has suggested the adoption of cod-livers, as a diet for pa- tients who are advised to take the oil. In order to prevent the loss of oil during the process of cooking, he recommends the livers to be immersed entire in boiling water, to which a sufficient quantity of salt has been added to raise the boiling point to about 220° Fahr. The sudden application of this high temperature coagulates the al- bumen of the liver, and prevents the escape of the oil. When the liver is cut, the oil exudes, and mashed potatoes may be used as a vehicle. Dr. Ure states, that having been advised to take cod-liver oil, he found the nauseous flavour ver}^ objectionable, until he con- trived this plan, which he found to answer extremely well. * Report on Materia Medica, &c, in Ranking's Abstract of the Med. Sciences, pt 2, p. 340, Amer. edit New York 184(5. 1 General Therap. and Mat Med. 3d edit ii. 323. Philad. 1846. X Pharmaceutical Journal, Nov. 1, 1842, p. 361. 31 478 OLEUM JECORIS ASELLI. Mistura olei jecoris aselli. Mixture of cod-liver oil. R. 01. jecor. aselli f. gss. Liquor potassae gtt. xl. Aq. menth. pip. f. gss. M. et fiat haustus. The draught to be washed down with a tea-spoonful of lemon juice to liberate the oil in the stomach. Percival. R. 01. jecor. asell. f. gj. Liq. potass, carb. f. 31 j. 01. calami gtt. iij. Syrup, cort. aurant. f. gi. M. Dose.—One or two tea-spoonfuls, morning and evening, in cases of rickets. Fehr. R. 01. jecor. aselli, Syrup, cort. aurant. Aquae anis^ aa. f. gj. 01. calam. aromat. gtt iij. M. Dose.—A spoonful, morning, noon, and night, in gouty swell- ings, rickets, &c. Rosch. Emnlsio olei jecoris aselli. Emulsion of cod-liver oil. R. 01. jecor. asell. alb. Vin. Hungaric. (vel Malag.) aa. f. giv. Acac. gj. Fiat emulsio, cui adde Syrup, cort. aurant. f. gj. Elaeosacchar. menth. pip. f. gij.* Dose.—Two table-spoonfuls, two or three times a day; shaking the mixture. Brefeld. Syrupns olei jecoris aselli. Syrup of cod-liver oil. R. 01. jecor. asell. f. gviij. Acac. pulv.gv. Aquae f. gxij. Syrup, commun. f. giv. Sacchar. gxxiv. Make an emulsion of the first four ingredients; dissolve the sugar at a moderate heat; clarify, and add Aq. flor. aurant. f. gij. Duclou.] Unguentum olei jecoris aselli. Ointment of cod-liver oil. R. Olei jecoris aselli f. 3i. Hydrarg. oxid. rubr. gr. iv. CeratBij. M. Cunier. * The eheosacrharum or oleosaccharum ment/ix piperita is officinal in the Pharma- copoeias of Austria, Denmark, Hanover, Oldenburg, Prussia, Ate. It is made by tritu- rating eight drops of the essential oil of peppermint with an ounce of sugar. t Journal de Pharmacie, Sept. 1837. I OLEUM SINAPIS. 47P Linimentum olei jecoris aselli. Liniment of cod-liver oil. R. 01. jecor. aselli f. gss. Plumbi acetat. gij. Vitell. ovor. (seu adipis,) giij. M. For external use in cases of ulcers, fistulce, &c. Brefeld. CXIX. O'LEUM SINATIS. Synonymes. Oleum iEthereum seu Volatile Seminum Sinapis, Oil of Mus- tard Seed. French. Huile Volatile de Moutard. German. iEtherisches Senfol. This preparation has been recently recommended to the notice of practitioners in Germany, by Dr. Meyer, of Minden, especially; at whose suggestion numerous experiments were made with it at the Charite in Berlin, the favourable results of which have been published by Dr. Wolff.* METHOD OF PREPARING. M. Faure, in France, and M. Hesse, in Germany, found that if bruised mustard seed be placed in a still with cold water, much more essential oil is obtained than if hot water or steam had been at once employed. M. Hesse, indeed, ad vises, that the seed should be macerated with cold water for several hours before the distil- lation is commenced. It would seem, too, that acids, alcohol, &c, exercise the same influence in preventing the separation of the oil. EFFECTS ON THE ECONOMY IN HEALTH. Volatile oil of mustard is of a yellowish-white colour. It ex- hales so strong a smell of mustard, that the attempt to test its odour instantaneously excites a violent pungent sensation in the nose, and tears in the eyes. Its acridity is so great, that its appli- cation to the sound skin immediately occasions a sense of burning, and intense redness and vesication in the parts with which it comes in contact. EFFECTS ON THE ECONOMY IN DISEASE. Mustard seed oil may be applied either externally or internally. For the first object, Dr. Meyer advises a solution in alcohol (twenty-four drops to the ounce,) or in oil of almonds (five or six drops to the dram.) In Berlin, the former of these is used. Even this solution exhales so strongly the characteristic odour of mus- tard, that simply smelling it induces a sense of pungency in the nose, as well as tears in the eyes. Owing to the great volatility of this oil, its property and efficacy is soon lost; and the strength • Schmidt's Jahrbucher, 1837. s 480 OLEUM SINAPIS. of the spirituous solution becomes less and less when the fluid is preserved for a long time in vessels that are not accurately closed or are frequently opened for the administration of the remedy, and afterwards not carefully attended to. It is therefore advisable in practice, that only small quantities should be prescribed at a time, and that these should be kept in well-closed vials, and in a cool place. The mode of external administration may be one of two—accord- ing to the sensibility of the skin, and the effect it may be desirable to induce. It, may consist either in rubbing the liquid on a part of the surface, or in applying strips of linen wetted with it. The first method is advisable where the skin is delicate—as in the case of women and children, and in those whose healthy sensibility has not been diminished—as by paralytic affections. The fluid, when rubbed on the surface, very quickly evaporates, and excites a vivid sensation of burning, with bright redness of the surface, which disappears in the course of a few hours at the farthest. The augmented sensibility, produced by friction with the solu- tion of the oil, continues generally for a longer period; and, con- sequently, if a fresh application be needed at a short interval— say in from four to six hours—it must be made on the neighbour- ing parts, avoiding those first implicated. It is sufficient to use the remedy in this manner two or three times a day. The application of the oil by means of strips of linen is adapted for skins, such as those of men, which are thicker, and less sensi- ble, as well as for morbid cases in which the healthy sensibility has been depressed. The size and shape of the strips must be determined by circumstances. The linen, dipped in the oil, is placed upon the prescribed portion of the skin, and suffered to dry, which generally happens in about eight minutes. Burning pain immediately succeeds, and is often so insupportable, that the patients object to wait until the linen is dry, and it has, therefore, to be removed earlier. Besides the more violent pain produced by this mode of applying the oil, the redness of the skin is much greater, and in many cases vesication succeeds. If the application he made twice a day, morning and evening, this is sufficient for the treatment of chronic diseases; but friction cannot be made on the same part of the surface on the same day, on account of the severe pain and vesication, which would be induced. This me- thod of applying the oil is considered to be especially proper in the case of the trunk and the extremities; whilst the first method is generally to be preferred, where it is desirable to use it upon the face, hehind the ears, or on the neck. The Oleum sinapis is indicated, wherever a counter-irritant or local excitement is demanded. Riecke* advises it in chronic * Die neuern Arzneimittel, S. 341; und 2te Auflage, S. 519. Stuttgart, 1840. OLEUM TIG MI. 481 cases unaccompanied by fever, as well as in light febrile affec- tions, where a gentle excitant may be needed; and in such fevers as are conjoined with a torpid state of the system, and which re- quire the use of excitants. He regards its powerfully excitant action as constituting it a most useful article in our lists of anta- gonizing or derivative, as well as of excitant agents. In the first relation, Wolff employed it with advantage both in sub-inflamma- tory diseases, and in nervous affections not of an inflammatory character—as in subacute rheumatism of the joints, aponeuroses and muscles, and in chronic rheumatism of those parts, where blisters would be serviceable; and for vvhich it may be substituted with advantage, in consequence of its not being attended with the inconveniences occasionally produced by the latter on the urinary organs. He employed it, likewise, in rheumatic neuralgia— otalgia, odontalgia, prosopalgia, and ischias—blood-letting be- ing prescribed or not, according to circumstances; and, also, as a palliative in chronic neuralgia, colic of the hysterical kind, and gastrodynia. As an excitant to arouse the vital activity in debilitated parts, Wolff used the solution of the oil in paralysis, in the sequelae of protracted rheumatism, and in neuralgia, which was probably the result of exudation into the neurilemma, &c. He gave it, also, internally several times with good effect, in disorders of the stomach, accompanied by too great a secretion of mucus (Verschleimung des Magens,) and producing complete loss of appetite. Two drops were formed into a mixture of six ounces, by the aid of gum Arabic and sugar; and of this a table-spoonful was given every two hours. In cases of atonic dropsy, it has been conceived, advantage might, in many cases, be derived from the internal use of this oil; as in the majority of those to whom it was given internally, the urinary secretion was largely augmented by it.* Kuhn,t indeed, exhibited it with signal benefit in a case of atonic dropsy as a sequel of in- termittent fever. The oleum sinapis has been received into the Hamburg Phar- macopoeia. CXX. O'LEUM TIG'LII. Synonymes. Oleum Crotonis, 0. Seminis Crotonis, Croton Oil. French. Huile de Pignon d'Inde. German. Krotonol, Crotonol, Granatillol. The seeds of Croton Tiglium, or purging croton—a tree indige- nous in the Molucca Isles, Ceylon, Java, &c, which belongs in the Sexual System to Moncecia Monadelphia, and to the Na- * Riecke, op. cit. S. 34!!, and 2te Auflage, S. r>20. Stuttgart, 1840. 1 Medicinische Zeitung, No. 38, Sept. 21, 1836, S. 191. 482 OLEUM TIGLII. tukal Family Euphorbiaceae—are characterized by their acrid drastic properties—which, indeed, belong to the whole family. These seeds were carried by the Dutch to Europe, two centuries ago, and were admitted into the old Pharmacopoeias under the names Grana Tiglii, G. Tilii, G. Moluccoz, &c, being prescribed as a drastic cathartic, but owing to their too violent operation, which frequently induced unpleasant results, they fell subse- quently into entire disuse. The oil of croton was also introduced into Europe about the same period, and was occasionally used in- ternally. It had, however, sunk into total neglect, when attention was recalled to it by Dr. Conwell, a physician in the English East India Company's service at Madras, by whom its employ- ment was reintroduced into Europe; and, in a short time, it ac- quired so much repute as an active cathartic, that it was received into various Pharmacopoeias.* Croton oil is a thickish fluid, of a honey-yellow colour, has a disagreeable smell, and a very acrid burning taste, so that it ex- cites inflammation of the tongue and fauces. It is a fixed oil, having a very acrid matter associated with it, wrhich appears to possess acid qualities—crolonic acid. In ether and turpentine it is wholly soluble; in alcohol, partially so. It is imported chiefly from Madras, but partly from Bombay, and is prepared like castor oil, being strained, however, instead of being boiled. It is likewise expressed in England.f About 50 per cent, may be ob- tained in this way; and 10per cent, more may be removed by the solvent action of sulphuric ether, which it afterwards expelled by a gentle heat4 EFFECTS ON THE ECONOMY. Croton oil holds a distinguished place amongst cathartics, inas- much as it can be given in small doses; and in cases of great torpor of the intestines, its action is very certain. Even a drop com- monly produces eight or ten fluid evacuations; but, at times, in unusual torpor of the canal, as many as four or five drops, and even more, have been given in the course of ten or twelve hours. Like most of the drastic cathartics, it occasions tormina, but these are less distressing than the burning sensation which it commonly excites in the pharynx, and which is least felt when the oil is given in the form of pill or lozenge. Not unfrequently, also, it causes nausea, often ending in vomiting, in delicate persons, or where the dose has been large, but without interfering materially with the cathartic effect. At times, it is formed into a soap with caustic soda—Sapo olei tiglii—which is given in doses of from one to three grains. This soap is said to be less excitant, and to * Recherches sur les Propriet6s Medicinales et l'Emploi de l'Huile du Croton Tiglium, &c Paris, 1824. t Pereira, Elements of Mat. Med. and Therap. ii. 1116. Lond. 1842; or 2d Amer. edit by Dr. Carson. Philad. 1846. X Christison, Dispensatory. Edinb. 1842. OLEUM TIGLII. 483 occasion less pain than the pure oil, and it has the advantage, that the dose can be better apportioned. As with other cathartics, the incautious employment of croton oil may occasion inflammation of the intestinal canal, and there- fore, it need scarcely be said, its use during inflammation of the canal is contraindicated. It does not appear to affect any other secretory organs than those of the bowels, although some physi- cians affirm, that they have remarked an increase of the urine after its use. Occasionally, when rubbed, in the quantity of four or five drops, around the umbilicus, it would seem to have acted as a cathartic, and even its odour has been known to produce the same effect. Like other active cathartics, it has been employed as an anthel- mintic, especially in cases of tape-worm, by Poccinotti, and others, and with success.* It has been recommended in dropsy by Dr. Geo. Fifet as possess- ing one very decided advantage over elaterium; viz:—that even when its extreme action is manifested, "it is not followed by the depression inseparable from the effective action of the latter; but that where the greatest vis inerliie has prevailed, accompanied by absolute incapacity for exertion, a sensible amelioration in these respects has followed its continued employment." Croton oil has been used externally as a revellent or counter-irri- tant, and at times to induce a cathartic effect; but in this respect it is uncertain.:): Rubbed on the surface in small quantity, it induces inflamma- tion of the skin, which gradually disappears of itself. When the friction is longer continued, pustules are caused, which, when they are numerous, run together or are confluent, and around the spot where the confluent eruption is seated, papula? or pimples appear over a wider extent, which are transformed into pustules, and are surrounded by a red base or areola. W7hen the pustules are discrete, they dry up more rapidly than when they run to- gether; and in the latter case they commonly form scabs. Fric- tion readily excites pustulation on the head, face, neck, chest, and on those parts of the extremities where the skin is thin. Where it is thicker, the effect is of course induced with more difficulty. Commonly, the eruption is perceptible in twelve hours after the first friction, but at times not till a later period; very rarely is the second friction ineffectual. In the course of from three to six days, the eruption again disappears. The pain usually commences in about an hour after the rubbing, being at first nothing more than a slight itching and burning, which gradually, but decidedly, augments; yet the eruption is never so painful as that caused by * Richter's Specielle Therapie, B. x. S. 248. Berlin, 1828. t Provincial Med. and Surg. Journ. Sept. 25, 1844, p. 397. t See a case of ileus cured in this manner, by Dr. Susewind, in Casper's Wochenschrift fur die gesammte Heilkunde, Jun. 24, 1837, S. 404. 484 OLEUM TIGLII. the ointment of tartarized antimony, or by the plaster of the same agent, with which it is capable of fulfilling like indications. These frictions with croton oil are adapted for all cases in which lo- cal counter-irritation is required. It is important, however, to bear in mind, that it may in this manner act on the bowels, and hence, that it may not be adapted for intestinal disorders, in which it is not desirable to produce such an effect. Frictions with it have been recommended by many physicians—as by Andral,* Elliotson, Hutchinson,! Short, Landsberg, Romberg, and oihers, in the following affections:—In chronic inflammations, and such as have a tendency to exsudation; in chronic, rheumatic, and gouty diseases, in aphonia% and chronic hoarseness,^ in phthisical af- fections, especially in incipient phthisis; and in the neuroses—as spasmodic asthma, hooping-cough, paralysis,^ &c. Guntherf advises them as almost specific in rheumatic odontalgia and in otalgia. In neuralgia faciei, the cause of vvhich is considered by Sir Charles Bell** to be seated primarily in the intestinal canal, and remotely in the fifth pair of nerves, croton oil has been recom- mended as a superior purgative, and this, as well as other forms of neuralgia^ would seem to have been removed by it,—doubt- less by the revulsion it excites upon the intestinal nerves. But it need scarcely be said, that it possesses no specific virtue, as has been imagined by some. In the only case of genuine tic in which Dr. Christison tried it, no benefit whatever was derived. It has been advised by Dr. Prankerd,|| as an efficacious remedy in delirium tremens; in which disease it acts, he conceives, as a direct sedative to the nervous system. The testimony is, how- ever, inadequate to establish the position: and but little reliance ought, therefore, to be reposed in it. Croton oil has likewise been used as a direct excitant. Cam- panelli§§ gives a case of paralysis of the upper eyelid, which was promptly relieved by the application of four drops to the affected lid, and to the eyebrow. It has been employed also, as proposed by M. Lafargue.|||| by Mr. A. Ure, TT in the way of inocu- * Gazette Medicale, Jan. 1832, and Archives Generates, Aout, 1833. t London Lancet, May, 1833, and Dr. Sauer, in Medicin. Zeitung, Aug. 10, 1836, S. 158, cited in Dunglison's Amer. Med. Intel, Nov. 1, 1837, p. 286. X Romberg, in Wochenschrift fOr die gesammte Heilkunde, 1835. § Dr. Sauer, op. cit. || Boileau (Paralysis of the Facial Nerve,) Bulletin Medical du Midi. Avril, 1839. IT Berliner Medicin. Central-Zeitung, Nov. 19, 1838. ** Practical Essays. Edinb. 1841, p. 101. See, also, Dr. Allnatt, on Tic Douloureux. Lond. 1841. tt J. Cochrane, Lond. and Edinb. Monthly Journ. of Med. Science. July, 1841; Dr. J. A. Easton, London Lancet, Jan. 29, 1841; and Dr. Newbigging, Edinb. Med. and Surg. Journ. Jan. 1841, cited in Amer. Journ. Med. Science, Jan. 1841, p. 209. X\ Provincial IVled. and Surg. Journ. April 29, 1846. § § Annali Universali di Medicina, July, 1835. |||| Cited in Provincial Med. and Surg. Journal, Feb. 17, 1844, p. 393. 1W Lond Med. Gaz. March 21,1845, p. 786, or Ranking's Half-yearly Abstract, Amer. edit i. 118. New York, 1845. OLEUM TIGLII. 485 lation, for the removal of a naevus or erectile tumour, at the in- ner angle of the right upper eyelid. Several minute punctures were made, with a cataract needle besmeared with oil, over the surface of the naevus. These gave rise to redness and swelling, which lasted a few hours; and subsequently to small points of suppuration. The operation was repeated at the interval of a week. A rapid diminution, with withering of the tumour, took place. A common lancet may be used for the purpose as in vaccinating. MODE OF ADMINISTRATION. Internally, the dose is from one-fourth or one-half a drop to two drops, given every three or two hours, or more frequently, if necessary. The dose is rarely carried higher, except in des- perate cases, and in mental affections, for which it is peculiarly appropriate. It may be prescribed either in the form of emulsion or of' pill. Hahnemann* and Hufeland recommended it as a sub- stitute for castor oil, which is expensive in Germany,—advising, that a drop of croton oil should be added to an ounce of oil of poppies, and that the mixture should be called Oleum Ricini Officinale. This preparation is well adapted for emulsions. In apoplexy, or other comatose diseases, it may be given on a piece of sugar, which may be introduced into the throat, or be simply placed on the back of the tongue. When applied exter- nally, to excite an eruption, from four to six drops, or even more, may be rubbed in twice a day. For women and children, a single application may be sufficient; but if the skin be thick and insensible, it will be well to rub it previously with flannel, or to apply first a rubefacient, especially when it is desirahle to pro- duce the effect speedily. On the other hand, where the skin is excitable, the croton oil should be mixed with from one to four or five parts or more of olive oil, oil of turpentine, or soap lini- ment.f Pilulae olei tiglii, Pills of croton oil. R. Olei tiglii gtt iv. Micae panis, q. s. ut fiant pilula? viij. Dose.—One, or two, or more. R. Olei tiglii gtt. v. Saponis, Acaciae pulv. aa. Qj. Misce et fiant pilulae xx. Dose.—One to three. Sundelin. R. Olei tiglii gtt. ii. Micas panis vel * Apotheker Lexicon, B. ii. Abth. 1, S. 203. t See the author's Gen. Therap. and Mat. Med. 3d edit ii. 267. Philad. 1846. 486 OLEUM TIGLII. Saponis Qj. M. et divide in pilulas viij. Dose.—One to four. Pilolrc olei tiglii composite. Compound pills of croton oil. R. Olei tiglii gtt x. Ext. colocynth. comp. gi. 01. menthae piper, gtt viij. M. et fiant pil. xviii. Two for a dose—to be repeated at short intervals, in cases of obstinate constipation. Hanstns olei tiglii. Draught of croton oil. R. Tinct. ol. tiglii f. gss. Syrup. Mucil. acaciae. la. f. gij. Aquae destill. f. gss. Fiat haustus. After swallowing a little milk, this draught must be taken very quickly, and be washed down with the same diluent. Nimmo. Em nisi o olei tiglii. Emulsion of croton oil. R. Olei tiglii gtt iij. Olei amygdal. f. gss. Acac. pulv. gij. Misce sensim terendo cum Syrup, flor. aurant. f. gj. Aq. anthemid. f. gv. M. Dose.—A spoonful every two hours until it operates—shaking the vial. Phoebus* R. Olei tiglii gtt. i.—ij. Olei anthemid. gtt. ij. Terendo misce cum Mucilag. acaciae Syrup, amygdal. aa. f. gss. M. Dose.—A tea-spoonful every two hours—shaking the vial. Lockstadl. Mistura olei tigl ii. Mixture of croton oil. R. Olei tiglii gtt ii. Mucilag. acac. f. gij. Aquae f. gj. M. Dose.—A fourth part, every two^hours, until the desired effect is induced. * Handbuch der Arzneiverordnungslebre, Th. ii. Berlin, 1836. OLEUM TIGLII. 487 Mistura olei tiglii saponacea. Saponaceous mixture of croton oil. R. Olei tiglii gtt viij. Potassae gr. vj. Aquae destillat. f. gij. M. This is a substitute for the Sapo Olei Tiglii, which is trouble- some in the preparation. Dose—Three to six drops.* R. 01. tiglii gtt. ij. Sacchar. gij. Acaciae pulv. gss. Tinct. card. f. gss. Aquae destillat. f. gx. M. Dose.—Two dessert-spoonfuls, to children ; to be repeated every three or four hours, if necessary. . Trochisci olei tiglii. Lozenges of croton oil. R. Olei tiglii gtt. ij. Sacchar. gj. Mucilag. acaciae q. s. ut fiant Trochisci, non torrendi, No. viij. Dose.—One every two hours, until the desired effect is induced. Seiler. f Sapo olei tiglii. Soap of croton oil. Sapo crotonis. R. Olei tiglii partes ij. Liquor, potassae partem j. Triturate in the cold, and when the mixture has acquired the proper consistence, run it into moulds of pasteboard, and. in the course of a few days, remove it by slices. Dose.—Two or three grains in water, or in the form of pill. Caventou. Linimentum olei tiglii. Liniment of croton oil. Linimentum crotonis. R. 01. tiglii p. i. — olivae p. v. M. To be rubbed on the skin night and morning, until pustulation is induced. R. Olei tiglii Liq. potassae aa. f. gss. Mix intimately by agitation. R. Soluti. hujusce rti,xxx. Aquae rosae f. gi. M. * Ellis's Medical Formulary, 8th edit by Dr. S. G. Morton, p. 58. Philad. 1846. t Hufeland's Journal, B. lix. St. 4, S. 134; und Rust's Magazin, B. xvui. St 2, S. 358. 488 OLEUM TIGLII. To be rubbed on the part night and morning, or even three times a day, until the peculiar eruption is induced. James Allen* Embrocatio olei tiglii cum antimonii ct potassa tartrate. Embrocation of croton oil with tartrate of antimony and potassa. \ R. 01. tiglii rrLxx. Antim. et potass, tartrat. Qj. Liq. potassae f. gi. Aquae f. gvij. M. Used to keep up a mild rash upon the skin. Morris. Unguentum olei tiglii. Ointment of croton oil. R. Olei tiglii m„x.—xxx. Adipis gss. M. A little of this to be rubbed on the part so as to excite the pe- culiar eruption. Emplastrum olei tiglii. Plaster of croton oil. Sparadrap de croton. M. Bouchardat melts over a very gentle fire 4 parts of diachy- lon plaster; and when it is in a semifluid state, he mixes with it 1 part of croton oil. This he spreads upon linen, so as to form an adhesive and irritating plaster. M. Caventou prefers the following form, as he considers the de- gree of heat employed in the process of M. Bouchardat may inter- fere with the powers of the croton oil. R. Adipis p. iiss. Cerae p. ss. 01. tiglii p. i. The wax and lard must be melted, and when nearly cold, the oil be incorporated.y A stronger plaster than the above is also advised by M. Bouchar- dat. | He melts over a gentle fire eight parts of diachylon plaster, and when it is semi-fluid, mixes with it twenty parts of croton oil. The resulting plaster must be spread thickly on muslin. It pro- duces considerable irritation of the skin, and may be employed in all cases in which revellents are required. It does not, he says, cause such severe pain as many other counter-irritants, and may be applied over an extensive surface, if desirable. Pope§ recommends a tinctura granorum tiglii, or a tincture of the seeds, to be made of two ounces of the seeds from which the rinds have been carefully removed, to one ounce of alcohol. This * Provincial Medical and Surgical Journal. Oct 28, 1843, p. 75. t Bulletin General de Therapeutique, Mars, 1842, or Journ.de Pharm. Avril, 1842, p. 453. X Annuaire de Th6rapeutique, &c., pour 1844, p. 210. Paris, 1844. § Medico-Chirurgical Transactions, vol. xiii. p. L PAULLINIA. 489 is allowed to digest for six days, and is then filtered. The smallest dose for an adult, is twenty drops. This preparation, he says, has the advantage of excluding the more acrid drastic matter contained in the epidermis and husk, whilst the kernel affords cathartic ma- terial enough to act powerfully and certainly. CXX1. PAULLINTA. Synonyme. Guarana. Paullinia is an extract from the plant of the same name, a native of Brazil. It is prepared by the Indians, and seems to possess considerable excitant powers. M. Gavrelle 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 Paullinia and the alkali are very bitter, and somewhat resemble Cafein. M. Gavrelle states, that Paullinia is obtained from Paullinia sorbilis; Guarana officinalis, Family, Sapindaceae. M. de Chastetus found it to be composed of a gum, starch, a resinous matter of a reddish-brown colour, a fat oil, tannic acid, and a crystallizable substance, possessing the chemical properties of ca- fein. EFFECTS ON THE ECONOMY IN DISEASE. In Brazil and the neighbouring countries, it is given in the form of tisane—the powder being" mixed with cocoa—in diarrhoza and dysentery. As a tonic, M. Gavrelle has employed it successfully in chlorosis, tedious convalescence, paralysis, the colliquative diar- rhoea of phthisis, and hemicrania. According to Von Martins, an extract is prepared in Brazil from Paullinia sorbilis, which is known there under the name of Guarana, and is administered in similar pathologicnl cases.* It is probably the same substance. MODE OF ADMINISTRATION. M. Gavrelle has given formulas for Lozenges, Syrup, Pills, Pow- der, Tincture, and Oinlmenlf of Paullinia. Trochisci panlliniac. I^ozenges of paullinia. R. Paullinia? gvss. Sacchar. (vanilla odorizat.) Ibis?. Make into lozenges each containing ten grains. * See art. Guarana, in Diet. Univers. de Mat. Med. par Merat et De Lens, torn, ii., p. 365. Bruxelles. 1838; Journ.de Pharmacie,cited,in Amer. Juurn.of Pharmacy, Jan. 1841, 'p.340; M. Dechastetus. Journ. de Pharm. Aout, 1840; J. J. Virey, ibid., and Von Schlech- tendal! Encyclop'ad. Worterb. der Medicin. Wissenschaft. xxvi. 433. Berlin, 1841. t Journal de Chimie Med., and Encyclographie des Sciences Medicales, Juillet, 1840, p. 230, cited in American Journal of Pharmacy, Oct. 1840, p. 208. 490 PHLOBIDZINA. Syrupus paullinia:, Syrup of paullinia. R. Paullin. giiss. Syrup. Oij. Haifa fluidounce may be given in the 24 hours. P ilulse rpaulliniae. Pills of paullinia R. Paullin. q. s. To be made into pills, each containing a grain and a half Pjilveres paullinirc. Powders of paullinia. R. Paullin. in pulv. gi. Sacchar. aromatizat. gsF. M. For a dose. Tinctura paulliniae. Tincture of paullinia R. Paullin. gi. Alcohol. (22°) Oi. M. Unguentum paullinise. Ointment of paullinia. R. Paullin. gij. Adipis gij. M. CXXII. PHLORIDZI'NA.* Synonymes. Phloridzinum, Phloiorrhizinum, Phloridzia, Phloridzine, Phlo- rizin, Phloridzin. German. Phloridzin, Phloionhizin. This bitter principle exists in the bark of both the trunk and the root of the apple, pear, cherry, and plum tree. METHOD OF PREPARING. The following plan is recommended by M. de Koninck, its dis- coverer (1834 or 1S35.)—The fresh bark of the root of the apple tree is to be boiled for two hours with sufficient water to cover it: the decoction is to be decanted, and a second one made by the addition of more water. On uniting the two decoctions, and per- mitting them to stand for twenty-four hours, a deposition of phlo- ridzin, in granular crystals, takes place. These are to be treated with distilled water and animal charcoal to purify them. An additional quantity is obtained by evaporating the mother waters to one-fifth. At this degree of concentration, all the phloridzin is deposited. This method affords about one part in three hun- * From yXoo;, inner bark, and gaa, root PHLORIDZINA. 491 dred. Another plan yields five per cent. It consists in digesting the fresh root in weak alcohol, at a temperature of 120°, for about eight or ten hours, distilling off the greater part of the alcohol, and crystallizing the residue.* Phloridzin crystallizes in silky spicula of a dead-white colour when in masses, or in long slender prisms or tables when crystal- lized with care. One thousand parts of water, at a temperature from 32° to 71°, only dissolve about one part; but at from 71° to 212°, water dissolves it in all proportions. It is also very soluble in pure alcohol at ordinary temperatures, although but slightly so in ether, even when boiling. It has no action on test papers. S. g. 1.429.f EFFECTS ON THE ECONOMY IN DISEASE. M. de Koninck found, that from ten to fourteen grains given for a dose, with a dram of sugar, produced the most marked effect in intermittent fever, where sulphate of quinia had failed.J In four cases, reported by Dr. Van Mons,§ of Bruxelles, the disease was arrested by the first sixteen grains: other cases required sixteen grains, a few hours before the first paroxysm; twelve grains before the second; six before the third; and four before the fourth. Five successful cases are likewise given by M. Mathysen,|| eleve interne at the Hospital St. Pierre, Bruxelles; and M. Lebaudy^f affirms, that its efficacy is so decided, that we cannot hesitate to class it with the most powerful febrifuges; and that it has this advantage over quinia, that it never induces gastralgia: yet M. Leonhard** is satisfied from his various trials, that phloridzin does not possess any febrifuge virtue! MODE OF ADMINISTRATION. It may be given in the form of pill or powder, like the sulphate of quinia. It was administered at the hospital at Bruxelles, in one case, in the way of lavement;—twenty-four grains being given in three lavements. The paroxysm returned, but was less vio- lent. In two days afterwards, the same quantity was administered in the same manner, and the fever did not recur. * Journal de Pharmacie, xxii. 78, cited in Amer. Joum. of Pharmacy, vol. ii. new series, p.240. See, also, M. Boullier, in Gazette Medicale de Paris, 17 Juin, 18:37, and M. Mar- chand, Journ de Chim. Med. Avril, 1841. t For some elaborate chemical researches on Phloridzine, see M. J. S. Stass, Annales de Chimie et de Physique, Dec. 1838. X See, also, Prince Louis Lucien Bonaparte, cited in Bouchardat, Annuaire de Thera- peutique, pour 1843, p. 2(13. Paris, 1843. § Bulletin Medical Beige, Mai, 1836. || Ibid. Oct. 1835. IT Journal des Connaiss. Med. Chirurg. cited in Braithwaite's Retrospect of Medicine and Surgery, IS'o. 5, p. 12!), Lond. 1842, where it is termed erroneously fldoridrine,. and whence it is copied into the Amer Journ. of the Medical Sciences, and the Amer. Journ. of Pharmacy, for Jan. 1843, under the name Fhloridine. ** Encyclographie des Sciences Medicales, Mai, 1838. 492 PIPERINA. CXXIII. PIPERPNA. Synonymes. Piperinum, Piperium, Piperine, Piperin. German. Piperin, PfefFersloff. This substance was discovered by M. Oerstiidt, in the year 1819, in black pepper, Piper nigrum.* It is found, also, in Piper longum, and it has been presumed to be the same, or an analogous principle, with the cubebin of Piper cubeba. It has been affirmed, that it exists only in black, and not in white pepper; but this is an error. Dr. Christisonf invariably obtained it from the latter in larger quantity than from the former, and more easily, because it is combined with less resin. M. Oerstadt at first regarded it as a vegetable alkali, but M. Pelletier subsequently analyzed it, and proved it not to be such, but to bear a considerable analogy to resins.J METHOD OF PREPARING. Let two pounds of black pepper, bruised, be digested, at a gentle hea^ in three pounds of alcohol, at 36° (.837.) This mixture must afterwards be raised to ebullition, then suffered to remain at rest, and grow cold ; when it must be decanted, and the operation be repeated with fresh alcohol. The two solutions must then be mixed together, and two pounds of distilled water and three ounces of muriatic acid be added. The liquor becomes turbid, and a precipi- tate, of a deep gray colour, is thrown down, which is composed in a great measure of fatty matter. The deposite beipg separated, crystals may be collected on the filter and sides of the vessel. These are piperin. On adding water, until the liquor is no longer rendered turbid, a fresh quantity is obtained. , The above process, which is that of Meli, is the same as one de- scrihed by M. Pelletier. He has likewise procured it by the fol- lowing method :—After having exhausted pepper by alcohol, and evaporated the alcoholic tinctures, a fatty or resinous matter is ob- tained : this must be subjected to the action of boiling water, vvhich must be added again and again, until it passes off colourless. By- dissolving this fatty matter—thus purified by washing—in alcohol, by the aid of heat, and leaving the solution to itself for some days, a multitude of crystals are obtained, which may be purified by so- lution in alcohol and ether, and by repeated crystallization. The alcoholic mother waters, left to themselves, will furnish fresh crys- tals. This crystalline matter is piperin. Piperin presents itself in the form of four-sided prisms, two of which—parallel to each other—are evidently broader than the others. In the pure state, it is of a white colour, and translucent: * Journ. de Physique, No. 2, 1820, and Gazette de Sante, Mai 25, 1820. 1 Dispensatory, p. 6!)8. Edinb. 1842. X Examen Ohimique du Poivre, par J. Pelletier. 8vo. Paris. PIPERINA. 493 it is frequently, however, coloured yellow by portions of resin being combined with it. It has been affirmed, that when Piperin is quite pure, it is bland ;* but Dr. Christisonf states, that the very whitest crystals he was able to obtain were as acrid as those vvhich are brownish, and they emitted an intensely irritating va- pour when thrown on a heated iron plate. It is inodorous, and of a feeble taste of pepper; fuses readily by heat; is not volatile, and is scarcely soluble in cold water, but somewhat more so in hot. In respect to its solubility in alcohol, testimony is discordant. According to Magendie, it dissolves very readily therein: accord- ing to C. G. Gmelin, it is soluble only in small quantity in cold, but in tolerable proportion in hot alcohol, as well as in ether and in the volatile oils. The solutions taste acrid and peppery, and * do not react on vegetable colours;—vvhich shows that it is not an alkaloid, as the discoverer conceived. With acids, it forms no in- timate chemical combinations; acetic acid, indeed, dissolves it in considerable quantity; it is, however, in great part, precipitated by water, and by evaporation the whole of the acid escapes. It is related to the resins. EFFECTS ON THE ECONOMY. Piperin has been exhibited chiefly by the Italian physicians for the cure of intermittent fever. Its employment was, doubtless, sug- gested by the use of pepper-corns as a popular remedy in that disease. According to Riecke,! the antiperiodic virtue of pepper is exhi- bited upon the healthy economy,—a few pepper-corns taken before the expected appearance of the menses, arresting them for several days. Of this, he himself has had no experience; but he affirms. that the females in a district of southern Germany have great confidence in their virtues. Meli,§ who treated many cases of intermittent with piperin, con- siders it as the best of all febrifuges, quinia not excepted. He forms twenty grains into ten pills, and gives these at intervals during the apyrexia. He ascribes the efficacy of the oleum acre piperis in the same complaint to the piperin it contains. The febrifuge virtue of piperin has been confirmed by many other Italian physicians,—by Brandolini, Iiertini, Gordini, Torelli, and others. According to'Brandolini, from forty to fifty grains are generally required to effect a cure. Bertini gave it in three doses during the apyrexia, to the extent of a scruple, made into pills with a bitter extract: after two or three closes, the fever was generally arrested. Gordini affirms, that relapses occurred less frequently after the use of piperin than after that of the sulphate * Dispensatory of the United States of America, 4th edit. p. 512. Philad. 1839 t Op. cit. p. 097. X Die neuem Arzneimittel, S. 361; und 2te Auflage, S. 522. Stuttgart, 1840. § Nuove Esperienze, &c. Milan, 1823, 8vo.; and Annali Universali di Medicina, xxvii. 161, and xxviii. 22. ^ 32 494 PIPERINA. of quinia. On the other hand, in the hospital at Turin, Christin was disappointed in it, and such seems to be the result of the trials made by Chiappa.* In the year 1823, he administered it in ten or twelve cases, but was unable to detect any great antipe- riodic property; not more than a fourth part of the sick expe- rienced benefit, whilst on the others cinchona acted like a charm. In general, a burning sensation was experienced in the stomach after taking it, as well as in the throat, with the same kind of feeling occasionally in the rectum, and in the whole abdomen ; and in two young individuals, the eyes were made red, and the eye- lids, nose, and lips were swollen. Piperin has been employed by others besides the Italian physicians. Dr. Blom, of Utrecht, has given it in intermit- tents, but not with as much success as quinia. According to him, the remedy, soon after it is taken, particularly in very impressible persons, occasions a sense of internal heat, especially in the epigastric region, and not unfrequently it causes perspira- tion, especially on the upper lip. Blom is, however, doubtful, whether these effects be ascribable to the piperin, or to a portion of the resin of the pepper remaining united with it. He is of opi- nion, that both in general debility and in debility of the digestive apparatus, piperin merits a preference over sulphate of quinia, both because it can be better borne by the stomach, and because it acts more tonically upon it. It has been given in intermittent fever, with great success, by Dr. Hartte,f Port of Spain, West In- dies. He prescribed it as soon as the sweating stage was estab- lished, until 18 grains had been taken, and on the following day, when the intermission was complete, he directed the same quantity every three hours. It succeeded, in every case, in checking the paroxysm, and as soon as this was accomplished he gave, for some days, pills composed of Pilulas Hydrargyri, Piperin, and Sulphate of Quinia, the formula for which is given below. In inflammatory intermittents, as well as in those with gastric complications, piperin is to be avoided. Magendie suggests that it should be given in blennorrhcea, in place of cubebs. METHOD OF ADMINISTERING. Pi 1 ii 1 sb piperinae. Pills of piperin. R. Piperin. gr. xij. Extract, gentian, q. s. ut fiant pilula; xij. Dose.—One every hour, during the apyrexia of fever. * Riecke, op. cit. S. 361; und 2te Auflage, S. 553. Stuttgart, 1840. t Edinb. Medical and Surgical Journal, Jan. 1841, p. 98. PLATINI PR.EPARATA. 495 Pilnlffi piperinae composite. Compound pills of piperin. R. Pil. hydrarg. gr. i. Piperin. gr. ij. Quinise sulphat. gr. ij. Syrup, q. s. ut fiat pilula. One to be taken morning, noon, and night. Hartte. CXXIV. PLAT'INI PRJEPARA'TA. Synonymes. Preparations of Platinum or Platina. French. Les Preparations de Platine. German. Platinpraparate. EFFECTS ON THE ECONOMY. The preparations of platinum have not been much used in me- dicine. Recently, experimental researches have been undertaken by M. F. Hofer,* in regard to their employment as physiological and therapeutical agents; and the following are the main results. Experiments were made on rabbits, dogs, and on himself, with the view of discovering the physiological action of the perchloride of platinum or chloroplatinic acid, of the chloroplatinate of sodium or the double chloride of platinum and sodium; of the chloroplatinate of potassium, and the chloroplatinate of am- monium. He found—First. That the chlorides of platinum are poisonous,—the perchloride in the dose of 15 grains; the chloro- platinate of sodium in that of 3ss. Secondly. The chlorides of platinum are less poisonous than the chloride of gold, and corro- < sive sublimate. Thirdly. The perchloride of platinum, in concen- trated solution, produces violent itching or irritation of the skin, followed by a slight eruption on the part to which the solution has been applied. Taken internally, it first of all irritates the mucous membrane of the stomach, occasions headache, reacts on the ner- vous centre, and through it exerts a special alterative action on the fluids of the economy. Fourthly. The chloroplatinate of so- dium produces no local irritation on the skin. Taken internally, it does not react on the nervous centres in as manifest a manner as the simple perchloride. It more especially increases the uri- nary secretion. Fifthly. The perchloride of platinum is a very efficacious remedy in the treatment of syphilitic diseases, and • especially in those that have been of long duration, and are inve- terate. Sixthly. The chloroplatinate of sodium is more proper for the treatment of recent syphilitic diseases. It is also very efficacious in the treatment of rheumatic affections. Se- venthly. Platinum ought to be ranked in the class of alterative remedies, by the side of gold, iodine, and arsenic. It differs from * Gazette Medicale de Paris, No.48,1840; or Journ. de Pharmacie, Avril, 1841, p. 213. 496 PLATINI BICHLORIDUM. mercury in previously inducing excitement, whilst its admi- nistration is not followed by any of the disagreeable consequences induced by mercury. Eighthly, and lastly. Platinum is pre- ferable, as an alterative, to mercury and gold. Mr. Tuson* remarks, that from what he was led to believe of the effects of the chloride of platinum on scirrhous tumours, as stated to him by a medical gentleman whom he met in consulta- tion, he fully expected some most striking results from it, but that he had been disappointed on ever}' occasion vvhen it had been pre- scribed. Still, it was his intention to watch carefully its effects on some future opportunity. From what he had seen, he had little faith in its use, either as a local application or as an internal remedy. CXXV. PLAT'INI BICHLO'RIDUM. Synonymes. Platini Perchloridum, Bichloride or Perchloride or Chloride of Platinum. French. Bichlorure ou Perchlorure de Platine. German. Chlorplatin, Platinchlorid. This preparation is made by dissolving platinum in aqua regia, and evaporating the solution to dryness. A very gentle heat ought to be used; otherwise the bichloride may be decom- posed; and the protochloride, or even reduced platinum, be the result. Bichloride of platinum in concentrated solution or in the solid state is of a deep red colour. It is very deliquescent: very solu- ble in water, and soluble also in alcohol. Mistura platini pcrchl oritli. Mixture of perchloride of platinum. (Potion platinique.) R. Platin. perchlor.id. sice. gr. iss. Mucilag. acac. Aqua? aa. f. giij. To be taken by table-spoonfuls in the course of the 24 hours. Pilulee platini perchloridi. Pills of perchloride of platinum. (Pilales platiniques.) R. Platin. perchlorid. gr. viij. Guaiac resin, gi. Glycyrrhiz. pulv. q. s. ut fiant pil. xx. Dose.—One, two, three, or four, morning and evening. • The Structure and Functions of the Female Breast, p. 428. Lond. 1846. PLUMBI IODIDUM. Unguentum platini perchloridi. Ointment of perchloride of platinum. (Pommade platinique.) R. Platin. perchlorid. gr. xv. Extract, belladon. gss. Adipis §i. To be applied to indolent ulcers. CXXVI. SO'DII CHLOROPLAT'INAS. Synonymes. Chloroplatinate of Sodium, Double Chloride of Platinum and Sodium. French. Chloroplatinate de Sodium, Chlorure Double de Platine et de So dium. The chloroplatinate of sodium is prepared by dissolving bichlo- ride of platinum and very pure chloride of sodium in proper pro- portions in water, evaporating and crystallizing. It is soluble in water and in alcohol, and crystallizes in beautiful transparent prisms of an intensely yellow colour. Mistura sodii chloroplatinatis. Mixture of chloroplatinate of sodium. (Potion de chlwoplatinate de sodium.) R. Platin. perchlorid. gr. v. Sodii chlorid. pur. gr. viij. Mucilag. acac. Aquae aa. f. §iij. To be taken by spoonfuls in the 24 hours. Injectio sodii chloroplatinatis. Injection of chloroplatinate of sodium. (Injection de chloroplatinate de sodium.) R. Sodii chloroplatinat. crystalliz. gss. Decoct, papaveris Oss. The experiments of M. Hofer with the salts of platinum have not been numerous; but they confirm the assertions of Magendie, that they possess properties analogous to those of the salts of gold. CXXVII. PLUMBI IO'DIDUM. Synonymes. Plumbi Ioduretum seu Iodatum, P. Hydriodas seu Hydroiodas seu Iodhydras, Plumbum Iodatum, P. Hydroiodicum, Iodide or Ioduret of Lead. French. Iodure de Plomb. T « , . »» i • i German. Bleiiodid, lodblei, Bleiiodixre, Einfach lodblei, Hydroiodsaures oder Iodwasserstoffsaures Blei. 498 PLUMBI IODIDUM. METHOD OF PREPARING. This preparation may be made by adding a solution of one hundred parts of iodide of potassium to a solution of seventy-five parts of acetate of lead. The London Pharmacopoeia of 1836, gives the following form; —Take of acetate of lead, nine ounces; iodide of potassium, seven ounces; distilled water, a gallon (imperial measure:) dis- solve the acetate of lead in six pints of tbe 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. In the Edinburgh Pharmacopoeia, it is directed to be prepared by the double decomposition of nitrate of lead and iodide of potassium. Dr. Christison* considers, that the nitrate is prefer- able to the acetate of lead, as being more uniform in composition, and free from any excess of oxide of lead, which interferes with the purity of the product. Iodide of lead is of a bright yellow colour. According to Soubeiran,t it is soluble in 1235 parts of cold water; and is some- what more soluble in boiling water, which, on cooling, deposits the iodide in minute, shining, yellow, crystalline scales. RieckeJ 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. Iodide of lead is not an irritant, when applied even to a denuded surface.§ M. Paton|| administered twelve grains of it to a cat of moderate size. In four hours the animal did not appear to expe- rience any inconvenience; twelve more grains were then given; in twelve hours, the animal became uneasy, and constantly re- fused every kind of food. It appeared to suffer in the 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 perceptible. 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 faeces. He then boiled the intestines and their contained matters in distilled water; the liquid was filtered and decolourized by charcoal, but no effect was induced by the tests for lead. The matter remaining on the filter was digested in di- lute nitric acid: the solution was filtered, and a precipitate obtained •• * Dispensatory, p. 711. Edinb. 1842. t Traite de Pharmacie, cited in Dispensatory of the United States of America, 6th edit. p. 1076. Philad. 1845. X Die neuern Arzneimittel, u. s. w. 2te Auflage, S. 563. Stuttgart, 1840. § Eager, Dublin Journal for 1834. || British Annals of Medicine, Mar. 3, 1837; and Journ. de Chimie Med., Jan. 1837. PLUMBI IODIDUM. 499 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 re-agents like the solutions of the salts of lead. M. Paton infers, that 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 admitting of detec- tion by the method described. When given internally, in the dose of a quarter or half a grain, Velpeau thought, that it occa- sioned, in one instance, irritation in the alimentary canal; but Dr. O'Shaughnessy thinks that this result must have been owing to idiosyncrasy, as ten-grain doses can be borne with perfect impu- nity. The experiments of Dr. Cogswell* show, that it is by no means an active agent, and that its physiological operations do not correspond vvith its therapeutical effects; as, in continued doses, it produced the constitutional action of lead, and not at all that of iodine. Owing to its not exciting cutaneous irritation—like iodine, and iodide of potassium—iodide of lead has been applied externally. Velpeaut treated three cases of enlarged glands with very gra- tifying success, although the patients had used frictions with other preparations of iodine ineffectually. Similar good effects were ob- served by Guersent, Roots, and others. Dr. Christisonj4>as seen it repeatedly useful to appearance in obstinate ulcers, especially vvhen "consecutive to mercurio-syphilitic eruptions in strumous habits." Pilulff plumbi iodidi. Pills of iodide of lead. R. Plumbi iodid. gr. iv. Confect. rosee Qj. 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. doy.§ Unguentum plumbi iodidi, Ointment of iodide of lead. R. Plumbi iodid. gj. Adipis ^viij. M. Applied to scrofulous and other indolent swellings in the form of friction. Lond. Pharm. * Essay on Iodine, p. 142. Edinb. 1837. 1 Lugol, Essays on Iodine, &c, by O'Shaughnessy, p. 20G. X Dispensatory, p. 712. Edinb. 1843. § Tweedie's Library of Medicine, v. 320. Lond. lt-10; or 2d American edit. vol. iii Philad. 1842. 500 POTASS^ CHLORAS. CXX VIII. PLUMBI TANNAS. Synonymes. Plumbum Tannicum, P. Scytodepsicum, Tannate of Lead. French. Tannate de Plomb. German. Gerbestoffblei, Bleitannat. METHOD OF PREPARING. Tannate of lead is formed by precipitating an infusion of oak bark by acetate of lead, according to the following formula: "Take of oak bark, in coarse powder, an ounce; boil in eight ounces of icaler, 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 con- sistence of a thin ointment." EFFECTS ON THE ECONOMY. Autenrieth* has strongly recommended tannate of lead in cases > of paratrimma ad decubilum, that is, of sores produced by lying, and its advantages have been confirmed by others. Dr. Tott has recommended it in cases of decubitus gangroznosus, or sloughing sores produced by lying.f In one case, in which it ap- peared to be inefficacious, he took two drams of the dried preci- pitate, mixed it with an ounce of unguentum rosatum, and used this UNGUENTUM PLUMB1CO-TANNICUM with SUCCesS. CXXIX. POTAS'S^ CHLORAS. Synonymes. Kali Chloricum, K. Chlorinicum, Chloras Kalicus Depuratus, Chloras Potassicus, Alcali Vegetabile Salito-dephlogisticatum, Chlorure- tum Potassae Oxidatum. Haloidum Oxygenatum, Murias Potasses Hyper- oxygenatum seu Oxygenatum, Oxygeno-chloruretum Potassii, Kali Oxy- muriaticum, Kali Muriaticum Hypeioxygenatum, Potassae Euchloras. Chlorate of Potassa, Chlorate or Protoxide of Potassium, Oxymuriate of Potassa, Hyperoxymuriate of Potassa. French. Chlorate de Potasse. German. Chlorsaures Kali, Oxydirt Salzsaures oder Hyperoxygenirt Salz- saures Kali. METHOD OF PREPARING. In the chemical manufactories, chlorate of potassa is prepared by passing chlorine gas into a solution of carbonate of potassa. In this way, chlorate of potassa is obtained mixed with more or less chloride of potassium. The salt prepared in the laboratories, before it is adapted to medical use, should be purified by recrystal- lization. It is to be observed, that when the adequate quantity of * British Annals of Medicine, June 2, 1837; and Journ. de Chim. Med., Mars, 1837. t Grafe und Walther's Journal der Chirurgie, B. xxiv. S. C76. Berlin, 1836; and Ga- zette Medicale, Jan. 1837. POTASS^ CHLORAS. 501 chlorine gas is not employed in the preparation, the resulting com- pound is analogous to chlorinated soda and chlorinated lime, and in action it agrees rather with those preparations than with the true chlorate of potassa. This may tend to explain the discre- pancy in the experience of different physicians. Chlorate of potassa crystallizes 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 water. When exposed to heat, oxygen escapes, and chloride of potas- sium remains. When beaten forcibly in a mortar, it crackles, and emits light and sparks. When rubbed lightly with inflammable substances, or when struck, it inflames readily, and hence its well known employment in the formation of matches. 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 this salt the 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; and the liquifying or resolvent (fluidisirende) property is mo- derated, but not removed. On the other hand, by the union of the chloric acid with the alkali, the powerful excitant action on the nerves, which the former exerts, is at the same time manifestly 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, andiwhich is capable of mitigating and pro- bably of removing any morbid erethism therein, with hyperaesthe- sia thereby induced. Such is the opinion of certain therapeutists. Others imagine, that it is capable of purifying the mass of blood in consequence of ^ie chlorine it contains; but a salt of chloric acid is not possessed of the same properties as chlorine; and, accordingly, when the au- thor has found occasion to administer it, he has never witnessed any of the efiects ascribed to it; nor has he seen any evidence of the modus operandi on the nervous system mentioned above, or of its imparting oxygen to the blood as supposed by some.f The saline powder given below, which was considered by Dr. Stevens to be so useful in many febrile affections, is affirmed by Mr. Braith- waite| to have been very beneficial in typhous cases, marked by * Riecke, Die neuern Arzneimittel, S. 300, und 2te Auflage, S. 451. Stuttgart, 1840. 1 See Stevens on the Blood, p. 29(5. London, 1832; and Pereira, Elements of Mat. Med. and Therap. 2d edit. i. 514. Lond. 1842; or 2d Amer. edit by Dr. Carson. Philad. 1846. ; Retrospect of Practical Medicine and Surgery, July to December, 1840, p. 275. 502 POTASSJE CHLORAS. drv, parched, brown or black tongue; dark sordes on the teeth and gums. &c, &c. In almost every case, he found the dark appearances in the mouth to be altered in an incredibly short time. 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, chlorate of potassa has been re- commended in chronic cutaneous diseases in general, as well as in hepatic and syphilitic affections. It has also been occasionally ad- ministered in cases of chronic asthenia. Kohler* employed it in several cases of tubercular phthisis, and notwithstanding the general results of his experiments were un- favourable, he thinks it ought to be admitted into the number of those remedies that are useful in phthisis, although its stimulating action on the circulating and pulmonary systems cannot be denied Its use is contraindicated where the fever runs high, and where there is any sign of inflammation of the lun^s. or tendency to haemoptysis. Dr. Christisonf states, that he has tried the efiects of seven-grain doses three times a day in phthisis, but could not observe any physiological or therapeutical action whatever. Sachs, in accordance vvith 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 afford- ed essential relief. Chisholm appears to have been one of the earliest to prescribe it in neuralgia faciei; and, after him, Herber, and subsequently, B. Schaffer, Jos. Frank, Meyer, and others. employed it both as a curative and palliative agent in that disease. It has likewise been advised in obstinate rheumatism of the nervous kind, by Knod von Helmenstreit; and Eyr has extolled it in ulce- ration of the mouth after violent salivation. In cancrum oris and phagedena of the cheek, both of which Dr. Henry Hunt± regards as identical, varying onlv in the decree of severity, and proceeding from a cachectic condition of the system. he has found the chlorate of potassa. freely given, followed by the best results.—the beneficial influence of the salt being generally apparent within 4S hours after its first administration; and it sel- dom failed to arrest the progress of the disease, and to effect a cure, if administered before the patient was much exhausted. He gave it in the dose of from 9j. to 9ij., according to the a^e of the child, in twelve hours. Dr. Watson§ affirms, that he has been in the habit of directing a solution of the chlorate of potassa in water (Potass, chlor. 3j'. Aq. Oj) as a drink for patients in scarlet ferer, and in the typhoid forms of continued,fever; a practice which was sug- gested to him by Dr. Hunt, who informed Dr. Watson, that he had * Rust's Magazin, B. xM. t Dispensatory, p. 730. Edinb. 1842. X Lond. Med. Gaz^ April 7,1543, p. 76, and Medico-Chiruxgical Transactions, xxm. 142. § Lectures on the Principles and Practice of Physic, 2d Amer. edit. p. 1 u24. Philad. 1845. POTASS.E CHLORAS. 503 long employed it with advantage. Under the use of a pint or a pint and a half of the solution daily, he has noticed, in many in- stances, a speedy improvement of the tongue, which from being furred or brown or dry, became cleaner and moist. MODE OF ADMINISTRATION. Sachs prescribed it in the dose of from three to six grains, three or four times a day, but some give it in much larger quan- tity. It may be administered either in the form of powder or of solution. It would appear, as Dr. Pereira has properly remarked,* that most of the uses of this salt have been founded on certain views of chemical pathology, some of which are now considered un- tenable. It passes through the kidneys unchanged, and conse- quently the notion, that it furnishes oxygen to the system must be discarded. From the results of the author's numerous trials with it, he is disposed to accord with Dr. Christison,! that no evidence has yet been published of such a nature as to entitle it to admission into the Pharmacopoeias: yet it is officinal in the London Pharmacopoeia. Pulvis potassiB chloratis compositus. Compound powder of chlorate of potassa. (Stevens's saline powder.) R. Potassae chlorat. gr. viij. Sodii chlorid. gr. xx. Sodae bicarbonat. gr. xxx. M. One of these to be given every two or three hours in low febrile cases. Stevens. Liquor potassae chloratis. ' Solution of chlorate of potassa. Solutio muriatis potassa oxygenati, Liquor ad ulcera atonica. R. Potassae chlorat. J5j. Aquae destillat. f. gxij. M. To be applied to indolent ulcers, by means of lint dipped in it, or of a camel's hair pencil, to excite the tissues. Swediaur.\ Potns potassae chloratis. Drink of chlorate of potassa. Potus oxygenatus.—French. Tisane oxygenee. R. Liquor, potass, chlorat. Oij. Aquae Oiv. M. Given internally, in cases of general asthenia. Dose.—One or two pints a day. Swediaur. * Elements of Mat. Med. and Therap., 2d Amer. edit, i. 448. Philad. 1846. t Ibid. p. 738. Edinb. 1842. \ Pharm. Med. Pract Bruxelles, 1817, 2d edit. 504 POTASSII BROMIDUM. Mistura potassae chloratis. Mixture of chlorate of potassa. R. Potassae chlorat. ^iss. Aquae destill. f. %i\. Solve. Dose.—A spoonful, every two hours. Von Helmenstreil. Eyr dissolves twenty-five grains of the chlorate in four fluid- ounces of distilled water, and administers a spoonful three times a day. R. Potass, chlorat. gj. Syrup, althaeas f. %}. Aquae destill. f. giv. M. Dose.—A table-spoonful, four times a day. Kohler. CXXX. POTAS'SII BRO'MIDUM. Synonymes. Kalium Bromatum, Bromuretum Potassicum, B. seu Brome- tum Kalii, B. Potassii, Bromide of Potassium. In solution. Hydrobromate of Potassa, Potassae Hydrobromas, Kali Hydrobromicum, Bromhydras Potassae. French. Brdmure de Potassium. German. Bromkalium, Kaliumbromid, jKaliumbromure, Bromwasserstoff- saures oder Hydrobromsaures Kali. METHOD OF PREPARING. According to Liebig, this preparation can be readily made by dissolving bromine in alcohol, and adding potassa until the spirit begins to change colour, then evaporating and heating to redness. In the London Pharmacopoeia, it is directed to bwmade 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 loater, are poured in: what remains is filtered and washed with two pints of boiling distilled water, and again filtered. The mixed solutions are then evaporated, that crystals may form. Liebig says it crystallizes in four-sided shining tables: accord- ing to Ballard,* commonly in cubes, and at times in long rectan- gular para 1 leiopipedons. It, has a pungent taste like that of com- mon salt, but more acrid; and is devoid of odour. 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 hydrobro- * Annales de Chimie, torn, xxxii. POTASSII BR0MIDUM. 505 mate of potassa. It is also soluble in alcohol, although in small quantity. The solution of bromide of potassium dissolves no more bromine than pure water. EFFECTS ON THE ECONOMY. Bromide of potassium excites the same phenomena as bromine, but with less intensity. From a dram and a half to two drams 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 bro- mide, like bromine, seems first to have been applied to therapeu- tical purposes by Pourche.* Two cases of scrofidous tumours are reported by him to have been removed by friction with an oint- ment composed thereof, and a cataplasm sprinkled with an aque- ous solution. In a third patient, chronic otorrhaza and scrofulous tumefaction 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 it internally in the form of pill, in the dose of four to eight grains in the day. Magendiet employed the preparations of bromine in scrofula, in amenorrhoea, and in hypertrophy of the ventricles of the heart. Prieger recommended an ointment of" Kali bromicum " in inveterate porrigo favosa as well as in obstinate and malig- nant tetter, and with good success; and Dr. Williams}: in cases of enlarged spleen. The last gentleman suggests, that it possesses "unusual, if not specific (?) powers in the cure of diseases of the spleen." It was owing to these results that the bromide was in- troduced into the London Pharmacopoeia, of IS36.§ Dr. Wil- liams also gave it with success in a case of ascites. . MODE OF ADMINISTERING. Liquor potassii bromidi. Solution of bromide of potassium. R. Potassii bromidi gr. vi.—viij.—x. Aquae lactucae f. ,^iij. Syrup althaeae f. §i. M. To be given in the course of the twenty-four hours, in table- spoon fu Is. Magendie. Unguentum potassii bromidi. Ointment of bromide of potassium. R. Potass, bromid. gr. xxxiv. Adipis §j. M. * Journ. de Chimie Medicale, iv. 594; see, also, Bulletin General de Therapeutique, No. 14, Juillet 30, 1837. t Formulaire, ed. cit X Elements of Medicine, i. 338. § Pereira, Elements of Mat. Med. and Therap. 2d edit. i. p. 4!)!). Philad. 1842; or 2d Amer. edit, by Dr. Carson. Fhilad. 1846; and Brande's Diet, of Mat Med. p. 126. Lond. 1839. 506 POTASSII CYANURETUM. From half a dram to a dram to be rubbed on scrofulous swell- ings- Magendie. M. Pourche employs 3j- of the bromide to the ounce of lard. R. Bromini gr. vi. ad xij. Potassii bromid. gr. xxiv. Axung. l\. M. Magendie. CXXXI. POTAS'SII CYANURETUM. Synonymes. Potassii Cyanidum, Kali Hydrocyanicum, Kalium Cyanoge- natum, Cyanuretum Potassicum seu Kalii, Cyanidum Kalii, Cyanetum Kalii, Hydrocyanas seu Cyanhydras Potassae seu Kalicus, Cyanide or Cyanuret of Potassium. French. Cyanure de Potassium. German. Cyankalium, Blaustoffkalium, Kaliumcyanure, Hydrocyansaures Kali, Cyanwasserstoffsaures Kali. This preparation was proposed by MM. Robiquet and Viller- me,* as a substitute for hydrocyanic acid. It is, in their opinion, far more certain in its effects than that preparation. METHOD OF PREPARING. Cyanuret of potassium is formed whenever potassa is calcined with an animal matter, as in the preparation of Prussian blue. It is commonly prepared after the process of Robiquet, by ex- posing to long continued heat the ferrocyanuret of potassium. The cyanuret of iron is completely decomposed, and that of po- tassium remains. The residuum, after this strong calcination, con- stitutes a solid, blackish mass, which consists wholly of cyanuret of potassium, soiled by the iron and the charcoal belonging to the cyanuret of iron. The mass is dissolved in water, when the iron and charcoal are deposited ; the cyanuret of potassium dis- solves, and is transformed into hydrocyanate of potassa. When the process has been well conducted, the solution is perfectly co- lourless, and retains no portion of iron. M. Chevalliert prepares the salt by calcining the ferrocyanuret of potassium, and then separating the cyanuret from the quadricarburet of iron by pure alcohol: on distilling this, the cyanuret is obtained very pure. Dr. Hamilton and Mr. Mackenzie, of Baltimore,^ recommend the following pro- cess as most convenient and simple:—Expose—say—four ounces of the dried ferrocyanuret of potassium in a common Hessian cru- cible to a red heat, until nitrogen ceases to pass over; (this gene- * Bulletin de la Societe Medicale d'Emulation, Juillet, 1823. See, also, Dr. James Hamilton and Mr. Thomas G. Mackenzie, in the Maryland Med. and Sure. Joum. April, J840, p. 201. . t Journ. de Chimie Medicale, and Journ. of Philad. College of Pharmacy, 1832. X Op. cit. p. 203. POTASSII CYANURETUM. 507 rally takes from one and a half to two hours;) then, breaking the crucible, powder the black mass quickly, and add—say—sixteen fluidounces of alcohol, stirring the mixture repeatedly, until it ac- quires the temperature of about 150° Fahr.; then filter, and eva- porate 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 decomposed 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 ferrocyanuret will .be found to have yielded six or seven drams of the cyanuret, which is dry, inodorous and perfectly white. The following process is directed in the last edition of the Pharmacopoeia of the United States (1842:)—Take of ferrocy- anuret of potassium, in powder, gviij.; Distilled water, f. gvj. Ex- pose the ferrocyanuret to a moderate heat until it becomes nearly white, and is wholly deprived of its water of crystallization. Put the residue in an earthen retort, with the beak loosely stopped, and expose it to a red heat for two hours, or till gas ceases to be disengaged. Withdraw the retort from the fire, close the orifice with lute, and then let the whole remain until quite cold. Break the retort, remove the black mass, reduce it to coarse powder, in- troduce it into a bottle of the capacity of twelve fluidounces, and then add the distilled water. Agitate the mixture occasionally for half an hour, throw it on a filter, evaporate the filtered solution rapidly to dryness, and keep the dry mass in .a closely stopped bottle. Pure cyanuret of potassium is white and transparent: it may be fused in the fire without being decomposed, and keeps for an indefinite period, provided it be preserved 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. It has a sharp, somewhat alkaline, and bitter almond taste, and an alkaline reaction. 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 gui- nea-pig in two or three minutes: a small drop of the hydrocyanate of potassa, containing only the hundredth part of a grain of the cya- nuret in solution, caused a linnet to drop down dead in half a mi- nute. Half a dram, containing five grains of the cyanuret, killed * Formulaire pour la Preparation, &c., de plusieurs Nouveaux Medicamens, &c. 508 POTASSII CYANURETUM. a dog of large size in a quarter of an hour; and three grains proved fatal to a man in three quarters of an hour.* Dr. Lethebyt states, as the result of his experiments on animals, that with the exception of hydrocyanic acid of the strength of four per cent. cyanuret of potassium is the most virulent and active of all the compounds into which cyanogen enters. Magendie proposes, that the cyanuret of potassium should be dissolved in eight times its weight of distilled water, when it be- comes transformed into hydrocyanate of potassa. To this solution, he gives the name medicinal hydrocyanate of potassa, and ad- vises that'it should be given under the same circumstances, and in the same doses, as the medicinal hydrocyanic acid (see pages 21 and 34.) He farther suggests, that to render it wholly indepen- dent of the action of the small portion of alkali contained in the cyanuret, a few drops of some vegetable acid may be added, or it may be prescribed with an acid syrup. The dose of the cyanuret is a quarter of a grain at first, gra- dually increased to a grain and more. M. Bally gave it to fifty- two individuals labouring under different diseases: it produced no effect on thirty-five; and, on the others, the result was neither con- stant nor salutary, so that he is not inclined to place more reliance upon the cyanuret than upon the hydrocyanic acid. By Dr. Lombard,% 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 com- posed of from two to four grains of the cyanuret to an ounce of lard. The aqueous solution, however, is considered by Dr. Lom- bard to be the most prompt in its effects. He regards the cyanu- ret to be contraindicated, where the nervous affection is compli- cated with inflammatory action. He has found it a useful remedy, also, in chronic rheumatism. In sciatic neuralgia, it was not successful. In white swelling, attended vvith acute pains, poul- tices moistened vvith the solution, gave great relief. Dr. Lombard, indeed, affirms, that the soothing properties of the cyanuret are superior to those of any remedy known. Lotions of hydrocyanic acid are not to be compared with it,—the acid being decomposed with facility, and not devoid of danger. In a case of acute rheumatism, attacking the articulations of a chlorotic young female, M. Malherbe,§ after leeching, applied compresses over the joints affected, moistened vvith a solution of * See Christison on Poisons, first Amer. edit. p. 593. Philad. 1845. t London Medical Gazette, Jan. 9, and Feb. 4 and 17, 1845. X Gazette des Hopitaux, and Lond. Med. Gaz., Sept. 1831. § Journal des Connaissances Medico-Chirurgicales. POTASSII CYANURETUM. 509 the cyanuret—ten grains to the ounce of distilled water. In forty- eight hours, the pains ceased. It is probable, however, that much of the good effect was owing to the compression. MM. Trous- seau and Rullier* also recommend the cyanuret, in the proportion of four grains to an ounce of water, as a local application in various forms i)f neuralgia. M. Andralf employed it with complete success in a case of in- tense cephalalgia, which, for ten months, had resisted the most pow- erful remedies, as bleeding, a seton in the neck, blisters and sina- pisms. It was used in solution, in the proportion 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. When nitrate of silver has been long used in affections of the eye, it turns the conjunctiva of a dark olive colour and greatly disfigures the patient. Mr. Guthriei states, that a solution of the cyanuret of potassium (Potass, cyanur. gr. vj; Aquoz f. 3j.,) applied by drops, every other day, is an admirable remedy. It is also equally effec- tive in removing the stain made by iodine on the skin. MODE OF ADMINISTERING. Mistnra potassii cyannreti. Mixture of cyanuret of potassium. Mixture of hydrocyanate of potassa. Pectoral mixture of Magendie. R. Potass, hydrocyan. me'd. f. -Ji. Aquae destillat. Oj. Sacchar. giss. M. Dose.—About five drams (a table-spoonful,) night and morning. (Pectoral potion.) R. Potass, hydrocyan. med. gtt. xv. Infus. heder. terrestr. f. gij. Syrup, althaea? f. gj. M. Dose.—Five grammes (a tea-spoonful) every three hours. Magendie. R. Potass, cyanur. gr. &. Syrup, althaea? f. gj. M. Aquas lactucae f. gij. Dose.—Five drams (a table-spoonful) every two hours. Magendie. R. Tinct. castor. Moschi, Potassae nitrat. aa. gr. iv. Potassii cyanuret. gr. ij. Aquae flor. tiliae seu Aqua? cinnamom. f. gviij. * Lond. Med. and Surg. Journ. Dec. 15, 1832; cited in Amer. Journal of the Medical Sciences, May, 1833, p. 238. t Gazette Medicale, Jan. 1832. { Cited in Amer. Journ. of the Med. Sciences, Oct. 1844, p. 517. 33 510 POTASSII HYDRARGYRO-IODIDUM. To be taken in the course of the twenty-four hours, in chorea. Fouquier. Syrupus potassii cyanureti. Syrup of cyanuret of potassium. R. Potass, hydrocyanat. medic, f. 3j. Syrupi Oi. This syrup may be added to pectoral draughts, and may be sub- stituted for other syrups, in appropriate cases. Pilulae potassii cyannreti. Pills of cyanuret of potassium. R. Potassii cyanur. Amyli aa. gr. iv. Syrup, q. s. ut fiat massa in pilulas viij. dividenda. Dose,—A pill, night and morning, in convulsions, dyspnoea, &c. Hospital of La Pitie.* Lotio potassii cyannreti. Lotion of cyanuret of potassium. R. Potass, cyanuret. gr. xij. Mist, amygdal. f. gvj. M. To be used in lichen, and other chronic eruptions attended with much itching. Louis. R. Potass, cyanur. gr. vj. Solve in Aquae destillat. f. gj. M. Compresses to be wretted vvith this, and applied in cases of neu- ralgia faciei, hemicrania, &c. Recamier, Trousseau, Blouquier.~\ Unguentum potassii cyanureti. Ointment of cyanuret of potassium. R. Potass, cyanur. gr. ij.—iv. Adipis gi. M. The size of a hazelnut to be rubbed in, in cases of neuralgia. Lombard. CXXXI1. POTAS'SII HYDRAR'GYRO-IO'DIDUM. Synonymes. Potassii lodo-Hydrargyras, Hydrargyro-iodidum Potassii, Hy- drargyrum Biiodatum cum Kalio-Iodato, Kali Iodatum Hydrargyratum. Iodo-Hydrargyrate of Potassium, lodhydrargyrate of Ioduret of Potas- sium, Hydrargyro-iodide of Potassium, Hydrargyro-biniodide of Potas- sium, Dihydrargyro-biniodide of Potassium. Dr. A. Channing4 who has highly extolled this preparation in various diseases, affirms, that this, with other new salts, was dis- covered by Bonsdorff, of the University of Finland, in 1S26; and * Ryan's Formulary, 3d edit p. 392. Lond 1839. t Lincke, Vollstandiges Recept-Taschenbuch, ii. 91. Leipz. 1841. X American Journal of the Medical Sciences, Feb. 1834, p. 388. POTASSII HYDRARGYRO-IODIDUM. 511 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 pure iodide of potassium in ten or fifteen minims of water would combine with a fraction less than eleven grains of red iodide of mercury, and maintain the combination in solution. when diluted with water or alcohol to any extent. If more than eleven grains of red iodide be added, although a small excess may be dissolved in the concentrated solution, on diluting with water, it is promptly precipitated. It would appear, therefore, as Dr. Channing has remarked, that in preparing this salt for administra- tion, the labour of crystallizing 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 po- tassium with eleven grains of the iodide of mercury, may be used as containing twenty grains of the hydrargyro-iodide of potas- sium. If it be desirable to obtain the preparation in a crystallized form, it is important that the definite proportions of the two iodides should be observed, and particularly, that there be no ex- cess of iodide of mercury; for the saturated solution of eight grains of iodide of potassium will dissolve, and enter into combi- nation with, more than thirteen grains of iodide of mercury, form- ing similar crystals soluble in alcohol, but in water precipitating more than two grains of iodide of mercury. This double salt may also be formed by dissolving one equiva- lent of bichloride or of pernitrate of mercury in a solution of four equivalents of iodide of potassium, evaporating to dryness, and dis- solving the double iodide from the chlorohydrate or nitrate of potassa by means of alcohol. When made from the pernitrate of mercury, it is liable, however, to contain nitre, vvhich may be de- tected by its insolubility in strong alcohol.* 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 hydrargyro-iodide is not, however, mucb employed, experience seeming to have shown, that it possesses no essential, if, indeed, any advantages over those preparations. It has been highly extolled by Dr. Charles C. Hildreth,f of Zanesville, Ohio, in several diseases, in which a combination of iodine and mercury might be expected to be beneficial. In ordinary dyspepsia, his faith in its remedial powers is so strong that he had prescribed but little else for the previous four or five years. He speaks highly of it, also, in en- largement of the spleen, amenorrhea, dysmenorrhea, leucorrhoza, dropsy. * Ambrose Smith, American Journal of Pharmacy, Jan. 1841, p. 271. 1 American Journal of the Medical Sciences, Aug. 1840, p. 314. 512 POTASSI HYDRARGYRO-IODIDUM. and glandular enlargement of a scrofulous character. In these last cases, he combines the internal use with the external, according to the form of ointment given below. Puche* has recommended it as not being so subject to produce salivation, or pains in the bones, as the other combinations of mer- cury and iodine. MODE OF ADMINISTRATION. Mistura potassii hydrargyro-iodidi. Mixture of hydrargyro-iodide of potassium. R. Hydrarg. iodid. rubr. gr. iv. Potassii iodid. 9j. Aquas destillat. f. gj. M. Dose.—Five drops, three times a day. Channing. R. Hydrargyri iodid. rubr. Potassii iodid. aa. gr. iv. Aquse f. gi. Solve. The dose of this is from two to six drops, equivalent to from about the thirteenth to the twelfth of a grain of the double salt.f R. Hydrarg. iodid. rubr. gr. viij. Potassii iodid. gr. viij. Aquae destillat. f. gviij. M. Dose.—f. 5ij. to f. 5ij. in twenty-four hours. Puche. Tinctura potassii hydrargyro-iodidi. Tincture of hydrargyro-iodide of potassium. R. Potass, hydrargyro-iodid. gr. j. Alcohol, dilut. f. gj. M. Dose.—Ten drops, three times a day. Channing. PiluljJD potassii hydrargyro-iodidi. Pills of hydrargyro-iodide of potassium. R. Hydrarg. iodid. rubr. gr. viij. Potassii iodid. gr. viij. Sacchar. lact. gr. lxiv. Mucil. acac. q. s. ut fiant pilula; xxxij. Dose.—One to eight, daily. Puche. Unguentum potassii hydrargyro-iodidi. Ointment of hydrargyro-iodide of potassium. R. Hydrarg. iodid. rubr. gr. vij. Potass, iodid. ^ij. Adipis----gf. M. To be applied to tumours, two or three times a day. Should it prove too irritating, the proportion of lard must be increased. Hildreth. " Journal des Connaissances Medicates, Oct., Nov. 1838, Janvier, 1839; and An- nales de Chimie, Oct. 1838. t Ambrose Smith, American Journal of Pharmacy, Jan. 1841, p. 270. POTASSII IODIDUM. 513 CXXXIII. POTAS'SII IO'DIDUM. Synonymes. Kalium Iodatum, Iodidum Kalii, Kali Hydroiodinicum, K. Hy- droiodicum, Hydroiodas Kalicus, H. Lixiviae, Ioduretum.Potassicum, Iod- hydras Kalicus seu Potassae, Potassii Ioduretum, Iodide or Ioduret of Potassium. In solution—Potassae Hydriodas, Potassii Proto-hydriodas, Potassii Protoxidi Hydriodas, Hydroiodas Kalicus, H. Lixivia?, Iodhydras Kalicus seu Potassaj, Hydriodate of Potassa. French. Hydriodate de Potasse, Iodure de Potassium. German. Iodkalium. Iodwasserstdffsaures Kali, Kaliumiodiire, Iodinvvasser- stoff Kali, Hydriodsaures oder Hydriodinsaures Kali, Kalihydroiodat. METHOD OF PREPARING. The process of Dr. Turner is, to take any quantity of solu- tion of caustic potassa, and to add to it gradually, at a gentle heat, iodine sufficient to neutralize the alkali; then evaporating to dryness, calcining strongly, dissolving in water, and crystallizing. Dr. William Gregory* suggested an improvement on this pro- cess, which has been regarded as one of the simplest.f He adds iodine to a hot solution of potassa until the fluid as- sumes a yellowish-brown colour, then evaporates, and heats 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 converted 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,—sha- king the vessel each time. The liquor is then heated until it loses its colour, is filtered, and the substance on the filter is washed with boiling water, until the liquid is tasteless; the liquor, and the vari- ous liquids used in the washings, are united, and the whole is heated in a sand bath. When the temperature approaches that of ebullition, enough of a solution of carbonate of potassa is added, to precipitate all the oxide of iron as carbonate; it is then filtered, and the substance on the filter washed until it is com- pletely 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 crystallize. Lastly, the crystals are washed with a little water and dried.! V * Edinb. Med. and Surg. Journ., xxxvi. 369, for Oct 1831. t Cogswell, on Iodine, p. 85. X Jourdan's Pharmacopee Universale, i. 662. Paris, 1828; also the London Pharma- copoeia, and Brande's Dictionary of Materia Medica, p. 317. Lond. 1839. This is essen- tially the process of the Pharmacopoeia of the United States (1842.) 514 POTASSII IODIDUM. Iodide of potassium is in white or transparent crystals.- These are readily fused, and are volatilized 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 in water. The odour is slightly that of iodine from the salt containing a little of that element uncombined. Taste acrid and saline. It would seem, that a slight contamination of iodide of potas- sium vvith 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 ad- ministered?" EFFECTS ON THE ECONOMY. As respects the action of iodide of potassium, and its adminis- tration 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 appear to accord with those of iodine; at least no differ- ence is perceptible on the organism. It has been supposed, that it is better than pure iodine, where the object is to act especially on the urinary organs, f For external use, iodide of potassium is usually preferred to iodine. It is constantly given internally, and often in combination with the latter; the solubility of which, as was before remarked, is aided by it. Many of the subjoined for- mulae contain both one and the other. As remarked under iodine, it is now administered in very large doses in a multitude of dis- eases of different nature, and often, doubtless, where it can render little or no service. Dr. Buchanan asserts, that he has given it in doses of gss., 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 administered it in such large doses. Two drams of it were taken by a young man affected with gonorrhoea, 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 impregnated with iodine.J On the other hand, Dr. Lavvrie, of Glasgow,§ considers it very * Edinb. Med. and Surg. Journal, April, 1838; and Dispensatory, p. 253. Edinb. 1842; also, Pereira, Elements of Mat. Med. and Therap. 2d edit. i. 491. Lond. 1842; or 2d Amer. edit, by Dr. Carson. Philad. 1846. 1 Riecke, Die neuem Arzneimittel, u. s. w. S. 306. See, also, Cogswell on Iodine, p. 96. X London Medical Gazette, July 2, 1836. § Ibid. July 3,1840, p. 591. POTASSII IODIDUM. 515 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 syphi- lis, so speedily as it. Lugol and others appear to have used-it mainly as a solvent to iodine, and he considers it inferior to the latter as a therapeutical agent; but no chemical or other prepos- session can set aside the testimony just cited; or that of such ob- servers as Ricord,f C. J. B. Williams,:): Joy, and a host of others. In the author's hands, it has appeared to afford as much benefit as any of the preparations of iodine. For the testimony in regard to its beneficial and injurious effects, see Iodine, page 382. Cases of salivation from its use have been published by Sir Francis W. Smith.§ According to the experiments of Magendie,|| iodide of potas- sium is one of the substances that promote the coagulation of the blood. MODE OF ADMINISTRATION. Liquor potassii iodidi. Solution of iodide of potassium. Potto resolvens ex Iodio, Solution de Coindet, CoindeVs Solution. R. Potassii iodidi gr. xxxvj. Aquae destillat. f. !§j. Solve. Dose.—The same as that of the tincture of iodine. Coindet fy Magendie. R. Potassii iodidi 3j. Aquae destillat. f. jf j. 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 potassii iodidi compositus. Compound solution of iodide of potassium. (LugoVs solution.) R. Iodin. »}j- Potassii iodid. J^ij- Aq. destillat. f. gvij. Solve. Dr. BachelT remarks, that " in the original it is seven ounces, but from the context of the author, this is evidently a misprint for se- ven drams." It is proper, however, to observe, that many of the * A Treatise on Syphilis, by Herbert Mayo, F. R. S. Lond. 1840. t Practical Treatise on Venereal Diseases, translated by Drummond, Amer. edit. Philad. 1343. Parker, Modern Treatment of Syphilitic Diseases, Dunglison's Amer. Med. Lib. edit. p. 77. Philad. 1840; and Bulletin General de Therap. Juillet, 1840. X Lectures on the Physiology and Diseases of the Chest, Bell's Medical Libraiy edit. p. 246. Philad. 183'J. § Dublin Journal of Medical Science, July, 1840, and Jan. 1841. |l Leyons sur le Sang; and translation in Lancet, for Jan. 26, 1839, p. 636. TT Dispensatory of the United States, 4th edit p. 374. Philad. 1839. V. 5lti POTASSII IODIDUM. successful cases were treated by the weaker solution, six drams of vvhich contain only Jg- of a grain, whilst six of the other contain f ths of a grain. Dose.—Six drops early in the morning, and in the middle of the day, in a glass of sugared water, in tetter, scirrhus, &c. IsUgol. Lugol has a solution of three strengths for internal use : I. II. III. R. Iodin. gr-.|- gr-.i- gr- \\- Potass, iodid. gr. iss. gr. ii. gr. iiss. Aq. destillat. f. jfviij. f. ^viij. f. 5 viij; Dose.—Two-thirds, daily, at first; afterwards, the whole. 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, vvhich might be pre- scribed in varied doses. R. Iodin. gr. v. Potass, iodid. gr. x. Aquae destillat. f. |xx. M. Dose.—f. 3ij. to f. 3yj. London Pharmacopoeia. Liquor iodini compositus. Compound solution of iodine. (LugoVs solution.) R. Iodin. 3yj. Potass, iodid. 3iss. Aquae destillat. Oj. Dissolve the iodine and iodide of potassium in the water. Dose.—Ten to twenty drops, three times a day. Pharm. United Stales. Tinctura iodini composita. Compound tincture of iodine. R. Iodin. l\. Potass, iodid. §ij. Alcohol. Oij. M.. Dose.—Ten minims. Lond. Pharmacopozia. The Pharmacopoeia of the United States adopts the same quan- tities; but the pint Imperial measure contains about one-fourth more than the pharmacopoeial pint of the United States. (Iodine paint.) R. Iodin. gr. Ixiv. Potass, iodid. gr. xxx. Alcohol, f. |j. M. POTASSII IODIDUM. 517 Applied in rheumatic affections of the joints, by painting the parts freely with a camel's hair pencil. King's College Hospital. Mistura potassii iodidi composita. Compound mixture of iodide of potassium. R. Iodin. gr. ss. Potass, iodid. gss. Syrup, papav. f. gss. Aq. destillat. Oss. Dose.—Two table-spoonfuls three times a day, in cases of com- plication of syphilis with scrofula. Tyrrel. R. Iodin. gr. iss Potassii iodid. gr. iij. Solve in i Aquae menth. pip. f. giv. Dose.—A spoonful two or three times a day. To children, a tea-spoonful. In cases of cancrum oris; also, in dropsy, gleet, and leucorrhoza. On renewing the prescription, the dose of the iodine may be increased one-half, and of the iodide one grain, each time. Coster «$• Friedrich. R. Potass, iodid. giv. Syrup, althaeae f. gj. ----menth. pip. f. gij. Aquas lactucas f. gviij. 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. giv. Tinct. digit, f. gj. ad f. gij. Syr. althaeae f. giss. Aq. lactuc. f. gviij. — flor. naph. f. gij. 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. Quassia?, Gentian, aa. gj. Aquae bullient. f. gxvj. Macera per horam et cola. Liquor colat. add. Potass, iodid. gr. xxxvj. Potassae carbonat. gij. M. Dose.—A table-spoonful, three times a day, in a glass of water. Cumming. Pilulae potassii iodidi. Pills of iodide of potassium. R. Potass, iodid. gr. xv. Aq. destillat. q. s. Spong. ust. Ext. dulcamar." aa. gij. Glycyrr. pulv. q. 8. Fiant pilulae clxxx. 518 POTASSII IODIDUM. Dose.—Six, two or three times a day, in scrofula, goitre, &c Vogt. Unguentum iodini composilum. Compound ointment of iodine.—Ioduretted ointment. R. Iodin. gss. Potass, iodid. gj. Alcohol, f. gj. Adipis gij. Rub the iodine and iodide with the alcohol, and mix with the lard. Pharm. Lond. fy United States. Unguentum potassii iodidi. Ointment of iodide of potassium. R. Potass, iodid. gss. Adipis giss. 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. 9j. 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. Tunnermann. In dry tetter, the ointment applied is formed of 3j. to giss. of the iodide to gj. of lard. (Unguentum kali hydroiodici. Pharmacop. Borussic.) R. Potass, iodid. gj. Magnes. carb. gr. vj. Aq. destillat. guttas nonnullas. M. terendo cum Ung. rosat:. gj. Or, R. Potass, iodid. Soda? carbon, depur. sice. aa. gss. Ung. rosat. giv. 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. Messrs. T. and H. Smith,* of Edinburgh, having found it im- practicable to make a neat ointment of iodide of potassium by the ordinary method, have recommended the following : Dissolvethe requisite quantity of iodide in its own weight of distilled or some perfumed water, and then mix thoroughly in a mortar with the pro- per quantity of lard. The two will incorporate perfectly with a very little heating, and form a smooth ointment. * London and Edinburgh Monthly Journal of Medical Science, Oct. 1841. POTASSII IODIDUM. 519 R. Potass, iodid. gss. Ext. opii ^ss. Cerat. gj. M. As a dressing to malignant cancerous ulcers. Unguentum potassii iodidi compositum. Compound ointment of iodide of potassium. R. Iodin. gr. xij. Potass, iodid. Qiv. Adipis gij. M. In scrofulous ophthalmia, ulcers, &c. Lugol. R. Iodin. gr. xv. Potass, iodid. gj. Tinct. opii f. gij. Adipis gij. M. In painful scrofulous ulcers, white swellings, &c. Lugol Unguentum potassii iodidi et hydrargyri. Ointment of iodide of potassium and mercury. R. Potassii iodid. gr. xij.—xv. Ung. hydrarg. ciner. gss. M. In herpes exedens. Blasius. Unguentum potassii iodidi anodynum. Anodyne ointment of iodide of potassium. (Pommade iodee calmante.) R. Potass, iodid. gr. xv. Morphia? muriat. gss. Adipis gx. M. Applied to painful tumours of the mammae, night and morn- ing. Chomel. Emplastrum potassii iodidi compositum. Compound plaster of iodide of potassium. R. Iodin. Potass, iodid. aa. Qss. ad 9j. Emplastr. hydrarg. seu --------saponis. gij. M. Applied in syphilitic and gouty swellings of the bones. Ebers. Linimentum potassii iodidi, Liniment of iodide of potassium. (Baume hydriodate.) R. Potassii iodid. gj. Alcohol. (20°) f. giv. M. R. Sapon. ex oleo animal, confect. giss. Alcohol. (20°) f. giv. M. Mix these two solutions together; aromatize with a small quan- tity of oil of lavender, and before the mixture congeals pour it 520 POTASSII IODIDUM. into wide-mouthed vials.* This liniment has been much used at Lausanne under the name Gelee pour le goitre. Lotio potassii iodidi composita. Compound lotion of iodide of potassium. R. Iodin. gr. i. ad ij. Potassii iodid. gr. ij. ad iv. Solve in Aquae destillat. f. gviij. This solution was commonly used by Lugol externally, injected under the eyelids in strumous ophthalmia, fistulas, &c. Lugol. R. Iodin. gss. Potassii iodidi gj. Solve in Aq. destillat. f. gvj. This "rubefacient solution of iodine," may be used two or three times a week, vvhen the last prescription loses its effect, or vvhen it is desirable to stimulate more actively. It is also added to baths— three or four ounces to an ordinary bath—as well as to poultices, being mixed vvith an ordinary cataplasm. Lugol. R. Iodin. gj. Potass, iodid. gij. Solve in Aquae destillat. f. gij. This "caustic iodine solution" may be used when the last loses its efficacy. It occasions a crust on the parts. Lugol em- ploys it chiefly vvhen the skin on the edges of the ulcers is greatly hypertrophied, red, and fungous, as well as in phagedenic or spreading letters. It may be applied two or three times a week, or daily should the case require it. Lugol. Collyrium potassii iodidi compositum. Compound collyrium of iodide of potassium. R. Iodin. gr. ss. ad i. Potassii iodid. ^ss. Solve in Aq. rosae f. giij. M. To be applied four times a day, in cases of scrofulous oph- thalmia, vvith ulceration of the conjunctiva and cornea. Magendie. * F. Boudet, Journal de Pharmacie, Avrfl, 1842, p. 335; and A. Duhamel, in Amer. Journal of Pharmacy, July, 1842, p. 102. QUINIA. 521 QUINIA ET EJUS SALES. Synonyme. Quinia and its Salts. CXXXIV. QUINIA. Synonymes. Quinina, Quina, Quininum, Quinium, Chininum, Chininium, Chinium, Kinium, Sal Essentiale Corticis Peruvian!. French. Quinine, Kinine. German. Chinin, Quinin. Chinastoff. Qiiina is a most important gift from modern analytical che- mistry to medicine. Not many years have elapsed since the dis- covery of this substance, and yet, by general consent, it is now- regarded as one of the most valuable remedies in the catalogue of the materia medica. The honour of the discovery—which had been facilitated by the investigations of other chemists, as to the composition of the cinchona barks—belongs to Pelletier and Ca- ventou, (1S20,*) and so rapidly and extensively was its efficacy promulgated, that in the year 1S26, in two laboratories in Paris for the preparation of quinia, fifty-nine thousand ounces of the sulphate—the form best known, and most frequently prescribed— were prepared. For this discovery, the Royal Academy of Sci- ences of Paris awarded MM. Pelletier and Caventou the Mon- thyon prize of ten thousand francs. It would appear from the observations of Henry and Plisson, that cinchonia and quinia exist in cinchona bark in combination vvith kinic acid and also with cinchonic red, vvhich is an insoluble red colouring matter, f Quinia is obtained from yellow bark by a similar process to the one described for the separation of cinchonia.:): In the pure state, it is of a white colour, and commonly appears in the form of pow- der; it crystallizes, hovvever, 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 quinia melts into a transparent fluid, which, on cooling, is translucent, and similar to resin. When melted in vacuo it has a crystalline appearance. In a strong heat it is decomposed. It has a very bitter taste, and is soluble in 200 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, solu- ble in ether, and somewhat so in oils. It exhibits an alkaline re- action,—restoring the colour of reddened litmus paper, and neutra- lizing acids. The observations of Piorry and Lavollee§ and of Quevenne,|| * Annales de Chimie et de Physique, xv. 289 and 337. t Joum. de Pharmacie, xiii. 2b'9 and 369, and Pereira, Elem. Mat. Med. and Therap. ii. 1397. Lond. 1842; or 2d Amer. edit, by Dr. Carson, fhilad. 184G. X See page 181. § Gazette Medicale, 1836, p. 73. || L'Experience, Juillet, 1838. 522 QU1NUE ACETAS. show, that quinia, 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 quinia we shall speak at length, under the head of sulphate of quinia with which it seems to accord entirely in medicinal agency. Several physicians, who have ex- perimented in regard to the efficacy of pure quinia 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 quinia in large doses—as much as five grains every four hours. A French physician, M. Blegnie,* even gives the preference to of sulphate of quinia and ^ij. of lard, has been rubbed with success into the axilla in cases of ague in children.* Vinum q~u i n i a. Wine of quinia. R. Quiniae sulphat. gr. xij. Vin. Mader. Oij. Wine of quinia may, also, be made extemporaneously, by add- ing two ounces of the tincture to a pint bottle of wine. CXLI. QUININE VALERIA'NAS. Synonymes. Valerianate of Quinia. French. Valerianate de Quinine. German. Valeriansaures Chinin. This salt was first formed of late years by Prince Louis Lucien Bonaparte. METHOD OF PREPARING. A cold solution of valerianic acid in distilled water is satu- rated by a concentrated solution of quinia in alcohol at 36° (s. g. .847;) and the valerianate of quinia, thus formed is subjected to spontaneous evaporation.! Or, it may be made by adding freshly * Lond. Med. Gaz., April 3, 1840. t Bouchardat, Nouveau Formulaire Magistral, p. 263. Paris, 1845. QUINliE VALERIANAE 547 precipitated quinia to a hot solution of valerianic acid, and then crystallizing. The crystals are in thin, colourless rhomboidal plates of a mother of pearl lustre, or in needles. It is not very soluble in water, but more so in alcohol and ether. It has a smell of valerianic acid, and a very bitter taste.* Another method of preparing it is the following. Into an alco- holic and concentrated solution of quinia a slight excess of vale- rianic acid is poured: the whole is then suspended in twice its bulk of distilled water: the mixture is carefully stirred, and sub- jected to evaporation in a stove at a temperature not exceeding 50°. When the evaporation of the alcohol has taken place the valerianate presents itself in the form of beautiful crystals, some- times isolated; at others grouped together. It may also be pre- pared by double decomposition, by mixing sulphate of quinia with chloride of calcium, or chloride of barium,—both being dissolved in weak alcohol.t EFFECTS ON THE ECONOMY. Prince L. L. Bonaparte administered the valerianate of quinia, to two inhabitants of the Maremma district, in Italy, and found that it did not produce the same neuropathic phenomena that occa- sionally follow the use of sulphate of quinia. Since then, the salt has been employed by different observers. M. Devay,| of Lyons, infers, as the result of his observations, that it is a more powerful antiperiodic than the sulphate, even when given in smaller doses. M. Castigloni§ gave it in eighteen cases of intermittent or remittent fever: in fifteen cases it effected a cure, and in three it produced only temporary relief. In two of the last cases the sul- phate of quinia had been employed without success; and in one the most vaunted remedies had proved useless. The minimum dose for curing the disease, was six grains; the maximum thirty- five; the medium quantity about ten grains and a half. The mini- mum time required for the cure, was two days; the maximum eight days, and the mean three days and a half. The high price, however, of the salt, will necessarily prevent it from being much used. MODE OF ADMINISTRATION. Valerianate of quinia being easily decomposed, it is best to ex- hibit it in the most simple form. M. Devay dissolves 30 centi- grammes, (about gr. 44,) in 632 grammes, (about f. giij,) of gum * Ballard and Garrod, Elements of Materia Medica and Therapeutics, p. 409. Lond. 1845 See also M. Galvani, cited in Med. Examiner, April, 184b', p. 249. \ Gazette Medicale de Paris, cited in Provincial Med and Surg. Journ. Dec 24.1844; and in Braithwaite's Retrospect, xi. 102, Amer. edit. New York, 1845; also, Bouchardat, Annuaire de Therapeutique, pour 1845, p. 136. X Journal de Pharmacie, cited in Pharmaceutical Journal, March, 1845. • § Bouchardat, op. cit. p. 138. 548 QUINIA ET CINCHONIA TANNAS. water; and directs it lo be taken at three times, in cases of rebel- lious fevers. It may also be given in pills, and as it dissolves readily in oil; one gramme (gr. 15.44,) may be dissolved in 60 grammes (about 5ij,) of olive oil, to form a liniment, which may be rubbed over the region of the spleen. When given in the form of enema, 5 decigrammes (gr. 5.7,) may be dissolved in 200 grammes (f. 5viss,) of water. CXLII. QUI'NLE ET CINCHO'NI^ TANNAS. Synonymes. Quina? et Cinchonia? Tannas, Chinium Tannicum, Tannas Chinii seu Cinchonicus seu Quinicus, Tannate of Quinia, and Cinchonia. German. Gerbstoffsaures Chinin, Gerbesaures oder Tanninsaures Chinin. Dr. Otto* has drawn the attention of physicians to the efficacy of the tannates of quinia and cinchonia as recommended by Dr. Ronander, 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 quinia and other powerful remedies. He found them likewise very useful in typhus and in states of general weakness and tendency to putrescency, where sulphate of quinia seemed to be ineffectual. Dr. Ronander's experiments establish the belief, that the tannic acid of the cinchonas may be instrumental in developing their full febrifuge powers, f Tannate of quinia has been found successful in typic or intermittent neuralgia, where the sulphate of quinia had failed.]: M. Oesterlen,§ however, considers it a superfluous prepa- ration. It is a cheaper remedy than the sulphate. OTHER PREPARATIONS OF QUINIA. On separating quinia from cinchona by means of acids, a resinous constituent of the bark remains behind, which affords no more quinia, but yet possesses considerable febrifuge povver, 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 quinia. Truessink adduces a series of observations of different physicians, all of vvhich confirm this, and he cites the experience of American physicians with the residuum. According to Dr. Chapman,|| a grain of this may be given every two hours during the apyrexia, in the form of pill. Strathing ascribes its efficacy * Dublin Journal of Medical Science, Sept., 1836. t Revue Medicale, Mai, 1837, cited in Dunglison's Amer. Med. Intelligencer, Oct. 16, 1837, p. 270. X Dr. Hauff, cited in Northern Journal of Medicine, Dec. 1845; from Oesterlen's Jahr- buch, and in Braithwaite's Retrospect, Jan.—June, 1846. § Handbuch der Heilmittellehre, S. 442. Tubing, 1845. [| Elements of Therapeutics, 6th edit. ii. 292. Philad. 1831. QUINLE ET CINCHONIA TANNAS. 54 to children, on account of its bitter taste, M. Trousseau:}: recom- mends the impure quinia, quinine brute, which, he says, is more active than the sulphate, is insoluble in the saliva, and has not much taste. CXLIII. SALICINA. Synonymes. Salicinum, Salicinium, Salicine, Salicin. French. Salicine. 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 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 salicin in a pure state in 1828, after it had been procured in an impure form by some German and Italian chemists.|| It is prepared, by preference, from Salix helix, but it is found likewise in the barks of other willows—Salix alba, S. vitellina, S. purpurea, S. Lamber- tiana, S. pentandra, S. polyandra, S. fra^ilis, S. viminalis, &c, i and in the leaves and barks of several varieties of poplar, Popu- lus tremula, P. tremuloides,1T P. alba, and P. Grseca.** METHOD^OF PREPARING. According to the method of Leroux, three pounds of dried and * London Lancet, May 28,1846, cited in Amer. Journal of the Medical Sciences, July, 1846, p. 207. t London Medical Gazette, June 26,1846, p. 1117. X Cited in British and Foreign Medical Review, Oct. 1842, p. 560. § Annales de Chimie, &c. xliii., and Journal de Chimie Medicale, torn. vi. || Dictionnaire de Mat. Med. par Merat and de Lens, art. Salicine. TT See Mr. L. Turnbull, on Populus Tremuloides, White Poplar or American Aspen, in American Journal of Pharmacy, Jan. 1843, p. 275. k* Riecke, Die neuern Arzneimittel, S. 365, and 2te Auflage, 572. Stuttgart, 1840. SALICINA. 551 powdered willow bark (salix helix) are boiled for three-quarters of an hour in fifteen pounds of water, to vvhich four ounces of carbo- nate of potassa, have been added. To the cold decoction are add- ed two pounds of liquid subacetate of lead. The mixture is per- mitted to settle, is filtered, treated with sulphuric acid, and the re- maining lead precipitated by a stream of sulphuretted hydrogen gas. The excess of acid is neutralized by carbonate of lime: the mixture is again filtered, the fluid inspissated and neutralized by dilute sul- phuric acid. It is deprived of its colour by ivory black,and filtered whilst boiling. It is then twice crystallized—if still coloured after the first crystallization—and dried in the dark. This process yields about an ounce of salicin. Braconnot* obtains it by adding subacetate of lead to a decoction of the bark, precipitating the excess of lead by sulphuric acid, eva- porating 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 salicin is deposited, on cooling, in a crystalline form.f The following plan was advised by Messrs. Fisher and Tyson, of Baltimore.:}: Willow bark is boiled with caustic lime in water; the decoction is filtered and sulphate of zinc added, so long as it produces 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 eva- porated, yields crystals of salicin, which may be purified by wash- ing with a saturated solution of the same principle in cold water. Salicin forms very fine silky masses of white crystals, which have the appearance of mother-of pearl. It bears a distant resem- blance to sulphate of quinia, 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 flavour, like the bark of the willow.§ One hundred parts of cold water dissolve six parts of salicin. In warm water, it is more soluble, and also in alcohol; but it is not soluble either in ether or the essential oils. It excites no alkaline reaction. By admixture with sulphuric acid, salicin 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 salicin in cases of intermit- * Journal de Chimie Medicale, Janvier, 1831. t For Peschier's method, see Annales de Chimie, vol. xliv., and Amer. Joum. 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 salicin, see M. R. Piria, Annales de Chimie et de Physique, Novembre, 1838. 552 SALICINA. lent fever. Miquel* appears to have been one of the first—if not the first—who instituted experiments with it; and he satisfied himself, that it merits a distinguished place amongst our febrifuge agents, although it requires larger doses than quinia. Soon after- wards it was given by other physicians—by Husson and Bally, Girardin, Magendie, Andral, Blaincourt, Graff, Linz, Stegmayer, Amelung, Stam, Van Sneek, Blom, Grafe, Von dem Busch,Kromb- holz, Pleischl, and others. The sentiments, respecting its value, are discrepant; some classing it far beneath quinia, whilst others assign it even a higher position. Its general properties are cer- tainly analogous to those of quinia; but it in no respect merits a preference,! not even in the article of price: for, although an equal weight of salicin may cost less, it requires so much more to pro- duce the same effect, that the cost, is perhaps equal. Still, as M. Pleischl,^: °f Prague, has suggested, even if salicin 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. Comparative trials with salicin and sulphate of quinia, have been recently directed by the able head of the medical department of the army, Dr. Lawson, so that before long we shall learn their relative value as antiperiodics. Such an examination was made by Dr. E. D. Fenner,§ of New Orleans, who arrived at the conclusion that "the average amount of quinia required to cure 20 cases of intermittent fever, and costing twenty-five cents, is fully three times as efficacious as the average amount of salicin required in a like number of cases, and costing seventy-five cents." Dr. Fen- ner's report bears the stamp of accurate and impartial observa- tion, and induction. MODE OF ADMINISTRATION. The ordinary dose of salicin, in a case of intermittent, is about four or six grains every three hours during the period of inter- mission; in the febres larvalae 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 sali- cin; ten required afterwards the sulphate of quinia. He considers it preferable to sulphate of quinia in intermittents that are accom- panied by irritation in the primae viae: he never saw it rejected or produce vomiting; and in cases of manifest irritation of the diges- tive tube, it has been borne perfectly well.|| * Gazette Medicale de Paris, Janv. 1830; see, also, Annales de Chimie, xliii. and xliv. t Richelot, in Archives Generates de Medecine, Sepr. 1833; see, also, Prof. Dierbach, in Heidelb. Klinisch. Annal. B. x. H. 1, S. 62. Heidelb. 1834. X Medicinisch. Jahrbiicher des k. k. 6. Staat. 1835; cited in Br. and For. Med. Rev. for April, 1836, p. 576. § New Orleans Med. and Surg. Journ. Nov. 1845. || Archives Medicates de Strasbourg, and Gazette Medicale de Paris, Fev. 25, 1837. SAPO MOLLIS. 553 Salicin 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—gradu- ally augmenting the dose. In cases of asthenia of the digestive organs, Von dem Busch prescribes a powder of salicin and sugar with the addition of cinnamon; and lozenges of salicin, sugar, gum Arabic, and oil of peppermint. In cases of copious secretion from the mucous membranes, especially in chronic bronchitis and leucorrhoea, he directs salicin to be combined with a decoction of polygala amara, or of lichen islandicus. In intermittents, Steg- mayer advises it to be associated with small doses of tartrate of antimony and potassa. P ilulffi salicinaD. Pills of salicin. R. Salicin. Ext. gentian, aa. gr. xxiv. Glycyrrh. pulv. q. v. ut fiant pilulae xij. Vavasseur. Pulveres salicinse. Powders of salicin. R. Salicin. gr. xij. Sacch. ^ij. Misce et fiat pulvis in partes iv. aequales dividendus. Dose.—One, three times a day. Krombholz. Pulveres salicinae compositi. Compound powders of salicin. R. Salicin. gr. xv. Antim. et potass, tartrat. gr. j. Sacchar. giiss. Misce et fiat pulvis, in partes x. asquales dividendus. •Dose.—A powder, every two hours. Slegmayer. Mistura salicinee. Mixture of salicin. R. Polygal. amar. rad. 3vj. Coque cum aquse f. ifxij. ad remanent, f. ^viij. Colaturae adde Salicin. gr. viij. ad. x. M. Dose.—One or two spoonfuls every two hours. Von dem Busch. CXLIV. SAPO MOLLIS. Synonymes. Sapo Viridis, S. Niger, S. Kalicus,-S. Domesticus Mollis, Sapo ex Olivae Oleo et Potassa Confectus, Kali elaiinicum. French. Savon Noir, Savon Mou, Savon a base de Potasse. German. Schmierseife, Griine Schmierseife, Kaufiiche Kaliseife, Schwarze Seife, Olsaures Kali. 554 SAPO MOLLIS. Under this name a soap is used, which is formed by a union of oil with potassa. It is the "sapo ex oleo et potassa confectus " of the London Pharmacopoeia, has of late years been brought for- ward in Germany as a remedial agent in cases of itch* and has been employed in many hospitals. MODE OF ADMINISTRATION. 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 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 then repeated, morning and evening, for six days. 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 vvhich are af- fected with the eruption or itching. On the eighth day the pa- tient takes a bath of tepid soap and water; and the body and bed linen, vvhich 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 erup- tion is generally effected in seven days, that is by fourteen rub- bings. During the period of treatment, the patient must remain in bed, avoid exposure to draughts of air, and reside in a cham- ber, whose temperature is from 73° to 77° of Fahrenheit. On ac- count of the strong smell of soap, not more than ten patients ought to be allowed 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 in the skin occur earlier than the sixth rubbing, the friction must be pretermitted. Pfeuf- fer, however, never observed this to be the case. In scrofulous 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 * Pfeuffer, Beobachtungen iiber die Kr'atze und ihre Behandlung durch die Schmier-oder griine Seife. Bamberg, 1833. SODA CHLORINATA. 555 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 it were, habitual, Pfeuffer directs, that a cathartic should be premised, and that in the course of the cure, a quart of the decoc- tion of the woods should be taken. This mode of treatment, ac- cording to Pfeuffer, is contraindicated by febrile conditions, espe- cially of the synochal kind; by acute cutaneous affections; pulmo- nary and abdominal catarrhs; pulmonary and abdominal phthisis; chronic headach; and hereditary or acquired tendency to epi- lepsy. In such cases he prefers the internal and external use of sulphur: and, after the cure, the establishment of issues. The great recommendation of this plan in hospitals 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 treat- ment 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 Si- cherer, Seyffer, Cless, and others, all of whom agree as to its ex- cellence : 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.t CXLV. SODA CHLORINA'TA. Synonymes. Sodae Chloridum, S. Chloruretum, S. Hypochloris, Chlorure^ turn Oxidi Sodii, Sodae Oxymurias, Natrum Chloratum, N. Chloricum, N. Oxymuriaticum, Chlorinated Soda, Chloride of Soda, Hypochlorite of Soda, Chloruret of Soda, Chlorite of Soda, Oxymuriate of Soda. French. Chlorure de Soude, Chlorure d'Oxide de Sodium. German. Chlornatron, Chlorsaures Natrum, Chlornatrum, Oxydirt oder Hyperoxygenirt Salzsaures Natrum. This preparation resembles in almost all respects chlorinated lime. Both it and chlorinated potassa were associated by Berthol- let under the common name Eau de Javelle, or 'bleaching liquor;' and it has of late generally received the name of Liqueur de La- barraque, or Labarraque's Soda Disinfecting Liquid. * H. Vezin, Ueber die Kr'atze und ihre Behandlung nach der Englischen methode. Os- nabriick 1836. See, also, Dunglison's Amer. Med. Intelligencer, Aug. 15, 1839, p. 158. t Riecke Die neuem Arzneimittel, u. s. w. 2te Auflage, S. 584. Stuttgart, 1840. 556 SODA CHLORINATA. METHOD OF PREPARING. Labarraque* recommended it to be prepared directly by pass- ing a current of chlorine gas into a solution of carbonate of soda. The following is the formula in the last London Pharmacopoeia for the Liquor Sodae Chlorinate Liquor Sodas Chloridi, L. Sodas Oxymurialicas, L. Chloreti seu Chlorureti Natri seu Sodoz, Natrum Chloratum Liquidum, Liquor seu Aqua Natri Oxymuriatici, Hypochlo- ris Sodicus Aqua, Solutus; German, Oxydirt salzsaures Natronwas- ser, Chlorsodaflussigkeit, or Labarraque's Disinfecting Liquid. "Take of Carbonate of soda, a pound; Distilled water, forty- eight fluidounces; Chloride of sodium, four ounces; Binoxide of manganese, three ounces ; Sulphuric acid, four ounces. Dissolve the carbonate of soda in two pints (imperial measure) 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 fluidounces of water, and cooled. Heat and transmit the chlorine first through five fluidounces of water, and afterwards into the solution of carbonate of soda above directed." The following form is given in the last edition of the Pharmaco- poeia of the United States (1842 :)—"Take of Chlorinated lime, ifej.; Carbonate of soda, Ifeij. Water, a gallon and a half. Dissolve the car- bonate of soda in three pints of the water, vvith the aid of heat. To the remainder of the water add, by small portions at a time, the chlorinated lime, previously well triturated, stirring the mix- ture after each addition. Set the mixture by for several hours, that the dregs may subside; then decant the clear liquid, and mix it with the solution of carbonate of soda. Lastly, decant the clear liquor from the precipitated carbonate of lime, pass it through a linen cloth, and keep it in bottles secluded from the light." When the solution of chlorinated soda is properly prepared, it is devoid of colour ; has 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 solution is exposed to the air, and allowed to evaporate spontane- ously, it gives out chlorine, and yields crystals of carbonate of soda.t EFFECTS ON THE ECONOMY. In its general remedial agency, chlorinated soda resembles chlo- rinated lime, and has been administered both internally and exter- nally in the same cases. It is preferred, however, for internal, whilst chlorinated lime is generally chosen for external use, and this, chiefly perhaps, owing to its being obtained more conveniently, and cheaply. Dr. Pereira states, hovvever, that he h; s carefully * Gazette de Sante, April 25, 1826. 1 Faraday, Quarterly Journal of Science, N. S. ii. 84, cited by Brande, Dictionary of the Materia Medica, p. 508. Lond. 1839. SODA CHLORINATA. 557 prepared and tried the two chlorides, and gives a decided prefer- ence to the chloride of soda. Labarraque, likewise, preferred it as an antiseptic, on the ground, that by the process of disinfection it becomes chloride of sodium, which is not a deliquescent salt; whilst chloride of calcium, formed by chloride of lime, attracts water from the atmosphere, and thereby furnishes one of the con- ditions—moisture—necessary to the putrefactive process. Hence, he thinks, whilst chloride of lime will serve equally well for sim- ple disinfection, chloride of soda is to be preferred where we wish at the same time to prevent a renewal of putrefaction.* By Bouillaud, Chomel and others, chlorinated soda has been given, with advantage, in typhous fevers; and by Kretschmar,y Lalesque, Colson, and GouzeeJ in intermittents:§ ten cases are re- ported by the last named gentleman; in two, the intermittent yielded immediately; two others were cured after a slight return; in one, there were four attacks, gradually diminishing; in two cases, the severity of the paroxysms abated, but it was thought necessary to have recourse to sulphate of quinia; in two others, no effect was produced, and in one, the disease was aggravated. Gouzee infers, that these cases prove the febrifuge properties of chlorinated soda to be less marked than those of sulphate of quinia, and, there- fore, that it ought not to be trusted to, except in the slighter cases, and where the patients are easily susceptible of the effects of medi- cine,—as women and children. In like manner, it has been found useful in scrofulous affections, and in various diseases in which chlorinated lime has proved serviceable. See Calx Chlorinata. MODE OF ADMINISTRATION. From ten drops to a dram mixed with plain or sugared water may be given internally for a dose. The form in which it was prescribed by Gouzee in intermittents was a mixture, composed of half a dram 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 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 ten or thirty 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 generally diluted with ten, twenty or thirty times its weight of water.|| * Pereira, Elements of Mat. Med. 2d edit p. 540. Lond. 1842; or 2d Amer. edit, by Dr. Therms, Grundriss der Medicin. Receptirkunst, S. 67. Weimar, 1838. t Rpvue Medicale, Fev. 1836. § Riecke, Die neuem Arzneimittel, S. 334, and 2te Auflage, S. 511. Stuttgart, 1840. || Payan,Revue Medicale, Aout, 1839. 36 558 SPIRITUS PYKO-ACETICUS. CXLVI. SPIRITUS PYRO-ACETICUS. Synonymes. iEther Pyro-aceticus, Pyro-acetic Spirit, Pyro-acetic Ether, Acetone, Mesitic Alcohol, Bihydrate of Mesitylene; called, also, Naph- tha, and Wood Naphtha. There has been some confusion amongst therapeutists in re- gard to the article meant by naphtha or wood naphtha, which Dr. John Hastings* brought forward within the last few years as an important remedy in tubercular phthisis. The term naphtha, ac- cording to Dr. Pereira,f had been applied but erroneously topyr- oxylie, or as he writes it pyroxilic spirit; and it is this article naphtha, which, according to Messrs. Ballard and Garrod,\ was given by Dr. Hastings. In this they are in error; and the confu- sion has probably arisen from Dr. Hastings having also given the erroneous name " naphtha," to the pyro-acetic spirit, which was the article really used by him. METHOD OF PREPARING. Pyro-acetic spirit may be prepared by distilling a mixture of two parts of crystallized acetate of lead and one part of quick-lime in a salt glaze jar (graybeard) the lower part of the jar being coated with fire clay, and a bent glass tube, half an inch in dia- meter, being adapted to the mouth by a cork so as to form a dis- tillatory apparatus. The jar is supported on the mouth of a small furnace, by vvhich the lower part only is heated to redness, and the vapours are conducted into a Liebig's condenser. The pro- duct is repeatedly redistilled from quick-lime, until its boiling point is constant at 132°.§ It is a colourless, volatile, inflammable liquid, having a peculiar penetrating odour, and a pungent taste like that of peppermint. Its specific gravity is 0.792. As found in the shops, its density is generally not lower than 0.820. It is miscible vvith water, ether and alcohol in all proportions. If, when mixed with water, it be- comes turbid, it has not been freed from empyreumatic oil. EFFECTS ON THE ECONOMY. Dr. Hastings|| states, that the reason why he was induced to deviate from the line of medical treatment of phthisis, vvhich has so universally, and for so long a period been in vogue, and to ad- mit a new method of management, was the fatal termination of all cases, whatever was the treatment adopted, during an experience of upwards of twenty years. " 1 was led," he say*, "to the con- * Pulmonary Consumption successfully treated with Naphtha. Lond. 1 843. t Elements of Mat. Med. and Therap. 2d Amer. edit, by Dr. Carson, i. 355. Philad. 1846. X Elements of Mat. Med. and Therap. p. 391. Lond. 1845. § Dr. Bache, Dispensatory of the United States, 6th edit. p. 1291. Philad. 1845. || Op. cit SPIRITUS PYRO-ACETICUS. 559 elusion, from a careful survey of the chemical analyses of tubercle made by Thenard, that it was defective, inasmuch as the compo- sition of the animal matter, which amounted to upwards of 98 parts out of 100, had not been investigated. From the greasy na- ture of tubercle in its crude state, there did not exist the slightest doubt in my mind, that carbon entered largely into its formation, and that its composition had a striking resemblance to fatty matter. In consequence of the lo. 1 American Journal of the Medical Sciences, Oct. 1844; cited from Medical Times, Au^. 31 1844. t°Brofferio, in Repertorio Medico-Chir. di Torino, 1825, and Revue Medicale, iv. 488. Paris 1 S25; 'and Weyland, Wochenschrift fur die gesammte Heilkunde, cited in Encycl. des Sciences Med. Janv. 1841, p. 65. § N. American Archives, No. 2, Nov. 1834. || Merat and De Lens, Diet, de Mat. Med. art. Strychnine. ir Formulary, 3d edit. p. 335. Lond. 1 KJ>9. ** Outlines of the Principal Diseases of Females, Dunglison's Amer. Med. Library edit P' tt Treatise on Diseases of the Chest, p. 125. Dublin, 1837, or Amer. Medical Library edit Philad. 1838. 572 STRYCHNIA. be added to it, it may be given in watery solutionis in this way a salt of strychnia 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 discontinuance, it ought not to be recommended in doses as large as the last, but with small doses, as at the beginning. In the endermic applica- tion 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 discontinue 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. Petrequin* thinks, that the endermic use of strychnia fre- quently fails owing to the vesicated surface to which it is applied becoming covered with a layer of coagulable lymph, in conse- quence of which the strychnia is unable to make its appropriate impression. This layer of hTmph should be removed as far as possible at each application ; and as the vesicated surface daily becomes less and less sensible, the dose must be proportionally increased. M. Petrequin'recommends, that a third or a fourth of a grain of strychnia should be mixed with two or three grains of -powdered nux vomica, and the compound be sprinkled on the surface; but it would seem to be far preferable to increase the dose of strychnia than to place so much insoluble and irritating pow- der on the sensitive surface. It has also been introduced by inoculation in the neighbourhood of the eye, in cases of amaurosis. A grain of the sulphate of strych- nia was in one case dissolved in two drops of water: the first day twelve inoculations were practised,—six above the eye in the course of the supra-orbitar nerve; six under and on the side of the nose, where the ethmoidal filaments and nasal branch terminate, and whence arise the filaments that go to the iris. On that day, there was no effect; but the next day slight tremors occurred in the neighbourhood of the inoculated spots. After a rest of two days, the inoculations were repeated, and the number of punctures increased to 18. The patient now became sensible of a slight ha- ziness. After five successive inoculations, carried to the length of thirty punctures, the patient began to distinguish objects: after the eighth, vision was completely restored, the contraction of the pupil gradually increased, and the other symptoms diminished, after five grains of the sulphate had been used. During the same time, inocu- lations were had recourse to in the neighbourhood of the other eye. After the lapse of two months, the patient was perfectly restored. * Bulletin General de Therapeutique, Mars, 1840. t Verlegh, Gazetta Medica di Milano, April, 1844, cited in London and Edinburgh Monthly Journal of the Medical Sciences, Aug. 1844, p. 713. STRYCHNIA. 573 PilulsB strychni a. Pills of strychnia. R. Strychnia? pur. gr. ij. Confect. rosEe gss. Divide in pilulas xxiv. Dose.—One to two, morning and evening. Magendie. R. Strychniae gr. j. Confect. ros. gss. Glycyrrhiz. pulv. Qss. Divide in pilulas xij. Dose.—One, night and morning. The quantity may be increased to four or five daily. Ryan. R. Strychnia? gr. ij. Ext. valerian, q. s. ut fiant pil. xxxij. Dose.—One, every morning fasting for five days:—afterwards one, morning and evening, in torpid amaurosis. Furnari Tinctura strychnia. R. Strychnia? pur. gr. iij. Alcohol 36° (.837) f. gj. M. Dose.—Six to twenty-four drops twice or thrice a day. Magendie. Mistura strychnia. Mixture of strychnia. (Potion stimulante.) R. Aq. destillat. f. gij. Strychnia? gr. i. Sacch. gij. Acid. acet. gtt. ij. M. Dose.—A dessert-spoonful, morning and evening. Magendie. Collyrium strychnia. Collyrium of strychnia. R. Strychnia? gr. ij.—iv.—vj.—viij. Acid. acet. dil. Aq. destillat. aa. f. gj. M. Two drops to be let fall into the eye, a few times a day, in amaurosis. % Henderson. Unguentum strychnia. Ointment of strychnia. R. Strychniae gr. xvj. Adipis gj. M. Used in friction on paralyzed parts. Sandras,* It may be well to dissolve the strychnia before admixture in a little alcohol. * Bouchardat, Nouveau Formulaire Magistral, p. 113. Paris, 1845. 37 574 STRYCHNIiE ACETAS. Linimentum strychnia. Liniment of strychnia. R. Strychniae gr. xxiv. 01. oliv. gj. M. Twelve drops of the oil to be rubbed on the temples four times a day in cases of amaurosis. Cunier. CXLVIU. STRYCH'Nl-ffi ACETAS. Synonymes. Strychnia? Acetas, Strychnium Aceticum, Acetas Strychnii seu Strychnicus, Acetate of Strychnia or Strychnine. German. Essigsaures Strychnin, Strychninacetat. In addition to the acetate, formed extemporaneously, as men- tioned under strychnia, the proper acetate of strychnia has been administered, especially by Liidersand Fricke. It may be made, like the acetate of quinia, from the direct combination of strychnia with acetic acid. According to Thenard, it is very soluble, and crystallizes with difficulty. Even when diluted 40,000 times, its solution occasions a sense of bitterness on the tongue. The following formulas have been given by the physicians ►cited. Gutta strychnia acetatis. Drops of acetate of strychnia. R. Strychnia? acet. gr. iij. Alcohol, f. gj. Aq. cinnam. f. sjvij. M. Dose.—Five drops, twice a day, gradually increasing the dose. Liiders. Tinctura strychnia acetatis. Tincture of acetate of strychnia. R. Strychnia? acet. gr. iss. Alcohol, f. gss. "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. CXLIX. STRYCH'NL^E I'ODAS. Synonymes. Strychnina? Iodas, Strychnina Iodata, Strychnium Iodicum, Iodas Strychnii seu Strychnicus, Iodate of Strychnia or 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 strychnia; in a moment, the mass swells up, absorbs water, be- STRYCHNUE IODAS. 575 comes thicker, and at times very consistent. It is now treated with\ boiling alcohol, filtered, and left to spontaneous evaporation In this way, beautiful crystals of iodide of strychnia are obtained. the iodic acid, proper for this preparation, is obtained according to treiger, in the following manner. Nine parts of iodide 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 consistence of a thin syrup, and is exposed to the air for spontaneous evaporation. Iodate of strychnia may likewise be formed by double decom- position, by mixing a soluble iodate, as iodate of soda, with a so- lution of sulphate or muriate of strychnia. The iodate of strych- nia is precipitated, which may be treated vvith boiling alcohol, and crystallized as above directed. The iodide is of a white colour, and crystallizes in beautiful prismatic needles: it is but slightly soluble in cold water, but more so in boding water and alcohol. EFFECTS ON THE ECONOMY. "This salt," says Magendie, " is one of the most active poisons with which I am acquainted. A single grain is sufficient to de- stroy a strong dog with tetanic symptoms. It acts, likewise, powerfully on the diseased organism. I gave it to several persons with a success vvhich 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 administered in vain." He gave it in pills, each of which contained one-eighth of a grain. One of these was prescribed night and morning, and the dose was gradually increased, until ultimately a grain was taken in the twent)r-four hours. The greatest circumspection was, however, necessary in its use. Magendie is of opinion, that the hydriodate of strychnia, strychnium hydroiodicum, hydriodas seu iodhydras strych- niae seu strychnicus; Germ, iodwasserstoffsaures strychnin, iodwasserstoffstrychnin, might be advantageously introduced into medicine. It is prepared by mixing a solution of iodide of potassium with a concentrated solution of acetate of strychnia: a white crystalline powder is precipitated, which is soluble in al- cohol, and is pure hydriodate of strychnia. It does not appear to have been used as yet in medicine. An iodide of iodhydrate of strychnia; French, Iodure cVIodhydrate de strychnine, has likewise been proposed. It is prepared by pouring a solution of ioduretted iodide of potassium into a solution of a salt of strychnia. A flocculent precipitate is formed of a liglit chestnut hue, which is dried, and treated with boiling alcohol. On cooling, the alcohol suffers crystals of iodu- 576 STRYCHNINE NITRAS. retted iodhydrate of strychnia to be deposited. It has the form of semi-transparent needles, of a deep ruby red colour; is soluble in alcohol and ether; but completely insoluble in water, even when slightly acidulated. M. Bouchardat* has administered this preparation to dogs, in the dose of three decigrammes (gr. 4.63.) It poisoned them like strychnia, but the action was much longer in developing itself. In the dose of five centigrammes, (gr. .771,) it occasioned, in about an hour, convulsive shocks, which persisted for some time; but the animal completely recovered. He thinks the advantage it pos- sesses over strychnia, is in being less poisonous and more persist- ent. It is always identical in composition, and easy to obtain pure. The dose is a centigramme (about a sixth of a grain,) a day, gradually increasing it. A double iodide of zinc and strychniahas also been prepared, which, according to M. Bouchardat, is a well defined salt, crystal- lizing regularly in beautiful needles of a brilliant white colour. It is composed of one atom of iodhydrate of strychnia, and one of iodide of zinc, and is soluble in water and in alcohol. When given to animals it acts like strychnia and its salts; but requires double the dose. It is prepared by digesting for several days, in hot water, the iodide of iodhydrate of strychnia and zinc; the boiling liquid is filtered, and, on cooling, the salt crystallizes. M. Bouchardatt thinks it may replace strychnia vvith advantage,—be- ing more manageable; and he suggests, that it may be a valuable agent in many serious neuroses, and especially in epilepsy. CL. STRYCHNINE NITRAS. Synonymes. Strychninae Nitras, Strychnium Nitricum, Nitras Strychnii seu Strychnicus, Nitrate of Strychnia or Strychnine. German. Salpetersaures Strychnin, Strychninnitrat. This preparation of strychnia has been more used in Germany than any other.J It has been received into the Prussian Pharma- copoeia, (Landespharmakopoe.) 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 filter- * Nouveau Formulaire Magistral, p. 114. Paris, 1845. 1 Ibid. p. 114. t Stumpf, art Strychnos, Encvclopad. Worterb. der Medicin. Wissensch. xxxii. 484. Berlin, 1844. STRYCHNINE SULPHAS. 577 ing, is dried and reduced to coarse powder. This is digested two or three times, with a sufficient quantity of the spirit, and after digestion it is strained. The tinctures are then subjected to dis- tillation, 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 pre- cipitate falls. The fluid, separated as much as possible from the precipitate, by means of the filter, is now evaporated to one-half, by a gentle heat. When cold, it is mixed with two ounces of calcined magnesia, and is suffered to stand 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 dis- tillation, until only a few ounces remain. The strychnia, 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 neutralized 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, colour- less, of a silky splendour, and a very bitter taste; they are soluble with difficulty in alcohol, but dissolve in ether. MODE OF ADMINISTRATION. The dose and mode of administering the nitrate of strychnia are the same as in the case of pure strychnia. Its endermic application will sometimes succeed vvhen the internal adminis- tration has heen more limited in its results. The experiments instituted by Dr. Stannius, and others, and referred to in a former page (567,) were vvith nitrate of strychnia. Magendie found, in his experiments, that this salt completely prevented the coagulation of the blood.* CLI. STRYCHNIA SULPHAS. Synonymes. Strychnina? Sulphas, Strychnium Sulphuricum, Sulphas Strych- nii seu Strychnicus, Sulphate of Strychnia or 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 strychnia with sul- phuric acid. 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 crystallizes, when neutral, in transpa- * Lecons sur le Sang; or translation in Lond. Lancet, Jan. 26, 1839, p. 637. 578 SULPHURIS CARBURETUM. rent cubes; when acid, in needles. Its taste is extraordinarily • bitter. It is decomposed by every soluble salifiable base. CUI. SUL/PHURIS CARBURE'TUM. Synonymes. Sulphuretum Carbonii seu Carbonei, Carbonium seu Carbo- neum Sulphuratum, Alcohol Sulphuris, Bisulphuretum Carbonii, Sulfi- dum Carbonii, Sulphuret of Carbon, Bisulphuret of Carbon, Carburet of Sulphur. French. Sulfure de Carbon, Carbure de Soufre, Soufre Carbure, Alcool de Soufre. German. Schwefelalkohol, Schwefelkohlenstoff, Fliissiger Kohlenschwefel, Kohlensulfurid. Carburet of sulphur or sulphuret of carbon was discovered by Lampadius in the year 1796. It is a transparent and colourless 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 volatilizes 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 w;ith the alkalies; but, of the acids, aqua regia — which is a mixture of the nitric and muriatic acids—alone lays hold of it. It dis- solves potassa, camphor, sulphur, and phosphorus. Lampadius, in the first instance, regarded 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 S5 or 86 to 15 or 14; according to Berzelius, and Marcet, of 84.84 to 15.16. METHOD 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 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 cnst iron, lined inter- nally with a coating 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 prevent 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 * Elemens de Chimie, traduits par M. B. Valerius, i. 156. Bruxelles, 1835. SULPHURIS CARBURETUM. 579 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 ordi- nary 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 aperture before mentioned, which must be carefully closed each time afterwards. The sulphur, on melting, runs towards the hottest parts of the tube, to which a slight inclination has been given on placing it in the furnace. It enters into ebullition, and is transformed 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, vvhich is carried off by the tube pass- ing through the window. 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. Carburet of sulphur holds a place amongst the transient or diffusible stimulants.* Its most marked effects are said to con- sist in its "exciting the functions of cutaneous transpiration to copious sweating; increasing the secretion of urine, elevating the temperature of the body, quickening the pulse, and causing congestions towards the head and those parts of the body whose vitality may have been already somewhat augmented."f 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 agent.;}: He particularly advised it, both inter- * Wutzer, Journ. de Chimie Med.; cited in Amer. Journ. Med. Sciences, Nov. 1831, p.'215. t Riecke,'Die neuern Arzneimittel, S. 109; and 2te Auflage, S. 166._ Stuttgart, 1840. X Lampadius, in Bulletin des Sciences Medicales de Ferussac, xi.315. 580 SULPHURIS CARBURETUM. nally and externally, in rheumatic and gouty affections. In Freiberg, a mixture of one part of camphor, two of carburet of sulphur, and four of alcohol, is a very common external appli- cation in rheumatic pains. Kappe found decided advantage from it in gout and rheumatism, and Mansfeld and Wutzer, resting upon a series of observations, maintain, that in rheumatism un- accompanied 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 car- buret of sulphur, and four parts of highly rectified spirit of wine, to be taken every two hours: and he directs the affected part to be rubbed vvith an embrocation, composed of one part of sulphuret of carbon, and four parts of olive oil. The cure, he states, is 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, y Mansfeld, also, employed it in cases of after-pains, rubbing it, without admixture, on the abdomen: and he affirms, that good effects resulted from it, even when ergot 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 vvay, he treated eleven cases, and only one—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 incarcerated hernia, no agent, he says, facilitates so much the taxis as the cold produced by drop- ping carburet of sulphur on the tumour.}: Lampadius found, that slight burns were instantaneously cured by it. Dr. Turnbull affirms—that the vapour of this substance was found useful, in cases of indurated lymphatic glands, and for the removal of deafness, dependent upon want of nervous energy, and deficiency of cerumen. It is applied by means of a bottle having a proper sized mouth, and containing a fluidram of the bisulphuret, im- bibed by a piece of sponge. In the casa of indurated lymphatic glands, the part is first well moistened wilh water. When the vapour is applied to the ear, the bottle, the neck of vvhich must * Annates de Chimie Medicate, cited in American Journal of the Medical Sciences, for Nov. 1836, p. 222. t G. Simon, art. SchwefelkohlenstofF, Encyelopad. W orterb. der Medicinisch. Wissen- schaft. xxxi. 270. Berlin, 1843. X Journal de Pharmacie, and American Journal of Pharmacy, ix. 264. SULPHURIS CARBURETUM. 581 be small to fit the meatus, is held close to the organ, until con- siderable warmth is induced.* Clarus recommends it in hypertro- phy of the coals of the stomach, and in contraction of the oesopha- gus—administered according to the formula given below. Every thing, indeed, says Riecke, encourages its farther trial as a reme- dial agent.f MODE OF ADMINISTRATION. Internally, carburet of sulphur may be given in doses of from one drop to four, every five or ten minutes, in cases of fainting and asphyxia; but where such a rapid analeptic agency is not de- manded, 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. Guttoe suiphnris carbureti. Drops of carburet of sulphur. R. Sulphur, carbur. f. gij. ^ther. sulphur, f. gj. M. Dose.—A few drops on sugar. Lampadius. R, Sulphur, carbur. f. gj. Alcohol, f. gss. M. Dose.—Four to six drops, every two hours, in rheumatism. Wutzer. R. Sulphur, carbur. f. gj. Alcohol, f. gij. M' Dose.—Five, ten, or fifteen drops, three times a day, in cases of rheumatism. Wutzer. Mistura suiphnris carbureti, Mixture of carburet of sulphur. R. Sulphur, carbur. 9j. Lact. vaccin. f. gvj. Sacch. gij. M. Dose.—A table-spoonful, four times a day, or oftener. Clarus. Embrocatio suiphnris carbureti. Embrocation of carburet of sulphur. R. Sulphur, carbur. gss. Olei amygd. dulc. gj. M. To be rubbed in, in casts of old gouty nodes. Mansfeld, & Otto.% * Pharm. Journ. and Transact, ii. 352; cited in Dispensatory of the United States, 6th edit. p. l--i.55. Philad. 1-45. t Die neuern Arzneimittel, u. s. w. S. 110. X Bibliothek for Laeger, lo35; cited in Brit and For. Med. Review, July, 1836, p. 252. 582 SULPHURIS IODIDUM. R. Sulphur, carbur. f. gij. 01. oliv. seu Linim. amnion, camphor, f. gij. M. To be rubbed in, in cases of rheumatism. \ Wutzer. R. Camphor, gij. Solve in Sulphur, carbur. f. gss. Adde Alcohol, f. gj. M. To be used in friction, in cases of rheumatism, and especially in rheumatic odontalgia. Lampadius. CLIII. SULPH'URIS IO'DIDUM. Synonymes. Sulphuris Ioduretum, Sulphur Iodatum, Ioduret or Iodide of Sulphur. French. Soufre Iodure, Iodure de Soufre. German. Iodschwefel, lodinschwefel, Schwefeliodur. METHOD OF PREPARING. 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 gray- ish-black mass, very deliquescent, and readily decomposed by water. M. G. Van Melekebeke,* has proposed the following form:—Take of iodine, two parts; washed sulphur, one part. Bruise them together, and introduce the mixture into a glass tube, pressing it down until the tube is well filled; then seal hermeti- cally. Heat at first gently, until the mixture begins to become of a darker colour; then augment the heat so as to fuse the iodide ; keep it for some time in this state, and turn the tube constantly, that the action may be uniform ; remove it from the fire, and shake it until the iodide begins to congeal, and until vapours of iodine no longer form ; open the tube, and compress again the iodide, in order to have it in fine cylinders. M. Van Melekebeke recom- mends this as a very expeditious process, and one which enables the pharmacien to prepare the iodide in very small quantity. The committee of the Societe des Sciences Medicales et Natu- relles de Malines approve of the process, but suggest, that the proportion of iodine to sulphur should be three to one. The following form for its preparation has been introduced into the last edition of the Pharmacopoeia of the United States:—Take of iodine, ^iv.; sulphur, ^j. Rub the iodine and sulphur to- gether in a glass, porcelain, or marble mortar, until they are tho- roughly mixed. Put the mixture into a matrass; close the orifice loosely, and apply a gentle heat so as to darken the mass without * Archives de la Medecine Beige, Mars, 1842, p. 307. SUiPHURIS IODIDUM. 5S3 melting it. When the colour has become uniformly dark through- out, increase the heat so as to melt the iodide; then incline the matrass in different directions, in order to return into the mass any portion of iodine which may have condensed on the inner surface of the vessel: lastly, allow the matrass to cool, break it, and put the iodide into bottles, which are to be well stopped. EFFECTS ON THE ECONOMY. Biett has used this agent in squamous, pustular, and papular diseases of the skin. It has been found especially effective in psoriasis, in the form of friction. Patients, who had been long affected with diseases of this kind, vvhich had resisted every other remedy, were cured in four or five months by 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 gulla rosacea of Alibert—when the inflammation of the skin had passed away. Even acne indurala was often completely cured by it.* He found it also beneficial in inveterate porrigo of the scalp.-f At times, after the rubbing, a diffuse red inflammation of the skin arises, with subsequent desquamation; and, in particular cases, the inflammation extends even to the subjacent cellular membrane. In old standing lepra, Rayer| prefers it for exter- nal use to calomel and white precipitate ; and he ranks it highly, with the iodides of mercury, for the cure of lupus non exedens; and by Dr. Volmar§ it has been used, vv%h great success, in her- pes pustulosus labialis. It 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 in tinea capi- tis, 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 astonished 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. Dr. Wilson has recommended, that the surface in porrigo, after ablution with warm water, should be rubbed gently twice a day vvith a liniment * See, also, Rayer, Traite Theorique et Pratique des Maladies de la Peau: and Cop- land, Dictionary of Practical Medicine, art. Acne. t Cazenave et Schedel, Maladies de la Peau, p. 219; and Cogswell on Iodine, p. 120. Edinb. Ic37. $ Diseases of the Skin, p. 634. 5 Die neuesten Entdeckung. in d. Mat Med.; cited by Pereira, Elements of Mat Med., ii. 477 2d edit Lond. 1842; or 2d Amer. edit by Dr. Carson. Philad. 1846. II London Medical Gazette, for Sept. 9,1837, p. 879. See, also, M. Cazenave, cited in American Journal of the Medical Sciences, Oct 1841, p. 460. e 584 UREA. composed of iodid. sulphur 3ss., ol. oliv., gj. In porrigo decal- vans it has been found beneficial, made into an ointment with 18 or 20 parts of lard, and rubbed on very gently night and morning. Dr. W. Davidson,* too, has extolled it highly. He affirms, that although it does not seem to have so much povver over lepra and psoriasis as over porrigo, it has succeeded more frequently than any agent He has tried, with the exception of blistering by can- tharides. The author has certainly obtained far more satisfactory results from the use of iodide of sulphur in chronic cutaneous dis- eases in general, and especially in porrigo, eczema, and psoriasis, than from any other external agent. The inhalation of the vapour of this substance has been em- ployed in humoral asthma^hy Dr. Copland,f with temporary benefit; and fumigations of iodine and sulphur have been used ad- vantageously in certain atonic ulcers, and chronic cutaneous dis- eases.^ With this view, the sulphur and iodine may be combined extemporaneously,—say four parts of iodine to one part of sulphur. MODE OF ADMINISTRATION. Ungnentnm snlphuris iodidi. Ointment of iodide of sulphur. R. Sulphur, iodid. 9j.—gss. Adipis gj. M. et fiat unguentum. Biett.—Rayer. CLIV. URE'A. Synonymes. Ureum, Uricum, Nephrine, Nephrin. French. Uree, Extrait Savonneux de l'Urine. German. Harnstoff. This immediate principle of the urine of man and quadrupeds was discovered in an impure state by Rouelle, in 1773; and since then it has been studied by Cruickshanks, Fourcroy and Vauque- lin, Berzelius, Proust, and Liebig more especially.§ 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 re- frigerative bath; by which means crystallized nitrate of urea is precipitated. On dissolving this in cold water, and decomposing by carbonate of potassa, reducing it almost to dryness, and treating the residue by alcohol at 40°, which takes up the urea, crystals * London and Edinburgh Monthly Journal of Medical Science, Dec. 1841: also, Dr. J. J. Ross, ihid. Sept. 1842, p. 792. t Diet, of Practical Medicine, art. Asthma. X London Lancet, vol. i. 1838, and Encyclographie des Sciences Medicales, Aout, 1838. § Annales de Chimie et de Physique, x. 369, and j^erat and De Lens, art Uree. urea. 585 may be obtained by evaporation, which may subsequently be pro- cured colourless by the agency of animal charcoal. 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, vvhich consists of oxide of lead united to the various acids of the urine, together with the mucus, and a great part of the animal matter; the decanted liquid is then treated with sulphuric acid in slight excess to separate the lead, and afterwards, in the progress 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 portion of animal charcoal during the ebullition. When the whole has become a clear syrup, pass it through linen of close texture, and then reduce it one-third by evaporation. On cooling, the li- quid is converted into a yellow mass, crystallized in needles, and 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 vvith a very small quantity of carbonate of soda, vvith the view of separating any remaining acetate of lime, and then digest- ed in alcohol of 38° to 40°. The alcoholic solution being filtered, and the alcohol separated by distillation, the urea remains, which may be crystallized afresh from water, if necessary.t Urea, thus obtained, is in silky or .prismatic needles, very solu- ble, and of a cooling taste. The following improved method of preparation has been pro- posed by Prof. Liebig.J Twenty-eight parts of ferrocyanuret of potassium perfectly dried are mixed with fourteen parts of per- oxide of manganese, both being reduced to as fine a powder as pos- sible; the mixture is then heated on an iron plate, not in a cruci- ble, over a coal fire to a feeble red heat. At this temperature it inflames, and is gradually extinguished. By shaking it several times at intervals, it is prevented from becoming agglutinated, and the access of air is facilitated. The mass on cooling is treated with cold water, and the liquor is mixed with twenty parts and a half of dry sulphnte of ammonia of commerce, prepared by saturating sulphuric acid with carbonate of ammonia, and evaporating it to dryness. It is well to put to one side the first concentrated wash- ings afforded by the ferrocyanuret of potassium; and to dissolve in the last washings, in the cold, the sulphate of ammonia, and to mix them vvith the first. Commonly, an abundant precipitate of sulphate of potassa forms immediately. The supernatant liquid is * Journal de Pharmacie, xi. 161. Paris, 1829. t Manual of Materia Medica and Pharmacy; by MM. H. M. Edwards and P. Vavasseur, p. 231. Philad. 1829. , X Annalen der Chimie und Pharmacie, B. xxxvin.; and Journal de Pharmacie, Aout, 1841, p. 502. -0 586 VERATRIA. poured off, and evaporated in a salt water bath, or rather in a warm place,—care being taken to prevent ebullition. Fresh crystalline plates of sulphate of potassa are deposited, and the liquor is decant- ed as far as possible. The decanted liquor is then evaporated to dryness, and the residuum is treated with boiling alcohol of eighty to ninety per cent. This dissolves the urea, which crystallizes by the cooling and evaporation of the alcohol, whilst the sulphates do not dissolve. 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 serious 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 employed it, also, but unsuccessfully, in diabetes* Laennec used it with advantage in a case of dropsy. In two cases reported by Mr. Kingdon,t he found that nitrate of urea acted as a very powerful diuretic; re- ducing, in a comparatively short time, anasarcous swellings of some standing, when ordinary diuretics had failed. In thefirst case, he gave one grain of the nitrate with one grain of calomel, in the form of pill, every night and morning for twelve days. The urine became copious, and the swelling disappeared. In the second case, a grain and a half of the nitrate was given alone three times a day. The like success attended this case: in ten days the anasarca had disappeared. According to Prof. Fee,| urea is received into the lists of the Materia Medica in the Batavian Pharmacopoeia, and in some others less known. It has also been admitted into the French Pharma- copoeia. MODE OF ADMINISTRATION. 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. CLV. VERATRIA. Synonymes. Veratrina, Veratrinum. Veratrium, Veratrine. French. Veratrine. German. Veratrin, Niesswurzstoff. \ * Journal de Physiol, de Magendie, ii. 344, and Formulaire pour la Preparation, &a, de plusieurs nouveaux Medicamens. t London Lancet, Sept 7, 1844, p. 729. X Cours. d'Hist Naturelle Pharm. ii. 764; cited in Merat and De Lens, Diet, de Mat Med. art. Uree. ^ VERATRIA. 587 This alkaloid, which was discovered in 1819, by MM. Pelle- tier and Caventou,* and almost at the same time by Meissneiyf is commonly prepared from the seeds of veratrum sabadilla—Saba- dilla or Cevadilla of the Pharmacopoeia of the United States. It is contained in several of the plants belonging to the family Colchi- caceae. METHOD OF PREPARING. Cevadilla is repeatedly treated with boiling alcohol. The tinc- tures, filtered when almost boiling, allow whitish flakes of wax to be deposited on cooling; the dissolved matters, brought to the con- sistence of an extract, are now dissolved 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 li- quid, a new and very abundant yellow precipitate is thrown down, which can be separated by means of the filter. The liquor, now nearly colourless, contains, besides other substances, acetate of lead, vvhich had been added in excess; this is separated by means of a stream of sulphuretted hydrogen: the liquor is then filtered, and concentrated by evaporation; treated by magnesia, and again fil- tered. The magnesian precipitate is digested in boiling alcohol, and on evaporating the alcoholic liquors, a pulverulent, extremely acrid matter is obtained, which possesses all the properties of the alkalies. It appears at first yellowish; but, by solutions in alcohol, and subsequent precipitations, caused by pouring water intq the al- coholic solutions, it is obtained in the form of a very white and perfectly inodorous powder.^ Veratria has been received into the London and United States Pharmacopoeias.§ In these it is directed to be prepared as follows: —Take of cevadilla, bruised, two pounds; alcohol, three gallons; dikUed sulphuric acid, solution of ammonia, purified animal char- coal, magnesia, each a sufficient quantity. Boil the cevadilla in a gallon of the alcohol, in a retort vvith a receiver attached, for an hour, and pour off the liquor. To the residue add another gallon of the alcohol, together with the portion recently distilled, again boil for an hour, and pour off the liquor. Repeat the boiling a third time with the remaining alcohol, and with that distilled in the previous operation. Press the cevadilla, mix and strain the liquors, and by means of a water bath distil off the alcohol. Boil * Annales de Chimie et de Physique, xiv. 69. , t Gilbert's Annalen der Physik, lxv. 335. t Magendie's Formulaire pour la Preparation, &c, de plusieurs nouveaux Medicamens. 5 Pharm. of the United States, p. 237. Philad. 1842. For M Righini's method of ob taining what M. Soubeiran calls " medicinal veratrine," see Journal de Pharmacie, Oct 1837. 588 VERATRIA. the residue three or four times in water acidulated with sulphuric acid, mix and strain the liquors, and evaporate to the consistence of syrup. Add magnesia in slight excess, shake the mixture fre- quently, then express, and wash what remains. Repeat the ex- pression and washing two or three times, and, having dried the residue, digest it with a gentle heat several times in alcohol, and strain after each digestion. Distil off the alcohol from the mixed liquors, boil the residue for fifteen minutes in water with a little sulphuric acid and purified animal charcoal, and strain. Having thoroughly washed what remains, mix the washings with the strained liquor, evaporate with a moderate heat to the consistence of syrup, and then drop in as much solution of ammonia as may be necessary to precipitate the veratria. Lastly, separate and dry the precipitate. The following is the rationale of this process. The cevadilla gives up its veratria united with a vegetable acid to the alcohol; and when the alcohol extract is treated with water and sulphuric acid, an impure solution of sulphate of veratria is obtained. The magnesia decomposes this, setting free the veratria, which is taken up by alcohol. The alcohol is then distilled off, and the extract is boiled in water with sulphuric acid and animal charcoal: the acid unites with the veratria, whilst the charcoal abstracts the colouring matter. Ammonia, added to the strained solution, unites with the sulphuric acid, and the veratria is precipitated.* Veratria—commercial or medicinal veratria—as prepared by the last process, is pulverulent, of a grayish-white colour, inodo- rous, and of a bitter acrid taste, causing a sensation of tingling with numbness in the tongue. Veratria is scarcely at all soluble in cold water; but boiling water dissolves one thousandth part of its weight, and becomes sensibly 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 uncrystallizable salts, which, on evaporation, 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 morphia, brucia, and impure strychnia, but very rapidly resolves the vegetable substance into its elements, and gives rise to a yellow detonating matter. Veratria 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. According to Couerbe,t when prepared in the modes above * Pereira, Elements of Mat. Med. and Therap. 2d edit. ii. 961; or 2d Amer. edit, by Dr. Carson. Philad. 1846. t Annales de Chimie et de Physique, ii. 308. VERATRIA. 589 Commercial veratria, mentioned, it still contains several other substances, sabadillina veratrin, gum resin of sabadilla, and a black, greasy substance, which unites the other matters, and conceals their properties. These may be separated from each other by the successive action of water, ether and alcohol, as in the following table : fl. Sabadillina, which yields to boiling water J crystallizes on cooling. ] 2. Resin ofveralria,\eit in the cold solution. 3. Veratria, soluble in ether. insoluble in boiling wa- ?, it is offered at a price so low as to place it within the reach of all. • This encyclopaedia of Materia Medica, for such it may justly be entitled, gives the fullest and most ample exposition of materia medica and its associate branches of any work hitherto published in the English language. It abounds in re=earch and erudition; its statements of facts are clear and methodically arranged, while its therant utical explanations are philosophical, and in accordance with sound clinical experience. It is equally adapted as a text-book for student;, or a work of reference for the advanced practitioner, and no one can con- sult its pa-es without profit The editor has performed bis task with much ability arid judgment. In the first Arnericaii°edition he adopted the Pharmacopoeia of the United States, and the formula; set forth in that stand- frd authority; in the present he has introduced an account of substances that have recently attracted attention bv their therapeutic employment, together with the mode of forming the characters and uses of new pharma- ceu the mein«-i to need any further remark. We have no c nary merits. — The New York Journal of Medicine. CONDIE ON CHILDREN—New Edition, 1847. A PRiVCTICAlTYREATISE on fHl BHSJlASISg ©IF ©MmLBSUKTo BY D. FRANCIS CONDIE, M. 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Anything emanating from the pen of Professor Horner, on anatomical science, is sure to be at once clear and correct. For more than 20 years this valuable little work has been before the profession, and during that period, sustained the high reputation of its author as a great practical anatomist. It is at the same time con cise and simple in its arrangement, beginning with the alphabet of the science, and gradually leading the stu dent onward to the more ample part of the study. Every student who wishes to acquire a correct knowledge of Anatomy, should have a copy of this book spread before him on the dissecting table.— The New Orleans Medical and Surgical Journal. Much Enlarged Edition—Now Ready. THE HISTORY, DIAGNOSIS AND TREATMENT OF THE FEYERS OF THE UNITED STATES. BY ELISHA BARTLETT, M. D., Professor of the Theory and Practice of Physic in the Medical Department of Transylvania University, &c. In One Octavo Volume of 550 Pages, beautifully printed and strongly bound. Decidedly the most valuable treatise on Fevers with which we are acquainted. As its title indicates, it contains the -History, Diagnosis and Treatment of the Fevers of the United States," comprehending Typhoid, Typhus, Periodical and Yellow Fevers. The work is remarkably systematic, and written in a clear, perspi- cuous and easy style. It is eminently calculated lo be useful to the profession, and cannot fail to secure to its Bble author a European reputation, as well as to reflect credit upon the medical literature of our country.— Southern Medical and Surgical Journal. LEA & BLANCHARD'S PUBLICATIONS. DUJVGLISON'S PRACTICE OF MEDICINE, Enlarged and Improved Edition, Brought up to 1848. THE PRAGTIGrOF MS6INE; A TREATISE ON SPECIAL PATHOLOGY AND THERAPEUTICS. THIRD EDITION. / By ROBLEY DUNGLISON, M. D., Professor ofthe Institutes of Medicine in the Jefferson Medical College; Lecturer on Clinical Medicine, ,\c In Two Large Octavo Volumes of Fifteen Hundred Pages. nm£°iifn°I Dun? Ki°n'.t W°rk haS ra,pidly paSSed t0 the third edition> and is now Presented to the / as probably the most complete work on the Practice of Medicine that has appeared m r„t«. n, th 7' ■ i 'S esPec!a"y c,ha"cter.zed by extensive and laborious research, minute and accu- ratepathological, seme.ological and therapeutical descriptions, together with that fullness of detail wnich is so important to the student. hav^Lnlnr^n^!! T*! bee", C0Ils,iderabIy enlarged j indeed the indefatigable author seems to ean SI °f the labyrinths of knowledge, from which important facts and opinions could be a&y f/miliar STmeSlT "^ W* ^^ C°mmend the ^ t0 tLe wh° "e "0t It is certainly the most complete treatise of which we have any knowledge. There is scarcely a disease which the student will not find noticed.-WWn Journal of Medicine and Surgery " 7 One ofthe most elaborate treatises of the kind we hue.—Southern Medical and Surg. Journal. analvsi^nt^L^' D"ngllson ls t0°. wel1 kr»rn' t0 re1uire at our hands> at the P^sent time, an analys s of its contents or any exposition ofthe manner in which the author has treated the several subjects embraced in it. The call for a third edition within five years from the appearance of the StrJ nel\* Buffi=,e2t evldence of the opinion formed of it by the medical profession of our country. That it is well adapted as a text-book for the use ofthe student, and at the same time as a book of reference for the practitioner, is very generally admitted; in both points of view, for accu- racy and completeness, it will bear a very advantageous comparison with any of the numerous co- temporary publications on the practice of medicine, that have appeared in this country or in Europe. The edition before us bears the evidence of the author's untiring industry, his familiarity with the various additions which are constantly being made to our pathological and therapeutical knowledge, and his impartiality in crediting the general sources from which his materials have been derived. Several pathological affections, omitted in the former editions, are inserted in the present, while every portion of the work has undergone a very thorough revision. It may with truth be said, that nothing of importance that has been recorded since the publication of the last edition, has escaped the attention of the author; the present edition may, therefore, be regarded as an adequate exponent of the existing condition of knowledge on the important departments of medicine of which it treats.—The American Journal of the Medical Sciences, Jan. 1848. The Physician cannot get a better work of the kind than this, and when he masters its contents he will have mastered all that such treatises can afford him.—St. Louis Med. &■ Surg Journal' June 1848. ' DUNGLISON ON NEW REMEDIES. NEW EDITION. NEW REMEDIES. BY ROBLEY DUNGLISON, M. D., &c. &c. Fifth edition, with extensive additions. In one neat octavo volume. A work like this is obviously not suitable for either critical or analytical review. It is, so far as it goes a dispensatory, in which an account is given ofthe chemical and physical properties of all the articles recently added to the Materia Medica and their preparations, with a notice of the diseases for which they are pre- scribed, the doses, mode of administration, &c.—The Medical Examiner. THE MEDICAL STUDENT, OR AIDS TO THE STUDY OF MEDICINE. A REVISED AND MODIFIED EDITION. BY ROBLEY DUNGLISON, M.D. In one neat 12mo. volume. HUMAN HEALTH; Or, the Influence of Atmosphere and Locality, Change of Air and Climate, Sea- sons, Food, Clothing, Bathing and Mineral Springs, Exercise, Sleep, Corpo- real and Intellectual Pursuits, &c. &c. on Healthy Man: Constituting ELEMENTS OF HYGIENE. BY ROBLEY DUNGLISON, M. D. A New Edition with many Modifications and Additions. In one Volume. 9vo. 10 LEA & BLANCHARD'S PUBLICATIONS. THE GREAT AMERICAN MEDICAL DICTIONARY, NEW AND ENLARGED EDITION, BROUGHT UP TO SEPTEMBER, 1848. NOW READY, n MEDICAL LEXICON; A DICTIONARY OF MEDICAL SCIENCE, CONTAINING A CONCISE EXPLANATION OF THE VARIOUS SUBJECTS AND TERMS, WITH THE FRENCH AND OTHER SYNONYMES; NOTICES OF CLIMATE AND OF CELEBRATED MINERAL WATERS; FORMULAE FOR VARIOUS OFFICINAL AND EMPIRICAL PREPARATIONS, Ere. BY EOBLEY DUNGLISON, M. D., PROFESSOR OF THE INSTITUTES OF MEDICINE IN THE JEFFERSON MEDICAL COLLEGE, PHILADELPHIA, ETC. ETC. SEVENTH EDITION, CAREFULLY REVISED AND GREATLY ENLARGED, Li One very large and beautifully printed Octavo Volume of over Nine Hundred Pages, closely printed in double columns. Strongly bound in leather, with raised bands. Since its first publication, many years since, this work has been steadily advancing in reputation and increasing in favor with the profession, till it may now safely be pronounced ' THE STANDARD AMERICAN MEDICAL DICTIONARY. Never having been stereotyped, the author has been able, in the successive reprints, to embody all the novelties and improvements of science as fast as they have appeared, to accomplish which great industry as well as great judgment has been necessary. As an exemplification of the man- ner in which this work is kept up to the day, it may be stated that this edition contains OVER SIX THOUSAND WORDS AND TERMS not embraced in the preceding, which, in its turn, had TWO THOUSAND FIVE HUNDRED more than the Fifth Edition. The profession, therefore, can understand the manner in which this work has gradually increased until it contains satisfactory definitions of OVER FORTY-FIVE THOUSAND WORDS. Thus becoming a vast reservoir of medical Science in all its branches. It will thus be seen why it is regarded as the STANDARD WORK OF REFERENCE FOR THE MEDICAL PROFESSION. Every means has been employed in the preparation of the present edition, to render its me- chanical execution and typographical accuracy in every way worthy its extended reputation and universal use. The size of the page has been enlarged, and the work itself increased more than a hundred pages; the press has been watched with great care; a new font of type has been used, procured for the purpose; and the whole printed on fine clear white paper, manufactured expressly. Notwithstanding this marked improvement over all former editions, the price is retained at the original low rate, placing it within the reach of all who may have occasion to refer to its pages. From among numerous notices of former editions, the publishers append a few. The most complete Medical Dictionary in the English language.— Western Lancet. "We but express the general opinion when we say that Dr. Dunglison's Dictionary has not its superior, if, indeed, its equal, in the English language. So much for the preceding editions. The present is, of course, an improvement on its predecessors, and contains all ihe new terms employed by advancing science. We hearti- ly recommend this Dictionary to medical men, as they will be able to find in it almost every term used in the medical and collateral sciences, and almost every topic embraced by these long and voluminous annals. It is a work deslined to constitute the proudest monument of its author's industry and learning—to perpetuate ihrough coming centuries the memory of his name and his services to science—to reflect honor on American medicine.—SJ. Louis Med. and Surg. Journal. The Dictionary of Professor Dunglison might, without any great stretch of propriety, be called a Cyclopedia of Medical Science, so comprehensive is it in its scope, and so minute in its details. In this respect it pos- sesses a great advantage over its contemporary publications of the kind. Whatever one may expect to meet with in a dictionary of terms, he is pretty sure to find in its ample pages, besides a vast deal of matter not commonly embraced in medical lexicons, and not readily found in other publications.—The Medical Examiner, LEA & BLANCHARD'S PUBLICATIONS. 11 A NEW EDITION OF DUNGLISON'S HUMAN PHYSIOLOGY. HUMAN P hTy S I O L O G Y. WITH THREE HUNDRED AND SEVENTY ILLUSTRATIONS. BY ROBLEY DUNGLISON, M.D., PROFESSOR OF THE INSTITUTES OF MEDICINE IN THE JEFFERSON MEDICAL COLLEGE, PHILADELPHIA, ETC. ETC. Sixth edition, greatly improved.—In two large octavo volumes, containing nearly 1350 pages. This work has been so long received throughout the Union as the leading textbook on Physiology, that in presenting this edition the publishers deem it necessary only 10 remark that they have endeavored to render the mechanical execution of the work in some degree worthy its acknowledged merits by an advance in both the number and beauty of the illustrations, and an improvement in the style of printing. The name of the author is sufficient guarantee that each new edition fully keeps pace with the advance of science. DUNGLISON'S THERAPEUTICS-New and Much Improved edition. GENERAL THERAPEUTICS AND MATERIA MEDICA. With One Hundred and Twenty Illustrations. ADAPTED FOR A MEDICAL TEXT-BOOK. BY ROBLEY DUNGLISON, M. D., Professor of Institutes of Medicine, &e. in Jefferson Medical College; late Professor of Materia Medica, &c. in the Universities of Virginia and Maryland, and in Jefferson Medical College. Third Edition, Revised and Improved, in Two Octavo Volumes, well bound. Our junior brethren in America will find in these volumes of Professor Dunglison a "Thesaurus Medica- minum." more valuable than a large purse of gold.—London Medico- Chirurgical Review. GRIFFITH'S UNIVERSAL FORMULARY—Nearly Ready. THE UNIVERSAL FORMULARY: A SYNOPSIS OF THE PHARMACOPOEIAS, DISPENSATORIES AND FORMULARIES OF EUROPE AND AMERICA. WITH NUMEROUS MAGISTERIAL FORMULAS FROM VARIOUS SOURCES, BY R. E. GRIFFITH, M. D., &c. &c, Author of " Medical Botany," &c. &c. In One Octavo Volume. This work is intended to embrace all thatisof practical importance in the numerous Pharmacopoeias, Form- ularies and Dispensatories of Europe and of this country, as well as such formulas as appeared deserving of notice in the Medical Journals, Treatises of Medicine, &c. &c, together with many others, derived from pri- vate sources, which have never been hitherto published. It will therefore include all that is really useful in Redwood's Edition of Gray's Supplement to the Pharmacopoeias, in Jourdan's Pharmacopee, and the several works of Ellis. Fee, Paris, Thomson, Beasley, Cottereau, Cooley, Bouchardat. &c. As, in accordance with its title of a Universal Formulary, it will not be confined solely to medical formulas, the publishers hope that the numerous scientific receipts embraced, will render it of much practical importance to the Chemist and Manufacturer. It will contain UPWARDS OF SIX THOUSAND FORMULAS, alphabetically arranged, with copious indexes, pointing out the diseases in which the preparations are to be used &c. &c, and thus combining the advantages of all the different modes of arrangement and reference. NEW AND COMPLETE MEDICAL BOTANY—Lately Published. M5IIM(DAI[71b©^AM1'b OR A DESCRIPTION OF ALL TM! MORE IMPORTANT PLANTS USED IN MEDICINE, AND ' OF THEIR PROPERTIES, USES AND MODES OF ADMINISTRATION. BY R. EGLESFELD GRIFFITH, M. D.; &c. &c. In One large Octavo Volume, handsomely printed, with nearly Three Hundred and Fifty Illustrations on Wood. The author of the volume is well known to be particularly qualified for this undertaking, by his botanical, n« JtpII as medical and pharmaceutical knowledge; and it strikes us, on cursory examination, that it has Wn nrenared with much care and faithfulness, and that it will take its place at once as the standard work Deen prep „„„„,,„ a snpn.innt introductory chanter is devoted to the nnatomv and structure of ArA\o *TP ihrOWn intO grOUpS Ulier llic llia.11.101 ". ^i. ^....u.^j. -..- ,----.» ........ ...~ i^«.,j. un|«it»i> '■» 1110 m t riaMpdica are described in full, as well as the officinal part or production; the others are more briefly Material references, which are faithfully made, both to the botanical and medical authorities, will serve in all cases to direct the inquirer to the original sources of information.—Silliman's Journal. 12 LEA & BLANCHARD'S PUBLICATIONS. A NEW DISPENSATORY, NOW READY. A DISPENSATORY, OK COMMENTARY ON THE PHARMACOPEIAS OF GREAT BRITAIN AND THE UNITED STATES: COMPRISING THE NATURAL HISTORY, DESCRIPTION, CHEMISTRY, PHARMACY, ACTIONS, USES AND DOSES OF THE ARTICLES OF THE MATERIA MEDICA. BY ROBERT CHRISTISON, M.D., V.P.R.S.E., PRESIDENT OF THE ROYAL COLLEGE OF PHYSICIANS OF EDINBURGH, PROFESSOR OF MATERIA MEDICA IN THE UNIVERSITY OF EDINBURGH, ETC. Second Edition, Revised and Improved, WITH A SUPPLEMENT CONTAINING THE MOST IMPORTANT NEW REMEDIES. WITH COPIOUS ADDITIONS, AND TWO HUNDRED AND THIRTEEN LARGE WOOD ENGRAVINGS, BY R. EGLESFELD GRIFFITH, M.D., AUTHOR OF "A MEDICAL BOTANY," ETC. SPECIMEN OF THE ILLUSTRATIONS. Artemisia Absinthium, "Wormwood." In One very large and handsome Octavo Volume of over One Thousand closely printed Pages, ivith numerous Woodcuts, beautifully printed, on fine white paper. Presenting an immense quantity of matter at an unusually low price. LEA & BLANCHARD'S PUBLICATIONS. 13 CHRISTISON AND GRIFFITH'S DISPENSATORY—Continued. The Dispensatory of Professors Wood & Bache has so long and so satisfactorily supplied the wants ot the profession that the publishers, in presenting a new work of the same description, feel tnat it should possess additional attractions to entitle it to notice. The value of the original work f .W' tth"stif?n 1S wel1 known in England, where it has long occupied a position similar to that ot the U. S. Dispensatory in this country. To this it is entitled by its clearness, conciseness, and completeness, and the care with which the author has kept it on a level with the improvements of medical science, by corrections, and embodying in it all the new articles of the materia medica, In preparing it for the use of the profession in this country, Dr. Griffith has made very exten- sive additions, introducing all the processes of the U. S. Pharmacopoeia, as well as a full medical, pharmaceutical and botanical history of all articles recognized by our national standard which have been omitted by the author. In addition to this, the editor has made free use of all European and American authorities on Materia Medica, among which may more particularly be mentioned Red- wood's Second Edition of Gray's Supplement to the Pharmacopoeia, just issued, which has supplied him with much useful information, and from which he has endeavored to convey all that appeared to him to possess especial interest—among other things, some very extended and useful tables, and accounts of various new remedial agents not as yet mentioned in the Pharmacopoeias of Great Bri- tain or of this country. In addition to this, over two hundred wood-cuts have been introduced, illustrative of articles of the Materia Medica, rendering this the only Dispensatory now before the profession presenting illustrations of the principal articles described therein. The attention of practitioners and students, as well as of all druggists and pharmaceutists, is especially invited to this work as one embodying in the smallest practicable space and at an exceed- ingly low price, an immense amount of indispensable information, and as presenting a complete view of the present practical state of the materia medicos of the four leading pharmacopeias, clearly arranged and concisely expressed. From T. Romeyn Beck, M.D., Prof, of Mat. Med. in the Albany Medical College, and author of "Medical Jurisprudence." ..T . ,. Albany, Sept. 8,1848. „ 'received from you this morning a copy of the Second Edition of Christison's Dispensatory, edited by Griffiih. I beg you to receive my thanks for this most acceptable present. "I have been a diligent reader of the first edition and know its value. 1 only regret that the Circular of our College has been published, or I would have placed it among my text-books. Next spring I will certainly do so if I live and hold the professorship." From W. T. Wilson, M. D., Prof, of Mat. Med. in the Washington University of Baltimore. .. , Baltimore. Aug.31,1848. 'Allow me to thank you most sincerely and cordially for your kind present of a copy of Christison and Griffith's Dispensatory, just published by you. After a cursory glance at the volume, which I shall peruse more at leisure hereafter, I most heartily join in your opinion in regard to its great merits, containing, as it does, all the most modern discoveries and improvements in the materia medica and pharmacy, and rendered still more acceptable to the American profession by its beautiful illustrations, the addition of Dr. Griffith, and the handsome style in which you have succeeded in bringing it out. I trust that your enterprise will be libe- rally respouded to by those forwhom the work is chiefly intended." There is not in any language a more complete and perfect Treatise.—N. Y. Annalist, Sept., 1848. It is not needful that we should compare it with the other pharmacopoeias extant, which enjoy and merit the confidence of the profession: it is enough to say that it appears lo us as perfect as a Dispensatory, in the present state of pharmaceutical science, could be made. If it omits any details pertaining to this branch of knowledge which the student has a right to expect in such a work, we confess the omission has escaped our scrutiny. We cordially recommend this work to such of our readers as are in need of a Dispensatory. They cannot make choice of a better.—The Western Journal of Medicine and Surgery, September, 1848. In conclusion, we need scarcely say that we strongly recommend this work to all classes of our readers As a Dispensatory and commentary on the Pharmacopoeias, it is unrivalled in the English or any other lan- guage.—The Dublin Quarterly Journal, July 1848. We earnestly recommend Dr. Christison's Dispensatory to all our readers, as an indispensable companion, not in the Study only, but in the Surgery also.—British and Foreign Medical Review. It is exactly the work we would give to the student for daily reading, or to the practitioner for regular refer- ence. Without being encumbered with unnecessary detail or research, it is sufficiently explicit in its litera- ture to render it an ample encyclopaedia of its subject; and at the same time, its practical information is so condensed and summary, yet without a sacrifice of even the least important fact, that to the student it cannot but be a text-book invaluable in its kind. Had we said less concerning this volume we should have been wanting in common duty ; but it is not ne- cessary that we should say more to convince our numerous readers that we consider Christison's Dispensa- tory to be the best English work extant upon the subject it embraces.-—The Medical Times, June 1848. It-comes not within our plan to enter into minute or detailed criticism of a work like the present. Its merits as a treatise on materia medica, chemical pharmacy, and pharmacology, we on a former occasion explained. It is sufficient to say that the reader will find the character given in that article most ably sustained by the present edition. The natural and chemical history of the articles is given with great clearness and accuracy. The important subject of adulterations and sophistications is throughout treated in detail. The pharmacolo- gical instructions show very great practical experience and knowledge, which can be obta:ned by experience alone. And lastly, the therapeutic directions are expounded in a judicious manner, avoiding the extremes of great confidence and unreasonable skepticism. In short, the work may be justly recommended as an excel- lent treatise on Materia Medica, Chemical Pharmacy, and Pharmacology.—The Edinburgh Medical and Sur- gical Journal, July ISIS. B.1RTLETT O.V CERTJHJYT1T IJ\' MEDICINE—Atw Ready. AN INQUIRY INTO THE DEGREeToF CERTAINTY IN MEDICINE, AND INTO THE NATURE AND EXTENT OF ITS POWER OVER DISEASE. BY EIJSHA BARTIETT, M. D., Author of "Fevers of the United States," "Philosophy of Medical Science." In One small Volume, crown 8w, extra cloth. 14 LEA & BLANCHARD'S PUBLICATIONS. FOWNES' CHEMISTRY FOR STUDENTS. A NEW AND IMPROVED EDITION. ELEMENTARY CHEMISTRY, THEORETICAL AND PRACTICAL. BY GEORGE FOWNES, Ph. D., Chemical Lecturer in the Middlesex Hospital Medical School, &c. &c. With Numerous Illustrations. Second American Edition. Edited, Avith. Additions, BY ROBERT BRIDGES, M. D., Professor of General and Pharmaceutical Chemistry in the Philadelphia College of Pharmacy, &c. &c. In one large duodecimo volume, sheep or extra cloth. Though this work has been so recently published, it has already been adopted as a text-book by many of the Medical Institutions throughout the country. As a work for the first class student, and as an introduction to the larger systems of Chemistry, such as Graham's, there has been but one opinion expressed concerning it, and it may now be considered as THE TEXT-BOOK FOR THE CHEMICAL STUDENT. An admirable exposition ofthe present state of chemical science, simply and clearly written, and display- ing a thorough practical knowledge of its details, as well as a profound acquaintance with its principles. The illustrations, and the whole getting-up ofthe book, merit our highest praise.—British and Foreign Med. Rev. Remarkable for its clearness, and the most concise and perspicuous work ofthe kind we have seen, admi- rably calculated lo prepare the student for the more elaborate treatises —Pharmaceutical Journal. From JAMES REN WICK, Professor of Chemistry, Columbia College, New York. "The very best manual of Chemistry with which 1 am acquainted in the English language." New York, Feb. 12th, 1S48. This work of Fownes, while not enlarging on the subject as much as Graham, is far more lucid and ex- panded than the usual small introductory works. Professors recommending it to their classes may rely upon its being kept up to the day by frequent revisions. MANUALS ON THE BLOOD AND URINE: CONSISTING OF I. A PRACTICAL MANUAL, CONTAINING A DESCRIPTION OF THE GENERAL, CHE- MICAL AND MICROSCOPICAL CHARACTERS OF THE BLOOD AND SECRETIONS OF THE HUMAN BODY, AS WELL AS OF THEIR COMPOUNDS, INCLUDING BOTH THEIR HEALTHY AND DISEASED STATES : WITH THE BEST METHODS OF SEPARATING AND ESTIMATING THEIR INGREDIENTS. ALSO, A SUCCINCT ACCOUNT OF THE VARIOUS CONCRETIONS OCCASIONALLY FOUND IN THE BODY AND FORMING CALCULI. BY JOHN WILLIAM GRIFFITH, M. D.. F.L.S., &c. II. ON THE ANALYSIS OF THE BLOOD AND URINE IN HEALTH AND DISEASE, AND ON THE TREATMENT OF URINARY DISEASES. BY G. OWEN REES, M. D., F.R.S., &c. &c. III. A GUIDE TO THE EXAMINATION OF THE URINE IN HEALTH AND DISEASE, FOR THE USE OF STUDENTS. BY ALFRED MARKWICK. The whole forming One large royal 12mo. Volume, of Four Hundred and Sixty Pages, With about one hundred figures on five plates. The three works embraced in the volume were published in London, separately, but the imme- diate connection ofthe subjects treated, and their increasing importance, have induced the Ameri- can publishers to embody them in a volume suitable for reference and preservation. Although addressed especially to students, it contains almost all the information upon these matters which the practitioner requires.—Dublin Medical Press. The chemical processes recommended are simple, yet scientific; and the work will be very useful to the medical alumni for whom it is intended.—Medical Times. The author must be admitted to have attained his object in presenting a convenient bedside companion.— Dr. Ranking's Abstract. CHURCHILL ON FEMALES—Edition of 1847. THE DISEASETOF FEMALES, INCLUDING THOSE OF PREGNANCY AND CHILDBED. BY FLEETWOOD CHURCHILL, M.D., Author of "Theory and Practice of Midwifery," &c. &c. FOURTH AMERICAN, FROM THE SECOND LONDON EDITION, WITH ILLUSTRATIONS. EDITED, WITH NOTES, BY ROBERT M. HUSTON, M.D., &c. &c. In One Volume, Octavo. The rapid sale of three editions of this valuable work stamps it so emphatically with the approbation ofthe profession of this country, that the publishers, in presenting a fourlh, deem it merely necessary to observe, that every care has been taken, by the editor, to supply any deficiencies which may have existed in former impressions, and to bring the work fully up to the date of publication. LEA & BLANCHARD'S PUBLICATIONS. 15 Sew and Enlarged Edition, Brought up to 1848. ■WILLIAMS' PATHOLOGY. Now Ready. PRINCIPLESl)F MEDICINE, COMPRISING GENERAL PATHOLOGY AND THERAPEUTICS, AND A BRIEF GENERAL VIEW OF ETIOLOGY, NOSOLOGY, SEMEIOLOGY, DIAGNOSIS, PROGNOSIS, AND HYGIENICS. BY CHARLES J. B. WILLIAMS, M.D., F.R.S., Fellow of the Royal College of Physicians, &c. EDITED, WITH ADDITIONS, BY MEREDITH CLYMER, M.D., Consulting Physician to the Philadelphia Hospital, &c. &c. Third American, from the Secowl and Enlarged London Edition. In One Volume Octavo. The delay which has prevented the appearance of this edition until the present time, has arisen from the extensive modifications and improvements introduced by the author, bringing the work fully up to a level ■with the present state of knowledge on the numerous and important subjects of which he treats. These ad- ditions pervade almost every portion of the work, but ihey preponderate in the following subjects, in which we can mention—in Etiologv, mechanical, chemical, and dietetic causes of diseases, defective cleanliness, ven- tilation and drainage. In Pathology, the tabular views of the elements of disease ; reflex action and sympa- thy ; elementary changes in the blood; congestion; determination of blood; inflammation, in its nature, manifold results, and modes of treatment; degeneration of textures; cacoplastic and aplastic deposits and their treatment, with a notice of the action of cod liver oil; and the whole chapter on Hygienics, comprising/ood ; clothing; air and temperature; exercise; sleep; mental occupation and excretion. In addition to this, the editor has introduced much new matter in the sections on Etiology, Diseases of the Constituents of the Blood, Structural Diseases, Semeiology, Prognosis and Hygienics, and he has also added a section on the Signs of Disease. It will be seen from this rapid summary, that the additions to this edition of Dr. Williams' Principles will fully maintain its high reputation, and render it worthy a continuance of the favor which has caused its in- troduction as a text-book into so many colleges throughout the Union. It is entitled to claim the reader's best attention, and its perusal and study will be amply remunerative. It is a work calculated to elevate the character of medical science, from its correct and lucid exposition of the great principles of scientific investigation, and its plain, practical character, will recommend it to the student and practitioner of medicine and surgery.— Am. Medical Journal, July 1848. ROYLE'S NEW WORK. MATERIA MEDICA AND THERAPEUTICS; INCLUDING THE PREPARATIONS OF THE PHARMACOPOEIAS OF LONDON, EDINBURGH, DUBLIN, AND OF THE UNITED STATES, ■WITH MANX NEW MEDICINES. BY J. FORBES ROYLE, M. D., F.R.S. Late of the Medical Staff in the Bengal Army, Professor of Materia Medica and Therapeutics, King's College London, &c. &c. EDITED BY JOSEPH CARSON, M.D., Professor of Materia Medica in the Philadelphia College of Pharmacy, &c. &c. WITH NINETY-EIGHT ILLUSTRATIONS. In one large octavo volume of about 700 pages. Being one of the most beautiful Medical works published in this country. This work is ably done—the botanical p't with great skill, and the chemical, natural history, and thera peutic department, most perfect and complete.—Edinburgh Medical Journal. This is another of that beautiful and cheap series of manuals published by Mr. Churchill. In the execution of the wood cuts, of plants, flowers and fruits, Mr. Bagg seems almost to have exceeded his former .doing?- The work is, indeed, a most valuable one. It would be injustice to the learned author not to state that, in addi- tion to what other works on the subject necessarily contained, the reader will find here not a little that is original, or introduced for the first time, more especially in the details of botany and natural history— British and Foreign Medical Review. RAMSBOTHAM'S MIDWIFERY. THE PRINCIPLES AND PRACTICE Or OBSTETRIC MEDICINE AND SURGERY, IN REFERENCE TO THE PROCESS OF PARTURITION. ILLUSTRATED BY One hundred and forty-tight Large Figures on 55 lithographic Platei. BY FRANCIS H. RAMSBOTHAM, M.D., &c. A NEW EDITION, FROM THE ENLARGED AND REVISED LONDON EDITION. In one large imperial octavo volume, well bound. Tor students ; clear, but not too minute lr " ely illustrated by plates (admirably chos De stupiu, inaeea, wuu uuC, ..ot understand the deiailsof this branch ol tion can make them intelligible.—DuftZin Journal of Medical Science. 16 LEA & BLANCHARD'S PUBLICATIONS. Now Ready, brought up to July 1848, A New Edition of WESON'S HUMAN ANATOMY, much Improved. A SYSTEM OF HUMAN ANATOMY, GENERAL AND SPECIAL. BY ERASMUS WILSON, M. D. FOURTH AMERICAN, FROM THE LAST ENGLISH EDITION. EDITED BY PAUL B. GODDARD, A.M. M.D., Professor of Anatomy in the Franklin Medical College, Philadelphia. WITH TWO HUNDRED AND FIFTY ILLUSTRATIONS. Beautifully printed in One large Octavo Volume of nearly Six Hundred pages. In passing through numerous editions, both in England and this country, this work has received many improvements and modifications, and it may now be confidently presented to the profession as containing all the important facts in general SBd special anatomy in a clear and lucid manner, fully brought up to the present level of science. It has long been known as the favorite text-book in this department of medical science, and it is now used in a large proportion of the colleges throughout the country, to which it is further recommended by its admirable series of illustrations, its beautiful mechanical execution, its neat and convenient size, and the very low rate at which it is furnished. In many, if not all the colleges of the Union, it has become a standard text book.—N. Y. Medical Journal. From Granville Sharp Pattison, M. D., Professor of Anatomy in the University of New York. " I have a very high opinion of the work of Wilson, and I feel that you have conferred a favor on the pro- fession by the very handsome edition of it which you have published." From J. N. Bybee, M. D., Professor of Anatomy in the Memphis Medical College. "I look upon this book as one of the best, if not the very best, in the English language, for the practical anatomist." From Professor W. R. Grant, of the Pennsylvania Medical College. "I have heretofore considered Wilson's Anatomy as one of the best books for the use particularly of stu- dents, and as such have recommended it to the classes of the Pennsylvania Medical College." FERGUSSON'S SURGERY-New and Improved Edition of 1848, Now Ready. A SYSTEM OF PRACTICAL SURGERY. BY WILLIAM FERGUSSON, F.R.S.E., Professor of Surgery in King's College, London, &c. &c. THIRD AMERICAN, FROM THE LAST ENGLISH EDITION. With Two Hundred and Seventy-four Illustrations by Bagg, Engraved by Gilbert. In One large and beautifully printed Octavo Volume of Six Hundred and Thirty large Pages. It is with unfeigned satisfaction that we call the attention of the profession in this country to this excellent work. It richly deserves the reputation conceded to it, of being the best practical surgery extant, at least in the English language.—Medical Examiner. Professor Fergusson's work, we feel persuaded, will be as great a favorite as it deserves, for it combines the powerful recommendations of cheapness and elegance, with a clear, sound, and practical treatment of every subject in surgical science. The illustrations, by Bagg, are admirable—in his very best style.—Edin- burgh Journal of Medical Science. DRUITT'S SURGERY, NEW EDITION, NOW READY, 1848. THE PRINCIPLES AND PRACTICE OF MODERN SURGERY. BY ROBERT DRUITT. A NEW AMERICAN, FROM THE LAST AND IMPROVED LONDON EDITION. Edited bt F. W. SARGENT, M. D., Author of "Minoii Schgery," With One Hundred and Ninety-three Beautiful Wood Engravings. In One well printed octavo Volume of Five Hundred and Seventy-six Pages. The improvement of this edition will be found fully to warrant a continuance of the favor so long extended to this excellent work. The size of the page has been increased, and the volume itself enlarged by about fifty pages, giving ample space for the addition of all new and interesting matter which the progress ofthe science has rendered necessary since the appearance of the last edition. The wood-cuts have been thoroughly revised, many of them rejected and their places supplied by better designs, and numerous new engravings added. The amount of these changes may be esti- mated from the fact, that over half of the illustrations in this edition have appeared in no former one. The mechanical execution will also be found much improved. An unsurpassable compendium not only of surgical but of medical practice.—London Medical Gazette. This work merits our warmest commendations, and we strongly recommend it to young surgeons as an admirable digest of the principles and practice of modern Surgery.—Medical Gazette. LEA & BLANCHARD'S PUBLICATIONS. 17 TAYLOR'S TOXICOLOGY. Just Published. ON P 0~I 8 O N S IN RELATION TO MEDICAL JURISPRUDENCE AND MEDICINE. BY ALFRED S. TAYLOR, F.R.S., Lecturer on Medical Jurisprudence and Chemistry in Guy's Hospital, and author of "Medical Jurispru- dence," &c. &c. Edited, with Notes and Additions, BY R. EGLESFELD GRIFFITH, M. D. In one large octavo volume, to match the "Medical Jurisprudence" of the same author. It is, so far as our knowledge extends, incomparably the best upon the subject; in the highest degree creditable to the author, entirely trustworthy, and indispensable to the student and prac- titioner, and likely to prove of immense service to the local practitioner, whether engaged in the duty of prosecuting the criminal or defending the innocent from condemnation.—JV. Y. Annalist.. It is safe to say, that the volume of Mr. Taylor forms one of the most complete treatises on poisons extant, and that it is a work which ought to be in the hands of every physician and lawyer. It is an elaborate epitome of all that is known on the subject of poisons. The subject is one of deep interest. We shall avail ourselves ofthe earliest opportunity to say more about this excellent treatise.— The Western Journal of Me- dicine and Surgery. We can most unreservedly recommend Mr. Taylor's treatise to our readers as the most complete, and at the same time, condensed system of Toxicology extant, and as the one which, we feel assured, will hence- forth rank in this country as the chief authority on the subject.— Medico-Chirurgical Review. The reputation acquired by Mr. Taylor, by his researches in Toxicology and Legal Medicine, is primA facie evidence in favor of anything coming from his hands; and we accordingly find that in the present treat- ise, he has not fallen shorl of his reputation. It, moreover, fills up what has been a gap in the science of Toxicology. Dr. Christison and M. Orfila have rather endeavored to elucidate the chemical history, modes of detection, and treatment in cases in poisoning. Dr. Taylor, on the contrary, with fewer chemical details, has directed his inquiries towards a careful review ofthe symptoms peculiar to each poison, theexamination and comparison ofthe symptoms of each with the other, and with similar symptoms which may be developed by diseased actions in the economy. His work thus, besides being an excellent guide to the medical prac- titioner, in assisting his diagnosis in cases of poisoning, is also valuable to the medical man who is called upon to give his testimony before a court in criminal cases.— The Charleston Medical Journal and Review. For ourselves, we feel confident that it will ere long be the table-book of every medical practitioner who has the least regard for his own reputation, and be found in the circuit-bag of the Barrister, in company with Archbold's Criminal Pleadings, and Roscoe's Criminal Evidence.—The Dublin Quarterly Journal. •Fust Published. THE HUMAN BRAIN; ITS STRUCTURE, PHYSIOLOGY AND DISEASES, WITH A DESCRIPTION OF THE TYPICAL FORM OF THE BRAIN IN THE ANIMAL KINGDOM. BY SAMUEL SOLLY, F. R. S., &C, Senior Assistant Surgeon to St. Thomas' Hospital, &c. FROM THE SECOND AND MUCH ENLARGED LONDON EDITION. In One Octavo Volume; with One Hundred and Twenty Wood-cuts. The most complete account of the anatomy, physiology, and pathology of the brain that has hitherto ap- peared. We earnestly advise all our professional brethren to enrich their libraries with this admirable treatise.—Medico-Chirurgical Review. In the arrangement of this admirable treatise we have, first, an excellent structural anatomy; second, a deeply interesting comparative anatomy, extending over many of the species of the different genera"which make up the great classes of the animal kingdom; third, an account of the protective apparatus ; fourth, a chapter on the weight; fifth, on the configuration of the brain. We have then an elaborate account of its dissection, and that ofthe spinal cord, ofthe cerebral nerves and circulation, ofthe developmentof the brain, and lastly some remarks (and here occurs the only deficiency we have to complain of) on the physiology ot the cerebrospinal axis, and some phrenological observalions. All the preceding topics being treated of ac- cording to the improved mode of dissection of the organ adopted at the present day, assisted by microscopi- cal research, and written professedly in elucidation of its internal structure, &c.; by one of the ablest cere- bro-anatomists, if we may coin a word, ofthe day, it is useless to say that this treatise is an unsurpassed guide to the student in his investigations ofthe delicate and complex structure of this beautiful and curious organ. The pathological portion of the volume occupies about one half of the whole, and we know of none better, and few as good. The various diseases to which the brain is liable are treated of scientifically, concisely, sufficiently, and ably ; and many valuable and well recorded cases are related in illustration of symptoms, effects, and treatment; and the whole is characterized by a profound knowledge of anatomy, and pathologi- cal anatomy, descriptive, histological and chemical. We should suppose that neither the encephalon, nor its diseases could be properly studied without reference to this volume —The Annalist. We have fell great satisfaction in again accompanying Mr. Solly in his lucid description of the exquisite structural arrangements of this wonderful organ ; and we can unhesitatingly say, that the student will find comprehended in the first ten chapters of Mr. Solly's treatise, a series of the most comprehensive and inte- of the brain,'' but which we do not hesitate to characterize as a very excellent and practical description of this important and obscure class of maladies. * * * * This work is one which fully deserves, and will certainly obtain a place among our medical classics. The subjects of which it treats, like almost all questions in anatomy and pathology, will doubtless, as science advances, receive numerous additions and modifications; but the scope of the treatise is so ample, and the arrangement of its various topics so judi- cious that we believe it need never be superseded as a standard work of reference.—London Med. Gazette. 18 LEA & BLANCHARD'S PUBLICATIONS. WATSON'S PRACTICE. A NEW EDITION. LECTURES ON THE PRINCIPLES AND PRACTICE OF PHYSIC. DELIVERED AT KING'S COLLEGE, LONDON. BY THOMAS WATSON, M.D., &c. &c Third American from the last London Edition, REVISED, WITH ADDITIONS, BY D. FRANCIS CONDIE, M. D., Author of a Work on the " Diseases of Children," &c. In One Octavo Volume. Of nearly ELEVEN HUNDRED LARGE PAGES, strongy bound with raised bands. The rapid sale of two large editions of this work is an evidence of its merits, and of its general favor with the American practitioner. To commend it still more strongly to the profession, the publishers have gone to a great expense in preparing this edition with larger type, finer paper, and stronger binding with raised bands. It is edited with reference particularly to American practice, by Dr. Condie; and with these nume- rous improvements, the price is still kept so low as to be within the reach of all, and to render it among the cheapest works offered lo the profession. It has been received with the utmost favor by the medical press, both of this country and of Europe, some ofthe notices of which maybe seen in the Supplement to the Medical News for June 1847. CARPENTER'S HUMAN PHYSIOLOGY. LATELY ISSUED. A NEW, MUCH IMPROVED AND ENLARGED EDITION OF THE PRINCIPLES OF HUMAN PHYSIOLOGY, WITH THEIR CHIEF APPLICATIONS TO PATHOLOGY, HYGIENE, AND FORENSIC MEDICINE. BY WILLIAM B. CARPENTER, M. D., F.R.S., Fullerian Professor of Physiology in the Royal Institution of Great Britain; author of " Elements of Physiology," "Principles of General and Comparative Physiology," "Principles of Animal Physiology," &c. &c. THIRD AMERICAN FROM THE LAST LONDON EDITION, WITH NOTES AND ADDITIONS BY MEREDITH CLYMER, M. D., Consulting Physician to the Philadelphia Hospital, &c. &c. Containing Three Hundred and Seventeen Wood-cut and other lustrations. In One Large and Beautifully Printed Octavo Volume of over seven hundred and fifty pages, strongly bound. THE GREAT iVIEDICAIi LIBRARY. THE CYCLOPEDIA OF PRACTICAL MEDICINE; COMPRISING Treatises on the Nature and Treatment of Diseases, Materia Medica and The- rapeutics, Diseases of Women and Children, Medical Jurisprudence, &c. &c. EDITED BY JOHN FORBES, M. D., F.R.S., ALEXANDER TWEEDIE, M.D., F.R. S., AND JOHN CONOLLY, M.D. Revised, with Additions, BY ROBLEY DUNGLISON, M. D. THIS WORK IS NOW COMPLETE, AND FORMS FOUR LARGE SUPER-ROTAL OCTAVO VOLUMES. Containing Thirty-two Hundred and Fifty-Four unusually large Pages in Double Columns, Printed on Good Paper, with a New and Clear Type. The whole well and strongly bound, with Raised Bands and Double Titles. Or, to be had in Twenty-four Parts, at Fifty Cents each. For a list of Articles and Authors, together with opinions of the press, see various Supplements to theMedical News and Library. 35 LEA & BLANCHARD'S PUBLICATIONS. 19 OTHER WORKS IN VARIOUS DEPARTMENTS OF MEDICINE AND SURGERY. PUBLISHED BY LEA AND BLANCHARD. AMERICAN JOURNAL OF THE MEDICAL SCIENCES. Edited by Isaac Hays, M.D. Pub- lished quarterly at $5 per annum. ARNOTT'S PHYSICS.—The Elements of Physics in plain or non-technical language. A new . ™™°n' edlteH by Isaac Hays' M- D- In l vo1- 8v0-> sheep, with 176 wood-cuts. ABERCROMBIE ON THE STOMACH.—Pathological and Practical Researches on Diseases of the Stomach, Intestinal Canal, &c. Fourth edition, in 1 vol. 8vo., sheep. ABERCROMBIE ON THE BRAIN.—Pathological and Practical Researches on the Diseases ofthe Brain and Spinal Cord. A new edition, in one octavo volume, sheep. ASHVVELL ON FEMALES.—A Practical Treatise on Diseases Peculiar to Women, edited by Goddard. New edition, 1848, 1 large vol. Svo. ALISON'S PATHOLOGY.—Outlines of Pathology and Practice of Medicine; in three parts; con- taining Preliminary Observations, Inflammatory and Febrile Diseases, and Chronic or Non-Febrile Diseases. In one neat octavo volume, sheep. BENNET'S PRACTICAL TREATISE ON INFLAMMATION, ULCERATION AND INDURA- TION OF THE NECK OF THE UTERUS. In one small 12mo. volume, cloth. BURROWS ON CEREBRAL CIRCULATION.—On the Disorders of the Cerebral Circulation, and on the Connection between Affections of the Brain and Diseases of the Heart. With colored plates, 1 vol. 8vo., 1848. BIRD ON URINARY DEPOSITS.—Urinary Deposits, their Diagnosis, Pathology and Therapeu- tical Indications. In one neat octavo volume, cloth, with numerous wood-cuts. BIRD'S NATURAL PHILOSOPHY.—Being an Experimental Introduction to the Study of the Physical Sciences. Especially intended for the Use of the Medical Student. In one handsome royal 12mo. volume, with 372 cuts. BERZELIUS ON THE KIDNEYS AND URINE. In 1 vol.8vo., cloth. BUCKLAND'S GEOLOGY.—Geology and Mineralogy, with reference to Natural Theology; a Bridgewater Treatise. In two octavo volumes, with numerous maps, plates, &c. BLAKISTON ON THE CHEST.—Practical Observations on certain Diseases of the Chest, and on the Principles of Auscultation. 1 vol. 8vo., cloth, 1848. BRODIE'S SURGICAL LECTURES.—Clinical Lectures on Surgery. 1 vol. 8vo., cloth. BRODIE ON THE JOINTS.—Pathological and Surgical Observations on the Diseases of the Joints. 1 vol. 8vo., cloth. BRODIE ON URINARY ORGANS.—Lectures on the Diseases ofthe Urinary Organs. 1 vol. 8vo., cloth. %* These three works may be had neatly bound together, forming a large volume of "Brodie's Surgical Works." BUDD ON DISEASES OF THE LIVER.—In one octavo volume, sheep, with beautiful colored plates and numerous wood-cuts. • BRIDGEWATER TREATISES. The whole complete in 7 vols. 8vo., containing Roget's Animal and Vegetable Physiology, in 2 vols., with many cuts; Kirby on the History, Habits, and In- stinct of Animals, 1 vol., with plates; Prout on Chemistry; Chalmers on the Moral Condition of Man; Whewell on Astronomy; Bell on the Hand; Kidd on the Physical Condition of Man; and Buckland's Geology, 2 vols., with many plates and maps. BARTLETT'S PHILOSOPHY OF MEDICINE.—Essay on the Philosophy of Medical Science. In two parts; one neat octavo volume, extra cloth. BRIGHAM ON MIND, &c.—The Influence of Mental Excitement [and Mental Cultivation on Health. In one neat 12mo. volume, extra cloth. BILLING'S PRINCIPLES OF MEDICINE.—The First Principles of Medicine. From the fourth London edition; in one octavo volume, cloth. BENEDICT'S CHAPMAN.—Compendium of Chapman's Lectures on the Practice of Medicine. One neat vol., 8vo. CHAPMAN'S LECTURES ON THORACIC AND ABDOMINAL VISCERA. 1 vol. 8vo. CHAPMAN'S LECTURES ON FEVERS, DROPSIES, GOUT, RHEUMATISM, &c. &c. 1 vol. 8vo. CARPENTER'S ELEMENTS OF PHYSIOLOGY.—For the Use of the Medical Student. One large vol. 8vo„ with 180 illustrations. CARPENTER'S VEGETABLE PHYSIOLOGY.—A Popular Treatise on Vegetable Physiology. With numerous wood-cuts; in one 12mo. volume, extra cloth. CLATER AND SKINNER'S FARRIER.—Every Man his own Farrier; containing the Causes, Symptoms, and most approved Methods of Cure of the Diseases of Horses. From the 28th London edition ; edited by Skinner; in one !2mo. volume, cloth. CLATER AND YOUATT'S CATTLE DOCTOR.—Every Man his own Cattle Doctor ; containing the Diseases of Oxen, Sheep, Swine, &c. Edited by Youatt, and revised by Skinner; with wood-cuts; in one volume 12mo. COOPER (SIR ASTLEY) ON THE ANATOMY AND TREATMENT OF ABDOMINAL HERNIA. 1 large vol., imp. 8vo., with over 130 lithographic figures. 20 LEA & BLANCHARD'S PUBLICATIONS. COOPER ON THE STRUCTURE AND DISEASES OF THE TESTIS, AND ON THE THYMUS GLAND. 1 vol., imp. 8vo., with 177 figures on 29 plates. COOPER ON THE ANATOMY AND DISEASES OF THE BREAST, WITH TWENTY-FIVE MISCELLANEOUS SURGICAL PAPERS. 1 large vol., imp. 8vo., with 252 figures on 36 plates. COOPER ON DISLOCATIONS AND FRACTURES OF THE JOINTS.—Edited by Bransby Cooper and J. C. Warren. 1 vol., Svo., with 133 cots. CLYMER AND OTHERS ON FEVER.—Fevers, their Diagnosis, Pathology and Treatment. In one large vol. 8vo. DURLACHER ON CORNS, BUNIONS, &c—A Treatise on Corns, Bunions, the Diseases of Nails, and the General Management of the Feet. In one 12mo. volume, cloth. DEWEES'S MIDWIFERY.—A Comprehensive System of Midwifery, for the Use of the Medical Student. Eleventh edition, 1 vol. 8vo., with plates. DEWEES ON FEMALES.—A Treatise on the Diseases of .Females. Ninth edition, 1 vol. 8vo., plates. DEWEES ON CHILDREN.—A Treatise on the Physical and Medical Treatment of Children. Ninth edition, 1 vol. 8vo. DUFTON ON DEAFNESS AND DISEASES OF THE EAR. In 1 12mo. vol., cloth, with a plate. ELLIS'S FORMULARY.—The Medical Formulary, being a Collection of Prescriptions derived from the Writings and Practice of the most eminent Physicians of America and Europe; to which is added an Appendix, containing the usual Dietetic Preparations and Antidotes for Poisons. By Benjamin Ellis, M.D. Eighth edition, with extensive alterations and additions. By Samuel George Morton, M.D. In one neat 8vo. volume. ESQUIROL ON INSANITY.—Mental Maladies, considered in relation to Medicine, Hygiene and Medical Jurisprudence. Translated by E. K. Hunt, M. D., &c. In 1 vol. 8vo. FOWNES' ELEMENTS OF CHEMISTRY for the Use of the Medical Student. In one handsome volume, royal 12mo., with numerous cuts. Second American edition, by Bridges. GRIFFITH'S CHEMISTRY OF THE FOUR SEASONS—Spring, Summer, Autumn and Winter. One neat vol. 12mo., with cuts. GUTHRIE ON THE BLADDER, &c—The Anatomy of the Bladder and Urethra, and the Treat- ment of the Obstructions to which those Passages are liable. In 1 vol. 8vo. HARRIS ON MAXILLARY SINUS.—Dissertation on the Diseases of the Maxillary Sinus. In one small octavo volume, cloth. HOPE ON THE HEART.—A Treatise on the Diseases of the Heart and Great Vessels. Edited by Pennock. 1 vol. 8vo., with plates. HARRISON ON THE NERVES.—An Essay towards a correct Theory of the Nervous System. In one octavo volume, sheep. HUGHES ON THE LUNGS AND HEART.—Clinical Introduction to the Practice of Auscultation, and other Modes of Physical Diagnosis, intended to simplify the Study of the Diseases ofthe Heart and Lungs. By H. M. Hughes, M. D., &c. In one 12mo. volume, with a plate. HOBLYN'S MEDICAL DICTIONARY.—Dictionary of the Terms used in Medicine. Edited by Hays. 1 vol. royal 12mo. HASSE'S PATHOLOGICAL ANATOMY.—An Anatomical Description ofthe Diseases ofthe Or- gans of Circulation and Respiration. Translated and edited by Swaine. In one octavo volume. INTRODUCTION TO PRACTICAL ORGANIC CHEMISTRY; based on the Works of Brande, Liebig, and others. In one volume 18mo., paper, price 25 cents. INTRODUCTION TO VEGETABLE PHYSIOLOGY.—With reference to the Works of De Can- dolle, Lindley, &c. In one volume, 18mo., paper, price 25 cents. KIRBY ON ANIMALS.—The History, Habits, and Instinct of Animals. A Bridgewater Treatise. In one large volume 8vo., with p ates. KIRBY AND SPENCE'S ENTOMOLOGY.—An Introduction to Entomology; or Elements of the Natural History of Insects; comprising an Account of Noxious and Useful Insects, of their Metamorphosis, Food, Stratagems, Habitations, Societies, Motions, Noises, Hybernation, In- stinct, &c. &c. In one large octavo volume, neat extra cloth, with plates, plain or beautifully colored. From the sixth London edition. LISTON AND MUTTER'S SURGERY.—Lectures on the Operations of Surgery. OnetArge vol. 8vo., with 216 cuts. LALLEMAND ON SPERMATORRHOEA.—The Causes, Symptoms, and Treatment of Sperma- torrhoea. Translated and edited by Henry J. M'Dougall, M. D. 1 vol. 8vo., 1848. LAWRENCE ON RUPTURES.—A Treatise on Ruptures, from the fifth London edition. In one octavo volume, sheep. MILLER'S PRINCIPLES OF SURGERY. One large vol. 8vo., 2d American edition, 1848. MILLER'S PRACTICE OF SURGERY. One large vol. 8vo. MAN'S POWER OVER HIMSELF TO PREVENT OR CONTROL INSANITY. One vol. 18mo., paper, price 25 cents. MAURY'S DENTAL SURGERY.—A Treatise on the Dental Art, founded on Actual Experience. Illustrated by 241 lithographic figures and 54 wood-cuts. Translated by J. B. Savier. In one octavo volume, sheep. MEDICAL NEWS AND LIBRARY, published monthly at One Dollar per annum. MULLER'S PHYSIOLOGY.—Elements of Physiology. Translated by Wm. Baly, M.D., and edited and arranged by John Beli, M.D. In one large octavo volume, sheep. MEIGS' COLOMBAT ON FEMALES.—Treatise on the Diseases of Females, and on the Special Hygiene of their Sex. Translated by C. D. Meigs, M. D. In 1 vol. large 8vo., with cuts. MATTEUCCI ON LIVING BEINGS.—Physical Phenomena of Living Beings. Edited by Pereira. 1 vol. royal 12mo., with cuts. PRACTICAL ORGANIC CHEMISTRY. 18mo., sewed, price 25 cents. PROUT ON THE STOMACH.—On the Nature and Treatment of Stomach and Renal Diseases. In one octavo volume, sheep, with colored plates. LEA & BLANCHARD'S PUBLICATIONS. 21 PHILIP ON INDIGESTION.—A Treatise on Protracted Indigestion. In 1 vol. Svo. PHILLIPS ON SCROFULA.—Scrofula, its Nature, its Prevalence, its Causes, and the Principles of its Treatment. In one neat octavo volume, cloth, with a plate. ROGET'S PHYSIOLOGY.—A Treatise on Animal and Vegetable Physiology, with over 400 illus- trations on Wood. In two octavo volumes, cloth. A Bridgewater Treatise. ROGET'S OUTLINES OF PHYSIOLOGY.—Outlines of Physiology and Phrenology. In one large octavo volume, cloth. RICORD ON VENEREAL.—A Practical Treatise on Venereal Diseases; with a Therapeutical Summary, and a special Formulary. In one vol. 8vo., cloth. ROBERTSON ON TEETH.—A Practical Treatise on the Human Teeth, with Plates. One small volume, octavo, cloth. SIMON'S CHEMISTRY OF MAN.—Animal Chemistry with reference to the Physiology and Pa- thology of Man. One large vol. 8vo., with plates. TODD & BOWMAN'S PHYSIOLOGICAL ANATOMY AND PHYSIOLOGY OF MAN, with nu- merous illustrations. Publishing in the Medical News and Library. TAYLOR'S MEDICAL JURISPRUDENCE.—With numerous Notes and Additions, and Refer- ences to American Practice and Law. By R. E. Griffith, M. D. In one vol. Svo. THE CONNECTION BETWEEN PHYSIOLOGY AND INTELLECTUAL SCIENCE. 1 vol. 18mo., paper, price 25 cents. THOMPSON'S SICK ROOM.—Domestic Management of the Sick Room, Necessary in Aid of Medical Treatment for the Cure of Diseases. Edited by R. E. Griffith. In one large royal 12mo. volume, extra cloth, with wood-cuts. TRAILL'S MEDICAL JURISPRUDENCE.—Outlines of a Course of Lectures on Medical Juris- prudence. Revised, with numerous Notes. In one octavo volume, cloth. VOGEL'S PATHOLOGICAL ANATOMY.—The Pathological Anatomy of the Human Body. Translated by Day. One large vol. 8vo., with plates. WALSHE ON THE LUNGS.—Physical Diagnosis ofthe Diseases ofthe Lungs. In one neat 12mo. volume, extra cloth. WILLIAMS AND CLYMER ON THE CHEST.—A Treatise on the Diseases of the Respiratory Organs, including the Larynx, Trachea, Lungs, and Pleura. With numerous Additions and Notes, by Meredith Clymer, M. D. In one neat 8vo. volume, with cuts. WHITEHEAD ON ABORTION AND STERILITY.—The Causes and Treatment of Abortion and Sterility, being the Result of an extended Practical Inquiry into the Physiological and Mor- bid Conditions of the Uterus. 1 vol. 8vo., 1848. WILSON'S DISSECTOR. THE DISSECTOR, OR PRACTICAL AND SURGICAL ANATOMY. With 106 illustrations. Modified and re-arranged by Paul B. Goddard, M. D., &c. In one large royal 12mo. volume, sheep. WILSON ON THE SKIN.—Anatomy and Diseases ofthe Skin. 2d edition, improved, 1 vol. 8vo. %* Same work, with colored plates; also the plates sold separate. YOUATT ON THE HORSE.—The Horse: containing,a full account of the Diseases of the Horse, with their Mode of Treatment; his Anatomy, and the usual Operations performed on him; his Breeding, Breaking, and Management; and Hints on his Soundness, and Purchase and Sale. Together with a General History of the Horse ; a Dissertation on the American Trotting Horse, how Trained and Jockeyed ; an Account of his Remarkable Performances ; and an Essay on the Ass and the Mule. By J. S. Skinner, Assistant Postmaster-General, and Editor of the Turf Register. In one volume octavo, with numerous cuts. GARDNER'S MEDICAL CHEMISTRY—NowReady. MEDICAL CHEMISTRY, FORME USE OF STUDENTS: BEING A MANUAL OF THE SCIENCE WITH ITS APPLICATIONS TO TOXI- COLOGY, PHYSIOLOGY, THERAPEUTICS, HYGIENE, &c. &c. BY D. PEREIRA GARDNER, M. D., Late Professor of Chemistry in the Philadelphia College of Medicine, and of Chemistry and Nat. Plulos. in Hampden Sidney College, &c. In One handsome royal \1mo. Volume, with Illustrations. This work, while embodying a full course of modern Chemistry, has been prepared especially for the use of the student of medicine. With this view, the author has endeavored not so much to make a treatise on abstract Chemistry, as to present all the applications of the science to the various departments of medicme. There appears lo be a necessity for a book of this kind, which has not as yet been supplied among the nu- merous and excellent textbooks before the profession. The limited time devoted to the study in our medical colleges does not permit the teacher to point out the numerous and important applicants of modern Che- mistry to Medicine, or enable the student to discover them for himself. These topics, therefore, have been dwelt on at large by the author, while he has paesed cursorily over those objects winch are known only as chemical or mineralogical curiosities. ____________________^^ JONES ON THE EYE—Lately Published. THE PRINCIPLES~AND PRACTICE OF OPHTHALMIC MEDICINE AND SURGERY. BY T. WHARTON JONES, F.R.S., &c. &c. WITH ONE HUNDRED AND TEN ILLUSTRATIONS. EDITED BY ISAAC HAYS, M.D., &c. In one very neat volume, large royal 12mo., with Four Plates, plain or colored, and 98 well executed Woodcuts. 22 LEA & BLANCHARD'S PUBLICATIONS. ILLUSTRATED SERIES OF^CIENTIFIC WORKS, NOW PUBLISHING- BY LEA & BLANCHARD. This series comprises works of the highest character on the various branches of practical science. In their illustration and mechanical execution they are prepared without regaTd to expense, and the publishers present them as equal, if not superior, to anything as yet executed. Each volume is superiniended by a competent editor, who makes such additions as the progress of science in this country may require, and at the same time corrects such errors as may have escaped the press in London. The publishers, therefore, hope that these works may attract the approbation of the scientific public by their intrinsic value, the cor- rectness of the text, the beautiful style in which they are produced, and the extremely low rate at which they are furnished. THE FIRST VOLUME IS PRINCIPLES OF PHYSICS & METEOROLOGY. BY J. MULLER, Professor of Physics at the University of Freiburg. WITH ADDITIONS AND ALTERATIONS BY THE AMERICAN EDITOR. ILLUSTRATED WITH NEARLY FIVE HUNDRED AND FIFTY ENGRAVINGS ON WOOD, AND TWO COL'D PLATES. In One large Octavo Volume. The Physics of Muller is a work superb, complete, unique: the greatest want known to English Science could not have been better supplied. The work is of surpassing interest. The value of this contributio n to the scientific records of this country may be estimated by the fact that the cost of the original drawings and engravings alone has exceeded the sum of £2 000.— Lancet. The style in which the volume is published is in the highest degree creditable to the enterprise of the pub- lishers. It contains nearly six hundred engravings executed in a style of extraordinary elegance We commend the book to general favor, his the best of its kind we have everseen.—N. Y Courier <$• Enquirer. We can safely say, that, if the forthcoming works be of equal merit, and produced in similar style, the series will prove one of a very invaluable character, which cannot fail to be in universal request.—North American. From Wm. H. Bartlett, Esq., Professor of Natural and Experimental Philosophy, U. S. Military Jlcademy, West Point. I deem this work a most valuable addition to the educational facilities ofthe country, and a rich source of information to the general reader, as it is truly an elegant specimen of typo- graphy. West Point, March 15th, 1848. THE SECOND VOLUME IS PRINCIPLES OF THE MECHANICS OF MACHINERY AND ENGINEERING. BY PROF. JULIUS WEISBACH. Edited by PROFESSOR W. R. JOHNSON, OF PHILADELPHIA. Volume I., now ready, containing about 500 pages, and five hundred and fifty wood-cuts. Volume II., completing the work, will be shortly ready, of about the same size and appearance. The most valuable contribution to practical science that has yet appeared in this country. The work em- braces not only the subjects of Statics and Dynamics, but also Hydrostatics, Hydraulics and Pneumatics— each treated in sufficient detail for every practical purpose, and no demonstration calling in the aid of higher mathematics than elementary geometry and algebra. The work is beautifully got up as to letterpress and illustrations, the diagrams being the most picturesque that we have seen.—London Athenaum. From Professor Elias Loomis of the New York University. I have examined Weisbaeh's Mechanics and Engineering with considerable attention, and I am much pleased with it. It is a work prepared with great care and judgment. The Prin- ciples of Mechanics are stated in a form which is clear, concise, and easily understood; they are reduced to precise rules or formulae, and are abundantly illustrated with numerical examples. The diagrams are numerous, neat, and well calculated to convey clear ideas.— The portion treating ofthe dynamics of fluid bodies is particularly rich, and the results both of theory and experiment are given in a brief and perspicuous form. The entire treatise is intelligible to one who is only familiar with the lower mathematics, and it must become a standard work with mechanics and engineers. New York, May 6th, 1848. From Henry Vethake, Esq., Professor of Mathematics in the University of Pennsylvania. I have examined, with some care, the first volume of " Weisbaeh's Principles of the Me- chanics of Machinery and Engineering," and I have been not a little gratified in doing so. It is the most comprehensive, accurate, and best executed work, on the subject of which it treats, with which I am acquainted in the English language ; and the labors of the American editor have considerably enhanced its original value. Let me say, too, that by presenting it, as well as the other volumes of the series of which it is a part, to the American public, you will, in my opinion, contribute largely to raise the standard of scholarship in our country, especially in respect to the applications of science to the mechanical an chemical arts. Philadelphia, May 26th, 1848. LEA & BLANCHARD'S PUBLICATIONS. 23 Illustrated Series of Scientific 'Works—Continued. THE THIRD VOLUME IS TECHNOLOGY; OR, CHEMISTRY AS APPLIED TO THE ARTS AND TO MANUFACTURES. BY F. KNAPP. TRANSLATED AND EDITED BY DR. EDMUND RONALDS, AND DR. THOMAS RICHARDSON, [Lecturer on Chemistry at the Middlesex Hospital.] [Of Newcastle.] Revised, with American Additions, by PROFESSOR WALTER R. JOHNSON, OF PHILADELPHIA. WITH NUMEROUS BEAUTIFUL WOOD-CUTS. Volume I., now ready, containing about 500 pages, and 214 beautiful wood engravings. Vol. II., preparing, of a similar size and appearance. This volume contains complete monographs on the subjects of Combustion and Heating, Illumination and Lighting, Manufactures from Sulphur, Manufacture of Common Salt, Soda, Alkalimetry, Boracic Acid Ma- nufacture, Saltpetre Manufacture, Gunpowder Manufacture, Nitric Acid Manufacture, and Manufacture of Soap, together with an appendix containing various miscellaneous improvements concerning the foregoing subjects. The object of this work is purely practical, presenting in each topic, a clear and condensed view ofthe present state of the manufacture, with all the improvements suggested by the discoveries of science ; the whole illustrated with numerous large and well executed engravings of apparatus, machinery, processes, &c. &c. One ofthe best works of modern times —N. Y. Commercial, June IMS. The original treatise is one of great value ; it has been carefully translated by gentlemen themselves well versed in the processes it describes, and consequently familiar with their technical language—and it has received from them numerous important additions in which are described the most recent improvements in the various chem ical arts as practised in this country.— Medico-Chirurgical Review. When we saythat this volume begins another of the superb "Library of Illustrated Books," republished from the London series by Lea& Blanchard, of which Muller's Physics and Meteorology, and Weisbaeh's Mechanics and Engineering, (the first volume ofthe latter) have already appeared; that the present work is on a subject coming home to the business and bosoms, because to the economic interests of Americans ; that its American editor is Prof. Walter R. Johnson, who has enriched it with numerous valuable additions, the results of his own industrious researches in the technological sciences ; and that it is illustrated and printed in the same superb style which marked the previous works;—we have sufficiently explained to our readers the value of a work which will not need any other commendation.—North American, June 1848. To be followed by works on PHARMACY, CHEMISTRY, ASTRONOMY, HEAT, HYDRAU- LICS, METALLURGY, PATHOLOGICAL ANATOMY, RURAL ECONOMY, &c. &c. Specimens may be had on application to the Publishers. BIRD'S NATURAL PHILOSOPHY. NOW READY. ELEMENTS OF NATURAL PHILOSOPHY, BEING AN EXPERIMENTAL INTRODUCTION TO THE PHYSICAL SCIENCES. ILLUSTRATED WITH NEARLY FOUR HUNDRED WOOD-CUTS. BY GOLDING BIRD, M.D., Assistant Physician to Guy's Hospital. FROM THE THIRD LONDON EDITION. IN ONE NEAT DUODECIMO VOLUME. Containing about 400 pages and 372 Wood-cuts. This work is confidently presented to students in Natural Philosophy as a text-book, uniting advantages scarcely possessed by any other. By the use of clear small type, a very large amount of matter has been compressed into the limits of a single low priced duodecimo volume, embracing in a concise but intelligible manner the elements of all that is known on the subjects of Statics, Dynamics, Hydrostatics, Pneumostatics, Hydrodynamics, Acoustics, Magnetism, Electricity, Voltaism, Electro-dynamics, Thermo-electricity, Gal- vanism, Unpolarized Light, Polarized Light, The Eye and Optical Apparatus,Thermotics, and Photography. " This book is written in amost pleasing style, and gives the results of abstruse researches in a form adapt- ed to the comprehension of the common reader. It appears to have been specially designed to meet the wants of medical students, whose circumstances often forbid the study of more complete treatises: and it must prove highly acceptable and valuable to all who seek acquaintance with Natural Philosophy, but have not the leisure or the inclination to devote much time to the mathematics " Elias Loomis, Prof, of Nat. Phil, in the Univ. of N. Y. New York, May Cth, 1848. Wow Ready--ILLUSTRATED DON QUIXOTE. DON QUIXOTEDE LA MANCHA. TRANSLATED BY JARVIS. WITH COPIOUS NOTES AND A MEMOIR OF THE AUTHOR AND HIS WORKS, ABRIDGED FROM VIARDOT BY THE EDITOR. With Numerous Illustrations after Tony Johannot, In Two handsome Crown Octavo Volumes, extra crimson cloth, half calf or morocco. 24 LEA & BLANCHARD'S PUBLICATIONS. CAMPBELL'S LORD CHANCELLORS. Now Complete in Seven Volumes. LIVES OF THE LORD CHANCELLORS AND KEEPERS OF THE GREAT SEAL OF ENGLAND, FROM THE EARLIEST TIMES TO THE REIGN GF RING GEORGE IV. BY JOHN LORD CAMPBELL, A.M., F. R. S. E. Now complete in seven handsome crown octavo volumes, extra cloth. ' Of the solid merit of the work our judgment may be gathered from what has already been said. We will add, that from its infinite fund of anecdote, and happy variety of style, the book addresses itself with equal claims lo the mere general reader, as to the legal or historical inquirer; and while we avoid the stereotyped commonplace of affirming that no library can be complete without it, we feel constrained to afford it a higher tribute by pronouncing it entitled to a distinguished place on the shelves of every scholar who is fortunate enough to possess it.—Frazer's Magazine, April 1848. A work which will lake its place in our libraries as one ofthe most brilliant and valuable contributions to the literature ofthe present day.— Athenceum, Dec. 1847. FRANCE UNDER LOUIS PHILIPPE—Now Ready. THE HISTORY OF TEN YEARS, 1830—1840: OR, FRANCE UNDER LOUIS PHILIPPE. 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During the long period in which it has been issuing from the press, it has assumed the character of a standard work, and as occupying ground hitherto untouched; as embodying numerous historical facts heretofore unnoticed, and as containing vivid sketches of the characters and manners of the times, with anecdotes, documents, &c. &c, it presents numerous claims on the attention of both the student of history and the desultory reader. Those who have been awaiting its completion can now obtain it, forming a handsome set, twelve volumes in six, in various styles of binding. CONTENTS OF THE VOLUMES. Volume I—Matilda of Flanders. Matilda of Scotland. Adelicia of Louvaine, Matilda of Boulogne, and Eleanora of Aquitaine. Volume II.—Berengaria of Navarre, Isabella of An- gouleme, Eleanor of Provence, Eleanor of Castille, Marguerite of France, Isabella of France, Philippa of Hainault. and Anne of Bohemia. Volume III—Isabella of Valois, Joanna of Navarre. 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Together with various important works now in course of publication MIRABEAU AND THE NATIONAL ASSEMBLY. Now Ready. MIRABEAU, A LIFE HISTORY, IN FOUR BOOKS. In one neat royal 12mo. volume, extra cloth. MISS MARTINE~AU'S new work. Now Ready. EASTERN LIFE, PRESENT AND PAST, BY HARRIET MARTINEAU. In One Handsome Crown Octavo Volume. SOMERVILLE'S PHYSIC AL G EOG RAPH Y. Now Ready. PHYSICAL GEOGRAPHY. BY MARY SOMERVILLE, AUTHOR OF " THE CONNECTION OF THE PHYSICAL SCIENCES," &C. &C. In one neat V2mo. volume, extra cloth. LEA & BLANCHARD'S PUBLICATIONS. 29 THE AMERICAN JOURNAL OF THE MEDICAL SCIENCES. EDITED BY ISAAC HAYS, M. D., Is Published Quarterly ON THE FIRST OF JANUARY, APRIL, JULY AND OCTOBER. Each Number contains about Two Hundred and Eighty Large Octavo Pages. And is appropriately Illustrated with Engravings on Copper, Stone, Wood, &c. THE MEDICAL NEWS AND LIBRARY, Is Published Monthly, and consists of THIRTY-TWO VERY LARGE OCTAVO PAGES, Containing the Medical Information of the day, as well as a Treatise of high character on a prominent department of Medicine. WATSON'S LECTURES ON THE PRACTICE OF PHYSIC, BRODIE'S CLINICAL LECTURES ON SURGERY, AND TODD & BOWMAN'S PHYSIOLOGY Have thus appeared in it, and the work at present publishing is WEST ON THE DISEASES OF INFANCY AND CHILDHOOD. TERMS. THE SUBSCRIPTION TO THE AMERICAN JOURNAL OF THE MEDICAL SCIENCES, IS FIVE DOLLARS PER ANNUM. When this amount is forwarded by the first of February, free of postage, it is considered in ad- vance, and the subscriber thereby becomes entitled to the MEDICAL NEWS AND LIBRARY FOR ONE YEAR, Without further charge. For the small sum of FIVE DOLLARS, therefore, the subscriber can obtain a Quarterly and a Monthly Journal ofthe highest character, presenting about FIFTEEN HUNDRED LARGE OCTAVO PAGES, With appropriate Illustrations: Or, for TEN DOLLARS, the publishers will furnish TWO COPIES OP THE JOURNAL, AND THREE OP THE NEWS; Or, for TWENTY DOLLARS, FIVE COPIES OF THE JOURNAL AND FIVE OF THE NEWS. Thus presenting strong inducements to Clubs. Postmasters and others will also thus find it worth their attention to obtain subscribers and remit their subscriptions for these works, which are among THE CHEAPEST OF AMERICAN MEDICAL PERIODICALS. try When the News is ordered separately, the subscription is One Dollar per annum, invariably ln*3 * A few copies ofthe Journal and News for 1848 being on hand, the publishers will still sup- ply both periodicals for Five Dollars, if remitted immediately. 30 THE AMERICAN JOURNAL OF THE MEDICAL SCIENCES. In calling the attention of the profession to the high character of the American Medical Journal, the publishers append an extract from the report of "The Committee on American Medical Literature," to the National Medical Association at their meeting in Baltimore, May, 1848. After adverting to other matters, they say:— " The 'Philadelphia Journal,1 which has been j Pepper, Hall, Dexter, Jarvis, Beck, Wharton, already mentioned, was succeeded by the ' Ame-lLovett, Nott, Moreton Stille, Boling, Tabb, rican Journal of the Medical Sciences,' esta- Taylor, Porter, Tuck, J. B. S. Jackson, Pee- blished in 1827, and still continued, having reach- bles, Kneeland, Gardner, Buckler, Mendenhall, ed its forty-first volume. The long standing of Lane, and R. S. Holmes. On Midwifery, and this publication, the support which it has received «Ae Diseases of Women and Children, among from many of the best writers in different parts the principal contributors of original papers ofthe country, and the elevated literary charac- have been Drs. Dewees, Horner, Bigelow, ter and spirit which have distinguished it, have Hodge, Gerhard, Geddings, Lindsay, E. War- rendered it a favourite organ of the profession. \ ren, Roberts, Lee, Kane, Shanks, Taylor, So much of what is valuable in our periodical Bowen, Buel, Barwell, Bond, Sargent, Sims, literature, during the long protracted period of and Baldwin. Many other names might be its existence, has found a place in its pages, that added to these lists, which, however, are suffi- it would be going beyond the limits of this re- \ cient evidence that the journal has been wil- port to attempt an analysis of its contents. Here \ lingly and heartily upheld by the profession." have been recorded many of those daring opera- After enumerating the other Medical Journals tions which are dwelt upon with so much pride published in the United States, the report con- by the American surgeon. Numberless cases > tinues:—■ of unusual interest have been here related by s " The committee will now proceed to a brief their observers, often accompanied by illustra- \ enumeration of the more important articles, tions, for the most part creditable to the art which have, within the past year, or at least which has furnished them. Many ofthe re- recently, been presented to the profession in the views which it contains are conceived and exe- \ medical journals of this country, taking them cuted in a higher spirit than the mere mechanical I up in the order in which they have been enu- analyses and Taliacotian abstracts which sofre- < merated. quently usurp this department of scientific as j " American Journal ofthe Medical Sciences. well as literary journals. This periodical is so >—The number for January, 1847, contains one well known through the country, and a com-1 of Dr. Norris's admirable resumes, a 'Table plete series of it so generally contained in public showing the mortality following the operation libraries, that a general index to it from the j of tying the iliac arteries.' It is founded upon commencement would be one of the most ac-1 a hundred and eighteen cases gathered from ceptable offerings which could be made to the j various sources, which are presented in a con- medical reader. S densed form and subjected to a careful analysis. " The committee had prepared an account of The committee have already fully expressed the most prominent articles under their several j their sense of the importance of Dr. Norris's heads, but it proves to be too voluminous for a labours. The paper which follows, by Dr. report like the present. The names of some of j Trask of Brooklyn, N. Y., is worthy of suc- ks contributors will be enough to show how j ceeding that just mentioned. Four very full extensively it has been supported by the ablest i tables containing the history of fifty-three cases writers and practitioners of the country. In of phlegmasia dolens are given in this essay, Anatomy and Physiology, original papers have 5 the final object of which is to establish the pa- been furnished by Drs. Horner, Moultrie, Coxe, thology of the affection. Articles like the two Mussey, Warren, Earle, Smith, Alison, Harri- just cited, are necessarily of permanent value. son, Gardner, Leidy and others. In Surgery, They cannot be superseded, because they have Drs. Godman, Mussey, Randolph, H. & J. M. a solid basis of fact, and even if some of their Warren, Coates, Mott, Norris, Kirkbride, Ged- conclusions were erroneous, the materials would dings, Nott, Shipman, Markoe, Parrish, Met- remain as the basis of future results. The in- tauer, Mutter, Horner, Pancoast, Watson, creased number of these laborious analytical Atlee, Hayward, are among those who have surveys is one of the most encouraging features lent their assistance, some of the best known > of our medical literature. In the midst of in- among them in many elaborate articles. In the s terminable discussions upon the value of the department of Practical Medicine, a great num- numerical system, the simple fact that tabula- ber of original Reports and Essays have been tion affords a final result respecting a given supplied by Drs. Chapman, S. Jackson, Emer-1 number of facts, which mere perusal fails to do, son, Coxe, Horner, Hayward, Ware, Wright, i is making itself felt like every truth which has Jackson (of Northumberland), Parrish, Pen- j time and fair play. The next article is one by nock, Gerhard, Fisher, Nichols, E. Warren, j Dr. Kirkbride on Hospitals for the Insane, and Paine, Bigelow, Webber, Lindsay, Forrey, the fourth a brief account by Dr.'Wilcocks, of Beck, Flint, Coale, Earle, Stewardson, Kirk- the epidemic remittent and intermittent of 1846. bride, Shanks, Parry, Mettauer, Whitney, \ Then follow four cases of acute affection of the THE AMERICAN JOURNAL OF THE MEDICAL SCIENCES. 31 spinal marrow, with dissections, by Dr. J. B. S. \ have preferred the easier plan of ministering to JacksDn of Boston, marked by his accustomed j this altered condition by the ingenious and stu- accuracy of description. Several other cases \ pendous system of modern therapeutics.' He are reported in this number, which contains two \ appears to believe, and as the Committee think, reviews of some interest, and the usual variety ^ very justly, that much indirect benefit may re- sult even from the experiments of the hydro- pathist and homceopathist, notwithstanding the illusions and impositions that surround the foun- tain of the Silesian boor and the laboratory of the Saxon necromancer. The interest of Dr. Brown's account of his visit to the Cretins, in the institution on the Abendberg, is owing not merely to the novelty of the subject, which is in its minor departments. " The first article in the number for April 1847, is one of great practical interest. It is the ' His- tory of seven cases of Pseudo-membranous Laryn- gitis or True Croup,' by Dr. J. F. Meigs. The fact that recovery took place, in four cases where< there was fibrinous exudation on the fauces, en- titles the history of these cases to the most care- ful examination, and affords a strong presumption \ just beginning to attract the attention of philan- in favour ofthe general plan of treatment adopted, thropists, but to the agreeable style of the nar- It is well known that long series of similar j rative. In a country which has done as much cases have been observed, every one of which i as our own for the insane, the blind and the has proved fatal, and that the whole question of deaf and dumb, it cannot be long before the treatment is considered as involved in perplexity ; by many able observers. The paper which fol-; lows, by Dr. Baldwin, Observations on the Poi- improvement ofthe condition of the unfortunate idiot will be felt to be a public duty. Dr. Met- tauer, whose name is familiar to the records of sonous Properties of the Sulphate of Quinine, operating surgery, reports two cases of vesico- has been most extensively quoted, and has called : out various other communications confirming | the results at which he has arrived. In the ma-; larious regions of our country, where the "mon- < ster doses" of this heroic remedy are so com-! monly given, it is of vital importance that all the ! risks they involve should be generally known.: Then follow various reports of medical and sur- vaginal fistula, with the operations for their relief, one of which was perfectly successful, and the other, though repeated again and again, was but partially so. But this, as Dr. Mettauer thinks, was owing to the patient's amiable in- discretions, and he is decidedly of opinion that every case of vesico-vaginal fistula can be cured. Dr. Harris relates a case of doubtful sex, in gical diseases, among which Dr. Earle's eleven connection with which the editor quotes that cases of general paralysis of the insane cannot described by Dr. Barry, in the New York fail to be noticed for their psychological and Journal of Medicine for January, 1847- Dr. pathological bearings, as well as the happy way; Boling's new sign of pneumonia of the apex of in which they are related. A practical essay by \ the lungs, needs confirmation by other observers. Dr. Hildreth, on letting blood from the jugular \ The Committee can affirm, at least, that it is in diseases of children concludes the list of \ not constant. It was extraordinary if, as Dr. original communications. \ Boling asserts, the chest remained still resonant "The July number opens with another sta-jon percussion over the apex of the lung in a tistical article from Dr. Norris, on the operation \ state of hepatization. This number contains a of tying the carotids, of the same high character \ long notice of Dr. Wood's Practice of Medicine, with those which he has furnished in previous /by one of the most searching and skilful review- numbers. The next paper is one by Dr. Hal- lowell, on cholera infantum, which he calls by the singular name of gastro-follicular enteritis; which would seem to imply inflammation of the intestines seated in the follicles of the stomach. The essay is an instructive one, based on con- !ers our periodicals have ever enlisted in their |service. It may be hinted, that one epithet, | however judicious, must not be repeated too ;often; the accomplished reviewer remembers : Gyas and Cloanthus. ; The number for October, 1847, has for its siderable experience and supported by two Heading article a continuation of Dr. Metcalf's reported cases with a tabular analysis of twelve I Statistics in Midwifery, containing the results It is post-mortem examinations. A 'Note on theiof 927 cases observed in private practice frequency of the pulse and respiration of the\a most creditable production to the author and aged,1 by Dr. Pennock, adds authority to the the friends by whom he was aided, and may curious results obtained by Leuret and Mitivie, serve as an encouragement and a model to other who found the average frequency of the pulse \ practitioners situated at a distance from the more in yodhg men to be 65 per minute, while that of J active centres of scientific industry. Dr. Michel ■ the aged was 73; a statement in direct opposition history of an early ovum is not without interest, to the prevailing belief on this point. ' Hydro- though its illustration is less exquisite than he pathy,ortheuseofcoldwatcrforthePrevention\'lcones> of Wagner and the style is^wanting and Cure of Disease,' by Dr. Kneeland, is the in the simplicity wh.ch should 1jelong to an title of a Boylston prize essay, here published anatomical description^ Dr. Harder ■ Es ay 0„ without any allusion to its laureate honours. Isopathia, agrees with the g neral be lief in The key to the author's position is found in the maintaining the "f^**^^'^ ...owing sentence: this number—certainly a very remarkable col- article which follows, by Dr. Frick, is one of lection of important medical and surgical histo- the first attempts at the investigation ofthe che- ries, and implying an ample supply of materials mical changes of the blood induced by disease, to allow of such selections. Add to this Dr. made in this country. Most of the conclusions Parson's 'Statistics of Large Surgical Opera- arrived at by the laborious observations which tions,' the Midwifery Statistics from private served as its basis, coincide with those of pre- practice, by Dr. Pleasants, and the continuation vious observers. One peculiar and novel result of Dr. Trask's paper on Rupture of the Uterus, arrived at by Dr. Frick is, that the quantity of probably the most complete account of that ac- the chlorides and phosphates of soda and potash cident to be found in print, and it must be cvned is dependent, not upon the particular disease, that the patriarchal quarterly has not falle* be- but upon the season of the year in which the j low its own high standard of merit, at the point examination is made, being much higher in where the Committee takes leave of it for the winter and spring than in summer and fall. Dr. present."* Foltz deserves credit for printing his valuable * These extracts are from copies of the "Report to Report on Scorbutus. It could be wished that j HolmeTo^Boston6 Chairman of that Committee, Dr. For a more particular description of the Journal and News, with numerous notices of the &c, see Supplement to the Medical News and Library for Dec. 1847. \ i %■ rm> \M';r ";l; ■•; •■ •* "'■».'•.-:xu Sfifc'i NLM031933074